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  1. Shariat A, Kargarfard M, Danaee M, Bahri Mohd Tamrin S
    J Strength Cond Res, 2015 Jan;29(1):151-8.
    PMID: 25051005 DOI: 10.1519/JSC.0000000000000632
    Strength and morphological adaptations to resistance exercise are mediated in part by anabolic hormones such as testosterone, yet the time course of variability in circadian hormone concentrations is not well characterized. This study, investigated how the circadian rhythm of salivary testosterone is altered by resistance exercise in young men. Twenty healthy young male recreational lifters (age, 18.0 ± 1.3 years) with 2 years of experience in weightlifting were recruited. A randomized controlled trial was conducted, and subjects were randomly assigned to either the resistance exercise group (n = 10), who completed a series of resistance exercise (3 times a week, in the afternoon, 6-7 repetitions, at 85% of 1 repetition maximum for 3 weeks), or a control group (n = 10), who did not exercise during the 3 weeks. Before and after the study, an unstimulated saliva sample (2 ml) was taken every 2 hours for a maximum of 16 hours during each day. A significant decrease was observed in the resistance exercise (44.2%, p = 0.001) and control group (46.1%, p = 0.001) for salivary testosterone at each time point compared with baseline (p = 0.001). There was also no significant difference between the exercise and resting conditions in both groups for salivary testosterone (p > 0.05), except a significantly higher increase by 38.4% vs. -0.02% (p = 0.001), at 1730 hours during exercise sessions in the resistance exercise group compared with the control group. Resistance exercise has no noteworthy effect on circadian secretion of salivary testosterone throughout the 16 waking hours. These results indicate that athletes can undertake resistance exercise in either the morning or afternoon with the knowledge that a similar testosterone response can be expected regardless of the time of day.
  2. Shariat A, Tamrin SB, Arumugam M, Ramasamy R
    Work, 2016 Mar 09;54(1):171-8.
    PMID: 26967034 DOI: 10.3233/WOR-162269
    BACKGROUND: The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was developed to assess the level of musculoskeletal discomfort among office workers related to their ergonomic situation.

    OBJECTIVE: The primary objective of this initial study is to analyze the validity and dependability of the Malay translation of the Cornell Musculoskeletal Discomfort Questionnaire.

    METHODS: The questionnaire was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. The study involved 115 participants.

    RESULTS: The range of Cronbach Alpha coefficient showed a considerable consistency of the items for each sub-scale (Cronbach's a > 0.95). The range of Kappa coefficients was between (ICC = 0.690-0.949, p 

  3. Pirbalouti MG, Shariat A, Sangelaji B, Taghavi M, Kamaliyeh NG
    Work, 2017;58(4):519-525.
    PMID: 29254133 DOI: 10.3233/WOR-172648
    BACKGROUND: Working in a closed environment for more than 7-8 hours can affect both psychological and physical health among kindergarten workers.
    OBJECTIVE: To determine the prevalence of musculoskeletal disorders (MSD) and depression as well as the correlation between them, if any, among kindergarten workers.
    METHODS: In a cross-sectional observation, one hundred and five healthy female staff members (age: 34.27±7.01 year, working duration: 7.42±0.81 hr/d, BMI: 24.50±2.61 kg/m2 (mean±SD)), who have had at least one year of working experience, were selected randomly from 10 kindergartens. The subjects completed both the Cornell musculoskeletal and Patient Health (PHQ-9) questionnaires to enable the assessments of MSD and depression scores accordingly. The correlation between both questionnaires was then measured to find any links. To assess the reliability of Farsi-language versions of the Cornell questionnaire and PHQ-9, the Inter-class Correlation Co-efficient (ICC) was measured through test-retest with 1-week delay and the prevalence of MSD and depression were subsequently assessed as well.
    RESULTS: The Inter-class Correlation Co-efficient (ICC) illustrated that the Farsi version of MSD instruments showed high levels of repeatability. The ICC coefficient was (0.932-0.987, p 
  4. Kargarfard M, Shariat A, Ingle L, Cleland JA, Kargarfard M
    Arch Phys Med Rehabil, 2017 Jul 20.
    PMID: 28735720 DOI: 10.1016/j.apmr.2017.06.015
    OBJECTIVE: To assess the effects of 8-weeks aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).

    DESIGN: A randomized controlled design.

    SETTING: Referral center of a multiple sclerosis society.

    PARTICIPANTS: Women (age: 36.4 ±8.2) diagnosed with relapsing-remitting (RR-type) MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program) or a control group.

    INTERVENTIONS: The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration; 45-60 min; 50-75% estimated maximum heart rate).

    MAIN MEASURES: Six-minute walk test (6-MWT); balance (Berg Balance Scale; BBS), and perceptions of fatigue (Modified Fatigue Impact Scale; MFIS), at baseline and after an 8 week intervention. Differences over time between the experimental and control groups were assessed by a 2x2 (group by time) repeated measures analysis of variance (ANOVA).

    RESULTS: 32 women completed the 8-week aquatic training intervention (experimental group, n=17; controls, n = 15). All outcome measures improved in the experimental group; 6-MWT performance (451±58 m to 503±57 m; P<0.001); BBS (pre-test mean, 53.59±1.70; post-test mean, 55.18±1.18; P<0.001), and in the MFIS (pre-test mean, 43.1±14.6, post-test mean, 32.8 ±5.9;P<0.01). A significant group-by-time interaction was evident between the experimental and controls groups for 6-MWT:P<0.001, ηp(2)=0.551; BBS:P<0.001, ηp(2)=0.423; and MFIS: P<0.001, ηp(2)=0.679.

    CONCLUSIONS: Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS.

  5. Shariat A, Mohd Tamrin SB, Arumugam M, Danaee M, Ramasamy R
    MyJurnal
    Lower back, neck and shoulder pain are the most prevalent musculoskeletal problems affecting office workers worldwide, and they have both personal and socioeconomic consequences as well. Several hypotheses regarding the underlying mechanisms and the maintenance behind office work-related musculoskeletal disorders have been presented. There is some evidence, based on epidemiological studies as well as studies upon smaller groups of subjects, that individuals who sit and work for a long time not only show cognitive impairment at the workplace, but also suffer from poorer and fragmented daytime sleep, in addition to increased risks of developing various psychological, physiological and medical impairments and musculoskeletal disorders. The related physical mechanisms behind musculoskeletal disorders are discussed in the context of new findings. The main causes, as well as varying levels in severity of musculoskeletal disorders,not to mentionthe link between such disorders in the neck, shoulder and lower back regions and physical activity among office workers are also stated. The main objective of this review paper is to conduct a systematic review to identify musculoskeletal disorders and how these disorders are
    correlated with physical activity among office workers. The results of this review indicate that the musculoskeletal disorder is a critical issue among office workers and the main cause is related to the absence of physical activity as well as the subjects’ sedentary lifestyle. As a practical message, regular physical activity can be effective in the prevention and decrease of physical discomfort among office workers who suffer from musculoskeletal pain.
  6. Shariat A, Tamrin SB, Arumugam M, Danaee M, Ramasamy R
    Work, 2016 Jun 8;54(3):753-8.
    PMID: 27286077 DOI: 10.3233/WOR-162313
    The accuracy of instruments such as questionnaires and the goniometer are critical for measuring the severity of musculoskeletal disorders among office workers.
  7. Shariat A, Bahri Mohd Tamrin S, Arumugam M, Ramasamy R, Danaee M
    Iran J Public Health, 2016 Apr;45(4):544-5.
    PMID: 27252928
  8. Shariat A, Mohd Tamrin SB, Arumugam M, Danaee M, Ramasamy R
    Malays J Med Sci, 2016 Jul;23(4):54-8.
    PMID: 27660545 MyJurnal DOI: 10.21315/mjms2016.23.4.7
    Pain in specific areas of the body (including the lower back, neck, and shoulders) due to extended periods of sitting and inactivity is the most widespread musculoskeletal disorder worldwide and has consequences that are both socio-economic and personal. This condition is particularly prevalent in industrialised countries, affecting roughly 70% to 80% of adults at some point in their lives; approximately 1% of the U.S. population is chronically disabled by this type of pain disorder. A practical way to reduce the prevalence of musculoskeletal pain among office workers would have a significant positive impact. More work is required to develop a package of exercises designed to prevent and treat musculoskeletal pain in office workers. Such a package would be preferable to pharmacological treatments, which can have undesirable side effects. The main objective of this package would be to increase the flexibility and strength of trunk muscles in order to decrease the soreness, pain, and degree of discomfort. In this article, we introduce our proposed package of exercises, which are based on guidelines issued bythe American College of Sports Medicine.
  9. Kargarfard M, Lam ET, Shariat A, Shaw I, Shaw BS, Tamrin SB
    J Sports Sci, 2016;34(10):959-65.
    PMID: 26334128 DOI: 10.1080/02640414.2015.1081264
    It is believed that sport massage after intensive exercise might improve power and perceptual recovery in athletes. However, few studies have been done in this area. This study aimed to examine the effect of massage on the performance of bodybuilders. Thirty experienced male bodybuilders were randomly assigned to either a massage group (n = 15) or a control group (n = 15). Both groups performed five repetition sets at 75-77% of 1RM of knee extensor and flexor muscle groups. The massage group then received a 30-min massage after the exercise protocol while the control group maintained their normal passive recovery. Criteria under investigation included: plasma creatine kinase (CK) level, agility test, vertical jump test, isometric torque test, and perception of soreness. All variables were measured over 6 time periods: baseline, immediately after the DOMS inducing protocol, right after the massage, and 24, 48, and 72 h after the massage. Both groups showed significant (P 
  10. Kargarfard M, Lam ET, Shariat A, Asle Mohammadi M, Afrasiabi S, Shaw I, et al.
    Phys Sportsmed, 2016 09;44(3):208-16.
    PMID: 27291761 DOI: 10.1080/00913847.2016.1200442
    OBJECTIVES: Obesity prevalence has increased in Iranian adolescents in recent years. However, few studies have examined the impact of intervention programs on this health issue. The main objective of this study was to evaluate the effects of 8-week endurance training (ET) and high intensity interval training (HIIT) on intercellular adhesion molecule-1(ICAM-1) and vascular adhesion molecule-1(VCAM-1) levels among obese and normal-weight male adolescents.
    METHODS: Thirty obese and 30 normal-weight subjects were assigned to the ET, HIIT, or control group for eight weeks. Before and after the intervention, ICAM-1, VCAM-1, body weight, BMI, VO2max, and blood pressures were measured. SPSS (Version 21) was used for data analysis, and the significance level was set at p 
  11. Shariat A, Lam ET, Kargarfard M, Tamrin SB, Danaee M
    Work, 2017;56(3):421-428.
    PMID: 28269804 DOI: 10.3233/WOR-172508
    BACKGROUND: Previous research support the claim that people who work in offices and sit for a long time are particularly prone to musculoskeletal disorders.

    OBJECTIVE: The main objective of this paper is to introduce an exercise training program designed to decrease muscle stiffness and pain that can be performed in the office setting.

    METHODS: Forty healthy office workers (age: 28±5.3 years old; body mass: 87.2±10.2 kg; height: 1.79±0.15 m) apart from suffering from any sub-clinical symptoms of muscle and joint stiffness, and who had at least two years of experience in office work were chosen and randomly assigned to either an experimental group (n = 20) or a control group (n = 20). The experimental group performed the exercise training program three times a week for 11 weeks. The Cornell Musculoskeletal Discomfort Questionnaire was used to measure the pain levels in the neck, shoulders, and lower back areas. The Borg CR-10 Scale was used to measure their perceived exertion when doing the exercises, and a goniometer was used to measure the changes in range of motion (ROM) of the neck, hips, knees, and shoulders.

    RESULTS: The overall results indicated that the exercise program could significantly (p 

  12. Shariat A, Lam ETC, Shaw BS, Shaw I, Kargarfard M, Sangelaji B
    J Back Musculoskelet Rehabil, 2017;30(3):641-647.
    PMID: 28372315 DOI: 10.3233/BMR-160526
    STUDY DESIGN: True experimental design.

    BACKGROUND: The back squat is an integral aspect of any resistance training program to improve athletic performance. It is also used for injury prevention of the lower limbs.

    OBJECTIVE: The purpose of this study was to examine the effect of back squat training at different intensities on strength and flexibility of the hamstring muscle group (HMG).

    METHODS: Twenty-two male recreational bodybuilders with at least two years of experience in resistance training were recruited to participate in a nine-week training program. They were randomly assigned to a heavy back squat group (90-95% of one repetition maximum) or a moderate-intensity back squat group (60-65% of one repetition maximum).

    RESULTS: The heavy back squat group resulted in a significantly (p < 0.001) increased in one repetition maximum strength but a significant (p < 0.001) reduction in HMG flexibility when compared to their counterparts. The results of the study indicate that while a heavy back squat training program is effective in improving strength, it has an adverse effect on the flexibility of the HMG.

    CONCLUSION: The implication of this study is that there is a tradeoff between strength and flexibility and trainers should select the appropriate training protocols for their athletes to maximize athletic performance.

  13. Shariat A, Cardoso JR, Cleland JA, Danaee M, Ansari NN, Kargarfard M, et al.
    Work, 2018;60(2):191-199.
    PMID: 29865103 DOI: 10.3233/WOR-182738
    BACKGROUND: Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck.

    OBJECTIVES: The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers.

    METHODS: 752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50).

    RESULTS: There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041).

    CONCLUSIONS: The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies.

  14. Shariat A, Cleland JA, Danaee M, Kargarfard M, Sangelaji B, Tamrin SBM
    Braz J Phys Ther, 2018;22(2):144-153.
    PMID: 28939263 DOI: 10.1016/j.bjpt.2017.09.003
    OBJECTIVE: To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain.

    METHODS: Participants (N=142) in this randomized controlled trial were office workers aged 20-50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention.

    RESULTS: There was significant differences in pain scores for neck (MD -10.55; 95%CI -14.36 to -6.74), right shoulder (MD -12.17; 95%CI -16.87 to -7.47), left shoulder (MD -11.1; 95%CI -15.1 to -7.09) and lower back (MD -7.8; 95%CI -11.08 to -4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD -9.99; 95%CI -13.63 to -6.36), right shoulder (MD -11.12; 95%CI -15.59 to -6.65), left shoulder (MD -10.67; 95%CI -14.49 to -6.85) and lower back (MD -6.87; 95%CI -10 to -3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p<0.05).

    CONCLUSION: To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification.

    CLINICAL TRIAL ID: NCT02874950 - https://www.clinicaltrials.gov/ct2/show/NCT02874950.

  15. Shariat A, Cleland JA, Danaee M, Kargarfard M, Moradi V, Bahri Mohd Tamrin S
    Iran J Public Health, 2018 Nov;47(11):1756-1762.
    PMID: 30581794
    Background: The Rapid Office Strain Assessment (ROSA) is a tool employed online to screen office workstations, which may require modification to decrease musculoskeletal discomfort of workers. This study aimed to examine if the ROSA is able to evaluate pain severity in the lower back, shoulder and neck of office workers accurately.

    Methods: Overall, 142 participants (height: 1.80 ± 0.15 m, BMI: 26.08± 6.70, age: 35±15 yr) with at least a year of working experience completed both questionnaires, the online ROSA and the Cornell musculoskeletal discomfort, in 2016 in Malaysia.

    Results: Relationship between the total scores of both questionnaires for lower back, shoulder and neck pain were significant but exhibited a weak to moderate relationship (range of r values from 0.012 (CI 95%, -0.153-0.176) to 0.503 (CI 95%, 0.369-0.616).

    Conclusion: The online ROSA does not appear to be a reasonable tool for evaluating the severity of lower back, shoulder and neck pain among office workers as the correlations were low. We suggest continued use of the musculoskeletal discomfort questionnaire. Additional studies are required to further examine the ROSA for other anatomical regions.

  16. Shariat A, Cleland JA, Danaee M, Alizadeh R, Sangelaji B, Kargarfard M, et al.
    Work, 2018;60(4):549-554.
    PMID: 30103362 DOI: 10.3233/WOR-182762
    BACKGROUND: There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist.

    OBJECTIVE: The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training.

    METHODS: The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined.

    RESULTS: Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P 

  17. Zahiri N, Abollahi I, Nabavi SM, Ehsani F, Arab AM, Shaw I, et al.
    Malays J Med Sci, 2017 Mar;24(1):69-80.
    PMID: 28381930 DOI: 10.21315/mjms2017.24.1.8
    BACKGROUND: Multiple sclerosis (MS) is the most widespread disabling neurological condition in young adults around the world. The purpose of this study was to investigate the impact of explicit information (EI) on motor-sequence learning in MS patients.

    METHODS: Thirty patients with relapsing-remitting MS (RRMS), age: 29.5 (SD = 5.6) years and 30 healthy gender-, age-, and education-matched control group participants, age: 28.8 (SD = 6.0) years, were recruited for this study. The participants in the healthy group were then randomly assigned into an EI (n = 15) group and a no-EI (n = 15) group. Similarly, the participants in the control group were then randomly assigned into EI (n = 15) and no-EI (n = 15) groups. The participants performed a serial reaction time (SRT) task and reaction times. A retention test was performed after 48 hours.

    RESULTS: All participants reduced their reaction times across acquisition (MS group: 46.4 (SD = 3.3) minutes, P < 0.001, and healthy group: 39.4 (SD = 3.3) minutes, P < 0.001). The findings for the within-participants effect of repeated measures of time were significant (F(5.06, 283.7) = 71.33. P < 0.001). These results indicate that the interaction between group and time was significant (F(5.06, 283.7) = 6.44. P < 0.001), which indicated that the reaction time in both groups was significantly changed between the MS and healthy groups across times (B1 to B10). The main effect of the group (MS and healthy) (F(1, 56) = 22.78. P < 0.001) and also the main effect of no-EI vs EI (F(1, 56) = 4.71. P < 0.001) were significant.

    CONCLUSION: This study demonstrated that that RRMS patients are capable of learning new skills, but the provision of EI prior to physical practice is deleterious to implicit learning. It is sufficient to educate MS patients on the aim and general content of the training and only to provide feedback at the end of the rehabilitative session.

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