فصلنامه طب توانبخشی
سال یازدهم شماره 4 (مهر و آبان 1401)

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

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

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

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

Inadequate mobility in intellectual disability causes imbalance. Therefore, the purpose of this review was to investigate the effect of motor interventions on improving the balance of intellectual disability.

Methods :

In this study, a comprehensive review of the effect of motor interventions on improving the balance of the intellectual disability was done by searching the Google Scholar, PubMed, and ScienceDirect databases with the keywords balance, equilibrium, balance in intellectual disability, balance in mentally retarded, intellectual disabled, and also Persian databases of Google Scholar, Megapaper, IranDoc, Magiran, SID, MedLib and IranMedex from 2000 to February 2021. In this search, two languages, Persian and English, were used. After collecting the search results, first, the title and then the abstract of the articles were studied. If the articles complied with the inclusion and exclusion criteria, their results were used in the present review study and otherwise discarded.

Results:

 In the search of texts, a total of 110 articles were found and after deleting similar cases, 44 articles (18 Persian articles and 26 English articles) were selected from the articles that were very closely related to the studied subject.

Conclusion :

A review of studies has shown that performing motor interventions in most studies improves the balance of intellectual disability. However, due to the limitations of the studies, the conclusions of the present study should be interpreted with caution. Although these results can help coaches, exercise teachers, physiotherapists, and therapists improve the balance of intellectual disability, more detailed studies are needed.

Balance is one of the important factors that help to maintain the independent life of people with intellectual disabilities. A variety of methods are used to assess balance in these individuals. However, so far no review study has been conducted to determine what kind of tests are used to assess balance in this group. Therefore, The purpose of this study was to investigate the methods of assessing postural control and balance used in studies on intellectual disabilities.

In this study, a comprehensive search was performed on functional assessment tests of balance in people with intellectual disabilities. PubMed, Medline, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, Scopus, Magiran, IranDoc, Iran Medex, MedLib, and SID were searched from 1991 to November 2020. After collecting the search results, first, the title and then the summary of the articles were studied. If the articles met the inclusion criteria, the results were used in the review study and otherwise discarded.

Based on the criteria and objectives of the research, 20 articles were selected after the evaluation process. All articles were provided in full text. Then, 23 Functional Balance Assessment Tests were used to measure functional balance in people with intellectual disabilities.

Studies had examined the evaluation of functional balance in intellectual disabilities in several ways; therefore, it seems that a specific test cannot be suggested to measure the balance of intellectually disabled people.

Background and Aims :

Blindness is one of the major health problems and diseases, such as corneal opacity, cataracts, glaucoma, and age-related macular degeneration due to diabetes are recognized as the most important causes of bilateral blindness worldwide. Among these factors, corneal diseases are considered as an important cause of blindness. The aim of this study was to review the prevalence, causative agents, treatment methods, and also the use of keratoprosthesis or artificial cornea as the last option to restore vision to blind patients with severe corneal injuries.

Methods :

Studies related to the subject were collected and reviewed using valid databases, such as PubMed and Google Scholar.

 Results :

Out of more than 1000 articles in the field of the artificial cornea, about 70 related articles were selected and reviewed.

Conclusion :

Generally, keratoprosthesis is used for patients for whom corneal transplantation is not possible or the risk of corneal transplantation rejection is high. The patient’s current condition and the outcome of the patient’s anterior and posterior segment examinations, previous treatments and surgeries, and the medications used should be considered. If a person has advanced retinal disease or glaucoma, he/she is not a good candidate for keratoprosthesis. If the patient’s vision in either eye is within the range of light perception or hand movement detection, while the optic nerve and macula are healthy, it is appropriate to use keratoprosthesis. It can be said that there is still no type of keratoprosthesis that can be used without side effects and for all patients in need, but researchers are still trying to improve the quality of keratoprostheses, which can restore patients’ lost vision with minimal complications.

Background and Aims :

Aging causes alterations in various body functions, such as motor, sensory, cognitive and psychosocial. The present study was performed to compare the effects of two types of gait-retraining approach on the balance and motor performance of elderly women at risk of falling.

Methods:

 This study is a semi experimental research with pretest-posttest plan, in which 45 women elderly between 60 and 75 years were randomly divided into two experimental (n=30) and  one control groups (n=15). The experimental group (8 weeks, 3 sessions per week, each session 45 minutes). In order to assess on balance and motor performance of subject, Berg Balance Scale, and 10 meter walk test was used. Analysis of covariance (ANCOVA) was used to analyze the data, SPSS statistical package was used for all analyzes. In this study, significance level equal was considered to 95% and level of alpha was considered less than or equal to 0/05.

Results :

The findings of this study showed that both selected exercises had significance effect on balance and motor performance in non reactive elderly women. Conducting a between-group comparison also showed that the which was related to the training with ground balance ladder, respectively (P≤0.05). However, there was no significant difference in the control group for all three variables.

Conclusion:

 This study showed that exercise two kinds of tutorial gait approach reduce can improve postural control and decrease the risk of falls in the elderly. Therefore it can be used to reduce risk of falls.

Background and Aims:

 Type 2 diabetes is the most common endocrine disease in the world. Various methods, such as medication and exercise can be helpful, although information on the issue is scarce. Therefore, the aim of the present study was to investigate the effect of eight weeks of TRX resistance training along with using taurine supplementation on glycemic indices of type 2 diabetic females.

Methods :

The sample of the present study consisted of 40 middle-aged females with inactive diabetes with an age range of 40 to 60 years. Subjects were randomly divided into four groups of ten, including the training group, supplement group, training+supplement group, and control group. Fasting blood glucose (FBS) and glycosylated hemoglobin (HBA1C) levels were measured before and after the training period. The duration of the training program for the training group was eight weeks for three sessions per week

Results :

The results showed that HBA1C levels decreased in the post-test compared to the pre-test in the supplement (P=0.027), exercise (P=0.001), and supplement+exercise (P=0.001) groups. While the levels of this variable did not show any significant difference in the control group in the post-test compared to the pre-test (P>0.05). The results showed that FBS levels in the exercise group were statistically lower than in the supplement + exercise group (P=0.012).

Conclusion:

 According to the findings, it can be concluded that resistance training using the TRX method along with taurine supplement can reduce resting FBS and glycosylated hemoglobin (HBA1C) levels in type 2 diabetic women and increase women’s health.

Background and Aims:

 Headache is one of the most common problems in adults and almost 47% of the world's population suffer from some kind of headache. High percentage of these headaches come from neck muscles these are called cervicogenic headaches. The purpose of this study is Comparison of the effect of comprehensive therapeutic protocol with and without manual treatment and kinesiotaping on pain and disability, postural and electrical activity of some neck muscles in men with non-traumatic cervicogenic headache.

Methods :

43 men aged 35 to 55 years with non-traumatic cervicogenic headache were selected for this study and randomly divided into four groups.Forward head angle, pain and disability and power of neck superficial muscle activation measured by using the photogrammetry, neck pain and disability scale (NPDS) and surface electromyography respectively in pre-test and after six weeks in post-test. Statistical methods, Shapiro-wilk and then repeated measures ANOVA and one-way ANOVA and paired t-test, repeated measure variance and finally and Bonferroni were used (α≤0.05).

Results :

The results showed a significant decrease in pain and disability, forward head angle and also a decrease in the activity of the superficial neck muscles in the experimental groups after six weeks of intervention. (P=0.00). Comparing the above three experimental groups, the comprehensive exercise therapy group with manual therapy had the highest statistical significance in reducing pain and disability, reducing the angle of head forward and reducing the activity of superficial neck muscles. (P=0.00).

Conclusion:

 comprehensive exercise therapy intervention with manual therapy had the greatest effect on improving the symptoms of men with non-thromatic  cervicogenic headache.

Background and Aims :

Considering the importance of balance and the prevalence of genu varum in soccer, this study evaluated the role of lower extremity corrective exercises on dynamic balance improvement and knee deformity in teenage football players (youth footballers). 

Methods :

This semi-experimental study was performed on 24 male soccer players aged 15-17 years with genu varum deformity (more than 5 cm knee distance), who were divided into two groups randomly. Collis for measuring the knee distances and the star balance test for dynamic balance were used in both groups. After six weeks of corrective exercise with traband (three times a week) in the training group and sport-specific activities in the control group, all measurements mentioned above were repeated in both groups. Analysis of covariance for balance and Mann-Whitney U test for knee position were used with a level of significance less than 0.05.

Results :

The results showed the significant positive effects of the exercise program on the knee position (P=0.002) and dynamic balance variables (ant: P=0.002, med: P=0.004, post: P=0.005, posterolateral: P=0.006, and other directions: P˂0.001) and balance improvement and knee distance decreasing were found in the training group.

Conclusion:

 It seems that six weeks of traband training exercises can improve dynamic balance in soccer players by reducing the knee genu varum deformity.

Knee osteoarthritis is a debilitating disorder. Limited studies have shown that Prolotherapy using saline instead of dextrose is effective, especially in diabetic patients and reduces the negative effects of this disease. In the present study, 40 patients with knee osteoarthritis along with joint effusion were divided into two groups of 20. The first group went under simultaneous intra-articular and peri-articular knee injection of hypertonic saline and the second one had only intra-articular injection. In each group, three sessions of injection were done in two weeks interval. The standard questionnaires of VAS, WOMAC and OKS, were completed for both groups, before intervention and in the 2nd and 4th weeks after the last injection. VAS was used for pain relief; WOMAC to assess pain in various daily activities; and OKS to assess the amount of pain, lameness and the ability to perform various activities. Using SPSS version 25, data was analyzed by independent and paired t- test. Although both groups showed improvement of outcomes after intervention there was a significant difference between simultaneous intra-articular and peri-articular Prolotherapy method compared to intra-articular Prolotherapy alone in favor of the first method.

Background and Aims:

 Shoulder impingement syndrome (SIS) can affect the proprioception and disturb the normal neuromuscular reactions that the protect the shoulder joint. There are various therapeutic strategies including stretching exercises to prevent the negative effects of SIS. This study aims to investigate the effects of static, slow and fast dynamic stretching on shoulder joint proprioception in male volleyball players with SIS.

Methods:

 Participants were 18 professional male volleyball players (Age: 26.52±1.5 years, weight: 89.72±7.02 kg, height: 196.78±6.32 cm) in Kerman, Iran suffering from SIS who were selected using purposeful and convenience sampling methods. All subjects were randomly performed one type of stretching exercises for three consecutive days at the same hour and their proprioception were measured by the Leighton flexometer and target angle reconstruction with external and internal shoulder rotations before and after stretching. The data were analyzed using repeated measures ANOVA.

Results:

 The static stretching signifcantly reduced the shoulder joint proprioception (P=0.001), while the dynamic stretching at different speeds had a significant positive effect on shoulder joint proprioception (P=0.001). There was no significant difference between the two types of slow and fast dynamic stretching (P=0.8).

Conclusion :

It seems that dynamic stretching at different speeds has a better effect on shoulder joint proprioception than static stretching in male volleyball players with SIS.

Background and Aims:

 Balance disorder has been recognized as a leading cause of falls in the elderly. One way to strengthen the balance of the elderly is to use new technologies such as virtual reality. Purpose of this study was to investigate the effect of virtual reality exercises on the dynamic and functional balance of the elderly.

Methods :

The present study was a quasi-experimental research with pre-test and post-test design. Subjects included 24 male aged 60-75 years that were selected by a convenience sampling method from Shabestar city and divided randomly into two virtual and control groups. Participants in the experimental group practiced for 9 weeks, but the control group continued their usual treatment programs. XBox device was used for virtual reality interventions. Also, in order to evaluate the functional and dynamic balance, Berg Balance Scale, and Up and go timed Test were used, respectively. MANCOVA and ANCOVA Tests were used at P<0.05 level to analyze the data.

Results :

MACNOVA test results showed a significant difference (P=0.001) between two groups at least in one balance variable (dynamic and functional). Also, based on the results of ANCOVA test, due to better balance scores in the experimental group, virtual reality practice using Xbox improved their dynamic and functional balance compared to the control group.

Conclusion:

 This study provides evidence that dynamic and functional balance is modifiable in elderly people and that they respond to short-time VR training. It is suggested to use virtual reality as well as balance exercises as a suitable method of improving dynamic and functional balance abilities in the elderly.

Background and Aims:

 Education in school is a key element of health and helps to freshness and vitality of the community through the promotion of the physical activity. In this regard, some practitioners try to be effective in community health through linear or non-linear training methods. Thus, this study tried to determine which educational method (linear, nonlinear) is effective in promoting perceived and real motor competence in children.

Methods :

In this study, two boy schools were selected whose education in the physical education class was linear in one and non-linear in the other. Therefore, 50 children from each school were selected as a sample randomly (Mean±SD age: 8.47±1.14 ). Motor proficiency was assessed by the Bruininks-Oseretsky Test, and perceived motor competence was assessed by the Incentive Motivation Questionnaire. 

Results:

 The results of the analysis of covariance by eliminating the effect of the pre-test showed that the nonlinear group in motor skills (P=0.00) and perceived motor competence (P=0.02) scored significantly higher than the linear group

Conclusion:

 The results emphasize the importance of using nonlinear training in physical education with manipulation of the environment and task without direct instructions and feedback. Nonlinear methods as new methods in schools can replace traditional methods. In this method, by manipulating the constraints, children can be helped to grow in various dimensions, including real and perceived motor skills. The results of this study are useful for teachers who teach basic motor skills in school.

Background and Aims :

Postural control of the kinetic variable of motion plays an essential role in maintaining stability in daily activities. Dual tasks for studying balance or postural control are accompanied by cognitive tasks. The aim of the present study was to investigate the effect of listening task complexity and offline learning on postural control.

Methods:

 Twenty-eight employees with an age range of 30-40 years from Alzahra University of Tehran (PBUH) were selected by available sampling and based on inclusion criteria and divided into three groups with different training distributions of 2 minutes, 15 minutes, and 24 hours with three levels of difficulty (easy, medium, and difficult). Each group performed three blocks of six attempts with each attempt time of 35 seconds, the interval between attempts of 20 seconds, and the time interval between blocks depending on the division of the group: 2 minutes, 15 minutes, and 24 hours with three difficulty levels. Findings were analyzed using a combined factor analysis of variance with repeated measures of three groups (mass, 15 minutes, and 24 hours) and three task levels (easy, moderate, and difficult) and the Bonferroni post hoc test.

Results :

Findings showed that the main effect of homework difficulty level and practice distribution was significant (P=0.001) and in the retention stage, there was a significant difference between the mean frequency power in the anterior-posterior direction in the low difficulty listening group and the high difficulty listening group. In the listening task, the interactive effect of task difficulty level in the distribution of practice was not significant. In the memorization stage, regarding the COP components (average frequency power in the anterior-posterior direction), the training group (24 hours), and in the listening task with an easy complexity level, the best condition was posture control, and in the training group (2 minutes) and in the listening task with difficult complexity level, the weakest condition was control posture. In the listening task with a high level of difficulty, the 24 hour training group had better average COP components than the mass training group and the 15 minute training group.

Conclusion:

 It seems that distance training over mass training along with the parameters of strengthening motor memory increases cognitive effort and motivation. According to Hacken, Kelso, and Bondes hypothesis (progress-regression), educators should include homework in teaching instruction and from simple to difficult in the curriculum.

Background and Aims:

 The purpose of this article was to present a local model for ecosystem analysis of the IoT business model in the field of rehabilitation in Iran with an emphasis on improving the quality of life of the disabled community in the country.

Methods:

 The current article can be categorized as applied, combined (qualitative and quantitative), and survey-based descriptive. The society, i.e., the statistical sample, included eight experts in the qualitative part and consisted of 100 executives and experts in the quantitative part. A questionnaire was used to analyze the dimensions and indicators. The face validation of the questionnaire was performed by the Delphi technique. Content validity ratio and content validity ratio were used as two content-related validity indicators for qualitative validation. The reliability of all dimensions and indicators was confirmed through Cronbach’s test with a population consisting of 30 experts. To analyze the proposed model of the researcher, we used inferential tests, loading factor analysis, t, structure equation modeling, and fitting techniques on a 100-person sample.

Results :

The fitness of the model was approved by experts with 99% confidence according to the philosophy, goals of the theoretical foundations of dimensions and components, feedback, and output of the model.

Conclusion :

The findings of this paper led to a model with several dimensions: (1) environment, (2) actors, (3) ecosystem cycle, and (4) IoT architecture in business. The corresponding indicators for the identified dimensions were validated. Independence, interaction, and empowerment were considered three principle values for the target community.