The Effect of Motor Imaginary Combined with Transcranial Direct Current Stimulation (tDCS) on Balance in Middle-Aged Women with High Fall Risk: A Double-Blind Randomized Controlled Trial.

Introduction: The risk of falling and its subsequent injuries increases with aging. Impaired balance and gait are important contributing factors to the increased risk of falling. A wide range of methods was examined to improve balance, but these interventions might produce small effects or be inapplicable for this population. The current study aimed at investigating the effect of motor imaginary (MI) training combined with transcranial direct current stimulation (tDCS) over the cerebellum on balance in middle-aged women with high fall risk. Methods: Thirty subjects aged 40-65 years old were divided into two groups including intervention (n = 15) and sham control (n = 15). The participants completed a 4-week program 3 times per week. The intervention group performed MI training combined with tDCS over the cerebellum, and the control group performed MI training combined with sham tDCS over the cerebellum. Static and dynamic balance were measured at baseline and after completing the 4-week program using balance error scoring system (BESS) and Y balance testing, respectively. Result: A one-way analysis of covariance and paired t-tests were used to analyze the data. Significant improvement was observed in both balance tests in the intervention group after the implementation of the 4-week intervention program compared to the control group. The within-group analysis showed that both static and dynamic balance improved significantly from the baseline values only in the intervention group (p < 0.05) and not in the control group (p > 0.05). Conclusion: The results of the study indicate that MI training combined with tDCS over the cerebellum can lead to balance improvement in middle-aged women with high fall risk.

The effectiveness of the comprehensive corrective exercise program on kinematics and strength of lower extremities in males with dynamic knee valgus: a parallel-group randomized wait-list controlled trial.

BACKGROUND: Dynamic knee valgus (DKV) is a prevalent movement impairment widely regarded as a risk factor for lower extremity disorders such as patellofemoral pain syndrome. The present study aimed to investigate the effectiveness of the comprehensive corrective exercise program (CCEP) on kinematics and strength of lower extremities in males with DKV. METHODS: Thirty asymptomatic young men with DKV between the ages of 18 and 28 years participated in this study. They were randomly assigned to the intervention (n = 15) and control groups (n = 15). The intervention group performed the CCEP for three sessions per week for eight weeks, while the control group only did activities of daily living. Hip external rotator and abductor muscle strength and three-dimensional lower extremity kinematics consisting of knee varus/valgus, femur adduction/abduction, femur medial/lateral rotation, and tibial medial/lateral rotation were measured at the baseline and post-test. The data were analyzed using the analysis of covariance (ANCOVA). RESULTS: There were significant improvements in all kinematics variables in the intervention group after the 8-week CCEP. Moreover, the strength of abductor and external rotator muscle improved in the intervention group (P < 0.05). CONCLUSIONS: The CCEP led to substantial improvements in the selected variables of lower extremity kinematics and muscle strength in participants with DKV during a single-leg squat. These results imply that practitioners should adopt a comprehensive approach to pay simultaneous attention to both proximal and distal segments for improving DKV. TRIAL REGISTRATION: The protocol has been approved in the Registry of Clinical Trials (Registration N: IRCT20180821040843N1 ) on 2018-12-30.

The effect of a suspension training on physical fitness, lower extremity biomechanical factors, and occupational health in Navy personnel: a randomized controlled trial.

Optimal physical fitness is essential for military personnel to effectively meet their rigorous physical demands. This study aimed to investigate the effectiveness of a suspension training program on physical fitness, biomechanical risk factors for lower extremity injury, mental health, and work-related factors in Navy personnel. A total of 50 young men participated in a randomized controlled trial. The participants were randomly assigned to two groups (n = 25): the intervention group and the control group. The intervention group performed an eight-week suspension training session three times per week, while the control group maintained their daily duties. The primary outcome was physical performance. The secondary outcomes were determined biomechanical risk factors for lower extremity injuries, mental health, and work-related factors. The data were analyzed using the analysis of covariance (ANCOVA). Compared with the control group, the intervention group showed significant improvements in physical performance, biomechanical risk for lower extremity injuries, and work-related factors from baseline to follow-up (p ≤ 0.05). However, there was no improvement in mental health. Based on these findings, suspension training positively impacted physical fitness, reduced injury risk, and enhanced the work-related factors of Navy personnel. This study provides new insights for various related experts and military coaches because it is an easy-to-use and feasible method with minimal facilities.

Bone Mineral Density and Content among Iranian Elite Male Athletes in Different Sports.

Objectives: Sport is one of the best ways to prevent osteoporosis; however, not all sports have the same impact on bones, for instance, swimming (SW) may have no effect or be harmful. Elite athletes are the best choice to detect the effects of any sport. Thus, this study was conducted firstly to compare the bone mineral density (BMD) and bone mineral content (BMC) of elite athletes in volleyball (VB), basketball (BB), and long-distance running (LR) together, and secondly to compare those corresponding values in SW athletes with those of non-athletes (NA). Methods: The subjects (n=58) of this cross-sectional study included elite male athletes (members of Iran's national teams, with a minimum of 12-15 hours of training per week) and NA (control; C) who were divided into BB, VB, LR, SW (n=12 for each), and C (n=10) groups. The DEXA scan measured the amount of BMD and BMC values in the lumbar spine (LS; L2-L4) and proximal femur (PF; neck, trochanter, and Ward's triangle) areas. Results: In the LS areas, LR had significantly higher BMD than the BB, VB, SW, and C groups (P<0.001), while for BMC, both LR and VB were significantly superior to other groups (P<0.001). Moreover, the BMD and BMC of the PF areas of VB and BB were significantly higher than those of the LR, SW, and C groups (P<0.001). Finally, in all areas, SW showed significantly higher BMD and BMC, compared to the C group (except for trochanter and femur neck BMC) (P<0.05). Conclusion: LR athletes showed the most bone acquisition in the LS areas and VB players in the PF areas, while BB players ranked third in osteoporosis prevention in the mentioned regions. Unexpectedly, SW athletes also had better BMD and BMC than NA; therefore, after weight-bearing sports, this type of sport can be effective in bone acquisition.

Effects of FIFA 11 + warm-up program on kinematics and proprioception in adolescent soccer players: a parallel­group randomized control trial.

This study aimed to compare the effects of 8 weeks 11 + warm-up injury prevention program on kinematics and proprioception in adolescent male and female soccer players. Forty adolescent soccer players (20 males, 20 females) aged between 14-16 years old were randomly assigned into four groups. The experimental group performed the 11 + program for 8 weeks and the control group did their warm-up program. The kinematic variable in a cutting maneuver was measured using VICON motion analysis and ankle and knees' proprioception by joint position sense (JPS) was measured using a digital inclinometer. For kinematic variables only significant differences in knee valgus among females 11 + compared with female and male control groups were found (P < 0.05). Moreover, there were significant improvements in joint position sense variables in 11 + groups compared to control groups (P < 0.05). In conclusion, the 11 + program was proven to be a useful warm-up protocol in improving knee valgus and JPS among female and male adolescent soccer players. We suggest adding more training elements to the 11 + program that aimed to enhance the proper alignment of lower extremities which may consequently improve joint kinematics.

Can lower extremity anatomical measures and core stability predict dynamic knee valgus in young men?

INTRODUCTION: Dynamic knee valgus (DKV) is a risk factor for lower extremity injuries such as anterior cruciate ligament and patellofemoral pain syndrome. Purpose of the current study was to investigate the relationship between lower extremity anatomical measures (LEAM) and core stability with DKV during the single-leg squat. METHODS: Thirty healthy men aged between 18 and 28 years participated in this cross-sectional biomechanical study.DKV was assessed using a 6-camera motion analysis system during a single-leg squat task. Anteversion of hip, hip internal and external rotation, Q-angle, knee hyperextension, tibial torsion, tibia vara, plantar arch index, and core stability were measured using standard clinical procedures. To predict DKV, a multiple linear regression model was used. RESULT: The stability index negatively and plantar arch index positively predicted greater DKV during the single-leg squat task (P = 0.001 and P = 0.09, respectively). Research variables together predicted 82% of the variance in DKV (F(4,26) = 28.09, p < 0.001). However, relationships between other variables and DKV were not found. CONCLUSION: The core stability index and plantar arch index were associated with observed DKV during the single-leg squat. These results suggested that proximal and distal variables to the knee should be considered when evaluating individuals who present DKV during the single-leg squat.

Focus on the Scapular Region in the Rehabilitation of Chronic Neck Pain Is Effective in Improving the Symptoms: A Randomized Controlled Trial.

Chronic neck pain is a common human health problem. Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain. The purpose of this study was to compare the effects of neck exercise training (NET) with and without scapular stabilization training (SST) on pain intensity, the scapula downward rotation index (SDRI), forward head angle (FHA) and neck range of motion (ROM) in patients with chronic neck pain and scapular dyskinesia. A total of sixty-six subjects with chronic neck pain and scapular dyskinesia were randomly divided into three groups: neck exercise training, n = 24, combined training (NET + SST), n = 24 and a control group, n = 24. Pain intensity, SDRI, FHA and ROM were measured by the numerical rating scale, caliper, photogrammetry and IMU sensor, respectively. When the combined intervention group consisting of NET and SST was compared with NET alone at six weeks, there was a statistically significant difference in pain intensity, SDRI, FHA and cervical ROM for flexion and extension (p ≤ 0.05). Adding scapular exercises to neck exercises had a more significant effect in decreasing pain intensity, SDRI, FHA and increased cervical ROM than neck exercises alone in patients with chronic neck pain. These findings indicate that focus on the scapular posture in the rehabilitation of chronic neck pain effectively improves the symptoms.