ملیحه حداد نژاد

Low back pain is known as the main cause of disability worldwide. The purpose of this review article was to review the effects of Pain Neuroscience Education(PNE) along with core stability exercises on patients with chronic low back pain.

In this narrative study, we reviewed randomized controlled trials (RCTs) that investigated the effects of PNE along with core stability exercises on chronic low back pain from 2000 to 2024. We searched six electronic databases, including Scopus, PubMed, Web of Science, Science Direct, Google Scholar, and PEDRO, to review the literature and background studies. The search terms included "low back pain", "Core stability", "Pain Neuroscience Education", Motor control. The PEDro scale was used to evaluate the methodological quality of the articles.

77 studies were reviewed, of which five studies that met the inclusion criteria were selected for review. RCTs showed that PNE along with core stability exercises reduces pain, increases functional ability, and improves psychological components, as well as improving other important factors, including improving strength and flexibility in people with low back pain.

The results of this study show that the synergy between these two interventions may be associated with the simultaneous reduction of pain, improvement of functional capacity and reduction of psychological distress. However, research combining the effects of these interventions is limited and should be interpreted with caution due to methodological limitations.

The effectiveness of neck stabilization exercises in reducing the pain of patients with neck pain has been reported in previous studies. Most of the interventions to improve thoracic mobility are dedicated to manual therapy, and the role of exercise therapy has received less attention. Therefore, the aim of this study was to compare the effect of neck stabilization exercises with and without thoracic mobility exercises on pain, proprioception, and posture of women with chronic neck pain and forward head posture.36 women with chronic neck pain and forward head posture were randomly divided into three groups of control, stabilization exercises, and stabilization exercises with thoracic mobility. The intervention groups did the exercises for 8 weeks, 3 sessions a week, and 45-60 minutes, and the control group continued their normal life. Pain, proprioception, and forward head posture angle were evaluated by visual analogue scale, cervical-cephalic relocation test, and craniovertebral angle, respectively. Data analysis was performed using repeated measure ANOVA and Bonferroni's post hoc test at an error level of 0.05 and using SPSS software version 26.The stabilization exercises group with and without thoracic mobility showed significant improvement in proprioception, pain, and posture compared to the control group (p≤0.001). There was no significant difference between the experimental groups (p≥0.05). However, the stabilization exercises group with thoracic mobility had more improvement in posture and pain.Performing neck stabilization with and without thoracic mobility exercises is an effective intervention in improving posture, proprioception, and reducing pain in women with chronic neck pain. Therefore, the use of this exercise protocol is recommended as an effective treatment approach for women with neck pain.

Today, there is a disagreement about the effect of various stretching movements on the performance of athletes. Therefore, the aim of this study was to investigate the acute effect of static and dynamic stretching on muscle activity and co-contraction of scapular stabilizer muscles during pull up in gymnasts.

According to the inclusion and exclusion criteria, 15 professional gymnasts with an age (23.25 ± 2.57), height (170.93 ± 5.88), and weight (64.54 ± 5/06) were selected as research samples and divided into three subgroups (each 5).In the pre-test, subjects performed pull up and muscle activity of serratus anterior, upper trapezius, middle trapezius and lower trapezius muscles was measured using a biometric electromyography device. Then each subgroup performed a different stretching protocol in each session and a post-test was performed similar to the pre-test. Repeated measures analysis of variance, Bonferroni post hoc test and paired t-test were used to test the hypotheses.

The results showed that static and dynamic stretching caused a significant decrease and increase of muscle activity in both concentric and eccentric phases. Also, the results showed that dynamic stretch caused a reduction in co-contraction of the serratus anterior and middle trapezius muscles in both concentric and eccentric phases. In addition, there is a significant difference between the effect of static stretch and dynamic stretch and between dynamic stretch and control on co-contraction of serratus anterior and middle trapezius muscles in two concentric and eccentric phases.

The results showed that the co-contraction of serratus anterior and middle trapezius muscles decreased after using dynamic stretching. Therefore, considering the importance of muscle co-contraction in the occurrence of shoulder joint injuries and in order to prevent injuries in the shoulder joint of gymnasts, it is suggested that coaches and gymnasts should use dynamic stretching exercises more carefully.

 People with postural malalignment such as tibiofemoral varus (TFRV) may experience movement patterns dysfunction during functional activities that are related to non-contact lower extremity injuries. Training protocols should be designed for these people to control and improve their functional dysfunctions. The present study aimed to investigate the effect of posterior X-taping (PXT) and real-time external feedback (RTF) on kinematic and electromyographic indices of the lower extremities during the single-leg squat task in individuals with TFRV.

 Electromyographic and kinematic information of the lower extremities of 24 recreational athletes with TFRV (PXT=12, RTF=12) were recorded while participants in both groups performed single-leg squat 5 times consecutively and took a 2-minute rest between two different conditions (before and after the intervention). To analyze the data, 2-way analysis of variance and Bonferroni post hoc test were used at the significant level of P≤0.05.

 The present study results indicated an increase in gluteus medius muscle activity (P=0.013) in the eccentric phase and a decrease in hip adduction (P=0.001) in maximal knee flexion (P=0.034) after the intervention compared to before the intervention in the RTF group. Also, there was a reduction in external tibiofemoral rotation of the knee after the intervention compared to before intervention in maximal knee flexion (P=0.034), eccentric phase (P=0.001), and concentric phase (P=0.001) in the PXT group. In addition, there was a decreased ankle pronation after the intervention compared to before the intervention in the eccentric phase (P=0.001) and concentric (P=0.001) in the PXT group and in the eccentric phase (P=0.004) in the RTF group. Besides, there was an increased ankle abduction after the intervention compared to before the intervention in the concentric phase (P=0.001), eccentric phase (P=0.001), and maximum knee flexion (P=0.004) in the PXT group, and in the eccentric phase in the RTF group (P=0.006). Finally, there was a decrease in ankle flexion dorsiflexion at maximum knee flexion after the intervention compared to before the intervention (P=0.017) in the RTF group.

 The results of the present study showed that PXT and RTF interventions can affect the kinematic parameters of individuals with TFRV malalignment in different ways and can be used to correct immediately postural defects during the single-leg squat task.

core stability is defined as the ability of muscles to control and maintain the position of the trunk and its movement on the pelvis and lower limbs in order to produce, transfer force and move to the extremities of the body during physical activities. Weakness in central stability leads to impaired energy transfer and reduced sports performance. Also, weakness in the central muscles is related to lower limb injuries. Investigating the effect of central body muscle fatigue on the performance of other organs can provide useful information about the role of central body stability in sports performance. Considering the importance of central stability in sports performance, the purpose of this research is to investigate the effect of central body muscle fatigue on upper limb performance and functional motor screening test scores of male athletes.

A semi-experimental research approach was used, involving 40 male students aged 19 to 26, selected purposefully and based on availability meeting the inclusion criteria. To assess upper limb function, two tests focusing on upper body and upper limb stability in a closed movement chain were employed. The functional movement screening test was also used to measure movement function before and after inducing fatigue. Data analysis was conducted using Wilcoxon and T-paired statistical tests (p<0.05).

The results from the Wilcoxon test indicated that after the fatigue protocol, individuals exhibited significantly poorer performance in deep squats (P=0.001), In-Line Lunge (P=0.001), Hurdle Step (P=0.001), trunk rotatory stability (P=0.001), and the total scores of the movement screening test (P=0.001). However, there was no significant difference in other subtests between the two measurement stages (P<0.05). The paired sample t-test also revealed that individuals performed poorer in the upper quarter Y balance test (P=0.001) and closed kinetic chain upper extremity stability test (P=0.001) after the fatigue protocol compared to before.

The study shows that core muscle fatigue significantly decreases scores in upper functional tests and motor screening, suggesting the need for endurance exercises targeting core muscles to improve fatigue resistance during prolonged activities.

 Abnormal posture and alterations in movement and muscle activity patterns have been reported in people with upper cross syndrome (UCS). These changes can lead to imbalance in muscle activation, altered movement patterns, and biomechanical changes. The present study aims to investigate the effect of corrective exercises on posture, upper extremity muscle activity, and shoulder kinematics in male handball players with UCS.

 This quasi-experimental study was conducted on 30 male handball players with UCS who were randomly divided into exercise (n=15) and control (n=15) groups. The variables including upper extremity muscle activation patterns, shoulder kinematics, forward head posture, forward shoulder posture, and kyphosis were evaluated before and after intervention. Should kinematics and activation patterns of upper extremity muscles (supraspinatus, lumbar erector spinae, upper trapezius, middle trapezius, latissimus dorsi, pectoralis major) were recorded using electromyography and motion analyzer. The angles of forward head and forward shoulder were assessed using photographic method taken from lateral view, and Kyphosis angle was measured using a flexible ruler before and after exercises. The exercise group performed the comprehensive corrective exercises for 8 weeks (3 sessions per week), but the control group did not receive any intervention. To analyze the data, two-way analysis of variance and Bonferroni test were used. The significant level was set at 0.05.

 Forward head posture (P=0.001), forward shoulder posture (P=0.003), and kyphosis (P=0.002) showed significant improvements in the exercise group compared to the control group from pretest to post-test phase. In the preparatory and throw phases (slow and fast throwing), higher activities of supraspinatus, lumbar erector spinae, upper trapezius, middle trapezius, latissimus dorsi, and pectoralis major were observed in the exercise group compared to the control group (P=0.05). Moreover, in the preparatory and throw phases, higher range of motion of shoulder flexion, forward flexion of shoulder, internal rotation of shoulder, external rotation of shoulder, and shoulder abduction were observed in the exercise group compared to the control group (P=0.05).

 Corrective exercises can significantly alter shoulder kinematics and upper extremity muscle activity patterns in male handball players with UCS, which can be used in future studies to prevent UCS in handball players during throwing the ball.

Neck pain is a prevalent problem negatively affecting individuals’ health and quality of life. Therefore, the present research was conducted to determine the impacts of neck stabilization and thoracic mobility exercises on disability, range of motion, and endurance of females with non-specific chronic neck pain.

This single-blinded clinical trial was conducted on 36 females with non-specific chronic neck pain in three 12-people groups in the city of Qom. The subjects of the first intervention group (those doing neck stabilization exercises) and the second intervention group (those doing neck stabilization exercises with thoracic mobility) performed the exercises as three 60-minute sessions per week for 8 weeks in the gym, and the control group received a set of corrective exercises. Disability, the neck range of motion, and muscular endurance were measured by the Neck Disability Index (NDI), goniometer and the Progressive Iso-inertial Lifting Evaluation (PILE) test, and biofeedback sphygmomanometer, respectively.

Disability, range of motion, and muscular endurance of the subjects in both intervention groups significantly improved compared to the control group (P<0.05). Compared to the first intervention group, the range of motion and muscular endurance of subjects in the second intervention group showed a significant improvement (P<0.05).

Doing neck stabilization and thoracic mobilization exercises was found to be an influential intervention in the improvement of disability, range of motion, and muscular endurance of females with non-specific chronic neck pain.

 The aim of this study was to investigate whether the application of the integrated neuromuscular inhibition technique combined with Electric stimulation can provide faster and greater improvement in maximum strength and isometric of the neck muscles in patients with chronic mechanical neck pain.

 The current research was a semi-experimental type with a pretest-posttest design. For this purpose, patients with non-specific chronic neck pain in Tehran were randomly divided into two experimental groups (n=17) and a control group (n=17). Pain, disability, strength and endurance of neck muscles before and after eight weeks of intervention were measured using visual pain index, neck disability index, dynamometer and craniocervical flexion test, respectively. Repeated measures analysis of variance and paired T-test and one-way analysis of variance were used to analyze the data.

 The results of the paired t-test and one-way analysis of variance did not show significant differences between the group and the out-group in the three groups, in contrast, the combined neuromuscular inhibition technique group with electrical stimulation showed a greater clinical effect size than the other two groups.

 According to the clinical effects reported for the combined neuromuscular inhibition technique with electrical stimulation in patients with neck pain, using this method as a complementary method in improving pain, disability and increasing the strength and endurance of neck muscles in patients with chronic neck pain Non-specific is suggested.

The aim of this research was effect of eight weeks of neuromuscular training (NMT) with and without cognitive-dual tasks (DTs) on proprioception and balance of athletes with ACL deficiency (ACL-D). 39 soccer players with ACL-D were selected purposefully and randomly divided into three groups of 13 (control group, neuromuscular training group and neuromuscular training with dual tasks group). Two training groups performed the exercises for eight weeks and three sessions per week. cognitive-motor dual tasks were performed in one of the groups along with neuromuscular exercises in the form of counting down numbers, memorizing numbers, calculating unexpected equations, specialized football skill movements.  The results of the current study indicated that there was no significant difference in knee joint proprioception in the open and closed kinetic chain after applying the intervention between the three groups, but there was a significant difference in lower extremity performance of the athletes based on the Y balance test in the anterior and posterior-lateral direction between the three groups (p<0.05). It seems that providing neuromuscular exercises along with cognitive-dual tasks can probably be considered as a useful approach to improve lower extremity performance based on the Y balance test in athletes with anterior cruciate ligament deficiency.

Non-specific chronic low back pain (LBP) is one of the most common types of LBPs. Due to the complexity of the injury mechanism in this condition, combined interventions and treatments have been suggested. People’s attitudes towards pain and the interaction between biological characteristics of people and social/psychological factors should be considered. Due to the high cost of face-to-face therapy and the difficulty of access to subjects, recent studies have used online methods. So far, the effectiveness of online interventions in the treatment of chronic LBP has not been studied. Therefore, this study aims to investigate the effect of an online cognitive-motor control training program on pain and its related psychological factors in people with non-specific chronic LBP.

This is a randomized clinical trial conducted on 44 female and male patients with non-specific chronic LBP aged 25-55 years, selected from the physiotherapy clinics in Tehran and Karaj provinces of Iran based on the inclusion and exclusion criteria, and randomly divided into two groups of 22 including training and control. The intervention was provided at 18 sessions for 12 weeks. Pain and its related psychological factors were assessed by the visual analog scale, fear-avoidance belief questionnaire, and pain self-efficacy questionnaire. For statistical analysis, repeated measures analysis of variance, independent t-test, and paired t-test were used. The significance level was set at 0.05.

There was a significant difference between the pre-test and post-test scores of the training group in pain, pain self-efficacy, avoidance of physical activity, and avoidance of work (P<0.001). In the control group, no significant difference was reported in these variables between the pre-test and post-test scores.

The online cognitive-motor control training program can relieve pain and improve the pain-related psychological factors of people with non-specific chronic LBP. It can be used for this purpose in these people.

Low back pain is one of the most common problems among pregnant women and requires further investigation and design of effective interventions. Therefore, the present study investigated the effect of adding breathing exercises to comprehensive exercises in water and dry land on lumbo-pelvic pain. pain, functional disability, SFMA scores in pregnant women during lumbo-pelvic pain.

A total of 60 pregnant women with lumbo-pelvic pain were randomly divided into two groups: breathing exercises with on-land training (30 people) and breathing exercises with water training (30 people) and performed 14 weeks of training. Measured variables included pain, functional disability, SFMA scores were examined in the pretest and posttest.

Intra-group results in pain, functional disability, and SFMA variables showed significant results after 8 weeks of treatment in both groups (P<0.001). No significant difference was seen between the two exercise interventions in improving pain (p=0.91), functional disability (p=0.77) and SFMA (p=0.53).

Adding breathing exercises to water and land exercises can improve pain, functional disability, and SFMA scores variables in pregnant women with lumbo-pelvic pain.Key Words: Pregnancy, lumbo-pelvic pain, breathing Exercise, Function

The aim of this study was to investigate the effect of menstrual cycle phases on the lower limb joints and segments kinematics during squats at different loads. Ten female subjects with normal and regular menstrual cycle voluntarily participated in this study. Kinematics of the lower limbs of subjects were recorded using Myomotion device in three phases of primary follicular (first to third days of the menstrual cycle), secondary follicular (eleventh to fifteenth days of the menstrual cycle), and luteal (twenty-first to twenty-fifth days menstrual cycles) during squats with body weight, 10 kg barbell, 25% body weight, and 50% body weight. Range of motion (ROM) and maximum angles of thigh flexion, adduction, and internal rotation, knee adduction and flexion, tibia internal rotation and ankle dorsiflexion in preferred leg of the subjects were calculated. The results of repeated measures analysis of variance showed that the ROM and maximum angles in different loads significantly increased in the secondary follicular phase with increase in load. Moreover, the ROM and maximum angles were generally higher in the luteal phase compared to the follicular phase in squat with body weight and higher loads. According to the results, it suggests female athletes use resistance exercises with lighter weights with more caution at the peak of the secondary follicular phase (ovulation). Moreover, it is siggests to reduce resistance training during luteal phase.

Most anterior cruciate ligament (ACL) injuries occur when the athlete’s attention is focused on performing tasks and cognitive challenges. Dysfunction of the performance and proprioception of the knee joint in the condition of divided attention exposes a person to ACL injury. Therefore, the purpose of this study was to investigate the effect of eight weeks of neuromuscular training with dual cognitive tasks on the performance and proprioception of futsal players with dynamic knee valgus deficits.30 futsal players with dynamic knee valgus deficit (mean age: 21.86 ± 3.27 years, weight: 68.91 ± 99.55 kg, height: 175.6 ± 6.49 cm) were purposefully selected and randomly divided into two groups (control=15, experimental=15). In the pre-test, performance by tuck jump test and single leg triple hop test, as well as proprioception of the knee joint by digital imaging of the goniometric method were evaluated. The experimental group participated in a neuromuscular training program with dual cognitive tasks for eight weeks. Both groups performed a pre-test prior to the training period and performed a post-test two days after the training period in the experimental group. After data collection, univariate analysis of covariance and independent t-test were used to examine the means and differences between groups at a significant level (P≤0.05).The results of statistical tests showed that there was a significant difference between the mean scores of the Tuck jump test (P = 0.001) and Single Leg Triple Hop Test (P = 0.001) between the subjects of the two groups in the post-test, so the experimental group performance was better than the control group. There was no significant difference in proprioception of the knee (P=0.459), however, the mean error of proprioception reconstruction was further improved in the experimental group.The results of the present study showed that performing neuromuscular training with dual cognitive tasks significantly improves performance and reduces knee proprioception error. Therefore, it is possible that combining neuromuscular training with dual cognitive tasks as a new training approach can be effective to prevent ACL injury.

Background and Aims:

 Headache is one of the most common problems in adults and almost 47% of the world's population suffer from some kind of headache. High percentage of these headaches come from neck muscles these are called cervicogenic headaches. The purpose of this study is Comparison of the effect of comprehensive therapeutic protocol with and without manual treatment and kinesiotaping on pain and disability, postural and electrical activity of some neck muscles in men with non-traumatic cervicogenic headache.

Methods :

43 men aged 35 to 55 years with non-traumatic cervicogenic headache were selected for this study and randomly divided into four groups.Forward head angle, pain and disability and power of neck superficial muscle activation measured by using the photogrammetry, neck pain and disability scale (NPDS) and surface electromyography respectively in pre-test and after six weeks in post-test. Statistical methods, Shapiro-wilk and then repeated measures ANOVA and one-way ANOVA and paired t-test, repeated measure variance and finally and Bonferroni were used (α≤0.05).

Results :

The results showed a significant decrease in pain and disability, forward head angle and also a decrease in the activity of the superficial neck muscles in the experimental groups after six weeks of intervention. (P=0.00). Comparing the above three experimental groups, the comprehensive exercise therapy group with manual therapy had the highest statistical significance in reducing pain and disability, reducing the angle of head forward and reducing the activity of superficial neck muscles. (P=0.00).

Conclusion:

 comprehensive exercise therapy intervention with manual therapy had the greatest effect on improving the symptoms of men with non-thromatic  cervicogenic headache.

Glenohumeral internal rotation deficit (GIRD) is one of the most important risk factors for overhead-throwing athletes and adversely affects the biomechanics of the Glenohumeral joint during overhead-throwing motions. The aim of this study was to review all the articles performed in the field on the effect of corrective exercises on pain, function, proprioception, and muscle activity in people with GIRD

Reputable domestic and external electronic databases such as Sid, Magiran, Noormags, Science Direct, Google Scholar, PubMed, Trip Database, and Scopus were searched in all years through relevant keywords. A total of 444 studies were reviewed, of which 7 articles were accepted based on inclusion and exclusion criteria’s. The PEDro scale was used to evaluate the quality of selected articles.

2 examined the effect of stretching exercises, 2 examined the effect of rotator cuff exercises, 1 examined the effect of throwing exercises augmented, 1 examined the effect of facial manipulation, and 1 compared the effects of Kinesio Taping and stretching in people with GIRD. The results suggested that corrective exercises were effective in reducing pain and improving function, proprioception, and muscle activity in people with GIRD.

A corrective exercises proposed to improve muscle activity, function, and proprioception and reduce pain in people with GIRD.

Changes in bone position and scapular movements affect shoulder function and can lead to scapular dyskinesia. The purpose of this validity review article was to evaluate the effect of scapular stabilization exercises on pain and motor function in patients with scapular dyskinesia.

Search with related keywords in all years and in Magiran, Google Scholar, Elmnet and PEDRO websites with keywords Scapular Stabilization exercise, Scapular-focused exercise, Scapular Dyskinesia, Motor function, Pain, Kinematics and scapular position was performed. Studies investigating the effect of scapular stabilization exercises on scapular dyskinesia were included in the study. PEDro scale was used to evaluate the quality of imported articles.

Thirty studies were reviewed, of which five studies that had inclusion criteria (score higher than 5 on the Pedro scale) were selected for review. There were many differences in the methodology, the main index to be evaluated, the number of samples, the method of implementation, the method of evaluating the variables, etc. in the studies. In people with dyskinesia, stabilizing exercise reduces pain and improves motor function.

The results of previous studies showed that scapular stabilization exercises improve scapular dyskinesia.

An ankle sprain leads to a decrease in proprioception and awareness of the sense of motion and has motor consequences. On the other hand, damage to this joint is an important factor in reducing balance and consequently re-injury. Strengthening the effective factors in maintaining balance and controlling posture, including profundity, can be a basic strategy in the treatment of balance and postural problems, as well as injuries.

In this quasi-experimental study, 30 patients with chronic ankle instability were randomly divided into experimental and control groups. Both groups were pre-tested and the experimental group performed balance exercises against perturbation for six weeks. Post-test was retaken from both groups. Data were analyzed using a one-way analysis of covariance. Statistical operations were performed by SPSS software version 22 at a significant level of α≤0.05.

Postural control index in the experimental group was higher in the first position and lower than the other in the sixth position. The mean of the postural control index in the experimental group was significant compared to the control group [α≤0.05].

Performing balance exercises or training on unstable surfaces with the involvement of sensory receptors is likely to cause the muscles to be more actively involved and the central nervous system to receive more appropriate and effective stimuli from the nerves of different sensory receptors, and thus this Exercises improve postural control.

The present study aimed to investigate the effects of 4 weeks of aquatic exercise prehabilitation pre-surgery along with eight weeks of exercise rehabilitation after laminectomy surgery on pain and core muscles electromyography in women with a chronic low back.

A total of 30 females with CLBP candidates for laminectomy surgery enrolled in this single-blind randomized controlled trial. The participants were randomly allocated into the intervention (n=15, Mean±SD age 46.2±5.45) and control (n=15, Mean±SD age 46.26±5.39). The Visual Analog Scale (VAS) was used to measure pain, and a surface Electromyography (EMG) device was also used to measure selective core muscles activity of participants. The intervention group participated in 4 weeks of aquatic therapy as a rehabilitation program pre laminectomy surgery and eight weeks of aquatic therapy as a rehabilitation program after surgery. The control group participated in the same program only eight weeks after surgery as a routine rehabilitation program. All tests and measurement procedures were done for all participants, pre-surgery and at the end of 8 weeks rehabilitation.

The findings of the presents study indicated that prehabilitation program pre laminectomy surgery in women with CLBP significantly reduced levels of pain (p<0.0001) and increased muscles strength or EMG of selective core muscles (p<0.0001) of the intervention group compared to the control group at the end of the program.

In general, the statistical analysis concluded that pre-rehabilitation exercises as a hydrotherapy protocol had significant pain intensity and main muscle activity. Therefore, a comprehensive rehabilitation program for women with chronic low back pain has more beneficial effects than a routine rehabilitation program for these patients. Therefore it is recommended it is most helpful if the healthcare system in Iran includes a rehabilitation program as part of a comprehensive program for patients with CLBP. They are a candidate to have laminectomy surgery.

Low back pain is one of the most common musculoskeletal disorders leading to disability around the world. Several studies have suggested that prolonged computer/ laptop work contributes to the development of low back pain and discomfort. The results of the studies conducted on the association of back discomfort and muscle activity are contradictory. Thus, the present study aims to evaluate the relationship between the activity level and relative rest time of the trunk muscles with back discomfort while working with a laptop in a sitting position.

First, 20 young healthy males performed laptop work including mouse work and typing in conventional and ergonomic setups. In the ergonomic setup, the screen height and keyboard placement were specifically adjusted for each individual. In addition, the electromyographic activity of the lumbar erector spinae, right and left multifidus and transversus abdominis, rectus abdominis, external oblique muscles, and the posture of the lumbar spine were recorded in the first and last two minutes of an 8-min task. After the end of each task, the participants scored their back discomfort.

The results showed a positive correlation (r=0.57 and p=0.009) between back discomfort and the EMG amplitude of the lumbar erector spinae muscle. In addition, back discomfort was negatively correlated to the relative rest time of the multifidus muscle (r=0.50 and p=0.023), and a positive correlation was reported with the relative rest time of the transversus and rectus abdominis (r=0.47, p=0.039, and r=0.45, p=0.049, respectively).

The relative rest time of the trunk muscles may be a better index than that of the EMG amplitude to highlight the risk factors for back discomfort. However, a causative link between muscle activity and discomfort cannot be implied from this study. The current results do not undermine the role of other factors associated with the increased level of discomfort during sitting.

Increasing participation in sports activities increases the number of people at risk of injury. These injuries should be properly identified and treated, in order to provide the opportunity to participate again in sports activities. Increasing awareness of hwo injures occur by identifying risk factors and their predictive role can reduce the likelihood of their occurrence and even prevent many of these injuries. resercher believe that the lower extremity is the most prone position for injury. According to studies, a variety of internal factors predispose athletes to injury. These factors include disproportionate ratios of strength and endurance of agonist and antistatic muscles, structural abnormalities, gender, physical fitness, and history of injury. Recently, other factors including postural control, neuromuscular control, core instability, and muscle imbalances have also been identified as contributing factors to injuries. Recently, due to the importance of injury prevention, a lot of research has been done to identify risk factors for injury. Previous research has examined the various factors associated with lower limb injury separately. Regardless of the differences, a study is hardly available that comprehensively examines the factors: postural (TTB) time-to-boundary stability and neuromuscular defects. The purpose of this study was to evaluate the predictive role of postural, biomechanical and neuromuscular factors in the incidence of lower limb injury in active women.                           

63 active woman students were selected according to the criteria of entering the research purposefully. The research variables were divided into three groups: neuromuscular, biomechanical (TTB), postural (height of the inner leg of the arch, distance between the knee condyles, the interval between the ankles, the angle of the quadriceps). The data collection form was used to collect information about injuries, force plate to measure TTB, Colice to measure the distance between the condylars and the distance between the ankles, a simple goniometer for measuring angles Q and a digital camera to determine the neuromuscular defects. The researcher participated in the training and competition sessions to complete the injury form in order to record the degree of injury to subjects during a term.   Finally, for statistical analysis, Pearson correlation coefficient test was used to determine the relationship between variables and regression test to predict effective variables at a significance level of 95%. The implementation method of the present study was that first the participants were asked to fill in the consent form and personal information. Before filling out the consent form, participants were given a full explanation of the process. Then the measurements of the height of the inner longitudinal arc were performed by a goniometer. Then the measurements of the height of the inner longitudinal arc were performed by a goniometer. The distance between the condyles of the thighs and the inner ankles of the foot was then measured by a caliper.To measure postural stability with the eyes closed, three 10-second standing attempts were made on the force plate with the foot of the mold. Subjects stood on a fixed location on the force plate in all attempts. Forces and torque were recorded at 200Hz and 2000 COP points were calculated for each attempt in each time series; This data was then filtered with a four-zero-order filter, a low-pass filter with a cutting frequency of 5Hz.To assess neuromuscular defects, the subjects performed a vine jump test for 10 seconds. The only information given to the person was the beginning and end of the movement and how to stand on the lines. The diagnosis of neuromuscular defects was made by observation, which was filmed from two front and side views of the person, and the desired sequences were extracted from the film and examined at angles. How to score This test was done using a 10-point scoring form, used in valid articles.

REsults showed that the Pearson correlation coefficient between the anterior-posterior TTB and the degree of injury (r = 0.295), between the height of the arch and the degree of injury (r = -0.239), Q angle and injury (301) / 0 = r, ankles and injury (r = 0.331), neuromuscular factors and damage (r = 0.42) were significant. Regarding the muscle neuromuscular factor (β = 0.81). Regarding the medioletral variable, the results showed that there was no significant relationship with the rate of injuries. In relation to the height of the arch of the foot, the obtained value is significant for the Pearson correlation coefficient between the height of the arch of the foot and the amount of injury (r = 0.263). Therefore, it is inferred that there is a negative and significant relationship between increased leg arch and the rate of lower limb injury in active women. Also, according to the results, there is no relationship between the distance of the condyles and the amount of lower limb damage. The value obtained for Pearson correlation coefficient There is a positive and significant relationship between neuromuscular factors and th rate t of injuries (r = 0.793). Thus, as the rate of neuromuscular factor deficiency increases, so does the amount of injures. Regarding the medioletral variable, the results showed that there was no significant relationship with the rate of injuries. In relation to the height of the arch, the obtained value is significant for the Pearson correlation coefficient between the height of the arch of the foot and the amount of injury (r = 0.263). Therefore, it is inferred that there is a negative and significant relationship between increased leg arch and the rate of lower limb injury in active women. Also, according to the results, it was found that there is no relationship between the distance of the condyles and the amount of lower limb injuries. The value obtained for Pearson correlation coefficient There is a positive and significant relationship between neuromuscular factors and the rate of injuries (r = 0.793). Thus, as the rate of neuromuscular factor deficiency increases, so does the rate of injuries.

According to the findings of the study, women with neuromuscular defects most likely to be injured. Since neuromuscular injuries are the most predictive power, it seems that attention to muscle neuromuscular factors to prevent injury before the season of games is practical.

Injury prevention training using a global systems approach has been suggested to reduce biomechanical risk factors for anterior cruciate ligament (ACL) injuries during landing. This study aimed to compare a traditional injury prevention program to injury prevention training using a global systems approach on trunk and lower extremity kinematics and kinetics during a single-leg cross drop task in athletes at risk of ACL injury.

Thirty-nine male and female athletes (control = 19 and injury prevention training using a global systems approach = 20) participated in this study. Peak knee and hip flexion, peak knee abduction, lateral trunk flexion angles, peak knee abduction moment, and peak vertical ground reaction forces (GRF) were assessed for all participants during a single-leg cross drop task at baseline and six weeks following injury prevention training. Repeated measures analysis of variance (ANOVA) was used to investigate the biomechanical data between-group differences.

A significant group × time interaction effect was found for peak vertical GRF (P = 0.007), peak knee abduction moment (P < 0.001), knee abduction (P = 0.006), and lateral trunk flexion (P = 0.036), favoring the global systems approach group at six weeks. Significant main effects of time were found for the vertical GRF, knee abduction moment, hip flexion, knee flexion, knee abduction, and lateral trunk flexion (P < 0.001) after the training. No significant group × time interaction effects were found for hip flexion (P = 0.734) and knee flexion (P = 0.103).

Global systems approach improved the biomechanical risk factors for ACL injuries during single-leg cross drop landing compared to thigh-focused exercises.

Falls have dangerous consequences, high prevalence, long-term effects, and significant costs among the elderly. The present study aimed at determining the effect of resistance and hydrotherapic exercises and on the balance and reaction time in the elderly with mild cognitive impairment.

The present study was a quasi-experimental pretest-posttest one with a control group. From among women with mild cognitive impairment referring to medical centers in Kermanshah in the spring of 2019, as many as 30 people were selected by using random convenience sampling. They were then randomly assigned into two groups i.e. experimental and a control (10 samples in each group). The experimental groups practiced for 8 weeks (3 sessions a week, each session lasting 40 minutes). Static balance was measured by using with both open and closed eyes and applying the Sharpened Romberg Test (SRT) and dynamic balance was measured by the Timed Up and Go Test(TUG) before and after the training period. Simple and selective reaction times were measured as well. The data were analyzed by analysis of covariance and paired t-test.

The difference between pre-test and post-test scores was not significant for the variables of static balance with open eyes, dynamic balance and simple reaction time. The difference between these scores was significant for Sharpened Romberg Test with closed eye; static balance and evaluation of selective reaction time was significant (p < 0.05). There was a significant difference between post-test and pre-test scores (except for dynamic balance) in the intervention groups (p < 0.05). There was no significant difference in the effectiveness of treatment methods.

Given the effectiveness of resistance exercises and hydrotherapy, these methods can be used as effective therapies by physiotherapists to improve the balance and selective reaction time among the elderly suffering from mild cognitive impairment.

Anterior cruciate ligament (ACL) injury is one of the most serious knee injuries and it happens frequently during sports activities. Appropriate muscle activity is essential to provide joint stability and prevention of ACL injury. This study was performed to determine the effect of external focus instructions and functional training on basketball knee stabilization muscle activity timing.

This clinical trial study was performed on 48 healthy male basketball players of the Iranian Provincial League in the age range of 19-25 years. The basketball players were randomly divided into 3 groups of 16 people including control group, functional training group with feedback and group without feedback. The timing of the onset of electrical activity in the quadriceps, hamstrings, and Gluteus medius muscles of individuals before and after eight weeks in the single-leg landing task was examined by electromyography.

There was a significant difference between the groups at the onset of Biceps Femoris, Gluteus Maximus, Gluteus Medius, Vastus Medialis, Vastus Lateralis, Rectus Femoris and Medial Hamstring muscles. There was a significant decrease in muscle activity onset between functional groups with and without feedback in compared to control group (P<0.05). There was no significant difference between the training groups at the beginning of the activity of the mentioned muscles.

Functional basketball training with and without feedback can optimize the activity time of the knee stabilizing muscles, during exercises such as jump-landing, increase the stability of the knee joint and possibly reduce ACL injury in athletes.

Fatigue can lead to harmful changes in landing kinematics and put the knee joint in a position that increases chances of injury to the anterior cruciate ligament. The purpose of the present study was to investigate the effect of eight weeks of jump training on selected kinematic factors conditions in Men's Handball Player Premier League who are at the Risk ofAnterior Cruciate Ligament Injury.

In the current study, 30 handball players in the Iranian Premier League were selected purposefully and randomly divided into two control and experimental groups. Prior to and eight weeks after the exercises (3 sessions per week) at the same time and place, after determining the participants' dominant leg and applying the fatigue protocol, they performed a single-leg landing jump. Kinematic factors of the lower limb and trunk were recorded during the single-leg landing using Motion Analysis device to investigate movements in the sagittal and frontal motion plate. During the research period, the control group did not perform any intervention training program. ANCOVA was run to analyze the study hypotheses in SPSS, version 20.

The results showed that after eight weeks of training in fatigue conditions, knee, hip, and trunk flexions increased in the exercise group (respectively p=0.001, p=0.002, p=0.001,) while no significant decrease was observed in lateral trunk tilt, knee valgus, and tibial torsion.

According to the results, plyometric exercises may be effective in preventing anterior cruciate ligament injury. These exercises prevent mechanisms that cause damage to the anterior cruciate ligament by affecting the kinematic angles of the joints and by increasing the muscular feedforward activity and the development of the entire musculoskeletal system.