Journal of Clinical Physiotherapy Research

Introduction: Lower limb prostheses by advancements in materials, design, and technology aimed at restoring mobility and decreasing energy consumption for individuals with amputations have evolved significantly over the past few decades. This study aims to review articles investigating the energy consumption of lower limb prostheses, focusing on design characteristics, material properties, and user-specific factors influence energy efficiency and functional performance. Materials and Methods: This literature review study reviewed design characteristics, material properties, and user-specific factors of lower limb prostheses by employing a comprehensive search strategy across multiple electronic databases, including PubMed, Web of Science, and Scopus, to identify relevant studies published up to November 2024. The search strategy was structured using the PICO framework, utilizing keywords such as "lower limb prostheses," "energy consumption," "design characteristics," "material properties," and "user-specific variables" to ensure a thorough exploration of the literature. Results: This literature review analyzes 10 articles on lower limb prosthetics and their impact on energy consumption of its users. Key findings revealed that advancements in materials, such as carbon fiber and smart technologies, significantly enhance energy efficiency, reduce fatigue, and improve user mobility. Furthermore, the integration of personalized fitting and rehabilitation strategies plays a crucial role in optimizing outcomes for users. Conclusion: The review underscores the importance of personalized fitting and rehabilitation strategies in enhancing the functionality and quality of life for amputees. By focusing on user-centered design and technological advancements, the findings highlight the potential for energy-efficient prosthetic devices to improve mobility and reduce healthcare costs, ultimately facilitating greater independence for users.

Infertility is a complex condition affecting approximately 15% of couples globally, with male factors contributing to 30-50% of cases. The etiology of male infertility encompasses hormonal imbalances, anatomical abnormalities, lifestyle choices, and environmental exposures. Traditional medical interventions primarily focus on hormonal therapies and surgical corrections, yet there is increasing interest in complementary strategies, including physical therapy, to enhance male reproductive health. This literature review systematically examines the role of physical therapy interventions specifically pelvic floor training, manual therapy, exercise regimens, and stress management techniques in improving male fertility outcomes. Research suggests that pelvic floor training can strengthen muscles crucial for sexual function and reduce performance anxiety. Manual therapy techniques, such as myofascial release and soft tissue mobilization, can improve blood circulation to the pelvic region, positively influencing sperm quality. Regular exercise has been linked to hormonal balance and enhanced overall fitness, contributing to better fertility outcomes. Furthermore, addressing psychological factors through stress management is essential, as chronic stress can adversely affect reproductive health. This review underscores the significance of multidisciplinary approaches in the management of male infertility and highlights the potential of physical therapy as a critical component in promoting male reproductive health and optimizing fertility. Future research directions are proposed to deepen understanding and inform clinical practice in this area.

Introduction: Walking is a complex activity that depends on the coordination between muscles and joints, a capability that is significantly impaired in individuals with spinal cord injuries (SCI). To enhance gait efficiency, reduce energy expenditure, and promote independence among patients with SCI, Medial Linkage Orthoses (MLOs) have been developed. In contrast, conventional orthotic solutions like Knee-Ankle-Foot Orthoses (KAFOs) and Hip-Knee-Ankle-Foot Orthoses (HKAFOs) often lead to high energy costs and low user satisfaction. Material and Methods: This review investigated the evolution and effectiveness of various orthotic devices, with a particular focus on MLOs, including the Walkabout and Prime Walk. A thorough literature search was conducted across databases covering the period from 1960 to 2024 using relevant keywords. 23 articles met the criteria for data extraction, guided by a standardized protocol. Results: The review’s findings emphasize the influence of spinal cord Orthoses on gait, energy consumption, and overall user satisfaction. The development of orthotic devices, particularly MLOs, marks a notable advancement in treating gait dysfunctions associated with SCI. Evidence suggests that MLOs, such as Walkabout and Prime Walk, offer significant advantages over traditional KAFOs and HKAFOs in terms of biomechanics, energy efficiency, and user satisfaction. Specifically, innovations like Ahmadi's model demonstrate improved biomechanical alignment and reduced energy expenditure, making walking more feasible for patients with SCI. Conclusion: Ultimately, the implementation of MLOs could greatly enhance independence and improve the quality of life for individuals with SCI. Further research is essential to optimize the designs of these orthotic devices and to investigate their long-term effects on functional outcomes within SCI populations.

Introduction: Anterior cruciate ligament (ACL) tears are a common sports injury, the incidence of which is increasing due to the population's increased participation in sports activities. ACL tears can lead to serious knee complications, including cartilage damage, meniscus tears, and osteoarthritis. This systematic review aimed to examine the pathogenesis and treatment of ACL injuris in athletes. Materials and Methods: Five electronic databases, Medline, Scopus, PubMed, Embase, and Cochrane, were comprehensively searched to identify published articles from January 1994 to October 2024 related to treatments of ACL rupture. According to the PICOS, the eligibility criteria were: 1) The samples were athletes who experienced ACL injury and 2) Studies were published in English language. The modified version of the Downs and Black checklist was used to assess the methodological quality of the included articles. Results: Findings demonstrated that the rate of ACL injury for basketball and handball players ranged from 4.1 to 5. Furthermore, the rates for soccer players are slightly lower, ranging from 2.3 to 2.5. Alpine skiing in high school has an injury rate of 3.1. In contrast, lacrosse, ice hockey, and Military training have rates of 1.4, 2.0, and 2.7 respectively. Conclusions: Based on findings it can be conclude that basketball and handball players have higher rates of ACL injuries, especially at the collegiate level.

Introduction: The Upper Limb Functional Index (ULFI) is a patient-reported outcome measure (PROM) designed to evaluate the functional status and level of participation of individuals with upper limb musculoskeletal disorders (ULMSDs). The purpose of this study was to translate the original ULFI into Persian (ULFI-Pr) and assess the psychometric properties of ULFI-Pr in Iranian individuals with ULMSDs. Materials and Methods: This cross sectional study was conducted in two stages based on standard guidelines. The ULFI was cross-culturally adapted through double forward and backward translations, and then its psychometric properties were validated. Participants (n=150) with various upper limb conditions for >12 weeks completed the ULFI and the Disabilities of the Arm, Shoulder, and Hand (DASH). Internal consistency and test-retest reliability were determined using Cronbach’s Alpha and the Intraclass Correlation Coefficient (ICC).  The full sample determined internal consistency, concurrent criterion validity, construct validity, and factor structure; a subgroup (n=30) determined reliability at 14 days interval. Results: The original ULFI was translated and cross-culturally adapted into Persian with only minor wording changes. The ULFI-Pr demonstrated high internal consistency (α = 0.93) and test-retest reliability (ICC=0.92). The correlation between ULFI and DASH was high (r = 0.71) and P<0.001). Construct validity was examined through exploratory factor analysis (EFA) using Maximum Likelihood Extraction with Promax rotation. The EFA demonstrated a one-factor structure that explained 38.2% of total variance. No floor or ceiling effects were observed. Conclusion: The ULFI-Pr can be considered a region-specific, single-factor structure PROM for the evaluation of ULMSDs for clinical and research purposes in Persian language populations.

Knee osteoarthritis (OA) is a prevalent degenerative joint disease that significantly impacts physical function and quality of life. While traditional management strategies focus on pharmacological and surgical interventions, the role of footwear modifications, such as lateral wedge insoles, has gained attention. This study aimed to investigate the effects of 6-degree lateral wedge insoles on pain, functional outcomes, and biomechanical parameters, such as the adductor moment, in patients with knee OA over six weeks. This was a randomized clinical trial study that twenty-one participants aged 50–75 years with moderate to severe knee OA were randomized into an intervention group (n=11), which received 6-degree lateral wedge insoles, and a control group (n=10), which used flat insoles. Pain levels, functional performance, and adductor moment were assessed at baseline and after six weeks. Results showed significant improvements in pain (45% reduction, P=0.003) and joint stiffness (30% reduction, P=0.001) in the intervention group, along with a 13% reduction in the adductor moment (P=0.021). Immediate effects also demonstrated a 35% reduction in pain (P=0.007) and a 42% reduction in stiffness (P=0.001). These findings suggest that 6-degree lateral wedge insoles can provide both immediate and sustained benefits for knee OA patients, highlighting their potential as a non-invasive management strategy.

Introduction: Lumbar hyperlordosis is a common problem among athletes, characterized by an excessive increase in the lumbar arch which can lead to chronic Low Back Pain (LBP). The central stabilizing muscles of the trunk are crucial for maintaining proper stability and alignment of the spine. Weakness in these muscles can increase the lumbar arch's severity and associated pain. This study aimed to investigate the correlation between the endurance of different groups of core stability muscles and pain in women athletes with lumbar hyperlordosis. Materials and Methods: 36 female athletes with lumbar hyperlordosis were randomly selected and examined. The study assessed the endurance of the different central stability muscles, including trunk flexors, extensors, and lateral flexors, using McGill tests. Additionally, the athletes' level of LBP was measured using the Visual Analog Scale (VAS). Data analysis used multiple linear regression to assess the correlation between muscle endurance and pain. Results: None of the endurance variables of the four central stability muscles are significantly associated with the pain of subjects with hyperlordosis (P³0.05). According to the reported beta values, the endurance of the muscles of the trunk extensor, left lateral flexor, right lateral flexor, and trunk flexor have the greatest association with LBP of athletes with lumbar hyperlordosis (P³0.05). Conclusion: These findings suggest that increasing the endurance of the central stabilizing muscles, could not significantly reduce LBP in athletes with lumbar hyperlordosis, for this reason, there is no need to separate the strengthening of the core muscles to reduce  LBP These results could be used to develop targeted exercise programs to correct posture and reduce pain in this population.