To investigate the efficacy of classical massage on stress perception and mood disturbances, 34 women diagnosed with primary breast cancer were randomized into an intervention or control group. For a period of 5 weeks, the intervention group (n = 17) received biweekly 30-min classical massages. The control group (n = 17) received no additional treatment to their routine health care. The Perceived Stress Questionnaire (PSQ) and the Berlin Mood Questionnaire (BSF) were used and the patients’ blood was collected at baseline (T1), at the end of the intervention period (T2), and 6 weeks after T2 (T3). Compared with control group, women in the intervention group reported significantly lower mood disturbances, especially for anger (p = 0.048), anxious depression (p = 0.03) at T2, and tiredness at T3 (p = 0.01). No group differences were found in PSQ scales, cortisol and serotonin concentrations at T2 and T3. However, perceived stress and cortisol serum levels (p = 0.03) were significantly reduced after massage therapy (T2) compared with baseline in the intervention group. Further research is needed to validate our findings.

From Real Bodywork, this beautifully produced DVD covers the pelvis, sacrum and lumbar spine. Specifically, this DVD includes corrections for a pelvis upslip, downslip, rotations, inflair and outflair and pubic bone dysfunctions. It also covers Sacral rotations, and unilateral flexion/extension dysfunctions. The lumbar section covers one or multiple vertebrae stuck in flexion or extensions. In addition to all this, there is also a section on using muscle energy to balance and relax all the muscles surrounding the hips. With 2 hours 20 min, It covers Gentle & Effective techniques with Amazing 3-D Animations in Widescreen.
Available from: http://www.terrarosa.com.au/dvd/muscle_energy_techniques.htm

Background and aims.  In recent years, the nursing profession used technology and pharmacology to relieve conditions such as pain, anxiety and insomnia that were once treated with massage. However, interest in massage has grown with the move to more holistic nursing. This review examines the physiological and psychological effects of slow-stroke back massage and hand massage on relaxation in older people and identifies effective protocols for massage in older people.

Design.  Review.

Methods.  Cooper’s five-stage model was used in the review process. The search strategy included all studies without limiters for dates through June 2009 in the following databases: Ovid Medline, Cochrane databases, PubMed, EBSCO, CINAHL, Health Resource, PychINFO and EMB Reviews 1991–June 2009. The quality of the research was evaluated using the Research Appraisal Checklist. Twenty-one studies met the inclusion criteria for massage, relevance to older people and rigorous research.

Results.  All studies using slow-stroke back massage and hand massage showed statistically significant improvements on physiological or psychological indicators of relaxation. The most common protocols were three-minute slow-stroke back massage and 10-minute hand massage.

Conclusion.  Physiological and psychological indicators suggest the effectiveness of slow-stroke back massage and hand massage in promoting relaxation in older people across all settings.

Relevance to clinical practice.  Studies are needed to analyse the feasibility and cost effectiveness of massage to develop best practices for massage interventions in older people.

Massage therapy is commonly prescribed for individuals that suffer from chronic pain, inflammation, or musculoskeletal injury. Despite the widespread belief that massage augments muscle repair and reduces inflammation, there is little objective, scientific evidence to support its practice. Therefore, the purpose of this study was to evaluate the molecular effects of massage following a single unaccustomed bout of exercise. Eleven recreationally active, healthy males (age 22±1 yrs, VO2peak 46±2 ml·kg–1·min–1) volunteered to participate in this study. Each subject completed an exhaustive endurance cycling protocol. After 15 mins of recovery, one quadricep was randomly chosen for 10 mins of massage (MASS) and the contralateral leg served as a control (CON). Muscle biopsies were acquired from the vastus lateralis at rest, immediately following massage, and 2.5h after massage was administered. Histology revealed that exercise induced significant muscle damage from rest at 2.5h (P<0.05), however there was no effect of massage (P>0.05). No differences were seen between CON or MASS in the oxidative stress markers 4HNE or protein carbonyls at any timepoint (P>0.05). Gene microarray analysis displayed 4 genes that were differentially expressed (P<0.05) for MASS vs CON immediately following massage as well as 11 genes at 2.5h that relate to pathways of inflammation and cellular remodeling. In summary, these data provide evidence that massage stimulates molecular events that may justify its use in the remediation of muscle injury.

FASEB Journal

http://www.fasebj.org/cgi/content/meeting_abstract/24/1_MeetingAbstracts/806.5

The Anatomy of Exercise & Movement serves as a bridge between biomechanics and exercise. Awareness of movement potential is the key to a healthy body and the prevention of injuries; this text allows the reader to help maintain health, weight, posture, strength, stretch, and performance skills. The practice of sport, pilates, yoga, and dance is emphasized, providing a better understanding of how the body functions whilst being exercised. The author’s background in movement sciences has led to a deep interest in the ability of the body to care for and/or heal itself, specifically through knowledge of muscles and what they can do.

192 pages, Available from http://www.terrarosa.com.au/book/anatomy_movement_exercises.htm

These individuals experience less physical impairment and spend less time in doctor’s offices or health clinics, says the study’s author Mark Seery, PhD, assistant professor of psychology at UB, who emphasizes that the key to the benefit is the experience of “some” prior adverse events as opposed to many or none at all.
“This study of 396 adults with chronic back pain (CBP) found that those with some lifetime adversity reported less physical impairment, disability and heavy utilization of health care than those who had experienced either no adversity or a high level of adversity,” Seery explains.
“The data suggest that adversity-exposure also may protect against psychiatric disturbances that occur with CBP,” Seery says, “and additional analyses found no alternative explanations of our findings.”
In addition to Seery, the research team included Raphael J. Leo, MD, associate professor of clinical psychiatry, UB School of Medicine and Biomedical Sciences; E. Alison Holman, PhD, assistant professor of nursing sciences, UC Irvine; and Roxane Cohen Silver, PhD, professor of psychology and social behavior and medicine, UC Irvine.
The study sample was drawn from a nationally representative web-enabled, population-based panel created through traditional probability sampling techniques such as random-digit dialing by Knowledge Networks, Inc. From 2001 to 2003, assessments were administered to subjects by KN online or by mail.
The subjects had previously acknowledged a history of CBP when reporting their physical health status in an online survey. They completed a survey of lifetime exposure to 37 adverse events, including one’s own or a loved one’s illness/injury, sexual and non-sexual violence, bereavement, social or environmental stress, disaster and various relationship stresses.
Subjects subsequently reported self-rated functional impairment, disabled employment status, frequency of back pain treatment, prescription painkiller use and whether they currently sought treatment for comorbid psychiatric disorders.
The researchers speculate that observed patterns of relationships between adversity and CBP-related outcomes may reflect the possibility that resilience, a phenomenon largely ignored in previous CBP research, is occurring.
“It appears,” says Seery, “that adversity may promote the development of psychological and social resources that help one tolerate adversity, which in this case leads to better CBP-related outcomes. It may be that the experience of prior, low-levels of adversity may cause sufferers to reappraise stressful and potentially debilitating symptoms of CBP as minor annoyances that do not substantially interfere with life.”
Seery says that previous attempts to understand the persistence, refractoriness and disability associated with CBP have underscored the importance of psychosocial variables and demonstrated an association between CBP and lifetime exposure to adverse events.
“Previous research suggests that exposure to adverse life events correlates with greater CBP severity,” he says. “This implies that the optimal situation would be one in which individuals have not been exposed to any adverse lifetime events.
“It appears, however, that the relationship between adversity and chronic pain is not so simple, in that experiencing some prior adversity is actually most beneficial,” Seery says.

Journal Reference:
Seery et al. Lifetime exposure to adversity predicts functional impairment and healthcare utilization among individuals with chronic back pain. Pain, 2010; DOI: 10.1016/j.pain.2010.06.007

BACKGROUND: The purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.

METHODS: This was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).

RESULTS: The MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedges's g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).

CONCLUSIONS: In this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.
“Core stability exercises (are) not superior to conventional physiotherapy exercises in terms of reducing pain and disability”

Abstract
Background The US Army has traditionally utilized bent-knee sit-ups as part of physical training and testing. It is unknown whether the short-term effects of a core stabilization exercise program without sit-up training may result in decreased musculoskeletal injury incidence and work restriction compared with traditional training. Objective The objective of this study was to explore the short-term effects of a core stabilization exercise program (CSEP) without sit-up training and a traditional exercise program (TEP) on musculoskeletal injury incidence and work restriction. Design The study was designed as a cluster randomized trial. Setting The setting was a 16-week training program at Fort Sam Houston (San Antonio, Texas). Participants The study participants were soldiers with a mean age of 22.9 years (SD=4,7, range=18-35) for whom complete injury data were available for analysis (n=1,141). Intervention Twenty companies of soldiers were cluster randomized to complete the CSEP (10 companies of 542 soldiers) or the TEP (10 companies of 599 soldiers). The CSEP included exercises targeting the transversus abdominus and multifidus musculature. The TEP comprised exercises targeting the rectus abdominus, oblique abdominal, and hip flexor musculature. Measurements Research staff recorded all injuries resulting in the inability to complete full duty responsibilities. Differences in the percentages of musculoskeletal injuries were examined with chi-square analysis; independent sample t tests were used to examine differences in the numbers of days of work restriction. RESULTS: /b> Of the 1,141 soldiers for whom complete injury data were available for analysis, 511 (44.8%) experienced musculoskeletal injuries during training that resulted in work restrictions. There were no differences in the percentages of soldiers with musculoskeletal injuries. There also were no differences in the numbers of days of work restriction for musculoskeletal injuries overall or specific to the upper extremity. However, soldiers who completed the TEP and experienced a low back injury had more days of work restriction: 8.3 days (SD=14.5) for the TEP group and 4.2 days (SD=8.0) for the CSEP group. Limitations A limitation of this study was the inconsistent reporting of injuries during training. However, the rates of reporting were similar between the groups. CONCLUSIONS:/b> The incidences of musculoskeletal injuries were similar between the groups. There was marginal evidence that the CSEP resulted in fewer days of work restriction for low back injuries.

BACKGROUND: Exercise programs may vary in terms of duration, frequency, and dosage; whether they are supervised; and whether they include a home-based program. Uncritical pooling of heterogeneous exercise trials may result in misleading conclusions regarding the effects of exercise on chronic low back pain (CLBP).
PURPOSE: The purpose of this study was to establish the effect of exercise on pain and disability in patients with CLBP, with a major aim of explaining between-trial heterogeneity.
DATA SOURCES: Six databases were searched up to August 2008 using a computerized search strategy.
STUDY SELECTION: Eligible studies needed to be randomized clinical trials evaluating the effects of exercise for nonspecific CLBP.
OUTCOMES: Of interest were pain and disability measured on a continuous scale.
DATA EXTRACTION: Baseline demographic data, exercise features, and outcome data were extracted from all included trials.
DATA SYNTHESIS: Univariate meta-regressions were conducted to assess the associations between exercise effect sizes and 8 study-level variables: baseline severity of symptoms, number of exercise hours and sessions, supervision, individual tailoring, cognitive-behavioral component, intention-to-treat analysis, and concealment of allocation.
LIMITATIONS: Only study-level characteristics were included in the meta-regression analyses. Therefore, the implications of the findings should not be used to differentiate the likelihood of the effect of exercise based on patient characteristics.
CONCLUSIONS: The results show that, in general, when all types of exercise are analyzed, small but significant reductions in pain and disability are observed compared with minimal care or no treatment. Despite many possible sources of heterogeneity in exercise trials, only dosage was found to be significantly associated with effect sizes.

Background
Exercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown. Objective This study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain. Design This was a randomized controlled trial with 1-year follow-up.

Setting
The study was conducted in a primary care setting in Norway. Patients The participants were patients with chronic nonspecific low back pain (n=109).
Interventions
The interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.
Measurements
The primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.

RESULTS: The postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (-0.7 to 1.3) and 0.4 (-0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (-0.6 to 2.0) and 0.3 (-0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (-0.1 to 2.0) and 0.7 (-0.3 to 1.7) for motor control exercises versus general exercises. Limitations The nature of the interventions made blinding impossible.

CONCLUSIONS: This study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.