Mahdieh Ravand; Mehri Ghasemi; Abbas Rahimi; Mohammad Reza Mohajeri-Tehrani; Alireza Akbarzadeh Baghban
Volume 23, Issue 5 , 2021
Abstract
Introduction: Peripheral neuropathy is one of the major complications of type II diabetes mellitus. Lower limb proprioceptive impairments due to neuropathy can lead to balance disorders in these patients. The present study aimed to investigate postural stability and neuropathic changes following ankle ...
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Introduction: Peripheral neuropathy is one of the major complications of type II diabetes mellitus. Lower limb proprioceptive impairments due to neuropathy can lead to balance disorders in these patients. The present study aimed to investigate postural stability and neuropathic changes following ankle proprioceptive training in type II diabetic patients with moderate neuropathy.
Materials and Methods: The present study was conducted on 24 type II diabetic patients with moderate neuropathy (9 females and 15 males) aged 40-65 years (with a mean age of 57.25 years). The treatment consisted of ankle proprioceptive training by the balance board and rocker for 10 consecutive days. Balance indices, including Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Medial-Lateral Stability Index (MLSI), were measured with Biodex system before and after the treatment, as well as two weeks after treatment in two conditions: condition1: Eyes open, head straight, without using trunk, pelvis, thigh, and knee constrained orthosis. Condition 2: Eyes closed, head back (hyperextension), with using trunk, pelvis, thigh, and knee constrained orthosis. Plate-based Biodex stability was fixed at levels 6 and 8 for condition1 and level 8 for condition 2. The severity of neuropathy was assessed using Valk and Michigan questionnaires, as well as light touch sensation. The analysis of variance with repeated measure was used to evaluate alterations in the stability of patients. Furthermore, the correlation of neuropathic changes and stability parameters were assessed by the Pearson correlation coefficients.
Results: Significant improvements were observed in OSI in all tests of condition 1 (Biodex Balance System (BBS) at level 8 (P=0.001) and level 6 (P=0.017), as well as test conditions 2 (level 8; P=0.004). After the treatment, at stability level 8, a significant improvement in the mean values of postural sways in the Anterior-Posterior (AP) direction demonstrated that the ankle strategy was improved in the patients. After the treatment, the scores of the Valk (P=0.02) and Michigan (P=0.001) questionnaires were significantly decreased. After two weeks of follow-up, the observed improvement was maintained in the mean values of balance indices (OSI, APSI) and neuropathy due to treatment.
Conclusion: As evidenced by the obtained results, 10 sessions of targeted ankle proprioceptive training improved stability, neuropathy, and light touch sensation of the foot in type II diabetic patients with moderate neuropathy. Foot somatosensory information is one of the most important causes of balance alterations in these patients
Fariba Yadolahi; Mohammad Mohsen Roostayi; Minoo Khalkhali-Zavieh; Abbas Rahimi; Masoud Mehrpour
Volume 21, Issue 8 , 2019, Pages 1-7
Abstract
Context: Postural stability is essential for performing everyday activities. The central nervous system (CNS) must modify balance control to provide stability to intrinsic and external perturbations. Methods considered as the main candidates for ultimate pro- motion of neural plasticity could be used ...
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Context: Postural stability is essential for performing everyday activities. The central nervous system (CNS) must modify balance control to provide stability to intrinsic and external perturbations. Methods considered as the main candidates for ultimate pro- motion of neural plasticity could be used for rehabilitation to enhance motor performance. The Transcranial Direct Current Stim- ulation (tDCS) as a non-invasive brain stimulation tool is applied over the cortex to accentuate and/or accelerate neural effects on network connectivity.Objectives: This study aimed to address the impact of tDCS intervention on balance recovery. We postulated that tDCS induces neuroplasticity that is fundamental for refining motor behaviors such as postural stability during rehabilitation.Methods: The present review discusses the tDCS application over the important areas of the CNS that are responsible for the senso- rimotor processing of balance-relevant information. We searched ProQuest, PubMed, Science Direct, Cochrane, and Google Scholar for randomized, controlled trials that assessed the efficacy of tDCS intervention in improving balance impairment following neu- rologic disorders and enhancing postural stability in a healthy population.Results: Recent studies provide insights into the effects of tDCS on postural stability. Based on the defined criteria, there is a positive response to tDCS, but the underlying neural mechanisms are yet unknown. We suggest that interventions promoting more neural plasticity are crucial for better balance training outcomes and improved effectiveness of rehabilitation programs.Conclusions: Balance recovery after tDCS needs to be more investigated. The tDCS might be considered as an adjunct preventive strategy to provide functional recovery and reduce the adverse effects of balance impairment
Mona Nahayatbin; Mehri Ghasemi; Abbas Rahimi; Khosro Khademi-Kalantari; Sedighe- Sadat Naimi; Seyyed-Mehdi Tabatabaee; Saeed Zarein-Dolab
Volume 20, Issue 4 , 2018, Pages 1-8
Abstract
Background: Osteoarthritis is a common chronic degenerative disorder. Exercise is regarded as a common practice for the elderly, especially those with knee osteoarthritis. Objectives: This study aimed to examine and compare the effects of Tai Chi and closed kinetic chain exercises on patients with knee ...
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Background: Osteoarthritis is a common chronic degenerative disorder. Exercise is regarded as a common practice for the elderly, especially those with knee osteoarthritis. Objectives: This study aimed to examine and compare the effects of Tai Chi and closed kinetic chain exercises on patients with knee osteoarthritis. Methods: Forty-eight patients with knee osteoarthritis participated in this clinical trial study, which was carried out in a private clinic (2016) in district thirteen of Tehran, Iran. They were randomly assigned equally to closed kinetic chain exercise (CKCE) group, Tai Chi Exercise (TCE) group, and no exercise group. All three groups were equally treated using a standard physical therapy protocol.The CKCE group performed static stretching and CKCE, and the TCE group performed Tai Chi warm-up and cool-down and the form 6 of Yang style of Tai Chi exercises. All three groups were evaluated at baseline, sixth, and twelfth sessions of treatment and one- month post- treatment using a six-minute walk test and the knee injury and osteoarthritis outcome score (KOOS) questionnaire. Results: According to KOOS subscale, the TCE improved the symptoms (68.94 ± 9.24) (P < 0.001), pain (75.13 ± 12.33) (P < 0.001), ADL (76.50 ± 12.03) (P = 0.01), and the total score (72.12 ± 8.63) (P < 0.001) significantly more than the CKCE (55.50 ± 13.61, 64.75 ± 10.58, 67.25 ± 9.96, 67.25 ± 7.82, respectively) and routine physiotherapy (34.62 ± 11.34, 53.06 ± 9.36, 61.69 ± 10.32, 51.50 ± 7.24, respectively) in patients with knee OA. Both the TCE (376.43 ± 88.18) (P < 0.001) and CKCE (353.50 ± 78.15) (P < 0.001) groups showedimproved walking distance significantly more than the no exercise group (315.35 ± 66.33) in patients with knee OA.Conclusions: In patients with knee OA, Tai Chi exercise relieved pain and symptom even in a short time, and improved QOL, sport, and recreational activities, and ADL. The effects of both TCE and CKCE on the improvement of QOL were similar.
Soulmaz Rahbar; Sedigheh Sadat Naimi; Asghar Reza Soltani; Abbas Rahimi; Alireza Akbarzadeh Baghban; Vahid Rashedi; Hossein Moein Tavakkoli
Volume 19, Issue 7 , July 2017, , Pages 1-9
Abstract
Background: Diabetes is a cosmopolitan health problem worldwide, especially in Asia. It is a metabolic disorder originating from insulin secretion deficiency, insulin performance or both. When both factors are involved, abnormal complications may result. Exercise training plays an important role in controlling ...
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Background: Diabetes is a cosmopolitan health problem worldwide, especially in Asia. It is a metabolic disorder originating from insulin secretion deficiency, insulin performance or both. When both factors are involved, abnormal complications may result. Exercise training plays an important role in controlling diabetic parameters, including biomechanical variables.Objectives: This study aimed at assessing the effectiveness of exercise on biochemical parameters in patients with diabetes.Methods: This study was a randomized control trial. A total of 30 volunteers met the inclusion criteria and were randomly divided to 2 groups, aerobic and control, by block randomization method. This study was performed during May to October 2016 in Iran. The intervention protocol included 24 sessions (8 weeks) of aerobic exercise on the treadmill with zero slope, 3 days per week for 30 minutes per session. Intensity of training protocol was 50% to 70% maximum heart rate. Measurements of biochemical parameters were done before and after the 24 sessionsResults: There were no significant differences in anthropometric, gender, age, diabetic history, cardiac ejection fraction, and biochemical variables (P > 0.05). After 8 weeks, results were as follows: fasting blood glucose (FBS) (130.92 (45.43) Mg/dL), glycosylated hemoglobin (HbA1c) (6.62 (1.52) percent), cholesterol (150.62 (24.07) Mg/dL), triglyceride (119.62 (39.18) Mg/dL), Low density lipoprotein (LDL) (77.23 (26.73) Mg/dL), and very low density of lipoprotein (VLDL) (23.92 (7.90) Mg/dL); these were significantly reduced in the training group (P < 0.05), yet, not in the control group. Alternatively, high density lipoprotein (HDL) remained unchanged in the aerobic group (47.85 (17.83) Mg/dL) while it was increased in the control group (42.07 (8.86) Mg/dL). Also, C-reactive protein (CRP)) 2.43 (1.03) Mg/L) and microalbumin (12.32 (1.21) Mg) values didn’t change between the 2 groups.Conclusions: Eight weeks of aerobic exercise was shown to be effective in controlling biochemical parameters. However, longer training duration is needed in order to modify CRP.
Zahra Ebrahimabadi; Sedigheh Sadat Naimi; Abbas Rahimi; Heydar Sadeghi; Seyed Majid Hosseini; Alireza Akbarzadeh Baghban; Syed Asadullah Arsalan
Volume 19, Issue 3 , March 2017, , Pages 1-8
Abstract
Background: Providing a clear picture of neuromuscular control mechanisms and deficits in patients with chronic ankle instability (CAI) requires further investigation. Gait initiation (GI) is a perfect task to evaluate concurrent open-loop (planned GI) and closedloop (unplanned GI) neuromuscular control ...
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Background: Providing a clear picture of neuromuscular control mechanisms and deficits in patients with chronic ankle instability (CAI) requires further investigation. Gait initiation (GI) is a perfect task to evaluate concurrent open-loop (planned GI) and closedloop (unplanned GI) neuromuscular control mechanisms in patients with CAI.Objectives: The current study aimed at evaluating neuromuscular control mechanisms via assessment of the center of pressure (COP) displacements during planned and unplanned GI in patients with CAI and healthy individuals.Methods: It was a case-control study. Twenty-two subjects with unilateral CAI and 22 healthy subjects stood on a force plate and initiated gait with maximal velocity under 2 conditions: i) planned (initiated gait after hearing the “all set” signal, when subjects felt ready to walk) and ii) unplanned (initiated gait “as soon as possible” after hearing acoustic signal). The COP parameters were assessed during the preparatory and the execution phase of GI.Results: The peak COP displacement toward swing leg decreased significantly, with P value = 0.003, in the preparatory phase of GI under planned and unplanned conditions in patients with CAI (0.028 ± 0.002) in comparison with the control group (0.038 ± 0.002). Forward velocity of the COP displacement increased in CAI patients (0.026±0.003) compared with the control group (0.018 ± 0.002) in the execution phase of GI, with P value = 0.039.Conclusions: According to the findings of the current study, both open-loop and closed-loop neuromuscular control mechanisms altered in patients with CAI.
