فصلنامه علوم پیراپزشکی و توانبخشی
سال دوازدهم شماره 3 (پاییز 1402)

Functional movements and balance are necessary requirements in many sports. However, there is little information about defects in functional movements and balance in professional athletes in different sports. The purpose of this study was to screen the functional movement patterns and balance in professional athletes with the aim of preventing sports injuries.This was a cross-sectional causal-comparative study. Among the active sports in Chaharmahal and Bakhtiari province, nine sports, including wrestling, basketball, wushu, badminton, judo, rock climbing, taekwondo, football, and volleyball (n=20 athletes in each sport), were randomly selected, and the professional athletes according to the inclusion and exclusion criteria were evaluated. In order to evaluate movement defects, three functional patterns, including the overhead squat, overhead squat with heel lift, and single leg squat, were used based on the Fusionetics scoring system. Balance was also evaluated using the Y balance test. Kruskal-Wallis and Wilcoxon tests were used to compare the scores of different sports fields in the evaluation of functional movement patterns and balance (p<0.05).The results showed that professional athletes in different sports showed good performance in squat and balance functional tests (75-100%), and in general, the risk of injuries in athletes was low. Nevertheless, significant differences were observed in the scores of functional tests and dynamic posture control in some sports fields, which indicated the presence of injury-prone athletes in different sports teams (p<0.05).From the findings of this research, it can be concluded that professional athletes had good scores in general, but they may have defects in functional movement pattern and balance, which make athletes prone to injury. Therefore, it is recommended that the trainers of sports teams and clubs continuously use injury prediction tests such as functional movement patterns and dynamic posture control in order to evaluate and screen their athletes.

The purpose of this study was to determine the effect of eight weeks of corrective exercises on anterior pelvic tilt, lumbar lordosis and movement patterns of women with lower cross syndrome.30 middle-aged women (20-30 years old) suffering Lower Cross Syndrome were purposefully selected and randomly divided into two groups of exercises (15 subjects) and control (15 subjects). First, the exercises and tests of the present study were explained to the subjects. Functional Movement Screen (FMS), Nine Test, Palpation Meter (PALM) and flexible ruler respectively to check movement patterns, Pelvic Inclination and women's lumbar lordosis were used. The subjects of the training group performed corrective exercises for eight weeks, the control group also did their daily activities, and the exercises were performed under the supervision of a corrective movements specialist. After the completion of the course, all the subjects were re-evaluated in all research variables as in the pre-test. All subjects who participated in this study had a special card for prescribing Corona vaccine. To check the difference between groups and within groups, Covariance and paired t-tests were used via SPSS26 software. The significance level in the present study is less than 0.05.The results of the present study show the effect of the corrective exercise program on reducing pelvic tilt (p≤0.001, Pre-test mean: 15.46 ± 1.50, post-test mean: 7.86 ± 1.59), lumbar lordosis (p≤0.001, Pre-test mean: 56.40 ± 4.79, post-test mean: 42.33 ± 1.49), FMS screening test (p≤0.001, Pre-test mean: 13.06 ± 1.53, post-test mean: 18.20 ± 1.26), and Nine test (p≤0.001, Pre-test mean: 17.07 ± 1.97, post-test mean: 22.26 ± 2.43).In general, the results of the present study show the effect of selected corrective exercises on reducing the pelvic tilt angle and lumbar lordosis and improving the results of functional screening tests in women with the lower cross syndrome. Based on this, it is recommended to use tensile-resistance corrective training program to reduce the amount of pelvic tilt angle and lordosis and generally prevent back pain in the future.

The alignment of the spine can alter the loading of spinal cord segments at different parts. Forward head posture by altering the position of the neck in relation to the body is effective in producing pain and disability in the spinal cord. The purpose of this study was to explore the reliability analysis of the neck and trunk endurance tests in peoples with and without forward head posture and also to evaluate the effect of gender and forward head posture on neck and trunk muscle endurance.

In this descriptive-analytic study, 67 students, including 40 males (mean age 23±1.5 years, mean height 173.6±16 cm, mean weight 69.13±8.69 kg) and 27 females (mean age 23.29±3.31 years, mean height 162.65±5.29 cm and mean weight 59.45±7.04 kg) were randomly assigned to the study and divided into two groups of with and without forward head posture based on craniovertebral angle measured through photography. Deep neck flexor and extension, transverse abdominis, flexors, extensors, and lateral flexor trunk muscles' endurance were assessed in females and males in a test-retest reliability design with one-week interval.

Neck and trunk endurance test were obtained excellent reliability (0.93-0.99). The interaction between forward head posture and gender was significant for the double prone straight leg raise endurance test (P<0.05). It means that the endurance of lower trunk extensor muscles were lower in males with forward head posture (P<0.05; difference=20.28), but no difference was observed in females (P>0.05). The effect of forward head posture was also significant in the Sorenson endurance test (P<0.05). The neck and trunk muscles endurance generally and significantly were lower in females compared to males (P<0.05; difference=9.37-176.68).

Gender is an important factor in the presence of forward head posture affecting trunk muscle endurance. In examining the complications of forward head posture, it is advisable to pay attention to the function of the whole spinal cord.

Core Stability is an important prerequisite to perform sports skills and all activities such as walking, climbing stairs and balance. Therefore, the aim of this study was the effect and durability of six weeks core stability exercises on balance and lumbo-pelvic function in women with core muscles weakness. This study was semi-experimental with a pre-test, post-test and follow-up design. A number of 30 active women of Mahabad city were selected purposive and available from the statistical population and were randomly divided into two groups of 15 subjects, control and experimental. To evaluate static balance, dynamic balance, lumbo-pelvic function and endurance of trunk muscles, respectively Stork, Y Balance, FSD) Forward Step-Down and McGill tests are used. After the pre-test, the experimental group performed the exercises for 6 weeks and three sessions per week, and the control group continued their daily activities. Then, both groups participated in the post-test, and one month after the exercises, variables of study were followed up. Repeated measured ANOVA at a significance level of 0.05 was used to compare the data.The results in the training group showed that core stability exercises had a significant effect on the variables of static balance (p=0.001), dynamic balance (p=0.001), lumbo-pelvic function (p=0.001) and trunk endurance (p=0.001). However, the effects of training after one month without training were durable only for the variable of lumbo-pelvic function (p=0.73). The results of the Bonferroni post hoc test in the post-test also showed that there was a significant difference between the two groups in all the variables studied and that the training group performed better (p < 0.05). In the follow-up phase, there was a difference between the two groups only in the variables of lumbo-pelvic function (p=0.001) and trunk endurance (p=0.001).According to the results of the study, core stability exercises improved static and dynamic balance, lumbar-pelvic function and trunk endurance of middle-aged women. Therefore, trainers and therapists are suggested to use core stability exercises as an effective training protocol in their programs.

Backward walking compared to forward walking in combination with resistance training and their interference effect have been less studied. So, the purpose of this study was to compare the effect of three resistances, concurrent forward walking, and backward walking training on the physical and cardiac function in middle-aged men.In a semi-experimental study design, 48 middle-aged (mean age 56.5±4.3 years, mean weight 79.4 ±4.9 kg and mean body mass index 27 ±2.9 kg/m2) were recruited and randomly assigned into four groups: Group 1) resistance training (n=8), Group 2) resistance–aerobic training forward walking/running (n=10), Group 3) resistance–aerobic training backward walking/running (n=11), and Group 4) control (n=9). The training was performed for eight weeks, three sessions per week. 48-h after the last exercise training, echocardiography (TAPSE, LVEDD, ESV, EF, and RHR), muscle strength, and aerobic capacity were performed. An analysis of variance with repeated measures test was used to analyze the data (p<0.05).The results showed that despite improvement in aerobic capacity (Group1.2,3 and 4, 6.1, 8.4, 7.5, and 1.3 percent respectively) and muscle strength (Group1.2,3 and 4, 5.5, 2.15, 3.8, and -1.1 kg respectively) there was no significant difference between or within groups in any cardiac performance variables (P>0.05). However, the training improved some physical performance.In middle-aged men, eight weeks of combined training regardless of aerobic type (forward or backward walking or running), although it improves aerobic capacity and muscle strength, has no significant effect on cardiac performance. Perhaps the duration or intensity of the training was not enough to affect these variables, which could be considered in future studies

Low Back pain is one of the most common disorders that affect people's functional ability in daily life and workplace activities, as well as their general health and quality of life This study aims to investigate the effect of eight weeks of water walking training on kinematics and trunk-pelvic coordination during walking in people with chronic back pain.In this semi-experimental with pre-post test research design, 50 subjects with chronic back pain were divided into two control (25 subjects) and experimental groups (25 subjects) based on their weight and VAS pain index, so there are no any significant differences between weight and pain. The Mean±SD of height, weight and age in the control group were 170.62±6.8, 81±6.63 and 44.74±5.92, and in the experimental group were 167.16±7.62, 78.32±8.01 and 43.66±5.32 respectively. Noraxon IMU system was used to measure the pelvis and trunk kinematic variables during walking. After that, the angular information of the pelvis and trunk was extracted and after processing the range of motion variables, coordination with continuous relative phase index and variability of coordination were calculated. After the pre-test, the subjects were exposed to eight weeks of water walking training with a frequency of three days a week, and after the training, the pelvic trunk kinematic test was taken. The control group continued their daily activities after the pre-test. For statistical analysis, the repeated measure ANOVA was used for comparison (P≤0.05).The results of this study showed that training in water within and between groups reduces the range of motion of the trunk (P=0.001). On the other hand, the results of this study showed that training in water increases the coordination between the trunk and pelvis, which indicates greater coordination between the trunk and pelvis during walking (P=0.001). Also, the results showed that the variability of coordination after training in water decreases significantly within and between groups (P=0.001).The results of this study showed that performing six weeks of water walking training at different speeds due to the features of water training such as buoyancy and flow resistance reduces the range of motion of the trunk, and this decrease in range of motion balances the movement of the trunk concerning the pelvis, and the coordination between these two segments is increased. On the other hand, the results of this study pointed to the greater stability of walking of patients with back pain after performing the exercise, which indicates that the walking pattern in high repetitions is closer to normal walking.

Assessing the severity of trauma is a quantifiable measure. For several years, various scales have been used to assess the severity of trauma in patients. Evaluation and early prediction of trauma severity, prognosis of mortality and probable survival will provide timely and better treatment. Therefore, we have reviewed the studies about different scoring systems to predict trauma mortality in Iran.

In this study, PRISMA guidelines were used to review the studies. For this purpose, PubMed, Scopus, Magiran, and SID databases were searched to retrieve English and Persian published studies. Searches were conducted without a time limit until February 21, 2023. The studies published that were conducted to compare scoring systems, were included in the study and their characteristics were examined. Data analysis was performed through the content analysis method.

A total of 663 studies were retrieved, after removing duplicates and unrelated ones based on the evaluation of the title, abstract and full text. Finally, 32 studies were included in the review. In 15.62% of the studies, the Trauma Injury Severity Score index has been suggested to evaluate the severity of trauma. Other suggested scoring systems are Acute Physiology and Chronic Health Evaluation (9.37), Glasgow coma scale (9.37), injury severity score (6.25).

According to studies in this study, application of the Trauma Injury Severity Score index is recommended in Iran. This quantitative measure can be used in predicting mortality and assessing plans for service quality. In order to avoid any possible errors, it is better to calculate other indices such as ISS and MGAP together with this index.

Training of athletes can be quantified by training load. In recent years, the concept of training load has received more attention, and this is important because the necessity of monitoring the athlete in line with the required adaptations of the desired sport's needs is of great importance. Therefore, studies considering the relationship between training load and the risk of injury and overtraining are more emphasized. The purpose of the present study is to answer the question of whether it is possible to prevent injuries by controlling the exercise load?

Articles were searched in the PubMed Medline and Science direct and Google scholar  database and keywords injury, exercise load, and combination of words Injury& Prediction and  Load & Injury 2016 and 2022. Only experimental and semi-experimental studies were reviewed.

A total of 25 articles were selected among 507 studies based on the inclusion criteria. Most of the reviewed studies introduced the ACWR criterion as an important criterion in measuring training load and reported its relationship as an injury risk factor. These studies investigated the relationship between training and competition load and athletes' injuries. The results of the reviewed studies showed that the ACWR criterion is an important criterion in measuring the training load and this criterion is introduced as an injury risk factor.

Results of the present study showed training load is related to the possibility of injury in athletes, but there is still a debate in scientific circles about the exact way of this relationship. Additionally, the best way to measure load training is the measurement of internal and external load together. Results also illustrated that the pattern of impact of training load on the probability of injury in athletes in individual and team sports is different.  In order to consider the principle of individual differences in the probability of injury, it is necessary to use criteria that can report the internal load of each athlete individually.