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behrouz attarbashi moghadam

  • Hassan Tamartash, Behrouz Attarbashi Moghadam, Kianoosh Hosseini, Shiva Musavi

    The Kansas City Cardiomyopathy Questionnaire (KCCQ) has been developed to measure the health status of Congestive heart failure (CHF) patients. This study aimed to translate KCCQ into a Persian version and assess its validity and reliability. We used a forward-backward procedure to translate the questionnaire. In a cross-sectional study, 150 CHF patients and 50 healthy subjects over 30 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire's validity. The validity was examined on a population of patients with CHF using the Persian version of the Minnesota Living Heart Failure Questionnaire (MLHF) health survey. Calculation of the Intraclass correlation coefficient (ICC) and Cronbach's alpha was done to evaluate the questionnaire's reliability. Test-retest reliability was examined by re-administering the KCCQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all domains was higher than 0.93, P≤0.000). Internal consistency was found by Cronbach's alpha to be 0.86 for the clinical summary and 0.87 for the overall summary, respectively. Also, the correlation between the components of KCCQ and MLHQ showed satisfactory construct validity. Good Pearson's Correlation Coefficient was seen between KCCQ and MLHF (r= -0.44, P≤0.000 for the clinical summary; r= -0.45, P≤0.000 for the overall summary). Analysing the data from 50 healthy persons and 150 patients were shown that the Persian version of KCCQ has acceptable discriminate validity for all domains except self-efficacy. The Persian version of the KCCQ had satisfactory reliability and validity for assessing health-related quality of life status for Iranian CHF patients.

    Keywords: Congestive Heart Failure, Health-Related Quality Of Life, Questionnaires, Reliability, Validity, The Kansas City Cardiomyopathy Questionnaire (KCCQ)
  • Sima Mosallaiezadeh, Siamak Bashardoust Tajali, Azadeh Shadmehr, Behrouz Attarbashi Moghadam
    Introduction

    Chronic neck pain (CNP) is of the most common symptoms of musculoskeletal disorder. Diaphragmatic exercises can reduce pain, and disability, improve proprioception, and correct forward head posture (FHP) in patients with CNP. The present study aims to determine the effect of combining diaphragmatic exercises with physiotherapy on pain, disability, and active range of motions of cervical and FHP in individuals with CNP.

    Materials and Methods

    Thirty women with CNP were randomly divided into two combined groups of diaphragmatic exercises and physiotherapy (DEPT) and PHYSIOTHERAPY ALONE (PT). Each person received ten sessions of treatment over two weeks. The results were assessed in the first and tenth sessions as well as two weeks later. Pain intensity was measured by visual analogue scale (VAS), disability by neck disability index (NDI), cervical active range of motions (CAROMs) by goniometry, and FHP by a lateral photograph.

    Results

    The VAS, neck disability index (NDI), CAROMs, and FHP were improved after the tenth session and in a two-week follow-up (P<0.001). A significant difference was observed between the groups for average changes of VAS (P=0.04) and active extension (P<0.001) after the tenth session, while the average changes between the two groups of cervical active left lateral flexion (P=0.82) and left rotation (P=0.11) in the next two weeks was not significant.

    Conclusion

    Both groups showed improvement in neck pain, disability, CAROMs, and FHP. However, diaphragmatic exercises and physiotherapy (DEPT) seem to have more lasting effects. Therefore, it is recommended to evaluate and modify the breathing patterns in the first line of treatment programs for patients with CNP.

    Keywords: Diaphragmatic exercise, Strength exercise, Pain, Chronic neck pain (CNP)
  • Monavar Hadizadeh, Siamak Bashardoust Tajali, Behrouz Attarbashi Moghadam, Shohreh Jalaei, Mahnaz Bazzaz
    Introduction

    The purpose of the present study was to investigate the effects of single-session intramuscular electrical stimulation (IMES) on pain and dysfunction following active trigger points in the upper trapezius muscle.

    Materials and Methods

    Volunteers (30 females) with active trigger points in the upper trapezius muscle were randomly divided into two IMES and placebo groups. For the IMES group, a needle was inserted into the trigger point, and electrical stimulation was applied to generate a pain-free contraction. For the placebo group, the intervention procedure was exactly the same, but there was no electrical stimulation. Pain by visual analog scale (VAS), pain pressure threshold (PPT), range of motion (ROM), and disability by neck disability index (NDI) were assessed as main outcome measures before, immediately after, and one week after conducting intervention by another blinded researcher.

    Results

    The VAS scales were improved in both groups but were significantly lower in the IMES group one week after treatment. The PPT and ROM scores were substantially higher in the IMES group one week after the treatment. The NDI indexes significantly reduced for both groups, with no significant differences between them.

    Conclusion

    IMES effectively improves pain, PPT, ROM, and NDI, following trigger points in the upper trapezius muscle. Further studies are required to investigate the IMES’s long-term effects.

    Keywords: Electrical stimulation, Dryneedling, Myofascial painsyndrome, Upper trapezius, Trigger point
  • Sara Fereydounnia, Azadeh Shadmehr, Behrouz Attarbashi Moghadam, Saeed Talebian Moghadam, Seyed Mohsen Mir, Parsa Salemi, Fereshteh Pourkazemi
    Introduction

    The present study aimed to investigate the immediate effects of two types of Kinesio taping on the temporal and spatial variables of gait initiation in individuals with and without Functional Ankle Instability (FAI).

    Materials and Methods

    Thirty semi-professional athletes (15 with and 15 without FAI [control]) were recruited for this study. The gait initiation task was examined before and after the two types of Kinesio taping on a force plate. Temporal (Reaction Phase [RP], Anticipatory Postural Adjustment Phase [APAP]), and spatial variables were recorded and compared between Groups, before and after the tape application.

    Results

    The results of multiple repeated-measure analyses of variance showed no significant differences for “factor” and “Group by factor” interaction effects for any outcome measure (P>0.05). There were no significant differences for Group effects except for the APAP (F=10.27, P=0.003). The APAA was 71.95 ms longer in the FAI Group (476.95±15.87 ms) compared to the control Group (405.04±15.87 ms).

    Conclusion

    Kinesio taping application does not influence any of the gait initiation parameters on the force plate. Participants with FAI demonstrated longer APAP which might be due to recurrent injury and instability during sports or physical activity.

    Keywords: Gait, Functional ankle instability, Kinesio tape, Soccer
  • Ashraf Vaseghnia, Azadeh Shadmehr *, Behrouz Attarbashi Moghadam, Gholamreza Olyaei, MohammadReza Hadian, Zahra Khazaeipour
    Objectives

    Muscle energy technique (MET) is one of the alternatives for the treatment of joint dysfunctions. Previous studies investigated this technique without considering the kind of dysfunctions. Therefore, the aim of this study was to evaluate the therapeutic effects of MET by considering the type of dysfunction and the direction of the corrective maneuver in women with iliosacral joint dysfunctions.

    Materials and Methods

    This randomized controlled clinical trial included 60 women with anterior innominate or posterior innominate dysfunctions and were randomly divided into the treatment group (n=30) receiving a session of MET and the control group (n=30). The range of flexion and extension of the lumbar, visual analogue scale (VAS), active straight leg raising (ASLR), and pressure pain threshold (PPT) at five points were measured before, after, and 24 hours after MET.

    Results

    Before, after, and 24 hours after the intervention, the mean change of the range of lumbar flexion and extension showed an increase. However, the mean change of the level of VAS and ASLR decreased significantly (P<0.05) in the treatment group with corresponding 95% confidence intervals.

    Conclusions

    According to the results of this study, using MET by considering the kind of dysfunction may more efficiently improve a patient’s symptoms.

    Keywords: Muscle energy technique, Sacroiliac dysfunctions, ant innominate, Posterior innominate
  • Masoud Ghofrani, Alireza Parsapour, Behrouz Attarbashi Moghadam, Amirahmad Shojaei *

    Codes of ethics are a set of moral standards based on a value system widely accepted by members of a profession. In order to choose the right course of action and resolve potential ethical challenges, these codes will need to be developed so that ethical values can be identified and prioritized. Medical ethics covers all areas of medicine, and surely, rehabilitation is not an exception. This study aims to codify the ethics of the rehabilitation profession while considering the cultural and religious issues in Iran. For this purpose, we used a qualitative research method, including literature review, questionnaire, targeted interviews, content analysis, group discussion, and code extraction. The results were categorized into seven sections: “respect and empathy”, “autonomy”, “offering responsible care and reducing suffering”, “doing the right thing”, “beneficence”, “privacy and confidentiality”, and “social responsibility”. The development of ethical codes for rehabilitation determines moral norms in order to protect the rights of people who need rehabilitation services. These codes can also be used as a guide to the ethical challenges of the profession.

    Keywords: ethics, Rehabilitation, Codifying, Develop
  • Maryam Motavalian, Siamak Bashardoust Tajali*, Behrouz Attarbashi Moghadam, Seyedeh Zohreh Hosseini
    Introduction

    This study aimed to compare the effects of Low-Level Laser Therapy (LLLT) combined with Dry Needling (DN) with DN alone on pain and neck disability index following myofascial pain syndrome.

    Materials and Methods

    Sixteen women with active Trigger Points (TrPs) in their upper trapezius muscles participated in this study. They were divided into two groups: Experimental and control. The experimental group received one session of the DN plus the LLLT with 6 j/cm2 energy at their TrPs. The patients in the control group were under a similar procedure, but they did not receive any energy by the LLLT (placebo). The pain score was assessed before, immediately, and 48 hours after the treatment. Neck Disability Index (NDI) was assessed before and 48 hours after the treatment.

    Results

    There was a significant improvement in pain intensity and NDI scores 48 hours after the treatment in both groups compared with the baseline scores (P<0.05). The pain was also significantly reduced at the patients following laser therapy immediately after the treatment (P=0.01).

    Conclusion

    A combination of the LLLT and DN might be more effective compared with using DN alone, and reduce immediate pain at the patients with the active TrPs. There was no difference between the groups 48 hours after the treatment. It seems that LLLT has no considerable effect on NDI and pain intensity 48 hours after the treatment.

    Keywords: Myofascial pain syndrome, Pain, Trigger points, Low-levellaser, Dry needling
  • Mohammad Javaherian, Narges Dabbaghipour, Zinat Mohammadpour, Behrouz Attarbashi Moghadam*
    BACKGROUND

    The current study aimed to update prior systematic review and meta-analyses (SRMA) in order to determine the effects of supervised exercise-based cardiac rehabilitation (EBCR) and introduce a suitable exercise protocol for management of lipid profile abnormalities in patients with cardiovascular disease (CVD).

    METHODS

    PubMed, Scopus, and Web of Science databases were searched from 1980 to December 2018. All published, randomized controlled trials (RCTs) reporting the efficacy of supervised EBCR in patients with CVD and measuring at least 1 component of lipid profile were included. The quality of articles was assessed based on the Physiotherapy Evidence Database (PEDro) scale. Random effect model was used to calculate the effect size of post-intervention data.

    RESULTS

    Initially 774 RCTs were reviewed, 14 of them were included in the study. In comparison with the control group, supervised EBCR was associated with higher serum levels of high-density lipoprotein (HDL) [weight mean difference (WMD): 1.297; 95% confidence interval (CI): -1.620, 4.214] and lower serum level of low-density lipoprotein (LDL) (WMD: -7.797; 95%CI: -14.005, -1.588), total cholesterol (TC) (WMD: -11.029; 95%CI: -20.716, -1.342), and triglyceride (TG) (WMD: -14.602; 95%CI: -28.992, -0.212).

    CONCLUSION

    It seems that EBCR is correlated with an insignificant increase in HDL serum level and a significant decrease in LDL, TC, and TG serum levels. Considering subgroup analysis results, it is suggested that long duration, moderate exercise volume (EV), and combination of aerobic exercise (AE) and resistance exercise (RE) be used to improve HDL and TG serum levels. Short duration, high EV, and AE+RE seem to significantly reduce LDL serum level. Moreover, moderate EV is associated with a significant reduction in TC level.

    Keywords: Cardiac Rehabilitation, Cardiovascular Diseases, Exercise, Lipids, Meta-Analysis
  • Maryam A. Saba, Shahin Goharpey*, Behrouz Attarbashi Moghadam, Reza Salehi, Sayed Mohammadreza Afshani
    BACKGROUND

    Decision making and the quality of care provided for chronic diseases have been shown to improve through patient participation. The HeartQoL questionnaire is a core healthrelated quality of life (HRQOL) tool specifically designed for individuals with ischemic heart disease (IHD) who have undergone interventions such as cardiac rehabilitation (CR).

    METHODS

    In this cross-sectional and multicenter study, 150 patients were recruited. The participants completed the HeartQoL, MacNew Heart Disease Questionnaire, and Short Form Health Survey (SF-36) on entering CR for validity assessment. The HeartQoL along with a Global Rating of Change (GRoC) scale (for responsiveness measurement) were completed by 100 participants 3 months later.

    RESULTS

    The mean age of all participants in validity assessment was 61.87 ± 8.13 years. Cronbach’s alphas of the total scales ranged from 0.70 to 0.81 and of the subscales from 0.70 to 0.82. The Pearson correlation coefficient was used to determine construct validity; similar constructs were confirmed with correlation coefficients ranging from 0.50 to 0.69 and dissimilar constructs with correlation coefficients ranging from 0.28 to 0.29 (P < 0.010). The assessment of the responsiveness of the questionnaire indicated that the area under curve (AUC) was greater than 0.70 (range: 0.74 to 0.91) and the optimal cut-off point was 0.65.

    CONCLUSION

    The Persian version of the HeartQoL questionnaire demonstrated satisfactory psychometric properties in the sample of participants admitted to CR after coronary artery bypass grafting (CABG). The present study results showed that the HRQOL can be used by clinicians and researchers in conjunction with other outcome measures to gain additional information about symptoms relevant to HRQOL in patients referred to CR and to evaluate change over time.

    Keywords: Health-Related Quality of Life, Outcomes Assessment, Validity, CardiacRehabilitation
  • Mohammad Javaherian, Narges Dabbaghipour, Mahboobeh Khabaz Mafinejad, Nastaran Ghotbi, AmirAli Khakneshin, Behrouz Attarbashi MoghadaM*
    Aim

    Using simulated patients (SPs) in clinical skills education is a common method of providing training to students to hone their skills for future client encounters. The aim of this systematic review is to provide an overview of the SP strategy in physical therapy (PT) education.

    Method

     PubMed, SCOPUS, and Web of Science databases were searched up to November 2019 with no language restriction. Different keywords related to the topic were selected using MeSh. Any types of quantitative study design which had used simulation-based learning in physical therapy student were eligible for inclusion. Two researchers reviewed studies and appraised them critically.

    Result

     A total of 1049 abstracts were retrieved and after reviewing the full-text paper, 11 full-text articles were included. These studies had used simulated patients for various aims including replicate different aspects of knowledge, self-perceived skills real, clinical practice, attitudes, and feasibility. Based on the result of studies, SP as an educational technique, can improve student’s clinical reasoning skills, communication, and motivation in a safe method.

    Conclusion

    The simulated patient is a useful modality to deliver learning activities in medical education and physical therapy curricula, facilitating feedback on students’ performance with opportunities to interact with realistic patients and environments.

    Keywords: Simulated patient, Simulation, Physical therapy, Physiotherapy, Education, Learning
  • Ashraf Vaseghnia, Azadeh Shadmehr*, Behrouz Attarbashi Moghadam, Gholamreza Olyaei, Mohammad Reza Hadian, Zahra Khazaeipour
    Introduction

    Lumbar stiffness is a common complaint of patients with low back pain. The Muscle Energy Technique (MET) is a common intervention to treat the spine and sacroiliac joint dysfunctions and their resulting disability in daily activities. This research aimed to evaluate the effects of MET on pain, functional disability, and lumbar stiffness of patients with sacroiliac joint dysfunctions by considering the type of dysfunction and the orientation of the correcting maneuver.

    Materials and Methods

    Fifty women with ant innominate or post innominate dysfunctions were recruited for the research and randomly divided into two groups (n=25). One group received one session of MET, and the other group received the sham position. Visual Analogue Scale (VAS), lumbar Stiffness Disability Index (SDI) and Oswestry Disability Index (ODI) were used for the evaluation of the participants before, 24 hours after and one week after the intervention.

    Results

    According to the results, MET significantly decreased the mean range of VAS and ODI, 24 hours, and a week after the intervention (P<0.01). We did not see any significant difference in SDI values before, 24 hours, and one week after MET in the patients (P>0.01).

    Conclusion

    Applying MET regarding the kind of dysfunction may reduce the patient’s pain and disability.

    Keywords: Sacroiliac joint, Muscle energy technique, Pain
  • Behrouz Attarbashi Moghadam*, Hasan Tamartash, Sara Fereydunnia, Mahdieh Ravand

    The Minnesota Living with Heart Failure Questionnaire (MLHFQ) has been developed to measure health-related quality of life (HRQoL) status of Heart Failure (HF) patients. The aim of this study was to translate MLHFQ into the Persian version and assess the validity and reliability of the translated version. We used a forward-backward procedure for translation. In a cross-sectional study, 105 HF patients and 50 healthy subjects were selected to assess the reliability and construct validity of the instrument. The face and content validity were used to assess the questionnaire validity. Validity was examined on the HF patients group, using the Persian version of the Short form-36 health survey (SF-36) Questionnaire. In order to assess the questionnaire’s reliability, the Intraclass correlation coefficient (ICC) and Cronbach’s alpha were calculated. Test-retest reliability was examined by re-administering the MLHFQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all 2 domains were higher than 0.91, P≤0.000). Internal consistency for Physical domain (PD), emotional domain (ED) and total scores using Cronbach’s alpha were 0.90, 0.84 and 0.92, respectively. ICC for PD, ED and total scores were 0.95, 0.94, and 0.97, respectively. Good and very good Pearson's Correlation Coefficient was seen between MLHFQ and SF-36 (r= -0.47 to -0.775, P≤0.000 for PD; r= -0.47 to -0.65, P≤0.000 for ED). The Persian version of the MLHFQ had satisfactory reliability and validity for assessing HRQoL status of Iranian HF patients.

    Keywords: Heart failure, Health-related quality of life, Questionnaires, Reliability, Validity, MLHFQ
  • Marzieh Beglari Neshat, Azadeh Shadmehr, Shohreh Jalaie, Seyed Mohsen Mir, Behrouz Attarbashi Moghadam
    Introduction

    Previous studies showed that Whole Body Vibration (WBV) is an effective modality for strength and power. WBV has many usages in training and rehabilitation. Core muscles have the central role in the stability of the spine and our daily activity; so, strengthening core muscles is essential. This study aimed to investigate the immediate effect of WBV on strength, endurance, and performance of core muscles in young, healthy females.

    Materials and Methods

    This study was a quasi-experimental interventional study. Twelve young, healthy females (18-28 years old) participated in this study; they received WBV in semi-squat position 5 times in 60 seconds separated by 30-second rest. The parameters of WBV included the frequency of 30Hz and an amplitude of 4mm. The tests used for the evaluation of core stability included Vertical Jump (VJ), pressure biofeedback, front abdominal power, trunk extensor endurance, and trunk flexor endurance tests. The tests were performed before, immediately after, and 30 minutes after the intervention.

    Results

    According to the results, the trunk extensor endurance test, front abdominal power test, and pressure biofeedback had a significant effect (P<0.05). However, no change was observed in the trunk flexor endurance test and VJ test (P>0.05).

    Conclusion

    This study indicated that WBV could be useful in core stability, specifically for trunk extensor endurance, lumbar strength, and front abdominal power. More studies are required to prove the effect of WBV on VJ and trunk flexor endurance.

    Keywords: Core stability, Whole body vibration, Immediate, Semi-squat
  • Narges Dabbaghipour, Mohammad Sadeghian, Azadeh Shadmehr, Behrouz Attarbashi Moghadam
    Introduction

    Percutaneous Coronary Intervention (PCI) is a non-surgical procedure for the treatment of Coronary Artery Diseases (CADs). One of the most common disorders associated with these procedures is the occurrence of Cognitive Impairments (CIs). This study aimed to assess the Reaction Time (RT) and anticipatory skill of PCI patients and healthy subjects, using computer-based software as a safe and easy method.

    Materials and Methods

    Ten male PCI patients and ten healthy male individuals participated in this cross-sectional study. Auditory choice and complex choice RT, visual choice and complex choice RT, and anticipatory skill of the low and high speed of the ball of both groups were analyzed by Speed Anticipation Reaction Test (SART) software.

    Results

    No significant difference was seen between two groups in terms of simple auditory RT (P=0.15), auditory complex choice of RT (P=0.19), and anticipatory skills of the low speed of the ball (P=0.16). However, the performance of PCI patients was significantly worse on the simple visual RT (P=0.01), visual complex choice RT (P=0.05), and anticipatory skill of the high speed of the ball (P=0.04) compared to those of the healthy controls.

    Conclusion

    The assessment of RT and anticipatory skill as neurocognitive tests is considered to be one of the useful methods for evaluating the cognition function of patients, who have cardiovascular diseases. Furthermore, the pilot study suggests that PCI patients had a similar or even poorer performance in cognitive function compared with healthy people.

    Keywords: Percutaneous coronary intervention, Reaction time, Anticipation
  • Hassan Tamartash, Behrouz Attarbashi Moghadam, Kianoush Hosseini, Shiva Musavi
    Introduction
    The present study aimed to determine the relationship between New York Heart Association (NYHA) classification and disease characteristics on the quality of life scores and the distribution of the scores at different stages of Heart Failure (HF).
    Materials And Methods
    A total of 150 patients with HF participated in this cross-sectional study. The method of data collection was interview based on NYHA classification and using the validated Persian version of the Kansas City Cardiomyopathy Questionnaire (PKCCQ).
    Results
    According to NYHA classification, 10% of patients were classified as mild HF, 16% as moderate HF, 63% as severe HF, and 11% as very severe HF. Significant differences were observed for total score and the component scores of PKCCQ among four stages of the disease (P
    Conclusion
    Distribution of the quality of life scores in patients with different stages of HF showed that quality of life scores overlap in the severe and very severe stages. Classifying the disease using NYHA classification cannot distinct patients with HF according to impairments in their health status between severe and very severe stages. In addition, the degree of education is the factor that may affect the quality of life.
    Keywords: Quality of life, Heart failure disease, New York Heart Association classification information, Clinical HF Questionnaire, Kansas City Cardiomyopathy Questionnaire
  • Zahra Salehitabar, Azadeh Shadmehr, Behrouz Attarbashi Moghadam, Seyed Mohsen Mir
    Introduction
    The present study aimed to determine the immediate effects of Whole Body Vibration (WBV) on Rounded Shoulder Posture (RSP) in healthy women.
    Materials And Methods
    Thirty female students aged between 18 to 30 years with RSP participated in this study. First, the examiner measured the RSP (in supine position), Pectoralis Minor Length (PML) and Total Scapular Distance (TSD). Then, the subjects performed 5 sets of 1-min WBV (frequency=30 Hz, amplitude=5 mm) with 1 min rest between each set. After intervention, the examiner immediately measured the above mentioned variables. The paired t test was used for data analysis.
    Results
    The analysis showed that WBV significantly decreased the supine measurement of RSP (P
    Conclusion
    It seems that WBV had immediate effect on postural correction of rounded shoulder posture in the study subjects.
    Keywords: Whole body vibration, Rounded shoulder, Posture
  • سمیه پیلان نژاد، صدیقه سادات نعیمی *، فرشاد اخوتیان، بهروز عطارباشی مقدم، سیدعلی جمالیان، علیرضا اکبرزاده باغبان
    مقدمه و اهداف شیوع نارسایی قلب در حال افزایش است. اثرات مراحل دوم و سومبازتوانی قلبی در کاهش علائم و بهبود کیفیت زندگی بیماران قلبی سرپایی (از بیمارستان ترخیص شده)، مکررا مورد بررسی قرار گرفته است، لیکن به علت خطرات موجود برای بقای بیماران قلبی در زمان بستری (احتمال کاهش شدید ظرفیت عملکردی بیمار در این مرحله) اثرات مرحله اول بازتوانی قلبی به ویژه برای مبتلایان به نارسایی قلبی مورد تحقیق قرار نگرفته است و حتی گزارشی از اثر تمرینات معمول در مرحله اول بازتوانی این بیماران نیز در دسترس نیست. از طرفی دیگر، سنجش کیفیت زندگی در سیستم مراقبت بهداشتی اهمیت روزافزونی دارد، به طوری که برخی بهبود کیفیت زندگی را مهم ترین هدف مداخلات درمانی به ویژه در بیماری های مزمن می دانند. بنابر این هدف از مطالعه حاضر بررسی اثر مرحله اول بازتوانی قلبی بر کیفیت زندگی و ظرفیت عملکردیبیماران بستری مبتلا به نارسایی قلبی است.
    مواد و روش ها این کارآزمایی بالینی کنترل شده یک سویه کور بر روی 34 بیمار بستری با نارسایی قلبی متوسط و نسبتا شدید (بر اساس طبقه بندی عملکردی انجمن قلب نیویورک) با کسر تخلیه بطن چپ کمتر از 40 درصد انجام شد. بیماران به طور تصادفی به دو گروه مداخله و کنترل تقسیم شدند. هر دو گروه مراقبت های معمول پزشکی در زمان بستری و فیزیوتراپی تنفسی را دریافت کردند. در گروه مداخله بیماران علاوه بر این مراقبت ها، با استفاده از دوچرخه ثابت ورزش هوازی نیز انجام دادند. در هر دو گروه علاوه بر پارامترهای معمول (مانند ضربان قلب، فشار خون و تعداد تنفس)، در روز اول و پنجم بستری کیفیت زندگی )با استفاده از نسخه فارسی شده ی پرسش نامه آنژین سیاتل ( و ظرفیت عملکردی (با آزمون 6 دقیقه راه رفتن) اندازه گیری شد. نرمال بودن داده ها در دو گروه با آزمون شاپیرو ویلکو تغییرات پارامترها با آزمون چند عاملی اندازه گیری های مکرر تحلیل واریانس بررسی شد.
    یافته ها قبل از شروع مداخله متغیرهای مربوط به شدت بیماری، دموگرافیکی و وابسته ی دو گروه با هم اختلاف معنادار نداشتند. از روز اول تا پنجم ظرفیت عملکردی هر دو گروه افزایش داشت. میزان این بهبود در گروه مداخله و کنترل به سطح معناداری نرسید. کیفیت زندگی در گروه مداخله به طور میانگین 84/53 درصد و در گروه کنترل 62/29 درصد بهبود یافت. میزان این بهبود بین دو گروه با 001/0P= تفاوت معنادار داشت.
    نتیجه گیری بازتوانی قلبی مرحله اول هم به صورت تمرینات معمول و هم با اضافه شدن ورزش هوازی به این تمرینات در طی پنج روز بستری بودن در بهبود کیفیت زندگی و توقف روال کاهشی ظرفیت عملکردی و حتی اندکی افزایش آن در بیماران نارسایی قلبی موثر است. کیفیت زندگی عامل پیش بینی کننده پیامدهای نارسایی قلبی به حساب می آید، لذا تحقیقات بیشتر در این زمینه پیشنهاد می شود.
    کلید واژگان: بازتوانی قلبی, نارسایی قلبی, کیفیت زندگی, ظرفیت عملکردی
    Sommayeh Pilannejad, Sedigheh Sadat Naimi *, Farshad Okhovatian, Behrouz Attarbashi Moghadam, Seyed Ali Jamalian, Alireza Akbarzadeh Bagheban
    Background And Aims
    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.
    Results
    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
    Conclusion
    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.
    Keywords: Cardiac rehabilitation, Heart failure, Quality of life, Functional capacity
  • Monavar Hadizadeh, Siamak Bashardoust Tajali, Behrouz Attarbashi Moghadam, Shohreh Jalaie, Mahnaz Bazzaz
    Introduction
    Myofascial Pain Syndrome (MPS) is a common disorder of musculoskeletal system. About one third of the people with musculoskeletal disorders have been diagnosed as having MPS. It is a painful condition caused by trigger points. A variety of treatment approaches are used to cure MPS and its associated disorders. This study aimed to investigate the effects of single session Intramuscular Electrical Stimulation (IMES) through dry needling on pain and Range Of Motion (ROM) following trigger points in upper trapezius.
    Material and
    Methods
    Sixteen volunteers with active trigger points in upper trapezius were randomly divided into two groups: 1) the IMES treatment group (8 females) and 2) placebo group (8 females). In the IMES group, trigger points of the affected side were injected through dry needling, then a burst current (2 Hz) was applied on the muscle while the electrical stimulation steadily increases to form a pain free contraction for the patient. In placebo group, the procedure was exactly the same but there was no applied electrical stimulation through dry needling. Pain sensation by Visual Analog Scale (VAS) and cervical flexion ROM were measured before treatment, immediately after treatment and one week later by another blinded researcher.
    Results
    VAS scores showed improvement in both groups at the end of the treatment session and also one week later. There was no significant difference between the groups; IMES and placebo in terms of the VAS after treatment session. However, the pain scores were substantially decreased in the IMES group one week after the intervention. The ROMs were significantly lower in placebo group one week after treatment. There was no significant correlation between improvement and duration of symptoms.
    Conclusion
    Both IMES and placebo methods might be effective in relieving symptoms of patients with the MPS in upper trapezius; however, patients following the IMES treatment showed higher level of improvement during one week after the intervention. Further relevant studies with higher number of volunteers and different treatment protocols are necessary to get high quality evidence.
    Keywords: Myofascial pain syndrome, Intramuscular electrical stimulation, Dry needling, Trigger point, Upper trapezius
  • Seyedeh Marjan Jaladat, Mehdi Abdolvahab, Behrouz Attarbashi Moghadam, Alireza Ashraf, Mahmoud Jalili, Ahmadreza Baghestani
    Background
    Splinting is the most common conservative method of treating patients with mild and moderate Carpal Tunnel Syndrome (CTS). The aim of this study was to determine the effectiveness of the limited dynamic wrist splint on the symptoms, function, and strength of women with CTS. In this controlled trial study, the subjects wore a splint of a new design called the “limited dynamic wrist splint”, which allowed the wrist motion in the range (between 15-degree flexion and 15-degree extension) that exerts minimum pressure on the median nerve and prevents extra pressure on the nerve by limiting the range of motions out of the allowed range.
    Methods
    In this study, 24 women diagnosed with mild to moderate CTS were initially evaluated on the basis of the Boston questionnaire, the dexterity test of the Purdue pegboard, grip and pinch strength, distal sensory latency, and sensory nerve conduction velocity. The subjects were randomly divided into two groups, control and treatment. Both groups received routine rehabilitation treatment for six weeks. The treatment group received the limited dynamic wrist splint for about six to eight hours a day. After six weeks, the initial examinations were repeated. The SPSS-16, independent t, and paired t-tests were used for data analysis.
    Results
    All the variables in the treatment and the control groups showed improvement. The function test of the Boston questionnaire, the Purdue pegboard test, and the pinch strength were significantly improved in the treatment group. The “severity of the symptoms” test of the Boston questionnaire and the pinch strength in the control group showed a statistically significant difference (P
    Conclusion
    This study showed that the use of the limited dynamic wrist splint for about six weeks for six to eight hours a day could have a significant effect on the function, dexterity, and the pinch strength of patients with CTS. Not only can the patients receive treatment by this method, but they can also perform their daily activities to some extent.
    Keywords: Carpal tunnel syndrome, Splint, Function, Symptoms, Strength
  • Behrouz Attarbashi Moghadam
    Background
    The clinical COPD questionnaire (CCQ) has been developed to measure health status of COPD patients. The aim of this study, was to translate CCQ into the Persian language and assess the validity and reliability of the translated version.
    Methods
    We used a forward-backward procedure to translate the questionnaire. In a cross sectional study 100 COPD patients and 50 healthy subjects over 40 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire validity. Validity was examined on a population of patients with COPD, using the Persian validated version of the St George's Respiratory Questionnaire (PSGRQ). In order to assess the questionnaire’s reliability, the Intraclass correlation coefiiicient(ICC) and Cronbach’s alpha were calculated. Test-retest reliability was tested by re-administring the Persian version of the CCQ (PCCQ) after 1 week.
    Results
    Test- retest carry out of data demonstrates that the PCCQ has excellent reliability ( ICC for all 3 domains were higher than 0.9). Internal consistency was found by Cronbach’s alpha to be 0.96, 0.94, 0.97, and 0.98 for symptom, mental state, functional state and total scores respectively. In addition, the correlation between the components of PCCQ and PSGRQ showed satisfactory construct validity. Analysing the data from healthy subjects and patients divulged that the PCCQ has acceptable discriminant validity.
    Conclusion
    In general, the PCCQ had satisfactory reliability and validity for assessing health related quality of life status of Iranian COPD patients.
    Keywords: Chronic obstructive pulmonary disease, Health, related quality of life, clinical COPD questionnaire, Reliability, Validity
  • Fatemeh Lahiji, Behnoosh Vasaghi Gharamaleki, Iraj Mirzaii Dizgah, Alireza Abdollahi, Behrouz Attarbashi Moghadam *
    Background
    Exercise and physical activity is an effective way for maintaining health by modifying lipid profile. Many studies reported that even a single session of exercise could affect blood lipid profile. Nowadays, saliva sampling is an effective and noninvasive method in disease diagnosis and monitoring health. Based on the results, there is a significant and positive association between saliva and blood lipid values..
    Objectives
    Our aim was to assess acute effects of aerobic and resistance exercise on salivary lipid profile..
    Materials And Methods
    In this randomized clinical trial study, forty-five non-athlete women (18-35 years old, 18.5 ≤ BMI ≤ 25) were put in three groups (aerobic, resistance and control). Aerobic group program consisted of 30 minutes of aerobic exercise at 60-75% maximum heart rate (MHR) intensity and resistance group performed five resistance exercises at intensity of 75% 2-RM. Salivary Lipid profile was measured after 12 hours of fasting at 8 a.m. and immediately after exercise..
    Results
    One single session of aerobic and resistance did not induce significant change in salivary lipid profile. However, a significant difference was observed between changes in aerobic and resistance groups (P=0.03)..
    Conclusions
    This study suggested that one session of aerobic and resistance exercise with moderate intensity did not change salivary lipid profile..
    Keywords: Exercise, Resistance Training, Saliva, Lipids
سامانه نویسندگان
  • دکتر بهروز عطارباشی مقدم
    دکتر بهروز عطارباشی مقدم
    دانشیار گروه فیزیوتراپی - دانشکده توانبخشی، دانشگاه علوم پزشکی تهران، تهران، ایران
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