Publications by authors named "Masumeh Hessam"

7 Publications

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Traditional physical therapy exercises combined with sensorimotor training: The effects on clinical outcomes for chronic neck pain in a double-blind, randomized controlled trial.

J Bodyw Mov Ther 2019 Oct 23;23(4):901-907. Epub 2019 Feb 23.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address:

Objective: This study examined the effects of combining traditional physical therapy exercises with sensorimotor training on joint position sense, pain, muscle endurance, balance and disability in patients with chronic, non-specific neck pain.

Design: Double-blind, randomized controlled trial.

Subjects: A total of 53 patients with chronic non-specific neck pain were randomized to either traditional or combined exercise groups.

Interventions: All patients received 12 sessions of supervised intervention 3 times per week. The traditional group performed traditional exercises, and the combined exercise group performed sensorimotor training in addition to traditional exercises.

Outcome Measures: Joint position sense, pain, neck flexor muscle endurance test, 10 Meter Walk Test, step test, and the Neck Disability Index.

Results: The combined exercise group showed significantly greater improvement compared to the traditional group in joint position sense during extension, flexion, right rotation, the 10 m walk test with head turn, and the step test. Pain intensity, muscle endurance, and disability improved in both groups. Additionally, there was a higher degree of effect on muscle endurance in the combined exercise group compared to a moderate effect in the traditional group.

Conclusions: A combination of sensorimotor training with traditional physical therapy exercises could be more effective than traditional exercises alone in improving joint position sense, endurance, dynamic balance and walking speed.
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http://dx.doi.org/10.1016/j.jbmt.2019.02.016DOI Listing
October 2019

Postural stability in patients with non-specific chronic neck pain: A comparative study with healthy people.

Med J Islam Repub Iran 2018 23;32:33. Epub 2018 Apr 23.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Impairment of cervical sensory input in patients with neck pain may disturb postural stability. The purpose of present study was to assess the dynamic postural stability of subjects with chronic neck pain compared to a matched control group. In this case-control study, 22 chronic non-specific neck pain and 22 healthy individuals participated. Postural stability was measured with Techno-body Prokin tilting platform. Subjects performed balance tests under two conditions: eyes open and closed. The parameters for assessment of postural stability were total stability index (TSI), anteroposterior stability index (APSI), mediolateral stability index (MLSI), and trunk deviation which demonstrated total trunk sway in medio-lateral and antero-posterior. We used a separate 2 (group) by 2 (postural difficulty) mixed-design analysis of variance (ANOVA) for analysis of postural performance. There were significant differences between the chronic neck pain and matched control groups in APSI, MLSI, and TSI, p<0.001 in both eyes opened and closed conditions. The trunk deviation was greater for non-specific neck pain in comparison to healthy subjects, p<0.05 in both conditions of eyes open and closed. The results of this study showed that patients with chronic neck pain have poorer postural control than healthy subjects. The findings suggest that clinicians take into account the importance of dynamic postural stability assessment in patients with chronic non-specific neck pain and consider the application of intervention programs for improvement of the dynamic balance.
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http://dx.doi.org/10.14196/mjiri.32.33DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108284PMC
April 2018

Relationship between functional balance and walking ability in individuals with chronic stroke.

J Phys Ther Sci 2018 Aug 24;30(8):993-996. Epub 2018 Jul 24.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Iran: Golestan St, Ahvaz, 6135733133, Iran.

[Purpose] The objective of this cross sectional study was to investigate the validity of Functional Ambulation Category in evaluating functional balance and identifying the relationship between balance impairment and functional ambulation in individuals with chronic stroke. [Participants and Methods] A total of 31 chronic stroke patients with first ever ischemic middle cerebral artery strokes, with no cognitive deficits were recruited. Participants had a mean age of 54.84 (SD=7.05) years and a time after stroke of 22.74 (SD=27.13) months. Community ambulation was determined by Functional Ambulation Category and functional balance was assessed by Berg Balance Scale. [Results] The mean Berg Balance Scale and the Functional Ambulation Category scores were 47.38 (SD=7.54) and 3.8 (SD=0.79), respectively. Correlation analysis revealed that balance impairment and ambulatory function was significantly positively correlated with each other (r=0.80). [Conclusion] The results shows that the Functional Ambulation Category is a valid tool in evaluating functional balance and suggest that functional balance may be an important goal for rehabilitation to achieve improvement in walking ability in people with chronic stroke.
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http://dx.doi.org/10.1589/jpts.30.993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110215PMC
August 2018

Effects of narrow-base walking and dual tasking on gait spatiotemporal characteristics in anterior cruciate ligament-injured adults compared to healthy adults.

Knee Surg Sports Traumatol Arthrosc 2017 Aug 9;25(8):2528-2535. Epub 2016 Feb 9.

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, MOVE Research Institute Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Purpose: The present experiment was conducted to examine the hypothesis that challenging control through narrow-base walking and/or dual tasking affects ACL-injured adults more than healthy control adults.

Methods: Twenty male ACL-injured adults and twenty healthy male adults walked on a treadmill at a comfortable speed under two base-of-support conditions, normal-base versus narrow-base, with and without a cognitive task. Gait patterns were assessed using mean and variability of step length and mean and variability of step velocity. Cognitive performance was assessed using the number of correct counts in a backward counting task.

Results: Narrow-base walking resulted in a larger decrease in step length and a more pronounced increase in variability of step length and of step velocity in ACL-injured adults than in healthy adults. For most of the gait parameters and for backward counting performance, the dual-tasking effect was similar between the two groups.

Conclusions: ACL-injured adults adopt a more conservative and more unstable gait pattern during narrow-base walking. This can be largely explained by deficits of postural control in ACL-injured adults, which impairs gait under more balance-demanding conditions. The observation that the dual-tasking effect did not differ between the groups may be explained by the fact that walking is an automatic process that involves minimal use of attentional resources, even after ACL injury. Clinicians should consider the need to include aspects of terrain complexity, such as walking on a narrow walkway, in gait assessment and training of patients with ACL injury.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-016-4014-4DOI Listing
August 2017

Responsiveness and minimally important differences for selected Persian-version of outcome measures used in patients with patellofemoral pain syndrome.

Disabil Rehabil 2015 22;37(14):1285-90. Epub 2014 Sep 22.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran .

Purpose: To investigate the responsiveness and determine the minimally important differences (MID) of Persian versions of the Kujala patellofemoral scale (KPS), lower extremity functional scale (LEFS), and functional index questionnaire (FIQ) in patients with patellofemoral pain syndrome (PFPS).

Method: Outcome measures including the Persian KPS, LEFS, and FIQ were administered to 233 patients at baseline and then again 4 weeks after physiotherapy. Moreover, the 7-point global rating scale was completed by the patients at 4 weeks. Responsiveness was evaluated using the correlation analysis and the receiver operating characteristics (ROC) method.

Results: Correlation analysis showed that the relationship of all outcome measures with the global rating scale falls within the fair range of relationship (Gamma = 0.26-0.40). Moreover, the results of ROC analysis showed that the all outcome measures have acceptable high responsiveness index. Furthermore, the MIDs of 9.5, 4.5, and 1.5 points were obtained for the Persian KPS, LEFS, and FIQ, respectively.

Conclusions: The Persian-versions of all outcome measures are responsive for evaluating change following physiotherapy intervention. The MID values obtained in this study will help the clinicians and researchers to determine if a patient with PFPS has experienced a true change following a physiotherapy intervention. Implications for Rehabilitation Persian-versions of the KPS, LEFS, and FIQ can be used as three "responsive" outcome measures in clinical studies of patients with patellofemoral pain syndrome (PFPS). These assessment tools have clinical relevance for rehabilitation specialists working on patients with PFPS. The minimally important differences provide valuable information for the clinicians and researchers to make decision about the identification of a clinical change in health status of patients with PFPS.
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http://dx.doi.org/10.3109/09638288.2014.962107DOI Listing
March 2016

Intra-limb coordination while walking is affected by cognitive load and walking speed.

J Biomech 2014 Jul 9;47(10):2300-5. Epub 2014 May 9.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Knowledge about intra-limb coordination (ILC) during challenging walking conditions provides insight into the adaptability of central nervous system (CNS) for controlling human gait. We assessed the effects of cognitive load and speed on the pattern and variability of the ILC in young people during walking. Thirty healthy young people (19 female and 11 male) participated in this study. They were asked to perform 9 walking trials on a treadmill, including walking at three paces (preferred, slower and faster) either without a cognitive task (single-task walking) or while subtracting 1׳s or 3׳s from a random three-digit number (simple and complex dual-task walking, respectively). Deviation phase (DP) and mean absolute relative phase (MARP) values-indicators of variability and phase dynamic of ILC, respectively-were calculated using the data collected by a motion capture system. We used a two-way repeated measure analysis of variance for statistical analysis. The results showed that cognitive load had a significant main effect on DP of right shank-foot and thigh-shank, left shank-foot and pelvis-thigh (p<0.05), and MARP of both thigh-shank segments (p<0.01). In addition, the main effect of walking speed was significant on DP of all segments in each side and MARP of both thigh-shank and pelvis-thigh segments (p<0.001). The interaction of cognitive load and walking speed was only significant for MARP values of left shank-foot and right pelvis-thigh (p<0.05 and p<0.001, respectively). We suggest that cognitive load and speed could significantly affect the ILC and variability and phase dynamic during walking.
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http://dx.doi.org/10.1016/j.jbiomech.2014.04.038DOI Listing
July 2014

Reliability and validity of the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower limb musculoskeletal disorders.

Disabil Rehabil 2014 27;36(1):10-5. Epub 2013 Mar 27.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran .

Purpose: The aim was to culturally translate and validate the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower extremity musculoskeletal disorders (n = 304).

Method: This is a prospective methodological study. After a standard forward-backward translation, psychometric properties were assessed in terms of test-retest reliability, internal consistency, construct validity, dimensionality, and ceiling or floor effects.

Results: The acceptable level of intraclass correlation coefficient >0.70 and Cronbach's alpha coefficient >0.70 was obtained for the Persian LEFS. Correlations between Persian LEFS and Short-Form 36 Health Survey (SF-36) subscales of Physical Health component (rs range = 0.38-0.78) were higher than correlations between Persian LEFS and SF-36 subscales of Mental Health component (rs range = 0.15-0.39). A corrected item--total correlation of >0.40 (Spearman's rho) was obtained for all items of the Persian LEFS. Horn's parallel analysis detected a total of two factors. No ceiling or floor effects were detected for the Persian LEFS.

Conclusions: The Persian version of the LEFS is a reliable and valid instrument that can be used to measure functional status in Persian-speaking patients with different musculoskeletal disorders of the lower extremity. Implications for Rehabilitation The Persian lower extremity functional scale (LEFS) is a reliable, internally consistent and valid instrument, with no ceiling or floor effects, to determine functional status of heterogeneous patients with musculoskeletal disorders of the lower extremity. The Persian version of the LEFS can be used in clinical and research settings to measure function in Iranian patients with different musculoskeletal disorders of the lower extremity.
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http://dx.doi.org/10.3109/09638288.2013.775361DOI Listing
July 2014