Effect of proximal exercises of lower extremity on static balance parameters during quiet standing.

Purpose: People who suffer from knee osteoarthritis (KOA) face reduced balance, which causes increased falling and many serious complications and injuries. The purpose of the extant study was to determine the effect of proximal exercises of lower extremity on static balance parameters during quiet standing. Materials and Methods: In the present randomized controlled trial, 36 patients were divided into intervention and control groups (n = 18 in each group). Both groups received routine physiotherapy in three sessions per week for 6 weeks, while the intervention group did proximal exercises in addition to physiotherapy routine. In the extant study, the pain intensity was measured through a visual analog scale (VAS), and individuals' static balance parameters were measured using Biodex Balance System. All measurements were done before and after the intervention, and then statistical data analysis was performed with Statistical Package for the Social Sciences (SPSS) 24 software. Results: Intergroup comparison indicated significant progress of pain intensity, anterior-posterior (AP), and Overall balance stability in both studied groups (P < 0.05). There was a significant increase in medial-lateral (ML) balance stability only in the intervention group (P < 0.05). Intergroup comparison showed that there was not any significant difference between variables before the intervention (P > 0.05). The results showed more progress in the intervention group than the control group after they received the intervention, which was significant in terms of ML balance stability (P < 0.05). Conclusion: Adding proximal exercises to physiotherapy had more effect on ML balance stability in KOA patients; however, 6 weeks of these exercises in addition to physiotherapy had also the same effect on pain intensity, Overall, and AP balance stability.

Effects of core stabilization exercises on thickness and activity of trunk and hip muscles in subjects with nonspecific chronic low back pain.

BACKGROUND: Changes in trunk and hip muscles are believed to be important in subjects with nonspecific chronic low back pain (NSCLBP), but little is known about specific changes, or how they might be affected by core stabilization exercises. The aim of this study was to compare six key muscles before and after these exercises. METHODS: Thirty two NSCLBP patients were assigned randomly into two groups: exercise (n = 17) and control (n = 15). On 5 days per week for 4 weeks, the Exercise group performed 16 core stabilization exercises and the Control group received transcutaneous electrical nerve stimulation and a 'hot-pack'. Surface electromyography (EMG) was used to assess maximum bilateral activity of transversus abdominis (TrA), multifidus (MF) and gluteus maximus (Gmax) muscles. Ultrasound imaging was used to measure the rest and contracted thickness of these muscles. Pain and disability were assessed using a visual analogue scale (VAS) and the Oswestry Disability Index. RESULTS: When left and right-side muscle data were combined, two-way ANOVAs showed a nonsignificant interaction effect for all dependent variables (P > 0.05), significant time effects on resting muscle thickness for TrA (P = 0.01), MF (P = 0.041) and Gmax (P = 0.003), EMG signals of TrA (P = 0.038), pain and disability (P = 0.000). There were a significant group effect on contracted thickness for TrA (P = 0.032) and Gmax (P = 0.026) and disability (P = 0.017). CONCLUSIONS: Core stabilization exercises increased contracted thickness of TrA and Gmax muscles and decreased disability in subjects with NSCLBP.

Comparison of balance and stabilizing trainings on balance indices in patients suffering from nonspecific chronic low back pain.

The objective of the current research was to compare the impact of balance and stabilizing trainings on balance indices in patients with nonspecific chronic low back pain. In this randomized, controlled, single-blinded clinical trial, 20 people suffering from nonspecific chronic low back pain were randomly assigned to two groups of balance and stabilizing trainings. Trainings of both groups were performed for 6 weeks and four sessions per week. The overall, lateral, and anterior-posterior stability indices, pain, and disability were measured using Biodex balance system, visual analog scale, and Oswestry scale, before and after treatment, respectively. Paired t-test and independent t-test were used for analyzing the data. In the balance group, the pain severity was changed from 6.33 ± 1.63 to 4.33 ± 2.6 (P = 0.005) and dynamic anterior-posterior stability index in the standing position on left leg with closing eyes was changed from 5.56 ± 2.25 to 3.45 ± 1. 57 (P = 0.03). In the stabilizing group, pain severity was changed from 4. 16 ± 1.47 to 1.33 ± 0.81 (P = 0.0001) and disability index was changed from 17.33 ± 5.60 to 5.33 ± 3.93 (P = 0.01). Reduction in pain and disability in the stabilizing group and increase in two balance indices were significant in the balance training group compared to those in other group (P < 0.05). Research findings revealed that the impact of stabilizing trainings was significant in reducing pain and disability compared to that in balance trainings.

The Effects of Balance Training on Static and Dynamic Postural Stability Indices After Acute ACL Reconstruction.

BACKGROUND: Proprioception and postural stability play an important role in knee movements. However, there are controversies about the overall recovery time of proprioception following knee surgery and onset of balance and neuromuscular training after ACL reconstruction. Therefore, it is necessary to evaluate the effect of balance training in early stage of knee rehabilitation after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of balance exercises on postural stability indices in subjects with anterior cruciate ligament (ACL) reconstruction. METHODS: The study was a controlled randomized trial study. Twenty four patients who had ACL reconstructed (balance training group) and twenty four healthy adults without any knee injury (control group) were recruited in the study. The balance exercises group performed balance exercises for 2 weeks. Before and after the interventions, overall, anteroposterior, and mediolateral stability indices were measured with a Biodex Balance System in bilateral and unilateral stance positions with the eyes open and closed. T-tests were used for statistical analysis (p<0.05). RESULTS: Results showed that amount of static stability indices did not change after training and there were not significant differences in static stability indices before and after balance training (p>0.05). Although amount of dynamic stability indices decreased, there were not significant differences in dynamic stability indices before and after balance training (p>0.05). Amount of dynamic stability indices were decreased in balance training group, however, there were not significant differences between groups (p>0.05). CONCLUSION: These results support that balance exercise could partially improved dynamic stability indices in early stage of ACL reconstruction rehabilitation. The results of this study suggest that balance exercises should be part of the rehabilitation program following ACL reconstruction.

Intra-Rater Reliability of Rehabilitative Ultrasound Imaging for Multifidus Muscles Thickness and Cross Section Area in Healthy Subjects.

INTRODUCTION: Rehabilitative Ultrasound Imaging (RUSI) must be valuable method for research and rehabilitation. So, the reliability of its measurements must be determined. The purpose of this study was to evaluate the intra-rater reliability of RUSI for measurement of multifidus (MF) muscles cross section areas (CSAs), bladder wall diameter, and thickness of MF muscles between 2 sessions in healthy subjects. METHOD: Fifteen healthy subjects through simple non-probability sampling participated in this single-group repeated-measures reliability study. MF muscles thickness at rest and during contraction, MF muscles CSAs at rest, and bladder diameters at rest and during pelvic floor muscles (PFM) contraction were measured through RUSI. Pearson's correlation coefficient test was used to determine intra-rater reliability of variables. FINDING: The results showed that intra-class correlation Coefficient (ICCs) values with 95% confidence interval (CI) and the standard error of the measurement (SEM) were good to excellent agreement for a single investigator between measurement occasions. The intra-rater reliability for the bladder wall displacement was high (ICCs for rest and PFM contraction state: 0.96 and 0.95 respectively), for the MF muscles CSAs at the L4 level was good to high (ICCs 0.75 and 0.91 for right (Rt) and left (Lt) side respectively), and for the thickness of MF muscles at two levels, at rest and during two tasks was moderate to high (ICCs: 0.64 to 0.87). CONCLUSION: The Trans-Abdominal (TA) method of RUSI is a reliable method to quantify the PFM contraction in healthy subjects. Also, the RUSI is a reliable method to measure the MF muscles CSAs, the MF muscles thickness at rest and during functional tasks in healthy subjects.

The effect of ankle taping and balance exercises on postural stability indices in healthy women.

[Purpose] The purpose of this study was to compare the effect of ankle taping and balance exercises on postural stability indices in healthy women. [Subjects and Methods] Thirty healthy female students were randomly assigned into two equal groups: ankle taping and balance exercise. The balance exercise group performed balance exercises for 6 weeks, with 3 sessions per week and each session lasting 40 minutes. Ankle joint taping was performed for 6 weeks and was renewed three times a week. Before and after the interventions, overall, anteroposterior, and mediolateral stability indices were measured with a Biodex Balance System in bilateral and unilateral stance positions with the eyes open and closed. [Results] In the taping group during bilateral standing with the eyes closed, the overall stability index changed from 6±1.4 to 4.8±1.3, anteroposterior stability index changed from 4.2±1.27 to 3.4±0.97, and mediolateral stability index changed from 3.2±0.75 to 2.7± 0.7. In the balance exercise group during bilateral standing with the eyes closed, the overall stability index changed from 5.7±1.69 to 4.5±1.94, anteroposterior stability index changed from 4.1±1.61 to 3±1.21, and mediolateral stability index changed from 3.5±1.4 to 2.2± 1.3. No significant difference was seen between the two groups regarding any study variables. [Conclusion] The results showed that compared with the taping technique, balance training increases postural stability in the majority of the studied balance situations.

Melioidosis: It is not Far from here.

In the modern world, with developed traveling facilities, tourism is an important factor in emerging new infectious diseases in non-endemic areas. Therefore, the epidemiology of infections is a considerable issue for physicians and should be taken into account. We report a case of melioidosis in a 69-year-old Iranian man during his trip to Southeast Asia. On admission, he was febrile with tachycardia and tachypnea and had diabetes mellitus and hypertension since eleven years ago. Bronchoscopy and bronchoalveolar lavage (BAL) were performed. Blood and BAL cultures revealed heavy growth of Burkholderia pseudomallei. According to the aforementioned culture results, the patient was treated with meropenem and TMP-SMX, while other antibiotics were discontinued. After 3 weeks, the patient was discharged with stable status and normal pulmonary function; and eradication therapy with TMP-SMX continued for about 3 months. The control lung CT scan after one month demonstrated significant improvement.

Effects of vacuum-compression therapy on healing of diabetic foot ulcers: randomized controlled trial.

A single-blind, randomized controlled trial was conducted to evaluate vacuum-compression therapy (VCT) for the healing of diabetic foot ulcers. Eighteen diabetic patients with foot ulcers were recruited through simple nonprobability sampling. Subjects were randomly assigned to either an experimental or a control group. Before and after intervention, the foot ulcer surface area was estimated stereologically, based on Cavalieri's principle. The experimental group was treated with VCT in addition to conventional therapy for 10 sessions. The control group received only conventional therapy, including debridement, blood glucose control agents, systemic antibiotics, wound cleaning with normal saline, offloading (pressure relief), and daily wound dressings. The mean foot ulcer surface area decreased from 46.88 +/- 9.28 mm(2) to 35.09 +/- 4.09 mm(2) in the experimental group (p = 0.006) and from 46.62 +/- 10.03 mm(2) to 42.89 +/- 8.1 mm(2) in the control group (p = 0.01). After treatment, the experimental group significantly improved in measures of foot ulcer surface area compared with the control group (p = 0.024). VCT enhances diabetic foot ulcer healing when combined with appropriate wound care.