Journal of Clinical Physiotherapy Research

The anterior cruciate ligament (ACL) tear and its subsequent reconstruction surgery can lead to many complications, such as strength deficit and muscle size reduction. Heavy load resistance training is an established method for improving muscle mass and strength but may be intolerable by patients recovering from ACL injuries due to its vigorous modality. Blood flow restriction (BFR) training is a novel technique which has been recognized as a promising alternative strategy, causing physiological adaptations with lower levels of resistance training and joint loading. Given the growing popularity of blood flow restriction, this narrative review seeks to explore the impact of BFR training on various facets of post-ACL reconstruction rehabilitation, comparing it to non-BFR training. A thorough literature search was conducted, and the effect of BFR training were examined on muscle strength, muscle size, pain, function, balance, comfort, willingness to use, bone mineral density, return to sport and ACL graft laxity. The results of this review suggests that BFR training post-ACL reconstruction may offer advantages in terms of muscle strength, muscle mass, bone mineral density, balance, knee joint pain, and function when compared to non-BFR training. However, there is a high variability in methodologies across existing studies, necessitating high-quality research with standardized methodologies and protocols to enable more effective application of BFR training in rehabilitation settings.

Introduction: To examine how rehabilitation exercises following rotator cuff surgery using the ASSET protocol affect shoulder kinematics. Material and Methods: This pre-post quasi-experimental study involved 15 individuals aged 40 to 65 who had a degenerative rupture of the supraspinatus tendon. Each participant underwent tendon repair surgery and two stages of rehabilitation. The first stage consisted of passive treatment for six weeks of ASSET protocol, totaling 18 sessions. The second stage included active-assisted and active motions over four weeks, with 12 sessions. Shoulder kinematics, such as scapular upward rotation and glenohumeral elevation, were assessed using a motion analysis system, measuring parameters like range of motion (ROM), peak time, and raising velocity. Kinematic data were collected before and after the ASSET protocol at the sixth and tenth weeks post-surgery. A paired t-test or Wilcoxon signed-rank test was used to compare the kinematic indices before and after the intervention. Results: The results on glenohumeral elevation and shoulder elevation indicated employing ASSET rehabilitation protocol between the sixth and tenth week following rotator cuff tendon repair lead to a significant increase in the ROM in sagittal and scapular planes (P<0.05), but not for ROM on scapula upward rotation (P=0.691). The peak time of scapula upward rotation significantly decreased in both sagittal and scapular planes (P=0.001), while the raising velocity significantly increased in the scapular plane (P=0.009), but not in sagittal plane (P=0.691). There was a significant decrease in peak time and a significant increase in raising velocity in both planes on glenohumeral elevation and shoulder elevation (P<0.05). For the scapulo-humeral rhythm in scapula upward rotation movement, the results showed no significant change in sagittal and scapular planes (P=0.061). Conclusion: The study's results demonstrate that ASSET protocol can enhance shoulder function following rotator cuff repair surgery by striking a balance between increasing ROM and preserving muscle control.

Introduction: Due to the significant risk of falls caused by overcoming obstacles, extensive research has focused on lower extremity movements to develop fall prevention strategies. So this study was conducted to identify kinematic analysis of gait during obstacle crossing in middle-aged women. Materials and Methods: The study population consisted of healthy middle-aged women aged 55 to 64 years old from the city of Tehran. The minimum sample size was determined to be 24 individuals using G-power software. Angles of lower limb joints were collected using movement analysis cameras during normal gait and obstacle crossing and F point was measured which is when big toe of one's left foot is at the greatest vertical distance from the ground. Paired-Sample T-Test was used with SPSS software version 22 at significant level of P≤0.05 for further statistical analysis. Results: At F point, the ankle and knee joint angles of both the right and left legs decreased significantly when crossing the obstacle compared to normal gait. In addition, Fpoint analysis showed a significant decrease in the hip joint angle of the right leg and a significant increase in the hip joint angle of the left leg. Conclusion: The observed kinematic changes indicate that obstacle navigation involves complex motor adjustments necessary to maintain balance and stability. Therefore, training and rehabilitation programs should address these adaptations by incorporating exercises to improve joint angles and minimize the risk of falls.

Introduction: Hypothyroidism, characterized by an underactive thyroid, is a prevalent condition often accompanied by metabolic changes and goiter. Despite successful treatment, previous research suggests that the quality of life for many patients may be reduced. This study aims to investigate the quality of life in women with hypothyroidism, specifically those treated with levothyroxine, by comparing them to a control group. Materials and Methods: A case-control study involving 61 women aged 18 to 65 with hypothyroidism treated with levothyroxine was conducted. The World Health Organization Quality of Life-26 questionnaire (WHO/QOL-BREF) was used to assess health-related quality of life (HRQOL). The collected data from the WHO/QOL-BREF questionnaires were compared between the patient group and a healthy control group. Serum T4 and TSH levels were also measured in both groups. Results: The average WHO/QOL-BREF score for the patient group was 84.7±10.9, while the healthy control group scored 88.3±12.1. Although there was no significant difference in overall HRQOL, significant differences were observed between the two groups in the physical health (13.75±2.54 for patients and 14.9±2.1 for healthy individuals) and psychological health domains (11.84±2.69 for patients and 13.2±2.3 for healthy individuals). No significant differences were found in the social and environmental health domains (social: patients 12.51±3.15, healthy individuals 12.1±3.4; environmental: patients 13.62±1.75, healthy individuals 13.3±2.2) (P-value=0.74). Conclusion: In this study, significant differences were observed only in the physical and psychological health domains of women with treated hypothyroidism, with their average scores being lower than those of healthy individuals. However, no significant differences were found in the social and environmental health domains between the two groups.

Introduction: In simultaneous assignments, "attention" must be divided between assignments. Due to the competition in processor resources, the result of this action is the reduction of the performance efficiency, at least in one of the tasks. Research on the effect of cognitive task on balance is not conclusive, and the effect of cognitive task and types of tasks at the same time on balance is unknown. The aim of the study is to investigate the intervention effect of two cognitive and visual tasks on balance. Materials and Methods: In this semi-experimental study, 20 young girls performed the test in 4 modes, balance without intervention, balance with cognitive intervention, balance with visual intervention, and balance with both interventions, on the Biodex machine at instability level 4. Overall stability index was recorded as dependent variable. Results: The results of variance analysis of repeated measurements at the level of P<0.05 did not show a significant difference between static balances in different situations. Therefore, all research hypotheses were rejected. Conclusion: It seems that the lack of significant difference between the different positions is related to the lack of control of the participants' cognitive capacity and the created cognitive load and its effect on the posture control mechanisms.

Introduction: This study aims to investigate how physical activities can help enhance static and dynamic balance in children with high functioning Autism Spectrum Disorder (ASD), who often experience difficulties with communication, cognitive abilities, and motor skills. Materials and Methods: The study is a randomized, single-blind clinical trial examining the impact of physical activities on static and dynamic balance in 6-12-year-old hildren with high-functioning ASD from Tehran's rehabilitation centers and special schools. Initially, 30 participants were chosen, then divided into two groups of 15 using block randomization. The intervention group underwent 24 sessions of physical exercises in 8 weeks, 3 sessions per week, and the control group followed their routine therapies as before while their balance was assessed using force plate tools and the Walking heel to toe test before and after the interventions. Results: Findings indicated that static and dynamic balance in children with high function ASD improved significantly by physical activities (P<0.05). The center of pressure sway decreased significantly in lateral displacement (P=0.001), Anterior-Posterior displacement (P=0.002), mean velocity of sway (P=0.003), and sway area (P=0.004), demonstrating improved stability and control. Moreover, the walking heel to toe test score improved significantly in the intervention group compared to the control group (P<0.001). Conclusion: It seems that physical activities can improve static and dynamic balance in children with high function ASD, so therapists can use physical activities to increase balance and improve movement disorders in children with high functioning ASD.