Journal of Clinical Physiotherapy Research

Introduction Scoliosis is a musculoskeletal disorder that can be treated by wearing full-time and part-time braces. It is not yet well understood whether part-time braces, such as Providence nighttime braces, are as effective as full-time braces in managing scoliotic curves. The aim of the present review study was to investigate the effect of Providence nighttime brace on correcting scoliosis in patients with adolescent idiopathic scoliosis (AIS). Methods: The search was performed using the keywords Scoliosis, Adolescent Idiopathic Scoliosis, Cobb angle, Nighttime Brace, Providence Brace, and Orthosis in PubMed, Science Direct, and ISI Web of Knowledge databases. Findings: A total of 10 relevant articles published between 2000 to December 2019 were selected for the final review according to the inclusion and exclusion criteria. Six articles investigated the effect of Providence brace before and after bracing treatment on the idiopathic scoliosis. Three articles compared the effect of Providence braces with full-time braces [Boston and Thoracic lumbar sacral Orthosis (TLSO)] on idiopathic scoliosis. One article also compared Providence brace with Charleston nighttime bending brace. Conclusion: Providence brace is an effective treatment approach to prevent the progression of scoliotic curves. However, it should be emphasized that its maximum effect is seen on the lumbar and thoracic curves< 35^° with lower apex.

Keywords: Cobb Angle; Nighttime; Providence Brace; Scoliosis

Introduction: The present study aimed to investigate the effects of inspiratory muscle training (IMT) on the spirometry parameters of patients with chronic obstructive pulmonary disease (COPD). Materials and methods. In this study, 60 men with COPD referring to Masih Daneshvari Hospital of Tehran were selected and randomly assigned to control (normal rehabilitation) and test (normal rehabilitation with IMT) groups. In addition to standard drug therapy, patients in the test group participated in a 4-week exercise therapy program (for sessions per week) consisting of strength training for the proximal muscles of the upper and lower extremities, aerobic exercises with treadmill, and IMT. The spirometry parameters including FEV1 and FVC were measured before and after the training period. The obtained data were statistically analyzed using the dependent t-test and analysis of covariance at the 0.05 level of significance. Results: The results revealed that IMT significantly improved the FEV1 and FVC in patients with COPD (P<0.05). In addition, the results showed that IMT was more effective than normal rehabilitation in improving the studied variables (P<0.05). Conclusion: It can be generally concluded that respiratory and rehabilitation exercises with an emphasis on inspiratory muscles strengthening can improve the spirometry parameters in patients with COPD. This suggests these patients should benefit from IMT programs.

Keywords: Inspiratory Muscle Training, Spirometry Parameters, Chronic Obstructive Pulmonary Disease

Introduction: The shoulder joint is the most used joint in volleyball players. Performing repetitive movements and over-the-top attacks, the shoulder joint is under stress and leads to an asymmetrical shoulder and pain in the shoulder joint. The purpose of this study was to evaluate the strength and range of motion of internal and external rotating muscles in the asymmetric shoulder of the affected and non-volleyball players. Methods and Materials: This research is descriptive and causal-comparative. The statistical sample of this study was randomly assigned into two groups of affected and non-affected patients according to the research criteria. To measure the strength of the muscles of the rotator in two positions of zero and 45 degree shoulder from the dynamometer device (MMT), we used goniometer to measure the range of shoulder muscles and the scolymeter device was used as a symmetrical shoulder diagnostic tool. Results: There was a significant difference between the strength of internal (P=0/03) and external (P=0/02) rotating muscles in both non-diabetic and non-affected groups. Also, in this study, the internal (P=0/02) and external (P=0/03) spin amplitudes were significantly different in the two groups with and without asymmetric shoulder. Conclusion: The findings of this study showed that high muscle strength in asymmetric shoulder volleyball players is known as a risk factor in many studies. Limitations in the range of motion of the shoulder movements in the shoulder joint of asymmetric shoulder volleyball players require attention to preventive approaches by creating corrective strategies.

Introduction: Vertigo is the third most common complaint among all outpatients worldwide. The cervical region impairment is one of the peripheral causes of the vertigo. Rehabilitative Ultrasound imaging (RUSI) has been introduced, as a non-invasive method to measure the muscle thickness. The purpose of this study was to assess the intra-rater reliability of musculoskeletal ultrasound (MSKUS), as a tool for measuring cervical flexor and extensor muscles thicknesses in the healthy subjects and the patients with cervical vertigo. Material and Methods: in this study, 44 subjects were assessed in similar sitting position and procedure. Examiner measured the cervical flexor and extensor muscles thicknesses, in two separate days, by the same musculoskeletal ultrasound specialists' raters. Data analysis and assessment of reliability were performed using the Intra-class Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and the Smallest Detectable Difference (SDD). Results: Results reflected the excellent intra-rater reliability of ultrasonography to measure the cervical flexor and extensor muscles thicknesses in the healthy participants and the patients with cervical vertigo. Conclusion: The results of the current study indicate that, MSKUS is a reliable tool for measuring the cervical flexor and extensor muscles thicknesses in healthy subjects and the patients with cervical vertigo.

Keywords: Cervical Spine, Muscle, Ultrasonography

Introduction: Balance is one of the basic required components for daily life activities, which is as one of the functional independent indicators. Proprioception plays a key role in maintaining balance and optimally doing exercise skills and preventing injury. In this research, the effect of biofeedback and TDCS was compared along with the promotion of balance, proprioception, and performance. Method: In the present experimental study, 36 athletes were randomly divided into three groups of biofeedback (12), TDCS (12), and control (12). Balance assessment was performed by force-plate, proprioception was done with digital photography, and the functional balance was determined by star testing before and after the intervention. Anova and T-stent pair tests were used at a significance level of 0.05 to analyze information. Results: The results show a significant difference in the absolute error rate of the reconstruction of the target angle following the biofeedback intervention at angles of 30^° (P=0.01), 45^° (P=0.03), and 90^°P=0.002) as well as improving the balance in the biofeedback group after intervene in the anterior, external, external, posterior, posterior, and TDCS groups in the anterior, posterior, posterior, internal, and internal posterior directions. Conclusion: The findings showed that the use of biofeedback and TDCS along with proprioception exercises could be recommended to athletes to improve their proprioception and functional balance.

Keywords: Electromyographic Biofeedback, Transcranial Direct Current Stimulation, proprioception, Balance, Functional Balance

Introduction: Coughing is the body’s defense mechanism to clear the airways from the foreign bodies and secretions. In patients with neuromuscular disorders or other diseases affecting the airways such as cystic fibrosis (CF), the effectiveness of this defense mechanism is often reduced due to respiratory exhaustion. The aim of our study was to evaluate the effectiveness of mechanical insufflation-exsufflation device (MI-E) in pediatric patients with CF.

Materials and Methods: In this study, we randomized 31 patient’s whit CF admitted to the pediatric pulmonary ward of Masih Daneshvari hospital (Tehran – Iran) into two groups of routine physiotherapy (including an active cycle of breathing technique, pursed-lips breathing, diaphragmatic/abdominal breathing, huffing, and coughing) or, routine physiotherapy plus 10 sessions of MI-E, each for 20 minutes. MI-E pressure was set +5 to +30 cmH2O for inspiration and -8 to -33 for expiration, for 1-3 and 3-5 seconds, respectively. Two groups were then compared regarding the results of the 6-minute walk test (distance), spirometry, echocardiography, and arterial blood gases.
Results: The mean age of the patients was 16.4± 4.6 years and 16 (23.6%) were male. Results of the analysis demonstrated that there were no significant differences between the two groups. Our results demonstrated similar efficacy for conventional physiotherapy versus physiotherapy and MI-E regarding the improvement of pulmonary function and airway clearance in CF patients.

Flexible flatfoot is one of the most common types of foot disorders. The aim of the present study was to assess the effectiveness of a custom-made 3D printed insole for a subject with flexible flatfoot. The subject was a 10-year-old boy who had the flexible flatfeet. The custom-made foot insoles for both feet were made using the 3D scanner for both feet. The feet data was evaluated after a 8-month use of insole compared with before wearing. The findings revealed that foot type improved in the subject after the 8-month use of the insoles. Right foot in dynamic surface and both feet in static surfaces changed from light flat to normal type. It seems using the 3D printed insoles can be useful in reducing the foot plantar pressure and the surface in individuals with flexible flatfoot.

Keywords: Orthotic, Insole, Flatfoot, Pressure