فصلنامه طب توانبخشی
سال نهم شماره 4 (زمستان 1399)

Sensory processing represents a significant factor in influencing behavioral responses. The purpose of the present study was to compare sensory processing in patients with autism and specific learning disorder and typical people.

The research method was descriptive-causal-comparative. The study population consisted of 30 children with autism spectrum disorder, 30 children with learning disorder, and 30 typical individuals, who were selected using targeted sampling. Sensory processing of information was assessed using a questionnaire of the child's sensory profile 2. Multivariate Analysis of Variance (MANOVA) was used to analyze the data.

The findings showed that individuals with autism had a significant difference in all sensory processing components of the sensory profile 2, except for the two components of tactile and body position compared with those of the normal individuals (P <0.05) and individuals with learning disorder had a significant difference with normal individuals in auditory and visual components of the sensory profile (p < 0/05).

Since the present study shows that there is a difference between several sensory processing components in children with autism and learning disorder and those in typical people, and these variations can cause a wide range of problems in children with autism spectrum disorder and specific learning disorder, it seems necessary to support children in considering proper sensory diet and taking measures to resolve their sensory problems and thus improve their sleep patterns. Besides, it is suggested that therapists should implement this test in other groups of vulnerable populations like developmental delay, attention deficit hyperactivity disorder, infertility, and Down syndrome.

Muscle injury during and after the competition affects the athletes’ performance. The purpose of the present study was to investigate the effect of a fencing tournament on the levels of muscle damage markers in fencer females.

In a semi-experimental research, 20 fencer females (mean age: 21.59 ± 4.03 years, body mass index 20.79 ± 3.13 kg.m-2, and mean VO2max 41.01 ± 4.98 ml.kg-1.min1) were selected purposefully and randomly divided into experimental and control groups. The experimental group competed fencing periodically and single-off. Blood samples were obtained before, immediately after, 24, and 48 hours after the tournament.  

The results showed that the differences in CK levels were significant before and immediately after, before and 24 hours after, before and 48 hours later, immediately after and 24 hours later, and 24 hours and 48  hours after the tournament (p < 0.05). The differences between CK levels immediately after and 48 hours after the tournament were not significant (p>0.05). Differences in the levels of LDH before and immediately after, immediately after and 24 hours later, and immediately after and 48 hours after the tournament were significant (p < 0.05), but before, 24 hours and 48 hours after the tournament, and 24 hours later and 48 hours after it (p> 0.05) were not significant.

The findings showed that a tournament can also lead to muscle damage in experienced fencers. Coaches and fencers can simulate the time and intensity of competitions in their workouts in order to be more adaptable to the muscles and reduce muscle injury.

Muscle imbalances in the upper quadrant of children occur due to improper physical posture for long periods of time in the school environment and misbehavior. This muscle imbalance can cause upper crossover syndrome. The purpose of the present study was to investigate the effect of corrective functional exercise and corrective games on upper crossover syndrome in boys aged 10-13 years.

A semi-experimental study was conducted on 36 male students, aged 10-13 years, with upper cross syndrome, purposefully selected and randomly divided into three groups of functional corrective exercises (age: 11/50 ±1/16 years, height: 147±7/54 cm, weight: 38/67± 6/97 kg), corrective games (age: 11/33± 1/07 years, height: 144±6/86, weight: 36/75± 6/98 kg), and control group (age: 11.66± 1/07 years, height: 148/5± 6/48 cm, weight: 40/08± 5/64 kg). The first group performed functional corrective exercises for eight weeks and the second group performed corrective games during the same period. The control group was involved only in their daily activities. Before and after exercise intervention, the Forward head and Round shoulder were measured using lateral view photography. Also, a flexible ruler was used to measure the amount of kyphosis. To analyze the data, ANCOVA at the significant level of P≤0.05 was used.

The results showed a significant difference in forward head angles (F = 108/269, P = 0/001), round shoulder (F = 89/774, P = 0/001), and kyphosis (F = 94/026, P = 0/001) in the two groups of  functional corrective exercises and corrective games (P≤0/05). Also, there was a significant difference between functional corrective exercises and corrective games on the effect of forward head and kyphosis (P = 0/01) so that corrective games had more favorable effect. But no significant difference was found in round shoulder malformations (P = 0/239)

According to the results of the present study, to prevent and to correct upper cross cyndrome in children, functional corrective exercises and corrective games can be used. According to the favorable impact of corrective games and more consistency of these programs with physical and psychological characteristics of children, it is suggested that use of corrective games be prioritized for this age period.

The purpose of the present study was to investigate the effectiveness of early education based on Quinn project on cognitive, verbal, and social-emotional learning in children with borderline intelligence performance.

The present semi-experimental with pretest-posttest design and follow-up with control group study was performed on 30 pre-school students with borderline IQ in Isfahan selected via convenience sampling who were randomly assigned to experimental and control groups. Research tools included the International Lighter Performance Scale and Wechsler Intelligence Scale for Preschool Children together with evaluation of socio-emotional learning. Early training based on the Quinn project was administered to the experimental group for eight sessions. Data were analyzed using repeated measure ANOVA.

Based on the findings, it can be stated that the main effects of group membership (early intervention based on Quinn project vs. no intervention) in groups showed significant differences in the scores of cognitive, verbal, and socio-emotional learning scores (P <0.05).

According to the results of the current study, it can be concluded that early education based on Quinn project increases the scores of cognitive, verbal, and socio-emotional learning scores of children with borderline IQ.

Recently, the effects of modern rehabilitation equipment, especially virtual balance practice, has attracted the attention of clinical researchers. The purpose of the current study was to investigate the effect of virtual balance practice on the dynamic and static balance of athletes after knee joints reconstruction of the anterior cruciate ligament.

In the present clinical trial study, 30 patients were selected purposefully and randomly divided into two groups of control (n=15) and experimental (n=15). The experimental group performed rehabilitation practice prescribed by sports medicine specialists and virtual balance practice for 15 weeks, and the control group performed only equilibrium rehabilitation during this period. Before and after the interventions, the static balance and dynamic balance were evaluated using a Stabilometery device and Star Scursion Balance Test (SSBT), respectively. Data were analyzed using SPSS, version 22, running paired and independent sample t-test at a significance level of P=0.05.

Comparison of static and dynamic balance indices that both groups had a significant statistical difference between pre-test and post-test in static (total COP sways, mediolateral COP sways, Anterio posterior Sways) and dynamic balance tests (p < 0.05). Moreover, pre-test to post-test mean differences for static balance values had significantly decreased (p < 0.01), but it increased for the dynamic balance (p < 0.01) compared with the control group.

According to the results, virtual balance exercises can be used as a challenging exercise that involves various stresses on several laps on ligation, musculoskeletal structures around the joints, and improves the balance and reduces knee ligament injuries, especially the anterior cruciate ligament.

The visible changes in the scapular position and motion are called scapular dyskinesis. Drawing a high poundage archery bow increases tissue pressure in the shoulder joints of archers, causing pain and decreasing performance and proprioception in the shoulder joint. The aim of the present study was to determine the effect of eight weeks of scapular stabilization exercises on the performance and shoulder proprioception of archers with scapular dyskinesis.

A total of 30 archers with SD and shoulder pain were selected and then randomly divided into two experimental and control groups (15 in each group). Proprioception assessment and performance were measured in all samples. Then, the experimental group performed scapular stabilization exercises (i.e. scapular retraction, push-up with plus, etc.) for eight weeks, three sessions per week and 40 minutes per session. The control group performed no exercise. At the end of the training, post-test was run for both groups. The covariance test was used to compare the differences between the research variables in the control and experimental groups.

The results of the current study showed that scapular stabilization exercises improved performance and proprioception of shoulder joint with scapular dyskinesis (p < 0/05) in both intra-group and inter-group comparisons. But in the intergroup comparison, the exercises did not show a significant effect on proprioception of shoulder joint without scapular dyskinesis (P˃0.05).

According to the results of the present study, scapular stabilization exercises can be used to improve performance and proprioception in the shoulder joint of archers with scapular dyskinesis.

Sensory problems can affect the functioning of individuals in a variety of daily activities in different aspects. One of these aspects of daily activity is the quality and quantity of sleep. Sensory processing is perhaps the most basic psychological element that determines how individuals perceive and respond to environmental stimuli. Given this, the present study aimed to investigate the effect of sensory processing disorder on students' sleep quality.

The current descriptive cross-sectional study was conducted on 184 students of the School of Rehabilitation at Shahid Beheshti and Iran Universities of Medical Sciences. Two Pittsburgh Sleep Quality Questionnaires and Adolescent-Adult Sensory profile were used for data collection. Data were analyzed using SPSS 18.

The results of data analysis showed that 49.1% of the students had undesirable sleep quality and most of the students had sensory processing disorder of sensory seeking type. The results showed a significant relationship between sleep quality and the three variables of low registering, sensory sensitivity, and sensory avoidance (P-values: 0/017, 0/003, 0/02, respectively).

The findings of the present study emphasized that students with poor sleep quality had sensory processing disorder and their sleep quality reduced. Also, there was a significant relationship between low registering, sensory sensitivity, and sensory avoidance with sleep quality. Therefore, it seems necessary to support students in considering proper sensory diet and taking measures to resolve their sensory problems and thus improve their sleep patterns.

Visually impaired compared to sighted youths experience more perceived stress and less social adjustment. Therefore, the purpose of the present study was to investigate the effectiveness of acceptance and commitment therapy (ACT) on reducing perceived stress and enhancing the social adjustment of youths with visual impairment.

The statistical population of the present study included all youth with blindness and severe visual impairment aged 20-35 in Isfahan having a dossier in the Welfare Organization of Isfahan county and blind associations. Among these people, 40 with visual impairment were selected using convenient sampling method and then randomly assigned to experimental and control groups. The research instruments included Cohen’s Perceived Stress Questionnaire (1983) and the California Social Adjustment Questionnaire (1939). The data were analyzed running repeated measure ANOVA using SPSS, version 24.

We found that in the post-test phase, compared to the control group, Acceptance and Commitment Therapy group had lower scores in perceived stress and higher scores in social adjustment (p < 0.01) and this pattern maintained one month after treatment (p < 0/05).

Therefore, it seems that ACT is a promising treatment for reducing perceived stress and enhancing the social adjustment of youths with visual impairment.

Acceptance and Commitment Therapy is one of the third generation behavioral therapies in the treatment of childhood and adolescent disorders that has recently received much attention. However, its effectiveness, especially among adolescents with Attention Deficit Hyperactivity Disorder (ADHD), with problems such as procrastination, swings and depression, has not been much noticed. The aim of present study was to investigate effectiveness of acceptance and commitment therapy on academic procrastination, resilience, and depression in students withADHD.

To this aim, in a pretest-posttest with control group quasi-experimental study, 28 students were selected purposively and randomly divided into experiment or control groups (13 in ACT group and 15 in control group). Conners rating scale, Beck Depression Inventory (BDI-II, Beck, 1996), Solomon students and academic procrastination version Roth Bloom (1984 ), and Conner- Davidson Resilience scale (CD-RISC, Beck,1996) were completed before interventions by all participants and then participants of experiment group individually received a 10-session ACT intervention, while control group received no intervention. After completing the intervention, once more, the instruments were administered.

The results of Covaraince analysis showed that in the three variables of academic procrastination, resilience, and depression, after controlling the covariate variable (pre-test scores) there were significant differences among the two groups (depression: f=14/81; p < 0/001; resilience: f=9/84; p < 0/001; academic procrastination: f=15/15; p < 0/001).

According to the results, ACT is an effective and promising intervention on academic procrastination, resilience, and depression in students with Attention Deficit Hyperactivity Disorder(ADHD)

Deficits in executive functions, such as behavioral adjustment skills (inhibition, attention transfer, emotion control) and metacognitive skills (planning, organizing materials, monitoring, working memory, initiation) and weak reading, writing, and maths, are common symptoms in learning disabilities. The purpose of the present study was to investigate the effect of Transcranial Direct Current Stimulation (TDCS) on executive functions of children with learning disabilities in Yazd province.

A semi-experimental with pre-test, post-test, and control group study was conducted. The statistical population included all students with learning disabilities in Yazd province during 2018-2019. A total of 30 students were selected as the sample group using the Purposeful sampling method.  We randomly divided the participants into two control and experimental groups (n = 15 each). The research tool was the executive functions questionnaire of Bariff (Gerard et al., 2000). The experimental group was exposed to 1.5 milliamperes direct and weak current by inserting the anode electrode 5 x 5 cm in the left posterior forehead area (FZ) and also exposed to 1 milliampere current by inserting the cathode 5 x 7 cm on the right forearm, for 10 sessions, each session lasting for 20 minutes. Data were analyzed using one-way analysis of covariance (ANCOVA) and multivariate covariance analysis (Mankova) as well as independent t-test.

The results showed that Transcranial Direct Current Stimulation (TDCS) has been effective in both behavioral regulation skills (inhibition, attention transfer, emotion control) and metacognitive skills (planning, organizing materials, monitoring, working memory, initiation).

According to the results, Transcranial Direct Current Stimulation (TDCS) seems effective in improving the executive functions of children with learning disabilities as well as their behavioral and cognitive skills.

The present study aimed to investigate the effect of kinesio taping with neuromuscular exercises on the balance, performance, and pain intensity of volleyball players with chronic ankle instability.

The research population included all female volleyball players within the age range of 18 to 28 years old in Tehran. Totally, 30 participants with chronic ankle instability were selected using convenience sampling based on research criteria and were randomly divided into two groups of 15 (experimental and control groups). Next, as the pretest, participants’ data on static and dynamic balance, three single leg jumps performance, excursion balance, lateral jump performance, and pain intensity was evaluated using relevant standard questionnaire and tests. The experimental group received eight weeks of kinesio taping with selective neuromuscular exercises, while the control group did not receive any specific exercise. At the end of intervention period, post-tests were administered and the data were analyzed using statistical tests, including Shapiro-Wilk Test and the analysis of MANCOVA in SPSS,  version 21, at the significance level of α=0.05.

The results of the present study showed that eight weeks of kinesio taping with neuromuscular exercises have positively significant effects on the variables including lateral jump performance, three single leg jumps performance, pain intensity, and the static and dynamic balance of volleyball players with chronic ankle instability (P=0.001).

It is recommended that athletes with the same disorder, and especially volleyball players with chronic ankle instability, use kinesio taping with neuromuscular exercises in the training period during exercises, in championships and in their health and rehabilitation protocols.

Patellofemoral Pain Syndrome (PFPS) is the most common overuse syndrome in athletes. It seems that individuals with PFPS have some impairments in knee joint proprioception. Patellar taping and neoprene knee sleeve are two common nonoperative methods for the treatment of this syndrome. However, the effectiveness of these interventions on proprioception is doubtful. The purpose of the current study was to investigate the effects of patellar taping and patella stabilizer neoprene knee sleeve on position sense in active men with patellofemoral pain syndrome.

A total of 18 active men with PFPS (age 23.55±0.41 years) were examined for their knee position sense using an electro goniometer. Absolute error of active angular reconstruction was calculated for 30°, 45°, and 60°. The data was analyzed running ANOVA repeated measure and bonferoni post hoc tests (α=0.05).

The results showed that in 30° knee flexion in both of neoprene knee sleeve and patellar taping cause significant improvement in position sense; however, in 45° and 60° flexions, only the neoprene knee sleeve cause significant improvement in knee position sense (p < 0.05).

According to the research findings, it can be concluded that patellar taping can improve the position sense in early degrees of knee flexion, but neoprene knee sleeve with patella stabilizer can improve the position sense in early and middle degrees of knee flexion in active men with patellofemoral pain syndrome.

Elderly is a process that changes all aspects of human existence on the basis of slow and progressive changes. A decline in physical function, especially balance, walking, and memory disorders are other problems in the elderly together with physical, psychological, and social consequences.The main purpose of the current study was to investigate the effect of eight weeks of cognitive, motor, and motor-cognitive exercises on explicit motor memory, balance, and walking of elderly women.

The statistical population of the study consisted of 48 elderly women (age: 67.83 ± 2.54 years) who were randomly divided into four groups of 12. Motor training consisted of eight weeks of rhythmic aerobic exercise. For cognitive exercises, Captain’s Log software was used. Hybrid exercise included performing aerobic and cognitive exercises in succession. Measuring instruments included Six-Minute Walk, Timed Up and Go as well as explicit motor memory test to evaluate the cognitive function. Repeated measures ANOVA was used for statistical analysis.

The results showed that eight weeks of cognitive exercise had significant effect on explicit motor memory among participants (p < 0.05) and improved their balance (p < 0.05) and walking (p < 0.05). In addition, hybrid exercises (motor-cognitive) improved both motor function (p < 0.05) and explicit motor memory (p < 0.05) in the participants. Comparison between groups showed that both cognitive and hybrid excersices relative to each other had similar effects on explicit motor memory (p < 0.05) and had rather the same effect on the participants’ balance (p < 0.05) and walking (p < 0.05).

According to the results of the present study, it can be concluded that most changes   regarding improvement time of getting up and going test was in the six minutes test time for motor training group and most changes in the improvement of explicit motor memory was related to cognitive-motor group.

Perceived Movement Competence (PMC) is the perception of individuals about their motor abilities which can affect motor skills acquisition. PMC is mostly considered as a mediating variable to achieve other desirable health-related outcomes, such as physical activity or exercise persistency. The aim of the present study was to evaluate the competence of perceived movement skills in preschool children and to compare it between boys and girls.

In the current descriptive comparative study, the statistical population was 4-6 year-old children from all preschool centers in Tehran. Convenience sampling was used to select 86 children from two preschools as statistical sample in 2017. After receiving consent letters from their parents, they were evaluated via pictorial scale of perceived movement competence. Descriptive statistics was used for statistical analysis, and Inferential statistics was applied to test the hypotheses using independent t-test and nonparametric Mann-Whitney test. All statistical analyses were performed using SPSS, version 25, and the significance level was considered 0.05 in all statistical calculations

The results revealed that there were no significant differences in perceived movement skills competence as well as locomotor and object control Perceived competence scores between preschool girls and boys (P>0.05).

According to the results, there was no difference in the perceived movement skills competence between preschool girls and boys.

The aim of the present study was to investigate the impact of chronic ankle instability on biomechanical parameters of gait initiation in semipro football players.

A total of 26 young were divided into two equal groups of normal and injured. To measure the biomechanical parameters, motion analysis system (Qualisys model with eight cameras) and two force plate system (Kistler 9286A) were used. We measured istance, time, and speed of gait initiation, swing and double stance time, speed of clearing the swing limb from ground, hip, knee and ankle range of motion and center of mass displacement in medio-lateral, anteroposterior, and vertical directions in  the current study.

The results showed significant increase in the knee (p = 0.016) flexion range of motion and significant decrease in center of mass displacement in vertical ((p=0.00) and medio-lateral (p=0.00) directions of gait initiation.

The results of our study did not show any significant change in injured joint and many other parameters. Thus, considering the significant changes that occur in adjacent joint, it is recommended that rehabilitation specialists use global training protocol for both the injured and non-injured limbs of chronic ankle instability patients to prevent motor control change and to restore proper motor control following a peripheral joint injury.

Muscular imbalance followed by musculoskeletal abnormality may result in weakness in athletic functions and ultimately lead to injury and reduce the level of health and ability of individuals to perform sports activities. The purpose of the present study was to compare the effect of pes cavus foot abnormality on functional lower extremity evaluation scores in active and inactive maleteenagers in two groups of normal andpes cavus foot.

In the present study, 80 students aged 13-15 (in active and inactive groups, 20 with normal foot and 20 with pes cavus foot) were recruited. To determine the pes cavus foot, navicular drooping technique and to evaluate the function of the lower extremity, the functional lower extremity evaluation,including the control sequence, hop test sequence, and endurance sequence, were used. For data analysis, descriptive statistics (mean and standard deviation) and T-test were used (p <0.05).

The results of the present study showed that there were significant differences between the two groups of normal andpes cavus foot in active and inactive male teenagers in all functional tests of the lower extremity (p <0.05). Comparison of Functional Lower Extremity Evaluationrevealed that pes cavus foot group had weaker scores compared with the normal foot.

According to our results, pes cavus foot abnormality leads to weakness in the performance of Functional Lower Extremity Evaluationas well as athletic activities and competitions. So, iIndividuals with pes cavus foot abnormality, regardless of being active or inactive, scored lower than those with normal foot on the Functional Lower Extremity Evaluation. Therefore, pes cavus foot abnormality is one of the most important risk factors and reasons for poor performance in exercise.

The aim of the present study was to compare the frequency spectrum of selected lower limb muscles between patients with diabetic neuropathy and healthy peers during walking.

The statistical sample of the present study included 20 patients (age: 54.85± 19.7, Body mass index: 28.38±5.03) with diabetic neuropathy and 10 healthy individuals (age: 52.60 ±4.06, Body mass index: 26.74 ±1.86) who were selected using convenience sampling. The electrical activity of selected lower limb muscles was recorded using electromyography system during walking. Independent sample t-test was used for statistical analysis.

During loading response phase, the frequency spectrum in the vastus medialis, biceps femoris, semitendinosus, and gluteus medius muscles were significantly greater in the patient group compared with that in the healthy group (p < 0.05). During mid-stance phase, all of the selected muscles showed a lower median frequency values in the patient group (p < 0.05).Duringpush off phase, gastrocnemius muscle had lower frequency spectrum in patient group compared with the healthy group (p < 0.05). During swing phase, vastus medialis, biceps femoris, semitendinosus, and gluteus medius muscles had a significantly lower frequency spectrum in the patient group as compared with the healthy group (p < 0.05).

Damage to peripheral nerve due to diabetic neuropathy in patients with moderate neuropathy results in abnormal frequency contentment of lower limb muscles during walking. Also, lowering the functional capacity of the lower limb muscles can lead to a lack of proper control of the ground reaction forces, which could increase the likelihood of injury and falls in patients.

The plantar pressure distribution should not cause any change in muscle activity. The aim of the present study was to compare plantar pressure distribution and electrical muscle activity during walking between viscous shoes and EVA shoes.

A total of 10 healthy male individuals were recruited in the current quasi experimental study. A special shoe with specific feature of liquid flow was made for this study, which could reduce pressure from damping mechanism. An EVA shoe was also used for comparison as reference shoe. Plantar pressure distribution was measured using Pedar insole system and muscle activity was measured using Myon EMG system. Data analysis was done using Pedar X and ProEMG softwares and in eight regions of foot.

It was found that special shoe with hydrodynamic mechanism could effectively reduce load in rear foot, forefoot, and toe regions but no significant differences were observed in muscle activity between shoes, except for gastrocnemius.

According to the results, damping effect of liquid shoe following impact force can effectively reduce the pressure and force in high risk regions of the foot.

The purpose of the present study was to evaluate the psychometric properties of the Berg balance scale instrument in Tehran's people lower limb amputations.  

A descriptive and cross-sectional study was conducted on 83 individuals (38 athlete and 45 non-athlete amputees) (age: 38±5 years) with lower limb amputation who were selected using convenience sampling based on inclusion criteria. The instruments of the present study were Berg balance test, artificial intelligence (mobility section) questionnaire, two-minute walk test, L functional mobility test, and digital scales to determine body mass index. For data analysis, we used Cronbach's alpha, intra-class correlation coefficient, Pearson correlation, and independent test. 

Internal consistency was obtained for Berg  balance scale (α = 0/89) and Cronbach's alpha variability in Berg balance subscales (0/73 to 0/76). The Intraclass correlation coefficient (ICC) was greater than 90% for all substructures. Also, the Intraclass correlation coefficients (ICC) for evaluating intra-rater reliability and inter-rater reliability was greater than %90 for all leaf balance subscales. Content Validity Index (CVI) was evaluated to be  0/94. Correlation coefficients related to the reliability of the Berg balance test constructs with each of the artificial limb assessment tests (r = 0/57), two-minute walking test (r = -0/25), functional mobility test (r=-0/48), and activity specific balance test (r = 0/59) were found. Independent test-retest results showed that the Berg balance test between athlete and non-athlete lower limb amputation had a discriminant validity (p < 0/05).

Given the validity and reliability of the Berg balance test, this instrument can be used to evaluate lower amputee individuals in Tehran.

In patients with lateral patellofemoral compression syndrome, the vastus medialis muscle is weaker than the vastus lateralis muscle. The purpose of the present study was to investigate the effect of an exercise protocol focusing on vastus medialis activation on the electrical activity and cross-sectional areas of the vastus medialis and vastus lateralis muscles.

In the current study, 30 females with lateral patellofemoral compression syndrome, aged 25.4±5.7, were selected and randomly divided into two groups. The experimental group participated in isokinetic knee extension exercises at terminal 30° extension arc with maximal external rotation of the leg for eight weeks. The control group did not participate in any regular exercise. Before and after the intervention, the cross sectional areas and electrical activities of the vastus medialis and vastus lateralis muscles were measured using ultrasonography and electromyography. Data were analyzed running independent and paired t-tests at the significance level of p < 0.05.

There were no significant differences in any of the variables between the two groups before intervention (p < 0.05). But after the intervention, the vastus medialis/vastus lateralis activity and cross-sectional area ratio in the experimental group were found to be significantly higher than those of the control group (p < 0.001).

According to the results, using isokinetic knee extension exercises can selectively strengthen the vastus medialis muscle and reduce the imbalance between vastus medialis and lateralis muscles in patients with lateral patellofemoral compression syndrome.

Knowing the changes of motor control strategies during landing provide well understanding to preventing knee injuries in people with flatfeet. Hence, the purpose of the present study was to compare the motor control strategies using lower limb joints power in different phases of single leg drop landing between athletes with flatfeet and normal foot.

A total of 10 individuals were randomly selected from among athletes with flatfeet and 10 were randomly selected from among athletes with normal foot. Lower limb joints power in three motion plates was recorded according to data from kinematic and kinetic motion analysis and force plate. Data was analyzed using Matlab and SPSS softwares and running independent t-test (p < 0/05).

There was a significant difference in knee power in sagital plane )P=0/003( in initial contact phase )IC(, knee power in sajital plane )P=0/0001(, and Thigh power in horizontal plane )P=0/05( in pick of knee flexion, Thigh power in sagital plane )P=0/022( in pick of ground reaction force between flat foot and a normal foot. However, there was no significant difference in joints in the other phases and plates between the two groups.

The results of our study study showed that significant differences were observed in Knee and Hip powers in sagital plane in three phases, which shows the impact transfere to the upper joints from incapability in lower joints in flatfeet people. This could be a major factor for foot injuries in the individuals with flat foot. The results of the current study can help better organizing a rehabilitation program and activities for those with flatfeet.

It is unclear how thoracic hyper-kyphosis (THK) and forward head posture deformities (FHP) relate to physical function. The purpose of the current research was to study the relationship between forward head posture (FHP) and thoracic hyper-kyphosis (THK) and pulmonary function, spinal deformities, neck, and shoulder muscle strength and range of motion (ROM).

In the present descriptive correlational study, after screening 80 patients via flexible ruler and posture assessment tools, 40 individuals who had inclusion criteria were recruited. Study variables were measured using an evaluator. We used Photography and Image J software to evaluate FHP, Spinal mouse to evaluate spine deformities, Spirometry to evaluate pulmonary volumes, PT-Scan to evaluate postural sways, Pull-Push-Dynamometer to evaluate muscles strength, and the Babble Baseline Inclinometer was used to assess neck and shoulder ROM. Pearson’s r was run to assess the relationship among variables.

The results showed that FHP had a negative correlation with trunk extension (P=0.029), neck flexion (P=0.010), and shoulder adduction (P=0.018) ROM, positive correlation with shoulder flexors (P=0.010) and abductors (P=0.010) strength as well as negative correlation with FEV1/FVC (P=0.004) and FEV1 (P=0.024). THK posture, also, had a negative correlation with trunk flexion (P=011), neck flexion (P=0.009), and shoulder adduction (P=0.049) ROM, but its had a positive correlation with lumbar lordosis (P=0.004).

Based on our results, THK was associated with neck and trunk flexion, shoulder adduction ROM, and lumbar lordosis. Also, FHP was associated with trunk extension, neck flexion and shoulder adduction ROM, shoulder flexor and abductors strength, and pulmonary function.

The kicks are performed by quick knee extension-flexion in karate. Any poor performance of joint proprioception is a risk factor for athletes. Muscular fatigue, as an inevitable factor of any physical activity, can cause problem in proprioception performance. The present study was carried out to investigate the effect of knee muscle fatigue on knee proprioception performance in karate athletes.

The sensations of knee joint position of 14 female elite karate athletes (age: 15±1.3 years, height: 161±7 cm, weight: 54 kg±34 kg) were evaluated using the isokinetic device at 30, 45, and 60 degrees before and after fatigue. Data analysis was carried out using paired t-test with p. value set at 0.05.

The muscle fatigue had a significant effect on reconstruction error of the knee joint in 60 degree angle. Fatigue caused an increase in reconstruction error and decreased knee joint sensation. Also, an increase in joint reconstruction error after fatigue at 30 and 45 degree angles was observed, which was not statistically significant.  

According to the results, it can be concluded that decrease in the ability to control knee joint position due to muscular fatigue in karate athletes, especially at the end of the range, may result in knee injury, in addition to weakness in correct technique implementation. Because the defect in the proprioception of the joints can lead to a defect in the simultaneous recall of the motor units of the quadriceps and hamstrings, and it may increase the risk of damage to the knee anterior cruciate ligament, thus, it can be stated that improving muscle endurance can increase the time to reach fatigue, and subsequently prevent the inability to control its condition and potential damage to karate athletes

Considering the role of fascia as a viscoelastic matrix that surrounds muscles, bones, organs and nerve fibers, and its effects on human motor function, including flexibility, strength, resistance to pressure and injuries, in the present systematic review, the effects of stretching, strengthening, endurance, and combination of endurance-stretching training on fascia function were investigated.

After reviewing articles in major databases, such as Pubmed, Science Direct, Magiran, Noormags, and SID, using the words Myofascia, Fascia and Connective tissue, a study was conducted with over 55 articles published during 1984 to 2018.

All findings in the field of stretching, strengthening, endurance, and resistance-stretching exercises emphasize the positive effects of these exercises on fascia's fitness and function. Stretching and endurance exercises increase the stiffness and elasticity of the fascia. Strength and combined resistance-stretching exercises increase stiffness and reduce hysteresis of the Fascia.

With reegard to the positive effect of exercise training on facia performance, it is sugested that athletes perform the facial training along with muscle strength and cardiovascular endurance training to increase facial readiness and prevent injuries. Considering the results of the present survey, more studies are needed to be carries out on facia and its effect in enhancing performance of skills, sport injuries, and where the effect of exercise and/or performance perturbations is the case.

Background and Amis: 

Shin splint is one of the most common causes of painful shins in athletes. The use of arch support foot orthosis can be used in the prevention and treatment of shin splint. The purpose of the present study was to investigate the effect of arch support foot orthosis on the pain intensity of recreational runners with shin splint during running.

A total of 50 women with shin splint aged 20-35 years were randomly assigned to either experimental (n = 25) or control (n = 25) groups. Experimental group received the foot orthosis for 18 weeks combined with the usual treatment. In control group, they underwent only usual treatment. Pain was assessed via Visual Analogue Scale and severity of injury was assessed using Medial Tibial Stress Syndrome questionnaire, extent of injury caused using running test, and patient's perceived level of change was assessed using the Global Change Scale. All variables were measured before the intervention and 6 weeks, 12 weeks, and 18 weeks after the intervention..

The results demonstrated that pain severity (P=0.001) and injury severity (P=0.02) were significant for the experimental group compared with those of the control group six months after the intervention. However, there was no significant difference between the two groups at weeks 12 and 18 (P˃0.05).

The results of the current study showed that the use of arch support foot orthosis combined with multi-component treatment result in the faster reduction of pain severity, severity of injury, and physical restraint, and patients with shin splint reported better perceived therapeutic effects.

Changes in the natural sapular position in wrestlers can affect the spine and their shoulders alignment and the combination of these changes affects the wrestlers’ performance. However, there is little scientific evidence for the effectiveness of training in the scapular position of these atheletes’ performance. The aim of the current study was to investigate the effect of 10 weeks of corrective exercises on scapular position and elite wrestlers performance with trunk and shoulder girdle disorders.

The statistical population of the study included the elite male 18-27 year-old wrestlers in Mazandaran province. Totally, 34 wrestlers with  forward  shoulder greater than 55° and increased kyphosis greater than 45° were selected purposefully and divided into two control groups (age: 21.35±3.27 years, height: 1.76±0.87 cm, weight: 78/94±13.00 kg) and exercise group (age: 20.29±2.11 years, height: 1.72±0.80 cm, weight: 71/11±16.70 kg). Increased thoracic kyphosis angle was measured using a flexible ruler and forward shoulders angle was measured via photogrammetry as an indicator of trunk and shoulder girdle disorder. Also, scapular position and wrestling performance were measured using the LSST and YBU-UQ functional test, respectively. The experimental group performed a standard training program for 10 weeks; the control group performed their daily activities. Data were analyzed using covariance analysis and t-test at the significance level of 0.05.

The results showed that the corrective exercise program had a significant effect on the improvement of scapular position in zero degree (p = 0.001), 45 degree (p = 0.001), and 90 degree (p = 0.001) lateral movements, forward shoulder angle (p = 0.001), kyphosis angle (p = 0.001), and performance of wrestlers (p = 0.001).

According to the results of the current study, it seems that targeted corrective exercises can have a positive effect on their performance by improving the position of scapula in wrestlers with trunk and shoulder girdle disorders. Improved scapular position can be effective in improving the performance of wrestlers.

Increase in the inter-recti abdominal muscle during pregnancy and postpartum is called diastasis rectus abdominis. Usually this distance must be more than 20 mm above the umbilicus and 25 mm in the umbilicus to be diagnosed. The prevalence of this disorder in women after postpartum is 66%. Due to the instability of the spine and pelvis in these individuals, impairment in proprioception and lumbopelvic control can be the causes of lumbar pain and disability. Thus, the present research was conducted to study the proprioception and lumbopelvic control in women with and without diastasis rectus and their relationship with postpartum pain and disability.

A total of 18 healthy persons, with the mean age of 25/77±4/55 years, and 18 patients with diastasis rectus, with the mean age of 28/88±5/69 years, with 2-3 years passed since their delivery, were recruited. The amount of error in the reconstruction of the lumbar position was measured using a goniometer with the eye closed while standing at a 30° angle of lumbar flexion and lumbo-pelvic control with lateral step down field test. The results of the tests were calculated and analyzed.

Mean error in 30° angle lumbar flexion reconstruction in patients with diastasis rectus was significantly higher than that in the healthy group (P <0.05). Also, in lateral step down test, there was a significant difference between healthy groups and patients suffering from this disorder (P <0.05).

The results of the present study showed that diastasis rectus causes problems in women with this problem, like disorder in proprioception and lumbopelvic control, which may lead to low back pain and disability.

ACL injury is one of the most serious and expensive injuries that is a nightmare for athletes. Increasing the knee valgus angle during dynamic movements such as landing and squat is one of the risk factors for knee injury and decreased mechanical efficiency of movement. The aim of the current study was to compare the preparatory knee muscle activity of female athletes with and without dynamic knee valgus during a single leg landing.

In the current quasi-experimental study, 32 female athletes were divided into two groups of healthy and dynamic knee valgus. Feed forward activities of Medial Hamstring, Lateral Hamstring, Vastus Medialis, Vastus Lateralis, Medial Gastrocnemius, and Lateral Gastrocnemius were recorded during a single-leg landing with the dominant leg on top of a 50-cm box. Muscle feed forward activity was measured since 150 ms prior to ground contact. Multivariate analysis of variance with a significance level of p≤0.05 was used for data analysis.

The findings of the present study showed that the preparatory Lateral knee muscle activities (Lateral Hamstring, Vastus Laterals, Lateral Gastrocnemius) in participants with dynamic knee valgus was higher than those of healthy individuals (p <0.05). In the case of Medial knee muscles, the results showed no difference between the two groups (p> 0.05).

According to the results, the preparatory Lateral knee muscle activity was more than that of medial knee muscles in female athletes with dynamic knee valgus compared to healthy female athletes, which increases the risk of knee valgus during dynamic activities, As a result, they are at a higher risk of ACL injury.

Various studies have pointed to the balance deficiency in children with attention deficit/hyperactivity disorder compared to normal individuals. The purpose of the present study was to investigate the effect of yoga exercises on static and dynamic balance in children with attention deficit/hyperactivity disorder.

In the current quasi-experimental study, statistical population included all 9-12-year-old girl with attention deficit/hyperactivity disorder in Kermanshah city. Participants were 30 children who selected via convenience sampling. Childen’s anthropometric characteristics and static and dynamic balance tests were first recorded. After matching, participants were randomly assigned into two groups of control or experimental (each 15). The experimental group then participated in the Yoga Exercise Protocol for 8 weeks, 3 sessions per week. After the last training session, post-test static and dynamic balance values ​​were measured in the same conditions as pre-test. Independent t-test and analysis of covariance were run in SPSS, version 23, to test the research hypothesis. Significance level was set at 0.05 for all stages.

Eight weeks of yoga training resulted in a significant increase in static balance with superior legs (p < 001), static balance with non-dominant legs (p < 001), and dynamic balance in different directions (p < 001) in children with attention deficit/hyperactivity disorder of Kermanshah city.

According to the results, it can be concluded that yoga exercise was a useful exercise to help children with ADHD to improve their static and dynamic balance.

Given that knee osteoarthritis, as one of the most common joint diseases in the elderly, causes pain and imbalance, leading to disruption of daily activities and performance of this group of society, the objective of this study was to investigate the effect of electrotherapy and strength training of the knee extensor and thigh extensor muscles on pain and balance in elderly women with osteoarthritis of the knee with emphasis on the type of focus of attention.

In the current study 31 elderly women aged 60 to 80 years with osteoarthritis of the knee from the elderly center of Kerman after filling out the consent form, accidentally participated in two research groups as subjects in this study. The individuals in each group were randomly divided into two subgroups: the external focus and the internal focus. The exercises were performed three times a week for eight weeks. To assess pain, a VAS scale, and to assess a static, dynamic and total balance, Rumberg, TGUG, and TBT tests were used before and after the test, respectively. For statistical analysis of the data with SPSS software, version 20 and dependent ammonia test were used for intragroup comparison and independent test for intergroup comparison for normal data and for non-normal data, Mann-Whitney and Wilcoxon tests were used. For all tests, a significance level was p≤0/05.

: The results showed a decrease in the amount of pain in both electrotherapy and strength training of the quadriceps muscles and hip abductors group, both of which showed external and internal focus. An improvement was seen in the equilibrium index, in the dynamic and total equilibrium (p≤0.05). The results of the independent t-test for comparing the groups did not show a significant difference in the pain variable based on the numerical measurement scale between the quadriceps training group and the hip abductor training group (p ˃ 0.05). While the difference between internal and external attention was significant (p ≤0.05). The results did not show a significant difference in the balance index in any of the balance indicators between the two groups of quadriceps and hip abductor (p˃0.05), but between the internal and external attention group in the dynamic balance index (TGUG), The difference between the two groups became significant (p ≤ 0.05).

According to the results of the research, strength training of the hip abductor muscles along with common electrotherapy treatments and attention-oriented guidelines can be recommended for pain management and improving the level of performance of the elderly with osteoarthritis of the knee.

Improvement of motion skills in children is facilitated by improved posture control. However, there is no comprehensive study on how to organize posture control sensing systems in children. Therefore, the present study was conducted to provide a comprehensive review on organizing sensory systems visual, proprioception, and vestibular in children’s posture control.

A comprehensive review was performed on the organization of sensory systems in postural control of children by searching the following English databases: Science Direct, PubMed, Web of Science, EBSCO, Springer, COCHRANCE REVIEW, Pedro, EMBASE, CINAHL, and Google Scholar, using the following keywords: visual system, proprioception system, somatosensory, vestibular system, computerized dynamic posturography, postural control, postural stability, children, child, postural balance, quiet stance, postural sway, stabilography, body sway, sensory organization, human development, and child development. In addition, Persian databases, such as MAGIRAN, IRANDOC, IranMedex, MedLib, Sid, and Google Scholar were searched for the following keywords: balance in children, postural control in children, postural control, balance, visual system, vestibular system, proprioception system, somatosensory, and sensory systems, from among papers published from 1985 to January 2020. Moreover, unable to find articles online, manual search and full review of resources of the articles were carried out to find the respective articles. Inclusion criteria included: study on the reweighting of sensory system, given the target population (children), study on healthy children, and use of computer devices that accurately measure the reweighting of sensory systems.

A total number of 16 studies were chosen based on our measures and objectives. In five studies, it was concluded that proprioception is organized much faster than visual system. However, three studies reported that visual system in children was organized faster than proprioception, similar to that in adults. It was agreed that vestibular system developed later compared with the other two systems to adult form.

In conclusion, the growth of postural control occurs by age non-linearly, and there are changes in some ages. It can be inferred that children are dependent on the visual system at first, but as time goes, by walking and standing time, they become more dependent on the proprioception system than on the visual system. Also, it seems that the organization of the proprioception system occurs sooner than the visual system. It can also be reported that the progression of the visual system does not occur linearly and is critical in some age groups. In addition, the vestibular system matures compared with than other systems.

Hearing is one of the most important factors in language acquisition. However, due to hearing losses, some children are unable to hear normal sounds. On this account, hearing-impaired children have difficulties in hearing voices and speech from a distance or in a noisy environment. In this regard, the present study aimed to investigate and compare phonological processes between Balochi hearing-impaired children and their hearing peers and to study the effect of age and gender in using phonological process in these two groups. The results of our study can lead to a better understanding of the problem and a possible solution to this problem in future studies.

A descriptive-analytical and cross-sectional study was conducted on 16 Balochi speaking hearing-impaired children (8 girls and 8 boys) and 16 hearing children (8 girls and 8 boys), aged 7-10 years old who were randomly selected from schools in Zahedan. The research instrument was a researcher-made test. It comprised of 80 pictures of concrete and common concepts in that the students should refer to the signifier in Balochi per se. The responses were all recorded individually using an mp3 player (Creative model). Then, the recordings were transcribed by one of the researchers based on the IPA system. Finally, the phonological processes were examined. The significant of the means of phonological processes in the two groups were evaluated using multivariate analysis and one-way ANOVA in Manova text analysis.

There was a significant difference between the overall performances of the two groups in using phonological process (P=0.00).

The present study showed that among the phonological processes, deletion of voiceless stop consonants was the most frequent process used by Baloch children. Cluster reduction was another high frequency process that occured in the speech of these children in onset and coda consonant clusters; the reduction of the cluster in coda consonant clusters had a higher frequency than onset consonant clusters. Stopping, fronting, syllable reduction, and devoicing were other high-frequency processes in the speech of these children. Reduplication was not observed in the speech of two groups.

Atherosclerosis in patients with type 2 diabetes is characterized by endothelial dysfunction that is associated with increases of assymetric dimethyargenin and nitric oxide reduction. The purpose of the present study was to compare the effects of 12 weeks of high-intensity interval (HIIT) and moderate-intensity continuous training (MICT) on plasma levels of vaspin, assymetric dimethyargenin (ADMA), and nitrite/nitrate (NOx) on type 2 diabetes.

The statistical population of the present study included patients with type 2 diabetes, aged 45-60 years old, from Tehran. The sample included 48 type 2 diabetic patients who were randomly assigned into three groups: HIIT (n= 16), MICT (n= 16), and control (n=16). The HIIT group intervention was 12 intervals at 85-90% maximal heart rate (HRmax) and 2 min at 55-60% Hrmax and the MICT group intervention was performed based on ergometer cycle for 42 min of exercise at 70% HRmax for 3 sessions per week during 12 weeks. The blood sample was collected 48-h before and 48-h after the last sessions of exercise training. The vaspin and ADMA were measured using ELISA, and NOx was measured using Griess assay. Data were analyzed using mixed-liner ANOVA in SPPS, version 18.

The results showed that VO2peak and plasama levels of vaspin (P= 0.028) and NOx (P= 0.016) increased significantly in HIIT as compared with those in the MICT group. Insulin resistance (P= 0.041), plasma levels of insulin (P= 0.039), glucose (P= 0.026), and ADMA (P= 0.018) decreased significantly in HIIT as compared with those of the MICT group (p < 0.05).

According to the results, HIIT via increase of vaspin led to a decrease in ADMA which eventually increased plasma levels of NOx in patients with type 2 diabetes.

The purpose of the present study was to investigate the scientific structure of studies related to basketball, volleyball, and handball injuries and to make a good compilation and provide more relevant information from the previous Iranian studies.

The search for articles was performed in specialized databases and 22 articles were selected based on the inclusion and exclusion criteria.

The results showed that most of the injuries in basketball, volleyball, and handball occur in the lower extremities, which is more of the sprain type, which includes ankle sprain and rupture of knee ligaments. Also, the results of the study showed that contact with an opponent and not warming before the practice was considered as the most important cause of injury in these sport fields.

By studying the research on basketball, volleyball, and handball sports in Iran, it has been shown that there are many conflicts in the reports. One of the conflicts that can be noted is that each of the researches used different patterns and terms for the type of injury, definition of injury, severity of injury, location of injury, and mechanisms of injury. This incompatibility of terms makes it difficult to reach a conclusion. It is possible that with correct training, sufficient warming up before competition, and practice by coaches and reviewing rules, especially in handball, as preventive measures, the effects of these measures on reducing injuries in these fields be understood in future studies.

The previous studies showed that there are different models of foot in terms of appearance and size of the toes, including Egyptian, Roman, Greek, Semi-Roman, and square feet. But no information is available on the features of the Iranian foot. The purpose of the current study was to obtain the Iranian foot model using statistical and image analysis methods to determine whether the Iranian foot model adheres to the previous models or develops a new one.

In the current study, eight Pedoscope devices were provided and sent to eight provinces of the country to obtain images of the foot shape. The Cochran method was used to estimate the sample size. The sampling method used was the random cluster and the optimal probability accuracy was considered to be 0.05. In the Cochran relation, the p-value was 0.5. Statistical calculations were performed using Cochran's formula (for the left and right feet) of 385 men and women. Image J software was used to analyze the images and to determine the characteristics of the foot models.

The largest model in the female community was the Egyptian model, which covers 39.5% of the female population. After that, the Semi-Roman model was the most prevalent covering 33% of the female population. In the study of men's society, the Semi-Roman and Egyptian foot models cover 43.59% and 42.92% of community, respectively.

The two Egyptian and Semi-Roman models are the two common foot models in Iranians that cover about 86% of the male population and more than 70 % of the female population in this study. Due to the predominance of the Egyptian foot shape, diseases such as Onychocryptosis are common among Iranians.