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Gh.r Oliaei , M Akbari , H Bagheri , Mr Hadian , S Talebian, N Ahamad Vand ,
Volume 58, Issue 1 (4-2000)
Volume 58, Issue 1 (4-2000)
Abstract
It is generally assumed that local muscular fatigue predisposes the individual to injury. Despite the significance of muscular fatigue and endurance, there are not much dynamic endurance studies for trunk muscles in the literature. Most of them have used isokinetic dynamometer which keeps the velocity of movement constant. In this studies with the help of an isoinertial dynamometer we have assessed the effect of repetitive and fatiguing flexion-extension movements patterns and motor output. 38 female subjects with no history of low-back pain for the 6 months volunteered for the study. A triaxial dynamometer was used that simultaneously provided measurement of torque, angular position, velocity impulse, work and power of each axis. Resistance were set independently for each axis by an interfaced computer. The subjects performed trunk flexion and extension movement against a saggital plane resistance equal to 50% of their maximum isometric extension strength in the upright position. The minimum resistance in the coronal and transverse planes were set-up at 5-7 Newton meters. The subjects were asked to perform trunk movement as quickly and as accurately as possible while exerting the maximum efforts until exhaustion. Immediately after dynamic test another isometric test was performed. A paired T-test procedure was performed among the selected parameters of the 1st middle and last 3 repetition cycles. The selected parameters are range of motion, velocity, torque, impulse, work, power, time interval and time of movement. Also, a paired T-test was performed between maximum isometric strength before and after dynamic test. All the selected parameters were significantly reduced in the saggital plane. Subjects displayed significantly less motor control and greater range of motion in the coronal and transverse planes in performing the primary task of flexion and extension. The reduction of the functional capacity of the primary muscles performing the required task is compensated by secondary muscle groups and the spinal structures is located in a more injury prone position, as identified by finite element models. In addition it is suggested that the fatigued muscles would be less able to compensate any perturbation in the load or position of the trunk. The repetitive loading results in a weakening of the viscoelastic passive elements of the spineless structure. The loss of ability to protect these weakened passive elements makes the spine susceptible to industrial and recreational injuries.
Naraghy Ma, Ragerdy Kashani I, Barbarestani M, Abdolvahhabi A, Pasbakhsh P,
Volume 59, Issue 1 (4-2001)
Volume 59, Issue 1 (4-2001)
Abstract
This study was conducted on 48 specimens of Rectus abdominis muscles for recognition and definition of passage and ramification of lower intercostal nerves. The main results of this study are as follows: 1- The seventh and eight intercostal nerves penetrated to posterior layer of the Rectus sheath while other intercostal nerves perforated to dorsal layer of internal oblique abdominis aponeurosis. 2- Distance between lateral border of the Rectus abdominis muscle till penetrate point for all nerves were 18±1 mm, but the subcostal nerve was 16±1 mm. 3- Each intercostal nerve was ramified in thickness of muscle and formed many branches that maximum of this was middle longitudinal region and minimum of that was lateral longitudinal region. In addition we did not observe the nerve anastomosis between intercostal nerves. 4- The lower primary branch of the intercostal nerve after piercing of anterior layer of the Rectus sheath was named anterior cutaneous branch and terminated to abdominal skin. 5- All of intercostal nerves at first was placed right angle to muscle fibers but immediately decrease its and was placed parallel to muscle fibers. 6- The entrance, passage and ramification of intercostal nerves in both male and female cadavers were similar.
Talebian S, Bahrami Sh, Olyaei Gr, Bagheri H, Hadian Mr,
Volume 64, Issue 7 (8-2006)
Volume 64, Issue 7 (8-2006)
Abstract
Background: The purpose of this study was to measure isokinetic maximum and average peak torque of internal and external rotators of glenohumeral joint in volley ball and tennis players
Methods: This study was performed on 17 professional female athletes (7 tennis players &10 volleyball players) with age ranged 18-28 years. The subjects had played in a skilled team for more than 3 years. They were free from injury to their dominant shoulder in the past year. Subjects performed a five minute warm up by shoulder wheel and Maximum average Peak Torque (APT) were obtained unilaterally by a Biodex System 3 with the arm of players in 90 degree abduction at 120,180 & 210 o/s. Players performed five trails of concentric movements with 30 second rest between them.
Results: Maximum and average of maximum torques of shoulder rotator, in both groups, expect for internal rotators of tennis players, reduced by increase of movement speed (P<0.05). There are not significant difference between two groups in maximum, average of maximum torques and normalized data (ratio of maximum torque to weight). There is significant difference between two groups in percentage of APT of External rotator / Internal rotator ratio at 210 o/s (P<0.05).
Conclusion: Volleyball and tennis have no effect on isokinetic strength of shoulder rotators. In high speed, ratio of External rotator / Internal rotator is reduced. This indicates that increase in movement speed increase internal rotator in comparison to external rotator in these professional female athletes.
Vasaghi Gharamaleki B, Keshavarz M, Gharibzadeh Sh, Marvi H, Mosayebnejad J, Ebrahimi Takamjani E,
Volume 66, Issue 6 (9-2008)
Volume 66, Issue 6 (9-2008)
Abstract
Background: The typical features of eccentric exercise-induced muscle damage are delayed-onset muscle soreness (DOMS) and prolonged loss of muscle strength. It has been shown that passive warmth is effective in reducing muscle injury. Due to the interaction of different systems in vivo, we used isolated perfused medial gastrocnemius skeletal muscle to study the direct effect of temperature on the eccentric contraction-induced force loss.
Methods: After femoral artery cannulation of a rat, the left medial gastrocnemius muscle was separated and then the entire lower limb was transferred into a prewarmed (35oC) chamber. With the chamber temperature at 31, 35 and 39oC before and during eccentric contraction. Isometric force loss was measured after 15 eccentric contractions (N=7-9).
Results: Maximum contraction force reduction has been used as an index for eccentric contraction-induced force loss. In this study eccentric contraction caused a significant reduction in maximum isometric tension (p<0.01), but no significant difference was seen in isometric force loss at 31oC and 39oC compared with that at 35oC.
Conclusions: Our results suggest that temperature changes before or during eccentric contractions have no effect on eccentric contraction-induced force loss.
Talebian S, Olyaei Gr, Abbaszadeh M, Partabian L,
Volume 67, Issue 5 (8-2009)
Volume 67, Issue 5 (8-2009)
Abstract
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Background: Muscle
weakness and fatigue are two factors that cause muscle injuries. The roll of
motor control is important in regulation and reduction of this effect.
Repetition of motion after muscle fatigue is due to the significant role of
motor control system. The aim of this study was to evaluate the quality of roll
control of central nervous system following fatigue in order to answer primary
questions in therapeutic exercises.
Methods: Twenty voluntary healthy subjects
participated in this study. Dominant abductor policis brevis after surface
electromyography (SEMG) of maximal voluntary contraction
(MVC) fatigued by maximum three
minutes isometric contraction in specific hand splint monitored by dynamometer
until reduction of activities to 50% MVC. Before and immediately after
fatigue test, 5 dynamic full range of motion in
abduction direction performed without resistance and muscle activities recorded
by SEMG. Three middle muscle activities
selected for comparison of Symmetrical Index (SI) as specificity of motor control assessment. Fatigue
indicators were percentage of reduction of MVC and median and mean frequency of power spectrum of MVC before and after fatigue test.
Results: Significant
reduction of MVC (46.77%), median (13.03%) and
mean (12.20%) frequency were showed (p=0.001),
whereas significant increase of SI (10.76%) appeared (p=0.000),
following fatigue test.
Conclusion: Fatigue reduces muscle
contraction velocity, therefore median and mean frequency decrease. Also after
muscle fatigue reduces of muscle proprioception sense appears, that can cause
slow dynamic joint motion. Upper central control systems try to correct this
situation by involving new motor units and changes of muscle timing.
Synchronization of primary and new motor units plays an important role in
increase of SI.
Guity Mr, Farhoud Ar,
Volume 68, Issue 2 (5-2010)
Volume 68, Issue 2 (5-2010)
Abstract
Background: Rupture of pectoralis major muscle is a very rare and often athletic injury. These days in our country this injury occurs more frequently. This could be due to increase in professional participation of amateur people in different types of sport, like body building and weight-lifting (especially bench-pressing) without adequate preparation, training and taking necessary precautions. In this article, we have tried to review several aspects of complex anatomy of pectoralis major muscle, epidemiology, mechanism, clinical presentations, imaging modalities, surgical indications and techniques of its rupture. Complex and especial anatomy of pectoralis major muscle, in its humeral insertion particularly, have a major role of its vulnerability to sudden and eccentric contraction as the main mechanism of rupture. Also, restoration of this complex anatomy seems to be important during surgical repair to have normal function of the muscle again.
Parvin Bastani , Sakineh Hajebrahimi , Fariba Ghaderi , Zahra Vakilazad , Morteza Ghojazadeh ,
Volume 74, Issue 7 (10-2016)
Volume 74, Issue 7 (10-2016)
Abstract
Background: Dyspareunia is a pain that is occurs in the genital area before, during or after intercourse and is an important factor for sexual dysfunction. The aim of this study was to evaluate the effect of pelvic floor physical therapy on sexual function and muscle strength and endurance of pelvic floor (as a non-invasive therapy) in women with dyspareunia.
Methods: In this clinical trial study, 32 women in the age range of 20-50-year-old and sexually active with complaints of dyspareunia, before the investigation were examined in terms of genital health and strength and endurance of the pelvic floor muscles. After the confidence of mental health, patients underwent pelvic floor rehabilitation for 10 sessions during 3 months. After assessment, myofascial release techniques and progressive pelvic floor muscles exercise was performed for patients based on their primary strength. Finally, patients were compared in terms of the severity of dyspareunia, sexual performance status (by using female sexual function index questionnaire), improvement of symptoms, pelvic floor muscle strength and endurance before (first session of physiotherapy) and after (after 3 months) investigation.
Results: In the remaining 32 patients with dyspareunia with a mean age of 38±1.24 years, desire index score 0.95 unit, arousal index score 1.01 unit, lubrication index score 0.67 unit, orgasm index score 0.71 unit, satisfaction index score 1.03 unit, pain index score was increased 1.05 unit, strength index score 2.44 unit, endurance index score 7.06 unit were increased in comparison to before the investigation that showed a significant different with P< 0.0001.
Conclusion: According to obtained results, pelvic floor physical therapy had a significant effect in women with dyspareunia. So that the severity of dyspareunia, pelvic floor muscle strength and endurance had clinically significant improvement after pelvic floor physiotherapy.
Davood Azimpour , Nahid Tahan , Fereshteh Poursaeed , Farideh Dehghan Manshadi , Erfan Ghasemi ,
Volume 75, Issue 5 (8-2017)
Volume 75, Issue 5 (8-2017)
Abstract
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).
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. |
Raheleh Dorosti , Mehri Ghasemi , Khosro Khademi-Kalantari, Alireza Akbarzadeh-Baghban ,
Volume 75, Issue 7 (10-2017)
Volume 75, Issue 7 (10-2017)
Abstract
Background: Patellofemoral pain syndrome (PFPS) is known as one of the most frequent knee diseases and is the most frequent cause of anterior knee pain. Despite the high prevalence of the disease, its predisposing factors are not clearly known. Neuromuscular control disorders of hip and lumbopelvic complex and instability of core redounds to instability of whole movement pack chain. The aim of the present was to comparing the electromyographic activities of core muscles and muscles around the knee joint during gait in patients with PFPS with healthy subjects.
Methods: This descriptive-analytic case-control study was carried out in School of Rehabilitation in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The present study was carried out during 10 months (April to February in 2016). Thirty-two subjects containing 17 patients with patellofemoral pain syndrome (10 females and 7 males) and 18 healthy subjects (10 females and 8 males) participated in this study. In both groups the electrical activities of some of the muscles around the knee joint and the core muscles containing vastus medialis (VM), adductor longus (AL), gluteus maximus (G Max), external oblique abdominis (EOA), internal oblique abdominis (IOA), transverse abdominis (TA) and multifidus (M) were recorded during gait. Onset and offset time, duration and intensity of muscles activities were compared between two groups.
Methods: This descriptive-analytic case-control study was carried out in School of Rehabilitation in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The present study was carried out during 10 months (April to February in 2016). Thirty-two subjects containing 17 patients with patellofemoral pain syndrome (10 females and 7 males) and 18 healthy subjects (10 females and 8 males) participated in this study. In both groups the electrical activities of some of the muscles around the knee joint and the core muscles containing vastus medialis (VM), adductor longus (AL), gluteus maximus (G Max), external oblique abdominis (EOA), internal oblique abdominis (IOA), transverse abdominis (TA) and multifidus (M) were recorded during gait. Onset and offset time, duration and intensity of muscles activities were compared between two groups.
Results: The results of the study showed that duration and intensity of the electrical activity of the gluteus maximus (respectively P=0.03, P=0.035) and offset time of electrical activity of the internal oblique abdominis (P=0.04) and the transverse abdominis (P=0.03) during gait, were significantly different between two groups. The external oblique abdominis and the multifidus electrical activities had not any significant differences between two groups (P>0.05).
Conclusion: It seems that electromyographic activities of some of core muscles in patients with patellofemoral pain syndrome in comparison with healthy subjects are different. However, there was no differences in electromyographic activities in some of the muscles around the knee between patients and healthy subjects.
Conclusion: It seems that electromyographic activities of some of core muscles in patients with patellofemoral pain syndrome in comparison with healthy subjects are different. However, there was no differences in electromyographic activities in some of the muscles around the knee between patients and healthy subjects.
Mohsen Sheykhhasan , Mahdieh Ghiasi ,
Volume 75, Issue 9 (12-2017)
Volume 75, Issue 9 (12-2017)
Abstract
Stem cells are undifferentiated biological cells that can differentiate into more specialized cells and divide (through mitosis) to produce more stem cells (self-renew). In mammals, there are two broad types of stem cells: embryonic stem cells, which are isolated from the inner cell mass of blastocysts, and adult stem cells, which are found in various tissues. Mesenchymal stem cells (MSCs) are multipotent cells that are called as one of the most adult stem cells. Due to their highly proliferative potential and their suitable self-renewal capacity, these cells have provided a powerful and promising source for use in the field of regenerative medicine. Also, mesenchymal stem cells are known for their important properties involving multilineage differentiation potential, trophic factor secretion and localization along various organs and tissues. So that MSCs can differentiate into a variety of cell lineages, including: Osteoblasts (bone cells), chondrocytes (cartilage cells), adipocytes (fat cells), myocytes (muscle cells), hepatocytes (liver cells) and endothelial cells. Efficacy of differentiated MSCs to regenerate cells in the injured tissues requires the ability to maintain the differentiation toward the desired cell fate. Since MSCs represent an attractive source for autologous transplantation, cellular and molecular signaling pathways and micro-environmental changes have been studied in order to understand the role of cytokines, chemokines, and transcription factors on the differentiation of MSCs. The differentiation of MSC into a mesenchymal lineage is genetically manipulated and promoted by specific transcription factors associated with a particular cell lineage. Recent studies have explored the integration of transcription factors, including Runx2, Sox9, PPARγ, MyoD, GATA4, and GATA6 in the differentiation of MSCs. Therefore, the overexpression of a single transcription factor in MSCs may promote trans-differentiation into specific cell lineage, which can be used for treatment of some diseases. In this review, we critically discussed and evaluated the role of transcription factors and related signaling pathways that affect the differentiation of MSCs toward adipocytes, chondrocytes, osteocytes, skeletal muscle cells, cardiomyocytes, and smooth muscle cells.
Razieh Nazari , Mehri Ghasemi , Farideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban ,
Volume 75, Issue 9 (12-2017)
Volume 75, Issue 9 (12-2017)
Abstract
Background: Sonography is used for measuring the muscle morphology including length, depth, cross-sectional area, bulk and pennation angle. The supraspinatus is the most common affected muscle among the rotator cuff muscles. There is no study about the reliability of sonographic measurement of supraspinatus thickness in the positions of empty can (EC), full can (FC) and hug up (HU) tests. The present study aims to investigate the intra-rater reliability of the measurement of sonographic thickness of supraspinatus muscle in the rest and positions of the EC, FC and HU tests.
Methods: The present study was a descriptive-analytic study which was carried out in a cross-sectional method on ten healthy women aged: 22.10±2.76 years without any tendon pathology. The study was carried out during four weeks (January to March in 2017). The supraspinatus thickness was scanned during rest and contracted states. The positions of measuring ultrasonic thickness of supraspinatus were as follow: position of EC test: the arm in 90-degree elevation in the scaption plane with the thumb-down, position of FC test: the arm in 90-degree elevation in the scaption plane with the thumb-up, position of HU test: the palm of hand was placed on the opposite shoulder with the elbow flexed using a 0.5-kg weight cuff. Intra-rater reliability of ultrasonic muscle thickness measurements were examined in one day.
Results: All intra-rater reliability values were equal or more than 0.90: the value was 0.90 (95%CI: 0.65-0.97) in the rest position, while for the measurement of ultrasonic thickness of the supraspinatus was 0.96 (95%CI: 0.87-0.99) in the position of EC test, 0.97 (95%CI: 0.90-0.99) and 0.96 (95%CI: 0.86-0.99) in the positions of FC and HU tests, respectively.
Conclusion: Measurement of ultrasonic thickness of supraspinatus muscle is a reliable method in the rest and positions of EC, FC and HU tests. This method can be used to compare the muscle thickness changes in the positions of the above tests.
Methods: The present study was a descriptive-analytic study which was carried out in a cross-sectional method on ten healthy women aged: 22.10±2.76 years without any tendon pathology. The study was carried out during four weeks (January to March in 2017). The supraspinatus thickness was scanned during rest and contracted states. The positions of measuring ultrasonic thickness of supraspinatus were as follow: position of EC test: the arm in 90-degree elevation in the scaption plane with the thumb-down, position of FC test: the arm in 90-degree elevation in the scaption plane with the thumb-up, position of HU test: the palm of hand was placed on the opposite shoulder with the elbow flexed using a 0.5-kg weight cuff. Intra-rater reliability of ultrasonic muscle thickness measurements were examined in one day.
Results: All intra-rater reliability values were equal or more than 0.90: the value was 0.90 (95%CI: 0.65-0.97) in the rest position, while for the measurement of ultrasonic thickness of the supraspinatus was 0.96 (95%CI: 0.87-0.99) in the position of EC test, 0.97 (95%CI: 0.90-0.99) and 0.96 (95%CI: 0.86-0.99) in the positions of FC and HU tests, respectively.
Conclusion: Measurement of ultrasonic thickness of supraspinatus muscle is a reliable method in the rest and positions of EC, FC and HU tests. This method can be used to compare the muscle thickness changes in the positions of the above tests.
Tayebeh Mirhashemi , Mehri Ghasemi , Frideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban , Alimohammad Faizi , Alireza Sabbaghian ,
Volume 76, Issue 5 (8-2018)
Volume 76, Issue 5 (8-2018)
Abstract
Background: Some studies show that frozen shoulder is due to the pathologic changes in the muscles around the shoulder. Measurement of the ultrasonic thickness of a muscle is a method for measuring the muscle changes. There is no study about the reliability of measurement of the muscle’s ultrasonic thickness around the shoulder in patients with frozen shoulder. The present study aims to investigate the intra-rater reliability of the ultrasonic thickness measurement of the supraspinatus, deltoid and upper trapezius muscles in women with frozen shoulder and healthy women.
Methods: This study was carried out during 4 months (June to October 2017). Twenty women consisted of 10 patients with frozen shoulder (mean age: 51.6±9.41 years) and 10 healthy subjects (mean age: 35.5±8.22 years) participated in this study. The patients from some clinics and hospitals in Tehran, and healthy subjects consisted of some personals and students in the School of Rehabilitation of Shahid Beheshti university of Medical Sciences participated in the present study. Measurements of ultrasonic thickness of the upper trapezius, supraspinatus and deltoid muscles in rest position carried out by the same rater two times in 48 hours. Ultrasonography instrument with linear probe (frequency: 7.5 MHz) were used for measurement of muscle thickness in millimeter.
Results: Reliability of the ultrasonic measurements of the muscle thickness in patients and healthy subjects was respectively as follow: The upper trapezius muscle (0.81, 0.81), the supraspinatus muscle (0.90, 0.92) and the middle deltoid muscle (0.93, 0.96). The reliability of the ultrasonic measurements of the muscle thickness for the upper trapezius muscle and the supraspinatus muscle was higher in healthy subjects compared to the patients with frozen shoulder. The reliability of the ultrasonic measurements of the middle deltoid thickness for the patients and healthy subjects was similar.
Conclusion: It seems that ultrasonography is a reliable method for measuring the thickness of the muscles around the shoulder in patients with frozen shoulder and healthy subjects.
Methods: This study was carried out during 4 months (June to October 2017). Twenty women consisted of 10 patients with frozen shoulder (mean age: 51.6±9.41 years) and 10 healthy subjects (mean age: 35.5±8.22 years) participated in this study. The patients from some clinics and hospitals in Tehran, and healthy subjects consisted of some personals and students in the School of Rehabilitation of Shahid Beheshti university of Medical Sciences participated in the present study. Measurements of ultrasonic thickness of the upper trapezius, supraspinatus and deltoid muscles in rest position carried out by the same rater two times in 48 hours. Ultrasonography instrument with linear probe (frequency: 7.5 MHz) were used for measurement of muscle thickness in millimeter.
Results: Reliability of the ultrasonic measurements of the muscle thickness in patients and healthy subjects was respectively as follow: The upper trapezius muscle (0.81, 0.81), the supraspinatus muscle (0.90, 0.92) and the middle deltoid muscle (0.93, 0.96). The reliability of the ultrasonic measurements of the muscle thickness for the upper trapezius muscle and the supraspinatus muscle was higher in healthy subjects compared to the patients with frozen shoulder. The reliability of the ultrasonic measurements of the middle deltoid thickness for the patients and healthy subjects was similar.
Conclusion: It seems that ultrasonography is a reliable method for measuring the thickness of the muscles around the shoulder in patients with frozen shoulder and healthy subjects.
Samane Khalkhali , Nahid Tahan , Alireza Akbarzadeh Baghban ,
Volume 76, Issue 8 (11-2018)
Volume 76, Issue 8 (11-2018)
Abstract
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<0.05.
Results: The result showed that mean TrA thickness on right and left sides during maximum isometric contraction of the upper and lower limb muscles was significantly thicker than in resting position (P<0.001). The type of isometric contraction had a significant effect on the thickness of the TrA muscle on dominant side (P<0.05). As a result, the greatest change in the thickness of TrA muscle on dominant side was observed in hip isometric extension (P<0.05). There was a significant difference between the thickness of TrA during upper limb isometric contraction of dominant and non-dominant side (P<0.001).
Conclusion: Isometric contraction of upper and lower limb muscles especially in hip extension can increase the ultrasonic thickness of the transversus abdominis 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<0.05.
Results: The result showed that mean TrA thickness on right and left sides during maximum isometric contraction of the upper and lower limb muscles was significantly thicker than in resting position (P<0.001). The type of isometric contraction had a significant effect on the thickness of the TrA muscle on dominant side (P<0.05). As a result, the greatest change in the thickness of TrA muscle on dominant side was observed in hip isometric extension (P<0.05). There was a significant difference between the thickness of TrA during upper limb isometric contraction of dominant and non-dominant side (P<0.001).
Conclusion: Isometric contraction of upper and lower limb muscles especially in hip extension can increase the ultrasonic thickness of the transversus abdominis muscle.
Mostafa Hosseinabadi, Mojtaba Kamyab, Fatemeh Azadinia, Javad Sarrafzadeh,
Volume 77, Issue 3 (6-2019)
Volume 77, Issue 3 (6-2019)
Abstract
Background: The back extensor muscles are the main spinal supportive factors which function establishes spinal stability and erect posture of the spine. Spine deviation from the ideal alignment, like abnormal increase in the forward curvature of the thoracic spine may cause changes in the trunk muscle activity which can lead to a change in the spinal proprioception. It seems that the corrected spinal alignment as a result of an orthotic treatment course facilitates the back muscles activity and improve proprioception. The present study aimed to investigate the changes occurring in thoracic kyphosis, trunk extensor muscle strength and trunk extensor force sense after using the Spinomed orthosis in elderly people with hyperkyphosis.
Methods: Twenty-six elderly people with hyperkyphosis who met the eligibility criteria participated in this preliminary study at School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran, from August to November of 2017. Subjects were randomly allocated to the experimental (wearing the orthosis with maintaining the daily physical activities) and control (maintaining daily physical activities) groups. Degree of kyphosis, absolute error of force sense and trunk extensor muscle strength were measured in all participants before and after intervention for 9 weeks.
Results: Thirteen elderly people with 63.85±4.63 years old in the experimental group and thirteen elderly people with 66.92±3.25 years old were participated in data analysis. The results showed significant reduction in degree of kyphosis (P<0.001) and absolute error of force sense (P=0.001), and improvement of trunk extensor muscle strength (P=0.021) in the experimental group. Independent t-test results showed a significant difference between experimental and control groups with better outcomes in terms of posture correction (P<0.001) strength (P=0.002) and force sense (P=0.035) in the orthosis group.
Conclusion: Using Spinomed orthosis for 2 months (2 hours per day) appears to have some benefit in terms of back extensor muscle strength and muscle force control. Also, Spinomed orthosis can be prescribed to improve spinal posture.
Methods: Twenty-six elderly people with hyperkyphosis who met the eligibility criteria participated in this preliminary study at School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran, from August to November of 2017. Subjects were randomly allocated to the experimental (wearing the orthosis with maintaining the daily physical activities) and control (maintaining daily physical activities) groups. Degree of kyphosis, absolute error of force sense and trunk extensor muscle strength were measured in all participants before and after intervention for 9 weeks.
Results: Thirteen elderly people with 63.85±4.63 years old in the experimental group and thirteen elderly people with 66.92±3.25 years old were participated in data analysis. The results showed significant reduction in degree of kyphosis (P<0.001) and absolute error of force sense (P=0.001), and improvement of trunk extensor muscle strength (P=0.021) in the experimental group. Independent t-test results showed a significant difference between experimental and control groups with better outcomes in terms of posture correction (P<0.001) strength (P=0.002) and force sense (P=0.035) in the orthosis group.
Conclusion: Using Spinomed orthosis for 2 months (2 hours per day) appears to have some benefit in terms of back extensor muscle strength and muscle force control. Also, Spinomed orthosis can be prescribed to improve spinal posture.
Davood Azimpour , Nahid Tahan ,
Volume 77, Issue 4 (7-2019)
Volume 77, Issue 4 (7-2019)
Abstract
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.
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.
Razieh Nazari , Mehri Ghasemi , Farideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban ,
Volume 77, Issue 8 (11-2019)
Volume 77, Issue 8 (11-2019)
Abstract
Background: Rotator cuff injuries are the most common causes of shoulder pain and supraspinatus muscle is usually involved. Clinical tests are available and inexpensive tools for assessment of shoulder dysfunctions. The empty can (EC) and full can (FC) tests are considered as shoulder gold standard tests. Recently, hug up (HU) test has been developed to assess the supraspinatus. So far, no ultrasonographic study has compared supraspinatus muscle thickness in these testing positions. The present study aimed to compare the supraspinatus muscle thickness in the hug up testing position with the full can and empty can testing positions in young and healthy women.
Methods: Forty healthy women (mean age 21.62±2.4 years) participated in this cross-sectional-comparative study from April to June 2018 in the Biomechanic Laboratory of Rehabilitation School, Shahid Beheshti University of Medical Sciences in Tehran, Iran. The supraspinatus muscle thickness was scanned during rest and contracted states with a 0.5 Kg weight cuff. For contracted states, (A) EC testing position: the arm was at 90º abduction in the scaption plane with the thumb-down, (B) FC testing position: the arm was maintained at 90º abduction in the scaption plane with the thumb-up, (C) HU testing position: the palm of hand was placed on the opposite shoulder with the elbow flexed.
Results: The Bonferroni test showed significant differences (P<0.001) between the muscle thickness in the rest and the testing positions. The muscle thickness in the empty can testing position was significantly less than the full can testing position (P=0.001), no significant difference was found between the muscle thickness in the hug up testing position compared to the full can and empty can testing positions.
Conclusion: All of the empty can, full can and hug up testing positions demonstrated increased mean muscle thickness when compared to the rest position and the greatest muscle thickness was in the full can testing position. It seems that supraspinatus muscle thickness in hug up testing position is similar with empty can and full can testing positions.
Methods: Forty healthy women (mean age 21.62±2.4 years) participated in this cross-sectional-comparative study from April to June 2018 in the Biomechanic Laboratory of Rehabilitation School, Shahid Beheshti University of Medical Sciences in Tehran, Iran. The supraspinatus muscle thickness was scanned during rest and contracted states with a 0.5 Kg weight cuff. For contracted states, (A) EC testing position: the arm was at 90º abduction in the scaption plane with the thumb-down, (B) FC testing position: the arm was maintained at 90º abduction in the scaption plane with the thumb-up, (C) HU testing position: the palm of hand was placed on the opposite shoulder with the elbow flexed.
Results: The Bonferroni test showed significant differences (P<0.001) between the muscle thickness in the rest and the testing positions. The muscle thickness in the empty can testing position was significantly less than the full can testing position (P=0.001), no significant difference was found between the muscle thickness in the hug up testing position compared to the full can and empty can testing positions.
Conclusion: All of the empty can, full can and hug up testing positions demonstrated increased mean muscle thickness when compared to the rest position and the greatest muscle thickness was in the full can testing position. It seems that supraspinatus muscle thickness in hug up testing position is similar with empty can and full can testing positions.
Sadegh Norouzi , Fateme Esfandiarpour , Ali Shakouri Rad , Nasim Kiani Yousefzadeh , Zeinab Helalat , Reza Salehi , Mehrnoosh Amin , Farzam Farahmand ,
Volume 77, Issue 8 (11-2019)
Volume 77, Issue 8 (11-2019)
Abstract
Background: The amount of anterior tibial translation during rehabilitation exercises is a key factor in organizing exercise regimen after anterior cruciate ligament injury. Excessive anterior tibial translation could increase the magnitude of tension imposed on injured and reconstructed anterior cruciate ligament knees. Forward lunge and open-kinetic knee extension exercises are commonly used in anterior cruciate ligament rehabilitation. However, there is insufficient data about the amount of anterior tibial translation in the eccentric and concentric phases of these exercises. This study compared the amount of anterior tibial translation in the eccentric and concentric phase of the lunge and seated knee extension in anterior cruciate ligament deficient and intact knees.
Methods: Using a non-probability sampling method, 14 men with unilateral anterior cruciate ligament rupture were selected for participation in this cross-sectional study. Participants were recruited from the university’s physiotherapy clinics. A uni-plane fluoroscope was used to image the knee joint while participants performed the forward lunge and open-kinetic knee extension exercises with the intact and injured legs in random order. Fluoroscopy imaging was performed in the radiology center at Sina Hospital, Tehran, Iran, from September 2013 to February 2014. Two factorial mixed ANOVA was used to analyze the data.
Results: There were no significant differences in the anterior tibial translation between the limbs and contraction phases during the lunge exercise. During open-kinetic knee extension, the anterior tibial translation in anterior cruciate ligament deficient knees was significantly more than that of healthy knees at 0⁰ (P=0.007). The anterior tibial translation in the eccentric phase of open-kinetic knee extension at flexion angles of 0⁰ (P=0.049) and 15⁰ (P=0.024) was significantly greater than that in the concentric phase.
Conclusion: In the lunge exercise, the amount of anterior tibial translation was similar between the eccentric and concentric phases and the intact and anterior cruciate ligament deficient knees, however, during open-kinetic knee extension exercise, in the eccentric phase was greater than that in concentric, and in the intact knees was greater than that in the intact knees, at 0-15⁰ angles.
Methods: Using a non-probability sampling method, 14 men with unilateral anterior cruciate ligament rupture were selected for participation in this cross-sectional study. Participants were recruited from the university’s physiotherapy clinics. A uni-plane fluoroscope was used to image the knee joint while participants performed the forward lunge and open-kinetic knee extension exercises with the intact and injured legs in random order. Fluoroscopy imaging was performed in the radiology center at Sina Hospital, Tehran, Iran, from September 2013 to February 2014. Two factorial mixed ANOVA was used to analyze the data.
Results: There were no significant differences in the anterior tibial translation between the limbs and contraction phases during the lunge exercise. During open-kinetic knee extension, the anterior tibial translation in anterior cruciate ligament deficient knees was significantly more than that of healthy knees at 0⁰ (P=0.007). The anterior tibial translation in the eccentric phase of open-kinetic knee extension at flexion angles of 0⁰ (P=0.049) and 15⁰ (P=0.024) was significantly greater than that in the concentric phase.
Conclusion: In the lunge exercise, the amount of anterior tibial translation was similar between the eccentric and concentric phases and the intact and anterior cruciate ligament deficient knees, however, during open-kinetic knee extension exercise, in the eccentric phase was greater than that in concentric, and in the intact knees was greater than that in the intact knees, at 0-15⁰ angles.
Majid Gholipour , Mastaneh Seifabadi , Mohammad Reza Asad ,
Volume 77, Issue 11 (2-2020)
Volume 77, Issue 11 (2-2020)
Abstract
Background: Skeletal muscle mass, which is regulated by a balance between muscle protein synthesis and degradation, is an important factor for movement to meet everyday needs, especially in pathological conditions and aging. The purpose of the present investigation was to compare the alterations of the gene expression involved in muscle protein synthesis and degradation signaling pathways induced by two exercise training protocols.
Methods: Eight weeks old Wistar rats have been assigned to the present experimental study, which was conducted from August 2018 to October 2018 at the animal laboratory of Tehran University. They were randomly divided into two resistance and endurance training groups and one control group, and run on a treadmill, 5 sessions per week for 8 weeks. 48 hours after the last exercise session, the rats in the two groups were anesthetized, and the dissected soleus muscles from euthanized animals were stored at -80° for RT-PCR and Western blot analysis later. Between-group differences were analyzed by the parametric and non-parametric tests for normally and non-normally distributed data respectively, at the significance level of α˂0.05.
Results: Compared with the control group, mTORC1 gene expression was increased significantly just in the endurance group (P=0.022), whereas both endurance and resistance exercise protocols caused a significant increase in Rps6kb1 (P˂0.001 and P=0.001 respectively). In protein degradation pathway, although, FOXO3a did not alter significantly (P=0.463), eIF4Ebp1 gene expression was inhibited by both endurance and resistance exercise training protocols (P˂0.001 and P=0.001 respectively). The alterations of Rps6kb1 and FOXO3a gene expression were confirmed by Western blot analysis.
Conclusion: The results showed that the exercise training protocols of the present study had approximately similar effects on alterations of gene expression involved in skeletal muscle protein synthesis and degradation pathways. Therefore, application of the protocols may be considered to prevent or reduce the muscle atrophy in pathological conditions such as motor neuron disease, aging, and/or muscle strength improvement in athletes.
Methods: Eight weeks old Wistar rats have been assigned to the present experimental study, which was conducted from August 2018 to October 2018 at the animal laboratory of Tehran University. They were randomly divided into two resistance and endurance training groups and one control group, and run on a treadmill, 5 sessions per week for 8 weeks. 48 hours after the last exercise session, the rats in the two groups were anesthetized, and the dissected soleus muscles from euthanized animals were stored at -80° for RT-PCR and Western blot analysis later. Between-group differences were analyzed by the parametric and non-parametric tests for normally and non-normally distributed data respectively, at the significance level of α˂0.05.
Results: Compared with the control group, mTORC1 gene expression was increased significantly just in the endurance group (P=0.022), whereas both endurance and resistance exercise protocols caused a significant increase in Rps6kb1 (P˂0.001 and P=0.001 respectively). In protein degradation pathway, although, FOXO3a did not alter significantly (P=0.463), eIF4Ebp1 gene expression was inhibited by both endurance and resistance exercise training protocols (P˂0.001 and P=0.001 respectively). The alterations of Rps6kb1 and FOXO3a gene expression were confirmed by Western blot analysis.
Conclusion: The results showed that the exercise training protocols of the present study had approximately similar effects on alterations of gene expression involved in skeletal muscle protein synthesis and degradation pathways. Therefore, application of the protocols may be considered to prevent or reduce the muscle atrophy in pathological conditions such as motor neuron disease, aging, and/or muscle strength improvement in athletes.
Fatemeh Bolhasani , Soofia Naghdi , Noureddin Nakhostin Ansari , Zahra Fakhari ,
Volume 78, Issue 1 (4-2020)
Volume 78, Issue 1 (4-2020)
Abstract
Background: Spasticity is one of the most important symptoms of stroke, which leads to movement constraints and disability. The presence of spasticity in the ankle and toe plantar flexor muscles disturbs the balance and gait of patients with stroke. Dry needling has been introduced as a new method for the treatment of spasticity. The aim of this study was to investigate the immediate effects of the ankle and toe plantar flexors dry needling on spasticity and balance in patients with stroke.
Methods: This study was a clinical pretest-posttest study. Twenty patients with stroke (12 males and 8 females), the mean age of 56.5±13 years were included. The assessments were performed before dry needling, immediately after dry needling and 15 minutes after that. Dry needling was used to treat gastrocnemius (ankle plantar flexor) muscles, flexor digitorum longus, and flexor digitorum brevis of the affected lower limb of the patients, for one session. Each muscle was needled for one minute with fast in-fast out technique. The outcome measures of the study were modified modified Ashworth scale (MMAS) for the assessment of the severity of muscle spasticity, timed up and go test and one leg stance test, for balance evaluation. The study was conducted in neurological physical therapy, Clinic of Rehabilitation School, Tehran University of Medical Sciences in Iran, from April 2017 to April 2018.
Results: The results showed a significant decrease in the ankle and toe plantar flexor muscles spasticity both immediately after dry needling and at 15 minutes follow-up (P=0.001). The duration of timed up and go test (P=0.001) and one leg stance test (P=0.001) improved significantly after dry needling and this improvement persisted for 15 minutes after dry needling. The effect size for timed up and go test and one leg stance test was small (Cohen'sd=0.33 and 0.32 respectively).
Conclusion: This study suggests that dry needling is effective in improving spasticity of ankle and toe plantar flexor muscles and the balance of patients with stroke. Further research with larger sample size and control group is necessary.
Methods: This study was a clinical pretest-posttest study. Twenty patients with stroke (12 males and 8 females), the mean age of 56.5±13 years were included. The assessments were performed before dry needling, immediately after dry needling and 15 minutes after that. Dry needling was used to treat gastrocnemius (ankle plantar flexor) muscles, flexor digitorum longus, and flexor digitorum brevis of the affected lower limb of the patients, for one session. Each muscle was needled for one minute with fast in-fast out technique. The outcome measures of the study were modified modified Ashworth scale (MMAS) for the assessment of the severity of muscle spasticity, timed up and go test and one leg stance test, for balance evaluation. The study was conducted in neurological physical therapy, Clinic of Rehabilitation School, Tehran University of Medical Sciences in Iran, from April 2017 to April 2018.
Results: The results showed a significant decrease in the ankle and toe plantar flexor muscles spasticity both immediately after dry needling and at 15 minutes follow-up (P=0.001). The duration of timed up and go test (P=0.001) and one leg stance test (P=0.001) improved significantly after dry needling and this improvement persisted for 15 minutes after dry needling. The effect size for timed up and go test and one leg stance test was small (Cohen'sd=0.33 and 0.32 respectively).
Conclusion: This study suggests that dry needling is effective in improving spasticity of ankle and toe plantar flexor muscles and the balance of patients with stroke. Further research with larger sample size and control group is necessary.
Hamed Behrad, Mahdi Zareei , Zeinab Borjian Boroujeni , Seyed Saeed Asadi, Zeinab Tabanejad , Mohammad Panji, Masoud Asgharpour-Arshad ,
Volume 78, Issue 10 (1-2021)
Volume 78, Issue 10 (1-2021)
Abstract
Life expectancy has increased throughout the world and, as a result, the population of the elderly is also rising. From the age of 30 years old, the human body mass loses about 0.1 to 0.5% of its skeletal muscle mass annually, which is accelerated after the age of 65 years old. Aging is characterized by a decrease in the progression of musculoskeletal and physical activity known as sarcopenia. Sarcopenia has a complex molecular pathogenesis that includes age-related changes in muscles’ neuromuscular activity, muscle protein replacement, the hormone levels and the related sensitivity of human body to these mentioned factors. The pathogenic conditions and other disorders in sarcopenia are the chronic inflammatory states that include oxidative stress and changes in behavioral factors, especially in nutritional status and physical activity. By definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia is determined by the presence of two main factors which are low muscle mass and low muscle function. Besides, specific sarcopenia-related biomarkers have been identified for early diagnosis and accurate identification of the main pathophysiology mechanisms involved in the development of the disease. Since sarcopenia has adverse outcomes on public health in terms of behavioral factors, frailty, hospitalization and mortality of people, it is an important necessity for the social health system to plan some therapeutic approaches to prevention. The main and more important of these therapeutic approaches have known as exercises, nutritional supplements and hormonal therapies. Also, other new therapeutic strategies are under investigation to be introduced in the future. However, currently, it has been shown that only physical exercise has a positive effect on the controlling and prevention of sarcopenia and its adverse effects on human and public health. However, the role of appropriate nutrition is also effective. Therefore, carefully designed studies in terms of better utilization of physical activity are needed to achieve useful therapeutic results for sarcopenia management. Thus, this survey aims to review the other considerable studies on the pathogenesis, appropriate evaluation of the disease and treatment options for sarcopenia.
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