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Objective Research has shown that exercises using the Wim Hof Method can positively affect the immune system. Therefore, this study aims to systematically review the impact of meditation, breathing exercises, and cold exposure using the Wim Hof Method on the autonomic nervous system. Methods This study is a systematic review. The number of articles in this field is limited. The search, conducted in both Persian and English, covered the period from 2013 to 2024 and included databases such as WoS, Civilica, ISC, PubMed, Scopus, and Google Scholar. Ultimately, 5 relevant articles were reviewed and analyzed. Results One study revealed that exercises incorporating this method effectively reduced perceived stress levels in participants. Additionally, two articles provided compelling evidence that young individuals practicing the Wim Hof Method experienced significant recovery from flu-like symptoms induced by bacterial endotoxins, such as shivering and headaches. Two other studies indicated that exercises associated with the Wim Hof Method positively influence the autonomic nervous system, suggesting potential benefits in managing autoimmune diseases. Conclusion These exercises were notably effective in reducing symptoms of autoimmune diseases. The results indicate that performing meditation, breathing exercises, and cold exposure using the Wim Hof Method has a significant impact on the body's autonomic nervous system and may help improve or manage autoimmune diseases.

Anterior Cruciate Ligament (ACL) injuries are among the most common sports and orthopedic injuries, significantly affecting an individual's physical performance. Treatment varies based on the severity of the injury and the patient's activity level. For partial tears or individuals with lower physical demands, non-surgical approaches—such as physiotherapy, muscle-strengthening exercises, and specialized knee braces—may be recommended. However, in cases of complete rupture, especially in professional athletes or those with high physical demands, surgery is often the preferred treatment option. Various surgical techniques are used for ACL reconstruction, including different grafting methods (autografts, allografts, and synthetic grafts), each with its own advantages and disadvantages. This article aims to provide orthopedic surgeons and specialists with a comprehensive comparison of these techniques, helping them choose the most suitable treatment method.

Purpose: Footwear used by military individuals is essential to be scientifically evaluated during daily activities. This research aims to examine muscular activities while running with rubber’s new boots compared to used boots in men with healthy and pronated feet. Methods: Twenty-four men aged 20-25 years (12 men in the pronated group, and 12 men in the healthy group) participated in this research using the convenience sampling method. The subjects received two used and new boots. The boots were made of rubber. Electromyography (EMG) data of the dominant limb were collected while running at constant speed. Results: The main effect of “boot type” for semitendinosus muscle activity (P=0.018, η2=0.248) during the loading phase and tibialis anterior (P=0.041, η2=0.177) during mid-stance. Conclusion: Rubber boots mileage effect on selected muscle activities in men with and without pronated feet. The use of used rubber boots can increase running-related risk factors.

Being overweight can influence the occurrence of pronated feet (PF). This research aimed to assess the interaction effect of overweight and PF along with sex on the frequency content of ground reaction forces (GRFs). 104 young male and female adults were allocated to four groups: normal body-mass-index/normal feet, normal body-mass-index/PF, excessive weight/normal feet, and excessive weight/PF. Subjects ran at constant speed over the walkway while an embedded force plate was located at the midpoint of the walkway. GRFs were recorded during 20 running trials. Findings demonstrated the significant main effect of “sex” (P

Introduction: Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of post-traumatic knee osteoarthritis. Current measures of gait mechanics have focused on peak magnitudes of knee kinematics, kinetics, and joint contact forces; nonetheless, they have seldom considered the plantar pressure and muscular frequency content in individuals with ACLR and pronate feet (PF). The present study aimed to compare ACLR and PF with healthy controls during walking. Material & Methods: The present study was conducted based on a quasi-experimental and laboratory design. The sample of this study comprised 13 people with ACLR and PF and 13 subjects from the healthy group. The mean age scores of patients in the two groups of healthy and sick participants were 22.9±4.1 and 23.2±4.5 years, respectively. During the test, subjects walked barefoot on an 18-m runway. Peak plantar pressure variables in both groups were recorded by a foot scan system (sampling rate: 300 Hz). The electromyography activity of the tibialis anterior, gastrocnemius medialis, vastus lateralis, vastus medialis, rectus femoris, biceps femoris, semitendinosus, and gluteus medius were recorded during walking. Results: The results demonstrated that the peak midfoot region plantar pressure values (P=0.018) were higher in the ACLR/PF group than in the healthy group during walking. In addition, the results highlighted a significant difference in the muscle frequency content of the rectus femoris (P=0.012, d=0.68) and vastus latelarlis (P=0.042) during the loading response and push-off phase in the ACLR/PF group compared to the healthy group during walking. Discussion & Conclusion: Peak plantar pressure values at the midfoot region and rectus femoris and vastus lateralis muscular frequency content in the ACLR/PF group differed from that of the healthy group during walking.

Purpose: People with both pronated feet and anterior cruciate ligament repair may benefit from walking on sand as a therapeutic option. The consequences of walking on sand on the muscular activity and gait biomechanics of these people are not well understood. This study aims to determine how sand training affects gait mechanics in individuals with both anterior cruciate ligament repair and pronated foot. Methods: The intervention and control groups included 28 adult males with pronated feet, where anterior cruciate ligament repair was randomly performed. The walking task was done on an 18-meter walkway at a consistent velocity. Muscle activities and ground reaction forces (GRF) were recorded using an electromyography system and a Bertec force plate, respectively. Results: Group-by-time interactions were significant for anterior and posterior reaction forces (P

In general segmentation, review studies are divided into two groups: narrative reviews and systematic reviews. The research methods for narrative and systematic reviews are completely different. Narrative review articles can be written based on the interests of the researcher, which is one of the weaknesses of this style of review, while systematic review articles have an organized structure and are more reliable. Narrative reviews cover diverse topics such as epidemiological findings, concepts and hypotheses of certain psychiatric diseases, current understandings of specific diseases, psychopharmacology, and treatment guidelines. This reflects the fact that systematic reviews have been rapidly and increasingly replacing traditional narrative (explicit) reviews as the standard platform for providing and updating currently available research findings as confident evidence. Most journals have changed their policy regarding the acceptance of review papers, giving priority to systematic reviews as regular review articles and excluding narrative reviews to provide the best evidence for all basic and clinical questions and further hypotheses. The major advantage of systematic reviews is that they are based on the findings of comprehensive and systematic literature searches across all available resources, minimizing selection bias and avoiding subjective selection.

Purpose: This study investigates the effects of exercises on sand on the frequency content of the lower limb muscles in individuals with anterior cruciate ligament reconstruction and pronated feet during walking. Methods: This was a semi-experimental and laboratory-type study. The study samples included 28 male students with pronated feet and anterior cruciate ligament reconstruction aged 22 to 25 years. The participants were randomly allocated into the following two groups: The experimental and the control group. The electrical activity of the lower limb muscles was recorded using an electromyography system before and after performing the exercises. The statistical analysis was done using a two-way analysis of variance method with a significance level of 0.05. Results: The findings showed that the main effect of time for the frequency content of the tibialis anterior, medial gastrocnemius, vastus medialis muscles during loading and push-off phases, the vastus lateralis muscle during the mid-stance, the rectus femoris at the mid-stance and push-off phases, semitendinosus muscle during the loading, mid-stance and push-off phases, biceps femoris muscle during the mid-stance and push-off phases, and gluteus medius muscle during the push-off phase (P

Purpose: Pronation in the foot is a normal rolling movement occurring at the subtalar joint during running. The human foot, as the primary interface with our environment, presents morphological and postural changes following prolonged running. This study aims to identify running mechanics while training on the sand in runners with pronated feet. Methods: Thirty runners with pronated feet were in the control group, and 30 runners with pronated feet were in the experimental group. An experimental group conducted an 8-week corrective exercise program, while a control group did not exercise. A force plate was included to collect ground reaction forces in the walkway. An analysis of variance (ANOVA) with repeated measures test was conducted to identify the presence of an interaction between the within-and between-subject factors on the dependent variables. The significance level was set at P

Background. Different shoe weights affect walking mechanics. Therefore, the purpose of this study was to determine the effect of sport shoe weight on lower extremity muscle activities in athletes with anterior cruciate ligament reconstruction during walking. It was hypothesized that reduced shoe weight results in decreased frequency content of selected muscles during walking. Methods. Twenty healthy males and athletes with ACL reconstruction volunteered and gave their written informed consent to participate in this study. Participants were male and physically active. Each participant performed three walking trials in each of the light (mass per shoe: 150 ± 18 g), medium (300 ± 18 g), and heavy (450 ± 18 g) conditions in a randomized order and electromyography were analyzed during shod walking. Results. EMG results showed that the increase in shoe weight was directly related to the increase in electrical activity of the muscles, but only in the swing phase was the electrical activity of the TA muscle decreased. Conclusion. Different shoe weights affect the electrical activity of the muscles and the walking speed. Therefore, lighter weight shoes are recommended for patients with ACL. Practical Implications. The results of this study show that light shoes are useful for patients with anterior cruciate ligament rupture and the use of lightweight shoes is recommended for people with anterior cruciate ligament rupture.

Background: Anterior cruciate ligament reconstruction (ACLR) reestablishes electromyography activity during moderate activities such as walking but it is unclear whether this is also the case in sports activities such as running. Therefore, the present study aimed to evaluate the acute effect of using anti- pronation insoles on muscle frequency content in an individual with anterior cruciate ligament reconstruction with pronated feet during running. Methods: The sample of this study consisted of 13 individuals with both ACLR and pronated feet aged 23.2±4.5 years and 13 healthy ones aged 22.9±4.1 years. During both Pre and Post-tests, participants ran barefoot on an 18-m runway at a constant speed of 3.3±5 m/s. The electromyography activity of the lower limb muscles was recorded during running with and without anti-Pronation insoles. Two-way ANOVA with repeated-measures test was used for statistical analysis. Results: The results indicated greater vastus medial frequency content in ACLR with the pronated feet group than that the healthy group during the loading phase (p=0.024). Also, results demonstrated that the rectus femoris frequency content was greater at the insole condition compared with and without it during the loading phase (p=0.014). Conclusion: The results of this research showed a significant change in the activity of the quadriceps, hamstrings, gluteus medius, and gastrocnemius when using anti-pronation insoles in people with anterior cruciate ligament reconstruction and pronate feet. Therefore, it could be useful clinically.

Obesity has become a global problem that can affect the mechanism of running in obese people. Abnormal running pattern can lead to skeletal-muscular disorders and subsequently a decrease in the absorption of shocks due to physical activity, an increase in knee and back pain, an increase in the joints’ instability, a reduction in the time to reach the peak of ground reaction forces, and an increase in the peak of ground reaction forces. On the other hand, a change and disorder in the aforementioned components can lead to an increase in loading rate, micro fractures of the tibia bone, patellofemoral pain syndrome, iliotibial band syndrome, plantar fascia, and other soft tissue injuries. Considering the importance of running mechanics in obese people and the lack of sufficient studies in this field, it is necessary to evaluate this issue scientifically. Therefore, all those interested in the field of biomechanics are suggested to conduct studies in this area.

A Letter to the Editor (LTE) is a brief communication to a journal’s editor or editorial team. It is usually written in response to a recent publication within the journal but can also cover an unrelated topic of interest to the journal’s readership. Many journals welcome LTEs within a dedicated section (e.g. LTEs/Correspondence) to stimulate intellectual discussions between readers and authors. LTEs may be handled by a dedicated ‘LTE’ team. Therefore, in this article, our aim is to provide practical tips on writing a successful LTE.

Background. Due to the special structure of the knee joint in genu valgus individuals, neuromuscular characteristics of muscles can be disturbed and this may change postural control. This study aimed to investigate the effect of 8 weeks of training with an elastic band on the frequency spectrum of lower limb muscles in genu valgum patients during running. Methods. This study was a clinical trial in which 24 male students (20-30 years old) were randomly divided into control and experimental groups. Corrective exercises were performed for 8 weeks using an elastic band for the experimental group. The electrical activity of selected muscles was recorded by an electromyography system. Statistical analysis was performed using repeated measures ANOVA test at the significant level of 0.05. Results. Findings showed a significant increase in the frequency spectrum of rectus femoris (P=0.026; d=1.669) after training. Conclusion. Quadriceps muscles increase knee joint stability along with balance during movements. Therefore, increasing the median frequency of knee joint muscles improve balance. Practical Implications. The results of this study showed that exercises with elastic bands are useful for people with Genu valgum, and in particular, the use of these exercises leads to improved balance and performance.

Introduction: Pronated foot, as one of the common foot abnormalities can affect the biomechanics of the lower extremity. The purpose of the present study was to investigate the scientific research related to the application of various exercise protocols on foot pronation complications, as well as to make favorable summary and provide more appropriate information from previous research. In this study, the search for articles in Persian and Latin languages in 2019-2022 was carried out on WOS, Magiran, PubMed, Springer databases, and Google Scholar. The number of 52 related articles was selected based on the inclusion and exclusion criteria. After another review on these papers, 18 articles that evaluated the effects of training protocols on body mechanics in individuals with pronated feet were selected. Conclusion: It seems that performing exercise to improve balance, strengthening the quadriceps muscles, and not change the lower extremity joints angles during activity has been effective. Therefore, it is suggested that rehabilitation professionals consider reinforcement activities in the process of recovering pronated using the principles and science practice.

Background and Aims People suffer from neck pain, headache, kyphosis and back pain while working with the computer for a long time, which seems to increase day by day with the advancement of technology. The present study aims to investigate the effect of two types of thoracolumbosacral braces (with and without sensors) on electromyography activity of selected muscles in people with thoracic kyphosis during typing.Methods In this quasi-experimental study, 15 males with thoracic kyphosis volunteered to participate in the study. Subjects performed typing task for one minute at three conditions (with no brace, with a simple brace, and with a brace having sensors). An 8-channel wireless electromyography system was used to record the activity of selected muscles in the upper limb and shoulder area. Repeated measures analysis of variance was used to compare the electrical activity of muscles between different conditions. The significance level was set at 0.05.Results The median frequency of trapezius muscle was significantly lower while using the brace with sensors compared to that without using brace (P=0.005). In median frequency of other muscles, no significant differences were observed among three conditions (P>0.05).Conclusion The use of thoracolumbosacral brace with sensors can reduce the median frequency of trapezius muscle in people with kyphosis. This reduction in median frequency may be related to the passive support of the brace. Reduction of electrical activity in trapezius muscle while using thoracolumbosacral brace can increase the time to reach fatigue.

Background and Aims Adipokines have a major role in aging pathobiology and age-related diseases. The present study aims to evaluate the effect of 12 weeks TRX on irisin and chemerin levels in older men. Methods In this randomized clinical trial, 16 older men (Mean age=62.06±1.53 years) were selected using a convenience sampling method and randomly divided into training and control groups. The training group performed TRX for 12 weeks, three sessions per week, each for 60 minutes. The training intensity was evaluated by the Borg rating of perceived exertion scale. Blood sampling was done 24 hours before and after training to measure irisin and chemerin levels. Statistical analysis was done by ANCOVA. The significant level was set at 0.05. Results In the training group, there were significant differences between pre- and post-test levels of irisin (P=0.001) and chemerin (P=0.001). The ANCOVA results showed a significantly higher level of irisin (P=0.001) a lower level of chemerin (P=0.001) in training group than in the control group. Also, the percentage of body fat and weight of people decreased significantly (P=0.001). Conclusion It seems that TRX, by increasing irisin level and reducing chemerin level, can lead to improvement in body fat percentage, weight, and Body Mass Index (BMI) of older men.

Background and Aims The increase in loading rate is associated with lower limb injuries such as tibial stress fracture. Quadriceps muscle activities absorb ground reaction force (GRF) shocks by eccentric activation. This study aims to evaluate the effect of aerobic training on the relationship between loading rate and quadriceps muscle activities in men with diabetic neuropathy (DN). Methods In this double-blinded, randomized, controlled clinical trial, participants were 40 men with DN who were selected by a convenience sampling method and randomly divided into two groups of training (n=20, age: 54.9±7.3, body mass index: 28.4±5.4) and control (n=20; age: 54.1±7.3, body mass index: 28.5±5.1). The GRF data was recorded using a force plate system during walking. The electrical activity of selected lower limb muscles was recorded using electromyography method. The training group performed aerobic training for 12 weeks (three sessions per week). Results The results showed an increase in the negative relationship between vertical loading rate and vastus lateralis activities after training (P=0.028). The activities of vastus medialis and rectus femoris muscles showed no significant relationship with loading rate after training (P>0.05). Conclusion Aerobic training can improve the relationship between vastus lateralis muscle activity and vertical loading rate in men with DN.

Foot pronation is a prevalent condition known to contribute to a range of lower extremity injuries. Numerous interventions have been employed to address this issue, many of which are expensive and necessitate specific facilities. Gait retraining has been suggested as a promising intervention for modifying foot pronation, offering the advantage of being accessible and independent of additional materials or specific time. We aimed to systematically review the literature on the effect of gait retraining on foot pronation. We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 20 June 2023. The Downs and Black appraisal scale was applied to assess quality of included studies. Two reviewers screened studies to identify studies reporting the effect of different methods of gait-retraining on foot pronation. Outcomes of interest were rearfoot eversion, foot pronation, and foot arch. Two authors separately extracted data from included studies. Data of interest were study design, intervention, variable, sample size and sex, tools, age, height, weight, body mass index, running experience, and weekly distance of running. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. Fifteen studies with a total of 295 participants were included. The results of the meta-analysis showed that changing step width does not have a significant effect on peak rearfoot eversion. The results of the meta-analysis showed that changing step width does not have a significant effect on peak rearfoot eversion. Results of single studies indicated that reducing foot progression angle (MD 2.1, 95% CI 0.62, 3.58), lateralizing COP (MD -3.3, 95% CI -4.88, -1.72) can effectively reduce foot pronation. Overall, this study suggests that gait retraining may be a promising intervention for reducing foot pronation; Most of the included studies demonstrated significant improvements in foot pronation following gait retraining. Changing center of pressure, foot progression angle and forefoot strike training appeared to yield more favorable outcomes. However, further research is needed to fully understand its effectiveness and long-term benefits.

Purpose: Pronated feet (PF) are associated with biomechanical changes during running. It seems that sand training can be a suitable intervention for rehabilitation in individuals with over-pronated feet. This study aims to investigate the effect of long-term exercises on the sand on the frequency of lower limb muscles during running in runners with over-pronated feet. Methods: The current study was a quasi-experimental type. A total of 29 controls with a mean age of 22.2±2.5 years (control group [CG]) and 30 pronated feet (PF) individuals with a mean age of 22.2±1.9 years (intervention group [IG]) participated in this study. In both pre and post-test phases, participants run barefoot on an 18-m runway at a constant velocity of 3.3±5% m/s while EMG activity was recorded using an EMG system. The sand training includes barefoot running for 3 sessions per week for 8 weeks. The frequency of lower limb muscle activities was used as a dependent variable. Repeated-measures analysis of variance (ANOVA) test was used for statistical analysis. Results: The results demonstrated a significant group×time interaction for gluteus medius (gluteus-M) frequency content at the mid-stance phase (P

Background and Aims Different shoe weights affect the gait mechanics. Some dynamic changes or adjustments induced by anterior cruciate ligament (ACL) reconstruction can be assessed through the analysis of the ground reaction forces (GRFs). This study aims to determine the effect of sports shoe weight on gait kinetics in athletes with ACL reconstruction.Methods Twenty healthy men and 20 athletes with ACL reconstruction volunteered to participate in this study. Each participant performed three walking trials with shoes having light (weight: 150±18 g), moderate (300±18 g), and heavy (450±18 g) weights in a randomized order. The GRFs were analyzed during shod walking. Results The GRF component at vertical direction during the heel contact phase changed significantly during the use of shoes with different weights (P=0.001). In addition, the GRF at vertical direction during the push-off phase and GRF at mediolateral direction during the push-off phase increased significantly (P=0.023 and 0.014, respectively).Conclusion The biomechanics of lower limbs and the GRFs are significantly different when using light and heavy shoes during the heal contact and push-off phases of walking.

Background and Aims Type 2 diabetes is the most common endocrine disease in the world. Various methods, such as medication and exercise can be helpful, although information on the issue is scarce. Therefore, the aim of the present study was to investigate the effect of eight weeks of TRX resistance training along with using taurine supplementation on glycemic indices of type 2 diabetic females.Methods The sample of the present study consisted of 40 middle-aged females with inactive diabetes with an age range of 40 to 60 years. Subjects were randomly divided into four groups of ten, including the training group, supplement group, training+supplement group, and control group. Fasting blood glucose (FBS) and glycosylated hemoglobin (HBA1C) levels were measured before and after the training period. The duration of the training program for the training group was eight weeks for three sessions per weekResults The results showed that HBA1C levels decreased in the post-test compared to the pre-test in the supplement (P=0.027), exercise (P=0.001), and supplement+exercise (P=0.001) groups. While the levels of this variable did not show any significant difference in the control group in the post-test compared to the pre-test (P>0.05). The results showed that FBS levels in the exercise group were statistically lower than in the supplement + exercise group (P=0.012).Conclusion According to the findings, it can be concluded that resistance training using the TRX method along with taurine supplement can reduce resting FBS and glycosylated hemoglobin (HBA1C) levels in type 2 diabetic women and increase women’s health.

Purpose: Military boots mileage is a main factor that can affect the risk of running injuries. The present study aims to evaluate the effect of three types of military boots mileage on knee muscular co-contraction during running. Methods: Fifteen healthy males received three pairs of new military boots. Participants wore these boots for more than 6 months. Electromyography activity of lower limb muscles during running at constant speed was recorded during pre- and post-intervention. Then, knee muscular co-contraction was calculated. Results: Results showed a significant increase during loading response (P=0.030, n2p=0.157) and push-off (P=0.008, n2p=0.302) phases for general knee co-contraction at post-test compared to the pre-test. Also, directed mediolateral knee co-contraction showed a significant increment during mid-stance (P=0.028, n2p=0.040) and push-off (P=0.039, n2p=0.115) phases at post-test compared to the pre-test. Conclusion: It can be concluded that knee joint instability while using polyurethane thermoplastic is more than polyurethane boots. Also, our results demonstrated that maintaining knee stability in the anterior-posterior direction while using polyurethane thermoplastic is better than in polyurethane boots.

Abstract Background Running on sand could be a promising exercise intervention for the treatment of over-pronated feet. However, there is a lack of knowledge about the effects of running on sand on muscle activities. Therefore, this study aims to evaluate the long-term effects of running on sand on the activities of selected lower limb muscles in individuals with OPF compared with healthy controls. Methods Sixty recreational adult male runners with over-pronated feet (foot posture index > 10) were divided into two equal groups (intervention and control). Participants ran barefoot at a pre-defined speed (⁓3.3 m/s) over level stable ground both before and after long-term training on the sand. Muscle activities were recorded using a surface bipolar electromyography system. Results For the intervention group, we found a reduced foot posture index (p

Introduction: As a person gets older, their gait patterns change and their ability to walk decreases. Orthoses are used to relieve musculoskeletal disorders, skeletal problems, disabilities, etc. Therefore, the aim of this study was to investigate the effect of orthoses on timing of lower limb muscles in the older adults during gait. Methods: The present study was a clinical trial. 14 females (with average age of 60.50±4.40 years) and 14 males (with average age of 63.35±5.55 years) were selected with available sampling, voluntarily participated in this research. Eight electrodes were placed on the selected muscles (tibialis anterior, gastrocnemius medial, vastus medialis, vastus lateralis, biceps femoris, semitendinosus, gluteus medius, erector spinae) to record electrical activity during the gait with and without orthoses. To analyze the data SPSS software (version 16), and a repeated analysis of variance test was used. The significance levels in all tests were considered to be 0.05. Results: The main effects of orthoses and the interaction effects of orthoses and sex for the onset of selected muscles activities did not show any significant differences (P>0.05). The effect of sex for the onset of activities in medial gastrocnemius (P=0.007), vastus medialis (P=0.002), vastus lateralis (P=0.027), semitendinosus (P=0.004), gluteus medius (P=0.030), and erector spinae (P=0.039) muscles was significant, so that the onset of muscle activity in the female group was earlier than in the male group. Conclusion: Orthoses showed no improvement on onset of selected muscles activities, although significant differences were observed between the male and female groups.

Background: Genu valgum is a postural malalignment in the knee joint. This malalignment is accompanied by altered mechanical forces in the tibiofemoral and patellofemoral joints. The purpose of this study was to investigate the effect of using a graded knee brace in two angles of 60 and 30 degrees on the frequency spectrum of ground reaction forces in individuals with genu valgum during landing. Methods: The present study was semi-experimental. Twenty non-athlete male students with genu valgus (age range: 20-30 years) were volunteered to participate in the study. The landing task was done during three conditions including without a knee brace, with a brace at two 30 and 60 degrees of flexion from a height of equal to 30 cm. Bertec force plate was used to record ground reaction forces. Fourier transform was used to calculate ground reaction force-frequency content during both landing conditions with and without a knee brace. Results: The results of this study showed a significant reduction in the frequency content with a power of 99.5% in the mediolateral direction (P=0.02; high effect size) and vertical direction (P=0.075; high effect effect) during landing with a knee brace at 60 degrees of flexion angle compared with without knee brace condition. Also, the median frequency component in the mediolateral direction (P=0.019; low effect size) and in the anterior-posterior direction (P=0.019; high effect effect) showed a significant decrease during wearing a knee brace compared with without it. Conclusion: Regarding the decreasing of median frequency after using the knee brace, it might be effective in the reduction of injury rate in individuals with genu valgum. However, further study warranted to better establish this issue.

Background: Foot pronation is in the open kinetic chain composed of eversion, abduction, and ankle dorsiflexion. Foot overpronation may be associated with different lower limb injuries. The purpose of this study was to investigate the effect of walking on the sand on co-Contraction of the lower limb muscles in individuals with overpronated foot. Methods: The present study was a semi-experimental and laboratory type. Thirty healthy individuals and 30 individuals with foot overpronation volunteered to participate in this study. Muscle activity was recorded by an 8-channel electromyography system with a surface electrode during walking on sand. Two-way ANOVA test was used for statistical analysis at the significant level P0/05). Conclusion: Individuals with overpronated foot demonstrated lower ankle-directed co-Contraction during walking on sand compared with walking on stable level ground. Individuals with overpronated foot showed a greater ankle-directed co-Contraction than the healthy group. Decreased ankle-directed co-Contraction indicated a positive effect of walking on sand in individuals with foot overpronation.

Background: Different factors affect walking biomechanics disturb the postural control. Genu valgus is one of the most important lower limb malalignments that affects the postural control and disrupts the posture. The purpose of the present study was to investigate the acute effect of knee brace on the electromyography activity of lower limb muscles in individuals with genu valgus during walking. Methods: In this semi-experimental and a laboratory typ study,. 24 boys with genu valgum (20-30 years old) volunteered to participate in the study. The electrical activity of the selected muscles was recorded by an electromyography system during walking with and without knee brace. Paired t-test was used for statistical analysis at a significance level of 0.05. Results: There was a significant increase in electrical activity of the semitendinosus muscle during walking with knee brace compared to walking without it (p = 0.037, d = 0.89). The electrical activity of other lower limb muscles did not show any significant differences during acute use of knee brace (P >0.05). Conclusion: The semitendinosus muscle in individuals with genu valgus is weak. Therefore, significant increase in the electrical activity of the semitendinosus muscle during wearing of knee brace means delaying the fatigue and indicating improvement in the muscular function.

Background:Walking is one the common daily activities. With the beginning of middle age, weakness in the lower limb muscles can reduce the ability to walk. The use of foot orthoses reduce the load on the limbs and supports the joints during walking. The purpose of the present study was to investigate the acute effect of foot orthoses on the frequency spectrum of ground reaction forces during walking in the older adults. Methods: In this semi-experimental and laboratory study, 21 elderly (15 females and 6 males) with a mean height of 164.19±4.26 centimeters and weight of 80.04±3.50 kg, and age of 66.00±3.50 years were volunteered to participate in the study. The walking trials were done during three conditions including walking without foot orthoses, walking with small and large textured orthoses. The Bertec force plate (made in USA) with dimensions of 40 * 60 cm was used to record ground reaction forces. Results: The results of this study did not show any significant differences between walking without foot orthoses, walking with small and large textured foot orthoses for frequency of 99.5%, median frequency, frequency band and number of essential harmonics (P>0.05). However, the comfort level during wearing of large texture insole condition significantly increased compared to other conditions (P

Purpose: The current study aimed to evaluate the effects of barefoot and shod running with two different styles on ground reaction force-frequency content in recreational runners with low arched feet. Methods: The statistical sample of this research was 13 males with Pronated Feet (PF) (Mean±SD age: 26.2±2.8 y; height: 176.1±8.4 cm; weight: 78.3±14.3 kg). A force plate (Bertec, USA) with a sample rate of 1000 Hz was used to record the reaction forces under each foot. Three test conditions in our study included shod running with rearfoot, midfoot, and forefoot patterns. Repeated-measures Analysis of Variance (ANOVA) was used for analyzing the data. Results: During forefoot running, the research subjects attained 10% higher GRF values in vertical direction, compared with rearfoot running (P˂0.001, d=2.133). Forefoot running decreased the peak vertical GRF, compared to rearfoot running (by 12%, P=0.01, d=0.826). Barefoot running decreased the peak vertical GRF, compared to shod running (by 6%, P=0.027, d=1.143). The collected results revealed a significantly lower FyMed (P

Background: Low back pain occurs between the lumbar vertebrae and the sacral bone and is affected by factors that often occur when trying to perform a particular operation or during a collision. The purpose of this study was to investigate the effects of long-term wearing of lumbar brace on the electromyography frequency spectrum of trunk and lower limbs in low back pain older adults with pronated feet during walking. Methods: This research was of a semi-experimental type. Fifteen patients with low back pain and pronated feet were selected as an experimental group (age: 68.3 ± 2.7 years) and Fifteen patients with low back pain and pronated feet were selected as a control group (age: 69.0 ± 3.9 years).The lumbar brace used in this research was Sacro Lumbar Support, BB-OPPO 2065 model, Taiwans. The electrical activity of the lower limb and trunk muscles were recorded by the electromyography system during walking in both pre and post-test. All statistical analysis was done on SPSS software by two way ANOVA analyses test at significant level of 0.05. Results: The findings in the experimental group demonstrated that the frequency content of the gastrocnemius medialis muscle during post-test was significantly lower than that during the pre-test (P=0.002). Also, two external oblique (P=0.007) and rectus abdominus (P

Background: In terms of physiological and biomechanical characteristics, over-pronation of the feet has been associated with distinct muscle recruitment patterns and ground reaction forces during running.Objective: The aim of this study was to evaluate the effects of running on sand vs. stable ground on ground-reaction-forces (GRFs) and electromyographic (EMG) activity of lower limb muscles in individuals with over-pronated feet (OPF) compared with healthy controls.Methods: Thirty-three OPF individuals and 33 controls ran at preferred speed and in randomized-order over level-ground and sand. A force-plate was embedded in an 18-m runway to collect GRFs. Muscle activities were recorded using an EMG-system. Data were adjusted for surface-related differences in running speed.Results: Running on sand resulted in lower speed compared with stable ground running (p < 0.001; d = 0.83). Results demonstrated that running on sand produced higher tibialis anterior activity (p = 0.024; d = 0.28). Also, findings indicated larger loading rates (p = 0.004; d = 0.72) and greater vastus medialis (p < 0.001; d = 0.89) and rectus femoris (p = 0.001; d = 0.61) activities in OPF individuals. Controls but not OPF showed significantly lower gluteus-medius activity (p = 0.022; d = 0.63) when running on sand.Conclusion: Running on sand resulted in lower running speed and higher tibialis anterior activity during the loading phase. This may indicate alterations in neuromuscular demands in the distal part of the lower limbs when running on sand. In OPF individuals, higher loading rates together with greater quadriceps activity may constitute a proximal compensatory mechanism for distal surface instability.

Introduction: Malalignments in the lower limb can affect the biomechanics of human movements such as walking. The ankle joint has a major role in shock absorption, however abnormalities such as genu valgum can disrupt its function. The objective in this study is to investigate the effect of corrective exercise with ThraBand® on the ankle joint co-contraction in patients with genu valgum during walking. Materials and Methods: 24 male students (20-30 years old) were randomly divided into the two control and experimental groups. Corrective exercises were performed for 8 weeks using TheraBand® for the experimental group. The electrical activity of the selected muscles was recorded by the electromyography (ECG) device (Biometrics Ltd, UK). The statistical analysis was performed using the SPSS software and repeated measures analysis of variance (ANOVA) at the significant level of 0.050. Results: Findings in the experimental group showed that the general co-contraction of ankle joint increased significantly in the heel contact phase during the post-test phase compared to the pre-test phase (P = 0.044; d = 0.12). Other components did not show any significant differences (P > 0.050). Conclusion: Generally, increased co-contraction of ankle during the heel contact phase indicated greater ankle joint support after the corrective exercise.

Objective The aim of this study was to evaluate the muscular activity timing during running in male children with forward head posture compared to healthy control ones. Methods 12 healthy male children with forward head posture (age: 11.7±1.4 years; height: 149.7±6.2 cm; Mass: 38.0±4.7 kg) and 16 healthy male children (age: 11.8±1.5 years; height: 148.2±6.6 cm; mass: 39.6±0.4 kg) were volunteered to participate in this study. The timing of muscular activity for erector spinae (cervical region), sternocleidomastoid, serratus anterior, upper and lower trapezius muscles of both right and left sides were evaluated during barefoot running. Muscular activity was recorded with a 16-chanels electromyography system. Independent sample t-test was used for statistical analysis. Results Finding did not demonstrate any significant differences in onset and offset of muscular activity during walking between both groups (P>0.05). The time duration of right erector spinae muscle in the healthy group was greater than that forward head group about 41 ms (P=0.024). Also, the time duration of left sternocleidomasteoid in the healthy group was longer than that in the forward head group by 64 ms (P=0.037). Conclusion In sum, these results could be used in rehabilitation protocols for children with forward head posture in clinical settings.

BackgroundThe prevalence of diabetes worldwide is predicted to increase from 2.8% in 2000 to 4.4% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility.ObjectiveWe aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN.MethodsSixty male and female individuals aged 45–65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40–55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s.ResultsNo statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p < 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p < 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001–0.037; d = 0.56–1.53). For IG, post-hoc analyses showed decreases in peak lateral (p < 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p < 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001–0.044; d = 0.54–0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p < 0.001; d = 1.28).ConclusionsThis study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics.

Background: Forward head posture is one of the most prevalent abnormal postures in patients with neck disorders. The aim of this study was to evaluate the effects of forward head posture on gait ground reaction force characteristics in children. Methods: Twelve children with forward head posture (age: 11.8±1.3 years) and sixteen healthy control children (age: 11.7±1.4 years) volunteered to participate in this study. Each participant was asked to walk 10 m in six trials with self-selected speed. The ground reaction force was measured by two Kistler Force Platforms at a frequency of 1000 Hz. MANOVA test ((version 16, SPSS Inc, Chicago, Il)) was used for between group comparisons. Results: In the non-dominant limb, the medio-lateral ground reaction force during push off phasein the forward head group was greater than that in the healthy group by 22.1% (P=0.049). In the dominant limb, time to peak for vertical ground reaction force during heel contact(by 13.7%; P=0.015) and push off(by 14.2%; P=0.004), mediolateral ground reaction force during heel contact (by 46.0%; P=0.006) and push off (by 15.1%; P=0.039) in the forward head group were significantly lower than those in the healthy group. Vertical loading, peak positive and negative free moment, and impulses in all axes were similar in the healthy and the forward head groups (P>0.05). Conclusion: Overall, the results reveal that gait ground reaction force components (especially time to peak for ground reaction forces) in forward head children may have clinical importance for the improvement of walking mechanics of these individuals. Rehabilitation protocols should be designed to increase time to reach peak ground reaction forces and decrease medio-lateral ground reaction force in forward head children during walking.

Introduction: Shoulder injuries are common among athletes in sports that involve overhead throwing of the ball such as handball. The objectives of this study were to evaluate the timing and activation intensity of shoulder muscles during handball penalty throwing in individuals with shoulder pain and in control subjects. Materials and Methods: Using BTS FREE EMG 300 system with bipolar surface electrodes, the timing (onset) and intensity of the activation of the shoulder muscles were measured including upper trapezius, anterior, middle and posterior deltoid, latissimus dorsi, pectoralis major, supraspinatus and triceps during penalty throwing. Multivariate analysis of variance (ANOVA) was used for between group comparisons with the significance level P< 0.05. Results: The activation intensity of upper trapezius and latissimus dorsi muscles in the healthy individuals were about 50.74% and 43.42% higher than in patients. Middle deltoid in healthy individuals was about 38.05% smaller than that in patients. In control group, supraspinatus muscle started earlier (23.5 ms) than the shoulder motion initiation. Triceps muscle was activated about 18.5 ms later than shoulder motion initiation. In patients, supraspinatus muscle started sooner (11 ms) and triceps brachialis muscle started later than the other muscles (22.16 ms). Conclusion: The coordination of shoulder muscles i.e. the onset and intensity of muscle activity is disturbed in the patient group during throwing. Hence, strength and stretching programs are recommended for athletes to reduce the risk of shoulder pain syndrome. The rehabilitation program can be focused on modifying the pattern of activity in upper trapezius, supraspinatus, latissimus dorsi and deltoid muscles in addition to pain control in the rehabilitation centers.

Objective: Shoulder muscle injuries are very prevalence. So determining of injuries mechanism could be a suitable way for identifying rehabilitation methods. The purpose of this study was to compare the electromygraphical activity of shoulder girdle muscles in lowback pain patients and healthy subjects during arm flexion with and without load. Methods: Tensubjects with chronic low back pain and ten age-matched control healthy subjects participated in this study. All participants were asked to perform arm flexion activities with and without load (with both dominant and nondominant sides) in a standing position. The outcome measures included electromygraphical activity of anterior and medial deltoid, infra and supra spinatus muscles for both groups. MANOVA and repeated measure statistical tests were used for between and within group comparisons. Alpha level was set at p˂0.05. Results:The intensity of muscle activity in anterior and medial deltoid, infra spinatus and supra spinatus muscles of dominant upper limb in healthy group were 26.3±2.67, 17.01±2.02, 11.1±1.67, 12.40±2.34 percent of maximum voluntary isometric cotraction, respectively. These values for patients group were 27.90±3.78, 14.73±3.14, 16.48±2.37, and 18.19±3.31, respectively. There were not any significant diffrences between groups (p˃0.05). Load effect in dominant upper limb for the groups accounted for 132% and 136% increase in the total muscular activity. Conclusion: Shoulder girdle muscle activity is similar in low back pain patients compred with the healthy subjects during arm flexion. It seems that low back pain didn't have any affect on shoulder muscular activiry; however, further studies are warranted.

BACKGROUND:Sand is an easy-to-access, cost-free resource that can be used to treat pronated feet (PF). Therefore, the aims of this study were to contrast the effects of walking on stable ground versus walking on sand on ground reaction forces (GRFs) and electromyographic (EMG) activity of selected lower limb muscles in PF individuals compared with healthy controls. METHODS:Twenty-nine controls aged 22.2±2.5 years and 30 PF individuals aged 22.2±1.9 years were enrolled in this study. Participants walked at preferred speed and in randomized order over level ground and sand. A force plate was included in the walkway to collect GRFs. Muscle activities were recorded using EMG system. RESULTS:No statistically significant between-group differences were found in preferred walking speed when walking on stable ground (PF: 1.33±0.12 m/s; controls: 1.35±0.14 m/s; p = 0.575; d = 0.15) and sand (PF: 1.19±0.11 m/s; controls: 1.23±0.18 m/s; p = 0.416; d = 0.27). Irrespective of the group, walking on sand (1.21±0.15 m/s) resulted in significantly lower gait speed compared with stable ground walking (1.34±0.13 m/s) (p0.05; d = 0.06-1.60). We could not find any significant group by surface interactions for peak GRFs and their time to peak. Significant main effects of "surface" were detected for anterior-posterior impulse and peak positive free moment amplitude (p0.05; d = 0.00-0.53). CONCLUSIONS:The observed lower velocities during walking on sand compared with stable ground were accompanied by lower peak positive free moments during the push-off phase and loading rates during the loading phase. Our findings of similar lower limb muscle activities during walking on sand compared with stable ground in PF together with lower free moment amplitudes, vertical loading rates, and lower walking velocities on sand may indicate more relative muscle activity on sand compared with stable ground. This needs to be verified in future studies.

Physical fatigue and pronated feet constitute two risk factors for running-related lower limb injuries. Accordingly, different running shoe companies designed anti-pronation shoes with medial support to limit over pronation in runners. However, there is little evidence on the effectiveness and clinical relevance of anti-pronation shoes. This study examined lower limb kinematics and kinetics in young female runners with pronated feet during running with anti-pronation versus regular (neutral) running shoes in unfatigued and fatigued condition. Twenty-six female runners aged 24.1±5.6 years with pronated feet volunteered to participate in this study. Kinetic (3D Kistler force plate) and kinematic analyses (Vicon motion analysis system) were conducted to record participants' ground reaction forces and joint kinematics when running with anti-pronation compared with neutral running shoes. Physical fatigue was induced through an individualized submaximal running protocol on a motorized treadmill using rate of perceived exertion and heart rate monitoring. The statistical analyses indicated significant main effects of "footwear" for peak ankle inversion, peak ankle eversion, and peak hip internal rotation angles (p

BACKGROUND:Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet. METHODS:Thirty boys aged 8-12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected. RESULTS:Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group. CONCLUSIONS:The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.