بهروز عطارباشی مقدم

Piriformis syndrome is a neuromuscular disease mostly caused by compression of the sciatic nerve by the piriformis muscle. The purpose of this study was to review the efficacy of different types of physiotherapy interventions on the signs and symptoms in patients with piriformis syndrome.

PubMed, Scopus, Web of Science and Google Scholar databases were searched to identify the published articles on the efficacy of physiotherapy interventions for the treatment of piriformis syndrome. The search was conducted from 1980 to august 2020. The used keywords were: piriformis syndrome, manual therapy, muscle stretch and electrotherapy. The references of the included studies were also reviewed. Finally, after studying 752 probable articles and removing irrelevant ones, 10 clinical trial articles were selected.

The included studies presented that manual therapy accompanying with stretching techniques show great improvement in range of motion of the hip joint and reducing pain in patients with piriformis syndrome. It is impossible to conclude a certain method of electrotherapy modalities such as laser and shockwave therapy for the treatment of patients, due to lack of valid studies.

Based on the current evidence, it seems that using muscle energy techniques (MET) with stretching of the piriformis and other hip muscles are effective in reduction of pain and disability and improvement of range of motion in patients suffering from piriformis syndrome.

The prevalence of heart failure is increasing. The effects of the second and third phases of cardiac rehabilitation in reducing symptoms and improving quality of life for ambulatory (discharged) heart patients has repeatedly been investigated. However, due to the threats to the survival of heart patients at hospitalization (and the possibility of a sharp decline in functional capacity of patients at this stage), the first phase of cardiac rehabilitation, especially for patients with heart failure, has rarely been studied. Meanwhile, the quality of life is becoming increasingly important in the health care system so that it is belived that the most important goal in interventions is to improve the quality of life, especially in chronic diseases. Thus, the aim of the present study was to evaluate the effect of the first phase of cardiac rehabilitation on the quality of life and functional capacity of patients with heart failure.
Methods and Materials: In the present one way blind clinical trial, 34 patients with moderate and severe heart failure (New York Heart Association functional classification basis) with left ventricular ejection fraction lower than 40 percent were included. The patients were randomly divided into two groups. Both groups received routine medical care during hospitalization and respiratory physiotherapy. In addition, patients in the intervention group care had aerobic exercise program using a stationary bicycle. In both groups, in addition to the usual parameters (such as heart rate, blood pressure and respiratory rate), the first and fifth day of hospitalization, quality of life (using the Persian version of the Seattle Angina Questionnaire) and functional capacity (6-minute walk test) were measured. Normality Shapiro-Wilk test was also performed. Then, dependent parameters in the two groups were tracked running multi-factor repeated measures analysis of variance.
In the beginning of the study, the two groups were not significantly different in terms of the variables related to disease severity and demographics. Then, functional capacity was increased in both groups from the first day to the fifth day, yet this improvement was not found to be significant. Also, the quality of life improved 53.84 percent in the intervention group and 29.62 percent in the control group, which is statistically significant (p Cardiac rehabilitation during the first five days of hospitalization can improve the quality of life (which is considered as a predictor of outcome in heart failure) as well as functional capacity in heart failure patients.

Flexibility is an important component of the normal musculoskeletal system function. Therefore, flexibility exercises as a basic component of athletes’ warm–up programs are generally recommended before training or participating in sports competitions. Due to the controversy in use of stretching in the warm-up programs, as well as the use of whole body vibration (WBV) in improving flexibility, the aim of the present study was to investigate the effects of WBV on lower extremity muscles flexibility in healthy young women.
A total of 25 healthy young women with an average of age 20/76±1/09 years old participated in the present study. Their flexibility were measured using passive knee extension test, hip flexion, test and modified sit and reach test before and after the intervention. Participants stood on WBV equipment (f=30 Hz, Amp=2mm 5×60s hold ⭺) in semi squat position.
After WBV, the flexibility of the hamstring and hip flexor as well as general flexibility significantly increased (P=0/000). The results showed that, before WBV, there was significant differences in hamstring and hip flexors flexibility between the two legs (P≤0/05), but after WBV, no significant difference was observed in hip flexors flexibility (P=0/14).
The findings of the study indicate that the WBV seems to be a suitable training method for improving lower extremity muscular flexibility.

The purpose of the present study was to determine the influence of demographic variables and disease characteristics on the quality of life scores and the distribution of the scores at different stages of Chronic Obstructive Pulmonary Disease (COPD). One hundred patients with COPD participated in this cross-sectional study. Interview and the validated Persian version of the clinical COPD questionnaire (PCCQ) were used for data collection. The method of data collection for the study was interview with a demographic and validated Persian version of the clinical COPD questionnaire (PCCQ). Six percent of patients were revealed as mild COPD, 34 percent of patients as moderate COPD, 49 percent of patients as severe COPD and 11 percent of patients as very severe COPD. Significant differences were observed for total score and the component scores of the PCCQ among four stages of the disease. The age and length of the disease correlated significantly with the total PCCQ score (P<0.05). In order to compare between the CCQ total score and three domains of male and female groups, the results showed that women compared to men had lower quality of life in CCQ total score and functional areas (P<0/5). Distribution of the quality of life scores in patients with different stages of COPD patients showed that there is an overlap quality of life scores in the mild, moderate, severe and very severe stages of COPD patients. As a result, classifying the disease using spirometry cannot distinct patients with COPD according to impairments in their health status. In adittion, the age, sex and length of the disease are the main factors that may affect the quality of life.

Pay attention to high prevalence of stress urinary incontinence (SUI) in women athletes and role of changes in lumbar lordosis، pelvic tilt and the type and number of delivery factors on the incidence of Urinary Stress Incontinence also lack of studies in this problem about risk factors (Predisposing factors) in Iranian population، this study was designed to investigate the relationship between changes in lumbar curvature and pelvic tilt with SUI and to determine the type and parity on the incidence of this problem. In this cross - sectional study through easy and available sampling، 17 volleyball player with SUI and 15 healthy volleyball player، aged 20-40 years old. Females after interview and taking demographic information participated in the study. The Persian questionnaire of ICIQ-UISF (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form) used to confirm the SUI. A flexible ruler and inclinometer were used to measure lumbar lordosis and pelvic tilt. A statistically significant difference was seen between the two groups in terms of the lumbar spine curvature (p< 0. 001) and pelvic tilt (p = 0. 02) respectively. Based on the findings، the number of delivery was no significant effect on the incidence of Stress Urinary Incontinence but there was significant relationship between type of delivery and SUI. With significant difference in the lumbar lordosis and pelvic tilt in athletic women with and without SUI، also advised to emphasize on the epidemiological and etiological investigation studies of lumbar lordosis and pelvic tilt in patients with Stress Urinary Incontinence.

Anterior Cruciate Ligament (ACL) is responsible for physical and somatosensory function. It is expected that additional sensory information improves dynamic balance of ACL reconstruction patients. This study is aimed to determine the effect of sensory information on knee dynamic balance after ACL reconstruction in comparison with normal people. The study was designed as a randomized clinical trial. Thirty two men (16 men with unilateral ACL reconstruction and 16 healthy men), assigned in three groups: ACLR, reconstructed knee ACLR, non-reconstructed knee and normal. All participants received tactile information during functional tests. Dynamic postural stability was assessed by two functional tests including: Star Excursion Balance test and Cross over Hop for distance. The functional tests scores were conducted both pre and post applying sensory information in ACLR and normal people. The data showed that tactile information improves functional performance of ACLR patients. There were significant difference in reconstructed knee’s SEBT scores in medial (p=0.005) and posteromedial (p=0.034) directions by adding touch information. Significant difference in dynamic balance by addition of touch sense, in COH scores of ACLR people and normal population was found. The findings of this study showed that additional sensory information improves dynamic balance in ACLR patients. The positive effect of tactile information supports to apply additional sensory information as a new method for increasing dynamic balance.

Myocardial Infarction (MI) is the major cause of death in the industrial countries. In addition to the clinical and economic burden، MI affects health related quality of life (HRQoL). Original version of the SAQ was developed cross-sectionally and may be used for measuring clinically important dimensions of coronary artery disease. However، the Persian translation is not available for Myocardial Infarction patients. After multi-stage translating based on Manufacturers Alliance for Productivity and Innovation (MAPI) protocol، the reliability examined on 130 patients with MI. The SF-36 was used to assess the validity of the SAQ. To assess test-retest reliability، the patients refilled the SAQ after 5 days. Reliability of the SAQ was assessed by Cronbach’s Alpha and the Intra-class Correlation Coefficient (ICC). Validity was determined using Pearson correlation matrix for the subclasses and the total scores (ρ). ICC exceeded 0. 6 in all domains. The weighted kappa ranged from 0. 492 to 0. 853. Reliability and validity of the Persian version of the SAQ is acceptable and seems that this questionnaire can be a useful tool in assessing health related quality of life in Persian speaking patients with myocardial infarction suffering from angina.

The translation، cultural adaptation and validation of the Persian version of the American shoulder and elbow surgeons (ASES) were carried out in accordance with published guidelines. The study was conducted on 100 athletes (25. 96±5. 81 years)، which suffered from different shoulder disorders. When the translation and cultural adaptation of the original questionnaire was carried out on the standardized method، the participants were asked to complete a questionnaire booklet including the DASH، the Short Form General Health Survey (SF-36) and ASES questionnaires. In addition، 30 randomly selected patients were asked to complete the ASES questionnaire 48 hours later for the second time. After data collection the Statistical analysis was performed by using SPSS software. The Cronbach''s alpha was used to indicate internal consistency. Cronbach''s alpha was 0. 91 for ASES. Test-retest reliability was quantified by use of the intraclass correlation coefficient. It was 0. 91 for ASES questionnaire. The Pearson Correlation Coefficient was used for the questionnaire validation study. The DASH questionnaire showed high correlation of ICC=0. 78 with ASES. The ASES showed moderate correlation of 0. 48 to 0. 62 with those of the various scales of the SF-36. The Iranian ASES showed good reliability and validity and can be used for shoulder-specific patient self-assessment.

One of the consequences of obesity is coronary artery disease (CAD) and diabetes. Effective exercise programs for patients with the coronary artery disease is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health. The purpose of this study was to compare the effectiveness of a physiotherapy and exercise based cardiac rehabilitation on the anthropometric measurements of obesity in the diabetic and non diabetic men. Seventy one 45- to 75-years-old male volunteers with coronary artery disease (32 diabetic & 39 non diabetic patients) participated in 6-8 weeks of moderate intensity aerobic exercise training consisting of 45 min sessions of treadmill، stationary bicycle and arm bicycle. Anthropometric measurements of obesity (body mass index (BMI)، waist circumference، hip circumference، waist to hip ratio and waist to height ratio) were measured at the beginning، in the middle and at the end of exercise sessions in both groups. Following the cardiac rehabilitation program، all of the anthropometric measurements except hip circumference in diabetic patients decreased significantly (P<0. 05). BMI، waist circumference and waist to height ratio increased in non diabetic patients (P<0. 05). Exercise training alone in cardiac rehabilitation program is not sufficient to reduce the anthropometric measurements of obesity in non-diabetic patients.

One of the most important part of management and modification of CAD risk factor is to control the level of plasma lipid profile. Application of comprehensive cardiac rehabilitation in patient with CAD could decrease the level of CHL, TG, LDL and increasing of HDL. There are a lot of studies that discuss the effect of rehabilitation on different people with different races and life style. Thirty six patients with the age (40-75) who were referred by cardiologist participated in this study. Fast walking on treadmill, biking on stationary bicycle and cycling with upper body ergometer were chosen as aerobic exercises. For assessing the short term and long term effects of this protocol, blood sampling were taken at three stages; before exercise initiation, after 12 and 24 sessions of exercise. Following the cardiac rehabilitation protocol, the level of CHL, LDL and the ratio of LDL/HDL and CHL/HDL decreased significantly. Cardiac rehabilitation could be used as means to improve lipid profile level in blood serum, prevention of cardiovascular disease and reducing mortality and morbidity rates.

Coronary artery disease is the most common cause of mortality in adult with atherosclerosis. Based on recent studies decrease of transferring level is very important in coronary vascular disease development. The main goal of this study was to survey the effects of endurance, resistance and combination training on the transferring level. Forty three volunteers with 18- 25 years old participated in this study. Transferring, heart rate and blood pressure assessed before & after one session of exercise. Subjects randomly put in to one of the four groups (control, endurance, resistance and combination). There was no significant difference between transferring before and after in endurance & combination groups; But there was a significant difference between transferrin before and after one session of resistance exercise group (P= 0.04). The results of this pilot study showed that one session of resistance exercises decreased the transferrin level whereas endurance and combination exercises were ineffective upon it.

The goal of this study is to determine the effects of comprehensive cardiac rehabilitation program (CCRP) on various domains of health related quality of life (HRQOL) in coronary artery bypass grafts (CABG) patients. Forty- four post CABG patients aged 40 - 60 years (mean age = 52.95, SD = 6.02) participated in Phase II CCRP. The SF-36 health survey was used to assess the HRQOL before and after the CCRP and at three-month follow up. The data of patients were compared before and after the intervention and with the normal values of age matched (45-64 Yrs., 882 persons). The findings showed that there was a significant difference in seven domains of HRQOL between patients prior to CCRP and general population (P ≤ 0.05). There was a significant difference in all HRQOL domains after CCRP (P ≤ 0.005). Five out of 8 domains of HRQOL were unchanged at least 3 months after the CCRP, whereas there was an improvement in 3 domains of HRQOL (P ≤ 0.05). The results of this study suggest that the physical and mental health interventions in CCRP are among critical keys to prevent and/or at least decrease the adverse effects of surgery on HRQOL.