Scientific Journal of Rehabilitation Medicine
Year:2023 | Volume:12 | Issue:5|Papers Count:14

Background and Aims Faulty movement patterns can lead to dysfunctional and uncoordinated mobility. A proper pattern can cause better movement. In fact, an efficient movement provides more energy for endurance and power with less effort and more mobility and agility. Many studies have reported the effect of feedback on improving faulty movement patterns as a risk factor for anterior cruciate ligament injury. This study aims to investigate whether feedback can affect the performance of people with abnormal lower extremity movement patterns or not.Methods This is a systematic review study. Related articles published from 2000 to 2020 were found by searching in international (Google Scholar, PubMed, ScienceDirect) and national (MagIran, IranDoc) databases using the keyword videotape augmented feedback, augmented feedback, feedback, jump-landing, immediate effect.Results Out of 10 reviewed studies, two were systematic review studies, one was a systematic meta-analysis study, and seven were interventional studies. In all studies, feedback methods had a positive effect on the biomechanics of the lower limb. Three studies examined the impact of feedback on performance, of which two studies stated that feedback caused a decrease in performance, while one study stated that feedback did not affect performance.Conclusion In many studies, feedback methods improved movement patterns, but further studies are needed to understand the effect of feedback on the performance of people with abnormal lower extremity movement patterns.

Background and Aims Low back pain (LBP) is the most common cause of activity limitation. Various treatments such as electrotherapy, hydrotherapy, and exercise therapy have been suggested to improve nonspecific LBP. The present study aims to review studies that have investigated the effect of different methods on pain and disability in people with nonspecific LBP.Methods This is a review study. A search was first conducted in Google Scholar, ScienceDirect, PubMed, and Scopus databases for related articles published from 2016 to 2021 using the keywords exercise therapy, corrective exercise, electrotherapy, treatment, and non-specific chronic low back pain. The PEDro scale was used to check the quality of articles.Results Among the articles found, 15 were selected for the review. These studies mainly examined the effect of therapeutic methods on pain, functional disability, thickness, and activity of core muscles in people with non-specific chronic low back pain.Conclusion Core stabilization exercises with an emphasis on deep muscles have a better effect on pain, functional disability, and muscle thickness of people with nonspecific LBP.

Background and Aims Sleep problems such as insomnia are common in individuals with severe mental disorders. The sleep-enhancing interventions provided by occupational therapists can be used for primary prevention and health promotion. This study aims to explore the existing evidence on occupation-based sleep interventions for individuals with severe mental disorders.Methods This is a scoping review, conducted based on Arksey and O’Malley’ five-step method. A search was first conducted in eight online databases (MagIran, SID, IranDoc, Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science , OT seeker, Psych INFO) to find articles that addressed sleep interventions for individuals with severe mental disorders Two raters reviewed all articles independently. Articles were categorized according to the type of sleep interventions.Results  Thirty-two studies were reviewed. Four categories of occupation-based sleep interventions were extracted, including cognitive behavioral therapy (n=12), physical activity (n=7), multicomponent interventions (n=5), and other interventions (n=8).Conclusion The occupation-based sleep interventions can improve sleep quality and health in people with severe mental disorders.  Occupational therapists and clinicians need to conduct more studies to provide evidence for occupation-based sleep interventions.

Background and Aims In recent years, the use of motor learning training methods to reduce anterior cruciate ligament (ACL) injuries has been considered by researchers, and finding the best training method in this field has become very important. In this study, we aim to compare the effects of linear and non-linear motor learning methods on kinematic variables during a landing task.Methods in this study, 24 students from Kharazmi University who were beginner basketball players, were selected by a convenience sampling method, and divided into two groups of linear pedagogy (LP) and non-linear pedagogy (NLP). They received training methods for two months, two sessions per week (each for 90-115 minutes). In the LP group, the presentation of movement patterns and feedback was used. In the NLP group, the manipulation of constraints (environmental factors and tasks) was used so that the individuals could discover their own unique performance. The measured kinematic variables were trunk flexion angle, hip flexion angle, knee flexion angle, knee valgus angle, ankle dorsiflexion angle, hip range of motion, knee range of motion, ankle range of motion, hip flexion range, and knee flexion range.Results The results of the analysis of covariance showed that the NLP had significantly better effects on all kinematic variables compared to the LP (P<0.05).Conclusion The NLP, by focusing on exploration and finding optimal solutions, is a more effective strategy to prevent ACL injury by affecting kinematic variables. This emphasizes the role of constraint manipulation in training.

Background and Aims A sedentary lifestyle can lead to cardiovascular diseases such as atherosclerosis. Despite the use of therapeutic interventions such as angioplasty in patients with atherosclerosis, the recurrence of stenosis is possible. Rehabilitation exercises can improve the function and structure of blood vessels by improving the biomechanics of the blood flow. In this study, we aim to assess the effect of eight weeks of aerobic exercise on selected blood biomechanical variables in the bilateral femoral artery of middle-aged men up to seven days after coronary angioplasty.Methods In this quasi-experimental study, participants were 30 men with coronary angioplasty aged 45-60 years, referred to the cardiac rehabilitation clinic of Tehran Heart Hospital. They were assigned to two exercise and control groups. Their systolic and diastolic blood velocity, pressure, and intensity were first measured. The aerobic exercise program was then performed according to the American College of Sports Medicine instructions. Analysis of covariance, paired t-test, or Wilcoxon test were used based on their results. The significance level was set at 0.05.Results The resting heart rate and systolic and diastolic blood pressures were at the same level in both groups, but the maximum heart rate of the control group was lower. The results showed no significant difference between two groups in any blood variables. Conclusion The effect of aerobic exercise was not confirmed in this study, may be due to heart disease or structural changes in the arteries (increased arterial stiffness and decreased arterial elasticity, especially in peripheral arteries). To increase the effect of rehabilitation exercises on peripheral arteries rather than central arteries, more intensity and duration of exercises are recommended to achieve the desired result.

Background and Aims Decreased muscle strength due to aging can lead to neuromuscular disorders, increased risk of falling, decreased function in daily activities, and reduced independence in the elderly. The present study aims to investigate the effect of eight weeks of TRX suspension training on lower limb muscle strength, balance, mobility, and fear of falling in older men.Methods This is a quasi-experimental. Participants were 30 elderly men with a mean age of 67.9±4.3 years who were assigned into two groups of TRX (n=16) and control (n=14). In the pre-test phase, lower limb strength was measured by the 30-second chair stand test, functional balance by the Berg balance scale, functional mobility by the timed up & go test, and fear of falling by the falls efficacy scale -international. Then, the TRX group performed the functional training for eight weeks, three sessions per week, each for about one hour. After performing the exercises, post-test assessments were performed in two groups. To compare the groups, the analysis of covariance and Bonferroni post hoc test were used in SPSS software, version 19. The significance level was set at 0.05.Results The TRX functional training significantly improved lower limb strength, balance, and functional mobility of the elderly (P≤0.001); however, it had no significant effect on their fear of falling (P>0.05).Conclusion Given the positive effects of TRX functional training on lower limb strength, functional balance, and mobility of elderly men, it seems that this suspension training can be used to improve lower limb muscle strength, functional balance, and mobility of older men.

Background and Aims The quality of life of hemodialysis patients who are in the final stages of renal failure is affected by various factors. Balance, as an important factor in physical ability, plays an important role in the physical and daily activities of people, including hemodialysis patients. Exercise and physical activity in these patients can reduce the symptoms of uremic syndrome, increase hemodialysis quality, and reduce mortality in these patients. This study aims to investigate the improvement of balance, quality of life, and satisfaction with life of hemodialysis patients after 8 weeks of combined exercises.Methods In this study, 24 patients with hemodialysis aged 40-60 years in Urmia, Iran participated voluntarily and were randomly divided into two groups of control (n=12) and exercise (n=12). Their quality of life (by 26-item World Health Organization quality of life questionnaire in four areas of physical health, psychological health, social relationships, and environmental health), satisfaction with life (by the satisfaction with life scale), static and dynamic balance (using the Prokin 212N device) were measured before and after 8 weeks of resistance-aerobic exercises in both groups. The control group had their normal daily activities during this period without any intervention.Results The combined exercise program significantly improved the static balance (P=0.001), dynamic balance (P=0.001), and quality of life (P=0.001 for physical, psychological, and environmental health; P=0.010 for social relationships) in the exercise group compared to the control group. In addition, a significant effect was found on the satisfaction with life in the exercise group (P=0.001).Conclusion The combined exercise program is effective in improving balance, satisfaction with life, and quality of life of hemodialysis patients. It is recommended to use these exercises to improve the balance, quality of life, and satisfaction with life of these patients.

Background and Aims There are different methods for quantifying the flexion-relaxation phenomenon (FRP). However, there is little standardization for them. This study aimes to evaluate the sensitivity of the ratio method in identifying the FRP in people with non-specific low back pain (LBP) and healthy people.Methods In this study,10 patients with nonspecific LBP and 10 healthy people participated voluntarily. They performed a trunk flexion with a straight knee. Each trunk flexion was done in four modes: (1) standing in the starting position, (2) trunk flexion at a fixed speed (using a metronome), (3) full flexion, and (4) trunk extension to the standing position. Each mode took 5 seconds and was performed 3 times. Then, the FRP was investigated using the ratio method as well as the visual inspection method.Results The sensitivity of all ratios in identifying the FRP in healthy people was 100%, except for the third ratio (the root mean square of EMG activity in a standing position divided by the root mean square in flexion mode), which was 60%. In the LBP group, the sensitivity of the first ratio was 70%; for the second ratio, it was 80%; for the third ratio, 40%; for the fourth ratio, 50%; for the fifth mode (the root mean square in extension mode divided by the root mean square in full flexion mode), 40%; and for the sixth mode, 50%.Conclusion All ratios (except for the second ratio) are valid for identifying the FRP in healthy people, but caution should be taken in using the ratio method for people with LBP; only the second ratio (maximum EMG activity in the extension mode divided by the average EMG activity in the full flexion mode) should be used for these individuals.

Background and Aims Dynamic knee valgus (DKV) is an abnormal pattern of movement or abnormal alignment of the lower limb that causes changes in lower limb function in the frontal plane and absorption of excessive reaction force by the knee ligaments during sports activities, which can increase the risk of anterior cruciate ligament injury. This study aims to compare the balance, strength, and range of motion (ROM) of hip and ankle joints in volleyball players with and without DKV.Methods This is a quasi-experimental and causal-comparative study. Participants were 60 volleyball players (30 with DKV and 30 without DKV). The tuck jump test was used to evaluate their DKV. The ROM of knee and ankle joints was measured using a goniometer, while the isometric strength of the hip and ankle muscles was determined using a hand dynamometer. Then static and dynamic balances were evaluated by the Stork test and the Y balance test, respectively. Independent t-test was used to compare the means of variables between the two groups in SPSS  software, version 24.Results The results showed a significant difference in static balance (P=0.005), dynamic balance (P≤0.05), hip abduction strength (P=0.03), hip external rotation strength (P=0.01), and ROM of ankle dorsiflexion (P=0.03) between the two groups, where those without DKV performed better. The difference in other variables was not significant between the two groups.Conclusion The results indicate the importance of improving hip abduction and hip external rotation strength as well as the ROM of ankle dorsiflexion for reducing the DKV, which should be considered in designing training protocols.

Background and Aims Weakness in the knee muscles and other components of the knee joint can cause various complications, including the genu varum. This study aims to investigate the effects of eight weeks of running on a treadmill and on the ground on muscle activities in individuals with genu varum.Methods This is a quasi-experimental and laboratory study. Forty-five young men with genu varus were randomly divided into three groups: control, ground-based training, and treadmill training. Running exercises were performed for eight weeks in the training groups. The electrical activity of selected muscles was recorded by an electromyography system. For statistical analysis, repeated measures analysis of variance was used. The significant level was set at 0.05.Results In the treadmill training group, the electrical activity of the biceps femoris and gastrocnemius medialis muscles increased significantly after training during the heel contact phase. In the ground-based training group, the electrical activity of the biceps femoris and vastus latralis muscles significantly increased after training. In the swing phase of running, the electrical activity of the tibialis anterior, gluteus medius, and semitendinosus muscles was also significantly increased after training in the ground-based training groupConclusion It seems that running on a treadmill may have been effective in improving muscle activity and preventing the progression of the knee genu varum.

Background and Aims Cerebral palsy is a common neuromuscular disease with non-progressive symptoms in children. The present study aims to investigate the effect of modified Hatha yoga exercises on the balance of children with spastic diplegia cerebral palsy.Methods This is a quasi-experimental study with a pretest/posttest design. The study population includs all children with spastic diplegia cerebral palsy (with levels 1 to 3 based on the Gross Motor Function Classification System and grades 0 to 3 based on the Modified Ashworth Scale) aged 7-14 years, who were selected from exceptional schools for the disabled students in Isfahan, Iran in 2018. Using a purposive sampling method, 14 eligible children were selected and randomly assigned into two groups of control and exercise. The exercise group performed the modified Hatha yoga exercise for eight weeks at three sessions per week; while the control group did not receive any intervention. The foot plantar center of pressure (COP) was recorded for six seconds (as the balance test) using a foot scanner in the pre-test and post-test phases. Finally, the data were analyzed using repeated measures analysis and independent t-test in SPSS software, version 23. The significance level was set at 0.05.Results The intervention significantly improved the balance of the exercise group compared to the control group. The reduction of COP fluctuations in anterior-posterior (P=0.044), mediolateral (P=0.033), and total directions (P=0.038) in the exercise group were significantly higher than in the control group (P<0.05).Conclusion The modified Hatha Yoga can be a suitable exercise to improve the postural control of children with spastic diplegia cerebral palsy. However, further research is needed to draw a definitive conclusion.

Background and Aims Patellofemoral pain syndrome (PFPS) is one of the common knee disorders, which can cause injuries or more complicated medical conditions. Proprioception is one of the factors that can be considered in the assessment of people with PFPS. The present study aims to compare the knee joint proprioception between female volleyball players with PFPS and healthy peers.Methods In this quasi-experimental study, 30 female athletes (16 with PFPS and 14 healthy) with a mean age of 24.33±3.39 years, height of 178.72±3.28 cm and weight of 67.76±8.04 kg participated. Knee joint proprioception was evaluated in two modes: weight-bearing (single-leg squat) and non-weight-bearing (knee extension). Kinematic data were recorded by eight motion capture cameras (Vicon, UK) at a frequency of 1000 HZ. Statistical analysis was done in SPSS software, version 26 using independent t-test. The significant level was set at 0.05.Results Findings showed that the error of reconstruction angles in weight-bearing (P=0.001) and non-weight-bearing (P=0.003) conditions was significantly different between the two groups.Conclusion The knee joint proprioception is weaker in female volleyball players with PFPS than in healthy peers, which can lead to more injuries. it is recommended to strengthen the proprioception in athletes with PFPS during treatment and rehabilitation, and more accurate tests should be designed to evaluate it.

Background and Aims This study aimed to investigate the effect of exercises using fitness equipment in parks on the lower limb muscle function of inactive women in Iran.Methods This is a prospective quasi-experimental study. The study population includes all inactive women in Tehran, Iran, aged 25-35 years. Of these, 40 women with no history of physical activity in the past year were selected using a convenience sampling method and randomly divided into two groups of control (n=20) and exercise (n=20). The training program consisted of workouts using fitness equipment in parks (sky walker, aero rider, and leg press machine) at 8 sessions, two sessions per week. The tests included Sargent jump test, triple jump test, star excursion balance test, and 6-meter single-leg timed hop test. The data were analyzed using descriptive statistics (mean and standard deviation), the Kolmogorov-Smirnov test (to examine the normal distribution of data), and the analysis of covariance (to examine differences in variables between the two groups) in SPSS software, version 24.Results After controlling the effect of pre-test scores, there was a significant difference between the two groups in the post-test score of the parameters of muscle function, indicating that exercises using the fitness equipment in parks can affect the lower limb muscle function of inactive women.Conclusion Exercises using park fitness equipment can be used to improve the lower limb muscle function of inactive women.

Background and Aims Stroke is the fifth leading cause of death in the world; which can cause disability. One of the main goals of rehabilitation in these patients is to improve their upper limb function. Dual-task training (DTT) is one of the rehabilitation methods in stroke patients, which include performing motor tasks along with mental exercises. This study aims to investigate the effect of DTT on upper limb function, elbow flexor muscle tone, wrist extension range of motion (ROM), and the ability to perform activities of daily living (ADL) in women with chronic stroke.Methods In this pilot study, 16 female patients suffering from chronic stroke for more than 6 months were selected and divided into two groups of 8 including training and control. In both groups, the routine treatment included electrical stimulation of quadriceps and dorsiflexors of the affected hand, 10 minutes of bicycling, and performing three movement tasks for the upper limb (sorting colored blocks, opening and closing the bottle cap with the affected hand, and moving the beans with a spoon towards a determined point). In the training group, DTT included performing these three movement tasks simultaneously with performing mental task (counting down from 100). The training was performed for 4 weeks at 12 sessions, three sessions per week. The upper limb function was measured by the box & block test; elbow flexor muscle tone by the modified Ashworth scale; active ROM of wrist extension by a goniometer; and ADL by the Barthel index before and after the treatments. Results No significant difference was found in any variables between the two groups (P>0.05). In both in groups, there was a significant improvement in the three variables of elbow flexor muscle tone, upper limb function, and the ability to perform ADL after interventions compared to baseline (P<0.05). However, no significant difference was found in the active ROM of wrist extension in any groups (P>0.05).Conclusion Training with and without DTT can lead to significant improvement in elbow flexor muscle tone, upper limb function, and the ability to perform ADL in women with chronic stroke. The DTT has no superior effect on these variables.