aliasghar jamebozorgi

There are ongoing debates among surgeons regarding the most effective surgical method for hip replacement, with varying preferences for the anterior and posterior approaches. Both methods have demonstrated excellent long-term outcomes, with clinical differences primarily observed in the early postoperative period.

This study aimed to compare the anterior and posterior methods of hip replacement after six months of surgery in terms of biomechanical and clinical indicators, as well as quality of life.

In this cross-sectional observational study, 42 patients who underwent hip replacement surgery using either the anterior (n = 22) or posterior method (n = 20) at least six months (and a maximum of 12 months) post-surgery, along with 20 healthy individuals, were evaluated. Biomechanical indices of the center of pressure (COP) were measured using a force plate during two-leg standing with eyes open and closed. Functional balance, independence, self-perception of performance, satisfaction, and quality of life were assessed using the timed up and go test (TUG), Barthel Index, Canadian Occupational Performance Measure (COPM), and the SF-36, respectively.

No significant differences were found between the anterior and posterior groups in terms of COP, clinical variables, and quality of life (P > 0.05). However, when compared to the control group, the anterior replacement group exhibited significantly higher COP displacement in the medial-lateral direction (P = 0.03) and COP velocity in the anterior-posterior direction (P = 0.02) during two-leg standing with eyes open. No significant differences in COP variables were observed in the posterior replacement group compared to the control group (P > 0.05).

The findings indicate no significant differences between the anterior and posterior approaches to hip replacement in terms of biomechanical and clinical indicators, as well as quality of life after six months. Therefore, the choice of surgical method can be based on the patient's condition and the surgeon’s expertise in the respective approach.

This study seeks to investigate how physical activities can help enhance static and dynamic balance in children with Autism Spectrum Disorder (ASD), who often experience difficulties with communication, cognitive abilities, and motor skills.

 The study is a randomized, double-blind clinical trial examining the impact of physical activities on improving static and dynamic balance in 6-12-year-old high-functioning ASD children from Tehran's treatment centers and special schools. Initially, 30 participants were chosen, then divided into two groups of 15 using block randomization. The experimental group underwent 24 sessions of physical activities, while their balance was assessed using force plate tools and the Walking heel to toe test before and after the intervention.

The results of the evaluation of center of gravity fluctuations using the power plate and also the Walking heel to toe test score showed that performing balance exercises for people with autism spectrum improves the static and dynamic balance of these people. More precisely, in the field of static balance, the center of gravity oscillation decreased in all parameters of lateral displacement, anterior-posterior displacement, average velocity of oscillation, and range of oscillation.

It seems that physical activities can improve static and dynamic balance in autistic children, so therapists can use physical activities to increase balance and improve movement disorders in autistic people.

 Following an anterior cruciate ligament (ACL) rupture, proprioceptive deficiency may be responsible for functional balance defects and joint instability. Recently, using transcranial direct current stimulation (tDCS) or biofeedback has been recommended for athletes with ACL rupture.

 This study aimed to evaluate the effects of tDCS and biofeedback modalities while performing contraction exercises in athlete with an ACL rupture.

 Thirty-three athletes with ACL rupture were randomly divided into three groups of tDCS, biofeedback, and control, with 11 people in each group. All groups underwent a ten-session training of intermittent contractions of the lower extremity muscles in a standing position at different knee angles, including 30, 45, and 90 degrees of knee flexion during four weeks. The control group received no tDCS or biofeedback modalities except the contraction exercises. All subjects were evaluated both before and at the end of interventions. The proprioception measured as rate of absolute error in the knee joint reconstruction was assessed by the digital photography technique at knee flexion angles of 30, 45, and 90 degrees. The functional balance was assessed by the star excursion balance test in eight different directions. All measurements were carried out on the injured limb.

 The results showed no significant difference among three groups regarding all variables related to the proprioception and functional balance (P > 0.05). Intra-group comparison (before and after intervention) indicated that biofeedback significantly improved both the functional balance in all directions and the proprioception of the injured knee at three knee flexion angles (P < 0.05). Moreover, tDCS significantly improved the functional balance in six directions, except anterior-lateral and posterior, and also improved the proprioception at all angles of knee flexion.

 Although the results did not show a large difference among groups, both tDCS and biofeedback modalities, along with intermittent isometric exercises, may have reduced knee absolute error at the knee flexion angles of 30, 45, and 90 degrees as well as improved the functional balance. Therefore, it was recommended that these modalities should be included in rehabilitation program targeting ACL-deficient knee subjects.

Physical exercise is a promising intervention to improve cognitive function and reduce the risk of dementia and other related neurodegenerative disorders. The present study aimed to investigate the effectiveness of an upper limb-focused physical exercise intervention on cognitive function and daily living activities in older adults. 

Forty older residents of a nursing home participated in this clinical trial and were randomly assigned to the experimental (n=20) or the control (n=20) groups. Participants in the experimental group received a physical exercise intervention for six weeks. This intervention included resistance training of the upper limbs using free weights. Evaluations were performed at baseline and after three and six weeks of the resistance training. Stroop test and Barthel index were used to evaluate cognitive function and daily living activities, respectively.

Upper limb resistance training significantly improved cognitive function in the experimental group, but there was no significant difference between the groups in the ability to perform daily activities.

The present study revealed that resistance training of the upper limb can yield cognitive improvement in older adults. Upper limb strengthening seems to have the potential to improve cognitive performance in the elderly and can be recommended as a regular exercise activity. However, further studies with more comprehensive outcome measures are needed.

Cerebral palsy (CP) is a non-progressive Neurodevelopmental disorder mainly treated using Single-event multilevel surgery (SEMLS). SEMLS contains using a casting method to immobilize the operated limb. However, in the present study, in addition to casting, the bandaging method was also applied. Bandaging is a newer method compared to casting. No study has used bandage for post-surgery immobilization. According to the best knowledge of the authors, no study has compared the outcome of bandage and cast for postoperative immobilization regarding the rehabilitation and quality of life (QoL) in the first and third months following the surgery, within the recovery period, which is associated with consequences like caring, hygiene, transferring, and mobility that affect the spirit and function of children. As a result, we decided to investigate the effect of these methods on the QoL of children the following surgery to treat CP.

Following an analytical cross-sectional design, 100 children (aged 4-12 years) were randomly divided into hemiplegic and diplegic CP. The Cerebral Palsy QoL questionnaire (CP QOL-Child) was filled by parents of the participants. Based on the type of administered immobilizer, 80 children were randomly divided into two groups (40 subjects in each group). All subjects were evaluated using a similar questionnaire in the first and third months after surgery. The non-parametric Mann-Whitney test and ANOVA test were used to compare the study groups.

The mean ratio changes of QOL based on CP QOL-Child questionnaire in bandage group significantly increased in the first month after surgery, but in the cast group this parameter significantly decreased( P <0.001). In third month after surgery, the mean ratio changes of QOL -in both method- significantly increased but the difference mean ratio changes of QOL between the methods wasn’t significant (P=0.64).

In the first month after surgery, the bandaging method was more effective than the casting method, but in the third month, the outcomes were similar for both groups.

Balance is a perquisite for performance of daily activities ranging from maintenance of static postures to complex dynamic activities and is considered as a functional independence index. Besides routine rehabilitation techniques, neurofeedback is an almost novel used to enhance balance. The aim of this study is to review the current literature on the role of neurofeedback on balance rehabilitation with a comprehensive and critical approach.

The literature was searched for relevant papers published between 1995 and 2018 with the keywords of “postural control”, “balance”, “neurofeedback”, “cognition” and “attention” in PubMed, Scopus, Web of science,Google Scholar and Web of Knowledge databases. Among the 60 papers found during the initial search, 22 passed the inclusion and exclusion criteria and were further investigated.

The 22 included studies were categorized into two protocols of neurofeedback balance training with Beta wave reinforcement/ theta wave inhibition (18 studies) and sensorimotor wave reinforcement (4 studies). The studies had investigated the effect of neurofeedback balance training on balance, dual and manipulative tasks, gait parameters, concurrent working memory functions and attention processes.

The findings of this systematic review showed that neurofeedback is effective on balance improvement, dual task performance and attention. It might be considered as safe method besides other modalities in the management of balance and attentional disorders.

Osteoporosis (OP) is the most common metabolic bone disease described by loss of bone mass and micro architectural deterioration of bone tissue, which causes serious problems for women. In Iran, more than 70% of women and 50% of men over age 50 are osteopenic. The most common conditions associated with OP are pain, mobility restrictions, functional reduction, psychological consequences, and secondary chronic disorders due to fracture which lead to reduced quality of life.The purpose of the present study was to assess the effects of balance exercise program on pain and quality of life in women with postmenopausal osteoporosis.

In the present randomized, double- blind trial, a total of 48 postmenopausal osteopenic women, aged 48-65 years (-1

A significant improvement was noted in the quality of life at the end of the exercise program in the balance exercise group. Pain significantly decreased in spine, upper, and lower extremities in the balance exercise group compared with those of the control group (P

Using common treatment of osteoporosis plus balance exercises improve the quality of life and decreases pain in women with postmenopausal osteopenia.

The gold standard for postural stability evaluation is the force platform; which has multiple limitations such as high costs, not being portable and being difficult to implement. Simple balance training devices have been recently tried to take this role. The validity and reliability of such devices have been a major concern.
Twenty symptom-free university students volunteered to take part in this methodological study. The center of pressure, anterior-posterior displacement range and total path length were measured during static standing tasks under four conditions of eyes opened and closed with firm and foam support surface by Bertec force platform and Wii Balance Board. Intra-class correlation coefficient and standard error of measurement were used to assess relative and absolute reliability, respectively. The mean differences of the measurements of the two devices were compared to zero by one sample t-test to check the construct validity of the Wii Balance Board. Bland and Altman plots were also used for descriptive evaluation of the mean and the variability of measurement differences of the two devices. Regression analysis was used to check if there was any systematic bias between the mean values and the differences between the two devices.
All center of pressure measures from both devices showed statistically significant relative reliability (P 0.05). Regression analysis of the pooled mean scores and the measurement differences revealed no significant systematic bias between them (P > 0.05).
Both Bertec force platform and Wii Balance Board devices showed acceptable reliability. While the center of pressure driven variables measured by the two devices are comparable, there is a trend toward overestimation of these variables by the Wii Balance Board. The difference between the measurements of the two devices was found to be highly variable without any significant systematic bias.

Mallet finger is a deformity caused by injury to the extensor mechanism of the distal phalanx. Rehabilitation is initial choice for the treatment of mallet finger in the treatment of extension lag. The aim of this study was to compare the three-point pressure splint designed by the researchers and aluminum splint routinely used for mallet finger treatment, while performing activities of daily living (ADL).
A quasi-experimental design was employed. The participants were 20 patients with mallet finger, who were, on average, 44 years of age. 3-point pressure splints designed by the researchers and aluminum splint common in the treatment of mallet finger were placed on patients with mallet fingers randomly assigned to control and treatment groups. The changes in the extension of the deficit fingers in the first, third and sixth week after placement were compared for activities of daily living. QUICK DASH test was used for evaluation of the results.
The results showed a significant difference between the treatment and control groups in terms of the performance of activities of daily living in the third week (t=-3.824, p0.280). After six weeks of replacement a statistically significant difference was observed between the two groups indicating the alleviation of the deformity in the treatment group (t=-2.762, p=0.006).
The results showed that three point pressure splint designed by the researchers had a greater impact on reducing extension lag in activities of daily living than aluminum splint did.

Cerebral palsy is a non-progressive neurological and developmental disability. One of the treatments for cerebral palsy is multi-level surgery in one session (SEMLS). After surgery, bandages and casting techniques are used for immobilization. Compared with the casting, bandage is a new method and no similar study is reported using bandage technique for immobilization after surgery. In the recent years, long-term immobilization after surgery is avoided because of muscle weakness, stiff joints, slow recovery and rehabilitation, and delayed return without restriction to daily activity. The aim of the present study was to evaluate the effect of early movements on the performance of children with cerebral palsy with spastic diplegia following surgery and immobilization in lower limb using two bandage and casting.
In the present cross-sectional study, 100 children with hemiplegic and diplegia cerebral palsy, aged 7-12 years old, with indications for surgery, were randomly selected and evaluated using Gross Motor Function Questionnaire (GMFM66). The children underwent surgery using two methods of bandages and casting according to an orthopedic surgeon's opinion. Then, based on the type of immobility used, two groups of 40 were randomly selected. In the first and the third month after the surgery, both groups were evaluated using GMFM66 questionnaire. To compare the two groups, ANOVA and nonparametric Mann-Whithney tests were used.
The mean ratio of gross motor function Based on Gross Motor Function Measure (GMFM66) changes in the first month after surgery was 0.0019 in the cases with bandage. The change was not statistically significant (P=0.42). Because in the first month of the child's leg in plaster, in casting group, the mean ratio changes of gross motor function was not measured. Three months after surgery, the mean ratio changes of gross motor function in both methods of casting and bandage after surgery increased significantly (P In the first month after surgery in bandaged group, children had mobility, but in the casting group, children were immobile. In the third month after surgery, improvement was observed in both methods and statistical results were similar in both groups.

Stroke is one of the most common neurological disease and it is the main cause of physical and mental disability and staying in house. Gait difficulties have high incidence in patients with stroke. So the aim of this study was to investigate the effect of gait retraining on balance, activities of daily living, quality of life and depressionin stroke patients.
This study was a clinical trial without control group. Sampling was performed by convenience sampling method and 18 patients participated. After recording demographic data, Berg Balance Scale, Barthel Index, SF36 questionnaire and Beck Depression Inventory-II used in pre-test and post-test to assess balance, activities of daily living, quality of life and depression, respectively.Data were analyzed using Pearson correlation coefficient and paired T-test.
The results showed statistically significant correlation in pre-test and difference between mean score of the all instruments before and after the intervention.
According to high prevalence of gait difficulties in stroke patients, it seems interventions in this area is necessary. Statistical results showed that the gait retraining intervention may have a positive effect on improving balance, activities of daily living, quality of life and depression of these patients. According to lack of information in this area, further research is needed.

Developmental dysplasia of the hip (DDH) increases the risk of secondary degenerative changes and subsequent total hip arthroplasty. The postoperative quality of life in patients with DDH who have been born and grown with this disability and adapted to it during the life, is one of the most challenging issues. This study aimed to compare the quality of life of patients with DDH before and after total hip arthroplasty (THA) operation.
This research has a quasi-experimental/interventional design. A group of 20 patients with DDH, who underwent THA operation in Akhtar and Shafaya Hyaiyan hospitals, were evaluated before operation and 6 months after it using SF36 quality of life questionnaire.
Findings showed significant improvement in all SF-36 subscales scores, including physical function, role physical, role emotional, vitality, mental health, social function, bodily pain, general function, and general health as well as total score (P=0.002). SF-36 mean(SD) scores before and after surgery was 27.41(22.75) and 79.12(28.03), respectively.
THA operation improves the quality of life of patients with DDH

Knee osteoarthritis (OA) is believed to be an important risk factor for falling. Total knee replacement (TKR) is a commonly used choice when other methods are not satisfactory. Proprioception impairment, risk of falling and balance disorder are within the main complications of this method. While multiple protocols have been suggested for TKR, efficacy of early isotonic exercise therapy aimed at improving body balance after TKR has not been thoroughly investigated. In this quasi-experimental study, ten female patients with severe OA, sampled by nonrandomized convenient method were randomly assigned into either “routine”or “early isotonic exercise” groups. The subjects were undergone TKR surgery. The rehabilitation process (being the same for both groups until the second week) was initiated the day after surgery and lasted for 6 weeks. From the second week, the experimental group received progressive, isotonic exercises, in addition to the routine rehabilitation protocol. Static balance was assessed prior to surgery and after the rehabilitation process in both groups by Sharpened Romberg tests. In both groups, static balance was significantly enhanced after surgery and rehabilitation (P<0.000). Prior to surgery the groups were indifferent according to their static balance scores (P=0.423) but, after surgery and rehabilitation, the patients receiving early isotonic exercise in addition to routine physical therapy, were significantly in better balance condition comparing the control group (P=0.000). Routine physical therapy with and without early isotonic exercise therapy enhances static balance but, the balance improvement was more pronounced with this type of exercise. Early administration of isotonic exercise therapy in addition to the routine physical therapy program may enhance balance and prevent fall in patients with TKR.

Sensory defects are common complications of a stroke. It has a major role in the proper activity of daily living. The aim of this study was to investigate the effect of Sensory-Motor Training on Recovery of basic and instrumental activity of daily living in chronic stroke patients. In this quasi-experimental 12 stroke patients (n = 6، right hemiparesis، left hemiparesis 6 patients) with a mean time of disease 41. 50 months were selected. Patients were trained with sensory-motor exercies for two consecutive weeks and 5 days a week، 90 minutes per session. Before and after the intervention the patients were evaluated by Barthel Index، Instrumental Activity of Daily Living Lawton version، Functional Independence Measure (FIM). The mean Barthel Index scores at pre-and post-test (p = 0. 007)، the mean scores of pre-and post-test with a significance level Lawton version (p = 0. 003)، the mean scores the Functional Independence Measure indicators before and after the test showed significance differnces (p=0. 002). No significant difference in the Barthel Index and Lawton version before and after treatment were seen. Also، the mean of the three tests showed a significant improvement. It seems that the sensory motor training could be an effective intervention in the rehabilitation of stroke patients، although further studies with larger sample sizes are needed.

Total Knee Replacement (TKR) is the treatment of choice for severe osteoarthritis with acceptable outcomes regarding pain management, function and quality of life enhancement. Because many patients require TKR procedure for their both knees, there has always been a challenge in the choice of simultaneous or consecutive operations. The aim of the present study was to compare the two protocols based on functional capabilities of patients with osteoarthritis (OA). In this quasi-experimental study, twenty five severe patients with OA candidates for bilateral TKR (sampled by simple convenient method) were assigned into unilateral (3 men, 9 women) and bilateral (3 men, 10 women) groups based on the preference of the patients for the surgery procedure. Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to evaluate functional capabilities of the patients prior to and 6 weeks after the operation and rehabilitation program. Repeated measures analysis of variance was used for the statistical analysis by SPSS 21 software. The findings indicated that the KOOS scores of the 2 groups were not significantly different before or after the interventions. Besides, patients in both groups showed significant improvement after TKR and the following rehabilitation program (P<0.01 for both groups and all KOOS subscales). TKR and the post-operative rehabilitation program could significantly enhance function of the severe OA patients but no priority for either unilateral or simultaneous bilateral methods was recognized.