فصلنامه طب توانبخشی
سال سیزدهم شماره 3 (امرداد و شهریور 1403)

Ultrasonography can be a suitable tool for measuring the muscle thickness of people with scoliosis. In the present study, the reliability and validity of ultrasonography for measuring the muscle thickness of people with idiopathic scoliosis are investigated.

 The method of this study was a systematic review. Based on this, a search was conducted in scientific databases of SID, Science Direct, Medline, Scopus, ISI and PubMed on articles examining ultrasonography’s reliability and validity for measuring muscle thickness in people with idiopathic scoliosis. The search keywords were “Reliability and Validity of Ultrasonography+Validity of Ultrasonography+ Reliability of Ultrasonography+Adolescence Idiopathic Scoliosis+Cross-section Muscles+Muscles.” Finally, the articles were entered into Endnote. In the selected studies, the intraclass correlation coefficient (ICC) of the reliability and validity of ultrasonography for measuring the thickness of all muscles of people with idiopathic scoliosis were investigated. 

 After reviewing the articles based on the inclusion criteria, 17 articles with 792 samples were selected. The methodological quality of the studied articles was confirmed with a modified criterion taken from Downs and Black (1989). As the findings show, the accepted criteria or level of reliability and validity and corresponding ICC threshold values could be found in most studies but were somewhat heterogeneous. Confidence intervals (CI) (typically 95%) have been reported along with the ICC in all studies.

 According to the results, ultrasonography is a valid and reliable imaging method for evaluating the thickness of the muscles of people with idiopathic scoliosis.

 Cardiovascular diseases are among the most common causes of death in the world. The prevalence of cardiovascular diseases increases with older age. Using cardiac exercise training to rehabilitate the heart after heart disease creates functional and structural adaptations in the patient’s cardiovascular system, reducing mortality from related diseases. Therefore, this study aimed to investigate the effect of two aerobic and combined exercise training methods on heart function capacity in middle-aged male patients after bilateral femoral artery coronary bypass grafting surgery. 

In this quasi-experimental study with a pre-test-post-test design, 68 middle-aged male patients (Mean±SD age: 56.19±1.26 years) were studied after bilateral femoral artery coronary bypass grafting surgery. The subjects were randomly and availably divided into 3 groups: Aerobic (n=20), combined exercise training (aerobic+resistance) (n=20), and control (n=28). The subjects in the intervention groups performed 8 weeks of training, 3 sessions per week. Each training session in the aerobic and combined groups was performed for 40 minutes with the intensity of 70-85% heart rate reserved and 60 minutes with the intensity of 40-80% of one repetition maximum for each patient. Levene’s test, multivariate analysis of variance (MANOVA), and Bonferroni statistical tests were used to analyze the obtained data at the significance level of P≤0.05.

The one-way MANOVA test showed that functional capacity, ejection fraction and maximal oxygen consumption increased significantly after aerobic and combined exercise training compared to the control group (P<0.05). However, the Bonferroni post hoc test showed no significant differences between functional capacity, ejection fraction, and maximal oxygen consumption at post-test levels in aerobic and combined exercise training groups (P>0.05).

 The findings of this study show that both aerobic and combined exercise training can improve the heart functional variables in middle-aged male patients after bilateral femoral artery coronary bypass grafting surgery, and these improvement levels appear to be independent of the types of training.

 Decreased vision is one of the sensory impairments that causes the sufferer to have difficulty in balancing and performing daily activities. The aim of this study was to investigate the effect of sensorimotor exercises on proprioception and balance in orderly women.

The present study is quasi-experimental and 30 women with visual impairment in the age range of 35 to 45 years were randomly divided into experimental and control groups. The experimental group performed sensory-motor exercises for 8 weeks and three sessions per week. Before and after the exercises, knee proprioception at 40 to 60 degrees with imaging method and functional balance was measured using the Y test. ANCOVA test was used to analyze the data at the significance level of (P=0.05).

The results showed that after the intervention of sensorimotor exercises, the proprioception of the knee joint at an angle of 40 to 60 degrees and functional balance in the experimental group compared to the control group significantly improved (P=0.0001).

 Strengthening the proprioception through motor-sensory exercises and improving motor-sensory input can increase balance in the elderly. Sensory-motor exercises in the closed motor chain strengthen the deep sensory feedback of the lower limb muscles and thus improve the balance and deep sense of the elderly.

 Body percussion improves cognitive, visual-spatial, and psychomotor skills such as body awareness, hand-eye coordination and writing skills, as well as laterality, social-emotional stimuli, and friendly relationships of the students. In addition to educational effects, this method has also led to the development of motor skills, attention, coordination, memory, and social interaction in patients with neurological disorders. This study aims to investigate the effectiveness of body percussion on the motor and social skills of boys with autism.

The study is quasi-experimental with an intervention. The research employed a pre-test-post-test design with a control group. The statistical population of this study comprised boys with autism (an age range of 8 to 14 years) studying at Tabassom 1 Elementary School in Mashhad City, Iran (allocated for autism spectrum disorders), in the academic year 2020-2021. The research population size was considered to be 55 students. In this study, the number of participants is 15 in the experimental group and 15 in the control group. The sampling was done through convenience sampling based on the inclusion criteria. The analysis of covariance was used to determine the statistical significance.

The Mean±SD age of children participating in the study was 11.2±0.34 years. After controlling the pre-test, significant differences were observed between the experimental and control groups regarding the motor skills variable (P<0.05). However, there was no significant difference between the experimental and control groups regarding the social skills variable (P>0.05) after controlling the pre-test.

Based on the findings, body percussion intervention is a physically never-ending stimulus and almost easily available. Thus, it can affect the motor skills of autistic students as a therapeutic modality. However, it has no significant effects on social skills and needs further evaluation.

 Despite the advancement of medicine in managing spinal diseases and the increasing development of treatment methods, back pain has remained one of the significant public health problems in industrial and non-industrial countries. Therefore, the present study aimed to investigate the effect of a course of exercise with a pelvic clock device on the endurance of central body muscles, torso range of motion, and pain intensity in middle-aged women with nonspecific chronic low back pain. 

 The present study was quasi-experimental with a pre-test-post-test design and a control group. The statistical population of the present study consisted of middle-aged women with nonspecific chronic low back pain in the age range of 35-50. The statistical sample of the study included 30 middle-aged women who were purposefully and accessibly selected from the study›s statistical population based on the inclusion and exclusion criteria. The exercise protocol was performed with a pelvic clock device for 8 weeks (3 sessions of 45 minutes per week) by a researcher in a sports club. Central body muscle endurance indices were measured using the McGill test (trunk flexural endurance test for abdominal muscle endurance) and modified Bearing Sorenson test. Also, the trunk range of motion and pain intensity were assessed using Schubert's modified test and visual analog scale. The measurement was made while the control group participated only in the pre-test and post-test stages. The paired t-test and independent t-test were used for intra-group and inter-group comparisons, respectively, at a significance level of 0.05.

 The results showed that 8 weeks of exercises with a pelvic clock device could affect the endurance of the muscles of the central body, the range of motion of the trunk, and the severity of pain in middle-aged women with nonspecific chronic low back pain. However, it did not affect the control group (P≤0.05). 

According to the present study findings, it is suggested that exercises with pelvic clock device are used as a cheap and practical modality to increase endurance of central body muscles and torso range of motion but reduce pain in middle-aged women with nonspecific chronic low back pain. It could also be used as a method of prevention.

Football is the most popular sport worldwide but has a high risk of injury. Optimal balance is one of the influential factors in injury prevention in sports, so this study aimed to compare the effect of 8 weeks of reactive neuromuscular training with core stability training on the balance of male football players.

 This research was a quasi-experimental study. Fifty-three male adolescent football players entered the study as subjects and were randomly divided into three groups: Reactive neuromuscular training (n=18), core stability training (n=17), and control (n=18). A balance error scoring system and Y balance tests were used for all subjects to assess the static and dynamic balance. Training groups then performed an 8-week training program, but the control group did not perform any specific training during this period. After 8 weeks, the tests were repeated. Statistical analysis was performed in SPSS software, version 26. To investigate the differences between groups, we used an analysis of covariance followed by an LSD post hoc test.

Both training groups in the post-test had significantly better static and dynamic balance than the pre-test (P<0.05). However, there was no significant difference between the two test stages in the control group (P>0.05). Also, between-group comparisons revealed that in the post-test, the reactive neuromuscular training group had better results than the other two groups in static and dynamic balance (P<0.05).

The results of this study show that reactive neuromuscular training has a greater effect on the balance of footballers than core stability training. According to the results obtained in this study, it is suggested that this type of training can be used in training programs for football players.

Muscle strength is one of the main factors in athletic success, injury prevention, and optimal rehabilitation for injured athletes. Also, the symmetry of the muscle strength ratio is fundamental to maintaining force-producing torques. Therefore, the present study aimed to evaluate and compare hip muscle imbalances in football athletes and normal individuals.

 The current research is causal-comparative. Fifteen football players and 15 normal healthy individuals volunteered for the study. Then, their flexor, extensor, abductor, adductor and internal and external rotator strengths were assessed using a hand-held strength test.

The present study showed a significant difference in the ratios of extensor to flexor muscle strength, adductor to abductor, and internal to external rotator strength between the dominant and non-dominant thigh (P<0.05). In addition, significant differences were observed in thigh muscle strength between football players and ordinary people (P<0.05).

 According to the results of the present study, the nature of football in greater use of the dominant leg can lead to an imbalance in the strength ratio of the agonist and antagonist muscles in the hip joint between the dominant and non-dominant limbs. Therefore, it is recommended that corrective exercises and movements be used for the antagonist part that caused an imbalance in muscle strength to reduce the possibility of injury in the future.

Intellectual disability manifests through defects in cognitive, motor, and perceptual skills as elements affecting learning and acquiring individual skills. Efforts to improve these skills are essential in these children. This study investigated the durable effects of perceptual-motor process-oriented interventions with the Ramon and Johnston protocol on the motor, cognitive, and perceptual performance of children with mild intellectual disability. 

In this quasi-experimental research, 21 children with mild intellectual disability aged 7 to 12 years were selected using the available sampling method and according to the inclusion criteria. Then, they were assigned to an experimental group of 10 students (10 weeks of perceptual-motor intervention according to the Johnstone and Ramon protocol, two sessions per week) and a control group of 11 students (no intervention) using a simple random method. The participants were evaluated before and 2 months after the intervention with movement assessment battery for children 2nd Edition, Conners’ continuous performance test-II, the working memory test of Wechsler intelligence scale for children fourth edition, and the test of visual perception skills revised. Univariate covariance test was used for data analysis.

The findings showed a significant difference between the intervention and control groups in general motor performance, aiming and catching, the correct answer in the attention test, visual sequential memory, and visual figure-ground in the delayed post-test stage (P<0.05). Also, no significant difference was seen in other subtests (P>0.05).

 Bottom-up approach interventions through Ramon and Johnston’s comprehensive perceptual-motor training can significantly help improve general and ball motor skills, sustained attention, visual sequential memory, and visual figure-ground in children with mild intellectual disability.

The prevalence of spastic cerebral palsy is increasing rapidly among children, with a prevalence of 2-4 per thousand people. This study aimed to investigate the effect of 12 weeks training program with TheraSuit and its durability on balance control and gait parameters in children with cerebral palsy.

 This quasi-experimental study was performed on children (age range of 6-12 years) with spastic diplegia cerebral palsy referred to occupational therapy and rehabilitation clinics in Hamadan City, Iran, in 2021. Twelve children were selected by convenience sampling. Without random assignment, the patients were divided into two groups: with and without TheraSuits. Before and after the intervention, the balance score and kinematic parameters, including step length, step width, walking speed, ankle, thigh and knee range of motion, were measured in stationary and moving positions in both groups. The exercises were performed for 12 weeks, three sessions every other day for one hour. The Mann-Whitney U and Wilcoxon tests were used to evaluate the effectiveness of the intervention. All statistical analyses were performed in SPSS software, version 24 at a significance level of 5%.

The results showed a significant improvement in balance score after the intervention in the intervention group compared to the control group (P=0.002), but the speed of walking, hip and knee range of motion significantly decreased compared to the control group (P<0.05). The results showed that 10 weeks and one month later, there was a lasting effect of training in both groups (P>0.05).

 Our results confirmed the effectiveness of corrective exercises in the group with TheraSuit, so its use in a rehabilitation program for cerebral palsy patients is recommended, and the durability of the exercise was seen in both groups.

 The most serious and severe injuries among female volleyball players is the knee injury, especially the anterior cruciate ligament (ACL) tear. Its key risk factors are dynamic knee valgus (DKV) and abnormal alignment during jump landing. One of the successful protocols regarding the prevention of knee injuries in female volleyball players is professional sportsmetrics volleyball training. In the present study, the effect of this protocol on DKV correction and landing error scoring system (LESS) was investigated.

 The current research is quasi-experimental with a pre-test-post-test design. The statistical sample included 30 female volleyball players (Mean±SD age: 20.83±2.22 years, Mean±SD height: 168.16±6.47 cm, Mean±SD weight: 59.13±7.4 kg, Mean±SD body mass index (BMI): 20.83±1.52 kg/m2, and Mean±SD sports experience: 5.46±1.8 years) who were randomly divided into the training (15 people) and control (15 people) groups. Double leg squat and LESS tests were used to evaluate DKV and landing error. The exercise group participated in the present protocol for 6 weeks, three sessions per week. Each session was approximately 90 minutes, including warm-up exercises, sportsmetrics volleyball training, and cool-down. The analyses of covariance were used to evaluate the data at a significant level of P=0.05.

The results of covariance analysis showed that performing these exercises significantly reduced (P=0.01) DKV (from 23.13 to 7.86) and landing error (from 17.46 to 7.6). In other words, the training group experienced a 66% decrease in DKV and a 56% decrease in landing error after performing six weeks of sportsmetrics volleyball training.

 Sportsmetrics volleyball training has successfully improved performance and prevented ACL injury in female volleyball players. According to the present study results, performing these exercises leads to correct DKV and improves lower extremity alignment and landing technique. Therefore, performing sportsmetrics volleyball training is strongly recommended for female volleyball players with DKV.

Integrated education is a movement towards educational justice and integration of the education program for all, the implementation of which is still facing challenges. The present study aimed to explain the challenges of implementing the integration plan for students with borderline mental functioning in the ordinary schools of Ahvaz City, Iran. 

The present study was conducted using a qualitative approach in primary schools in Ahvaz City using conventional content analysis based on the approach of Lundman and Graneheim from December 2020 to August 2021. Data were collected through field notes and 17 in-depth semi-structured interviews with 12 individuals, including 7 teachers, 2 principals and 3 assistants. Data coding and analysis were performed using MAXQDA software, version 18.

Data analysis led to the emergence of 28 codes, including 3 categories of educational system challenges (with two subcategories of lack of planning and poor system of appraising borderline students), teachers’ challenges (with 5 subcategories of annoyance and objection of ordinary students, not following educational calendar program, high workload in integration classes, crowding and confusion of integration classes, and the teacher’s emotional reaction to not learning of the borderline students), and the attitude and response to integration plan (with 3 subcategories of reaction of ordinary students’ parents toward the integration plan, negative attitude of educational staff toward integration plan, and teachers’ objection toward integration plan).

 The results showed that the administrators have a negative attitude toward implementing the integration plan and are against it. The successful implementation of the integration plan depends on solving the challenges in the path of this plan. It seems that the results of the present study can help education managers and policymakers design suitable and desirable programs to solve the challenges and facilitate the integration of students with borderline mental functioning in ordinary schools.

During pregnancy, a woman’s body undergoes many changes, which can be studied from physiological and psychological aspects. The purpose of this research is to compare functional disability and body image after normal and cesarean delivery.

 The current research is of a comparative causal type. In this study, 114 non-athlete women who gave birth in Urmia City, Iran, were selected voluntarily and availably within one month after delivery. Of these, 58 had a normal delivery and 56 a cesarean delivery. Back functional disability was evaluated by the Oswestry disability index questionnaire, knee functional disability by the international knee documentation committee questionnaire, and body image by body image questionnaire in pregnant women. The data were analyzed using SPSS software, version 24.

 The independent t test showed a significant difference between the functional disability of the back and knees in the two groups with normal delivery and cesarean delivery. So, the cesarean section group had more disability in the low back and knee area compared to the normal delivery group (P=0.001). Also, the normal delivery group had a better body image compared to the cesarean group.

 Normal delivery can be considered a safe delivery method to prevent the occurrence of functional disability in the back and knees and effectively reduce adverse symptoms related to body image after delivery.

 Treatment adherence is a key factor in improving patient safety and the quality of care according to the needs of older people. Non-adherence prevents older adults from accessing the best treatment, and this issue may be especially problematic in chronic medical conditions. Therefore, the present study aims to determine the relationship between interpersonal conflicts and self-compassion with treatment adherence in the elderly with type 2 diabetes.

 The method of this research was descriptive and correlational. The study’s statistical population included all older people with type 2 diabetes referred to the endocrinology clinic of the fifth district of Tehran City, Iran, during the first 6 months of 2023. Based on the formula of Tabachnick and Fidell (2007), 138 people were randomly selected as a sample. In this research, Rahim’s standard interpersonal conflict resolution style questionnaire, self-compassion scale, and treatment adherence questionnaire were used. Finally, the data was entered into SPSS software, version 26 to check the correlation between the variables, and the Pearson correlation coefficient and multiple regression were used simultaneously to analyze the data.

This research showed that interpersonal conflicts predict 29.9% and self-compassion 26.5% of changes in treatment adherence. Among these, the components of interpersonal conflict styles included integrity (r=0.24), avoidant (r=-0.33), and required (r=-0.17), and the components of self-compassion, including self-kindness (r=0.24), avoiding self-judgment (r=0.21) and absence of over-identification (r=0.17) can predict treatment compliance in older people with type 2 diabetes

This research has shown that interpersonal conflicts and self-compassion have a positive and significant relationship with treatment adherence in older people with type 2 diabetes and can predict treatment compliance in these older people.