Search

Background and Aim: The Acceptable Noise Level (ANL), which is an effective clinical tool for quantitative assessment of noise tolerance, is affected by some known variables related to both subject and testing materials. The present study examined how the characteristics of different babble noises may affect the ANL results in normal adult listeners. Methods: Forty Persian listeners with normal hearing participated. In addition to typical ANL testing with 12-talker noise, the ANL was obtained in 8 different conditions varying in number of talkers from 2 to 10 in the babble noises presenting forward and backward. Results: There was a significantly lower ANL for 2-talker babble compared to 4, 8, 10, and 12-talker babble in both forward and backward noise conditions. With the increase in talkers in noise, the ANL becomes worse but reaches almost a plateau with more than 4 talkers in babble noise. There was a statistically significant difference between 2-talker forward and 2-talker backward noises, with no difference for the other conditions. Conclusion: This finding that the ANL is affected by the number of talkers in babble noise and by the forward and backward background noise suggests that informational masking and listening in dip mechanisms are involved in ANL for normal hearing people at least. [ABSTRACT FROM AUTHOR]

Background: Pregnant women have poor knowledge of oral hygiene during pregnancy. One problem with the follow-up of dental caries in this group is zero accumulation in the decayed, missing, and filled teeth (DMFT) index, for which some models must be used to achieve valid results. The studied population may be heterogeneous in longitudinal studies, leading to biased estimates. We aimed to assess the impact of oral health education on dental caries in pregnant women using a suitable model in a longitudinal experimental study with heterogeneous random effects. Materials and Methods: This longitudinal, experimental research was carried out on pregnant women who visited medical centers in Tehran. The educational group (236 cases) received education for three sessions. The control group (200 cases) received only standard training. The DMFT index assessed oral and dental health at baseline, 6 months, and 24 months after delivery. The Chi-square test was used for comparing nominal variables and the Mann-Whitney U test for ordinal variables. The zero-inflated Poisson (ZIP) model was applied under heterogeneous and homogeneous random effects using R 4.2.1, SPSS 26, and SAS 9.4. The level of significance was set at 0.05. Results: Data from 436 women aged 15 years and older were analyzed. Zero accumulation in the DMFT was mainly related to the filled teeth (51%). The heterogeneous ZIP model fitted better to the data. On average, the intervention group exhibited a higher rate of change in filled teeth over time than the control group (P = 0.021). Conclusion: The proposed ZIP model is a suitable model for predicting filled teeth in pregnant women. An educational intervention during pregnancy can improve oral health in the long-term follow-up. [ABSTRACT FROM AUTHOR]

Background and Aim: Experiencing dizziness/vertigo is often an indication of dysfunction in the vestibular system. Recent findings show a connection between peripheral vestibular dysfunction and cognitive impairments. The Neuropsychological Vertigo Inventory (NVI) can assess physical, emotional, and cognitive issues in individuals with dizziness/vertigo. The aim of this research was to translate, cultural adaptation and evaluation of the reliability and validity of NVI to Persian. Methods: In this descriptive-analytical study, the NVI scale was translated and adapted to the Iranian cultural context following the international quality of life assessment protocol for translation and equivalence. After obtaining face validity, the scale was administered to 140 patients with peripheral vestibular system dysfunction and 70 control group (age between 25 and 80 years). After one week, 50 participants were asked to complete the questionnaire again. Eventually, reliability was evaluated with both methods of internal consistency and test-retest reproducibility. Results: Out of the 28 items in the NVI scale, 3 items were modified to better align with the cultural conditions of Iranians. The impact scores for most items in this scale were found to be higher than 1.5. The Cronbach's alpha coefficient values for the overall scale (0.90) and test-retest reliability with intra-class correlation coefficient for the overall scale (0.91) were confirmed. Conclusion: The Persian version of NVI scale demonstrates excellent validity and reliability, and it exhibits a high level of content alignment with the original version. Therefore, it can be a useful tool to better understand the physical, emotional and cognitive disturbances in patients with vertigo/dizziness. [ABSTRACT FROM AUTHOR]

Background/Aims: Muscle imbalance in patella stabilisers leads to patellar lateral glide and can cause patellofemoral pain syndrome. This study investigated the effect of progressive strengthening exercises of the vastus medialis oblique on pain and patellar alignment in patients with patellofemoral pain syndrome and patellar lateral glide. Methods: A double-blind, randomised controlled trial was conducted with 40 individuals with patellofemoral pain syndrome with patellar lateral glide aged 20–40 years. The study group received vastus medialis oblique-specific strengthening exercises and routine physiotherapy treatment, and the control group received routine physiotherapy treatment only (stretching exercises, gluteal and quadriceps isometric exercises and conventional transcutaneous electrical nerve stimulation). Participants performed these exercises three times a week for 8 weeks. Pain intensity was measured before and after the intervention using a visual analogue scale and patellar alignment was measured using ultrasonographic parameters, including the trochlear angle, patella offset angle and distance between patellar tip and trochlear groove. Results: In the between-groups comparison, there was a significant decrease in pain intensity in both the study and control groups, although the study group had a greater decrease (study group before intervention: 71.15 ± 1.54, study group after intervention: 22.21 ± 0.35, P=0.001); control group before intervention: 70.09 ± 1.22, control group after intervention: 31.82 ± 0.36 (P=0.001)) and patella offset angle (in the study group compared to the control group after 8 weeks of intervention. In within-groups comparison, a significant decrease of the patella offset angle in the study group was observed (before intervention: 16.2 ± 1.53; after intervention: 13.2 ± 1.87, P=0.001). No significant differences were found for the other parameters. Conclusions: Specific strengthening of the vastus medialis oblique muscle in patients with patellofemoral pain syndrome and patellar lateral glide can lead to pain reduction and improvement of patellar alignment to correct lateralisation. This change may delay the process of patellofemoral joint degeneration. Including vastus medialis oblique-specific strengthening exercises in standard physiotherapy treatments may help to reduce pain levels in people with patellofemoral pain syndrome. Implications for practice: Investigating the main cause of patellofemoral pain syndrome could have an essential role in the rehabilitation treatment of patients. [ABSTRACT FROM AUTHOR]

Background and Aim: Questionnaires are useful tools for clinicians. This study aimed to translate the Dizziness Handicap Inventory for Patient Caregivers (DHI-PC) into Persian (DHI-PC-P) and assess its psychometric properties for children aged 5-12 years. Methods: This is a descriptive-analytical psychometrics study. After obtaining permission from the developers of the DHI-PC, translation into Persian and cross-cultural adaptation were done according to the international guidelines for self-assessment tools recommended by the American Association of Orthopedic Surgeons. Participants were 21 parents (mean age: 38.05 years, SD=6.1 years, 18 female) and their children with dizziness (mean age 8.69 years, SD=2.41 years, 9 female) between the ages of 5-12 years old. Face validity, content validity, and test-retest reliability at an interval of 14-21 days were evaluated for the DHI-PC-P. Results: The face validity was confirmed qualitatively by the experts' opinions and quantitatively by calculating the item impact score. Content validity was confirmed by calculating the content validity index and the content validity ratio (0.97 and 0.86, respectively). The internal consistency was good (Cronbach's alpha=0.90). For the testretest reliability, the intraclass correlation coefficient was obtained 0.94, indicating an excellent reliability. Conclusion: The DHI-PC-P can be used clinically as a valid and reliable tool for children with dizziness aged 5-12 years. [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]

Background: The application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of pain and discomfort, especially in younger patients. The purpose of the present systematic review is to evaluate the efficacy of the methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. Materials and methods: English-language literature from inception until September 6th, 2022 was searched in MEDLINE (via PubMed), SCOPUS, Web of Science, Cochrane, EMBASE, and ProQuest Dissertations & Theses Database Global for articles. Randomized controlled trials (RCTs) comparing methods of reducing the pain and/or discomfort associated with rubber dam clamp placement in children and adolescents were retrieved. Risk of bias assessment was performed using a Cochrane risk of bias-2 (RoB-2) risk assessment tool and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profile. Studies were summarized and pooled estimates of pain intensity scores and incidence of pain were calculated. The meta-analysis was conducted in the following groups according to type of interventions (LA, audiovisual (AV) distraction, behavior management (BM), electronic dental anesthesia (EDA), mandibular infiltration, inferior alveolar nerve block (IANB), TA), outcome (intensity or incidence of pain), and assessment tool (face – legs – activity – cry – consolability (FLACC), color scale, sounds – motor – ocular changes, and faces pain scale (FPS)): (a) pain intensity using (LA + AV) vs (LA + BM), (b) pain intensity using EDA vs LA (c) presence or absence of pain using EDA vs LA (d) presence or absence of pain using mandibular infiltration vs IANB (e) Comparing pain intensity using TA vs placebo (f) Presence or absence of pain using TA vs placebo. Meta-analysis was conducted using StataMP software, version 17.0 (StataCorp, College Station, Texas). Restricted maximum-likelihood random effect model (REML), Mean difference (MD) with 95% confidence interval, and log odds ratio (OR) with 95% CI were calculated were calculated. Results: Initially, 1452 articles were retrieved. Sixteen RCTs were finally included for reviewing and summarizing. Nine articles with a total of 867 patients were included for quantitative meta-analysis. The differences in pain intensity scores were not significant in any comparison groups (group a: [MD = -0.04 (95% CI = − 0.56, 0.47), P = 0.87, I2 = 0.00%], group b: [MD = 0.25 (95% CI = -0.08, 0.58), P = 0.14, I2 = 0.00%], group c [MD = -0.48 (95% CI = -1.41, 0.45), P = 0.31, I 2 = 0.00%], group d: [MD = -0.67 (95% CI = -3.17, 1.83), P = 0.60, I 2 = 0.00%], group e: [MD = -0.46 (95% CI = -l.08, 0.15), P = 0.14, I 2 = 90.67%], and group f: [MD = 0.61 (95% CI = -0.01, 1.23), P = 0.06, I 2 = 41.20%]. Eight studies were judged as having some concern for risk of bias and the remaining studies were considered as low risk for bias. The certainty of evidence was considered medium for all comparison groups. Discussion: In the present meta-analysis, a considerable difference was obtained between the included studies regarding intervention methods and pain assessment tools and the analysis was performed in groups with small numbers of the studies. Owing to the mentioned variabilities and the small number of studies, the results of the analysis should be interpreted with caution. The indistinguishability of the manifestations of pain/discomfort from fear/anxiety, particularly in children, should also be considered while using the results of the present study. Within the limitations of the current study, no significant differences were found between the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. A larger number of more homogenous studies regarding intervention methods and pain assessment tools need to be conducted in order to draw stronger conclusions. Trial registration: This study was registered in PROSPERO (ID number: CRD42021274835) and research deputy of Mashhad University of Medical Sciences with ID number 4000838 (https://research.mums.ac.ir/). [ABSTRACT FROM AUTHOR]

Background and Aim: The Acceptance Noise Level (ANL) which determines the tolerable noise level while listening to running speech, is related to factors such as hearing loss and speech presentation level. This study aims to investigate the effect of speech presentation level on the ANL in people with unilateral Meniere's Disease (MD) compared to the normal-hearing people. Methods: In this study, 33 people aged 32-60 years with unilateral MD and 38 normal-hearing people aged 20-46 years participated. The ANL growth was evaluated unilaterally at four different speech presentation levels: Most Comfortable Level (MCL), -10 dB lower than the MCL, +10 dB higher than the MCL, and a range between MCL and uncomfortable level. Results: In MD patients, the ANL of the affected ear was significantly different from that of the contralateral ear (p<0.010). Compared to the normal-hearing people, the pattern of ANL growth in MD patients was significantly different, but the ANL growth patterns were similar between the affected and contralateral ears. Conclusion: ANL and its growth pattern are different between the affected and contralateral ears of patients with unilateral MD, but are similar compared to normal-hearing people. Despite the apparently normal hearing thresholds, the performance of the contralateral ear in noise at various speech presentation levels in patients with unilateral MD seems to be similar to that of the affected ear. [ABSTRACT FROM AUTHOR]

To evaluate the effect of using lavender oil as an olfactory stimulus with vestibular rehabilitation (VR) on balance, fear of falling down, and activities of daily living of people with multiple sclerosis. Forty participants were randomly assigned into experimental and control groups. The experimental group did the VR exercises while smelling the lavender oil scents. The control group did the VR exercises without it. Both groups did the exercises in ten 45-min sessions. We assessed the participants with the timed up and go (TUG) test, Berg balance scale (BBS), fall efficacy scale – international (FES-I), and the 29-item multiple sclerosis impact scale (MSIS-29). We did the tests at the baseline and after the last exercise session. The experimental group performed significantly better in the BBS (p = 0.007), TUG (p = 0.045), and FES-I (p = 0.016) tests as well as in the MSIS-29's psychological subscale (p = 0.034) than did the control group. Using lavender oil as olfactory stimulus while doing the VR exercises can improve balance and reduce fear of falling down compared to doing the VR exercises without it in people with multiple sclerosis. It seems that using lavender oil, as an olfactory stimulus, while doing vestibular rehabilitation exercises can improve balance and reduce fear of falling down in people with multiple sclerosis compared to doing the vestibular rehabilitation exercises without it. This treatment significantly alleviates the psychological effects of multiple sclerosis on daily life such as sleeping problems, feeling unwell, anxious, tense, depressed, etc. [ABSTRACT FROM AUTHOR]

Background and Aim: Spatial hearing is a prerequisite for the proper function of the listener in complex auditory environments. In the present study, a Persian version of the dynamic spatial-quick speech in noise (DS-QSIN) has been developed with respect to all possible factors affecting the test and to run five lists for normal hearing subjects and assessment of reliability. Methods: To construct five new lists according to the original quick speech in noise (QSIN) test, we used frequent, familiar, and difficult words to construct unpredictable sentences. After determining the content and face validity of the sentences, 30 selected sentences were played using a DS-QSIN software for 35 subjects aged 18-25 years. The reliability of the test was assessed after repeating the test after two weeks. Results: According to expert judges, these 30 sentences showed acceptable content and face validity with the changes. The average signal-to-noise ratio (SNR) loss of five lists was -5.2 dB. No significant difference was seen between men and women in all lists. The results indicate no difference in the average SNR loss between the five lists. Regarding the reliability assessment, the test-retest correlation coefficient was 0.5 to 0.7 (p<0.05). The intra-class correlation coefficient between test-retest was statistically significant (p>0.001) and confirmed that the lists have high reliability and repeatability. Conclusion: DS-QSIN test showed good validity and reliability and can be helpful in diagnosis and selecting the best method for rehabilitation of people with a spatial hearing disorder. [ABSTRACT FROM AUTHOR]

Background and Aim: Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere's disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears. Methods: This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32-60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated. Results: The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of250, 500, and 1000 Hz. Conclusion: MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise. [ABSTRACT FROM AUTHOR]

Background/Aims: The participation of children and adolescents with cerebral palsy in leisure activities is associated with their preferences. A better understanding of their leisure preferences and the factors that influence them can help therapists to promote young patients' participation in leisure activities. The aim of this study was to describe the role of individual factors in the prediction of leisure preferences of children and adolescents with cerebral palsy in Iran. Methods: A cross-sectional study design was used. A total of 152 children and adolescents with cerebral palsy were selected to complete the Preferences for Activities of Children questionnaire. Simple and multiple linear regression analyses were performed to assess the role of individual factors in the prediction of preferences for leisure activities. Results: Individual factors played a significant role in the prediction of leisure preferences. Their influence on the preferences for recreational, physical and self-improvement domains (r2=0.215; 0.154; 0.127, respectively) were greater than for social and skill-based domains (r2=0.045; 0.052, respectively). Conclusions: Preferences for physical activities need to be augmented while a high preference for social and recreational activities could be used to promote participation in leisure activities. Therapists and other healthcare professionals should consider individual factors relating to leisure preferences when devising therapeutic plans that aim to promote participation in leisure activities. [ABSTRACT FROM AUTHOR]

Background and Aim Lip reading is extraction of speech data from the activity of the lower part of face, particularly jaws, lips, tongue, and teeth that is a natural skill in people with hearing loss. The main purpose of lip reading is to increase the independence of people with hearing loss. Looking at the speakers facial movements significantly increase the ability to understand the spoken words, particularly in the environments where noise is present. In fact this reflects the important role of visual signals. In current study we consider the effects of education on lip reading ability by planning and instructing a lip reading program in male subjects. Methods & Materials Sara lip reading test 1 and 2 were used for the assessment of lip reading skills and for studying the effects of lip reading training on recognition of speech. This intervention as a semi-experimental study, was conducted on 27 male students, selected by available sampling. For data analysis, statistical analysis of variance with repeated measurements and Mcnemar was used. Ethical Considerations This research with the code IR.SBMU.REC.1394.144 has been approved by the ethics committee of Shahid Beheshti University of Medical Sciences. Results There were significant differences between Sara lip reading test 1 scores in 2 positions (P=0.000). Lip reading test scores also showed significant differences in Sara lip reading test 2 in 2 positions (P=0.000). Also between the scores of Consonant-vowel, consonant-vowel syllables, in the position before teaching lip-reading and then,was significant difference (P<0.05). Conclusion The findings of this study showed that instructing lip reading has a positive effect on lipreading ability in people. [ABSTRACT FROM AUTHOR]

Background and Aim: Amblyaudia is a diagnostic issue in central auditory processing disorder (CAPD), which is characterized by asymmetry in dichotic listening performance. This disorder negatively affects the academic performance of children by influencing their information processing, reading, attention, etc. The present study aimed to investigate the effect of the dichotic interaural intensity difference (DIID) training on all auditory processing categories of the Buffalo Model using the Persian staggered spondaic word (P-SSW) test. Methods: The study was conducted on 17 children (11 girls and 6 boys) aged 8-12 years old diagnosed with amblyaudia. All children were first evaluated by the P-SSW test, and then participated in 10-12 sessions of the DIID training. The P-SSW test was taken again after completing the training program in order to evaluate the training effect. Results: The paired t-test results showed a significant reduction in the mean scores of decoding (p < 0.001) and tolerance fading memory (p < 0.004) categories as well as the total mean score of P-SSW test after training. The Wilcoxon test also showed the effect of this training on the integration category (p < 0.025). The McNemar test, however, showed no statistically significant effect of the DIID training on the organization category. Conclusion: The DIID training causes significant improvement in some central auditory processing categories of the Buffalo Model, including decoding, tolerance fading memory and integration. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to test a model of child, family and environment and identify factors affecting the intensity of leisure participation by children with cerebral palsy (CP). Materials & Methods In this cross-sectional study, 232 children with cerebral palsy (141 boys and 91 girls), aged 6 to 14 years old and their parents were selected from four schools of children with special needs and five rehabilitation centers through the convenience sampling method in Shiraz, Iran. To evaluate the intensity of leisure participation, we used the Persian version of Children's Assessment of Participation and Enjoyment (CAPE) completed by the participants. Demographic form, Craig Hospital Inventory of Environmental Factors (CHIEF), Strengths and Difficulties Questionnaire (SDQ), Family Environmental Scale (FES), SPARCLE cognitive level and parents' version of Gross Motor Function Classification System, Manual Ability Classification System and Communication Function Classification System were sent to the parents with some necessary explanations. Structural equation modeling was used to test the model hypothesis. SPSS version 18 and AMOS version 16 were used for data analysis. Results Comparative fit indexes indicated a moderate to good model fit. The presented model explained 44% of the variance in the intensity of participation. Constructs such as Family Activity Orientation with standardized total effect of 0.31 and path coefficients of P< .05 showed the most significant direct effect on participation, followed by higher gross motor function (-.26), higher manual ability (-.19), communication function (-.17), higher cognitive level (-.16), more siblings in the family (.15) and less emotional-behavioral problems (-.15). Family structures and relationships (.17) and unsupportive environment constructs (-.14) demonstrated an indirect but significant effect (P< .05). The relationship of family education level and income with participation was not significant (P>.05). Conclusion The intensity of CP children's participation is influenced by child, family and environmental factors. Parents' knowledge of recreational activities and their preference to participate in leisure and recreational activities provide children more opportunities to participate. Higher gross motor function, manual ability, and communication function also play an important role in their participation. Family structure means family cohesion, roles organization, and conflicts between family members and encountering physical, attitudinal and structural barriers at home and community indirectly impact children's participation pattern. To enhance children's participation, we suggest therapists to support children's behaviors, family relationships and involvement in community activities and optimize physical function of children with limitations in self-mobility. [ABSTRACT FROM AUTHOR]

The present study evaluated the depression and marital satisfaction in mothers of 36-48 months old children with developmental delay in comparison with mothers of normal children. Materials & Methods This cross-sectional study was performed on 616 mothers and their children, aged 36 - 48 months, from Apr 2015 to Feb 2016, in some kindergartens in Tehran, Iran. Participants were selected through multi-stage random sampling. The children were divided according to the developmental status into two groups of normal development and developmental delay. The following instruments were used: A demographic and children specification questionnaire, marital satisfaction scale, the Beck Depression Inventory, and the Ages and Stages Questionnaire. The data were analyzed using SPSS16 software. Independent t-test and Pearson correlation were employed at significance level of 0.05. Results The mean age of children with developmental delay and normal development was 41.94±4.48 and 42.17±5.02 months, respectively. The prevalence of developmental delay in children aged 36-48 months was 17.4% and in normal development children was 82.6%. Developmental delay in boys was 23%. The highest incidence of developmental delays was in fine motor skills. Independent t-test revealed a significant difference between mothers' depression and marital satisfaction with and without developmental delays in their children (P=0.0001). In addition, the correlation was observed between the mother's depression and marital satisfaction (P=0.0001). Conclusion Mothers of children with developmental delay suffer more from depression and have less marital satisfaction compared to mothers of healthy children. Interventional studies to reduce depression and increase marital satisfaction and its impact on development status should be conducted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare static maximal back extensor muscle force, endurance, and characteristics of flexion relaxation phenomenon (FRP) in older women with and without age-related hyperkyphosis. Maximum back extensor force and endurance measured in a sitting position with a designed load cell setup; appearance, onset, and offset angles of FRP; and extension relaxation ratio (ERR) during a dynamic flexion-extension task were compared between 24 older women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 65 ± 4.4 years, and 24 older women without hyperkyphosis (thoracic kyphosis angle ≪50°), mean age 63 ± 4.3 years. Variables of force, endurance, angles of FRP, and ERR were analyzed using an independent sample t test. A χ2 test was used to identify differences between groups in FRP appearance. Static back extensor force and endurance were significantly lower among those with versus those without hyperkyphosis (P ≪.001). Although the 2 groups did not differ in FRP appearance and ERR in the superficial erector spinal muscles (P ≫.05), FRP in the hyperkyphosis group started sooner and ended later than in the group without hyperkyphosis (P ≪.05). Our study indicates that women with age-related hyperkyphosis had decreased static maximal force and endurance of the back extensor muscles and prolonged myoelectrical silence of the superficial erector spinal muscles. Reduced endurance of the superficial erector spinal muscles may trigger early onset of FRP and prolonged relaxation of these muscles. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a chronic disease that reduces cardiorespiratory fitness and increases systolic and diastolic blood pressures as well as resting heart rate due to the activity level of the sympathetic nervous system. The aim of this study was to assess the effectiveness of 2 types of aerobic exercise, with and without external loading, on cardiac parameters in diabetic patients. Methods: This randomized controlled trial was carried out on 45 volunteers. These individuals were randomly divided into aerobic, weighted vest, and control groups. The aerobic protocol comprised 24 sessions of aerobic exercise. The exercise program for the weighted vest group was identical to that of the aerobic group, except that the subjects wore a weighted vest. The parameters were measured before and after the 24 sessions. Results: The mean age of the study population was 48.30 ± 5.02 years in the aerobic group, 48.33 ± 5.74 years in the weighted vest group, and 48.60 ± 4.79 years in the control group. Males comprised 7 (53.8%) patients in the aerobic group, 7 (58.3%) in the weighted vest group, and 8 (53.3%) in the control group. After 8 weeks, maximum oxygen consumption in the aerobic group (mean ± SD = 37.54 ± 8.02 mL/kg/min, 95% CI: 5.48 to 11.60; p value < 0.001) and the weighted vest group (mean ± SD = 35.92 ± 3.96 mL/kg/min, 95% CI: 4.36 to 9.64; p value < 0.001) was increased, similar to metabolic equivalent of task in the aerobic group (mean ± SD = 11.60 ± 1.62 kcal/kg x h, 95% CI: 1.48 to 2.72; p value < 0.001) and the weighted vest group (mean ± SD = 11.21 ± 1.11 kcal/kg x h, 95% CI: 1.23 to 2.28; p value < 0.001). Furthermore, resting heart rate decreased significantly in the aerobic group (mean ± SD = 90.23 ± 8.90 bpm, 95% CI: -13.93 to -1.29; p value = 0.022) and the weighted vest group (mean ± SD = 90.58 ± 9.19 bpm, 95% CI: -0.16 to -12.33; p value = 0.045). Conclusion: These findings suggest that 24 aerobic exercise sessions might improve cardiac parameters in type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: The purposes of this study were to (1) measure the thickness of cervical multifidus muscle (CMM) in different maximal voluntary contraction percentages of isometric contraction of shoulder muscles, (2) evaluate the differences of the CMM thickness in different directions of the shoulder movement, and (3) compare the changes in the CMM thickness of participants with neck pain and also of healthy individuals. Methods: Twenty healthy men (age, 27.45 ± 4.37 years; height, 177 ± 4.66 cm; weight, 72.85 ± 6.46 kg) and 20 men with chronic mechanical neck pain (age, 28.90 ±5.53 years; height, 176 ± 5.98 cm; weight, 73.15 ± 7.82 kg) participated in the study. Both the right and left CMM thicknesses were measured using an ultrasound device while participants performed isometric contraction of shoulder muscles in 6 movement directions. Results: In both groups, an increment of CMM thickness followed as the increase of isometric force (P <,01).The increase of muscle thickness of healthy participants was substantially more than the chronic mechanical neck pain participants (P= .03). Although no significant difference of CMM thickness was seen among the effects of the 6 force directions (P > .05), there was a significant difference of activity noted between the left and right sides (P = .047). Conclusion: The results of the present study indicate that isometric contraction of shoulder muscles caused an increase in the CMM thickness regardless of force direction. This increase was seen in both groups of healthy participants and patients with neck pain. However, less thickness changes were observed in participants with neck pain, which may be interpreted as reduced CMM activity in such people. [ABSTRACT FROM AUTHOR]

Background: There have been numerous researches on ozone application in dentistry; yet the data regarding its whitening effect is very limited. The present study compares the bleaching effect of ozone with offi ce bleaching. Materials and Methods: In this experimental study, 15 maxillary premolar teeth were selected and sectioned mesio-distally and bucco-lingually. The sections were then placed in tea for 1 week according to the Sulieman method and were divided into three groups each comprised of 15 sections. The samples were bleached as followed; Group I: Bleached with 35% hydrogen peroxide in three intervals of 8 min each, Group II: Underwent ozone treatment using Ozotop unite for 4 min and Group III: Bleached with a combination of both methods. The color indices of the samples, i.e., (a) green-red pigment, (b) blue-yellow pigment, (L) brightness, (ΔE) overall color change, were evaluated pre- and post-bleaching utilizing a digital camera, Photoshop software and CIE lab index. The color changes of specimens then were calculated and analyzed through randomized analysis of variance and Tukey tests. P < 0.001 was considered to be signifi cant. Results: The color change (ΔE) in Group II was signifi cantly lower than those in the two other groups (P < 0.001). There was no signifi cant difference between the color change of Groups I and III (P = 0.639). In addition, the results of L, a and b brought forth a similar pattern to the fi ndings obtained from ΔE. Conclusion: The hydrogen peroxide gel has a more powerful whitening effect than ozone; in addition, ozone has no synergistic effect when is used simultaneously with hydrogen peroxide. [ABSTRACT FROM AUTHOR]

Background: The accuracy and reproducibility of measurements in a locally made three dimensional (3D) simulator was assessed and compared with manual caliper measurements. Materials and Methods: A total of 20 casts were scanned by our laser scanner. Software capabilities included dimensional measurements, transformation and rotation of the cast as a whole, separation and rotation of each tooth and clip far. Two orthodontists measured the intercanine width, intermolar width and canine, molar and arch depth on the casts and in 3D simulator. For calculating the reliability coefficient and comparing random and systematic errors between the two methods, intra-class correlation coefficient of reliability (ICC), Dahlberg and paired t-test were used, respectively. The ICC and Dahlberg's formula were also applied to assess intra-examiner and inter-examiner reliability of measurements on the casts and in the simulator (P < 0.05). Results: Canine and molar depth measurements had low reliability on the casts. Reliability between methods for the remaining three variables was 0.87, 0.98 and 0.98 in the maxilla and 0.92, 0.77 and 0.94 in the mandible, respectively. The method error was between 0.31 and 0.48 mm. The mean intra-observer difference were 0.086 and 0.23 mm in the 3D method and caliper. The inter-observer differences were 0.21 and 0.42 mm, respectively. Conclusion: The maximum average absolute difference between the two methods was <0.5 mm, indicating that the new system is indeed clinically acceptable. The examiner reliability was higher in 3D measurements. [ABSTRACT FROM AUTHOR]

Background: Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on M breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection PH herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous 0 breastfeeding women. Materials and Methods: This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm) and to measure the severity of damage, Amir scale (1-10 cm) were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. Results: The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74) and day 10 after delivery (4.26 ± 1.57) and before treatment and day 14 after delivery in the case group (1.32 ± 1.02) had a significant difference (P < 0.001). Nipple discharge between the two groups, before treatment (%75.2) and day 10 after delivery (%31.6) and before treatment and day 14 after delivery (%15.7), the case group had a significant difference (P < 0.001). Conclusion: Menthol essence can improve nipple fissures in the primiparous breastfeeding women. [ABSTRACT FROM AUTHOR]

Background: This study sought to assess symphyseal morphology in adolescents with different mandibular growth patterns (MGPs) in order to see if a relation exists. Materials and Methods: In this study the symphyseal parameters (height, depth, and ratio) of normal subjects were compared with four groups with malocclusion (cl III vertical, cl II vertical, cl III horizontal, and cl II horizontal). These groups (15 samples each) were matched (for sex and cervical maturation stage [CVMS]) based on their cephalograms and patient charts. Growth patterns were differentiated by seven vertical parameters and the Wylie analysis. After confirmation of normality of the groups and similarity of their variances the two-way analysis of variance (ANOVA) was used for analysis of data assessed by adjusted chi-square (P < 0.001). The comparison of cases with the normal group was performed by the Dunnett method. Intraclass Correlation Coefficient (ICC) was used for evaluation of intraobserver reliability. Results: We found the symphyseal ratio to have a significant correlation with the MGP (P < 0.001). The symphyseal ratio (Height/Depth) was small in a mandible with vertical growth pattern Cl II or Cl III. Conversely, a horizontal growth pattern of a Cl II or Cl III mandible was associated with a larger ratio of the symphysis in comparison with the normal group. The symphyseal ratio was also found to be greater in females. Conclusion: The symphyseal ratio was found to be strongly associated with the MGP. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cupping therapy has been used widely as a safe and common method to tackle soft tissue lesions in most Asian countries, Central Europe, and parts of the United States. In this study, cupping therapy has been used for the treatment of carpal tunnel syndrome (CTS), which is the most common entrapment neuropathy. The aim of this study was to investigate the effect of cupping therapy on the clinical findings of patients with CTS. Methods: This is a randomized clinical trial. For this research, a total of 56 hands with CTS were studied, aged 18–60 years, and of both genders. The participants were divided into two groups: test and control, regardless of the severity of their CTS. In the control group, 28 were treated with routine physiotherapy (transcutaneous electrical nerve stimulation and ultrasound), and in the test group, the other 28 were treated with routine physiotherapy with cupping therapy. The variables used to determine the effect of cupping were symptom severity scale, functional status scale, distal sensory latency, and distal motor latency. The severity of symptoms and functional status of patients was evaluated with the help of the Boston questionnaire, and the distal latency was evaluated through electromyography. Results: The results of study demonstrated a significant improvement in symptom severity (p = 0.006) and also a significant decrease in distal sensory latency (p = 0.007) of the test group (routine physiotherapy with cupping) as compared with the control group (routine physiotherapy). Conclusions: The results showed that incorporation of cupping therapy in a routine physical therapy programme can reduce the severity of symptoms and improve the distal sensory disturbance of the median nerve. Therefore, it is suggested that cupping, as a convenient and low‐cost method, can be used as a complementary therapy in the treatment of CTS. [ABSTRACT FROM AUTHOR]

Background: Forward head posture (FHP) is a forward positioning of the head relative to the trunk in the sagittal plane. This posture is one of the most prevalent poor postures in patients with head and neck pain. Rehabilitative Ultrasound Imaging (RUSI) is a reliable method to objectively evaluate muscle thickness and function. Objective: To compare thickness of cervical muscles that control both head and neck posture between asymptomatic women with and without FHP. Methods: Seventy asymptomatic women aged between 20 and 40 years, with and without FHP (35 in each group), participated in the study. The thickness of the cervical muscles (rectus capitis posterior -- RCP, oblique capitis superior -- OCS, semispinalis capitis -- SSC, sternocleidomastoid -- SCM, and longus coli -- LCo) was measured using RUSI and the data was compared between the two groups. Results: The comparison of cervical muscle thickness between women with and without FHP revealed significant difference only with regard to the muscle thickness of the SCM muscle (mean difference: 0.7 mm, 95% confidence interval of the difference: 0.14, 1.26 mm, p value: 0.014). The thickness of this muscle was greater in women with FHP. Conclusion: Tonic contraction of the SCM muscle can lead to greater thickness of this muscle in subjects with FHP. [ABSTRACT FROM AUTHOR]