Investigating the visual-oral effect of Quran verses on the intensity of labor pain among prim-parous patients

For downloading the full-text of this article please click here.Background and Objective: The pain of travail is categorized among the most severe pains, so that relieving it can lead to simplicity of the process and avoiding unseasonable cesareans. Given the research into the effect of Quran's sound on pain and anxiety reduction, this study aimed at investigating the auditory and visual effects of Quran verses on the pain intensity of step of travail among prim-parous women.Method: In this semi-experimental clinical trial study, 102 eligible prim-parous women were randomly divided into intervention and control groups. In the intervention group, until the end of the active phase of the first stage of travail, about 20 minutes of the verses of Maryam were displayed each hour through the screen by hearing the Quran's audio via the headphones. In both groups, pain intensity and vital signs were measured every hour and the heart rate of the fetus was recorded. All ethical issues were observed in this study and the authors did not report any conflicts of interest.Results: There was a significant difference between the control and intervention groups as for the duration of the first step of travail using independent t-test (p<0/05). The mean of the first step of travail in the intervention group was shorter than 100 minutes. The Mann-Whitney test showed a faster opening of the uterine cavity during the active phase of the first stage of travail (p<0/05), so that all intervention group members passed this step for a maximum of seven hours. The intensity of pain recorded at the fourth and fifth hours of the active phase of the first step of travail in the mothers of the intervention group was significantly lower (p<0/05) and in general, the average severity of pain was lower in the intervention group (p<0/05).Conclusion: Using sound and image of Quranic verses significantly reduces the duration and severity of labor pain in a way that it can calm mothers down during childbirth.For downloading the full-text of this article please click here.Please cite this article as: Esmaeili M, Ardestani N, Karamkhani M. Investigating the visual-oral effect of Quran verses on the intensity of labor pain among prim-parous patients. J Res Relig Health. 2019; 5(1): 112- 22.  doi: https://doi.org/10.22037/jrrh.v5i1.1738

TKA patients with unsatisfying knee function show changes in neuromotor synergy pattern but not joint biomechanics

Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies. Gait and electromyography (EMG) data were collected during level walking for three groups of participants: (i) high-functional TKA patients (n = 13); (ii) low-functional TKA patients (n = 13) and (iii) non-operative controls (n = 18). Synergies were extracted from EMG data using non-negative matrix factorization. Analysis of variance and Spearman correlation analyses were used to investigate between-group differences in gait and neuro-motor synergies. Results showed that synergy patterns were different among the three groups. Control subjects used 5–6 independent neural commands to execute a gait cycle. High functional TKA patients used 4–5 independent neural commands while low-functional TKA patients relied on only 2–3 independent neural commands to execute a gait cycle. Furthermore, stride-to-stride variability of muscles’ response to the neural commands was reduced up to 15% in low-functional TKAs compared to the other two groups

Improved walking function in laboratory does not guarantee increased community walking in stroke survivors: Potential role of gait biomechanics

Reduced daily stepping in stroke survivors may contribute to decreased functional capacity and increased mortality. We investigated the relationships between clinical and biomechanical walking measures that may contribute to changes in daily stepping activity following physical interventions provided to participants with subacute stroke. Following ≤40 rehabilitation sessions, 39 participants were categorized into three groups: responders/retainers increased daily stepping >500 steps/day post-training (POST) without decreases in stepping at 2-6 month follow-up (F/U); responders/non-retainers increased stepping at POST but declined >500 steps/day at F/U; and, non-responders did not change daily stepping from baseline testing (BSL). Gait kinematics and kinetics were evaluated during graded treadmill assessments at BSL and POST. Clinical measures of gait speed, timed walking distance, balance and balance confidence were measured at BSL, POST and F/U. Between-group comparisons and regression analyses were conducted to predict stepping activity from BSL and POST measurements. Baseline and changes in clinical measures of walking demonstrated selective associations with stepping, although kinematic measures appeared to better discriminate responders. Specific measures suggest greater paretic vs non-paretic kinematic changes in responders with training, although greater non-paretic changes predicted greater gains (i.e., smaller declines) in stepping in retainers at F/U. No kinetic variables were primary predictors of changes in stepping activity at POST or F/U. The combined findings indicate specific biomechanical assessments may help differentiate changes in daily stepping activity post-stroke

Locomotor Kinematics and Kinetics Following High-Intensity Stepping Training in Variable Contexts Poststroke

Background and Purpose Previous studies suggest individuals post-stroke can achieve substantial gains in walking function following high-intensity locomotor training (LT). Recent findings also indicate practice of variable stepping tasks targeting locomotor deficits can mitigate selected impairments underlying reduced walking speeds. The goal of this study was to investigate alterations in locomotor biomechanics following three different LT paradigms. Methods This secondary analysis of a randomized trial recruited individuals 18–85 years old and >6 months post-stroke. We compared changes in spatiotemporal, joint kinematics and kinetics following up to 30 sessions of high-intensity (>70% heart rate reserve [HRR]) LT of variable tasks targeting paretic limb and balance impairments (high-variable, HV), high-intensity LT focused only on forward walking (high-forward, HF), or low-intensity LT (<40% HRR) of variable tasks (low-variable, LV). Sagittal spatiotemporal and joint kinematics, and concentric joint powers were compared between groups. Regressions and principle component (PC) analyses were conducted to evaluate relative contributions or importance of biomechanical changes to between and within groups. Results Biomechanical data were available on 50 participants who could walk ≥0.1 m/s on a motorized treadmill. Significant differences in spatiotemporal parameters, kinematic consistency, and kinetics were observed between HV and HF vs LV. Resultant PC analyses were characterized by paretic powers and kinematic consistency following HV, while HF and LV were characterized by non-paretic powers. Conclusion High-intensity LT results in greater changes in kinematics and kinetics as compared to lower-intensity interventions. The results may suggest greater paretic-limb contributions with high-intensity variable stepping training that targets specific biomechanical deficits

Comparing the expression levels of mRNA for MMP-7 in gastric mucosa of patients with H. pylori infection and uninfected patients

Background and purpose: The expression of growth factors, proteolytic enzymes, fibrogenic factors, and cytokines are altered in Helicobacter pylori (H. pylori) infected gastric mucosa. Matrix metalloproteinases (MMP) are a family of zinc-dependent homologous enzymes digesting most of the components of the extracellular matrix and basement membrane and are involved in remodeling and functioning of the biological processes. The purpose of this study was to compare gene expression of matrix metalloproteinase-7 (MMP-7) in patients with H. pylori-infected and uninfected individuals with gastrointestinal diseases. Materials and methods: This study was conducted in 50 H. pylori-negative patients and 50 H. pylori-positive patients being admitted to Shahrekord Hajar Hospital due to gastrointestinal diseases in 2014. The participants’ demographic information was collected and sampling was done. First DNA was extracted, and then PCR was performed to check for the presence of 16sRNA and UreC. The RNA from each sample was also extracted and cDNA was prepared. Afterwards, the expression of MMP-7 was measured by real time-PCR using specific primers and probes. Results: MMP-7 mRNA expression was significantly higher in biopsies of H. pylori-infected patients compared to that in H. pylori-uninfected patients (P<0.0001). Conclusion: Increased expression of MMP-7 can be effective in inflammatory response and development of the disease. It could be used as a key marker for early diagnosis of gastrointestinal diseases and gastric cancer. © 2016, Mazandaran University of Medical Sciences. Engineering. All rights reserved

Contributions of Stepping Intensity and Variability to Mobility in Individuals Poststroke

Background and Purpose: The amount of task-specific stepping practice provided during rehabilitation post-stroke can influence locomotor recovery, and reflects one aspect of exercise “dose” that can affect the efficacy of specific interventions. Emerging data suggest that markedly increasing the intensity and variability of stepping practice may also be critical, although such strategies are discouraged during traditional rehabilitation. The goal of this study was to determine the individual and combined contributions of intensity and variability of stepping practice to improving walking speed and distance in individuals post-stroke. Methods: This Phase 2, randomized, blinded assessor clinical trial was performed between May 2015-November 2018. Individuals between 18-85 years old with hemiparesis post-stroke of >6 months duration were recruited. Of the 152 individuals screened, 97 were randomly assigned to 1 of 3 training groups, with 90 completing >10 sessions. Interventions consisted of either high intensity stepping (70-80% heart rate [HR] reserve) of variable, difficult stepping tasks (high-variable), high intensity stepping performing only forward walking (high-forward), and low intensity stepping in variable contexts at 30-40% HR reserve (low-variable). Participants received up to 30 sessions over 2 months, with testing at baseline, post-training and a 3-month follow-up. Primary outcomes included walking speeds and timed distance, with secondary measures of dynamic balance, transfers, spatiotemporal kinematics and metabolic measures. Results: All walking gains were significantly greater following either high-intensity group vs low-variable training (all p<0.001) with significant correlations with stepping amount and rate (r=0.48-60; p<0.01). Additional gains in spatiotemporal symmetry were observed with high-intensity training, and balance confidence increased only following high-variable training in individuals with severe impairments. Conclusion: High intensity stepping training resulted in greater improvements in walking ability and gait symmetry than low-intensity training in individuals with chronic stroke, with potential greater improvements in balance confidence

Gait modification and optimization using neural network-genetic algorithm approach: Application to knee rehabilitation

Gait modification strategies play an important role in the overall success of total knee arthroplasty. There are a number of studies based on multi-body dynamic (MBD) analysis that have minimized knee adduction moment to offload knee joint. Reducing the knee adduction moment, without consideration of the actual contact pressure, has its own limitations. Moreover, MBD-based framework that mainly relies on iterative trial-and-error analysis, is fairly time consuming. This study embedded a time-delay neural network (TDNN) in a genetic algorithm (GA) as a cost effective computational framework to minimize contact pressure. Multi-body dynamic and finite element analyses were performed to calculate gait kinematics/kinetics and the resultant contact pressure for a number of experimental gait trials. A TDNN was trained to learn the nonlinear relation between gait parameters (inputs) and contact pressures (output). The trained network was then served as a real-time cost function in a GA-based global optimization to calculate contact pressure associated with each potential gait pattern. Two optimization problems were solved: first, knee flexion angle was bounded within the normal patterns and second, knee flexion angle was allowed to be increased beyond the normal walking. Designed gait patterns were evaluated through multi-body dynamic and finite element analyses. The TDNN-GA resulted in realistic gait patterns, compared to literature, which could effectively reduce contact pressure at the medial tibiofemoral knee joint. The first optimized gait pattern reduced the knee contact pressure by up to 21% through modifying the adjacent joint kinematics whilst knee flexion was preserved within normal walking. The second optimized gait pattern achieved a more effective pressure reduction (25%) through a slight increase in the knee flexion at the cost of considerable increase in the ankle joint forces. The proposed approach is a cost-effective computational technique that can be used to design a variety of rehabilitation strategies for different joint replacement with multiple objectives