Middle East Journal of Rehabilitation and Health Studies
Volume:7 Issue: 2, Apr 2020

Low back pain (LBP) is one of the most frequently occurring conditions, affecting many individuals worldwide. The best ways to manage LBP usually contradict the thoughts of the professionals, the patients, and the general public. No musculoskeletal pain is more burdened with serious misconceptions than LBP and the persistence of these misconceptions can impede the way treatment is being administered, which may also impair recovery and promote unnecessary suffering and disability. Given the myths about low back pain, there is the need to acknowledge some of its riddles particularly those pertaining to treatment and look for positive solutions. As professionals, each physiotherapist uses his or her own guiding principles and choices as evidence. However, our guiding principles and choices are important, but they usually bring partiality in decision making. It is essential to examine and identify our core values so that they do not subdue other sources of evidence

The current study aimed at investigating the effect of applied Kinesio tape on the affected ankle on the amount of exerting force by the non-affected foot in patients with chronic stroke during the stand to sit task.

The current quasi-experimental clinical trial was conducted on 26 patients with chronic stroke. The stand-to-sit task was performed in three positions (symmetric foot placement, and placing the unaffected foot ahead of the affected foot and the unaffected foot behind the affected one), and the vertical axis of the ground reaction force was recorded instantly by a force plate at three time points of 2, 5, and 8 seconds of the stand-to-sit task. Then, Appropriate taping was applied on subjects` affected ankles and all measurements were repeated.

At the time points of 2 and 5 seconds, the main effect of foot positions was significant (P = 0.002 and P < 0.0001, respectively); when the tested foot was placed behind, the main effect was significantly different from those of other positions (P = 0.018). However, the main and interactive effect of the tape was not significant (P > 0.05). At the second eight, no significant change was observed (P > 0.05).

The current study findings showed that placing the unaffected foot behind the affected one led to more force and there was no significant difference between the forces with and without using the tape

Given the high prevalence of the symptoms of mental disorders among prisoners, it was assumed that the semi-open prison system could be an appropriate way to decrease many damages caused by the prison environment.

This study aimed to compare the symptoms of mental disorders between two groups of prisoners in semi-open and closed prison systems in the central prison of Zahedan.

The current study was conducted from January to March 2015 in the Central Prison of Zahedan located in Southeastern Iran. This descriptive study used an ex post facto design, and the statistical method was Multivariate Analysis of Variance (MANOVA). The sample of the present study included 598 prisoners selected by applying the simple random sampling method (sortation). In this study, the symptom checklist (SCL-90) was used to collect the data. The obtained data were analyzed via SPSS23.

A total of 253 prisoners with semi-open prison sentences (29 ± 5-years-old) and 345 prisoners with closed prison sentences (31 ± 4-years-old) participated in this study. The results of MANOVA indicated that closed prisoners had higher mean scores on all symptoms of mental disorders (somatic complaints, obsession, interpersonal sensitivity, depression, anxiety, aggression, phobia, paranoid thoughts, and psychosis) than semi-open prisoners, indicating the prevalence of the symptoms of mental disorders among closed prisoners (F = 21.25, Wilks’ Lambda = 0.70, P < 0.001).

According to the results, there was a significant difference in the symptoms of mental disorders between the two groups of prisoners in semi-open and closed prison systems.

Vacillation between conventional healthcare professionals and traditional bone setters (TBS) for musculoskeletal (MSK) disorders is still common despite shortcomings and complications associated with TBS services.

This study assessed knowledge and attitude about the practice of TBS and its use for MSK disorders among Nigerian rural dwellers.

This cross-sectional study utilized a multistage sampling method based on the World Health Organization procedures for a community-based survey to recruit 398 (213 males and 185 females) respondents from two randomly selected rural communities. A validated questionnaire adapted from relevant previous studies was used as a tool in this study. A household was served as the Primary Sampling Unit (PSU) and 60 PSUs were randomly selected.

The lifetime and 12-month prevalence of MSK disorders were 27.6% and 25.6%, respectively. Based on 12-month prevalence, neck (16, 21.6%) and shoulder (12, 17.6%) were the most affected body parts. The lifetime (i.e. “ever use”) and point (“current use”) prevalence of treatment by TBS were 19.3% and 3.8%, respectively. Among those who had ever experienced MSK disorders, 13.3% had experienced only treatment by TBS services, whereas 6.0% had used both treatment by TBS and orthodox medicine. Common services received by TBS were massage (61.0%), splinting (14.3%), traction (11.7%), and scarification (10.4%). Cost-effectiveness (42.9%), distance/accessibility (35.1%), and cultural beliefs (15.9%) were the major reasons for TBS patronage. Using TBS services was not significantly associated with socio-demographic variables (P > 0.05). Also, 57.3% of the respondents acknowledged that TBS services were associated with complications, such as gangrene (19.7%), malunion/nonunion of fractures (36.0%), paralysis (19.3%), joint instability (7.5%), and chronic osteomyelitis (6.6%). Users of the TBS services believed that they were effective in maintaining a healthy life (40.7%), with fewer side effects (30.0%), more effective (11.7%), and healthier than orthodox medicine (23.1%).

There was a positive attitude towards treatment by TBS for MSK disorders, despite the complications and shortcomings that arise from the practice. Cost-effectiveness, socio-cultural beliefs, and easy access have increased patronage of treatment by TBS regardless of the socio-demographic characteristics of the people.

There are promising data that exercise training and dietary polyphenols intake may alter the tumor microenvironment to facilitate conventional treatment.

The purpose of this study was to investigate the effect of eight weeks of aerobic training (AT) and green tea extract (GTE) consumption on matrix metalloproteinases-2 and -9 (MMP-2/-9) and vascular endothelial growth factor (VEGF) in normal and prostate cancer tissue of rats.

Ninety Wistar rats were assigned to two healthy and cancer groups, then the healthy group was divided into four subgroups, including healthy control (Ctr), healthy AT (treadmill exercise for 5 days/week), healthy GTE (three times of week for eight weeks by gavage) and healthy AT + GTE, and after tumor induction, the cancer group was divided into five subgroups, including cancer control (CaCtr), cancer AT (CaAT), cancer GTE (CaGTE), cancer AT + GTE and sham groups.

The results showed that there was no significant difference between healthy and CaCtr groups in the MMP-2 levels (P = 0.07), but MMP-2 levels in the CaAT group were lower than the healthy AT (P = 0.01). No significant changes were found in the levels of MMP-9 and VEGF between the healthy and cancer groups (P = 0.23 and P = 0.08, respectively).

The present study demonstrated that low to moderate-intensity aerobic training and treatment with a low dose of green tea extract did not change angiogenesis and metastasis markers. These results pave the way for further researches on modulation approaches for tumor metastasis and vascularization in responses to exercise training and antioxidant supplementation

Although studies have shown that vitamin D deficiency in pregnancy is associated with gestational diabetes mellitus (GDM), the clinical evidence of the preventive role of high-dose vitamin D supplementation in pregnancy is in doubt.

The study aimed to evaluate the effect of vitamin D supplementation on the GDM occurrence.

In a randomized clinical trial conducted in Semnan, Iran, in 2014, we recruited 175 eligible pregnant women at 8 - 12 weeks with vitamin D deficiency and normal fasting blood sugar (FBS) and randomly divided them into intervention (n = 87) and control groups (n = 88). From the 14 to 16 weeks, both groups received the 400 IU/daily doses of vitamin D. The intervention group received an additional 50,000 IU every two weeks for six weeks. In the 24 - 26 weeks, we measured FBS, serum vitamin D level, and oral glucose tolerance (75 g).

The baseline levels of serum vitamin D (mean ± SD) were 15.38 ± 7.69 and 14.00 ± 8.81 (P = 0.728) in the intervention and control groups, respectively. There was no difference between the two groups in severe vitamin D deficiency (27.6% vs. 30.7%, P = 0.652). After the intervention, the serum vitamin D level was significantly different between the two groups (16.63 ± 6.77 vs. 66.96 ± 21.13, P < 0.001). However, it did not reach the toxic serum level in any of the participants. The level of vitamin D in 85 (97.7%) and 0 (0.0%) participants reached the normal range; there were 0 (0.0%) and 16 (18.8%) cases of severe deficiency in the groups. Twelve women (13.6%) in control and eight (9.2%) in intervention groups developed GDM (P = 0.356).

A high dose of vitamin D supplementation at 14th - 16th weeks of pregnancy could improve vitamin D deficiency effectively and safely. Despite the decreased incidence of GDM, there was no significant evidence of its preventive role.

Complex regional pain syndrome (CRPS) is a frequent and devastating complication that occurs after trauma and immobilization and is very frequent after wrist fractures (1% - 37%) and after volar locking plate fixation (3% - 10%). The development of CRPS considerably lengthens the time of recovery after a traumatic injury, causing a great impact on work, social activities and psychological well-being.

To demonstrate the efficacy of physical therapy and TIOBEC® (a combination of α-lipoic acid and vitamin B, C, and E) in terms of pain amelioration and edema reduction in the management of CRPS in a small series of patients.

Prospective before-and-after study. The protocol of treatment included physical therapy (electromagnetic fields applied to the symptomatic limb [20 Hz-50 Gauss-20 min] followed by manual therapy [assisted, active and resisted mobilization plus manual drainage]) plus oral medication (TIOBEC® 400 mg) prescribed twice a day. Components of TIOBEC® included α-lipoic acid (800 mg), vitamin C (60 mg), niacin (36 mg), vitamin E (10 mg), vitamin B1 (25 mg), vitamin B2 (25 mg), vitamin B6 (9.5 mg), vitamin B12 (25 µg) and folic acid (400 µg). Outcome measures included VAS (visual analog scale) pain scale, reduction of edema at the metacarpal phalangeal joint (hand/foot) and functional evaluation (by Kapandji score) before-and-after treatment. Outcome measures were evaluated at baseline and at mid-term (4 months follow-up period).

Five patients (mean [SD] age: 61 [7.9]) who had been diagnosed clinically by neurophysiological sympathetic skin-response, gammagraphy, and radiography were recruited in the study. Mean electrotherapy and manual therapy sessions were 40 ± 27.83. Mean oral medication (TIOBEC®) was 84 ± 13.41 days. Physical therapy and TIOBEC® decreased pain from 6.6 ± 0.54 to 2.8 ± 1.3 (P = 0.001), decreased edema from 12 ± 5.7 mm to 4 ± 4.18 mm (P = 0.035) and improved functional Kapandji score from 6.2 ± 2.77 to 9.4 ± 1.34 (P = 0.029). Neither of the patients stopped oral medication nor reported adverse events.

The protocol that includes the electromagnetic field, manual therapy, and TIOBEC® may be safely used in patients with CRPS in an attempt to ameliorate pain, to reduce edema and to improve function. In light of the results of this study, the protocol used might accelerate recovery time. More studies are needed to corroborate the present results observed in this pilot study.

Lipoma is a benign neoplasm of the fat tissue. Although, lipoma represents as the most common soft tissue neoplasm, lipomas of the oral cavity are very rare. This neoplasm contains 0.1 - 0.5% of all benign tumors of the oral cavity.

We reported two cases of fibrolipomas; the first case was in a 36-year-old female as a swelling in retromolar pad area and the second one in a 71-year-old female as an exophytic mass in pterygomandibular raphe.

The novelty of these reported cases of fibrolipomas is that they have been occurred in infrequent area such as retro molar pad area and pterygo mandibular raphe. The lesions were removed by electro cutter with no recurrence at the follow up sessions. Although fibrolipoma is pretty rare in the oral cavity, there are several lesions can also have similar clinical features. Therefore, the histopathological examination is recommended for the clinicians in order to accomplish the final diagnosis

Piriformis syndrome (PS) is one of the most commonly misdiagnosed neuromuscular conditions characterized by buttock pain which radiates down the ipsilateral lower extremity. This case report describes the use of integrated neuromuscular inhibition technique (INIT) in the management of a patient with piriformis syndrome (PS).

A 40-year-old man presented with a complaint of right buttock pain which radiated to the ipsilateral lower limb. The patient was diagnosed as having PS. The treatment of the patient included INIT followed by stretching exercises for 6-weeks. Outcome measurements included visual analogue scale (VAS), Rolland-Morris disability questionnaire (RMDQ), Sciatica bothersome index (SBI), Sciatica frequency index (SFI), and global rating of change scale (GROC) and were assessed at baseline (T0), at 3 (T1) and 6-weeks (T2) of intervention, and then at 12-weeks (T3) follow-up.

At 12-weeks follow-up (T3), the outcomes indicated improvement in all symptoms (VAS = 0, RMDQ = 0, SBI = 0, SFI = 0, and GROC = +7). Integrated neuromuscular inhibition technique is effective in the management of a patient with piriformis syndrome.

In the current study, we report a patient of crossed aphasia in dextrals (CAD) that presented with aphasia and typical neuropsychological deficits following right hemisphere brain damage. To the best of the authors’ knowledge, it is the first Persian language patient of CAD reported internationally.

The patient was a 59-year-old right-handed female with no history of left-handedness or ambidexterity in her family. Right handedness was measured in the current patient by the Edinburgh right-handedness inventory. Speech and language functions were measured by the Persian Western-Aphasia Battery (P-WAB) and the Bilingual Aphasia test (BAT). Also, the bedside version of Persian WAB (P-WAB-1) was used. Hemianopia/neglect was investigated by line bisection, painting, and cancellation tasks that confirmed left visuospatial neglect. Telegraphic speech was her dominant output feature. She had a problem with sentence construction; also, her morphological derivation skills were impaired. The syntactic structures of utterances were very simple. In writing tasks, her sample was unintelligible semantically. The auditory comprehension of the patient was impaired at the level of semi-complex and complex commands. It should be mentioned that difficulty in topic maintenance was observed in storytelling. Left visuospatial neglect was confirmed in the patient by assessments. The results confirmed the presence of neglect and language disorder, typologically consistent with Broca’s aphasia.

The current study patient represented the typical symptoms of language dominant left hemisphere damage and a range of deficits indicating right hemisphere pathology. Analysis of patient symptoms confirmed the right hemisphere language dominance.