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A reprint of "Note on the knee-jerk and the correlation of action of antagonistic muscles" by C.S. Sherrington, communicated by Professor M. Foster and published in 1893, is presented. The note discusses Sherrington's early research on the knee-jerk reflex, which later led to the development of his law of reciprocal innervation. It describes the involvement of the afferent and efferent pathways in the knee-jerk reflex and the antagonistic excitation and inhibition of opposing muscle groups.

Questions: What is the prevalence of mobility-related disability 3 months after discharge from inpatient aged care rehabilitation? Can a clinical tool predict which individuals will experience mobility-related disability 3 months after discharge? Design: Prospective cohort study. Participants: 442 patients newly admitted to two large inpatient rehabilitation units. Outcome measures: Predictors were co-morbidities; pre-admission mobility; and discharge cognition, pain, vision, muscle strength, and mobility. The outcome of interest was inability to climb a flight of stairs and walk 800 m without assistance. Results: 157 participants (36%) were unable to climb a flight of stairs and walk 800 m without assistance prior to hospital admission. Three months after discharge, 254 participants (59%) were unable to complete both tasks. A simple clinical prediction tool based on pre-admission ability to complete the two tasks, co-morbidity on admission, and pre-discharge measurement of: leaning while standing (Maximal Balance Range test), low-contrast visual acuity, and knee extension strength, had good discrimination (area under the receiver-operating characteristic curve [AUC] = 0.77, 95% CI 0.72 to 0.81, bootstrap adjusted AUC = 0.77) and was well calibrated. This tool provided substantially better (p < 0·001) discrimination than pre-admission ability alone (AUC = 0.64, 95% CI 0.60 to 0.68, bootstrap adjusted AUC = 0.64). The observed risk of persisting disability ranged from 13% in those with no predictors to 93% in those with 5 predictors. Conclusion: Mobility-related disability 3 months after discharge from inpatient rehabilitation is common and can be predicted easily with a clinical tool. [ABSTRACT FROM AUTHOR]

Question: What is the feasibility and effectiveness of a novel weight-bearing strengthening program compared with that of a traditional non-weight-bearing strengthening program for older inpatients undergoing rehabilitation? Design: Randomised, controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants: Eighty-eight inpatients (11% loss to follow-up) aged on average 82 years old from three rehabilitation units with no contraindications to exercise. Intervention: Both the weight-bearing and non-weight-bearing strengthening programs were supervised by physiotherapists and were of similar intensities (10 to 15 RM) for two weeks. Outcome measures: The primary outcomes were standing up performance measured as minimum chair height, and strength measured as maximum isometric knee extensor force of both legs. The secondary outcomes were other mobility measures such as standing-up rate, walking, standing and overall mobility, and other strength measures such as maximum isometric hip extensor, hip abductor, and knee flexor force of both legs. Results: After the two-week intervention, the weight-bearing strengthening group had decreased their minimum chair height by 5.3 cm (95% CI 0.7 to 9.8) and increased their hip extensor strength on the weaker leg by 9 N (95% CI 1 to 17) more than the non-weight-bearing strengthening group. There were no clinically-worthwhile or statistically-significant differences between the groups for any other measures. Conclusion: This novel weight-bearing strengthening program was feasible and safe in an inpatient rehabilitation setting and had some additional benefits over a traditional non-weight-bearing strengthening program. [ABSTRACT FROM AUTHOR]