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Assessment of Gait Symmetry Improvements in National Athletes after Anterior Cruciate Ligament Reconstruction during Rehabilitation

Hadizadeh M, Amri S, Roohi SA, Mohafez H

Int J Sports Med, 2016 Nov;37(12):997-1002.
PMID: 27551935

This study aimed to quantify changes in gait parameters and their symmetries among athletes with anterior cruciate ligament (ACL) reconstructions during a rehabilitation program. Twenty-two national players with ACL reconstructions and 15 healthy athletes were recruited. The gait data were collected between postoperative weeks 4-5, 8-9 and 12-13 using a three-dimensional motion analysis system. The spatio-temporal gait parameters and symmetry indexes (SIs) were evaluated for the patients and the control group. One-way and repeated-measures multivariate analysis of variance were used to analyse the data. The results demonstrated significant differences among spatio-temporal (P<0.001) and SIs (P=0.007) of patients for Test 1 and the control group. Repeated measure analysis revealed significant changes in the linear combinations of spatio-temporal gait variables (P=0.002) and SIs (P=0.043) over time. The injured limb's step length, cadence and weight acceptance time presented significant improvement across time (P<0.001). Moreover, the SI of the stance time was reduced significantly by 46.48% (P=0.004) among SI parameters. After three months, no significant differences were found between patients and healthy controls for the measured gait components (P>0.05). The rehabilitation program allowed national athletes to restore symmetry in spatio-temporal gait parameters toward the control group's range 12-13 weeks post-reconstruction.
Effects of Family-Professional Partnerships in Adapted Physical Education on the Fundamental Motor Skills, Adaptive Behaviors, and Physical Activity Levels of Children with Autism Spectrum Disorder and on Parent Satisfaction

Feng XW, Hadizadeh M, Cheong JPG

J Autism Dev Disord, 2024 Apr 12.
PMID: 38607473 DOI: 10.1007/s10803-024-06342-1

PURPOSE: This study aimed to explore the effect of family-professional partnerships in adapted physical education on the fundamental motor skills, physical activity levels, and adaptive behaviors of children with autism spectrum disorder (ASD) and on parental satisfaction.
METHODS: A randomized controlled trial design was used, with pre-and post-intervention evaluations. Participants (n = 40), including children with ASD and their parents, were divided into three groups: (a) a family-school group (FSG-A, n = 14), (b) a school group (SG-B, n = 13), and (c) a control group (CG-C, n = 13).
RESULTS: After 12 weeks of intervention, the within-group comparison revealed that the FSG-A performed better than the SG-B and CG-C for all variables. The among-group comparison further revealed that the FSG-A had greater fundamental motor skill scores than the SG-B (p = 0.021) and CG-C (p
Gait analysis of national athletes after anterior cruciate ligament reconstruction following three stages of rehabilitation program: Symmetrical perspective

Hadizadeh M, Amri S, Mohafez H, Roohi SA, Mokhtar AH

Gait Posture, 2016 07;48:152-158.
PMID: 27318454 DOI: 10.1016/j.gaitpost.2016.05.002

This study aimed to objectively evaluate changes in gait kinematics, kinetics and symmetry among anterior cruciate ligament (ACL) reconstructed athletes during rehabilitation. Twenty-two national athletes with ACL reconstruction and 15 healthy athletes were recruited for the study. Gait data were collected between the weeks 4-5, 8-9, and 12-13 post-operation using three-dimensional motion analysis system. Five separate components, including knee range of motion (ROM), vertical ground reaction force (VGRF), their symmetries and knee extension moment were evaluated. One way and repeated measure multivariate analysis of variance (MANOVA) were used to analyze the knee ROMs. The VGRF and extension moment were tested using repeated measure ANOVA and independent sample t-test. Findings indicated significant alterations in all measured components between patients' Test 1 and control group. Repeated measure analysis revealed significant effect for time in components of knee angular and VGRF (P<0.001), their symmetry index (P=0.03) and knee extension moment (P=0.045). Univariate outcomes demonstrated significant improvement in the injured limb's stance and swing (P<0.001), and single-stance (P=0.005) ROMs over time. Symmetry indexes of stance and swing ROM, and VGRF reduced significantly by 26.3% (P=0.001), 17.9% (P<0.001), and 31.9% (P=0.03) respectively. After three months, symmetry indexes of single-stance ROM and VGRF along with operated knee extension moment were the only variables which showed significant differences with control group. The rehabilitation program allowed national athletes to restore the operated limb's gait parameters except knee extension moment by 12-13 weeks post-reconstruction; however, more time is required to normalize single-stance ROM and VGRF asymmetries.
Fulltext Analysis of Research Trends on Elbow Pain in Overhead Sports: A Bibliometric Study Based on Web of Science Database and VOSviewer

Li WH, Hadizadeh M, Yusof A, Naharudin MN

Healthcare (Basel), 2022 Nov 09;10(11).
PMID: 36360583 DOI: 10.3390/healthcare10112242

The publications on elbow pain (EP) in overhead sports are increasing. The results of previous studies mostly focus on the influence of EP in the ball game and throwing sports. Thus, a bibliometric analysis of these publications may show the direction of hot topics and future research trends. The purpose of this study is to identify the research trends on EP in overhead sports. For the methods, the first step is to use the main keywords of 'Elbow pain' and 'Overhead sport' merging auxiliary vocabulary to reach the relevant global publications between 1970 and 2022 in the Web of Science (WoS) database. The literature data set is imported into EndNote literature manager software to remove duplication. Secondly, the duplication-reduced articles are imported to an Excel sheet according to the inclusion and exclusion criteria of this study. In the third step, VOSviewer software is applied as the main analysis tool in extracting data for analysis from the articles. Then, the main research results for three aspects are obtained by VOSviewer software which extracted and analyzed the parameters of author name, article title, publication journal, keywords, organization, publication country/region, and the sum of times cited from 455 qualified papers. The study found that the United States of America made the most outstanding contribution to this theme study. The research on EP in overhead sports in China requires more attention from scholars. EP in swimming is a new research direction worthy of attention. In conclusion, the research results prove the growth trend of EP in overhead sports. The EP problem not only exists in the ball game and throwing sports but also swimming. Sport commercialization and the involvement of related professional sports organizations determine the degree of EP's attention in a specific sport and the development of solutions. The development of a region or country also affects the depth and scope of EP study. Clinical research development and in-depth exploration are one of the bases to solve EP problems. Non-clinical action is beneficial to EP patients, but it still needs to be explored and studied.
Fulltext Effects of isometric training and R.I.C.E. treatment on the arm muscle performance of swimmers with elbow pain

Li W, Hadizadeh M, Yusof A, Naharudin MN

Sci Rep, 2024 Feb 27;14(1):4736.
PMID: 38413632 DOI: 10.1038/s41598-024-54789-0

The effects of IT and R.I.C.E. treatment on arm muscle performance in overhead athletes with elbow pain (EP) have been partially validated. However, there is a lack of research evidence regarding the efficacy of these two methods on arm muscle performance among swimmers with EP. The aim of this study was to investigate the trends and differences in the effects of IT and R.I.C.E. treatment on arm muscle performance among swimmers with EP. The main outcomes were the time effects and group effects of interventions on muscle voluntary contraction (MVC). Sixty elite freestyle swimmers from Tianjin, China, voluntarily participated in the study and completed a 10-week intervention program. Swimmers with EP in the IT group showed a positive trend in MVC, with an approximately 2% increase, whereas the MVC of subjects in the R.I.C.E. treatment group and control group decreased by approximately 4% and 5%, respectively. In comparison, the effects of the IT intervention on the MVC of the triceps and brachioradialis muscles in swimmers with EP were significant (p = 0.042 m freestyle swim drills in order for swimmers with EP to return to this sport.
Kinematic characteristics of elbow joint range of motion in elite Chinese freestyle swimmers with elbow pain during dry-land simulations of swimming strokes

Li W, Hadizadeh M, Yusof A, Naharudin MN

J Sports Sci, 2024 Apr 15.
PMID: 38616704 DOI: 10.1080/02640414.2024.2340887

The aim of this study was to obtain quantitative data on elbow joint ROM in elite freestyle swimmers with EP in China. Of the 50 elite freestyle swimmers recruited, 41 completed all measurements during dry-land swimming stroke simulations. Elbow joint angle, velocity, and acceleration were measured using inertial measurement units. The RMSE/D was calculated to determine the elbow joint ROM deviation. Joint angle (3.33 ∘-42.96 ∘), angular velocity (-364.15 to 245.69 ∘/s), and angular acceleration (-7051.80 to 1465.35 ∘/s2) were significantly different between the critical pain and healthy. The probability distributions of joint angle (15.47 ∘ ±14.54 ∘), angular velocity (2.41 ∘ ±111.06 ∘/s), and angular acceleration (1.93 ± 2222.6 ∘/s2) in the slight pain group were significantly different betweenhealthy and critical pain. The RMSE/D distributions of angular velocity (28.3%) and acceleration (21.48%) in the critical pain deviated from the healthy. The peak value-RMSE/D matrix model obtained proved that elbow ROM significantly differed between the elite freestyle swimmers with EP and the healthy. Angular velocity and acceleration indicate the weakness and negative influence of kinematics on patients with EP. Thus, Potential solutions are to constantly optimise freestyle swimming techniques and strengthen the arm muscles.
Quantitative assessment of wound healing using high-frequency ultrasound image analysis

Mohafez H, Ahmad SA, Hadizadeh M, Moghimi S, Roohi SA, Marhaban MH, et al.

Skin Res Technol, 2018 Feb;24(1):45-53.
PMID: 28557064 DOI: 10.1111/srt.12388

PURPOSE: We aimed to develop a method for quantitative assessment of wound healing in ulcerated diabetic feet.
METHODS: High-frequency ultrasound (HFU) images of 30 wounds were acquired in a controlled environment on post-debridement days 7, 14, 21, and 28. Meaningful features portraying changes in structure and intensity of echoes during healing were extracted from the images, their relevance and discriminatory power being verified by analysis of variance. Relative analysis of tissue healing was conducted by developing a features-based healing function, optimised using the pattern-search method. Its performance was investigated through leave-one-out cross-validation technique and reconfirmed using principal component analysis.
RESULTS: The constructed healing function could depict tissue changes during healing with 87.8% accuracy. The first principal component derived from the extracted features demonstrated similar pattern to the constructed healing function, accounting for 86.3% of the data variance.
CONCLUSION: The developed wound analysis technique could be a viable tool in quantitative assessment of diabetic foot ulcers during healing.
Fulltext Effects of Tele-Pilates and Tele-Yoga on Biochemicals, Physical, and Psychological Parameters of Females with Multiple Sclerosis

Najafi P, Hadizadeh M, Cheong JPG, Mohafez H, Abdullah S, Poursadeghfard M

J Clin Med, 2023 Feb 16;12(4).
PMID: 36836119 DOI: 10.3390/jcm12041585

BACKGROUND: People with multiple sclerosis (PwMS) suffer from some comorbidities, including physical and psychiatric disorders, low quality of life (QoL), hormonal dysregulation, and hypothalamic-pituitary-adrenal axis dysfunction. The current study aimed to investigate the effects of eight weeks of tele-yoga and tele-Pilates on the serum levels of prolactin and cortisol and selected physical and psychological factors.
METHODS: Forty-five females with relapsing remitting multiple sclerosis, based on age (18-65), expanded disability status scale (0-5.5), and body mass index (20-32), were randomly assigned to tele-Pilates, tele-yoga, or control groups (n = 15). Serum blood samples and validated questionnaires were collected before and after interventions.
RESULTS: Following online interventions, there was a significant increase in the serum levels of prolactin (p = 0.004) and a significant decrease in cortisol (p = 0.04) in the time × group interaction factors. In addition, significant improvements were observed in depression (p = 0.001), physical activity levels (p < 0.001), QoL (p ≤ 0.001), and the speed of walking (p < 0.001).
CONCLUSION: Our findings suggest that tele-yoga and tele-Pilates training could be introduced as patient-friendly, non-pharmacological, add-on therapeutic methods for increasing prolactin and decreasing cortisol serum levels and achieving clinically relevant improvements in depression, walking speed, physical activity level, and QoL in female MS patients.
Effects of tele-exercise training on physical and mental health and quality of life in multiple sclerosis: Do the effects differ by modality and clinical disease course?

Najafi P, Hadizadeh M, Cheong JPG, Motl RW, Abdullah S, Mohafez H, et al.

Mult Scler Relat Disord, 2023 Dec;80:105129.
PMID: 37977056 DOI: 10.1016/j.msard.2023.105129

INTRODUCTION: Tele-exercise training has improved mental and physical health and quality of life (QOL) in people with multiple sclerosis (PwMS), but there is little known about the comparability of effects across modalities and clinical disease courses.
OBJECTIVE: To evaluate the effect of tele-Pilates and tele-yoga training on physical and mental factors and QOL in PwMS, with a focus on two phenotype classifications - relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).
METHODS: Eighty-two persons with RRMS (n = 48) and SPMS (n = 34) were randomly assigned into tele-Pilates (n = 29), tele-yoga (n = 26), or control (n = 27). The tele-exercis training was conducted three times per week for eight weeks.
RESULTS: Significant time × group interactions were observed for QoL (p = 0.01), physical activity levels (p < 0.001), mental health (p = 0.05), and a decline in depression (p = 0.002) following tele-Pilates and tele-yoga. The corresponding subfactors, including pain, energy, emotional well-being, and role limitation due to emotional and physical problems, have shown significant improvements after interventions compared with control (all p < 0.05). The effects of exercise over control did not depend on MS phenotype (all p > 0.05).
DISCUSSION: Tele-yoga and tele-Pilates exercises improved QoL and mental and physical health in PwMS, and the benefits were similar across both MS phenotypes. These findings highlight the potential of implementing tele-yoga and tele-Pilates as non-pharmacological mind-body symptomatic treatments for individuals with both RRMS and SPMS.