Journal of Paramedical Science and Rehabilitation
Year:2017 | Volume:5 | Issue:4|Papers Count:8

Purpose: Osteoarthritis frequently affects the knee joint and many people are dealing with its consequences every year. Treatment of the osteoarthritis includes conservative and non-conservative methods. Using orthotics such as insoles and knee braces are one of the non-conservative methods of treatment in osteoarthritis. The aim of this research was to evaluate the effect of a medical insole with arch support and lateral wedge on kinetics and kinematics variables of the knee joint during gait in patients with medial compartment knee osteoarthritis.Methods: Ten patients with medial compartment knee osteoarthritis with age range of 30 to 60 years and height of 176.10±14.20 cm and weight of 75.5±6.3 kg participated in this study. A medical insole with arch support and lateral wedge was used. A Kistler force platform and seven cameras were utilized to analyze the kinetics and kinematics variables of the knee joint during gait in each of the following conditions: (a) wearing the medical insole with arch support and lateral wedge (b) barefoot.Results: There was no significant difference regarding mean velocity of gait with or without wearing the medical insole (P=0.42). The first peak of the applied ground reaction force on the knee joint was significantly increased while wearing the medical insole (P=.031). The applied adductor moment on the knee joint during gait while wearing the medical insole was 0.45±.05 N/m which was significantly lower than that of the bare foot condition (P<0.01).Conclusion: The medical insole with arch support and lateral wedge reduces the applied adductor moment on the knee joint during gait which results in gait facilitation and reducing the applied forces on medial compartment of the knee joint. The medical insole improves the alignment of the femur.

Purpose: To investigate the refractive error and visual acuity before and six months after myoring implantation in patients with keratoconus at Farabi hospital in Tehran, Iran.Methods: In this retrospective study, thirty-four eyes of twenty-eight keratoconic patients with mean age of 29 ± 7.41 years who underwent myoring operation and reevaluated after 6 months were recruited. In these patients, best corrected visual acuity (BCVA), refractive outcomes and Pentacam [Oculus GmbH] findings were assessed. All patients had clear central corneas, contact lens intolerance, and a central corneal thickness of more than 360 mm.Results: Six months postoperately, the mean BCVA (in LogMAR value) improved significantly from 0.30 ±0.22 to 0.20 ± 0.20 (p=0.006) and the mean spherical refractive error improved from -4.66 D ± 3.76 to -1.48 D ± 3.72 (p<0.001). The mean cylindrical refractive error decreased significantly from -4.27D ±3.15 to -2.18D ±1.63 (p<0.001). In cylindrical refraction, the frequency percent of with the rule, oblique and against the rule axes of astigmatism before operation were 21%, 44% and 35%, respectively and after operation have changed to 18%, 24% and 58%, respectively.Conclusion: Myoring operation provided significant improvement in BCVA, spherical and cylindrical refractive errors.

Purpose: Novice runners are at high risk of running-related injuries. However, their injury mechanisms are less well understood. The purpose of this study was to evaluate the effect of running-induced fatigue on foot roll-over pattern in novice runners.Methods: Eighteen (12 male and 6 female) novice runners participated in this study. Before and after the fatigue, plantar load distribution was recorded by Footscan system. Peak plantar pressure, peak force underneath of each zone and Medio-lateral force distribution ratio were calculated during forefoot push-off phase. Furthermore, temporal data such as time to peak force for each region and duration percent for each phase were calculated.Results: After the fatigue, an increase in forefoot and midfoot loading was observed. Results showed statistically significant reduction in the Medio-lateral force distribution ratio in forefoot push off (p=0.029). Moreover, timing percent of initial contact phase and forefoot contact phase were decreased (p=0.001 and p=0.009 respectively) and percent of forefoot push off phase duration was increased significantly (p=0.036). Time to peak force in the 4th metatarsal reduced.Conclusion: The findings of the present study demonstrated that running-induced fatigue caused load and plantar pressure distribution consequently, roll-over deviations in novice runners. These results may provide useful information related to several running related injuries.

Purpose: Anxiety is one of the most common problems of patients prior to the surgery. Although the surgical techniques are quite advanced, most patients still experience anxiety before the surgery. This study investigated the relationship between neurosurgery patients’ awareness of surgery procedures and complications on preoperative stress level in teaching hospitals, affiliated to Mashhad University of Medical Sciences.Methods: This descriptive-analytical study was conducted in 2014. The study population consisted of all patients with relative consciousness that had been waiting for neurosurgery. Based on previous studies, 10% of patients (104 cases) who were candidates for neurosurgery were selected in the first eight months of 2014. The data collection tool for assessing patients’ awareness of surgery procedures and complications was created by researchers and the anxiety of surgery patients was measured using the Beck Anxiety Inventory (BAI) questionnaire. Data analysis was performed using the SPSS statistical software.Results: The results showed that 3.8% of patients had very little or no anxiety, 34.6% mild anxiety, 43.3% moderate anxiety, and 18.3% severe anxiety. The patients’ anxiety mean was 14.05 ± 19.16. Patients’ familiarity with complications was moderate. People who were hospitalized previously, were less anxious in comparison to others (P=0.027).Conclusion: According to the present findings, people who were familiar with the hospital environment felt less anxious providing the appropriate information. The anxiety levels of patients who are candidates for neurosurgery may be reduced by responding to their information needs. It was found that anxiety levels could also be reduced by familiarizing the patients with the conditions and environment of the operating room. Attention to the needs of these patients should be continuously evaluated and monitored.

Purpose: Since impairment in body alignment affects dynamic stability during sport movements and skills, the purpose of this study was to compare center of pressure to center of mass changes during sideward cutting in the elite karatecas with and without genu varum.Method: Twenty elite male karate athlete (ten genu varum and 10 healthy control individuals) participated in this semi-experimental study. Center of pressure changes to center of mass was calculated during sideward cutting.Results: The results showed that center of pressure to center of mass changes in medial- lateral direction in dominant (p=0.024) and non-dominant (p=0.004) limb in genu varum group was significantly higher than normal group. However, there was not a significant difference in anterior- posterior direction between groups (p³0.05). The difference between dominant and non-dominant limbs (cutting manoeuvre direction) was not significant in neither anterior- posterior and medial- lateral components (p³0.05).Conclusion: According to results of present study, an increase in genuvarum could be considered as an effective factor on center of pressure to center of mass changes during sideward cutting.

Purpose: Smoking is one of the most important factors in laryngeal lesions and voice disorders. Larynx and voice make speech audible. Speech communication has undeniable and important role in human life. Investigation of the smoking effect on the smoker’s voice is necessary for prevention, treatment and rehabilitation plan.Methods: This cross- sectional study was performed on 45 smokers (34 male and 11 female, mean age: 38.4 ± 9.7 years) attending to stop smoking center of Beheshti University of Medical Sciences and 32 non-smokers (19 male and 13 female, age range: 28.43 ± 7.8 years). The vowel /a/ was sustained for 5 seconds and the acoustic characteristics i.e. fundamental frequency (F0) and its variation, jitter, Shimmer, changes in amplitude and Noise to harmonic ratio was analyzed with Multi Dimensional Voice Program software (MDVP).Results: The results show that F0 and Fmin (Fundamental frequency minimum) decreased in smokers and there is a significant difference with non-smokers (p<0.05). The NHR (Noise to harmonic ratio), vAm (Amplitude variation), Atri (Amplitude Tremor Intensity Index), vF0 (Fundamental frequency variation) in smokers are significantly higher than non-smokers (p<0.05). In addition, the relation between the number of cigarettes smoked per day showed that it has a significant correlation with parameters F0 (P=0.010; r=-0.374) and Fmin (p=0.004; r=-0.423) however, no significant correlation with acoustic voice features.Conclusion: Acoustic voice characteristics in individual who smokes longer were significantly reflects larynx and voice dysfunction. Smoking 15 cigarettes per day and more than 10 years can affect the larynx significantly and also disturbed voice.

Purpose: Reduction in sensory integration and a decline in the deep sensory receptors, visual and vestibular are the important factors that decreased the balance. The present study investigated the effect of manipulating sensory afferent information on balance of knee below amputation.Methods: In this cross-sectional study 23 patients with lower limb amputation were participated. To assess postural control and balance sensory organization test was used in Posturography device. This devise assessed the state of balance in the first six items (there are three senses of visual, vestibular and proprioception), second (delete vision), third (removal vestibular), fourth (delete proprioception), fifth (delete vision and proprioception) and sixth (remove all sense of visual, vestibular and proprioception). Sensory Organization Test was determined balance score with two variable displacements in central of gravity and stability.Results: The analysis of variance with repeated measures for stability variable showed statistically significant difference between the first and third condition with other condition. However, there was no significant difference between the second with the fourth, fifth with sixth conditions. Also the difference was statistically significant in lower limb amputees for variable displacement in central of gravity in the first and second situations. People with lower limb amputees have in the first position based on the displacement of the center of gravity, better than five other situations.Conclusion: The results showed that by removing two or three sensory afferent information balance is reduced in amputees.

Purpose: Noise and ototoxic drugs are among the most common causes of permanent hearing loss. It is commonly believed that simultaneous presentation of these harmful elements often non-linearly increases the level of hearing problems. However, careful selection of the presentation method of these ototoxic agents not only control the amount of damage, but may establish some levels of protection. This study tried to review the issue that under what circumstances simultaneous presentation of two damaging factors can cause protection and / or damage on hearing.Methods: In this review, the latest articles were studied about ototoxic and noise-induced hearing damage during 1960- 2015 released in Science direct, Google scholar, springer, Magiran, scopus, Proquest and Pubmed databases on. About 125 articles were obtained that by removing duplicate articles and irrelevant ones, finally 59 related articles, were examined carefully.Conclusion: Presentation of hearing damaging element in low doses may activate the cellular protective systems in a limited timeframe. This process provides some cochlear resistance against more intense damaging elements by itself. A thorough understanding of this period will provide the possibility of providing appropriate therapeutic interventions.