نشریه پژوهش در توانبخشی ورزشی
پیاپی 22 (پاییز و زمستان 1402)

In recent years, statistical significance alone cannot determine the impact of interventions in RCT studies, and the minimum clinically important difference (MCID) is used to check the real value of an intervention to enter the treatment and health system. The present study is a narrative review of the concepts and methods of MCID calculation in clinical trial studies to understand this diagnostic approach better.

Researchers searched Google Scholar, Web of Science, and PubMed by combining the keywords "MCID","distribution-based approach","anchor-based approach" and "minimum clinically important difference" in English. , and reviewed more than a thousand studies related to the determination and calculation of MCID, and finally the general concept of MCID and related methods were identified and the basic assumptions, statistical biases, and shortcomings of each method were examined in detail.

Two acceptable methods compared to other methods were identified, distribution-based and anchor-based. Also, the general limitations in the exact determination of an identified MCID were: the number and difference of scores obtained from different methods of MCID calculation, the loss of the patient's perspective, and the relationship between the change scores before and after treatment.

The purpose of MCID calculation is to determine the most optimal treatment method both in terms of time and cost for patients. In recent years, the importance of this issue seems more and more; Therefore, researchers and specialists in clinical fields can use these methods cautiously to measure the performance of their interventions in the work and study environment.

This study aimed to investigate the activity of soccer players’ rectus femoris and vastus medialis muscles by simulated soccer tests during landing.

The timing and activity of rectus femoris and vastus medialis muscles of soccer players (15 subjects) during different periods of the test (i.e., before the test, immediately after 1st and 2nd half of the test) were investigated. A surface electromyography device (ME6000) was used to collect data during single leg drop (before the game, after the first and the second half time). Descriptive and repeated measures of ANOVA were used to analyze data.

The results of this study show that fatigue affects the timing of muscles, but in different periods of the test, it wasn’t significant (P>0.05, F=2.95, F=2.82). Significant differences were observed for the feed-forward activity of vastus medialis (P≤0.05, F=4.55), but for rectos, femoris, it wasn't significant (P>0.05, F=1.68), but significant differences weren't observed for feedback activity of rectos femoris and vastus medialis (P>0.05, F=2.46, F=0.55).

Our results show that fatigue doesn't affect the timing of muscles during different periods of the test, but a difference was found for the feedforward activity of the vastus medialis muscle. Regarding the results, a comprehensive investigation of the effects of fatigue on the rectus femoris and vastus medialis muscles and their effects on the knee joint during long-term studies is suggested.

Anterior cruciate ligament (ACL) injury is common in football. Its mechanism mostly lands after heading, and it causes disturbances in proprioception and knee function and secondary injuries. This study aimed to investigate the effect of kinesio tape on proprioception and landing mechanics in soccer players at high risk of ACL injury.

30 male soccer players with a high risk of ACL injury with an average age of 21.76 ± 2.46 years were purposefully selected and randomly assigned to two control and experimental groups. Proprioception was evaluated with a goniometer and landing mechanics using the LESS test in both groups. Then, kinesio tape was applied to the knee area for the experimental group. The control group received no intervention, and both groups’ proprioception and landing mechanics were rechecked. Paired t-tests and Wilcoxon tests were used to examine the within-group effect. A covariance analysis and the Mann-Whitney U test were used to investigate the between-group effect. The data was analyzed using SPSS software version 24.

The results showed a significant difference in proprioceptive variables (p=0.002) and landing mechanics (p=0.004) after kinesio tape application.

By improving landing mechanics and proprioception, applying kinesio tape can effectively reduce the risk of non-contact ACL injury in people at high risk of ACL injury.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by premature defects in social communication and unusual behaviors.Autistic children have movement problems such as positional orientation disorders and ability. As for an inactive lifestyle as these children and more effective physical activity in reducing the incidence of these problems, games are a suitable option for increasing discipline in children. In this study, 16 boys with autism spectrum disorder in the age range (7-17) in the Rasht city were selected by convenience sampling and randomly assigned to control and experimental (n = 8). Protocol was performed for six weeks (three days each week), while the control group did not receive any program. The modified stork test was used to measure static balance, the heel-toe test was used to measure dynamic balance, and the Azerty short form was used to measure orientation. For statistical analysis of variables, mixed analysis of variance (groups*time), paired t-test, independent t-test, Mann-Whitney U, and Willcoxon tests were used at a significant level (p≥0.05). Data were analyzed using SPSS software (version 26). Results showed a significant difference in improving children’s dynamic balance and orientation, while no difference was observed in the control group. In addition, no significant effect was observed in improving static balance in subjects (p≥0.05). The result showed that the protocol in the form of a corrective game is effective on the dynamic balance and orientation of autistic children and is not significant on the static balance.

The present study aimed to investigate the effect of rhythmic exercises with music on the trampoline on motor ability and balance of educable mentally retarded children.  This research used a semi-experimental method with pre-test and post-test designs for two experimental and control groups. The statistical sample of the research was 30 educable mentally retarded children who were 9-10 years and were selected as available. Bruininks-Oseretsky (BOTMP), time up and get (TUG) tests were used to measure fine motor skills and balance, respectively. Using the counterbalance method. The experimental group performed exercises on a trampoline for eight weeks, and the control group did not receive any intervention. After the intervention, a post-test similar to the pre-test was conducted. After six months, the follow-up period was taken from samples of both groups. The results of Mixed ANOVA showed that rhythmic exercises with music on the trampoline had a significant effect on children's fine motor skills and balance from pre-test to post-test, so 91% of the changes in children's fine motor skills and balance were influenced by rhythmic exercises on the trampoline. In the follow-up test after six months, there was no significant difference in fine motor skills between the two groups. The balance of the experimental group was better than that of the control group. So, it can be said that rhythmic exercises with music on the trampoline are effective in the rehabilitation of educable mentally retarded children, and this method can be used in the movement rehabilitation of these children in schools.

This research aimed to compare the effect of six weeks of electrical stimulation and isometric contraction of the quadriceps muscle on the pain and performance of male athletes with knee osteoarthritis.

thirty-two male soccer players with at least 2 years of playing experience in the provincial league and suffering from mild to moderate knee osteoarthritis with an average age of 45-50 years participated in this research. Eligible people were randomly divided into 4 groups of 8 people including electrical stimulation, isometric contraction, electrical stimulation+isometric contraction and control. Interventions were implemented in the target groups for six weeks. The intensity of knee pain was determined according to VAS (Visual Analogue Scale), 6-minute walking test (6MWT), SCD test and fast walking test of 10 x 4 meters were evaluated to measure the performance of patients with osteoarthritis. After ensuring the normality of the data distribution, analysis of covariance statistics was used to determine inter-group changes and despite the significance of Tukey's test.

Six weeks of electrical stimulation, isometric and combined contraction (electrical stimulation and isometric contraction) caused a significant decrease in changes in pain index levels (vas) and functional indices in patients with knee osteoarthritis compared to the control group (p≤0.05) and No significant difference was observed between the experimental groups (p>0.05).

According to the results of the research, it is recommended to use both treatment methods or a combination of them to reduce pain and improve the performance of athletes with knee osteoarthritis.

To investigate and compare two water and land walking programs on the balance index of overweight elderly people.

The current research was quasi-experimental with a pre-test and post-test design. The statistical population included 64 seniors available in Gilan province aged 65 to 75 years. By Cochran's test, the statistical sample consisted of 54 people, and they were divided into three groups: 1. Walking in water (18 people), 2. Walking on land, 3. Control (18 people). Correlated t-test and two-way analysis of variance were evaluated to evaluate the values of overall balance, medial-lateral balance, and anterior-posterior balance in the pre-test and post-test in Spss version 25 software.

In the water walking group, the overall balance index had a mean difference of 0.22 and t value (3.592), the medial-lateral balance index (frontal) had a mean difference of 0.18 and t value (3.633), the anterior-posterior index value (sagittal) had a mean difference of 0.19 and the t value (3.501) was at a significant level (0.05). Also, in the dry walking group, the overall balance index had a mean difference of 0.11 and t value (2.412), the frontal balance had a mean difference of 0.14 and t value (3.015), the sagittal balance had a mean difference of (0.06) and t value (2.006) and the significance level was P<0.05.

Walking exercises on land and walking exercises in water have been associated with improving overall, anterior-posterior, and medial-lateral balance in overweight elderly people.

Core stability and strengthening of core stability muscles are among the new debates in sports medicine. The present study aimed to determine the effect of CX WORX exercises, one type of stability exercise, on proprioception and strength of selected muscles in basketball players with trunk defects.

Thirty female basketball players with trunk defects were selected by available sampling and randomly placed in two control and training groups. Trunk defects through the tuck jump test, knee, and ankle proprioception using a goniometer, trunk proprioception using Kinovea software, the strength of knee flexors and extensors, hip abductors and external rotators, and basketball players' trunk flexors and extensors using a dynamometer were evaluated. CX WORX exercises were performed by the training group for six weeks. Paired sample t-tests and covariance analysis were used to analyze the data.

The results of the present study show a significant effect of CX WORX exercises on trunk (P=0.014), ankle (P=0.000), and knee (P=0.000) proprioception and the strength of knee (P=0.000), and trunk extensors (P=0.000), abductors (P= 0.000) and external rotator of the hip (P=0.000) of the subjects of the experimental group compared to the control group, but no significant difference was observed between the strength of the knee flexor muscles between the two groups (P>0.05).

According to the results, CX WORX exercises improved trunk, ankle, and knee proprioception and the strength of the knee and trunk extensor, hip abductor, and external rotator muscles of basketball players with trunk defects. Therefore, it is suggested that experts in the field of health and corrective exercise use CX WORX exercises with the aim of increasing proprioception and muscle strength of basketball players with trunk defects.

The foot is crucial for maintaining balance and bearing weight, as it is the lowest part of the movement chain of the lower limb. Pes planus is a common condition where the height of the medial longitudinal arch of the foot decreases or disappears. In this study, we aim to determine the effect of kinesio tape and dynamic tape on the balance and ankle dorsiflexion range of motion (DFROM) of men suffering from pes planus following fatigue. In this cross-sectional study, 35 men aged between 18 and 35 with pes planus participated, meeting the inclusion and exclusion criteria. The study evaluated dynamic balance and ankle DFROM on three separate days under each of the three conditions: control (without tape), kinesio-tape, and dynamic tape before and after fatigue. The modified low-dye method was used for taping. The data was analyzed using a repeated measure analysis of variance test, with a significance level of P<0.05. No significant differences were found in ankle DFROM before and after fatigue (P<0.05). Additionally, DB results were not significant differences before fatigue (P<0.05). However, after fatigue, a significant difference was found between the dynamic tape and other conditions in all three directions: anterior, posteromedial, and posterolateral (P<0.05). According to the results obtained, DT is recommended to improve DB in men with pes planus after fatigue.

The present study was conducted to compare the effect of dynamic neuromuscular stabilization (DNS) exercises and Otago on balance, proprioception and trunk endurance of elderly women.

45 elderly participants were divided into three groups: control, DNS, and Otago exercises, each consisting of 15 individuals. Sharpand-Romberg tests as well as standing and walking time were used to evaluate static and dynamic balance (DB). Trunk endurance was evaluated with a 60-degree flexion test and trunk proprioception with a goniometer. After evaluating the variables, the subjects of the training groups performed the exercises for 6 weeks. The control group did their daily activities. After the training program, a post-test was conducted, and statistical analysis was performed using SPSS version 24 software. The analysis of covariance and post hoc Bonferroni test were utilized to compare the research factors between the experimental and control groups at a significance level of 0.05.

The results of the research showed that between the control group with DNS and the control group with Otago in static balance (p=0.001), DB (p=0.001 and p=0.005), trunk proprioception (p=0.001) and trunk endurance (p=0.001, p=0.003). Also, a significant difference was observed between the two groups of DNS-Otago in the variables of trunk proprioception (p=0.004) and trunk endurance (p=0.002). However, this difference was not significant in the field of static and DB (p>0.05).

The results of this study demonstrate the effectiveness of both DNS exercises and Otago in improving balance, endurance, and trunk proprioception in the elderly. These findings emphasize the importance of utilizing these exercises to enhance the functional level of older adults.

The present study was conducted to determine the effect of Yumeiho-therapy massage on pain, proprioception, and range of motion (ROM) of the back and shoulders in men with back pain caused by trigger points. In order to conduct this study, 30 men with hidden trigger points were randomly assigned to two control groups and Yumeiho-therapy massage. After selecting the subjects, the amount of back pain was determined using the Visual Analogue Scale (VAS). Also, the proprioception and ROM of internal and external rotation of the shoulder were evaluated using a goniometer. In addition, the back's ROM was evaluated using the Schuber method. After evaluating the variables, the subjects were divided into two groups: control and massage, and the Yumeiho-therapy massage was applied for six weeks (3 sessions per week and a duration of 30 minutes). During this period, massage was not applied to the control group. ANCOVA and Paired Sample t-tests were used to test the hypothesis. The study’s results showed that applying massage significantly reduced back pain (P=0.001), shoulder proprioception (P=0.001), back range of motion (P=0.001), internal rotation shoulder range of motion (P=0.001), and shoulder external rotation range of motion (P=0.001). However, no significant difference was observed in the control group after six weeks. the results of the study showed that the use of Yumeiho-therapy massage is suggested to therapists as an effective intervention to reduce pain and improve performance in people with back pain caused by trigger points.

This research aimed to investigate the effect of virtual reality games on the balance and lower extremity function of children with Down syndrome. The present study's participants were 30 girls aged 8-12 years old with Down syndrome and an IQ between 50 and 70. They were invited to this research in a purposeful and accessible way and were randomly divided into two groups 15. The intervention program consisted of an average of 30 minutes of movement games (two 15-minute boxing and skiing games) with an Xbox device for eight weeks (three days a week with the supervision of the researcher). Assessment of balance was done using the Berg balance test, and assessment of lower extremity performance was done using long jump, vertical jump, single-leg jump, and 20-meter shuttle run. Based on the results obtained from covariance analysis, a significant difference was observed between the two experimental and control groups in balance (P=0.0001; F=39.9), long jump (P=0.0001; F=32.07), vertical jump (F=0.001) (P = 62.52 F), single-leg jump (P = 0.0001; F = 76.4), and shuttle run (P = 0.0001; F = 38.5). The research results showed that playing virtual reality games can improve the balance and lower extremity function of children with Down syndrome. It is recommended that virtual reality games be used more to improve these capabilities in children with Down syndrome.