Search

Aim Adherence to lifestyle recommendations, medical regimens and cardiac rehabilitation is poor among patients with acute coronary syndrome. The aim of this study was to examine the effect of nurse‐led counselling and education using a person‐centred care approach on short‐term cardiac self‐efficacy in patients with acute coronary syndrome. Design A parallel, two‐armed, randomized controlled trial was conducted. Methods One hundred twenty patients who were hospitalized with diagnosis of acute coronary syndrome were selected and randomly assigned into intervention (n = 60) or control (n = 60) groups. In the intervention group, in addition to routine care, the nurse‐led counselling and education programme included two face‐to‐face sessions, two telephone counselling and education sessions, using the person‐centred care approach. Participants in the control group received only routine care. Data were collected using the cardiac self‐efficacy scale before the intervention and 1 month after discharge. Results After the intervention, we found that cardiac self‐efficacy, including the perceived self‐efficacy to control symptoms and maintain function, was statistically significantly higher in the intervention group than the control group.

Summary Background and aims Non-alcoholic fatty liver disease (NAFLD) is known as a serious disease associated with malnutrition and overweight habits. The aim of this study was to investigate the effect of the eight-week high-intensity interval training (HIIT) and the low-intensity endurance training (ET) on the expression of HIF-1α, HIG2 and intrahepatic lipid content (IHL) in the rats suffering from non-alcoholic fatty liver disease (NAFLD). Methods To this aim, forty Wistar rats were selected randomly and divided into four groups: NAFLD, NAFLD + HIIT (N + HIIT), NAFLD + ET (N + ET), and control groups. The protocol of the N + HIIT group consisted of high-intensity running separated with light running; the protocol of the N + ET group was matched with the whole ran distance of the N + HIIT group with a lower intensity. After eight weeks, a portion of the liver of each rat was excised and frozen in liquid nitrogen for assessment of HIF-1α, HIG2 mRNA levels, and IHL. Results The results showed that there was a significant difference between the groups in terms of the expression of HIF-1α (X2 = 16.42, P = 0.001), HIG2 (X2 = 12.43, P = 0.006) and IHL content (X2 = 32.84, P = 0.001). Moreover, HIF-1α and HIG2 mRNA levels were found to be decreased in N + HIIT vs. NAFLD (P = 0.024 and P = 0.031) and N + ET vs. NAFLD (P = 0.012 and P = 0.012), respectively. There was no significant difference in the expression of HIF-1α and HIG2 between N + HIIT and N + ET groups (P = 0.895 and P = 0.453). There were also significant differences in terms of IHL between NAFLD and N + HIIT groups (P = 0.001), and between NAFLD and N + ET groups (P = 0.001). A significant difference was also observed in the IHL content between N + HIIT and N + ET groups (P = 0.003). Conclusion Overall, it could be concluded that both N + HIIT and N + ET protocols reduced the content of liver fat, thereby decreasing fatty liver disease by reducing the expression of HIF-1α and HIG2 genes. It seems that the decrease of hypoxia and lipid droplet-associated with proteins in hepatocytes could lead to the improvement of fatty liver disease.

Objective This study aimed to assess the effect of peer education on the quality of life and self-care behaviors of patients with myocardial infarction. Methods In this clinical trial, 70 patients with myocardial infarction meeting the inclusion criteria were assigned to experimental (n = 35) or control (n = 35) groups using block randomization. Patients in the intervention group received two one-hour training sessions on the third day after myocardial infarction during the CCU stay along with routine care. Education intervention was performed by peers. The control group will follow routine care. All patients selected were assessed using McNews' quality of life questionnaire and Miller self-care questionnaire, respectively before the intervention and also one month after discharge. Chi-square and t-test were used to analyze the data. Results After the intervention, the mean of quality of life and the mean score of self-care behaviors in the experimental group were significantly higher compared to the control group. Conclusions According to the results, to improve the quality of life and promote the self-care behaviors in such patients, using peer education along with healthcare professionals is recommended. Practice Implication This patient education approach had a significant impact on quality of life and self-care behavior.

Background and Aims Fatigue is one of the most common complaints of the elderly. This study was conducted to assess the effect of zinc supplements on fatigue among the elderly. Methods This randomized clinical trial was conducted on 150 elderly aged ≥60 years who were recruited from the health centers (Kashan, Iran) with a convenience sampling method. Participants were allocated to intervention and control groups by block randomization. Participants in the intervention group received a daily dose of 30 mg of zinc supplement for 70 days; meanwhile, in the control group, no intervention was performed. The level of fatigue was measured by the multidimensional fatigue inventory before and after the intervention. Both groups were homogeneous in terms of demographic variables, fatigue, and serum zinc level before the intervention. The significance level was considered as 0.05 in all tests. Results Zinc supplementation significantly reduced fatigue (mean difference: −10.41 vs 1.37, P

Purpose The purpose of this study was to evaluate the effect of preoperative visitation on preoperative anxiety in patients receiving elective hernia surgery. Design Quasi-experimental study. Methods Seventy patients undergoing hernia surgery were selected and assigned to the experimental group (N = 35) and the control group (N = 35). In the intervention group, the surgical technologist visited the patient in the surgical ward the night before surgery and after transferring the patient to the waiting room in the operating room department. The control group received only routine preoperative care by nurses in the surgical ward and operating room department. For both groups, the Spielberger State-Trait Anxiety Inventory was completed in two stages, on the night before surgery and on arrival time in the operating room. Findings Average age was 41.2 ± 13.4 years. Statistical tests showed a significant reduction in anxiety after intervention (42.3 ± 9.2) compared with before intervention (45.6 ± 9) and between the two groups after intervention (50.9 ± 10.7 in the control group vs 42.3 ± 9.2 in the intervention group). Conclusions Using an anxiety evaluation approach in preoperative training programs to manage anxiety in surgical patients is recommended.

[Purpose] The purpose of this study was to determine the effect of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger. [Participants and Methods] A randomized controlled trial was conducted. Fifty eight patients having trigger finger were randomly assigned as either an experimental group that received a single session of dry needling over pulleyA1 and flexor tendon or a control group that received no intervention. Thickness of tendon-pulley, and pain-hand function (by disability arm-shoulder questionnaire score and pinch grip strength) were measured by a blinded assessor before and one week after intervention. [Results] The two way mixed ANOVA in the experimental group showed that the thickness of pulley-tendon decreased, pinch grip power increased and DASH questionnaire score was decreased in comparison to the control group. [Conclusion] This study results suggest that a single session of Dry Needling (DN) was effective in decreasing pain, DASH score, pulley-tendon thickness and improving pinch grip power in patients with trigger finger.

[Purpose] This study was conducted to investigate the immediate prophylactic effects of local vibration on quadriceps muscle fatigue in young non-athletic males. [Participants and Methods] Thirty healthy young males were randomly assigned to vibration and sham control groups. Participants in the local vibration group received a single session vibration (2 minutes, 30 Hz). They also in the control group received a 2-minute vibration, while the vibration system was off. MVC, RMS and median frequency of EMG findings and time to reach fatigue were measured. [Results] Time to reach fatigue and MVC in the local vibration group was significantly high than those in the sham control group. [Conclusion] It seems that the prior local muscle vibration may be useful to attenuate some signs and symptoms of muscle fatigue.

Background One of the factors associated with readmission is inappropriate sexual activity after myocardial infarction (MI). This study aimed to assess the effect of peer education on the sexual quality of life (SQOL) in patients with MI. Methods In this randomized controlled clinical trial, 70 patients with MI meeting the inclusion criteria were assigned to experimental or control groups using block randomization. Peer education for the intervention group was provided on the third day after MI. Education sessions lasted from 90 to 120 minutes. Data were collected using demographic, sexual quality of life-female (SQOL-F), and sexual quality of life-male (SQOL-M) questionnaires during the fourth week after MI. Results There was no significant difference between the two groups before the intervention in terms of demographic and SQOL. The mean of SQOL in the peer education group was significantly higher than the control group at the 4-week follow-up. Conclusions According to the results, using peer education is recommended for the sexual health care professionals.

Background: Appropriate breastfeeding reduces health disorders and death among infants. Objectives: The present study was conducted to evaluate the effects of educational intervention based on the extended theory of planned behavior. Methods: In this semi-experimental study, 168 pregnant women from 20 health centers were allocated into intervention and control groups by a multi-stage sampling method. The data collecting tool included demographic and constructs of an extended theory of planned behavior. The validity and reliability of the questionnaire were confirmed by an expert panel and Cronbach's alpha test, respectively. The educational methods encompassed face to face training, pamphlet and flashcards distribution, and clip presentation. Two 45-minute educational sessions were conducted; the data were recollected 6 months after the delivery. Results: The mean ages of the intervention and control group were 29 ± 6 and 28.7 ± 5.9. The pregnancy rate and age of the pregnancy in the intervention group were 2.7 ± 1.4 and 29 weeks, respectively. After the intervention, the mean score of the behavior in the intervention group increased compared to the control group. The intention (B = 0.4, P = 0.01) and perceived behavior control (B = 0.42, P = 0.03) were the predictors of the behavior. Conclusions: The structures of the extended theory of planned behavior are suitable framework to promote exclusive breastfeeding among pregnant women.

Background and Aim: Balance disorders are among common complications of chronic low back pain (LBP). Since the tissue and echo­genicity of thoracolumbar fascia changes in chro­nic LBP, the independent motion of fascia layers would negatively alter, and it may affect the con­trol of spine movements. It has been shown that myofascial release (MFR) improves the function of transversus abdominis as a core muscle in LBP. So, MFR may affect the balance and pos­tural control in these patients. The aim of this study was to evaluate the immediate effects of MFR and core stability (CS) exercises on dyna­mic balance and pain in women with chronic non-specific LBP. Methods: In this pilot study, with a pretest-posttest design, 10 females aged 30 ± 9.04 parti­cipated. The participants received one session of MFR on thoracolumbar fascia and CS exercises. The outcome measures were dynamic balance by Y balance test (YBT) and pain with visual ana­logue scale (VAS), which were assessed before and immediately after the intervention. Results: Dynamic balance improved signifi­cantly (p < 0.02) after intervention. The VAS as an indicator of pain intensity showed significant improvement (p = 0.005). Conclusion: The application of MFR plus CS exercises for a single session is effective in improving dynamic balance and pain in women with chronic non-specific LBP. Keywords: Dynamic balance; core stability; low back pain; myofascial release

Introduction: Nitric oxide (NO) has some important roles in endothelial functioning and renal hemodynamics. Based on previous studies, NO function is different in both genders. Probably, antioxidant vitamins, as free radical scavengers, have some protective effects on renal injury. Objectives: This study aims to search the possible antioxidant effects on nitrite level in both sexes. Materials and Methods: The rats were divided into 8 groups each including both male and female ones; The categories include 1) gentamicin treated, 2) gentamicin and vitamin E-treated, 3) gentamicin and vitamin C-treated, 4) gentamicin plus vitamin E and C treated. Nine days after administering drugs, blood samples were collected from the heart. The level of urea, creatinine (Cr), and nitrite were measured in the animals serum. Also, nitrite level was measured in the homogenized kidney tissue. Results: Gentamicin, in male and female rats enhanced serum urea and Cr levels significantly at the level of P

The objective of study was to investigate the effects of video game training in comparison with traditional motor-cognitive dual-task training on dual-task interference in older adults. Sixty older adults were allocated to the video game (intervention group) or the motor-cognitive dual-task training (control group). The outcome measures were dual-task cost (DTC) of linear metrics (Standard deviation (SD) of amplitude and velocity) and DTC of nonlinear metrics (approximate entropy, Lyapunov and correlation dimension) acquired from postural sway time series from both the mediolateral (ML) and anteroposterior (AP) directions. The results revealed in both groups, dual-task cost of SD of amplitude and velocity as well as Lyapunov were significantly decreased in post-training and follow-up compared with pre-training (p 0.017), while there was no significant difference between the groups. Video game and motor-cognitive dual-task training could be recommended as suitable treatments to improve dual-task interference.

Objective The reliability of surface electromyography (SEMG) derived parameters is of high importance, but there is distinct lack of studies concerning the reliability during dynamic contractions. Particularly, the similarity index reliability has not been investigated during functional task yet. The purpose of this study was to evaluate the reliability of trunk muscle activities measured by means of surface electromyography during lifting tasks over repeated trials within a day. Methods Seven volunteers were assessed twice a day. SEMG signals were recorded bilaterally from seven trunk muscles. Intra class correlation coefficients (ICC) and standard error of similarity index, magnitude and timing were calculated. Results Investigation of ICC and correlation between trials showed that similarity index (ICC 0.73–0.97, correlation 0.6–0.95) is more reliable and repeatable than muscles magnitude (ICC 0.41–0.69, correlation 0.54–0.65) and it's timing (ICC 0.41–0.69, correlation 0.31–0.74) while timing had the least reliability. Conclusion Similarity index can be mentioned as an appropriate motor control index and evaluation of muscle recruitment pattern should be done by considering similarity index and magnitude.

Background: Nephrotoxicity is the most recognized side effect of gentamicin. Vitamin E and vitamin C demonstrate their effective role in the prevention of nephrotoxicity. Likewise, previous studies have suggested that women have low risk of end-stage renal disease at premenopausal period. to antioxidant effects vitamins E and C in gentamicin-induced nephrotoxicity. Materials and Methods: Wistar rats were randomly assigned to 6 groups each including both male and female rats. The first and second groups received saline (control group) and almond oil, the third group received gentamicin. The fourth group received a regular dose of gentamicin + vitamin E. Similarly, the fifth group received a regular dose of gentamicin + vitamin C. The sixth group received a dose of gentamicin + vitamin C and E simultaneously constantly. This protocol continued for 9 days. (MDA), but it decreased superoxidase dismutase (SOD) level (P < 0.05). Treatment with antioxidant vitamins improved urea, creatinine, MDA, and SOD serum level significantly in both genders (P

[Purpose] The purpose of this study is to evaluate the reliability of linear and nonlinear measures of the center of pressure (COP) during visual deprivation. [Subjects and Methods] Fifteen young adults participated in this study. COP signals were recorded in two conditions: eyes open and eyes closed. Three trials were performed in each condition with a rest period of approximately 1 min. The intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) were calculated. [Results] The investigation of ICC and SEM between trials showed that the Lyapunov exponent (ICC: 0.76-0.96, SEM: 0.03) and total mean velocity (ICC: 0.71-0.95, SEM: 0.05) were more reliable and repeatable than range and area (95% confidence ellipse), while area had the least reliability (ICC: 0.49-0.77, SEM: 0.56). [Conclusion] The Lyapunov exponent can be considered an appropriate postural control index, and the evaluation of postural stability should be done by considering linear and nonlinear tools.

Study Design This is a single-blinded clinical trial study. Clinical Trial Number registry: IRCT201610223551N4. Introduction Stroke is the second cause of death around the world. Motor and sensory problems are common complications of the stroke. These defects in the upper limb cause reduced use of the affected limb and consequently a decrease in the quality of life. Purpose of the Study The purpose of this study was to examine the effect of exteroceptive and proprioceptive stimulations on motor function, spasticity of the upper limb, and activities of daily living in people who have had stroke. Methods Sixty people with chronic stroke selected by convenience sampling. Before the intervention, Modified Ashworth Scale, Fugl-Meyer assessment of Motor Recovery after Stroke, and Barthel Index were measured and then the intervention phase was started. Exteroceptive and proprioceptive sensory stimulations were performed for 6 weeks. Independent t-test was used to compare groups. Results The intervention group made improvement in motor function (P = .0001, Cohen's d = 2.14), activities of daily living of upper limb (P = .0001, Cohen's d = 1.32), and spasticity (P = .002, Cohen's d = −0.94). Discussion Motor function and activities of daily living and spasticity of the upper limb can be improved through exteroceptive and proprioceptive stimulations. In this study, this type of intervention had the most impact on motor function compared with the rest. Conclusion Exteroceptive and proprioceptive stimulations in upper limb can be used in chronic phase of stroke. Improvement in motor function and activities of daily living and reducing spasticity are the results of these stimulations.

INTRODUCTION AND AIM: The aim of this study was to evaluate the effect of two concentrations of caffeine (1.5% and 3%) powder added to Bio-Oss xenograft on bone healing rate of iatrogenic mandibular defects in dogs. MATERIALS AND METHOD: The researchers implemented a pilot study on ten male adult mongrel dogs. Two 4-mm circular critical-sized defects were trephined on each side of the mandibular body (a total of 4 defects for each dog). One of the defects remained empty as a control group. The other three defects in each case were randomly filled with 1.5% or 3% caffeinated Bio-Oss or pure Bio-Oss. The mandible specimens were sent for histological and histomorphometric assessments, 4 months postoperatively. Our predictor variable was the type of bone substitute. The study outcomes were new bone formation, angiogenesis, and fibrosis. The p value was set at 0.05 using SPSS 16. RESULTS: The histological assessment showed that the administration of 1.5% caffeinated Bio-Oss to mandibular defects caused more angiogenesis and more new bone formation as well as less fibrosis compared to the other groups (p

Currently, numerous remote sensing satellites provide a huge volume of diverse earth observation data. As these data show different features regarding resolution, accuracy, coverage, and spectral imaging ability, fusion techniques are required to integrate the different properties of each sensor and produce useful information. For example, synthetic aperture radar (SAR) data can be fused with optical imagery to produce 3D information using stereogrammetric methods. The main focus of this study is to investigate the possibility of applying a stereogrammetry pipeline to very-high-resolution (VHR) SAR-optical image pairs. For this purpose, the applicability of semi-global matching is investigated in this unconventional multi-sensor setting. To support the image matching by reducing the search space and accelerating the identification of correct, reliable matches, the possibility of establishing an epipolarity constraint for VHR SAR-optical image pairs is investigated as well. In addition, it is shown that the absolute geolocation accuracy of VHR optical imagery with respect to VHR SAR imagery such as provided by TerraSAR-X can be improved by a multi-sensor block adjustment formulation based on rational polynomial coefficients. Finally, the feasibility of generating point clouds with a median accuracy of about 2m is demonstrated and confirms the potential of 3D reconstruction from SAR-optical image pairs over urban areas., Comment: This is the pre-acceptance version, to read the final version, please go to ISPRS Journal of Photogrammetry and Remote Sensing on ScienceDirect

Background: Heart failure is a major growing problem and affects not only patients but also their families and community networks and reduces the functional capacity of patients and impairs their social life. Research questions: This study was conducted to investigate relationship between illness-related worries and social dignity in patients with heart failure. Design: The study had a descriptive-analytic design, and data collection was carried out by means of two specific questionnaires. Participants and context: A total of 130 inpatients from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. Results: The highest mean score of illness-related worries was attributed to the dimension of patient’s worry of physical–mental complications, and the least mean score was related to the dimension of the worry about the future of disease. The highest mean score of social dignity was associated with the dimension of social communication and support, and the least is attributed to the dimension of burden to others (economic). Pearson’s statistical test showed a significant correlation (r = 0.455, p < 0.05) between the score of illness-related worries and social dignity. Discussion: As the result of this study showed that reducing illness-related worries in patients with heart failure can improve their social dignity, using strategies to decrease worries and promote social dignity in these patients is recommended. Conclusion: This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. We hope these results will help to promote actions by patient-care staff that honor and support patient dignity, resulting in benefits to patients and developing the quality of care based on human rights.

It is thought that gait initiation (GI) might be an optimal task for identifying postural control deficiencies. Thus, the aim of this study was to clarify the strategies adopted by older subjects during this task. 16 healthy younger and 15 healthy older adults participated in the study. Subjects were instructed to begin forward stepping with their dominant limb in response to an auditory stimulus. The mean muscle activity, co-contraction index, and intra-subject coefficients of variation (intra-subject CVs) of dominant limb muscles in different phases of GI were measured. The level of association between the co-contraction index and intra-subject CV of muscles was also explored. This study showed that in the anticipatory phase, the younger group had larger amplitudes and more intra-subject CVs than older the group, particularly for the tibialis anterior muscle. However, the co-contraction index was greater in older subjects relative to younger subjects. During the weight transition phase, tibialis anterior, semitendinosus and vastus lateralis muscles of older adults had a lower amplitude as compared to younger adults. However, during the locomotor phase, the activity of tibialis anterior was greater in comparison to younger adults. Also, during this phase, similar to the anticipatory phase, the co-contraction index between tibialis anterior and gastrocnemius muscles was greater in older subjects relative to younger subjects. Additionally, the larger co-contraction index of some muscles was associated with smaller intra-subject CV. These findings suggest that muscle behaviors are altered with aging and older adults employ different strategies in the different phases of GI as compared to younger adults.

Purpose The purpose of this study was to evaluate the effect of preoperative visitation on postanesthesia complications after hernia surgery. Design In this quasi-experimental study, 70 patients receiving elective hernia surgery were purposefully selected. Methods In the evening preceding surgery, the surgical technologist visited the patient in the surgical ward. Data were collected by checklist of vital signs and postanesthesia complications. Findings A greater increase is observed in the systolic blood pressure of the experimental group at the moment of entering the postanesthesia care unit. A significant difference was found between groups in the intensity of postanesthesia agitation in the postanesthesia care unit patients, with a higher incidence among the experimental group. Conclusions According to the findings, preoperative education programs for operating room staff and other behavioral and mental interventions to manage surgery and its consequences in elective surgical patients is recommended.

Static stretch is a safe and feasible method which usually is used before exercise to avoid muscle injury and to improve muscle performance. The purpose of this study was to determine the effects of cyclic static stretch (CSS) on fatigue recovery of triceps surae (TS) in female basketball players. Nine athlete volunteers between 20 and 30 years participated in this study containing two sessions. After warm-up a pressure cuff was fastened above the knee joint and its pressure was increased to 140 mmHg. The subjects were asked to perform one maximum voluntary contraction (MVC) followed by a fatigue test including maximum isometric fatiguing contraction of TS. These steps were similar in both sessions. Then, a two-minute rest was included in the first session while 4 static stretches were performed to TS in the second session. After interventions, one MVC was done and the pressure cuff was released. During these steps, peak torque (PT) and electromyography (EMG) were recorded. The amount of lower leg pain was determined by the visual analogue scale (VAS). The value of PT increased significantly after CSS but its increase was not significant after rest. It seems that the effects of rest and CSS on the EMG parameters, PT and pain are similar.

The purpose of study was to demonstrate age-related changes during gait initiation (GI). Therefore, displacement, velocity, total power, mean and median frequency of COP trajectories were measured during phases of GI in anteroposterior (AP) and mediolateral (ML) directions. The older group demonstrated the slower and lesser displacement in comparison with the younger group during anticipatory phase in AP direction and during locomotor phase in AP and ML directions. In addition, the median and mean frequency were greater in the older relative to the younger group during anticipatory phase in AP direction, while these were lesser in older than younger group during locomotor phase in AP and ML directions. Moreover, total power was greater among older than younger adults during the anticipatory phase in ML direction and during all phases in AP direction. This study suggests that COP-related parameters extracted from time and frequency domains have the ability to demonstrate age-related changes.

Aims Little is known of the short-term effects of combined aerobic and strengthening exercises—as components of phase III cardiac rehabilitation— in patients of Middle Eastern origin who have undergone coronary artery bypass grafting (CABG). This study aimed to assess the efficacy of exercise protocols used during phase III cardiac rehabilitation of patients from Iran who had undergone this procedure. Methods The study compared the effect of combined aerobic and strengthening exercises vs aerobics alone on the functional capacity, muscle strength, serum lipids and blood pressure of 88 patients, 4-5 weeks after CABG. A control group performed aerobics while three experimental groups performed combined aerobic and strengthening exercises, 5 days a week over 5 weeks. The functional capacity, muscle strength and serum lipids were determined at baseline and specific time points during the study. Heart rate and blood pressure were measured before and after each session. Findings The combined exercise protocols improved the functional capacity and muscle strength to a significantly greater extent than the aerobic protocol. Serum total cholesterol, low-density lipoproteins and triglyceride levels decreased insignificantly, however, the high-density lipoproteins level increased significantly in all groups. Systolic blood pressure declined insignificantly but the diastolic blood pressure remained unchanged in all groups. Conclusions The results suggest that the combined exercises were superior to the aerobics alone for positive changes in patients’ functional capacity and muscle strength, with effects lasting up to follow-up.

Patellar bracing is a component of treatment of patellofemoral joint (PFJ) problems. A new vacuumic brace was designed by the researchers that act based on an external vacuuming suction. Ten patients were undertaken for the CT scan study at both 0 degrees and 30 degrees knee flexion immediately pre- and post-bracing. Also they examined clinically pre, post and 1 week after using the brace. Measurements of patellofemoral joint space width (PFJSW) and patellofemoral joint area (PFJA) showed that the application of the vacuumic brace is able to create a significant patellofemoral joint distraction at both knee angles. A significant reduction in visual analog scale (VAS) and increase in kujala patellofemoral score (KPS) was found in subjects after using the brace for 1 week. In conclusion, the results conveyed that application of the vacuumic brace is able to create a joint distraction and useful changes in VAS and KPS parameters.

Background Lateral scapular slide test (LSST) quantitatively measures the distance between thoracic spine (T7) and inferior angle of scapula. Objective In this study, the intra-rater reliability, inter-rater reliability and diagnostic accuracy of LSST were measured using a caliper. Methods Three measurements of each test position were obtained bilaterally. Intraclass correlation coefficient (ICC) (2.1), 95% CI and 2 SEMs were calculated for intra-rater and inter-rater reliability of the absolute scapular distance. Sensitivity, specificity, positive and negative likelihood ratios were determined. Results 27 people with and 30 people without shoulder pain participated. The mean age (SD) for the participant was 47.7 (11.6) years and 33.5 (11.7) years, respectively. The ICCs for intra-rater reliability were high. A range of poor to good ICCs was found for inter-rater reliability. The 2 SEMs ranged from 4.6 to 7.9 mm for intra-rater reliability and from 6.8 to 13.4 mm for inter-rater reliability for people with shoulder pain. Positive and negative likelihood ratios from 0.94 to 1.22 and from 0.21 to 2.5, respectively, were demonstrated. Conclusion SST did not show a consistent high reliability. The diagnostic accuracy of the LSST was low, which questions the clinical importance of the tests outcomes.

The aim of this study was to determine the effects of a phase II cardiac rehabilitation programme on health-related quality of life (HRQoL) domains in cardiac patients following coronary artery bypass grafting (CABG). The study looked at post-CABG patients of Iranian origin who had been admitted to the Tehran Heart Center, Iran. Forty-four patients aged between 40–60 years, participated in the programme, 4–5 weeks after CABG. The SF-36 Health Survey was used to assess the health-related quality of life (HRQoL) domains before and after the programme, and at 3-month follow-up. The data were then compared with corresponding values for 882 healthy Iranian individuals of similar ages from the general population. The programme was safe and well-tolerated. The mean scores for all patients showed significant gains in all HRQoL domains, both at last exercise session and follow-up. Compared with mean scores at the last exercise session, the values at follow-up remained essentially unchanged in five domains. There were further significant gains in the mean scores for Role physical, Role Emotion and Bodily Pain at follow-up. The results suggest that the programme produced significant short-term and long-term improvements in physical, mental and emotional aspects of the patients' quality of life in this patients Further research is needed to correlate the values of the SF-36 scores with clinical outcomes, and to investigate the mechanisms by which the programme is effective.

Aim and objective. The aim of this study was to investigate the effect of group counselling program on quality of life in survivors of myocardial infarction. Background. Myocardial infarction is one of the most dramatic illnesses that can afflict patients. Despite decreases in mortality from coronary heart disease in most developed countries, mortality is increasing in most eastern European countries and developing countries. Design. A randomized-controlled trial design. Methods. Sixty-two patients with myocardial infarction were chosen, case group, (31 patients), distributed in five subgroup (each subgroup conclude six or seven patients) and control group (31 patients). A group-counselling program was performed two days per week, each session last one hour. However, no counselling was performed for the control group. The quality of life score was estimated in both groups by the use of the MacNew Quality of Life after Myocardial Infarction questionnaire, before the group counselling program, and one month after the group counselling program, and the quality of life between both groups were compared. The data were analyzed using SPSS software. Results. Results indicated that there was no significant difference between the mean quality of life score of case and control groups before group counselling program. While there was a significant difference (P = 0·001) between the mean of quality of life score after the group counselling in both groups. The mean of quality of life score, before and after group counselling program indicated a significant difference (P

It has been thought that for scientific acceptance of a parameter, its psychometric properties such as reliability, validity and responsiveness have critical roles. Therefore, this study was conducted to estimate how many trials are required to obtain a reliable center of pressure (COP) parameter during gait initiation (GI) and to investigate the effect of number of trials on the relative and absolute reliability. Twenty older adults participated in the study. Subjects began stepping over the force platform in response to an auditory stimulus. Ten trials were collected in one session. The displacement, velocity, mean and median frequency of the COP in the mediolateral (ML) and anteroposterior (AP) directions were evaluated. Relative reliability was determined using the intraclass correlation coefficient (ICC), and absolute reliability was evaluated using the standard error of measurement (SEM) and minimal detectable change (MDC95). The results revealed with respect to parameter, one to five trials should be averaged to ensure excellent reliability. Moreover, ICC, SEM% and MDC95% values were between 0.39-0.89, 4.84-41.5% and 13.4-115% for single trial and 0.86-0.99, 1.74-19.7% and 4.83-54.7% for ten trials averaged, respectively. Moreover, the ML and AP COP displacement in locomotor phase had the most relative reliability as well as the ML and AP median frequency in locomotor phase had the most absolute reliability. In general, the results showed that the COP-related parameters in time and frequency domains, based on average of five trials, provide reliable outcome measures for evaluation of dynamic postural control in older adults.

Background Patients with diabetes type 2 suffer from many complications such as peripheral neuropathy (PN). PN impairs postural stability and muscle strength. Therapeutic exercise may improve functional abilities of diabetic patients but they are unwilling to participate in exercise programs. Whole Body vibration (WBV) is a new somatosensory stimulation which is easy to use and time-efficient. The effects of WBV on balance and strength of diabetic patients had not been studied; therefore the aim of this study was to assess the effects of WBV in type 2 diabetes patients. Methods It was a quasi-RCT study performed between March 2011 and February 2013. Twenty patients were randomly assigned into either a whole body vibration group, or a control group. WBV group received vibration (frequency: 30 Hz, amplitude: 2 mm) twice a week for 6 weeks. Muscle strength, Timed Up & Go Test (TUGT) and Unilateral Stance Test and balance parameters were measured at baseline and after the intervention. Results WBV had significantly increased strength of tibialis anterior (P = 0.004) and quadriceps muscles (P = 0.05) after 6 weeks of training. TUGT time decreased significantly (P = 0.001) in the WBV group. Conclusions Application of WBV enhanced muscles strength and balance in patients with diabetes type 2-induced peripheral neuropathy. The changes may be due to muscle tuning hypothesis and altered postural control strategies. Trial registration IRCT201106156806N1

Summary Background Motor control approach towards chronic non-specific low back pain (CNLBP) has gained increasing attention. CNLBP patients have shown to be more visually dependent for the postural control process than control subjects but no study has yet investigated the treatment programs effect on this disorder. Methods Forty CNLBP patients volunteered to participate in this experimental study. The subjects were randomly assigned into either stabilization exercise (SE) or control group both receiving 12 sessions of routine physiotherapy for four weeks. The SE group also received intensive stabilization exercise. Balance (in terms of overall (OSI), anteroposterior (APSI) and mediolateral stability indices (MLSI)) and functional disability were assessed by Biodex Balance System ® (BBS) and Oswestry Low Back Disability Questionnaire, respectively prior and after the interventions. The balance tests were performed with open and closed eyes. Results Both interventions significantly decreased all stability indices but the SE group showed a more pronounced improvement in OSI and APSI. In the SE group, vision deprivation had smaller destabilizing effects on OSI and APSI as compared with the control group. The groups were not statistically different prior and after the interventions on all dependent variables. Oswestry index reduction in the SE group was more pronounced but the interaction of time and group variables were not significant on pain intensity. Conclusion Both interventions effectively enhanced stability indices and functional capabilities and reduced pain intensity in CNLBP patients. The SE protocol made the patients less visual dependent perhaps via better stability. Since pain reduction was not different between the groups, more functional improvement in SE group cannot simply be interpreted via the pain interference and might be related to postural control capabilities of the patients.

The most postural adjustments studies have focused on electromyographic and biomechanical events to identify the mechanisms involved in falling, whereas direct recording of central processor system could be an optimal approach to provide new insights into this field. Therefore, the purpose of this study was to determine neurophysiological and biomechanical aspects of the preparatory postural adjustments during gait initiation (GI) in healthy younger and older adults. 16 healthy younger and 15 healthy older adults participated in the study. Stimuli of warning and response were played with an inter-stimulus interval of 2s and subjects were instructed to begin forward stepping with the dominant limb in response to response stimulus. The contingent negative variation (CNV), onset time of electromyographic activity in leading limb muscles and center of pressure (COP) trajectory in the anticipatory phase of GI were measured. Results revealed the peak time of CNV and mean amplitude of Late CNV were earlier and smaller in older group, respectively. However, peak amplitude of CNV did not differ significantly between groups. Moreover, the older group exhibited a delayed onset activity of gluteus medius and tibialis anterior muscles as well as a slower velocity and lesser backward displacement of COP trajectories in comparison with the younger group. Additionally, there were strong relationships between neurophysiological and biomechanical parameters. Findings suggest the age-related changes in the brain activities and preparatory postural adjustments during GI which could be valuable in designing assessment and prevention approaches for falls in this group of people.

Muscle function and functional performance are affected in patients with osteoarthritis (OA). The aim of the study was to investigate and compare the concentric torque of knee muscles (quadriceps and hamstring) and functional status in two matched groups: one group of patients with low grade of tibiofemoral OA, and one group of matched healthy subjects. Concentric peak torques of quadriceps and hamstring were measured in both groups at an angular velocity of 90 and 150 degree/second. In addition, selected functional tests, selected lower extremity range of motion (ROM) and thigh girth were assessed in both groups. The independent t-test revealed statistically significant differences between the two groups with regard to isokinetic concentric peak torque at different angular velocities and for the timed walking test, as a measure of functional status. However, no significant difference in lower extremity joints' ROM and thigh girth were seen. In conclusion, patients with knee OA, even in low grades and with minimum symptoms and signs, had muscle weakness and functional limitation in comparison with the matched healthy subjects. This weakness may result from a variety of factors, leading to muscle strength loss and functional limitation.

Peripheral neuropathy is a common complication of diabetes mellitus. Muscle strength and the balance deficits are seen in these patients. Whole-Body Vibration (WBV) is a time-efficient method which may be beneficial for them. The immediate effects of WBV on muscle strength and balance have not been studied yet. The aim of this study was to investigate the effects of one session of WBV on muscle strength and the balance of diabetic patients. Ten diabetic patients with peripheral neuropathy took part in this study. Outcome measurements were total strength, strength of tibialis anterior and quadriceps femoris muscles and the balance parameters including Unilateral Stance Test and Timed Up and Go Test. Tibialis anterior muscle strength and Timed Up and GO Test parameters showed significant differences post-exercise in comparison to baseline. A session of WBV had positive effects on muscle strength and the balance in patients with type-2 diabetes associated with neuropathy.

BACKGROUND AND OBJECTIVES The common description of muscular fatigue is the failure of muscle in maintaining a target force. Even in sustained contraction, when muscle force is held at a stable level, physiological, biomechanical and electromyographic changes can occur. The purpose of this study is to compare the effects of triceps surae (TS) fatigue on the torque, falling slope and electromyographic (EMG) parameters between athletes and non-athletes. MATERIALS AND METHODS Nineteen healthy women (10 non-athletes and 9 basketball players) participated in this study. After warm-up, subjects performed one maximum voluntary contraction (MVC) followed by fatigue test including sustained maximum isometric contraction of TS until the peak torque (PT) decreased to 50% of maximum value. Immediately after the test, subjects were asked to perform one MVC; then, root mean square (RMS), median frequency (MDF), median frequency slope (MDF slope), PT, falling slope (FSL) and the amount of pain were measured. RESULTS In both groups shift of MDF slope to negative values, significant decrease of MDF and RMS occurred at the end of the fatigue test (P < 0.05). Immediately after the test, PT decreased significantly in both groups (P < 0.05), however, decrease of FSL was significant in non-athletes (P < 0.05) but not in athletes. After fatigue test, increase in Pain was significant in both groups (P < 0.05). Before fatigue test, at the end, and immediately after the test, MDF of non-athletes was more than athletes. There was no significant difference in RMS between the two groups. CONCLUSION Our findings suggest that TS fatigue affects EMG parameters, PT and pain in athletes and non-athletes similarly.

Background: Trunk muscle fatigue has high relevance in human performance. Most authors agree that the use of the median frequency is preferred as a fatigue indicator. Most work has to date, been done on dynamic fatigue measurements, using the similarity index (SI). Objective: Repeated trunk flexion-extensions were measured using the B200 Isostation. Muscle activity was recorded by surface electromyography (EMG) in order to evaluate fatigue of trunk flexor and extensor muscles. Twenty male university studen ts participated in this pilot study, including 6 apparently he althy subjects with a history of low back pain (LBP), and 14 healthy matched controls. All participants were instructed to perf orm repeated trunk flexion-extension against 50% of their ba ck extensors maximal volutary contractions (MVCs) resistance until they could no longer perform the task. The SI was calculated from quantitative analysis of EMG data recording during dynamic trunk flexion extension task. Median frequency was also meas ured before and after fatiguing contractions. Results: The results of this study revealed a significant decrease in the SI and median frequency measurements following fatigue in both groups (p < 0.05). Conclusion: The results of this study indicated that in both groups changes in SI measurements following fatigue are in agreement with the changes in median frequency measurements.