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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.

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).

Primary dysmenorrhea is the most common complaint in adolescent and young women. It interferes with daily activities and imposes many social costs on the community. The objective of this research was to compare anxiety and depression in female students with primary dysmenorrhea and without dysmenorrhea. This case-control study was conducted in Zahedan University of Medical Sciences in 2016 on 120 girls in 3 groups of without dysmenorrhea, primary dysmenorrhea with low back pain, and primary dysmenorrhea without low back pain. The Spielberger questionnaire was used to determine the anxiety score and Beck Depression Inventory was used to determine the depression score. To describe the data, central indicators, dispersion and frequency distribution tables (absolute and relative) were used and statistical analysis of variance and linear regression were used to analyze the data. The anxiety score was 60.69 ± 12.10, 56.36±11.54, and 51.57±12.03 in the non-dysmenorrhea group, primary dysmenorrhea with low back pain group, and in the dysmenorrhea without low back pain group, respectively, and the depression score was 10.51 ± 8.47, 14.12±9.41, and 16.29± 10.21 in the non-dysmenorrhea group, primary dysmenorrhea with low back pain group, and primary dysmenorrhea without low back pain group, respectively. There score of anxiety and depression showed significant difference among the three groups (P

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.

Because of the importance of lumbo-pelvic stability as one of the suggested factors to prevent low back pain and since to date no study accomplished to compare lumbo-pelvic stability between chronic low back pain (CLBP) and healthy subjects, the aim of this study was to determine and to compare lumbo-pelvic stability, lumbar lordosis, and lumbar mobility between CLBP and healthy subjects. Thirty CLBP patients and thirty healthy subjects through simple non-probability sampling participated in this cross-sectional analytical study. Lumbar lordosis, lumbar flexion and extension range of motion, lumbo-pelvic stability was measured through flexible ruler, modified modified schober test, and Pressure Biofeedback Unit (PBU) respectively. ANCOVA test were used for statistical analysis (p0.05). Also lumbar lordosis, and lumbar flexion and extension range of motion did not significantly differ between two groups (p>0.05). There is no difference between CLBP and healthy subjects in terms of the lumbo-pelvic stability, lumbar lordosis, lumbar flexion and extension range of motion. The present study supported that lumbar lordosis, lumbar mobility, and lumbo-pelvic stability not affected by CLBP.

The impact of myofascial release technique alone has not been investigated in the patients with non-specific chronic neck pain. Thus, the aim of this study was to investigate the impacts of myofascial release technique on pain, disability, the maximum contraction of isometric extensor muscles of neck and pressure pain threshold in the patient with non-specific chronic neck pain compared with control group. In this clinical, randomized, double-blind trial, the patients with non-specific chronic neck pain have been entered the study by the available sampling method and have been located randomly into two groups of myofascial release therapy group, and control group. Pressure pain threshold, pain intensity, disability and isometric power of neck extensor muscles before and after intervention were registered through pressure algometer, visual analogue scale, neck disability index, and pressure biofeedback. The treatment was performed for 4 sessions and each session for 20 minutes. The paired t-tests and independent t-test were used for within group and between group comparison respectively. Comparing the mean of pain intensity, pressure pain threshold, neck disability index in the intervention group compared with control group showed significant reduction (P0.05). Myofascial Release is one of the effective manual therapy techniques in reducing pain, disability, improving the isometric extension strength of neck in patients with nonspecific chronic neck pain.

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