مجله پژوهش در علوم توانبخشی
سال چهاردهم شماره 1 (فروردین و اردیبهشت 1397)

  The main purpose of physiotherapy in patients with knee osteoarthritis includes reducing pain, improving individual functional abilities, and increasing quality of life. Thus, the therapists need a tool to measure the outcome of these changes after intervention. In order to utilize these tools, they should have acceptable validity, reliability, and responsiveness. The Oxford Knee Score (OKS) is one of the most common tools used for assessment of the patients with knee osteoarthritis. However, to our knowledge, there has been no study on its responsiveness in this group of the patients. Therefore, the purpose of this study was to investigate the responsiveness of this outcome measure, and to measure minimal clinically important change in the patients with knee osteoarthritis following physiotherapy. 146 Iranian men and women with knee osteoarthritis referred to physiotherapist were entered the study via a nonrandomized convenience sampling method. The Oxford Knee Score was completed in the first session, and again after four weeks of physiotherapy. In the last session, the patients filled a 7-item retrograde Likert questionnaire, too The area under the curve (AUC) of 0.78, and δ correlation coefficient of 0.59 indicated high responsiveness of Oxford Knee Score. The sensitivity and specificity of scale was 0.50 and 0.91, respectively. The minimal clinically important change (MCIC) of this tool was 6.5. Our findings provide evidence for selection of appropriate outcome measure for assessment of changes in these patients. The minimal clinically important change of this tool was determined which provide practical information for clinicians to make decision on clinical significance of changes in patients status.

  Scoliosis is a complex deformity of the spine. The possibility of surgery decrease by early diagnosis. The aim of this study was to investigate the efficiency of the functional movement screen test to predict scoliosis. Of 1672 university girl students, 98 were selected and divided into two group of scoliosis (43 cases with left thoracic curvature) and health (55 cases). The degree of curvature and functional movements were assessed by photography and functional movement screen test, respectively. Logistic regression analysis was used to evaluate the effect of predictor variables (functional movement screen test) on the criterion variable (scoliosis and health). There was significant inverse correlation between scoliosis with deep squat (P < 0.001), hurdle step (P < 0.001), in-line lunge (P = 0.006), active straight-leg raise (P < 0.001), trunk stability push-up (P < 0.001), and rotary stability (P < 0.001). The logistic regression analysis revealed that low scores in hurdle step (P = 0.006) and active straight leg raising (P=0.02) could predict probability of scoliosis. Movement assessment seems to be an effective way to predict the probability of nonstructural scoliosis.

  Patients with nonspecific chronic low back pain experience deficit in joint position sense acuity and two-point discrimination, and these deficits are associated with pain in these patients. The aim of present study was to evaluate the effect of hydrotherapy on pain, joint position sensee, and two-point discrimination in patients with nonspecific chronic low back pain and motor control impairment. Material and 25 women with nonspecific chronic low back pain were selected using Oswestry Disability Questionnaire, and randomly assigned into 2 groups of hydrotherapy (n = 12) and control (n = 13). The experimental group performed an eight weeks of hydrotherapy exercises, and control group did not perform exercise. Before and after complementation of intervention, visual analogue scale, goniometer, and caliper were used to assess pain, joint position sense, and two-point discrimination, respectively. Within and between group comparisons were done using paired t and independent t tests. In hydrotherapy group, there were significant differences between pretest and posttest in pain (P = 0.007), joint positon sense (P = 0.005), and two-point discrimination (P = 0.008); whereas there was not any significant difference in control group. Hydrotherapy exercises result in decreasing pain, improvement in joint position sense, and two-point discrimination of women with nonspecific chronic low back pain and motor control impairment. So, use of these exercises is recommended for treatment of nonspecific chronic low back pain.

 

The purpose of this study was to investigate the effect of attentional focus and frequency of feedback on performance and kinematics in basketball free throwing.

In this semi-experimental research, fifty students were randomly selected using convenience sampling method, and were randomly divided in one control and 4 experimental groups (internal focus and 33% feedback, internal focus and 100% feedback, external focus and 33% feedback, and external focus and 100% feedback). Experimental groups conducted six blocks of ten attempts (every day two blocks of ten attempts) in one week, and in three sessions of training, and received internal or external focus feedback with the corresponding frequency (33% or 100%). After 72 hours, retention and transfer tests were performed with ten-attempt blocks. Performance (throwing accuracy) and kinematic data (joint angle and range of motion) were collected. Data were analyzed using ANOVA with repeated measures and one way ANOVA.

Feedback with external focus (100% and 33%) was more effective in improving throwing performance in retention and transfer tests (P < 0.050). Kinematic data analysis showed that external focus feedback groups had the least maximum flexion in the knee joint in retention test compare to acquisition stage (P < 0.050). Moreover, external focus groups had the least maximum flexion at the knee in retention test compared to internal focus groups (P < 0.050). In range of motion of the knee, external focus groups had more range of motion in retention and transfer tests compared to internal focus groups (P < 0.050).

Performance improvement in external focus groups may be limited to certain changes in kinematic data, and in line with constrained-action hypothesis.

  For people, the difficulty in setting up emotions is a kind of incompatibility, and represents a high risk factor for mental health. The present study examined the predictive role of emotion regulation in the posttraumatic growth and development of blind veterans. In this descriptive-correlation study, participants were 110 blind veterans who were selected using convenience sampling method. Calhoun and Tedeschi emotion regulation difficulty questionnaire as well as Gratz and Roemer posttraumatic growth and development questionnaire were completed with the help of questioners. The data were analyzed using Pearson correlation and multiple linear regression tests via SPSS software. There was a negative relationship between emotion regulation difficulty with posttraumatic growth and development. Moreover, as a result of regression analysis between emotion regulation difficulty with posttraumatic growth and development, F statistic value was 4.319, and the standardized regression coefficient was -0.196. Therefore emotion regulation was able to predict posttraumatic growth and development (P < 0.05). According to research findings, it seems that if emotional regulation is appropriately performed, it is not only possible to prevent high-risk behaviors, but also leads to individual’s growth and development.

  Poor postural control in patients with knee osteoarthritis (KOA), according to the abnormal excursions of center of pressure (COP), has been proven. On the other hand, the results of the previous studies indicate that pulsed ultrasound (PUS) improves joint and muscle structure and function. The aim of this study was to evaluate the effect of pulsed ultrasound on postural sways in patients with knee osteoarthritis. 11 healthy women and 27 women with bilateral knee osteoarthritis, who were matched in terms of age and weight, assigned randomly to three groups. The groups of the study included: sham ultrasound with exercise, ultrasound without exercise, and ultrasound with exercise. Subjects were examined in comfort double leg standing (CDLS), Romberg standing (RS), and near tandem standing (NTS) positions on a force plate. Pulsed ultrasound was used for 10 sessions at a frequency of 1 MHZ and 1 W/cm2. In groups with exercise therapy, lower limb strengthening exercises were prescribed. It was determined in baseline assessment that COP sways in mediolateral direction were affected more than other directions. After the treatment, in the ultrasound without exercise group, mediolateral (ML) range (P < 0.001) and standard deviation of the mediolateral range of the COP (P < 0.001) in comfort double leg standing (CDLS) position significantly increased. In the ultrasound with exercise group, antroposterior (AP) range (P = 0.010), standard deviation of mediolateral velocity (P = 0.010), and mediolateral mean velocity (P = 0.010) significantly decreased in Romberg standing position. In women with knee osteoarthritis, COP displacements in mediolateral direction was more affected than other sway directions. Pulsed ultrasound could improve the postural sways in mediolateral direction, and bring its parameters closer to the healthy group.  

  The lower extremity is one of the important factors affecting performance, and lower limb muscles play a significant role in the performance of individuals. Lower limb muscles play an important role in maintaining postural control, especially in single movements. Ineffectiveness or weakness of these muscles during dynamic movements may increase incomplete dynamical control, and muscle tiredness affects muscle activity. The aim of this study was to compare the electromyography activity of lower extremity muscles before and immediately after fatigue 20 men students in the field of physical education participated in this study. Surface electromyography activity of rectus femoris, lateral hamstring, tibialis anterior, and medial gastrocnemius muscles before and after using the device were evaluated. Lower extremity muscle fatigue protocol to exhaustion by Biodex machine was used. The paired t test was used for statistical analysis with a significance level of P < 0.050. There was significant difference between before and after fatigue in the level of activity of rectus (P = 0.020), hamstrings (P < 0.001), tibialis anterior (P < 0.001), and medial gastrocnemius (P < 0.001) muscles. Lower extremity muscle fatigue has negative effect on the activity of the muscles around the knee joint. Muscle fatigue may cause changes in lower limb muscles, which may increase joints vulnerability. These results can be addressed in the design of athletes’ rehabilitation and training programs to prevent biomechanical parameters changes which lead to loss or damage.

  The gait has an approximately symmetric pattern which comprises two general phases, stance and swing. Using lower limb prosthesis alters this symmetry. In order to achieve quantitative results, and integrate the results of various researches, this systematic review and meta-analysis of stance time of the gait cycle was carried out. These quantitative results can be a proper tool for the optimal design of prostheses, and reliable prescribing for prosthesis according to physical features of amputees. Searching related keywords in valid databases of ScinceDirect, PubMed and IEEE, the researcher found 98 studies out of 1350 investigations carried out between 2007 and 2018, all of which were in line with the systematic review procedures. Finally, due to the qualitative evaluation of selected papers, 15 experimental studies meeting the required criteria were included in the present meta-analysis for further processes of calculation and interpretation of the reasonable effect size. The stance time with the residual limb is 4.07 percent shorter than the intact limb. Moreover, the control group had less stance phase of 1.65 percent in comparison with the prosthesis limb. Finally, it was found that the intact limb had approximately 1.84 percent longer stance time than the control group. According to qualitative results of the present meta-analysis, asymmetry of stance time for amputees in contrast to the control group would be beneficial for evaluating the prosthesis design, improving neuromuscular studies in rehabilitation field, and compensating the walking asymmetry caused by movement problems in prolonged use of prosthesis.