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PURPOSE: Diabetic peripheral neuropathy (DPN) leads to decreased sole sensation and balance disorder, all of which increase the risk of falls and socioeconomic costs. Since the physiotherapists do not use the same manner to lessen the complications of this problem. Therefore, this review study was directed to appraise physiotherapy intervention efficiencies in diminishing DPN’s symptoms and complications. METHOD: A database search of Pubmed, Elsevier, Google Scholar, and Embase was performed to determine DPN’s published documents. Finally, studies of DPN and treatments available in this field, particularly physiotherapy that included electrotherapy, exercise therapy, and other therapies, were identified. RESULT: According to a database search on August 1, 2019, from 1989 to 2019, in the last 30 years, about 968 articles were found, 345 of which were free full text available, and finally, 19 articles were approved. These articles examined the effects of physiotherapy interventions, including exercise therapy, electrotherapy, and other treatment techniques on DPN patients. CONCLUSIONS: The results showed that most diabetic peripheral neuropathy patients suffer from muscle weakness, pain, loss of balance, and lower limb dysfunction. As a result, their daily activity and Life satisfaction are gradually impaired. Exercise therapy, electrotherapy, and other physiotherapy methods have been used to reduce the mentioned cases. Among these interventions, exercise therapy has been the most effective. Although there was little evidence of aerobic exercise in these patients, further studies should be done on other therapies’ effects. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40200-020-00652-8) contains supplementary material, which is available to authorized users.

Objectives: The present research aimed to evaluate the relationship of supra patella effusion with pain and disability in patients with knee osteoarthritis by Ultrasonography (US). Methods: In a cross-sectional study, 60 patients with knee OA (Mean±SD score of body mass index: 29.81±5.64 kg/m2 and age: 50.48±7.57 years) were selected by nonprobability sampling method. Supra patella effusion was evaluated using an US. All study subjects completed the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and disability outcomes, respectively. To evaluate the relationship between effusion, disability, and pain, the Pearson’s correlation coefficient was employed. Results: There was a poor but significant relationship between the area of effusion (r=0.27, P=0.03), the thickness of effusion (r=0.32, P=0.01), with pain. No correlation was found between the trace of effusion (r=-0.08, P=0.5) and pain. The area of effusion (r=0.1, P=0.17), the thickness of effusion (r=0.08, P=0.51), and the trace of effusion (r=0.0, P=0.9) were not correlated with disability. Discussion: The effusion of supra patella was slightly correlated with pain. In contrast, the effusion of supra patella demonstrated no correlation with disability.

The effect of stabilization exercises on pain, disability, and pelvic floor muscle function in postpartum lumbopelvic pain.This is a single-blind, randomized controlled trial.This study was performed at the physiotherapy clinic, Zahedan University of Medical Science, from January to November 2017.Thirty-six multiparous women with persistent postpartum lumbopelvic pain were recruited at least 3 mos after delivery.Subjects in the training group (n = 18) received electrotherapy modalities and specific stabilizing exercises. The control group (n = 18) received only electrotherapy modalities.Pain, disability, and bladder base displacement (at rest and pelvic floor muscles contraction) were measured through visual analog scale, Oswestry Disability Index questionnaires, and transabdominal ultrasound imaging respectively at baseline and after 6 wks of intervention.Between-groups comparison showed significant improvement in pain, disability, and bladder base displacement in the training group (P0.05). In within-group comparison, training group had significant difference for all variables (P0.05). In the control group, pain and disability had significant difference (P0.05), whereas bladder base displacement had no significant change (P0.05).The stabilizing exercises can remarkably improve pain, disability, and pelvic floor muscles function in postpartum lumbopelvic pain (Clinical Trial Registry: NCT03030846).

The objective of the current research was to compare the impact of balance and stabilizing trainings on balance indices in patients with nonspecific chronic low back pain. In this randomized, controlled, single-blinded clinical trial, 20 people suffering from nonspecific chronic low back pain were randomly assigned to two groups of balance and stabilizing trainings. Trainings of both groups were performed for 6 weeks and four sessions per week. The overall, lateral, and anterior-posterior stability indices, pain, and disability were measured using Biodex balance system, visual analog scale, and Oswestry scale, before and after treatment, respectively. Paired t-test and independent t-test were used for analyzing the data. In the balance group, the pain severity was changed from 6.33 ± 1.63 to 4.33 ± 2.6 (P = 0.005) and dynamic anterior-posterior stability index in the standing position on left leg with closing eyes was changed from 5.56 ± 2.25 to 3.45 ± 1. 57 (P = 0.03). In the stabilizing group, pain severity was changed from 4. 16 ± 1.47 to 1.33 ± 0.81 (P = 0.0001) and disability index was changed from 17.33 ± 5.60 to 5.33 ± 3.93 (P = 0.01). Reduction in pain and disability in the stabilizing group and increase in two balance indices were significant in the balance training group compared to those in other group (P < 0.05). Research findings revealed that the impact of stabilizing trainings was significant in reducing pain and disability compared to that in balance trainings.

INTRODUCTION: Rehabilitative Ultrasound Imaging (RUSI) must be valuable method for research and rehabilitation. So, the reliability of its measurements must be determined. The purpose of this study was to evaluate the intra-rater reliability of RUSI for measurement of multifidus (MF) muscles cross section areas (CSAs), bladder wall diameter, and thickness of MF muscles between 2 sessions in healthy subjects. METHOD: Fifteen healthy subjects through simple non-probability sampling participated in this single-group repeated-measures reliability study. MF muscles thickness at rest and during contraction, MF muscles CSAs at rest, and bladder diameters at rest and during pelvic floor muscles (PFM) contraction were measured through RUSI. Pearson's correlation coefficient test was used to determine intra-rater reliability of variables. FINDING: The results showed that intra-class correlation Coefficient (ICCs) values with 95% confidence interval (CI) and the standard error of the measurement (SEM) were good to excellent agreement for a single investigator between measurement occasions. The intra-rater reliability for the bladder wall displacement was high (ICCs for rest and PFM contraction state: 0.96 and 0.95 respectively), for the MF muscles CSAs at the L4 level was good to high (ICCs 0.75 and 0.91 for right (Rt) and left (Lt) side respectively), and for the thickness of MF muscles at two levels, at rest and during two tasks was moderate to high (ICCs: 0.64 to 0.87). CONCLUSION: The Trans-Abdominal (TA) method of RUSI is a reliable method to quantify the PFM contraction in healthy subjects. Also, the RUSI is a reliable method to measure the MF muscles CSAs, the MF muscles thickness at rest and during functional tasks in healthy subjects.

[Purpose] This study compared the effectiveness of stabilization and McKenzie exercises on pain, disability, and thickness of the transverse abdominis and multifidus muscles in patients with nonspecific chronic low back pain. [Subjects] Thirty patients were randomly assigned into two groups: the McKenzie and stabilization exercise groups. [Methods] Before and after intervention, pain, disability, and thickness of the transverse abdominis and multifidus muscles were evaluated by visual analogue scale, functional rating index, and sonography, respectively. The training program was 18 scheduled sessions of individual training for both groups. [Results] After interventions, the pain score decreased in both groups. The disability score decreased only in the stabilization group. The thickness of the left multifidus was significantly increased during resting and contracting states in the stabilization group. The thickness of the right transverse abdominis during the abdominal draw-in maneuver, and thickness of the left transverse abdominis during the active straight leg raising maneuver were significantly increased in the stabilization group. The intensity of pain, disability score, thickness of the right transverse abdominis during the abdominal draw-in manouver, and thickness of the left transverse abdominis during active straight leg raising in the stabilization group were greater than those on the Mackenzie. [Conclusion] Stabilization exercises are more effective than McKenzie exercises in improving the intensity of pain and function score and in increasing the thickness of the transverse abdominis muscle.

BACKGROUND: Proprioception and postural stability play an important role in knee movements. However, there are controversies about the overall recovery time of proprioception following knee surgery and onset of balance and neuromuscular training after ACL reconstruction. Therefore, it is necessary to evaluate the effect of balance training in early stage of knee rehabilitation after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of balance exercises on postural stability indices in subjects with anterior cruciate ligament (ACL) reconstruction. METHODS: The study was a controlled randomized trial study. Twenty four patients who had ACL reconstructed (balance training group) and twenty four healthy adults without any knee injury (control group) were recruited in the study. The balance exercises group performed balance exercises for 2 weeks. Before and after the interventions, overall, anteroposterior, and mediolateral stability indices were measured with a Biodex Balance System in bilateral and unilateral stance positions with the eyes open and closed. T-tests were used for statistical analysis (p RESULTS: Results showed that amount of static stability indices did not change after training and there were not significant differences in static stability indices before and after balance training (p>0.05). Although amount of dynamic stability indices decreased, there were not significant differences in dynamic stability indices before and after balance training (p>0.05). Amount of dynamic stability indices were decreased in balance training group, however, there were not significant differences between groups (p>0.05). CONCLUSION: These results support that balance exercise could partially improved dynamic stability indices in early stage of ACL reconstruction rehabilitation. The results of this study suggest that balance exercises should be part of the rehabilitation program following ACL reconstruction.

Background and Purpose: There is a hypothesis that restoring the lumbar lordosis will increase a patient's voluntary muscular strength and decrease back pain symptoms. This study aimed to evaluate the effects of stabilization exercises on lumbar lordosis and functional improvement. Methods: Thirty-two patients with chronic low back pain (LBP) were recruited through simple nonprobability sampling for this double-blind, randomized clinical trial, performed at the Razmejo-Moghadam Physiotherapy Clinic, Zahedan University of Medical Sciences. Participants were randomly assigned to either stabilization exercise group (n = 16) or control group (n = 16). Before and after intervention, we assessed pain (ordinal) through the McGill Pain Questionnaire, disability (ordinal) with the Oswestry Disability Index (ODI), and lumbar curve (degree) with flexible ruler. Twelve sessions daily exercise program was performed for both groups. t-tests were used for data analysis (P 0.05). However, pain score and Oswestry score showed significant differences between two groups after intervention (P