فهرست مطالب mohammad reza hadian

Foot posture is proposed as an important factor that may affect the lower limb alignment. Variations from the normal foot posture may contribute to musculoskeletal injuries of the lower extremity especially knee joint. Considering variations in foot posture and knee joint alignment, this study aimed to assess and compare pennation angles of the vastus medialis oblique (VMO), vastus medialis (VM) and vastus lateralis (VL) in women with pronated foot posture and normal ones.

This observational, case-control study was carried out on 31 women with pronated foot posture (foot posture index: 6-12) and 31 women with normal foot posture (foot posture index: 0-5) in the age range of 18 to 35 years old.  Participants were recruited from female students of university communities using Non-probability Sampling method. Sampling was carried out from September 2019 up to February 2020 at the biomechanics laboratory of rehabilitation faculty of Tehran University of Medical Sciences. The pennation angle of VMO, VM and VL muscles was measured by using two dimensional. B-mode ultrasound imaging (USI) .A 7.5MHz linear transducer with 50mm footprint was used for the measurements. The ultrasound images were analyzed using Image J software. Three longitudinal scans were captured for each muscle pennation angle while the probe removed between each scan.

The results of this study showed that there is no statistical significant difference between the pennation angles of  VMO, VM and VL in women’s foot posture compare to the normal ones (P>0.05).
However, the results of intraclass correlation coefficient (ICC) of USI measurements showed “good” intrarater reliability for VMO (ICC=0.88), VM (ICC=0.87) and VL (ICC= 0.77) pennation angles.

Based on the results of this study, the pennation angle of knee extensor muscles (VMO, VM, and VL), which was measured in non-weight bearing, is not different in young women with pronated foot compared to the normal ones. In addition, USI demonstrated good reliability for measuring VMO, VM and VL pennation angles.

Carpal tunnel syndrome (CTS) is a common peripheral entrapment neuropathy with squeezing of the median nerve and the patient is unable to function properly. There are different physiotherapy interventions for the management of these patients and recently, shock wave therapy and low-power laser (LPL) have been widely used, but there is no strong evidence comparing the effect of shock wave therapy and LLLT. Therefore, this trial was designed to compare the effect of extracorporeal shock wave therapy (ESWT), LPL, and routine interventions on clinical outcomes and electrophysiological parameters in patients with moderate CTS.

Fifty-four patients were randomly assigned to the control (routine interventions), ESWT, and LPL therapy groups. All participants received transcutaneous electrical nerve stimulation (TENS) therapeutic ultrasound, hot pack, mobilization, and stretching for ten sessions over two weeks. Additionally, the ESWT group received radial ESWT in four sessions, and the LPL therapy group received laser in ten sessions. The primary outcomes were pain (assessed by the visual analog scale), function (assessed using the Boston questionnaire (BQ)), hand grip, and finger pinch strength. Secondary outcomes were electrophysiological parameters (distal motor and sensory latency and nerve conduction velocity (NCV) of the median nerve. 

Time group interactions were significant for pain, the symptom severity subscale of BQ, finger pinch, and hand grip strength (p<0.001). Significant improvements were seen in clinical and sensory latency and motor NCV of the median nerve (p<0.05). The ESWT group experienced significant improvements with a large effect size in pain, function, and finger pinch strength compared to the control group (p<0.01). Additionally, the LPL therapy group showed significant changes in the function and finger pinch and hand grip strength compared to the control group. There were no significant differences between the LPL therapy and ESWT groups except for pain in favor of the ESWT group. No significant differences were found among the three groups in electrophysiological parameters (p>0.05).

Although laser therapy increased the efficacy of routine interventions, it seems adding ESWT to the routine treatment may be superior for the management of moderate CTS patients.

Estimation of the sediment load in rivers is one of the important issues in studies related to water quality and transport of pollutants, construction and operation of hydraulic structures, maintenance of reservoirs, water transmission networks, and water resources management. An accurate understanding of the sedimentation of a watershed can provide a correct understanding of soil erosion and its consequences. Since sediment changes in the river are often a function of flow discharge changes; therefore, methods of measuring suspended sediment load based on the suspended sediment concentration and flow discharge will be useful in estimating the amount of sediment load. The sediment rating curve is one of the methods that is based on flow discharge and sediment discharge and expresses the relationship between these two parameters in the form of power regression (Eq 1). (1) where Qs  is the suspended sediment discharge (in tons per day), Qw is the flow discharge (in cubic meters per second), and a and b are the coefficients of the equation . Rating curves can be drawn in different ways according to the way of data separation. Among these methods, we can refer to one-line, multi-line, mean of categories, seasonal, monthly, annual models, etc. The presence of bias in the sediment discharge relationship makes this relationship unable to show the exact sediment concentration in different flow discharges. This bias causes the amount of sediment to be underestimated. Various researchers have proposed some statistical correction factors to achieve the minimum error, which are applied in the sediment rating equation. In this research, in order to increase the accuracy of sediment estimation by using a sediment rating curve, at first, different types of rating curves were drawn for the station and, finally, correction factors consisting of QMLE, Smearing, MVUE, and (Beta) β were applied for the selected curve. Also, an attempt was made to separate the data into three categories of dry, normal and wet by using the percentage of normal precipitation and to draw the sediment rating curve for each. At the end, the results obtained from the statistical model (SRC) were compared with artificial intelligence models including two models of multilayer perceptron (MLP) and radial basis set (RBF) neural networks.

In this research, the flow and sediment discharge data from 1350 to 1397 for the Jelogir station in Khuzestan province located on the main Karkhe River were prepared from the Khuzestan Regional Water Organization. Sediment rating curve models, including common linear curve (USBR), mean of categories, monthly, seasonal, bilinear, trilinear, dry, normal and wet models were drawn for the station. Then, for the drawn curves, evaluation criteria including RMSE, ME and P were checked and, finally, by ranking these criteria, the curve with the least error was selected. In determining the rank of each model, the values of the evaluation indices were compared with each other. In this way, the closest P and ME index value to 1 and the closest RMSE index value to zero, which indicates the least difference between the estimated and observed sediment values, was assigned the first rank. In order to investigate the effect of skew correction coefficients on the accuracy of sediment rating curves, coefficients including MVUE, FAO, QMLE and Smearing were applied on the rating curve which was selected as the optimal model in the previous step. The data were processed using neural network models. For this purpose, different structures of neural networks with different layers, neurons and functions were investigated through trial and error.

According to the obtained results, the mean categories method has the highest correlation coefficient (0.85). The RMSE in rainy and flooding months (April and March) and also in high flow discharge rates (in bilinear, and trilinear models, at flow discharge greater than 201 and 114 cubic meters per second, respectively), has allocated the largest amount. The lowest value of RMSE is related to the months of August and September, which is reasonable due to the lack of rainfall and flooding in these months and as a result of low erosion of sediments. According to the ranking values, the periods of low rainfall, including summer and July, August and September are in the first ranks, and as a result, the sediment rating curve has more accuracy in estimating sediments. Finally, the rating curve of August, which has the lowest total ranking value, was chosen as the optimal curve. According to the ranking of the correction coefficients, it can be seen that the sediment rating curve without applying the correction coefficients (the highest rank) has the highest amount of error and by applying the coefficients, the error of sediment flow estimation can be reduced. Finally, MVUE with the lowest total ranking was chosen as the optimal correction coefficient, and by applying it, the accuracy of the model in estimating the sediment discharge increases. In the neural network model, Lunberg-Marquardt optimization algorithm was used and the number of hidden layer neurons in the best MLP and RBF structure was obtained as 5 and 6, respectively. Also, the activator function in the hidden layer in MLP was selected as sigmoid tangent and Gaussian function in RBF. The results show that by using neural networks of multilayer perceptron, it is possible to predict the amount of suspended sediment with higher accuracy, and the accuracy of the results obtained from the artificial neural network method is far higher than the accuracy of the rating curve method with and without data classification. According to the results, the MLP model has shown a lower error value than the RBF radial base model.

In this article, in order to estimate the suspended sediment in the Jelogir station, the data were separated into different forms and the sediment rating curves were drawn into linear curve (USBR), mean of categories, monthly, seasonal, dry, normal, wet, bilinear, and trilinear types. The obtained results showed that the accuracy of the relationship obtained for the classification of data based on August (R2= 0.785) and the total rating of 9 (the lowest value) was more than the other models. And at high flow discharge, the accuracy of the models decreases. It was found that the correction coefficients are effective in increasing the accuracy of the models, and the lowest amount of error for the optimal model is obtained by using MVUE. Comparing the results of statistical methods and neural networks showed that neural network models are more accurate in estimating daily sediment. The better performance of artificial neural networks compared to statistical methods can be expressed in the nonlinear approximation capability of neural networks.

Many studies have investigated ankle sprain injury and it has been reported that in 80% of cases, ankle sprains lead to functional ankle instability (FAI). The conventional exercises for FAI rehabilitation neglect the associated neurocognitive dysfunction.

This study aims to evaluate the effect of Wii Fit Plus as a virtual reality training on neurocognitive function in athletes with FAI compared to athletes without FAI.

In this matched randomized clinical trial study, 25 athletes with unilateral FAI and 25 athletes without FAI were assigned to two groups randomly: 1) the intervention group, subjects performed the Wii training including balance and strengthening games three times a week for 12 sessions and 2) subjects in the control group received no intervention. Before and after the training, the neurocognitive function was assessed through the computerized-reaction time test based on the detection or identification of ‘X’ mark on a computer monitor. Between-groups and within-group comparisons were done by the independent T-test and paired T-test, respectively.

A significant difference was observed in mean differences of neurocognitive function between athletes with and without FAI. Comprising before and after training was significant in the intervention group. 

Based on the results, the information-processing speed of athletes with FAI increased after the training, utilized for rehabilitation protocols.

Flexibility or the ability of a muscle to increase in length is an integral part of musculoskeletal characteristics and is essential in preventing musculoskeletal injuries and increasing functional levels. Hamstring muscles rupture is a common injury. One of the important factors in the occurrence of this injury is poor hamstring muscle flexibility, which because of its stiffened structure, has less ability to quickly increase in length. Some researchers have recently suggested that the dry needling technique could reduce the number of treatment sessions for hamstring muscle tightness and bring faster and more effective results. Accordingly, this study aims to investigate the effect of the application of dry needling through an acupuncture technique on hamstring muscle flexibility.

The present study is a single-blinded randomized controlled trial in which 16 individuals with bilateral hamstring muscle shortness were randomly allocated into dry-needling and sham-needling groups. The sampling method was non-probability convenience. The outcome measures were the right and left active knee extension range of motion, assessed before and after the first, third, and fifth sessions of intervention. A 2-factor mixed analysis of variance was applied to determine the differences between and within the two groups.

Except for the group main effect, time main effect and interaction effect were statistically significant for the right and left active knee extension range of motion (P<0.001). There were differences in behavioral patterns in groups; accordingly, in the real dry-needling group, a significant difference was detected across times. However, in the sham dry-needling group, no significant difference was observed.

The application of dry needling into motor points of hamstring muscles in individuals with bilateral hamstring muscles shortness could improve flexibility and increase the range of knee extension after 3 and 5 sessions of intervention because of the therapeutic effects of the dry needling technique in improving the muscle flexibility.

Functional ankle instability (FAI) is a common injury. Traditional training improved the reported balance impairment and subjective sense of instability in athletes with FAI.

This study aims to compare the effects of traditional and virtual reality training on a subjective sense of instability and balance in athlete with FAI.

In this single-blinded matched randomized clinical trial design, Fifty-four basketball players were randomly assigned in the virtual reality (n=27) or control (n=27) groups. All athletes performed 12 sessions Wii exercises or traditional training in the virtual reality and the control group, respectively, for three days a week. To assess the subjective-sense of instability and balance, we used Cumberland Ankle Instability Tool (CAIT) and Star Excursion Balance Test (SEBT), respectively. Measures were taken at pre- and post-test and one month after training as a follow-up. The between-group comparisons were done by the analysis of Covariance.

At the pre-test, the CAIT score was 22.37, 22.04 in the control and virtual reality groups, respectively and at the post-test, these scores increased to 26.63, 27.26. The involved limb showed significant differences in posteromedial and posterior directions of the SEBT and CAIT score in the post-test and in the posterior direction and CAIT score in the follow-up. The virtual reality group had better performance than the control group but the effect size is small (cohen’s d<0.2). 

Based on our results, both training protocols were effective in reducing the subjective-sense of instability and improved balance in athletes with FAI. Moreover, virtual reality training was very attractive for the participants.

The purpose of this work was to explore cervical position sense and electromyographic (EMG) responses of cervical muscles during head repositioning movements in students with and without upper trapezius muscle trigger points.

Forty-six right-handed men and women subjects without upper extremity disorders participated in this study. The maximal voluntary contraction (MVC) was measured three time before the fatigue test. A force gauge was used to measure force while recording with a monitor. Measurement was initiated with a MVC force before and after fatigue pain and head positioning were measured. When the protocol was accomplished, the subjects showed signs of exhaustion; however, they were not subjectively evaluated for fatigue. As the protocol aimed at assessing muscle fatigue, a force level of 80% MVC was induced.

These findings support the argument that the precision of the neck position sense can be reduced by the fatigue of the neck muscle. Fatigue impaired balance in the trapezius muscles. After removing vision this resulted in an increased center of pressure excursions on a force platform. Motor control did not change significantly in this study.

Fatigue had a more significant effect on cervical kinematics in the healthy subjects, probably due to the fact that altered neck motor control in volunteers implied that these individuals were not completely able to make up for fatigue of the neck muscle. Significant pain and head positioning changes were identified following fatigue applied to the pre-determined myofascial trigger points, but the changes were insignificant in the sham control group.

several studies have revealed the positive effects of daily moderate to vigorous physical activity on student performance and academic achievement. The purpose of this study was to determine the effect of a specific physical activity program on academic performance among children aged 9 to 14 in the Lebanese schools. Participants were eligible if they did not participate in any sport activity during the lockdown due to the COVID-19 pandemic in the first semester of the academic year 2020 – 2021 and were able to complete a three-month PA program at the BH CLUB-KYOKUSHIN JAMMAL academy with no psychological or physical limitations. A well-trained physical coach established a PA program consisting of karate and general fitness exercises for three months, three times per week, one hour per session. Academic performance was measured using the official marks from three core academic classes at each school, as well as the overall GPA. Out of 250 eligible children, only 60 students, 47 males and 13 females, with a mean age of 11.7 ± 1.68 years old, participated in the study. All scores for all participants from both genders improved significantly (p<0.05) with exception of mathematics and science scores of the females. Furthermore, no significant gender differences were observed in any of the variables with p-value>0.05 and a size effect of Cohen’s d<0.219. PA had a significant impact on academic achievement in children aged 9 to 14 years old, and it may help to offset the unavoidable negative impact of the COVID-19 outbreak. As a result, Lebanon's parents and schools should prioritize PA for their children.

To demonstrate the effectiveness of extracorporeal shock wave therapy (ESWT) in treating active trigger points to relieve pain and increase range of motion (ROM) and improve the function of the cervical region in fewer sessions.

In this single-group, pretest-posttest study, 15 participants with active myofascial trigger points (MTrPs) in the upper trapezius muscle took part. Before and after each treatment, visual analog scale (VAS), pressure pain threshold (PPT), neck disability index (NDI) questionnaire, and range of active contra lateral flexion (CLF) were assessed. Participants were given three treatments over a week, with at least a two-day break between them, and then all outcomes were evaluated.

The general results of this study demonstrate a significant reduction in pain perception in terms of VAS (P=0.0001), increased pressure pain threshold (P=0.0001), increased CLF of ROM (P=0.0001), and improved neck function by reduction of NDI (P=0.0001), after the third session of ESWT intervention in participants with MTrP in the upper trapezius muscle.

It reveals that ESWT has positive effects on pain reduction, cervical range of motion, and cervical function in participants treated with MTrPs in the upper trapezius muscle.

This study aimed to assess the test-retest intra-rater reliability and convergent validity of digital photography (DP) in detecting the postural orientation of children with cerebral palsy (CP).

The study recruited children with various types of CP with the Gross Motor Function Classification System level I or II and spasticity < 2 on the Ashworth Scale, without any visual or cognitive impairments. Children who had undergone any surgical intervention or received a botulinum toxin injection within the previous six months were excluded. A digital camera was fixed at 1.5 meters from the participants at the height of 90 cm. Non-reflective markers were attached to eight anatomical landmarks to localize the upper and lower center of mass on both sides. The same examiner took three digital photos to detect intra-rater reliability using the intraclass correlation coefficient (ICC). Pearson's correlation and linear regression analysis were used to assess the convergent validity of the DP method compared with the Pediatric Balance Scale (PBS) scores.

Thirty children (7.44 ± 2.38 years) were assessed to test the reliability of DP, and 55 others (8.06 ± 2.19 years) participated in the convergent validity study. Intra-rater reliability was found to be perfect (ICC > 0.995) and there was a strong significant negative correlation between DP measures and PBS scores (Pearson's correlation > 0.75) with high adjusted R2 (R2 > 0.567), indicating goodness of fit between the measures.

Digital photography (DP) is a reliable and valid method for assessing postural orientation in children with various types of CP.

Cerebral palsy (CP) results from damage to the central nervous system, leading to disturbances of motor and sensory functions, especially the balance. Virtual reality exercise intervention (VRI) is a promising technique to improve motor function in children with CP by engaging such individuals in real-like world events through simulations. This review study examines the effects of VRI on static and functional balances and summarizes the effective protocols of virtual reality-based rehabilitation interventions for the CP patients.

A comprehensive search was performed using the following databases: Medline/PubMed, Scopus, Cochrane Library, PEDro, EBSCOhost, and the Online Library of the University of London. The PEDro scale was used to assess the methodological quality. The data extracted from the reviewed studies were coded according to Cooper and Hedges’ guidelines considering the following criteria: (I) Patients' characteristics, (II) intervention protocols, (III) outcomes, and (IV) results. To this end, twelve RCTs with 248 patients aged 4 - 20 years old were analyzed and assessed as "fair" to "good" methodological quality according to Pedro’s scale (4 to 8). VRI alone or in combination with a standard physiotherapy program or with other tools such as tDCS was applied.

Twelve RCTs met the inclusion criteria. The meta-analysis showed the good effect of VRI on the static and functional balances of patients with CP (Cohen’s d = 0.66). The funnel plot revealed no significant asymmetry or heterogeneity among the studies (P = 0.271, I2 = 19.71%), reflecting the absence of publication biases.

This review reports four major perspectives of the VRI applications: (1) VRI settings, (2) selection of exercises, (3) outcome measures, and (4) long-term effects. Moreover, this review summarizes the specific effects of VRI on balance improvement in patients with CP from different perspectives. However, considering the limited number of well-conducted RCTs in this field, a large homogeneous samples size is still needed for future RCTs.

Proprioceptive training in the aquatic environment is more beneficial owing to water properties. Theprimary goal of the present study was to investigate the effectiveness of the incorporation of innovative aquaticproprioceptive training into conventional accelerated land-based rehabilitation protocol in knee function and jointposition sense in male athletes after anterior cruciate ligamen t reconstruction (ACLR). A total of 38 athlete male athletes with ACLR were randomly assigned to two rehabilitation groups. Theconventional therapy group (CT) (n=19) received conventional rehabilitation for 6 weeks, while the hydrotherapygroup (HT) (n=19) received the same conventional rehabilitation, in addition to 12 sessions of innovative aquaticproprioceptive training. The outcomes included the joint position sense (JPS) errors, visual analog scale (VAS), andinternational knee documentation committee (IKDC). Repeated measures analysis of variance (ANOVA) was usedto compare the means between the two groups. Cohen’s d from an independent t-test was used to calculate theeffect sizes for all variables after the intervention for both gr oups. Base on the results, there were a significant difference in absolute errors (AE) (FAE=56.231, p <0.001)and variable errors (VE) (FVE=60.245, p <0.001) between the two groups. No significant differences were detectedin constant error (CE), VAS, and IKDC between the two groups (P>0.05). Both groups displayed a significantdifference in terms of AE, VE, VAS, and IKDC after the intervention (p <0.05). Percent changes after the interventionfor AE(69.19%), VE (68.20%), CE (65.20%), VAS37.50%, and IKDC (38.61%) were greater in the HT group,compared to the CT group. As evidenced by the obtained results, innovative aquatic proprioceptive training incorporate into theconventional rehabilitation accelerated protocol offers the improvement of proprioception efficiency for individualswith ACL reconstruction. Therefore, it could be useful to clinicians when designing rehabilitation protocol to ensurethe optimal engagement of proprioception.Level of evidence: I

The present study aimed to cross-culturally adapt and assess the validity and reliability of the English version of the Wexner questionnaire translated into the Persian language in Iranian patients.

Constipation is one of the most common gastrointestinal disorders; therefore, it is necessary to utilize an index for both the clinic and research studies.

In the first phase, the English version of the Wexner questionnaire was translated into the Persian language. In the second phase, the Persian version was assessed to evaluate the psychometric properties in 136 patients with functional constipation who referred to gastrointestinal and physical medicine clinics. Content validity was assessed by face validity. Construct validity was tested based on hypothesis testing and structural validity. The correlation of the total scores of the Wexner questionnaire and the Patient Assessment Constipation Quality Of Life (PAC-QOL) questionnaire was used for concurrent criterion validity. Internal consistency and test-retest reliability were calculated using Cronbach's α and intraclass correlation coefficient (ICC).The floor/ceiling effect of the questionnaire was also evaluated.

The content validity of the Persian version of Wexner’s questionnaire was acceptable. The construct and concurrent criteria validity showed moderate correlation. The internal consistency and intrarater reliability were moderate (0.51) and excellent (rp = 0.97, p-value <0.001), respectively. No floor/ceiling effect was seen.

The Persian version of the Wexner questionnaire showed good validity and reliability in Iranian patients and can therefore be applied in clinics as well as in research for Persian-speaking countries.

The main aim of this study was to determine and compare the effects of innovative aquatic proprioceptive training plus conventional rehabilitation with conventional rehabilitation alone on voluntary response index (VRI) components in athletes with anterior cruciate ligament reconstruction (ACLR).

Forty male athletes with ACLR (18 - 35 years of age) voluntarily participated in this study. They were randomly allocated into two groups. The conventional therapy group (n = 20) underwent conventional rehabilitation for ten weeks, three sessions a week. The aquatic proprioceptive training plus conventional rehabilitation (n = 20) group received the same conventional rehabilitation plus 30 sessions of innovative hydrotherapy exercises. Voluntary response index analysis was carried out to determine changes in motor control and muscle activation patterns based on electromyographic (EMG) outcome measures.

There was a significant difference in the magnitude (MAG) and similarity index (SI) between the two groups at all phases of the functional task (sit-stand-sit) (P < 0.05). Also, both groups showed a significant change in MAG and SI at all phases of the functional task (sit-stand-sit) after the intervention (P < 0.05). Effect size in both groups for MAG and SI at all phases of the functional task (sit-stand-sit) ranged from 2.5 to 4.61 and from 0.29 to 1.7, respectively.

The incorporation of innovative aquatic proprioceptive training into conventional accelerated rehabilitation protocol leads to changes in motor control due to changes in the muscle activation pattern after the intervention.

Until now, a variety of techniques have been introduced to address the adverse effects of NS-CLBP, including spinal manipulation technique (SMT) and muscle energy technique (MET). However, most of these techniques have focused on pain assessment and disability. In other words, the intermuscular synchronization between the co-contracting muscles was not considered, and hence, the effectiveness of these techniques on the corticospinal tract function was not studied.

This study aimed to compare the effects of SMT and MET on corticospinal tract function during four phases of standing, flexion, relaxation, and extension in flexion-extension task (F-ET) in NS-CLBP using pair-wise coherence of Beta-band intermuscular coherence (Bb-IMC).

Twenty volunteer healthymale subjects and twenty-fourmale subjects with NS-CLBP (20 - 45 years of age) participated in this work. The patients had continuous or recurrent symptoms for three months or more without any referral pain to the lower extremities. The patients were randomly assigned to two equal intervention groups (SMT and MET), and the techniques were applied as described by Greenman. Surface electromyography (sEMGs) from lumbopelvic muscles was recorded for all participants (i.e., healthy group and the patient groups), while they performed three trials of F-ET, and the pair-wise coherence for all muscles was calculated using Bb-IMC analysis. Besides, in the patient’s groups, sEMGs from the muscles were recorded before and after the interventional techniques (i.e., SMT and MET), while they performed three trials of F-ET, and the pair-wise coherence was calculated. Multivariate analysis of variance test was used to compare the healthy subjects and patient groups before the interventions in A and B muscle cross at different phases of F-ET task. Furthermore, in the NS-CLBP patients, comparisons were made before and after the interventions in each group (i.e., SMT and MET groups) as well as between the two groups in A and B muscle cross at different phases of the F-ET task.

In the standing phase of F-ET, there were no significant differences in the SMT and MET group before and after the intervention in PWC of A muscle cross and B muscle cross (P < 0.05). Considering the flexion phase, there were significant differences in the SMT group in all pair muscles as PWC (M1-M4), PWE (M1-M6), PWC (M4-M6) (P < 0.05), whereas there was one significantly in PWC (M4-M6) in the MET group (P < 0.05). In the relaxation phase, the SMT had significantly in PWC (M2-M5), whereas there was one significantly in PWC (M4-M6) in MET group (P < 0.05). In the extension phase, although the SMT was not significant (P < 0.05) in the MET intervention group, there were significant differences in the PWC (M2-M3) and PWC muscles (M2-M5).

This study provided some pieces of evidence about the effects of one of the common manual therapy techniques on the primary motor cortex and corticospinal drive in the NS-CLBP patients. The results showed that, by increasing the pair-wise coherence in all phases of FE-T, SMT intervention was more effective than MET intervention. Therefore, the pair-wise coherence of Bb-IMC can be considered an approach for clinicians when designing the rehabilitation protocol to ensure optimal treatment.

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.

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.

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.

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

 Sacroiliac Joint Dysfunction (SIJD) is considered an origin of low-back pain. It can change the motor control strategy and postural control (PC).

 We aimed to find any probable differences in PC between subjects with and without SIJD and determine the effects of the pelvic belt (PB) on PC.

 Thirty-eight subjects were assigned into two equal groups with and without SIJD. They started to walk from the place marked on a force plate for 10 seconds after hearing an auditory signal and performed three attempts for each foot. They repeated six more ones with PB. Raw data were imported to an excel software (version 2007) spreadsheet to calculate the reaction time (RT) and anticipatory postural adjustment (APA) as the components of PC.

 Our results showed a significant difference in RT between the SIJD-affected and non-affected sides (P = 0.035), but there was no significant difference in APA (P = 0.057). There were significant differences in RT and APAs between the control and SIJD-affected side groups (P = 0.001 and P = 0.010, respectively). The PB application showed a significant difference in RT and APAs of the SIJD-affected side (P = 0.001 and P = 0.047, respectively).

 It seems pain could lead to the postural sway into instability and change the motor control strategy. The proprioception signals from the neuromuscular system of SIJ improved after PB. Therefore, PB, as a feasible tool, can be recommended for PC improvement.

 Proprioceptive deficits are one of the most important challenges after anterior cruciate ligament reconstruction (ACLR).

 The current study aimed to investigate the effects of incorporating innovative land-based proprioceptive training into the conventional accelerated land-based rehabilitation protocol, as compared to the conventional accelerated land-based rehabilitation protocol alone, on knee function and joint position sense in male athletes after ACLR.

 Thirty male athletes with ACLR were randomly assigned to two rehabilitation groups. The conventional therapy (CT) group (n = 15) received conventional rehabilitation for six weeks, and the proprioception training (PT) group (n = 15) received the same conventional rehabilitation in addition to 12 sessions of innovative land-based proprioceptive training. Outcomes included joint position sense (JPS) errors, International Knee Documentation Committee (IKDC) form, and Visual Analog Scale (VAS).

 There were significant differences in absolute errors (AE) (FAE = 56.81, P < 0.001) and variable errors (VE) (FVE = 60.95, P < 0.001) between the two groups. No significant differences were found in constant error (CE), VAS, and IKDC score between the two groups (P > 0.05). Both groups showed significant changes in terms of AE, VE, VAS, and IKDC after the intervention (P < 0.05). Percent changes after the intervention for AE, VE, CE, VAS, and IKDC were greater in the PT group than in the CT group, which were 70.19%, 69.22%, 66.20%, 38.50%, and 39.61%, respectively.

 Innovative land-based proprioceptive training incorporated into the conventional accelerated rehabilitation protocol offers the improvement of proprioception efficiency for individuals with ACL reconstruction, and therefore, it could be useful for clinicians when designing rehabilitation protocols to ensure the optimal engagement of proprioception.

Voluntary Response Index (VRI) is used as a measure of motor control to study abnormalities of voluntary movements. This study aimed to evaluate the reliability of voluntary response index analysis in subjects with Anterior Cruciate Ligament Reconstruction (ACLR).

Using surface electromyography, the VRI components of both groups of 15 ACLR and 15 healthy controls were assessed during the functional task (sit-stand-sit). The outcome variables of VRI included the magnitude and similarity index.

In sit to stand phase, high reliability was found (ICC=0.80-0.89) for the magnitude and similarity index in both groups. In the standing phase, high to very high reliability was found for the magnitude and similarity index in both groups (ICC=0.75-0.91). In stand to sit phase, high to very high reliability was found (ICC=0.78-0.92) for the magnitude and similarity index in both groups.

Surface electromyographic measurements of VRI analysis demonstrated high to very high reliability in athletes with ACLR during the functional task (sit-stand-sit). The results of the current study showed that the VRI analysis in athletes after ACLR was a reliable method and can be used to evaluate motor control before and after ligament injury in these patients.

Kinesio taping (KT) is recently used as a therapeutic tool for the treatment of chronic low back pain (CLBP). However, the effectiveness of different types of lumbar KT is still unclear when not combing with other therapeutic methods. This review aimed to summarize the results of studies investigating the effect of various methods of lumbar KT alone on pain and functional disability in patients with CLBP.

A search was performed on the electronic databases PubMed, ProQuest, Science Direct, Thomson, OVID, Google Scholar, Scopus, MEDLINE, and PEDro, from 1990 to January 31, 2020, using the following keywords: Kinesiology Taping, Kinesio Taping, chronic low back pain. In total, seven studies met the inclusion criteria using three different methods of KT and corresponded to the aim of this review.

The methods consisted of I shape, Y shape, and star shape of KT. The studies suggested that all three KT methods can reduce pain and disability in CLBP patients. Based on the included studies, it seems that KT might reduce pain and disability.

Three methods of lumbar KT, including I shape, Y shape, and star shape, may reduce pain and disability in patients with CLBP, possibly by improving pain, circulation, muscle tone, and proprioception. However, owing to limited studies, they cannot be compared, and the best method is unclear, which should be investigated by future high-quality studies.

Ankle sprain is a common sports injury that can cause Functional Ankle Instability (FAI). Neurocognitive function impairment had been reported in subjects with musculoskeletal injuries. Consequently, information processing deficits might be associated with FAI. This study aimed to compare information processing speed and accuracy in athletes with and without FAI.

Eighteen control healthy male basketball players and 18 male basketball players with FAI voluntarily participated in the study. They were matched according to age, height, weight, duration of physical activity, and upper-limb dominance. The neurocognitive function of subjects was assessed with the computerized neurocognitive test. The computerized neurocognitive assessment is based on the presentation of ‘X’ on a computer monitor and includes detection (i.e. simple reaction time [SRT]) or identification (i.e. Choice Reaction Time [CRT]).

Significant differences were observed between study groups in the SRT, CRT, and the number of errors (P<0.001). Subjects in the control group had a shorter reaction time and fewer errors.

Athletes with FAI had significantly slower reaction times. FAI affects processing speed and accuracy, which may be modifiable through the performance of exercises designed to accelerate neurocognitive processing of visual input.

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.

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.

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).

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