ramin kordi

Non-specific chronic low back pain (CLBP) is a common painful condition and is responsible for different physical disorders. Despite alternative therapies, patients still suffer from persistent pain. Repetitive transcranial magnetic stimulation (rTMS) has provided much evidence of pain reduction, but results have not been examined deeply in CLBP symptoms.

The analgesic effect of rTMS in non-specific CLBP patients was evaluated by the amplitude of low-frequency fluctuation (ALFF) analysis in resting-state fMRI.

In this experimental study, fifteen non-specific CLBP participants (46.87±10.89 years) received 20 Hz rTMS over the motor cortex. The pain intensity and brain functional scan were obtained during pre and post-stimulation for all participants. The ALFF maps of the brain in two scan sessions were identified and the percentage of pain reduction (PPR%) was determined using paired t-test. Also, correlation analysis was used to find a relationship between ALFFs and pain intensity.

Pain intensity was significantly reduced after induced-rTMS in non-specific CLBP (36.22%±13.28, P<0.05). Positive correlation was found between ALFF in the insula (INS) and pain intensity (rpre-rTMS=0.59, rpost-rTMS=0.58) while ALFF in medial prefrontal cortex (mPFC) and pain intensity had negatively correlated (rpre-rTMS=-0.54, rpost-rTMS=-0.56) (P<0.05). ALFF increased in mPFC while INS, thalamus (THA), and supplementary motor area (SMA) showed decremental ALFF followed by rTMS. 

This study demonstrated that ALFF in INS, THA, mPFC, and SMA is associated with CLBP symptoms and analgesic effects of rTMS. ALFF potentially seems to be a proper objective neuroimaging parameter to link spontaneous brain activity with pain intensity in non-specific CLBP patients.

Built environment determinants of engaging in physical activity are dependent on the properties of societies. This study investigates the relationship between structural variables of the environment using geographic information systems (GIS) and the level of physical activity in 22 districts of Tehran.

This cross‑sectional study was based on Urban Health Equity Assessment and Response Tool (Urban HEART‑2). Physical activity level was assessed via the Global Physical Activity Questionnaire (GPAQ). The characteristics of the neighborhood environment, including land use, street pattern, population density, and traffic, were determined via ArcGIS software. Walkability index (population density, street pattern, land use) was calculated to assess the effect of the main variables of living environment on physical activity level.

Among the built environmental variables, land use was associated with the total physical activity and travel‑related physical activity level (r: 0.155, P value: 0.001, and r: 0.122, P value: 0.007, respectively). The walkability index indicated an association with the total physical activity level and travel‑related physical activity level (r: 0.126, P value: 0.006, and r: 0.135, P value: 0.001, respectively). Higher levels of the walkability index were associated with an improved level of physical activity (OR: 2.04).

Walkability index and land use positively correlate with total physical activity level, and providing action plans that improve walkability index and land use might lead to increased physical activity level.

Chronic pain is a serious secondary problem for many individuals with disabilities.

A total of 231 disabled athletes invited to compete in a multi-sport national sports tournament for para-athletes in Ahvaz, Iran, participated in the study to be investigated whether spinal pain (SP) prevalence and characteristics are different among different sports and disabilities. Athletes’ demographic information, SP prevalence, characteristics, and disability using the athlete disability index questionnaire were obtained. SP prevalence, characteristics, and factors affecting SP intensity and disability caused by low back pain (LBP) were determined as primary outcome measures before data collection.

The mean (95% confidence intervals) disability percentage and LBP intensity score were 22.2% (19.2-25.3) and 2.14(1.84-2.47) of 10, respectively. The highest LBP intensity was among physical fitness participants and patients with spinal lesions. Weightlifting athletes and athletes with arm movement limitations had the highest disability. The mean (95% confidence intervals) neck pain intensity score was 2.16(1.80-2.54).

A high prevalence of SP was observed among most disabilities and sports. Although its intensity is rarely severe among a population of any disability or sports, it is undeniably disabling among the vulnerable population of para-athletes.

Nowadays, the largest part of the world's population in all age groups is burdened with the non-specific chronic low back pain (NS-CLBP), as a serious health condition, which might develop from a pool of bio psychosocial (BPS) factors. Against this background, the present study initially aimed to design some interventions, and then deliberate their effectiveness with reference to the BPS Model (BPSM), to relieve LBP and its resultant disabilities among students.

This study was a two-group pretest-posttest randomized clinical trial (RCT).

This study was conducted on the statistical population of the female students enrolled at the first-stage secondary school in the city of Hamadan, Iran. Applying cluster sampling, 200 students were accordingly selected, and then randomized into two groups, viz. intervention and control. The primary evaluation was also performed by the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), the 12-item Short Form Survey (SF-12), the International Physical Activity Questionnaire-Short Form (IPAQ-S), the World Health Organization Disability Assessment Schedule (WHODAS), and the Visual Analogue Scale (VAS). Upon developing and implementing the BPSM-based interventions for 10 weekly two-hour sessions, the secondary evaluation was fulfilled, and the extracted data were analyzed, using the IBM-SPSS Statistics (v.21) software package.

The independent-group t-test results revealed that the mean scores of quality of life (QoL) and physical activity significantly elevated in the intervention group, compared to those in the controls. As well, the mean value of disabilities, the amount of disorder in the lumbar region, and the VAS scores in the intervention group substantially declined, compared to those in the control one.

The significant variations in the BPS factors demonstrated that the development of some interventions based on the BPSM could help manage the NS-CLBP and its ensuing disabilities. Therefore, the BPSM-based interventions could be exploited to minimize the musculoskeletal disorders (MSDs) in students.

According to the importance of physical activity in the child’s physical and mental development and cognitive health, developing a valid, reliable, and comprehensive assessment tool for children’s physical activity is mandated. The purpose of this study is the translation, cross‑cultural adaptation, and validation of the Persian version of the Thailand Physical Activity Children Survey questionnaire to measure the level of physical activity in children aged between 6–9 years in Iran.

This study consisted of three stages, first, the questionnaire translation into Persian language and modification of the sections according to the Iranian culture, then the evaluation of the questionnaire via a pilot study, and finally, assessing the reliability and validity of the tool. Participants of the pilot study were 250 healthy children, aged 6 to 9 years, meeting eligibility criteria, recruited through a stratified cluster sampling method from schools across Tehran.

The Persian version of the questionnaire demonstrated an acceptable content validity (Content Validity Index between 0.88‑1). The test‑retest reliability reported the Intra‑Class Correlation coefficient in the acceptable range in all sections (between 0.71‑1). Cronbach’s alpha was reported 0.993, which indicated excellent internal consistency.

According to the acceptable validity and reliability of the Persian version of the Thailand Physical Activity Children Survey for children aged 6–9 years, it is recommended in research and surveillance studies to determine the level of physical activity of children of that age group in Iran.

 The internationalization of universities allows the exchange of knowledge, experiences, attitudes, and cultures across geographical borders, which leads to benefits such as visibility, human resource development, quality improvement and revenue generation for universities. Therefore, the assessment of universities is very important in terms of internationalization. The purpose of this study was to identify the indicators of internationalization assessment for medical universities in a logical framework.   

 The reporting of this scoping review conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review checklist (PRISMA- ScR).  Articles were retrieved through the search of related keywords in databases including Web of Science, PubMed, Scopus, Science Direct, and Google Scholar from January 2000 to October 2021 and by searching the references of retrieved articles. After applying the inclusion criteria, 36 papers were selected from a total of 1264. Data analysis is underpinned by the Ritchie and Spencer five-step framework.   

 102 indicators have been identified and organized in the framework of IPO, which has provided input, process and output indicators in the educational, research, and management dimensions. Most indicators have been classified in the “Education” dimension (n=40) which consists of 6 inputs, 14 processes and 20 Outputs. The “Research” dimension consists of 3 inputs, 9 processes and 12 Outputs, and the “Management” dimension consists of 13 inputs, 16 processes and 9 Outputs.    

 There is no single set of target indicators for the internationalization of all medical universities. Therefore, the selection of target indicators for medical universities to proceed toward internationalization depends on the strengths and weaknesses of universities in each dimension, as well as the feasibility of further ambition according to the national context. Also, the identified indicators are mainly in the four areas of facilities management, visibility, marketing, and networking.

The use of exoskeletons as a new ergonomics intervention to reduce musculoskeletal disorders risk factors and increase human performance has emerged in the fourth-generation industrial revolution. The aim of this study was to assess the cervical exoskeleton effect on the neck and shoulder muscles electrical activity.

In this experimental study, 14 male participants were asked to perform the simulated overhead work with and without using the cervical exoskeleton at two neck postural angles randomly. During the task, electromyography of the target muscles in the neck and shoulders was recorded. In addition, at the end of each task, participants completed a perceived discomfort questionnaire. Electromyographic signals were processed with Matlab 2017b software and the level of the electrical activity of the target muscles was normalized to the maximum muscle activity. Data analysis was performed using Random intercept mix model in STATA 14 software.

Mean perceived discomfort in the neck and shoulders regions significantly reduced by the exoskeleton device, but there was no statistically significant difference in other areas. Also, the mean activity level of sternocleidomastoid and splenius capitis muscles on the right and left was significantly decreased during the use of the cervical exoskeleton. However, this difference showed a significant increase in trapezius muscles.

The use of the neck exoskeleton was associated with a reduction of muscle electrical activity and the perceived discomfort in the neck area. These results may be related to transferring neck and head weight by the exoskeleton retaining jack during the neck extension to other areas of the body. The exoskeleton design did not provide support for the shoulder and arm area, which explains the reason for the non-significant results in the shoulder area. Using the exoskeleton with the additional support in shoulder area could be considered as an ergonomic intervention in such overhead works.

Considering the well-established benefits of physical activity in the health domain, the economy, and environment, physical activity programs should be considered as an important agenda in public health policymaking.

The objective of this qualitative study was to identify “Why the prevalence of physical inactivity has increased during the past decade in Iran, despite having various national physical activity documents? "using a Delphi technique.

The “Delphi technique” process in this study consisted of literature review, selecting the research question, selection and recruitment of panel members, pilot study and conduction of round one (using an open question), round 2 (using a 5-point Likert scale), and round three (final ranking).

Statements with the highest scores in round three were recognized as the most important causes of the decreased level of physical activity based on the experts’ responses in Iran.

The absence of executive support, coordination mechanisms, and appropriate infrastructure for conducting physical activity were the top challenges in improving the physical activity level in Iran.

We aimed to examine the validity and reliability of the empathy quotient (EQ) and systemizing quotient (SQ) in a Farsi-speaking population.
This study explores the factor structure and psychometric properties of the Farsi translations of the 22-item version of EQ and the 25-item version of SQ among 542 young university students.
Applying a cross-validation approach, a 14-item two-factor model and a 15-item four-factor model for the Farsi translations of the short versions of EQ and SQ, respectively, were extracted from the exploratory dataset using exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) on the validation dataset confirmed the factor structures identified by EFA. In addition, acceptable internal consistency and test-retest reliability were demonstrated for the Farsi translations of the 14-item two-factor EQ model and the 15-item four-factor SQ model.
The results suggested further evidence in favor of the multi-factorial constructs of the EQ and SQ and validity and reliability of the scales.

The aim of this study was to examine the incidence and patterns of primary exercise headache (PEH) in resistance trained male athletes. PEH is observed particularly during or after severe physical exercise and lasts up to 48 hours. While the focus of the literature has mainly been on the prevalence of PEH in the general population, few studies on athlete populations have been conducted so far. Therefore in a cohort study we examined the incidence and patterns of PEH in resistance trained athletes in an Iranian male sample.
A population of 116 resistance trained athletes, between 14 to 63 years old, was recruited. PEH was identified in the athletes according to a questionnaire based on the 3rd international classification of headache disorders. The athletes were followed up for six months on a monthly basis while the incidence, pattern and risk factors of PEH were evaluated in them in a precise manner.
The incidence of PEH in overall participants was evaluated 4.8 in 1000 hours exercise. The prevalence of headache during the follow-ups was 19.8% in which the highest headache incidence occurred in 20-30 years old athletes. PEH mainly occurred after sports and the quality of PEH was mainly a sudden (81%) pulsating (47%) headache which was felt mostly in the occipital region (39%). The incidence of PEH had a strong statistical correlation with having a history of PEH (odds: 3.8; 95% CI: 1.02 - 14.3).
Our study showed that incidence and prevalence of PEH in resistance trained athletes might be higher than general population. History of PEH was the main risk factor for developing PEH in resistance trained athletes.

It has been suggested that weakness and asymmetry of core stabilizing muscles have an important role in the development of scoliosis and its complications, especially low back pain. However there is insufficient data comparing symmetry and function of these muscles in scoliotic patients with the normal population. Also there are only a few studies assessing the relationship between the degree of spinal deviation and asymmetry of core stabilizing muscles. This study evaluates the thickness, symmetry, and activation of the external oblique (EO), the internal oblique (IO) and the transversus abdominis (TrA) muscles of patients with AIS and compares these data with a group of normal adolescents..
The objective of this observational study was to know the asymmetry pattern of lateral abdominal muscles at rest and during the abdominal drawing-in maneuver (ADiM) in adolescents with idiopathic scoliosis and to compare it with a group of healthy adolescents..
Twenty healthy adolescents and twenty patients with AIS, aged 10 to 18 years, were included. The thickness of lateral abdominal muscles was measured, using ultrasound, at the end of normal exhalation at rest and during the abdominal drawing-in maneuver (ADiM). Muscular activity was represented as absolute difference and percentage change in the muscle thickness during the ADiM compared with rest..
There was no side to side asymmetry in muscle thickness at rest and also during ADiM in two groups. Thickness of right EO [0.39 (0.09) in the AIS group compared to 0.51 (0.12) in the normal group] and left EO [0.38(0.10) in the AIS group compared to 0.50 (0.11) in the normal group] at rest was higher in the normal group (P The EO muscle was thinner and had higher activity during ADiM in the AIS group. Analysis of our data showed that in the AIS group the higher the lumbar spinal curve to the right, the thicker the right TrA compared to the left TrA..

Screening of psychosocial risk factors for chronic low back pain (LBP) is essential. The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) is one of the most recognized and widely used instruments for this purpose. This study aimed to translate the ÖMPSQ into Persian, to adapt it for Iranian culture, and to investigate its psychometric properties.
Using a linguistic methodology, the ÖMPSQ was translated into Persian according to the World Health Organization guideline. A total of 106 patients with LBP participated in the study. Internal consistency and test‑retest reliability were evaluated. Concurrent validity was estimated with Pearson’s correlation between the ÖMPSQ and short form health survey (SF‑12), Hospital Anxiety and Depression Scale (HADS), and visual analog scale (VAS). Factor analysis was used to evaluate dimensionality.
The content validity index was 0.80. The instrument had a good test‑retest reliability (intraclass correlation coefficient = 0.82) and internal consistency (Cronbach’s α =0.82). Factor analysis indicates that factorial structure of Persian version was similar to original questionnaire. There was a significant correlation (r = 0.252–0.639, P The Persian version of ÖMPSQ was as a valid and reliable instrument and also a good cross‑cultural equivalent for original English version.

Low back pain (LBP) is a common complaint amongst adolescent athletes. While different studies have shown association between LBP and trunk muscle thickness in the general population, few articles have studied it in adolescent athletes.
The aim of this study is to compare lateral abdominal muscle thickness and function, and cross sectional area (CSA) of lumbar multifidus (LM) in adolescent soccer players with and without LBP.
In total, 28 adolescent soccer players with and without LBP, from the premier league participated in this study. The thickness of external oblique, internal oblique and transversus abdominis and the CSA of the LM muscles at L4 level on both sides were measured at rest and contraction via ultrasound imaging (USI). In addition, leg length discrepancy, hamstring flexibility, active lumbar forward flexion, and isometric muscle endurance of trunk extensors were measured in both groups. (study design/setting: case control study).
The mean (SD) age in LBP group and non-LBP group were 14.0 (1.1) and 14.1 (0.9) years, respectively. There was no significant difference in baseline characteristics of participants between groups. Findings showed no significant difference between LBP and non-LBP groups comparing all measured variables.
The data obtained support that there is not a correlation between abdominal muscle thickness and CSA of the lumbar multifidi and LBP in adolescent soccer players. These findings suggest that other factors rather than the thickness of deep trunk muscles may play a more significant role in the etiology of LBP in adolescent soccer players.

This study aimed to examine the differences in the co-activation of the rectus femoris (RF) and biceps femoris (BF) using the co-contraction index (CI) in aquatic and land environments during a drop-landing task in active and non-active females.
In this casual-comparison study, 10 active and 10 non-active females volunteered to participate. The CI was calculated from recorded surface electromyographic (SEMG) activity of the RF and BF. To calculate CI, the amount of overlap between the linear envelopes of the agonist and antagonist muscles was found and divided by the number of data points. MathLab software (version 10) was used to process row data. Also, 2-way analysis of variance (ANOVA) assessed differences between groups and environments.
Results indicated that the CI was not affected by activity level in pre- and post-contact (P>0.05) while it was significantly higher (P Our findings show the differences in co-contraction of knee muscles between different environments. Our measure of co-contraction was lower in water compared to land, with no difference between the active and non-active groups. This may indicate that regardless of activity level, an aquatic environment may be an appropriate choice as an early phase in rehabilitation process.

Chronic pain has been estimated to affect between 2% - 40% of the adult population and its prevalence is increasing.. This study aimed to provide epidemiological data of chronic pain and associated factors in Tehran, capital of Iran..Patients and We analyzed the data of 23457 people, from the Urban HEART-2 (health equity assessment and response tool) study in Tehran, collected in October 2011, and determined the association between any type of chronic pain and other variables using multiple logistic regressions.. The prevalence of chronic pain among adults in Tehran City was 24%. Chronic low back pain and chronic knee pain were the most common complaints (12.4% and 11.2%, respectively). A significant difference was found in the prevalence of chronic pain between districts of Tehran (P < 0.001). Associated factors were different for different types of chronic pain, and anxiety and increasing age were identified as common risk factors associated with all types of chronic pain (P < 0.001).. The results of this study show a considerable prevalence of chronic pain among adults in Tehran. Therefore, it is necessary to pay more attention to different types of chronic pain by planners and policy makers..

Context: Low back pain (LBP) is among the most prevalent musculoskeletal conditions in the developed countries. It is a common problem causing disability and imposing a huge economic burden to individuals and state organizations. Imaging plays an important role in diagnosis of the etiology of LBP..Evidence Acquisition: The electronic databases included: PubMed (1950 to present), Ovid SP Medline (1950 to present) and ISI (1982 to present) and Google Scholar. In every search engine another search was performed using various permutations of the following keywords: ultrasonography, ultrasound imaging, low back pain, back muscles, paraspinal muscles, multifidus, transverse abdominis, muscle size, spinal canal, sacroiliac joint and spondylolisthesis.. Magnetic resonance imaging (MRI) is widely used in evaluation of patients with LBP; however, high costs, limited availability and contraindications for its use have restricted MRI utilization. In a quest for a less expensive and readily available tool to investigate LBP, clinicians and researchers found ultrasonography (US) as an alternative. In this review we discuss the US application in diagnosis of some common causes of non-specific chronic LBP. Discussed topics include evaluation of spinal canal diameter, paraspinal and transabdominal muscles, sacroiliac joint laxity, pregnancy related LBP, sacroiliitis, and spondylolisthesis using US in patients with LBP.. While the first researches on employing ultrasound in diagnosis of patients with LBP had been focused on spinal canal diameter, recent studies have been mostly performed to evaluate the role of transabdominal and paraspinal muscles on core stability and thereby LBP occurrence. On the other side, Doppler ultrasonography has recently played an important role in objective measurement of joint laxity as a common etiology for LBP. Doppler imaging also in pregnant patients with LBP has been recommended as a safe and sensitive method. As conclusion, according to recent and most prestigious studies, focusing more on transabdominal muscle thickness can be considered as future approach in investigations.

Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. Patients and We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. The findings of this study suggest that apart from non sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

Although the effect of Conjugated Linoleic Acids (CLAs) on blood pressure and body composition is revealed in several in vitro and animal studies، the results of human studies are controversial. The purpose of the current clinical double blind trial was to determine the effect of 2 months CLA supplementation on blood pressure and body composition of non trained healthy young male students. This randomized، double-blind، placebo-controlled clinical trial was conducted on 66 non trained healthy male students. Before and after eight weeks supplementation with 4´0. 8g. d-1 CLA or placebo (soybean oil)، lean body mass and fat mass were measured with BIA، trunk and visceral fat and waist circumference were measured with ViScan. Physical activity amount and dietary intake of participants were similar together، because they lived in dorms. Statistical analyses were performed using the SPSS16 software، the statistical tests being analysis of covariance، Independent sample t test، paired-sample t-test and Mann-Whitney U tests. CLA supplementation had no effect on blood pressure، lean body mass، body fat mass، trunk and visceral fat and waist circumference. These results show that CLA does not affect on body composition and blood pressure in non trained young male students.

Current evidence consistently confirm inequalities in health status among socioeconomic groups, gender,ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health of the population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural,educational, political or environmental problems. Measuring inequalities, improving daily living conditions, andtackling inequitable distribution of resources are highly recommended by international SDH commissioners in recentyears to ‘close the gaps within a generation’. To measure inequalities in socio-economic determinants and core healthindicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2)was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre). For ‘assessment’ part of the project, 65 indicators in six policy domains namely ‘physical and infrastructure’,‘human and social’, ‘economic’, ‘governance’, ‘health and nutrition’, and also ‘cultural’ domain were targetedeither through a population based survey or using routine system. Survey was conducted in a multistage random sampling,disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households (118000 individuals) were collected. For ‘response’ part of the project, widespread community based development (CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013. Following the first round of Urban HEART project in 2008, the second round was conducted to trackchanges over time, to institutionalize inequality assessment within the local government, to build up community participationin ‘assessment’ and ‘response’ parts of the project, and to implement appropriate and evidence-based actionsto reduce health inequalities within all neighborhoods of Tehran.

Prevalence of obesity and overweightness in different societies is increasing. Role of physical activity in weight loss and also prevention from some chronic diseases has been discussed previously. The objective of this study was to compare the effect of two different aerobic exercises (intermittent and continuous exercises) while prescribed with concurrent calorie-restrict diet on the weight loss and body fat of overweight and obese females. Fifteen individuals in intermittent group performed 40 min medium intensity exercise in 3 bouts per day for 5 days per week; the 15 participants of continuous group exercised a single 40 min bout per day, 5 days per week. Also, 15 participants were included in control group without exercise program. A self-monitoring calorie-restrict diet was recommended to all participants. The body fat percentage, waist circumference, and also skin fold thickness of all participants were assessed at baseline and 12th weeks. The reduction of weight and BMI of participants in intermittent group (-3.33 ± 1.80 and -1.34 ± 0.70, respectively) was significantly more than comparable changes in continuous group (-1.23 ± 1.60 and 0.49 ± 0.65, respectively) (P = 0.048 and 0.041, respectively). After the intervention, there was no significant difference between case and controls in terms of body fat percentage, waist circumference, and sum of skin fold thickness. It seems that medium intensity intermittent exercise for more than 150 min/ week is more efficient than continuous exercise in weight loss of obese and overweight women.