Journal of Clinical Physiotherapy Research

Background: The aim of this study was to compare the effectiveness of transcranial direct current stimulation (tDCS) and motivational interviewing on self-control, reduction of substance use craving, and psychological distress in men addicted to drugs. Methods: This research was applied in terms of its objective and quasi-experimental in terms of data collection method. The statistical population consisted of drug-addicted individuals supported by the Imam Khomeini Relief Committee in Alborz Province, selected from Razi Clinic, Khomeh Barakat Addiction Treatment Center in Mohammadshahr, and Dr. Fayyaz Addiction Treatment Center in Karaj. Sixty participants were selected through convenience sampling from this population and were randomly assigned into four groups: 15 participants in the tDCS experimental group, 15 participants in the sham tDCS group (designed to control for the placebo effect by placing electrodes according to a specific protocol with or without real stimulation), 15 participants in the motivational interviewing group, and 15 participants in the control group who did not receive any intervention. The research instruments included the Drug Desire Questionnaire (DDQ), the Self-Control Scale, and the Psychological Distress Standard Questionnaire. For data analysis, descriptive statistics (mean and standard deviation) and inferential statistics (multivariate analysis of covariance) were employed using SPSS software. Results:The findings indicated that both transcranial direct current stimulation and motivational interviewing had significant effects on self-control, reduction of substance use craving, and psychological distress among men addicted to drugs (P ≤ 0.05), with motivational interviewing being more effective than tDCS. Conclusion: Considering the higher effectiveness of motivational interviewing, it is recommended that special training programs be designed and implemented for counselors and addiction treatment specialists to enable them to use motivational interviewing more effectively during the treatment process.

Background: Flexible flatfoot is linked to changes in lower-limb alignment and increased dynamic knee valgus (DKV), which may predispose individuals to musculoskeletal disorders. Limited evidence exists comparing corrective exercises and custom foot orthoses on foot alignment and knee kinematics. Methods: Thirty male adolescents (12–15 years) with flexible flatfoot were randomly assigned to three groups: a combined comprehensive exercise program with custom-made orthoses, custom orthoses only, or a control group. Interventions lasted 6 weeks. Outcome measures included navicular drop, medial longitudinal arch angle, rearfoot eversion, and 3D lower-limb kinematic variables during a single-leg step down task. MANCOVA was used with baseline adjustments (p ≤ 0.05). Results: A significant multivariate group effect was observed (Wilks’ Λ = .000, F (14, 28) = 476.67, p < .001, partial η² = .996). The combined intervention group showed greater improvements across all foot alignment variables and DKV kinematics compared to orthoses-only and control groups. Effect sizes were large (0.14 < η²), and all changes exceeded MCID values. Conclusion: Combining a comprehensive exercise program with customized foot orthoses results in greater improvements in foot alignment and DKV kinematics than orthoses alone. This approach addresses both distal and proximal aspects of the kinetic chain and may benefit adolescents with flexible flatfoot. Long-term follow-up studies are recommended. 

Background: Work-related musculoskeletal disorders (WMSDs) are major occupational health problems linked to various ergonomic and biomechanical exposures. This scoping review aimed to map the available evidence on ergonomic risk factors associated with WMSDs among Iranian workers, focusing on occupational groups, ergonomic exposures, musculoskeletal outcomes, and assessment methods. Methods: PubMed, Scopus, Web of Science, and Google Scholar were searched from database inception to September 2026. Eligible studies were those conducted in Iran that examined ergonomic or physical/biomechanical risk factors in relation to WMSDs or musculoskeletal symptoms among workers. Two reviewers independently performed study selection. Findings were synthesized descriptively and narratively without quantitative pooling. Results: Thirty-one studies met the inclusion criteria and covered diverse occupational settings, including industrial and manufacturing, agricultural, office, healthcare, and service jobs. The most frequently investigated ergonomic risk factors were awkward or sustained postures, repetitive movements, manual handling, physical workload, force exertion, prolonged standing or sitting, and workstation-related factors. RULA, QEC, REBA, and ROSA were the most commonly used assessment methods. Musculoskeletal outcomes most often involved the low back, neck, shoulders, upper extremities, and multiple body regions. Higher ergonomic exposure or risk scores were frequently associated with greater musculoskeletal symptoms. Several studies that evaluated ergonomic interventions generally reported improvements in musculoskeletal outcomes or reductions in ergonomic risk. Conclusion: Substantial ergonomic risks exist across diverse Iranian occupational groups, although the distribution of evidence remains uneven. Greater standardization of ergonomic and musculoskeletal assessments, inclusion of underrepresented occupations, and further evaluation of targeted workplace interventions are needed.