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عضویت

جستجوی مقالات مرتبط با کلیدواژه « knee joint » در نشریات گروه « پزشکی »

  • Fatemeh Azizi, Zahra Raeisi*, Safoura Ghasemi
    Purpose

    This study aims to investigate the effects of an eight-week sensorimotor training (SMT) program with visual feedback (VF) on knee joint proprioception and alignment in women with dynamic knee valgus (DKV).

    Methods

    In this quasi-experimental study, 30 women with DKV were selected and randomly divided into two groups (intervention and control groups) of 15 participants each. The intervention group underwent an eight-week VF-based SMT program consisting of three sessions lasting 60 minutes each week. Meanwhile, the control group continued with their daily routine during this period. After the training, all participants’ knee joint proprioception and alignment were assessed using the single-leg squat test (SLST) and single-leg landing test (SLLT). The results were analyzed using the analysis of covariance (ANCOVA) in the IBM SPSS Statistics software, version 26, with a significance level of P<0.05.

    Results

    The analysis of covariance (ANCOVA) results indicated a significant improvement in proprioception (P=0.038) and knee alignment (P=0.001) in the intervention group compared to the control group.

    Conclusion

    The study suggests that practicing SMT with VF can enhance knee joint proprioception and alignment in women with DKV.

    Keywords: Visual Feedback (VF), Proprioception, Knee Joint, Posture}
  • منصور صاحب الزمانی، عبدالحمید دانشجو*، سعید بحیرایی، شیما شیخ بهایی، ساناز نمازی زادگان، فائزه فیروزی، الهه نصرالله زاده، ملیحه سلطانبی
    زمینه و اهداف

    افزایش سن تغییرات مهم در عملکرد حرکتی ایجاد می کند. کاهش تعادل و قدرت عضلانی باعث افزایش خطر سقوط می شود. هدف از تحقیق حاضر بررسی اثر آنی تمرینات حس عمقی بر تعادل، حس عمقی و قدرت عضلانی سالمندان و بزرگسالان بود.

    روش بررسی

    در این تحقیق نیمه تجربی، تعداد 20 نفر بزرگسال و 20 نفر سالمند (به ترتیب با میانگین های سنی 27.20 و 65.73 سال) به صورت تصادفی انتخاب شدند. تعادل با استفاده از آزمون برخاستن و رفتن (TUG)، حس عمقی با دوربین دیجیتال و نرم افزار اتوکد و قدرت ایزومتریک عضلات چهارسر رانی و همسترینگ، به وسیله دستگاه دینامومتر دستی مورد بررسی قرار گرفت. تست ها در سه مرحله قبل، بلافاصله بعد و یک ساعت بعد از تمرینات انجام شد. داده ها با آزمون سنجش مکرر ترکیبی تجزیه و تحلیل شدند.

    یافته ها

    حس عمقی در گروه بزرگسال و سالمند به ترتیب به میزان 32.21% و 30.54% پیشرفت معنی داری داشت (0.05>p). بین دو گروه تفاوت معنی داری در TUG مشاهده شد و همچنین در این آزمون بزرگسالان و سالمندان به ترتیب 7.77% و 2.02% نسبت به قبل از تمرین پیشرفت داشتند (0.05>p). بین دو گروه تفاوت معنی داری در قدرت ایزومتریک همسترینگ و چهارسر رانی وجود داشت (0.05>p). قدرت عضلات چهارسر ران فورا بعد از تمرینات به میزان 9.88% در بزرگسالان و 4.30% در سالمندان پیشرفت نشان داد (0.05>p).

    نتیجه گیری

    متخصصان سلامت و افراد جامعه جهت تقویت عملکردهای حرکتی سالمندان و بزرگسالان می توانند از اثر آنی تمرینات حس عمقی استفاده کنند.

    کلید واژگان: حس عمقی, مفصل زانو, قدرت عضلانی, سالمند}
    Mansour Sahebozamani, Abdolhamid Daneshjoo*, Saeid Bahiraei, Shima Sheikhbahaie, Sanaz Namazi Zadegan, Faeze Firouzi, Elahe Nasrolahzade, Maliheh Soltanabi
    Background and aims

    The aging process leads to changes in motor performance, including decreased balance and weakened muscular strength, increasing the risk of falls. This study aimed to investigate the immediate impact of proprioceptive exercises on balance, proprioception, and muscle strength in elderly individuals and adults.

    Methods

    In a semi-experimental, 20 adults and 20 elderly individuals (with average ages of 27.20 and 65.73 years) were randomly selected. Balance was assessed using the Timed Up and Go (TUG) test, while proprioception was measured with a digital camera and AutoCAD software. Isometric muscle strength of the quadriceps and hamstring muscles was evaluated with a hand-held dynamometer. Assessments were conducted before, immediately after, and one hour post exercises. Data analysis was performed using a mixed model for repeated measures design.

    Results

    Significant improvements were showed in proprioception, with both adult and elderly groups experiencing enhancements of 32.21% and 30.54%, respectively (p<0.05). The TUG test revealed a significant difference between the two groups, with the adults and elderly showing improvements of 7.77% and 2.02%, respectively, compared to their pre-exercise performance (p<0.05). Additionally, there was a significant variation in isometric strength of the hamstring and quadriceps muscles between the groups (p<0.05). Following the exercises, quadriceps muscle strength improved by 9.88% and 4.30% in the adults and elderly groups, respectively (p<0.05).

    Conclusion

    The immediate benefits of proprioceptive exercises can be harnessed by healthcare professionals and community members to enhance the motor functions of both elderly individuals and adults.

    Keywords: Proprioception, Knee Joint, Muscle Strength, Elderly}
  • Shubham Agarwal *
    Background

    The anterior cruciate ligament (ACL) is a vital knee joint stabilizer with rising injury rates. Anatomic ACL reconstruction (ACLR) aims to restore the ACL to its original dimensions, collagen orientation, and insertion sites, but complete restoration may not be possible. Suture augmentation (SA) involves the use of autologous hamstring tendons with a braided ultra-high molecular weight polyester or polyethylene (UHMWPE) suture or suture tape to act as a secondary stabilizer until complete integration. This study aimed to compare the outcomes of ACLR using hamstring grafts with and without SA.

    Methods

    This trial was conducted at a tertiary-level health care center, with 50 patients divided randomly into two groups: 25 patients for standard ACLR (group A) and25 patients for ACLR with SA (group B). Participants provided informed consent. Baseline clinical characteristics including range of motion (ROM), pain [Numeric Pain Rating Scale (NPRS)], and functional outcomes [Lysholm and International Knee Documentation Committee (IKDC) scores] were collected.

    Results

    The mean age was 25.5 years, with 96% male and 4% female participants. A statistically significant improvement was found in both groups in ROM, NPRS scores, and functional outcomes at 1 and 6 months. There was no significant difference in both groups regarding the IKDC score. Lysholm’s score showed a remarkable improvement in both groups.

    Conclusion

    SA could be an effective technique for ACLR, with comparable outcomes to standard ACLR.

    Keywords: Anterior Cruciate Ligament Injuries, Knee Joint, Anterior Cruciate Ligament Reconstruction, Sutures, Clinical Trial}
  • Neelam Harsha, Rakesh Kotha*, Alimelu Madireddy
    Background and Objectives

    Septic arthritis is an uncommon condition in neonates. It is a serious disorder, especially because of the possibility of sequelae, if not identified and treated early. In addition, due to the rarity of this condition in neonates and the paucity of signs and symptoms, the diagnosis of septic arthritis is more difficult in older children. The published literature is limited to case series, which is why the purpose of this systematic review is to provide a comprehensive summary of neonatal septic arthritis based on the existing literature. This study identifies the changing trends over time, specifically focusing on intravenous cannulation as a major risk factor that led to the undertaking of the study.

    Methods

    The preferred reporting items for systematic reviews and meta-analyses protocol guidelines were used in this study. Three search engines were used for 239 articles. A total of 26 studies were screened in full text, of which 16 articles underwent quantitative analysis. Due to limited data and heterogeneous reporting, the data were summarized descriptively.

    Results

    The total number of babies and joints studied was 307 and 313, respectively, of which the proportion of male babies was mentioned in 12 case series, accounting for 136(228) (60% [42%-71%]) subjects. The most common presenting symptoms were swelling at the involved joint, erythema, and decreased range of motion in variable order. The most common site of involvement was the hip joint (42%), followed by the knee joint (27%). Staphylococcus aureus (40%) was the most commonly cultured pathogen, followed by Klebsiella (18%). Antibiotics were reported in only 12% (38 babies) of the cases. Open surgery was performed on 16% of the 49 babies. The rest of the babies responded to joint aspiration and irrigation, with or without immobilization. Prompt laboratory and radiographic evaluations could help reduce delays in diagnosis and improve outcomes. Blood and tissue cultures were positive in most of the cases. Previous culture reports for the same unit guide the addition of empirical antibiotics.

    Conclusions

    In our case series, the majority of the babies were premature. The most common joint involved is the hip joint. The most common underlying cause is sepsis and catheterization. Intravenous canulation is also a major risk factor because of the continuity of metaphysis and epiphysial vessels. The most common presenting symptom is local signs. Unexplained fever and irritability make it better to look for a local examination of joints. Follow-up is mandatory as a long-term sequel is more.

    Keywords: Neonate, Sepsis, Septic arthritis, Knee joint}
  • Milad Piran Hamlabadi, Amirali Jafarnezhadgero*, Iman Bakhshodeh Nia, Hamid Hassannejad
    Purpose

    Military boots mileage is a main factor that can affect the risk of running injuries. The present study aims to evaluate the effect of three types of military boots mileage on knee muscular co-contraction during running.

    Methods

    Fifteen healthy males received three pairs of new military boots. Participants wore these boots for more than 6 months. Electromyography activity of lower limb muscles during running at constant speed was recorded during pre- and post-intervention. Then, knee muscular co-contraction was calculated.

    Results

    Results showed a significant increase during loading response (P=0.030, n2p=0.157) and push-off (P=0.008, n2p=0.302) phases for general knee co-contraction at post-test compared to the pre-test. Also, directed mediolateral knee co-contraction showed a significant increment during mid-stance (P=0.028, n2p=0.040) and push-off (P=0.039, n2p=0.115) phases at post-test compared to the pre-test. 

    Conclusion

    It can be concluded that knee joint instability while using polyurethane thermoplastic is more than polyurethane boots. Also, our results demonstrated that maintaining knee stability in the anterior-posterior direction while using polyurethane thermoplastic is better than in polyurethane boots.

    Keywords: Co-contraction, Military boots, Rubber, Polyurethane, Polyurethane thermoplastic, Knee joint}
  • Parisa Fakhari, Azadeh Shadmehr*, Roya Khanmohammadi, Mohammad Reza Hadian, Amir Hooman Kazemi Motlagh
    Introduction

    Flexibility or the ability of a muscle to increase in length is an integral part of musculoskeletal characteristics and is essential in preventing musculoskeletal injuries and increasing functional levels. Hamstring muscles rupture is a common injury. One of the important factors in the occurrence of this injury is poor hamstring muscle flexibility, which because of its stiffened structure, has less ability to quickly increase in length. Some researchers have recently suggested that the dry needling technique could reduce the number of treatment sessions for hamstring muscle tightness and bring faster and more effective results. Accordingly, this study aims to investigate the effect of the application of dry needling through an acupuncture technique on hamstring muscle flexibility.

    Materials and Methods

    The present study is a single-blinded randomized controlled trial in which 16 individuals with bilateral hamstring muscle shortness were randomly allocated into dry-needling and sham-needling groups. The sampling method was non-probability convenience. The outcome measures were the right and left active knee extension range of motion, assessed before and after the first, third, and fifth sessions of intervention. A 2-factor mixed analysis of variance was applied to determine the differences between and within the two groups.

    Results

    Except for the group main effect, time main effect and interaction effect were statistically significant for the right and left active knee extension range of motion (P<0.001). There were differences in behavioral patterns in groups; accordingly, in the real dry-needling group, a significant difference was detected across times. However, in the sham dry-needling group, no significant difference was observed.

    Conclusion

    The application of dry needling into motor points of hamstring muscles in individuals with bilateral hamstring muscles shortness could improve flexibility and increase the range of knee extension after 3 and 5 sessions of intervention because of the therapeutic effects of the dry needling technique in improving the muscle flexibility.

    Keywords: Dry needling, Hamstringmuscles tightness, Flexibility, Range of motion, Knee joint}
  • میلاد پیران حمل آبادی، امیرعلی جعفرنژادگرو*
    زمینه و هدف

    استفاده از ارتزهای کمری مکانیک دویدن را تغییر می دهد. یکی از عوامل بیومکانیکی مهم در توانبخشی و پیشگیری از آسیب، انقباضات همزمان مفاصل زانو و مچ پا است. این مطالعه به منظور تعیین اثر دو نوع بریس تراکولامبوساکرال بر مقادیر هم انقباض مفاصل مچ پا و زانو در مردان مبتلا به کایفوز در حین دویدن انجام شد.

    روش بررسی

    این مطالعه شبه تجربی روی 15 مرد 25-18 ساله مبتلا به کایفوز بزرگتر از 40 درجه در آزمایشگاه بیومکانیک مرکز سلامت و تندرستی دانشگاه محقق اردبیلی طی تابستان 1399 انجام شد. هریک از شرکت کنندگان به طور تصادفی سه تست دویدن را در هر یک از سه حالت بدون بریس، با بریس دارای سنسور و با بریس ساده انجام دادند. این آزمایش شامل داده های الکترومیوگرافی عضلات منتخب اندام تحتانی بود که انقباض عضلات زانو و مچ پا را در پای راست هنگام دویدن با سرعت ثابت ثبت نمود.

    یافته ها

    مقادیر هم انقباض عمومی مفصل زانو در حالت بریس سنسوردار نسبت به حالت بدون بریس حدود 6 درصد طی فاز پاسخ بارگذاری کاهش یافت (P<0.05). هنگام استفاده از بریس ساده نسبت به حالت بدون بریس مقادیر هم انقباض جهت دار مچ پا در فاز هل دادن حدود 38 درصد کاهش یافت (P<0.05). هم انقباضی جهت دار عضلات پهن داخلی و پهن خارجی در حالت استفاده از بریس سنسوردار نسبت به حالت بدون بریس در فاز پاسخ بارگذاری حدود 49 درصد و در فاز میانه اتکا در حالت بدون بریس نسبت به بریس ساده حدود 47 درصد افزایش یافت (P<0.05).

    نتیجه گیری

    به دلیل افزایش هم انقباضی عمومی زانو در حین استفاده از بریس سنسوردار، استفاده از بریس ساده توصیه می شود.

    کلید واژگان: بریس, توراکولومبار, کایفوز, مفصل مچ پا, مفصل زانو, دویدن}
    Milad Piran Hamlabadi, AmirAli Jafarnezhadgero*
    Background and Objective

    Using lumbar orthoses changes the running mechanics. An essential biomechanical factor in rehabilitation and injury prevention is the co-contraction of the knee and ankle joints. Therefore, this study aimed to investigate the effect of 2 types of thoracolumbosacral braces on ankle and knee joint co-contraction in people with kyphosis during running.

    Methods

    This quasi-experimental study was conducted on 15 men aged 18-25 years suffering from kyphosis greater than 40 degrees in the Biomechanics Laboratory of the University of Mohaghegh Ardabili Health Center during the summer of 2020. Each participant randomly performed 3 running tests in each condition: without a brace, with a sensor brace, and with a simple brace. The test consisted of electromyographic data of the selected lower limb muscles, which also recorded the contraction of the knee and ankle muscles in the right leg when running at a constant speed.

    Results

    The results showed a reduction of the general knee co-contraction while using a sensory brace compared to without the brace by 6% during the loading phase (P<0.05). Additionally, using a simple brace compared to the condition without a brace, the ankle-directed contraction during the push-off phase decreased by 38% (P<0.05). Directed vastus medialis and lateralis co-contraction while using a sensory brace increased by about 49% compared to without the brace at the loading phase and increased by about 47% at the mid-stance phase without a brace condition compared to the simple brace condition (P<0.05).

    Conclusion

    General knee co-contraction after using a sensory brace was lower than when a simple brace was used.

    Keywords: Brace, Thoracolumbar, Kyphosis, Ankle Joint, Knee Joint, Running}
  • Ergali Nabiyev, Arnat Baizakov, Khadisha Kashikova*, Ramazan Askerov, Zhassulan Argynbayev, Bauyrzhan Bissaliyev
    Background

    This article presents a mathematical justification for a new approach to arthroscopic stitching of the knee joint meniscus, based on a 3D computer model of the meniscus developed using the COMPASS-3D (APMFEM) program and AutodeskInventorPRO. The research with the patent RK No. 35413 dated 10.12.2021, titled "Method of arthroscopic stitching of the meniscus of the knee joint" builds upon the work of Yu.V. Labunsky.

    Methods

    Mathematical analysis was performed to compare two methods of stitching the meniscus: the new oblique-vertical stitch and the classical vertical stitch. The contact area of the meniscus tissues in the area of the rupture was measured for both stitching methods.

    Results

    The findings demonstrate that the new oblique-vertical stitch offers a 1.5 times larger contact area of the meniscus tissues in the area of the rupture, compared to the classical vertical stitch. Additionally, the new method provides a more significant grip on the radial and circular fibers of the meniscus, surpassing the capabilities of the classic seam.

    Conclusion

    The results of this study can be utilized to develop practical recommendations for traumatologists regarding arthroscopic stitching of the meniscus in the knee joint. The new approach, supported by mathematical analysis and a 3D computer model, offers improved outcomes in terms of contact area and grip on the meniscus fibers, potentially leading to enhanced surgical techniques and patient outcomes.

    Keywords: Biomechanics, Mathematical Justification, Finite Element Method, Knee Joint, Menisci, Meniscus Stitch}
  • محسن برغمدی*، کیوان شهبازی اوغلو، ابراهیم پیری، هادی الله وردی دوست، علی نصرتی هشی
    پیش زمینه و هدف

    فرود از فعالیت های مهم در اجرای حرکات ورزشی است که فعالیت عضلات را به شدت تحت تاثیر قرار می دهد. افراد مبتلا به زانوی ضربدری به علت تغییرات ساختاری در مفصل زانو در معرض آسیب های گسترده ای در این مفصل می باشند. لذا هدف از پژوهش حاضر بررسی تاثیر استفاده کوتاه مدت از بریس زانوی محافظت کننده بر هم انقباضی عمومی و جهت دار مفصل مچ پا و زانو در افراد مبتلا به زانوی ضربدری طی پرش و فرود بود.

    مواد و روش کار

    پژوهش حاضر از نوع نیمه تجربی بود. تعداد 10 پسر مبتلا به زانوی ضربدری در گروه آزمایش و 10 پسر سالم که هیچ گونه اختلال اندام تحتانی نداشتند، به عنوان گروه کنترل انتخاب شدند. بریس زانوی مورداستفاده از نوع BeActive model 1031 بود. فعالیت الکتریکی عضلات منتخب به وسیله دستگاه الکترومایوگرافی (Biometrics ltd, uk) ثبت شد. جهت تحلیل های آماری از نرم افزار SPSS V21 و آنالیز واریانس با اندازه های تکراری (Repeated measure ANOVA) در سطح معنی داری 05/0>P استفاده شد.

    یافته ها

    نتایج بین پیش آزمون و پس آزمون گروه زانوی ضربدری هیچ گونه اختلاف معنی داری را نشان نداد (063/0=P، 276/2=t). بررسی هم انقباضی عمومی مچ پا در گروه کنترل که از بریس زانو استفاده کرده بودند نشان داد کاهش معنی داری در پس آزمون طی مقایسه با پیش آزمون وجود دارد (001/0=P، 831/6=t).

    بحث و نتیجه گیری

    با توجه به نتایج تحقیق می توان نتیجه گرفت کاهش هم انقباضی مفصل زانو نشان دهنده کاهش فعالیت هم زمان عضلات حمایت کننده مفصل زانو است. احتمالا بریس زانو توانسته نقش حمایتی و حفاظت کننده در مفصل زانو داشته باشد و در نتیجه منجر به کاهش فعالیت عضلات حمایت کننده اطراف مفصل شده است.

    کلید واژگان: مفصل مچ پا, هم انقباضی, زانوی ضربدری, بریس زانو, فرود, مفصل زانو}
    Mohsen Barghadi*, Kivan Shahbazioghli, Ebrahim Piri, Hadi Allahverdidost, Ali Nosrati Hashi
    Background & Aims

    Jumping and landing are important activities in performing sports movements that strongly affect muscle activity. People with Genu Valgum are prone to extensive damage to the knee joint due to structural changes. The aim of this study was to investigate the effect of short-term use of protective knee brace on ankle and knee joint co-contractions in people with genu valgum during jumping and landing.

    Materials & Methods

    The present study was a quasi-experimental and laboratory study. 10 boys with genu valgum in the experimental group and 10 healthy boys who did not have any lower limb disorders were selected as the control group. The knee brace used was BeActive model 1031. Electrical activity of selected muscles was recorded by electromyography (Biometrics LTD, UK). For statistical analysis, SPSS V21 software and analysis of variance (ANOVA) with repeated measures were used at a significant level of P<0.05.

    Results

    The results showed no significant difference between the pre-test and post-test of the genu valgum group (P = 0.063, t = 2.276). Examination of all general co-contractions of ankle joint in the control group who used knee brace showed a significant decrease in post-test during pre-test comparison (P = 0.001, t = 6.831).

    Conclusion

    According to the results of the research, it can be concluded that the decrease in co-contraction of the knee joint indicates a decrease in the simultaneous activity of the muscles supporting the knee joint. Probably, the knee brace has been able to play a supporting and protective role in the knee joint, and as a result, it has led to a decrease in the activity of the supporting muscles around the joint.

    Keywords: Ankle Joint, Co-Contraction, Crossed Knee, Knee Brace, Landing, Knee Joint}
  • Monireh Maleki, Fereidoun Nowshiravan Rahatabad *, Majid Pouladian
    Purpose

    Musculoskeletal systems have a complex nature, and it is very difficult to control issues in these systems due to various characteristics such as speed and accuracy. Thus, investigating these musculoskeletal systems requires simple and analyzable methods. Also, due to sudden changes during the movement process, the speed and accuracy of the calculations should be proportional to the operating speed of the system. Predicting the system norms and fulfilling them for the system are the next challenges for relevant studies.

    Materials and Methods

    Accordingly, this study aimed to investigate the knee joint function, the joint condition in an incomplete Spinal Cord Injury (SCI), as well as its rehabilitation conditions by designing a simple mathematical model. This model was designed based on the interactions between Hamstring Muscles (HAM) and the vasti muscle group. Considering changes in the Central Pattern Generator (CPG) as a variable input, we analyzed the model output in fixed point, periodic and chaotic modes.

    Results

    The results of the present study showed that the knee joint model output was a chaotic and fixed point for the healthy and incomplete SCI modes, respectively. Increasing the values of afferents was enhanced in the central pattern generating model to rehabilitate the model. According to the modeling results, by applying coefficients of 1.98, 2.21, and 3.1 to the values of afferents Ia, II and Ib, the incomplete spinal injury model changed permanently from the fixed point to the periodic position, indicating movement with rehabilitation in the knee joint.

    Conclusion

    Based on the results obtained from the knee joint mathematical model in comparison with the reference articles in relation to the expected results, it can be stated that this model has an acceptable output while being simple in calculations and has the ability to predict different norms. It can also be hoped that improved and more detailed results will be achieved in the study of musculoskeletal systems with the development of this model .

    Keywords: Knee Joint, Central Pattern Generator, Spinal Cord Injury, Rehabilitation, Hamstring Muscles, Vasti Muscle Group}
  • ماندانا رضایی، نادر صدری اقدم، محمود رضا آذغانی، فریبا قادری، حکیمه آدی گوزلی*
    زمینه و هدف

    روش مرسوم اندازه گیری قدرت عضلانی جهت تخمین آسیب های ورزشی اندام تحتانی در ورزشکاران و نیز طراحی پروتکل های پیشگیری از آسیب، روش دینامومتری می باشد. هدف از این مطالعه بررسی تاثیر وضعیت مفصل ران بر شاخص های دینامومتری مفصل زانو در ورزشکاران فوتبال و دومیدانی بود.

    روش بررسی

    44 ورزشکار مرد (فوتبال=22 و دومیدانی=22) با نمونه گیری غیراحتمالی ساده وارد این مطالعه توصیفی-تحلیلی شدند. شاخص های دینامومتری مفصل زانو شامل حداکثر گشتاورهای فلکسوری و اکستانسوری، طول بهینه، زاویه کراس اور و نسبت های تعادل عملکرد عضلانی در سرعت 60 درجه بر ثانیه و در دو وضعیت نشسته و خوابیده (با توجه وضعیت مفصل ران) در دو گروه ارزیابی و با یکدیگر مقایسه شدند. این مطالعه در آزمایشگاه بیومکانیک دانشکده علوم توانبخشی دانشگاه علوم پزشکی تبریز (از مهر 1398 تا مهر 1399) اجرا شد.

    یافته ها: 

    اثر متقابل گروه و وضعیت مفصل ران در شاخص ها معنادار نشد (05/0<P). میزان گشتاور کانسنتریک و اکسنتریک اکستانسوری و فلکسوری و نسبت مرسوم فلکسوری به اکستانسوری در وضعیت نشسته به صورت معناداری بیشتر از وضعیت خوابیده بود. طول بهینه فلکسوری در وضعیت خوابیده بیشتر از نشسته و زاویه کراس اور در وضعیت خوابیده کمتر از وضعیت نشسته بود (05/0>P). وضعیت مفصل ران بر روی نسبت عملکردی فلکسوری به اکستانسوری تاثیری نداشت (05/0<P). شاخص های دینامومتری بین دو گروه فوتبال و دومیدانی نیز با یکدیگر تفاوت معناداری نداشتند (05/0<P).

    نتیجه گیری:

     یافته های مطالعه حاضر اهمیت وضعیت دهی مفصل ران را در اندازه گیری قدرت عضلانی مفصل زانو در ورزشکاران فوتبال و دومیدانی نشان می دهد که می تواند بر طراحی تمرینات تقویتی در ورزشکاران و تخمین میزان آسیب های ورزشی اثرگذار باشد.

    کلید واژگان: فوتبال, مفصل ران, مفصل زانو, دینامومتر قدرت عضلانی, دومیدانی}
    Mandana Rezaei, Nader Sadri-Aghdam, MahmoodReza Azghani, Fariba Ghaderi, Hakimeh Adigozali*
    Background

    Isokinetic dynamometry is a golden standard test to estimate lower extremity sport related injuries in the athlete assessment. Dynamometry is also commonly used to design preventive protocols. The aim of this study was to explore the effects of hip joint positioning in seated and lying positions on knee joint dynamometry indices, including extensor and flexor peak torques in football and track and field athletes.

    Methods

    Forty four male athletes (including 22 football players and 22 track and field athletes) have participated in this descriptive-analytic study. The sampling method was simple nonrandom sampling. This study was conducted in the Biomechanics laboratory of the Rehabilitation Sciences, Faculty of Tabriz University of Medical Sciences since October 2019 to October 2020. Knee joint dynamometry indices were consisted of concentric and eccentric flexor and extensor peak torques at 60 degrees per second velocity. Optimum length, angle of crossover, and the muscle balance ratios (concentric extensor peak torque/concentric flexor peak torque and eccentric extensor peak torque/concentric flexor peak torque) were also evaluated. All assessments were performed in both seated and lying positions. The indices were compared between football players and track and field athletes.

    Results

    The interaction effect of group and hip joint was not significant (P<0.05). Further, concentric and eccentric flexor and extensor peak torques and conventional flexor to extensor ratio were higher meaningfully in the seated position compared to the lying (P<0.05). Optimum length was significantly higher in the lying position, but the angle of crossover was higher in the seated position (P<0.05). The hip joint position was not effective on the functional flexor to extensor ratio (P>0.05). Also, dynamometry indices were not different between football and track and field groups (P<0.05).

    Conclusion

    Findings revealed the effects of hip joint position on strength measurements in football and track and field athletes. This factor should be considered to design strengthening exercises for athletes and also to estimate the sport injury risk.

    Keywords: football, hip joint, knee joint, muscle strength dynamometer, track, field}
  • بابک وحدت پور، صادق برادران مهدوی، سحر ارزاقی، شیلا حقیقت، محمدمیلاد صادق*

    مقدمه:

     استیوآرتریت، از علل شایع درد زانو و ناتوانی می باشد. تاکنون مطالعات محدودی در مورد اثر داروهای گیاهی حاوی عصاره های سنجد و زردچوبه بر روی استیوآرتریت زانو انجام شده است. هدف ما در این مطالعه، بررسی و مقایسه ی اثر درمانی عصاره ی سنجد با عصاره ی زردچوبه در بیماری استیوآرتریت خفیف تا متوسط زانو می باشد.

    روش ها

    این مطالعه ی کارآزمایی بالینی در سال 1398-1399 بر روی 50 بیمار مبتلا به استیوآرتریت زانو در شهر اصفهان انجام شده است. درد و عملکرد بیماران توسط مقیاس آنالوگ بصری (Visual analogue scale) VAS، پرسش نامه ی (Knee Injury and Osteoarthritis Outcome Score) KOOS و مقیاس Roles and Maudsley تکمیل شد. بیماران به دو گروه تقسیم شدند و تحت درمان خوراکی با کپسول های 250 میلی گرمی Elartrit (عصاره ی سنجد) و درمان خوراکی با کپسول های 370 میلی گرمی کورکومین (عصاره ی زردچوبه) قرار گفتند (هر 12 ساعت یک کپسول به مدت 15 روز). متغیرها قبل، 2 هفته و 4 هفته پس از درمان مقایسه شدند. همچنین، نتایج بین دو گروه مورد مقایسه قرار گرفت.

    یافته ها

    استفاده از هر دو دارو در درمان درد و بهبود عملکرد بیماران موثر بود. بعد از 4 هفته، بیماران در موارد زیر اختلافی نداشتند: ناراحتی زانو، خشکی، درد، فعالیت روزانه، ورزش و تفریح، کیفیت زندگی و نمره ی کل پرسش نامه KOOS. همچنین از نظر وضعیت عملکرد نیز اختلاف معنی داری بین دو گروه نبود. با این حال بیماران هر دو گروه نسبت به ابتدای مطالعه، بهبود معنی داری در پارامترهای خشکی، درد، فعالیت روزانه و نمره ی کل پرسش نامه ی KOOS در طی مطالعه داشتند.

    نتیجه گیری

    در بهبود درد، خشکی مفصلی (مقیاس VAS و پرسش نامه ی KOOS) و عملکرد بیماران استیوآرتریت زانو (مقیاس Roles and Maudsley) با شدت خفیف تا متوسط، تفاوتی بین عصاره ی سنجد و زردچوبه در درمان کوتاه مدت وجود نداشت.

    کلید واژگان: استئوآرتریت, درد, مفصل زانو, سنجد, کورکوما}
    Babak Vahdatpour, Sadegh Baradaran Mahdavi, Sahar Arzaghi, Shila Haghighat, MohammadMilad Sadegh *
    Background

    Osteoarthritis is a common cause of knee pain and disability. So far, limited studies have been performed on the effects of herbal medicines containing Elaeagnus angustifolia versus curcumin extracts on knee osteoarthritis. The aim of this study was to evaluate and compare the therapeutic effect of Elaeagnus angustifolia vs. curcumin extracts in mild to moderate knee osteoarthritis.

    Methods

    This clinical trial study was performed on 50 patients with knee osteoarthritis in Isfahan during 2019-2020. Patients' pain and function were assessed using the Visual Analogue Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Roles and Maudsley Scale. Patients were divided into two groups and treated orally with 250 mg Elartrit capsules (Elaeagnus angustifolia extract) and with 370 mg Curcumin capsules (curcumin extract) (one capsule every 12 hours for 15 days). Variables were compared before, 2 weeks, and 4 weeks after treatment. Also, the outcomes were compared between two groups.

    Findings

    The use of both drugs was effective in treating pain and improving patients' function. After 4 weeks, patients had no differences in the following items: knee discomfort, joint stiffness, pain, daily activity, exercise and recreation, quality of life and total score of KOOS questionnaire. Also, in terms of functional status, there was no significant difference between the two groups. However, compared to the beginning of the study, patients in both groups had significant improvements in parameters of joint stiffness, pain, daily activity, and the total score of the KOOS questionnaire during the study.

    Conclusion

    In improving pain, joint stiffness (VAS and KOOS questionnaire) and function (Roles and Maudsley Scale) in patients with mild to moderate knee osteoarthritis, there is no difference between Elaeagnus angustifolia and curcumin extracts in the short-term treatment.

    Keywords: Osteoarthritis, Pain, Knee joint, Elaeagnus angustifolia, Curcuma}
  • نگار کورش فرد، فرشته افتخاری*
    هدف

    آسیب های اندام تحتانی در رشته های ورزشی دارای حرکات پلایومتریک که خستگی نروماسکولار (Neuromuscular) بیشتری را ایجاد می کند، بیشتر رخ می دهد که در میان روش های درمانی، سرمادرمانی به عنوان یک روش فوری درمان بعد از آسیب حین رویدادهای ورزشی، کاربرد بسیاری دارد. از آنجایی که سردکردن مفصل در حالت خستگی، ممکن است ریسک ابتلا به آسیب مجدد را در فرد حین برگشت به رقابت افزایش دهد،  بنابراین، هدف از انجام پژوهش حاضر بررسی تاثیر حاد خستگی نروماسکولار بدنبال سردکردن مفصل بر کنترل پاسچرال (Postural) و کینماتیک زانو حین حرکت فرود-پرش می باشد.

    روش بررسی

    پژوهش حاضر، از نوع کاربردی بوده که به روش نیمه تجربی انجام گرفت. جامعه آماری پژوهش حاضر، دانشجویان دختر تمرین کرده رشته تربیت بدنی بودند که از بین آن ها تعداد 40 نفر سالم که حداقل دوسال از مدت تحصیلشان گذشته باشد و در رشته های والیبال و بسکتبال فعال بودند و حداقل 3 جلسه در هفته فعالیت ورزشی داشتند و در شش ماه گذشته آسیب در اندام تحتانی نداشتند، به صورت هدفمند و داوطلبانه انتخاب شدند که به شکل تصادفی در سه گروه تجربی و یک گروه کنترل (هر گروه 10 نفر) قرار گرفتند. اندازه گیری ها در سه زمان (پیش آزمون، پس آزمون اول و پس آزمون دوم) انجام شد. از صفحه نیرو (Bertec 40*60 USA) برای ثبت داده های مرکز فشار و از الکتروگونیامتر (Biometrics) برای ثبت دامنه حرکتی حین حرکت فرود-پرش تک پا به طور همزمان استفاده شد. سرمادهی به مدت 20 دقیقه (برای گروه سرمادهی و سرمادهی پس از خستگی) و پروتکل خستگی (برای گروه خستگی و سرمادهی پس از خستگی) شامل انجام پرش های مکرر در جهات مختلف از سکوی 20 سانتی متری بود. در گروه سرمادهی پس از خستگی، آزمودنی ها ابتدا پروتکل خستگی را انجام داده، سپس بلافاصله سرمادهی مفصل زانو اعمال شد. تمامی متغیرها قبل از اعمال مداخله ها، بلافاصله پس از آن ها (پس آزمون اول) و 20 دقیقه بعد از آن ها (پس آزمون دوم) در تمام گروه ها اندازه گیری شدند. از آزمون تحلیل واریانس با داده های تکراری، در سطح معناداری 0/05>p جهت تجزیه و تحلیل داده ها با نرم افزار SPSS استفاده شد.

    یافته ها

    مشخص شد که در مرحله اکسنتریک (Eccentric) میانگین تغییرات COPx در همه گروه ها از پس آزمون اول به پس آزمون دوم افزایش معنا دار داشته (0/01=p)، اما میانگین تغییرات COPX و COPy بین گروه ها تفاوت معنا داری را نشان ندادند (0/05<p). همچنین، زاویه زانو در زمان تماس (Knee Angle of Landing; KAL) در افراد تمرین کرده از پیش آزمون به پس آزمون اول در تمام گروه ها کاهش معنادار  داشته است (0/04=p)، اما تغییرات زاویه زانو زمان تماس و پرش و ماکزیمم زاویه زانو بین گروه ها معنادار نبود (0/05<p).

    نتیجه گیری

    بر اساس نتایج بدست آمده از پژوهش، به نظر می رسد، سرمادهی به صورت سطحی (با استفاده از کیسه یخ) بعد از خستگی نروماسکولار، مشابه با شرایطی که در رویدادها و مسابقات ورزشی وجود دارد، بر عملکرد بیومکانیکی اندام تحتانی و تعادل افراد ورزشکار، تاثیر معناداری ندارد. لذا، سرمادهی موضعی مفصل، به عنوان یک روش درمانی فوری که دارای فواید و آثار مثبت فیزیولوژیکی زیادی، برای کاهش عوارض حاد ناشی از آسیب می باشد، حتی با وجود کاهش دمای موضعی مفصل و در شرایطی که ورزشکار خسته است، خطر جدی برای ورزشکاران حین برگشت به فعالیت ایجاد نمی کند و احتمال آسیب دیدگی مجدد نیز در آن ها بعد از سرمادهی در شرایط خستگی، وجود ندارد.

    کلید واژگان: کنترل پاسچرال, دامنه حرکتی, پلایومتریک, خستگی نروماسکولار, مفصل زانو}
    N. Kooroshfard, F. Eftekhari *
    Purpose

    Lower limb injuries are more common in sports with plyometric movements that cause more neuromuscular fatigue. Among the treatments, cold therapy has many applications as an immediate treatment after injury during sport events. Because cooling the joint in a fatigue state may increase the risk of re-injury when returning to competition. Therefore, the purpose of this study was to investigate an acute effect of neuromuscular fatigue following local joint cooling on postural control and knee kinematics during drop-landing movement.

    Methods

    The present study was done using semi-experimental design. The study population of the present study were 40 female students of physical education field.  All had at least two years of their education and had been active in volleyball and basketball and had at least 3 sessions per week of sport activities and they had no injury in the lower extremities in the past six months. They were randomly divided into three experimental groups and one control group (10 people in each group). Measurements were performed at three times (pre-test, post-test 1 and post-test 2). The force plate (Bertec 40*60 USA) was used to measure center of pressure and the electrogoniameter (biometrics) to measure the range of knee motion during the drop landing, simultaneously. Cooling was performed for 20 minutes (for cooling and cooling after fatigue group) and fatigue protocol (fatigue and cooling after fatigue group) included repeated jumping in various directions from 20 cm platform. In the cooling after fatigue, the subjects first performed the fatigue protocol, then the knee joint cooling was applied immediately. All variables were measured before the interventions, immediately after them (first post-test) and 20 minutes after them (second post-test) in all groups. Analysis of variance with repeated measures and SPSS software in significant level α=0.05 was used for data analysis.

    Results

    It has been shown that the mean of COPx changes increased during eccentric phase in all groups following 2nd post-test compared to 1st post-test(P=0/01). However, there was no significant difference between groups in the mean of COPx and COPy changes (p>0.05). Also, landing knee angle decreased in all groups in 1st post-test compared to pretest (p=0.04). There was no significant difference between groups in landing, takeoff and maximum knee angle (P>0.05).

    Conclusion

    Based on the results of the study, it seems that superficial cooling (using an ice pack) after neuromuscular fatigue similar to the conditions in sport events and competitions, has no significant effect on the biomechanical function of the lower extremities and balance of athletes. Therefore, local cooling of joint, as an immediate treatment method that has many benefits and positive physiological effects, to reduce the acute complications of injury, even despite the reduction of local joint temperature and in conditions where the athlete is tired, does not cause a serious risk for athletes during return to activity and there is no possibility of re-injury in them after cooling in a tired condition.

    Keywords: Postural control, Range of motion, Plyometric, Neuromuscular fatigue, Knee joint}
  • سحر فرخی*، محمدعلی سلیمان فلاح، محمد یوسفی
    مقدمه و اهداف

    امروزه از مهم‌ترین و پر تکرارترین آسیب‌های ورزشی اندام تحتانی در بسیاری از رشته‌های ورزشی آسیب رباط صلیبی قدامی است که دانش در این زمینه و برنامه‌های تمرینی مناسب برای جلوگیری از این آسیب می‌تواند برای تمام ورزشکاران و مربیان راهگشا باشد. هدف از پژوهش حاضر، بررسی شیوع این آسیب در رشته بسکتبال و بررسی نتایج حاصل از برنامه‌های تمرینی متفاوت در کاهش ریسک ابتلا به آسیب رباط صلیبی قدامی می‌باشد.

    مواد و روش‌ها

    در این مطالعه مروری با استفاده از منابع اطلاعاتی بین المللی ساینس دایرکت، امرالد اینسایت، پروکوییست، تیلور اند فرانسیس، اسکوپوس، وب آو نالج، اسپرینگر  و همچنین منابع اطلاعاتی داخلی مگ ایران، سیویلیکا، پایگاه جهاد دانشگاهی، ایرانمدکس صورت گرفت. بازه زمانی این پژوهش بین سال‌ها 2000 تا 2019 تعیین شد. در جستجوی مقالات کلید واژه‌های آسیب رباط متقاطع قدامی، آسیب زانو، فرود تک پا، پرش، فرود، برنامه تمرینی در مقالات داخلی مورد توجه قرار گرفت. با توجه به معیارهای خروج مقاله‌ها از مجموع 220 مقاله مرتبط یافت شده 42 مقاله انتخاب و مورد بررسی قرار گرفت.

    یافته‌ ها

     ابتلای زنان با این آسیب به‌طور معناداری در تمام سطوح مهارت بیشتر است، به‌طوری که در سطح مهارت حرفه‌ای، زنان، 5 برابر بیشتر از مردان به این آسیب مبتلا شدند و در سطح غیر حرفه‌ای نیز نرخ ابتلا حدود 3 تا 4 برابر بیشتر است. بیشترین میزان ابتلا مربوط به زنان بسکتبالیست حرفه‌ای با نرخ 5/5 در هر 1000 ورزشکار-تمرین و کمترین مربوط به ورزشکاران مرد غیر حرفه‌ای با نرخ 02/0 با همان معیار است. از مجموع مقالات بررسی شده در حیطه برنامه تمرینی مناسب پیشگیری از آسیب، 32 درصد مقالات به بررسی تاثیر تمرینات عصبی عضلانی، 18 درصد تمرینات ترکیبی، 26 درصد تمرینات قدرتی و 24 درصد تمرینات ثبات هسته مرکزی پرداختند. به نظر می‌رسد تمرینات ثبات هسته مرکزی با 80 درصد تاثیرگذاری، موثرترین برنامه تمرین پیشگیرانه آسیب است.

    نتیجه‌گیری

      با توجه به نرخ ابتلای به این آسیب و میزان تاثیر این آسیب در هزینه‌های درمان، طول مدت بازگشت به ورزش و ایجاد زمینه برای سایر آسیب‌ها، بررسی جامع در مورد تمرینات موثر بر پیشگیری از این آسیب دارای اهمیت باشد. این موضوع برای بسکتبالیست‌های زن حرفه‌ای دارای اهمیت بیشتری است. در بین برنامه‌های تمرینی، برنامه تمرینی ثبات هسته مرکزی بیشترین تاثیرگذاری موثر و برنامه تمرینی ترکیبی کمترین تاثیر را با توجه به معیارهای مختلف بررسی آسیب در پیشگیری از این آسیب داشته‌اند.

    کلید واژگان: مفصل زانو, آسیب رباط متقاطع قدامی, برنامه تمرینی}
    Sahar Farokhi *, Mohammad Ali Soleymanfallah, Mohammad Yousefi
    Background and Aims

     The most essential and common sports injury in the lower limb in many sports fields is the injury of the anterior cruciate ligament (ACL). Knowledge in this field and appropriate exercise programs can help prevent this injury for all athletes and coaches. The present research aims to investigate the prevalence of this injury in different sports fields and the results of various training programs in reducing the risk of injury to ACL.

    Methods

     The current review was conducted using international information resources, Scopus, Taylor and Francis, ProQuest, Emerald Insight, ScienceDirect, Springer, Web of knowledge, and internal information resources including Magiran, Civilica, SID, and Iran Medex were applied. The research date range was defined between 2000 to 2020. In international articles, keywords such as Single-leg Landing, Landing, Injury, Knee injury, Drop-landing, Training, Exercise, ACL, and in domestic papers, keywords such as ACL, Knee Injury, Single-leg Landing, Jump, Land, and Training program were considered. According to the exclusion criteria, only 42 articles were selected and examined out of 220.

    Results

    Women with this injury are more affected at all skill levels, so at the professional skill level, women were affected up to 5 times more than men, and at the amateur level, the infection rate is about 3 to 4 times higher. The highest incidence is related to women professional basketball players with a speed of 5.5 per 1000 athletes training, and the lowest is among amateur male athletes with a rate of 0.02 with the same criteria. Of the articles reviewed in the appropriate injury prevention training program, 32% examined the effect of neuromuscular training, 18% combined training, 26% strength training, and 24% central core stability training. With 80% effectiveness, core stability training seems to be the most effective injury prevention program.

    Conclusion

     Considering the rate of this injury and the impact of this injury on treatment costs, the duration of returning to exercise, and creating the ground for other injuries, a comprehensive review of exercises effective in preventing this injury for athletes and coaches it’s important. This is especially important for professional female basketball players due to the incidence rate. The central core stability training program had the most practical effect among the training programs. The combined training program had the least impact according to different criteria for assessing and preventing injury.

    Keywords: ACL injury, Exercise program, Knee joint}
  • آیدین ولی زاده اورنج*، امیرعلی جعفرنژاد گرو، سعید علی حسینی
    مقدمه و اهداف

    هدف پژوهش حاضر بررسی اثرات استفاده از کفش‌ کنترل حرکتی بر هم‌انقباضی مفصل زانو طی دویدن در افراد دارای اضافه وزن با کف پای صاف اس.

    مواد و روش‌ها

     تعداد 15 زن دارای اضافه وزن با افت استخوان ناوی بیش از 10 میلی‌متر به‌صورت در دسترس انتخاب شدند. ویژگی‌های جمعیت‌شناختی آزمودنی‌ها شامل سن 8/5±26/2 سال، قد 0/1±1/7 متر، وزن 3/2±82/5 کیلوگرم و شاخص توده بدنی 1/1±28/2 کیلوگرم بر متر مربع بود. پژوهش حاضر در دو شرایط دویدن با کفش کنترل و کفش کنترل حرکتی انجام شد. فعالیت الکتریکی عضلات منتخب توسط دستگاه الکترومیوگرافی ثبت و سپس مقادیر هم‌انقباضی محاسبه شد. برای تحلیل آماری از آزمون آماری تی همبسته استفاده شد. 

    یافته‌ها

    یافته‌ها نشان داد طی فاز بارگیری میزان هم‌انقباضی جهت‌دار بین دو عضله پهن داخلی و پهن خارجی هنگام استفاده از کفش کنترل حرکتی در مقایسه با کفش کنترل به‌طور معناداری بالاتر است (0/035=P).  مقادیر هم‌انقباضی جهت‌دار بین عضلات جانب داخلی و جانب خارجی مفصل زانو طی فاز هل دادن و طی شرایط دویدن با کفش کنترل حرکتی در مقایسه با شرایط دویدن با کفش کنترل به‌طور معناداری بالاتر است (0/020=P). 

    نتیجه‌گیری

    کفش کنترل حرکتی سبب بهبود هم‌انقباضی جهت‌دار در افراد دارای اضافه وزن با کف پای صاف به‌ویژه در صفحه فرونتال می‌شود که می‌تواند منجر به تعدیل بارهای وارده بر این مفصل گردد.

    کلید واژگان: دویدن, هم انقباضی, کفش, مفصل زانو}
    Aydin Valizadehorang *, Amirali Jafarnezhadgero, Saeid Alihosseini
    Background and Aims

     The study aimed to evaluate the effects of motion control shoes on knee joint co-contraction in overweight individuals with flat feet.

    Methods

    15 overweight females with a navicular drop greater than 10 mm were selected with available sampling. Demographic characteristics of participants include Mean±SD age: 26.8±2.5 years, height: 1.7±0.1 m, weight: 82.5±3.2 kg, and Body Mass Index: 28.2±1.1 kg/m2. This study was done during running with both control (Supernova control, Adidas) and motion control (Supernovacushion, Adidas) shoes. An electromyography system recorded selected muscles’ electrical activity and then computed co-contraction values. Paired sample t-test was used for statistical analysis.

    Results

     Finding demonstrated that during the loading phase, the directed co-contraction of vastus medialis/lateral while using motion control shoes was greater than control shoes (P=0.035). Also, mediolateral-directed knee joint co-contraction while running with a motion control shoe was greater than the control shoe during the push-off phase (P=0.020). 

    Conclusion

    Motion control shoes improved directed co-contraction in overweight individuals with flat feet, especially in the frontal plane that could modify imposed knee joint loads.

    Keywords: Running, co-contraction, Shoe, Knee joint}
  • Ali Asghar Norasteh, Hamed Zarei*
    Context

    The present study provides an analysis of methods in assessment and measurement of knee arthrokinematic movements.

    Evidence Acquisition

    in this study, an exhaustive review of the methods for assessment of knee joint arthrokinematics is provided. For this, some known databases including Science Direct, PubMed, EMBASE, CINAHL, and Google Scholar, for the period 1985 to February 2020 are explored.

    Results

    After the assessment steps, 14 articles were chosen based on the criteria and objectives of the research; 13 articles in entirety and one as a summary. Through a review of the studies, it was observed that various methods were used in assessment and measurement of the knee joint arthrokinematic movements. In the beginning, focus was on transitional motion in which knee arthrokinematic movements were studied in static state; but with time, knee transitional movement was studied in dynamic state as well. More recent studies scrutinized three main types of arthrokinematics: motion rolling, gliding and spinning. There were also studies that tried to implement tools which required minimum cost and scrutinized the knee arthrokinematic movements without complicated state-of-the-art equipment. All the said equipment were designed with the aim of diagnosis of how the arthrokinematic movements of an injured knee compared to a healthy one.

    Conclusion

    Results of our analysis show that the literature is rich with a variety of instruments for measuring knee arthrokinematic movements. By classifying the instruments, it was found that studies of four different measurement methods including static, dynamic, functional and qualitative have examined the arthrokinematic movements of the knee.

    Keywords: Knee Joint, Knee Arthrokinematics, Arthrokinematic Assessment}
  • Mahmoud Ahmadi Fakhreh, Giti Torkaman*, Roya Ravanbod
    Introduction

    Knee Osteoarthritis (OA) is one of the most important etiologies of pain and disability among adults. The effects of pulsed Ultrasound (US) on pain reduction and joint function have been proven, but its role on joint friction and inflammatory mediators is still unclear. Therefore, this study was designed to investigate the effects of US on knee joint friction and inflammation in non-traumatic experimental knee OA.

    Materials and Methods

    Forty-eight guinea pigs were randomly assigned into four groups: OA+US, OA+US sham, 30 days after OA induction (OA30), and normal control (n=12 for each group). OA was induced by intra-articular injection of 3 mg/kg of Mono-Iodoacetate (MIA) in the animal’s left knee. Joint circumstance and weight of the animals were measured at baseline, before (i.e., after 30 days of MIA injection), and after US treatment. Joint friction was evaluated by a pendulum friction tester system. Cytokine levels, including Tumor Necrosis Factor (TNF)-α and Interleukin (IL)-1β, were measured by the ELISA method. The Pearson correlation coefficient was calculated to study the relationships between friction and inflammation variables.

    Results

    Joint circumference was increased in the OA30 group. Joint friction variables, including exponential curve fitting, cycle number, and friction coefficient, were significantly better in the US group (P<0.05). TNF-α and IL-1β cytokine levels were significantly lower in the US group. A significant positive correlation was observed between joint friction indices and TNF-α and IL-1β cytokine levels (P<0.05).

    Conclusion

    US was an effective approach for reducing joint friction and inflammation in OA30. Moreover, the relationship between knee joint friction and inflammation could help us better understand the etiology, mechanism, and treatment strategies of this disease.

    Keywords: Ultrasound, Friction, Inflammation, Knee joint, Osteoarthrosis, Guinea pig}
  • Afshin Rahbari, Abbas Rahimi *, Khosro Khademi Kalantari, Alireza Akbarzadeh Baghban
    Objectives

    Diminished proprioception after an anterior cruciate ligament (ACL) rupture causes disabilities following injury. The aim of this study was to investigate the trend of this change during six months following an isolated unilateral complete ACL rupture.

    Materials and Methods

    In this cohort study, a total of 58 male and female athletes, aged 20-40 years, were surveyed in equal groups with 29 subjects. The healthy (first) and ACLD (second) groups included athletes with isolated unilateral complete ACL ruptures (the ACL-deficient knee group). Knee proprioception was investigated in both groups in three stages, namely, at the beginning of the study (two months after the injury in the ACL-D group) and the intervals of two and four months after the first assessment. The active reproduction of passive positioning (ARPP) method was used in this study. The selected angles were 45° and 60° of knee flexion, and an isokinetic device was the measuring instrument. Three reproduction angular errors were compared between three measurements in each test, including constant error (CE), absolute error (AE), and variable error (VE).

    Results

    The results showed that AE and VE, unlike CE, significantly changed within both groups. AE (P ≤ 0.002, P ≤ 0.001 for 45° and 60°, respectively) and VE (P ≤ 0.043 for 45°), as well as AE (P ≤ 0.002, P ≤ 0.001 for 45°and 60°, respectively) and VE (P ≤ 0.005, P ≤ 0.016 for 45° and 60°, respectively) were significant in the healthy and ACL-D groups, respectively. In addition, a significant difference was observed between healthy and ACL-D groups regarding knee proprioception. At 45°, CE, AE, and VE were significant in the first (P ≤ 0.024), the third (P ≤ 0.014), and all three (P ≤ 0.001, P ≤ 0.027, & P ≤ 0.001) tests, respectively. Finally, AE, VE, and CE were found to be significant in the second (P ≤ 0.001), second (P ≤ 0.004), and third (P ≤ 0.026) tests, at 60°, respectively.

    Conclusions

    In general, ACL rupture reduced knee proprioception after the injury in athletes compared to healthy individuals. Within-group differences, as well as differences between healthy and injured athletes diminished over time within six months after the injury. Eventually, knee proprioception improved in individuals with ACL rupture although the exact mechanism of these changes remains unknown

    Keywords: Knee joint, ACL-deficient knee, Proprioception, Trends, Biomechanics}
  • محمود احمدی فخره، گیتی ترکمان*، رویا روانبد

    اهداف:

     استیوآرتروز شایع ترین نوع آرتریت مفصلی و از مهم ترین علل درد و ناتوانی در بزرگسالان است. در مطالعه حاضر میزان سیتوکین های التهابی IL-1β و  TNF-α و میزان اصطکاک مفصل پس از القای آرتروز غیر تروماتیک در مفصل زانوی خوکچه هندی بررسی شده است.

    مواد و روش ها

    بیست و چهار سر خوکچه هندی نر سفید بالغ، نژاد دانکین-هارتلی به صورت تصادفی به دو گروه استیوآرتروز (OA)  و کنترل (12 سر در هر گروه) تقسیم شدند. القای مدل غیر تروماتیک استیوآرتروز به وسیله تزریق مونو یدو استات mg/kg, MIA) 3) در مفصل زانو انجام شد. محیط مفصل ابتدا و بعد از 30 روز از تزریق MIA، اندازه گیری شد. پس از قربانی کردن حیوان در روز 30، میزان سیتوکین های IL-1β و TNF-αدر غشای سینویال و اصطکاک مفصل زانو در در دو گروه اندازه گیری شد. در گروه کنترل هیچ تداخلی انجام نشد و ارزیابی ها در مفصل زانو، بعنوان نمونه کنترل ، انجام شد.

    یافته ها

    القای استیوآرتروز سبب افزایش معنی دار تورم مفصل نسبت به گروه کنترل شد (P<0.05) .  30 روز پس از القای استیوآرتروز، اصطکاک مفصل در حرکات فلکشن و اکستنشن نسبت به مفصل زانوی سالم در گروه کنترل افزایش معنی دار نشان داد (P<0.05). در گروه OA، سطح IL-1β و TNF-α نسبت به گروه کنترل به صورت معنی داری بالاتر بود (P<0.001).  همبستگی مثبت بین سطح  IL-1β،TNF-αو پارامترهای اصطکاک مفصل مشاهده شد (P<0.01).  

    نتیجه گیری

    استیوآرتروز غیر تروماتیک با افزایش سیتوکینهای التهابی و افزایش اصطکاک مفصل همراه است که در این شرایط حرکت مفصل موجب تشدید آسیب غضروف می شود.

    کلید واژگان: استئوآرتروز, IL-1β, TNF-α, اصطکاک, مفصل زانو}
    Mahmoud Ahmadi Fakhre, Giti Torkaman*, Roya Ravanbod
    Introduction

    Osteoarthritis is the most common type of arthritis and is one of the most common causes of pain and disability in adults. In the present study we investigated the level of inflammatory cytokines IL-1β and TNF-α and the amount of joint friction after non-traumatic model of knee osteoarthrosis in guinea pig.

    Materials & Methods

    Twenty-four matured albino male Dunkin-Hartley guinea pigs were assigned randomly into two groups; osteoarthrosis (OA) and control (n=12 in each group). The non-traumatic OA was induced by intra-articular injection of mono iodoacetate (MIA, 3 mg/kg) in the knee joint. Joint circumstance and weight of subjects were measured initially and after thirty days of MIA injection. After scarifying the animals on day 30, the level of IL-1β and TNF-α in synovial membrane and knee joint friction were measured. Control group received no intervention and all evaluations were performed on the normal knee joint.

    Results

    The induction of OA caused a significant increase in the joint circumstance compared to control group (P<0.05). 30 days after induced OA, the knee joint friction in flexion and extension movement was significantly increased compared to control group.  In OA group, the level of IL-1β and TNF-α showed a significant increase compared to control group (P<0.05). There was a positive correlation between IL-1β, TNF-α and knee joint friction (P<0.01).

    Discussion

    Non-traumatic osteoarthritis may increase the expression of inflammatory cytokines and joint friction, which in this condition the joint movement can aggravate cartilage damage.

    Keywords: Osteoarthrosis, IL-1β, TNF-α, friction, knee joint}
  • Zahra Mirfeizi, Nasim Norouzbeigi, Maryam Sahebari, Mohammadhassan Jokar, Zahra Rezaei Yazdi, Seyed Rasoul Zakavi, Sousan Shafiei, Atena Aghaee *

    Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes chronic synovial inflammation. Reactor-producedβ-particle emitting radionuclides is a new therapeutic strategy in the management of RA. This study was conducted in 2019and analyzed the toxicity and feasibility of 188Re-tin colloid injection, Three-Phase Positive Bone Scan, and Refractory KneePain. Ten patients with RA were administered radiosynovectomy with 188Re-tin colloid. The main complications after theintervention were assessed and compared with patients’ pre-intervention condition. Patients showed alleviation of pain,tenderness, and morning stiffness after the administration of radiosynovectomy. Only one RA patient received a corticosteroidinjection; the other 6 patients did not need a corticosteroid injection after radiosynovectomy. Intra-articular 188Re-tin colloidinjection seems to be an effective treatment modality for refractory knee joint pain in rheumatoid arthritis patients. Thus, it issuggested as a safe and effective strategy to apply.

    Keywords: Knee joint, Pain, Rheumatoid arthritis, 188Re-tin}
نکته
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