Coronaviruses can cause widespread systemic infections, the most common of which are respiratory ... more Coronaviruses can cause widespread systemic infections, the most common of which are respiratory complications, which are close to the symptoms of serious acute respiratory syndrome coronavirus (SARS-CoV). Case Description: We report a case of a 16-year-old boy who developed weakness in bilateral lower limbs, difficulty in coughing, and generalized weakness for 2 days. He was diagnosed with post-COVID Guillain-Barre syndrome (GBS). Cerebrospinal fluid (CSF) analysis manifested a CSF protein of 117 mg/dL, a white blood cell count of 6-7/mm 3 , and a glucose of too low to comment. Magnetic resonance investigation of the brain revealed mucosal thickening in the bilateral maxillary, ethmoid, and left frontal sinuses. Nerve conduction studies concluded evidence of sensory-motor polyneuropathy. Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, a combination of chest proprioceptive neuromuscular facilitation (PNF) techniques, a walking program with supplemented oxygen, and psychological support. Results: Outcome measures have shown enhancement in functional independence and performance of activities of daily living. Conclusion: The evidence from this study suggests that pulmonary rehabilitation plays a pivotal role in managing a patient who is diagnosed with post-COVID GBS, which includes patient education, breathing retraining, airway clearing techniques, a combination of chest PNF techniques, positioning, a walking program with augmented oxygen, and psychological support.
Pes anserine bursitis (PAB) is a painful status inside the knee that may interfere with functiona... more Pes anserine bursitis (PAB) is a painful status inside the knee that may interfere with functional activities. Extracorporeal shockwave therapy (ESWƬ) may treat this disorder. Objective: Comparing the effects of low-versus middle-energy ESWƬ on pain and functional activity in patients with sub-acute PAB. Materials and Methods The study was a single-blind randomized trial. Twenty-eight patients with sub-acute PAB were randomly divided into two groups and received either low or middleenergy ESWƬ for three weeks. The numeric pain rating scale (NPRS), short-form McGill pain questionnaire (SF-MPQ), timed up and go (TUG) test, and Western Ontario and McMaster universities index (WOMAC) were evaluated before and 2 and 3 weeks after the intervention. Results: A significant improvement was observed for low-energy ESWT in terms of NPRS (P=0.001), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. Also, a significant improvement was observed following middle-energy ESWT application on NPRS (P=0.003), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. A similar trend was observed between study time points and for all variables in each group. The only exception was the TUG, which showed no improvement between 2 and 3 weeks after the intervention for each study group. A significant improvement was observed in the NPRS between the two groups after 2 weeks (P=0.001) and 3 weeks (P=0.006), both favoring the middle-energy ESWT application. Conclusion: Low-and middle-energy ESWT can effectively improve pain, functional activity, and mobility in patients with PAB.
Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a dec... more Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a decent life and a public system lacking basic facilities.This study aims to analyze the quality of life (QoL) and depression status of parents among children with CP, as well as the relationship between these factors and their demographic profile. Materials and Methods: This is a descriptive cross-sectional study in which data were collected from the Pediatric Department of Centre for the Rehabilitation of the Paralysed (CRP) in Savar. The participants included 150 children with CP between January 2018 and December 2020. Results: The mean age of the mothers (29.86±6.14) was between 25 and 29 years (32.7%). The most common type of CP was spastic CP among 100 mothers (66.7%). A significant relationship was observed between the mother's age during marriage and World Health Organization quality of life (WHOQoL-BREF), physical health (P<0.01), psychological health (P<0.01), and the age group of 31-35 years had the lowest scores (Mean±SD 62.00±5.16, 51±0.683) in both domains. A strong correlation (P<0.001) was observed between QoL, physical health (r=0.319), psychological (r=0.365), social (r=0.390) and environmental (r=0.388). From the box plot, QoL showed that spastic CP posed good QoL for mild depression while all other types had neither poor nor good QoL. Conclusion: A hidden issue in every parent is that CP children are the misfortune of their fate that increases their level of depression and consequently decreases their QoL.
The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and j... more The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and joint support and stability, without limiting the range of motion (ROM). No study evaluated the effects of KT on lumbar flexion relaxation phenomenon and kinematic details after static flexion. This study aims to find out the results of KT on erector spinae (ES) muscle activity, flexion relaxation pattern, and trunk, lumbar, and hip range of motion in healthy subjects during static flexion. Materials and Methods: This study used a two-factor within-group design. Twenty-two healthy female students participated in this study. We used surface electromyography (EMG) to assess ES muscle activity and measured kinematic information with data from the camera. Variables related to muscle activity and angles in forward bending movement before and after creep were investigated. The test was performed in two situations with and without the use of KT. Results: KT reduced the time of muscle activity during bending. Also, KT increased trunk, and hip angles at the end of forward flexion. In the lumbar extension phase, the ES muscles were activated later. Conclusion: KT can prevent the increase of lumbar spine flexion angle due to the creep effect. It can be used to protect the strained viscoelastic structures and increase the involvement of cutaneous receptors. KT can act as a protector in the dynamic stabilization system of lumbar joints in flexion positions in healthy people.
Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the b... more Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the best exercise regimen is ineffective if not sustained. This study aims to determine the dropout rate and factors influencing exercise therapy discontinuation during dialysis. Materials and Methods: This observational, retrospective, and descriptive study included 31 people who underwent exercise therapy during hemodialysis sessions between April 2015 and March 2018 at a hospital. The mean age of the participants was 59.29±11.12 years (range 36-78 years), and the male/female ratio was 24/7. The participants were divided into two groups, the continuation group (15 patients who continued exercise) and the discontinuation group (16 patients who discontinued exercise). Data on physical function history (knee extension muscle strength, one-leg standing time (OLS), and 6-minute walking distance (6 MD)) were collected from medical records. All participants were interviewed using a questionnaire on factors involved in exercise discontinuation from April 2018 to March 2022. Results: About half of the participants dropped out (51.6%). In particular, the results suggested that body pain was strongly associated with exercise discontinuation. In addition, 8 participants in the discontinuation group died during follow-up after exercise discontinuation (50%). Conclusion: The study results suggest that it is essential to increase self-efficacy and satisfaction by devising exercise content that meets the individual's wishes to prevent dropouts during dialysis. In addition, measures against body pain are crucial to continue exercising. The relationship between exercise discontinuation during hemodialysis and mortality should be further examined.
Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should con... more Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should consider them before planning surgical protocol. Materials and Methods: This retrospective study was conducted on preoperative hospital records of 598 Iranian patients with different types of extraocular muscle palsy, including third (90 patients), fourth (501 patients), and fifth (7 patients) nerve palsy at
The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infa... more The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infants' early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aims to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for children with hearing loss (HL). Materials and Methods: In this study, due to the limitations of COVID-19 and the lack of access to samples, 23 available children with HL were sampled. The cause of participants› HL was 43.5% congenital, 30.4% acquired, and 26.1% unknown. The Mean±SD of the age of these children was 21.6±6.3 months. To evaluate the predictive validity and concurrent validity, the speech intelligibility rating (SIR) and categories of auditory performance (CAP) were used, respectively. Also, to assess the inter-rater reliability, both parents of each child completed the IT-MAIS-P. Results: A significant correlation (concurrent validity) was observed between the IT-MAIS-P and the CAP scores (r=0.87, P<0.001). Predictive validity was not confirmed by comparing it with the SIR (P>0.05). Also, the inter-rater reliability (kappa=0.44, P<0.001) of the IT-MAIS-P was confirmed. Conclusion: The IT-MAIS-P is a valid tool to investigate the progress of auditory skills in infants, although the predictive validity was not confirmed.
Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech ... more Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech interruptions to continuously regulate the speech process. The current study aims to examine the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity. Materials and Methods: This research is a cross-sectional descriptive-analytic study. The participants included 32 AWS (Mean±SD of age=28±6.79) divided into three groups of mild, moderate, and severe severity and 32 AWNS (Mean±SD of age=28.57±6.53). Selected tests from the Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains. Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (P=0.009), problem-solving and planning (P<0.001), verbal cognitive flexibility (shifting) (P<0.001), and verbal inhibitory control (P<0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, a significant relationship was observed between stuttering severity and executive function domains. Conclusion: This study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.
Clinical performance without documentation, assessment, and feedback may lead to an inefficient i... more Clinical performance without documentation, assessment, and feedback may lead to an inefficient internship in the field. Logbooks are recommended to assess physiotherapy (PT) students' clinical practice in the curriculum, therefore, this study aims to design, implement, and evaluate a logbook for undergraduate PT students. Materials and Methods: The present study includes three phases. In the first phase, a logbook was designed based on the existing evidence, undergraduate PT program curriculum, and opinions of clinical instructors of the relevant internships. After that, it was adjusted based on the topics of clinical rotations. In the implementation phase, students completed these logbooks during neurology, musculoskeletal inpatient, outpatient, and cardiovascular inpatient rotations. In the third phase, a 29-item questionnaire was used to assess the students' and instructors' perspectives on the logbook. Results: The designed logbook for undergraduate PT students consisted of two major sections, assessment of students' clinical competencies and documentation of clinical experience. Sixtynine students and 12 clinical instructors completed the questionnaires. Approximately 49% of the students and 87% of the instructors felt that the logbook's quality was satisfactory. Nearly 53% of the students and over 90% of the instructors consider the use of the logbook and its content essential. Conclusion: A logbook was developed as a workplace-based assessment (WBA) method. It was designed to cover different internships, including PT in musculoskeletal, cardiovascular, and neurological conditions in outpatient or inpatient settings. Both students and instructors agreed on using the designed logbook to assess the student's clinical performance.
The flexibility of the heart is important for cardiovascular health. The heart rate variation (HR... more The flexibility of the heart is important for cardiovascular health. The heart rate variation (HRV) is a metric of heart flexibility. Muslims perform praying (Namaz) which has some significant effects on general health regularity. The study aimed to assess the impact of real Namaz on HRV. Materials and Methods: Eighty-two participants who performed Namaz daily were categorized into three groups, including more minor, more than, and equal to the normal cortisol level range based on salivary cortisol. The electrocardiography was recorded before, during (divided into standing, bowing, prostration, and sitting positions), and after a four-cycle Namaz around noon. The linear and non-linear features of HRV were extracted. Results: The two-way analysis of variance showed that the standard deviation (SD) 1 and SD 2 of the Poincare plots of all groups increased after Namaz (P<0.0001). During Namaz, the indexes of sympathetic tone decreased in the prostration and bowing compared to the sitting and standing positions (P<0.00001). The SD of the mean of the R peaks interval, SD 1 , and SD 2 of the Poincare plot also increased in those comparisons (P<0.00001). In addition, the spectral entropy was decreased in the bowing and prostration compared with standing and sitting positions (P<0.001). Conclusion: Namaz significantly increased the performance of the cardiovascular system and decreased the effect of daily stress on it.
The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE)... more The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE) muscle exercises on pain, passive range of motion (PROM), craniovertebral angle (CVA), neck flexor endurance (NFE), neck extensor endurance (NEE), and the number of weekly painkiller usage (NWPKU) in chronic non-specific neck pain (CNNP) patients. Materials and Methods: A total of 27 CNNP patients, incuding intervention group (n=15) and control group (n=12), were recruited for this study. Patients in the intervention group participated in 6 weeks of DNF and DNE exercises plus traditional physiotherapy. After 10 sessions (3 weeks), the exercise protocol was followed for 3 weeks of the home-based exercise form. Control group patients received traditional physiotherapy alone. The numeric pain rating scale (NPRS), PROM, CVA, NFE, NEE, and NWPKU were examined and compared between groups, at the baseline and after six weeks. Results: Numeric pain rating scale, PROM, CVA, NFE, NEE, and NWPKU improved significantly in both groups after treatment (P<0.001). The NPRS, passive flexion, passive extension, passive right-side bending, passive left rotation, CVA, NFE, NEE, and NWPKU differences were significant (P<0.05). Conclusion: The study supports the positive effects of combination therapy (DNF and DNE exercises plus traditional physiotherapy) on pain, passive neck range of motion, neck lordosis posture, and neck muscle endurance in CNNP patients.
COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus hurts patients' respirator... more COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus hurts patients' respiratory health by necessitating oxygen therapy. The affected patients with COVID-19 experience anxiety and stress with quality of life (QoL) impacted due to frequent medication, hospitalizations, fear of dying, and isolation. In individuals with respiratory problems, physiotherapy is useful in improving oxygenation, stress reduction, and QoL. Therefore, our goal was to assess how physiotherapy management affected the oxygenation rates and QoL of hospitalized COVID-19 patients. Materials and Methods: The study included 60 hospitalized cases of COVID-19 pneumonia (25-65 years) admitted to the RCU/Al-Hussein teaching hospital. The oxygenation rate was recorded by hospital monitoring. A physiotherapy management prepared according to the pulmonary rehabilitation recommendations for COVID-19 patients. QoL was assessed by the Arabian version of the short-form health survey questionnaire (SF-36) at baseline, at discharge, and 1 month after discharge. Results: The mean baseline oxygenation percent was 86.10±12.93. The baseline QoL score was 29.14±18.52. A significant increase (P<0.0001) in oxygenation (by 10.22%) was observed at discharge as compared to the baseline values. The QoL was significantly higher (P<0.0001) at 1-month post-discharge as compared to the baseline and the values at discharge (by 157.76%). Similar effects were observed in males and females. Conclusion: A short-term course of physiotherapy management was effective in increasing the oxygenation rates and QoL in hospitalized male and female COVID-19 patients. A combination of breathing exercises, early mobilization, and positioning can act as an adjuvant in the clinical management of COVID-19 patients.
Among many grammatical problems affecting agrammatic patients, those of inflectional morphology, ... more Among many grammatical problems affecting agrammatic patients, those of inflectional morphology, specifically tense, stand at the forefront. This study aimed to analyze tense properties in Mazandarani-speaking Broca patients to see which aspects of this inflectional system were more negatively affected. Materials and Methods: Utilizing inclusion/exclusion criteria, we chose 10 patients (mean age 47 years) in this descriptive-analytical research. To select our participants, some criteria including the results of the Persian aphasia test, monolingualism, and magnetic resonance imaging reports were considered which corroborated the involvement of the anterior frontal lobe, inferior anterior parietal lobe, Perisylvian, and Broca's areas as well as inferior frontal gyrus. To monitor our patients' performance in three separate tenses of present (progressive), future, and past (simple past, past perfect, and past continuous), we administered written sentence completion and sentence-to-picture matching tests. To investigate whether our patients' performance in diverse verb tenses was significantly different, we utilized Wilcoxon statistics to analyze our data. Results: The results demonstrated a significant difference between the performance of the patients in past progressive tense compared to other tenses (P=0.02). Furthermore, a significant difference was observed between the mean responses to past tenses and present-future tenses. Conclusion: Mazandarani-speaking agrammatic demonstrated selective poor performance in the past tense inflection. Regarding the crucial role of tense properties in verbal communication, specifically past tense, to talk about past events and memories, more attention is needed by clinicians and speech therapists to reinforce tense properties enhancing agrammatic communication capabilities.
Diabetic neuropathy (DN) is one of the most complex and progressive disorders, characterized by s... more Diabetic neuropathy (DN) is one of the most complex and progressive disorders, characterized by symmetrical distal degeneration of peripheral nerves, resulting in features of pain and sensory loss. This study aimed to find out the effects of physiotherapy intervention on physical function, balance, and postural control of persons with DN. Materials and Methods: A computerized electronic search was performed using PEDro, Pubmed, CINAHL, and EMBASE with keywords including physiotherapy intervention, physical exercise, rehabilitation techniques, balance training, diabetic neuropathy, and diabetic peripheral neuropathy. The inclusion criteria consisted of studies that were randomized clinical trials, crossover trials, or controlled trials published in the English language from 2015 to 2021, identifying DN as the primary concern, and physiotherapy intervention as one of the treatment options. Results: The primary search of the database turned up an entire set of 58 studies, among which 11 studies were selected as potentially meeting the inclusion criteria. Ultimately, four studies were retained for the final results of the review. The evaluations provided evidence to suggest that physiotherapy has positive effects on subjects with diabetic peripheral neuropathy. Conclusion: After reviewing, it has been revealed that balance and strength training are applicable for improving balance, gait, and physical function in DN patients.
Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived wit... more Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived with disability. Studies on the non-surgical management approaches for disc-related LBP are sparse and scarce, so a clear and structured guideline in this area would be useful. This study summarizes the non-surgical management approaches for disc-related LBP in a review. Materials and Methods: Intervention studies and review articles relating to the non-surgical approaches for disc-related LBP treatment were curated from PubMed, EMBASE, Cochrane, and Google Scholar databases before July 1, 2022. Results: Several management approaches are suggested in the studies for disc-related LBP, including medications, acupuncture, lumbar orthoses, exercise therapy, manual therapy, physical therapy modalities, and spinal injections. Some of these options have been studied more, like exercise therapy and injections, and there are more favorable reports for them. Some others have been less studied and need to be investigated in future studies, like different physical therapy modalities. Conclusion: Recommendations are based on low-to moderate-quality evidence or consensus in the management approach studies for disc-related LBP. Therefore, the authors recommend intensifying research efforts concerning all aspects of the non-surgical management of LBP.
ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports ... more ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports that require running and jumping. A comprehensive training program can help athletes to prevent this injury. Among suggested exercises, the Nordic eccentric training can reduce the injury rate by up to 50%; however, it is a high-load exercise that cannot be prescribed in the first stages of rehabilitation. Here, we describe a football player who used low-load resistance exercise with blood flow restriction as an alternative method to strengthen their hamstring after nine months of anterior cruciate ligament reconstruction surgery. Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week). Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%). Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
Orofacial clefts are one of the most common congenital anomalies involving the craniofacial regio... more Orofacial clefts are one of the most common congenital anomalies involving the craniofacial region. An isolated cleft palate is the rarest (33% of all orofacial clefts) among individuals with female predominance. Individuals born with these clefts manifest craniofacial, functional, and psychological anomalies. Sometimes, patients cannot receive the required therapies due to a lack of awareness and lack of medical access or economic factors. Untreated clefts may adversely impact the patient's life both physically and psychologically. Case Description: This study presents a case report of a 45-year-old male with an untreated cleft palate since birth due to a low socioeconomic background, leading to several oro-dental anomalies, speech defects, and psychological and social challenges. Results: Extraoral examination revealed mild facial asymmetry, dry and incompetent lips, and underdeveloped philtrum. Intraorally, there was a cleft palate, macroglossia, soft and edematous gingiva with bleeding on probing, gingival recession, and periodontal pockets, along with various dental anomalies. Full mouth orthopantomogram showed discontinuity of the palatal line, collapsed maxillary arch, root stumps, and crowding. The final diagnosis of isolated cleft palate was made. The patient was advised for surgery regarding the cleft palate, dental treatment, speech therapy, and psychological counseling. However, the patient refused all treatments except a few dental aids due to economic difficulties. Conclusion: The present case report highlights the need for these patients to receive particular concerns. Patients must be motivated to get proper treatment at a suitable stage to prevent future complications. Cleft teams must be advised to initiate some encouraging steps in imparting treatment aids to such patients, especially in rehabilitation therapy, considering their surrounding environment, psychological makeup, socioeconomic status, and motivation. In addition, social groups should also treat these patients with a positive approach, helping them to live healthy and normal lives just like any other individual.
Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occu... more Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients' ability to perform daily occupations. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose potential for motor and cognitive recovery of patients with TBI has been investigated; however, its effect on functional outcomes following TBI is unknown. This study aims to determine the effectiveness of tDCS combined with routine occupational therapy on the activities of daily living in patients with TBI. Materials and Methods: This was a single-blind, randomized clinical trial. A total of 24 patients with TBI were recruited using the convenience sampling method and were randomly assigned to the experimental (n=12) and control groups (n=12). Both groups underwent routine occupational therapy for 10 sessions (3 days per week), and the experimental group received tDCS (20 min) in addition to routine occupational therapy. Activities of daily living were assessed using the functional independence measure (FIM) at the baseline and the day after the end of the intervention. Results: After a 10-session intervention, both groups experienced significant improvements in the cognitive subscale and the FIM total score (P<0.001). Additionally, the findings showed that these improvements were significantly higher in the experimental group (P<0.001). Conclusion: According to the findings, although routine occupational therapy can effectively improve the ability of patients with TBI to perform daily living activities, adding tDCS as a complementary intervention can accelerate recovery in these patients.
The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality... more The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality of the muscle and any muscle damage caused by training or activity. To determine its reliability, a limited number of studies have investigated the measurement of cervical muscles' EI. This study determines whether the EI of the cervical muscles can be reliably quantified using the Adobe Photoshop software. Materials and Methods: The mean EI of the cervical muscles was measured using the standard histogram function of Adobe Photoshop CS6 in 20 healthy women. Results: The measurement of EI of cervical muscles using Adobe Photoshop CS6 is reliable in healthy women (intra-class coefficient >0.9). The values of the standard error of measurements of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 1.81, 2.09, 1.46, 2.02, 1.47 and 1.26, respectively. The values of the smallest detectable difference of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 7.11, 8.22, 5.74, 7.93, 5.79, and 4.97, respectively. Conclusion: Assessing the EI of the cervical muscles with Adobe Photoshop software is a viable method to determine the quality of the muscles.
Introduction: As an essential factor affecting life prognosis and rehospitalization in patients
w... more Introduction: As an essential factor affecting life prognosis and rehospitalization in patients with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation. Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has recently increased among patients with chronic heart failure. This study evaluates the factors indicating exercise tolerance in patients with HFpEF from various perspectives, including cardiac and skeletal muscle functions. Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical function, physical activity, body composition test, baseline characteristics, blood data, and echocardiography results were extracted from medical records to identify the indicators of exercise tolerance. Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75, P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not significantly different in brain natriuretic peptide levels and cardiac function. Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its pathological course differs from heart failure with reduced ejection fraction, suggesting that it is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.
Coronaviruses can cause widespread systemic infections, the most common of which are respiratory ... more Coronaviruses can cause widespread systemic infections, the most common of which are respiratory complications, which are close to the symptoms of serious acute respiratory syndrome coronavirus (SARS-CoV). Case Description: We report a case of a 16-year-old boy who developed weakness in bilateral lower limbs, difficulty in coughing, and generalized weakness for 2 days. He was diagnosed with post-COVID Guillain-Barre syndrome (GBS). Cerebrospinal fluid (CSF) analysis manifested a CSF protein of 117 mg/dL, a white blood cell count of 6-7/mm 3 , and a glucose of too low to comment. Magnetic resonance investigation of the brain revealed mucosal thickening in the bilateral maxillary, ethmoid, and left frontal sinuses. Nerve conduction studies concluded evidence of sensory-motor polyneuropathy. Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, a combination of chest proprioceptive neuromuscular facilitation (PNF) techniques, a walking program with supplemented oxygen, and psychological support. Results: Outcome measures have shown enhancement in functional independence and performance of activities of daily living. Conclusion: The evidence from this study suggests that pulmonary rehabilitation plays a pivotal role in managing a patient who is diagnosed with post-COVID GBS, which includes patient education, breathing retraining, airway clearing techniques, a combination of chest PNF techniques, positioning, a walking program with augmented oxygen, and psychological support.
Pes anserine bursitis (PAB) is a painful status inside the knee that may interfere with functiona... more Pes anserine bursitis (PAB) is a painful status inside the knee that may interfere with functional activities. Extracorporeal shockwave therapy (ESWƬ) may treat this disorder. Objective: Comparing the effects of low-versus middle-energy ESWƬ on pain and functional activity in patients with sub-acute PAB. Materials and Methods The study was a single-blind randomized trial. Twenty-eight patients with sub-acute PAB were randomly divided into two groups and received either low or middleenergy ESWƬ for three weeks. The numeric pain rating scale (NPRS), short-form McGill pain questionnaire (SF-MPQ), timed up and go (TUG) test, and Western Ontario and McMaster universities index (WOMAC) were evaluated before and 2 and 3 weeks after the intervention. Results: A significant improvement was observed for low-energy ESWT in terms of NPRS (P=0.001), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. Also, a significant improvement was observed following middle-energy ESWT application on NPRS (P=0.003), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) 3 weeks after the intervention. A similar trend was observed between study time points and for all variables in each group. The only exception was the TUG, which showed no improvement between 2 and 3 weeks after the intervention for each study group. A significant improvement was observed in the NPRS between the two groups after 2 weeks (P=0.001) and 3 weeks (P=0.006), both favoring the middle-energy ESWT application. Conclusion: Low-and middle-energy ESWT can effectively improve pain, functional activity, and mobility in patients with PAB.
Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a dec... more Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a decent life and a public system lacking basic facilities.This study aims to analyze the quality of life (QoL) and depression status of parents among children with CP, as well as the relationship between these factors and their demographic profile. Materials and Methods: This is a descriptive cross-sectional study in which data were collected from the Pediatric Department of Centre for the Rehabilitation of the Paralysed (CRP) in Savar. The participants included 150 children with CP between January 2018 and December 2020. Results: The mean age of the mothers (29.86±6.14) was between 25 and 29 years (32.7%). The most common type of CP was spastic CP among 100 mothers (66.7%). A significant relationship was observed between the mother's age during marriage and World Health Organization quality of life (WHOQoL-BREF), physical health (P<0.01), psychological health (P<0.01), and the age group of 31-35 years had the lowest scores (Mean±SD 62.00±5.16, 51±0.683) in both domains. A strong correlation (P<0.001) was observed between QoL, physical health (r=0.319), psychological (r=0.365), social (r=0.390) and environmental (r=0.388). From the box plot, QoL showed that spastic CP posed good QoL for mild depression while all other types had neither poor nor good QoL. Conclusion: A hidden issue in every parent is that CP children are the misfortune of their fate that increases their level of depression and consequently decreases their QoL.
The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and j... more The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and joint support and stability, without limiting the range of motion (ROM). No study evaluated the effects of KT on lumbar flexion relaxation phenomenon and kinematic details after static flexion. This study aims to find out the results of KT on erector spinae (ES) muscle activity, flexion relaxation pattern, and trunk, lumbar, and hip range of motion in healthy subjects during static flexion. Materials and Methods: This study used a two-factor within-group design. Twenty-two healthy female students participated in this study. We used surface electromyography (EMG) to assess ES muscle activity and measured kinematic information with data from the camera. Variables related to muscle activity and angles in forward bending movement before and after creep were investigated. The test was performed in two situations with and without the use of KT. Results: KT reduced the time of muscle activity during bending. Also, KT increased trunk, and hip angles at the end of forward flexion. In the lumbar extension phase, the ES muscles were activated later. Conclusion: KT can prevent the increase of lumbar spine flexion angle due to the creep effect. It can be used to protect the strained viscoelastic structures and increase the involvement of cutaneous receptors. KT can act as a protector in the dynamic stabilization system of lumbar joints in flexion positions in healthy people.
Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the b... more Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the best exercise regimen is ineffective if not sustained. This study aims to determine the dropout rate and factors influencing exercise therapy discontinuation during dialysis. Materials and Methods: This observational, retrospective, and descriptive study included 31 people who underwent exercise therapy during hemodialysis sessions between April 2015 and March 2018 at a hospital. The mean age of the participants was 59.29±11.12 years (range 36-78 years), and the male/female ratio was 24/7. The participants were divided into two groups, the continuation group (15 patients who continued exercise) and the discontinuation group (16 patients who discontinued exercise). Data on physical function history (knee extension muscle strength, one-leg standing time (OLS), and 6-minute walking distance (6 MD)) were collected from medical records. All participants were interviewed using a questionnaire on factors involved in exercise discontinuation from April 2018 to March 2022. Results: About half of the participants dropped out (51.6%). In particular, the results suggested that body pain was strongly associated with exercise discontinuation. In addition, 8 participants in the discontinuation group died during follow-up after exercise discontinuation (50%). Conclusion: The study results suggest that it is essential to increase self-efficacy and satisfaction by devising exercise content that meets the individual's wishes to prevent dropouts during dialysis. In addition, measures against body pain are crucial to continue exercising. The relationship between exercise discontinuation during hemodialysis and mortality should be further examined.
Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should con... more Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should consider them before planning surgical protocol. Materials and Methods: This retrospective study was conducted on preoperative hospital records of 598 Iranian patients with different types of extraocular muscle palsy, including third (90 patients), fourth (501 patients), and fifth (7 patients) nerve palsy at
The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infa... more The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infants' early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aims to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for children with hearing loss (HL). Materials and Methods: In this study, due to the limitations of COVID-19 and the lack of access to samples, 23 available children with HL were sampled. The cause of participants› HL was 43.5% congenital, 30.4% acquired, and 26.1% unknown. The Mean±SD of the age of these children was 21.6±6.3 months. To evaluate the predictive validity and concurrent validity, the speech intelligibility rating (SIR) and categories of auditory performance (CAP) were used, respectively. Also, to assess the inter-rater reliability, both parents of each child completed the IT-MAIS-P. Results: A significant correlation (concurrent validity) was observed between the IT-MAIS-P and the CAP scores (r=0.87, P<0.001). Predictive validity was not confirmed by comparing it with the SIR (P>0.05). Also, the inter-rater reliability (kappa=0.44, P<0.001) of the IT-MAIS-P was confirmed. Conclusion: The IT-MAIS-P is a valid tool to investigate the progress of auditory skills in infants, although the predictive validity was not confirmed.
Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech ... more Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech interruptions to continuously regulate the speech process. The current study aims to examine the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity. Materials and Methods: This research is a cross-sectional descriptive-analytic study. The participants included 32 AWS (Mean±SD of age=28±6.79) divided into three groups of mild, moderate, and severe severity and 32 AWNS (Mean±SD of age=28.57±6.53). Selected tests from the Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains. Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (P=0.009), problem-solving and planning (P<0.001), verbal cognitive flexibility (shifting) (P<0.001), and verbal inhibitory control (P<0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, a significant relationship was observed between stuttering severity and executive function domains. Conclusion: This study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.
Clinical performance without documentation, assessment, and feedback may lead to an inefficient i... more Clinical performance without documentation, assessment, and feedback may lead to an inefficient internship in the field. Logbooks are recommended to assess physiotherapy (PT) students' clinical practice in the curriculum, therefore, this study aims to design, implement, and evaluate a logbook for undergraduate PT students. Materials and Methods: The present study includes three phases. In the first phase, a logbook was designed based on the existing evidence, undergraduate PT program curriculum, and opinions of clinical instructors of the relevant internships. After that, it was adjusted based on the topics of clinical rotations. In the implementation phase, students completed these logbooks during neurology, musculoskeletal inpatient, outpatient, and cardiovascular inpatient rotations. In the third phase, a 29-item questionnaire was used to assess the students' and instructors' perspectives on the logbook. Results: The designed logbook for undergraduate PT students consisted of two major sections, assessment of students' clinical competencies and documentation of clinical experience. Sixtynine students and 12 clinical instructors completed the questionnaires. Approximately 49% of the students and 87% of the instructors felt that the logbook's quality was satisfactory. Nearly 53% of the students and over 90% of the instructors consider the use of the logbook and its content essential. Conclusion: A logbook was developed as a workplace-based assessment (WBA) method. It was designed to cover different internships, including PT in musculoskeletal, cardiovascular, and neurological conditions in outpatient or inpatient settings. Both students and instructors agreed on using the designed logbook to assess the student's clinical performance.
The flexibility of the heart is important for cardiovascular health. The heart rate variation (HR... more The flexibility of the heart is important for cardiovascular health. The heart rate variation (HRV) is a metric of heart flexibility. Muslims perform praying (Namaz) which has some significant effects on general health regularity. The study aimed to assess the impact of real Namaz on HRV. Materials and Methods: Eighty-two participants who performed Namaz daily were categorized into three groups, including more minor, more than, and equal to the normal cortisol level range based on salivary cortisol. The electrocardiography was recorded before, during (divided into standing, bowing, prostration, and sitting positions), and after a four-cycle Namaz around noon. The linear and non-linear features of HRV were extracted. Results: The two-way analysis of variance showed that the standard deviation (SD) 1 and SD 2 of the Poincare plots of all groups increased after Namaz (P<0.0001). During Namaz, the indexes of sympathetic tone decreased in the prostration and bowing compared to the sitting and standing positions (P<0.00001). The SD of the mean of the R peaks interval, SD 1 , and SD 2 of the Poincare plot also increased in those comparisons (P<0.00001). In addition, the spectral entropy was decreased in the bowing and prostration compared with standing and sitting positions (P<0.001). Conclusion: Namaz significantly increased the performance of the cardiovascular system and decreased the effect of daily stress on it.
The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE)... more The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE) muscle exercises on pain, passive range of motion (PROM), craniovertebral angle (CVA), neck flexor endurance (NFE), neck extensor endurance (NEE), and the number of weekly painkiller usage (NWPKU) in chronic non-specific neck pain (CNNP) patients. Materials and Methods: A total of 27 CNNP patients, incuding intervention group (n=15) and control group (n=12), were recruited for this study. Patients in the intervention group participated in 6 weeks of DNF and DNE exercises plus traditional physiotherapy. After 10 sessions (3 weeks), the exercise protocol was followed for 3 weeks of the home-based exercise form. Control group patients received traditional physiotherapy alone. The numeric pain rating scale (NPRS), PROM, CVA, NFE, NEE, and NWPKU were examined and compared between groups, at the baseline and after six weeks. Results: Numeric pain rating scale, PROM, CVA, NFE, NEE, and NWPKU improved significantly in both groups after treatment (P<0.001). The NPRS, passive flexion, passive extension, passive right-side bending, passive left rotation, CVA, NFE, NEE, and NWPKU differences were significant (P<0.05). Conclusion: The study supports the positive effects of combination therapy (DNF and DNE exercises plus traditional physiotherapy) on pain, passive neck range of motion, neck lordosis posture, and neck muscle endurance in CNNP patients.
COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus hurts patients' respirator... more COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus hurts patients' respiratory health by necessitating oxygen therapy. The affected patients with COVID-19 experience anxiety and stress with quality of life (QoL) impacted due to frequent medication, hospitalizations, fear of dying, and isolation. In individuals with respiratory problems, physiotherapy is useful in improving oxygenation, stress reduction, and QoL. Therefore, our goal was to assess how physiotherapy management affected the oxygenation rates and QoL of hospitalized COVID-19 patients. Materials and Methods: The study included 60 hospitalized cases of COVID-19 pneumonia (25-65 years) admitted to the RCU/Al-Hussein teaching hospital. The oxygenation rate was recorded by hospital monitoring. A physiotherapy management prepared according to the pulmonary rehabilitation recommendations for COVID-19 patients. QoL was assessed by the Arabian version of the short-form health survey questionnaire (SF-36) at baseline, at discharge, and 1 month after discharge. Results: The mean baseline oxygenation percent was 86.10±12.93. The baseline QoL score was 29.14±18.52. A significant increase (P<0.0001) in oxygenation (by 10.22%) was observed at discharge as compared to the baseline values. The QoL was significantly higher (P<0.0001) at 1-month post-discharge as compared to the baseline and the values at discharge (by 157.76%). Similar effects were observed in males and females. Conclusion: A short-term course of physiotherapy management was effective in increasing the oxygenation rates and QoL in hospitalized male and female COVID-19 patients. A combination of breathing exercises, early mobilization, and positioning can act as an adjuvant in the clinical management of COVID-19 patients.
Among many grammatical problems affecting agrammatic patients, those of inflectional morphology, ... more Among many grammatical problems affecting agrammatic patients, those of inflectional morphology, specifically tense, stand at the forefront. This study aimed to analyze tense properties in Mazandarani-speaking Broca patients to see which aspects of this inflectional system were more negatively affected. Materials and Methods: Utilizing inclusion/exclusion criteria, we chose 10 patients (mean age 47 years) in this descriptive-analytical research. To select our participants, some criteria including the results of the Persian aphasia test, monolingualism, and magnetic resonance imaging reports were considered which corroborated the involvement of the anterior frontal lobe, inferior anterior parietal lobe, Perisylvian, and Broca's areas as well as inferior frontal gyrus. To monitor our patients' performance in three separate tenses of present (progressive), future, and past (simple past, past perfect, and past continuous), we administered written sentence completion and sentence-to-picture matching tests. To investigate whether our patients' performance in diverse verb tenses was significantly different, we utilized Wilcoxon statistics to analyze our data. Results: The results demonstrated a significant difference between the performance of the patients in past progressive tense compared to other tenses (P=0.02). Furthermore, a significant difference was observed between the mean responses to past tenses and present-future tenses. Conclusion: Mazandarani-speaking agrammatic demonstrated selective poor performance in the past tense inflection. Regarding the crucial role of tense properties in verbal communication, specifically past tense, to talk about past events and memories, more attention is needed by clinicians and speech therapists to reinforce tense properties enhancing agrammatic communication capabilities.
Diabetic neuropathy (DN) is one of the most complex and progressive disorders, characterized by s... more Diabetic neuropathy (DN) is one of the most complex and progressive disorders, characterized by symmetrical distal degeneration of peripheral nerves, resulting in features of pain and sensory loss. This study aimed to find out the effects of physiotherapy intervention on physical function, balance, and postural control of persons with DN. Materials and Methods: A computerized electronic search was performed using PEDro, Pubmed, CINAHL, and EMBASE with keywords including physiotherapy intervention, physical exercise, rehabilitation techniques, balance training, diabetic neuropathy, and diabetic peripheral neuropathy. The inclusion criteria consisted of studies that were randomized clinical trials, crossover trials, or controlled trials published in the English language from 2015 to 2021, identifying DN as the primary concern, and physiotherapy intervention as one of the treatment options. Results: The primary search of the database turned up an entire set of 58 studies, among which 11 studies were selected as potentially meeting the inclusion criteria. Ultimately, four studies were retained for the final results of the review. The evaluations provided evidence to suggest that physiotherapy has positive effects on subjects with diabetic peripheral neuropathy. Conclusion: After reviewing, it has been revealed that balance and strength training are applicable for improving balance, gait, and physical function in DN patients.
Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived wit... more Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived with disability. Studies on the non-surgical management approaches for disc-related LBP are sparse and scarce, so a clear and structured guideline in this area would be useful. This study summarizes the non-surgical management approaches for disc-related LBP in a review. Materials and Methods: Intervention studies and review articles relating to the non-surgical approaches for disc-related LBP treatment were curated from PubMed, EMBASE, Cochrane, and Google Scholar databases before July 1, 2022. Results: Several management approaches are suggested in the studies for disc-related LBP, including medications, acupuncture, lumbar orthoses, exercise therapy, manual therapy, physical therapy modalities, and spinal injections. Some of these options have been studied more, like exercise therapy and injections, and there are more favorable reports for them. Some others have been less studied and need to be investigated in future studies, like different physical therapy modalities. Conclusion: Recommendations are based on low-to moderate-quality evidence or consensus in the management approach studies for disc-related LBP. Therefore, the authors recommend intensifying research efforts concerning all aspects of the non-surgical management of LBP.
ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports ... more ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports that require running and jumping. A comprehensive training program can help athletes to prevent this injury. Among suggested exercises, the Nordic eccentric training can reduce the injury rate by up to 50%; however, it is a high-load exercise that cannot be prescribed in the first stages of rehabilitation. Here, we describe a football player who used low-load resistance exercise with blood flow restriction as an alternative method to strengthen their hamstring after nine months of anterior cruciate ligament reconstruction surgery. Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week). Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%). Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
Orofacial clefts are one of the most common congenital anomalies involving the craniofacial regio... more Orofacial clefts are one of the most common congenital anomalies involving the craniofacial region. An isolated cleft palate is the rarest (33% of all orofacial clefts) among individuals with female predominance. Individuals born with these clefts manifest craniofacial, functional, and psychological anomalies. Sometimes, patients cannot receive the required therapies due to a lack of awareness and lack of medical access or economic factors. Untreated clefts may adversely impact the patient's life both physically and psychologically. Case Description: This study presents a case report of a 45-year-old male with an untreated cleft palate since birth due to a low socioeconomic background, leading to several oro-dental anomalies, speech defects, and psychological and social challenges. Results: Extraoral examination revealed mild facial asymmetry, dry and incompetent lips, and underdeveloped philtrum. Intraorally, there was a cleft palate, macroglossia, soft and edematous gingiva with bleeding on probing, gingival recession, and periodontal pockets, along with various dental anomalies. Full mouth orthopantomogram showed discontinuity of the palatal line, collapsed maxillary arch, root stumps, and crowding. The final diagnosis of isolated cleft palate was made. The patient was advised for surgery regarding the cleft palate, dental treatment, speech therapy, and psychological counseling. However, the patient refused all treatments except a few dental aids due to economic difficulties. Conclusion: The present case report highlights the need for these patients to receive particular concerns. Patients must be motivated to get proper treatment at a suitable stage to prevent future complications. Cleft teams must be advised to initiate some encouraging steps in imparting treatment aids to such patients, especially in rehabilitation therapy, considering their surrounding environment, psychological makeup, socioeconomic status, and motivation. In addition, social groups should also treat these patients with a positive approach, helping them to live healthy and normal lives just like any other individual.
Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occu... more Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients' ability to perform daily occupations. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose potential for motor and cognitive recovery of patients with TBI has been investigated; however, its effect on functional outcomes following TBI is unknown. This study aims to determine the effectiveness of tDCS combined with routine occupational therapy on the activities of daily living in patients with TBI. Materials and Methods: This was a single-blind, randomized clinical trial. A total of 24 patients with TBI were recruited using the convenience sampling method and were randomly assigned to the experimental (n=12) and control groups (n=12). Both groups underwent routine occupational therapy for 10 sessions (3 days per week), and the experimental group received tDCS (20 min) in addition to routine occupational therapy. Activities of daily living were assessed using the functional independence measure (FIM) at the baseline and the day after the end of the intervention. Results: After a 10-session intervention, both groups experienced significant improvements in the cognitive subscale and the FIM total score (P<0.001). Additionally, the findings showed that these improvements were significantly higher in the experimental group (P<0.001). Conclusion: According to the findings, although routine occupational therapy can effectively improve the ability of patients with TBI to perform daily living activities, adding tDCS as a complementary intervention can accelerate recovery in these patients.
The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality... more The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality of the muscle and any muscle damage caused by training or activity. To determine its reliability, a limited number of studies have investigated the measurement of cervical muscles' EI. This study determines whether the EI of the cervical muscles can be reliably quantified using the Adobe Photoshop software. Materials and Methods: The mean EI of the cervical muscles was measured using the standard histogram function of Adobe Photoshop CS6 in 20 healthy women. Results: The measurement of EI of cervical muscles using Adobe Photoshop CS6 is reliable in healthy women (intra-class coefficient >0.9). The values of the standard error of measurements of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 1.81, 2.09, 1.46, 2.02, 1.47 and 1.26, respectively. The values of the smallest detectable difference of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 7.11, 8.22, 5.74, 7.93, 5.79, and 4.97, respectively. Conclusion: Assessing the EI of the cervical muscles with Adobe Photoshop software is a viable method to determine the quality of the muscles.
Introduction: As an essential factor affecting life prognosis and rehospitalization in patients
w... more Introduction: As an essential factor affecting life prognosis and rehospitalization in patients with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation. Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has recently increased among patients with chronic heart failure. This study evaluates the factors indicating exercise tolerance in patients with HFpEF from various perspectives, including cardiac and skeletal muscle functions. Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical function, physical activity, body composition test, baseline characteristics, blood data, and echocardiography results were extracted from medical records to identify the indicators of exercise tolerance. Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75, P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not significantly different in brain natriuretic peptide levels and cardiac function. Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its pathological course differs from heart failure with reduced ejection fraction, suggesting that it is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.
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Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week).
Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%).
Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation.
Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has
recently increased among patients with chronic heart failure. This study evaluates the factors
indicating exercise tolerance in patients with HFpEF from various perspectives, including
cardiac and skeletal muscle functions.
Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac
rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical
function, physical activity, body composition test, baseline characteristics, blood data, and
echocardiography results were extracted from medical records to identify the indicators of
exercise tolerance.
Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75,
P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not
significantly different in brain natriuretic peptide levels and cardiac function.
Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its
pathological course differs from heart failure with reduced ejection fraction, suggesting that it
is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.
Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week).
Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%).
Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation.
Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has
recently increased among patients with chronic heart failure. This study evaluates the factors
indicating exercise tolerance in patients with HFpEF from various perspectives, including
cardiac and skeletal muscle functions.
Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac
rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical
function, physical activity, body composition test, baseline characteristics, blood data, and
echocardiography results were extracted from medical records to identify the indicators of
exercise tolerance.
Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75,
P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not
significantly different in brain natriuretic peptide levels and cardiac function.
Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its
pathological course differs from heart failure with reduced ejection fraction, suggesting that it
is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.