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Research Interests: Psychology, Speech Language Pathology, Photogrammetry, Adolescent, Medicine, and 15 moreVoice, Humans, Female, Male, Reliability, Specialization, Posture, Clinical Sciences, Head, Observer Variation, Adult, Reproducibility of Results, Anatomic Landmarks, Physical Therapists, and Predictive value of tests
OBJECTIVE The use of frameless stereotaxy has expanded the spine surgeon's ability to perform surgical procedures with instrumentation in areas of narrow anatomic tolerance. In many circumstances, however, it is difficult to register... more
OBJECTIVE The use of frameless stereotaxy has expanded the spine surgeon's ability to perform surgical procedures with instrumentation in areas of narrow anatomic tolerance. In many circumstances, however, it is difficult to register the frameless stereotactic probe using known anatomic landmarks. This occurs typically because landmarks are indistinct, and congenital or surgical defects limit the availability of anatomic fiducials. We propose an accurate and efficient method for registering the frameless stereotactic probe for spinal surgery when a staged procedure is planned. METHODS During the first stage of a planned two-stage procedure, a minimum of four cranial fiducial screws are implanted in the posterior element of each vertebra in which stereotactic registration is desired. Stage 1 is completed, and all suture closure is performed. A computed tomographic scan formatted for the frameless stereotactic unit is obtained postoperatively. In the second stage of surgery, regis...
Research Interests: Neurosurgery, Spine, Medicine, Humans, Clinical Sciences, and 3 moreNeurosciences, Stereotaxy, and Bone screws
Previous research has shown inconsistent findings regarding muscle endurance in chronic low back pain (CLBP). Questions also remain about muscle endurance in patients with clinical instability. The aim of this study was to investigate... more
Previous research has shown inconsistent findings regarding muscle endurance in chronic low back pain (CLBP). Questions also remain about muscle endurance in patients with clinical instability. The aim of this study was to investigate trunk muscles strength and endurance in CLBP patients with and without clinical instability. 32 CLBP patients (15 with and 17 without clinical instability) and 39 matched healthy subjects participated in this study. The standing extension test was performed to assess the strength and endurance of the lumbar extensors while recording their electromyographic activity. The patients' disability was evaluated using the Oswestry and Roland-Morris Disability Questionnaires. Patients with clinical instability showed lower maximal voluntary exertion (MVE) and higher time to fatigue (TTF) compared to healthy subjects (P=0.000 and P=0.008, respectively) and patients without instability (P=0.002 and P=0.02, respectively). There was no difference in these variables between patients without instability and healthy controls. A negative relationship between MVE and TTF and a positive correlation between disability and pain intensity were seen. Strength training of trunk extensor muscles can be considered as part of the treatment protocol for CLBP patients with clinical instability. Although patients without instability suffered from pain or disability, they showed more similarity to healthy subjects in terms of trunk muscles strength and endurance.
Research Interests: Skeletal muscle biology, Medicine, Physical Therapy, Low back pain, Muscle strength, and 15 moreHumans, Chronic Disease, Female, Male, Resistance Training, Electromyography, Questionnaires, Adult, Muscle Fatigue, Postural Balance, Case Control Studies, Physical Endurance, Disability Evaluation, lumbar, and Torso
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Background: Biomechanical factors, such as spinal deformities can result in balance control disorders. Objectives: The purpose of this study was to examine the effect of bracing on static and dynamic balance control of hyperkyphotic... more
Background: Biomechanical factors, such as spinal deformities can result in balance control disorders. Objectives: The purpose of this study was to examine the effect of bracing on static and dynamic balance control of hyperkyphotic female adolescents. Study Design: Clinical trial. Methods: A force platform was employed to record center of pressure (COP) parameters. Ten adolescents undergoing Milwaukee brace for hyperkyphosis and 14 normal subjects participated in the study. The COP data were collected with and without brace immediately on first day and after 120 days of continuous brace wear. Results: No significant difference was found in dynamic and static balance tests with and without brace on the first day ( P…
Research Interests: Biomedical Engineering, Biomechanics, Treatment Outcome, Adolescent, Medicine, and 15 morePhysical Medicine and Rehabilitation, Humans, Child, Female, Braces, Prosthetics and orthotics, Bracing, Pressure, Time Factors, Postural Balance, Buckling Restraint Braces, Dynamic balance, Biomechanical Phenomena, Force Platform, and Brace
Background: Hyperkyphosis increases the risk of falls for elderly people by reducing postural balance. Spinomed orthosis and the posture-training support are two available options for improving postural balance but have never been... more
Background: Hyperkyphosis increases the risk of falls for elderly people by reducing postural balance. Spinomed orthosis and the posture-training support are two available options for improving postural balance but have never been compared. Objectives: To compare the effect of the Spinomed orthosis and the posture-training support on balance in elderly people with thoracic hyperkyphosis. Study Design: This study is a clinical trial on an accessible sample of elderly people with thoracic kyphosis. Method: Eighteen participants (16 women and 2 men), aged 60–80 years, with thoracic kyphosis greater than 50°, completed the study procedure. Subjects were randomly allocated to two groups, namely, Spinomed orthosis and the posture-training support groups. Sensory organization test and limits of stability were assessed using the EquiTest system and the Balance Master system, respectively. Balance score, directional control, and reaction time were measured to evaluate balance with and withou...
Research Interests: Biomedical Engineering, Ergonomics, Human Factors, Injury Prevention, Medicine, and 15 morePhysical Medicine and Rehabilitation, Physical Therapy, Humans, Elderly People, Female, Male, Aged, Middle Aged, Occupational Safety, Age Factors, Equipment Design, Kyphosis, Orthotic Devices, Dynamic balance, and Accidental falls
Background: Ankle-foot orthoses are usually used in combination with footwear. Shoe design can have a significant effect on kinematics of the lower limb joints and line of action of the ground reaction force during walking. But,... more
Background: Ankle-foot orthoses are usually used in combination with footwear. Shoe design can have a significant effect on kinematics of the lower limb joints and line of action of the ground reaction force during walking. But, ankle-foot orthosis–footwear combination is not appropriate for indoor barefoot walking in some Asian cultures. In this study, we have modified a solid ankle-foot orthosis in order to set it in the same position as a solid ankle-foot orthosis–footwear combination. Objective: To investigate the effect of a modified solid ankle-foot orthosis; a solid ankle-foot orthosis which can be locked in different positions on gait and balance performance in comparison with a conventional solid ankle-foot orthosis, a common solid ankle-foot orthosis–shoe combination in asymptomatic adults. Study Design: Cross sectional. Methods: Two standard solid ankle-foot orthoses were manufactured with the ankle joint in neutral position. Then, one of these solid ankle-foot orthoses w...
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... RADIATION ON SENSORY AND MOTOR ELECTRONEUROGRAPHIC PARAMETERS OF MEDIAN NERVE HEYDARABADI AFSHIN,EBRAHIMI TAKAMJANI E.,FOROUGH B.*,MAROUFI N.,SALAVATI MAHYAR * SCHOOL OF REHAB IMITATION, SHAH NAZARIST., MOHSENI ...
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ABSTRACT Objective: Comparison of the ability of reproducing isometric quadriceps force in patients with patellofemoral pain syndrome [PFPS] and healthy normal control subjects. Methods: The Ipsilateral Limb Matching method was utilized... more
ABSTRACT Objective: Comparison of the ability of reproducing isometric quadriceps force in patients with patellofemoral pain syndrome [PFPS] and healthy normal control subjects. Methods: The Ipsilateral Limb Matching method was utilized to assess the acuity of the sense of isometric force in the quadriceps muscle. At first, participants produced 20 and 60% of quadriceps maximal voluntary isometric contraction using an isokinetic dynamometer and visual feedback, and then they attempted to reproduce the target forces without visual feedback. They were asked to estimate and reproduce the target forces based on their own perception of the quadriceps force used earlier during the isometric contraction with feedback. This test was performed in 20° and 60° of knee flexion. The absolute error, constant error and variable error were used to measure the subjects' errors in their perception of sense of force. Results: Seventeen patients with PFPS [19 to 39 years old] and 17 matched healthy controls participated. The results of the three-way analysis of variance disclosed a significant difference in absolute error [p = 0.05, F value = 8.29] and variable error [p = 0.00, F value = 55.50] between the two comparison groups. An interaction effect of knee position by group in the three-way analysis of variance showed that the patients with PFPS had more absolute error, constant error and variable error particularly with 60° of knee flexion. Conclusion: The sense of force may be impaired in patients with PFPS. This syndrome may cause changes in the afferent signals from the muscle receptors and subsequently lead to mismatching between central and peripheral mechanisms of the sense of force.
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Research Interests: Biomedical Engineering, Low back pain, Lumbar spine, Humans, Kinematics, and 15 moreFemale, Fluoroscopy, Male, Digital Video, Clinical Sciences, Adult, Joint Instability, Chronic Low Back Pain, Kinematic Analysis, Healthy Subjects, Control Group, Case Control Studies, Biomechanical Phenomena, lumbar vertebrae, and lumbar
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Reports of interactive between lumbar spine and hip movement vary for stoop & squat, loading conditions. This study analysis two groups of subjects (45 subjects) during stoop & squat lifting with loaded & unloaded. A Three-Dimensional... more
Reports of interactive between lumbar spine and hip movement vary for stoop & squat, loading conditions. This study analysis two groups of subjects (45 subjects) during stoop & squat lifting with loaded & unloaded. A Three-Dimensional Optoelectric Motion Analysis System was ...
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According to the conventional arch model of the pelvis, stability of the sacroiliac joints may require a predominance of form and force closure mechanisms: the greater the vertical shear force at the sacroiliac joints, the greater the... more
According to the conventional arch model of the pelvis, stability of the sacroiliac joints may require a predominance of form and force closure mechanisms: the greater the vertical shear force at the sacroiliac joints, the greater the reliance on self-bracing by horizontally or obliquely oriented muscles (such as the internal oblique). But what happens to the arch model when a person stands on one leg? In such cases, the pelvis no longer has imposts, leaving both the arch, and the arch model theory, without support. Do lumbopelvic muscle activation patterns in one-legged stances under load suggest compatibility with a different model? This study compares lumbopelvic muscle activation patterns in two-legged and one-legged stances in response to four levels of graded trunk loading in order to further our understanding the stabilization of the sacroiliac joints. Thirty male subjects experienced four levels of trunk loading (0%, 5%, 10% and 15% of body weight) by holding a bucket at one side, at three conditions: 1) two-legged standing with the bucket in the dominant hand, 2) ipsilateral loading: one-legged standing with the bucket in the dominant hand while using the same-side leg, and 3) contralateral loading: one-legged standing using the same leg used in condition 2, but with the bucket in the non-dominant hand. During these tasks, EMG signals from eight lumbopelvic muscles were collected. ANOVA with repeated design was performed on normalized EMG's to test the main effect of load and condition, and interaction effects of load by condition. Latissimus dorsi and erector spinae muscles showed an antagonistic pattern of activity toward the direction of load which may suggest these muscles as lateral trunk stabilizers. Internal oblique muscles showed a co-activation pattern with increasing task demand, which may function to increase lumbopelvic stability (P < 0.05). No unilateral pattern of the internal obliques was observed during all trials. Our results suggest that the lumbopelvic region uses a similar strategy for load transfer in both double and single leg support positions which is not compatible with the arch analogy. Our findings are more consistent with a suspensory system (wire-spoke wheel model). If our proposed model holds true, the pelvic ring can only be integrated by adjusting tension in the spokes and by preserving rim integrity or continuity. Thus, we propose that in order to restore tension integrity throughout the pelvic ring, efforts to unlock restrictions, muscular correction of positional faults and lumbopelvic or even respiratory exercises following sacroiliac joint dysfunctions must be taken into consideration. Our hypothetical model may initiate thinking and act as a guide to future work based on a biomechanical approach to the problem of sacroiliac joint dysfunction.
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ABSTRACT Introduction: Postural control deficits after lateral ankle sprain have been shown in patients withfunctional ankle instability (FAI). Numerous researchers have shown different effects of orthosis onpostural control in FAI... more
ABSTRACT Introduction: Postural control deficits after lateral ankle sprain have been shown in patients withfunctional ankle instability (FAI). Numerous researchers have shown different effects of orthosis onpostural control in FAI patients. It seems that the condition of chosen control group might explain thedifferent results obtained from those studies. To the authors' knowledge, no study has compared theeffect of orthosis on postural control against different control conditions.Materials and Methods: Twenty patients with functional instability of ankle and twenty werematched healthy subjects participated in the study. Postural control in single limb stance was assessedfor both affected and unaffected foot while using soft and semi-rigid orthosis. Standing without usingorthosis was considered as the baseline condition. Balance control was evaluated by force platform.Results: Our results showed that interaction between group and orthosis was significant for all ofthe parameters extracted from center of pressure (COP) data, meaning that orthosis has a differentialeffect on postural control between the two groups. Also, interaction between foot side and orthosiswas not significant for all of the COP parameters. In another words, orthosis has the same effect oninvolved and uninvolved foot side.Conclusion: Although orthosis improved postural stability in patients with FAI, it showed no suchan effect in healthy subjects. As the other finding, it was demonstrated that orthosis has no differentialeffect on postural control between involved and uninvolved foot side in both groups. Therefore, thepositive effects of orthosis on postural control in FAI patients may be revealed when healthy subjectsare involved as control group in research design.
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Research Interests: Acupuncture and Medicine
Research Interests: Kinetics, Statistical Analysis, Science, Postural Control, Humans, and 15 moreStandard Deviation, Female, Male, Young Adult, Adult, Public health systems and services research, Analysis of Variance, Joint Instability, Postural Balance, Ankle, Postural Sway, Orthotic Devices, Center of Pressure, Sprains and strains, and Ankle injuries
Background Static and dynamic postures of lumbopelvic in low back pain (LBP) are considered as two important aspects of clinical assessment and management of LBP. Thus, the focus of the current study was to compare the posture and... more
Background Static and dynamic postures of lumbopelvic in low back pain (LBP) are considered as two important aspects of clinical assessment and management of LBP. Thus, the focus of the current study was to compare the posture and compensatory strategy of hip and lumbar region during trunk flexion between LBP subgroupsand health subjects. LBP cases are subdivided into active extension pattern (AEP) and flexion pattern (FP) based on O'Sullivan's classification system (OCS). Methods This work was a cross-sectional study involving 72 men, 21 low back pain patients with FP and 31 low back pain patients with AEP and 20 healthy groups. Lumbar and hip angles during trunk flexion were measured by a 3D motion analysis system in neutral standing posture and end-range of trunk flexion. The participants were asked to full bend without any flexion of the knees. The bending speed was preferential. Hip and lumbar ranges of motion were divided into four quartiles (Q). The quartiles were com...
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BACKGROUND The prevalent method for investigating the effect of therapeutic interventions on walking in the individuals with chronic low back pain (CLBP) is component-level approach in which all measurements focus on the spine component... more
BACKGROUND The prevalent method for investigating the effect of therapeutic interventions on walking in the individuals with chronic low back pain (CLBP) is component-level approach in which all measurements focus on the spine component alone. However, this approach cannot disclose information about the overall function of the movement system such as complex walking patterns, which, in turn, reveal the underlying movement control. OBJECTIVES To compare the effect of 3-week wearing of lumbosacral orthosis (LSO) along with routine physical therapy with routine physical therapy alone on walking complexity in the individuals with nonspecific CLBP on the basis of the systems approach. STUDY DESIGN Preliminary randomized clinical trial. METHODS Twenty-four subjects were randomly allocated to two groups. The control group received the routine physical therapy for 3 weeks. The intervention group received the same program plus an LSO. Nonlinear analysis was used to quantify walking complexity, as behavior of the entire movement system, before and after the intervention and at 1-month follow-up. RESULTS An average of 496 strides during ten minutes of walking was used for analysis. There was no significant difference (p > 0.05) in degree of walking complexity between two groups during all evaluation periods. CONCLUSIONS The administered orthotic intervention did not alter walking complexity. This suggests that therapeutic goal of current LSOs, which is not based on the systems approach, cannot recover the emergent behavior of the movement system. This may be a potential source of controversies. CLINICAL RELEVANCE To achieve an effective treatment, orthotists should focus on the individuals themselves, not only on their CLBP symptoms. Although the component-level approach aims to decrease the symptoms, the systems approach focuses on the whole context that fosters LBP symptoms.
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Changes in postural and trunk muscles responses in patients with chronic nonspecific low back pain during sudden upper limb loading
ObjecƟ ve One of the most common faulty posture of cervical spine is forward head posture (FHP). According to biomechanical changes in the muscles and ligaments of the neck which are rich source of mechanoreceptors, in forward head... more
ObjecƟ ve One of the most common faulty posture of cervical spine is forward head posture (FHP). According to biomechanical changes in the muscles and ligaments of the neck which are rich source of mechanoreceptors, in forward head posture there is the possibility for the propriocepƟ on to be impaired. Assessment of neck reposiƟ oning angles can be an indicator to assess propriocepƟ on of this region. The aim of this study was to invesƟ gate cervical propriocepƟ on in forward head posture subjects in sagiƩ al plane and compare it with normal subjects. Materials & Methods This is a case-control study and subjects were selected by available sampling from students of Iran University of Medical Sciences. Eighteen subjects with FHP (mean age 23.18 years) and twenty two normal subjects (mean age 22.72 years) were parƟ cipated in this study. Photography of sagittal view was done in standing posture to determine the amount of FHP, as well as craniovertebral angle (CVA) and the angle less th...
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Background: Psoas major (PM) is a challenging muscle from the functional and anatomical point of view. The dysfunction of this muscle can result in low back pain (LBP). This study aimed to assess the intrarater reliability of ultrasound... more
Background: Psoas major (PM) is a challenging muscle from the functional and anatomical point of view. The dysfunction of this muscle can result in low back pain (LBP). This study aimed to assess the intrarater reliability of ultrasound imaging (USI) of PM muscle thickness in subacute LBP patients and healthy participants without LBP in rest and during muscle contraction conditions. Methods: PM thickness was measured in all lumbar segments (L1-L5) using a USI device in 10 healthy and 10 subacute LBP participants. The intrarater data were assessed on the same day with 1- hour interval and after 7 days. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and independent t test were used for analyses. Significant level was set at 0.05. Results: PM thickness in all lumbar levels had excellent reliability (ICC range 80-98) for both groups and conditions. SEM (0.42- 2.29) and MDC (1.16-6.34) were low, and PM thickness was greate...
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Introduction: Most knee anterior cruciate ligament injuries happen during challenging activity like drop landing. Core muscles feedforward activity can control challenging activity and prevent injury. The aim of this study is to... more
Introduction: Most knee anterior cruciate ligament injuries happen during challenging activity like drop landing. Core muscles feedforward activity can control challenging activity and prevent injury. The aim of this study is to investigate core muscles feedforward activity in patients after anterior cruciate ligament reconstruction (ACLR) and control group. Materials and Methods: 11 males with ACLR, between 18-40 years old, with at least 6 to 24 months after surgery and 11 males as control group were enrolled in this study. Muscle activity of geluteus medius, abdominis external oblique, quadratus lumborum and erector spine in landing was recorded in both groups. Cross hop functional test and International Knee Documentation Committee (IKDC) questionnaire were evaluated and compared in both groups. Significance level was considered less than 0.05 in all analysis. Results: Score of IKDC subjective questionnaire and cross hop functional test in control group were significantly more th...
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Background and Aim: Controversy regarding feedforward activation of transversus abdominis and limited studies regarding bilateral activation of trunk muscles during unilateral arm movement lead us to perform a study to evaluate bilateral... more
Background and Aim: Controversy regarding feedforward activation of transversus abdominis and limited studies regarding bilateral activation of trunk muscles during unilateral arm movement lead us to perform a study to evaluate bilateral anticipatory activity of trunk muscles during unilateral arm flexion. Materials and Methods: Eighteen healthy subjects participated in this study. The electromyographic activity of the right Anterior Deltoid (AD) and bilateral trunk muscles including the Transversus Abdominis/Obliquus Internus (TA/OI), Superficial Lumbar Multifidus (SLM) and Lumbar Erector Spinae (LES) during rapid flexion of the right upper limb in response to a visual stimulus was recorded and the onset latency and anticipatory activity of the recorded trunk muscles were calculated. Results: The cotralateral TA/OI was the first muscle activated in anticipation of the right arm flexion. The ipsilateral TA/OI activated significantly later than all other trunk muscles (P 0.05). Concl...
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Background Balance disorder is one of the most-studied fields in low-back pain patients (LBP). However, there is insufficient information regarding the effect of LBP subgrouping on postural control. The purpose of the present study was to... more
Background Balance disorder is one of the most-studied fields in low-back pain patients (LBP). However, there is insufficient information regarding the effect of LBP subgrouping on postural control. The purpose of the present study was to compare postural control between subgroups of chronic nonspecific LBP and healthy subjects during lifting. Methods A total of 35 men with chronic LBP (19 active extension pattern [AEP] and 16 flexion pattern [FP]) and 15 healthy controls were enrolled in this cross-sectional study. Pooled LBP was subdivided based on the O'Sullivan's classification system (OCS). The participants were asked to lift a box from the ground to the waist level and hold it for 20 seconds. The load was 10% of the subject's weight. Force plate system was used to record balance parameters, including standard deviations (SDs) of center of pressure (COP) amplitude and COP velocity in anterior-posterior and medial-lateral directions and mean total velocity. The test ...
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Aim and Background : There is a relation between patients' levels of physical functioning and their acceptance of chronic pain. However, this relation has not been examined amongst Iranian chronic pain patients. The purpose of this... more
Aim and Background : There is a relation between patients' levels of physical functioning and their acceptance of chronic pain. However, this relation has not been examined amongst Iranian chronic pain patients. The purpose of this paper was to evaluate the relation between acceptance of chronic pain and physical disability. Methods and Materials : In a descriptive-correlational study, convenience sampling was used to select 245 chronic pain patients from pain clinics in Tehran, Iran during spring and summer of 2010. The participants completed the Chronic Pain Acceptance Questionnaire (CPAQ) and a demographic questionnaire. They also provided information about physical disability, pain intensity, and daily dysfunction. Data was analyzed using Pearson's correlation and multiple hierarchical regression models. Findings : There were significant relations between acceptance of pain and pain intensity and disability (P < 0.001). According to the regression model, acceptance of...
Research Interests: Psychology and Medicine
Background and purpose: Proprioception is one of the somatic senses which is used by the nervous system for muscular control. Inappropriate posture or pain could result in impaired proprioception. One of these poor postures is forward... more
Background and purpose: Proprioception is one of the somatic senses which is used by the nervous system for muscular control. Inappropriate posture or pain could result in impaired proprioception. One of these poor postures is forward head posture (FHP). The aim of this study was to investigate cervical repositioning error in FHP subjects with and without neck pain and normal individuals. Materials and methods: A case-control study was conducted consisting of people who had FHP without neck pain (n=31), individuals with FHP and neck pain (n=31), and healthy subjects (n=31). Cervical total range of motion (ROM) and then repositioning error in target angle (50% of full ROM in each movement( of flexion, extension, right and left lateral flexion, and right and left rotation were measured by cervical range of motion (CROM) device. Pain intensity was measured using the visual analog scale (VAS). Results: Cervical ROM in FHP subjects was significantly less than that of healthy subjects in ...
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Introduction: Knee joint injuries usually occur in a short time, so analyzing the mechanism and process of this short time can be helpful to prevent similar injuries. This study aimed to determine and compare the reaction time of knee... more
Introduction: Knee joint injuries usually occur in a short time, so analyzing the mechanism and process of this short time can be helpful to prevent similar injuries. This study aimed to determine and compare the reaction time of knee muscles and investigate the effect of knee position and perturbation direction on the reaction time of knee muscles in response to horizontal rotational perturbation applied to lower leg from support surface area. Materials and Methods: A total of 30 healthy women volunteers were received ±35 degrees of horizontal rotational perturbation and speed of 120 degrees per second from the sole while standing on the right leg in four conditions (external versus internal rotation of surface while the knee was in both extension and flexion position). Electromyography of knee muscles (vastus medialis and lateralis, medial and lateral hamstring and medial and lateral gastrocnemius) was measured to study the reaction time. Results: The reaction time of knee muscle...
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Objective: We aimed to study the kinematic indices of the pelvic floor, anorectal angle and the descent of perinea, and the differing movement, in dyssynergic defecation patients in comparison with healthy controls, based on MR... more
Objective: We aimed to study the kinematic indices of the pelvic floor, anorectal angle and the descent of perinea, and the differing movement, in dyssynergic defecation patients in comparison with healthy controls, based on MR defecography. Methods: Twenty-two individuals involved with dyssynergic defecation constipation and fourteen healthy asymptomatic subjects fell into this study. In four dynamic pelvic floor MRI indices, namely paradox (unusual change of anorectal angle), perineal descent during straining, perineal ascent, and narrowing of anorectal angle at squeeze, were measured in patients and healthy subjects. Results: Paradox Index had the highest sensitivity (95.45%) and specificity (92.86%) for detection of dyssynergic defecation, with an R2 value of near 1 (0.902). The sensitivity and specificity of other indices were not high; therefore, no significant improvement could be achieved using other indices along with Paradox Index. Negative Predictive Value (92.85%) and Positive Predictive Value (95.45%) were only high in Paradox Index. Conclusion: Paradox Index was indicated to be the best finding of MR defecography for identifying dyssynergic defecation patients from healthy controls. Hence, MR defecography could be exploited as an authentic tool to manifest the patients the paradoxical function and the relevant muscles of pelvic floor, which could enhance their imagination of the correct defecation pattern during their treatment.
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Objectives: Knee bracing as a conservative treatment option for patients with medial knee osteoarthritis (KOA) is of great interest to health practitioners and patients alike. Optimal orthotic knee joint structure is essential to achieve... more
Objectives: Knee bracing as a conservative treatment option for patients with medial knee osteoarthritis (KOA) is of great interest to health practitioners and patients alike. Optimal orthotic knee joint structure is essential to achieve biomechanical and clinical effectiveness. Therefore, this study aimed to identify the effects of a knee orthosis with a new two-degrees-of-freedom (DOF) joint design on selected gait parameters and in a sit-to-stand task in patients with mild-to-moderate medial KOA. Methods: This study was conducted both at the Physical Medicine and Rehabilitation Clinic in Shahid Modarres Academic Hospital and the Biomechanical Laboratory of Rehabilitation Faculty of Iran University of medical Sciences in Tehran, Iran from September 2015 to October 2017. The gait performance of 16 patients was assessed without an orthosis, using a common one-DOF (DOF) knee orthosis and using the same knee orthosis with a two-DOF orthotic joint design. The interactive shearing force...
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Background and objectives: The study aimed to compare the effectiveness of craniosacral therapy (CST), muscle energy technique (MET), and sensorimotor training (SMT) on pain, disability, depression, and quality of life of patients with... more
Background and objectives: The study aimed to compare the effectiveness of craniosacral therapy (CST), muscle energy technique (MET), and sensorimotor training (SMT) on pain, disability, depression, and quality of life of patients with non-specific chronic low back pain (NCLBP). Methodology: In this randomized clinical trial study 45 patients with NCLBP were randomly divided in three groups including CST, SMT, and MET. All groups received 10 sessions CST, SMT, and MET training in 5 weeks. Visual analogue scale (VAS), Oswestry functional disability questionnaire (ODQ), Beck depression inventory-II (BDI-II), and 36-item short form health survey (SF-36) were used to evaluate the pain, disability, depression, and quality of life, respectively, in three times, before treatment, after the last session of treatment, and after 2 months follow up. Results: The Results showed that VAS, ODI, BDI, and SF-36 changes were significant in the groups SMT, CST and MET (p < 0.001, p < 0.001, p ...
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Study DesignClinical pilot study.PurposeTo objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance... more
Study DesignClinical pilot study.PurposeTo objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs.Overview of LiteratureWearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects.MethodsTwelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradu...
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Motor abundance allows reliability of motor performance despite its variability. The nature of this variability provides important information on the flexibility of control strategies. This feature of control may be affected by low back... more
Motor abundance allows reliability of motor performance despite its variability. The nature of this variability provides important information on the flexibility of control strategies. This feature of control may be affected by low back pain (LPB) and trunk flexion/extension conditions. Goal equivalent manifold (GEM) analysis was used to quantify the ability to exploit motor abundance during repeated trunk flexion/extension in healthy individuals and people with chronic non-specific LBP (CNSLBP). Kinematic data were collected from 22 healthy volunteers and 22 CNSLBP patients during metronomically timed, repeated trunk flexion/extension in three conditions of symmetry, velocity, and loading; each at two levels. A goal function for the task was defined as maintaining a constant movement time at each cycle. Given the GEM, flexibility index and performance index were calculated respectively as amounts of goal-equivalent variability and the ratio of goal-equivalent to non-goal-equivalent...
Research Interests: Engineering, Mathematics, Medicine, Physical Medicine and Rehabilitation, Human Movement Science, and 15 moreLow back pain, Humans, Movement, Kinematics, Female, Male, Reaction Time, Middle Aged, Adult, Postural Balance, Biomechanical Phenomena, Functional Laterality, lumbar vertebrae, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Alterations in the neuromuscular control of the spine were found in patients with chronic low back pain (CLBP). Sudden loading of the spine is assumed to be the cause of approximately 12% of lower back injuries. However, some aspects of... more
Alterations in the neuromuscular control of the spine were found in patients with chronic low back pain (CLBP). Sudden loading of the spine is assumed to be the cause of approximately 12% of lower back injuries. However, some aspects of this problem, such as alterations in the sensory-motor control of the spine, remain questionable. This study investigated postural and neuro- motor changes in trunk muscles during sudden upper limb loading in patients with CLBP. Electromyography of the erector spinae (ES) and transverses abdominis/internal oblique (TrA/IO) and external oblique (EOA) muscles were recorded in 20 patients with CLBP and 20 asymptomatic individuals with eyes open (EO) and eyes closed (EC) conditions. Moreover, measurements of the center of pressure (COP) and vertical ground reaction force (GRF) or Fz were recorded using a force plate. Data were analyzed using paired t-test and independent t-test at the significance level of 0.05. In patients with CLBP, decreased electrica...