Children with CP have difficulties with co-ordination and motor planning. Providing resistance in non-functional tasks (repetitive leg presses) will not enhance motor learning or translate to improvements of functional performance. We need Gemcitabine to consider the context in which we train and measure ambulatory performance using measures of habitual physical activity (Clanchy et al 2011). We should consider the density of training and

whether the number of repetitions is sufficient to drive muscle plasticity. Current research suggests the dose and density of most neurorehabilitation frequently may not be sufficient to drive neuroplasticity (Nielsen and Cohen 2008). This needs to be considered in future trials aimed at improving ambulatory performance. “
“Summary of: Stafne SN et al (2012) Regular exercise during pregnancy to prevent gestational diabetes. Obstet Gynecol 119: 29–36. [Prepared by Nora Shields, CAP Enzalutamide cost Editor.] Question: Does a 12-week exercise program prevent gestational diabetes and improve insulin resistance in healthy pregnant women with normal body mass index (BMI)? Design: Randomised, controlled trial with concealed allocation and blinded outcome assessment. Setting: Two University hospitals

in Norway. Participants: White adult women with a single fetus. High-risk pregnancies or diseases that would interfere with participation were exclusion criteria. Adenosine Randomisation of 855

participants allocated 429 to the exercise group and 426 to a control group. Interventions: Both groups received written advice on pelvic floor muscle exercises, diet, and lumbo-pelvic pain. In addition, the intervention group participated in a standardised group exercise program led by a physiotherapist, once a week for 12 weeks, between 20 and 36 weeks gestation. The program included 30–35 minutes low impact aerobics, 20–25 minutes of strength exercises using body weight as resistance and 5–10 minutes of stretching, breathing, and relaxation exercises. They were also encouraged to follow a 45-minute home exercise program at least twice a week. The control group received standard antenatal care and the customary information given by their midwife or general practitioner. Outcome measures: The primary outcomes were the prevalence of gestational diabetes, insulin resistance estimated by the homeostasis model assessment method (HOMA-IR), and fasting insulin and oral glucose tolerance tests at baseline and at the end of the training period. Fasting and 2-hour glucose levels were measured in serum by the routine methods. Gestational diabetes was diagnosed as fasting glucose level 2-hour value ≥7.8 mmol/L. Secondary outcome measures were weight, BMI, and pregnancy complications and outcomes. Results: 702 participants completed the study.