The Effect of Combined Intervention on Improvement of Early Lexical Development in Minimally Verbal Children with Autism Spectrum Disorder.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by severe communication deficits and limited and repetitive behavioral tendencies. There are several treatment approaches and methods for minimally verbal children with ASD; nonetheless, there is inconclusive evidence about how early lexical development could be improved. The present study aimed to investigate the effect of combined intervention derived from the principles of different theories-including contemporary behaviorism, schemas, sociocultural, and event representation theories-to improve early lexical development in minimally verbal children with ASD. Methods: In this single-group pretest-posttest study, 10 children with ASD (mean age, 47.9 ± 8.3 months), including 7 boys and 3 girls, participated. Participants received 16 intervention sessions in 8 weeks. The combined intervention consisted of various methods derived from contemporary behaviorism, schemas, sociocultural, and event representation approaches. The MacArthur-Bates Communicative Development Inventory 1 (Infant form) assessed early lexical development before and after intervention and after a 2-month follow-up. The Friedman test was used to analyze the data, and pairwise comparisons were performed with the Will-Coxon test. Cohen's d was used to investigate the effect sizes. Results: Significant increases in expressive vocabulary (P < 0.001) and receptive language (P < 0.001) were seen after the end of the intervention and at the follow-up (P = 0.005). Large effect sizes were found for expressive vocabulary (d = 3.7) and receptive vocabulary (d = 2.17). Conclusion: This study suggests that the combination of intervention based contemporary behaviorism, schemas, sociocultural, and event representation approaches improved receptive and expressive vocabulary in minimally verbal children with ASD.

Narrative Microstructure and Macrostructure Skills of Persian-Speaking Children with Autism Spectrum Disorder.

Background: Studies examining narrative production skills in children with autism spectrum disorder (ASD) have demonstrated variable and inconsistent results. This study aimed to investigate to what extent narrative difficulties in children with ASD reflect difficulties with language. Methods: Accordingly, the spoken narrative skills of 16 children with ASD were compared with those of their 16 chronological age-matched (CAM) and 16 language-matched (LM) peers. A Kruskal-Wallis non-parametric test was then used to examine the differences between groups in regard to NTC, NSG and SI variables .For other studied variables (NTW, number of T-units, ATL and total score), one-way analysis of variances (ANOVA) was also used. Results: At the level of microstructure, the results showed that productivity (number of total words, total clauses, and T-unites) and syntactic complexity (average of T-unit length and subordination index) were predominantly similar in ASD and LM children. However, children with ASD scored lower than their CAM counterparts (P < 0.001). At the macrostructure level, we found that the total score of story grammar elements and the number of story grammars in the narrative production of children with ASD were lower than those in both CAM and LM children (P < 0.001). Conclusion: The present study, thus, showed that creating a coherent narrative could be more demanding for children with ASD than productivity and syntactic complexity.

Cross-cultural Adaption, Validation and Factor Analysis of the Persian Version of the Eating Assessment Tool: EAT-10.

The eating assessment tool (EAT-10) is a self-reported questionnaire to assess the patient's perception of swallowing difficulties. The aim of this study was to cross-culturally adapt and determine validity and reliability of the Persian version of the EAT-10 (P-EAT-10) in patients with oropharyngeal dysphagia. The EAT-10 was translated into Persian language and cross-culturally adapted. One hundred patients with dysphagia (mean age ± SD = 44.44 ± 14.69 years) participated. The test-retest reliability (time interval = 7 days) was assessed in 50 patients. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable change (SDC) were analyzed. The Persian version of functional oral intake scale (FOIS-P) was also recorded to assess construct validity. One hundred healthy subjects completed the P-EAT-10 for clinical validity. Factor analysis was performed to determine the P-EAT-10 structure. There were no missing responses and floor or ceiling effects. Internal consistency was high (Cronbach's α 0.91). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.62-0.83). The test-retest reliability was excellent [(ICC)agreement 0.96]. The SEM and SDC were 2.61 and 7.23, respectively. Construct validity was confirmed by a significant correlation between the P-EAT-10 and FOIS-P scores (r = 0.84). Clinical validity was supported by a significant discrimination between patients and healthy subjects (t = 29.97, P < 0.001). Factor analysis indicated 2 components for the P-EAT-10. The P-EAT-10 is a valid and reliable tool and can be used in clinic and research for the assessment of oropharyngeal dysphagia in Persian-speaking patients.

Occupational Performance Outcome for Survivors of Childhood Cancer: Feasibility of the Canadian Occupational Performance Measure.

The aim of the study was to determine the feasibility of the Persian version of the Canadian Occupational Performance Measure (COPM) to assess self-reported occupational performance in a group of children with cancer at least one-year post-cancer diagnosis and intervention and to describe the self-reported occupational performance problems of children with cancer. Forty-three children with cancer (mean age 11.59 years; SD 4.94) participated in a cross-sectional study, using a convenience sampling approach. Performance and satisfaction were assessed through a validated Persian version of the COPM and feasibility and ease of administration were also considered. This study showed that feasibility was found to be adequate and this measurement was perceived as easy to understand; completion took from 20 to 51 minutes. Children with cancer prioritized 115 occupations within six of the nine COPM subcategories. Among the prioritized occupations, the highest number was found in self-care 61.7%, followed by productivity (26%), and leisure (12.1%). The mean ratings of performance varied from 3.7 to 8.4. The lowest mean rating was in the subgroup play/school (3.7). For satisfaction, the mean ratings were from 2.6 to 5.2, with functional mobility as the highest and play/school the lowest. The results support the use of the COPM in clinical practice for children with cancer. Based on these findings, children with cancer perceive problems with occupations related to all aspects of daily life. This underlines the need to provide rehabilitation services, especially occupational therapy services for these children.

The Persian Brief Illness Perception Questionnaire: Validation in Patients with Chronic Nonspecific Low Back Pain.

BACKGROUND: Illness perceptions may influence coping behaviors as well as treatment and recovery among patients with chronic pain including low back pain (LBP). These perceptions may vary across different conditions. The Brief Illness Perception Questionnaire (BIPQ) is used as an instrument to assess the patients' perception of illness. Although the BIPQ has been previously translated into Persian, its psychometric properties have not been evaluated among patients with chronic nonspecific LBP. The aim of this study was to determine the reliability and validity of the Persian BIPQ in patients with chronic nonspecific LBP. METHODS: 116 patients with chronic nonspecific LBP with a mean (standard deviation) age of 36.4 years (10.7) participated in this cross-sectional study. Fifty patients were reexamined after 10 to 12 days for test-retest reliability. Internal consistency reliability, construct validity, concurrent criterion validity, and structural validity were evaluated. The concurrent validity was examined by using the Short Form-36 Health Survey. RESULTS: There were no floor and ceiling effects. Cronbach's alpha for the total score was 0.90. The intraclass correlation coefficient (ICC) for test-retest reliability was 0.90. The standard error of measurement and the minimal detectable change was found to be 3.26 and 9.04, respectively. The convergent correlations confirmed the construct validity. The concurrent criterion validity was demonstrated by significant negative correlations with the SF-36. The Exploratory Factor Analysis produced the 2 factors (emotional illness representations and cognitive illness representations) with an eigenvalue >1.0 that jointly accounted for 58.86% of the total variance. CONCLUSION: The Persian BIPQ is a reliable and 2-factor instrument and can be used for assessing illness perception in patients with chronic nonspecific LBP.

Therapeutic ultrasound for chronic low back pain.

BACKGROUND: This is an update of a Cochrane Review published in 2014. Chronic non-specific low back pain (LBP) has become one of the main causes of disability in the adult population around the world. Although therapeutic ultrasound is not recommended in recent clinical guidelines, it is frequently used by physiotherapists in the treatment of chronic LBP. OBJECTIVES: The objective of this review was to determine the effectiveness of therapeutic ultrasound in the management of chronic non-specific LBP. A secondary objective was to determine the most effective dosage and intensity of therapeutic ultrasound for chronic LBP. SEARCH METHODS: We performed electronic searches in CENTRAL, MEDLINE, Embase, CINAHL, PEDro, Index to Chiropractic Literature, and two trials registers to 7 January 2020. We checked the reference lists of eligible studies and relevant systematic reviews and performed forward citation searching. SELECTION CRITERIA: We included randomised controlled trials (RCTs) on therapeutic ultrasound for chronic non-specific LBP. We compared ultrasound (either alone or in combination with another treatment) with placebo or other interventions for chronic LBP. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the risk of bias of each trial and extracted the data. We performed a meta-analysis when sufficient clinical and statistical homogeneity existed. We determined the certainty of the evidence for each comparison using the GRADE approach. MAIN RESULTS: We included 10 RCTs involving a total of 1025 participants with chronic LBP. The included studies were carried out in secondary care settings in Turkey, Iran, Saudi Arabia, Croatia, the UK, and the USA, and most applied therapeutic ultrasound in addition to another treatment, for six to 18 treatment sessions. The risk of bias was unclear in most studies. Eight studies (80%) had unclear or high risk of selection bias; no studies blinded care providers to the intervention; and only five studies (50%) blinded participants. There was a risk of selective reporting in eight studies (80%), and no studies adequately assessed compliance with the intervention. There was very low-certainty evidence (downgraded for imprecision, inconsistency, and limitations in design) of little to no difference between therapeutic ultrasound and placebo for short-term pain improvement (mean difference (MD) -7.12, 95% confidence interval (CI) -17.99 to 3.75; n = 121, 3 RCTs; 0-to-100-point visual analogue scale (VAS)). There was also moderate-certainty evidence (downgraded for imprecision) of little to no difference in the number of participants achieving a 30% reduction in pain in the short term (risk ratio 1.08, 95% CI 0.81 to 1.44; n = 225, 1 RCT). There was low-certainty evidence (downgraded for imprecision and limitations in design) that therapeutic ultrasound has a small effect on back-specific function compared with placebo in the short term (standardised mean difference -0.29, 95% CI -0.51 to -0.07 (MD -1.07, 95% CI -1.89 to -0.26; Roland Morris Disability Questionnaire); n = 325; 4 RCTs), but this effect does not appear to be clinically important. There was moderate-certainty evidence (downgraded for imprecision) of little to no difference between therapeutic ultrasound and placebo on well-being (MD -2.71, 95% CI -9.85 to 4.44; n = 267, 2 RCTs; general health subscale of the 36-item Short Form Health Survey (SF-36)). Two studies (n = 486) reported on overall improvement and satisfaction between groups, and both reported little to no difference between groups (low-certainty evidence, downgraded for serious imprecision). One study (n = 225) reported on adverse events and did not identify any adverse events related to the intervention (low-certainty evidence, downgraded for serious imprecision). No study reported on disability for this comparison. We do not know whether therapeutic ultrasound in addition to exercise results in better outcomes than exercise alone because the certainty of the evidence for all outcomes was very low (downgraded for imprecision and serious limitations in design). The estimate effect for pain was in favour of the ultrasound plus exercise group (MD -21.1, 95% CI -27.6 to -14.5; n = 70, 2 RCTs; 0-to-100-point VAS) at short term. Regarding back-specific function (MD - 0.41, 95% CI -3.14 to 2.32; n = 79, 2 RCTs; Oswestry Disability Questionnaire) and well-being (MD -2.50, 95% CI -9.53 to 4.53; n = 79, 2 RCTs; general health subscale of the SF-36), there was little to no difference between groups at short term. No studies reported on the number of participants achieving a 30% reduction in pain, patient satisfaction, disability, or adverse events for this comparison. AUTHORS' CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP.

Dry Needling for Hamstring Flexibility: A Single-Blind Randomized Controlled Trial.

CONTEXT: Hamstring muscle tightness is one of the most common problems in athletic and healthy people. Dry needling (DN) was found to be an effective approach for improving muscle flexibility, but there is no study to compare this approach with static stretching (SS) as a common technique for the increase of muscle length. OBJECTIVE: To compare the immediate effects of DN and SS on hamstring flexibility in healthy subjects with hamstring tightness. STUDY DESIGN: A single-blind randomized controlled trial. SETTING: A musculoskeletal physiotherapy clinic at Tehran University of Medical Sciences. SUBJECTS: Forty healthy subjects (female: 32, age range: 18-40 y) with hamstring tightness were randomly assigned into 2 groups of DN and SS. INTERVENTION: The DN group received a single session of DN on 3 points of the hamstring muscles, each for 1 minute. The SS group received a single session of SS of the hamstrings, consisting of 3 sets of 30-second SS with a 10-second rest between sets in the active knee extension test (AKET) position. MAIN OUTCOME MEASURES: The AKET, muscle compliance, passive peak torque, and stretch tolerance were measured at the baseline, immediately, and 15 minutes after the interventions. RESULTS: Improvements in all outcomes was better for the DN group than for the SS group. DN increased muscle compliance significantly 15 minutes after the intervention, but it did not improve in the SS group. CONCLUSION: DN is effective in improving hamstring flexibility compared with SS. One session of DN can be an effective treatment for hamstring tightness and increase hamstring flexibility. The improvements suggest that DN is a novel treatment for hamstring flexibility.

Reliability and validity of the Persian adaptation of the Core Outcome Measure Index in patients with chronic low back pain.

BACKGROUND: The purpose of the study was to determine whether the Persian Core Outcome Measures Index (PCOMI) is reliable and valid in patients with chronic low back pain (CLBP). METHODS: The Persian COMI was developed using forward-backward translational method. Subjects were100 patients with CLBP. Patients completed the PCOMI, Persian functional rating index, and visual analog scale. Fifty patients completed the PCOMI for the second time after 7days to evaluate test-retest reliability. Fifty healthy subjects participated to assess discriminant validity. RESULTS: There was no ceiling or floor effect. Cronbach's alpha was 0.85. The construct validity coefficient was 0.72. The ICCagreement for test-retest reliability was 0.86. Pearson correlation for criterion validity was 0.70. The PCOMI discriminated between patients and healthy subjects. The standard error of measurement and the smallest detectable change was 0.75 and 2.1, respectively. Factor analysis extracted 1 component. CONCLUSIONS: The results support the reliability and validity of the PCOMI for assessing patients with CLBP.

Simple shoulder test and Oxford Shoulder Score: Persian translation and cross-cultural validation.

PURPOSE: To translate, culturally adapt, and validate the simple shoulder test (SST) and Oxford Shoulder Score (OSS) into Persian language using a cross-sectional and prospective cohort design. METHODS: A standard forward and backward translation was followed to culturally adapt the SST and the OSS into Persian language. Psychometric properties of floor and ceiling effects, construct convergent validity, discriminant validity, internal consistency reliability, test-retest reliability, standard error of the measurement (SEM), smallest detectable change (SDC), and factor structure were determined. RESULTS: One hundred patients with shoulder disorders and 50 healthy subjects participated in the study. The PSST and the POSS showed no missing responses. No floor or ceiling effects were observed. Both the PSST and POSS detected differences between patients and healthy subjects supporting their discriminant validity. Construct convergent validity was confirmed by a very good correlation between the PSST and POSS (r = 0.68). There was high internal consistency for both the PSST (α = 0.73) and the POSS (α = 0.91 and 0.92). Test-retest reliability with 1-week interval was excellent (ICCagreement = 0.94 for PSST and 0.90 for POSS). Factor analyses demonstrated a three-factor solution for the PSST (49.7 % of variance) and a two-factor solution for the POSS (61.6 % of variance). The SEM/SDC was satisfactory for PSST (5.5/15.3) and POSS (6.8/18.8). CONCLUSIONS: The PSST and POSS are valid and reliable outcome measures for assessing functional limitations in Persian-speaking patients with shoulder disorders.

Therapeutic ultrasound for chronic low-back pain.

BACKGROUND: Chronic non-specific low-back pain (LBP) has become one of the main causes of disability in the adult population around the world. Therapeutic ultrasound is frequently used by physiotherapists in the treatment of LBP and is one of the most widely used electro-physical agents in clinical practice. OBJECTIVES: The objective of this review is to determine the effectiveness of therapeutic ultrasound in the management of chronic non-specific LBP. SEARCH METHODS: Electronic searches were performed using CENTRAL, MEDLINE, EMBASE, PEDro, and PsycLIT databases in October 2013. Reference lists of eligible studies and relevant systematic reviews were checked and forward citation searching was also performed. SELECTION CRITERIA: Randomised controlled trials on therapeutic ultrasound for non-specific chronic LBP were included. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the risk of bias of each trial and extracted the data. When sufficient clinical and statistical homogeneity existed, a meta-analysis was performed. The quality of the evidence for each comparison was determined using the GRADE approach. MAIN RESULTS: Seven small randomised controlled trials involving a total of 362 participants with chronic LBP were included. Two of the studies had a low risk of bias, meeting six or more of the 12 criteria used for assessing risk of bias. All studies were carried out in secondary care settings and most applied therapeutic ultrasound in addition to exercise therapy, at various intensities for six to 18 treatment sessions. There was moderate quality evidence that therapeutic ultrasound improves back-specific function (standardised mean difference (SMD) [95%CI] -0.45 [-0.84 to -0.05]) compared with placebo in the short term. There was low quality evidence that therapeutic ultrasound is no better than placebo for short-term pain improvement (mean difference (MD) [95%CI] -7.12 [-17.99 to 3.75]; zero to100-point scale). There was low quality evidence that therapeutic ultrasound plus exercise is no better than exercise alone for short-term pain improvement (MD [95%CI] -2.16 [-4.66 to 0.34]; zero to 50-point scale), or functional disability (MD [95%CI] -0.41 [-3.14 to 2.32]; per cent). The studies comparing therapeutic ultrasound versus placebo or versus exercise alone did not report on overall satisfaction with treatment, or quality of life. There was low quality evidence that spinal manipulation reduces pain and functional disability more than ultrasound over the short to medium term. There is also very low quality evidence that there is no clear benefit on any outcome measure between electrical stimulation and therapeutic ultrasound; and that phonophoresis results in improved SF-36 scores compared to therapeutic ultrasound. None of the included studies reported on adverse events related to the application of therapeutic ultrasound. AUTHORS' CONCLUSIONS: No high quality evidence was found to support the use of ultrasound for improving pain or quality of life in patients with non-specific chronic LBP. There is some evidence that therapeutic ultrasound has a small effect on improving low-back function in the short term, but this benefit is unlikely to be clinically important. Evidence from comparisons between other treatments and therapeutic ultrasound for chronic LBP were indeterminate and generally of low quality. Since there are few high quality randomised trials and the available trials are very small, future large trials with valid methodology are likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

From Editorial Board of Special Issue Entitled "Post-Stroke Rehabilitation".

Diseases affecting the nervous system are diverse [...].

Developing a Content Model of a Mobile-Based Application to Manage Patients with Low-Back and Neck Pain.

Introduction: As a complementary tool in health, the design of mobile applications to influence care and increase awareness of patients has grown a lot. The purpose of this study is to design and validate the content model of a mobile-based application for managing patients with low-back and neck pain. Methods: This descriptive-analytical study was conducted in two main stages to determine the content model of the application. The first stage consisted of three steps: finding the right exercise, determining the right scale to assess the pain intensity, and determining the appropriate features of the application. In the second stage, data elements collected from the previous stage were prepared in the form of a questionnaire that was given to 12 experts in physical therapy and sports medicine for validation. After collecting the questionnaire, data elements in all parts were analyzed based on the content validity ratio (CVR) and descriptive statistics indicators. Result: The content of the application was prepared in the three axes of exercises for low-back and neck pain, assessment of pain intensity, and features of the application. In the axis of sports exercises, 8 exercises for back pain and 3 exercises for neck pain were included according to the reference books. A Functional Rating Index (FRI) scale with 10 elements was selected in the axis of determining pain intensity. Also, 12 features such as the daily exercise section, using the animation, and using an audio file to explain how to do exercises were included in the model. Conclusion: According to the gaps identified in the existing applications, determining the content model of the application that is based on evidence and according to the opinion of experts is useful in improving the apps. The content model of this study was presented in 3 axes to increase the patient's willingness to do exercises, the correct way to perform exercises, conservative treatment, and check the progress of the treatment. The software developers can use these findings as a basis for designing new apps to manage low-back pain and neck pain.

Efficacy of trigger point dry needling on pain and function of the hip joint: a systematic review of randomized clinical trials.

OBJECTIVE: The objective of this study was to assess the evidence for the impact of dry needling (DN) on hip pain and function. METHODS: Medline/PubMed, Embase, Scopus, Web of Science and Cochrane CENTRAL databases were searched systematically through June 2022 for randomized clinical trials (RCTs) investigating the impact of DN on hip pain and function. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias. Descriptive analysis was conducted to explain the outcomes and adverse events of DN in hip joint diseases. Meta-analysis was not feasible due to significant heterogeneity. RESULTS: A total of seven eligible studies (including 273 patients) were included out of 2152 screened records. Five studies were in participants with hip osteoarthritis (OA; n = 3), greater trochanteric pain syndrome (GTPS; n = 1) or piriformis syndrome (n = 1); the other two studies were conducted in healthy athletes (n = 2). Two articles assessed changes in participants' short-term visual analog scale (VAS) scores (<1 week), one of which showed that DN significantly reduced pain (P < 0.05). One-week VAS scores were analyzed in three studies, all of which demonstrated reduced scores following DN (P < 0.05). Hip range of motion (ROM) and muscle force were also improved following DN. No serious side effects were reported. CONCLUSION: DN may be safe and effective at relieving hip pain and improving hip function. DN performs significantly better than several different types of control intervention (including sham DN, no treatment, corticosteroid injections and laser). Strong evidence (high degree of certainty around the results) is lacking, and future studies should ideally use longer follow-up periods and larger sample sizes. REVIEW REGISTRATION NUMBER: CRD42022297845 (PROSPERO).

Effects of dry needling on spasticity and motor function in paralympic athletes: a study protocol for a randomised controlled trial.

No study has evaluated the effects of dry needling on Paralympic athletes. Therefore, in this study, we will evaluate the effect of dry needling on lower limb spasticity and motor performance, as well as the range of motion of Paralympic athletes. The study will be a triple-blinded, randomised controlled trial. Twenty-four athletes aged 18-45 in T35-T38 groups of the International Paralympic Committee classification will be included in the study. Twelve participants will receive dry needling of the quadriceps and gastrocnemius muscles, and 12 will receive placebo treatment with sham needles at similar points. We will assess the spasticity of the quadriceps and gastrocnemius muscles using the Modified Ashworth Scale, evaluate motor function using the Selective Control Assessment of the Lower Extremity Scale and measure ankle range of motion (ROM) with a goniometer. Considering our hypothesis, the athletes who will undergo the dry needling are supposed to achieve better improvements in spasticity, ROM and motor performance. This study can provide useful information to help better decide on managing complications in Paralympics and its long-term outcomes, to cover the current lack in the literature.

The assessment methods of laryngeal muscle activity in muscle tension dysphonia: a review.

The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

Effects of dry needling session frequency on wrist flexor spasticity and motor recovery after stroke: a single-blind randomized clinical trial.

BACKGROUND: Determining the optimal number of dry needling (DN) sessions to satisfactorily treat a stroke patient with spasticity is important from both clinical and economic perspective. OBJECTIVE: To explore the effects of one versus three sessions of DN on spasticity of the wrist flexors and motor recovery after stroke. METHODS: In this single-blind randomized clinical trial, 24 patients were randomly and equally divided into two groups: one group received one session of DN, while the other group received three sessions of DN in one week. Both groups received one minute of DN of the flexor carpi radialis and flexor carpi ulnaris. The outcome measures were the Modified Modified Ashworth Scale (MMAS), passive resistance torque (PRT), wrist active and passive extension range of motion (ROM), and the Brunnstrom Stages of Stroke Recovery (BSSR) measured before, immediately after, and one week after the last DN session. RESULTS: Both groups demonstrated a significant improvement in all outcomes (p < .05). The MMAS scores in both groups meaningfully improved (p < .001). No significant differences were found between the two groups; however, a significant time-by-group interaction was observed for the PRT (p = .02; Cohen's d = 0.23-0.73), wrist active extension ROM (p = .001; Cohen's d = 0.37-0.67), and wrist passive extension ROM (p = .02; Cohen's d = 0.32-1.30). The BSSR significantly improved from 3 to 4 in both groups (p < .001). CONCLUSION: Administering three sessions of DN can effectively improve spasticity and motor function after stroke.

Telestroke: A Novel Approach for Post-Stroke Rehabilitation.

Despite the tremendous technologic advancements of recent years, the prevalence of stroke has increased significantly worldwide from 1990 to 2019 (a 70 [...].

Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial.

Background: : Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods: : A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and Hmax - Mmax ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion: : The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR.

Brain Analysis with a Complex Network Approach in Stroke Patients Based on Electroencephalography: A Systematic Review and Meta-Analysis.

BACKGROUND AND PURPOSE: Brain function can be networked, and these networks typically present drastic changes after having suffered a stroke. The objective of this systematic review was to compare EEG-related outcomes in adults with stroke and healthy individuals with a complex network approach. METHODS: The literature search was performed in the electronic databases PubMed, Cochrane and ScienceDirect from their inception until October 2021. RESULTS: Ten studies were selected, nine of which were cohort studies. Five of them were of good quality, whereas four were of fair quality. Six studies showed a low risk of bias, whereas the other three studies presented a moderate risk of bias. In the network analysis, different parameters such as the path length, cluster coefficient, small-world index, cohesion and functional connection were used. The effect size was small and not significant in favor of the group of healthy subjects (Hedges'g = 0.189 [-0.714, 1.093], Z = 0.582, p = 0.592). CONCLUSIONS: The systematic review found that there are structural differences between the brain network of post-stroke patients and healthy individuals as well as similarities. However, there was no specific distribution network to allows us to differentiate them and, therefore, more specialized and integrated studies are needed.

Comparison of the immediate effects of plantar vibration of both feet with the plantar vibration of the affected foot on balance in patients with stroke: Preliminary findings.

OBJECTIVE: Plantar vibration is one of the strategies to enhance balance in stroke patients. This study compared the effects of the plantar vibration of both feet and the plantar vibration of the most affected side in patients with stroke. METHODS: This study was a single-blind clinical trial. Post-stroke patients with balance impairment were enrolled in the study and underwent two treatment sessions with a one-week interval. They received both feet's plantar vibration in one session and plantar vibration of the most affected side in the other session (frequency 100 Hz, 5 min). Mini-BESTest, Modified Modified Ashworth Scale (MMAS), and Semmes-Weinstein monofilament examination (SWME) were used to evaluate balance, spasticity, and plantar sensation, before and after the treatment sessions. RESULTS: Ten patients with a mean age of 52.9 (SD = 5.48) years were enrolled in the study. Mini-BESTest scores of balance and plantar flexor muscle spasticity were significantly improved after both feet plantar vibration and plantar vibration of the more affected side. There was no significant difference between the effectiveness of both sides plantar vibration and the most affected side plantar vibration. There were no significant improvements in SWME sensory scores after plantar vibration of either both sides or the most affected side. CONCLUSION: Plantar vibration of both sides had no additional benefits in this group of patients with chronic stroke. Plantar vibration of more affected side can be used for improving balance and plantar flexor spasticity post-stroke. The Plantar vibration had no effects on the affected foot sensibility.