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

Determination of Effect of Platelet Rich Plasma Injection on Improving Pain and Function in Young Healthy Athletes with Isolated Grade 2 or 3 Knee Medial Collateral Ligament Sprains

Background: Knee medial collateral ligament (MCL) sprain is common in athletes, which keeps them away from trainings. Platelet-rich plasma (PRP) injection is used as an adjunct for treatment of musculoskeletal injuries. This study was supposed to define effect of PRP injection on high-grade MCL sprain healing, in comparison to rehabilitation alone.Materials and Methods: This study was performed on 46 healthy athletes with high-grade MCL sprains who came to sports medicine clinic of Taleghani Hospital, Tehran over a one-year period (2017-2018). In first visit injury grade, its location, baseline pain, Lysholm score and joint stability was determined. Participants randomly allocated to 2 groups (n=23), “group A” had 12-week functional rehabilitation and “group B” had the same rehabilitation plus a single PRP injection. At 4-week intervals valgus stress testing, pain and Lysholm scores was reassessed. The scores of 4th, 8th and 12th weeks was compared to the baseline scores.Results: Mean baseline pain score in control and intervention group was 5.09±0.949 and 5.26±0.810 respectively that in the fourth week of study reduced to 1.30±0.765 and 2.43±0.507 (p<0.001). In intervention group, fourth week pain was significantly reduced while stability and Lysholm scores of the groups had no significant difference.Conclusion: PRP injection had a short-term statistically significant pain reduction effect that may assist in faster rehabilitation progress, shorter return to play and less detraining which is crucial to professional athletes

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

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

Prevalence of Different Electrocardiographic Patterns in Iranian Athletes

To explore the abnormalities in Iranian athletes' electrocardiogram and find any relation with body fat. 239 international athletes were involved in this cross sectional study. Body-fat percentage and resting 12-lead ECGs were recorded from all participants. Of 239 participant athletes, 212 were male and 27 female. 60% of participants had sinus bradycardia. A total of 84% of the athletes demonstrated at least 1 abnormal ECG finding. Average values for the PR, QRS and QT intervals, P-wave duration and QRS axis were in normal range. Frequencies of various ECG abnormal findings in all athletes were as follows: right axis deviation 4.2%, left ventricular hypertrophy 6.2%, sinus arrhythmia 5.8%, right bundle branch block (RBBB) 24.2% (incomplete RBBB 16.8%, complete RBBB 7.4%), ST elevation 72.5%, prolonged QT interval 1.7%, T inversion 3.1% and Mobitz type I 1.2%. The athletes' ECG response to treadmill stress test was normal with no ischemia or arrhythmia. The means of BMI and body-fat percentage were 24.04 ± 3.5 kg/m² and 9.15 ± 2.12%, respectively. Pearson correlation coefficient between body-fat percentage and ST changes was 0.65 (P=0.008) in anterior leads and 0.198 (P=0.017) in lateral leads. Also, the correlation coefficient between the body fat percentage and right bundle branch block was 0.36 (P=0.013). The results of current study support the inclusion of ECG in athletes' cardiac screening before they engage in vigorous exercises in order to detect the potentially fatal arrhythmias

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

Association between physical activity and severity of diabetic retinopathy in patients with diabetes mellitus

Background: Diabetes mellitus (DM) and its related complications such as diabetic retinopathy (DR) are among considerably growing global concerns. Many efforts have been done toward a better understanding of the modifiable risk factors of DR, to stop progression as well as prevention of this complication. Physical activity (PA) is a known modifiable risk factor of DM but its effect on the severity of DR is not clearly understood. In this study, we aimed to evaluate the association between PA and severity of DR. Materials and Methods: A case-control study was done comprising 232 patients with DM (type 1 or 2), 58 of whom were in control group with no sign of DR, while the others were divided into three subgroups each contained 58 individuals, according to the severity of DR. PA of patients was assessed by the International Physical Activity Questionnaire (IPAQ) short-version and total scores of PA were compared among different groups. Result:  Total PA scores in (metabolic equivalent [MET]-hour/week) in control group, in patients with mild to moderate non-proliferative diabetic retinopathy (NPDR), severe to very severe NPDR, and proliferative diabetic retinopathy were 24.6 ±28.3, 23.7 ±30.6, 17.1 ± 27.0, and 7.1 ±10.2, respectively. The lower the score of PA, the higher the stage of DR (r=-0.284, p<0.001). Low PA levels came with higher stages of DR (odds ratio [OR]=2.7, P=0.023) than moderate PA (OR=2.1, P=0.114). When adjusted for age, sex, duration of DM, and type of medication regimen, the association of DR severity with PA level was still statistically significant in mild PA group (P=0.049) and statistically insignificant in moderate PA group (P=0.132). Adjusting for hemoglobin A1c (HbA1c) and body mass index (BMI) showed no significant correlation between PA level and DR severity (OR=1.1 and P=0.794 in low PA group, OR=1.2 and P=0.670 in moderate PA group). Conclusion: Low PA level can be identified as a risk factor for DR, but not a completely independent one. It is more likely that PA lowers the risk of DR progression through lowering BMI and achieving better glycemic control (HbA1c)