khadijeh otadi

Myofascial pain syndrome is a common musculoskeletal injury, especially among athletes, typically treated with symptomatic invasive and non-invasive methods. This study compares the effects of massage guns and radial extracorporeal shock wave therapies on myofascial pain syndrome symptoms in amateur athletes.

In this clinical trial, 45 amateur athletes (18-30 years old) were recruited, who were randomly assigned to 15-member groups of shock wave, massage gun, and control (routine treatment included electrotherapy and stretching, which was applied on three groups). After initial evaluations of the pain intensity, pain pressure threshold (PPT), isometric muscle strength, and range of motion (ROM), the patients received single-session treatment and were immediately reassessed.

The results showed pain relief and improved PPT following shock wave plus routine treatment (P=0.03). The control group had less pain, while pain intensity and PPT did not change. The variables were not significantly different between the groups (P=0.12). Shock wave along with routine treatment increased plantar flexion ROM (P=0.00), unlike the massage gun. Additionally, dorsiflexion ROM (P=0.63) and maximal isometric gastrocnemius muscle strength (P=0.95) remained unchanged in all groups.

One session of massage gun therapy immediately reduced gastrocnemius muscle pain, while it failed to change PPT, maximal isometric gastrocnemius muscle strength, or dorsiflexion and plantar flexion ROM. However, shock wave therapy immediately increased plantar flexion ROM and PPT, and reduced pain intensity. These modalities led to limited changes, suggesting the need for repeated sessions and supplementary treatments.

Subacromial Pain Syndrome (SAPS) is one of the most common causes of shoulder pain, leading to long-lasting disability if left untreated or if there is no access to a rehabilitation center. Treating musculoskeletal shoulder pain is challenging; however, evidence suggests that a combination of Exercise Therapy (ET) and Manual Therapy (MT) can be an effective approach for addressing shoulder dysfunctions. To ensure timely treatment and prevent the pain from becoming chronic, tele-physical therapy appears to be an effective method for properly delivering ET and MT
A prospective, assessor-blind, randomized controlled clinical trial study protocol
include 33 patients with Subacromial Pain Syndrome (SAPS). These patients will be divided into three groups (11 participants in each group): the Control group (supervised Exercise Therapy (ET) + Manual Therapy (MT)), the Videoconferencing group (ET + self-release therapy), and the Video-based group (ET + self-release therapy). Self-release therapies include self-joint mobilization and self-myofascial release with a tennis ball. MT includes joint mobilization techniques and transverse friction massages. ET consists of stretching and strengthening exercises. Each patient in the three groups will receive 10 sessions of ET and MT over three weeks. Assessments will be conducted three times: at baseline, midterm, and post-treatment. The Visual Analogue Scale, function by the Shoulder Pain and Disability Index, and Range of Motion will measure pain. The Telehealth Satisfaction Scale and Physical Therapy Patient Satisfaction Questionnaire will also be assessed.
Repeated measures ANOVA will be used for analysis of data after data gathering
This trial will focus on the assessment of tele-physical therapy based on ET and myofascial release, in comparison to a face-to-face approach with supervised ET and MT, on pain, function, Range of Motion, and patient satisfaction.

COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus hurts patients’ respiratory health by necessitating oxygen therapy. The affected patients with COVID-19 experience anxiety and stress with quality of life (QoL) impacted due to frequent medication, hospitalizations, fear of dying, and isolation. In individuals with respiratory problems, physiotherapy is useful in improving oxygenation, stress reduction, and QoL. Therefore, our goal was to assess how physiotherapy management affected the oxygenation rates and QoL of hospitalized COVID-19 patients.

The study included 60 hospitalized cases of COVID-19 pneumonia (25–65 years) admitted to the RCU/Al-Hussein teaching hospital. The oxygenation rate was recorded by hospital monitoring. A physiotherapy management prepared according to the pulmonary rehabilitation recommendations for COVID-19 patients. QoL was assessed by the Arabian version of the short-form health survey questionnaire (SF-36) at baseline, at discharge, and 1 month after discharge.

The mean baseline oxygenation percent was 86.10±12.93. The baseline QoL score was 29.14±18.52. A significant increase (P<0.0001) in oxygenation (by 10.22%) was observed at discharge as compared to the baseline values. The QoL was significantly higher (P<0.0001) at 1-month post-discharge as compared to the baseline and the values at discharge (by 157.76%). Similar effects were observed in males and females.

A short-term course of physiotherapy management was effective in increasing the oxygenation rates and QoL in hospitalized male and female COVID-19 patients. A combination of breathing exercises, early mobilization, and positioning can act as an adjuvant in the clinical management of COVID-19 patients.

Forward head posture (FHP) is one of the most common positional deviations. Frequent users often exhibit incorrect posture because of the rising popularity of media devices, such as smartphones and computers. This posture leads to changes in muscle activity in cervical flexion and extension. It is defined by hyperextension of the upper cervical vertebrae and forward translation of the cervical vertebrae. This study evaluates the effect of dry needles as a new method in the upper trapezius muscle on the neck’s angles and range of motion (ROM) in individuals with FHP.

In this quasi-experimental interventional study, 18 women with FHP underwent a dry needle session. The photogrammetry of the cranio-vertebral angle measured the degree of FHP. Visual analog scale (VAS), pain pressure threshold (PPT), cranio-vertebral angle (CVA) and cranio-horizontal angles (CHA), ROM, scapular index (SI), and forward shoulder translation (FST) were assessed before and after the intervention.

The results demonstrated that after the intervention, right and left PPT, flexion, and proper neck rotation, right and left SI, CVA, and CHA were significantly improved (P<0.05).

The results showed that one session of dry needling with stretching exercises intervention could improve PPT, ROM, SI, CVA, and CHA and consequently improve FHP.

Carpal tunnel syndrome (CTS) is a common peripheral entrapment neuropathy with squeezing of the median nerve and the patient is unable to function properly. There are different physiotherapy interventions for the management of these patients and recently, shock wave therapy and low-power laser (LPL) have been widely used, but there is no strong evidence comparing the effect of shock wave therapy and LLLT. Therefore, this trial was designed to compare the effect of extracorporeal shock wave therapy (ESWT), LPL, and routine interventions on clinical outcomes and electrophysiological parameters in patients with moderate CTS.

Fifty-four patients were randomly assigned to the control (routine interventions), ESWT, and LPL therapy groups. All participants received transcutaneous electrical nerve stimulation (TENS) therapeutic ultrasound, hot pack, mobilization, and stretching for ten sessions over two weeks. Additionally, the ESWT group received radial ESWT in four sessions, and the LPL therapy group received laser in ten sessions. The primary outcomes were pain (assessed by the visual analog scale), function (assessed using the Boston questionnaire (BQ)), hand grip, and finger pinch strength. Secondary outcomes were electrophysiological parameters (distal motor and sensory latency and nerve conduction velocity (NCV) of the median nerve. 

Time group interactions were significant for pain, the symptom severity subscale of BQ, finger pinch, and hand grip strength (p<0.001). Significant improvements were seen in clinical and sensory latency and motor NCV of the median nerve (p<0.05). The ESWT group experienced significant improvements with a large effect size in pain, function, and finger pinch strength compared to the control group (p<0.01). Additionally, the LPL therapy group showed significant changes in the function and finger pinch and hand grip strength compared to the control group. There were no significant differences between the LPL therapy and ESWT groups except for pain in favor of the ESWT group. No significant differences were found among the three groups in electrophysiological parameters (p>0.05).

Although laser therapy increased the efficacy of routine interventions, it seems adding ESWT to the routine treatment may be superior for the management of moderate CTS patients.

The Objective Ankle sprains are among the most common injuries in athletes. One of the limitations of people with chronic ankle instability is the lack of postural control. Balance and coordination training are among the most common interventions for people with chronic ankle instability. Therefore, the aim of this study was to investigate the effect of balance training on postural control in athletes with chronic ankle instability.

Randomized clinical trials (RCTs) that examined the effects of balance training on postural control in athletes with chronic ankle instability were searched through the Scopus, PubMed, Cochrane and PEDro databases using keywords and concepts of postural control, balance training, and ankle instability from inception until April 2022. The quality of studies was assessed using the PEDro scale.

Eight RCTs were included in this study, based on inclusion and exclusion criteria. Balance exercises reduced postural sway, decreased the distribution of center of mass, improved the overall body balance index and anterior-posterior balance index in the Biodex balance system, increased the duration of balance maintenance, and reduced the number of errors in the foot lift test when checking static postural control, and improved the reaching distance in the star balance test when checking dynamic postural control.

Four to six weeks of balance training can improve postural control in both static and dynamic situations in athletes with chronic ankle instability.

Although carpal tunnel syndrome (CTS) is an incident entrapment neuropathy disorder, there has been inadequate evidence about the effect evaluation of adding low-level laser therapy to ultrasound (US) plus median nerve glide exercises in these patients. Hence, this research investigated the trace of US plus median nerve glide exercises with and without low-level laser therapy (LLLT).

Thirty-six patients with moderate CTS in two groups of intervention were assessed. One group received 10 sessions of adding LLLT to median nerve glide exercises plus US and the other group received median nerve glide exercises plus US without LLLT. Outcome measures were hand grip strength (HGS), visual analogue scale (VAS), Boston questionnaire (BQ), and cross-sectional area (CSA) of the median nerve.

Baseline analysis revealed similarities between the two groups in all parameters. Statistical analysis indicated significant improvement of HGS, VAS, BQ, and CSA of the median nerve in two groups of intervention.

In patients with CTS, US and median nerve glide exercises with and without LLLT significantly improved without the superiority of adding LLLT to mentioned treatment.

This study aimed to investigate the satisfaction rate of patients referred to Bahrami Hospital, Tehran City, Iran, by telerehabilitation and hands-on provision during the COVID-19 pandemic.

Six pediatric patients with torticollis’ disorders, Erb’s palsy, and muscle weakness were referred to Bahrami Hospital. All those subjects were assessed and advised with different exercises and interventions, and then the rest session followed with the online managing with videos or WhatsApp consultation. Then satisfaction rate of the patients was evaluated based on a Likert-type scale.

The patients revealed low satisfaction for alone telerehabilitation. However, all patients preferred to combine teleconsultation and hands-on rehabilitation. Of course, they were all satisfied with telerehabilitation.

It seems that most patients are afraid of the inability to perform accurate exercises and prefer to come on face-to-face rehabilitation, sometimes used in addition to telerehabilitation and teleconsultation.

Osteoarthritis (OA) is a common disease without definite and exact treatment. Interventions such as chemical drugs, physiotherapy, and even surgery are suggested for treatment. Herbal medicine, which is currently very popular, has also been suggested for treatment because of fewer side effects, low cost, and the possibility to use it topically home. Satureja khuzestanica jamzad, the native plant of Lorestan and Khuzestan, is known for its analgesic effects.

We aimed to compare the effect of Satureja khuzestanica jamzad 3% ointment with piroxicam gel for pain relief in patients with knee osteoarthritis.

70 patients with mild to moderate knee OA were randomly divided into experimental groups (essential oil extract of Satureja khuzestanica jamzad 3% or piroxicam gel). The severity of pain was recorded at baseline, and after one and two weeks by visual analogue scale. ANOVA was used for data analysis and the effect size was computed by Cohen’s d.

Reduction of pain was seen in both groups and group comparisons also showed a significant difference (P<0.05). The more effect size was detected in the group receiving Satureja khuzestanica jamzad 3% ointment compared with the piroxicam group.

The topical use of Satureja khuzestanica jamzad 3% essential oil is a good choice to reduce pain in patients with knee OA. It may be used as a drug in phonophoresis

This study aimed to investigate the foot function, range of motion, plantar pressure, and plantar contact area in the distance runners with normal, pronated, highly-pronated, supinated, and highly-supinated foot posture groups during static standing.

In this comparative cross-sectional study, a total of 75 distance runners were divided into 5 groups using the foot posture index. The foot function and knee and foot range of motion were assessed using the Foot And Ankle Ability Measure questionnaire (FAAM) and the goniometer, respectively. The mean of the plantar pressure percentage and the mean of the contact area on the forefoot and rearfoot were investigated during static standing. One-way ANOVA was used to compare the outcomes between the groups.

Among the groups, the normal foot group showed the highest scores in the activities of daily living subscale and sport subscale. Compared with the other groups, the highly-pronated foot group had a significantly greater range of motion in the ankle plantar flexion (P<0.002), and the normal foot group showed more range of motion in the first metatarsophalangeal extension (P<0.0001). In all groups, the mean plantar pressure percentage on the rearfoot was greater than the mean plantar pressure percentage on the forefoot. Of the groups, the highly-supinated foot group showed the highest plantar pressure percentage on the rearfoot (P<0.0001). However, the highly-pronated foot group showed the highest plantar pressure percentage and the largest contact area on the forefoot (P<0.0001) and the rearfoot (P>0.0001), respectively.

Based on the results of this study, the foot posture is an important option that could affect function and range of motion of foot and ankle and distribution of the plantar pressure and plantar contact area.

Studies have shown that 75% of men and 35% of women over the age of 10 have hamstring tightness. Hamstring tightness is one of the major causes of hamstring injury and loss of function. Dry needling which is a common intervention used by physiotherapists for the treatment of common various conditions can improve hamstring flexibility in less time than other interventions. So, the present study aimed to investigate the effect of dry needling on flexibility and electrophysiological indices in healthy men with hamstring tightness.

In this two-way blind clinical trial with a control group, which was performed from November 2018 to February 2019 in the laboratory of the Faculty of Rehabilitation of Tehran University of Medical Sciences, 30 healthy men with hamstring tightness were randomly divided into two groups of dry needling (n=15) and sham needle (n=15). In both groups, dry needling and sham needle, three points of hamstring muscle were needled, each point for one minute during a single session. Outcome measures included flexibility based on passive knee extension test, H-reflex latency, and motor neuron excitability, which were measured three times: before the intervention, immediately after the intervention, and one week after the intervention.

The results revealed that the mean of passive knee extension test (P=0.54), the mean delay time of H-reflex (P=0.84) and the mean of excitability of the motor neuron (P=0.41) didn’t have significant different between two groups after intervention.

The findings of this study showed that dry needling had no effect on hamstring flexibility and electrophysiological indices recorded in the soleus muscle of healthy individuals with hamstring tightness.

This review article aims at finding papers comparing conventional treatment with new interventions in females affected with stress urinary incontinence (SUI). Therefore, we selected papers with exercise therapy and electrical stimulation (ES) compared with vibration therapy.

We searched PubMed, Scopus, Ovid, and Springer for the papers published in English and the field of human-study registered from 2009 to 2019. The articles should be about pelvic floor muscle training (PFMT), electrical stimulation (ES), and new intervention like vibration in the treatment of SUI.

We managed to identify 1276 articles on this topic. After deleting duplicate articles, we chose 22 of them. Based on the inclusion criteria, only 7 articles were finally included in this review article. PFMT and ES are conventional treatments, but some studies have focused on the efficiency of new modalities, such as vibration in the treatment of SUI.

Based on our review, new intervention (vibration) has superior effects over ES and PFMT in the treatment of SUI; however, ES and PFMT are the first line of therapy.

Dry Needling (DN) is a procedure to treat neuromusculoskeletal disorders. This study aimed to examine the effects of DN on quadriceps muscle fatigue in healthy young adults.

Fifteen healthy young subjects (13 male, 2 female; mean±standard deviation 26.1±5.9 years) participated in a pretest-posttest study. Subjects received one session of DN for a total of 3 minutes with one minute each for the vastus medialis, vastus lateralis, and rectus femoris muscles. The Isometric Peak Torque (IPT), Single Leg Hop (SLH) test, and Y Balance Test (YBT) were measured at baseline, immediately after completion of the fatigue protocol, and after DN.

Repeated measures ANOVA demonstrated significant improvements in the IPT, SLH, and YBT scores after DN. Effects sizes were medium for IPT (d =0.61) and SLH test (d=0.57), and large for YBT (d=0.7).

Dry needling had a significant effect on recovery of quadriceps muscle fatigue, functional performance, and dynamic balance. These findings suggest that DN can be utilized as a novel recovery strategy to manage muscle fatigue. Further research is warranted.

Physical exercise acts as a mechanical stressor that can provoke biochemical alterations. Accordingly, muscular effort is able to modify blood concentrations in some cellular enzymes. Cupping is one of the traditional methods used to restore and revive the balance of the budy. This study aimed to evaluate the impact of cupping and a practice session on the level of some liver enzymes in men handball team members of Zahedan city, Iran. The participants were all the members of the Zahedan men handball team with the mean age of 23.66 ± 5.86 years, mean height of 177.19 ± 4.58 cm, mean weight of 80.12 ± 12.58 kg and mean body mass index (BMI) of 24.53 ± 3.60 kg/m2. All the team members, as the samples, were chosen via voluntary sampling method on a voluntary basis. They were randomly positioned into two groups of training (n = 12) and cupping (n = 10). Serum concentrations of creatine kinase (CK) and lactate dehydrogenase (LDH) were measured before and immediately and 24 hours after the training and cupping using the enzyme-linked immunosorbent assay (ELISA) methods. Data were analyzed using independent-t test and multi variety. There was a significant difference between the average concentration of the enzymes in before, next, and 24 hours after the test. According to the results of this study, the exercise and cupping caused muscle damage and increased the damage markers in blood

Constraint-induced movement therapy (CIMT) forces the use of the affected side by restraining the unaffected side. The purpose of this article is to explore the changes of motor and functional performance after modified CIMT (mCIMT) in comparison with traditional rehabilitation (TR) in chronic post-stroke patients.
Material and A total of 12 patients randomly assigned into two treatment groups. Six patients in the mCIMT group received intensive training in a more affected limb for 2 hours daily, 5 days/week using shaping method over a period of 21 days. Participants less affected limb were restrained in arm - hand splint with a target of wearing it for 5 hours daily. The patients in TR group received bimanual and unilateral activities, stretching, strengthening and coordination exercises of the impaired side, tone modification and coordination exercises of the affected side. The focus was to increase independence in activities of daily living activities using affected side. The motor activity log (MAL), wolf motor function test (WMFT), and modified ashworth scale were measured at pre-test (1 day before training), post- test (1 day after training) and follow-up in 3 weeks after training.
The Friedman test found significant differences between pre-test, post-test, and follow-up in MAL and WMFT in mCIMT group. Furthermore, mCIMT group showed significant decreased spasticity (P = 0.030) that measured by ash worth scale. The effect sizes between post-test and pre-test in the above-mentioned outcome measures were moderate to large in mCIMT, ranging from 0.3 to 0.76, but in TR group the effect size were small, ranging from 0 to 0.2.
Therefore, it seems that the mCIMT treatment was more effective than TR in improving some parameters.

Having a proper posture is one the aspects of good health which has important role in activity of daily living and sport skills. Spine abnormality is the most prevalent disorder and hyperkyphosis is more propagated one. The purpose of present study was to compare the effect of conventional corrective exercise and physioball exercise on improvement hyperkyphosis and vital capacity in girl students.
44 girl students (13±0.83 age) with the hyperkyphosis were participated in this study. Participants did not have any history of surgery, trauma or pain in their limbs. In pre-test and post-test, curvature of the back measured by a flexible ruler and vital capacity measured by a digital spirometer.
Students in terms of the curvature of the back were divided in to three subgroups of experimental 1 (Corrective exercises physioball), experimental 2 (conventional corrective exercise), and the control group (did not participated in any exercise program). The training program was done eight weeks, 3 times per week.
The result of ANOVA showed that there are significant differences between pre-test and post-test. The results of Tokey showed that there are significant differences between both experimental groups compare to control group in hyper kyphosis and vital capacity in post-test. However there is not different between 1 and 2 experimental groups (P≥0/05).
Performance training with physioball and without physioball are useful for improvement of hyperkyphosis and vital capacity in young female students. There is not different between two groups.

The calculated parameters of the center of pressure (COP) are suitable indicators for evaluating balance in patients after rehabilitation. Therefore، determining the reliability level of each parameter is a matter of great importance. This study tried to determine the reliability of some parameters of the COP sway in patients with myofascial neck pain in different postural situations. The present study is a test-retest reliability design. Twenty patients with myofascial neck pain performed a single and a double leg test with open and closed eyes on a force plate and with open eyes on foam in three sessions with a 30 minute intervals for 30 seconds. Antero-posterior and medio-lateral sway range، mean velocity and mean area of sway were calculated. The mean velocity showed high reliability (0. 98) in all situations، but the other parameters were variable in different situations. The results showed that some COP parameters are highly reliable in assessment of patients with myofascial neck pain.

Neck pain is one of the common diseases (66.7%), which contains different age's groups such as youn. Results of researches indicate prevalence of women neck pain is higher than men, so experiment in neck disease in female is more necessary. The aim of this study is to evaluate changes of postural stability in patient with muscular neck pain.

Twenty patients and fifteen healthy subjects contribute in this study. Postural sway in quiet standing was assessed in both limb stance (BLS), one limb stance (OLS) of dominant side, on a force platform with open eyes (rigid-open); and standing on a force platform with closed eyes (rigid-closed); and standing on the foam (10.5 cm-thick) with open eyes (foam-open) without shoes. All of above conditions were done with dual task. Mean changes of logarithmic displacement in medial-lateral and for- aft directions were calculated.

There are significant differences between two groups, especially following dual task, and difficult conditions of OLS and standing on the foam.

Patients with neck pain have difficultly in postural control that need to attending in treatment and prevention of following damages.