Effects of Exercise Therapy Plus Quadriceps, Gluteus Medius and Quadratus Lumborum Muscles Self-myofascial Release on Pain, Function, and Balance in Patients with Patellofemoral Pain Syndrome through Telerehabilitation: A Study Protocol for a Randomized Clinical Trial

Background: Patellofemoral pain syndrome (PFPS) is one of the most common knee pathologies that is highly prevalent in adolescents and adults. Patients who suffer from this syndrome usually experience weakness in the hip and knee muscles, as well as myofascial trigger points in the lumbopelvic- hip region, which can negatively impact their lower limb biomechanics. The purpose of this study is to evaluate the effectiveness of exercise therapy combined with self-myofascial release (SMFR) techniques for quadriceps, gluteus medius, and quadratus lumborum muscles on pain, function, and balance in these patients through telerehabilitation.Methods: The study will be a prospective, single-blinded, randomized controlled clinical trial, involving 60 patients who will be randomly allocated to either an experimental group that will receive four weeks of exercise therapy with SMFR techniques through telerehabilitation or a control group that will receive four weeks of exercise therapy only in the same manner.  The outcome measures will include pain, pressure pain threshold, function, and balance. Data will be collected at baseline, at the end of treatment and two weeks after treatment.Results: Ultimately, the results of this study will provide evidence regarding the efficacy of exercise therapy combined with SMFR techniques for quadriceps, gluteus medius, and quadratus lumborum muscles on pain, function, and balance in patients with PFPS through telerehabilitation

Comparison of Head, Neck, and Upper Trunk Postures between Patients Who Have Undergone Coronary Artery Bypass Grafting and Healthy Subjects: A pilot study

Background: Coronary Artery Bypass Grafting is an effective treatment for reducing symptoms and mortality in coronary artery patients.Although patients experience post sternotomy complications such as musculoskeletal disorders. So, the aim of this study was to compare the head, neck and upper trunk postures between patients who underwent coronary artery bypass grafting and healthy individuals. Methods: In this cross-sectional case-control study, twenty-one men (56.38 ± 8.64 years) were randomly selected from among patients who had been referred to Al-Zahra Cardiac Rehabilitation Center in Shiraz and undergone coronary artery bypass grafting (CABG), and the angles of forward head, thoracic kyphosis, and rounded shoulder were measured. Twenty healthy men (51.70 ± 10.40 years) were also evaluated and compared in terms of the above variables. This study was designed and conducted as a pilot. The angles of the forward head and rounded shoulder were assessed by placing reflective markers on the body and processing the images by Digimizer MedCalc software, version 4.6.1. Thoracic kyphosis angle was measured by a flexible ruler. The Persian version of the SF36 questionnaire was used to assess the quality of life, and the Kolmogorov-Smirnov test to verify the normal distribution of data. Independent sample t-test and Mann-Whitney test were used for between-group comparison for data with normal and non-normal distribution, respectively. Results: The comparison of the forward head, rounded shoulder, and thoracic kyphosis angles showed no significant difference between post-surgical and healthy subjects (P> 0.05). Patients' quality of life was significantly different from that of the control group in all aspects, except for general and mental-emotional health (p <0.05). Conclusion: There was no significant difference between the case and control groups in the angles of forward head, thoracic kyphosis, and rounded shoulder. Patients who underwent CABG, however, experienced a significant reduction in their quality of life compared to the control group. Therefore, it seems necessary to pay attention to patients and find solutions to manage and improve various aspects of life, such as physical and mental health

Prevalence of musculoskeletal disorders risk factors and ergonomic assessment of posture among senior students of Rehabilitation School of Shiraz University: a cross-sectional study

Objective: The current study aimed to estimate the prevalence of musculoskeletal disorders and evaluate the risk of work-related musculoskeletal disorders (WMSDs) in senior students at the Rehabilitation School of Shiraz University.Methods: Fifty-three senior physical and occupational therapy students with an average age of 22-42 years participated in this cross-sectional study. The Nordic Musculoskeletal Questionnaire was used to evaluate work-related musculoskeletal disorders, and postural analysis was performed using Rapid Entire Body Assessment (REBA).Results: In this study, a high prevalence of musculoskeletal pain in the lower back, hand, neck, and shoulder regions was observed. Approximately 47% of the students reported having experienced lower back pain in the past 12 months, and this disability was the most common disorder (23%) among the study population. The results of sub-group analysis based on sex showed the lower back to be the body region with the highest prevalence of pain. Based on the body mass index (BMI), the neck was highly reported as a site of pain. In addition, the REBA results revealed that 36% and 49% of the senior students in this study had a high and medium risk level for developing musculoskeletal disorders, respectively.Conclusion: The current results indicate that lower back pain is the most common musculoskeletal disorder among senior physiotherapy and occupational therapy students. This research also shows that based on the REBA tool, 36% of the senior students were at high risk for developing musculoskeletal disorders

Efficacy of combined endurance-resistance training versus endurance training in patients with heart failure after percutaneous coronary intervention: A randomized controlled trial

Background: This study aimed to compare the effects of combined endurance-resistance training (CT) versus endurance training (ET) on some cardiovascular markers in patients with heart failure after percutaneous coronary intervention (PCI). Materials and Methods: The study applied a randomized, controlled design in which 75 patients with heart failure who had undergone PCI were randomly assigned to one of three groups: ET, CT, and control. The ET group performed ET for 45 min, three times a week for 7 weeks. The CT group performed the same ET for 30 min followed by a resistance exercise protocol. The control group received usual care. Functional capacity, N-terminal pro-brain natriuretic peptide (NT-pro BNP), and high sensitivity C-reactive protein (hs-CRP) levels were measured. Results: After the intervention, functional capacity was improved (P < 0.001) and NT-pro BNP level was significantly reduced (P = 0.004 in the CT group, P = 0.002 in the ET group). Hs-CRP level was significantly reduced only in the ET group (P = 0.030). The control group showed no significant changes in any cardiovascular parameters (P ≥ 0.05). Changes in functional capacity (P < 0.001) in both training groups were significantly different from the control group. No significant differences were found between the ET and CT groups regarding changes in all outcomes after exercise training (P ≥ 0.05). Conclusion: Exercise training is safe and feasible in post-PCI patients, even in those with reduced ejection fraction. CT was as effective as ET in reducing NT-pro BNP level and improving functional capacity in heart failure patients after PCI

The comparison of the therapeutic effect of ischemic compression on upper trapezius trigger points in neutral and passive stretched positions in computer's operators

Introduction: Myofascial pain syndrome (MPS) is thought by some authors to be the main cause of neck and shoulder pain. MPS is characterized by myofascial trigger points (MTrPs). The aim of this study was to compare effects of ischemic compression (IC) in stretched & neutral position on the trigger points of trapezius muscle. Materials & Methods: Sixty computer’s operators with upper trapezius MTrP participated in this study. Subjects were divided randomly in two groups. Group1 that was treated with the IC in stretched position and group 2 that was treated with IC in neutral position of upper trapezius muscle. The local pain intensity , degree of active cervical lateral flexion ROM  and pain pressure threshold (PPT) were measured before intervention. Outcome measures were repeated within 5min and 3days after treatment. Statistical methods were kolmogorov-smirnov test, repeated measures ANOVA, independent T-test and Chi-square test. Results: The results showed a significant improvement in PPT, active cervical lateral flexion ROM and a significant decrease in the local pain intensity within each group. There was no significant difference between two groups. Conclusion: IC technique in stretched & neutral position was shown to be effective in increasing active cervical lateral flexion ROM, PPT and reducing pain intensity. IC technique in stretched position was more effective but difference between groups was not significant statistically. Key words: ischemic compression, stretching, trigger point, upper trapezius muscl

Flexibility of Knee Joint Muscles in Women with Knee Osteoarthritis and Healthy Controls

Background: Osteoarthritis is one of the most common diseases in synovial joints. Due to high loading forces during weight-bearing activities, the knee joint is prone to degenerative processes. This study aimed to compare the flexibility of muscles around the knee joint in patients with knee osteoarthritis with those of healthy individuals. Methods: Twenty-three women with bilateral knee osteoarthritis and 23 healthy women matched with the patient group for age, height and weight participated in this study. Flexibility of the quadriceps, hamstring, iliotibial band, adductor and gastrocnemius muscles was evaluated with a goniometric device. Pain intensity was assessed with a visual analogue scale. The data were analyzed with independent t-tests to compare the two groups, and Pearson correlation coefficient was calculated to correlate muscle flexibility and pain intensity. Results: significant lower flexibility of the bilateral quadriceps muscles was found in patients compared to healthy women (P<0.05). No significant differences were detected between groups regarding other muscles. Quadriceps flexibility correlated significantly with pain intensity in patients (P<0.001). Conclusion: In patients with osteoarthritis, quadriceps flexibility may be decreased although other muscles may remain unaffected. Quadriceps stretching is thus a potentially important component of treatment, which may influence pain reduction in these patients

Is application of Kinesio tape to treat hyperlordosis more effective on abdominal muscles or hamstrings?

Background: Hyperlordosis is defined as an abnormal increase in the lumbar arch of >40°. This study compared two taping techniques include abdominal muscles and hamstrings taping for the treatment of lumbar hyperlordosis. Materials and Methods: The randomized clinical trial was performed in Shiraz, Iran, during June and September 2014. Thirty women aged 20–45 years old with at least 40° lumbar lordosis participated. The women were randomized into two groups (n = 15). Abdominal muscles taping was performed for the first group, whereas the other group underwent hamstrings taping with 30% tension. Lumbar lordosis was measured before, immediately after, and 24 h after taping. The two-way repeated measures analysis of variance was used to compare the two groups for lumbar lordosis angle. Results: No significant differences were detected between the lumbar lordosis angles before and immediately after taping in the two groups (P > 0.05). However, a significant reduction was observed in lordosis angle in the abdominal group and the hamstring group 24 h after taping relative to before intervention (P < 0.01). Conclusion: Taping of the abdominal and hamstring muscles was not effective immediately, whereas it decreased lordosis after 24 h