The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects

Study DesignWhiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars.PurposeThe present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion.Overview of LiteratureMany studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane.MethodsTwenty-nine healthy subjects aged 18–26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm2 were used to record kinematic data. According to the normality of the data, a paired t-test was used for statistical analyses. The level of significance was set at α=0.01.ResultsAll motion significantly decreased when subjects used soft collars (p<0.01). According to the obtained data, flexion and lateral rotation experienced the maximum (39%) and minimum (11%) immobilization in all six motions using soft collars. Rigid collars caused maximum immobilization in flexion (59%) and minimum immobilization in the lateral rotation (18%) and limited all motion much more than the soft collar.ConclusionsThis study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions

Extracting Sustainable Urban Water Policies with Dynamic System Approach (Case Study: Qom City)

Qom city (located in the central desert of Iran) has always faced the problem of water shortage. In recent years, due to various reasons such as urbanization, increased immigration and tourism prosperity, this problem has become a more serious trending water crisis. In spite of the steps taken to maintain the sustainability of potable water, predictions indicated that if the existing situation persists, in 2022 the city will be in a state of unstable water. To overcome this dilemma, this paper aims to identify and present sustainable urban Potable water policies on a thirty-year horizon through system dynamics and the use of Vensim software. These policies are generally presented in two parts: Supply and Demand. The supply policies include separation of potable water from non potable water, using fresh water or wastewater, and managing the water supply losses. In demand management, the policies are to control the population, control the pattern of domestic demand, and control the Exempt Demand. The new policy investigated and proposed by this research which is proportional to the problem was the separation of potable water from non potable water and control the exempt demands over time and their impact on the sustainability of urban potable water

Evaluating Kyphosis and Lordosis in Students by Using a Flexible Ruler and Their Relationship with Severity and Frequency of Thoracic and Lumbar Pain

Study DesignA cross-sectional, descriptive study.PurposeThis study aimed to investigate the relationship between kyphosis and lordosis measured by using a flexible ruler and musculoskeletal pain in students of Hamadan University of Medical Sciences.Overview of LiteratureThe spine supports the body during different activities by maintaining appropriate body alignment and posture. Normal alignment of the spine depends on its structural, muscular, bony, and articular performance.MethodsTwo hundred forty-one students participated in this study. A single examiner evaluated the angles of lumbar lordosis and thoracic kyphosis by using a flexible ruler. To determine the severity and frequency of pain in low-back and inter-scapular regions, a tailor-made questionnaire with visual analog scale was used. Finally, using the Kendall correlation coefficient, the data were statistically analyzed.ResultsThe mean value of lumbar lordosis was 34.46°±12.61° in female students and 22.46°±9.9° in male students. The mean value of lumbar lordosis significantly differed between female and male students (p<0.001). However, there was no difference in the level of the thoracic curve (p=0.288). Relationship between kyphosis measured by using a flexible ruler and inter-scapular pain in male and female students was not significant (p=0.946). However, the relationship between lumbar lordosis and low back pain was statistically significant (p=0.006). Also, no significant relationship was observed between abnormal kyphosis and frequency of inter-scapular pain, and between lumbar lordosis and low back pain.ConclusionsLumbar lordosis contributes to low back pain. The causes of musculoskeletal pain could be muscle imbalance and muscle and ligament strain

A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature.

Prosthetic alignment is a subjective concept which lacks reliability. The outcome responsiveness to prosthetic alignment quality could help to improve subjective and instrument assisted prosthetic alignment. This study was aimed to review variables used to assess clinically acceptable alignment in the literature. The search was done in some databases including: Google Scholar, PubMed, EBSCO, EMBASE, ISI Web of Knowledge and Scopus. The first selection criterion was based on abstracts and titles to address the research questions of interest. The American Academy of Orthotics and Prosthetics checklists were used for paper risk of bias assessment. A total of 25 studies were included in this study. Twenty-four studies revealed the critics of standing position or walking to locate clinically acceptable alignment, only one study measured outcomes in both situations. A total of 253 adults with transtibial amputations and mean age of 48.71 years participated in included studies. The confidence level of included studies was low to moderate, and before-after trial was the most common study design (n = 19). The joint angle, load line location with respect to joints and center of pressure-related parameters were reported as sensitive outcomes to prosthetic alignment quality in standing posture. The amount of forces at various parts of gait cycle and time of events were sensitive to prosthetic alignment quality during walking. Standing balance and posture and temporal parameters of walking could help to locate clinically acceptable alignment.N/

Effect of Rocker Bar Ankle Foot Orthosis on Functional Mobility in Post-Stroke Hemiplegic Patients: Timed Up and Go and Gait Speed Assessments

Objectives: Ankle Foot Orthoses (AFOs) are widely utilized to improve walking ability in&nbsp;hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot&nbsp;Orthosis (RAFO) on functional mobility in post-stroke hemiplegic patients. Methods: Fifteen hemiplegic patients (men and women) who were at least 6-months poststroke&nbsp;and able to walk without an assistive device for at least 10 meters voluntarily participated&nbsp;in this study. The patients were examined for three conditions: shoes only, with SAFO and with&nbsp;RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG) test. In addition, paired t-test was used to analyze the obtained data. Results: When the patients used RAFO, their gait speed significantly increased (P<0.05).&nbsp;Moreover, the time of performing TUG test experienced a significant decrease using RAFO&nbsp;compared with utilizing shoe only (P<0.05). Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic&nbsp;patients post stroke. This may be due to the positive effect of rocker modification on improving&nbsp;push off and transferring weight during the stance phase of gait

Correlation between Type D Personality and Adherence to Low-Sodium Diet in Patients with Systolic Heart Failure

Background and Objectives: Adherence to low-sodium diet is an important aspect of self-care behaviors, which plays a role in improving the quality of life, and in reducing readmission rate, mortality, and healthcare costs. This study aimed to investigate the correlation between type D personality and adherence to low-sodium diet in patients with systolic heart failure. Methods: This descriptive-correlational study was conducted on 100 patients with heart failure with at least one year history and ejection fraction below 40% hospitalized in the internal ward of Alborz Social Security Hospitals of Karaj and Shahriar in 2013, who were selected by convenience sampling. Demographic characteristics form, type-D personality questionnaire, and adherence to low-sodium diet, were completed by interview. The data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: In this study, there was a poor significant positive correlation between adherence to low-sodium diet and dimensions of depression/anxiety (p=0.032), social inhibition (p=0.008), and total score of type D personality (p=0.023). Conclusion: The results of this study showed that heart failure patients with type D personality had lower adherence to low-sodium diet. Hence, screening and evaluation of heart failure patients in terms of type D personality, referring patients for consultation, and use of appropriate therapies, can help to improve adherence to low-sodium diet and quality of life in heart failure patients

The Effect of Rocker Bar Ankle Foot Orthosis on Functional Mobility in Post-Stroke Hemiplegic Patients

Objectives: Ankle Foot Orthoses (AFOs) are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO) on functional mobility in post-stroke hemiplegic patients. Methods: Fifteen hemiplegic patients (men and women) who were at least 6-months post-stroke and able to walk without assistive device for at least 10 meters voluntarily participated in this study. The patients were examined with and without RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG) test. Also, paired t-test was used to analyze obtained data. Results: When patients used RAFO, their gait speed significantly increased (P<0.05). Also, the time of performing TUG test experienced a significant decrease using RAFO compared with utilizing shoe only (P<0.05). Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic patient&rsquo;s secondary to stroke. It seems that, it has been due to the positive effect of rocker modification on improving push off and transferring weight during stance phase of gait