Introduction: Diabetic neuropathy (DN) is one of the most complex and progressive disorders, characterized by symmetrical distal degeneration of peripheral nerves, resulting in features of pain and sensory loss. The purpose of the study was to find out the effects of physiotherapy intervention on physical function, balance, and postural control of the persons with diabetic neuropathy.
Materials and Methods: A computerized electronic search was performed using PEDro, Pubmed, CINAHL, and EMBASE with key words including physiotherapy intervention, physical exercise, rehabilitation techniques, balance training, diabetic neuropathy, and diabetic peripheral neuropathy. Inclusion criteria consisted of studies that were randomized clinical trials, crossover trial or controlled trial; published in the English language from 2015 to 2021, identified diabetic neuropathy as the primary concern, and identified physiotherapy intervention as one of the treatment options.
Results: The primary search of the database turned up an entire set of 103 studies. Of those studies, 17 were selected as potentially meeting the inclusion criteria. Ultimately, four studies were retained for the final results of the review. The evaluations provided evidence to suggest that physiotherapy has positive effects on subjects with diabetic peripheral neuropathy (DPN).
Conclusion: After reviewing, it has been revealed that balance & strength training is applicable for improving balance, gait & physical function in diabetic neuropathy patients.

Introduction: Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived with disability. Studies on the non-surgical management approaches for disc-related LBP are sparse and scarce, so a clear and structured guideline in this area would be useful.
Objective: This study summarizes the non-surgical management approaches for disc-related LBP in a review.
Methods: Intervention studies and review articles relating to the non-surgical approaches for disc-related LBP treatment were curated from PubMed, EMBASE, Cochrane, and Google Scholar databases before July 1, 2022.
Results: Several management approaches are suggested in the studies for disc-related LBP, including medications, acupuncture, lumbar orthoses, exercise therapy, manual therapy, physical therapy modalities, and spinal injections. Some of these options have been studied more like exercise therapy and injections, and there are more favorable reports for them. Some others have been less studied and need to be investigated in future studies like different physical therapy modalities.
Conclusion: Recommendations are based on low to moderate-quality evidence or consensus in the management approach studies for disc-related LBP. Therefore, the authors recommend intensifying research efforts concerning all aspects of the non-surgical management of LBP.

Introduction: Among many grammatical problems affecting agrammatic patients, those of inflectional morphology and specifically, tense, stands at the forefront. Our goal in this study was to analyze tense properties in Mazandarani-speaking Broca's patients to see which aspects of this inflectional system were more negatively affected.
Materials and Methods: Utilizing inclusion/exclusion criteria, we chose 10 patients (mean age 47 years) in descriptive-analytical research. In order to select our participants, some criteria including the results of Persian aphasia test, monolingualism, and MRI reports were taken into consideration which corroborated the involvement of anterior frontal lobe, inferior anterior parietal lobe, perisylvian and Broca's areas as well as inferior frontal gyrus. To monitor our patients' performance in three separate tenses of present (progressive), future, and past (simple past, past perfect, past continuous), we administered written sentence completion and sentence –to- picture matching test. In order to investigate whether our patients' performance in diverse verb tenses was significantly different, we utilized Wilcoxon statistics to analyze our data.
Results: The results demonstrated significant difference between the performance of the patients in past progressive tense compared to other tenses (P=0.02). Furthermore, a significant difference was observed between the mean responses to past tenses and present - future tenses.
Conclusion: Mazandarani-speaking agrammatics demonstrated selective poor performance in the past tense inflection. Regarding the crucial role of tense properties in verbal communication, specifically past tense, to talk about past events and memories, more attention is needed by clinicians and speech therapists to reinforce tense properties enhancing agrammatic's communication capabilities.

Introduction: COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus, has a negative impact on patients' respiratory health with necessitating oxygen therapy. These affected patients with COVID-19 experience anxiety and stress with quality of life (QoL) impacted due to  frequent medication, hospitalizations, fear of dying, and isolation. In individuals with respiratory problems, physiotherapy has been found to be useful in improving oxygenation, stress reduction and QoL. Therefore, our goal was to assess how physiotherapy management affected the oxygenation rates and QoL of hospitalized COVID-19 patients.
Materials and Methods: The study included 60 hospitalized cases of COVID-19 pneumonia (25–65 years) admitted to the RCU/Al-Hussein teaching hospital. The oxygenation rate was recorded by hospital monitoring. A physiotherapy management prepared according to the pulmonary rehabilitation recommendations for COVID-19 patients. QoL was assessed by the Arabian version of the Short-Form health survey questionnaire (SF-36) at baseline, at discharge, and 1-month post-discharge.
Results: The mean baseline oxygenation % was 86.10±12.93. The baseline QoL score was 29.14±18.52. A significant increase (p<0.0001) in oxygenation (by 10.22%) was observed at discharge as compared to the baseline values. The QoL was significantly higher (p<0.0001) a 1-month post discharge as compared to the baseline and the values at discharge (by 157.76%). Similar effects were observed in males and females.
Conclusion: A short-term course of physiotherapy management was effective in increasing the oxygenation rates and QoL in hospitalized male and female COVID-19 patients. A combination of breathing exercises, early mobilization, and positioning can act as an adjuvant in the clinical management of COVID-19 patients.

Aim: The study aimed to investigate the effects of deep neck flexor (DNF) and deep neck extensor (DNE) muscle exercises on pain, passive range of motion (PROM), craniovertebral angle (CVA), neck flexor endurance (NFE), neck extensor endurance (NEE), and the number of weekly painkiller usage (NWPKU) in chronic non-specific neck pain (CNNP)patients.
Materials and Methods: A total of 27 CNNP patients (intervention group = 15, control group = 12) were recruited for this study. Patients in the intervention group participated in 6 weeks of DNF and DNE exercises plus traditional physiotherapy. After 10 sessions (3 weeks), the exercise protocol was followed for 3 weeks of the home-based exercise form. Control group patients received traditional physiotherapy alone. The Numeric pain rating scale (NPRS), PROM, CVA, NFE, NEE, and NWPKU were examined and compared between groups, at the baseline and after six weeks.
Results: Numeric pain rating scale, PROM, CVA, NFE, NEE, and NWPKU improved significantly in both groups after treatment (P < 0.001). The NPRS, passive flexion, passive extension, passive right side bending, passive left rotation, CVA, NFE, NEE, and NWPKU differences were significant (P < 0.05).
Conclusion: The study results support the combination therapy (DNF and DNE exercises plus traditional physiotherapy) positive effect on pain, passive neck range of motion, neck lordosis posture, and neck muscle endurance in CNNP patients.

Background: the flexibility of the heart is important for cardiovascular health. The heart rate variation (HRV) is a metric of it. Muslims perform praying (Namaz) has some significant effects on general health regularity. The study aimed to assess the impact of real Namaz on HRV.
Methods: Eighty-two participants who performed Namaz dairy were categorized into three groups, including more minor and more than, and equal to the normal cortisol level range based on salivary cortisol. The electrocardiography (ECG) was recorded before, during (divided into standing, bowing, prostration, and sitting positions), and after a four-cycle Namaz around noon. The linear and non-linear features of HRV were extracted.
Results: The Two-way ANOVA test showed that the standard deviation (SD)1 and SD2 of the Poincare plots of all groups increased after Namaz (P<0.0001). During Namaz, the indexes of sympathetic tone decreased in the prostration and bowing compared to the sitting and standing position (P<0.00001). The SD of mean of the R peaks interval, SD1, and SD2 of the Poincare plot also increased in those comparisons (P<0.00001). In addition, the spectral entropy was decreased in the bowing and prostration compared with standing and sitting positions (P<0.001).
Conclusions: Namaz significantly increased the performance of the cardiovascular system and decreased the effect of daily stress on it.

Introduction: Fluent speech requires executive functions for identification, inhibition, and modification of speech interruptions to continuously regulate the speech process. The current study examined the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity.
Materials and methods: This research is a descriptive-analytic cross-sectional study. The participants included 32 AWS (mean age = 28 years; SD = 6.79 years) who were divided into three groups of mild, moderate, and severe severity and 32 AWNS (mean age = 28.57 years; SD = 6.53 years; 28). Selected tests from Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains.
Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (p = 0.009), problem solving and planning (p < 0.001), verbal cognitive flexibility (shifting) (p < 0.001), and verbal inhibitory control (p < 0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, there was a significant relationship between stuttering severity and executive function domains.
Conclusion: Together, this study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.

Background: The Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) can evaluate toddlers and infants’ early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aimed to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for young children with hearing loss (HL).
Material and Methods: In this study, due to the limitations of COVID-19 and the lack of access to samples, a total of 23 available children with HL were sampled. The cause of participants' HL was 43.5% congenital, 30.4% acquired, and 26.1% unknown. The mean ± SD age of these children was 21.6 ± 6.3 months. To evaluate the predictive validity and concurrent validity, the Speech Intelligibility Rating (SIR) and Categories of Auditory Performance (CAP) were used, respectively. Also, in order to assess the inter-rater reliability, both parents of each child completed the IT-MAIS-P.
Results: There is a high and significant correlation (concurrent validity) between the IT-MAIS-P and the CAP scores (r= 0.87, P < 0.001). Predictive validity was not confirmed by comparing with the SIR (P> 0.05). Also, the inter-rater reliability (kappa=0.44, P < 0.001) of the IT-MAIS-P was confirmed.
Conclusion: The IT-MAIS-P is a valid tool for investigating the progress of auditory skills in very young children, although the predictive validity was not confirmed.

Background: Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should consider them before planning surgical protocol.
Material and Methods: This retrospective study was performed on preoperative hospital records of 598 Iranian patients with different types of extraocular muscles palsy, including 3^rd (90 patients), 4^th (501 patients), and 6^th (7 patients) nerve palsies at Farabi Hospital, Tehran, Iran.
Results: In terms of 4^th nerve palsy, the mean spherical equivalent (SE) in the right and left eye was 0.23 ± 1.51 and 0.19 ± 1.45 diopter, respectively. Also, the mean angle of vertical deviation was 15.54 ± 8.85 Δ at near and 15.66 ± 8.93 Δ at far. In patients with 3^rd nerve palsy, the mean SE in the right and left eye was -0.02 ± 2.08 and 0.08±1.95 diopter, respectively. Also, the mean angle of vertical deviation was 17.8 ± 17.4 Δ at near and 17.8 ± 17.5 Δ at far. In terms of 6^th nerve palsy, the mean SE in the right and left eye was -1.27 ± 3.37 and -1.08 ± 2.52 diopter, respectively. Also, the mean angle of esotropia was 32.4 ± 7.7 Δ at near and 33 ± 6.7 Δ at far. The frequency of amblyopia in patients with 3^rd, 4^th, and 6^th nerve palsies were 21 (23.3%), 70 (14%), 4 (57.1%), respectively.
Conclusions: The clinical characteristics of patients with different types of EOM palsy are remarkably different, which can be attributed to the different properties of these kinds of deviations.

Background: Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the best exercise regimen is ineffective if not sustained. This study aimed to determine the dropout rate and factors influencing exercise therapy discontinuation during dialysis.
Methods: This observational, retrospective, and descriptive study included 31 people who underwent exercise therapy during hemodialysis sessions between April 2015 and March 2018 at a hospital. Mean age of the participants was 59.29±11.12 (range 36–78) years, and male/female ratio was 24/7. The participants were divided into two groups—the continuation group (patients who continued exercise) (n=15) and discontinuation group (patients who discontinued exercise) (n=16). Data on physical function history (knee extension muscle strength, one-leg standing time, and 6-minute walking distance) were collected from medical records. All participants were interviewed using a questionnaire on factors involved in exercise discontinuation from April 2018 to March 2022.
Results: About half of the participants dropped out (51.6%). In particular, the results suggested that body pain was strongly associated with exercise discontinuation. In addition, half of the participants in the discontinuation group had died during follow-up after exercise discontinuation (50%, n=8).
Conclusions: The findings of the study suggest that it is important to increase self-efficacy and satisfaction by devising exercise content that meets the individual’s wishes to prevent dropouts from exercise during dialysis. In addition, measures against body pain are important for exercise continuation. The relationship between exercise discontinuation during hemodialysis and mortality needs to be further examined.

Abstract:

Background: The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and joint support and stability, without limitation of the range of motion. The Erector spinae (Es) muscle's response to static flexion is an interesting model for the lumbar spine stability. There are few studies that have evaluated the effects of KT on a range of motion (ROM) and muscle activation during lumbar flexion and there is no study that evaluated the effects of KT on lumbar flexion relaxation phenomenon and kinematic details after static flexion in the healthy subjects. The goal of this study was to find out the results of KT on Es muscles activity, flexion relaxation pattern, and trunk, lumbar, and hip ROM within the healthy subjects when the static flexion.

Methods: This study was a two-factor within-group design, and 22 healthy female students participated in this study, we used surface EMG to assess Es muscle activity, and kinematic information was measured with data from the camera.

Results: KT caused the ES muscles to relax earlier during lumbar flexion, and increased trunk and hip angles. And ES muscles to be activated later during the lumbar extension phase.

Conclusion: KT was able to prevent the effect of the Creep on increasing the angle of the lumbar flexion. It is possible to use for protection of the strained viscoelastic structures, increase the involvement of cutaneous receptors, and represent a dynamic stabilization system of the lumbar joints in a flexion position in healthy subjects.

Background: Children with cerebral palsy (CP) in Bangladesh suffer immensely. With no means or hope of leading a decent life and a public system lacking basic facilities.
Objective: The purpose of this study was to analyze the Quality of life (QoL) and depression status of parents among the children with CP, as well as the relationship between these factors and their demographic profile.
Method: This is a descriptive cross-sectional study where data were collected from the pediatric department of Centre for the Rehabilitation of the Paralysed (CRP), Savar. Total participants was 150 child with CP in between January 2018 to December 2020.
Result: The mean age of the mothers was (29.86±6.14) years old ranging from 25 and 29 years (32.7%). The most common type of CP was spastic CP, accounting for 66.7% (n=100). Mother's age during marriage had a significant relationship with WHO QoL, physical health (p<.01), psychological health (p<.01), and the 31-35 years old aged group had the lowest scores (Mean±SD 62.00±5.16, 51±.683) in both domains. There is a strong correlation (p<0.001) among overall QoL, physical health (r= 0.319), psychological (r= 0.365), social (r= 0.390) and environmental (r= 0.388). From the box plot, overall QoL shows spastic CP poses good QoL for mild depression whereas all other types found neither poor nor good QoL.
Conclusion: An issue that is hidden inside the closet of every parent is that CP children are the misfortune of their fate that increases their level of depression and consequence decreases their QoL.

Background: Pes anserine bursitis (PAB) is a painful status inside knee may interferes functional activities. Extracorporeal shockwave therapy (ESWƬ) with different may affect the disorder.
Objective: Comparing effects of low versus middle energy ESWƬ on pain and functional activity in patients with sub- acute PAB.
Method: The study was a single-blind randomized trial. Twenty eight patients with sub-acute PAB were randomly divided into two groups and received either low or middle- energy ESWƬ for three weeks. The Numeric Pain Rating Scale (NPRS), Short Form McGill Pain Questionnaire (SF-MPQ), Timed Up and Go (TUG) test, and Western Ontario and McMaster Universities Index (WOMAC) were evaluated before any intervention and after 2 and 3 weeks of treatment.
Results: There was a significant improvement for low- energy ESWT in terms of NPRS (P=0.001), SF-MPQ (P<0.001), WOMAC (P<0.001, and TUG (P<0.001) after 3 weeks of intervention. There was also a significant improvement following middle- energy ESWT application on NPRS (P=0.003), SF-MPQ (P<0.001), WOMAC (P<0.001), and TUG (P<0.001) after 3 weeks of intervention. There was a similar trend between occasions and for all variables in each group. The only exception was the TUG that did not show any improvement between 2 and 3 weeks of intervention for each group of study. There was a significant improvement in NPRS comparison between two groups after 2 weeks (P=0.001) and after 3 weeks (P=0.006), both in favor of middle energy ESWT application.
Conclusion: Low and middle-energy ESWT can be effective in improving pain, functional activity, and mobility in patient with PAB.

Objective: This preliminary study investigated the effects of adding exergame training to conventional exercises on the functional activities of newly fitted patients with unilateral transtibial amputation.
Patients & Methods: A total of 22 newly fitted patients with unilateral transtibial amputation were equally and randomly divided into two groups: Exergame (EG), those performing exercises and exergame training; and Control (C), those performing exercise only. The 2-Min Walk test (2MWT), Timed Up and Go (TUG) test, Amputee Mobility Predictor with Prosthesis Test (AMPPRO), and Physiological Cost Index were assessed at baseline and after 2 and 4 weeks of the intervention.
Results: Both interventions effectively improved the 2MWT distance, TUG test time, and AMPPRO score in patients with newly fitted transtibial amputation (P < 0.001). Additionally, a significant improvement in the TUG test time in the EG versus C group after the 4-week intervention (P = 0.04, effect size: 0.53).
Conclusion: The findings of this preliminary study further support that adding exergames to exercises significantly increases movement speed among amputee patients.

Introduction: It is well known that Coronaviruses can cause widespread systemic infections, the most common of which are respiratory complications, which are close to the symptoms of serious acute respiratory syndrome coronavirus (SARS-CoV).
Case presentation: We report a case of a 16-year-old boy who developed weakness in bilateral lower limbs, difficulty in coughing, and generalized weakness for 2 days. He was diagnosed with post-Covid Guillain-Barre Syndrome (GBS). Cerebrospinal fluid (CSF) analysis manifested a CSF protein of 117 mg/dL, white blood cell count of 6-7/mm3, and glucose of too low to comment. Magnetic resonance investigation of the brain revealed mucosal thickening in the bilateral maxillary, ethmoid, and left frontal sinuses. Nerve conduction studies concluded evidence of sensory-motor polyneuropathy. Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, a combination of chest PNF techniques, a walking program with supplemented oxygen, and psychological support.
Result: Outcome measures have shown enhancement in functional independence and performance of activities of daily living.
Conclusion: The evidence from this study suggests that pulmonary rehabilitation plays a pivotal role in managing a patient who is diagnosed with post-COVID GBS, which included patient education, breathing retraining, airway clearing techniques, a combination of chest PNF techniques, positioning, a walking program with augmented oxygen, and psychological support.

Background: Clinical performance without documentation, assessment and feedback may lead to an inefficient internship in the field. Logbooks have been recommended to assess physiotherapy (PT) students’ clinical practice in the curriculum, so this study was performed to design, implement and evaluate a logbook for undergraduate PT students.
Methods: The present study includes three phases. In the first phase, a logbook was designed based on the existing evidence, undergraduate PT program curriculum, and opinions of clinical instructors of the relevant internships. After that, it was adjusted based on the topics of clinical rotations. In the implementation phase, students completed these logbooks during neurology, musculoskeletal inpatient, outpatient, and cardiovascular inpatient rotations. In the third phase, a 29-item questionnaire was used to assess the students’ and instructors’ perspectives on the logbook.
Results: The designed logbook for undergraduate PT students consisted of two major sections: students’ clinical competencies assessment and clinical experience documentation. Sixty-nine students and 12 clinical instructors completed the questionnaires. Approximately 49% of the students and 87% of the instructors felt the logbook’s quality was satisfactory. Using the logbook and its contents is considered essential by nearly 53% of the students and over 90% of the instructors.
Conclusions: A logbook was developed as a workplace-based assessment (WBA) method. It was designed to cover different internships, including PT in musculoskeletal, cardiovascular, and neurological conditions in outpatient or inpatient settings. Both students and instructors agreed on using the designed logbook for assessing the students’ clinical performance.