Journal of Rehabilitation Sciences & Research

The Interaction of Knee, Hip and L5-S1 Joint Contact Forces and spatiotemporal variables between Sound and Prosthetic Leg in Patients with Unilateral below-knee Amputation during Walking

Keyvan Sharifmoradi; Mostafa kamali Ardekani; Mohammad Taghi Karimi

Volume 4, Issue 2 , June 2017, , Pages 53-59

Abstract

  Background: there is little knowledge explaining how forces applied on knee, hip and L5-S1 joint between the sound and prosthetic leg in unilateral Below-Knee Amputation (BKA), so the ...  Read More Background: there is little knowledge explaining how forces applied on knee, hip and L5-S1 joint between the sound and prosthetic leg in unilateral Below-Knee Amputation (BKA), so the aim of this study was to assess the interaction of knee, hip and L5-S1 joint contact forces between sound and prosthetic leg in patients with unilateral BKA during walkingMethods: Five patients with BKA were recruited in this study. A Qualisys motion system capture with seven cameras and a Kistler force plate were used to record kinematics and kinetics variables of walking. The forces applied on knee, hip and L5-S1 joint contact forces (JCF) were calculated by using Open-SIM software. SPSS software was used to analyze data at an alpha set point of 0.05.Result: The propulsive and second peaks of ground reaction forces applied on sound leg were significantly higher than prosthetic leg (p<0.05). Although the forces applied on hip, knee and L5-S1 joint in the sound leg were higher compared to prosthetic leg, the interaction between side and joint factor was not significant (p>0.05).Conclusion: The results of this study showed that the meaningful JCF applied on the sound leg were more than that of prosthetic leg. Insignificant increases in JCF on the sound leg during life can create cumulative forces on knee and low-back and endanger these joints at the risk of knee OA and chronic low-back pain. Balanced forces applied on sound and prosthetic leg is important, if this is the case, so indicating using a proper usage of socket pin and prosthetic feet which may have beneficial impact on sound side loads.

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More realistic dynamical modeling of a humanoid robotic arm to reduce control effort with uncertainty using self-impact joint constrained

Seyed Iman Hosseini; Yousef Bazargan Lari

Volume 6, Issue 2 , June 2019, , Pages 68-79

Abstract

  Background:The main challenge of modeling humanoid robots is establishing a compromise between the simplicity of the model and accuracy of the system. One of the realities of movement ...  Read More Background:The main challenge of modeling humanoid robots is establishing a compromise between the simplicity of the model and accuracy of the system. One of the realities of movement which is important about humans is moving their hands to keep balance and reduce energy consumption while they are walking. Methods: In this context, the role of elbow joint and the limitation that the joint exerts in terms of movement on the forearm and arm as self-impact joint constraint is undeniable. This paper deals with modeling and control of humanoid robot’s hand as double-pendulum will consider mentioned constraint while normal walking and also in throwing darts. Results: The presence of the self-impact joint constraint contributed to about a 26% saving in power consumption of robot motors within an impact range of 0.6346 to 0.6896 during normal human walking.  Since this control has a high power, 10 to 30% of the uncertainty was added to the length and mass parameters. As was observed, this controller routed the desired curves in the least possible time. Conclusion: As mentioned earlier, consideration of this constraint in elbow joint of the humanoid robot will help in approaching the reality of system in comparison with past models previously designed. As constraint causes addition of severe nonlinear terms to dynamic system equation, the control of systems with this type of constraint faces a great deal of complexity. For adaptive-neural controller to control of the system of humanoid robot’s hand will be used. Also, to display the ability of control system, the uncertainty of length and mass for this system will be considered. The existence of self-impact joint constraint will cause saving in consumption power of robot engines within the impact range.

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The Comparison of Neurodevelopmental- Bobath Approach with Occupational Therapy Home Program on Gross Motor Function of Children with Cerebral Palsy

Faranak Behzadi; Hesammedin Noroozi; Marzieh Mohamadi

Volume 1, Issue 1 , March 2014, , Pages 21-24

Abstract

  Background & objectives: Traditional Bobath approach (TBA) is one of the several methods using in treatment of children with cerebral palsy (CP) who referred to occupational therapy ...  Read More Background & objectives: Traditional Bobath approach (TBA) is one of the several methods using in treatment of children with cerebral palsy (CP) who referred to occupational therapy setting. In this study, the effect of TBA compared with home program Bobath approach (HPBA), on the gross motor function (GMF) of children with CP.Methods: in this clinical trial, 30 children with CP studied in two groups of 15, randomly. Control group received Bobath traditional services 12 sessions. In the intervention group, along with these services, parents participated in training program and fallowed the exercises. Peabody scale assessed GMF before and after intervention.Results: GMF increased significantly in both groups. In addition, differences between the two groups were significant (p=.007).Conclusions: the results of this study showed that TBA with HPBA was more effective than the traditional ones.

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Comparison of the Effects of Massage and Cryotherapy on the Knee Extensor Muscles Fatigue and Isokinetic Parameters in Soccer Players

Mohsen Razeghi; Hassan Nouri

Volume 2, Issue 1 , March 2015, , Pages 1-7

Abstract

  Background:Fatigue can cause a significant effect on the mechanics of complex motor skills and reduce physical and mental efficiency. One of the common ways to reduce fatigue is passive ...  Read More Background:Fatigue can cause a significant effect on the mechanics of complex motor skills and reduce physical and mental efficiency. One of the common ways to reduce fatigue is passive recovering or using massage and cryotherapy after exercise. The present study aimed to compare the effects of massage and cryotherapy on muscles fatigue and isokinetic parameters.Methods:This study was conducted on54 healthy athletes aged 20-30 years who were randomly divided into three groups: cooling (ice therapy), massage, and control (resting). Each of the volunteers was evaluated in two sessions. The first session was to familiarize the participants with isokinetic contraction. The second session started with a brief warm up subsequently, using Biodex Isokinetic System Average Peak Torque (APTQ), Average Power (AP), and Total Work (TW) were measured. Then, the fatigue protocol was applied. Afterwards, interventions were performed for 15 minutes. After the intervention, isokinetic parameters were evaluated again. Also, perceived fatigue and Fatigue Index (FI) were recorded before and after the intervention.Results:APTQ, AP, and TW significantlyincreased in massage and cryotherapy groupsafter the intervention, while perceived fatigue and FI decreased significantly in both conditions (P<0.05). In the control group, however, no significant differences were observed in APTQ, AP, and TW before and after the intervention (P>0.05), but perceived fatigue and FI decreased significantly (P<0.05). Moreover, isokinetic variables (APTQ, AP, and TW) were higher in the massage group compared to cryotherapy and control groups (P<0.05), but such a difference was not observed between the massage and cryotherapy groups (P>0.05).Conclusion: Massage and cryotherapy could increase isokinetic parameters and decrease FI and perceived fatigue. Therefore, massage and cryotherapy have been more effective than rest as a strategy to return to normal state and no significant difference was observed between these two groups.

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Effect of Kinesiotaping and Stretching Exercise on Forward Shoulder Angle in Females with Rounded Shoulder Posture

Arghavan Hajibashi; Ali Amiri; Javad Sarrafzadeh; Nader Maroufi; Shohreh Jalae

Volume 1, Issue 4 , December 2014, , Pages 78-83

Abstract

  Background: Rounded shoulder posture is a common abnormal posture in upper quarter. Kinesiotape is a new intervention that recently used in rehabilitation. There are no studies have ...  Read More Background: Rounded shoulder posture is a common abnormal posture in upper quarter. Kinesiotape is a new intervention that recently used in rehabilitation. There are no studies have examined the effect of kinesiotape on rounded shoulder posture. Therefore the purpose of this study was to determine the effect of scapular kinesiotaping and pectoralis minor stretching exercise on forward shoulder angle in female subjects with rounded shoulder posture.Methods: Twenty female students aged between 18 to 25 years old with rounded shoulder posture participated in this study. Then, the subjects were randomly and equally assigned to two groups: the stretch group and the stretch plus kinesiotape group. Both groups were trained for doing home exercise to stretch Pectoralis minor bilaterally for two weeks. Kinesiotape group received kinesiotape on scapular area additionally. Forward shoulder angle was measured in four sessions including pre-intervention (first session), immediately after the first intervention (second session), fourth day (third session) and at the end of two weeks (fourth session). Two-way repeated measures ANOVA (4x2) was used for data analysis.Results: kinesiotape group showed significant within-group decrease in forward shoulder angle between first session with three other sessions (P≤0.05).There was no significant within-group difference in stretch group and between groups (P=0.20) forward shoulder angle-by-group interaction in measurement sessions was significantly different (P=0.02)Conclusion: scapular kinesiotaping along with pectoralis minor stretching exercise improved rounded shoulder posture in subjects of the present study. kinesiotape is suggested as a complementary treatment with immediate effects on postural correction of rounded shoulder.

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Literature Reviews

Hearing loss in patients with Covid -19: a narrative review

Shaghayegh Omidvar; Afsaneh Doosti; Zahra Jeddi; Zeinab Moradi Ganjeh

Articles in Press, Accepted Manuscript, Available Online from 05 March 2022

Abstract

  Objective: Although the most common symptoms of Covid-19 are otolaryngological symptoms including cough, sore throat, shortness of breath, loss of sense of smell and taste, reports ...  Read More Objective: Although the most common symptoms of Covid-19 are otolaryngological symptoms including cough, sore throat, shortness of breath, loss of sense of smell and taste, reports of autologous and audiological manifestations of the disease such as hearing loss, tinnitus, dizziness and. .. There is also. The present study reviews existing studies to investigate the occurrence of hearing loss, its types and possible causes in patients with Covid-19.findings:Studies show that the risk of transient hearing loss, sensory neurosis, and sudden deafness increases following Covid-19. Upper respiratory tract infection, followed by acute otitis media, can be a major cause of transient hearing loss in people with Covid-19. Regarding the causes of sensorineural hearing loss and sudden deafness, various reasons such as direct viral damage to peripheral organs, vascular disorders, and the use of autotoxic drugs used in the treatment of the disease have been cited.Conclusion:Because persistent hearing loss has devastating effects on quality of life, early detection of hearing loss and early intervention are essential. According to the available reports, it seems that hearing loss can be one of the complications of Covid-19, but due to the lack of sufficient evidence and heterogeneity among the existing studies, this issue can still not be stated with certainty. Therefore, longitudinal studies on a larger number of patients using appropriate assessment tools are recommended.

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Literature Reviews

A Review on Voice Indices Available for Voice Assessment

Saeed Saeedi; Mahshid Aghajanzade; Ahmad Reza Khatoonabadi

Articles in Press, Accepted Manuscript, Available Online from 13 March 2022

Abstract

  Background: In recent years, some voice indices have been developed for multiparametric objective voice evaluation. This study aims to review these indices and examine their efficiency ...  Read More Background: In recent years, some voice indices have been developed for multiparametric objective voice evaluation. This study aims to review these indices and examine their efficiency through literature. Methods: This study design is traditional narrative review. Five databases, including ‘PubMed’, ‘Scopus’, ‘Google Scholar’, ‘Science Direct’, and ‘Web of Science’ were searched by keywords including ‘voice index’, ‘acoustic’, ‘voice assessment’, and ‘acoustic analysis’. It was attempted to include only the acoustic indices that are validated and fairly user-friendly. Results: Five voice indices were found that met the inclusion criteria: Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Cepstral Spectral Index of Dysphonia (CSID), The Acoustic Breathiness Index (ABI), and Acoustic Psychometric Severity Index of Dysphonia (APSID). Conclusions: The results do suggest using AVQI, ABI, DSI, and CSID in the evaluation and treatment of voice disorders. Of course, it is recommended to examine the efficacy of these indices in more languages and also developing new indices by considering more aspects of voice.

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Original Articles

Rehabilitation Educators′ Perceptions of Clinical Education Challenges in Iran; Are COVID-19 Having Redundant Effects?

zeinab rashidi; Neda Orakifar; Meimanat Akbari; Razieh Mofateh; Fereshteh Zamani-Alavijeh; Marzieh Araban

Articles in Press, Accepted Manuscript, Available Online from 12 April 2022

Abstract

  Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Despite the importance of clinical education, this field has more shortcomings ...  Read More Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Despite the importance of clinical education, this field has more shortcomings than the other fields of education that should be improvedMethods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators. Moreover, the COVID-19 outbreak has added new challenges that should be mentioned. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were performed with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.Results: By data analysis, 240 initial codes were extracted. They were revealed in three main categories and nine sub-categories indicating redundant challenges faced by COVID -19: restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), the inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).Conclusion: The results of this study provided a deeper insight into the perceptions and experiences of rehabilitation educators about clinical education challenges. At present, the accidental and unexpected problematic event (COVID-19 pandemic) has detrimental effects in various aspects of clinical rehabilitation sciences. It is necessary to implement the changes in futuristic plans for adaptation with COVID-19.

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Systematic Reviews

A systematic review of speech recognition assessment tools for Persian-speaking children with and without hearing disorders

Mohammad Majid Oryadi-Zanjani

Articles in Press, Accepted Manuscript, Available Online from 26 April 2022

Abstract

  Background  Speech recognition is a significant component of speech perception assessment as a main clinical target in children with hearing disorders. So, this article presents ...  Read More Background  Speech recognition is a significant component of speech perception assessment as a main clinical target in children with hearing disorders. So, this article presents a systematic review designed to provide clinical and research guideline for the speech recognition assessment in Persian-speaking children with and without hearing disorders. Methods A systematic search was conducted to determine the research evidence dedicated to the assessment of speech recognition in Persian-speaking children with and without hearing disorders. Therefore, peer-reviewed journal articles published between 1982 and December 2021 were identified using the following electronic databases: PubMed, Scopus, MEDLINE, Web of Science,Magiran, IranMedex, Scientific Information Database (SID), and Google Scholar. The included papers were analyzed according to different variables including: test age, vocabulary competency, cognitive demands, response format, presentation mode, stimulus format,stimulus variability, stimulusmode, and test condition. Results The review identified four papers related to the development of five assessment tools to measure speech recognition in Persian-speaking children including: Persian Monosyllabic Lexical Neighborhood Tests (PMLNTs), Persian Disyllabic Lexical Neighborhood Tests (PDLNTs), Persian version of the words-in-noise (WIN), Tavana(test for evaluating auditory skills), and closed-set speech recognition test for Persian speaking children. The properties and the limitations of each test were considered in this review article. Conclusion According to this systematic review, there are just four speech recognition assessment tools to measure specifically spoken word recognition in Persian-speaking children. The results of this review article can be used as a clinical and research guideline for the speech recognition assessment in Persian-speaking children with hearing disorders.

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Original Articles

Prevalence of musculoskeletal disorders risk factors and ergonomic assessment of posture among senior students of Rehabilitation School of Shiraz University: a cross-sectional study

Mostafa Mehraban Jahromi; Sara Abolahrari-Shirazi; Sahar Safari; Farzaneh Moslemi Haghighi

Articles in Press, Accepted Manuscript, Available Online from 30 April 2022

Abstract

  Objective: To estimate the prevalence of musculoskeletal disorders and to evaluate the risk of work-related musculoskeletal disorders (WMSDs) in senior students of Rehabilitation School ...  Read More Objective: To estimate the prevalence of musculoskeletal disorders and to evaluate the risk of work-related musculoskeletal disorders (WMSDs) in senior students of Rehabilitation School of Shiraz University. Methods:  53 senior physical and occupational therapy students with an average age of 22-42 years participated in this cross-sectional study. The Nordic Musculoskeletal Questionnaire was used to evaluate work-related musculoskeletal disorders and the postural analysis was performed using Rapid Entire Body Assessment (REBA). Results: In our study, there was a high prevalence of musculoskeletal pain in the lower back, hand, neck, and shoulder regions. Approximately, 47% of the students reported lower back pain in the past 12 months, respectively. Disability in the lower back (23%) was the most common disorder in senior physical and occupational therapy students.  The results of sub-group analysis based on sex showed that the low back was the body region with the highest prevalence of pain. Also based on the BMI, the neck is highly reported for having pain. In addition, 36% of the senior students based on the REBA tool had a highly risk level for developing musculoskeletal disorders, while the prevalence of medium risk level was 49%. Conclusion: The results of the present study indicate that lower back pain was the most common musculoskeletal disorder among the senior physiotherapy and occupational therapy students. This research also showed that based on the REBA tool, 36% of the senior students had a high risk level of developing musculoskeletal disorders.  

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Meta-Analyses

The effect of exercise training programs on postural control and dynamic balance in individuals with flat feet and Cavus feet: A systematic review and meta-analysis

Parisa Sedaghti; Mohammad Adib Chamachaei; Hamed Zarei

Articles in Press, Accepted Manuscript, Available Online from 08 May 2022

Abstract

  Background. Considering the high prevalence of flat feet and cavus feet abnormalities among people and the adverse effects resulting from these complications on both the balance and ...  Read More Background. Considering the high prevalence of flat feet and cavus feet abnormalities among people and the adverse effects resulting from these complications on both the balance and function, a systematic review on the effect of various exercise programs on postural control and dynamic balance of these individuals seems to be essential. Thus, the aim of this systematic review and meta-analysis study is to examine the effect of exercise training programs on postural control and dynamic balance among individuals with flat feet and cavus feet. Method. The papers were identified through searching across eight databases of PubMed, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar. The search period ranged from the beginning of available date up to November 2021. In addition, manual search and complete investigation of the references of papers were also performed. Results. 13 studies were included in the systematic review and meta-analysis. The results of meta-analysis indicated that the exercise programs had a significant effect on posture control (p=0.001) and dynamic balance (p=0.001) among individuals with flat feet and cavus feet. The effect size of Hedges's g of the exercise programs on postural control was 1.81 with confidence interval 95% (1.40-2.22). The effect size of Hedges's g of the exercise programs on the dynamic balance was 1.32 with 95% confidence interval (0.98-1.67). Conclusion. In the present systematic review, it was found that exercise programs had a significant effect on postural control and dynamic balance of individuals with flat feet and cavus feet abnormalities. The results of studies revealed that to better correct abnormalities and thus improve the postural control and dynamic balance further, the period of exercise program should be increased. Also, exercise programs should also focus on greater involvement of neuromuscular systems and direct effect on the central nervous system so that greater effect would be observed on improving postural control and dynamic balance.

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Original Articles

Psychometric properties of the Persian version of the Burden Scale for Family Caregivers-short version in patients with stroke

Ali Reza Jamali; Afsoon Hassani Mehraban; malek amini

Articles in Press, Accepted Manuscript, Available Online from 11 May 2022

Abstract

  Background: Regarding the prevalence of stroke, an economical and reliable questionnaire is needed for use in research and rehabilitation to measure the amount of burden of these patients’ ...  Read More Background: Regarding the prevalence of stroke, an economical and reliable questionnaire is needed for use in research and rehabilitation to measure the amount of burden of these patients’ caregivers. In addition, to our knowledge there is no exclusive instrument to assess stroke caregivers’ burden in Persian language. Objectives: This study was conducted to investigate the validity and reliability of burden scale for family caregivers-short (BSFC-s) in stroke patients’ caregivers. Methods: In this cross-sectional study, 51 stroke patients and their caregivers were studied.Construct validity of the questionnaire was evaluated by Spearman and Eta correlation. Cronbach’s Alfa was used to assess internal consistency. Factorial structure was evaluated by exploratory analysis. It is a translated version of English questionnaire. Results: The test-retest reliability of the questionnaire was calculated to be 0.93 and the questionnaire’s internal consistency was 0.93. The construct validity of the questionnaire was acceptable. Conclusions: In general, it can be said that this questionnaire has a good structure for assessing the burden of caregivers. In addition, by 10 items we can consider this questionnaire as an economically viable option in research and practice.

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Original Articles

Investigating the relationship between locus of control, emotional intelligence and resilience among young male opium abusers in Shiraz

Bahareh Zeynalzadeh Ghoochani; Seyed Alireza Derakhshanrad; Mohammad Ahmadpour

Articles in Press, Accepted Manuscript, Available Online from 17 May 2022

Abstract

  Background:Addiction destroys lifestyles and affects the individual, family and society. The aim of the present study was to investigate the relationship between resilience, locus of ...  Read More Background:Addiction destroys lifestyles and affects the individual, family and society. The aim of the present study was to investigate the relationship between resilience, locus of control and emotional intelligence in opium addicts. Recognizing the weaknesses of this group helps them to recover and can provide preventive strategies for society.Methods: A total 40 male opium addicts were selected by convenience sampling from Ibn-e-Sina Center in Shiraz. Rotter, Shrink, Connor-Davidson and Demographic questionnaires were used in this cross-sectional study and Pearson test was used to obtain the correlation coefficient.Results:Less resilient people reported more relapses after quitting (r= -0.424, p = 0.006). People with higher social awareness used psychological therapies to liberate from addiction (r = 0.337, P=0.033). Longer addition was reported among people who consumed opium more frequently during the day (r = 0.433, p = 0.005). More frequency of daily consumption and more years of consumption had a positive relationship with increasing the number of quits and relapses (r=0.323, p = 0.042 and r = 0.362, p = 0.022).Conclusion:Addiction treatment centers should evaluate and improve the level of resilience, emotional intelligence, and type of locus of control in addicts. Most of the participants started their addiction between the ages of 20 and 25 due to curiosity, and the media and policymakers are recommended to play a vital role in raising social awareness and clarifying its devastating consequences. Most of the participants were unemployed and even needed money for more treatments, therefore, it is advisable that rehabilitation centers use occupational therapists for pre-vocational and vocational rehabilitation programs in the treatment process.

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Original Articles

The Relationship between Neural Properties, Mechanical Properties, Functional Outcomes, and Clinical Parameters in Spastic Chronic Stroke Patients: An Observational Study

Ehsan Ghasemi; Khosro Khademi-Kalantari; fateme bokaee; Alireza Akbarzadeh Baghban; Majid Ghasemi

Articles in Press, Accepted Manuscript, Available Online from 22 May 2022

Abstract

  Background: Subsequent to spasticity, which is a positive impairment of stroke, neural and mechanical changes often occur in paretic muscles, affecting muscle function. The aim of this ...  Read More Background: Subsequent to spasticity, which is a positive impairment of stroke, neural and mechanical changes often occur in paretic muscles, affecting muscle function. The aim of this study was to find more accurate indices, which could affect decisions about spasticity treatment by investigating the relationship among neural, mechanical, functional outcomes, and clinical parameters in spastic chronic stroke patients.  Methods: In this cross sectional study, 45 spastic chronic stroke patients were included. Clinical assessments, such as spasticity evaluation, were conducted, using the Modified Modified Ashworth Scale (MMAS). Neural properties including H-reflex latency and Hmax / Mmax ratio were acquired. Also, mechanical properties including fascicle length, pennation angle, and thickness of spastic medial gastrocnemius muscle were evaluated. Functional outcomes were evaluated through Timed Up and Go (TUG) test and Timed 10-Meter Walk Test (10-m WTT). Spearman's rank correlation analysis in SPSS version 22.0 was used to find correlations between parameters. Results: There was a low negative correlation between MMAS and H-reflex latency (r= -0.320, p = 0.032). MMAS score had a low significant relationship with pennation angle (r=0.296, p= 0.049) and thickness of muscles (r=0.389, p=0.008). However, there was no significant correlation between MMAS and functional outcomes. Conclusion: Based on these findings, MMAS can partly identify changes in neural and mechanical properties of spastic muscles.

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Original Articles

The Effect of Mulligan Mobilization Technique on Static and Dynamic Balance in Patients with Moderate to Severe Knee Osteoarthritis

Javid Mostamand; Maryam Adeli; Hosseinali Ahmadi; Akbar Hassanzadeh

Articles in Press, Accepted Manuscript, Available Online from 22 May 2022

Abstract

  Background: Knee osteoarthritis is the most degenerative joint disease which can consequently cause a defect in balance control. Controlling the balance is necessary to prevent physical ...  Read More Background: Knee osteoarthritis is the most degenerative joint disease which can consequently cause a defect in balance control. Controlling the balance is necessary to prevent physical and psychological damages. This study aimed to investigate the effect of Mulligan mobilization technique on static and dynamic balances in patients with moderate to severe knee osteoarthritis. Methods: In a randomized controlled clinical trial, 31 patients with moderate to severe knee osteoarthritis were included and then assigned randomly into two groups of treatment (16 patients) and control (15 patients). Static and dynamic balances and pain score were evaluated in these patients once before and once after 10 sessions of treatment. Independent t-test and paired t-test were used for statistical analysis. The level of statistical significance was set at p < 0.05. Results: Pain significantly decreased in both groups after intervention (P<0.001). Pain reduction in the treatment group was significantly more than that of the control group (P=0.005). A significant improvement was found in static (P=0.01) and dynamic balances (P=0.006) after performing the intervention in the treatment group. Additionally, there was a greater improvement in static (P=0.04) and dynamic balances (P=0.02) in the treatment group compared to the control group. Conclusions: The results of the present study reveal that Mulligan mobilization technique could improve balance in patient with moderate and severe knee osteoarthritis.

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Original Articles

Psychological and muscular beneficial effects of the resistance exercise in patients with chronic heart failure – A randomized controlled trial

Marzieh Saeidi; Roya Ravanbod; Mohammad Hossein Pourgharib-Shahi; Hosein Navid; Babak Goosheh; Abdolvahab Baradaran; Giti Torkaman

Articles in Press, Accepted Manuscript, Available Online from 22 May 2022

Abstract

  Aims: Patients with chronic heart failure (CHF) are characterized by debilitating muscle weakness, inability of moving, and resultant psychological disadvantages. Therefore, this study ...  Read More Aims: Patients with chronic heart failure (CHF) are characterized by debilitating muscle weakness, inability of moving, and resultant psychological disadvantages. Therefore, this study aimed to investigate the acute effects of resistance exercise (RE) and its impact on psychological health and peak muscle contraction (PMC) in patients with CHF. Methods: This randomized controlled trial was performed between October 2019 to December 2020. Fifty-seven patients with CHF (NYHA Class II, III) underwent initial assessments for 6 minutes walking test (6MWT), psychological response to exercise and PMC. They were randomly divided into R1, R2, and control groups. The intervention consisted of performing a short aerobic exercise including 15 minutes of walking at an intensity of 50%-reserved heart rate for all three groups and additional RE with the intensity of 50%-1RM and 75%-1RM for R1 and R2 groups, respectively. Results: The results showed that there was no significant difference between groups for 6MWT, peak muscle contraction and psychological response to exercise after the intervention (P≥0.05). PMC and psychological response to exercise improved significantly in all groups, however 6MWT increased significantly just in group R2 after the intervention. PWB was related to peak muscle contraction of left knee extensors and dorsiflexors positively and PD and FATwas related to walking distance and peak muscle contraction of left knee extensors and dorsiflexors negatively.  Conclusions: Performing just one session of exercise had significant beneficial impacts on, PMC, and psychological response in patients with CHF regardless of the exercise type and RE intensty.However, walking distance (6MWT) increased significantly in group R2 (75% of 1-RM) that shows performing higher resistance exercise is both safe and lead on functional advantages in CHF patients. There was a positive relationship between PWB and 1RM and negative relationship between PD and fatigue with 1RM.

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Original Articles

Are tension-type headaches associated with flexible flat feet? A cross-sectional study

Negar Azhdari; Ali Ghanbari; Marzieh Mohamadi

Articles in Press, Accepted Manuscript, Available Online from 11 June 2022

Abstract

  Background: Several peripheral and central factors are believed to contribute to the pathology of tension type headache (TTH). We carried out this study to identify a connection between ...  Read More Background: Several peripheral and central factors are believed to contribute to the pathology of tension type headache (TTH). We carried out this study to identify a connection between TTH and flat feet. Methods: This is a cross-sectional comparative study. A total of 61 people with chronic TTH (13 male and 48 female) and 61 matched controls participated in this study. The frequency of flat feet in the two groups was the primary outcome of this study. The presence of myofascial trigger points in the head and neck areas and degree of neck disability were also assessed in both groups. A Pearson's chi-square test and logistic regression models were used to determine the relative contribution of demographic and clinical predictive variables to the TTH. Results: The chi-square test showed that frequency of flat feet, uni- or bilateral, was significantly higher (x2= 17.5, df= 2, p<0.001) in TTH group compared the control group. Further analysis revealed that people with flat feet are 4.32 to 5.05 times more likely to develop TTH than people who have normal foot posture. The probability of developing TTH in participants with 4 or more trigger points was 7.93 times higher than participants with less than 4 trigger points. Similarly; the probability of developing TTH in participants with a Neck Disability Index score of 4 or more was 11.96 times higher than participants with a score less than 4. Conclusion: Our findings indicate that there is a probable link between presence of flat feet and chronic TTH.

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Original Articles

The contrast of the Maximum Functional Torque Shoulder Joint in Overhead Athletes with and without sub-acromion impingement during Sitting Throw

Aboozar Saadatian; Mansour Sahebozamani; Mohammad Taghi Karimi

Articles in Press, Accepted Manuscript, Available Online from 12 June 2022

Abstract

  Background: Throwing movements are repetitive movement in overhead athletes that causes soft tissues adaptation and ultimately lead to shoulder joint damage. The purpose of this study ...  Read More Background: Throwing movements are repetitive movement in overhead athletes that causes soft tissues adaptation and ultimately lead to shoulder joint damage. The purpose of this study was to determine the torque of internal and external rotation of joint shoulder overhead athletes with and without impingement syndrome in the throwing ball position. methods: This study was Cross-sectional and 63 male overhead athletes selected (30 participants without shoulder impingement syndrome and 33 participants with shoulder impingement syndrome. ( simulation maximum functional torque evaluated during throwing a ball to the net during sitting position. A 6-camera Vicon Motion Capture system incorporated the markers on the upper limb and trunk. To evaluate the maximum torque, a kinematic model of the upper limb was used in OpenSim software, with inverse dynamic used to obtain maximum torque. Results: The results showed that the internal and external rotation and elevation torque were significantly different in the athletes with shoulder impingement syndrome in comparison to those without impingement syndrome (P <0/001, p= 0.012 and P <0/001, respectively), while depression torque wasn’t a significant difference (p=0/283) in two groups. Conclusion: These findings suggest that there may be adaptations to shoulder strength and torque in response to throwing a ball that ultimately causes injury to the shoulder.

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Original Articles

Time and frequency analysis of EMG signals for simultaneous evaluating of knee muscles in concentric and eccentric strength training in healthy men

mehdi zeygham jahani; Ali Yaghoubi; Mohamad Amin Younessi Heravi

Articles in Press, Accepted Manuscript, Available Online from 22 June 2022

Abstract

  Background: Strength training has been commonly used as an intervention to improve neuromuscular activity within the synergic and/or agonist-antagonist muscles. This study aimed to ...  Read More Background: Strength training has been commonly used as an intervention to improve neuromuscular activity within the synergic and/or agonist-antagonist muscles. This study aimed to evaluate simultaneous electrical activity of quadriceps and hamstrings muscles after strength eccentric training versus concentric training. Methods: This study was an experimental study with a between-group comparison design. 26 male participated in two groups (eccentric training group and concentric training group). Maximal knee extension force, and bipolar surface electromyography (EMG) signals from quadriceps and hamstrings muscles were simultaneously recorded pre- and post- concentric and eccentric strength training. After EMG pre-processing for noise reduction, EMG signals were evaluated in two groups by time and frequency analysis. Nine EMG features (six time features and three frequency features) were analyzed in two groups pre- and post-training by statistical analysis. Results: the results showed that the maximal voluntary isometric contraction (MIVC) of quadriceps muscle were significantly increased in both groups from pre- to post-training (P< 0.05). Moreover, eccentric training resulted in greater increase in time features of EMG for quadriceps and hamstrings muscles as compared to concentric training (P< 0.05). All frequency features showed significant changes in pre-test and post-test for eccentric training group (P< 0.05). However, no significant difference was observed in the frequency features in the post-test compared to the pre-test in the concentric training group (P>0.05). Conclusion: based on our results, the great changes in time and frequency features of quadriceps and hamstring EMG were observed using eccentric training. So, eccentric strength training could be more effective to trigger neuromuscular activity within the agonist and antagonist muscle simultaneously.

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Original Articles

Do undergraduate physiotherapy students believe back pain myths? A cross-sectional survey

Ammar Suhail; Sarah Quais

Articles in Press, Accepted Manuscript, Available Online from 22 June 2022

Abstract

  Background: Low back pain (LBP) is a global public health issue. Physiotherapy is one of the most imperative conservative approaches for LBP patients. Beliefs of physiotherapists ...  Read More Background: Low back pain (LBP) is a global public health issue. Physiotherapy is one of the most imperative conservative approaches for LBP patients. Beliefs of physiotherapists is seen to have a significant impact on treatment choices. Beliefs that are not based on the current evidence may lead to erroneous clinical decision-making. The present study explores the beliefs of physiotherapy students about low back pain. Methods:This cross-sectional study was designed to detect the presence of myths among Indian undergraduate physiotherapy students using a predesigned survey outlining the ‘myths of back pain.’ Bachelor of Physiotherapy students from different academic years of various colleges across India’s north zone participated in the study. Survey questions were designed to identify the myths related to disease pathophysiology, treatment, and diagnostic tools. Results A total of 265 physiotherapy students participated in the study. Among the participants, 31.7% were males, and 61.3% were females. The data discovered that most physiotherapy students hold wrong beliefs, with major myths being (1) LBP is caused by poor posture when sitting, standing, and lifting, (2) LBP will become persistent and deteriorate in later life, and (3) LBP is caused by weak core muscles and having a strong core protects against future LBP. There was a difference in a few myths based on academic years. Conclusion: Physiotherapy students had wrong beliefs associated with LBP. Educational programs should work towards developing courses that dispel these erroneous “beliefs.”

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Original Articles

The effect of fatigue on the time to stability in jumping and landing in football players who have undergone anterior cruciate ligament reconstruction

moosareza ghorbani; amir shamloo kazemi; farideh babakhani

Articles in Press, Accepted Manuscript, Available Online from 25 June 2022

Abstract

  Background: Jumping and landing are common activities in soccer  that are often reported in connection with anterior cruciate ligament injury.  Since most injuries occur during ...  Read More Background: Jumping and landing are common activities in soccer  that are often reported in connection with anterior cruciate ligament injury.  Since most injuries occur during fatigue, the present study intends to investigate the effect of fatigue on the component of time to stability (TTS) during landing between healthy soccer players and soccer players who have undergone anterior cruciate ligament reconstruction. Methods: 24 professional soccer players were divided into control and experimental groups. 12 active professional soccer players (control group) and 12 soccer players with 6-24 months of anterior cruciate ligament reconstruction with hamstring graft (experimental group) participated in this study. Athletes jumped and landed on the obstacle to a height of 7.5 cm, after the fatigue protocol, these movements were repeated. )TTS( data were collected using force plate. MANOVA test at the significant level of P <0.05 was used to compare pre-test and post-test data between the groups. Results: According to the results of this study, fatigue did not affect the time to stability in any of the anterior-posterior (P=0.104), internal-external (P=0.668) and vertical components (P=0.894) between the two groups. And fatigue could not make a significant difference between the two groups.  Also, before fatigue, no significant difference was observed between the two groups in any of the components. Conclusion: It seems that a plyometric fatigue training session can not be effective in differentiating between healthy soccer players and soccer players who have had anterior cruciate ligament reconstruction.

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Original Articles

Comparison of Auditory Localization Ability between Preschool Bilateral Hearing-Impaired Children and Normal Hearing Children

nasrin gohari; zahra hosseini dastgerdi; foozieh dehghani; ehsan negin; atta heidari

Articles in Press, Accepted Manuscript, Available Online from 28 June 2022

Abstract

  Background: Sound localization is a valuable skill whose maturation is influenced by au­ditory experience and is limited by bilateral sensorineural hearing loss. No study has assessed ...  Read More Background: Sound localization is a valuable skill whose maturation is influenced by au­ditory experience and is limited by bilateral sensorineural hearing loss. No study has assessed auditory localization in bilateral hearing-impaired children (BHIC) aged 5-6 years. The present study aimed to investigate the auditory localization skill in children with moderate-to-severe bilateral hearing loss and using hearing aids compared to their normally hearing peers.Methods: This cross-sectional study recruited 19 participants aged 5-6 years (60-72 month) with a mean age of 65.31± 3.83 month as the BHIC group, and 21 participants aged 5-6 years with a mean age of 60.21±3.02 years as the normally hearing children (NHC) group. The localization ability of both groups was tested in 24 positions with 15-degree intervals by a speaker connected to a laptop and a calibrated speech stimulus named "test". A score of +0.5 for each 15 degree of error on the right side of the position, and -0.5 on the left side of the position were considered.Results: The results showed that there was a significant difference in the error rates between the two groups in four (out of 24) positions (p<0.05). The difference was not statistically significant in other positions.Conclusion: The BHIC had a defect in the localization skill in some situations. Therefore, localization test, and localization training are recommended for these children.

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Original Articles

Narrative and reading comprehension performance in dyslexic Persian student

farshad khazraie; Salimeh Jafari; Maryam Jalalipour

Articles in Press, Accepted Manuscript, Available Online from 04 July 2022

Abstract

  Introduction: Among different studies about the role of narrative skills in the acquisition of literacy skills, specifying the high and low ability of students with dyslexia in narrative ...  Read More Introduction: Among different studies about the role of narrative skills in the acquisition of literacy skills, specifying the high and low ability of students with dyslexia in narrative skills, specifically in microstructures, has been less attention. Methods: Our searching methods were descriptive. we used two Iranian normative tests to identify grade two elementary school students that have a reading disability. (1) Screening test of reading for elementary schools children, Shafiei et al (2008) and (2) Diagnostic test of reading, Shirazi-Nilipoor (2005). Based on students' performance in the second test, we diagnosed 31 students with poor reading ability. The rest of the students were placed into the control group (n=35). we assessed the narrative skills of students, using the story retelling test, Jafari et al (2010). Data were analyzed by SPSS 21 (statistical analysis software). Result: analyzed data showed that students with dyslexia significantly performed lower than their normal peers in three of four elements of microstructure, including syntax complexity, Mean Length of Utterance (MLU), and using Conjunction. The two groups didn’t show any significant difference in using references. (P< 0.5). Conclusions: Results showed dyslexic students were weaker than their normal peers in most elements of microstructures of retelling test. In other words, these students have weaker language and cognitive subskills to develop their literacy skills. The results also showed that how much narrative skills can have direct role in the acquisition of literacy skills.  

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Case Report

Dysphagia as a main symptom of myasthenia gravis in a middle-aged adult male: A case report

Payam Sariaslani; Ghazaleh Homagostar; Hiwa Mohammadi

Articles in Press, Accepted Manuscript, Available Online from 13 July 2022

Abstract

  Introduction: Myasthenia gravis (MG) is a rare neuromuscular disorder resulted from the destruction of acetylcholine receptors at the neuromuscular junction by IgG antibodies. Although ...  Read More Introduction: Myasthenia gravis (MG) is a rare neuromuscular disorder resulted from the destruction of acetylcholine receptors at the neuromuscular junction by IgG antibodies. Although dysphagia is a common symptom in generalized form of MG, rarely reported as a sole manifestation of the disease, specifically in the younger patients. In the present study, we reported a middle-aged adult patient with a dysphagia as a sole manifestation of MG. Case presentation: A 49 years-old dysphagic male patient with severe dysphagia complaint was undergoing an excessive clinical and paraclinical examination. Oropharyngeal dysphagia confirmed by an experienced speech-language pathologist using water swallowing test. Unilateral right paresis of the soft palate and vocal fold was confirmed using laryngeal video strobosopy. Chest CT scan, brain MRI, routine blood, urine and thyroid tests were normal. In electromyography, slow repetitive nerve stimulation (RNS) showed a decremental response in right nasalis muscle. Diagnostic neostigmine test by 1.5 mg of intramuscular neostigmine led to significant recovery of laryngeal and pharyngeal motor dysfunction and dysphagia within 12 hours, so MG diagnosis was confirmed. The patient was treated with plasmapheresis, pyridostigmine and prednisolone, which had an improving course and led to a better swallowing of solid and liquid foods. Conclusion: MG should be considered as a diagnosis in middle-aged adult with dysphagia complaint.  

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Original Articles

Quality of life in acromegaly disease among Iranian population: One longitudinal before- after study

Arezoo Chouhdari; Farnaz Saberian; Omidvar Rezaei; Mohammad Samadian; Kaveh Ebrahimzadeh; Guive Sharifi; Zahra Davoudi

Articles in Press, Accepted Manuscript, Available Online from 16 July 2022

Abstract

  Background : We aimed to determine the quality of life(QoL) score before and after treatment in the patients with acromegaly.  Methods: In this before-after study, AcroQol questionnaire ...  Read More Background : We aimed to determine the quality of life(QoL) score before and after treatment in the patients with acromegaly.  Methods: In this before-after study, AcroQol questionnaire was used to assess the QOL. Demographic, clinical manifestations and co-morbidity data, pituitary axis involvement, biochemical and hormonal component tests ,and HRQoL (Health-Related Quality of Life) before and after treatment (Endoscopic transsphenoidal surgery, medication , radiotherapy) were evaluated in the patients over 18. To compare the mean of continuous data independent t and Mann–Whitney test were used.  To compare the mean QOL score before and after study paired-t and Wilcoxon test performed.  The significance level was set up at p<0.05. Results: Among 80 patients with acromegaly who underwent trans-sphenoid surgery with or without radiotherapy or medication therapy with somatostatin analogs 52(65%) entered the remission phase within 6 months. There was association between remission phase and female gender(p=0.004), lower growth hormone (GH) (p=0.04) so lower insulin like growth Factor-I (IGF1) after surgery(p=0.02) and no gonadal axis disorder after treatment(p<0.001) statistically. Also, there was significant association between not being in the remission phase and gonadal axis disorder before treatment (p=0.04). Qol score in all dimensions of the AcroQol questionnaire increased 6 months after treatment (p<0.001). Total AcroQol score after treatment was higher in remission group (p=0.03). As well as   psychological scale had a significant higher score both in the total scale (p<0.001) and in two subscale of appearance (p<0.001) and personal relationship (p=0.003). Conclusion: Due to the importance of the Qol  in acromegaly patients, further studies in this field are recommended.      

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Original Articles

Depression, Anxiety, Stress and their associated factors among Iranian physical therapists during COVID-19 pandemic: An online-based cross-sectional survey

leila valizadeh; Razieh Mofateh; maryam Seyedtabib

Articles in Press, Accepted Manuscript, Available Online from 30 July 2022

Abstract

  Introduction: Most physiotherapy treatments need direct contact with patients. It could predispose physical therapists to the transmission of infection. The purpose of the study was ...  Read More Introduction: Most physiotherapy treatments need direct contact with patients. It could predispose physical therapists to the transmission of infection. The purpose of the study was to investigate the depression, anxiety, and stress of physical therapists during the coronavirus disease 2019 (COVID-19) pandemic. Method: A cross-sectional, web-based survey was applied during the pandemic. The survey was completed by 135 physical therapists that were working in Iran. The Depression-anxiety and stress scale 21 (DASS-21) was used to evaluate their depression, anxiety and stress status. A multiple regression analysis was used to identify the demographic characteristics factor related to depression, anxiety or stress. Results: The results showed that 43.7%, 43.8%, and 54.8% of physical therapists had severe and very severe levels of depression, anxiety and, stress respectively. In additions, female physical therapists had higher level of depression, anxiety, and stress. The level of anxiety was higher in physical therapists who were working in hospital and those who had more work experience. Conclusion: Our findings indicated that COVID-19 resulted in high levels of depression, anxiety and stress in Iranian physical therapists. Therefore, the mental health of physical therapists should be regularly monitored and the proper support and training of coping strategies should be provided for them.        

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Original Articles

Comparison of the effectiveness of parenting training with life skills training on the mental health of mothers of children with hearing loss: A randomized clinical trial

Sara Dehbozrgi; Somaye Yazdani; Mohammad Majid Oryadi-Zanjani; Maryam Vahab; Mohamad Nikandish

Articles in Press, Accepted Manuscript, Available Online from 13 August 2022

Abstract

  Introduction Hearing loss is one of the most common sensory disorders. The consequences of hearing loss and its effect on the mothers of these children on the one hand and the ...  Read More Introduction Hearing loss is one of the most common sensory disorders. The consequences of hearing loss and its effect on the mothers of these children on the one hand and the emphasis of previous research on the effectiveness of educational interventions along with the lack of comparative studies on the other hand prompted us to do this research. The purpose of this study was to compare the effectiveness of parenting education and life skills training for the mental health of mothers with hearing-impaired children in the Covid-19 crisis and quarantine virtually.MethodsThis study was a randomized clinical trial. The research sample consisting of 46 mothers who have child with hearing loss were divided into two groups: a positive parenting training group and a group that was trained in a life skills program. The workshops of both groups were accomplished online due to the limitations caused by the Covid-19 pandemic. Data collection tools were three questionnaires of parenting, life skills, and general health that were completed in both pre-test and post-test stages. For data analysis, SPSS software version 26 was used.ResultsThe results indicate that parenting education in mothers with children with hearing impairment has significantly reduced anxiety and depression. ConclusionsThis research showed that parenting education has increased the quality of life of mothers with children with hearing impairment and the positive effects of this education are confirmed.

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Letter to Editor

Cardiac telerehabilitation, an effective way against Covid-19 epidemic

Mohammad Rafati fard; Behnam Shakerian

Articles in Press, Accepted Manuscript, Available Online from 23 August 2022

Abstract

  Covid 19 infection has a profound effect on cardiac rehabilitation (CR) program. With public quarantine policies, hospital based cardiac rehabilitation services were impossible in most ...  Read More Covid 19 infection has a profound effect on cardiac rehabilitation (CR) program. With public quarantine policies, hospital based cardiac rehabilitation services were impossible in most countries, including Iran. that the consequences of reduced access and long term closure of CR centers may lead to long term complications include increased hospital admission and re-exposure of this vulnerable population to. These challenges have led many countries' rehabilitation centers and health care systems to develop and replace cardiac rehabilitation models such as E - health interventions and the use of mobile technology to provide these services with remote patient monitoring in order to reduce the effects of the spread of the epidemic, and to remove the barriers between physician – patient communication and in order to continue care and secondary prevention measures for cardiovascular patients. Therefore, due to the prolongation of the COVID-19 pandemic period and the identification of various types of coronavirus mutations, it is suggested that health - care services and cardiac rehabilitation associations in Iran create the necessary infrastructure to support and use digital methods and smartphone application

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Meta-Analyses

The effect of warm up on knee position sense: A systematic review and meta-analysis

parisa sayyadi; Hooman Minoonejad; Foad Seidi; Rahman Sheikhhoseini; ramin arghadeh

Articles in Press, Accepted Manuscript, Available Online from 24 August 2022

Abstract

   background  : The aim of this systematic review and meta-analysis study is to investigate the effect of warming up on knee position sense. Method: The keywords of this review ...  Read More  background  : The aim of this systematic review and meta-analysis study is to investigate the effect of warming up on knee position sense. Method: The keywords of this review study were searched on December 1 by two authors in the following electronic databases: PubMed, web of science, Scopus, and Google Scholar. The quality of articles was checked by the Downs and Black checklist. Statistical analysis was performed using CMA software, and I-square was used for examining the heterogeneity of data and I2 was utilized for estimating the percentage of heterogeneity. Besides, Funnel Plot method was used for assessing the risk of bias of articles and trim-and-fill method was used in case of observation of possible bias. Results: Out of 5,133 studies found in selected databases, 31 ones were selected after reviewing the title and abstract, and 7 articles were included in the study after reviewing the full text. The results indicated that warming up has a significant effect on reducing the active absolute angular error (P<0.05) and the active relative angular error (P<0.05) but has no significant effect on the passive absolute angular error (P>0.05). Conclusion: Warming can reduce absolute and relative angular error. Therefore, it has a significant effect on improve proprioception.  

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Original Articles

Leisure Questionnaire of People with Multiple Sclerosis

Seyed Mohammad Sadegh hosseini; sahar nurani; Ali Asgari

Articles in Press, Accepted Manuscript, Available Online from 28 August 2022

Abstract

  Background: Leisure activities are an important part of activities that people with Multiple Sclerosis do in their life. As a while, unfortunately, there are not any proper assessment ...  Read More Background: Leisure activities are an important part of activities that people with Multiple Sclerosis do in their life. As a while, unfortunately, there are not any proper assessment tools for evaluation of it. The purpose of this research is to develop a leisure questionnaire and finding the factor structure of it for Multiple Sclerosis patients. Methods: This psychometric study in order to find the factor structure of the leisure questionnaire was conducted in two explanatory and confirmatory phases. Results: The leisure questionnaire was filled up and data was entered in SPSS for the explanatory phase and LISREL for the confirmatory phase. The lowest Eigenvalue is 1.01, which corresponds to the Kaiser criterion. The validity coefficients of the extracted factors are considerable. There is a very slight difference between the highest coefficient that is related to the third factor (0.846) and the lowest coefficient that is related to the fifth factor (0.799), indicating correct determination of the number of factors. Confirmatory factor analysis illustrated that the GFI and CFI indices were considerable (higher than 0.95), showing good fit of data. Also RMSEA was 0.024. Conclusion: It can be concluded that the 5-factor structure (difficult, social, spiritual/religious, outdoor-physical and cultural-artistic activities) of multiple sclerosis leisure questionnaire with 50 items is confirmed.    

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Original Articles

Examination of the relationship between upper limb volume with disability, thoracic kyphosis, scapular protraction, and forward head posture in patients with upper limb lymphedema after breast cancer surgery

Sara Abolahrari-Shirazi; Narges Meftahi; Donya Jaberolansar; Maryam Taherpour

Articles in Press, Accepted Manuscript, Available Online from 03 September 2022

Abstract

  Background: Upper extremity (UE) lymphedema, which negatively affects patients' personal and social well-being, is the most common complication after breast cancer treatment. Previous ...  Read More Background: Upper extremity (UE) lymphedema, which negatively affects patients' personal and social well-being, is the most common complication after breast cancer treatment. Previous studies have shown the adverse effects of surgical interventions after breast cancer on spine postures and UE disability; however, the relationships between UE volume and postural changes and between UE volume and UE disability in patients with lymphedema have not been studied. Furthermore, some postural changes in the spine like forward head posture has not been assessed in these patients.  Therefore, the aim of this study was to investigate the relationship between the volume of the affected UE with the forward head posture (FHP), kyphosis, shoulder protraction, and UE disability in lymphedema patients. Methods: In this cross-sectional study, 32 women with unilateral UE lymphedema participated. UE volume and kyphosis were measured by volumetry and a flexible ruler, respectively. Cervical angle was used to assess FHP. For shoulder protraction and FHP calculation, data obtained from markers and photography was analyzed by ImageJ software. The disability of the affected UE was assessed by the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Pearson's correlation test was used to analyze the data.Results: A significant positive correlation was shown between UE volume and UE disability as well as kyphosis. A significant negative correlation was shown between UE volume and shoulder angle and cervical angle. A significant negative correlation was seen between UE disability and shoulder angle. The relationships between upper limb disability and kyphosis and cervical angles were not significant. Conclusion: An increase in the affected UE volume because of lymphedema is related to an increase in UE disability, kyphosis angle, forward head posture, and shoulder protraction. In addition to treatments for UE volume reduction in lymphedema patients, accurate posture evaluation is also recommended.  

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Original Articles

Evaluation of the quality of life of pregnant women with lumbar pain using the new pregnancy belt and compare to the current belt

Zhaleh Heydari; Mohammad Ali Mardani; Akbar Biglarian; Maryam Shokrpour; Gholamreza Aminian

Articles in Press, Accepted Manuscript, Available Online from 13 September 2022

Abstract

  Background: Quality of life is a multidimensional concept that includes physical, mental, emotional, and social functions. Lumbar pain during pregnancy can reduce the quality of ...  Read More Background: Quality of life is a multidimensional concept that includes physical, mental, emotional, and social functions. Lumbar pain during pregnancy can reduce the quality of life and using the pregnancy belts can improve it. Today, the most common design pattern of belts is in the form of an adjustable one-piece panel at the pelvic girdle and did not support the lumbar region. But the new pregnancy belt supports the lumbar and pelvic girdle simultaneously. The purpose of this study is evaluation of the quality of life of pregnant women with lumbar pain using the new pregnancy belt compared to the current belt.  Methods:  The total of 48 pregnant women with pregnancy-related lumbar pain participated in this randomized control trial study and were divided into three groups (current belt, new belt, and control group). All groups completed a demographic questionnaire and quality of life questionnaire (SF36) at the beginning of the study and after three weeks of follow-up. Results: All eight health concepts of the (SF36) questionnaire increased in both belt user groups but decreased in the control group after three weeks of follow-up. On physical health and mental health scales, there was a significant difference in the new belt group compared to the current belt group. Although there was no significant difference in the 2 variables (p=1.00, p=0.15, respectively). Conclusion: The new pregnancy belt can have a greater impact on enhancing the quality of life of pregnant women than the current belt.    

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Original Articles

Audiological findings of speech perception in noise test and speech, spatial and qualities of hearing scale questionnaire in patients with chronic kidney diseases

Ahmad Reza _Zamani; Sima Tajik; Somayeh Falahzadeh; Mina Bandad; Seyyed Mohammad Reza Seyyed Mohammad Reza Taghavi; Farshid Oliaei

Articles in Press, Accepted Manuscript, Available Online from 24 September 2022

Abstract

  Background: Disturbance in the nervous system of patients with chronic kidney diseases (CKD(, including uremic neuropathy, may lead to changes in the auditory processing of these patients. ...  Read More Background: Disturbance in the nervous system of patients with chronic kidney diseases (CKD(, including uremic neuropathy, may lead to changes in the auditory processing of these patients. The impairment of auditory processing results in communication, social and emotional problems in the life. Accordingly, in this study, communication abilities and speech perception in noise in CKD patients are analyzed to identify the disorders more rapidly. Methods: In this cross-sectional/comparative study, 30 CKD patients and 29 normal adults aged 20-55 years with normal peripheral hearing were randomly selected and the consonant-vowel (CV) test was performed with 5 signal-to-noise ratios (SNR) and silence, and speech, spatial and qualities of hearing scale questionnaire (SSQ) was applied to them with three subscales. The scores of the two groups were compared with the Mann-Whitney U test. Results: In both groups, the increase in noise led to a decrease in the consonant-vowel recognition scores. However, the normal group outperformed the patients at all levels. Patients in three subscales of the SSQ obtained a lower score than the normal group, but this difference was not statistically significant. Conclusions: The chronic renal failure reduces speech perception abilities in noise, and this finding indicates the auditory neurological involvement in CKD. Although the self-assessment by patients did not reveal any speech processing disability, for the early diagnose of hearing disability and mitigation of the consequences of hearing disability, it is recommended to periodically and regularly control the central hearing of patients and take proper rehabilitation measures if a disability is diagnosed.  

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Meta-Analyses

Electromyographic analysis of trapezius and serratus anterior muscles in individuals with scapular dyskinesis in different types of push-up: A systematic review and meta-analysis

ramin arghadeh; Hooman Minoonejad; Mohammad Hosein Alizadeh; Rahman Sheikhhoseini; parisa sayyadi

Articles in Press, Accepted Manuscript, Available Online from 24 September 2022

Abstract

  Background: It has been recommended to use push-up for strengthening the scapular stabilizers and to use unstable surfaces for increasing the neuromuscular system involvement. However, ...  Read More Background: It has been recommended to use push-up for strengthening the scapular stabilizers and to use unstable surfaces for increasing the neuromuscular system involvement. However, the effect of this instability on the electromyography activity of the periscapular muscles during push-up in individuals with Scapular dyskinesis is not clear. Thus, the present study aimed to determine the effect of unstable surfaces on the electromyography activity of trapezius and Serratus anterior muscles in individuals with scapular dyskinesis during push-up. Methods: A systematic search was conducted in Web of Science, PubMed, and Scopus databases without time limit for start date until September 25, 2021. Using the search strategy, 5,249 articles were identified using the three main keyword categories, including Scapular dyskinesis, electromyography, and push-up. After reviewing the full text of the articles, four studies were included in the final review. Data extraction and methodological quality evaluation were conducted. For meta-analysis, the SMD and the 95% CI were obtained using CMA Software, Ver.3. P-value smaller than 0.05 was considered statistically significant. Results: According to the results, the use of unstable surfaces in individuals with scapular dyskinesis caused an increase in the activity of the upper trapezius (P= 0.011; SMD= 0.807 [95%CI 0.188, 1.427]) and a reduction in the activity of the Serratus anterior (P= 0.000; SMD= -0.665 [95%CI -1.023, -0.307]). However, it did not significantly affect the electromyography activity of the Lower trapezius (P= 0.176). Conclusion: Unstable surfaces should be used with higher caution in individuals with scapular dyskinesis because these people have an imbalance of the upper trapezius muscle compared to the serratus anterior muscle and incorrect use of unstable surfaces can cause exacerbation of muscle imbalance in these individuals.  

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Original Articles

The effect of a neuromuscular training program on landing kinematics in young soccer players with poor landing mechanics

Nezam Nemati; Ali Asghar Norasteh; Ali Shamsi Majelan

Articles in Press, Accepted Manuscript, Available Online from 01 October 2022

Abstract

  Background: increased knee valgus, decreased knee flexion and poor landing pattern are contributing risk factors for anterior cruciate ligament (ACL) injuries in young soccer players. ...  Read More Background: increased knee valgus, decreased knee flexion and poor landing pattern are contributing risk factors for anterior cruciate ligament (ACL) injuries in young soccer players. This study aimed to investigate the effect of the Prevent Injury and Enhance Performance (PEP) program on knee valgus and knee flexion angles and Landing Error Scoring System (LESS) test scores in young male soccer players with poor landing mechanics. Methods: The present study was quasi-experimental. 47 soccer players with poor landing mechanics were purposefully recruited and they were randomly assigned to the intervention group (n=23 players, age= 12.69±0.70 years, height= 1.53±0.06 m, weight= 49.91±6.76 kg) and control group (n=24 players, age= 12.55±0.64 years, height= 1.51±0.08 m, weight= 51.25±7.73 kg). Knee Valgus angle, Knee flexion angle and LESS test scores were measured at the baseline and the end of the study. The intervention group used the PEP program as a warm-up for 8 weeks while the control group performed its routine warm-up during this time. ANCOVA and paired-sample t-test were used to evaluate changes. Results: The results obtained in the intervention group showed there was a significant reduction in knee valgus angle (p=0.001) and there were significant enhancements in knee flexion angle (p=0.003) and LESS test scores (p=0.001) but there were no significant differences in the control group in knee valgus and knee flexion angles (p>0.05) except for LESS test scores (p=0.001). Moreover, the outcome showed significant differences between groups in knee valgus angle (p=0.001), knee flexion angle (p=0.025) and LESS test scores (p=0.001). Conclusion: This study demonstrated that PEP program was effective in reducing dynamic knee valgus angles, increasing knee flexion angles and improving LESS test scores in young soccer players. Thus, it seems that this program can reduce the risk of ACL injuries in young male soccer players.

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