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Objective Electromyography (EMG) biofeedback has been suggested as a relatively new approach to help resolve muscle disorders. This research aimed to evaluate the influence of 8 weeks of proximal pelvic muscle training and biofeedback on pain, muscle strength, and their EMG activity in individuals suffering from patellofemoral pain syndrome (PFPS). Materials & Methods This randomized clinical trial was performed on 30 young people aged 22 to 45 with PFPS. People in the intervention group (15 people) received EMG biofeedback of the abductor (gluteus medius) and external rotator (gluteus maximus) muscles along with routine physiotherapy treatments, including stretching exercises, isometric exercises of gluteal and quadriceps muscles, and conventional transcutaneous electrical nerve stimulation. In the control group (15 people), routine physiotherapy treatments were only performed on the patients. The participants of two groups were treated for 8 weeks, 3 sessions every week. Pain by a visual analog scale (VAS), maximal voluntary isometric strength (MVIC) of the abductor and external rotator muscles of the thigh with a dynamometer, and activity of these muscles, including maximum contraction, integrated EMG and onset EMG using EMG, were measured before and after the interventions. Results MVIC and EMG of the gluteus medius muscle demonstrated that the intervention group had more maximum EMG activity (P=0.043) and MVIC (P=0.003) than the control group. MVIC and the maximum EMG activity of the gluteus maximus muscle showed no significant difference between the two groups. Still, the increase in the integrated EMG of this muscle in the intervention group indicated a greater increase than in the control group (P=0.0001). Moreover, people in the intervention group had significantly less pain than the group of routine exercises alone after 8 weeks of treatment (P=0.016). Conclusion Adding 8 week biofeedback training of abductor and external rotator muscles to the routine therapeutic exercise in PFPS can lead to pain reduction, improvement of muscle strength and better performance of these muscles. This change could potentially slow down the degenerative process of the patellofemoral joint. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the relationship between psychological factors and clinical outcomes of therapeutic exercise after 3 months in individuals undergoing total knee arthroplasty (TKA). Another aim of this study was to evaluate the effect of 3 months of therapeutic exercise on the psychological factors of these patients. Materials & Methods This quasi-experimental study involved 29 patients with an average age of 62.76 years who had undergone TKA for their first knees. These patients performed therapeutic exercises for three months. Pain intensity and range of motion (ROM) of flexion and extension were assessed 3 times: before surgery, at the beginning of physiotherapy and 12 weeks after therapeutic exercises. Patients' functional ability and psychological indicators were evaluated in two phases: Before surgery and at the end of the 12th week. Clinical outcomes, including pain, knee ROM, and functional ability, were assessed using the visual analog scale, goniometer and Oxford knee score, respectively. The depression index was assessed with the Beck depression inventory (BDI) second version, anxiety with the state-trait anxiety index, fear of movement with the tampa scale of kinesiophobia (TSK) questionnaire and pain catastrophizing with the pain catastrophizing scale questionnaire. Results The results showed that two psychological indices, including trait anxiety and pain catastrophizing, had a significant negative correlation with the clinical outcomes of physiotherapy after TKA. The higher the trait anxiety before surgery was, the lower the pain reduction during the activity (r=-0.574, P=0.002) and the lower the improvement in functional abilities (r=-0.402, P=0.038). Also, the higher the index of preoperative pain catastrophizing, the lower the pain reduction during activity (r=-470, P=0.013) and the lower the improvement in functional abilities (r=-0.436, P=0.023). No significant correlation was found between other psychological indicators before surgery and the clinical outcomes of physiotherapy. On the other hand, among the psychological factors, trait anxiety (P=0.01) and fear of movement (P=0.01) were significantly improved after 3-month therapeutic exercise. Conclusion Psychological factors can play an essential role in predicting the clinical outcomes of physiotherapy after TKA. In addition, the improvement of psychological factors after therapeutic exercises may indicate that these psychological problems can be improved by reducing pain and achieving better ROM during treatment, so psychological factors are not considered an obstacle to surgery. [ABSTRACT FROM AUTHOR]

Background: To our knowledge, there is scant research on the use of rehabilitative ultrasound imaging (RUSI) method for evaluating bladder base displacement in pregnant women. The RUSI is a non-invasive and simple method that assesses the function of pelvic floor muscles (PFM) based on the movement of the bladder base. Objectives: This study aims to assess the reliability of the RUSI for the assessment of PFM function in pregnant women during voluntary muscle contractions. Materials & Methods: In this cross-sectional study, 18 pregnant women with different gestational ages participated. The amount of bladder base displacement during PFM contraction was assessed in all women and considered an indicator of PFM function. The test re-test reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plot. The percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were also calculated. Results: The mean amount of bladder base displacement during PFM contraction at time points 1 and 2 was 4.89±1.43 and 4.81±1.41, respectively. The ICC was 0.989 (95% CI, 0.969%, 0.996%), which indicates excellent reliability. The Bland-Altman plot showed that all the points were within the 95% limits of agreement with no considerable trend or bias. The SEM% and MDC% were 3.09% and 8.41%, respectively. Conclusion: The intra-rater reliability of the RUSI to assess PFM function in pregnant women is high, and can be useful for further studies on the PFMs in pregnant women. [ABSTRACT FROM AUTHOR]

Objective Patients with knee osteoarthritis (KO) commonly show quadriceps muscle weakness. One of the important reasons for this weakness is arthrogenic muscle inhibition (AMI), a process in which neural inhibition causes the failure of quadriceps activation. The present study aims to evaluate the effect of cross-education on the AMI and the maximum extensor force of quadriceps in women with unilateral KO. Materials & Methods In this study, 21 women with unilateral KO (grade 2) participated. The AMI and the maximum extensor force of the quadriceps in the affected knee were measured before, immediately after, and 15 minutes after cross-education. The cross-education included isometric training of the contralateral quadriceps in 5 sets of 8 repetitions in one session. For measuring the AMI and maximum extensor force of the quadriceps, a burst of electrical stimulation was superimposed on the maximal voluntary contractions in 6 seconds. Results Immediately after one session of cross-education, the AMI of the affected knee significantly decreased and the maximum extensor force of quadriceps significantly increased compared to the pretest phase (P=0.001). Fifteen minutes after cross-education, AMI significantly increased compared to the post-test phase (P=0.018), but was still lower than that in the pre-test phase (P=0.001) Conclusion One session of cross-education can reduce AMI and increase maximum extensor force of quadriceps in women with KO, and this effect remains for at least 15 minutes. [ABSTRACT FROM AUTHOR]

Objective Due to the substantial prevalence of patellofemoral pain syndrome and the importance of quadriceps strengthening in knee rehabilitation, determining the best way to activate and strengthen the patella stabilizing muscles is considered as one of important keys of treatment. The aim of this study is to evaluate the effect of different hip rotations associated with ankle dorsiflexion during maximal straight leg raising (SLR) maneuver in the sitting position on thickness and fibers angle of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles using ultrasonography. Materials & Methods This quasi-experimental study was performed on 40 individuals (healthy group: 20, patellofemoral pain syndrome [PFPS] group: 20). VMO and VL thickness and fiber angle were measured using ultrasonography during maximal SLR in 6 positions: hip internal, hip external, and neutral rotations with and without ankle dorsiflexion. Results In between-group comparison, no significant difference was found for all variables with different SLR maneuvers (P>0.05). In the within-group comparison, hip external rotation compared to other hip positions without ankle dorsiflexion resulted in a significant increase in VMO thickness and fiber angle in both groups (P<0.05). Also, adding ankle dorsiflexion to different hip rotations during SLR significantly increased the thickness and fiber angle of VMO and VL. Conclusion By changing hip rotations with or without ankle dorsiflexion during SLR, the trend of changes in VMO and VL thickness and fiber angle in the two groups followed the same pattern. Moreover, performing SLR in hip external rotation with ankle dorsiflexion can be recommendable for the rehabilitation of PFPS. [ABSTRACT FROM AUTHOR]

Objectives: Sensory processing patterns can be related to children's preferences for various activities. Still, our understanding of how different sensory processing patterns are related to children's participation in leisure activities is fairly limited. Therefore, this study aimed to investigate the association between sensory processing patterns and children's participation in leisure activities. Methods: In this systematic review, the PRISMA (The Preferred Reporting Items For Systematic Reviews And Meta-Analyses) Guidelines were followed. We searched PubMed, Google Scholar, Springer, ProQuest, Scopus, Cochrane Library, Medline, OT Seeker, SID, and Healio databases using the following keywords: "Participation", "leisure", "play", "sensory processing", "sensory integration", "sensorimotor", "sensory", and "children". A total of 5040 articles were found, of which 5027 were eliminated after the review, and finally, 13 articles were included in the study based on the inclusion criteria; 6 of them entered the meta-analysis process. The meta-analysis was performed using CMA software. Results: The meta-analysis of 6 studies illustrated a significant correlation between the energy level and desire to participate in leisure activities, the auditory-visual sensitivity and willingness to participate in leisure activities, the sensory processing patterns and the intensity of involvement in leisure activities, the general sensory processing and desire to participate in leisure activities, the sensory processing patterns and desire to participate in informal activities, the olfactory sensitivity and desire to participate in leisure activities, the auditory filtering and desire to participate in leisure activities, the sensory processing patterns and enjoyment of participation in leisure activities, and finally sensory processing patterns and desire to participate in recreational activities. Discussion: The evidence in articles on sensory processing patterns and participation in play and leisure activities is inadequate. The only conclusion drawn from all patterns of sensory processing is the significant relationship between these patterns and the preference to participate in recreational activities (which is just one of the several leisure activities). [ABSTRACT FROM AUTHOR]

Objective: Moral distress may occur when people are unable to follow professional standards and ethical values in their profession. It is a significant issue in the healthcare profession and has negative consequences. In addition, there is a concern that it may adversely affect clinical performance and, in some cases, patient outcomes. Based on the evidence, occupational therapists experience moral distress, Therefore, there is a need for a tool that enables researchers to identify the extent of moral distress in each individual and to measure the effectiveness of strategies designed to reduce distress and prevent employee burnout. The aim of this study was to develop and evaluate the face and content validity of the Moral Distress Questionnaire in occupational therapists. Materials & Methods: This psychometric study was performed in two stages. The first stage involved preparing a pool of questionnaire items, and the second stage examined the face and content validity of the questionnaire. First, texts and related studies were reviewed to extract the questionnaire items. Searching various databases was done to find any conditions that create moral distress in occupational therapy. Three qualitative studies conducted in the field of ethical issues of occupational therapists in the field of psychiatry, children and adults were fully studied. The codes extracted from these studies and the quotations of the interviewees were read. Then the questionnaire items were extracted from the codes, sentences and phrases of the studies. The items were read several times and edited in terms of content clarity, grammar and concept comprehension, and duplicate topics were removed. After preparing the pool of items for the preliminary questionnaire, the scientific stages of face and content validity of the questionnaire were completed. The face validity of the questionnaire was measured qualitatively and quantitatively by 30 occupational therapists who were selected by available sampling from clinics, hospitals and public and private centers. Inclusion criteria were at least one year of work experience in various fields of occupational therapy. Quantitative face validity was performed by determining the impact score of the item. In order to perform qualitative content validity, experts in the field of teaching ethics in occupational therapy and familiar with tool development were invited to review the questionnaire and exchange views in a face-to-face meeting. Seven people participated in the panel of experts. Participants were told that the tool would be an Evaluative tool designed to assess the extent of moral distress among occupational therapists working in clinical settings. After carefully studying the tool, they were asked to consider and comment on the four criteria of clarity, simplicity, transparency, and relevance of items to moral distress. To assess the quantitative content validity of the questionnaire, 20 occupational therapists with doctoral degrees were asked to complete the relevant forms for assessing Content Validity Ratio (CVR) and Content Validity Index (CVI). Results: After reviewing the texts and related studies and analyzing the findings and concepts, a preliminary questionnaire with 50 items was extracted. The items of the questionnaire reached 22 items after completing qualitative and quantitative face and content validity. The impact score of the item was between 2.85 to 4.83. The CVR was in the acceptable range of 0.5 to 1 with an average of 0.7. The CVI of the questionnaire was 0.93. Conclusion: The Moral Distress Questionnaire in Occupational Therapists with 22 items on a four-point scoring scale has appropriate content validity and can be used to measure moral distress in occupational therapists after completing the validity and reliability steps. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed at evaluating the correlation between mother-child relationship and the rate of participation of children and adolescents with cerebral palsy in leisure time activities. Methods: This study is a descriptive and correlational research. The statistical population included cerebral palsy children aged 7-17 years with a mother who is at least 25 years old. A sample size of 152 children was selected using systematic random sampling. The children filled the King's assessment of participation and enjoyment questionnaire, whereas the mothers responded to a survey of Roth's mother-child relationship evaluation. We collected the data and analyzed them (Spearman's correlation test, One-way ANOVA, Kruskal-Wallis, and Mann-Whitney) using SPSS 16 software. Results: The results showed that there is a correlation between mother-child relationship and the rate of participation of cerebral palsy children in leisure time activities. There was a significant correlation between acceptance of child and the increasing involvement in leisure activities in case of cerebral palsy children. Over protection, excessive ease, and child rejection in a mother-child relationship was associated with reduction in the participation rate of the cerebral palsy children and adolescents in leisure activities. In case of quadriplegic children, the acceptance of child and participation rate was low compared to hemiplegic and diplegic children. Excessive ease of a mother-child relationship in girls was more than boys, but boys experienced more child rejection of a mother-child relationship than girls. Discussion: Participation rate, frequency (how often), and the enjoyment of participation in leisure time activities were correlated with mother-child relationship. Participation differences were existed among CP groups. [ABSTRACT FROM AUTHOR]