Journal of Clinical Physiotherapy Research

Introduction: Lower urinary tract dysfunction (LUTD) is highly prevalent in patients with multiple sclerosis (MS) who suffer from some degrees of voiding dysfunction and/or urinary incontinence (UI), six to eight years after the initial diagnosis of MS. Electrostimulation is an established therapeutic option for neurogenic LUTD. This study aimed to investigate the efficacy of various types of electrical stimulation (ES) used for LUTD in MS patients. Materials and Methods: A systematic review of English-language articles was carried out in PEDro, PubMed, Science Direct, and Google Scholar databases between 1980 and 2017 using the following keywords: multiple sclerosis, electrical stimulation, LUTD, and neurogenic bladder. All the titles and abstracts were checked. Thereafter, full-text copies were obtained in cases where the studies had possible relevance. We carried out a background search by examining reference lists of all obtained articles. Ten treatment studies were identified in the search process. Results: Out of 10 articles, four were about the effects of percutaneous tibial nerve stimulation (PTNS) on LUTD. In three studies, neuromuscular ES, and in one study, interferential current was used. One study surveyed the effect of ES on the dorsal penile or clitoral nerve, and another studied the effect of ES on sacral dermatomes with regard to urinary symptoms. Also, three studies surveyed the effect of ES and its combination with pelvic floor muscle (PFM) training. Conclusion: This review showed that various types of non-invasive ES used for neurogenic LUTD in patients with MS for suppressing detrusor overactivity have also improved bladder compliance. Patients with MS require daily home stimulation treatments. Also, a combination of ES with PFM training is effective in reducing the symptoms of LUTD in MS patients.

Introduction: Cervicogenic headache is a secondary headache, whose cervicogenic disorders is known as its background factor. Considering the important role of cervical spine in providing deep-feeling entrances, a change in deep-feeling entrances can lead to disorder in these individuals. The aim of this study was to investigate the relationship between stability and severity of pain, disability and duration of headache in these patients. Methodology: In this cross-sectional study, 30 cervicogenic patients, headache index, duration of illness, disability inventory and visual acuity scale were recorded. To measure the stability, stability tests were performed in four standing positions on two extremities with open and closed eyes and with low and high stability level by Biodex stability device. The overall stability index, internal-external index and anterior-posterior index were measured. Pearson correlation test was used to examine the relationship between variables. Results: There was a significant relationship between the history of headache reporting and most of the stability indices (p=0.002, r=0.548). There was a significant relationship between the general stability index (p=0.001, r=0.563) and internal-external index and pain severity, and no significant correlation was found between the anterior-posterior index. There was no significant relationship between disability inventory (p=0.727) and headache index (p=0.186) with stability indices. Conclusion: With increasing duration of headache and increased pain intensity, stability indices increase, which can indicate a weaker stability in cervicogenic headache patients with longer illness history and more pain intensity.

Introduction: Functional movement screen test is a valid test for evaluation of functional impairment and diagnosis of asymmetric motor patterns. The aim of this study was to investigate the relationship between (FMS) test and static and dynamic balances in adolescent volleyball players. Materials and Methods: This study was a correlational research which involved 30 male volleyball players in the Golestan Province League. The FMS tests include: (shoulder mobility, straight leg raise, Trunk Balance Push-Up, Rotary Balance, In-Line Lunge, Deep Squat, Hurdle Step). As a measurement tool for sport injury prevention and to evaluate static and dynamic balances, the Stork stand and Y balance test were used. Results: The results showed that there was a significant relationship between FMS test and dynamic balance (R²=36.24, R=0.602, P=0.001) and static balance (R²=19.62, R=0.443, P=0.001). Conclusion: Given the moderate relationship between variables, other performance tests such as balance tests to prevent sports injury and the athlete's return to exercise after the injury have been introduced. Selecting the appropriate test for athletes to prevent injuries by coaches and sports professionals are required and can be effective in reducing the cost of treatment and increasing exercise levels.

Introduction: Functional movement screen (FMS) test may be able to detect athletes who may be at risk of further injury by identification of muscle imbalances and movement impairment syndromes. The aim of this study was to examine the correlation between FMS test and dynamic balance and endurance of core muscles in male and female volleyball players. Materials and Methods: FMS test, the Y balance test and the McGill trunk endurance tests were employed in the present study to evaluate the quality of movement, dynamic balance and the core muscle endurance, respectively. Subjects voluntarily participated in the study for three consecutive days. The correlation coefficient was employed to investigate the relationship between variables. All statistical analyzes were carried out at confidence interval of 95% (P<0.05). Results: 30 volleyball players (men=15, height 183/80±7/82 cm, Weight 74/93±9/58 kg) (Women=15, height 168/93±8/25 cm, Weight 58/13±9/41 kg). The results showed that there is only a significant correlation between the men's trunk flexor muscles and the left foot balance of the women's with functional movement test (P<0.05). There was no significant relationship between other measured factors. Conclusion: Considering the results and limitations of the present study, it seems that the correlations between FMS scores and the core endurance and balance may be different between males and females; therefore, further studies are strongly recommended to clarify the issue.

Introduction: Wrestling is always accompanied by damage to various body parts. Most trainers recommend exercises to increase balance in order to improve performance and reduce the risk of injury. Therefore, the present study examines the relationship between neuromuscular mechanisms with dynamic balance and upper extremity function of wrestlers. Materials and Methods: This is a correlation study whose participants include free-style and Greco-Roman wrestlers of 21.05±2.25 years old in Rasht. This study was conducted on 42 wrestlers who met the criteria to enter the research and were selected by the available sampling method. In this study, in order to evaluate the dynamic balance and the upper extremity function, Y Balance Test and Upper Quarter Y-Balance Test (YBT-UQ) were used, respectively. In addition, to measure the depth of shoulder flexion, ankle plantar flexion, shoulder flexion amplitude, and ankle plantar flexion, and to assess the strength of shoulder flexion force, ankle plantar flexion, muscle flexion of shoulder, and ankle plantar flexion, an electrogonimeter device and a dynamometer were used, respectively. Pearson correlation coefficient and multivariate regression were used to study the research hypotheses. Results: The results show that there is a significant positive relationship between the range of motion of ankle plantar flexion (r=0.64) and the normalized power of plantar flexors (r=0.85) with lower limb dynamic balance (P=0.03). There is also a significant negative relationship between the sensory errors of ankle plantar flexors force (r=-0.84) and the reconstruction of ankle plantar flexion (r=-0.85) with the lower limb dynamic balance (P=0.02). Moreover, the results show that there is a significant positive relationship between the range of motion of the Shoulder flexion (r=0.71) and the normalized power shoulder flexor (r=0.74) with upper limb function (P=0.001). There is also a significant negative relationship between the sensory error of shoulder flexor (r=-0.72) and the sense of reconstruction of shoulder flexion angle (r=-0.75) with upper limb function (P=0.03). Conclusion: It appears that the neuromuscular mechanisms are effective factors in upper extremity function and dynamic balance of wrestlers. Therefore, consideration of these neuromuscular mechanisms is necessary to prevent injury and improve wrestlers' athletic performance.

Introduction: The evaluation of cognitive impairment in people with Parkinson’s disease is important for timely use of medical and rehabilitation services. To achieve this goal, this study was conducted to verify the reliability and validity of the Persian Version of the clock drawing test (CDT). Materials and Methods: In the first session, the cognitive function of 180 subjects with Parkinson's disease and mean age (±SD) of 57.6 (±7.8) were evaluated using the CDT. The test was redone within 7 to 10 days. The test-retest and inter-tester reliability were evaluated by the IntraClass Correlation Coefficient (ICC). The concurrent validity was also measured through the relationship between the CDT and the Clinical Dementia Rating scale (CDR), the Parkinson Disease Questionnaire-8 (PDQ-8) and the Mini-Mental Status Examination (MMSE). Results: An acceptable level of reliability between the raters (ICC=0.94 (95% CI, 0.92–0.97)) and test-retest (ICC=0.92 (95% CI, 0.90–0.95)) was obtained among these patients. There was also a moderate to high correlation between the CDT with CDR, and the PDQ and MMSE. Conclusion: The results of this study showed that the clock drawing test has a high reliability and an acceptable validity for measuring cognitive function in Iranians with idiopathic Parkinson's disease.

Introduction: Since the use of medical insole is recommended as one of the strategies to deal with the potential for joint injuries, Flatfoot is one of the most common abnormalities in body structure that Due to the decrease in the height of the medial longitudinal arch of the foot and its functional defect, the increases risk of joint damage due to changes in the transfer of ground reaction forces. One of the treatment options that is suggested is the use of a medical insole. The purpose of this study was to investigate the effect of two different forms of silicone insoles on the peak of the ground reaction force, loading rate and time to stability in the landing-jumping-landing skill of active young women with flat foot. Materials and methods: 28 women with a history of regular activity exercise were divided into two groups of 14 (flat foot and normal foot). The subjects landed two legs on a level with a height of 0.5 m on the forwards of the first force plate, jumped without stopping and landed on second force plate. In this study, two types of silicone insoles were used that support the entire sole of the foot (type I), and only the inner portion of the foot and the medial longitudinal arch (Type II). The flat foot subjects performed without using the insole and using two types of insoles. The Data Analysis of data Evaluation of Variables were done by MATLAB software. Also its statistical analysis was done by using spss (P≤0.05). Results: The results of statistical analysis of variance analysis showed a significant difference in the amount of ground reaction forces in all three axes between normal and flat foot subjects, while the use of medical insoles only in outer medial- lateral & anterior- posterior directions has been significant. The rate of loading at the first landing showed a significant difference between the subjects with flat foot and normal foot. But there was no significant effect after using the medical insole. However, there was no significant difference between the time to stability in the two groups of flat foot and normal foot. Conclusion: According to the results of the study, it can be said that flat foot abnormality in high intensity plometric skill has effect on the ground reaction forces in all three directions, and the use of a Type I insole can reduce the amount of force in all three directions. On the other hand, the decrease in the height of the longitudinal arch of the foot is associated with the rate of loading during the landing, which is identified as a risk factor for joint and muscular damage. But the use of silicone insoles cannot effect on the rate of loading. The results of this study indicate that the time to stability in active subject does not correlate with the height of the medial longitudinal arch, or the time to stability is corrected in the active subjects with flat feet with the help of compensatory mechanisms.

Introduction: The aim of this study was to examine the anatomic alignment of shin, ankle and feet in elite runners with and without medial tibial stress syndrome (MTSS). Materials and methods: The number of subjects employed in this study was 70 male elite runners who were divided into two groups: those with MTSS and a mean age of 25.9±3.21 and the control group with a mean age of 25.3±33.3. They were investigated for plantar arch index (Staheli), navicular drop, ankle dorsi flexion, plantar ankle flexion, tibia vara and tibial torsion. Data were analyzed employing SPSS software, version 18 and independent samples t-test. Results: The results of data analysis revealed  that there was a significant difference between the two groups in the mean navicular drop, dorsi flexion and tibial torsion, such  that the rate of navicular drop in the affected group was higher than that of the control group (P=0.011). In addition, the affected group had limited dorsi flexion of the ankle (P=0.048) and low tibial torsion angle (P=0.002). However, there was no significant difference between the two groups in the mean plantar arch index (Staheli) (P=0.428), plantar flexion (P=0.448) and tibia vara (P=0.672) (P>0.05). Conclusion: According to the results of this study, abnormal plantar arch, dorsi flexion limitation and tibial torsion are imperative risk factors in the occurrence of MTSS, which can be forestalled with timely diagnosis of abnormalities and early intervention.