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Objective Osteoporosis is a widespread skeletal condition due to decreased muscle strength and bone density. The most common complications are fractures followed by pain and reduced quality of life (QoL). Therefore, this research aimed to examine the effect of exercise therapy on muscle strength, QoL, and bone mass in osteoporotic women. Materials & Methods Available literature was reviewed using ScienceDirect, PubMed, Google Scholar, and Cochrane. Studies were considered eligible if they were randomized controlled trials (RCT) conducted on postmenopausal osteoporotic women, used exercise therapy as an intervention, and investigated muscle strength, QoL, and bone mass as outcomes. Two authors independently assessed the quality of the articles using the physiotherapy evidence database (PEDro) scale. The Cohen’s d effect size was computed by dividing the mean standardized difference by the standard deviation to measure the treatment effect, which includes exercise therapy. Results Seven papers were chosen to be included in this research. Their PEDro scores varied between 6 and 9 out of a possible 10. The effect size mean differences, resulting from exercise therapy, ranged from 0.32 to 0.63, indicating “small” to “moderate” effects in enhancing the condition of osteoporotic postmenopausal women. It was reported that there was a small effect size in 5 studies and a medium effect size in 2 studies. The research findings suggested the effect of balance, strengthening, stretching, stability, and motor control exercises on bone mass and muscle strength in osteoporotic postmenopausal women. Conclusion Findings indicate that exercise therapy interventions positively affect muscular strength, QoL, and bone mass in osteoporotic postmenopausal women. Additional well-conducted research is required to support this assumption further. more...

Background and Aims: Balance disorder in patients with stroke can cause the loss of independence and increase possibility of falling. The olfactory stimuli can activate the brain areas involved in balance activities. This study aims to investigate the effect of balance exercises combined with olfactory stimuli on the balance of patients with stroke.Methods: In this randomized clinical trial, 32 patients with stroke were randomly assigned into groups of balance+olfactory stimulation and balance. The first group performed the balance exercises while wearing a mask containing the lavender essential oil. The second group performed the balance exercises while wearing a mask containing distilled water. Both groups performed the exercises for 20 min at one session. The timed up & go (TUG) test, 10-m walk test with self-selected speed, and Mini-Balance Evaluation Systems Test (Mini-BEST) were used for assessments. The data were analyzed in SPSS software, version 22. P more...

Objective: Spasticity is one of the components of an Upper Motor Neuron (UMN) lesion that occurs usually after a period of flaccidity in the form of velocity-dependent resistance to passive stretch. Spasticity is a significant cause of limited mobility and disability in neurological diseases. There are several clinical approaches to control spasticity. Recently, Shock Wave Therapy (SWT) has been reported to be a new, safe, and effective method for reducing spasticity for people with upper motor neuron lesions. We conducted a meta-analysis of relevant clinical trials to assess the effect of applying SWT on spasticity in UMN lesions. Materials & Methods: An electronic search was performed in PubMed, ISI Web of Science, Scopus, Science Direct, MEDLINE, and Google scholar from January 2005 to January 2020. Studies were included if they measured spasticity with the Modified Ashworth Scale (MAS) or/and neurophysiological indices in patients with stroke, multiple sclerosis, and cerebral palsy. The keywords of muscle hypertonia or spasticity, extracorporeal shock wave therapy, stroke, multiple sclerosis, and cerebral palsy were used. Two independent researchers searched articles, screened eligible studies against the inclusion criteria, and assessed the methodological quality of included studies. The methodological quality of studies was evaluated using the Downs and Black tool. The difference between the means was considered as the effect size in the MAS and Hoffman reflex/motor response (H/M) ratio before and after the intervention with 95% CI in random-effects models. Analyzes were performed using STATA software version 11. Results: The initial search led to the retrieval of 98 studies based on the inclusion and exclusion criteria, of which 24 full-text articles were reviewed and 14 articles were included in the meta-analysis process. All 14 articles had examined the effects of shockwave on the MAS. Four studies with 120 patients had examined the effects of shockwave therapy on the H/M ratio. Significant reduction in MAS grade was observed immediately [I2 = 100%, P more...

Background: Spasticity is a common motor impairment in patients with stroke that not only has a negative impact on the patient’s quality of life but also has high economic burdens for society. Recently the application of shock wave therapy has attracted considerable attention as a safe and effective method in treatment of spasticity. The objective of the present study was to investigate the effect of application shock wave on spasticity of quadriceps femoris and triceps surae muscles in patients with stroke. Methods: This was a quasi-experimental study on 15 stroke patients which were selected according to inclusion criteria between September 2016 and May 2017. This study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences, Iran. The intervention included one session placebo shock wave and three sessions of true shock wave. Level of the spasticity was measured at quadriceps and gastrocnemius muscles by Ashworth scale (AS) and passive range of motion (PROM) of the knee and ankle joints was recorded by a manual goniometer (Enraf-Nonius Corp., Delft, Netherlands). Participants were assessed at baseline, after the placebo shock wave, after the final session of active shock wave and 4 weeks after the last treatment. Results: Placebo shock wave had not significant effect on grade of AS of spastic muscles as well as PROM of knee and ankle joints. True shock wave induced a statistically significant reduction in AS of triceps surae and quadriceps femoris muscles and improvement of PROM of knee and ankle joints. The reduction in AS of triceps surae and improvement of ROM ankle joint continued 4 weeks after the last treatment. However, after 4 weeks, there was a significant reduction in the PROM of knee joint compared to the last session. Conclusion: Three sessions shock wave therapy can reduce the tone of triceps surae and quadriceps muscles and improved the passive range of motion in the knee and ankle joints for up to 4 weeks, but these effects were not stable on the PROM knee joint. more...

Background: The transverse abdominis (TrA) muscle is one of the most important muscles that contribute to the stability of the lumbar spine. Strengthening of trunk muscles that have a significant role in trunk stability is very important in the field of professional sport, sport medicine and rehabilitation of patient with low back pain (LBP). Identifying the exercises that can improve the strength and endurance of these muscles in the efficient way is an important challenge in rehabilitation of LBP patients. The aim of this study was to investigate the effect of maximum voluntary isometric contraction of upper and lower limb muscles on ultrasonic thickness of the TrA muscle. Methods: This is a pre-test post-test study. Thirty healthy young male subjects with mean age of 23 years were recruited from the university staff and student population (non probability sample). Ultrasonic thickness of the right and left TrA muscle (as an indirect measure of muscle activity) was taken at rest and during maximum isometric contraction of six muscle groups: shoulder and hip flexor, extensor and abductor muscles. Mixed-model ANOVA with repeated measures design were used to analyze data. To further analyses post hoc comparisons were performed with paired t-tests adjusted with the Bonferroni method. The significance level was set at P more...

Background: The previous studies showed that the odor can improve balance in the elderly. The purpose of the current study was to determine the effect of olfactory stimulus and its gender specific effect on the balance of young healthy people. Methods: This is a pretest-posttest semi experimental study comprised 40 healthy volunteers (age range 18-73 years) from February 2016 through May 2017. The static balance test with one-leg standing time (OLST) and dynamic balance test using Biodex balance system to measure overall stability index (OSI), anterior/posterior stability index (APSI), medial/lateral stability index (MLSI) and overall limit of stability index (OLOSI) randomly were performed before and after application of lavender scant as the olfactory stimuli. A two-way repeated measurement ANOVA was used to assess the effect of olfactory stimulus conditions and gender on dynamic balance indexes (OSI, APSI, MLSI, and OLOSI). Since the distribution of the OLST was not normal, the generalized estimating equations (GEE) method was used. Significance level of P0.05). There were significant differences in relation to the interaction of the gender and odor in OSI (P=0.026), APSI (P=0.019). For gender, there were statistically significant differences in OSI (P=0.002, F (1,38) =11.649), APSI (P=0.001, F (1,38) =12.057), and MLSI (P=0.007, F (1,38) =8.228) for females. Conclusion: Although there was no effect of odor on balance control of young healthy people, we found that the odor has gender specific effect. This is probably due to the more sensitivity of females to the odor. more...

Background: Spasticity is a clinical deficit of upper motor neurons lesions that presented immediately or at delayed times after lesions and occurs in about 38% of stroke patients. Extracorporeal shock wave therapy (ESWT) has been recently reported as a safe and effective method for reducing spasticity in stroke patients. In the present study, we sought to investigate the impact of the ESWT on post stroke spasticity using a meta-analysis method. Methods: All primary reports of spasticity indexed in PubMed, MEDLINE, Science Direct, Scopus and search engine of Google Scholar from January 2000 to December 2016 were searched. The following terms were used as keywords: Spasticity, muscle hypertonicity, ESWT, stroke and hemiplegia. Any report was included if it met the following criteria: involving clinical trials, full-version availability, and being written in english. Two reviewers selected articles independently and reviewed the studies considering quality and eligibility, and then they extracted general information on objectives, design, participants, and outcomes. The methodologic quality of each study was assessed using the Pedro Scale. In the statistical analyses, we considered two outcomes; Modified Ashworth scale (MAS) grade and passive rang of movement (PROM). The meta-analysis was done using random effect model in Stata, version 11 (Stata Corp., TX, USA). Results: Eleven studies within a total of 261 patients were included in this review. In seven studies the shock waves were applied to the upper limb muscles, and in four other studies, the effects of ESWT on the spasticity of the lower limb muscles were assessed. Immediately after applying the ESW, MAS grade was significantly decreased in comparison to the baseline values. (Standardized mean difference [SMD], -1.62; 95% confidence interval [CI], -2.2 to -1.04). The PROM was significantly increased immediately after ESWT in comparison to the baseline values (SMD, 3.23; CI 95%, 1.35 to 5.12). Conclusion: The results of this study showed that ESWT can immediately improve the spasticity and increased PROM, but it seems that the mechanism of action of shock waves on spasticity is still unclear. Further clinical trial studies with higher methodological quality should be recommended. more...

Background: Low back pain is one of the most important causes of disability among people around the world. Although only 2-5% of low back pain disorders resulting from herniation of lumbar intervertebral discs but surgery for lumbar disc herniation is a common procedure. The aim of this study was to determine the relation between some bio-psycho-social variables and treatment outcomes in patients who undergo first time single-level lumbar discectomy. Methods: This is a prospective observational analytic study comprised 100 patients (age range 18-73 years) underwent single-level lumbar disc surgery. The patients who met our inclusion criteria and were willing to participate in the study were recruited from the neurosurgery ward of Logman and Imam Khomaini hospitals in Tehran, Iran, between October 2015 and March 2016. The patient completed SF-36 quality of life Questionnaires before, one and two months after surgery. Results: In comparison to standard values, before the surgery patients had significantly lower baseline SF-36 (36-Item Short Form Survey) Questionnaire value in all 8 domains. The role limitations due to physical health had greatest impact on quality of life. At the eight weeks’ follow-up SF-36 scores showed significant improvement in both physical and mental scales. Age had no significant impact on mental scales of weeks’ Questionnaire but in age less than 30 years there was a positive relation between the patient’s age at surgery and physical aspects of quality of life. Although there was no significant difference in physical aspects of SF-36 Questionnaire between males and females but males had a significantly higher mean mental health score than females after surgery. Smokers had lower value of mental scales of SF-36 Questionnaire than in nonsmokers. Conclusion: The result of this study showed that surgery for lumbar disc herniation had a great impact on both physical and mental scales of SF-36 Questionnaire two months after surgery. Factors such as age, sex, smoking and psychological factors can play the role of predictor for patient’s outcomes after lumbar disc surgery. more...

Objective: The purpose of this study was to determine the reliability of electromyography measurements of abdominal muscles activity during different manoeuvres (pelvic floor muscle (PFM) contraction, abdominal hollowing and abdominal bracing with and without PFM contraction) in subjects with and without chronic low back pain (LBP). Materials & Methods: In this methodology research 21 subjects (9 with LBP, 12 without LBP) who were selected simply & conveniently participated in the study. Abdominal muscle activation amplitude was assessed. Each maneuver was performed in triplicate and repeating of the test was done on the same day with a period of at least 30 minutes. Data were analyzed by Kolmogroff–Smirnoff test and Interclass correlation coefficient. Results: The results showed high reliability for the muscle activation amplitude during abdominal hollowing with and without pelvic floor muscle contraction and isolation pelvic floor muscle contraction and abdominal bracing (ICC=80–90). Also moderate reliability in abdominal bracing with pelvic floor muscle contraction (ICC=70–80). Conclusion: Electromyography is a reliable method for assessment of voluntary and automatic activity of abdominal muscles during different conditions. more...