This study was designed to evaluate the effects of whole body vibration (WBV) exercise, mental training (MT), and the concurrent effect of WBV and MT on lower body balance, neuromuscular performance, and leg muscle strength in elderly men. In a randomized control trial study with parallel group design, 42 older men (mean±standard deviation age, 68±5.78 years) were randomly divided into four groups: WBV (n=11), MT (n=12), WBV+MT (n=10), and control (n=9) groups. The protocol of training consisted of three sessions per week for 8 weeks and about 30 min for each session. The WBV exercise was performed on a vibration machine. In MT group, participants were asked to mentally visualize to do the Timed Up and Go and relaxation technics. postural stability, the Timed Up and Go test, 5-repetition chair-rising test, 6-m tandem gait test, 10-m walking, and leg isometric strength were measured in baseline and after 8-week intervention. Repeated measures-analysis of variance followed by post hoc was used to analyses the data. The results of this study showed that there were significant improvements (P<0.05) in postural stability, Timed Up and Go, 5-repetition chair-rising, 6-m tandem gait test, 10-m walking, and leg isometric strength in WBV, MT, and WBV+MT in comparison with baseline and in comparison with control group. It seems that older adults can take benefit from WBV and MT and WBV+MT exercise as a cost-effective and practical way without side effects to improve postural control, mobility, and functional performance.

Background: Patients with idiopathic Parkinson's disease (PD) have a flexed posture and are at an increased risk of falls. In addition, fear of falling (FOF) is among the main complaints of PD patients. To reduce the risk of falling, complex non-drug interventions are required, involving balance-challenging exercises with proper strength, along with posture alignment through corrective exercise interventions (Alexander techniques), which are often utilized to manage patients with PD and thoracic hyperkyphosis. Objectives: To investigate the effects of Alexander-based corrective techniques (ABCT) on forward flexed posture (thoracic hyperkyphosis and forward head posture), risk of falling, and FOF among idiopathic PD patients. Methods: In this interventional study, 26 male and female patients were randomly assigned to the experimental (n, 13) and control groups (n, 13). The subjects participated in a postural realignment program, consisting of 60-minute sessions over 8 weeks (3 sessions per week). Pre-and posttest evaluations were also carried out. Results:The results of paired t test regarding the effects of ABCT on the thoracic kyphosis angle (TKA), craniovertebral angle (CVA), falls efficacy scale-international (FES-I) score, freezing of gait (FOG), and functional reach test (FRT) score revealed a significant difference between the pre-and posttest stages in the control group (P = 0.05). In addition, the t test results showed a significant difference in the mean changes of TKA, FES-I score, FOG, and FRT score between the groups in the pre-and postintervention stages. The Pearson's correlation test showed that TKA had a significant positive correlation with FES-I and FOG in the groups. On the other hand, the results of Pearson's correlation test showed a significant negative correlation between TKA and FRT. Finally, the Pearson's correlation coefficient showed a significant positive correlation between CVA and FES-I, but not FRT in the groups. Conclusions: The findings of this study indicated that 8 weeks (24 sessions) of ABCT in the experimental group caused considerable improvements in TKA, CVA, FOF, FOG, and risk of fall in patients with PD.

Background:Telenursing is a low-cost, highly accessible method that can lead to increased awareness on the principles of care, and may eventually help reduce the stress experienced by caregivers of patients with stroke. The present study aimed to investigate the effect of telenursing through phone consultation on the levels of depression and anxiety in family caregivers of patients with stroke.Materials and Methods:This was a randomized clinical trial including 152 caregivers of stroke patients discharged from Mohammad Vase'ee Hospital in Sabzevar in 2016. Participants were recruited through purposive sampling method and were randomly assigned to control (n = 76) and intervention (n = 76) groups. The intervention consisted of 32 sessions of phone consultation. Research tools included demographic characteristics form, needs assessment questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory. Data were analyzed with independent t test using SPSS, version 23.Results:Mean (SD) post-intervention anxiety scores for the intervention and the control group were statistically significant (t = 3.51, p = 0.001). However, the difference in mean depression scores after intervention was not significant (p = 0.70).Conclusions:Telenursing can be employed to facilitate the care of chronic patients as well as increase the psychological well-being of the caregivers through providing practical and specialized information.

Background: A decline in neuromuscular function can cause a decrease in physical fitness in elderly women. Objective: The present study aimed at investigating whether whole body vibration (WBV) training and creatine supplementation could affect muscle strength, mobility, and balance in elderly women in short-term. Methods: The participants were 22 healthy elderly women aged 60 to 80 years, who were randomly divided into the whole-body vibration and creatine (WBV + Cr) group, whole-body vibration and placebo (WBV + P) group, and control group. The whole-body vibration group performed exercises for 10 days. The participants in WBV + Cr group consumed 20 g oral creatine supplement per day from the first to the fifth day, which was followed by consuming 5 g of creatine per day for the next 5 days. To assess mobility performance, a 30-meter walking and tandem gait tests were applied. Static and dynamic balance were measured by Flamingo and Timed-Up and Go (TUG) tests. Muscle isometric and isotonic strength were assessed by dynamometer and leg extension tests. Results: No significant difference was found in static balance (P = 0.11), but WBV + Cr and WBV + P groups showed better results in dynamic balance (P = 0.001 and P = 0.009, respectively). Moreover, leg isotonic strength improved significantly in WBV + Cr and WBV + P groups (P = 0.001 and P = 0.001, respectively). However, leg isometric strength and 30-meter walking performance significantly improved only in WBV + Cr group compared to the control group. Moreover, no significant differences were observed in isometric strength of the hand (P = 0.89) and tandem gait test results among the groups (P = 0.25). Conclusions: A short-term WBV exercise improves isotonic strength of the leg muscle and dynamic balance, while creatine supplementation with and without WBV training increases isometric strength of the leg muscle and mobility in elderly women.

<p class="abstract"><strong>Background:</strong> Knee pain is one of the most common complains which cause patients to visit a doctor and Magnetic Resonance Imaging (MRI) is one of the common diagnostic methods which are common to find the cause of Knee pain. This study aim to determine knee MRI appropriateness, in Valiasr hospital of Birjand in 2014.</p><p class="abstract"><strong>Methods:</strong> In this study descriptive – analytical study, 150 patients referred to MRI unit were selected using convenient sampling method. Data were gatherers using a Questionnaire and then analyzed by SPSS16 using descriptive statistics and Pearson, chi-square and Fisher's exact tests.  </p><p class="abstract"><strong>Results:</strong> Of 150 cases, 70 (46.7%) were considered inappropriate, 7 (4.7%) were uncertain, and 73 (48.7%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was 46200000 Rails. A statistical significant relation was observed between appropriateness of prescription with sex, jobs, education, physician specialist and referring institution.</p><strong>Conclusions:</strong> Considering the high rate of inappropriate prescriptions, it is necessary to find the causes. Developing, customization, and perform clinical guidelines in all of our country may help reducing this rate.

Purpose Good posture plays a significant role for the elderly in achieving optimal quality of life. This study aimed to evaluate the impact of multicomponent functional training with postural correction on functional balance in the elderly with a history of falling. Methods This study was a randomized controlled, single-blind study. Subjects (n = 28, mean age = 70 years) with a history of falling were selected and randomly allocated to either a multicomponent functional training (n = 14) or a control group (n = 14). The experimental group exercised for 8 weeks, three days per week for 60 min per day. The training program with strength, endurance, and balance parts was conducted in the multi-task conditions to stimulate the physical and cognitive abilities focusing on the attentional-correct posture. The control group received conventional care. The Berg balance and short physical performance battery tests were used in the pre-test and post-test. The adjusted post-test means of experimental and control groups were analyzed using the ANCOVA test to eliminate any pretest effects. Results This study found a significant effect of training on Berg balance test (P = 0.001), Timed Up and Go with D-T (P = 0.01), Timed Up and Go (P = 0.002), and Short Physical Performance Battery (P = 0.001). Conclusions Eight weeks of multicomponent exercise training has beneficial effects on balance and physical function and results in improved equilibrium and a decreasing probability of falling. Therefore, practitioners can use this 8-week training program for older adults.

Our results confirmed the protective effect of the rs1572931 SNP on PD and replicated the results of previous studies, in Iranian subjects. We suggest further studies in other populations.

Large artery atherosclerosis (LAA) is known as an important cause of ischemic stroke (IS), which is a multifactorial disorder. Many candidate genes have been proposed for IS like (TBXAS1) that plays a significant role in LAA stroke pathogenesis. This is the first study on the evaluation of the association of the five single‐nucleotide polymorphisms (SNPs) in TBXAS1 promoter region and the level of TBXAS1 transcript with large‐artery atherosclerosis stroke. Five SNPs in TBXAS1 genes were investigated in 248 patients with large‐artery atherosclerosis stroke and 199 healthy controls in Iranian population in this case‐control study through using the high‐resolution melting assay. In addition, the relationships between the selected SNPs with alteration of TBXAS1 gene expressions were investigated in terms of blood platelets through the reverse transcription‐quantitative polymerase chain reaction. Multivariate logistic analysis with adjustments indicated that rs10256282CC, rs10237429CC, and rs4590360GG genotypes were associated with large‐artery atherosclerosis stroke (adjusted odds ratio = 2.804, 2.872, and 2.432, respectively; P < 0.05, q < 0.05). Furthermore, the frequency of CACCG haplotype in the patients was greatly higher than that in the controls (OR = 1.424, 95% CI: 1.071‐1.893, P = 0.014738). In addition, TBXAS1 expression was higher in patients compared to the controls (P = 0.021), and individuals with the homozygous mutated genotypes of these SNPs showed a higher expression level compared to other genotype (P < 0.05). In total, our findings indicate a significant association of TBXAS1 gene rs10256282CC, rs10237429CC, and rs4590360GG polymorphisms with large‐artery atherosclerosis stroke susceptibility and the level of TBXAS1 expression, which was not previously reported in any population.