Scientific Journal of Rehabilitation Medicine
Year:2024 | Volume:12 | Issue:6|Papers Count:13

Background and Aims Exercises are mostly used to control balance and reduce the risk of falling in the elderly. However, the effect of exercise in the frontal plane has been less studied. Therefore, this study aims to compare the effect of 8 week exercises in the sagittal and frontal planes on the postural sway of elderly men.Methods In this quasi-experimental study, 24 elderly males (Mean age: 67.21±1.56 years) were divided into two intervention groups of sagittal-plane and frontal-plane exercises. The exercises were performed for 8 weeks. The center of pressure (CoP) parameters in two groups before and after the intervention were evaluated using a foot scanner system. Finally, the ANCOVA was used for data analysis. P≤0.05 was considered statistically significant.Results The results showed a significant decrease in CoP perturbations in the Y-axis at the medial-lateral, anterior-posterior, and lateral-medial directions in the frontal plane group compared to the sagittal group (P<0.05). Moreover, there was a significant decrease in the CoP area after perturbations at the medial-lateral, anterior-posterior, and lateral-medial directions in the frontal group compared to the sagittal group (P<0.05).Conclusion It seems that exercises in the frontal plane can reduce postural sway in elderly men compared to sagittal-plane exercises. Therefore, it is recommended to emphasize the exercises of the hip abductor and adductor muscles in the frontal plane in designing exercise protocols for elderly men.

Background and Aims Diabetes mellitus is one of the most prevalent metabolic conditions in the world. One of its consequences is overactive bladder (OAB), which is a syndrome whose symptoms appear during the urine storage phase in the form of increased urinary frequency or urinary urgency. The prevalence of this disorder is estimated to be 22.5-24.2 % in people with type 2 diabetes (T2D). Recently, a useful technique for the treatment of OAB, named transcutaneous tibial nerve stimulation (TTNS), has been introduced. This study aims to investigate the effect of TTNS in women with T2D and OAB.Methods This randomized, double-blind clinical trial was conducted on 40 women with T2D and OAB symptoms, who were divided into two control and intervention groups. The control group performed pelvic floor muscle (PFM) training daily for one month, while the intervention group received 12 sessions of TTNS combined with PFM training. Before and after the intervention, the lower urinary tract symptoms were recorded using the Persian version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Independent t-test, paired t-test, Wilcoxon test, Mann-Whitney U test, and chi-square test were performed for data analysis using SPSS software, version 24.Results There was no significant difference between the two groups in the ICIQ-FLUTS score, incontinence quality of life, or PFM strength, and endurance (P>0.05). However, their scores were significantly different after treatment in each group compared to the pre-treatment phase (P≤0.05).Conclusion The combination of TTNS and PFM training has no advantage over PFM training alone in managing OAB symptoms and improving PFM strength and quality of life in women with T2D.

Background and Aims The anterior cruciate ligament injury in athletes is associated with disorders related to balance and postural control. Poor balance is a predictor of lower limb injury in athletes. This study aims to investigate the different neuromuscular parameters that affect the static and dynamic balance in adolescent male football players with Dynamic Knee Valgus (DKV). Methods This is a correlational study. Participants were 83 adolescent male football players with DKV (age: 12.63±0.72 years, height: 1.69±0.07 meters, weight: 23.23±7.74 58 kg, BMI: 20.32±2.38 kg /m2), who were selected using a purposive sampling method. The presence of DKV was assessed by the squat test. The strength of the trunk and hip muscles was assessed by manual muscle testing (MMT), trunk endurance by the McGill test, and range of motion (ROM) of hip and ankle joints by a goniometer. Moreover, the static and dynamic balances were evaluated by the Bass Stick test and Y balance test, respectively. The Pearson correlation test was used to examine the relationships at a significance level of 0.05. All statistical operations were performed by SPSS software, version 24.Results The results of the present study showed a significant relationship between static balance and the study parameters (P≤0.05) except for trunk flexion strength (P=0.16) and ROM (P<0.05), hip flexion ROM (P=0.83), hip extension ROM (P=0.96), hip abduction ROM (P=0.77) and ankle dorsiflexion ROM (P=0.94). The dynamic balance at anterior-posterior direction had a significant relationship with trunk endurance and left-side plank (P=0.07) and strength (P=0.05), but not with plank test score (P=0.45). The dynamic Y balance at posteromedial direction had a significant relationship with all variables except for 60° flexion (P=0.40), plank (P=0.53), left-side plank (P=0.09), and trunk extension strength (P=0.23). The results of the study also showed the significant relationship of dynamic balance at posterolateral direction and the total score of Y balance test with total trunk endurance test score (P=0.03, P=0.003) and right-side plank (P=0.005, P=0.001). Moreover, trunk extension strength and hip strength variables had a significant relationship with posterolateral dynamic balance and total Y balance test score (P≤0.05). Furthermore, the ROM of ankle dorsiflexion had a significant relationship with balance at the posteromedial (P=0.03), posterolateral (P=0.02) directions and the total Y balance score (P=0.02). Conclusion Static balance of adolescent male soccer players with DKV has a significant relationship with trunk endurance, trunk strength and thigh strength. There is a significant relationship between dynamic balance and trunk endurance, trunk strength, hip strength, and ankle dorsiflexion ROM.

Background and Aims Children have a very high ability to learn. With correct planning, we can provide conditions for them to perform various movement patterns to increase their motor skills and thus reduce the risk of skeletal injuries and obesity. This study aims to investigate the relationship between fundamental movement skills, body composition, and flat feet in children.Methods This is a descriptive-correlational study on 50 healthy children (girls and boys) aged 3-6 (mean age: 5.13±0.831 years) who were selected using a convenience sampling method from Novak Kindergarten in Tehran, Iran. To evaluate the fundamental movement skills, Ulrich (2015)’s test of gross motor development was used. The InBody 270 device was used to examine the body composition, and a digital photo scanner was used to evaluate the flat feet deformity. Data analysis was performed by using the Pearson correlation test and multiple regression analysis in SPSS software, version 24. P≤.0.05 was considered statistically significant.Results The results showed a negative and significant relationship of body weight (P=0.001), body mass index (P=0.001), body fat percentage (P=0.001), and flat feet (P=0.009) with fundamental movement skills. Also, the relationship between musculoskeletal mass and fundamental movement skills was positive and significant (P=0.001), but its relationship with flat feet was negative and significant (P=0.004). The body weight had the highest power to predict fundamental movement skills, and musculoskeletal mass had the highest power to predict flat feet (P=0.001) in preschool children.Conclusion It seems that, by improving fundamental movement skills and musculoskeletal mass index, the development of flat feet and overweight in preschool children can be prevented.

Background and Aims Volleyball is one of the most popular sports in Iran and every year more teenagers and adults are attracted to this sport. However, there is no systematic injury prevention program for Iranian volleyball players in accordance with the cultural, economic and social conditions of the country. Therefore, the purpose of this study is to design an intervention program to prevent volleyball sports injuries in a systematic manner using the intervention mapping protocol.Methods The IM method was used to design the program which has 6 steps: (1) Needs assessment, (2) Determining intervention outcomes and objectives, (3) designing the intervention by selecting theory and their practical applications, (4) producing the intervention program, (5) Developing an implementation plan, and (6) Developing an evaluation plan. To design the intervention, we used the steps 1 to 4.Results The designed program included a warm-up program with more than 45 movements (with different types and levels for players with different abilities) that should be performed at least two sessions a week before training or competition. The program consisted of three 3-week phases and provided to the trainers every week to observe the gradual improvement in intensity, repetition, complexity, and time of training. The duration of each weekly session was 15 minutes, including 4-5 minutes of cardiorespiratory exercises (to increase body temperature and cardiorespiratory preparation) and 9-10 minutes of exercises to prevent shoulder, knee and ankle injuries.Conclusion Despite being time consuming, the IM is a suitable method for designing an intervention to prevent injuries in volleyball. The designed injury prevention intervention is a 15-minute warm-up program that includes more than 45 exercises for amateur volleyball players. The feasibility of this program is under investigation and the study of its effect will be conducted in the upcoming months.

Background and Aims Liver heptokines are important factors in obesity-related diseases. Both exercise and diet are essential interventions for obesity control. This study aims to compare the effectiveness of six weeks of aerobic and resistance exercises and ketogenic diet on fibroblast growth factor 21 (FGF21) selenoprotein P. levels and blood lipid profile in overweight or obese men.Methods This is a quasi-experimental study with a pretest-posttest design. Participants were 36 overweight or obese male college students with a body mass index above 25 kg/m2 , who were selected using a convenience sampling method, and were randomly divided into three groups including aerobic exercise + ketogenic diet (n=12), resistance exercise + ketogenic diet (n=12), and ketogenic diet (n=12). Aerobic exercise consisted of moderate-intensity running for six weeks at three sessions per week. Resistance training consisted of circuit training for six weeks at three sessions per week. The ketogenic diet included the restriction of carbohydrate intake to ≤10% of total daily energy intake. Fasting blood samples were collected in pre-test and post-test phases. Serum levels of FGF21 and selenoprotein P. were measured by the ELISA method, and blood lipid profile including total cholesterol, HDL, and LDL were measured by enzyme assay method. Two-way mixed analysis of variance (ANOVA) was used for statistical analysis. Bonferroni post hoc test was used for between-group comparison and paired t-test was used for within-group comparison.Results The interaction effect of time and group was no significant for FGF21 (P˃0.05), but the main effect of time was significant (P=0.001). All three groups showed a significant increase in FGF21 in the posttest phase compared to the pretest phase (P≤0.05). The selenoprotein P. serum level was not significantly different between groups or between two evaluation times (P˃0.05). The interaction effect of time and group was not significant for lipid profile (P˃0.05). The within-group comparison indicated a significant decrease in LDL and total cholesterol and an increase in HDL in all groups (P≤0.05).Conclusion It seems that both aerobic and resistance exercises during a ketogenic diet can increase FGF21 and improve lipid profile in overweight or obese men. There is no significant difference between the two methods. They have no superiority over the ketogenic diet alone in affecting heptokines and lipid profile.

Background and Aims Studies have shown that individual constraints such as IQ positively affect the efficacy of motor development interventions, but the role of genes in this field has not been studied so far. Therefore, the present study aims to assess the effect of ACE genotypes on the effectiveness of the Sports, Play, and Active Recreation for Kids (SPARK) program in developing fundamental movement skills.Methods The study population consists all boys aged 6-8 years (Mean age: 7.4±1.45 years) in Tehran (district 4), Iran, of whom 50 were selected as samples by a simple random sampling method. The instrument was Ulrich’s gross motor development test III. The DNA extraction was also done from the saliva of participants. After determining genotypes II (n=11), ID (n=25), DD (n=14), pre-test assessment was conducted. Then, the groups received the SPARK motor intervention for 8 weeks at 24 sessions. Finally, post-test assessment was performed, and the collected data were analyzed in SPSS software using analysis of covariance.Results The effect of different ACE genotypes on the effectiveness of the SPARK program on children’s locomotor skills was significant (P=0.005), but it was not significant regarding ball skills (P=0.14). Children with genotype DD showed more improvement in locomotor skills than those with genotype II. Conclusion Our results support Newell’s theory that individual constraints play a role in learning and development. In this study, the ACE gene, as an individual constraint, has an effective role in the effectiveness of the SPARK program in improving locomotor skills in children.

Background and Aims Abnormal posture and alterations in movement and muscle activity patterns have been reported in people with upper cross syndrome (UCS). These changes can lead to imbalance in muscle activation, altered movement patterns, and biomechanical changes. The present study aims to investigate the effect of corrective exercises on posture, upper extremity muscle activity, and shoulder kinematics in male handball players with UCS.Methods This quasi-experimental study was conducted on 30 male handball players with UCS who were randomly divided into exercise (n=15) and control (n=15) groups. The variables including upper extremity muscle activation patterns, shoulder kinematics, forward head posture, forward shoulder posture, and kyphosis were evaluated before and after intervention. Should kinematics and activation patterns of upper extremity muscles (supraspinatus, lumbar erector spinae, upper trapezius, middle trapezius, latissimus dorsi, pectoralis major) were recorded using electromyography and motion analyzer. The angles of forward head and forward shoulder were assessed using photographic method taken from lateral view, and Kyphosis angle was measured using a flexible ruler before and after exercises. The exercise group performed the comprehensive corrective exercises for 8 weeks (3 sessions per week), but the control group did not receive any intervention. To analyze the data, two-way analysis of variance and Bonferroni test were used. The significant level was set at 0.05.Results Forward head posture (P=0.001), forward shoulder posture (P=0.003), and kyphosis (P=0.002) showed significant improvements in the exercise group compared to the control group from pretest to post-test phase. In the preparatory and throw phases (slow and fast throwing), higher activities of supraspinatus, lumbar erector spinae, upper trapezius, middle trapezius, latissimus dorsi, and pectoralis major were observed in the exercise group compared to the control group (P=0.05). Moreover, in the preparatory and throw phases, higher range of motion of shoulder flexion, forward flexion of shoulder, internal rotation of shoulder, external rotation of shoulder, and shoulder abduction were observed in the exercise group compared to the control group (P=0.05).Conclusion Corrective exercises can significantly alter shoulder kinematics and upper extremity muscle activity patterns in male handball players with UCS, which can be used in future studies to prevent UCS in handball players during throwing the ball.

Background and Aims Dynamic knee valgus (DKV) and impaired static and dynamic balances are the risk factors of the anterior cruciate ligament injuries in football players. This study aims to investigate the effect of the knee control program on knee valgus angle and static and dynamic balances in young male football players with DKV. Methods This is a quasi-experimental study. Of 156 young male football players, 48 with DKV were recruited and randomly assigned to intervention group (n=24, Mean age=12.70±0.62 years, height=1.52±0.07 m, weight=48.87±6.67 kg, BMI=21.10±2.18 kg/m2) and control group (n=24, mean age=12.58±0.65 years, height= 1.52±0.08 m, weight= 50.45±6.79 kg, BMI=21.88±2.92 kg/m2). The drop-jump test, Stork test, and Y balance test were used to measure dynamic knee valgus angle, static balance, and dynamic balance, respectively. The intervention group received the knee control program as a warm-up exercise for 8 weeks, while the control group performed their routine warm-up exercises during this time. Analysis of covariance and the paired t-test were used to evaluate differences in the study variables.Results In the intervention group, there was a significant reduction in knee valgus angle (P=0.001) and significant improvements in static balance (P=0.001) and dynamic balance (P=0.001) in the post-test phase compared to the pre-test phase, but there were no significant differences in the control group (P>0.05). Moreover, the results showed significant differences between the two groups in knee valgus angle (P=0.001), static balance (P=0.001) and dynamic balance (P=0.002).Conclusion The knee control program is effective in reducing dynamic knee valgus angle and improving static and dynamic balances in young football players with DKV. Thus, it seems that this program can reduce the risk of anterior cruciate ligament injuries in young male football players.

Background and Aims With the increase in the aged population, the physical and mental health of the elderly have become more important. Since resilience is an important concept in the mental health of the elderly, this study aims to predict the resilience of the elderly in Tehran, Iran, based on their religious orientation, mental toughness, physical health, and sleep disorders.Methods This is a descriptive-correlational study with a cross-sectional design. Participants were 256 elderly people aged >60 years (Mean age: 66.42±4.37 years) selected by a simple random sampling method from those living in Kahrizak Nursing Home in Tehran, Iran. They completed the Connor-Davidson resilience scale, Clough et al.’s mental toughness questionnaire-48 items, physical health questionnaire, and Lynch’s sleep disturbance questionnaire to measure resilience, religious orientation, mental toughness, physical health, and sleep disorders. Finally, the collected data were analyzed using structural equation modeling in AMOS and SPSS software, version 23.Results Religious orientation (t=4.32, r=0.24, P<0.001), mental toughness (t=6.87, r=0.68, P<0.001), physical health (t=5.12, r=0.57, P<0.001) and sleep disorders (t=-5.18, r=-0.52, P<0.001) could significantly predict the resilience of the elderly in Tehran. Conclusion The resilience of the elderly in Tehran has a positive and significant relationship with their religious orientation, mental toughness, physical health, and sleep disorders. These components can predict the resilience of the elderly. Therefore, by controlling these components, the resilience of the elderly can be improved.

Background and Aims Socialization and the ability to interact with others is essential. Healthy social growth requires the natural and healthy development of personality and learning social skills. Storytelling is a great way to help intellectual development in children. This study aims to investigate the effect of storytelling on the social-emotional skills of primary school male students in Iran.Methods This is a quasi-experimental study with a pre-test/post-test/follow-up design. The study population included all 12-year-old primary school male students in Tehran (educational district 1) in 2019-2020. Using a purposive sampling method, 40 eligible students were selected and randomly assigned to intervention (n=20) and control (n=20) groups. The intervention group received the storytelling program at 14 sessions of 30 minutes, two sessions per week. The Social-Emotional and Character Development Scale was used to collect the data, which was completed by the students. Analysis of covariance was used to analyze the data.Results There was a significant difference between the two groups in social-emotional skills (P<0.05).  The scores increased in the intervention group after storytelling. In the two-month follow-up phase, the changes were stable.Conclusion Storytelling is an effective way to increase primary school male students’ social-emotional skills and can be used in educational settings.

Background and Aims People with intellectual disabilities (ID) are a vulnerable social group whose physical performance, quality of life (QOL), and ability to live independently are affected. This study aims to investigate the relationship between QOL, executive functioning, and physical performance of adults with ID in northwest Iran.Methods This is a descriptive-correlational study. Participants were 61 adults (Mean age=34.31±8.895 years) with ID in Ardabil, Tabriz, and Urmia cities who were selected by a convenience sampling method.. The 26-item WHO QOL Questionnaire, the Barclay deficits in executive functioning scale - short form, and the short physical performance short battery were used to measure QOL, executive functioning, and physical performance. Pearson correlation test to investigate the relationship between these three variables. Regression analysis was used to assess the role of executive functioning and physical performance in predicting QOL.Results The results showed a significant relationship between QOL and physical performance (r=0.31, P=0.015), between QOL and deficits in executive functioning (r=-0.37, P=0.004), and between physical performance and deficits in executive functioning (r=-0.42, P=0.001). Executive functioning and physical performance together predicted 16% of changes in the QOL of patients.Conclusion Executive functioning and physical performance have a relationship with the QOL in adults with ID in northwest Iran. There is a positive relationship between QOL and physical performance, and a negative relationship between QOL and deficits in executive functioning and between physical performance and deficits in executive functioning. The QOL of patients can be predicted based on their executive functioning.

Background and Aims Previous studies have shown that core stability exercises reduce the applied force on the upper limbs in swimmers. However, the effect of these exercises on the range of motion (ROM), muscle strength, and pain in the shoulder of swimmers is unclear. Therefore, this study aims to investigate the effect of a core stability exercise program on shoulder pain, muscle strength, and ROM in female swimmers with shoulder impingement syndrome (SIS).Methods The study population consists of all female swimmers with SIS in Tabriz, Iran. Twenty eligible swimmers were selected and randomly divided into two exercise (n=10) and control (n=10) groups. The shoulder pain, ROM, and muscle strength were measured by the shoulder pain and disability index, a goniometer, and the bench press (One repetition maximum), respectively. The exercise group participated in a specific core stability exercise program. The data were analyzed in SPSS software, version 24 using repeated measures analysis of variance, independent t-test, and paired t-test for within-group and between-group comparisons. The significance level was set a t 0.05. Results After exercise, the amount of shoulder pain in the experimental group was significantly reduced compared to the control group (P=0.0001). It also had a significant effect on the ROM of the shoulder in this group. In addition, there was a significant difference in shoulder muscle strength in the experimental group before and after exercise (P=0.0001), but this difference was not significant in the control group (P=0.138). Moreover, there was a significant interaction effect of time and group in the shoulder girdle muscle strength (P=0.001).Conclusion The core stability exercises can reduce shoulder pain and improve shoulder ROM and muscle strength in female swimmers with SIS. Performing core stability exercises is recommended to reduce pain and improve shoulder girdle function in these swimmers.