فصلنامه طب توانبخشی
سال دوازدهم شماره 1 (فروردین و اردیبهشت 1402)

Numerous treatment modalities have been suggested for patients with medial tibial stress syndrome (MTSS), but the effectiveness of these interventions is still unknown. Therefore, this study aimed to provide a systematic review of the therapeutic efficacy of kinesio taping (KT) and foot orthosis for patients with MTSS.

The related articles were searched using selected keywords in Embase, Scopus, Medline, SPORTDiscus, Web of Science, Biomed Central, and PubMed databases from inception to May 2021. After deleting duplicate and unrelated articles, the full text of 9 articles was received from the databases. 

According to the inclusion and exclusion criteria, only 9 articles were eligible for the present review study, of which 5 articles examined the effectiveness of KT and 4 articles the effectiveness of plantar orthosis for people with MTSS. Previous studies showed that using anti-pronation KT can help reduce peak plantar pressure and pain and improve the function of patients with MTSS. Additionally, using the arch support foot orthosis can help correct the pressure distribution pattern under the foot and reduce the foot contact time, resulting in faster pain relief and the physical limitations caused by the MTSS. Kinesio taping, Foot orthosis, Medial tibial stress syndrome, Shin splintBased on the review articles, results indicate that both therapeutic interventions can be used to correct the pressure distribution pattern under the foot, reduce the pain and eliminate physical limitations caused by injuries in individuals with MTSS.

Exercise training is an important intervention in the pulmonary rehabilitation of adults with chronic respiratory diseases. High-intensity exercise is challenging for these patients. Thus, interval exercise has received much attention as a suitable option for optimizing a tolerable load during exercise. This study aimed to investigate the effects of high-intensity interval training (HIIT) on peak power, peak oxygen uptake, functional capacity, and health-related quality of life in people with chronic respiratory diseases.

In this study, the related studies were collected and examined from Google Scholar, PubMed, and Science Direct databases.

A total of 14 randomized controlled trials were selected based on the study subject. The results demonstrated that HIIT and continuous training in adults with chronic obstructive pulmonary disease (COPD) led to significant improvement in peak power, peak oxygen uptake, and 6-minute walk test (6MWT) or 12-minute walk test (12MWT) distance and health-related quality of life and there was no significant difference between the two groups. And HIIT, compared to no exercise training, showed greater significant changes. Few studies have examined HIIT in patients with cystic fibrosis, with different results. We found no studies investigating the effect of HIIT on non-cystic fibrosis bronchiectasis and interstitial lung diseases. Conclusion studies confirm the positive effect of HIIT on cardiorespiratory fitness, exercise capacity, functional capacity, and health-related quality of life in people with COPD. In other respiratory diseases, more studies are needed to investigate the effects of HIIT.

This study addresses only those interventions, such as feedback and kinesio taping, that affect lower limb function in athletes with impaired lower limb movement patterns.

This research is a systematic review study that examined all published articles in English about the effect of feedback and kinesio taping on correcting defective movement patterns and reducing injury risk factors. The current study was conducted by searching foreign databases such as Google Scholar, PubMed, and ScienceDirect and domestic databases, including Magiran and Irandoc with the keywords of “videotape augmented feedback,” “taping,” “kinesio taping,” and “lower extremity” from January 2000 to January 2021.

After reviewing the full texts of 45 articles, 24 articles were finally selected according to the purpose of the research. Of 24 articles, 20 were interventional studies, 1 was a systematic review, 1 was a meta-analysis, and 2 were meta-analysis and systematic reviews. In all studies, feedback training methods positively affected lower limb biomechanics, and tipping methods improved pain.

After comparing the effects of feedback and kinesio taping interventions in the studied studies, it can be concluded that feedback is better than kinesio taping taping in improving kinetic and kinematic variables in people with lower limb movement pattern defects.

Memory consolidation is a set of processes that converts memory from an unstable state to a stable one. Various factors affect the consolidation of memory, including sleep and the type of exercise have an effect on consolidation. Given that little research on consolidation has used a motor task for the age group of children, the aim of thise study was to investigate the effect of sleep, type of exercise (Physical and Combine it whit observation of action) and posterior interference on consolidation processing based on stability and promotion of motor memory.

This research was a semi-experimental study with an pretest- posttest design. The statistical population included girls aged 10 to 12 years who had registered in volleyball in clubs in east Tehran in 2018. The sample included 62 novice girls in volleyball who were selected by available sampling method according to the inclusion and exclusion criteria. The experiments were divided into combined observation and physical exercise groups. The tools used in this study were, Landgrafe and Abetz child health questionnaire (1996), owens children's sleep habits questionnaire (2000), Aahperd Volleyball Serving Test (1969). Data were analyzed using combined factor analysis of variance with repeated measures and Benfferroni post hoc test.

The results of the analysis of variance-covariance with repeated measures showed that a night's sleep has a positive effect on stabilizing processing based on stability and promoting motor memory in children (F=15.40, P=0.001), but the type of exercise (F=0.18, P=0.67), (Physically or observational) and type of posterior interference (performing or observing the action) (F=0.48, P=0.489) have no significant effect on consolidation processing. Comparison of averages showed that physical practice is more stable and promotion motor memory than observation.

  Coaches and educators are recommended in addition to physical exercise, children can use observational exercise to process memory consolidation

Studies show that individuals with upper crossed syndrome have poor balance compared to healthy people for various reasons, including displacement of their center of gravity toward forward. This study aimed to evaluate the effectiveness of the Alexander technique on the static and dynamic balance of young men with the upper crossed syndrome.

In this quasi-experimental study, 24 subjects were purposefully selected and assigned to the experimental and control groups. The static and dynamic balance of the subjects were assessed by the Sharpened Romberg and timed up and go tests. The experimental group underwent 12 sessions of Alexander technique training during 6 weeks in individual and group sessions. The duration of individual sessions was 40, and that of group sessions was 60 minutes. The control group did not receive any training. During the training sessions, the subjects were taught the Alexander technique via manual guidance, as well as tactile, verbal, visual, and proprioception feedback. After collecting data, the data were analyzed using the analysis of covariance (ANCOVA) and paired sample t test. 

The study’s final results showed a significant difference (P<0.001) between the experimental and control groups in the static balance after the Alexander technique intervention. Also, there was a significant difference (P<0.001) between the experimental and control groups in the dynamic balance after the Alexander technique intervention. 

Based on the findings, the Alexander technique had high effectiveness on the static and dynamic balance and improved the balance of the subjects. Considering the importance of balance in health and improving daily activities, the researchers suggested that health and rehabilitation professionals can apply the Alexander technique as a psychophysical re-education method to improve balance in people with upper crossed syndrome.

Since gait disorder is the most common complication among patients with multiple sclerosis. This study aims to examine the effect of hippotherapy on the onset activity of selected lower limb muscles in patients with multiple sclerosis (MS) during the gait initiation protocol with a perturbation response approach.

A total of 20 MS patients with EDSS score <4.5 were selected by simple convenience sampling method and were randomly divided into two groups of exercise n=10 and control n=10. Ten healthy and matched individuals were selected and placed in the healthy control group. The MS patients in the training group underwent hippotherapy for 4 sessions per week. Before and after the exercises, the electrical activity of the selected muscles of the lower extremities was recorded during the gait initiation protocol.

Data analysis showed a significant difference between groups (P<0.05). Hippotherapy exercises were effective in the onset activity time of the lower limb muscles and reduced the reaction time of the muscles.

According to the results of the present study and the effect of hippotherapy on improving reaction time, hippotherapy can be used as a rehabilitation method in MS patients.

Patellofemoral pain syndrome often results from misalignment of the patellofemoral joint that can affect lower limb function. Therefore, the present study investigated the relationship between patellar position and lower limb function and balance in athletes with patellofemoral pain syndrome. 

In this exploratory analytical study, 39 male and female athletes with this syndrome with an average age of 25.6±4.7 years were selected by available sampling. Lower limb function and dynamic balance were measured by the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scale and Y balance test, respectively, and patellar position was assessed by digital radiology. The Pearson correlation test was used to analyze the data at a significance level of 0.05. 

The results showed that the position of the patella was significantly associated with lower limb function and dynamic balance (P<0.01). Accordingly, lower limb function on the WOMAC scale had a significant positive relationship with patellar tilt angle and patellar congruence angle (P=0.001). Also, dynamic balance showed a significant negative relationship with patellar tilt angle (P=0.007) and patellar congruence angle (P=0.002). 

According to the results of the present study, the higher the tilt angle and patellar homogeneity, the weaker, the lower limb function and dynamic balance. Therefore, it is suggested that the position of the patella should always be considered and corrected to improve performance and balance and promote the record of sports activities of athletes with this disorder and facilitate their return to sports.

Single-leg landing is a difficult task for the lower limbs. This movement is very common in basketball and is one of the main causes of lower limb injuries, especially anterior cruciate ligament injuries. Single-leg landing causes a ground reaction force and torque to the lower limb. By increasing the internal torque and controlling the reaction force at the level of its application, the muscular strength of the lower limb can control the ground reaction force of the surface applied to the limb. This study aims to investigate the effects of 8 weeks of strength training on the ground reaction force in single-leg landing

In this study, 20 semi-professional male basketball players were divided into two equal groups of test and control. The samples of both control and test groups were asked to perform three single-leg landings from a 40-cm platform on the force plate. Then, the test group underwent 8 weeks of lower limb strength training, and after the end of the training, the members of the test and control groups were asked to repeat the landing movement. An average of three movements per person was considered. For data analysis, the paired t test was used for intra-group comparison, and the 1-way ANCOVA method was used to compare inter-group effects. Statistical analysis of the study was performed using SPSS software version 20, at a significance level of 0.05 for all tests.

The results showed that the training program had no significant effects on the ground reaction force in the X direction in both internal and external directions, as well as, in the Y direction in the anterior and posterior directions, both within the group and between the groups. But, the training program had a significant and incremental effect on both within the group (P=0.005) and between the groups (P=0.002) in the Z direction.  

The strength training program lacks enough effect to reduce ground reaction force applied to semi-professional basketball players during a single-leg landing movement.

Karate is one of the most popular martial arts worldwide, and flat foot deformity is one of the most common disorders in people participating in this sport. This disorder can negatively affect the static and dynamic balance in individuals. Therefore, this study aimed to investigate the effect of corrective exercises on foot posture and balance in female karate athletes with flat foot.

This research was a quasi-experimental study performed in two phases: pre-test and post-test. Forty female karatekas with flexible flat foot postures entered the study as subjects. They were randomly divided into exercise group (Mean±SD age: Mean±SD 20.00±1.81 y, Mean±SD height: 161.4±6.49 cm, and Mean±SD weight: 55.27±6.56 kg) and control (Mean±SD age: 21.02±2.19 y, Mean±SD height cm: 160.4±4.23, and Mean±SD weight: 55.75±3.90 kg). As one of the inclusion criteria, a navicular drop test was performed for all subjects to assess the condition of the foot posture. Also, the balance error scoring system and Y balance tests were used for all subjects to check the static and dynamic balance. Then, the exercise group performed 6 weeks of corrective exercises, but the control group did not perform any specific exercises during this period. After 6 weeks, the tests were repeated. Statistical analysis was performed in SPSS software version 26. A covariance analysis test was used to evaluate the between-group differences, and paired sample t test was used to evaluate the within-group changes.

This study’s findings showed that the corrective exercise group in thepost-test had a better performance than the pre-test in the navicular drop test, in all three directions of the Y balance test, and in the balance error scoring system (P=0.0001). But in the control group, no significant difference was observed between the two stages of the test (P>0.05). It was also observed in the comparison between groups that in thepost-test in the variables of the navicular drop test and also in all three directions of the Y balance test and the test of the scoring system, the balance error scoring system of the experimental group achieved better results than the control group (P>0.05). 

This study showed that 6 weeks of corrective exercises has significantly improved foot posture and static and dynamic balance in karate women with flexible flat feet. According to the results obtained in this study, it seems that comprehensive corrective exercises can be used in this group to improve balance and posture.

Autism is a highly debilitating neurodevelopmental condition that affect behaviors and is caused by impairment in neurological functions, especially executive functions. In many studies, it has been reported that the brain areas including the frontal lobe, limbic system, basal ganglia, occipital lobe and cerebellum, and the frontal cortex and its connections with the striatal and occipital brain areas are involved in a wide range of cognitive functions called “executive functions”. The current study aims to investigate the effectiveness of Baran's cognitive rehabilitation program on executive functions (working memory, sustained attention, and cognitive flexibility) of children with high-functioning autism.

This study has a single subject design with repeated measurements. The study population consists of all children with high-functioning autism who referred to Baran Clinic in Tehran, Iran in 2016-2017. Samples were 3 boys with autism spectrum disorder aged 8-11 years who were selected using a convenience sampling method. Assessments were done in 5 stages. The first stage was 2 weeks before the treatment. The second stage was performed 2 days before the start of treatment. The third stage was done after 5 sessions of treatment, which was held as a 1-hour session. The fourth stage was performed after 10 one-hour treatment sessions, and finally, the fifth stage was performed 4 weeks after the end of the treatment. Digit span, word span, and non-word span tests were used to assess the working memory. Digit span, Word span, non-word span tests was used to assess the sustained attention. Trial making test (A and B ) was used to assess the cognitive flexibility. After collecting and analyzing the data, the methods of visual analysis and effect size assessment was used 

The performance of children in working memory, sustained attention, and cognitive flexibility improved significantly after treatment. Hence, Baran’s cognitive rehabilitation program based on balance movements was effective in improving executive functions of children with high-functioning autism.

cognitive rehabilitation program based on balance movements can improve working memory, sustained attention, and cognitive flexibility of children with high–functioning autism.

Autism spectrum disorder in children manifests as qualitative degradation in communication and developing stereotyped patterns in behavior and interests. Some researchers believe that the reason for creating stereotyped patterns in children’s behaviors is some sensory impairment in response to sensory stimuli. Children with autism spectrum can use endorsed and predictable systems such as computers. Robots may be used as friends or assistant therapists to teach various social and cognitive skills. The present study aimed to compare the effectiveness of sensory integration exercises on stereotyped behaviors with and without robots in boys with autism spectrum disorder.

This research method was quasi-experimental with a pretest-posttest and follow-up design with a control group. The statistical population comprised all boys aged 7-9 years studying in Tehran boys’ autism schools (the academic year 2018-2019). Of whom, 45 children with autism were selected by convenience sampling and randomly assigned to two experimental groups (sensory integration exercises with and without robots) and one control group. Data were collected using the stereotyped behaviors section of the second edition of the Gilliam Autism Diagnosis Test (1994) in the pretest, posttest, and a 2-month follow-up. Both experimental groups used the 15-session sensory integration method, but one group also worked with the robot for 15 sessions. The control group received no intervention. The obtained data were analyzed using repeated measures analysis of variance and the Bonferroni post hoc test with SPSS 22 software at a significance level of 0.05.

The results showed that the changes in stereotyped behavioral disorders were different in the three groups. The study of significant effects showed that in the experimental situation, the mean scores of the sensory integration exercises using the robot decreased more than those without the robot and the control group (P<0.05). 

Findings show that combining sensory integration therapy and robot therapy improves the stereotypical behaviors of children with the autism spectrum more than sensory integration therapy alone.

Autism is a common disorder among children. Physical and architectural factors of rehabilitation centers may affect the quality of rehabilitation. This study aims to investigate the effect of physical and architectural elements of educational and therapeutic spaces on autism rehabilitation.

The present analytical-observational research was cross-sectional. This study used the standard Minnesota Questionnaire (MSQ) to assess employees’ job satisfaction. The standard sensory profile questionnaire 2 (short form) was employed to determine the sensory function pattern of autistic children aged 3 to 14 years. Finally, a researcher-made questionnaire of architecture quality assessment was used to evaluate the quality of physical space architecture, interior architecture, and standard facilities of educational and therapeutic spaces. In this cross-sectional study, 32 occupational therapists from university and hospital treatment centers, welfare centers, and private clinics, and 50 parents of children with autism participated as the available sample group. The Pearson correlation coefficient was used to examine the relationship between variables.

Findings from the study population showed significant relationships between the variables studied in the groups of sensation seeking, sensation avoiding, sensation sensitive, and sensation register (from the analysis of sensory profile) and improving the quality of rehabilitation of children with autism (P<0.05).

According to the study findings, job satisfaction, physical factors, sensory processing, and assessing the quality of architecture in the design of educational and therapeutic spaces of rehabilitation centers for children with autism are of particular significance. Utilizing the factors studied in this study will not only positively affect the treatment process of these patients, but it will also increase the job satisfaction of occupational therapists working in rehabilitation centers for autism.