function

Biofeedback therapy is widely used as a treatment method for rehabilitating stroke patients. This study examines the effects of long-term hand biofeedback therapy on the upper limb function and quality of life of elderly people who have had a stroke. 

A total of 40 stroke patients were divided into a control group and an electromyography biofeedback training group. After two years of treatment, evaluations were performed to assess the impact of electromyography biofeedback training on upper limb function and quality of life for both groups. 

The results indicated that after two years of hand biofeedback, only the quality of life improved, while the function of the upper limb did not show significant changes (P≤0.05). 

Long-term use of the biofeedback exercise method in stroke patients primarily impacts their quality of life rather than significantly affecting the function of their upper limbs.

 High-intensity laser therapy (HILT) and low-level laser therapy (LLLT) combined with exercise therapy (ET) have emerged as effective treatment options for musculoskeletal pain. However, there have remained uncertainties regarding the magnitude of their effects in reducing pain and improving function in patients with knee osteoarthritis. Hence, we performed a systematic review and network meta-analysis of available evidence in the literature to answer this query.

 A literature search was carried out in Embase, PubMed, and Scopus databases without any language restrictions from 1 January 1990 to 31 December 2023. We examined randomized controlled trial (RCT) studies that investigated the efficiency of HILT or LLLT plus knee osteoarthritis ET in pain and functional improvement of the knee. We performed a network meta-analysis and provided the standardized mean difference (SMD) with a 95% confidence interval (CI) by pooling the continuous data on the visual analogue scale (VAS) pain score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score using a random-effects model.

 In total, 11 eligible RCTs were included. Our analysis revealed significant improvements in the VAS pain and WOMAC function scores on weeks 4 and 8 after interventions in groups treated with LLLT+ET and HILT+ET compared with placebo+ET. Moreover, HILT+ET showed a greater reduction in the VAS pain score (SMD=-1.41; 95% CI: -2.05 to -0.76) and improvement in the WOMAC function score (SMD=-2.20; 95% CI: -3.21 to -1.19) than LLLT+ET in week 8.

 Based on our findings, both HILT+ET and LLLT+ET treatments effectively reduced pain and improved function, but HILT+ET showed a more significant improvement in both outcomes compared to LLLT+ET.

Considering the important and sensitive position of Emergency Operations Centers (EOC) and little scientific research has been done on the subject, the purpose of this comparative study is to identify the structural and functional requirements of EOCs.

In this comparative research, structural and functional requirements and considerations of modern EOCs were extracted to facilitate the process of managing operations and responding to disasters by studying the guidelines and standards for the design and construction of modern EOCs, as well as examining the experiences of different countries in using and operating these centers.

By reviewing the studies, these components were extracted as the important structural and functional requirements of these centers including: common hazards in the region, the purpose of creating an EOC, the flexibility and multi-purpose nature of the EOC, audio and visual features of the operation control room, the number of administrative and operational positions, ergonomics and allocated space, required and technologies, the existence of a space for holding group meetings as well as people's rest, the amount of allocated budget and also the conditions of people's access to modern EOC.

Based on the findings, assessing the risks in the region and developing different possible scenarios, along with paying attention to the structural and functional requirements of modern EOCs based on the obtained criteria, can improve the disaster management process.

We aimed to examine how electroacupuncture and manual acupuncture affect treatment results, pain levels, and joint function in individuals with knee osteoarthritis.

Research was carried out in various databases including PubMed, Medline, Embase, CENTRAL, and CNKI. Following the "Cochrane manual", the risk of bias of included RCTs was assessed. A funnel plot was utilized to evaluate any potential bias in the publications. The impact size was indicated by the average discrepancy along with its 95% confidence interval.

The EA group showed a higher effectiveness rate (P = 0.001) and a lower WOMAC pain score (P < 0.00001) compared to the control group. The EA group had a lower WOMAC pain score compared to the SA/exercise group and the group that received manual acupuncture. The WOMAC pain score was significantly lower in the EA group compared to the manual acupuncture group under intense electroacupuncture stimulation (P < 0.0001). The WOMAC pain score was significantly lower in the EA group compared to the manual acupuncture group when weak current acupuncture was applied (P = 0.0001). However, no significant difference in WOMAC function score between EA and control group.

Comparison to manual acupuncture, placebo acupuncture, and exercise training, electroacupuncture enhanced the effectiveness of treating KOA and decreased the WOMAC pain score in patients with KOA. The level of pain relief achieved may be linked to the strength of the current stimulation. However, electroacupuncture had no significant effect on WOMAC function score.

Knee osteoarthritis often causes disability due to the pain it causes and affects a person's quality of life.The purpose of this study is to investigate the effect of ankle-foot-orthosis with and without lateral wedge on pain, function and displacement of the center of pressure in patients with the medial compartment knee osteoarthritis.

The research method was quasi-experimental with a pre-test and post-test design. This study was conducted on  patients with medial compartment knee osteoarthritis in the age range of  to  years as available sampling. Demographic information and Womac questionnaire were completed and the displacement of the center of pressure in the internal-external plane was recorded by the Kistler force plate device, in three situations: bare feet, ankle-foot orthosis with lateral wedge and ankle-foot orthosis without lateral wedge. The obtained data were analyzed using SPSS software. Shapiro-Wilk test was used to check the conformity of distribution of quantitative variables with normal distribution. According to the normality (p>0.05), variance analysis tests, multiple comparisons and generalized linear models were used for data analysis.

 patients participating in this study were examined in three situations, and the pain of the patients in the state of using the orthosis with the lateral wedge was significantly reduced (p=), the function of the patients was better in the state of using the orthosis with the lateral wedge. (p=), but the displacement of the center of pressure in the case of using the orthosis without wedge had a significant decrease (p=).

the use of an orthosis with an lateral wedge was effective in improving pain and function, but the use of an orthosis without an wedge led to a reduction in the displacement of the center of pressure in the internal-external plane. Therefore, it will probably reduce the knee adduction moment.

Amyotrophic lateral sclerosis (ALS) is an adult-onset motor neuron disease with a poor prognosis that leads to limb and or bulbar muscle degeneration. Several demographic and biological factors have prognostic importance, but little data exist on the relationship between clinical, electrodiagnostic, and laboratory markers as predictors of disease progression. We aimed to assess the relationships between different aspects of ALS patients’ clinical, electrodiagnostic, and laboratory features and their level of functioning. 

We included 27 ALS patients diagnosed within the last two years. A neurology resident conducted clinical assessment and electrodiagnostic studies. The motor unit number index (MUNIX) and compound motor action potential (CMAP) were used to measure motor unit loss. Serum creatinine, urea, albumin, and creatine kinase were measured as laboratory markers. We used the Persian version of the ALS functional rating scale (ALS-FRS) as the main outcome measure. The Pearson correlation coefficient was calculated to assess the correlations using the SPSS software, version 16.

None of the demographic or laboratory parameters were correlated with ALS-FRS. Patients with the onset of disease in the limbs had a higher MUNIX score than those with bulbar onset. Also, increased body mass index (BMI) was associated with lower CMAP and MUNIX scores (P=0.02). Higher serum creatinine levels were significantly associated with higher lower limb MUNIX (P=0.04). Higher lower limb MUNIX was associated with a higher lower limb functional score. 

Decreased serum creatinine may indicate lower limb motor unit loss in patients with ALS. Also, MUNIX scores may be used as substitutes for ALS-FRS in ALS trials. Further research is needed to elucidate the clinical application of these findings.

This study aims to determine the relationship between pain, muscle strength, function, and quality of life (QoL) in overhead players with chronic shoulder internal impingement syndrome.

Forty-seven overhead players consisting of 15 men, 32 and women (mean age 32.45±7.2) with chronic shoulder internal impingement were enrolled. The pain was measured by a visual analogue scale (VAS). Disabilities of the arm, shoulder, and hand (DASH) and shoulder pain and disability index (SPADI) questionnaires were used to measure pain and function, and a short form (SF)-36 questionnaire to measure QoL. Muscle strengths were evaluated in both hands with a hand-held dynamometer and players were asked to hold the maximal voluntary isometric contraction (MVIC) in the middle range for 3 s and rest for 30 s between each test and each contraction was repeated three times on both affected and healthy side and the average of contractions was considered for each side. 

The study showed a significant relationship between pain, the strength of shoulder muscle groups (-0.354), function (-0.935), and QoL (-0.861) in overhead throwers with chronic shoulder internal impingement syndrome and the strength of internal rotators of the affected shoulder decreased more than others. (P<0.05)

This correlational study showed a significant relationship between pain and strength of shoulder muscles and function and QoL in overhead throwers with this syndrome.

Pes anserine bursitis (PAB) is a painful status inside the knee that may interfere with functional activities. Extracorporeal shockwave therapy (ESWƬ) may treat this disorder.

Comparing the effects of low- versus middle-energy ESWƬ on pain and functional activity in patients with sub-acute PAB.

Materials and Methods :

The study was a single-blind randomized trial. Twenty-eight patients with sub-acute PAB were randomly divided into two groups and received either low or middle-energy ESWƬ for three weeks. The numeric pain rating scale (NPRS), short-form McGill pain questionnaire (SF-MPQ), timed up and go (TUG) test, and Western Ontario and McMaster universities index (WOMAC) were evaluated before and 2 and 3 weeks after the intervention.

A significant improvement was observed for low-energy ESWT in terms of NPRS (P=0.001), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. Also, a significant improvement was observed following middle-energy ESWT application on NPRS (P=0.003), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. A similar trend was observed between study time points and for all variables in each group. The only exception was the TUG, which showed no improvement between 2 and 3 weeks after the intervention for each study group. A significant improvement was observed in the NPRS between the two groups after 2 weeks (P=0.001) and 3 weeks (P=0.006), both favoring the middle-energy ESWT application.

Low- and middle-energy ESWT can effectively improve pain, functional activity, and mobility in patients with PAB.

Context:

 A methodical review and meta-analysis of cognitive intervention studies were conducted to clarify the effect of such interventions on memory.

The present study aimed to investigate the effects of cognitive training on the improvement of cognitive function in older adults. Evidence Acquisition: The programs for improving cognitive performance, along with characteristics, among older adults were assessed by considering a literature review of previous studies. A total of 174 articles published between 1990 to 2017 in the area under study were selected. Each article was reviewed by two independent reviewers. In this study, 15 studies and 910 subjects were selected for data analysis, and the meta-analysis was performed according to the Hedge method.

Based on the results, a positive effect size of 0.30 (SE = 0.07, 95% confidence interval [CI] = 0.165 - 0.436) was observed regarding the subjects’ cognitive function stemming from the interventions on individual and group cognitive-related therapies. The results were consistent, indicating that variances in effect size might be related to sampling error (Q = 88.592, df = 14, P = 0.000).

The results confirm previous meta-analyses and methodical reviews showing that memory training plays a positive role in enhancing cognitive function.

This study was conducted to investigate the effect of 6 weeks of core stability exercises in the trunk area on lower limb alignment and lower and upper limb function in Kyokushin athletes. 

The statistical sample of the research included 30 female Kyokushin players aged 14-18 years, who were randomly divided into two experimental and control groups. The control group performed common Kyokushin exercises and the experimental group performed core stability exercises for 6 weeks. Analysis of covariance (ANCOVA) and paired t-tests were used to compare between groups and within groups. 

The results of the paired t-test showed a significant effect of training programs on changes in upper and lower limb function in both experimental and control groups (P≤0.05); however, a significant difference was observed between the pre-test and post-test in both control and experimental group. The test was not observed in the Q angle (P>0.05). The results of ANCOVA test showed that after controlling the effect of the pre-test, a significant difference was observed in lateral jump (P≤0.05) between the experimental and control groups. However, no difference was observed between the two groups in the changes of closed kinetic chain upper extremity stability test (CKCUEST), square jump, and Q angle (P>0.05).

Considering the nature of Kyokushin and the research results, it is suggested that people working in Kyokushin do not feel the need for core stability exercises separately.

High prevalence of knee osteoarthritis (OA) in Iran and the subsequent disability have resulted in representing multifarious non-aggressive interventions with distinct influences on the disease. The aim of this study was to review previous domestic studies about the effects of conservative therapeutic options on patients with knee OA.

Using search engines involving IranMedex, MedLib, ISC, Google Scholar, Magiran, SID, rehabilitation, and medical journals based on defined keywords, 98 Persian language articles were found, and 37 studies were finally included in our study after applying the exclusion criteria. The type of study, the pattern of choosing subjects, patient information, the measurements, interventions, and the results were exploited from each article, and the physiotherapy evidence database (PEDro) scale was administrated to evaluate the studies.

Based on analysis of PEDro scale results (Mean±SD for articles score: 5.89±1.29), the quality of most articles was as fair and good. The focus of conservative treatments was on exercise therapy methods, assistive devices, and physical therapy management. From a clinical perspective, the evidence indicates the appropriate effects of such treatment choices on alleviating pain, enhancing function, and improving quality of life in individuals with knee OA.

Most conservative methods can reduce pain, and improve quality of life and physical performance in patients with knee OA. However, further high-quality studies with larger sample sizes and long-term follow-ups are required to determine whether knee OA can be managed by conservative methods.

 Angiotensin-converting enzyme 2 (ACE2) is a receptor for SARS-CoV-2, expressed in many organs’ cells, including the thyroid gland. Therefore, COVID-19 may influence thyroid gland function.

 In this article, we aimed to investigate the thyroid gland function in COVID-19 patients and compare them to healthy society to indicate whether thyroid hormones level differ in the disease or not.

 This is a single-center retrospective case-control, cross-sectional study on 191 COVID-19 patients and 179 non-COVID-19 individuals as the control group. The status of the thyroid hormones was determined in COVID-19 patients and then compared with the control group. Patients in the case group were divided into 2 groups with and without normal thyroid function and were compared with each other in different aspects of COVID-19. Also, we compared thyroid hormone levels in the patient group with different underlying diseases to show the status of thyroid function in COVID-19 infection.

 Of the 191 COVID-19 patients, 98 (51.3%) were male, and the mean age of patients was 64 ± 15 years. The thyrotropin level was lower in the patient group than in the control group (1.34 ± 1.29 vs. 2.21 ± 1.99; P < 0.001). The T3 status was meaningfully associated with the level of SpO2 (P < 0.05; r = -0.258). The results demonstrated that thyrotropin (P = 0.653), T3 (P = 0.404), and T4 (P = 0.147) levels were not different in expired and discharged patients. The 2 groups of patients with and without normal thyrotropin levels did not appear significantly different in any aspect of the disease.

 Thyrotropin level was lower in COVID-19 patients, and the T3 level can predict the SpO2 level. The thyroid gland may be theoretically affected by SARS-CoV-2 infection.