Physical Treatments Journal
Volume:7 Issue: 2, Summer 2017

Purpose Providing better services in physiotherapy clinics, awareness of perception and expectation of clients in these clinics, and determination of the gap between these two components, are of utmost importance. This study aimed to investigate the gap between expectation and perception of the physiotherapy patients using government health centers in Zahedan City, Iran.
Methods A sample of 240 clients of public physiotherapy clinics in Zahedan City, Iran were participated in this cross-sectional (descriptive-analytical) study which was done from July 2015 to April 2016. The subjects were selected using stratified random sampling method. The relevant data were collected using modified SERVQUAL questionnaire. The data were analyzed in SPSS.21 using Mann-Whitney and Kruskal-Wallis tests.
Results The results demonstrated negative quality gaps in all five SERVQUAL dimensions (tangibles, reliability, responsiveness, assurance, and empathy) in public clinics (P0.05).
Conclusion Based on the results, perception of patients in all dissensions was lower than their expectations. Therefore, there are some opportunities of improving delivered physiotherapy services in these clinics. It is recommended that managers of public physiotherapy clinics pay attention to the opinions of clients more than ever, welcome their critics and suggestions about the reform and workplace issues.

Forward Walking (FW) and Backward Walking (BW) on different gradients of the treadmill is a common exercise for lower extremity rehabilitation. However, limited studies are found about the three-dimensional analysis of lower extremity and status of the knee joint during FW and BW on different gradients. Therefore, this study aimed to investigate the lower extremity joints kinematics during FW and BW on incline and decline surfaces.
The current research has a quasi-experimental design. Sixteen healthy males with the mean (SD) age of 22.4(2.5) years, volunteered to participate in this study. The subjects’ FW and BW with their preferred speed on a treadmill at four gradients (-7.5%, 0%, % and %), were analyzed by using motion capture system. All data were analyzed using paired sample t test (P Significant differences were seen between FW and BW in most angular variables in sagittal plane. However, there were no significant differences between FW and BW in most parameters of knee angle in frontal plane.
Based on the results, with increase in FW inclination and decrease in BW inclination, the knee varus angle in frontal plane reduces. Therefore, FW on the upslope surfaces or BW on downslope surfaces, probably is a suitable solution to reduce the loads exerted on medial compartment of the knee.

Genu varum deformity changes the line of gravity from center of knee towards the medial side. This deviation results in changes in the upper part of the lower extremity that can affect postural control as well as the position and activity of the proximal muscles of the knee joint, like the gluteus medius muscle. Therefore this study aims to investigate the effect of genu varum disorder on the activity of gluteus medius muscle and postural control during single-leg jump-landing exercise.
A total of 28 male students of Physical Education Major (Mean [SD] age, weight, and height: 21.53[1.65] y, 66.76[7.51] kg, and 173.38[4.54] cm, respectively) were enrolled and studied in two groups of genu varum (14 students) and normal ones (14 students). The activity level of gluteus medius muscle and the ground reaction force were measured using electromyography device and force plate, respectively in single-leg jump-landing exercise. In order to analyze the data, we used the Independent t test at significance level of P There is a significant difference between the genu varum and normal group in terms of mean activity of gluteus medius muscle before and after the landing. There were significant difference between these groups with regard to time to stabilization in anterior-posterior direction, while significantly higher time to stabilization was found in the genu varum group compared to the normal groups in medial-lateral and overall direction. The time to stabilization of the subjects in the directions of medial-laterallateral and anterior-posterior and total Resultant Vector (RV) using the force plate in the jump-landing movement was evaluated. There was no significant difference in the time to stabilization between the two groups of the knee parenthesis and the normal knee in the anterior-posterior direction (P>0.05), but the time to stabilization in the medial-lateral and in resultant vector direction in the genu varum group was significantly more than those in normal knee group (P Participants with genu varum have weakness in postural stability in medial-lateral and total RV direction that might decrease the activity of gluteus medius muscle. This might increase the demand on the muscle for stabilizing hip and pelvis which decreases control of transverse and frontal part of hip and finally affects postural stability in medial-lateral direction (may be due to inappropriate activity of the hip). Thus, improvement of gluteus medius muscle might improve medial-lateral control of the posture in individuals with genu varum.

The elderly patients undergoing hemodialysis who developed end-stage renal failure are at higher risk for falling and its critical outcomes compared with their healthy counterparts due to of poor balance, reduced muscle endurance, and sedentary lifestyle. The current study aimed at evaluating the effect of selected core stability exercises on balance and muscle endurance in the elderly patients undergoing hemodialysis.
In the current quasi-experimental study, a total of 30 patients undergoing hemodialysis with the mean age of 62.24±6.51 years, the mean hemodialysis duration of 29.4±18.44 months, and the history of falling at least once during the last year were selected using the purposive convenience sampling method and then, the subjects were randomly allocated into 2 groups of intervention (n=15) and control (n=15). To assess the static balance, dynamic balance, and muscle endurance in the patients, the stork stand test, the timed Up and Go test (TUG), and the sit-to-stand-to-sit test for 60 seconds (STS-60) were used, respectively. The selected core stability exercises were performed for the intervention group in 6 weeks, three 45-minute sessions per week. To analyze data, the repeated measures analysis of variance (RM ANOVA) with SPSS version 22 was used; P Results of the current study indicated significant differences between the groups in terms of static balance, dynamic balance, and muscle endurance (P Based on the obtained results, the therapists can suggest the core stability exercises as a safe and functional strategy to improve balance and muscle endurance in patients undergoing hemodialysis, which may result in increased independence of action and reduced risk of falling due to loss of balance.

Considering the role of spine in protecting the body alignment and various body activities, this study aims to examine the relationship between the spine curvature disorders and resting habits among the students of the University of Social Welfare and Rehabilitation Sciences.
In this correlational study, a total of 108 students of Tehran University of Social Welfare and Rehabilitation Sciences, aged 18 to 29 years, were selected through simple random sampling method. Their curvatures of their spines were measured by scoliometer and a flexible ruler, and their resting habits were assessed through the Resting Habits questionnaire. The obtained data were analyzed by performing Kolmogorov-Smirnov, linear regression, Pearson, Spearman, Mann-Whitney, and Independent t statistical tests using SPSS.V22.
There was no significant relationship between the resting habits of the study participants with their degrees of lordosis (P=0.858, r=0.574) and degree of scoliosis (P=0.603, r=0.857). However, there was a significant relationship between lordosis and gender (P In this study, the resting habits were not identified as risk factor for abnormal spine curvatures in the younger ages. However, bad resting habits at older ages and in females can be risk factors for lordosis.

Predicting body Center of Mass (COM) acceleration is carried out with more accuracy based on the acceleration of three joints of lower limb compared to only accounting joints of hip and ankle. Given that trunk movement during quite standing is noticeable, calculating trunk acceleration in model might increase prediction accuracy of COM acceleration. Moreover, in previous research studies, dominant and nondominant limb was neglected as influencing variables in prediction accuracy. Therefore, this study aimed to investigate the accuracy of predicting COM acceleration based on the accelerations of lower limb joints and trunk, with emphasis on weight distribution on legs.
The relevant kinematic data were collected using motion analysis systems. In this regard, visual 3D software was used to create a 14-segment model for each subject and estimate the positions of body COM. A force plate was used to assess the body weight distribution between legs. Calculation of the summation of joints angular accelerations was done using algebraic addition of time series data.
Prediction of COM acceleration, based on the individual acceleration of lower limb joints and trunk, revealed that just acceleration of hip joint in both dominant and nondominant lower limbs was an appropriate variable for predicting COM acceleration (R2adj =0.40). However, during prediction based on the summation of trunk and joints accelerations, its accuracy showed a significant increase (R2adj=0.90).
The summation of angular accelerations of trunk and lower limb joints is the most accurate predictor of COM acceleration during quiet standing balance control. Simultaneous changes of lower limb joints and trunk accelerations control COM acceleration.

Neck pain is one of the most common health problems that its prevalence ranges from 34% to 50%. Chronic Neck Pain (CNP) is also a frequent complaint in the general population. The pathogenesis of nonspecific CNP is not clear. This study aimed to assess the effects of soft tissue release, muscle energy techniques and exercise on neck Range of Motion (ROM), Neck Disability Index (NDI), and pain in patients with nonspecific CNP.
This is a randomized, single-blind, clinical study conducted on two groups of patients in Iran, during 2016-2017. Group A received intervention treatment and group B, as control, received no treatment for 21 days. Each group consisted of 12 participants who were selected considering inclusion and exclusion criteria. Each patient in group A received manual treatment protocols (soft tissue release and muscle energy techniques) plus exercise therapy, in six sessions, one session per day, two days a week over a period of 21 days. Clinical assessments were performed at the first and last session (before and after the treatment). Before starting the study, the reliabilities of measurement methods were evaluated and the results were acceptable. Clinical assessments included neck ROM, NDI and pain based on Visual Analogue Scale (VAS). Repeated measures ANOVA test was performed for data analysis using SPSS (version 20).
Totally, 16 women and 8 men were participated in this study. To test the hypothesis and analysis of the study variables at regular intervals from the beginning to the end of treatment, repeated measures ANOVA was used. In the intervention group, the indexes showed significant improvements (P The study results support the effectiveness of the combination therapy (soft tissue release, muscle energy techniques plus exercise therapy) with some improvements in the neck ROM, NDI and pain (Based on VAS scores) for the management of patients with non-specific CNP.