Publications by authors named "Ehsan Sinaei"

10 Publications

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A Randomized Controlled Trial on the Effects of 12 Weeks of Aerobic, Resistance, and Combined Exercises Training on the Serum Levels of Nesfatin-1, Irisin-1 and HOMA-IR.

Front Physiol 2020 16;11:562895. Epub 2020 Oct 16.

Department of Biochemistry, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

This study aimed to investigate the impacts of a 12-week training of the aerobic exercise (AE), resistance exercise (RE), and combined exercise (CE) on the serum levels of nesfatin-1, irisin-1 and some other metabolic and anthropometric indices in overweight women with metabolic syndrome. Sixty overweight women with metabolic syndrome were assigned equally into four groups: aerobic exercise (AE, = 15), resistance exercise (RE, = 15), combined exercise (CE, = 15), and control ( = 15). All groups underwent 12 weeks of intervention. The study variables were measured before and 24 h after the intervention period. Twelve weeks of training resulted in an increase of irisin-1 in the AE and CE groups and nesfatin-1 in all the intervention groups. As expected, all the trained groups exhibited a positive alteration in anthropometric indices and lipid profile in comparison with the control group. Besides, compared with the control group, insulin resistance (based on the homeostatic model assessment) in AE ( = 0.022), RE ( = 0.032), and CE ( < 0.001) groups were reduced significantly. According to the observed changes in the measured indices, serum irisin-1 was significantly correlated with body weight, BMI, body fat percentage, fasting insulin, and HOMA-IR. However, with regard to nesfatin-1, only a negative correlation was observed with body fat percentage and LDL-cholesterol. The 12-week systematic training program changed circulating irisin-1 and nesfatin-1. Also, change in the serum irisin-1 and nesfatin-1 were correlated with the change in glycemic and anthropometric indices in addition to LDL-cholesterol. Also, exercise training significantly reduced fasting insulin and HOMA-IR in all the intervention groups. IRCT20180806040721N2.
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October 2020

Normative Data for the Balance Error Scoring System in Iranian Adults.

J Sport Rehabil 2020 Jul 30:1-6. Epub 2020 Jul 30.

Context: The Balance Error Scoring System (BESS), originally designed to diagnose and assess athletes with concussion syndrome, is now widely used to evaluate postural stability. To interpret balance status, a normative database can be a reliable source. However, different anthropometric characteristics and sociocultural backgrounds across populations hinder the application of previously developed databases in different populations.

Objective: The present study was designed to develop a normative data set for the general population of healthy Iranian adults according to their age groups and to study the correlation between BESS scores and the participants' sex, height, weight, and body mass index.

Design: A cross-sectional study.

Participants: A total of 1051 community-dwelling adults aged 20-69 years not suffering from balance disorders, dizziness, or other neurological or musculoskeletal diseases were recruited and stratified into 5 different age groups by decade.

Main Outcome Measures: The BESS tests were composed of single-leg, double-leg, and tandem stances, each on a rigid surface and a foam pad. The individuals maintained each position for 20 seconds with eyes closed. The assessor recorded the total number of errors as the individuals' BESS score (range: 0-60).

Results: Significant but weak correlations were found between BESS score and height (r = -.13, P < .001) and between BESS score and body mass index (r = .11, P < .001), and the difference between sexes in BESS score was statistically significant in the 50- to 59-year-old (P = .021) and 60- to 69-year-old (P < .001) groups. The BESS scores were significantly different between all age groups (P < .05), except between the 20- to 29-year-old and 30- to 39-year-old groups (P = 1.000) and between the 40- to 49-year-old and 50- to 59-year-old groups (P = .086).

Conclusions: This study provided a normative database for different age groups of asymptomatic Iranian adults. The BESS score had weak correlations with height and body mass index and no correlation with weight, and significant differences were found between sexes in 50- to 69-year-old individuals. This study emphasizes the importance of obtaining specific normative data for different populations.
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July 2020

Combined effects of whole body vibration and unstable shoes on balance measures in older adults: A randomized clinical trial.

Arch Gerontol Geriatr 2018 Sep - Oct;78:30-37. Epub 2018 May 30.

Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Objective: The purpose of this study was to compare the efficacy of 4 weeks of whole body vibration training on balance in older adults who word two different types of shoes: unstable (unstable group) versus standard shoes (stable group).

Design: Randomized, single-blind clinical trial.

Participants: Seventy eight eligible older adults were initially enrolled; 59 participants (mean age 69.7±5.3 years) completed the program.

Intervention: Participants were randomized 1:1 to an intervention group that received whole body vibration with unstable shoes, and a control group that received whole body vibration with standard shoes.

Outcome Measures: The Fullerton Advanced Balance scale, preferred gait speed, maximum gait speed, and Fall Efficacy Scale were recorded at baseline, after the 4-week intervention, and 1 month after the end of the training program.

Results: Both groups showed improvement in all outcome measures at 4 weeks (p < 0.01) with no significant between-group differences. In the unstable group, the gains were maintained at follow-up (p < 0.01) whereas the scores returned to baseline values in the stable group. At follow-up, significant between-group differences were found for Fullerton Advanced Balance scale (p < 0.001), preferred gait speed (p = 0.007) and maximum gait speed (p = 0.007), and all were in favor of the unstable group.

Conclusion: Combining whole body vibration with unstable shoes can be proposed as a beneficial method with relatively long-term effects to improve balance measures in older people.
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May 2019

Comparing spinal manipulation with and without Kinesio Taping in the treatment of chronic low back pain.

J Bodyw Mov Ther 2018 Apr 26;22(2):540-545. Epub 2017 Jul 26.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: Chronic non-specific low back pain (CNLBP) is a prevalent problem among athletes that can cause long-lasting disability and time lost from sporting activities. Thus far, a variety of methods have been suggested to address this problem, including spinal manipulation (SM) and Kinesio Tape (KT). The aim of this study was to investigate whether adding KT to SM can provide any extra effect in athletes with CNLBP or not.

Method: Forty-two athletes (21males, 21females) with CNLBP were randomized into two groups of SM (n = 21) and SM plus KT (n = 21). Pain intensity, functional disability level and trunk flexor-extensor muscles endurance were assessed by Numerical Rating Scale (NRS), Oswestry pain and disability index (ODI), McQuade test, and unsupported trunk holding test, respectively. The tests were done before and immediately, one day, one week, and one month after the interventions and compared between the two groups.

Results: After treatments, pain intensity and disability level decreased and endurance of trunk flexor-extensor muscles increased significantly in both groups. Repeated measures analysis, however, showed that there was no significant difference between the groups in any of the evaluations.

Conclusions: The findings of the present study showed that adding KT to SM does not appear to have a significant extra effect on pain, disability and muscle endurance in athletes with CNLBP. However, more studies are needed to examine the therapeutic effects of KT in treating these patients. CLINICAL TRIAL REGISTRY NUMBER (IRCT.IR): IRCT2016020624149N5.
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April 2018

Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility: a quasi-experimental study.

Chiropr Man Therap 2018 17;26:16. Epub 2018 May 17.

1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: To investigate the effect of lumbar and sacroiliac joint (SIJ) manipulation on pain and functional disability in patients with lumbar disc herniation (LDH) concomitant with SIJ hypomobility.

Methods: Twenty patients aged between 20 and 50 years with MRI-confirmed LDH who also had SIJ hypomobility participated in the trial in 2010. Patients who had sequestrated disc herniation were excluded. All patients received five sessions of spinal manipulative therapy (SMT) for the SIJ and lumbar spine during a 2-week period. Back and leg pain intensity and functional disability level were measured with a numerical rating scale (NRS) and the Oswestry Disability Index (ODI) at baseline, immediately after the 5th session, and 1 month after baseline.

Results: A significantly greater mean improvement in back and leg pain was observed in the 5th sessions and 1 month after SMT. Mean changes in ODI in the 5th session and 1 month after treatment also showed significant improvement. The MCIC for NRS and ODI scores in the present study were considered 20 and 6 points, respectively. Therefore, the mentioned improvements were not clinically significant in the 5th session or at 1-month follow-up.

Conclusion: Five sessions of lumbar and SIJ manipulation can potentially improve pain and functional disability in patients with MRI-confirmed LDH and concomitant SIJ hypomobility.

Trial Registration: (Identifier: IRCT2017011924149N33), registered 19 February 2017 (retrospectively registered).
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August 2019

Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome.

J Sport Rehabil 2019 Mar 30;28(3):243-249. Epub 2018 Nov 30.

Context: Chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points (MTrPs), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe postneedle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard.

Objective: To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. The authors hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP.

Design: Single-blind randomized clinical trial.

Setting: Sports medicine physical therapy clinic.

Participants: A total of 40 overhead athletes (age = 36 [16] y; 20 females and 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n = 21) and ISP DN (n = 19) groups.

Intervention: An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in 3 sessions (2-day interval between each sessions) for each group.

Main Outcome Measures: Pain intensity (visual analog scale), pain pressure threshold, and disability in the arm, shoulder, and hand were assessed before and after the interventions.

Results: Pain and disability decreased significantly in both groups (P < .001) and pain pressure threshold increased significantly only in the ISP group (P = .02). However, none of the outcome measures showed a significant intergroup difference after treatments (P > .05).

Conclusions: Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.
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March 2019

Effects of Kinesio Taping on knee function and pain in athletes with patellofemoral pain syndrome.

J Bodyw Mov Ther 2017 Oct 27;21(4):835-839. Epub 2017 Jan 27.

Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective: To compare the knee performance and pain in athletes with patellofemoral pain syndrome (PFPS) before and after applying Kinesio Tape (KT) on vastus medialis obliquus (VMO) muscle.

Participants: Fifteen participants (10 females, five males) with unilateral PFPS were examined and compared under taped and untaped conditions.

Intervention: VMO of the involved leg was taped from origin to insertion, with 75% of KT's maximal length tension.

Main Outcome Measures: Maximal eccentric and concentric peak torques of quadriceps were measured at 60 and 180°/s angular velocities by an isokinetic dynamometer. Functional performance and pain were evaluated by functional tests (step-down and bilateral squat) and visual analog scale, respectively.

Results: Paired t-test showed statistically significant increase in VMO peak torque and also repetition of step-down test and bilateral squat after using KT. Pain intensity was also decreased significantly following KT application (p < 0.05).

Conclusions: KT application over VMO can decrease pain and improve the functional performance, generally and quadriceps muscle strength, particularly, in athletes with PFPS. However, more research is needed to evaluate the long-term effects of this therapeutic procedure.
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October 2017

The immediate effect of talocrural joint manipulation on functional performance of 15-40 years old athletes with chronic ankle instability: A double-blind randomized clinical trial.

J Bodyw Mov Ther 2017 Oct 25;21(4):830-834. Epub 2017 Jan 25.

Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective: To evaluate the immediate effect of talocrural joint manipulation (TCJM) on functional performance of athletes with chronic ankle instability (CAI).

Participants: Forty athletes (18males, 22females) with CAI divided into TCJM group (n = 20) and sham manipulation group (n = 20).

Intervention: TCJM was performed as a quick thrust on the involved talus, in the posterior direction. Sham manipulation was maintaining the same position, without any thrust.

Main Outcome Measures: Functional performance of athletes was assessed with single leg hop; speed and Y balance tests, before and after the interventions.

Results: All functional tests evaluated in this study improved significantly after TCJM (p-value<0.05). These findings were not seen in the control group. Between-group comparisons also showed significant changes for all the measurements after the interventions (p < 0.05).

Conclusions: TCJM can significantly increase the functional performance of athletes with CIA and can be an effective supplementary treatment for these subjects. However, this was a pre-post study and future studies with long-term follow-ups may provide more reliable results about the long-term effectiveness of this type of treatment.
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October 2017

The Effect of 12 Weeks Aerobic, Resistance, and Combined Exercises on Omentin-1 Levels and Insulin Resistance among Type 2 Diabetic Middle-Aged Women.

Diabetes Metab J 2017 Jun 18;41(3):205-212. Epub 2017 May 18.

Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Recent studies have shown that omentin-1 derived from adipokines can affect physiological regulations and some metabolic dis-eases such as type 2 diabetes mellitus (T2DM).

Methods: The purpose of this study was to examine the impact of 12 weeks of aerobic (cycle ergometer), resistance, and combined exercises on omentin-1 level, glucose and insulin resistance indices in overweight middle age women with T2DM. In this study, 60 overweight middle age diabetic women were selected using simple random sampling and they were assigned to three groups of aerobic exercise (n=12), resistant exercise (n=12) and combined exercise (n=13), and one control group (n=15). Exercises were done in a three times per week sessions for a total of 12 weeks. Blood samples were collected before each exercise session and 24 hours after of the last session.

Results: Present study showed that fasting blood sugar decreased significantly in all intervention groups, while homeostasis model assessment of insulin resistance (HOMA-IR) decreased only in the aerobic and combined exercises groups. Furthermore, there was a significant increase in the omentin-1 level only in the combined exercise group.

Conclusion: Compared to aerobic and resistance exercises, 12 weeks of combined exercise was more efficient in improving HOMA-IR and increasing serum omentin-1 among women with T2DM.
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June 2017