جستجوی مقالات مرتبط با کلیدواژه « کشش » در نشریات گروه « پزشکی »

 The injury significantly disrupts the performance of the individual and the team and the prevention should be the priority of training programs. To design prevention programs, the first step is to identify risk factors. The joint position sense is one of these factors. The purpose of this study is to investigate the effect of muscle stretching interventions on the sense of the position of the lower limbs with an injury prevention approach.

 The keywords of this review were investigated on 24 September by two researchers in the electronic databases of Pub Med, Web of Science, Scopus, Google Scholar, elmnet, Magiran, SID. The quality of the articles was checked by the Downs and Black checklist. Statistical analysis was done with the help of CMA software and Q- test was used to check the homogeneity of data and I2 was used to estimate the percentage of heterogeneity. Also, Funnel Plot and Egger - test were used to evaluate the risk of bias in the articles, and trim - and - fill method was used if the was a possibility of bias.

 Out of 7487 studies found in selected databases, 25 ones were selected after reviewing the title and abstract, and 10 articles were included in the study after reviewing the full text. The results indicated that stretching exercises do not affect the joint position sense of the knee and ankle.

 It seems that stretching does not have a significant effect on the ankle and knee joint position sense. Considering that the duration of stretching in most studies was short, duration of stretching was one of the important reasons for the non - significance of the stretching. Therefore, more studies with longer periods of time are needed.

Chronic neck pain is one of the most common musculoskeletal disorders that has a great impact on people's quality of life, health, and work efficiency. Due to the high costs of drug treatments, the search for simple and low-cost treatment solutions is inevitable. Stretching and tissue release techniques are effective solutions for correcting skeletal-muscular disorders. Therefore, this study aimed to investigate their effectiveness in controlling pain and improving the performance of people suffering from non-specific chronic neck pain.

In this semi-experimental study with parallel groups and pre-test-post-test design, 39 patients with non-specific chronic neck pain with an average age of 25 to 45 years, in a non-random and available form, were selected from the office workers. Individuals were randomly assigned into three groups of traction stretch, release, and control, and received interventions for six weeks. At the beginning and after the completion of the interventions, pain intensity, qualitative fatigue, and quality of life were evaluated using the visual measure of pain, multidimensional fatigue questionnaire, and SF36 questionnaire, respectively. To compare the averages, one way ANCOVA a mixed analysis of variance test was used.

Intra-group comparisons showed that pain intensity, quality of life, and fatigue improved significantly in both intervention groups (P<0.05). Stretching and release exercises both had a significant effect on improving the variables (P<0.05). However, the results of the release exercises group were more significant.

Six weeks of releasing and stretching techniques in non-specific chronic neck pain patients reduces pain and fatigue and increases their quality of life.

Determining the income elasticities of the household health expenditures, especially for income deciles, leads to adoption of appropriate policies to control and manage health expenditures among income deciles. Therefore, the main purpose of this study was to estimate the income elasticities of urban household health expenditures by income quintiles, and also calculate inequality in distribution of urban household health expenditures in Iran.

This was a descriptive-analytical and applied study performed cross-sectionally with the Hackman two-stage method in Stata 16 software in 2021. The sample included 16,943 urban households in Statistics Center of Iran, and the data was extracted from the raw data of different sections of the cost and income questionnaire regarding urban households. Health expenditure inequality was measured by Gini coefficient, Robin Hood and Herfindal-Hershman indices.

The results showed that the income elasticity of health expenditures was 0.31 for the entire sample and 0.28, 0.66 and 0.36 for the first, second and fifth quintiles, respectively. The Gini, Robin Hood and Herfindal Hirschman indices were 0.240, 0.272 and 0.231, respectively. The increase in parents' educational level and household income, and having a child under seven and a private home had a positive effect and maternal employment had a negative effect on the increase of household health expenditures.

Health is an important asset for urban households and the income quintiles; therefore, the adoption of redistributive policies is recommended to support households, especially the ones in the 2 lowest quintiles. The results of inequality indicators demonstrate the existence of inequality in the distribution of health expenditures; so, it is recommended to upgrade health insurance programs for low-income deciles, expand the coverage of essential medical services and receive premiums based on their ability to pay.

Piriformis syndrome is a neuromuscular disease mostly caused by compression of the sciatic nerve by the piriformis muscle. The purpose of this study was to review the efficacy of different types of physiotherapy interventions on the signs and symptoms in patients with piriformis syndrome.

PubMed, Scopus, Web of Science and Google Scholar databases were searched to identify the published articles on the efficacy of physiotherapy interventions for the treatment of piriformis syndrome. The search was conducted from 1980 to august 2020. The used keywords were: piriformis syndrome, manual therapy, muscle stretch and electrotherapy. The references of the included studies were also reviewed. Finally, after studying 752 probable articles and removing irrelevant ones, 10 clinical trial articles were selected.

The included studies presented that manual therapy accompanying with stretching techniques show great improvement in range of motion of the hip joint and reducing pain in patients with piriformis syndrome. It is impossible to conclude a certain method of electrotherapy modalities such as laser and shockwave therapy for the treatment of patients, due to lack of valid studies.

Based on the current evidence, it seems that using muscle energy techniques (MET) with stretching of the piriformis and other hip muscles are effective in reduction of pain and disability and improvement of range of motion in patients suffering from piriformis syndrome.

Non-specific chronic low back pain is the most common type of chronic low back pain in todaychr('39')s society and achieving a therapeutic exercise program has always been the focus of improvement in patients with non-specific chronic low back pain. The current study aims at investigating the effects of four-week exercise in the water on the disability, flexibility, and muscle strength of middle-aged men with non-specific chronic low back pain.

 In the present quasi-experimental study, 25 middle-aged men with nonspecific chronic low back pain referred to Noorafshar Hospital in Tehran were randomly divided into two groups, exercise in water (n = 13) and control (n = 12). The training group carried out the selected exercise for 4 weeks and 3 sessions in a week. Before and after the exercise protocol, disability, flexor and extensor muscles strength, and hamstring flexibility were measured using the Oswestry Disability Questionnaire, Straight Leg Lowering test, Dynamometer, and SLR Test, respectively. Data were analyzed by SPSS software using Paired t-test (intra-group changes) and independent t-test (inter-group differences). 

After the intervention, the level of disability in the experimental group was significantly reduced compared to the control group (P = 0.001). Also hamstring flexibility (P = 0.001) and the strength (P = 0.001) and flexibility of trunk flexor muscles (P = 0.001) were significantly increased in the experimental group.

 The results of the present study indicated that exercise in water could have positive effects on reducing disability, increasing hamstring flexibility and trunk muscle strength in men with nonspecific chronic low back pain. Therefore, exercise in water recommended as a method for middle-aged men with non-specific chronic low back pain that has trunk muscle weakness, reduced hamstring flexibility, and increased disability. However, a comprehensive statement on this issue requires further study in this area.

The hamstring muscle is one of the muscles with a high risk of injury due to loss of flexibility. Using deep heat modalities is one way to improve muscle flexibility. Given that TECAR therapy is a new way to produce heat in deep tissues, the present study was conducted to compare the short-term effects of TECAR therapy and static stretching on hamstring flexibility in athletes.

This single-blinded randomized clinical trial was performed on 20 male athletes. Samples were randomly divided into two groups of TECAR therapy with static stretching (n=10) and static stretching (n=10) and were treated for three sessions. Active knee extension (AKE) test, passive knee extension (PKE) test, and sit and reach test were performed before treatment, after the first session and after the third session.

The mean values of active knee extension and passive knee extension (degree) and mean values of sit and reach test (cm) after the third session in the TECAR therapy group were 72.10±1.59 and 71±1.49 and 35.20±2.39, respectively, and in the static stretching group were 70.70±1.49, 69.70±1.05 and 34.80±1.61, respectively. The results of this study showed that in both groups, the range of active knee extension (p<0.0001), the range of passive knee extension (p=0.004), and the range of motion in sit and reach test (p=0.004) improved significantly after the first and third sessions. The improvement of all three flexibility indices in the TECAR therapy group was higher than static stretching, but there was no statistically significant difference between the two groups.

The present study showed that TECAR therapy with static stretching causes a greater increase in hamstring flexibility than static stretching alone.

The trigger point is the irritable point associated with a tight band of skeletal muscle which is painful against stress and strain. The real goal in treating trigger points is to achieve a degree of pain relief so that the sufferer can return to his usual activities and functions in spite of some pain. This study was carried out to compare of two methods of sports massage and cold stretch on the threshold of pain in passive trigger points in shoulder girdle muscles of the female volleyball players.
In this quasi-experimental study, 32 females national volleyball palyer who has a latent trigger point in the shoulder girdle region were non-randomly divided into to three groups of sports massage (n=11), stretching along the cold (n=11) and control (n=10) groups. Threshold of pain test was carried out in two steps, prior and immediately after sports massage and stretching along the cold.
The mean of pain threshold prior and immediately after the study in control group was 38.84±11.348 and 35.16±9.311, respectively. The mean of pain threshold prior and immediately after the study in sports massage group was 39.40±9.88 and 43.54±9.63, respectively. This differernce was not significant. The mean of pain threshold prior and immediately after the study in stretching along the cold group was 39.22±10.57 and 41.10±10.95, respectively. This differernce was not significant.
Sports massage and stretching along the cold did not significant effect on the threshold of pain in passive trigger points in shoulder girdle muscles of the female volleyball players.

Osteoarthrosis is a common condition in the cervical region due to the high mobility of this region. Despite the clinical popularity of traction that is often prescribed for patients with neck pain, there is no agreement on the effectiveness of traction. Due to the high controversy and the lack of experimental documents in the efficiency of the pneumatic traction device in reducing symptoms of neck pain, present study was conducted to evaluate the efficacy of the pneumatic traction device in reducing pain and amount of drug use, and improving disability level in patients with neck osteoarthrosis compared to the control group.
Twenty-six patients with neck pain aroused by osteoarthrosis were randomly assigned into two groups of control or experimental. The control group received hot pack, TENS, US, exercise therapy and ergonomic training as their usual physical therapy care. Patients in the experimental group also benefited from the sustained traction via the pneumatic traction device too. All participants were treated for 10 sessions. Pain (NPRS), the level of disability (NDI), the number of sedative drugs and NSAIDs were evaluated in the beginning of the first session and at the end of the last session.
A significant decrease in the levels of the pain and disability in both groups were found (P0.05).
Although physical therapy and ergonomic trainings may lead to a significant improvement in neck pain and related disability in the osteoarthrosis patients, the use of pneumatic traction device can increase the rate of improvement.

Myofascial pain syndrome (MPS) is thought by some authors to be the main cause of neck and shoulder pain. MPS is characterized by myofascial trigger points (MTrPs). The aim of this study was to compare effects of ischemic compression (IC) in stretched & neutral position on the trigger points of trapezius muscle. Sixty computer’s operators with upper trapezius MTrP participated in this study. Subjects were divided randomly in two groups. Group1 that was treated with the IC in stretched position and group 2 that was treated with IC in neutral position of upper trapezius muscle. The local pain intensity, degree of active cervical lateral flexion ROM and pain pressure threshold (PPT) were measured before intervention. Outcome measures were repeated within 5min and 3days after treatment. Statistical methods were kolmogorov-smirnov test, repeated measures ANOVA, independent T-test and Chi-square test. The results showed a significant improvement in PPT, active cervical lateral flexion ROM and a significant decrease in the local pain intensity within each group. There was no significant difference between two groups. IC technique in stretched & neutral position was shown to be effective in increasing active cervical lateral flexion ROM, PPT and reducing pain intensity. IC technique in stretched position was more effective but difference between groups was not significant statistically.

Osteoarthritis is the most common joint disease in adults around the world and plays a great role in inducing disability in elderly. Patients suffering from severe knee osteoarthritis usually complain of pain and severe functional disability. For these patients، conservative treatments are often induces least remedy for pain and improvement of functional ability. This study evaluates the effects of knee mechanical traction on pain، edema، range of movement and functional ability in patients with severe knee osteoarthritis.

In this clinical trial، forty women with severe knee OA (grade 3 & 4 on the Kellgren-Lawrence grading scale) were recruited and randomly divided into two groups with different treatment protocols (common physiotherapy treatment and common physiotherapy treatment accompanied by knee traction). Functional capacity and level of pain were assessed by 6-minute walking test and visual analog scale respectively. A goniometer was used to measure knee range of movement and edema was also evaluated by use of measuring tape.

Common physiotherapy treatment accompanied by knee traction compared to common physiotherapy treatment leads to significant decrease in pain (P<0. 01) and increase in functional capacity (P<0. 05).

Common physiotherapy treatment accompanied by knee traction is a more effective treatment than common physiotherapy procedure in patients with severe knee osteoarthritis.

One method to increase the performance and efficient use of hospital resources is using tools of economic analysis such as production function. The aim of this study was the estimation of production function among public hospitals of Kermanshah University of Medical Sciences during 2001- 11 using Cub Douglas production function.

The data about the dependent variable (number of hospitalized patients) and explanatory variables (numbers of active beds، nurses، doctors and other staffs) for six public hospitals during 2001- 11 were collected using information form. The Data was analyzed employing Eviews software version 6.

The production elasticity and the marginal production for all inputs were positive. The marginal production of active beds، doctors، nurses and other staffs were 76. 7، 73. 7، 19. 3 and 6. 7 respectively. The results also showed that the return to scale was increasing and the total input coefficient was equal to 1. 45.

The maximum of elasticity and marginal production belonged to the active beds. This implies that the hospitals administrators in response to change demands can use active beds more than others inputs. Besides، the marginal production of other staffs was less than other studies، so incentive policies for effective and efficient use in hospital resources will be essential.

Osteoarthritis (OA) is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.

In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire.

Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01).

Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone.

The purpose of the study was comparing the three methods including massage، static stretching and combination of massage and stretching in lower limb muscle on flexibility، power and agility tests performance in soccer players. 45 soccer players contributed in this semi-experimental study. The players were randomly assign in three groups; massage (15 cases)، stretching (15 cases) and a combination of massage and stretching group (15 cases). They warmed up themselves by 5-min jogging before test. Massage، static stretching and combination of massage and stretching were performed on lower limbs for 15 min. Each test was performed three times and the best record was accepted. Flexibility، power and agility of all players were evaluated before and after the interventions. In order to compare the effect of these three protocols، correlated t-test and analysis of variance were used and p

Stretching is an ancient method of treating soft tissue structures amongst the historical cultures. This method, in addition to other manual techniques such as, massage and manipulation has been taught in ancient medicine. Nowadays, a wide range of studies have been performed to reveal the effects of this manual method on different muscle groups in patients, as well as healthy athlete subjects. Different methods of stretching have also been introduced for applying on various tissues. One of these methods is static stretching, which has been considered by researchers during recent decades. It can be concluded from the previous studies that static stretching may result in long-term effects on mobility of joints and decreasing tissue resistance. It is also revealed that permanent effects of stretching on tissues require performing this method for about two months. This article aims at reviewing research- based findings related to static stretching in healthy subjects during last three decades. Providing the results of recent studies in a single complex may help therapists to make a decision easier for applying stretching on different muscle groups.

Statement of Problems: The main disadvantage of elastic chains is their rapid force decay. Thus, pre-stretching has been recommended as a method to overcome this ever existing problem. However, the information regarding the magnitude and the method of its performance are still obscure or varied. This study was designed to evaluate the effect of pre-stretching on force degradation of the synthetic elastomeric chains. This experimental study had two categories of synthetic elastomeric chains: 1. Control (unprestretched) 2. Test (prestretched). The test groups were pre-stretched to 33%, 100% and 200% of the original length. We evaluated 4 control and 16 test groups from four manufacturers. In a period of 5 seconds, each specimen was pre-stretched in the rate of 30 mm per minute. Then, all the specimens were stretched to 25 mm and fixed in this distance on the frames and were merged in 37 degree water. Their forces were measured at 0 hour, 1 hour, 24 hours, 1 week, and 3 weeks. Data were analyzed using Friedman, ANOVA and Green house-Geisser test. All the 20 groups had force degradation in the study period (p <001). The highest rate of force degradation (about half of the total force degradation) occurred at the first hour. But the rate of force degradation declined over time. In all brands, force degradation was smaller in pre-stretching 200% than the control group (p <0.01-0.001). Synthetic elastomeric chains from several companies have different effects from different distances of pre-strectching, so the appropriate pre-stretching length must be defined for each kind of synthetic elastomeric chain.

Introduction & Management of post intubation tracheal stenosis in patients with cardiac problems hasnt been considered as a separate item. In this study, we tried to investigate this problem and to find the potential differences in this group. In a retrospective study of patients with post intubation tracheal stenosis, treated between 1994-2008 at Masih Daneshvari Hospital, results were compared between two groups, study group (a group of cardiac patients with primary heart diseases or history of cardiac surgeries), and all other patients (control group). Patients in the study group had a higher mean age than the control group, but the results of treatment were similar in both groups. However, the response to the non surgical methods was better in the study group. The presence of cardiac problems in the patients with post intubation tracheal stenosis shouldnt affect our decisions for the treatment of these patients. Tracheal resection and anastomosis isnt considered a highly stressful operation in these patients.

Background and

Trigger points have been described as causing pain in clinical practice and are a common source of musculoskeletal pain. Trigger point injection can effectively inactivate the trigger points and provide symptomatic relief. Efficacy of injection in the treatment of trigger points depends strongly on the technique of trigger point injection. This study compares muscle stretching immediately after injection of methyl prednisolon vs. injection without stretching in the treatment of trigger points.

Patients with trigger point pain in the gluteal muscles were recruited using strict inclusion and exclusion criteria from Shiraz Medical School Clinic. Subjects under went two office visits and two phone follow-ups. All patients received injection of lidocaine and methyl prednisolon. In group A, injection was without stretching. In group B, stretching of muscle was done immediately after injection. Evaluation measure tools were 0-10 NRS, VAS and BPI.

In respect to VAS, there was a significant statistical difference between both groups one month following injection. In respect to NRS, there was a significant statistical difference between both groups 1 month and 2 months after injection. However, there was no significant statistical difference between both groups in all measurement aspect of BPI, except mood.

Muscle stretching immediately after injection was more effective up to two months, than without muscle stretching in the symptomatic treatment of gluteal trigger points.

Shortage and eventual weakeness of the Iliopsoas muscle is directly related to low back pain. Constant activity of the Iliopsoas in the straight posture along with its shortened position during sitting and lack of stretch of this muscle are probable causes of its shortening. This study aimed to determine the optimal duration of post isometric stretching to increase Iliopsoas flexibility. Thirty-eight girl students, 20-26 years old, were recruited for this clinical trial by simple sampling from Zahedan University of medical sciences. Subjects were randomly assigned as either a 5 second stretch group or a 15 second stretch group. The range of active and passive hip extension and hip flexion (degrees) during Thomas test were measured using Goniometer before and after 15 sessions of intervention. Post isometric stretching of Iliopsoas was carried out for 5 weeks, 3 times per week, lasting 2 min on each occasion for both groups. Data were analyzed using independent and paired t tests. In 5 second stretch group, passive hip extension was increased from 11.7˚±1.4˚ to 14.9˚±0.96˚ and active hip extension was increased from 10.1˚±1.58˚ to 13.7˚±1.03˚ (p<0.001). In 15 second stretch group, passive hip extension was increased from 11.8˚±2.4˚ to 16.3˚±2.4˚ and active hip extension was increased from 9.7˚±1.7˚ to 14.3˚±2.05˚ (p<0.001). Hip flexion during Thomas test was decreased from 14.4˚±1.18˚ to 4.3˚±1.4˚ and from 14.2˚±3.3˚ to 4.1˚±1.7˚ in 5 sec and 15 sec stretch groups, respectively (p<0.001). The results indicate that flexibility of Iliopsoas and consequently the range of hip extension were increased and hip flexion during Thomas test were significantly decreased using 5 second or 15 second stretch duration. No significant difference was found between two stretching duration in terms of muscle flexibility.