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Background and Objectives: The localized and referral pain of lumbar disc herniation can lead to compensatory strategies to reduce perceptual pain. The purpose of this study was to determine the foot pressure distribution pattern, symmetry index, and center of pressure sways in people with and without low back pain due to lumbar disc herniation. Materials and Methods: The present descriptive study was performed in Razi University Sports Rehabilitation Laboratory in 2019, Iran. Thirty-four people were purposefully divided into two groups: low back pain due to disc herniation (n=17) and healthy (n=17). Study variables were evaluated by PT scan. The indexes of anterior-posterior sways (SDy), medial-lateral sways (SDx), sways velocity, the center of pressure path length, sway area, length of the minor axis, length of the major axis, and symmetry index (SI) were evaluated during quiet stance. Independent t-test was used to compare the means across the two groups. Results: The results of this study showed a significant increase in the center of pressure path length (p=0.001), sways velocity (p=0.001), and SDy(p=0.001), and a significant decrease in SI (p=0.001) in the lumbar disc herniation group compared to the control. Conclusion: According to the findings of the study, people with lumbar disc herniation have a unilateral plantar pressure distribution that can be a result of delayed muscles activation of the spine due to the pain and can cause knee and ankle joints injuries. As a result, using neuromuscular exercises, with the aim of timely activation of spinal stabilizers, is a good way to reduce subsequent injuries. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS) can increase cortical excitability of a targeted brain area. This study aimed to investigate the effect of adding anodal-tDCS (a-tDCS) to neuromuscular training (NMT) on the dynamic knee valgus (DKV) and feedforward activity (FFA) of knee muscles. Thirty-four Taekwondo athletes with DKV, were randomly assigned to either NMT + a-tDCS (N = 17) or NMT + sham tDCS (N = 17). DKV and the knee muscles' FFA at the moment of single and double-leg landing and lateral hopping tasks were evaluated before and after the interventions. DKV and FFA of the knee muscles was improved in all tasks (P < 0.05), however, between-group differences were not significant (P > 0.05). The FFA of the semitendinosus, vastus medialis, gluteus medius, and gastrocnemius muscles in the single-leg landing (P < 0.05), the gluteus medius, gluteus maximus, semitendinosus, biceps femoris, and gastrocnemius muscles in the double-leg landing (P < 0.05), and the gluteus medius, gluteus maximus, and gastrocnemius muscles in the lateral hopping (P < 0.05) tasks were significantly different between the groups. A-tDCS achieved significantly larger improvements in the feedforward activity of lower extremity muscles compared with sham-tDCS. However, between-group comparisons did not show a significant difference in DKV., (© 2024. The Author(s).)

Objective: Coronary artery disease (CAD) is a debilitating condition that can lead to myocardial infarction (MI). Exosomal miRNAs (exo-miRNA) can be diagnostic biomarkers for detecting MI. Here, we conduct a study to evaluate the efficacy of exo-miRNA-21-5p/3p for early detection of MI., Methods: A total of 135 CAD patients and 150 healthy subjects participated in this study. Additionally, we randomly divided 26 male Wistar rats (12 weeks old) into two groups: control and induced MI. Angiographic images were used to identify patients and healthy individuals of all genders. In the following, serum exosomes were obtained, and exo-miRNA-21-5p/3p was measured by reverse-transcriptase polymerase chain reaction., Results: We observed an upregulation of exo-miRNA-21-5p/3p in CAD patient and MI-induced animal groups compared to controls. Analysis of the ROC curves defined 82% and 88% of the participants' exo-miRNA-21-5p and exo-miRNA-21-3p diagnostic power, respectively, which in the animal model was 92 and 82., Conclusion: This study revealed that the mean expression levels of exo-miRNA-21-5p/3p were significantly increased in CAD patients and animal models of induced MI. Also, these results are associated with the atherogenic lipid profile of CAD patients, which may play an important role in the progression of the disease. Therefore, they can be considered as novel biomarkers., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Purpose: This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA)., Methods: This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF 36 , and balance with Biodex were evaluated before and after interventions., Results: Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week ( p  < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups ( p  < 0.05)., Conclusion: Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.

Introduction: Pulmonary embolism (PE) is a potentially fatal condition. Several non-invasive clinical decision rules (CDRs) were developed for the safe exclusion of PE. All CDRs used to safely rule out PE have been created and tested within hospital or acute care environments. However, CDRs that are designed in one specific setting may not perform as effectively when used in a different setting. In this study, we aimed to compare the performance of four common CDRs; Wells Score, Simplified Wells Score, revised Geneva Score, and simplified revised Geneva Score., Methods: This was a cross-sectional study in which patients suspected of PE presenting to Imam Reza Hospital or Ghaem Hospital were recruited from September 23, 2013, to March 19, 2016 in Mashhad, Iran. The specificity, sensitivity, and accuracy were utilized as metrics to compare the CDRs in our region., Results: Two hundred and forty patients were included in the study. The mean age of patients was 57.91±19.97 years, and 54.16% of them (n=130) were female. 120 patients were confirmed to have PE with CT angiography. Wells score showed the highest sensitivity (90.4%) and revised Geneva score represented the highest specificity (84.9%). The highest accuracy belongs to the simplified Wells score (62.3%)., Conclusion: In this study, we demonstrated that the Wells criteria with its high sensitivity, can be used as a score for screening, and the revised Geneva score with its high specificity, can be used in the second stage for healthy people who have been diagnosed as unhealthy by the Wells score., Competing Interests: Authors declare that there is not any conflict of interests about this study., (© 2024 The Author(s).)

Background: There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients., Objective: This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients., Methods: This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments., Results: Except for the chest expanding, all variables in the Aqua Stretch group changed significantly after six weeks (p< 0.05). QOL (p= 0.002), 6MWT (p= 0.016), and Schober flexion (p= 0.011) showed changes, while BASDAI (p= 0.0001), VAS (p= 0.0001), fatigue (p= 0.0001), and Schober extension (p= 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates (p> 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion (p= 0.021) and a decreasing trend in BASDAI (p= 0.002), VAS (p= 0.0001) and fatigue (p= 0.002). Except for QOL (p= 0.016), no statistically significant differences were found between the groups., Conclusion: All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI.

Background: Diastasis recti abdominis (DRA) affects a significant number of women in the postpartum period., Objective: This study compared the effectiveness of suspension training system (STS) with that of isometric-isotonic (ISoM-ISoT) exercises in the treatment of DRA and its secondary complications., Methods: Thirty-six women with DRA participated in this study. They were divided into the three groups of STS, ISoM-ISoT, and control. Inter-recti distance (IRD), proprioception, lumbopelvic control, postural stability, low back pain, and disability were assessed using a digital caliper, a goniometer, a lateral step-down test, a Biodex balance system, a visual analogue scale (VAS), and the Oswestry Disability Index (ODI), respectively. Two intervention groups underwent training for 8-week and the control group resumed their normal lives., Results: Positive effects were observed in the STS and ISoM-ISoT groups compared with the control group in: IRD (P = .001); lumbopelvic proprioception (P = .001); lumbopelvic control (P = .001); overall static balance (P = .010); overall dynamic balance (P = .012); low back pain (P = .001); and disability (P = .001). However, there was no significant difference between the training groups in: IRD (P = .12, MD = -2.76); lumbopelvic proprioception (P = .48, MD = -0.50); lumbopelvic control (P = .14, MD = 1.53); static balance (P = .62, MD = 0.07); dynamic balance (P = .27, MD = 0.33); pain (P = .25, MD = -0.52); and disability (P = .48, MD = -1.74). The results of the minimal clinically important difference (MCID) and minimal detectable change (MDC) suggested that the STS exercises outperformed ISoM-ISoT training regarding IRD, pain, disability, and proprioception, whereas ISoM-ISoT training had a better effect in lumbopelvic control and balance., Conclusion: The results of our study showed that the STS had a positive effect on women with DRA and like the ISoM-ISoT exercises can be used to treat this dysfunction.

Background: Holding incorrect postures over a long period could lead to chronic nonspecific neck pain (CNNP) in office employees., Objective: The present study aimed to evaluate the effects of different typing positions on the activity of the neck extensor and upper trapezius (UT) muscles of office employees diagnosed with CNNP., Methods: This assessor-blinded cross-sectional study was performed on 22 female subjects with the mean age of 39.95±5.30 years. The neck extensors and UT muscle activities of the participants were assessed in the upright, forward, and slouching postures by electromyography (EMG). In addition, neck proprioception and the performance of the cervical stabilizer muscles were evaluated using an inclinometer and biofeedback pressure unit, respectively., Results: A significant difference was observed between the cervical erector spine (CES) and UT muscle activities in the upright, forward, and slouching typing positions (P < 0.05). In addition, a difference was observed between the upright and slouching postures in these muscles. A positive correlation was denoted between CES muscle activity in the slouching and forward postures and the activation index of neck muscles (P < 0.05). Furthermore, a significant, negative correlation was observed between the UT muscle activity in the slouching posture and neck proprioception (P < 0.05). A positive correlation was also noted between the pain index and repositioning error rates (P < 0.05)., Conclusion: CES muscle activity increased in a forward head posture, which could damage neck proprioception through causing early fatigue and stimulating a cumulative damage cycle.

Background: Aqua Pilates and Aqua Stretch exercises are different and new methods for the rehabilitation of musculoskeletal disorders. This study aimed to compare the effectiveness of Aqua Stretch and Aqua Pilates interventions in the treatment of pain, function, and posture of the spine in ankylosing spondylitis (AS) patients., Methods: Forty patients participated in this study who were randomly allocated into Aqua Stretch, aqua Pilates, and control. The experimental groups received four 60-min training sessions each week for six weeks. However, the control group had only its routine drug treatment (NSAIDs & Anti TNF). Pain with Visual Analog Scale (VAS), function with Bath Ankylosing Spondylitis Functional Index (BASFI) and 40-m walking test (MWT), quality of life with ankylosing spondylitis quality of life (ASQoL), and posture of the spine with the Spinal Mouse were evaluated. Evaluations were performed before and after the interventions. Repeated measure ANOVA was employed to determine the main and interaction effects., Results: Aqua Stretch and Aqua Pilates had a significant effect on pain (Aqua-Pilates: P = 0.0001; Aqua-Stretch: P = 0.0001), BASFI (Aqua-Pilates: P = 0.01; Aqua-Stretch: P = 0.02), 40-MWT (Aqua-Pilates: P = 0.006; Aqua-Stretch: P = 0.0001) and ASQoL (Aqua-Pilates: P = 0.01; Aqua-Stretch: P = 0.001), spinal range of motion (ROM) (Aqua-Pilates: P = 0.0001; Aqua-Stretch: P = 0.0001) at a similar ratio. However, the control group did not present any improvement in these factors (P > 0.05). Moreover, the minimal clinically important difference (MCID) revealed that the Aqua Stretch group performed better than the Aqua Pilates group in terms of VAS, ASQOL, and 40-MWT factors., Conclusions: Aqua Stretch and Aqua Pilates had statistically the same effect on improving pain, function, quality of life, and spinal ROM, while MCID results revealed that the Aqua Stretch group performed better than the Aqua Pilates in terms of VAS-ASQOL-40-MWT. Trial registration It is notable that local ethics committee approval was obtained (IR.KUMS.REC.1399.1137), and the study was registered in Iranian Registry of Clinical Trials (IRCT; IRCT20190426043377N3; registered on 22/05/2021, https://fa.irct.ir/user/trial/56058/view ) and patient recruitments were started on 06/07/2021., (© 2022. The Author(s).)

Background: Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI)., Methods: This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device., Results: Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior-posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior-posterior stability (p = 0.001), medial-lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p < 0.05)., Conclusions: According to the results, there were significant differences between the mean pain scores, static and dynamic balance, and the rate of fall between the women with knee osteoarthritis with and without the KI index. Therefore, patients with knee osteoarthritis, which also has an index of KI, are more susceptible to falls, and proper strategies are required to reduce the level of KI in these patients., (© 2021. The Author(s).)

Background: Lumbopelvic control (LPC) has recently been associated with function, kinesiology, and load distribution on the limb. However, poor LPC has not been studied as a risk factor for lower limb injury in sports requiring frequent jump landings. The present study investigated the effects of LPC on landing mechanics and lower limb muscle activity in professional athletes engaged in sport requiring frequent landing., Methods: This study was conducted on 34 professional female athletes aged 18.29 ± 3.29 years with the height and body mass of 173.5 ± 7.23 cm and 66.79 ± 13.37 kg, respectively. The landing error scoring system (LESS) and ImageJ software were used to assess landing mechanics. Wireless electromyography was also used to record the activity of the gluteus medius (GMed), rectus femoris, and semitendinosus. Lumbopelvic control was evaluated using the knee lift abdominal test, bent knee fall-out, active straight leg raising, and the PRONE test using a pressure biofeedback unit. Based on the LPC tests results, the participants were divided into two groups of proper LPC (n = 17) and poor LPC (n = 17)., Results: There were significant differences between the groups with proper and poor LPC in terms of the LESS test scores (P = 0.0001), lateral trunk flexion (P = 0.0001), knee abduction (P = 0.0001), knee flexion (P = 0.001), trunk flexion (P = 0.01), and GMed muscle activity (P = 0.03). There were no significant differences in the activity of the rectus femoris and semitendinosus muscles, and ankle dorsiflexion (P > 0.05)., Conclusions: Poor lumbopelvic control affects the kinematics and activity of the lower limb muscles, and may be a risk factor for lower limb injuries, especially of the knee., (© 2021. The Author(s).)

Background: Hyperkyphosis (HKP) and forward head posture (FHP) occur due to prolonged poor postures and repetitive activities., Objective: The present study aimed to compare the effects of the National Academy of Sports Medicine (NASM) and Sahrmann corrective exercises on HKP and FHP correction., Methods: This quasi-experimental study was conducted on 30 subjects with HKP and FHP, who were randomly assigned to the NASM (n= 15) and Sahrmann groups (n= 15). The ImageJ software and a spinal mouse device were used to measure FHP and HKP deformities, and neck and shoulder muscle strength, range of motion (ROM), and pulmonary function were assessed as the secondary outcomes before and after the eight-week intervention., Results: FHP improved more significantly in the Sahrmann group compared to the NASM group (P< 0.05), while no significant difference was observed between the groups in HKP (P> 0.05). The improvement in the neck and shoulder muscle strength was more significant in the Sahrmann group compared to the NASM (P< 0.05), except for the neck flexors. In addition, the neck extension ROM enhanced more significantly in the Sahrmann group compared to the NASM group (P< 0.05)., Conclusion: According to the results, the Sahrmann corrective exercises that focused on the correction of imbalanced muscle stiffness had more significant effects on the correction of FHP, neck and shoulder muscle strength and neck extension ROM.

Background: Knee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities. High prevalence (60-80%) has been reported for KI amongst the patients with knee osteoarthritis (KOA). In this line, the present study targeted the effect of two interventions on self-reported KI and affected factors., Methods: In this single blind, randomized, and controlled trial, 36 patients with radiographic grading (Kellgren-Lawrence ≥ II) of KOA were selected. Patients were divided into three groups namely, aquatic ( n  = 12), Total Resistance exercises (TRX) (n = 12) and control (n = 12) by random. Then both 8-week TRX and aquatic exercises were carried out by experimental groups. The following measure were taken before and after interventions: Pain by visual analog scale (VAS), balance by Berg Balance Scale (BBS), quadriceps strength by dynamometer, knee flexion range of motion (ROM) by inclinometer, knee stiffness with Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and self-reported KI with Felson's questionnaire., Results: The results demonstrated that KI, VAS, BBS improved over time both in TRX and aquatic groups significantly ( p  < 0.05), but WOMAC (stiffness) , knee flexion ROM, and quadriceps strength were significantly improved over time only for TRX ( p  < 0.05). Post hoc test, also, showed that there were significant differences between interventions and control groups (p < 0.05) for the VAS, KI, BBS, but for WOMAC (stiffness), a significant difference was observed only between TRX and control groups ( p  = 0.05)., Conclusions: Although TRX and aquatic interventions had a similar effect on the patients' balance, pain and KI, TRX had more effect on WOMAC (stiffness) , quadriceps strength, and knee flexion ROM than aquatic exercises., Trial Registration: This study was registered in the Iranian Clinical Trial Center with the number IRCT20181222042070N1, http://www.irct.ir/trial/36221, registered 02 February 2019., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)