Effects of neurorehabilitation with and without dry needling technique on muscle thickness, reflex torque, spasticity and functional performance in chronic ischemic stroke patients with spastic upper extremity muscles: a blinded randomized sham-controlled clinical trial.

PURPOSE: Evaluation the effects of dry needling on sonographic, biomechanical and functional parameters of spastic upper extremity muscles. METHODS: Twenty-four patients (35-65 years) with spastic hand were randomly allocated into two equal groups: intervention and sham-controlled groups. The treatment protocol was 12-sessions neurorehabilitation for both groups and 4-sessions dry needling or sham-needling for the intervention group and sham-controlled group respectively on wrist and fingers flexor muscles. The outcomes were muscle thickness, spasticity, upper extremity motor function, hand dexterity and reflex torque which were assessed before, after the 12th session, and after one-month follow-up by a blinded assessor. RESULTS: The analysis showed that there was a significant reduction in muscle thickness, spasticity and reflex torque and a significant increment in motor function and dexterity in both groups after treatment (p < 0.01). However, these changes were significantly higher in the intervention group (p < 0.01) except for spasticity. Moreover, a significant improvement was seen in all outcomes measured one-month after the end of the treatment in the intervention group (p < 0.01). CONCLUSIONS: Dry needling plus neurorehabilitation could decrease muscle thickness, spasticity and reflex torque and improve upper-extremity motor performance and dexterity in chronic stroke patients. These changes were lasted one-month after treatment.Trial Registration Number: IRCT20200904048609N1IMPLICATION FOR REHABILITATIONUpper extremity spasticity is one of the stroke consequences which interfere with motor function and dexterity of patient hand in activity of daily livingApplying the dry needling accompanied with neurorehabilitation program in post-stroke patients with muscle spasticity can reduce the muscle thickness, spasticity and reflex torque and improve upper extremity functions.

The effect of perturbation training with and without applying the dry needling on leg muscles in patients with chronic ankle sprain.

INTRODUCTION: Ankle sprain is a common musculoskeletal injury that leads to recurrent instability. Repeated ankle sprain can be a mechanism for creating trigger point. Proper treatment of trigger points, in addition to preventing recurrence of sprains, may reduce pain and improve muscle function. This improvement can be the result of preserving the surrounding tissues from excessive pressure. OBJECTIVE: Investigate the added value of dry needling into perturbation training protocol for chronic ankle sprain. DESIGN: Randomized clinical trial; assessor-blind; before and after comparison. SETTING: Treatment of patients referred to the institutional rehabilitation clinics. MAIN OUTCOME MEASURE(S): Functional assessment with FAAM questionnaire score, Pain with NPRS scale, ankle instability severity with Cumberland tool. METHODS: Twenty-four patients with chronic ankle instability participated in this clinical trial and were randomly divided into two groups. Intervention was 12 sessions in which one group received only perturbation training and the other group received perturbation training along with dry needling. Repeated measures ANOVA was used to investigate the effect of treatment. RESULTS: Data Analysis showed significant difference in NPRS and FAAM and Cumberland score before and after treatment in each group (P < 0.001). Comparison of the results between the groups did not show any significant difference (P > 0.05). CONCLUSION: The findings showed that adding dry needling technique to the perturbation training does not have greater effects on the pain and function of patients with chronic ankle instability.

Suspended sediment load prediction based on soft computing models and Black Widow Optimization Algorithm using an enhanced gamma test.

The suspended sediment load (SSL) prediction is one of the most important issues in water engineering. In this article, the adaptive neuro-fuzzy interface system (ANFIS) and support vector machine (SVM) were used to estimate the SLL of two main tributaries of the Telar River placed in the north of Iran. The main Telar River had two main tributaries, namely, the Telar and the Kasilian. A new evolutionary algorithm, namely, the black widow optimization algorithm (BWOA), was used to enhance the precision of the ANFIS and SVM models for predicting daily SSL. The lagged rainfall, temperature, discharge, and SSL were used as the inputs to the models. The present study used a new hybrid Gamma test to determine the best input scenario. In the next step, the best input combination was determined based on the gamma value. In this research, the abilities of the ANFIS-BWOA and SVM-BWOA were benchmarked with the ANFIS-bat algorithm (BA), SVM-BA, SVM-particle swarm optimization (PSO), and ANFIS-PSO. The mean absolute error (MAE) of ANFIS-BWOA was 0.40%, 2.2%, and 2.5% lower than those of ANFIS-BA, ANFIS-PSO, and ANFIS models in the training level for Telar River. It was concluded that the ANFIS-BWOA had the highest value of R2 among other models in the Telar River. The MAE of the ANFIS-BWOA, SVM-BWOA, SVM-PSO, SVM-BA, and SVM models were 899.12 (Ton/day), 934.23 (Ton/day), 987.12 (Ton/day), 976.12, and 989.12 (Ton/day), respectively, in the testing level for the Kasilian River. An uncertainty analysis was used to investigate the effect of uncertainty of the inputs (first scenario) and the model parameters (the second scenario) on the accuracy of models. It was observed that the input uncertainty higher than the parameter uncertainty.

Comparison between massage and routine physical therapy in women with sub acute and chronic nonspecific low back pain.

OBJECTIVE: The aim of this study was to investigate the comparison of massage therapy and routine physical therapy on patients with sub acute and chronic nonspecific low back pain. METHODS AND MATERIALS: Thirty volunteer female subjects with a sub acute or chronic nonspecific low back pain were randomly enrolled in two groups, massage therapy and routine physical therapy. After massage application, the hamstring and paravertebral muscles stretching and also stabilizing exercises were prescribed. In the routine physical therapy group, TENS, US and vibrator were used besides exercises. Pain intensity according to Numerical Rating Scale, functional disability level in accordance to Oswestry Disability Index, and modified Schober test, for measurement of flexion range of motion, before and after ten sessions of treatment were used to evaluate the effectiveness of the treatment. RESULTS: Pain intensity, Oswestry Disability Index and flexion range of motion had shown significant differences before and after intervention in both groups (p<0.001). The statistical analysis revealed that the massage therapy had significantly improved the pain intensity and Oswestry Disability Index compared to routine physical therapy (p=0.015, p=0.013 respectively), but the range of motion changes were not significant between two groups (p=1.00). CONCLUSION: It can be concluded that both massage therapy and routine physical therapy are useful for sub acute and chronic nonspecific low back pain treatment especially if accompanied with exercise. However, massage is more effective than other electrotherapy modalities, and it can be used alone or with electrotherapy for the treatment of patients with low back pain.