aliasghar jamehbozorgi
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Introduction
We evaluated the effect of electromyography biofeedback on proprioception and functional balance in healthy young athletes.
Materials and MethodsIn this clinical trial, 24 athletes were randomly divided into two study (n=12) and control (n=12) groups. The study group received rehabilitation exercises, including one-foot standing, squatted standing, and isometric contraction of quadriceps muscle at different knee angles, including 30, 45, and 90 degrees of knee flexion along with electromyography biofeedback. The control group received only rehabilitation exercises without electromyography biofeedback. Exercises were performed by both groups for a 4-week period in three sessions per week. Functional balance and proprioception before and after exercises were measured using the star excursion balance test and a system consisting of digital photography non-reflective markers, respectively. The data of the center of pressure and time of vertical ground reaction force using a force plate was also collected to evaluate static balance and dynamic balance, respectively.
ResultsThe absolute error in knee joint reconstruction for 30° (P=0.005), 45° (P=0.001), and 90° (P=0.033) angles significantly decreased after the intervention in the study group compared to the control group. Star excursion balance test scores in all directions did not show any significant differences between the two groups (P>0.05), except for the anterior-lateral direction (P=0.03). Moreover, all variables related to static and dynamic balance did not show a significant difference between two the groups after the interventions (P>0.05).
ConclusionThe electromyography biofeedback intervention can probably be used as a rehabilitation protocol in recovering and healing proprioception injuries resulting from sports injuries.
Keywords: Balance, Electromyographybiofeedback, Proprioception, Athletes, Rehabilitation -
Introduction
Immobility and limited usage of operated limbs lead to weakness and atrophy of the muscle after anterior cruciate ligament (ACL) reconstruction. However, training programs for preventing biomechanical risk factors such as lower limb alignment and increased muscular contraction are very limited. Thus, the current study was carried out to evaluate the recovery of quadriceps muscle strength and the improvement of knee function using adjuvant electromyographic biofeedback (EMG-BF) after ACL reconstruction.
MethodsThis prospective randomized controlled trial was conducted among 40 patients (20 = EMG-BF group, 20 = Control group) with ACL reconstruction, who were referred to Akhtar Hospital from 2021 to 2022. In the EMG-BF group, EMG BFB was added to the standard rehabilitation protocol, and in the control group, the standard rehabilitation protocol with full postoperative weight-bearing, knee brace (zero degree of extension, 90 degrees of flexion), and electrical stimulation with maximal voluntary isometric knee extension was performed. Each group was intervened for 4 weeks and three sessions of 30 minutes per week. It should be noted that each patient participated in 16 outpatient physiotherapy sessions after surgery. Nicholas Hand-Held Dynamometer (HHD) was used for measuring quadriceps strength, and Knee Outcome Survey-Activities of Daily Living (KOS-ADLs) and Knee Outcome Survey Sports Activities Scale (KOS-SAS) questionnaires were used for assessing the knee function.
ResultsFour weeks after the treatment, the EMG-BF group showed a significant increase in quadriceps strength (P = 0.0001). Quadriceps strength had a significant difference before and after 4 weeks of intervention (P = 0.0001), but in the control group, no significant difference was observed (P = 0.368). The EMG-BF group had a significant increase in KOS-ADLs and KOS-SAS scores after 4 weeks of intervention (P = 0.0001).
ConclusionIn our study, isometric strengthening of quadriceps with adjuvant EMG-BF significantly increased the strength of quadriceps and knee function during 4 weeks. EMG-BF is a low risk, low cost, and less invasive intervention and has high safety and adjustment ability. It is a valuable adjuvant method for achieving better functional recovery in a shorter time.
Keywords: Electromyographic biofeedback, Adjuvant method, Quadriceps strength, Rehabilitation, Anterior cruciate ligament reconstruction -
پیشزمینهانحراف به خارج شست پا، شایع ترین دفورمیتی پا می باشد و با تغییر راستای انگشتان و تغییر در مرکز فشار کف پا و قدرت تعادل فرد همراه است. هدف از این مطالعه، بررسی تاثیر کاربرد پدهای سیلیکونی بین انگشتی در وضعیت تعادلی و بیومکانیکی مبتلایان به این دفورمیتی بود.مواد و روش هامطالعه از نوع شبه تجربی بود و برروی 24 فرد مبتلا به انحراف به خارج شست پا در یک بیمارستان آموزشی تهران انجام شد. اطلاعات مربوط به نوسانات مرکز فشار کف پا، ازطریق صفحه نیروی BERTEC جمع آوری گردید. سنجش تعادل با دو آزمون TUG و FR انجام شد. نوسانات مرکز فشار در دو مرحله بدون استفاده از پد و با استفاده از پد به مدت 15 ثانیه بررسی گردید و متغیرهای جابه جایی مرکز فشاردر جهت جلویی پشتی، داخلی خارجی، طول مسیر طی شده مرکز فشار، سرعت جابه جایی مرکز فشار و سطح نوسان وضعیتی به دست آمد. داده ها با روش های آماری بررسی شدندیافته هااستفاده از پد بین انگشتی در جابه جایی مرکز فشار در جهت جلویی پشتی، داخلی خارجی، سطح نوسان وضعیتی، سرعت جابه جایی مرکز فشار و طول مسیر مرکز فشار تاثیر نداشت (p≥0/05)؛ اما نتایج آزمون های تعادلی را بهبود بخشید (p<0/05)نتیجه گیریاستفاده از پد بین انگشتی باعث تغییر در جابه جایی مرکز فشار کف پا و مقادیر سرعت، سطح نوسان وضعیتی و طول مسیر جابه جایی مرکز فشار کف پا دچار انحراف به خارج شست پا نمی شود، اما در بهبود نتیجه آزمون های تعادلی موثر است.کلید واژگان: هالوکس والگوس, پد بین انگشتی, آزمون تعادلی, طب سالمندی, پاBackgroundHallux valgus is one of the most prevalent deformities which causes changes in the center of pressure (COP) and standing balance. This paper looks at the mechanical changes of spacer pads used for such a deformity.MethodsIn this quasi experimental study, 24 people suffering from hallux valgus were reffered to a trainig hospital in Tehran, Iran. A Bertec force plate was used to collect data related to COP parameters. The balance tests of TUG and FR were used to evaluate the changes in balance. The tests were done without and with toe spacers in a 15 second period of time and the COP displacement in anteroposterior and mediolateral directions and also the path length of COP displacement, velocity of COP displacement and confidence ellipse of the COP were measured. The data were analyzed using statistical tests.ResultsUsing the toe spacers did not cause a significant change in displacement of COP in anteroposterior and mediolateral directions, confidence ellipse, velocity of COP displacement and the path length of COP displacement (p≥.05). But the change in the results of FR and TUG tests was significant (pConclusionsUsing the toe spacers in hallux valgus causes no significant changes in COP displacement, path length, velocity and confidence ellipse, but shows improvement in results of balance tests in elderly suffering from hallux valgus deformity.Keywords: Hallux valgus, Orthotic devices, balance test, Geriatrics, Foot
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هدفنشانگان درد ناحیه ای مزمن یکی از مهمترین و شاید بدخیم ترین اشکال مشکلات عصبی به خصوص در اندام فوقانی می باشد. تعیین تاثیر توانبخشی با تلفیق روش های فیزیوتراپی و کاردرمانی در درمان نشانگان درد ناحیه ای مزمن هدف این مطالعه بود.روش بررسیدر این مطالعه شبه تجربی که از نوع قبل و بعد می باشد، 20 بیمار مبتلا به نشانگان درد ناحیه ای مزمن (سی. آر. پی. اس. ) نوع یک با نمونه گیری ساده انتخاب و میزان درد، دامنه حرکتی، ادم و قدرت عضلانی آنها ثبت شد. سپس مداخلات درمانی که ترکیبی از مدالیته های فیزیوتراپی و کاردرمانی بود، طی 20 جلسه و یک روز در میان توسط یک گروه درمانگر انجام شد. پس از دوره درمانی بیماران مجدد ا بررسی شدند. داده ها با استفاده از آزمون آماری تی زوجی تحلیل شد.یافته هاپس از درمان مشاهده شد که میانگین میزان درد و ادم بیماران به طور معنا داری کاهش و دامنه حرکتی و قدرت گیرش به طور معناداری افزایش یافت(05/0 > پی).نتیجه گیریاجرای به موقع و تلفیق روش های فیزیوتراپی و کاردرمانی همزمان در بیماران مبتلا به نشانگان درد ناحیه ای مزمن نوع اول موجب کاهش درد و تورم و افزایش دامنه حرکتی مفاصل و قدرت گرفتن دست می شود.
کلید واژگان: نشانگان درد ناحیه ای مزمن, توانبخشی, کاردرمانی, فیزیوتراپیObjectiveChronic regional pain syndrome (CRPS) is one of the most important and worst types of peripheral nervous system, especially in upper extremity. The aim of this study was determination of the effect of a combined rehabilitation program in the treatment of patients with CRPS type I.Materials and MethodsIn this quasi-experimental and before-after study, 20 patients with chronic regional pain syndrome were selected simply and their pain, range of motion, edema and muscular strength were examined and recorded before intervention. Then, patients under went a combined treatment programs included some modalities from physical and occupation therapy. Patients attended at clinic for 20 therapeutic sessions with one day intervals. Finally, data were analyzed using paired–t test.ResultsPost operatively, pain and edema were decreased and range of motion and grip strength was increased significantly (P > 0.05).ConclusionCurrent study demonstrated that early and combined physical and occupational therapy efficient in the treatment of patients suffering from CRPS type I. This combined program can relieve pain and edema and increase ROM and grip strength.Keywords: Chronic regional pain syndrome, Rehabilitation, Occupational therapy, Physical therapy
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