Journal of Clinical Physiotherapy Research

Introduction: Plantar fasciitis is the most prevalent cause of pain in heels and widely treated using the shockwave therapy. Materials and Methods: Thirty patients (12 males and 18 females) randomly participated in this single blind clinical trial study that aimed to evaluate the effects of low energy extracorporeal shockwave therapy on pain in patients with chronic plantar fasciitis. Group 1 patients were treated with low energy shockwave and stretch, and group 2 control patients were treated by stretch and a placebo shockwave. The groups were demographically similar with respect to age, gender, and BMI. The patients were assessed for pain using the visual analog scale (VAS). Results: After 2 weeks of treatment, a significant difference in pain was observed between the two groups. The VAS results showed 76% reduction of pain in group 1 and 46% in group 2. Discussion: The use of low energy radial shockwave has significant short-term effects on pain relief in chronic plantar fasciitis and is, thus, recommended as a relatively painless and safe therapy prior to surgery.

Introduction: This study aimed to compare the short-term effects of Low-Level Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) on hand pain and function in patients with low or moderate levels of Carpal Tunnel Syndrome (CTS). Materials and Methods: Twenty-four patients with confirmed mild to moderate CTS were recruited for this study. The eligible patients were randomly divided into two groups: LLLT and TENS. Patients in the LLLT group were exposed to GaAlAs diode laser, 808 nm with 6.5 J/cm² for two points perpendicularly over the carpal area. Patients in the TENS group were treated daily by conventional TENS with 80 µs duration for a period of 30 minutes per day. All patients were treated daily, five days per week for a period of two weeks. The researchers performed clinical assessment using visual analogue scale and McGill Pain questionnaire for pain rating and Disabilities of the Arm, Shoulder and Hand questionnaire for functional scales. For statistical analysis, paired t-test was used in each group, and analysis of variance was used for comparison between groups. Results: All outcome measures in the LLLT group were substantially improved while the TENS group provided better pain sensation. Conclusion: This study documented that LLLT might be effective in reducing pain and improving function in patients with mild to moderate CTS. Electrical stimulation might have been effective (short term) in controlling pain in these patients.

Introduction: Sprain of the anterior cruciate ligament (ACL) is the most common sports injury. Kinesio-taping (KT) method could be used for rehabilitation after ACL reconstruction (ACLR) surgery. The purpose of this study was to evaluate the immediate effect of KT on the knee joint position sense after ACLR surgery. Observational, descriptive, and comparative study. Materials and Methods: Twenty male football players with ACLR surgery, aged 20 to 30 years with matched pre-injury activity level, and 4 months post surgeries were enrolled. The knee joint position sense error rate was assessed before and after taping in injured and uninjured limbs in weight bearing and non-weight bearing positions from flexion to extension and vice versa at angles of 15^°, 30^° and 60^°. Repeated measure ANOVA test was used for data analysis. Results: The knee joint position sense error rates were significantly smaller after taping compared to before taping in injured and uninjured control limbs in weight bearing and non-weight bearing positions from flexion to extension and vice versa at repositioning angles mentioned above. The knee joint position sense error rates were significantly lower in control uninjured limbs than injured limbs before taping in all tests. There was no significant difference between the two limbs in knee joint position sense error rates after taping in all tests. Conclusion: This study showed that, in people who underwent ACLR surgery, the knee joint position sense in injured limb was impaired after 4 months. Joint position sense error rate after ACLR surgery can be reduced by increasing the sensory inputs through taping.

Introduction: Patellofemoral Pain Syndrome (PFPS) is known as one of the most frequent knee diseases in athletic and non-athletic people and the most frequent cause of anterior knee pain. Despite the high prevalence of PFPS, its predisposing factors are not known. Among the potential factors, neuromuscular control disorders of lumbopelvic hip complex or core have been recently focused because the stability of this complex is vital for movements of limbs and the instability of core redounds to the instability of whole movement chain. The knee is the most prevalent joint influenced by core disorders; it seems that knee is a victim of core stability disorders. Materials and Methods: This is a descriptive-analytic case-control study. Thirty-two subjects including 17 patients with PFPS (10 female, 7 male) and 15 healthy subjects (8 female, 7 male) participated in this study. Electrical activity of vastus medialis obliqus, adductor longus, gluteus maximus, external oblique abdominus (EOA), internal oblique abdominus (IOA) and transverse abdominus (TA) and multifidus was recorded during the stair-stepping activity. All statistical analyses were performed with the SPSS version 20.0 software. Results: The results showed there was a significant difference (P=0.026 for EOA, P=0.03 for IOA and TA) between the offset time of electrical activity of core abdominal muscles in patients with PFPS and healthy subjects during stair-stepping. However, there were no significant differences in other parameters. Conclusion: The end of electrical activity of abdominal muscles in patients with PFPS during stair-stepping was longer than healthy subjects. However, managing patients with PFPS is challenging because there is no consensus regarding its predisposing factors and treatment. Therefore, more accurate recognition of this syndrome is needed to develop an appropriate treatment.

Introduction: Fatigue is one of the most debilitating conditions associated with cancer and anticancer therapy. The purpose of this study was to translate the fatigue questionnaire in Persian for developing an appropriate instrument to evaluate the effect of rehabilitation and other interventions on fatigue in intended patients. Materials and Methods: The present study was analytical and descriptive. Thirty experts and 15 children with cancer who were treated at Mahak Hospital and their parents were asked to participate in the study through convenience sampling. For content validity, CVI (content validity index) has been calculated as an aggregation of concessions for each item that has earned "Relevant but Needed to Review" and "Completely Related" points divided by the total number of specialists. To determine the CVR (content validity ratio), experts were asked to check each item based on the three-part spectrum. To assess the face validity of the scales, forms for rating and explaining the scoring for questionnaires of all three scales were given to 15 participants, and they were asked to answer each question scale based on the three concepts of relevance, clarity and simplicity on the 4-point graph. Scores higher than 0.79 indicated the suitability of the items for further analysis. Results: The translated questionnaire was completed by the participants. In the content validity section, according to the critical point of the Lawshe table, CVR was acceptable at 0.49. The translation of items by CVI less than 0.79 was modified. Finally, CVIs of all items were averaged, and the final score was determined as the CVI level. In the face validity section, scores higher than 0.79 indicated the suitability of items for further analysis. Conclusion: The Persian version of fatigue scale can be considered as one of the suitable instruments in measuring the influence of fatigue on activities of daily living.

Introduction: Injuries related to lordosis 30 to 40 percent of spinal disorders have been allocated that the economic aspects of health care has also attracted attention. The aim of the present study was comparison of effect of eight weeks training in dry and water on change in lordosis of female students in Yazd. Materials and Methods: In this research 42 girls with lordosis in 9 to 12 years old were randomly selected from schools in Yazd and randomly divided into three groups of training in water (14 cases), land (n=14) and control group (14 people). Training program participants for eight weeks was carried out. Subject's lordosis was measured by flexible ruler as a noninvasive and reliable method of exercise before and after eight weeks. Repeated measures method was used for data analysis of pre-test and post-test. Results: The findings show that training on land and water had a positive effect on improving participant’s lordosis (P≤/05), but there was no significant difference in lordosis correction between two study groups (P≥/05). Conclusion: According to the results, both on land and water corrective exercise program for girls with lumbar lordosis is useful and there was no difference between the two programs in the reduction of lumbar lordosis. It is recommended that the land and water exercises for people with lumbar lordosis given, and each of these methods has its own specific characteristics which, according to experts identify the persons recommended.

Introduction: This prospective, single-blind trial aims at assessing the efficacy of low-level laser therapy in rotator cuff tendinopathy. Materials and Methods: Fifty-four patients with painful impingement syndrome were equally divided into two groups, of which one was treated using an inactive machine via the placebo procedure (group A) and another from a functional machine (group B). The Range of Motion and Western Ontario Rotator Cuff Index (WORC) questionnaires were implemented to conduct the comprehensive shoulder examination of the patients for four times within the research period of 2 months. Results: After one month of treatment, the patients in group B recorded better WORC score compared to group A (38 versus 46), which was significant (P=0.03). However, after one more month, the score changed to 40 for group A and 36 for group B, which was not statistically significant. In each group, the WORC score changed after treatment with significant difference (P value=0.023 in group A and 0.04 in group B), but the difference between both the groups was not significant after the final visit. Conclusion: The results suggest that low-level laser therapy had no significant effect and acted primarily as a placebo treatment in rotator cuff tendinitis.

Introduction: Unsatisfactory results of conventional medical treatment methods for pressure sores in patients with spinal cord injury (SCI) have instigated the use of non-medical treatments, such as electrotherapy. However, the risk of burning in exposure to direct current (Galvanic) and contradictory propositions on the best applicable electrotherapeutic current during the method have prevented widespread application of electrotherapy. The purpose of this study was to show the effects of High-Voltage Pulsed Current (HVPC) on the treatment of pressure sores resistant to routine medical treatment practices. Materials and Methods: The case series study involved the analysis of 8 SCI subjects with grade III and IV pressure sores around the pelvic area. All the subjects received HVPC electrotherapy for 12 daily sessions, during which the electrodes were placed as per the recommendations of routine electrotherapy protocol. The electric currents increased gradually until muscle contraction was observed. The treatment time was kept at 20 minutes per treatment session. Single session was performed each day for 12 consecutive days. The wounds were photographed at day 1 before starting the treatment, on day 6, and finally, on day 12 after the treatment. The area of wound on each of these days was calculated with the help of the AutoCAD Software. Results: The results obtained after 12 consecutive days of electrotherapy indicated that the wound size of the studied SCI subjects reduced by 56.87%. Conclusion: The results confirmed positive effects of HVPC electrical stimulation for healing SCI associated pressure sores in patients resistant to the routine medical approaches of treatment. Moreover, HVPC application was found to accelerate the healing process in these subjects.