khodabakhsh javanshir

Dynamic neuromuscular stabilization (DNS) or core stabilization exercises have been used to improve core stability, but their effect on nonspecific low back pain (NSLBP) is still not fully understood. This study aimed to investigate the effect of DNS exercises on the electromyography (EMG) activity of the external oblique muscle in people with NSLBP.

In a randomized clinical trial, 44 people with chronic NSLBP were randomly assigned to the experimental and the control groups, with 22 participants in each group. The control group received standard physical therapy exercises, while the experimental group performed DNS exercises. Each group underwent an 8-week therapeutic exercise program, 5 sessions per week, with each session lasting approximately 60 minutes. Surface EMG was utilized to assess the core muscle activity of the external oblique. The EMG activity of the external oblique was measured in both groups before and after the 8-week intervention.

Nineteen people in the control group and 21 in the DNS group were analyzed. The results showed that after the intervention, patients in the DNS group obtained, on average, an 8.82% (95% CI, 6.53%, 11.10%) higher increase in the EMG activity of the external oblique muscle compared to the patients in the control group (P<0.001, effect size: 0.622).

DNS exercises can be recommended for improving the activation of superficial core muscles like the external oblique in individuals with NSLBP.

This paper presents a novel algorithm for the control of a 2D rehabilitation cable robot for the lower limb, addressing the dynamic model of the lower limb movements in the sagittal plane. Considering the nonlinear dynamic interactions between subsystems, the proposed control algorithm utilizes impedance control for torque and position control in knee and hip during passive and active-assistive rehabilitation modes. A switching algorithm is implemented for the cable forces. The system features two connected cables for each limb, with one active cable at any given time, positioned at the front and back, aiming to enhance patient comfort and perception of rehabilitation. The simulation results indicate a short run-time and negligible tracking error in torque and position for the limb.

Among four joints of human foot in the ankle area, the tibiotalar and subtalar joints play the most important role in making it possible for the foot to perform rotational movements such that kinematic behavior of foot is almost completely affected by orientation of their rotation axes. Deviation of the axis of rotation from the normal position can impair the function of the ankle and even the lower extremity. In this study, a new non-invasive method has been proposed, through which, using a gyroscopic mechanism, the orientation of the rotation axes of the tibiotalar and subtalar joints can be determined. This method is based on indirect data acquisition from the kinematic behavior of the foot. Using the calculated matrices and through the optimization method, the orientation and position of the rotation axes were respectively calculated at relatively high precision. These results were also assessed in practice by building an ankle mechanical model and a robotic gyroscopic mechanism which is used as a robotic rehabilitation device for ankle rehabilitation. Obtained results show that the maximum error in determining the orientation of the rotation axes is about 2 degrees.

Knee osteoarthritis (KOA) is the most common joint disease in the elderly and one of the main causes of disability. Although many studies have been conducted on the osteoarthritis risk factors, studies on the outcomes of risk factors of KOA are limited. Therefore, this study aimed at exploring the outcomes of contributing risk factors in older adults with KOA.

The study was conducted on 332 older adults with KOA. Knee injury and Osteoarthritis Outcome Score (KOOS) was applied to measure KOA outcomes and outcomes risk factors questionnaire were completed to assess potential explanatory variables. Univariate analysis and multivariate logistic regression were done to identify the risk factors for KOA outcomes.

The results of multiple linear regression analysis showed that repetitive use of joints (B= -0.420 to -0.509, p <0.001) and diabetes (B=-0.250, p <0.01 to -0.445, p <0.001) were the most common risk factors related to all KOA outcomes, followed by BMI (B=-0.247, p<0.05  to -0.458, p<0.001) and multimorbidity (B =-0.225, p<0.01  to -0.345, p<0.001). Increasing age, gender, and hypertension variables were associated with only some of the KOA outcomes, which generally included a decrease in sport/recreation, quality of life, activity daily living and an increase in pain and other symptoms.

The multiplicity of chronic diseases can complicate the KOA outcomes by influencing management decisions. Although, proper management of chronic diseases can improve the KOA outcomes, more studies on multimorbidity in KOA are needed. Pay attention to the guidelines for preventing the KOA outcomes by focusing on lifestyle modification, correct use of the knee joint and weight control, is necessary in future researches.

Chronic back pain is the most common type of musculoskeletal pain and the main cause of disability in the elderly. The self-management training program for chronic back pain control has positive consequences for the elderly and the health system. This research was conducted with the aim of determining the effect of implementing a self-management program on self-efficacy and acceptance of pain in the elderly with chronic back pain who referred to the specialized clinics of Babol University of Medical Sciences in 2021.

The present study was a clinical trial of a pre-test-post-test design, applied type. The research sample of 100 elderly people was allocated to two intervention and control groups by means of available sampling and random sequence using variable blocks method. The self-management program included awareness and cognition, problem solving process, stress control, muscle relaxation, and sports exercises. The patients were trained for four weeks and followed up for one month. Data were collected with pain self-efficacy questionnaire and pain acceptance questionnaire before, after and one month after the intervention. The results were analyzed using SPSS version 22 software at a significance level of <0.05.

There was no significant difference in the average self-efficacy and pain acceptance between the intervention and control groups before the intervention, while there was a significant difference between the two groups after the intervention in the average self-efficacy and pain acceptance (P<0.001). Also, the findings indicated that there was a significant improvement in the average self-efficacy and acceptance of pain before and after the implementation of the intervention in the intervention group (P<0.001).

Self-management program training has a positive effect on improving self-efficacy and acceptance of pain in the elderly, so the use of this non-pharmacological and supportive method can be used by nurses as an effective method to control chronic back pain.

This study aimed to assess the satisfaction of physiotherapy students with the general structure of objective structured clinical examination (OSCE).

A researcher-made questionnaire consisting of eight items was distributed to 43 graduate and undergraduate physiotherapy students to evaluate the general structure of OSCE. Data analysis was done through SPSS software v. 20, considering a significance level of P<0.05.

Among 43 participants with a mean age of 23.7±2.4 years old, the percentage of desirable attitude toward attractiveness of the OSCE was 46.6%, being fair was 21%, identifying strengths and weaknesses was 53.5%, the ability to assess knowledge and information was 11.7%, good assessment of practical skills was 30.3%, good assessment of clinical diagnosis skills was 34.9%, and appropriateness was 34.9%. In total, 88.4% of the participants believed that OSCE increases students’ stress. The total satisfaction of all the participants with the OSCE was 2.7±0.8, with last year’s students significantly less than graduate ones (2.6±0.9 vs 2.9±0.3).

The findings showed that the satisfaction of physiotherapy students regarding the general structure of the OSCE was not desirable, and OSCE was considered stressful. Therefore, due to the importance of OSCE in assessing clinical skills, it is better to improve the quality of holding the OSCE by fixing existent shortcomings, including shortness of time at each OSCE station and establishing training sessions.

Holding classes based on a university-set date is a form of discipline and compliance with educational regulations. But what we currently observe is one or more weeks of delay in starting the semester. This study aimed to determine the causes of irregularities at the beginning of each semester in medical universities from the viewpoint of faculty members.

This cross-sectional descriptive study was conducted in 2016, using the available sampling method on 59 faculty members of three Universities of Medical Sciences (Babol, Shahid Beheshti and Iran). The research tool was a 22-item questionnaire consisting of four sections on factors affecting irregularities. The validity of the research tool was confirmed by six faculty members and its reliability was confirmed by the test-retest method (r = 0.82).

The majority of faculty members participating in the study were male (34 people), most of them were assistant professors (23 people) with the average work experience of 15.24±8.6 years. Asking them about the reasons for the students' absence showed that they believed the most important reason was their friends persuading them not to attend the first classes of each semester (4.29±0.773) and the lack of facilities such as dormitory and dining room at the beginning of the semester (3.74±1.28).

According to the findings, the occurrence of irregularities at the beginning of university semesters is influenced by various factors, especially encouraging classmates not to attend the classes, but the teachers can prevent it with their desired influence.

Holding the classes in the first weeks of the official semester is one of the main problems for the university education system. This study aimed to determine assessing the causes of students' irregularities in class formation at the beginning of each semester in medical sciences universities.

This cross-sectional study was conducted at three universities of Babol, Shahid Beheshti and Iran University of Medical Sciences, on two groups of students, those who attended the first classes of semester and those who missed the classes; available sampling method was used to select participants. The researcher-made questionnaires were used to collect data, including students' personal and educational information, students' viewpoints on the reasons for absenteeism during the first classes of the semester, questions about their familiarity with absenteeism codes and regulations, and their viewpoints on canceling classes at the first days of semester.

The viewpoints of two groups of present and absent students (218 and 130 students, respectively) at classes on the first week of the semester, were analyzed using scores 1-5 in the Likert scale, and indicated that the main reason for the students attending at their first classes of the semester was the importance of specialized courses (4.16±0.94) and teachers’ emphasis (4.13±0.96). The most important factors for the students' absence were their experience of canceling first classes of previous semester (3.51±0.95) and students not paying attention to timely attend the first sessions (3.22±1.01). T-test showed that there was a significant direct relationship between students' age and their timely attendance at the beginning of the semester (p=0.035).

The presence or absence of students at classes on first days of new semester is influenced by various factors and actions taken by influential individuals such as educational staff and faculty members.

The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy.
Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines.
In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders.
Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patient's adherence to exercise programs.

Irregularity or delay in the beginning of classes at each semester, due to absence of students and/or professors, is a common problem in most Iranian universities. This study aimed to investigate the reason for irregularities at the beginning of each semester according to the viewpoints of educational experts.
This cross-sectional study was carried out at three universities of medical sciences namely; Babol University of Medical Sciences, Shahid Beheshti University of Medical Sciences, and Iran University of Medical Sciences in the first academic semester of 2015-2016. This study investigated the viewpoints of educational experts working in four schools of medicine, dentistry, paramedicine, and public health using a researcher-made instrument. The instrument’s face validity was surveyed and confirmed by six faculty members and its reliability was tested by test-retest method (r=0.82). Descriptive statistics were used for data analysis.
According to a forty-two member panel of educational experts’ opinions, the main reasons for academic irregularities at the beginning of each semester is students’ absence followed by weak disciplinary rules, lack of implementation of regulations, teachers’ reluctance to hold classes on time, as well as not completing roll calls and not passing them to the registrar’s office.
From the educational experts’ point of view, the factors related to students and teachers have greater effect on the recession of classes at the beginning of each academic semester. Therefore, a better planning for semesters and more control by authorities are required.

Neck pain is the second common musculoskeletal disorders in societies. According to studies، personal characteristics and school bags are predisposing factors for musculoskeletal problems in students. Due to the risk of neck pain، the aim of this study was to investigate the effect of risk factors on high school students. Methods and Materials: This study was carried out on 1000 high school students of Babol، Iran in 2012 and 2013. Students were chosen randomly. Student profiles and school bag characteristics and other information were collected by questionnaire. The VAS was used to assess pain intensity. Results were analyzed by SPSS software. The mean age of students was 15. 96±1. 13. Average bag weight and average bag weight to body weight ratio were 2. 76±0. 97 kg and 4. 47±1. 87%، respectively. Students with neck pain had lower age (P<0. 001)، lower height (P<0. 001)، lower weight (P=0. 002)، and more bag weight to body weight ratio (P=0. 001) than normal students. Use of backpacks was significantly more than other bag types in the students experiencing neck pain (P=0. 002). The results showed that the prevalence of neck pain was greater in students who had smaller physical dimensions. School bag characteristics can also be effective in causing neck pain. Given the importance of students as future adults، detailed investigation into the causes of neck pain prevalence in this age group is necessary. This study can also provide area for appropriate treatment.

Background and Assessment of neck extensor strength and measurement of neck muscles dimensions utilizing ultrasonography are reliable and valid methods. Cervical muscles strength and dimensions may change in different ranges of cervical spine motions. The aim of this study was to compare the strength of cervical extensor muscles and dimensions of semispinalis capitis muscle in three different neck positions in healthy subjects Thirty female students (18-24 years) participated. An ultrasonography device was used to scan the right semispinalis capitis muscle at the level of third cervical vertebrae. A measurement device was used to assess the isometric strength of neck extensor muscles at three positions: neutral, flexion and extension. The lateral dimension and anterior posterior dimension were measured and the size of the muscle was calculated by multiplying the anterior-posterior dimension at lateral dimension of the muscle. The semi spinalis capitis muscle SECM size was significantly larger in extension than that of neutral and flexion positions (P<0.001). The strength of extensor muscles in neutral position was more than that of flexion and extension positions. There was no significant relationship between size and strength of the muscle in all three positions. The result of this study indicated that the size of SECM and the strength of head and neck extensor muscles were reversely increased from neck flexion to extension. The maximum performance of cervical extensor muscles appeared in neutral position of cervical spine, when the muscles were not maximally lengthened of shortened.