The Efficacy of Cupping Therapy Added to Electroacupuncture and Exercise Therapy on Knee Osteoarthritis

Background: Electroacupuncture and exercise therapy have been used to treat knee osteoarthritis, but evidence for adding cupping to this treatment is lacking. Therefore, this study aimed to investigate the effect of cupping and acupuncture combined with exercise on knee osteoarthritis. Materials and Methods: This randomized control trial was done on 56 patients with knee osteoarthritis. We had two groups: a control and an intervention group. Both groups received electroacupuncture and exercise therapy programs. The intervention group received cupping after electroacupuncture plus exercise therapy. The Western Ontario and McMaster Universities Index (WOMAC) questionnaire and Visual Analogue Scale (VAS) measured patient outcomes before and after treatment. Results: All patients' VAS and WOMAC scores decreased in these two groups after treatment. The difference between VAS and WOMAC scores and pain and knee function was significant compared to the intervention group with the control group (p<0.05). The difference in knee stiffness was not significant comparing the intervention group with the control group (p>0.05). Conclusion: Adding cupping therapy following electroacupuncture and exercise therapy significantly decreased pain and improved function

Determination of Effect of Oral Vitamin D to Improve Ventilatory Threshold in Healthy Young Adults with Vitamin D Deficiency

Background: Many studies have shown a high prevalence of vitamin D deficiency in different communities. Due to multiple roles of vitamin D in the body, this study was aimed to determine the effect of oral vitamin D3 on ventilatory threshold-1 in a condition of vitamin D deficiency.Materials and Methods: Recent study performed on 25 healthy young adults with the serum levels of 25 Hydroxyvitamin D3 lower than 20 ng/ml, had referred to the sports medicine clinic of Taleghani Hospital of Tehran, in a one-year period (2016-2017). After primary evaluation, baseline ventilatory threshold-1 were determined by cardiopulmonary exercise testing (CPET). Then persons were treated with 50,000 IU/week of oral vitamin D3 for 8 weeks, and one week after the completion of treatment, ventilator threshold-1 was measured again, similar to the beginning conditions of the study, and its changes were studied.Results: The mean baseline ventilatory threshold-1 of participants before any intervention was 22.46 ± 6.45 (ml/kg/min), and after 8 weeks of treatment by 50000 IU/week of oral vitamin D3, increased to 26.79 ± 5.33 (ml/kg/min) at the end of study, which there was a statistically significant increase in ventilatory threshold-1 (p<0.001).Conclusion: Recent study showed that proper treatment of the vitamin D deficiency, improves ventilatory threshold-1 in healthy young adults

Knowledge and attitude of medical interns about doping and its regulations

Objective: Doping is known as an important public health problem. Prominent sports events can be blemished due to doping. The role of general practitioners as an important part of the health system in the prevention of doping is obvious. Previous studies have shown they have been presumed themselves ill-prepared in dealing with this topic. This study set out to investigate the amount of knowledge and attitude among medical interns toward doping. Materials and Methods: This cross-sectional study was conducted on 100 medical interns in Taleghani hospital, Tehran, Iran Subjects were asked to complete a 35-item questionnaire. The questionnaire consisted of four parts: demographic data, status of physical activity, knowledge, and attitude. Knowledge was measured by questions regarding identifying prohibited drugs, adverse effects of banned drugs, WADA as an original source of published list of prohibited drugs, and regulations related to anti-doping rules violation. The attitude was measured based on a 5-point Likert scale. The more negative attitude toward doping was shown by higher scores. Results: The mean age was 25.39+/-1.43. Only 8% of students were familiar with WADA as an original source of doping. Approximately 90% of students were not aware of sanctions of anti-doping rules infraction. 65%, 33% and 2% of our subjects had poor, good and very good knowledge respectively. The mean score of attitude was 19.68+/-2.88. Conclusion: Our findings revealed, the senior medical students had negative attitudes toward doping and also their level of knowledge was poor in this regard. &nbsp

Evaluation of Efficacy of Neuro Muscular Electrical Stimulation and Electro Acupuncture in Improving the Pain and Disability in Patients with the Lumbar Degenerative Intervertebral Disk Disease

Background: Chronic low back pain (CLBP) due to the degenerative intervertebral disk diseases is one of the most common musculoskeletal conditions in contemporary societies. A variety of pharmacological, non-pharmacological and surgical options is available for treatment of CLBP. The use of non-pharmacological methods have drastically increased in recent years, offering fewer complications and expenses. This study was conducted to compare the efficacy of the neuromuscular electrical stimulation (NMES) and electro acupuncture (EAP) with exercise therapy alone in patients with chronic low back pain. Materials and Methods: This was a randomized case-controlled clinical trial. Sixty patients with CLBP were randomly assigned to 3 groups (20 cases each) of the EAP with exercise therapy, NMES with exercise therapy, and exercise therapy only. Severity of pain and disability improvement were assessed using the visual analog scale (VAS) and Quebec back pain disability scale respectively. Results: A total of 66 individuals were enrolled, out of which 6 were excluded due to patients’ lack of cooperation. A significant decline in the amounts of Quebec and VAS was observed in the three groups (p<0.001). The pain and disability improvements did not display any significant difference in the NMES or EAP groups compared to the control group. However, the severity of disability and pain in the NMES group were significantly higher than the EAP group (p<0.05). Conclusion: These findings may indicate an almost identical efficacy of exercise therapy alone compared to the combination with electrical stimulation techniques in improving the pain and disability in patients suffering CLBP

The Assessment of Acupuncture and Exercise Therapy in Patients with Carpal Tunnel Syndrome: Randomized Clinical Trial

Background: The efficacy of acupuncture and exercise therapy in the treatment of carpal tunnel syndrome (CTS) has been investigated in limited studies with controversial results. The purpose of this study was to compare the short-term efficacy of acupuncture and exercise therapy in patients with mild to moderate CTS.Materials and Methods: This study was a randomized controlled clinical trial study conducted on 60 patients (55 women) with mild to moderate CTS referring to Imam Hossein Hospital in Tehran in 2017. The patients were randomly divided in to 3 equal groups; groupa1: only night splint was used for 6 weeks (control), group2: splint with tendon and nerve gliding exercises (2 times a day for 6 weeks) were applied, group3: splint and electroacupuncture was performed for 12 sessions (2 sessions/week). The score on the Boston Carpal Tunnel Questionnaire (BCTQ) for Functional Status and Symptom Severity (BCTQ FUNCT and SYMPT) and visual analog scale (VAS) score were evaluated at baseline and after the treatment.Results: At the final follow up, significant improvements in all parameters of quality of life and VAS were found in third groups (p<0.05). Acupuncture affected the score on the BCTQ FUNCT and SYMPT, the VAS score more than exercise therapy. In addition, the efficacy of splint alone was less than intervention groups in all parameters.Conclusion: Acupuncture with splint has a high effect on reducing pain and improving the quality of life in patients with mild to moderate CTS and could be adopted in the management of these patients.

The Efficacy of Cupping Therapy Added to Electroacupuncture and Exercise Therapy on Knee Osteoarthritis

Background: Electroacupuncture and exercise therapy have been used to treat knee osteoarthritis, but evidence for adding cupping to this treatment is lacking. Therefore, this study aimed to investigate the effect of cupping and acupuncture combined with exercise on knee osteoarthritis. Materials and Methods: This randomized control trial was done on 56 patients with knee osteoarthritis. We had two groups: a control and an intervention group. Both groups received electroacupuncture and exercise therapy programs. The intervention group received cupping after electroacupuncture plus exercise therapy. The Western Ontario and McMaster Universities Index (WOMAC) questionnaire and Visual Analogue Scale (VAS) measured patient outcomes before and after treatment. Results: All patients' VAS and WOMAC scores decreased in these two groups after treatment. The difference between VAS and WOMAC scores and pain and knee function was significant compared to the intervention group with the control group (p0.05). Conclusion: Adding cupping therapy following electroacupuncture and exercise therapy significantly decreased pain and improved function

Comparing strength and range of motion of the upper limb with AV fistula access with the contralateral upper limb among patients treated with hemodialysis

Introduction:The arteriovenous (AV) fistula is a gold standard method for safe and effective repeated vascular access for patients on hemodialysis (HD). The patients, with AV-fistula access in their upper limb, have some limitations in using the involved limb both in daily living and during the dialysis process. The aim of this study was to compare range of motion (ROM), muscle strength and arm circumference of fistula created limb with the contralateral upper limb. Material and Methods: 23 patients (50-85 year), receiving HD through AV fistula in one of their upper limbs, at least for 3 months, were enrolled. ROM, muscle strength, and arm circumference of both upper limbs were measured using goniometer, dynamometer and tape-measure, respectively. Then the values of the both sides were compared together. Results: In ROM tests shoulder forward flexion, backward extension, internal rotation, external rotation, horizontal extension, and horizontal adduction, and in muscle strength tests shoulder abduction and hand grip were significantly (p<0.05) more limited or weaker at the fistula side. Arm circumference was significantly greater at the fistula created limb. Conclusion: The upper limb, which is involved during HD process, is weaker and has more limited ROM in comparison with the contralateral limb. We suggest more attention to develop specific exercise programs for maintaining the abilities of the limb with AV-fistula access. 

Investigating Eccentric Contraction Mechanism in the Prevention of Sports Injuries

Introduction: Eccentric contraction exercises such as hamstring Nordic have been used nowadays to prevent injury. Maximum force in the muscle happens when the outer force is more than the force made by the muscle. Muscle force can reach its maximum in eccentric contraction and this damages contraction components and cytoskeleton (infraconstruction) of the muscle fiber and weakness and pain happens. But how a contraction which causes pain and injury can help in preventing injury? The goal of the present study was to evaluate the eccentric contraction mechanism in the prevention of sports injuries. Materials and Methods: For this study, background research has been done using search engines from 1980 to 2017. Studies including information about eccentric exercises and sports injury prevention have been chosen next after eliminating unrelated articles. Results: Eccentric exercises affect muscle morphology and peripheral and central nerve activities. Muscle structure characteristics can create force which include pennation angle, muscle thickness, and fascial length and differ according to mechanical trigger. When the muscles are lengthened, the force attracts the mechanical work and acts as a spring. The energy which has been attracted during muscle and tendon lengthening, is usually wasted as heat and then recovery of stretching combustion energy happens. Stretching and energy recovery depend on the energy and resilience of the muscle. Eccentric contraction respectively causes more stretching of the sarcomeres, detatchment of the sarcomeres, cortex damage, localized contraction, muscle fiber inflammation and eventually inflammation and pain which shows injury to the muscle tissue. Moreover eccentric exercises change the call for alpha motor units, sarcomere activity, corticopostal sensitivity and brain activity. Continual muscle adaptation ability to tissue damage is a step for preventing acute injury in the future in eccentric contraction. Conclusion: Eccentric exercises have caused small injury in muscle tissue which eventually causes adaptation in the muscle and increases their strength and resistance and this happens by increasing muscle diameter and fascia length and pennation angle. Although it could be damaging but it is better to consider useful as muscle adaptation.Keywords: Sports Injury, Eccentric Contraction, Preventing Injury, Eccentric Exercises, Nerve-Muscl