Journal of Clinical Physiotherapy Research

Introduction: Lateral wedge insole (LWI) is one of the therapeutic interventions in the management of medial compartment knee osteoarthritis. The aim of this study was to investigate the effect of the LWI with and without a medial arch on the pain and the ankle function in patients with medial compartment knee osteoarthritis. Methods and Materials: Twenty-six people with medial knee osteoarthritis were assigned. All participants were asked to complete the questionnaires of the Foot and Ankle Outcome Survey (FAOS) and the Visual Analog Scale (VAS) in the first session. Then, participants were divided into two groups. The first group was given a LWI and the second group a LWI with the medial arch support. After a 6-weeks use of the insoles, participants were asked to complete the questionnaires again. Result: The use of LWI and arch support did not alter all items of the FAOS including the stiffness, pain, activity level, sports restriction, and quality of life restrictions and the VAS score after six weeks compared with the first session (P>0.05), but the using only LWI increased all subscales of FAOS and VAS score after six weeks wearing the insole (P<0.05) and there was no significant change just in the stiffness subscale (P=0.6). Also, the difference between the two groups was significant by increase of all outcomes using only the LWI compared with the LWI along with an arch support (P<0.05). Conclusion: Using a LWI in isolation can result in pain and discomforting in the ankle joint. However, LWI combined with arch support could prevent joint stiffness, pain and discomforting in the ankle joint of patients with medial knee osteoarthritis.

Keywords: Ankle; Arch support; Function; Lateral wedge Insole; Medial Knee Osteoarthritis; Pain

Introduction: The prevention of foot ulcer and the improvement of gait pattern in the diabetic patients are crucial to understand the lower limbs kinematics. Various kinds of rockers can be used in shoes to reduce the forces applied on the plantar surfaces in patients with diabetic foot. The aim of this study was to investigate the kinematic parameters of gait using toe-only rocker shoes in patients with diabetic foot. Methods and Materials: Forty type 2 diabetic patients (22 females; mean age 58.2) were recruited for participation in this study. Examination of the subject's gait in this study was based on two walking conditions including standard shoes and shoes with toe-only rocker. A three-dimensional gait analyses was conducted to assess the kinematic parameters. For comparison the two test conditions, a paired t-test was utilized. Results: With the application of shoes with toe-only rocker, there was no significant differences in the walking speed improvement compared with standard shoe(P=0.260), However, the step length and cadence (P˂0.001) were significantly increased when walking with toe-only rocker shoe compared with standard shoe. The range of motion of all three lower limb joints (ankle, knee, and hip) was significantly decreased using toe-only rocker shoe (P˂0.05). Conclusion: The present study demonstrated a significant increase in the cadence and step length and a significant reduction in range of motion of lower limb joints during walking using toe-only rocker shoes compared with standard shoes in diabetic patients. Based on the results of this study, it seems that toe-only rocker can improve the gait pattern of people with diabetes. More study with long term follow-up is needed.

Keywords: Diabetic Foot, Kinematic, Gait, Toe-only Rocker, Shoe

Introduction: low back pain is one of the most common and expensive musculoskeletal disorders which due to its disability, the health care system is faced with great problems such as social and remedial ones. Different methods are used in order to alleviate the pain .one of the most common way to alleviate the complications of the low back pain is the foot reflexology. The aim of this study is to investigate the effect of adding this kind of treatment as an inexpensive nonaggressive way to the routine physical therapy plan. Methods and Materials: In this quasi experimental study, 30 women with chronic nonspecific low back pain returnee to physiotherapy clinic in Tehran, first were selected by purposive sampling then they with random allocation method had been divided to two groups: routine physiotherapy (electrotherapy and strength training of flexor and extensor muscles) and routine physiotherapy plus foot reflexology. The amount of pain and functional disability and flexor and extensor endurance were measured by VAS and Oswestry disability questionnaire and ITOO test before, just after 8 weeks treatment and with a month interval after intervention. Data were analyzed using repeated measure ANOVA. The statistical significance was resumed to be a P<0.05. Results: Before intervention anthropometric, quantitative, and qualitative specifications were not significantly different between two patients groups participating in this study. Immediately after completing their physiotherapy treatment plan, although the pain and disability reduction were seen in both groups, the reflexology group was better than routine physiotherapy (P<0.05), Endurance of trunk muscles was not significantly different in both groups. A month after the final physiotherapy session, the pain, disability and endurance were not significantly different between two groups (P>0.05). Conclusion: Adding reflexology to the treatment plan had a positive effect only for a short term in improving the pain and disability, but in long term, applying reflexology besides the routine physiotherapy treatment had no additional effect and the routine results were established. Future studies with more subjects and in acute low back pain is recommended.

Introduction: Sensory problems can affect the functioning of individuals in a variety of daily activities in different aspects. One of these aspects of daily activity is the quality and quantity of sleep. Sensory processing perhaps is the most basic psychological element that determine how individuals perceive and respond to environmental stimuli. Given this, this study aimed to investigate the effect of sensory processing disorder on sleep quality of children with autism spectrum disorder and learning disorder. Materials and Methods: The present study was a descriptive cross-sectional study. The study was performed on 23 children with autism spectrum disorder and 20 children with learning disorder from 6 to 14 years' old. Two Child Sleep Habits Quality (CSHQ) and Sensory profile 2 questionnaires were used for data collection. Data were analyzed by Mann-Whitney U test in SPSS 22 software. Results: The results of data analysis showed that children with ASD have lower sleep quality than children with specific learning disorder (P=0/033). Children with autism also received higher scores on sensory profile 2 subtests except visual and olfactory processing than children with specific learning disorders. In children with ASD the highest scores are related to Sensory Sensitivity (45.83) and sensory registration (45.17) and lowest score is related to visual processing (10.96). However, children with specific learning disorders have highest score in sensory registration (43.40) and lowest score in body position processing (8.55). Conclusion: The findings of the study emphasized children with poor sleep quality had sensory processing disorder and sleep quality were reduced. There was a significant relationship between sensory registration (P=0.005) and sensory sensitivity (P=0.012) with sleep quality. Therefore, it seems necessary to support children in considering proper sensory diet and taking measures to resolve their sensory problems and thus improve their sleep patterns.

Keywords: Autism Spectrum Disorder; Learning Disorder; Quality of Sleep; Sensory Processing Disorder

Introduction: Measurement of Active Cervical Contra-Lateral Flexion (ACCLF) and Pressure Pain Threshold (PPT) is an integral part of the patients' assessment with myofascial pain syndrome and cervical disorders. This study aimed to investigate the inter- and intra-examiner reliability of goniometer in measuring ACCLF and algometer in measuring PPT in the upper trapezius muscle. Materials and Methods: ACCLF and PPT in upper trapezius muscle were measured in 20 healthy young adult female volunteers. Measurements were performed in two sessions one hour apart by two examiners, each consisting of 3 trials with 60-second rest periods. Data analysis was performed using the Interclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). Results: For ACCLF measurement with the goniometer, the intra-examiner reliability was as follows: first examiner in first session=0.985, first examiner in second session=0.959, and the inter-examiner reliability was first session=0.954 and second session=0.969. For PPT measurement with the algometer, the intra-examiner reliability was as follows: first examiner in first session=0.928, first examiner in second session=0.877 and the inter-examiner reliability were: first session=0.742 and second session=0.866. Conclusion: Goniometer and algometer exhibited a good inter- and intra-examiner reliability in measuring ACCLF and PPT, respectively, in the upper trapezoid muscle.

Keywords: Cervical Contra-lateral Flexion; Inter-examiner; Intra-examiner; Pressure Pain Threshold; Reliability

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