فصلنامه طب توانبخشی
سال یازدهم شماره 6 (بهمن و اسفند 1401)

Background and Aims:

 Different shoe weights affect the gait mechanics. Some dynamic changes or adjustments induced by anterior cruciate ligament (ACL) reconstruction can be assessed through the analysis of the ground reaction forces (GRFs). This study aims to determine the effect of sports shoe weight on gait kinetics in athletes with ACL reconstruction.

 Twenty healthy men and 20 athletes with ACL reconstruction volunteered to participate in this study. Each participant performed three walking trials with shoes having light (weight: 150±18 g), moderate (300±18 g), and heavy (450±18 g) weights in a randomized order. The GRFs were analyzed during shod walking. 

The GRF component at vertical direction during the heel contact phase changed significantly during the use of shoes with different weights (P=0.001). In addition, the GRF at vertical direction during the push-off phase and GRF at mediolateral direction during the push-off phase increased significantly (P=0.023 and 0.014, respectively).

The biomechanics of lower limbs and the GRFs are significantly different when using light and heavy shoes during the heal contact and push-off phases of walking.

 Diabetes is associated with dysfunction and damage in various organs due to abnormal pressure on ten plantar regions. This study aims to compare the effect of offloading plantar pressure on peak pressure of ten plantar regions and gait speed in men with diabetes and active diabetic foot ulcers, and healthy men.

Methods:

 This is a causal-comparative study. Participants were 30 healthy men, 30 diabetic men and 30 men with active diabetic foot ulcers who needed no leg amputation according to their physicians. Sampling was done using random and convenience methods. Diabetic foot ulcers were classified based on the Meggitt-Wagner classification criteria, according to which grade 1 indicates grade 1 indicates a superficial ulcer and was used as a criterion for selecting people with diabetic foot ulcers. Plantar pressure variables were recorded using RSscan software (RSscan International, Belgium; 0.5×0.5×0.02 m, 4363 sensors) at a sampling frequency of 300 Hz and the gait speed was measured using a digital stopwatch. Correct walking considered as the full impact of the foot on the middle of the foot scan machine. Data were analyzed using independent t-test in SPSS software, version 24.

Results:

 The peak pressure in the metatarsal 3 (P<0.001), metatarsal 4 (P= 0.020), medial heel (P= 0.004) and lateral heel (P= 0.007) in the diabetic foot ulcer group significantly increased compared to the diabetic group. In addition, the peak pressure in the medial heel (P= 0.013) and lateral heel (P= 0.019) in the diabetic group significantly decreased compared to the healthy group.

Conclusion:

 Men with diabetic foot ulcers are more exposed to abnormal peak pressures in different plantar regions, which can cause irreversible clinical injuries. Diabetic men have a lower gait speed than healthy men which can be important in their rehabilitation.

Background and Aims:

 Nowadays, the musculoskeletal disorders and postural problems due to inappropriate postural habits and uninterrupted repetitive movements are important issues in sports medicine. Recently, the National Academy of Sports Medicine (NASM)’s corrective exercise protocol has received attention from scholars. This study aims to evaluate the effect of a corrective exercise program based on NASM’s protocol on the forward head angle and cervical joint position sense.

Methods :

This is a quasi-experimental study. Participants were 30 female college students, aged 18-25 years with a forward head angle > 46 degrees, who were randomly divided into two groups of control (N=15, age=20±2 years, height=1.59±3.03 m, weight=58.13±5.08 kg, BMI=22.71±1.41 kg/m2) and exercise (N=15, age= 20.53±1.55 years, height=1.60±0.02 m, weight=60.53±4.10 kg, BMI=23.61±1.20 kg/m2). The exercise group performed corrective exercises for eight weeks, three sessions per week, each for 30-70 minutes, while the control group did not receive any intervention. The lateral photography method was used for measuring forward head posture. The cervical joint position sense was assessed using the target angle repositioning error test before and after corrective exercises. Data were analyzed using paired t-test and analysis of covariance. The significance level was set at 0.001.

Results:

 Eight weeks of corrective exercises reduced the forward head angle and target angle repositioning error in the exercise group compared to the control group (P≤0.001).

Conclusion:

 Corrective exercises based on NASM’s protocol seem to reduce the forward head angle and improve the cervical joint position sense. Therefore, correctional treatment specialists and therapists are recommended to use the program to improve the forward head posture and cervical proprioception in women with this postural deformity.

 Balance disorders and frequent falling are the important problems in the elderly, which is directly related to changes in their body structure and function. Many studies have been conducted to find new and safe ways to improve the balance of the elderly. This study aims to compare the effects of Pilates exercises on stable and unstable surfaces on the functional balance and core stability of older women.

Methods :

In this quasi-experimental study, the study population includes all older women living in private nursing homes, in Rasht, Iran. Of these, 36 women aged 60-75 years were selected by a convenience sampling method and randomly assigned to three groups of control, Pilates on stable surface, and Pilates on unstable surface. The variables were assessed using the Fullerton advanced balance test, timed up & go test, and the McGill core endurance test. Experimental groups performed Pilates exercises for 8 weeks, while the control group performed their routine daily activities. Data were analyzed by one-way analysis of variance, t-test and Bonferroni’s post hoc test. The significance level was set at 0.05.

Results:

 There was a significant difference between the experimental and control groups; however, there was no significant difference between the experimental groups performed exercises on stable and unstable levels (P>0.05) 

Conclusion:

 It is recommended to use Pilates exercises on stable or unstable surfaces for older women, especially residents of nursing homes with low mobility, to achieve their personal autonomy.

 hamstring injury is the most common injury in football. Nordic hamstring exercise (NHE) is one of the best hamstring injury prevention strategies. This study was aims to compare the effect of six weeks of standard NHE and modified NHE on electromyography of hamstring, hip and trunk muscles and sprint performance in young male football players

Methods:

 In this study, participants were 26 male football players in Kerman, Iran who were selected using purposeful and convenience sampling methods and randomly divided into two groups of NHE (Age: 16.31±0.51 years, Height: 173.08±5.15 cm, weight: 59.85±5.71 kg) and modified NHE (Age: 16.41±0.54 years, Height: 173±6.84 cm, weigh: 64.20±8.76 kg). Sprint performance was measured by the 20-meter sprint test, and muscles activity was measured by electromyography. Repeated-measure analysis of variance was used for data analysis.

 In the modified NHE group, there was a significant difference between the pretest and posttest phases in the electrical activity of biceps femoris (P=0.001), semitendinosus (P=0.001), gluteus maximus (P=0.016) and erector spinae muscles (P=0.001). In the NHE group, although the activity of muscles increased by 13% in the biceps femoris, 11% in the Semitendinosus, 9% in the gluteus maximus and 4% in erector spinae muscles, the difference was significant only in the biceps femoris (P=0.001) and Semitendinosus (P=0.024). The results also showed a significant difference between the two groups in electrical activity of biceps femoris (P=0.021), semitendinosus (P=0.046) and erector spinae muscles (P=0.039). 

 Both standard and modified NHE are effective in preventing hamstring injury by increasing the electrical activity of the Biceps femoris and Semitendinosus, but the modified NHE is more effective in prevention of injury by changing the parameters of NHE and increasing the training load.

Athletic groin pain (AGP) is one of the most common injuries among athletes. It causes the use of compensatory mechanisms to adjust pain and affects lumbar-pelvic and hip movements, which leads to prolonging the pain healing process. This study aims to compare the timing of electromyographic activity in selected lumbar-pelvic muscles during a cross-cutting maneuver in football players with AGP and healthy peers.

In this quasi-experimental study, 28 football players in the second division league of Iran participated in two groups of control (n=14) and AGP (n=14). The timing of electromyography activity in the gluteus medius, adductor longus, rectus abdominis, multifidus, and transverse abdominis/internal oblique during a cross-cutting maneuver was recorded bilaterally with a one-minute interval since the time of foot-ground contact in two groups.

Results:

 The time for the onset of activity in the gluteus medius muscle in the dominant foot (P=0.033) and in the multifidus muscle in the opposite foot (P= 0.023) for the AGP group was significantly delayed in compared to the control group; however, the rectus abdominis muscle in the dominant foot was activated significantly earlier and before the heel contact with the ground (P=0.001).

 It seems that AGP changes the timing of electromyographic muscle activity in football players. These changes and compensatory mechanisms may put the athletes at the potential risk of lower limb injuries. It is recommended to find solutions to reduce the effects of AGP and the resulting changes.

 Weakness in receptors involved in proprioception can limit the range of motion of the ankle and knee, as one of the most important causes of lower limb movement disorder and the risk of falling. People with sensory disorders such as visual impairment, have limitations in performing daily activities, and their physical activity, muscle strength, cardiovascular endurance, balance, and athletic performance decrease. This study aims to compare the effects of three foot massage techniques on movement performance, risk of falling, and quality of life of visually impaired men, and assess the persistence of their effects.

 This is a quasi-experimental study with a pretest/posttest/follow-up design. Thirty men with blindness were randomly divided into three intervention groups including foot massage with a ball (n=10), foot massage with a brush (n=10), and foot massage with hands(n=10). They received foot massage for 21 days, massage day for 10 minutes (5 minutes for each foot). The Tinetti test was used to assess movement performance. The timed up & go test was used to measure the risk of falling, and the 36-item short form survey (SF-36) was used for evaluating the quality of life in the pretest, posttest, and follow-up (Short-term persistence) phases. One-way analysis of variance was used for between-group comparisons and repeated measures analysis of variance was used for within-group comparisons.

There was no significant difference among groups in the quality of life and the risk of falling. There was a significant difference among them only in movement performance, where the group received foot massage with hands had higher performance. The results of repeated measures analysis of variance for the factor of time showed that the three methods improved movement performance, quality of life and reduced the risk of falling. All three methods had a significant effect on the study variables (P<0.05).

 Three methods of foot massage have a significant effect on movement performance, risk of falling, and quality of life of men with blindness, by strengthening their proprioception receptors.

 In previous studies, different results have been reported regarding the effect of corrective exercises on improving scapular dyskinesis and its related symptoms. The present study aims to investigate the effect of eight weeks of selected corrective exercises on strength and range of motion (ROM) of shoulder rotation in male boxers with scapular dyskinesis.

 This is a quasi-experimental study that was conducted on 30 male boxers in Guilan province of Iran including 15 in the control group (age: 24.05±3.80 years; weight: 73.54±5.52 kg; height: 177.18±5.08 cm) and 15 in the exercise group (age: 25.01±4.05 years; weight: 74.14±6.31 kg; height: 176.69±5.14 cm). The boxers in the exercise group performed selected corrective exercises for 8 weeks (strengthening the serratus anterior and middle retractors and stretching the pectoralis minor). Diagnosis and severity of scapular dyskinesis was measured by the lateral scapular slide test. The ROM of shoulder rotation was measured using a manual goniometer, and the shoulder rotation strength was assessed using a manual dynamometer. All tests were performed in pre-test and post-test phases. Statistical analyses were performed using paired t-test and analysis of covariance. The significance level was set at 0.05.

The selected corrective exercises had a significant effect on improving scapular dyskinesia and the external rotation strength of the shoulder in the exercise group compared to the control group (P≤0.05), but had no significant effect on improving the internal rotation strength of the shoulder and the ROM of shoulder rotation (P>0.05)

 The selected corrective exercises can improve scapular dyskinesis and increasing the external rotation strength of the shoulder in male boxers with scapular dyskinesis. Therefore, trainers, athletes and therapists can use these exercises to reduce the symptoms related to this disorder and improve performance of boxers with scapular dyskinesis.

Today, traumatic brain injury and defects in cognitive functions and memory are the most frequent problems after brain injury. This study aims to examine the effectiveness of emotional and cognitive rehabilitation on cognitive performance and memory in patients with traumatized brain injury.

This study is an applied study in terms of purpose and experimental in terms of collecting information method. Considering purposive sampling and random selection of samples, we used the randomized block experiment with a pre-test-post-test design with a control group. We used the emotional cognitive rehabilitation protocol based on Gross model (2002) and Nejati cognitive rehabilitation to train emotional and cognitive rehabilitation (2017). The study's statistical population included all brain-injured patients with cognitive defects and memory problems referred to Neurology Clinic, Shahid Motahari Hospital, and Razmehr Psychiatric Clinic, Shiraz City, Iran, from June 22, 2019, to January 20, 2020. This study consisted of 3 groups (2 experimental and 1 control group) at three levels (mild, moderate, and severe patients). The study participants were 45 patients selected after a brief mental examination with a mini-mental state examination test. 

 Cognitive rehabilitation significantly (P<0.001) increased the brain-injured patients' cognitive performance. Also, emotional and cognitive rehabilitation significantly (P<0.001) affected the brain-injured patients' cognitive performance. Finally, cognitive rehabilitation significantly (P<0.001) increased the brain-injured patients' memory performance.

 It seems that through delivering necessary training and education regarding effective interpersonal skills, computer drills, practices at home, and so on, emotional and cognitive rehabilitation helps the brain injured people to properly manage emotions, effectively establish interpersonal communication, and lighten the load of negative emotions, and consequently memory gets improved will less stress. In fact, emotional and cognitive rehabilitation is a complete collection of training for regulating emotions and enhancing and growing memory. Thus, emotional and cognitive rehabilitation's significant effect on memory enhancement is logical and acceptable. In conclusion, this protocol effectively improves brain-injured people's cognitive performance.

 Ageing is associated with physical changes where balance impairment is one of  important consequences. In this study, we aim to investigate the effect of an 8-week dynamic neuromuscular stabilization (DNS) program on the balance of older men.

Thirty-six older men (age: 66.5±1.02 years, height: 171.8±1.17 cm, and weight: 75.4±2.16 kg) were purposefully selected based on the inclusion criteria. They were then paired based on the functional reach test score and randomly assigned to exercise (n=18) and control (n=18) groups. The pre-test and post-test assessments included the functional reach test and the Y balance test. The exercise group performed the DNS exercises for eight weeks (three sessions of one hour per week), while the control group performed their routine daily activities. The collected data were analyzed by repeated measures ANOVA in SPSS software.

 There was a significant interaction effect of time and group on the scores of both functional reach test and Y balance test (F(1,23)=12.17, P=0.002, η2>0.35). From the pre-test to the post-test phase, there was a significant improvement in the exercise group, while no significant improvement was reported in the control group.

 The DNS program can affect the balance of older men. It is recommended to use these exercises to improve their balance.

 Balance deficiency is one of the risk factors for falls, injury or even death of the elderly. This study aimed to investigate The Effect of a Fall Proof training on balance and fear of falling in older women was conducted. 

 This study was a quasi-experimental study with a pretest-posttest design. Thirty elderly women aged 60-70 years were selected as available for the sample. Subjects were randomly divided into control (n=15) and experimental (n=15) groups. To assess static and dynamic balance, Sharpend Romberg test and time up and go test and to assess fear of falling the fear of falling questionnaire were used. Exercises were performed for 8 weeks, three sessions per week and each session for 60 minutes by experimental group, while the control group did not do any exercise. Analysis of covariance and paired t-test were used to analyze the data

The results of this study showed that a period of Fall Prof Training significantly increased static (P=0.01) and dynamic balance (P=0.01) and a significant decrease in fear of falling (P=0.01) In the experimental group compared to the control group.

 Due to the weak balance and high fear of falling in the elderly, based on the findings of this study, we can use fall proof exercises in elderly rehabilitation and exercise.

Water exercise is one of the most important interventions to reduce the risk of falls in the elderly. However, the effect of exercise in different depths of water has been less studied. Therefore, the aim of this study was to investigate and compare the effect of 8 weeks aquatic exercise in shallow and deep parts of the pool on postural stability and balance recovery strategies of the elderly.

 In this quasi-experimental study, a total of 45 elderly males (60-70 years old) were randomly selected and classified into a control and 2 intervention groups of shallow and deep-water exercises. The intervention groups participated in a water exercise program for 8 weeks, while the control group did not receive any intervention. Postural stability and balance recovery strategies of all groups before and after the intervention were evaluated using Biodex balance system and Motion Analysis system, respectively. Finally, the Mixed ANOVA test was used for data analysis(P≤0.05).

The results showed a significant increase in postural stability after conducting both types of water exercise programs(P<0.05). However, there was no significant difference between balance recovery strategies of all groups(P>0.05). The results also showed that there was no significant difference between the scores of two intervention groups(P>0.05).

In brief, it seems that both types of shallow and deep-water exercises can significantly improve the postural stability of the elderly. While these exercises cannot significantly change their balance recovery strategies. However, due to the more effective role of shallow water exercises in transferring balance strategies from the hip to ankle joint, it is recommended to pay more attention to the role of these exercises in improving the balance of older people.

 Nowadays, Participating in sports activities along with mental fatigue causes musculoskeletal injuries and one of the most important factors in reducing the rate of these injuries is having proper recovery. Swedish relaxation massage and meditation are some of the interventions that can possibly affect people’s mental fatigue. Therefore, the purpose of this study was immediate effect of Swedish relaxation massage and meditation after mental fatigue on dynamic and semi-dynamic balance and Lower extremity function in collegiate female athletes.

 the current study is a pre-experimental design with pre- and post-test and intervention practices in an experimental group. 16 female athletes aged 20 to 24 years at Razi University were purposefully selected as samples that they were subjected to protocols of mental fatigue (45 minutes of cognitive activity [stroop test]), Swedish relaxation massage (30 minutes) and meditation (30 minutes) with an interval of 48 hours. We were evaluated Dynamic balance with a Y-balance device, semi-dynamic balance with a Lafayette Stability Platform, Lower extremity function with left test. Data analysis was performed using SPSS software, version 22 through paired t-test. 

 There was a significant difference between the semi-dynamic, dynamic balance and lower extremity function means in pre-test to post-test, as the means decreased after fatigue (P<0.05). Also, there was a significant difference between post-tests means of semi-dynamic, dynamic balance and lower extremity function between Swedish relaxation massage and meditation (P<0.05).

 In order to prevent injury to athletes, Swedish relaxation massage and meditation can be used as interventions to reduce mental fatigue and improve balance and Lower extremity function.