behrooz attarbashi moghadam

Patients with ACL reconstruction often return back to activity with diminished quadriceps activity and strength. (Patients suffering from ACL can be often rehabilitated with the help of ACL reconstruction, although quadriceps strength and muscle activity might be weak or limited after the surgery.)The present study aimed to compare the effect of Transcutaneous Electrical Nerve Stimulation (TENS), Functional Electrical Stimulation (FES) and Biofeedback Electromyography (B-EMG) on improvement in quadriceps strength and mean value of VMO activation pattern (MVVA) among patients with reconstruction of ACL.

The study was designed as a randomized control trial. 102 patients, who filled a demographic questionnaire relating to important factors mainly age, height, and weight before the intervention, (all sportsmen) were randomly divided into four groups known as, FES (n=21), TENS (n=21), B-EMG (n=22) and control (n=38). In this study, hand-held dynamometry and biofeedback electromyography were used to assess Quadriceps strength and MVVA respectively. All samples were evaluated at three different time intervals, including prior to the, after and 4 weeks after the treatment. Additionally, all four groups received Ice pack around the knee and Michle Duck exercise therapy protocol. The treatments provided totally lasted 3 to 5 weeks. The participants in 4 groups received TENS, FES and B-EMG as their main treatments 5 times a week for 45, 15 and 15 minutes successively.

The mean scores of MVVA and quadriceps strength after the intervention and after the follow-up increased significantly in all four groups. However the effect of FES on MVVA in comparison with TENS and control group was statistically meaningful in favor of FES group. (As instructed here the last sentence omitted)

TENS, FES and B-EMG in combination with cryotherapy and exercise as well as cryotherapy with exercise can reduce VMO inhibition and improve quadriceps strength in patients who undergo ACL reconstruction. However FES in combination with cryotherapy and exercise can be the most effective one.

Musculoskeletal disorders are among the main causes of disability in modern life. Myofascial trigger points are very common among musculoskeletal disorders and may occur through ordinary common activities. This study aimed to determine the combined effects of laser therapy and Ischemic Compression (IC) on the treatment of Myofascial Trigger Points (MTrPs) at the upper trapezius muscle.

Twenty men with at least one active trigger point at their upper trapezius muscle voluntarily participated in this study. Trigger points were under treatment of laser irradiation (6 Joules per point) and also ischemic compression. Treatment approaches were applied over the pain point every other day for 5 sessions in 10 days. Neck disability index, pain intensity by visual analog scale, pressure pain threshold by algometry, and cervical lateral flexion by goniometer were assessed and recorded before the intervention, and immediately after the last session.

At the end of treatment, statistically significant improvements were seen in the neck disability index, VAS value, pressure pain threshold, and cervical lateral flexion. VAS values of the treatment and control groups were compared with the baseline (P<0.001).

Application of combined laser and compression therapy was effective on the pain and level of disability of patients with trigger points in the upper trapezius muscle.

Myofascial Pain Syndrome (MPS) is a common muscular disorder characterized by a referral pain to a particular area after irritating the myofascial trigger point. This study aimed to determine the combined treatment effect of laser therapy and ischemic compression of an active myofascial trigger point in the upper trapezius muscle.

This is a clinical trial study conducted on 15 subjects with Active Trigger Points (ATPs). In one session, 15 subjects received laser therapy and ischemic compression. The assessment was done immediately after the treatment. We used the visual analog scale for the measurement of pain intensity, algometry (FG-5020, Taiwan made) for pressure pain threshold, and goniometer for cervical lateral flexion.

The cervical lateral flexion after the intervention was significantly higher than that before the intervention (P<0.001). Also, the post-operative pressure pain threshold was significantly higher than that before the intervention (P<0.001). The level of pain decreased after the intervention, but this difference was not statistically significant (P=0.90).

according to this study, the laser therapy combined with ischemic compression can significantly change the pressure pain threshold and cervical lateral flexion in patients with active trigger points in their upper trapezius muscles.

Carpal Tunnel Syndrome (CTS) is the most common and most well-known compression neuropathy which may manifest as mild, moderate, or severe and lead to various degrees of disability in people. The present study aimed to compare the effect of high-power diode laser beam and Transcutaneous Electrical Nerve Stimulation (TENS) separately and in combination on improvement of wrist pain and function in patients with CTS.

Method and Materials: 

The study was designed as a randomized trial. A total of 45 patients (7 men and 38 women) were randomly divided into three groups of high-power laser (n=15), TENS (n=15), and high-power laser with TENS (n=15). The TENS group received conventional TENS on pain site for two weeks as 5 sessions per week and 30 minutes per session. The high-power laser group received 6.5 J/cm2 laser for two weeks, 5 sessions per week. The group of high-power laser with TENS received conventional TENS and then 6.5 J/cm2 laser for two weeks as 5 sessions per week and 30 minutes per session. The Persian McGill Pain Questionnaire, Visual Analogue Scale (VAS), and the 5-point scale of pain severity of McGill Pain Questionnaire (pain severity) were used to assess pain and the Persian version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire was administered to evaluate hand function before and after treatment. All the patients filled a demographic questionnaire including age, height, and weight prior to the intervention.

The mean scores of McGill, VAS, pain severity, and DASH questionnaires reduced significantly in high-power laser and high-power laser with TENS groups; however, these variables had no significant difference in the TENS group.

High-power laser diode (808 nm, 6.5 j/cm2) can reduce pain and improve hand function in patients with mild to moderate CTS. Laser-induced anti-inflammatory effects and blood flow improvement are possible causes of decreased pain and sensory signs followed by improvement in hand function.

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.