Journal of Rehabilitation Sciences & Research

Abstract Background: Stretching is widely used to improve joint range of motion (ROM). This study examined the immediate effects of different stretching protocols on scapular muscle activity and motion in elite gymnasts.
Methods: A semi-experimental crossover design was employed. Fifteen elite gymnasts (mean age: 23.25 ± 2.57 years; height: 170.93 ± 5.88 cm; weight: 64.54 ± 5.06 kg) participated. Each athlete was assessed before and after five stretching conditions: dynamic stretching, static stretching, dynamic followed by static stretching, static followed by dynamic stretching, and no stretching (control). Myoelectric activity was recorded using surface electromyography (EMG), and scapular kinematics were assessed via the Kestrel model motion analysis system. Pre- and post-intervention values were compared to evaluate changes.
Results: Two-way repeated measures ANOVA revealed significant effects of stretching protocols on both muscle activation and scapular kinematics (tilt and rotation) (p < .05). Post hoc analysis showed significant differences between pre- and post-test values, as well as among the five stretching conditions (p < .05).
Conclusion: Both static and dynamic stretching protocols induced immediate changes in gymnasts' scapular muscle activity and kinematics. These alterations, particularly in muscle activation and scapular tilt, may influence performance and potentially elevate the risk of injury.

Abstract Background: Chronic nonspecific low back pain (CNLBP) is a prevalent cause of disability, despite advancements in management. The diaphragm, a key respiratory muscle crucial for adjusting intra-abdominal pressure and maintaining lumbar spine stability, often exhibits dysfunction in chronic LBP. Improving diaphragm function may yield positive effects on chronic LBP. Therefore, the main aim of the present study is to assess the addition of myofascial release of the diaphragm to traditional treatment on pain, balance, and quality of life in patients with chronic nonspecific LBP.
Methods: A prospective, double-blind, randomized controlled clinical trial will include 24 participants with CNLBP, randomly assigned to a control group (sham diaphragm myofascial release) or an interventional group (diaphragm myofascial release). All patients will receive three sessions of either the main release or sham interventions, followed by the application of Transcutaneous Electrical Nerve Stimulation (TENS). Outcome measures will be assessed at baseline, after the third session (post-treatment), and after one week (follow-up). Pain will be measured using the Visual Analogue Scale (VAS), disability using the Roland-Morris Questionnaire, static balance via the single-leg stance test, dynamic balance using the functional reach test, lumbopelvic mobility via the tip-to-floor test, and chest expansion with a tape measure. This study is the first to investigate the effects of diaphragm myofascial release in individuals with chronic low back pain. Considering the diaphragm’s potential role in postural control and interdependence of body regions, this intervention may offer benefits beyond pain relief, including improved balance and function. The randomized controlled design enhances the reliability of findings. Although blinding and objective diaphragm assessment were limited, the results may support the inclusion of this safe and simple technique as an adjunct in managing chronic LBP.
Results: Repeated measures ANOVA will be used for data analysis after collection.
Conclusion: This trial will examine the effects of diaphragm myofascial release compared with sham diaphragm myofascial release on pain, balance, chest expansion, lumbopelvic mobility, and disability in individuals with chronic nonspecific LBP. Potential implications for clinical practice and future research will be discussed, and the limitations of the study will also be considered.

Abstract Background: This study aimed to compare the effectiveness of the Integrated Neuromuscular Inhibition Technique (INIT)—a manual therapy approach combining Muscle Energy Techniques (MET), Ischemic Compression (IC), and Strain-Counterstrain (SCS)—with posture correction using a postural belt in individuals with mechanical neck pain.
Methods: In this single-blinded randomized clinical trial, 40 participants with mechanical neck pain (mean age: 34.32 ± 7.90 years) were randomly assigned to two groups. Group A received INIT, while Group B received posture correction through a postural belt. Interventions were administered three times per week over three weeks. Pain intensity, craniovertebral angle (CVA), and neck disability were assessed at baseline and after the third week of intervention.
Results: Both groups showed statistically significant improvements in pain, CVA, and neck disability scores after the intervention (p < 0.05). However, the INIT group demonstrated superior outcomes across all measured variables compared to the posture correction group.
Conclusion: INIT proved more effective than posture correction in reducing pain and disability and improving craniovertebral angle in individuals with mechanical neck pain. Nonetheless, posture correction using a belt may still serve as a viable secondary treatment option due to its simplicity, ease of use, and demonstrated benefits in pain relief and functional improvement.

Abstract Background: Lower Crossed Syndrome (LCS) is characterized by muscle imbalances and reduced flexibility, often leading to altered posture and movement dysfunctions. This semi-experimental pre-test/post-test study compared the effects of National Academy of Sports Medicine (NASM) exercises and kinetic chain training on lumbar lordosis, pelvic tilt, and hip joint range of motion (ROM) in individuals with LCS.
Methods: Thirty participants with LCS were purposefully and conveniently selected and randomly assigned to three groups: NASM, kinetic chain, and control. The NASM and kinetic chain groups completed an 8-week training program, with three sessions per week. Lumbar lordosis angle was measured using a flexible ruler, pelvic tilt angle was assessed via a tilt meter, and hip joint ROM was measured using a goniometer before and after the intervention. Data were analyzed using repeated measures ANOVA with significance set at P < 0.05. Analysis was performed with SPSS version 26.
Results: Both NASM and kinetic chain training significantly reduced lumbar lordosis (P = 0.000) and anterior pelvic tilt (P = 0.000), and increased considerably hip joint ROM in both flexion and extension (P = 0.000). Post-hoc analyses revealed that NASM exercises had a greater impact on reducing lumbar lordosis, anterior pelvic tilt, and increasing hip flexion ROM than kinetic chain exercises. Conversely, kinetic chain training was more effective in increasing hip extension ROM than NASM exercises.
Conclusion: Both NASM and kinetic chain exercises are practical corrective interventions for improving posture and mobility in individuals with LCS. NASM exercises are particularly beneficial for reducing lumbar lordosis and anterior pelvic tilt and enhancing hip flexion ROM, whereas kinetic chain exercises are more suitable for improving hip extension ROM.

Abstract Background: Clinical reasoning refers to the professional decision-making involved in physical rehabilitation. The hypothetico-deductive reasoning (HDR) model integrates clinicians' self-perceptions with structured clinical decision-making processes. This study aimed to evaluate the application of the HDR process in the physiotherapy management of a patient with a meniscus injury.
Methods: The case involved a 42-year-old male banker referred for physiotherapy rehabilitation, presenting with severe pain, swelling, catching, and locking of the right knee joint. This single-case study was addressed using the HDR process.
Results: By the eighth week of intervention, improvements were observed in pain reduction, muscle strength, and range of motion of the knee joint. Additionally, the meniscus evaluation score improved from 20.9% to 71.4%. The subject is now able to participate in routine daily activities. Clinical reasoning, central to practice, was critical in this atypical presentation of a meniscus tear; thus, the HDR process was employed for diagnosis and problem-solving.
Conclusion: The HDR process offers a holistic treatment framework and can be effectively applied to unfamiliar or atypical clinical conditions such as meniscus injuries.

Abstract Background: There is a growing need for online therapy due to various factors, such as the COVID-19 pandemic, long travel distances, and the duration of speech therapy sessions. This study aimed to develop an application to assist parents in providing speech therapy for children with stuttering. This app aims to facilitate dynamic interaction between Speech Language Pathologists (SLPs) and the families of children with stuttering.
Methods: A cross-sectional study design was carried out to develop and evaluate the effectiveness of an app for parents of children with stuttering aged 3 to 12 years. The app included brief descriptions of analogies for stuttering, accompanied by video demonstrations of these analogies. Three speech and language pathologists evaluated the app's content with at least five years of experience working with children with fluency disorders. Thirteen parents of children with stuttering participated in the study. The parents and their children used the app. Descriptive statistics and percentage analysis were applied to assess background variables.
Results: The findings revealed that almost all parents found the instructions provided in the app to be easily understandable. Seventy percent of the parents rated the app as highly satisfying in its usefulness. Regarding the app's functionality, nearly 77% of parents found it highly satisfying. Additionally, approximately 85% of parents found the app very user-friendly.
Conclusion: Most parents found this prototype app easy to use, efficient in training their children, and highly functional. The app appears to impact children's speech positively and facilitate effective communication. In the future, this app has the potential to reach a large number of clients, promoting better fluency skills cost-effectively and efficiently.

Abstract Background: Chronic non-specific low back pain (CNSLBP) is a leading cause of work absenteeism and increased dependence on healthcare services and insurance. Despite its prevalence, limited research has explored the effects of open and closed kinetic chain (O/CKC) exercises performed in water on improving CNSLBP-related outcomes. This study aimed to assess the impact of hydrotherapy-based closed and open kinetic chain exercises on lumbo-pelvic stability, pain intensity, kinesiophobia, rate of loading (ROL), and vertical ground reaction force (vGRF) in men with CNSLBP.
Methods: The double-blind randomized controlled trial was designed with a pre-post test in men aged 40–60 (48.10 ± 5.97) with CNSLBP. Patients were randomly assigned to two hydrotherapy groups—CKCE and OKCE—and a control group. Pain intensity, kinesiophobia, lumbo-pelvic stability (LPS), rate of loading (ROL), and vertical ground reaction force (vGRF) were measured using the visual analog scale, Tampa Kinesiophobia Scale, biofeedback pressure device, and plantar pressure device. The intervention groups performed prescribed exercises for eight weeks, with three sessions per week. Covariance analysis was used to compare group differences.
Results: In the comparison within the OKCE and CKCE groups, significant differences were observed between the pre- and post-intervention measurements (p < 0.05). Moreover, statistically significant differences were found in pain (p = 0.001) and kinesiophobia scores (p = 0.001), both with a large effect size. Additionally, noteworthy differences were noted in vGRF (p = 0.003), ROL (p = 0.012), and LPS (p = 0.022).
Conclusion: The study results indicate that hydrotherapy exercises involving open and closed kinetic chains benefit individuals with CNSLBP. It is recommended that healthcare professionals, including physicians, physiotherapists, and occupational therapists, incorporate these exercises into comprehensive rehabilitation programs for such patients.

Abstract Background: Creating a calm and supportive home environment is vital for children with Autism Spectrum Disorder (ASD) and their families. This scoping review aimed to examine the impact of personalized home-based modifications on the well-being and development of children with ASD.
Methods: Following the PRISMA-ScR guidelines, a comprehensive literature search was conducted across PubMed, Cochrane, ScienceDirect, and Scopus databases through June 2023. Emphasis was placed on key concepts related to home-based interventions for children aged 3 to 18 with ASD. From an initial pool of 6,022 articles, 23 relevant studies, including reviews, were selected for inclusion.
Results: Home-based modifications—including behavioral, sensory, and technological interventions—are prevalent and contribute to enhancing the quality of life for children with Autism Spectrum Disorder (ASD) while promoting their independence. This study underscores the importance of individualized living spaces and advocates for further research into integrating technology and architectural design within home environments. These findings provide valuable insights for healthcare professionals and caregivers.
Conclusion: Establishing a safe and supportive home environment for children with ASD is crucial. Tailored home modifications have been shown to improve their quality of life. Future research exploring architectural strategies, targeted interventions, and the integration of assistive technologies within home settings is recommended to further support children with ASD.