Comparison of Single Session Auditory Versus Visual Feedback on Performance and Postural Balance in Hemiplegic Children With Cerebral Palsy.

BACKGROUND:  Cerebral palsy (CP) is a pediatric disorder characterized by a motor impairment resulting from a permanent, non-progressive lesion in the brain. Cerebral palsy is marked by movement and postural control impairments, which greatly affect body structure, function, daily activities, and participation. OBJECTIVE: To compare the single-session auditory versus visual feedback on performance and postural balance in children with hemiplegic cerebral palsy. METHOD: The study was a crossover clinical trial involving a group of 25 patients diagnosed with CP hemiplegia, aged between 6 and 12 years, including both genders. Each patient underwent conventional balance therapy followed by either auditory feedback or visual feedback intervention. After a 48-hour wash-out period, they received conventional balance therapy again before undergoing the alternative intervention initially assigned. The Modified Ashworth scale (MAS), pediatric balance scale (PBS), timed one-leg stance, time up and go test (TUG), and center of pressure (CoP) displacements were assessed as the outcome measures before and after the interventions. RESULTS: Based on the one-leg stand test, TUG, and CoP displacement outcome measures results, both interventions improved balance time, speed of movement, and postural stability in children with hemiplegic spastic cerebral palsy (P < 0.05). Moreover, after a single session of the intervention, the visual feedback group demonstrated a significantly greater improvement in the TUG test, one-leg stand test, and CoP displacement compared to the auditory group (P < 0.05). CONCLUSIONS: The results of the study suggest that combining auditory or visual feedback with conventional balance therapy is effective in treating children with hemiplegic spastic cerebral palsy; furthermore, the utilization of visual feedback would be more effective. Further research is needed to determine the long-term effects of visual and auditory feedback on the assessed outcome measures.

Comparing the Effect of Bone-loading Exercises and Pulsed Electromagnetic Fields on Bone Turnover Markers in Women with Osteoporosis: A Randomized Clinical Trial Study Protocol.

Objective: Given the bone sensitivity to mechanical stimulus, bone-loading exercises and applying the Pulsed Electromagnetic Fields (PEMF(s)) are recommended for promoting bone strength. In this context, these two interventions 's effect on bone turnover markers (BTMs) in osteoporosis patients is yet to be clarified; consequently, an attempt is made in this study to compare the effect of these two interventions on bone turnover markers in women with Postmenopausal Osteoporosis (PMOP). Methods: This study is design as a randomized, single-center, three-arms, controlled trial. A total of 51 women with PMOP will be randomly assigned to three groups of 17, using opaque, sealed envelopes containing labels for A, B, and C groups. Group A) will receive bone-loading exercises, B) will follow the PEMF(s) and C) will be exposed to the combination of A and B. These three groups will require intervention for 24 sessions (2 sessions/week) next to their routine medical treatment (Alendronate+ Calcium+ Vitamin D). The primary outcome of this study is the serum biomarker of bone formation (bone-specific alkaline phosphatase, BSALP) and resorption (N-terminal telopeptide, NTX). The secondary outcomes consist of thoracic kyphosis angle, fear of falling, and quality of life. The outcomes are measured three times: at baseline, after 24 sessions of intervention, and at 12 weeks follow-up. A primary outcome will be measured and reported by a laboratory expert who is blinded to the participant grouping. Result: The trial has the code of ethics for research (IR.TUMS.FNM.REC.1401.126) and the code of Iranian Registry of Clinical Trials (IRCT) (IRCT20221202056687N1). Study results are expected to be available by mid-2024. Conclusion: This trial will provide new practical knowledge on the bone-loading exercises and PEMFS(s)'s effect on PMOP women. This knowledge is of the essence for physiotherapists, clinicians, other healthcare professionals, and policymakers in the healthcare system.

The immediate effects of deep transverse friction massage, high- power pain threshold ultrasound and whole body vibration on active myofascial trigger points.

BACKGROUND: The most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs). MATERIALS AND METHODS: sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions. RESULTS: The VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group. CONCLUSION: All three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius. CLINICAL TRIAL REGISTRATION NUMBER: IRCT20200518047498N1.

Does Kinesio taping of tibialis posterior or peroneus longus have an immediate effect on improving foot posture, dynamic balance, and biomechanical variables in young women with flexible flatfoot?

BACKGROUND: Flexible flatfoot is common in young adults. One of its causes is the failure of dynamic stabilizers, which play an important role in the medial longitudinal arch support, and their appropriate function is necessary for the integrity of the lower extremity and the spine. OBJECTIVE: The study aimed to determine Kinesio taping on which extrinsic foot muscle provides greater benefit regarding enhancement of foot posture, dynamic balance, and biomechanical parameters in functional tasks immediately. METHODS: Thirty women were recruited for the study. They were randomly divided into groups (A = 15, B = 15). In group A, Kinesio taping was applied on the tibialis posterior (TP), and in group B, Kinesio taping was applied on the peroneus longus (PL) and remained for 30 min. Outcome measures were the navicular drop test (NDT), foot posture index (FPI), Y-balance test, and biomechanical parameters in functional tasks. Before/After within-group and between-group comparisons of outcome measures were performed. RESULTS: NDT and FPI decreased in both groups (p < 0.05) with no significant difference between groups. In group A, maximum total force of the stance phase (MaxTFSP) during running increased, and some temporal parameters were changed. (p < 0.05). In group B, Y-balance test improved in all directions, and the width of the gait line during walking increased. There were no significant differences in the postural stability parameters in the within-group comparison, except for mean center of pressure displacement in group B (p = 0.04). CONCLUSION: Kinesio taping of both muscles could improve foot posture. TP Kinesio taping can increase the MaxTFSP during running and alter some temporal parameters during walking and running tasks. PL Kinesio taping could lead to better dynamic stability and coordination during dynamic tasks. Each muscle can be considered a therapeutic target for a specific purpose.

Comparison between the effects of tibialis posterior versus fibularis longus Kinesio taping on foot posture, physical performance, and dynamic balance in young women with flexible flatfoot.

Purpose: The purpose of the study is to compare the effectiveness of the tibialis posterior Kinesio taping and fibularis longus Kinesio taping on the foot posture, physical performance, and dynamic balance in young women with flexible flatfoot. Methods: Twenty-four subjects were recruited for the study. They were randomly divided into groups (A = 12, B = 12). In group A, Kinesio taping was applied on the tibialis posterior, and in group B, Kinesio taping was applied on the fibularis longus and remained for 30 min. Outcome measures were the navicular drop test (NDT), foot posture index (FPI), timed up and go (TUG) test, and Y-balance test. The pre- and post-treatment results were compared for each group; between-group differences were determined as well. Results: For group A, NDT, FPI, and TUG test changed significantly (P = 0.01, P = 0.001, P = 0.006, respectively). For group B, the FPI score decreased (P = 0.03), and the Y-balance test in the anterior direction improved significantly (P = 0.01). Any variables have not shown a significant difference between groups (P > 0.05). Conclusion: Kinesio taping of the tibialis posterior and fibularis longus can improve foot posture in young women with flexible flatfoot. Also, physical performance and dynamic balance improved by Kinesio taping of the tibialis posterior and the fibularis longus, respectively. In addition to the tibialis posterior, we found that the fibularis longus muscle can be considered a therapeutic target for managing flexible flatfoot in healthy young women.

Acute effect of inhibitory kinesio tape on range of motion, dynamic balance, and gait in athletes with hamstring shortness.

OBJECTIVE: The goal of the present study was to investigate the acute effects of kinesio tape on range of motion (ROM), perceived stiffness, and kinetic parameters in athletes with hamstring shortness. METHODS: Fifteen athletes with bilateral hamstring shortness were divided randomly into intervention (inhibitory application of kinesio tape plus static stretching) and control (static stretching) groups. Outcome measures were straight leg raise (SLR), active knee extension (AKE) tests for ROM, visual analogue scale (VAS) for perceived stiffness and kinetic parameters which are recorded and calculated by Moticon SCIENCE insoles during four functional performance task of single leg stance (SLS), slow and fast walking and running. RESULTS: ROM, stiffness, and kinetic parameters examined with insoles during SLS and walking tasks changed in both the intervention and control groups (P < 0.05). Furthermore, study groups were different in some variables. The increase in ROM in SLR test and the decrease in perceived stiffness in the intervention group were more evident than in the control group (P = 0.03 and P = 0.001, respectively). There was no difference between the intervention and control groups for the variables in SLS test, slow and fast walking, and running tasks, except for the mean swing duration (MSWD) (P = 0.002) in fast walking. CONCLUSION: The static stretching alone and the kinesio tape plus static stretching could change many of the kinetic parameters during walking and balance tasks, but the rate of these changes were more significant with kinesio tape plus stretching compared to the stretching alone.

The Comparison of the Effectiveness of Respiratory Physiotherapy Plus Myofascial Release Therapy Versus Respiratory Physiotherapy Alone on Cardiorespiratory Parameters in Patients With COVID-19.

Background: Respiratory involvement is a common consequence of COVID-19; changes in cardiorespiratory parameters of these patients during respiratory rehabilitation program are very important. Previous studies showed that myofascial release therapy (MFRT) could affect the respiratory muscle and adjunct fascia. Purpose: The aim of this study was to evaluate the effects of MFRT techniques and respiratory physiotherapy, in comparison with respiratory physiotherapy alone, on improving cardiorespiratory parameter in patients with COVID-19. Setting: A hospital affiliated to Tehran University of Medical Sciences in Tehran, Iran, from February to July 2021. Participants: Fifty patients with COVID-19 participated in this study. Research Design: A single-blind, randomized control design. Intervention: The patients with COVID-19 randomly assigned to an intervention group who received respiratory physiotherapy combined with MFRT or a control group receiving respiratory physiotherapy alone. Main Outcome Measures: Heart rate, systolic and diastolic blood pressure, respiration rate, oxygen saturation, chest expansion, and ease of breathing were assessed at baseline and after the first and third session of treatment. Dyspnea and fatigue perception and 6-minute walking were assessed at baseline and at the end of treatment. Patient's thoughts about the treatment were examined through the 4-point Likert scale. Results: The ANOVAs found significant time effect for ease of breathing, dyspnea perception (F = 32.33, p < .01 and F = 11.72, p < .01, respectively). Also significant time by group interaction was found for chest expansion at xiphoid level (F = 4.02, p = .02). Conclusions: The present study provided evidence that both programs could result in improving ease of breathing and dyspnea perception, although the inclusion of MFR techniques into a respiratory physiotherapy program did not result in better outcomes in cardiorespiratory function of patients with COVID-19.

Efficacy of whole body vibration on neurocognitive parameters in women with and without lumbar hyper-lordosis.

INTRODUCTION: The prevalence of lumbar hyper-lordosis is high in young women. Considering the previous studies into the effects of the whole body vibration (WBV) on the physiological parameters, the present study aimed to evaluate the immediate effects of WBV on the neurocognitive parameters in women with and without lumbar hyper-lordosis. METHOD: A total of 15 women with normal lumbar lordosis and 15 women with lumbar hyper-lordosis participated in the study. The effects of the WBV (30 Hz, 5 mm, and 5 min) on the visual and auditory reaction time and anticipatory skills were assessed using the Speed Anticipation Reaction Time (SART) Test. RESULTS: The results indicated that the auditory complex choice reaction time decreased, and the anticipation skill with high speed increased after the WBV in women with normal lumbar lordosis (P = 0.01, P = 0.01, respectively). Additionally, the visual choice reaction time in women with lumbar hyperlordosis significantly decreased after WBV intervention. Although other variables in the two groups decreased after vibration, these changes were not statistically significant. CONCLUSION: The present study demonstrated that WBV had positive immediate effects on the reaction time in both groups, however, it had negative effects on anticipatory skill with high speed in women with normal lumbar lordosis; these negative effects appeared to be due to mental fatigue in the participants. This finding indicated WBV had the potential to enhance neuro-cognition. Therefore, further evaluations with different study settings and populations should be conducted.

Improvements in strength and functional performance after Kinesio taping in semi-professional male soccer players with and without functional ankle instability.

OBJECTIVE: The objectives of this study were to compare the immediate effects of two methods of Kinesio taping on muscle strength, functional performance, and balance in athletes with and without functional ankle instability (FAI). METHODS: The present study investigated the effects of distal taping (muscle application over peroneus longus) and proximal- distal taping (muscle application over gluteus medius and peroneus longus) on the strength of evertor and hip abductor muscles, side hop test, figure of 8 hop test, and star excursion balance test in semi-professional male soccer players with and without FAI (n=15 in each group). A Multifactorial repeated measure ANOVA was used for comparison. RESULTS: There were significant differences for factor effect in all outcome measures (P<0.05), except for the figure of 8 hop test. No significant differences for group effects and group by factor interaction effects (P>0.05) was observed except for the side hop test. CONCLUSION: Kinesio taping had immediate effects on improving strength, performance and balance. However, there were no differences on the method of application. Clinicians can consider the application Kinesio taping during the rehabilitation process of athletes with FAI, to improve balance and strength. The long-term impacts of taping on the functional, balance and strength measures should be investigated in future studies.

Muscle timing in injured and non-injured leg of athletes with chronic ankle instability in response to a visual stimulus during forward jumping.

OBJECTIVE: The aim of this study was to investigate premotor time, motor time and reaction time of the injured and non-injured leg muscles of athletes with chronic ankle instability in response to a visual stimulus during forward jumping. METHODS: Surface electromyography was performed on injured and non-injured leg of eight athletes with chronic ankle instability during forward jumping. RESULTS: Results showed that premotor time of the peroneus longus was significantly longer in non-injured leg compared with injured leg (489.37 ± 220.22 ms vs. 306.46 ± 142.92 ms, P = 0.031); on the contrary, motor time of the peroneus longus was significantly shorter in non-injured leg compared with injured leg (569.04 ± 318.62 ms vs. 715.12 ± 328.72 ms, P = 0.022). No significant difference was noted in the timing of other calf muscles (P > 0.05). CONCLUSION: According to the results of this study, rehabilitation protocols, regarding ankle instability, need to put greater emphasis on tasks that require proper timing of muscles and muscle re-education so that protocols could reduce residual symptoms after sprain and prevent recurrent sprains.