In this research, the imposed forces on three muscles including: Gastrocnemius muscle, Trapezius muscle and Quadratus lumborum of the tractor drivers during clutching have been studied. The sample included 30 persons and the research was conducted on two domestic tractors including: MF285 and MF399 models. The clutching forces for these tractors were measured as 340 N and 290 N, respectively. The difference between drivers’ knee angle of the two tractors was proved significant at the one percent level. The decrease of pain threshold after 30 seconds and 60 seconds clutching and 60 seconds rest after clutching in MF285 tractor in all three muscles were more than that of MF399 tractor. The impact of clutching on the average decrease of pain threshold, among all the drivers, and for all time intervals, during and after clutching in the Quadratus lumborum muscle for both tractors was more than the other two muscles. In order to reduce the imposed force of clutching for MF285 tractor, some modifications is suggested. In this regard the force transfer joint between the pedal and the disc in the mechanism of clutching can be replaced with one made of cast iron.

Aim: The aim of the study is to determine the effectiveness of Myofascial Trigger Release Technique versus Muscle Energy Technique on muscle activity and pain among individuals with Text Neck Syndrome Methodand Materials: A total of 112 subjects with Text neck syndrome were selected using simple random sampling technique from Saveetha medical college and hospital based on inclusion and exclusion criteria after which detailed study procedure were explained to patients and written informed consent were obtained. The participants age from 18 to 30 years and both male and female gender had been diagnosed with Text neck syndrome. The 56 individuals in each group into two groups. The experimental group (Myofascial trigger release technique) Control group (Muscle energy technique) for both groups pretest results from, EMG and pressure ALGOMETER were documented. Treatment intervention consisted of 4 weeks with 3 sessions per week. Findings: On comparing pre-test and post-test within experimental group & control group on EMG and Pressure ALGOMETER score shows highly significant difference in mean values at P ≤ 0.0001. Conclusion: The study concluded that the myofascial trigger release technique was more effective than muscle energy technique.

Objectives: Painful trigger points (PTP) may be caused or exacerbated by many factors, including abnormal spinal posture. This study compares PTP in the shoulder and scapular areas of mildly kyphotic subjects versus subjects with a normal spine among physiotherapy (PT) students enrolled at Shiraz University of Medical Sciences, Shiraz City, Iran. Methods: A total of 60 PT students, 30 with mild kyphosis and 30 with a normal spine, were randomly and voluntarily recruited. The data collection was planned based on the subjects’ spinal posture, shoulder and scapular pain levels, and the intensity of pain evoked in response to pressure. The spinal posture was assessed using a flexible ruler, while the trigger points were evaluated as described previously by Travell and Simon. A digital pressure ALGOMETER assessed the subjects’ pain thresholds, and the pain levels were quantified using a visual analog scale (VAS). Results: The data indicated significant differences between the mildly kyphotic subjects and individuals with a normal thoracic spine posture concerning their trigger points, pain scales, and pressure thresholds that caused pain. Despite the significant differences between both groups for their latent trigger points, the mean scores for the active trigger points were not significantly different. Discussion: There were more trigger points in students with mild kyphosis than in subjects with a normal spine posture. Meanwhile, mild thoracic kyphosis, likely from imbalanced paraspinal muscles, may be linked to the development and or severity of trigger point pain in mildly kyphotic students.

Background: Fatigue is one of the risk factors for injuy in sports. As a consequence of this phenomenon, the pain threshold is reduced in the soles of the feet, leading to the improper distribution and loading of forces, which can alter the mountaineers’,walking patterns and the skeletal structure of their feet, ultimately resulting in soft tissue damage, pain, falls, and even death. Objectives: The present study aims to investigate the effect of fatigue on the pain threshold of the soles of the feet. Methods: In this semi-experimental study, 35 mountaineers (age range = 20-35 years) were selected by non-random sampling method. In this research, a test was taken before and after an eight-kilometer mountaineering session at a moderate pace, and an ALGOMETER device was used to evaluate foot pain and pain threshold. The Shapiro-Wilk test was used for statistical analysis of the normality of the data distribution, and the paired sample t-test was used for data evaluation and comparison. All statistical operations were carried out using SPSS software version 24, and the significance level of the tests was considered 0. 05. Results: According to the results, fatigue reduces the pain threshold in the soles of the feet, with the greatest effect being observed in the central region of the heel and the second toe. Conclusions: The present research showed that fatigue could increase risk factors in mountaineers, hinder optimal performance, reduce the pain threshold in the soles of the feet, and increase pain sensitivity, which can affect the way of mountaineering and the pressure distribution in the soles, leading to increased risk of injuries, strains, sprains, and falls of mountaineers.

Background: Based on new evidence, exercise with type and intensity consideration may impact on pain relief and good cardiovascular responses in patients with multiple sclerosis (MS).Objective: To investigate the effect of resistance (RE) and aerobic exercise (AE) on the threshold, pain perception and cardiovascular responses in women with MS.Methods: In this semi-experimental study, Ten female patients with MS selected from MS society of Rasht who had necessary criteria and average systolic blood pressure (SBP) of 112.90 and diastolic blood pressure of 74.50 (mmHg) participated as a purposeful and available sample in 2014. Resistance exercise included 2 sets of 10 repetitions for 5 exercises as circuit and aerobic exercise consisted of cycle ergometry with intensity of 50-60% HRmax. Pain threshold, perception and blood pressure were measured with ALGOMETER, pain scale and sphygmomanometer ALPK2 respectively. The ANOVA repeated measures and Pearson correlation coefficient were used for data analysis.Findings: SBP had a normal process, but it was non-significant after exercises. Heart rate increased (P<0.05) immediately after both exercises compared with pre-exercise significantly and at minutes of 10-60 after the exercise was significantly reduced comparing to immediately post aerobic exercise (P<0.05).Pain perception was not significant after both exercises, Pain threshold than pre-exercise level was decreased in both exercises, but significant relationship with Heart rate was observed only in aerobic exercise (P=0.041).Conclusion: Based on the findings, resistance exercise and aerobic exercise with moderate intensity probably can lead to decrease pain threshold, blood pressure and heart rate to 15 minutes after the exercise in female patients with MS.

Purpose: The purpose of the present study was to evaluate the association of ultrasonography findings with pain, range of motion, disability, and pressure pain threshold in patients with upper trapezius myofascial pain syndrome.Methods: A total of 60 subjects with upper trapezius myofascial pain syndrome (mean age: 25.90±4.47 y; mean weight: 63.53±7.76 kg; mean height: 166.55±5.65 cm; and pain duration: 9.75±6.04 month) were selected with nonprobability convenient sampling method and examined. After methodological study, all participants were evaluated regarding their pain, cervical range of motion, functional disability, pressure pain threshold (PPT), maximum muscle and fascia thickness as well as strain ratio by the following instruments, respectively: visual analogue scale, goniometry, neck disability index, ALGOMETER, sonography, and sonoelastography.Results: The ICC values for intra- and inter-examiner reliability of variables were high to very high (0.72-0.96). The correlation coefficients between pain (r=0.22), range of motion (r=0.11), disability (r=0.13), PPT (r=0.32), and maximum thickness of muscle were moderate. The correlation coefficients between pain (r=0.13), range of motion (r=0.23), disability (r=0.17), PPT (r=0.23) and maximum thickness of fascia were low. The correlation coefficients between pain (r=-0.65), range of motion (r=-0.23), disability (r=-0.41), PPT (r=0.71) were high. Values of β for strain ratio and pain were -0.35 (P=0.01), range of motion, -0.14, (P=0.03); disability, -0.19, (P=0.03); and PPT, 0.41 (P<0.001).Conclusion: Strain ratio of upper trapezius muscle in subjects with myofascial pain syndrome has strong correlation with pain, disability, and PPT. However, maximum muscle thickness and fascia of the upper trapezius are correlated with these variables poorly. PPT is the highly correlated factor with strain ratio.

Introduction: Blood flow restriction (BFR) training, in which an inflatable cuff partially occludes blood flow around the proximal portion of a limb, coupled with low-load resistance exercise (LLRE) has resulted in gains comparable with traditional progressive resistive exercise in healthy populations. The use of BFR with LLRE may help people with supraspinatus tendinopathy through proximal effects to improve strength and muscle size. The purpose of this case report is to describe the proximal effect of the LLRE+BFR program on a patient with supraspinatus tendinopathy. Materials and Methods: The patient was a 40-year-old man with a history of shoulder pain and weakness for the past months. He received an LLRE+BFR program for his right shoulder including rotator cuff and scapular strengthening exercises and lower limbs aerobic exercises based on protocols of strengthening and aerobic exercises of BFR. Outcomes measured at baseline and 4 weeks included the 4 items: 1) Strength of supraspinatus muscle and four scapular stabilizer muscles including serratus anterior strength, middle trapezius strength, and lower trapezius strength by dynamometer, 2) supraspinatus thickness by ultrasound, 3) pain pressure threshold of supraspinatus and deltoid muscles by ALGOMETER, and 4) pain reported bay in each session based on pain numeric scale. Results: After 6 weeks, the strength of supraspinatus and scapular stabilizers except for the lower trapezius increased. The supraspinatus thickness and pain pressure threshold in the supraspinatus and deltoid muscle also increased after 4 weeks. The mean of pain reported by the patient based on the pain numeric scale before and after each session was also decreased. Conclusion: The patient had measurable improvements following the use of an LLRE+BFR program. LLRE+BFR program may be an option for strength training in people with supraspinatus tendinopathy,however, more research is needed to determine effectiveness across the population of people with supraspinatus tendinopathy.

Background: Myofascial pain syndrome (MPS) is one of the most frequent causes of chronic musculoskeletal pain which is characterized by myofascial trigger points (MTrPs). Hence, it is of crucial importance to identify practical approaches for the treatment of these points. Upper trapezius muscle (UT) is highly susceptible to the development of MTrPs that are commonly resulted from overuse and micro-trauma. Objectives: The present study aimed to compare the effects of dry needling (DN) and low-level laser therapy (LLLT) regarding the reduction of pain and muscle thickness and improvement of the range of motion (ROM) and pressure pain threshold (PPT) in patients with latent MTrPs (LTrPs) in their UT muscles. Methods: In total, 60 patients with LTrPs in UT muscle participated in this randomized clinical trial. The subjects were randomly divided into two treatment groups of DN and LLLT. The PPT was evaluated by visual analog scale (VAS) and ALGOMETER while ROM and muscle thickness were assessed using goniometer and ultrasonography, respectively. It should be noted that the variables were evaluated before the first and after the sixth sessions. Finally, the collected data were analyzed using independent and paired t-tests. Results: Based on the results, the VAS and muscle thickness significantly reduced, while the PPT and cervical ROM increased in both groups after treatment (P<0. 001). The independent t-test revealed a statistically significant improvement in the DN group in terms of PPT (9. 9-14. 17, P=0. 009) and ROM (37. 33-42. 67, p=0. 005), compared to the LLLT group. Nevertheless, no significant difference was found between the two groups regarding VAS and muscle thickness variables (P>0. 05). Conclusion: The DN and LLLT effectively improved symptoms in the UT muscles of patients with LTrPs. However, the DN was more effective in the improvement of ROM and PPT variables.