Background: Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder, impairing balance and motor function. Virtual reality (VR) and motor imagery (MI) are emerging techniques for rehabilitating people with PD. VR and MI combination have not been studied in PD patients. This study was conducted to investigate the combined effects of VR and MI techniques on the balance, motor function, and activities of daily living (ADLs) of patients with PD.Methods: This study was a single-centered, two-armed, parallel-designed randomized controlled trial. A total of 44 patients of either gender who had idiopathic PD were randomly allocated into two groups using lottery methods. Both groups received Physical therapy (PT) treatment, while the experimental group (N: 20) received VR and MI in addition to PT. Both groups received assigned treatment for three days a week on alternate days for 12 weeks. The Unified Parkinson’s Disease Rating Scale (UPDRS) (parts II and III), Berg Balance Scale (BBS), and Activities-specific Balance Confidence (ABC) Scale were used as outcome measures for motor function, balance, and ADLs. The baseline, 6^th, and 12^thweeks of treatment were assessed, with a 16^thweek follow-up to measure retention. The data was analysed using SPSS 24.Results: The experimental group showed significant improvement in motor function than the control group on the UPDRS part III, with 32.45±3.98 vs. 31.86±4.62 before and 15.05±7.16 vs. 25.52±7.36 at 12-weeks, and ap-value < 0.001. At 12 weeks, the experimental group's BBS scores improved from 38.95±3.23 to 51.36±2.83, withp-value < 0.001. At 12 weeks, the experimental group's balance confidence improved considerably, from 59.26±5.87to 81.01±6.14, with ap-value of < 0.001. The experimental group's ADL scores improved as well, going from 22.00±4.64 to 13.07±4.005 after 12 weeks, with ap-value of < 0.001.Conclusion: VR with MI techniques in addition to routine PT significantly improved motor function, balance, and ADLs in PD patients compared to PT alone.Trial registration: IRCT20200221046567N1. Date of registration: 01/04/2020

Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. The purpose of this study was to determine the prevalence of nonspecific LBP and associated risk factors in school-age children. After ethical approval, a cross-sectional study was conducted on 5000 randomly recruited secondary schoolchildren aged 11-14 years in the north of Iran. A structured questionnaire including questions concerning demographic, mechanical, and lifestyle data as well as the prevalence and characteristics of LBP was used. Of the original sample, 4813 (96.2%) children returned the questionnaire. Point, last month, last 6 months, and annual prevalence were 15%, 14.4%, 15.6%, and 17.4%, respectively. No association was found between schoolbag weight and prevalence of LBP (P = 0.824). Low back pain was significantly correlated with age (P = 0.000), position and time spent watching television (P = 0.028 and P = 0.002, respectively), position and duration of homework (P = 0.021 and P = 0.012, respectively). There was no association between LBP and body mass index (P = 0.596) or between LBP and sex (P = 0.412). The results indicated that the prevalence of LBP in schoolchildren is relatively high. Further studies focusing on the effect of different preventive strategies to reduce the impact of such a problem in schoolchildren is strongly recommended.

Low back pain (LBP) is a common and costly occupational injury among health care professionals. The purpose of this study was to investigate the prevalence and risk factors of LBP in surgeons and to analyze how individual and occupational characteristics contribute to the risk of LBP. A cross sectional study was conducted on 250 randomly selected surgeons including 112 general surgeons, 95 gynecologists and 43 orthopedists from 21 hospitals at northern Iran. A structured questionnaire including demographic, lifestyle, occupational characteristics as well as prevalence and risk factors of LBP was used. Visual analogue scale and Oswestry low back disability questionnaires were also used to assess the pain intensity and functional disability, respectively. Point, last month, last six months, last year and lifetime prevalence of LBP was 39.9%, 50.2%, 62.3%, 71.7% and 84.8%, respectively. The highest point prevalence was related to the gynecologists with 44.9%, and the lowest for general surgeons (31.7%). Age, body mass index, smoking, general health, having an assistant, job satisfaction, using preventive strategies and years of practice were found to be correlated with the prevalence of LBP (P < .05 in all instances except for age and job satisfaction). Prolonged standing, repeated movements and awkward postures were the most prevalent aggravating factors (85.2%, 50.2% and 48.4%, respectively). Rest was found to be the most relieving factor (89.5%). The results of this study demonstrate that the prevalence of LBP amongst surgeons appears to be high and highlights a major health concern. Further large scale studies, including other specialties and health professions such as physical therapy, chiropractic, and general medicine, should be performed.

Objective: To determine within-rater and between-rater reliability of the universal goniometer (UG) for measuring active cervical range of motion (ACROM) in asymptomatic healthy subjects.Methods: Nineteen healthy subjects were tested in an identical seated position. Two raters used UG to measure active cervical movements of flexion, extension, right side flexion, left side flexion, right rotation and left rotation. Each motion was measured twice by each of the two raters and was re-measured all over again after one week. Data analysis was performed using the intraclass correlation coefficient (ICC).Results: The results demonstrated excellent within-session (ICC2,1 = 0.83 to 0.98) and between-session (ICC2,2 = 0.79 to 0.97) intra-rater reliability and excellent inter-rater reliability (ICC2,2 = 0.79 to 0.92).Conclusion: Considering above results it is concluded that UG is a reliable tool for assessing ACROM in a clinical setting for healthy subjects.doi: http://dx.doi.org/10.12669/pjms.322.8747How to cite this:Farooq MN, Mohseni Bandpei MA, Ali M, Khan GA. Reliability of the universal goniometer for assessing active cervical range of motion in asymptomatic healthy persons. Pak J Med Sci. 2016;32(2):457-461.

The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P < .05 in all instances). Prolonged sitting and standing, working hours with computer, and correcting examination papers were the most aggravating factors, respectively. Rest and participation in physical activity were found to be the most relieving factors. The prevalence of LBP in teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population.