Original Articles


Introduction: High-fat diets and physical exercise are associated with increased expression of genes involved in the metabolism and browning of adipose tissue; however, their molecular mechanisms are not fully understood. In the present study, the effect of high-intensity interval training (HIIT) over a period of a ketogenic diet (KD) on serum levels of uncoupling protein 1(UCP1), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC) in females with overweight and obesity were investigated. Materials and Methods: In this quasi-experimental study with pre- and post-test design, 16 inactive females with overweight and obesity (BMI>25 kg.m-2, aged 18-24 years) were randomly divided into two groups of eight individuals (KD+HIIT: Experimental group or KD: Control group) and participated in a six-week experimental period (KD: 70% fat, 20% protein and 10% carbohydrate; HIIT: 4×4 min running with an intensity of 85-95% of maximal heart rate, three 45-min sessions per week). Blood samples were collected and analyzed 48 h before and after the experimental period. The data were analyzed using ANCOVA and paired-samples t-tests at the 95% confidence level. Results: From pre-test to post-test, KD+HIIT was associated with a significant increase in UCP1 (P=0.007) and HDL (P<0.001) and a significant decrease in LDL (P=0.001) and TC (P=0.009), whereas KD led to a significant increase in HDL (P<0.001) and a significant decrease in LDL (P=0.002). After controlling for pre-test effects, the levels of UCP1 (P=0.006) and HDL (P<0.001) in experimental group  in post-test were significantly higher than in KD group, whereas differences in LDL (P=0.486) and TC (P=0.665) levels were not statistically significant (P>0.05). Conclusion: Combining HIIT with a KD is more effective than KD alone in activating the browning pathways of adipose tissue and improving blood lipid profile, which can be used to manage overweight and prevent the cardiovascular consequences of obesity.

The Effect of Two Types of Thoracolumbosacral Braces on Electromyography Activity of Selected Muscles in Patients with Kyphosis during Walking

Milad Piran Hamlabadi, Amir Ali Jafarnezhadgero, Sevda Abdullahi Goliki, Ebrahim Piri

Journal of Clinical Physiotherapy Research, Vol. 7 No. 3 (2022), 1 July 2022, Page e62
https://doi.org/10.22037/jcpr.v7i3.39946

Introduction: The relationship between the use of braces and gait parameters in people with kyphosis has been not well understood. The aim of the present study was to evaluate the effect of two types of thoracolumbosacral braces on erector spinae, and gluteus medius muscles activities in individuals with kyphosis during walking. Materials and Methods: Fifteen males with kyphosis volunteered to participate in the present study. All participants were right footed. Each participant performed three walking trials in each of the three brace conditions including without brace, with alarm brace, and with simple brace. Muscle activities were recorded during walking at constant walk speed. Statistical analysis was performed using repeated measures ANOVA test at the significant level of 0.05. All analyses were performed using the SPSS version 22. Results: There is no significant difference in electromyography activities of the lower limb muscles at the loading response and mid-stance phases (P>0.05). Also, results showed a significant difference during push-off phase for gastrocnemius medialis muscle (P<0.05). Conclusions: The use of thoracolumbosacral braces reduced the electrical activity of the gastrocnemius medialis muscle during the push-off phase. These changes may lead to gait efficiency while using thoracolumbosacral braces.

The Effect of Physical Activity Levels on Body Image, Self-esteem, and Quality of Life in Women after Breast Cancer Surgery

Fatmeh Akbari, Seyed Kazem Mousavi Sadati, Keyvan Molanorouzi

Journal of Clinical Physiotherapy Research, Vol. 7 No. 3 (2022), 1 July 2022, Page e61
https://doi.org/10.22037/jcpr.v7i3.38634

Introduction: Based on many evidences, physical activity levels are one of the most important factors in maintaining personal and social health. The current study aimed to investigate the effect of physical activity (PA) on body image, self-esteem, and quality of life in women after breast cancer surgery. Materials and Methods: The participants of the present study were 252 women with breast cancer who had undergone breast cancer surgery at least once in the Mo'tamed hospital in Tehran. Assessment tools were the international Physical Activity questionnaire (IPAQ), self-administrated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30), Multidimensional Body-Self Relations Questionnaire (MBSRQ), and Coopersmith self-esteem (SEI) questionnaires. To analyze the data, the ANOVA, and Tukey post hoc test were used respectively. Results: Results showed a significant difference between low and moderate, low and high, and moderate and high PA level on body image, self-esteem, and quality of life (P≥0.05). The moderate level of PA had more effect compared to the low and high levels of PA. Conclusion: Our study suggested that physicians, Physical Therapists, Occupational Therapists, should be schedules more PA and sports plans for patients with breast cancer surgery and increase patients’ awareness of PA benefits.

The Effect of Increasing Running Speed on Mechanical Work of the Lower Limbs in Elite Male Runners

Razieh Yousefian Molla, Rozhin Molavian, Ali Fatahi

Journal of Clinical Physiotherapy Research, Vol. 7 No. 3 (2022), 1 July 2022, Page e63
https://doi.org/10.22037/jcpr.v7i3.42356

Introduction: Understanding the biomechanical performance of the lower limb joint during running is of the utmost importance for enhancing our current understanding of high human performance, as well as for identifying potential factors that may be associated with injuries. Given that the mechanical work of the lower limb joints conveys crucial information about joint function, the objective of the present study was to examine the impact of increasing running speed on the mechanical work of elite male runners. Materials and Methods: The current study is an observational cross-sectional study.28 healthy male elite runners aged 22 - 51 years ran on a treadmill with a force plate in the middle of the walk-way, at three different speeds, 2.5, 3.5 and 4.5 m/s respectively, and the data related to the mechanical work of the lower limbs were recorded and extracted. Also, in order to compare the averages of the Hip, Knee and Ankle mechanical work variables, ANOVA repeated measurements method with Bonferroni post hoc test was used. Results: It was found that increasing the speed leads to a significant difference in the mechanical work of the joints of the lower limbs including hip and ankle in both absorption and production phases(P<0.05) except in the knee joint at a speed of 3.5 to 4.5 in positive mechanical work (P=0.121). Conclusion: Considering the biomechanics of running is very important as a basic skill that every person performs during his life. The mechanical work aspects of the hip, knee, and ankle joints during increased running speed may potentially provide a biomechanical explanation for these clinical observations.

Predicting the Performance Anxiety of Musicians Based on Coping Strategies and Emotional Self-Regulation with the Mediation of the Conscious Mind

Rahin khodadadeh, Khoda Morad Momeni, Hooshang jadidi, Maryam Akbari

Journal of Clinical Physiotherapy Research, Vol. 7 No. 3 (2022), 1 July 2022, Page e68
https://doi.org/10.22037/jcpr.v7i3.39685

Introduction: Music performance anxiety has been the focus of psychological research in recent years. The anxiety of music performance is a big problem which musicians, students of the music field are involved with, and at high levels this anxiety prevents the performance or even leads to an impact on the performance or even leaving the stage The aim of this study was to develop a causal model for predicting music performance anxiety based on coping strategies and emotional self-regulation mediated by mindfulness. Materials and Methods: This research was descriptive-correlation type. The statistical population of this study included all musicians, music teachers, and music students in Kermanshah (1,200 persons). A sample of 300 music students and musicians (according to Morgan's table) were selected as available sampling. In this study, information collection tools included 4 standard questionnaires of music performance anxiety of Kenny, Andler and Parker Coping Styles, emotional self-regulation of Garnfsky & Kreich, and the pentagonal mindset of Bayer et al. For inferential analysis of the data, the effects have been investigated using structural equation modeling and Smart PLS software. Results: The results showed that emotion-oriented coping style (β=0.04, T=6.50) and avoidance coping style (β=0.03, T=7.12) had a positive and significant effect on music performance anxiety, but problem-oriented coping style has a negative and significant effect (β=-0.05, T=-7.04). Also, positive cognitive-emotional self-regulation had a negative and significant effect (β=-0.08, T=7.73), and negative cognitive-emotional self-regulation had a positive and significant effect (β=0.04, T=7.10). There was a negative and significant effect between mindfulness and music performance anxiety (β=-0.26, T=5.74). Conclusion: Music performance anxiety is predictable and appropriate strategies can be used to control and reduce it. In this regard, it is important to educate and inform musicians about coping strategies, emotional self-regulation, and mindfulness.