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Background:  Cerebral palsy (CP) is a pediatric disorder characterized by a motor impairment resulting from a permanent, non-progressive lesion in the brain. Cerebral palsy is marked by movement and postural control impairments, which greatly affect body structure, function, daily activities, and participation., Objective: To compare the single-session auditory versus visual feedback on performance and postural balance in children with hemiplegic cerebral palsy., Method: The study was a crossover clinical trial involving a group of 25 patients diagnosed with CP hemiplegia, aged between 6 and 12 years, including both genders. Each patient underwent conventional balance therapy followed by either auditory feedback or visual feedback intervention. After a 48-hour wash-out period, they received conventional balance therapy again before undergoing the alternative intervention initially assigned. The Modified Ashworth scale (MAS), pediatric balance scale (PBS), timed one-leg stance, time up and go test (TUG), and center of pressure (CoP) displacements were assessed as the outcome measures before and after the interventions., Results: Based on the one-leg stand test, TUG, and CoP displacement outcome measures results, both interventions improved balance time, speed of movement, and postural stability in children with hemiplegic spastic cerebral palsy (P < 0.05). Moreover, after a single session of the intervention, the visual feedback group demonstrated a significantly greater improvement in the TUG test, one-leg stand test, and CoP displacement compared to the auditory group (P < 0.05)., Conclusions: The results of the study suggest that combining auditory or visual feedback with conventional balance therapy is effective in treating children with hemiplegic spastic cerebral palsy; furthermore, the utilization of visual feedback would be more effective. Further research is needed to determine the long-term effects of visual and auditory feedback on the assessed outcome measures., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Tehran University of Medical Sciences’ ethical committee issued approval IR.TUMS.FNM.REC.1402.158. The study was done after receiving the ethical approval of the Tehran University of Medical Sciences’ ethical committee with the reference number [NO: IR.TUMS.FNM.REC.1402.158] and registered in the Iranian registry of clinical trials under IRCT ID [IRCT20230903059340N1]. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alhashimi et al.)

Objective: The purpose of this review was to evaluate the effectiveness of dry needling (DN) to improve function, proprioception, and balance and to reduce pain in individuals with chronic ankle instability (CAI)., Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for this review. We searched PubMed, ISI Web of Knowledge, Scopus, Science Direct, Google Scholar, and ProQuest databases from inception until July 2022 using the PICO (population, intervention, comparison, outcome) method. Inclusion criteria were as follows: studies that (1) investigated individuals with CAI; (2) used DN as a main intervention; (3) compared DN with exercise therapy, shockwave therapy, and placebo DN; and (4) compared the effect of DN in CAI cases with healthy individuals. The risk of bias assessment was examined through the Downs and Black checklist. Where possible, a meta-analysis was performed using standardized mean difference (SMD; Cohen's d) and 95% CIs. A narrative analysis was conducted where data pooling was not feasible., Results: Seven studies consisting of 169 individuals with a history of CAI in chronic phase (more than 12 months after the initial injury) were selected for final evaluation. Using DN in fibularis longus may positively have immediate, short-term (1 week), and medium-term (1 month) effects on pain (SMD: -1.31, 95% CI: -3.21 to 0.59), function, proprioception, and static and dynamic postural control compared with before intervention ( P < .05). One study reported the superiority of DN over shockwave therapy to significantly improve range of motion of ankle ( P < .05) but not for pain. Additionally, the results of 1 study were in favor of the superiority of DN intervention compared with placebo DN with regard to postural control and pre-activation variables. Moreover, spinal plus peripheral DN was not preferable to peripheral DN for improving patients' outcomes ( P > .05)., Conclusion: Although almost all of the reviewed articles showed some immediate, short-term, and medium-term benefits of DN for improving postural control, pain, and function for people with CAI, this review found that there was heterogeneity among included trials and many of them had a high risk of null findings due to insufficient power and inconsistent techniques, control groups, and outcome measures. Therefore, scientific evidence supporting the use of DN for ankle instability is premature, and the results of the current review should be interpreted with caution. This area may be worth exploring by conducting large-scale, placebo-controlled randomized trials., (© 2024 by National University of Health Sciences.)

Objective: Given the bone sensitivity to mechanical stimulus, bone-loading exercises and applying the Pulsed Electromagnetic Fields (PEMF(s)) are recommended for promoting bone strength. In this context, these two interventions 's effect on bone turnover markers (BTMs) in osteoporosis patients is yet to be clarified; consequently, an attempt is made in this study to compare the effect of these two interventions on bone turnover markers in women with Postmenopausal Osteoporosis (PMOP)., Methods: This study is design as a randomized, single-center, three-arms, controlled trial. A total of 51 women with PMOP will be randomly assigned to three groups of 17, using opaque, sealed envelopes containing labels for A, B, and C groups. Group A) will receive bone-loading exercises, B) will follow the PEMF(s) and C) will be exposed to the combination of A and B. These three groups will require intervention for 24 sessions (2 sessions/week) next to their routine medical treatment (Alendronate+ Calcium+ Vitamin D). The primary outcome of this study is the serum biomarker of bone formation (bone-specific alkaline phosphatase, BSALP) and resorption (N-terminal telopeptide, NTX). The secondary outcomes consist of thoracic kyphosis angle, fear of falling, and quality of life. The outcomes are measured three times: at baseline, after 24 sessions of intervention, and at 12 weeks follow-up. A primary outcome will be measured and reported by a laboratory expert who is blinded to the participant grouping., Result: The trial has the code of ethics for research (IR.TUMS.FNM.REC.1401.126) and the code of Iranian Registry of Clinical Trials (IRCT) (IRCT20221202056687N1). Study results are expected to be available by mid-2024., Conclusion: This trial will provide new practical knowledge on the bone-loading exercises and PEMFS(s)'s effect on PMOP women. This knowledge is of the essence for physiotherapists, clinicians, other healthcare professionals, and policymakers in the healthcare system., Competing Interests: The author(s) do NOT have any potential conflicts of interest for this manuscript, (2024 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.)

Background: Respiratory involvement is a common consequence of COVID-19; changes in cardiorespiratory parameters of these patients during respiratory rehabilitation program are very important. Previous studies showed that myofascial release therapy (MFRT) could affect the respiratory muscle and adjunct fascia., Purpose: The aim of this study was to evaluate the effects of MFRT techniques and respiratory physiotherapy, in comparison with respiratory physiotherapy alone, on improving cardiorespiratory parameter in patients with COVID-19., Setting: A hospital affiliated to Tehran University of Medical Sciences in Tehran, Iran, from February to July 2021., Participants: Fifty patients with COVID-19 participated in this study., Research Design: A single-blind, randomized control design., Intervention: The patients with COVID-19 randomly assigned to an intervention group who received respiratory physiotherapy combined with MFRT or a control group receiving respiratory physiotherapy alone., Main Outcome Measures: Heart rate, systolic and diastolic blood pressure, respiration rate, oxygen saturation, chest expansion, and ease of breathing were assessed at baseline and after the first and third session of treatment. Dyspnea and fatigue perception and 6-minute walking were assessed at baseline and at the end of treatment. Patient's thoughts about the treatment were examined through the 4-point Likert scale., Results: The ANOVAs found significant time effect for ease of breathing, dyspnea perception (F = 32.33, p < .01 and F = 11.72, p < .01, respectively). Also significant time by group interaction was found for chest expansion at xiphoid level (F = 4.02, p = .02)., Conclusions: The present study provided evidence that both programs could result in improving ease of breathing and dyspnea perception, although the inclusion of MFR techniques into a respiratory physiotherapy program did not result in better outcomes in cardiorespiratory function of patients with COVID-19., Competing Interests: CONFLICT OF INTEREST NOTIFICATION The authors declare there are no conflicts of interest., (Copyright© The Author(s) 2022. Published by the Massage Therapy Foundation.)