Review Article

Pennation Angle and Fascicle Length of Human Skeletal Muscles to Predict the Strength of an Individual Muscle Using Real-Time Ultrasonography: A Review of Literature

Mahboobeh Rekabizaheh, Asghar Rezasoltani, Behzad Lahouti, Newsha Namavarian

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 42-48

Introduction: Muscle fascicle length and pennation angle are two muscle structural parameters which can be non-invasively measured using methods like ultrasonography. The aim of the present literature review was to introduce fascicle length and pennation angle for the estimation of the force of an individual skeletal muscle using ultrasonography. Methods and Materials: The data for the current review study was obtained from Pubmed, Science Direct, Scopous, Google Scholar, Sprinter Link Database, and other authoritative references available on the Internet and in libraries between the years 1995-2015. A total number of 113 articles were obtained. In sum, 45 articles were collected and reviewed. Keywords such as muscle, fascicle, length, angle, force, and ultrasonography were searched to fulfill the purpose of the study. Results: Detailed information on the pennation angle and fascicle length is essential to predict the force of an individual muscle. It has been suggested that changes in muscle fascicle angle and length correlated variably with the muscles force production. Conclusions: Real-time ultrasonography has been introduced as a valuable measurement tool for estimation of the force individual muscle via measuring the muscle architecture parameters, such as pennation angle and fascicle length. However, factors like physiological, anatomical, and biomechanical properties have to be considered when predicting the force of an individual skeletal muscle.

Key words: Muscle, Fascicle, Length, Pennation angle, Force, Ultrasonography

Original Articles

Relationship between Duration of Patellofemorall Pain Syndrome and Patellar Alignment

Zohre Ebrahimi, Mohammad Akbari, Ali Amiri

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 54-60

Introduction: Patellofemoral Pain Syndrome (PFPS) is one of the most common musculoskeletal disorders. The cause of PFPS has been reported to be multifactorial. Patellar malalignments are accepted as the leading causes of PF pain and PF joint disorders. The purpose of the present study was to assess the relationship between duration of PFPS and patellar alignment. Method and Materials: The patellar alignment of participants was compared in three groups: patients with 2-3 month PFPS duration, patients with 12-15 months PFPS duration, and matched healthy participants. Congruence angle, Q angle, Patella height (Insall-Salvati index), Lateral patellar tilt angle, and Pain and Function score were measured among these three groups. Results: The patella height (Insall-Salvati index) (r=0.32), lateral patellar tilt angle (r=0.28), Visual Analogy Scale (r=0.77), and function score (r=-0.80) correlated with duration of PFPS. The patella height (Insall-Salvati index), lateral patellar tilt angle, and pain in patients group with 12-15 months of PFPS duration were significantly greater and function score was less than those of the control group. The patella height (Insall-Salvati index) and pain in patients group with 2-3 months of PFPS duration were significantly greater and function score was less than those of the control group. There was no significant difference in other measurements among the three groups. Conclusions: It can be concluded that duration of PFPS affects alignment of patella and knee joint function score. Therefore, early and complete treatment of PFPS is recommended.

Key words: Patellofemoral Pain Syndrome, Duration, Malalignment

Effects of High-Power Diode Laser Irradiation Combined with Electrical Stimulation on Wrist Pain and Function Following Carpal Tunnel Syndrome

Seyed Mohammad Reza Tabatabai, Siamak Bashardoust Tajali, Behrooz Attarbashi Moghadam, Seyed Mohsen Mir

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 61-67

Introduction: Carpal Tunnel Syndrome (CTS) is the most common and most well-known compression neuropathy which may manifest as mild, moderate, or severe and lead to various degrees of disability in people. The present study aimed to compare the effect of high-power diode laser beam and Transcutaneous Electrical Nerve Stimulation (TENS) separately and in combination on improvement of wrist pain and function in patients with CTS. Method and Materials: The study was designed as a randomized trial. A total of 45 patients (7 men and 38 women) were randomly divided into three groups of high-power laser (n=15), TENS (n=15), and high-power laser with TENS (n=15). The TENS group received conventional TENS on pain site for two weeks as 5 sessions per week and 30 minutes per session. The high-power laser group received 6.5 J/cm2 laser for two weeks, 5 sessions per week. The group of high-power laser with TENS received conventional TENS and then 6.5 J/cm2 laser for two weeks as 5 sessions per week and 30 minutes per session. The Persian McGill Pain Questionnaire, Visual Analogue Scale (VAS), and the 5-point scale of pain severity of McGill Pain Questionnaire (pain severity) were used to assess pain and the Persian version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire was administered to evaluate hand function before and after treatment. All the patients filled a demographic questionnaire including age, height, and weight prior to the intervention. Results: The mean scores of McGill, VAS, pain severity, and DASH questionnaires reduced significantly in high-power laser and high-power laser with TENS groups; however, these variables had no significant difference in the TENS group. Conclusions: High-power laser diode (808 nm, 6.5 j/cm2) can reduce pain and improve hand function in patients with mild to moderate CTS. Laser-induced anti-inflammatory effects and blood flow improvement are possible causes of decreased pain and sensory signs followed by improvement in hand function.

Key words: Carpal Tunnel Syndrome, High-Power Laser, Hand, Pain, Transcutaneous Electrical Nerve Stimulation

Effect of Low Intensity Cathodal Direct Current on Rate of Healing and Quality Of Life in Diabetic Patients with Ischemic Foot Ulcer

Mohammad Reza Asadi, Giti Torkaman, Mehdi Hedayati, Mohammad Reza Mohajeri-Tehrani

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 68-72

Introduction: Adjunctive treatment using electrical stimulation has recently been shown to promote healing in patients with diabetic foot ulcer. The aim of the present study was to evaluate whether low intensity cathodal direct current electrical stimulation improves healing rate of foot ulcers and health related quality of life in diabetic patients. Materials and methods: A total of 30 type 2 diabetic patients with ischemic foot ulcer were included in the present randomized, single-blind, placebo controlled trial. Participants were randomly assigned to receive either electrical stimulation therapy (direct current with low intensity, ES group, n=15) or sham treatment (placebo group, n=15) for 1 h/day, 3 days/week, for 4 weeks (12 sessions). Improvement ratio of wound and quality of life was evaluated at the 1st and 12th sessions. The quality of life was assessed using SF-36 questionnaire. Results: The mean of improvement ratio was significantly higher in the electrical stimulation group (59.4%) compared with that of the placebo group (27.07%) at the 12th session (P=0.02). Overall score of quality of life significantly increased in the electrical stimulation group as compared with that for the placebo group (0.01). Conclusion: By promotion of wound healing, applied low intensity cathodal direct current may increase the health-related quality of life in diabetic patients with ischemic foot ulcer.

Key words: Diabetics, Ischemic foot ulcers, Low intensity direct current, Wound improvement rate, Quality of life

The Effect of Quadriceps Kinesio Tape on Functional Disability, Pain, and Knee Joint Position Sense in Knee Osteoarthritis Patients

Maedeh Sarallahi, Ali Amiri, Javad Sarafzadeh, Ali Ashraf Jamshidi

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 73-78

Introduction: Osteoarthritis is one of the most common joint and musculoskeletal problems, particularly within the knee joint, which causes functional disability and impaired proprioception. The aim of the present study was to study the effect of quadriceps kinesio tape on functional disability, pain, and knee joint position sense in females suffering from osteoarthritis of the knee. Methods and Materials: A total of 38 females suffering from knee osteoarthritis were randomly assigned to either the control group (n=19) or kinesio tape group (n=19). The extent of pain was measured using a Visual Analogue Scale (VAS), the extent of functional disability was measured using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the absolute error of reconstructing the active angle in 30 and 60 degrees of knee flexion was measured using an inclinometer. The results were analyzed using independent sample t-test to compare the treatment groups before the treatment and paired sample t-test to compare the groups before and immediately after the treatment. Results: In the kinesio tape group, a statistically significant improvement was observed in the reconstruction of the joint sense position at 30 and 60 angles of knee flexion before and after treatment (P<0.0001). However, there no statistically significant difference was observed in the control group at 30° and at 60°. Moreover, the results from the VAS and WOMAC tests revealed no statistically significant difference between the control and kinesio tape groups. Conclusion: The quadriceps kinesio tape improves knee joint position sense in patients with knee osteoarthritis, but it does not cause significant changes in their pain and functional ability.

Key Words: Functional disability; Joint position sense; Kinesio tape; Knee osteoarthriti

The effect of Hand Positions on the Vibration Platform on Shoulder Muscle: Strength and Proprioception

Sedigheh Sadat Naimi, Khosro Khademi Kalantari, Azadeh Shadmehr, Alireza Akbarzadeh Baghban

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 79-85

Introduction: To compare the short-term effect of one session of Whole Body Vibration (WBV) in two positions of hand on the vibration platform on isokinetic strength of Rotator cuff and shoulder proprioception. Method and Materials: A total of 60 young healthy students participated in the present study completing three positions of control (no vibration), push up with straight elbow, and push up with semi flexed elbow (two vibration positions) running for two minutes with 30-minute rest between the positions. After control position, vibration positions were tested randomly on the Power Plate device (F: 30Hz and low amp). The isokinetic strength of Rotator Cuff and the absolute angular error in joint repositioning test in 3 target angles of 0°, 45°, and 90° were measured using Kin-Com dynamometer before and after each position. Then, the results of the three positions were compared together. Results: Despite decrease in dynamic strength of medial rotators after three positions, this decrease was observed to be significantly less in push up with straight elbow compared with that in control position (P=0.03). Also, there was a significant difference in Concentric MPT of Lateral Rotators between the three positions with control position revealing the greatest decline in lateral rotators strength (P=0.01) and push up with straight elbow was found to be more effective than semi flexed elbow (P=0.03). Moreover, There was a significant improvement in angle repositioning for the three positions; however, it was considerably more only in zero degree in the push up with semi flexed elbow position as compared with that in the control position (P=0.03). No significant changes were found between push up with straight elbow and semi flexed elbow positions, either. Conclusions: The two different hand positions did not alter the effect of vibration on neuromuscular system in young and healthy individuals. Although a single session of WBV had a positive effect on the neuromuscular system of the young healthy participants, the two positioning did not make a significant difference.

Key words: Whole body vibration training, shoulder muscle strength, proprioception

Spinal Stabilization Exercise with and without Whole–Body Vibration: A Randomized Controlled Clinical Trial

Maede Torabi, Farshad Okhovatian, Sedigheh Sadat Naimi, Alireza Akbarzadeh Baghban

Journal of Clinical Physiotherapy Research, Vol. 1 No. 2 (2016), , Page 86-90

Introduction: The present study aimed to compare the impacts of core stability exercises with and without Whole Body Vibration (WBV) training sessions lasting two weeks on trunk muscle endurance in patients with non-specific chronic low back. Methods and Materials: Thirty participants were randomly placed into either a WBV group or a spinal stabilization group at Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2013. The dependent variables manipulated included the abdominal and spinal muscular endurance, assessed prior to, midway through, and after two weeks and the WBV or spinal stabilization intervention program implemented using stabilizer pressure biofeedback unit and Biering Sorensen test. Results: Changes in transverse abdominal and internal oblique muscle endurance in prone position were statistically significant among the participants in both groups (P<0.05). However, changes in transverse abdominal muscle endurance in supine position and multifidus muscle endurance were not observed to be statistically significant in both groups. In addition, inter-group analysis showed that except for the percentage of changes of multifidus muscle endurance, the vibration group demonstrated significant improvement over the non-vibration group. Conclusion: As no significant difference was observed between the two treatment methods, none of treatment methods was more effective comparatively in terms of improving mid-term trunk muscle endurance.

Keywords: Whole body vibration, Trunk muscle endurance, Non-specific chronic low back pain, Core stability