Journal of Clinical Physiotherapy Research

Introduction: Eccentric contraction exercises such as hamstring Nordic have been used nowadays to prevent injury. Maximum force in the muscle happens when the outer force is more than the force made by the muscle. Muscle force can reach its maximum in eccentric contraction and this damages contraction components and cytoskeleton (infraconstruction) of the muscle fiber and weakness and pain happens. But how a contraction which causes pain and injury can help in preventing injury? The goal of the present study was to evaluate the eccentric contraction mechanism in the prevention of sports injuries. Materials and Methods: For this study, background research has been done using search engines from 1980 to 2017. Studies including information about eccentric exercises and sports injury prevention have been chosen next after eliminating unrelated articles. Results: Eccentric exercises affect muscle morphology and peripheral and central nerve activities. Muscle structure characteristics can create force which include pennation angle, muscle thickness, and fascial length and differ according to mechanical trigger. When the muscles are lengthened, the force attracts the mechanical work and acts as a spring. The energy which has been attracted during muscle and tendon lengthening, is usually wasted as heat and then recovery of stretching combustion energy happens. Stretching and energy recovery depend on the energy and resilience of the muscle. Eccentric contraction respectively causes more stretching of the sarcomeres, detatchment of the sarcomeres, cortex damage, localized contraction, muscle fiber inflammation and eventually inflammation and pain which shows injury to the muscle tissue. Moreover eccentric exercises change the call for alpha motor units, sarcomere activity, corticopostal sensitivity and brain activity. Continual muscle adaptation ability to tissue damage is a step for preventing acute injury in the future in eccentric contraction. Conclusion: Eccentric exercises have caused small injury in muscle tissue which eventually causes adaptation in the muscle and increases their strength and resistance and this happens by increasing muscle diameter and fascia length and pennation angle. Although it could be damaging but it is better to consider useful as muscle adaptation.

Introduction: The purpose of the present study was to measure the thickness and the strength of craniocervical extensor muscles in men with chronic non-specific neck pain and healthy controls. Materials and Methods: Fifteen men with chronic non-specific neck pain (CNNP) and 15 healthy controls were participated in this study. The thicknesses of the craniocervical extensor muscles (rectus capitis posterior major(RCPM)) and oblique capitis superior (OCS) in addition to the strength of upper cervical extensor muscles were measured at resting position and during maximal voluntary isometric contraction (MVIC) of craniocervical extensor muscles using ultrasonography device and a dynamometer which was designed for the purpose of study. Results: The thicknesses of RCPM and OCS muscles were significantly smaller in the patients group than the healthy controls at resting position and during maximal isometric contraction (P<0.001). There was a significant reduced MVIC in patients with CNNP when compared to controls (P=0.008). Conclusion: The reduced craniocervical extensor muscles strength and thickness in patients with CNNP may be due to pain and reflex inhibition which is originating from cervical neuromusculoskeletal structures. Craniocervical muscles assessments may be needed while evaluating patients with CNNP.

Introduction: Based on the role of static balance and anthropometric indicators in shooters’ performance, the present study aimed to compare the static balance of female and male shooters in two fields of rifle and pistol with an emphasis on main anthropometric indicators. Materials and Methods: Two static balance tests (Sharpened Romberg and Stork) and 18 anthropometric indicators as well as the descriptive statistics and inferential statistics including: Shapiro-Wilk test, multiple correlation coefficient, PCA, Spearman test, and the one –way analysis of variance test were used to determine the relationship between the static balance and main anthropometric indicators in four groups of female and male rifle and pistol shooters (P≤0.05). Results: The findings showed a significant relationship between stork balance test and anthropometric indicators of knee width among male pistol shooters as well as significant relationship between Sharpened Romberg balance test and anthropometric indicators of weight and BMI among the female rifle shooters and height, sitting height, the length of two hands, and lower limb length among the male rifle shooters. Comparison of the balance mean score among four participating groups in the study indicated that the male pistol shooters had a higher balance than the female pistol shooters and male and female rifle shooters. Discussion: The postural balance of the male pistol shooters and female rifle and pistol shooters was associated with the main anthropometric indicators of weight, BMI, standing height, sitting height, the length of two hands, lower limb length, and knee width. The maximum mean value of stork balance was related to male pistol shooters while the minimum one was related to female rifle shooters. In the Sharpened Romberg test, the maximum mean value was related to male pistol shooters while the minimum value was related to female rifle shooters.

Introduction: Low back pain is a common pain among ping pong players and the presence of functional impairment due to low back pain, is one of the important reasons for absence of these athletes in trainings and competitions. The purpose of the present study is to evaluate the pain and functional impairment and Kinesiophobia which caused by low back pain among ping pong players in the league 1 and premier league of Iran and factors such as the relationship between pain prevalence and some variables; age, weight, height, and activity level. Materials and Methods: This cross-sectional study was conducted on 80 ping pong players of premier league and league 1 of Iran (80 men with a mean age of 23.26±5.74 years, height of 177.18±7.07 cm and weight of 71.63±9.26 Kg). Demographic and athletic data was collected by a researcher-devised questionnaire. Pain level was measured through the Visual Analogue Scale (VAS), functional disability through Oswestry Questionnaire and Poverty Scale through the Tampa Scale for Kinesiophobia (TSK). Statistical methods were used for analysis. Results: The results of this study show that by 16.3% of patients had pain at the moment, by 33.7% had pain in the last six months, by 40% had pain in the past year and by 45% had a history of pain during their lifetime. Also, by 43% of ping pong players had degrees of functional disability with a mean score of 9.07±7.93 and a mean score of Kinesiophobia of 39.63±6.68. There is also a significant and direct relationship between the intensity of the present pain in the players and the degree of functional disability and their kinesiophobia (P<0.05). The results of the study show a significant relationship between pain prevalence, weight, age, athletic level (ranking of players) and the number of training hours per session (P<0.05). Conclusion: The results of this study indicate a high prevalence of pain, functional disability and kinesiophobia among elite ping pong players in Iran. Factors such as age, athletic level, weight and number of training hours per session are among the risk factors of pain prevalence and functional disability in ping pong players. Considering foresaid risk factors, it has been recommended to take necessary measures in order to prevent the occurrence of low back pain in Iranian ping pong players.

Introduction: Piriformis syndrome may be a source of low back, buttock pain or sciatica, due to existence of myofascial trigger point in piriformis muscle. The aim of this study was to investigate the immediate effects of dry needling on improvement of pain and hip internal rotation range in piriformis syndrome. Materials and Methods: 40 athletes participants with piriformis syndrome were randomly divided into two groups, experimental group (conventional physiotherapy besides dry needling) (n=20) and control group (conventional physiotherapy) (n=20). 5 sessions of conventional physiotherapy was performed for both groups, but dry needling was performed at the end of 1^th, 3^th and 5^thsessions. Hip internal rotation and pain were respectively measured by goniometer and visual analog scale. All the data were measured before applying intervention, and at the end of odd sessions. The repeated measures ANOVA with between subjects factor was used to analyze the data and significant level was set at P<0.05. Results: The results showed that there were significant reduction in pain and significant increase in hip internal rotation at different time in two groups (P<0.05) and this differences was more apparent in the experimental group. Conclusion: The result of this study showed that, the use of dry needling plus conventional physiotherapy has a superiority immediate effect on pain and hip internal rotation range.

Introduction: In the etiology of tension type headache, the weakness of the upper posterior cervical muscles is associated to myofascial pain in cranio-cervical area. The aim of this study was to compare the strength and the thickness of the upper posterior neck muscles in women with chronic tension type headache and healthy control. Materials and methods: The strength and the thickness of upper posterior neck muscles were measured in 33 women (16 women with chronic tension type headache and 16 healthy controls). The strength of the upper cervical extensor muscles and the thickness of semispinalis capitis, splenius capitis, rectus capitis posterior major and oblique capitis superior muscles were measured by a custom made isometric device and a real-time ultrasonography machine. Pain was assessed by a visual analogue scale. Results: The strength of the muscles was significantly lower in patients with chronic tension type headache than the control group (P<0.001). Only, the thicknesses of rectus capitis posterior major and oblique capitis superior muscles were significantly smaller in patients compare to the healthy controls (P<0.001). A statistical negative correlation had been found between the levels of pain and the strength of upper posterior neck muscles (r=-0.65, P=0.006). Conclusion: The results have indicated that rectus posterior major and oblique capitis superior muscles may be weaker in patients with chronic tension type headache than controls. The results may be useful when evaluating the patients with chronic tension type headache by means of the level of upper cervical muscle strength and the muscle thickness measurements.

The present case study explains the rare condition of polyostotic fibrous dysplasia of a 35 year old female. The case could be stated as a McCune-Albright syndrome. The protocol of physiotherapy clinical evaluation and conservative physiotherapeutic treatment approach has significantly improved the pain status and physical functioning of a patient at 4 weeks of intervention. The physiotherapy treatment protocol will help to improve the health status in fibrous dysplasia cases.

Introduction: postural muscles, such as trapezius. The aim of this study was to evaluate the effect of instrument-assisted soft tissue mobilization technique (IASTM) on the active trigger points of the upper trapezius muscle and muscle fiber changes. Methods and Materials: A 29-year-old woman with the history of intermittent cervical pain and the active trigger point of upper trapezius muscle has been presented. Physiotherapist evaluated the local pain intensity through VAS (Visual Analog Scale) and pressure pain threshold (PPT) using algometer. Iranian version of Neck Disability Index (NDI) questionnaire was used to determine patient’s ability to manage her everyday life. Also, thickness of the muscle was recorded by means of real-time images taken by ultra-sonographic apparatus. 50 days after completion of treatment, pressure pain threshold and local pain intensity were evaluated at 1^st and 6^th sessions. Muscle thickness and NDI were evaluated at 1^st and 6^th sessions. Results: The results of this study have shown that 6 sessions of IASTM technique were performed every other day, reduce the intensity of pain, increase the PPT, and decrease the patient’s disability (NDI). Also, this technique has changed the muscle fiber thickness after 6 sessions of treatment. Conclusions: According to the present study, applying the complete protocol of IASTM technique had better and more durable effects on improving the active trigger point of the upper trapezius muscle.