Journal of Paramedical Science and Rehabilitation
Year:2019 | Volume:7 | Issue:4 |Papers Count:10

Purpose: Low back pain is one of the most common musculoskeletal problems. Although abnormal muscle function is known as one of the possible causes of low back pain, no research was found concerning the forces applied on the lumbosacral joint in patients with low back pain. Thus, the aim of this study was an investigation of the interaction of forces applied on lumbosacral and lower limb joints in patients with chronic low back pain compared to healthy subjects while walking. Methods: The present study consisted nine female with nonspecific low back pain (NLBP) with mean height and weight of 158. 81± 5. 56cm and 61. 68± 8. 88 kg, respectively and 8 height and weight matched healthy females. Medio-lateral, vertical, braking and propulsive joint contact forces of lumbosacral and lower limbs joints are the variables of this study. Qualysis motion capture system and a Kistler force plate were used to record spatiotemporal and kinetic (joint contact forces) data. Qualysis and Open-SIM software were used to extract the data. All data were analyzed by utilizing the SPSS 22 software at α =0. 05. Results: Joint contact forces applied on ankle joint (P=0. 04), knee (P<0. 01) and lumbosacral (P<0. 01) joint were different between two groups. There also was an interaction between joint forces and groups in this regards. Conclusion: Although total forces applied on ankle and knee in both groups were the same, however, the forces acting on the hip and lumbosacral joints in NLBP was more than that of healthy group. The patterns of forces applied on these joints were different between groups. Different pattern of forces applied on the joints NLBP is associated with different muscle activity; therefore, it is recommended that rehabilitation program should be focus on these joints and surrounding muscles in order to help NLBP patients and reduces pain.

Purpose: One of the goals of medical research is to determine the factors association of diseases in prognosis. One of the most common metabolic diseases in Iran is diabetes. The aim of this study was to identify the related factors that predict diabetes by using artificial neural network and decision tree algorithms. In this study we will compare the performance of these models. Methods: In this study, 901 cases of people referred to health centers in Mashhad were used. Initially, data were analyzed using descriptive and analytical statistics. Then, 70% of the data were randomly selected for constructing artificial neural network and decision tree models and the remaining 30% were used to compare the performance of the models. Finally, the performance of the models was compared using the ROC curve. Results: Development of two predictive models was performed by using13 input (independent) variables and 1 output (dependent) variable. The two models were evaluated in terms of area under the ROC curve, sensitivity, specificity and accuracy. Area under ROC curve, sensitivity, specificity and accuracy for artificial neural network model were 69. 1, 74. 2, 56. 03 and 61. 3. For CART algorithm of decision tree the under ROC curve, sensitivity, specificity and accuracy were obtained as 68. 9, 64. 77, 63. 47 and 65. 3 respectively. In all modes, family history of diabetes, triglycerides, body mass index, low density lipoprotein, and systolic and diastolic blood pressure were the most important factors associated with type 2 diabetes. Conclusion: The results showed that the perceptron multi-layer neural network model had a better result than the CART decision tree in term of area under the ROC curve for prediction of diabetes type 2. Also, low density lipoprotein was identified as the most important related factor of type 2 diabetes. The study suggests that modern data mining techniques such as artificial neural network and decision trees can be used to identify associated disease factors.

Purpose: To predict the spherical refractive error and astigmatism based on Snellen chart and OPD-scan III visual acuity in visually normal individuals. Methods: This study was performed on seventy five participants with an age range of 18 to 35 years. Visual acuity and refractive errors were evaluated using both subjective Snellen chart and OPD-scan III devices. The Pearson correlation test was used to evaluate the correlation between visual acuity and refractive errors. Moreover, to predict refraction based on the visual acuity, linear regression was performed. Results: The results of the Pearson correlation test showed a significant negative correlation between visual acuity and refractive error in the myopic group (p<0. 0001, r=-0. 859 for subjective visual acuity, r=-0. 788 for objective visual acuity). In addition, there was a significant positive correlation in the hyperopic group (p<0. 0001, r= 0. 882 for objective visual acuity). However, there was no significant correlation between subjective visual acuity and spherical refractive errors. Also, no significant correlation was found between astigmatism and visual acuity of the eye (p>0. 05). Conclusion: Considering the high correlation between visual acuity and spherical refractive errors in myopic groups, refraction may be estimated based on the visual acuity of the eye. While in hyperopic group, there is no possibility to predict the refraction based on subjective visual acuity. Considering the poor correlation between visual acuity and astigmatism, astigmatism cannot be estimated based on the visual acuity of the eye.

Purpose: The rate of performed work by most muscles is rarely constant with time. Because of rapid time-course changes, it has been necessary to calculate muscle power as a function of time. The aim of the present study was to assess the differences in Hamstring and Quadriceps muscular work and power in elite karate athletes before and after fatigue in order to identify injury risk factors. Methods: Fourteen female elite karate athletes (15. 5± 1. 3 years) were evaluated using isokinetic dynamometer at 60◦ /s, 180◦ /s and 300◦ /s before and after Hamstring and Quadriceps muscular fatigue. Results: No differences were found in Hamstring and Quadriceps muscular power before and after fatigue at the 180◦ /s speed (p>0. 05). At 180◦ /s speed, the Hamstring presented no differences in muscular work after fatigue muscular test (p<0. 05). At the 60 and 300◦ /s speeds, Hamstring and Quadriceps muscular power presented a lower power after fatigue test (p=0. 04). Conclusion: Based on the present results, fatigue does not have a significant effect on power and the work done by karate athletes' muscles around knee joint at medium speed however, generally, fatigue probably causes imbalance in mechanical power and work done by hamstring and quadriceps at other angular joint speeds that increases the probability of knee joint injury.

Purpose: Some cancer patients who receive radiation therapy have metal objects in their body. There is a difference between atomic numbers of these metal objects and body tissues. This creates artifacts in images and creates large difference in CT numbers and errors in the calculations. This study was performed to evaluate the effect of correcting metal artifact on images and compare the absorbed dose estimated by ISOgray treatment planning system (TPS) and measurement. Methods: Homogeneous cylindrical phantom was prepared from Perspex material to simulate human body conditions. Cavities were created for Farmer dosimeter and titanium metal rods acting as prosthesis. CT images of phantom were acquired in the presence and absence of metal rods. The correction of metal artifact was performed using Metal Detection Technique (MDT) and CT control softwares. Dose calculation was done at the phantom center for 100 MU at the photon mode with the energies of 6, 10 and 15 MV at ISOgray TPS. The results were compared with Farmer dosimeter. Results: The results show that there is no significant difference in absorbed dose calculated for different images corrected using two softwares by ISOgray TPS. The lowest and highest errors are 0. 1% and 1. 09% related to the images corrected by MDT software with the slice thickness of 3. 0 cm and the distance of 2. 5 cm and photon energies of 6 and 15 MV, respectively. Conclusion: The correction of artifacts in CT images does not have a significant effect on the dose calculated by ISOgray.

Purpose: Functional movement screening tests provide beneficial information regarding the movement and stability in kinetic chain. The core region of body, as the basis of movement chain, accounts for the facilitation of force and torque transmission. The aim of the present study was to investigate the relationship between functional movement screen composite scores and core stability muscles endurance in Taekwondoists. Methods: In this cross sectional study, 55 male taekwondoist were randomly participated in the study, according to research criteria. The McGill's tests were used for the assessment of the endurance of core stability muscles. In addition, a series of functional movement screening tests were used for the assessment of the movement function of the participants. The normality of data was tested using the Kolmogorov– Smirnov test. Linear regression test at a significant level of p≤ 0. 05 was used for the analysis. Results: Among the predicting variables, a significant association was found only between the endurance of right lateral flexors and the functional movement screening scores (p≤ 0. 05). No significant association was found between the endurance of trunk flexors/extensors and the functional movement screening scores. Conclusion: The result of the present study showed the failure of regression model to predict the functional movement screening scores. In other words, the regression model could weakly predict the functional movement screening scores (36%). Although the endurance of bodily core stability muscles is considered important for the movement function, other factors besides the core stability (e. g. the range of motion for the back, thigh and foot wrist joints) play an important role.

Purpose: Given the growing importance of evaluating and improving the quality of life as an important factor in determining the therapeutic outcomes, it is essential to validate the instrument that measures this category. This study was designed to evaluate the validity and reliability of the Persian version of the European Quality of Life questionnaire (EQ-5D-3L) in Iranian patients with meniscus and knee ligaments injury. Methods: After obtaining permission and receiving the Persian version of the EQ-5D-3L questionnaire from Euro QOL group, this questionnaire was completed with SF-36 and KOOS questionnaires by 143 patients suffering from meniscus and knee ligaments injury (92 patients before and 51 patients after the surgery). Construct validity was tested by apriori hypotheses and discriminative validity was tested by known group method. To evaluate the test-retest reliability, 65 patients who did not report a significant change in their status after one week re-completed the EQ-5D-3L questionnaire. Results: According to the findings, the total score of the EQ-5D-3L questionnaire with the total scores of SF-36 a valid generic instruments (r= 0. 445) and dimensions of EQ-5D-3L questionnaire with related dimensions from SF-36 questionnaires (r= 0. 37-0. 45) and KOOS (r= 0. 30-0. 45) had a moderate correlation. The EQ-5DIndex score was able to differentiate patients according to the severity of the disease based on the EQ-5DVAS (p=0. 000). The intra class correlation coefficients for EQ-5DIndex and EQ-5DVAS were 0. 753 and 0. 896, respectively. Conclusion: The results showed that the Persian version of the EQ-5D-3L questionnaire has acceptable reliability and validity for measurement of the health-related quality of life in patients with meniscus and knee ligaments injury.

Purpose: Research is a logical and rational process that leads to revision, critique and refinement, or production and creation of a thought. The purpose of this research is to investigate the challenges of doing research and provide an appropriate solution to facilitate the research process in health insurance staff of the country. Methods: The present study was a descriptive analytical research on 834 experts working in health insurance departments of the country in 2016 using self-administered questionnaire finally, 646 questionnaires were completed. Validity of the questionnaire was assessed using the views of health insurance experts and health system management specialists. To determine the reliability of the questionnaire, 50 health insurance experts from Khorasan Razavi province were interviewed at two stages. Results: 314 (50%) women and 313 (50%) men were among the respondents. 276 (43. 5%) of the respondents had a history of participation in the research methodology workshop. The rate of familiarity with the underlying factors and the research basis among the participants in the research (44. 5%) was estimated. Among the most important barriers to research, the lack of access to library resources (47. 8%) was 47. 9% from the perspective of its staff, the most important way to support research in the country's health insurance organization is to allocate sufficient funds for research and provide sufficient opportunity to present research ideas (74%). Conclusion: The limited scientific capability of experts, the organization and management of managers, the proportion of work and responsibility, limited library resources, and analytical thinking and inadequate communication with academic institutions are among the issues mentioned in this study; therefore, strengthening the domestic infrastructure and strengthening communication outsourcing, creating a suitable platform for research in the organization and developing organizational interactions, will be an effective steps to improve the research process in Iranian Health Insurance Organization.

Head trauma is common in adults because of different reasons such as car crash and work related accidents. Headache, vertigo and imbalance are the most common consequences of head trauma and patients suffer from many vestibular disorders including BPPV, rupture of round window membrane, labirynthine damage, endolymphatic hydropse and perilymphaticfistule. These disorders involve different places of vestibular system. The purpose of the present article is a review on results of vestibular rehabilitation in patients with head trauma and vestibular system abnormalities. Related articles from different data bases including PubMed, Web of science, Scopus, Magiran and SID were evaluated during January 1980 to December 2017. The key words were vestibular rehabilitation, head trauma, vertigo and imbalance. Total 37 articles were evaluated. Vestibular rehabilitation showed good therapeutic success in treatment and management of acute and chronic head trauma patients but some patients needs longer treatment and some may be challenging.

Aptamers are short single-stranded nucleotides (or peptide) folded into particular three-dimensional structure which can bind to their targets with high specificity and affinity. Small size, inexpensive and rapid production process, low immunogenicity and high stability, made them very attractive biomolecules in some investigational fields especially in planning of innovative diagnostic and therapeutic approaches. In this review, we have described the process of nucleic acid aptamers development, advantages and disadvantages of aptamers compared to antibodies, and potential applications of these new agents in medicine. Limitations of aptamers and existing answers to overcome this limitations has also been discussed.