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Background — Although wearing masks is inevitable these days, the effects of wearing them on physiologic parameters have not been reported. This study aimed to assess the effects of wearing no mask, a three-layer standard surgical mask, and wearing an N95 mask on blood oxygen saturation, aerobic tolerance, and performance during exercise. Methods — Twenty-one participants were enrolled in the study. Each participant was monitored with electrocardiography (ECG) while performing an exercise tolerance test using the Bruce treadmill protocol. Testing was conducted three times on different dates. Participants did not use any mask in the first test but did wear surgical and N95 masks during the second and third tests respectively. Respiratory rate (RR) was assessed for 10 seconds and then multiplied by 6. Heart rate (HR) was monitored by ECG, and oxygen saturation levels were monitored (O2Sat) via digital pulse-oximetry. Assessments were done before warm-up, at the middle and end of each Bruce stage, and as well at 1, 2, and 5 minutes into recovery (masks were worn during recovery). Results — HR, RR, and O2Sat measured data were all significantly different between the three trials at end-stage 3 of Bruce treadmill protocol (p

Introduction: This study aimed to explore foot pronation deformity on the postural control of the body and the onset time of the electrical activity of ankle muscles during landing. Materials and Methods: In this cross-sectional study, 27 people with a pronated foot deformity and 27 normal people participated. The force plate was used to measure the postural control of the body. Surface electromyography signals were recorded in landing tests with electromyography, which synchronized with a force plate. To compare the performance of the two groups, we used multivariate analysis of variance. Results: The results indicated a statistically significant difference in the medial-lateral direction of differences between center of pressure and center of mass (COP-COM) between foot pronation (pronated) and normal group during landing (P

Background: Obesity is a risk factor for severe, radicular, and debilitating lumbosacral pain. The use of non-surgical treatment methods in obese patients is important. Epidural steroids injection (ESI) is a common procedure that helps patients with low back pain and radicular symptoms. So far, using ESI in patients with lumbar herniated discs remains to be controversial among physicians. Thus, the current study was carried out to compare therapeutic effects of ESI's in obese and non-obese patients with spinal disc herniation. Methods: This prospective, clinical trial study was conducted among 124 patients (58= non-obese, 66= obese) with low back pain caused by lumbar herniated disc, who referred to our Pain Clinic during 2017 to 2018. The ESI was done using the parasagittal inter-laminar approach.Severity of pain was measured by the patients’ self-report of pain and using the visual analog scale (VAS), before the treatment and two and six weeks after the treatment. The Oswestry Disability Index (ODI) was also measured in the treatment groups. Patients were followed for 6 weeks (IRCT20131124015515N3). Results: Overall, 58 (46.8%) patients had a BMI of 20-25 kg/m2, 38 (30.6%) had a BMI of 25-30 kg/m2, and 28 (22.6%) patients had a BMI of >30 kg/m2. The changes in the pain scores and ODI at different time periods showed no statistically significant differences in the two groups, (P=0.685, P=0.995), respectively. Conclusion: The ESI is an effective, safe, minimally invasive, and cost-effective method which can result in pain relief and improvements in patients' function after a short period of time. Hence, we suggested that this treatment to be considered for all patients with acute/chronic low back pain as well as radiculopathy.

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. The aim of this study was to investigate the effects of inspiratory muscle training (IMT) and aerobic exercise on health-related quality of life of patients with COPD. Materials and Methods: This randomized controlled clinical trial was conducted on 60 patients with moderate to severe COPD, who were referred to Imam Hossein Hospital of Tehran, Iran in 2016. The patients were randomly assigned to four groups and treated for eight weeks. Group 1 (n=16) participated in 16 sessions of IMT (15 minutes per session), group 2 (n=14) performed aerobic exercises twice a week (40 minutes per session), group 3 (n=15) performed IMT and aerobic exercises, and group 4 (n=15) received no intervention, except for routine treatments (control). Quality of life was evaluated based on the Saint George’s Respiratory Questionnaire (SGRQ) at baseline, week 4, and week 8 after the intervention. Results: After eight weeks, all four groups experienced a significant improvement in their quality of life (P

Background: Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral neuropathy. There are various treatments for carpal tunnel. Objectives: In this study, we evaluated the effect of electroacupuncture and exercise on pinch and grip strength and wrist range of motion in patients with mild to moderate CTS. Methods: Sixty patients with carpal tunnel syndrome were evaluated in this study, only five of whom were male. In this study, patients were divided into three groups. The control group consisted of 20 patients who only used splints in the second group, in addition to splints, special exercises were administered, and the third group, electroacupuncture, and brace were prescribed for 12 sessions of 40- minute duration. study time was 6 weeks. The parameters of pinch force, grip force, ROM (flexion and extension) were evaluated at baseline and after the treatment. Results: In this study, 55 women and 5 men with an average age of 49.23 ± 8.96 were enrolled. At the final follow up, significant improvements in all parameters were found in third groups (P < 0.05), except flexion of the wrist in the control group (P = 0.098). Our findings indicate that exercise therapy had more effect on ROM of flexion than acupuncture and acupuncture had more effect on pinching than exercise therapy but the effect sizes were weak. Also, the efficacy of splint alone was less than intervention groups in all parameters. Conclusions: Results of this study demonstrated that adding exercise or acupuncture to nocturnal splinting, the functional improvement is more in patients with mild to moderate carpal tunnel syndrome and these interventions could be adopted in the management of these patients.

Objectives: In accordance with the multiple causes of impingement syndrome being a major injury of the swimmers' shoulder, choosing an effective method in preventing shoulder injury is important. The purpose of this study was to compare the effect of eight weeks open and closed kinetic chain exercises on muscle torque of internal and external rotators of shoulder in elite swimmers. Methods: In this study, 45 swimmers were selected based on the inclusion criteria and divided randomly and equally into three groups of open chain, closed chain exercises, and control. Both open and closed chain groups performed their own exercises three times a week for eight weeks, but no upper extremity exercises were given to the control group. Before the training, the pick torque of the external and internal rotators of shoulder were measured by the isokinetic HUMAC NORM machine at various speeds of 60, 120 and 180 degrees/s. After eight weeks of practice, the variables were re-measured. Shapiro-Wilk test was used for data normalization, one-way ANOVA and Tukey post hoc testes were used accordingly to compare the groups and to show the intra-group difference (P < 0.05). Results: The results of this study showed that eight weeks of open and closed chain training improved the torque of internal and external shoulder rotator muscles at 60, 120 and 180 degrees per second (P < 0.05). There was a significant difference between open chain and closed chain exercises, and the effect of open chain was more than closed chain training (P < 0.05). Conclusions: According to this study, it can be concluded that open and closed kinetic chain exercises improve the torque of the external and internal rotating muscles in swimmers. They also suggest that kinetic chain exercises are more effective than closed kinetic chain exercises in this regard so could be prescribed for swimmers.

Acromioclavicular (AC) joint injuries are common and often seen in contact athletes, resulting from a fall on the shoulder tip with adducted arm. This joint is stabilized by both static and dynamic structures including the coracoclavicular (CC) ligament. Most reconstruction techniques focus on CC ligament augmentation as the primary stabilizer of the AC joint. The best surgical technique for some AC joint dislocations is still controversial. In this study, we explained a modification of the CC ligament reconstruction technique described by Wellmann. The method is based on minimally invasive CC ligament augmentation with a flip button/polydioxanone (PDS) repair, typically used for extracortical ACL graft fixation. Patients commonly complain that heavy sutures under the skin in subcutaneous tissue irritate the skin and sometimes require reoperation for suture removal. We present an augmentation technique that resolves this issue by changing the suture knot location to the sub-clavicular position.

Background: Athletes’ health is an important issue and for promoting it, pre-participation examination (PPE) is widely performed by responsible bodies around the world. Objectives: This study was to determine prevalence of cardiovascular disorders among athletes participating in the Asian games and answering the question whether the electrocardiogram (ECG) is a necessary part of pre-participation examination (PPE) for prevention of sudden cardiac death. Materials and Methods: All athletes participated at Asian games came to sports medicine federation for a PPE including a comprehensive questionnaire, physical examination and ECG. In this retrospective study all profiles of 338 athletes have been studied as well as their electrocardiograms. Multiple logistic regressions as well as Firth’s bias reduction were used with R statistical software and SPSS. For predicting the changes in ECG, receiver operating characteristic (ROC) curve has done. Results: Among 388 athletes, 80 (20.6%) were female and 308 (79.4%) male with mean age of 23.2 + 8 years. Nine athletes (2.3%) were smokers, 28 of them (7.2%) experienced chest pain and discomfort, 45 of them (13.3%) had palpitations and 28 (7.2%) had history of anemia. Study of their electrocardiograms showed that long Q-T interval was not seen for anyone, but evidence of left ventricular hypertrophy was seen in 12 (3.1%), inverted T wave in 6 (1.5%), and right bundle branch block in 45 (13.3%). Conclusions: PPE provides very important information of athletes’ health. This study has shown that there was not any significant relation between current examination and electrocardiogram changes but regarding the ECG changes we recommend it as a routine part of PPE.

This was Presented in 5th International congress of Iranian Iranian Society of Knee Surgery, Arthroscopy, and Sports Traumatology (ISKAST), 14-17 Feb 2018- Kish, Iran

In this paper, an adaptive control scheme, based on fuzzy logic systems, for pH control is addressed. For implementation of the proposed scheme no composition measurement is required. Stability of the closed-loop system is established and it is shown that the solution of the closed-loop system is uniformly ultimately bounded and under a certain condition, asymptotical stability is achieved. Effectiveness of the proposed controller is tested through simulation and experimental studies. Results indicate that the proposed controller has good performances in set-point tracking and load rejection and much better than that of a tuned PI controller.

In this paper, an adaptive fuzzy controller, based on backstepping technique, has been proposed for temperature control of a general class of continuous stirred tank reactors (CSTRs). Using the observability concept, an adaptive fuzzy controller using temperature measurement has been designed. A fuzzy logic system is used to estimate the concentration dependent terms and other unknown system parameters appearing in the control law. It is shown that the closed loop system is asymptotically stable and influences of minimum approximation error and external disturbance on the L"2 norm of the output tracking error can be attenuated arbitrarily. The performance of the proposed controller has been examined for temperature control of an unstable reactor and its effectiveness has been demonstrated through computer simulation.

In this paper, an adaptive fuzzy temperature controller is proposed for a class of continuous stirred tank reactors (CSTRs) based on input–output feedback linearization. Since for control implementation concentrations of all species are needed, based on the observability concept, a fuzzy logic system is used to estimate the concentration dependent terms and other unknown system parameters in the control law, using temperature measurements. It has been shown that the H ∞ tracking control performance with a prescribed attenuation level is achieved, by using the proposed controller. Finally the effectiveness of the proposed controller has been demonstrated by applying it to a benchmark chemical reactor through computer simulation.

In this paper, two nonlinear observer based controllers for temperature control of a continuous stirred tank reactor in which a special class of parallel exothermic reactions take place are proposed. A reduced order nonlinear observer is constructed to estimate the concentration in the reactor. The observer is coupled with two nonlinear controllers, designed based on two well-known techniques, namely input–output linearization and backstepping for controlling the reactor temperature. For dampening the effect of observer error dynamics, a compensating term is used in each control law. The asymptotical stability of the closed-loop system is shown by the Lyapunov's stability theorem. The effectiveness of the proposed controllers has been demonstrated through computer simulations.

Objectives While a few studies have done on professional athletes’ cardiac adaptation and it has not performed about elite athletes yet, the question raises whether the long time endurance and resistance trainings have different morphological and functional effect on heart. The purpose of this study was to review the effect of training type on cardiac adaptations in elite Iranian athletes. Methods This cross-sectional study was performed on elite athletes who came to Iran Sports Medicine Federation for Pre-Participation Examination of Major International Tournaments during autumn of 2015. Thirty-one elite male athletes were divided into dynamic (n = 9), static (n = 10) and combined (n = 12) groups according to their exercise components and control group was 12 non-athletic students. 2-dimensional echocardiography was performed and One-Way-ANOVA and LSD-post-hoc tests were applied (P ≤ 0.05) for comparing variables. Results The largest Fractional Shortening (FS), Inner Ventricular Septum (IVS), Septal Thickness (ST), and Left Ventricle Mass (LVM) belonged to Combined, Static, Dynamic, and control groups respectively. Ejection Fraction wasn’t different among groups (P = 0.13). LVM, ST, Left Ventricular Inner Dimension (LVID) and Posterior Wall Thickness (PWT) in diastole and systole were lesser in the control group (P = 0.001). LVID in diastole and systole was different in combined (P = 0.014) comparing to dynamic (P = 0.041). LVID in systole was different in combined comparing to static (P = 0.019) and LVM was different in combined comparing to dynamic (P = 0.012) as shown at Table 1. Conclusion Among the factors affecting morphological adaptations in athletes’ heart, type of training has an important role.

Carpal Tunnel Syndrome (CTS) is the most common disorder of neural involvement and the purpose of this study was to determine the impact of Stretching and Massage Therapy on Pain and Function of Females suffering Carpal Tunnel Syndrome. This Randomised Clinical Trial was implemented on 30 females (age: 32 + 4, height: 165 + 8, and weight: 62 + 6) who divided into 3 groups of 10 persons. First group received 20 session of massage therapy while the second had 20 session of stretching exercises and the third group just used the wrist brace. Standard Visual Analogue Scale for Pain (VAS Pain), Boston questionnaire have been used. Descriptive statistics were used for stratifying data and Shapiro test, independent T-test and U Mann Whitney test were used for analysis of data by SPPS version 18. Based on U Mann Whitney test, the effect of massage therapy on pain reduction in CTS is significant (p = 0.5). It has also has shown that massage therapy is effective on severity of symptoms of CTS and improvement of wrist and hand function (p = 0.022), but it doesn’t have any significant impact on paresthesia (p = 0.281), range of motion (p = 0.655), grip force (p = 0.427), and pinch force (p = 0.145) of CTS patients. Independent T-test between stretching group and wrist brace group showed that stretching had a significant effect on pain (p = 0.017), function (p = 0.011), and severity of signs and symptoms of CTS (p = 0.024), but it didn’t have any meaningful impact on paresthesia (p = 0.176), range of motion (p = 0.0537), grip force (p = 0.0587), and pinch force (p = 0.481) of patients. It has been concluded that stretching and massage could be used for treatment of Carpal Tunnel Syndrome.