mohammad mohsen roostayi

Ankle Sprain (AS) is one of the most common musculoskeletal injuries in athletes. Without proper intervention, acute AS have a high recurrence rate, which is associated with the development of chronic ankle instability. Currently Limited evidence exists to support the best intervention in related to individuals with AS. Blood Flow Restriction Training (BFRT) has emerged as a promising approach in physiotherapy for individuals with AS. The aim of present study was to review the effectiveness of BFRT treatment in individuals with AS narratively.

This narrative review was conducted to reviewing the available research’s about the role of BFRT in treatment of individuals with AS. The search encompassed studies published from 2000 to 2024 across multiple electronic databases, including Google Scholar, PubMed, Scopus, and Science Direct using relevant keywords.

Evidence suggests that the BFRT can be used as a new method in the treatment and rehabilitation process of individuals with AS.

Research has shown that utilizing BFRT can lead to significant improvements in recovery rates, strength gains, and overall patient satisfaction.

Infertility is a complex condition affecting approximately 15% of couples globally, with male factors contributing to 30-50% of cases. The etiology of male infertility encompasses hormonal imbalances, anatomical abnormalities, lifestyle choices, and environmental exposures. Traditional medical interventions primarily focus on hormonal therapies and surgical corrections, yet there is increasing interest in complementary strategies, including physical therapy, to enhance male reproductive health. This literature review systematically examines the role of physical therapy interventions specifically pelvic floor training, manual therapy, exercise regimens, and stress management techniques in improving male fertility outcomes. Research suggests that pelvic floor training can strengthen muscles crucial for sexual function and reduce performance anxiety. Manual therapy techniques, such as myofascial release and soft tissue mobilization, can improve blood circulation to the pelvic region, positively influencing sperm quality. Regular exercise has been linked to hormonal balance and enhanced overall fitness, contributing to better fertility outcomes. Furthermore, addressing psychological factors through stress management is essential, as chronic stress can adversely affect reproductive health. This review underscores the significance of multidisciplinary approaches in the management of male infertility and highlights the potential of physical therapy as a critical component in promoting male reproductive health and optimizing fertility. Future research directions are proposed to deepen understanding and inform clinical practice in this area.

The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA).

This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound.

The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased.

PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

The anterior cruciate ligament (ACL) tear and its subsequent reconstruction surgery can lead to many complications, such as strength deficit and muscle size reduction. Heavy load resistance training is an established method for improving muscle mass and strength but may be intolerable by patients recovering from ACL injuries due to its vigorous modality. Blood flow restriction (BFR) training is a novel technique which has been recognized as a promising alternative strategy, causing physiological adaptations with lower levels of resistance training and joint loading. Given the growing popularity of blood flow restriction, this narrative review seeks to explore the impact of BFR training on various facets of post-ACL reconstruction rehabilitation, comparing it to non-BFR training. A thorough literature search was conducted, and the effect of BFR training were examined on muscle strength, muscle size, pain, function, balance, comfort, willingness to use, bone mineral density, return to sport and ACL graft laxity. The results of this review suggests that BFR training post-ACL reconstruction may offer advantages in terms of muscle strength, muscle mass, bone mineral density, balance, knee joint pain, and function when compared to non-BFR training. However, there is a high variability in methodologies across existing studies, necessitating high-quality research with standardized methodologies and protocols to enable more effective application of BFR training in rehabilitation settings.

In simultaneous assignments, "attention" must be divided between assignments. Due to the competition in processor resources, the result of this action is the reduction of the performance efficiency, at least in one of the tasks. Research on the effect of cognitive task on balance is not conclusive, and the effect of cognitive task and types of tasks at the same time on balance is unknown. The aim of the study is to investigate the intervention effect of two cognitive and visual tasks on balance.

In this semi-experimental study, 20 young girls performed the test in 4 modes, balance without intervention, balance with cognitive intervention, balance with visual intervention, and balance with both interventions, on the Biodex machine at instability level 4. Overall stability index was recorded as dependent variable.

The results of variance analysis of repeated measurements at the level of P<0.05 did not show a significant difference between static balances in different situations. Therefore, all research hypotheses were rejected.

It seems that the lack of significant difference between the different positions is related to the lack of control of the participants' cognitive capacity and the created cognitive load and its effect on the posture control mechanisms.

Tennis elbow involves the lateral part of the elbow that seriously impairs upper extremity function. Recently, radial shock wave therapy (RSWT) and dry needling (DN) have been proposed for the treatment of various tendinopathies. This study aims to compare the effects of DN and RSWT on the pain, disability and grip strength of patients with tennis elbow.

 In this pilot study, 12 patients with tennis elbow aged 30-50 years participated. They were randomly divided into two groups: RSWT (n= 6; three sessions per week; 1.5-Bar, 10-Hz, 2000 shock waves) and DN (n=6; five sessions). To assess the pain level, we used the visual analog scale (VAS) and pressure pain threshold (PPT). To assess functional disability, the quick disabilities of the arm, shoulder and hand (Quick DASH) questionnaire was used. We also measured the hand grip strength. All outcome measures were assessed before, immediately after and four weeks after the intervention.

In the RSWT group, the pain (VAS score) and disability (grip) in the follow-up phase showed a significant decrease compared to the pre-test phase (P<0.05), while the post-test scores showed no significant decrease compared to pre-test scores (P˃0.05). The score of quick DASH significantly decreased in the post-test and follow-up phases compared to the pre-test phase (P<0.05). In the DN group, the pain significantly decreased in the follow-up phase compared to the pre-test phase (P<0.05) and the disability significantly decreased in the post-test and follow-up phases compared to the pre-test phase (P<0.05). No significant difference in the quick DASH score was found among different time points (P>0.05). The mean PPT scores of the first and second trigger points and the PPT for the average of the first and second trigger points were not significantly different among different time points in any group (P>0.05). Moreover, none of the study variables were significantly different between the two treatment groups in the post-test and follow-up phases (P>0.05).

 Both DN and RSWT can reduce pain and improve the hand grip strength of patients with tennis elbow. Their effects on pain reduction were maintained four weeks after the intervention. The RSWT can reduce the Quick DASH score. There is no significant difference between their effects on pain, grip strength, and Quick DASH score. Therefore, both DN and RSWT have a therapeutic potential in treating tennis elbow.

Erectile dysfunction (ED) is a common issue in men, often associated with various factors, such as obesity, diabetes, and more. This case study examines the impact of friction massage combined with pelvic floor exercises on ED in three patients, linked to prostatic adenectomy, aging, and diabetes.

Case Description:

 Patients followed a one-month regimen of pelvic floor exercises and techniques. The technique’s progress was monitored via video calls twice a week. Exercises lasted for 10 min daily, along with a 10-min massage. We assessed improvement using the international index of erectile function 15 (IIEF15) questionnaire and erection hardness score (EHS), as well as ultrasound scans.

Following treatment, all three patients showed increased EHS and IIEF15 15 scores. Muscular thickness increased in the ischiocavernosus and bulbospongiosus muscles, while the cavernosal artery exhibited higher systolic velocity and lower diastolic velocity, although maximum blood flow velocity in the posterior vein decreased. Treatment had the most significant impact on the adenectomy patient, followed by the elderly patient and then the diabetic patient.

Combining friction massage and pelvic floor exercises led to improved erection-related indicators and increased patient satisfaction.

Stroke is one of the most debilitating diseases among adults worldwide and leads to persistent rehabilitation needs even at the chronic stage. Achieving good postural control is a critical requirement for daily activities which enhances quality of life (QoL) in patients with stroke. There is increasing evidence that transcranial direct current stimulation (tDCS) can be considered a promising adjunct technique to improve motor recovery after stroke. Evidence of augmented neuroplasticity after tDCS suggests that paired rehabilitation followed by consecutive use of tDCS may optimize recovery outcomes. Although a few randomized controlled trials have been conducted on upper limb rehabilitation in chronic stroke using tDCS, no study focused on balance training in chronic stroke patients. The present randomized, sham-controlled, double-blinded clinical study addresses brain stimulation targeting postural control using tDCS in chronic stroke.

The study participants included chronic ischemic stroke individuals with postural control impairments who passed the exclusion criteria. Active or sham anodal tDCS was delivered to the lesioned leg motor cortex combined with balance training. The experimental group received active anodal tDCS stimulation (2 mA) for 20 min, daily for 5 days paired with balance training. Linear and nonlinear approaches were used to analyze postural sway changes pre-and post-intervention. Postural sway fluctuation, functional balance assessment using the Berg balance scale, and timed up-and-go test were conducted to compare the active and sham groups. 

This trial could have significant implications for balance rehabilitation after stroke in the ambulatory setting. If effective, this novel approach may improve rehabilitation protocol in this population.

Low back pain is one of the most common and costly musculoskeletal problems that affects more than 80% of people in the community at some point in their lives. Control of pain and functional disability of patients with low back pain is the most important part of physiotherapy and rehabilitation, and recently, the use of vibrating tools to achieve this goal has been considered. A flexi-bar is a vibrating instrument that causes low-frequency vibration in the body through active movements in the upper extremities. According to the articles, these vibrational stimulations, in addition to the stimulation of vibratory receptors and pain relief, can activate muscle spindles, increase the activity of alpha neurons, and improve neuromuscular control in the trunk muscles. The aim of this review study was to evaluate the effectiveness of flexi-bar as a vibrational exercise therapy tool in the rehabilitation of patients with low back pain.

In this study, an electronic search was performed in PubMed, Scopus, and Google Scholar search engines from 2000 to 2020, and studies that examined the effectiveness of flexi-bar on pain, functional disability, or trunk muscle activity in patients with low back pain or healthy individuals were selected. The keywords of low back pain, flexi-bar, body blade, vibrating rod, and trunk muscle activity were used for the search.

Using keywords and considering the inclusion and exclusion criteria, 17 articles that were most relevant to the subject of this article were reviewed.

The results of these studies showed that flexi-bar is useful in reducing pain and improving functional disability in patients with low back pain, but more studies are needed in the future to more accurately evaluate the effectiveness of flexi-bar in trunk muscle activity in patients with low back pain.

The risk of falling in patients with chronic obstructive pulmonary disease (COPD) is higher than healthy people, imposing a great financial burden on patients due to clinical diagnosis and treatment.This study aimed to compare static balance between two groups of healthy people and COPD patients, based on cognitive tasks and vision tests, using linear and non-linear analyses.

A total of 15 patients with COPD and 14 age- and gender-matched healthy individuals were recruited in this study. Variations in the center of pressure were recorded in both medial-lateral (ML) and anterior-posterior (AP) directions by implementing visual feedback and cognitive tasks, with the subject standing on a force plate. Data related to the center of pressure were analyzed in the AP and ML directions by linear methods (i.e., standard deviation of displacement, standard deviation of maximum velocity, average velocity, and phase plane). Also, the nonlinear method (Lyapunov exponents) was used in both directions.

The cognitive tasks improved the center of pressure variables in both groups. In association with the vision tests, only lack of vision had a significant effect on the patients. The results of the linear analysis in the ML direction were significantly higher in the COPD group as compared to the healthy group; however, the results were not significant in the AP direction. Also, the non-linear analysis showed significant differences between the groups.

Use of both linear and non-linear analyses is necessary for evaluating the balance of patients with breathing difficulties. Balance disorders in COPD patients were mostly in the ML direction; therefore, postural deformities might be one of the reasons for balance problems in the AP direction.

Hemophilic arthropathy (HA) causes severe joint damage and impairs the quality of life (QoL) of hemophiliacs. This study was undertaken to evaluate the effect of pulsed electromagnetic fields (PEMFs) on the clinical signs and QoL of patients with severe hemophilia A experiencing moderate HA in the knee joint.

Thirty-six severe hemophiliacs with HA of the knee joint were randomly assigned into the PEMF (n = 20) or placebo (n = 16) groups. The PEMF group received 60 min of PEMF (2 Hz, 25 Gauss for 30 min and 70 Hz, 30 Gauss for 30 min) on the knee joint, three times per week for 6 weeks. The clinical signs, QoL, and pain intensity were measured by the Hemophilia Joint Health Score, A36 Hemofilia-QoL Questionnaire, and visual analog scale, respectively, before and after treatment.

In the PEMF group, a significant difference before and after intervention in terms of clinical signs, QoL, and pain intensity (P < 0.05) was founded. Between-group analysis showed a significant improvement in clinical signs (except for atrophy, strength, and swelling duration), QoL, and pain intensity in the PEMF versus control group (P < 0.05).

PEMF can improve the clinical signs, QoL, and pain intensity of severe hemophilia A patient with moderate knee hemophilic arthropathy.

Dimethylsulfoxide is a potent solvent which is used to increase the transdermal transport of medicines. The aim of this study was to examine the effects of phonophoresis with hydrocortisone alone and in combination with dimethylsulfoxide on the upper trapezius trigger points. Sixty patients were divided into three groups and received ten treatment sessions with different protocols using ultrasound: 1% hydrocortisone gel, a solution of 10% dimethylsulfoxide and 1% hydrocortisone gel, and a neutral ultrasound gel. The pain, pressure pain threshold, and the range of motion of the neck were assessed at four intervals in all three groups. The results revealed that phonophoresis with the two treatment gels and ultrasound with neutral gel significantly reduced the pain and the pressure pain threshold (P=0.01). The range of ipsilateral lateral flexion and contralateral lateral flexion of the neck was significantly improved following phonophoresis with 10% DMSO and 1% hydrocortisone gel (P=0.01 and P=0.02, respectively). Thus, it was concluded that the addition of 10% DMSO to 1% hydrocortisone gel enhanced the persistence of the beneficial effects of hydrocortisone on the pain, pressure pain threshold, and the range of motion of the neck.

One of the treatment methods for patients with carpal tunnel syndrome is kinesio tape. Since there have not been any systematic review on this issue, the present systematic review was conducted to investigate the effects of kinesio tape in patients with carpal tunnel syndrome.

Using several keywords, including Carpal tunnel syndrome, Median nerve, Kinesio tape, and Physiotherapy, a literature search was performed for the period between 2000-2018, in Google scholar, Pubmed, PEDro, Science Direct, Springer, Ovid, ProQuest, Cochrane library, and Scopus databases.

Among the articles found, only those using kinesio tape for the treatment of carpal tunnel syndrome were included in the study. Out of 50 articles, only 11 were included in the study and other studies were excluded.

All the papers studied showed pain relief, increased grip and pinch strength, decreased median nerve cross sectional area, reduced distal latency, increased median nerve speed, and improvement in the questionnaires. Studies that used kinesio tape along with other physiotherapy treatments indicated an increased effect on the recovery of patients with carpal tunnel syndrome, especially in the long term.