Scientific Journal of Rehabilitation Medicine
Year:2020 | Volume:9 | Issue:2|Papers Count:36

Background and Aims: The aim of the current study was to investigate the effect of hip abductor andexternal rotator muscles strengthening exercises on pain, muscle strength, and lower extremity kinematicsin people with patellofemoral pain (PFP). Materials and Methods: A total of 35 patients with PFP were randomly assigned into exercise and control groups. The exercise group received abductor and external rotator strengthening exercises withthera-band 3 times per week for 12 weeks. The control groups did not receive any training intervention. Then, the two groups were compared to study the effect of independent variable on the experimentalgroup. Pain (VAS), hip muscle strength (handheld dynamometer), and lower extremity kinematics (videoanalysis) were assessed at baseline and post-intervention. Participants included patients with bilateral orunilateral patellofemoral pain; if pain was bilateral, exercises were performed bilaterally on both lowerextremities but measurements were performed only on the lower extremity which was more painful; whenever the pain in both knees was equal, data were collected only from the superior lower extremity. Repeated measures ANOVA was applied using SPSS to assess the effects of the exercises on measuredvariables. Results: Pain decreased significantly in exercise group from baseline to post-intervention (P=0. 000). Hipabductor muscles strength (women, P=0. 000 and men, P=0. 003) and external rotator muscles strength (women, P=0. 024 and men, P=0. 000) increased significantly in exercise group after 12 weeks of strengthening program. There was a significant improvement in dynamic knee valgus during single-legged squat (women, P=0. 018 and men, P=0. 017) and contralateral pelvic drop during stair descendingjust in women (P=0. 04) in exercise group. There were no significant differences between men and women in the effect of exercises on the variables studied (P>0. 05). Conclusion: According to the results, hip strengthening can decrease pain, increase muscle strength, and change kinematics in the frontal plane movement patterns of the lower extremity, which can possibly be the mechanism of effect of this intervention on PFP symptoms. According to findings of the present study, it might be concluded that gender-specific rehabilitation program is not needed in patients with PFP.

Background and Aim: Cryotherapy is commonly used in the treatment of acute and chronic athletic injuries. The present study aimed to investigate the immediate effect of cryotherapy on the kinetic factors associated with injury during the side-cutting maneuver in healthy male athletes. Materials and Methods: A total of 14 professional athletes (age: 24. 3± 3. 5 years and weight: 74. 1± 19. 2 kg) took part in the study. The kinetic factors, including ground reaction force, and their rate of loading, the center of mass to center of pressure changes, and free momentum, were assessed by force plate during the side-cutting maneuver. Simultaneously, using spray cooling, cold was applied to participants' inside and outside parts of the ankle with a distance of 30 cm from lateral and medial malleolus for 5 seconds; the test was repeated three times. Paired t-tests were used for statistical analysis, with a significance level of P≤ 0. 05. Results: The results of the Paired t-test showed that both peak ground reaction force (P = 0. 042) and the rate of loading in the Medio-lateral direction significantly increased (P = 0. 046) after applying the cold protocol compared to the pre-test (before intervention). The center of mass to center of pressure displacement in both Medio-Lateral and Anterior-Posterior directions also showed a significant increase (P = 0. 01 and P = 0. 004), respectively. Conclusion: According to the results of the current study, it seems that cold enhances the risk of injuries due to increased force and its rate of loading and reduces the dynamic stability of athletes during the side-cutting maneuver and can put the athletes at risk of potential injuries. It is recommended that further studies be conducted using larger sample size to investigate the use of cooling sprays during the treatment of ankle injuries in shear activities.

Background and Aim: Pyarmid and Reverse Pyramid loadings are used in resistance training to increase training load. Although physiological researches have tried to compare these two patterns, the differences between these two patterns on lower extremity joints biomechanics from injury risk have not been understood. The purpose of the present research was to compare hip and knee kinematics during squat at pyramid and reverse pyramid loading. Materials and Methods: A total of 15 amateur bodybuilders from Karaj city voluntarily participated in five Repeated Maximum (5RM) calculation tests as well as a squat test with pyramid and reverse pyramid loading at 60%, 80%, and 100% of 5RM during three days with 48 hours interval. Hip and knee three-dimensional angles were registered with MyoMotion Noraxon motion capture system at 100 Hz frequency during squat tasks. The mean value for peak hip flexion, adduction, and internal rotation, as well as knee flexion and valgus during five squat repeats, were calculated and compared in similar loads during two kinds of pyramid and reverse pyramid loadings. Results: The results of dependent t-test showed that peak hip flexion, adduction, and internal rotation, as well as knee flexion and valgus at similar loads, had significant increase in reverse pyramid loading compared with pyramid loading (P ≤ 0. 05). Conclusion: According to the results of the present study, since the increase in peak value of examined angles is an indicator for increase knee joint injuries, regarding the increase in these peak angles during reverse pyramid loading as compared with pyramid loading, it is suggested that coaches and amateur athletes use pyramid loading during their trainings.

Background and Aim: Athletes usePyarmid and Reverse Pyramid loadings in resistance training to increase training load. Although researches have shown that each loading is effective in increasing strength and muscle mass, from the viewpoint of risk of injury and biomechanics, the differences between these two patterns on athletic performance have not been fully understood. The purpose of the current study was to examine muscular electromyography during deadlift in pyramid and reverse pyramid loadings. Materials and Methods: A total of 15 amateur female bodybuilders voluntarily participated in the current study taking part in five Repeated Maximum (5RM) calculation test as well as deadlift test with pyramid and reverse pyramid loading at 60%, 80%, and 100% of 5 RM during three days with 48 hours rest. Rectus Femoris, Vastus Medialis, Biceps Femoris, Tibialis Anterior, Gastrocnemius, Gluteus Maximus, and Erector Spine EMG were collected using MyoMuscle Noraxon system at 1500 Hz frequency during deadlift tasks. The muscular IEMG and hamstring to quadriceps co-contraction during five squat repeats were calculated and compared in similar loads during pyramid and reverse pyramid loadings. Results: The results of dependent t-test showed that lower extremity muscular EMG did not have significant differences in similar loads at pyramid and reverse pyramid loadings (P > 0. 05); however, hamstring to quadriceps co-contraction was significantly higher in pyramid compared with reverse pyramid in similar loadings (P ≤ 0. 05). Conclusion: According to the results, both pyramid and reverse pyramid loadings in deadlift can cause similar muscular activation in females, and female athletes and coaches can use both these methods to increase muscular force capacity. However, because of higher hamstring to quadriceps co-contraction in pyramid, compared with reverse pyramid loading, it seems that using pyramid loading is more reasonable to increasing joint stability and reducing injuries.

Background and Aims: Educational self-efficacy implies one's belief in his abilities in achieving educational goals and activities, and is influenced by several factors. The purpose of the present study was to compare the effectiveness of teaching self-regulation strategies of motivation and communication skills on academic self-efficacy of female Tabriz talented students. Materials and Methods: In the current quasi-experimental study with pre-test, post-test, and control groups, a total of 90 female high school third grade students in regions 1 and 4 of Tabriz in 2016-2017 were selected using cluster random sampling and were randomly assigned to experimental and control groups. The first group received a training course on motivational self-regulation strategies in 10 sessions, the second group received 10 sessions of communication skills training, and the third group (control) continued its regular classroom programs. A self-efficacy questionnaire was used for data collection. Results: Data analysis, using single-variable covariance, showed that self-regulation of motivation and communication skills had different effects on academic self-efficacy, and selfregulating strategies of motivation were more effective on academic self-efficacy. Conclusion: According to the results, it seems that planning effective interventions to promote academic self-efficacy is imperative for female students.

Background and Aims: Language acquisition naturally takes place in a certain space of time in typically developing children, but this is different in children with Autism spectrum. In Autism spectrum disorder, the child’ s speech is defective for some reasons, and, in fact, language acquisition is accompanied by a deviation from language development. The present study aimed to provide a comparative study of the comprehension and production of inflectional categories of noun including number, definiteness, case, and possession between 7-9 year-old high functional autistic Persian-speaking children and their typically developing peers. Materials and Methods: In the current study, the research data were gathered through three sub-tests: grammatical understanding, sentence imitation, and word production of Persian Told test. To this end, 15 typically developing children from ordinary schools and 15 high functional autistic children from Autism school in Kerman city were asked to answer the tests. Then, SPSS software, version 22. 0, was used running t-test to compare the means between the groups. Results: The research results showed that the comprehension and production of inflectional categories of noun in typically developing children were higher compared with those with high functional autism and there was a significant difference between the typically developing children and children with high functional autism in comprehension and production (P<0/05). Conclusion: It seems that the typically developing children have a better performance in understanding and producing inflectional categories of noun compared with children with high functional autism.

Background and Aims: The purpose of the present study was to investigate the effect of three methods of kinesthetic imagery, active, and combination exercises on electromyographic pattern of femur hypertension in women with hyperlordosis. Materials and Methods: In the current investigation, 36 women with lumbar hyperlordosis were chosen and divided into three groups of imagery, active and combined exercises. The groups trained for six weeks, three times a week. The lumbar lordosis was measured making use of flexible ruler and electromyographic activity of the selected muscles of pelvic in the femur motion in prone condition using surface electromyogram before and after the intervention. Results: There was a significant difference between the three training methods (P = 0. 005). Conclusion: According to the results, combination exercises were effective in changing pelvic muscle activity; therefore, it is suggested that kinesthetic imagery exercises be used along with physical exercises to correct abnormalities.

Background and Aims: Macromastia is a condition according to which the breasts grow larger than normal. The most important complications of large breasts include cervical, thoracic, and lumbar curves as well as pain in these areas. The present study was conducted to examine the effect of selected corrective exercises on the pain and neck status of females with large breasts. Materials and Methods: In the current study, 32 females, aged 23-28, who had large breasts (cup size 13) participated on a voluntary basis. Participants were randomly divided into control and experimental groups. In the pre-and post-test sessions, the neck pain was evaluated using VAS pain scale and forward head posture was assessed via digital photos of half a neck. Then, experimental group performed training program for eight weeks. Finally, Shapiro wilk test and paired t-test at 95% significance level were run to analyze the data. Results: The results showed that neck pain decreased, and forward head posture improved significantly. Conclusion: According to the results, we found that eight weeks of corrective training, by reducing elongated muscles, strengthening weakness muscles, increasing muscle blood flow, relaxing antagonist muscles and subsequently increasing neck range of motion, has led to reduction in the incidence of complications from enlarged breasts. Considering the high impact of the training group, it is suggested that corrective training program be used to improve the essential factors for the females with large breasts.

Background and Aims: Using pre-injury tests and designing a harm-prevention program for progress are essential in any discipline. The main purpose of the present study was to investigate the effect of eight weeks of core stability exercise on balance and functional movement screen of soccer players in Babol Matin club. Materials and Methods: A total of 30 healthy adolescent soccer players volunteered to participate in the study, and then randomly divided into experimental and control groups. Before the beginning of the exercise, participants performed dynamic balance test by Y-test, static balance with Lak Lak test and Functional Movement Screen test (FMS) as a pre-test. Players performed core stability exercise for eight weeks and after completing the exercises, post-test was conducted. Descriptive statistics were used to examine mean and standard deviation as well as participants' height, weight, and body mass index and to report the results of the measurements for each group. In addition, for comparison of both groups, independent and independent t-tests, at a significance level of P <0. 05, were used. Results: The findings of the study showed a significant difference between the experimental and control groups in the post-test, and that the experimental group had better performance in anterior (p = 0. 001), internal posterior (p=0. 001), external posterior directions (P=0. 001) and the total score on the dynamic balance test (p=0. 001), the Lak Lak test (p=0. 001), and the overall score of functional movement screen test (p<0. 003). Conclusion: The results of the cutteny study showed that core stability training of the central body could plays a significant role in improving the static and dynamic balance and Functional Movement Screen test (FMS) of soccer players.

Background and Aims: Lower back pain is one of the most common and costly medical problems and the main cause of absenteeism. The aim of the present study was to investigate the effect of conventional core stability and special suspension exercises on functional disability and pain in non-specific chronic tow back pain patients. Materials and Methods: A quasi-experimental study was conducted on purposefullyselected patients with chronic low back pain referring to neurological and orthopedic clinics as well as the health center of lama in Neyshabur city. The samples were selected and randomly divided into two groups. First, pre-test measurements were performed and in the second stage, each of the two groups performed their own training protocol (core stability TRH training and common core stability exercise protocol) for 12 weeks, 3 sessions per week, each session for 45-60 minutes. After measurements, post-test measurements were performed. The severity of low back pain and disability were measured using Oswestry and Quebec questionnaire; respectively. These measurements were repeated after 12 weeks in both groups. In order to analyze the data, SPSS, version 21, was used for within and between group comparisons using independent and paired t-tests. Results: The results showed that both types of stability trainings reduced the amount of pain and functional disability in patients with non-specific chronic low back pain. This decline was significant in special suspension exercises. Conclusion: Core stability training is recommended as a proposed and complementary method in the treatment of patients with non-specific chronic low back pain. According to the results of the present study, the suspension core stability exercises can be used more effectively, compared with core stability exercises, on fixed surfaces for patients with nonspecific chronic low back pain.

Background and Aims: Joint kinematics, muscle activity, plantar pressure, and ankle joint position changes with wearing high heeled shoes can decrease walking stability, so the assessment of walking stability during walking with high heeled shoes is necessary. The aim of the present study was to assess the effect of high heel shoes on spatiotemporal and dynamic stability during walking. Materials and Methods: Nine girls with the mean weight of 593. 25± 17. 24 N and height of 1. 48± 0. 14 m participated in the present study. Qualysis motion analysis system and a Kistler force plate were used to record data. Visual 3D software was used to extract spatiotemporal and Centre of Mass (COM) variables. SPSS software was used to analyze data, running dependent t-test, at the set point of 0. 05. Results: The mean displacement of the center of mass in the anterior-posterior plane was 96. 69± 15. 66 cm during walking with 6 cm high heeled shoes which was 7. 7cm (P = 0. 03) and 7. 45cm (P = 0. 02) lower compared with walking without shoes and walking with 3-cm high heeled shoes. Walking speed of 3-cm high heeled shoes (1. 51 ± 0. 17 m / s) (P <0. 001) and walking speed without shoe (1. 31± 0. 36 m/s) (P = 0. 02) were significantly higher than those of walking with 6-cm high heeled shoes. Conclusion: According to the results, high heeled shoes reduce the dynamic stability of walking. Waking speed and anterior-posterior displacement of COM of walking with 6-cm high heeled shoes decreased, thus decreasing dynamic stability, and endangering users at the risk of collapse and instability and injury. It is advisable that wearing high heeled shoes be avoided in all populations.

Background and Aims: Pronated foot involves the reduction of the inner longitudinal arch of the foot that is associated with other anatomical abnormalities. The purpose of the present study was to investigate the effects of long-term use of motion control shoes on the muscular frequency spectrum in individuals with pronated foot during walking. Materials and Methods: A semi-experimental and laboratory study was conducted on 24 men with pronated foot who took part in the study on a voluntary basis. They were randomly divided into two equal groups, including control (age: 24. 1± 5. 6 years, height: 166± 2. 6, weight: 52. 66± 6. 3 kg) and experimental (age: 24. 1± 5. 6 years, height: 166± 2. 2 cm, weight: 52. 66± 6. 3 kg). The electrical activity of the lower limb and trunk muscles were recorded using electromyography system during walking before and after four months of wearing control and motion control shoes. Wilcoxon, U Mann-Whitney, and Friedman tests were used to analyze the data. Results: The findings showed that the frequency spectrum of the vastus lateralis muscle (P = 0. 003; high effect size) significantly increased during the post-test compared with that of the pre-test. Also, in the experimental group, the gluteus medius muscle (P=0. 015; high effect size) showed a significant increase in frequency spectrum during the post-test compared with the pre-test. Other muscles did not show any significant difference before and after long-term use of motion control shoes (P >0. 05). Conclusion: Generally, the long term use of motion control shoes change lower limb muscular frequency spectrum. Further studies on the long term effects of motion control shoes on body mechanics are suggested.

Background and Aims: The previous studies have shown that FIFA +11 program considerably reduces soccer players' sport injuries, but there is limited information about the effect of this program on EMG and kinetic factors of adolescent soccer players. Thus, the aim of the current study was to investigate the effect of comprehensive FIFA +11 injury prevention program on EMG and kinetic factors of knee joint in 10-12 year-old soccer players. Materials and Methods: A total of 30 males (aged 10. 88± 0. 39 years, height 146. 69± 4. 91 cm, and weight 43. 95± 6. 31 kg) were randomly assigned to FIFA 11+ (n=15) and control (n=15) groups. The FIFA 11+ group completed training 3 times a week for 8 weeks; training lasted for 20 min for each session. EMG and kinetic factors were respectively measured using EMG and forceplate sets during landing. For data analysis, repeated measures analysis of variance, independent-sample, and paired t tests were used. Results: It was found that FIFA11+ training caused significantly increased EMG activity of vastus medialis, gluteus medius muscles, and decreased EMG activity of lateral hamstring and lateral gastrocnemius muscles, but there was no significant decrease in EMG activity of vastus lateralis. Also, peek vertical and posterior ground reaction forces and anteroposterior and mediolateral time to stabilization values decreased significantly. Conclusion: We found that FIFA11+ program can improve the neuromuscular and kinetic characteristics of lower extremities in adolescent soccer players, and potentially reduce the risk of ACL injury during landing. Thus, it is recommended that coaches and athletes use the FIFA 11+ trainings at the beginning of training sessions to reduce the risk factors associated with anterior cruciate ligament injury.

Background and Aims: Given that voice problems can have a huge impact on the teachers' ability to work and as a result on the whole society, the aim of the present study was to determine the prevalence of voice disorders in primary school teachers in Arak. Materials and Methods: To evaluate the prevalence of voice disorders, 965 teachers of the first to sixth levels from Arak primary schools were evaluated using voice Disorders Questionnaire for primary School Teachers, which enjoys high reliability and validity indices. Particpants who received score 9 or higher were classified as teachers with voice disorders. Results: The prevalence of voice disorders among primary school teachers in Arak was 28. 9% (29. 9%, male teachers and 28. 9% female teachers). Increase in the teaching grade (P = 0. 815) and the teacher's gender (P = 0. 666) did not significantly increase the prevalence of the disorder, but the type of school (P = 0. 001) and the type of area (1 or 2) with P = 0. 044 had a significant effect on the prevalence of this disorder. Conclusion: In general, the prevalence of voice disorder in teachers was found to be 28. 9%. Gender and the basis of teaching factors do not make a difference in the prevalence of this disorder, but the type of school and educational area is effective in the prevalence of this disorder.

Background and Aims: The overhead throwing is a complex motor pattern, and limitation in the ROM of hip and shoulder joints can have a negative effect on the performance of this skill and lead to injury in this joint. The purpose of the present study was to compare the ROM of the hip and shoulder joints in elite handball players with and without shoulder injury. Materials and Methods: Totally, 60 professional handball players from the Iranian Premier League were purposefully selected and divided into two groups: 27 players of the first-line (Center and Back) and 33 players of the second-line (pivots, wings) were studied. The ROM of shoulder internal/external rotation and hip extension/internal rotation, as the variables, were measured using a goniometer at the beginning of the season. Also, shoulder injuries were recorded during the Premier League season. The Kolmogorov-Smirnov test was used to examine the normality of the data and independent t-test was used to compare the ROM of hip and shoulder joints in players with and without shoulder injuries at a significance level of P <0. 05. Results: According to the findings of current study, players in the first-line with shoulder injuries demonstrated increased external rotation and limited internal rotation in shoulder joint compared to players without shoulder injuries. Also, there was a significant difference between the ROM of the internal rotation of the shoulder joint in the dominant hand with non-dominant hand in the first-line players with shoulder injuries. There was also a significant difference between the ROM of hip extension in the dominant limb and also ROM in internal rotation of the hip joint in the first-line players with shoulder injury. Conclusion: Based on the results of the current study, decrease of the internal rotation in the shoulder joint in dominant hand, the increase of external rotation in the shoulder joint in non-dominant hand, limitation of the hip extension in dominant limb and internal rotation in the non-dominant limb, and also difference in ROM of internal rotation in shoulder joints in both dominant and non-dominant hands can be a risk factor in the incidence of shoulder injuries in handball players.

Background and Aims: Theory of mind, as the central core of social cognition, is one of the important components of psycho-social development during childhood and selective attention plays a critical role in developing the advanced aspects of this theory. Various interventions have been suggested so far for the rehabilitation of children with disorders, but deisgning interventions based on the perceptual-motor abilities have been overlooked. In the present study, therefore, the effect of a perceptual-motor skills training program on selective attention and improving theory of mind in children aged 8-12 years was studied. Materials and Methods: The research method used was quasi-experimental with pre-and post-test design with a control group. A total of 24 girls, with an average age of 10. 5 years, were selected among all students in Tehran and were randomly divided into two experimental and control groups (12 individuals in each group). Stroop and theory of mind tests were used to measure the variables before and after the experimental period (16 sessions, each session for 45 minutes, 4 session per week, for one month). The experimental protocol consisted of training perceptual-motor skills with emphasis on balance, spatial awareness, temporal awareness, body awareness, and lateralization. Data analysis was performed using covariance analysis at the 95% confidence level. Results: The effects of group on selective attention (p=0. 015), recognition of emotions and pretense (p>=0. 023), understanding of false belief (p>=0. 011), and understanding of humor and second-order false belief (p>=0. 048) were significant after controlling for the effects of pre-test levels. Therefore, the experimental group, as compared with the control group, had shorter Stroop time and higher levels of theory of mind. Also, the effect size of experimental intervention on the advanced aspects of theory of mind was smaller than that of the primary aspects (0. 17 vs. 0. 35). Conclusion: Perceptual-motor skills training is effective in improving selective attention and development of theory of mind in healthy girls aged 8 to 12 years, but there is a need for more complex interventions with an emphasis on interpersonal interaction in order to influence the more advanced aspect of theory of mind (understanding of humor and second-order false belief).

Background and Aims: Balance is a health-related fitness factor that is one of the most essential neuromuscular functions in performing simple and complex exercise activities. Vision plays a decisive role in processing and integrating other sensory inputs for balance control. The purpose of the present study was to investigate the relationship between core muscle endurance with movement function and postural control in blind people. Materials and Methods: The samples consisted of 32 blind men, aged 18-29 years old, selected through purposeful sampling method. Modified stork stand balance, tandem walking, and berg balance tests were used to assess the balance and Tinetti test and time up and go were used to assess function. Moreover, we used trunk lateral endurance test, Trunk Extensor Endurance Test, and Trunk flexor endurance test to evaluate endurance of core stabilizing muscles retrieved from McGill protocol. Normality of data was measured using Shapiro-Wilk Test. In addition, Spearman correlation test was used to determine the correlation between core stability, balance, and movement function at the significance level of 0. 05. Results: Pearson correlation test showed that there is a significant relationship between dynamic balance in tandem walking tests and trunk extension only (P<0. 05). Also, a significant relationship was found between the results obtained from static balance test and trunk endurance extension, non-dominant side-bridge test, and trunk flexor (P<0. 05). The results of Pearson correlation test showed that there is a significant relationship between endurance of trunk extension and lateral flexion endurance of non-dominant side and the results obtained from Berg, Tinetti, and Time Up and Go tests (P<0. 05). Conclusion: According to the results of the present study, strengthening core muscle endurance seems to be necessary to improve balance and function of the blind and also to prevent the occurrence of impaired balance injury.

Background and Aims: Does long-term training modify the neural control of walking pattern? The purpose of the present study was to investigate the effect of being athlete on the structure and organization of walking neural control with and without disturbance. Materials and Methods: The present study was performed as a semi-experimental study. Participants included 12 football plyer students and 12 non-athlete students at the University of Mazandaran. They performed treadmill walking pattern with open-eyes and closed-eyes conditions. Lower extremity muscles electromyography was collected using Noraxon system during walking. Muscle synergy variables, including sum, duty, peak, and area muscle activities, were calculated using Non-negative matrix factorization. The data comparisons for the assessment of the variables were performed running the two-way ANOVA test in SPSS software. Results: Athletes showed less duty and the total muscle activity compared with non-athletes during open eyes walking (p < 0. 001). Peak muscle activity was higher during open eyes walking compared with closed eyes walking in athletes (p = 0. 003). In contrast, duty, area, and the total muscle activity of athletes were lower than those in non-athletes (p < 0. 001). Conclusion: The results of the present study suggested that doing exercise training for long-term period can change modules of neuromuscular system in walking pattern. Soccer players have the ability to employ muscle groups with higher peak muscle activity. In contrast, duty, area, and the total muscle activity are lower in soccer players compared with non-athlete individuals and can be an evidence for different decision of neuromuscular system of these groups when doing walking pattern.

Background and Aims: Mental fatigue usually occurs after prolonged cognitive activities that decrease cognitive function and lead to changes in motor coordination. The purpose of the present study was to investigate the effect of mental fatigue on balance, lower extremity function, and landing biomechanic changes in amateur male athletes. Materials and Methods: In the current quasi-experimental study, 35 amateur male students volunteered. Mental fatigue was induced by 45 minutes of cognitive activity (Stroop test). Before and after mental fatigue, the followings were evaluated: dynamic balance using Y-Test, semi-dynamic balance using Lafayette Stability Platform, knee proprioception using Inclinometer, lower extremity function using LEFT Test, landing mechanic using Balance Error Scoring System, and Jump-Landing skill film assessment using AutoCAD and Kinovea software. Data were analyzed making use of SPSS software (version 22) and running paired sample t-test at the significance level of 0. 05. Results: The results of Paired sample t-test showed that lower extremity function (P=0. 0001), dynamic balance (P=0. 0001), semi-dynamic balance (P=0. 0001), and knee proprioception (P=0. 0001) decresed and landing biomechanics (P=0. 004), which have been reported as the predictors of lower extremity injuries risks after undergoing mental fatigue, increased significantly. Conclusion: According to the results, significant decrease in balance, lower extremity function factors, and increased landing mechanics of amateurs after mental fatigue have been shown, and injury prevention experts should study the strategies for the prevention of mental fatigue.

Background and Aims: Balance is generally defined as the ability to maintain the body’ s center of gravity within its base of support. Both static and dynamic balance require integration of visual, vestibular, and somatosensory inputs to produce a proper efferent response to control the body within its base of support. With regard to the importance of balance in sport activities and prevention of injuries, there is a question whether continuous participation in sport activities and the nature of the sport can cause a difference in efficiency of the involved sensory systems in postural control. The aim of the present study was to compare efficiency of involved sensory systems among swimmers, soccer players, and non­-athletes. Materials and Methods: In the current study, Centers of foot pressure of 3 homogeneous groups, consisting of 30 soccer players, 30 swimmers, and 30 non-athletes were assessed using Biodex balance system according to the modified CTSIB protocol. One-way ANOVA and LSD post hoc test were run in SPSS, version 24, with the p-value set at p≤ 0. 05. Results: The results showed that soccer players and swimmers had better dynamic balance compared with non-athletes. There was no significant difference among static balance of the three groups. Also, we found that soccer players and swimmers had better visual system efficiency compared with non-athletes. The soccer players had higher somatosensory system compared with non-athletes and the swimmers had the highest vestibular system efficiency. Conclusion: According to the results, it seems that swimming as a sport activity can enhance the efficiency of visual and vestibular systems and playing soccer can enhance the efficiency of visual and somatosensory systems. Then, it is advised that swimmers should pay attention to somatosensory system efficiency in addition to vestibular system efficiency and soccer players should consider enhancing vestibular system efficiency beside somatosensory system efficiency in their balance training.

Background and Aims: Children with developmental coordination disorder are at greater risk of physical and mental disorders than regular children, so it is important to timely and effectively undergo preventive and therapeutic interventions to improve motor coordination. The purpose of the present study was to investigate the effect of attending 12 sessions of Nintendo game console training on spatial working memory and perceptual-motor skills (eyebrows-hand coordination) in 6-8 year-old children with developmental coordination disorder. Materials and Methods: The present study was conducted in a pretest-posttest research design with control group. For the purpose of the present study, 20 female students with developmental coordination disorder (DCD-Q), identified by parents and those with suspected developmental coordination disorder, were included in the MABC-2 test. After selecting the research sample, all partcipants in pre-test phase participated in two tests of frosting (eye-hand coordination) and N-Back spatial working memory and scores were recorded. Then, they were randomly divided into experimental and control groups. The experimental group played the Nintendo console for 12 sessions, each for 20 minutes, but the control group did not participate in any training. After the training, both groups participated in the post-test, which was similar to the pre-test. After making sure that the distribution of data was normal using Kolmogorov-Smirnov test, analysis of variance with repeated measures was run to test the research hypotheses and dependent t-test was used to examine the exact location of differences. Results: The results of dependent t-test showed that there was a significant difference between the scores obtained in the pre-test and post-test in the Nintendo game console group (p = 0. 001, df = 9, t = 12. 10). In post-test, they performed better on eye and hand coordination test, while the results of dependent t-test showed no significant difference between pre-test and post-test scores in the control group (p = 0. 555, df = 9, 61. 61). 0 t =). So, it is obvious that using the Nintendo game console has improved eye-hand coordination for children with developmental coordination disorder. Also, the dependent t-test results showed that there was a significant difference between the scores obtained in the pre-test and post-test in the Nintendo game console group (p = 0. 001, df = 9, t = 10. 58). The posttest scores were better in the spatial working memory test compared to the pre-test score, while the dependent t-test results showed that there was no significant difference between the pre-test and post-test scores in the control group (p = 0. 009, 9 df =, 0. 01 t =). Conclusion: The results showed that using the Nintendo game console has led to improved spatial working memory in children with developmental coordination disorder.

Background and Aims: During the recent years, attention has been paid to the importance of aerobic exercises in MS (Multiple sclerosis) patients. Therefore, the present research studies the effect of two methods of training on the functional ability (lower limb, hand and head coordination ability, and cognitive ability) of patients with MS. Materials and Methods: In the current research, 45 women with MS, aged 20-40 years old, were randomly assigned to three groups. The two groups continued to practice supportive treadmill and fixed bike for 12 weeks, 3 days a week, and the control group received no training. Functional ability test (25 time steps, 9 nails in the hole, consecutive acoustic scans) were taken from the participants in the pre-test and post-test. ANCOVA, and MANCOVA were run to test the hypotheses. Results: There was no significant difference between the moderated mean performance of the training group with the supportive treadmill and fixed bike (p> 0. 05). In order to investigate the effect of MANCOVA analysis of covariance training on post-test scores, the functional abilities components were tested. The average of moderated components of lower limb function, hand and head coordination ability, and cognitive ability of exercise groups with fixed bike and exercise with supportive treadmill were significantly higher than those of the control group (p <0. 05). However, there was no significant difference between the moderated means of the components of the fixed bike and the supportive treadmill (P> 0. 05). Conclusion: According to the results, both supportive treadmill training and fixed bike are effective in improving lower limb function, hand and head coordination ability, and cognitive ability of people with multiple sclerosis.

Background and Aims: The spinal alignment affects the scapular condition and shoulder belt function. It seems that corrective exercises can improve the performance of boxing athletes by reducing head and shoulder abnormalities. Materials and Methods: In the present study, 30 boxers, aged 16-19 years old, participated voluntarily from Urmia, after measuring the angles of forward head and shoulder, the internal and external shoulder movement of the shoulder, the assessment of the strength of the muscles of the shoulder rotation, and finally the speed measurement and reaction time using a camcorder. Then, they were randomly divided into control (n=15) and experimental (n=15) groups. Experimental group participated in selected exercises during the course of six weeks, including Chin tuck movement, Stretching of the chest muscle with wood, Retraction of the scapula with Thera band, along with chin tuck, shoulder flexion, and external shoulder spin with Thera band. Results: The findings of the covariance study showed that the corrective exercise has a significant effect on the forward head and shoulder, speed, reaction time, and strength and range of motion (internal and external) of the shoulder in the participants. Conclusion: Based on the results of the present study, it is suggested that boxers can be use these exercises to improve their performance.

Background and Aims: Patellofemoral pain syndrome is a common musculoskeletal disorder. Quadriceps exercises are used as standard exercises for patellofemoral pain syndrome rehabilitation, but in addition to the weakness of quadriceps muscles, the weakness and shortness of the knee proximal and distal muscles are also effective in the incidence of this syndrome. The aim of the current study was to investigate the effect of knee local, proximal, and distal training on performance, dynamic balance, and pain in athletes with this syndrome. Materials and Methods: A total of 39 athletes with patellofemoral pain syndrome, diagnosed by a specialist practitioner, with an average age of 25. 5 ± 3. 35 years, were voluntarily included in the study and were randomly assigned to three groups of proximal, including hip and knee muscles exercises (n=12), distal, including ankle and knee muscles exercises (n=11), and and control, including only knee muscles local exercises (n=12). Training was performed for 8 weeks. To evaluate the patients’ performance, dynamic balance, and pain severity, the WOMAC questionnaire, Y test, and visual analogue scale were used, respectively. Results: The results showed that in anthropometric characteristics, pain and function before intervention, there were not any significant differences between three experimental groups. In all the three groups, the pain, dynamic balance and performance in post-test were significantly improved compared with pretest (P = 0. 001). Also, there was a significant difference in pain intensity between the proximal group and those of the other two groups (P = 0. 016). Conclusion: Based on the research findings, all three types of exercises are effective in reducing pain and improving performance and dynamic balance of patients, but the proximal exercises have a greater effect on reducing pain in patients with patellofemoral pain syndrome. Therefore, it is suggested that the combined hip and knee exercises be used in rehabilitation of patients with patellofemoral pain syndrome.

Background and Aims: A pronated foot is one of the lower limb malalignments which can lead to running related injuries. Another cause of running related injuries is running induced fatigue. The aim of the current study was to investigate the interaction effect of both pronated foot and fatigue at the heart rate deflection point on the frequency spectrum of ground reaction forces during walking. Materials and Methods: Participants were assigned into two healthy (number=15) and pronated foot (number=15) groups. A Bertec force platform was used to record the ground reaction forces during barefoot walking before and after fatigue in heart rate deflection point. Ground reaction force was measured in vertical, anterior-posterior, and medio-lateral directions. Two way ANOVA with repeated measure was used for statistical analysis. Results: The results showed significant Group by Fatigue interaction effect for the frequency with power 99. 5% in the anterior-posterior ground reaction force (p=0. 030, ƞ 2=0. 181). Also, the significant Group by Fatigue interaction effect for the frequency with the power 99. 5% in the vertical direction (p=0. 018, ƞ 2=0. 212) was observed. In addition, findings demonstrated significant Group by Fatigue interaction effect for the number of essential harmonics in the free moment curve (p=0. 044, ƞ 2=0. 158). Conclusion: According to the results, the interaction of both pronated foot and fatigue could be a risk factor for running injuries.

Background and Aims: Video modeling training program is becoming a more practical method to improve cognitive emotion regulation of mothers and behavioral problems of deaf children and using this program has been associated with desirable outcomes. The purpose of the present research was to investigate the effectiveness of video modeling training on cognitive emotion regulation of mothers and behavioral problems of deaf children in Isfahan city. Material and Methods: A semi-experimental study with pre-test, post-test design, and control group was conducted. Participants were 24 deaf children from rehabilitation center of Mother Child selected via convenient sampling method, who were then divided into experimental and control groups, each group consisting of 12 children. The experimental group participated in video modeling training in 8 sessions (two sessions weekly; each for 40 minutes), while the control group did not take part in any training. The instruments used in this research were cognitive emotion regulation questionnaire and child behavior checklist (CBCL). The obtained data were analyzed using analysis of covariance test in SPSS, version 24. Results: The results showed that video modeling training had a significant effect on the cognitive emotion regulation of mothers and behavioral problems of deaf children in the experimental group post-intervention (P<0. 001). Conclusion: Considering the obtained findings, it is suggested that beside other educational and rehabilitation methods for deaf children, video modeling training program be implemented, too.

Background and Aims: Non-verbal Learning Disorder (NLD) is characterized by specific dysfunction in motor, vision spatial, and social skills in patients with normal intelligence and development of language. The purpose of the present study was to investigate the effectiveness of motor based cognitive rehabilitation on orientation, learning memory, attention, and cognition in children with NLD. Materials and Methods: The present study followed a quasi-experimental (with pretest, posttest, and control group) design. The target population included children with NLD in BAFGH city. A total of 30 children were randomly selected and assigned to experimental and control groups. The instruments used were Conner Psychological Neuropsychological Questionnaire, Goldstein Questionnaire, and Oseretsky Motor Development Questionnaire. The data were analyzed using Analysis of Covariance (ANCOVA) in SPSS. Results: The results of the study showed that attention, learning memory, and cognition of experimental group improved after intervention (P<0/001). Also, the results of the statistical analysis showed that motor based cognitive rehabilitation can improve neuropsychological and orientation in NLD children (P<0/01). Conclusion: According to the results of the statistical analysis, motor based cognitive rehabilitation can improve neuropsychological and orientation in NLD children.

Background and Aims: People with intellectual disabilities receive lower scores on cognitive-motor tests compared with normal people due to impaired integration of sensory and motor information, and their balance status is more unstable than healthy individuals. Specialists also recommend programs for children with cognitive-motor deficits that are consistent in structure and tailored to their needs and problems. So, the purpose of the present study was to investigate the effect of rhythmic exercises with music on the gross motor skills development and visual perception among educable mentally retarded children. Materials and Methods: A semi-experimental study with pre-test, post-test, and experimental and control groups was conducted. The research sample included 30 educable mentally retarded students, aged 7-11 years old (15 in experimental group and 15 in control group). To evaluate gross motor skills, Test of gross motor development-2 (TGMD-2) was used and Benton test was used for the assessment of visual perception. In order to analyze the data, the mix ANOVA (2×2) was used at the significance level of 0. 05 to examine the differences between the two groups between the pre-test and post-test. Results: The results of mix analysis of variance showed that rhythmic exercises with music (experimental group) had positive and significant effects on gross motor skills development (P = 0. 24) and visual perception (P = 0. 049) among educable mentally retarded children. Conclusion: According to the results, rhythmic exercises with music may improve gross motor skills and visual perception of children with educable mentally retarded, so it is better to use these exercises for this children in rehabilitation centers.

Background and Aims: The purpose of the present study was to compare the effects of four and six weeks of neuromuscular exercises on male knee alignment during landing. Materials and Methods: A total of 36 male students of Applied-Science University of Mashhad were selected and divided into three groups (four weeks of neuromuscular training, six weeks of neuromuscular, and control). The kinematics of volunteers' knees were measured using the SKILL SPECTOR software in running the jump-landing motion. Results: The results revealed that neuromuscular training in both groups of four weeks and six weeks showed a significant increase in knee flexion angle in the sagittal plane in three landing situations with both legs, upper legs, and non-superior feet (P<0. 05). There was also a significant difference between the two groups of four weeks and six weeks of neuromuscular training in the moment of peak knee flexion and it was quite favorable for the group of four weeks (P<0. 05). Also, at the moment of landing, there was a significant difference between the two groups of four and six weeks of practice in landing conditions with non-premium foot (P<0. 05). However, at the moment of landing between the two groups, no significant difference was observed in the landing status of both sides and landing with the upper leg (P>0. 05). Conclusion: According to the findings, the current study showed that four weeks of neuromuscular training (24 sessions) improved the alignment of lower limb at sagittal level and increased knee bending angles in hop-landing with high effect size at the level of six weeks of training. Therefore, this program can be used as a training model for preventing injuries due to inappropriate knee orientation, especially ligamental injuries.

Background and Aims: Brain electrical stimulation is a low-cost stimulant technique, which has attracted the attention of many researchers in recent decades. The aim of the present study was to investigate the effect of one session transcranial direct current simulation on postural control of disabled athletes with lower limp amputees. Materials and Methods: In the present study, participants included 45 disabled athletes with lower limb amputees, aged 30-45. Two experimental groups were exposed to electrical stimulation for 2 mA for 20 minutes, and one control group was exposed to sham transcranial direct current simultion. Then, all groups were evaluated by SOT postural control to exposed variables in sensory organizing test. Data were analyzed using ONE way ANOVA to test the difference in the significance of the variables and Bonfrrons post hoc test was used to adjust significance level of multiple comparisons (p˂ 0/05). Results: Findings showed that brain electrical stimulation had a significant effect on the improvement pf postural control in athletes with lower limb amputees in both experimental groups in all six values Equilibrium compared to those in the control group. Conclusion: According to the results of the current study, one session transcranial direct current simultion can improve kinetic postural control parameters in athletes with lower limb amputees.

Background and Aims: Children with developmental coordination disorder show deficits in working memory, especially visual-spatial memory. In the present study, we investigated the efficacy of interventions based on the cognitive rehabilitation and purposeful-movement plays in improving working memory performance among 7-10 year-old girls with developmental coordination disorder. Materials and Methods: The research method was experimental with pre-and post-test design and a control group. A total of 60 girls, aged 7-10 years (mean age 8. 43 years), were selected from among all elementary school students in Broujen using multistage cluster sampling and were randomly divided into four groups (three experimental groups and a control, each group including 15 individuals). Developmental Coordination Disorder Questionnaire-Parent Version and Raven’ s Intelligence Test were used for initial screening and the N-Back Test was applied to measure the performance of working memory before and after the experimental period (24 sessions, each for 45 minutes, three sessions per week for eight weeks). Experimental protocol for cognitive rehabilitation was designed to improve problem-solving skills, sensory-motor coordination, and hand-eye coordination. Also, purposeful-movement plays were designed to develop fine and gross motor skills with an emphasis on the balance, coordination, and lateralization. Data were analyzed using paired-samples t test and covariance analysis at the confidence level of95%. Results: The performance of working memory was significantly increased from pre-test to post-test in the groups of cognitive rehabilitation, purposeful play, and combined intervention (p <. 001), whereas no significant change was observed in the control group (p >. 05). After controlling for differences of groups in the pre-test, the working memory of the combined intervention (M = 98. 86) and cognitive rehabilitation (M = 95. 63) in the post-test were significantly higher than those of the purposeful play (M = 86. 54) and control (M = 57. 01) groups and the working memory performance in the group of purposeful play was significantly higher than that of the control group (p <. 001). Conclusion: Combining cognitive rehabilitation with purposeful games based on the perceptual-motor activities can lead to greater efficacy in improving working memory among 7-10 year-old girls with developmental coordination disorder.

Background and Aims: Arm Swing during gait is proven as an interaction tool between arms, legs, and trunk, and has important implications for the normal gait pattern in the lower extremity. The aim of the present study was to investigate the effect of changes in upper limb movement pattern on gait biomechanical variables. Materials and Methods: The scientific database, including Scopus, PubMed, Google Scholar, Ovid, Science Direct, ProQuest, Mesh, DOAJ, Medline, and Clinical Key, were searched for the studies with relevant keywords published from 1990 to 2019. The researches were selected based on the inclusion and exclusion criteria. Results: Findings of the present study indicated that changes in upper extremity patterns have different effects on kinematics, Spatio temporal, and kinetic variables of gait. Conclusion: The variables related to velocity, frequency, and step length in relation to kinematic and Spatio temporal domains as well as torque variable in kinetic domain changed the most when these patterns changed.

Background and Aims: One of the major causes of sensorineural hearing loss is Noise-induced hearing loss. Cochlear damage following noise exposure occurs through two major mechanisms: direct mechanical damage and biochemical pathways. Direct mechanical damage causes hair cell loss through mechanical damage of sterreocilia and direct damage of sensory and protective cells. Cochlear damage following noise exposure through biochemical pathway result in cell death through apoptosis or necrosis. The reason for this is Oxidative Stress and generation of reactive oxygen species following noise exposure. This may remain in the cochlea long after noise exposure has been terminated. Materials and Methods: In order to review the relationship between Cell death, Oxidative Stress and Noise induce hearing loss, all of the articles in this field published between 1990-2017 in Ovid, ProQuest, and Google Scholar databases were searched. Conclusion: This fact shows the importance of preventing apoptosis even after exposure to noise. Understanding noise-induced cochlear damage, especially the importance of free radical expression in the cochlea, can lead to advancements in preserving the hearing.

Background and Aims: There is a general agreement regarding the importance of surface on which human beings walk as a key factor on the frequency and severity of lower limb injuries. The aim of the preset study was to investigate the effect of surface stiffness on the risk factors of lower limb injuries during bilateral landing. Materials and Methods: In the current study, we investigated the lower limb stiffness and the ground reaction force of 15 young male individuals during the landing on five surfaces with different stiffness from 200 to 500 KN/m. Results: The results of ANOVA showed that there is a significant difference between lower limb stiffness and maximum ground reaction force during landing on surfaces with different stiffness. Conclusion: According to the results of the present study, during landing and when approaching to the surface, humans act differently in comparison to rigid masses, so that, depending on the task, maintain the natural dynamics of the center of mass and effectiveness of movement and reduce the loads.

Background and Aims: Balance is a perquisite to perform daily activities, ranging from maintenance of static postures to complex dynamic activities, and is considered as a functional independence index. Besides routine rehabilitation techniques, neurofeedback is an almost novel technique used to enhance balance. The present study was conducted to review the current literature on the role of neurofeedback on balance rehabilitation using a comprehensive and critical approach. Materials and Methods: The literature was searched for relevant papers published between 1995 and 2018 using the keywords: “ postural control” , “ balance” , “ neurofeedback” , “ cognition” , and “ attention” in PubMed, Scopus, Web of science, Google Scholar, and Web of Knowledge databases. Among the 60 papers found in the initial search, 22 passed the inclusion and exclusion criteria and were further investigated. Results: The 22 included studies were categorized into two protocols of neurofeedback balance training with Beta wave reinforcement/ theta wave inhibition (18 studies) and sensorimotor wave reinforcement (4 studies). The studies had investigated the effect of neurofeedback balance training on balance, dual and manipulative tasks, gait parameters, concurrent working memory functions, and attention processes. Conclusion: The findings of the current systematic review showed that neurofeedback is effective on balance improvement, dual task performance, and attention and it might be considered as safe method besides other modalities in the management of balance and attentional disorders.