ISSN: 2476-3888

Spring 2021
Vol. 6 No. 2 (2021)

Systematic Review

Shoulder Injuries in Sport: A Systematic Review

Ali fatahi, Rozhin Molavian

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021


Background: The purpose of this study was to, present and discuss the accumulated knowledge involvement in various shoulder injuries and highlight the clinical implications for the evaluation and treatment of shoulder injuries. Shoulder injuries are common in both athletes and non-athletes. Risk factors for shoulder injuries are unknown despite the increase in injury rates. We seek to summarize the causes of shoulder injuries in athletes.

Study Design: Systematic review.

Methods: Searches were performed on 4 databases using keywords related to shoulder injury factors and a review of all applicable manuscripts was performed.

Result: Ninety-three articles met criteria for inclusion. Of the all independent variables that were analyzed, age, overhead throw sport and other sport, professional or amateur, contact and non-contact sports, male and female and related fall in sports were found to be independent risk factors for shoulder injuries.

Conclusion: The comparison of sport to non-sport shoulder injury incidence rates suggests that the increased risk of shoulder injuries in young males is mainly attributable to sports injuries. Men are more exposed to upper limb injuries.

Original Articles

Effectiveness of Eight Weeks Aerobic and Aerobic-resistance Cardiac Rehabilitation Exercise Training on Hemorheologic Variables among Middle-aged Men with Coronary Artery Disease

Abolghasem Razzaghi, Heydar Sadeghi, Adel Johari Moghadam, Kamran Azma, Sharif Najafi, Seyed Ahmad Raeissadat

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021 , Page e32

Introduction: Hemorheologic disorders are the most important causes of impaired circulation and cardiovascular events. It is also documented that regular and continuous exercise training could improve vascular adaptation to exercise and provide protection against major cardiovascular events. The aim of this study was to evaluate effectiveness of eight-week cardiac rehabilitation exercise by aerobic and aerobic-resistance methods on hemorheologic variables among middle-aged men with coronary artery disease (CAD). Materials and Methods: The present quasi-experimental study was carried out on 51 middle-aged men with CAD aged 45-65 years. Participants were randomly divided into three groups including aerobic exercise, aerobic-resistance exercise, and control group. The experimental groups performed sub-maximal aerobic exercises for eight weeks. Exercise protocol consisted rehabilitation exercises for three sessions a week. In addition to aerobic exercise, aerobic-resistance group received two sessions of resistance exercise using free weights per week for 15 minutes. Results: There was a significant improvement in all hemorheologic variables including fibrinogen concentration (P=0.001), hematocrit concentration (P=0.002), and erythrocyte sedimentation rate (P=0.001) in both aerobic and aerobic-resistance exercise groups compared to the control group. There was also a significant decrease of mentioned hemorheologic variables in aerobic-resistance group compared to aerobic group. Conclusion: Our study showed that eight-week cardiac rehabilitation exercises, especially aerobic-resistance exercise training, could improve the blood hematologic variables in middle-aged men with CAD.

The Effectiveness of Aerobic Exercises on Components of Executive Functions in Children with Attention Deficit Hyperactivity Disorder

Zahra Shakib, Majid Zargham Hajebi, Alireza Aghayousefi

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021 , Page e33

Introduction: It is necessary to investigate the cognitive and behavioral status of children with attention deficit hyperactivity disorder (ADHD) to improve their performance. Therefore, the aim of the present research was to investigate the effect of aerobic exercises on the components of executive functions (cognitive flexibility, impulsivity, response inhibition, and selective attention) in children with ADHD. Methods: This was a quasi-experimental study with pretest-posttest design. After performing the Raven screening test and SNAP-4, among the participants, 30 children aged 7-10 years who had IQ scores above 90 and met the ADHD criteria were randomly assigned to experimental (n:15) and control (n:15) groups. Before and after the intervention, both Stroop color and word test and continuous performance test were performed on both groups. Aerobic exercises were performed three sessions per week for three months in the experimental group. Data analysis was carried out using multivariate analysis of covariance. Results: The findings showed that aerobic exercise training had a significant increase on cognitive flexibility, response inhibition, and selective attention and significant reduction on the impulsivity in the experimental group compared to the control group. Conclusion: Aerobic exercise as a non-pharmacological and non-invasive treatment strategy, free of side effects, seems to be necessary to improve the executive functions of children with ADHD, which emphasizes the need for physical activity.

Correlation of Hip Passive Range of Motion with Lower Limbs Injuries in Iranian Professional Football Players

Elham Karaminia, Hooman Angoorani, ali mazaherinezhad, bahar Hassanmirzaei , navid moghadam

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021 , Page e34

Introduction: Football is a popular sport with a high injury rate. Lower limb injuries are accounted for 85% of injuries in professional football players. It is important to identify the predisposing factors in professional football players for screening players at an increased risk of injury. Limited hip range of motion (ROM) is one of these factors. This study aimed to evaluate the association between hip passive ROM and lower limb injury in Iranian professional football players.

Results: The most common lower limb injuries were ankle and foot injuries (12.4%), groin pain (11.5%) and muscle strain (10.9%), respectively. Non-injured athletes had a significantly higher left abduction and bilateral internal rotation (IR) ROM. right side injury was associated with higher contralateral flexion and external rotation (ER) and left side injury was associated with a significantly higher contralateral extension, abduction, and IR. Restricted hip IR was associated with a higher incidence of groin pain (OR = 2.06), ACL injury (OR = 2.56), and knee injuries (OR = 4.18). A significant correlation was observed between decreased hip ER with muscle strain (OR = 1.89) and knee injuries (OR = 4.25). The higher knee and ACL injuries were also associated with reduced hip abduction (OR = 4.76 and 9.01, respectively). There was no association between ankle and foot injuries and hip passive ROM.

Conclusions: This study showed that the hip passive ROM could be used to identify football players at a higher risk of lower limb injuries. Hip rotational ROM and abduction limitation were significantly associated with the incidence of several common football injuries, including groin pain, muscle strain and ACL/knee injuries and precedes their development and could be used as a screening tool for professional athletes.

Introduction: Appropriateness of ergonomic properties of outdoor fitness equipment with respect to anthropometric features of their users can reduce risk of injuries. The aim of this study was to investigate the appropriateness of the ergonomic indices of outdoor leg presses, chest presses, and pull chair machines with respect to anthropometric parameters in Iranian female athlete users. Material and Methods: 124 Iranian female athletes who used outdoor fitness machines in Iran were recruited. An engineering tape measure and an anthropometric kit were used to measure the dimensions of the chest press, leg press, pull chair machines and also anthropometry of female users. Next, using the anthropometric data and the fitness device standards based on trigonometric calculations, standard anthropometric computational dimensions of devices were obtained. Standard indices of outdoor fitness devices based on athlete’s anthropometric data were compared with the dimensions of outdoor fitness machines. A one-sample t-test was conducted on the collected data using SPSS software, version 21. Results: Comparison among all calculated ergonomic indices of leg press, chest press, and pull chair machines according to anthropometric features of female users and certain measured indices showed a significant difference (P<0.05), with exception of ergonomic variable of optimal horizontal distance from the back of seat pad to foot plate tip in the leg press machine (P=0.68). According to this significant difference, these devices were not ergonomic in terms of female athletes’ anthropometry. Conclusion: Based on the findings, ergonomic properties of leg press, chest press, and pull chair outdoor fitness machines did not meet the anthropometric variations in Iranian female users. Given this mismatch could play an important role in the occurrence of musculoskeletal injuries among female users of these devices, this study highlight the necessity of following ergonomic standards in the design and production of fitness equipment.

Studying the Changes of Time To Stabilization (TTS) and Center of Pressure Velocity (CoP Velocity) in Athletes with an Unilateral Isolated Anterior Cruciate Ligament (ACL) Rupture in a Six-Month Follow-Up.

Abbas Rahimi, Afshin Rahbari, Khosro Khademi Kalantari, Alireza Akbarzadeh Baghaban, Yaghoob Shavehee

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021 , Page e36

Objectives: Anterior cruciate ligament rupture has shown vast changes in kinematics and kinetics parameters. The aim of this study is to investigate the balance changes including of the time to stabilization (TTS) and velocity of the Center of Pressure (CoP) displacement in functional activities.

Materials and Methods: The present cohort study was conducted on 58 male and female professional athletes. The subjects were divided into two healthy and ACL-deficient knee groups, each with 29 subjects. The time to stabilization (TTS) and velocity of CoP displacement parameters in both anterior-posterior and medial-lateral directions were calculated in a forward jumping test on a force platform. The test was performed three times consisted on the end of the 2nd, 4th and 6th months post injury.

Results: The results of this study showed that although in the ACL-D group, none of the TTS and CoP velocity parameters showed a significant difference during the six months after the injury (P=0.686 for TTS, P=0.603 for CoP velocity in AP direction and P=0.185 in ML direction), there was a significant difference between the healthy and ACL-D groups. The TTS was different between groups (P=0.494 for 2nd, P=0.008 for 4th and P=0.041 for 6th month post injury). The CoP velocity in AP direction did not show difference between groups (P=0.419 for 2nd, P=0.196 for 4th and P=0.36 for 6th month after injury) but in ML direction there was a significant difference between groups in 4th month post injury (P=0.359 for 2nd, P=0.01 for 4th and P=0.331 for 6th post injury).

Conclusion: In a six month period after ACL injury balance parameters change without a constant trend. CoP velocity in ML direction showed more significant and clear changes in comparison within and between groups. Considering all parameters, it seems between 2nd and 4th month improvement was occurred but no improvement was seen between 4th and 6th month. It can be said that most of the changes occur in the first months after the injury.

Keywords: ACL deficient knee, Time to Stabilization, Center of Pressure, Balance, Velocity

Attitude of Iranian Orthopedic Residents towards Online Educating Programs in COVID-19 Pandemic

Reza Jahanshahi, Adel Ebrahimpour, Hossein Mohebbi, Shiva Momen, Mehrdad ghobadi, Javad Ahmadlou, Peyman Zia, Mehdi Aarabi, Seyyed-Mohsen Hosseininejad

Journal of Clinical Physiotherapy Research, Vol. 6 No. 2 (2021), 21 June 2021 , Page e37


The current COVID-19 pandemic impose many challenges including maintain educational programs delivery obstacles. The aim of this study was to investigate orthopedics residents’ opinion towards using online methods to sustain medical education.


A cross sectional study applying an 8-item questionnaire was performed to investigate 150 Iranian residents’ attitudes towards online medical learning programs.


One-hundred thirty two residents (88%) replied back the questionnaire. 89% of the participants reported they use online methods; most frequent method was online webinars by 84%. They frequently used Skyroom (76%) to take part in the educational events. Satisfaction rate for webinar was reported as well as 8.2. Weak internet connection and speed was the main problem reported by the participants. 91.8% of the residents supposed continuing the online education would be useful.


Orthopedic residents believed that Online educating programs would be favorable and useful to continue after the current pandemic.