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Knee osteoarthritis (KOA) is a prevalent disabling condition characterized by pain, stiffness, and functional limitations, significantly impacting quality of life, particularly among older adults. Instrument-assisted soft tissue mobilization (IASTM) is a technique that has shown promise in reducing pain and increasing the range of motion.

This study aimed to investigate the effects of IASTM on functional measures and quality of life in KOA patients.

Thirty participants with unilateral KOA were randomized into IASTM and sham groups. The intervention consisted of four sessions over two weeks, combining IASTM with exercise therapy. Functional performance was assessed using the 6-minute walking test (6MWT) and the timed up and go test (TUG). Quality of life was evaluated using the 36-item short-form health survey (SF-36) and the Lequesne Algofunctional Index (LAI) Questionnaires.

A mixed ANOVA revealed significant improvements in functional performance in both groups after treatment in the 6MWT (P < 0.001) and TUG (P = 0.003) tests. Significant improvements were observed in the SF-36 subgroups for physical functioning (P = 0.002), role limitations due to physical problems (P < 0.001), energy/vitality (P < 0.001), pain (P < 0.001), and total score (P < 0.001). There was also a significant time*group interaction effect for role limitations due to emotional problems (P = 0.005), with the IASTM group showing improvement after treatment while the sham group experienced a decline. The LAI questionnaire also indicated significant improvements in both groups (P < 0.001) after treatment.

Both IASTM and sham interventions, combined with exercise therapy, led to improvements in functional measures and quality of life. However, the IASTM group exhibited a more pronounced positive trend in the 6MWT and TUG tests, as well as a significant interaction effect for emotional role limitations. These findings suggest that while exercise alone can improve function and quality of life, the addition of IASTM may further enhance these outcomes, supporting its integration into KOA management strategies to improve activities of daily living and overall quality of life.

Since physical performance is one of the important parts of health, proper evaluation of people's performance is so much important, as it helps rehabilitation team to choose the best methods to improve performance. Involving all the muscles and joints, jumping is an activity used to evaluate performance. The accelerometer is an instrument that has recently been considered in the field of performance evaluation for some reasons like being economical, accessible, and the ability to replace expensive tools in the health system. This article reviews some studies that use accelerometer to evaluate performance of the neuromuscular system.

Method and Materials: 

Keywords were searched in PubMed, Scopus, and Google Scholar databases to find studies on the reliability and validity of accelerometers in jump performance from 2010 to January 2024.

In calculating most variables including jump height, flight time, contact time, stiffness, force, power, and reactive strength index of countermovement, squat, and drop jumps, studies have revealed high validity and reliability for this device. In calculating peak power and peak velocity, accelerometer has low validity and reliability, though.

Under the ground of the fact that accelerometer is a valid and reliable instrument in evaluating most jump performance variables, it may be counted as a useful instrument. Rehabilitation team, physical medicine, and sports medicine specialists would use this device to evaluate musculoskeletal system performance; Therefore, they will be able to adjust, modify, and finally improve the rehabilitation program for patients or athletes and thus promote health in society.

Flat feet are prevalent among individuals with medial compartment knee osteoarthritis (KOA), showing a correlation with elevated knee pain and cartilage degeneration. This study investigates the relationship between calcaneal eversion angle (CEA) and medial longitudinal arch angle (MLAA) with knee kinetics and pain.

This analytical observational study included 30 volunteers with moderate KOA. The Vicon motion analysis system and two synchronized force plates were employed to capture level walking and the static standing position to measure CEA and MLAA. The study assessed the first and second peaks of the knee adduction moment, knee adduction moment impulse, peak knee flexion moment, and the peak knee flexion angle at heel strike (PKFA-HS). The Western Ontario and McMaster Universities arthritis index (WOMAC) pain and physical function were evaluated.

A significant positive correlation was found between CEA and the knee pain sub-score (Pearson correlation [PC]=0.446, P=0.011) and WOMAC total score (PC=0.363, P=0.049). Additionally, a significant negative correlation was observed between CEA and peak knee flexion moment/PKFA-HS (PC=-0.418, P=0.022, and PC=-0.479, P=0.001, respectively). The results also indicated a negative significant correlation between MLAA and WOMAC pain sub-score (PC=-0.389, P=0.034).

Increased CEA and decreased MLAA are associated with elevated WOMAC pain sub-score and decreased PKFA-HS in individuals with moderate KOA. Addressing flat feet should be considered in KOA management to enhance pain relief and functional outcomes.

The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics parameters and functional tests with Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores in people with moderate KOA.

Twenty- three participants with moderate KOA participated in this study. Gait analysis involved the measurement of the external peak knee adduction moment (PKAM), peak knee flexion moment (PKFM), knee adduction moment impulse (KAM impulse), and knee flexion moment impulse (KFM impulse) during level walking. Functional tests included timed up and go (TUG) and figure of eight walkings (FO8W) tests. Pearson’s correlation coefficient was used to investigate the correlation between kinetics parameters and functional test scores with WOMAC total scores and sub-scores.

There was a significant inverse correlation between the first PKAM and WOMAC total score and pain sub-score (r=-0.43 P=0.03 and r=-0.6 P=0.002, respectively). Also, there was a significant inverse correlation between the second PKAM and pain sub-score (r=-0.46 P=0.02). There was no significant correlation between functional tests and WOMAC scores.

The low score of the WOMAC in the moderate KOA should not be attributed to the low level of joint knee moments.

Patients with chronic heart failure (CHF) are characterized by debilitating muscle weakness, the inability to move, and resultant psychological disadvantages. The current study investigated the acute effects of resistanceexercise (RE) and their impact on psychological health and peak muscle contraction (PMC) in patients with CHF. This randomized controlled trial was performed between October 2019 and December 2020. Fifty-seven patients with CHF (NYHA Class II, III) underwent initial assessments of the 6-minute walking test (6MWT),psychological response to exercise, and PMC. They were randomly divided into three groups, namely R1, R2, and the control group. The intervention consisted of a short aerobic exercise comprising 15 minutes of walking at an intensity of 50%-reserved heart rate for all three groups and an additional RE with the intensity of 50%-1RM and 75%-1RM for groups R1 and R2, respectively. No significant difference among the groups were observed in 6MWT,peak muscle contraction, and psychological response to exercise after the intervention (P≥0.05). PMC and psychological response to exercise improved significantly in all groups; however, only group R2 showed a significant increase in 6MWT after the intervention. Positive well-being (PWB) had a positive correlation with peak muscle contraction of the left knee extensors and dorsiflexors, and psychological dystress (PD) and FAT were negatively correlated to walking distance and PMC of the left knee extensors and dorsiflexors. Performing just one session of exercise had significant beneficial impacts on PMC and psychological response in patients with CHF, regardless of exercise type or RE intensity. However, walking distance (6MWT) increasedsignificantly in the R2 group (75% of 1-RM), indicating that performing higher resistance exercise is safe and leads to functional advantages in CHF patients.There was a positive relationship between PWB and 1RM and a negativerelationship between both psychological distress (PD) and fatigue and 1RM.

Background and Aims:

 Whole body vibration (WBV) is one of the relatively new interventions that is widely used in physiotherapy and sports physiotherapy. It is becoming more common due to its positive effects on the neuromuscular system. The WBV device produces oscillations and its intensity is determined based on the parameters of frequency, amplitude, and duration of vibration. According to the previous studies, some parameters of this device results in increased muscle activity, strength, and power. Muscle strength and power are the two most important factors in musculoskeletal efficiency. As a result, sports performance variables such as jump height and running speed are affected by WBV. According to previous studies, if the vibration is applied with appropriate parameters, it can be effective in improving the performance of individuals in activities such as jumping and running. Furthermore, it has been shown that frequency parameter is more important than other vibration parameters since it has a greater effect on musculoskeletal performance. As a result, this study aims to review the studies on the effects of various WBV frequencies on functional variables in sports activities.

Methods:

 A search was conducted in PubMed, Scopus, and Google Scholar databases to find studies about the effect of WBV frequencies on jumping and running.

Results:

 According to previous studies, the frequency of 30-50 Hz resulted in an immediate increase in countermovement jump and squat jump heights. The frequencies of 18-35 Hz and 40 Hz, when used for a long time, also increased the heights of countermovement and squat jumps, respectively. In a few studies, the 26 and 20-Hz frequencies improved the heights of horizontal, countermovement, and squat jumps. Moreover, 30-Hz frequency increased running speed and step length and reduced the running duration in a certain distance. The frequency of 45-Hz immediately reduced the step length and increased the step rate during running on a treadmill.

Conclusion:

 The 30-Hz frequency is the most common WBV frequency with a positive effect on jumping and running abilities. In both acute and chronic conditions, this frequency may have a positive impact on the kinetic and kinematic variables of jumping and running. As a result, this frequency is suggested for improving an individual's neuromuscular performance in sports activities.

Knee Osteoarthritis (OA) is one of the most important etiologies of pain and disability among adults. The effects of pulsed Ultrasound (US) on pain reduction and joint function have been proven, but its role on joint friction and inflammatory mediators is still unclear. Therefore, this study was designed to investigate the effects of US on knee joint friction and inflammation in non-traumatic experimental knee OA.

Forty-eight guinea pigs were randomly assigned into four groups: OA+US, OA+US sham, 30 days after OA induction (OA30), and normal control (n=12 for each group). OA was induced by intra-articular injection of 3 mg/kg of Mono-Iodoacetate (MIA) in the animal’s left knee. Joint circumstance and weight of the animals were measured at baseline, before (i.e., after 30 days of MIA injection), and after US treatment. Joint friction was evaluated by a pendulum friction tester system. Cytokine levels, including Tumor Necrosis Factor (TNF)-α and Interleukin (IL)-1β, were measured by the ELISA method. The Pearson correlation coefficient was calculated to study the relationships between friction and inflammation variables.

Joint circumference was increased in the OA30 group. Joint friction variables, including exponential curve fitting, cycle number, and friction coefficient, were significantly better in the US group (P<0.05). TNF-α and IL-1β cytokine levels were significantly lower in the US group. A significant positive correlation was observed between joint friction indices and TNF-α and IL-1β cytokine levels (P<0.05).

US was an effective approach for reducing joint friction and inflammation in OA30. Moreover, the relationship between knee joint friction and inflammation could help us better understand the etiology, mechanism, and treatment strategies of this disease.

Overweight is related to increased risks of cardiovascular diseases and dyslipidemia, and reduced quality of life (QOL). Exercise training improves QOL and modifies cardiovascular risk factors and lipid profile. The present study was conducted to compare three types of exercise in terms of their short term effects on QOL and lipid profile in overweight individuals with moderate hemophilia A (IWMHA).  

This study was a randomized, controlled, assessor-blinded trial (IRCT20180128038541N1). Sixty IWMHA with a body mass index (BMI) of 25-30 kg/ m2 and a mean age of 35-55 years were randomly assigned to four groups of 15, namely aerobic training (AT), resistance training (RT), combined training (CT) and control. The intervention groups participated in 45-minute exercises three days a week for six weeks. The 36-item short-form health survey (SF-36) was used to measure QOL. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), waist-to-hip ratio (WHR), and waist circumference (WC) were measured before and after six weeks of training. For the data analysis using SPSS version 20, the ANCOVA was used to determine the differences among the four groups.

A significant decrease was observed in the intervention groups compared to the control group in terms of weight, BMI, LDL-C, TC, WHR, and WC (p<0.05). Significant increase was observed in HDL-C and SF-36 subscales in the intervention groups compared to the control group (p<0.001). There was no significant difference among the intervention groups (p>0.05). In comparison with the control group, more significant improvement was observed in the TC, TG, LDL-C, HDL-L, and SF-36 subscales in the CT group compared to the RT and AT groups.

CT was the most effective training method in improving lipid profile and QOL in overweight IWMHA.

Osteoarthritis is the most common type of arthritis and is one of the most common causes of pain and disability in adults. In the present study we investigated the level of inflammatory cytokines IL-1β and TNF-α and the amount of joint friction after non-traumatic model of knee osteoarthrosis in guinea pig.

Twenty-four matured albino male Dunkin-Hartley guinea pigs were assigned randomly into two groups; osteoarthrosis (OA) and control (n=12 in each group). The non-traumatic OA was induced by intra-articular injection of mono iodoacetate (MIA, 3 mg/kg) in the knee joint. Joint circumstance and weight of subjects were measured initially and after thirty days of MIA injection. After scarifying the animals on day 30, the level of IL-1β and TNF-α in synovial membrane and knee joint friction were measured. Control group received no intervention and all evaluations were performed on the normal knee joint.

The induction of OA caused a significant increase in the joint circumstance compared to control group (P<0.05). 30 days after induced OA, the knee joint friction in flexion and extension movement was significantly increased compared to control group.  In OA group, the level of IL-1β and TNF-α showed a significant increase compared to control group (P<0.05). There was a positive correlation between IL-1β, TNF-α and knee joint friction (P<0.01).

Non-traumatic osteoarthritis may increase the expression of inflammatory cytokines and joint friction, which in this condition the joint movement can aggravate cartilage damage.

Adjunctive treatment using electrical stimulation has recently been shown to promote healing in patients with diabetic foot ulcer. The aim of the present study was to evaluate whether low intensity cathodal direct current electrical stimulation improves healing rate of foot ulcers and health related quality of life in diabetic patients.

A total of 30 type 2 diabetic patients with ischemic foot ulcer were included in the present randomized, single-blind, placebo controlled trial. Participants were randomly assigned to receive either electrical stimulation therapy (direct current with low intensity, ES group, n=15) or sham treatment (placebo group, n=15) for 1 h/day, 3 days/week, for 4 weeks (12 sessions). Improvement ratio of wound and quality of life was evaluated at the 1st and 12th sessions. The quality of life was assessed using SF-36 questionnaire.

The mean of improvement ratio was significantly higher in the electrical stimulation group (59.4%) compared with that of the placebo group (27.07%) at the 12th session (P=0.02). Overall score of quality of life significantly increased in the electrical stimulation group as compared with that for the placebo group (0.01).

By promotion of wound healing, applied low intensity cathodal direct current may increase the health-related quality of life in diabetic patients with ischemic foot ulcer.

Considering the Importance of Back Extensor Muscles on the Postural Control and Risk of Falling in Osteoporotic Postmenopausal Women, We Investigated the Effects of Back Extensor Endurance on the Thoracic Kyphosis and Static Balance Control in Hyper and Normal Kyphotic Women with osteoporosis.

a total of 22 Osteoporotic Women, based on the Kyphosis Degree, were evaluated in two groups: Hyperkyphotics (No=10) and Normal Kyphotics (No=12). The Kyphosis Degree Measured by Flexi curve ruler. The Isometric Strength of the Back Extensors measured by a Digital Hand-held Dynamometer. Modified Sorensen Test was used for Back Extensor Endurance Evaluation. Static Balance Parameters Evaluated in Double Stand Position by Force plate.

In the Hyperkyphotic Group, the time duration of Modified Sorensen Test was Significantly Lower than that in the Normal Kyphotic Group (P=0.029), there was also a significant negative correlation to the Medio-Lateral Displacement of the center of pressure (Correlation Coefficient: - 0/521, P = 0.047). The Multiple Regression test showed a significant effect of the modified Sorensen's time Duration on the increase of thoracic kyphosis (P = 0.044). In Hyperkyphotic Group, Standard deviation of the Anterior-Posterior of the Center of Pressure displacement was significantly higher than that in the normal kyphotic Group (P = 0.05).

Regarding to the negative correlation between the Trunk Extensor Endurance and Thoracic Hyperkyphosis and also medio-lateral of COP displacement, it suggests the Trunk Extensor Endurance exercise be considered in therapeutic programs of osteoporotic women.

The aim of this study was to determine the effect of whole-body vibration at a constant frequency and different amplitude in femur and tibia bones in ovariectomized rats. 23 ovariectomized rats divided into two exercise groups (n=9) and a SHAM group (n=5). Six healthy and non-surgical rats formed the control group. Rats in exercise and SHAM groups were placed on vibration platform for 8 weeks on the progressive time 2-5 minutes, 3-7 set and 1-minute inter-set rest time. Mechanical properties including stiffness, stress, and energy absorption and displacement percentage of the femoral and tibial were evaluated with three-point bending test after the period of the study. Stiffness index between training groups HA (P=0.024) and LA group (P=0.006) in femur and tibia compared with the sham group showed a significant increase. Stress index significantly increased between HA groups (P=0.000) and LA group (P=0.001) relative to the sham group in tibia. Energy absorb in just LA group (P=0.006) with the sham group showed a significant increase in tibia. Significantly increased control group compared to the sham was also observed in the indices (P=0.014, 0.000, 0.011) Our findings indicate a positive effect of whole-body vibration on the mechanical properties of the bone in both low and high amplitude conditions, but it was more effective in low-amplitude than high-amplitude condition. Also, whole-body vibration training is more effective to mechanical properties of tibia. Mechanical properties of bone in ovariectomized rats were close to control group level during whole body vibration.

  Poor postural control in patients with knee osteoarthritis (KOA), according to the abnormal excursions of center of pressure (COP), has been proven. On the other hand, the results of the previous studies indicate that pulsed ultrasound (PUS) improves joint and muscle structure and function. The aim of this study was to evaluate the effect of pulsed ultrasound on postural sways in patients with knee osteoarthritis. 11 healthy women and 27 women with bilateral knee osteoarthritis, who were matched in terms of age and weight, assigned randomly to three groups. The groups of the study included: sham ultrasound with exercise, ultrasound without exercise, and ultrasound with exercise. Subjects were examined in comfort double leg standing (CDLS), Romberg standing (RS), and near tandem standing (NTS) positions on a force plate. Pulsed ultrasound was used for 10 sessions at a frequency of 1 MHZ and 1 W/cm2. In groups with exercise therapy, lower limb strengthening exercises were prescribed. It was determined in baseline assessment that COP sways in mediolateral direction were affected more than other directions. After the treatment, in the ultrasound without exercise group, mediolateral (ML) range (P < 0.001) and standard deviation of the mediolateral range of the COP (P < 0.001) in comfort double leg standing (CDLS) position significantly increased. In the ultrasound with exercise group, antroposterior (AP) range (P = 0.010), standard deviation of mediolateral velocity (P = 0.010), and mediolateral mean velocity (P = 0.010) significantly decreased in Romberg standing position. In women with knee osteoarthritis, COP displacements in mediolateral direction was more affected than other sway directions. Pulsed ultrasound could improve the postural sways in mediolateral direction, and bring its parameters closer to the healthy group.  

Applying Pulsed Electromagnetic Field (PEMF) on the primary osteoporotic women have been effective in increasing the bone synthesis biomarkers and decreasing of the amplitude and velocity of center of pressure. In the present study, in order to investigate the possible effect of PEMF on the neuromuscular responses, the acute effect of PEMF on the lumbopelvic area in the postmenopausal women with Osteoporosis was studied by recording the soleus and gastrocnemius recruitment curves.
For investigating the acute effect of PEMF, 22 postmenopausal women with osteoporosis (age 48-65) voluntarily entered in the study and randomly participated in two separately sessions applying PEMF and placebo (magnet device off). PEMF was applied on the lumbopelvic area with frequency of 30Hz and intensity of 40G for 45 min. One-week interval was considered between placebo and PEMF sessions. Before and after each session, H- reflex recruitment curve was recorded for soleus and gastrocnemius muscles and then amplitude, intensity of stimulation and latency of threshold, maximum and final H-reflex were determined.
After application of 45 min PEMF, the mean stimulus intensity for recording of initial H-reflex was decreased significantly, in soleus and gastrocnemius muscles (0.48 and 0.55 mA respectively). The latency of this H threshold was decreased significantly also in both muscles (2.01 and 1.67 ms, respectively). The peak to peak amplitude of maximum H response increased significantly, in both muscles compared to the placebo session (p Immediately after applying of PEMF, facilitation in H-reflex response was observed in both soleus and gastrocnemius as a slow and fast twitch muscle. In both muscles, after applying PEMF, recruitment curves shifted to the left side by decreasing the stimulus intensity of initial and maximum H-responses and also their latencies. Conlusivly, this may be caused by the facilitation in the activities of alpha motoneurons in the spinal cord level.

Computer modeling studies have shown that depolarization of the posterior and anterior root fibers can be achieved by surface tripolar electrical stimulation. This study investigated the soleus and gastrocnemius H-reflex recovery curve after applying tripolar electrical stimulation on the anesthetized skin of vertebral column. We emphasized on the early and secondary facilitation phases of the H-reflex recovery curve.
Material and A total of 15 healthy nonathletic female volunteers (mean±SD age: 27.20±3.17 years) were enrolled in this study. H-reflex recovery curves of the soleus and gastrocnemius muscles were recorded before skin anesthesia and then 15 minutes after it (with lidocaine 10%) and finally after application of Transcutaneous Electrical Nerve Stimulator (TENS) or placebo TENS (TENS on/off). Tripolar TENS with pulse width of 300 µs, frequency of 80 Hz and intensity of 1.5 times of the sensory threshold was used for 15 minutes at the level of T11. To record the H-reflex recovery curve, 34 paired stimuli were used with the intensity of 30% H max and interstimulus intervals between 1 and 202 ms. After drawing the H-reflex recovery curve, amplitude, slope, area under the curve, and threshold of the early and secondary facilitation phases were calculated.
After application of topical lidocaine, the sensory threshold of the skin vertebral column increased significantly. Fifteen minutes after applying local anesthesia, peak amplitude, slope, and area under the curve of the early facilitation phase significantly decreased in gastrocnemius and soleus muscles. After tripolar TENS application on the anesthetized skin of vertebral column, the slope of the early facilitation phase decreased significantly in the soleus (P=0.047). Also, area under the curve of the secondary facilitation phase significantly increased in both muscles.
These findings suggest the excitatory effect of skin anesthesia on the motoneurons activities. Changing the H-reflex recovery curve after application of tripolar TENS on the anesthetized skin may confirm deep penetration of this type of electrical stimulation.

Regular physical activity as a non-pharmacological intervention to increase bone strength, bone density and fracture prevention is recommended. The aim of this study was to evaluate the effect of eight weeks’ endurance training on biomechanical and geometrically parameters of the femur and tibia bones in male Wistar rats. 16 rats with an age range of 50 to 60 days and an average weight of 160 ± 10 gr, were randomly divided into two groups: eight weeks of endurance training (running five days a week, according to the training protocol) and control group (no activity). After the end of the training, the rats were sacrificed, the right femur and tibia bones were harvested, then By mechanical three-point bending test, the biomechanical parameters (stiffness, maximum mechanical strength and maximum energy to the point of maximum strength) and by digital caliper, geometric parameters (length and width) were measured. One way-ANOVA was used to compare biomechanical and geometrical parameters between groups. The results demonstrated a significant increase in biomechanical parameters (stiffness, maximum mechanical strength and maximum energy to the point of maximum strength) and geometrical parameters (length and width) of the femur and tibia (except length) bones after eight weeks’ endurance training. Eight weeks’ endurance training (used in this study) improved the biomechanical and geometrical parameters of the femur and tibia bones.

Resistance exercises improve muscle strength and joint's physical status. The aim of this study was to assess the effect of progressive resistive exercise on joint's physical characteristics and quality of life in hemarthrosis joint in severe haemophilic A patients.
Twenty-four severe haemophilia A patients (18-35 years old) with knee hemarthrosis, were assigned randomly to a resistance training (n=15) and control (n=12) groups. Resistance training group was required to perform six weeks trunk and lower limb exercises with low load and high repetition (40 min per session, three days per week). The control group was requested not to change their physical activity routines. Knee joint physical characteristics including joint range of motion (ROM), contracture, and crepitus were measured through Modified Colorado questionnaire and quality of life were investigated through SF-36 questionnaire before and after six weeks of training protocol.
six weeks resistance training significantly improved extension ROM (P=0.00), flexion contracture (P=0.02) and crepitus (P=0.03) in hemarthrosis knee joint compared to the control group. Quality of life also was significantly improved in the resistance training group compared to both the control group and baseline values (P=0.00).
Resistance training with low intensity and high repetition, can improve ROM, muscle strength, pain, and crepitus in hemarthrosis knee joint. This may be effective to improve the quality of life in hemarthrosis especially in patient with severe haemophilia A, in whom rebleeding is unavoidable.

Although, the effect of direct intra-articular injection of bone marrow stem cells (BMSCs) on the repair of articular cartilage and the effect of Elaeagnus angustifolia extract on pain relief in patients with osteoarthritis have been investigated, no studies has been conducted to compare the effects of these two therapeutic methods on the mechanical properties of articular cartilage. In the present stuy, the effect of these two methods on the mechanical strength of knee articular cartilage in a model of rat osteoarthritis has been studied. In the present research, 48 mature, male Wistar rats were used. Animals were randomly divided into 6 groups of 8 as follows: control group (healthy animals), saline with mono-iodoacetate (MIA), MIA with Elaeagnus angustifolia extract, MIA with BMSCs, and MIA with a combination of Elaeagnus angustifolia extract and BMSCs. Osteoarthritis was induced by injection of 50 &muL solution of MIA in rats of groups 3 to 6. About 500 mg/kg Elaeagnus angustifolia extract was injected intraperitoneally daily for 4 weeks and nonautologous mesenchymal stem cells were injected into the knee joint on the 14th day. Stress-relaxation test was conducted applying 0.1 mm displacement at the rate of 5 mm/min for 1000 seconds. Then, the maximum initial force, instantaneous stiffness,equilibrium force, and equilibrium stiffness were calculated. Induction of osteoarthritis model decreased instantaneous stiffness, maximum initial force, and equilibrium stiffness as compared to the healthy group (P=0.05). Using Elaeagnus angustifolia extract and bone marrow stem cells increased instantaneous stiffness and equilibrium stiffness compared to MIA group, although this increase was statistically significant only in the BMSCs group (P=0.04 and P=0.026, respectively). In the BMSCs group, maximum initial force also significantly increased compared to MIA group (P=0.04). Apparently direct injection of BMSCs into the knee joint with osteoarthritis is more effective in increasing mechanical strength of the cartilage and improving the performance of the weight-bearing joint compared to using Elaeagnus angustifolia extract.

There are many disputes concerning the role of skin receptors on excitability of spinal motoneurons. The purpose of the present study is to evaluate the motoneuron excitability and H-reflex recovery curve of Soleus and Gastrocnemius muscles after application of local anesthesia on the skin of vertebral column.

Thirty healthy non-athlete female volunteers with a mean age of 27.20 ± 3.11 years old, were tested in two separated sessions. The H-reflex recovery curve of Soleus and Gastrocnemius were recorded before intervention and 15 minutes after the application of anesthesia (lidocaine 10%) or placebo anesthesia (water), with two excitation intensity of 30% and 100% of Hmax and interval interpulses of 1-202 ms. After extraction the amplitude of H1 and H2 response and fitting the recovery curve; their amplitude and interval of the peak, area under the curve and, thresholds of the early and secondary facilitation were calculated and analyzed.

After application of lidocaine, the sensory threshold of the vertebral column skin increased significantly. Due to a significant increase in H1 amplitude, peak, and area under the curve of the early facilitation showed a significant decrease (p<0.05). Threshold of the secondary facilitation showed a significant decrease in the Gastrocnemius and Soleus muscles (p<0.05).

The results suggest that decrease of skin receptors activity after anesthesia can facilitate motoneurons excitability and H-reflex recovery. It seems that using the method of paired stimulation and H-reflex recovery curve may be useful to investigate the effect of physical therapy modalities on the fast and slow motoneuron excitability.

Change of control strategy in osteoporotic people and their focus on the hip strategy, also the occurred postural changes, result in the displacement of center of pressure (COP). This study was carried out to compare the static stability parameters in healthy, osteopenic and osteoporotic women.
Seventy-one volunteer postmenopausal women aged 48-65 years were divided into three Normal (n=15), Osteopenic (n=26) and Osteoporotic (n=30) groups according to their bone mineral density of lumbar spine. Static balance was evaluated using force plate, in two positions: double leg standing (DLS) and Romberg standing (Rom), with eyes open, for 20 s. Standard deviation of velocity and amplitude of COP displacement in A-P and M-L direction and path length were evaluated.
In DLS, SD of velocity and amplitude for A-P displacement, showed a significant increase in osteoporotic and osteopenic groups in comparison with normal women (P Increase in SD velocity and SD amplitude of COP displacement in A-P direction, that increase with the decrease in bone mineral density, may be due to the change of control strategy mechanisms in osteopenic and osteoporotic women. Investigation of these changes will be necessary to design the therapeutic methods for prevention of falling and bone fracture in osteoporotic patients.

Covering tissue defects using skin flaps is a basic surgical strategy for plastic and reconstructive surgery. The aim of this study was to evaluate the effects of chicken embryo extract (CEE) and bone marrow derived mesenchymal stem cells (BM-MSCs) on random skin flap survival (RSF) in rats. Using chicken embryo extract can be an ideal environment for the growth and proliferation of transplanted cells. Forty albino male Wistar rats were divided into 4 groups; each group consisted of 10 rats. BM-MSCs and CEE were transplanted into subcutaneous tissue in the area, where the flap would be examined. On the 7th postoperative day, the survival areas of the flaps were measured by using digital imaging with software assistance, and tissue was collected for evaluation. Survival area was 19.54±2 in the CEE group and 17.90±2 in the CEE/BM-MSC group when compared to the rates of the total skin flaps, which were significantly higher than the control group (13.47±2) (P<0.05). The biomechanical assessment showed a slight difference, although there was no statistically significant difference between the experimental groups and the control group (P>0.05). The findings from this study demonstrated that in operative treatment with BM-MSCs and CEE transplantation could promote flap survival, but the biomechanical parameters were not contrasted with a saline injection.

According to the further tendency of osteoporotic people to use the hip strategy to maintain stability, in present study, the relationship between hip, ankle and back extensor muscles strength and functional balance in healthy and osteoporotic postmenopausal women were evaluated. Forty-five volunteer postmenopausal women were divided into two normal and osteoporosis groups according to their bone mineral density. Maximal isometric strength of hip, ankle, and back extensor muscles were assessed by a hand-held digital dynamometer. Functional balance was assessed by Near Tandem Stand (NTS), Star excursion (SE) and Figure of 8 walking (F8W) tests. In osteoporosis group, all muscle groups were significantly weaker than the normal group (P<0.05), and the time of F8W test was significantly more than normal group (P=0.031). Also, in osteoporosis group, hip adductors and extensors showed a significant correlation with three functional balance tests (P<0.05). Regarding to decrease of muscle strength in osteoporotic women and its relationship to declining of functional balance in ADL, strengthening of hip and ankle muscle groups should be considered in their rehabilitation programs.

Examination of cartilage repair in animal work is dependent upon the thickness and radius of the induced impalement. Full-thickness defects with a radius of 3 mm have been commonly used in animal studies to evaluate new procedures designed to improve the quality of articular cartilage repair. The aim of the present study was to define the biomechanical characteristics of the repair of 5×4 mm full-thickness osteochondral defects in adult male rabbits. In a controlled clinical trial study 5 mm diameter and 4 mm deep osteochondral defects were drilled in the femoral patellar groove of twenty-one rabbits, and examined at 4, 8, and 16 weeks. The left knee was kept intact and was regarded as control. The knee joints were removed, and both legs were examined biomechanically by in situ indentation method at three time intervals (4, 8, 16 weeks). The instantaneous and equilibrium elastic- modulus (after 900 second) were measured during the test. There were no differences in cartilage mechanical properties (instantaneous and equilibrium elastic-modulus) in different weeks (4, 8, 16 weeks) in the two groups (P=0.08). However, significant differences were seen between the experimental and control groups in 16 weeks in instantaneous elastic_ modulus (P=0.44). It suggests that new tissue in this group had more stiffness than control in 16 weeks. Full-thickness osteochondral defect, measuring 5×4mm in the patellar groove of the adolescent rabbit knee healed spontaneously.

Background and Stroke patients often suffer from several impairments such as sensory، motor، cognitive and emotional disorders. These conditions cause limitations in performing daily activities. This study sought to assess the effect of action observation and imitation on improvement of functional activity indices in hemiparetic patients based on mirror neuron theory. A single blind clinical trial was carried out including 36 men and women (aged 45 to 60 years) suffering from ischemic CVA for the first time. Subjects were randomly divided into 3 groups of functional film، non-functional (symbols) film and a control (that did not watch any film) group. Usual rehabilitation treatments were performed for all groups. Timed up and go، and sixminute walk were done and Barthel Index and Berg balance scale were applied. The differences in functional activity indices were statistically significant in all 3 groups before and after the intervention. However، these differences were more significant in group 1. (Timed up and go (P=0. 001)، six-minute walk (P=0. 003)، Barthel functional activities (P=0. 006)، and Berg balance (P=0. 000)). Action observation and imitation with rehabilitation exercises and targeted motor activities (by stimulating the brain''s plasticity) had a positive effect on improvement of functional activity indices in post-stroke patients.