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Raeesi J, Negahban H, Kachooei AR, Moradi A, Ebrahimzadeh MH, Daghiani M. Comparing the effect of physiotherapy and physiotherapy plus corticosteroid injection on pain intensity, disability, quality of life, and treatment effectiveness in patients with Subacromial Pain Syndrome: a randomized controlled trial. Disabil Rehabil 2023; 45:4218-4226. [PMID: 36398695 DOI: 10.1080/09638288.2022.2146215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the short and medium-term effects of physiotherapy plus corticosteroid injection (combined) with physiotherapy alone on pain intensity, disability, Quality of Life (QoL), and treatment effectiveness in patients with Subacromial Pain Syndrome (SAPS). METHODS In this double-blind, parallel Randomized Controlled Trial (RCT), 50 patients with SAPS were randomly assigned into combined (N = 25, a single injection 3-6 days before physiotherapy) and physiotherapy alone group (N = 25). Pain, disability, QoL, and treatment-effectiveness were measured at pre-intervention, post-intervention, and 3 and 6-month follow-up with Visual Analog Scale (VAS), Shortened Disability of the Arm, Shoulder, and Hand (Quick-DASH), Shoulder Pain and Disability Index (SPADI) (primary outcome measure), Western Ontario Rotator Cuff (WORC), and Global Rating of Change (GRC) respectively. A 2 × 4 (group × time) mixed model analysis of variance (ANOVA) was applied for analysis. RESULTS The ANOVA revealed statistically significant group-in-time interaction for all outcome measures (p-value < 0.05). The independent t-test showed more effectiveness in the combined group at medium-term, as the mean scores of almost all outcome measures were substantially lesser (p < 0.01). Moreover, in short-time, despite a greater number of patients stating "completely recovered" in the combined group, there was no statistically significant difference between groups. CONCLUSIONS Effects of physiotherapy plus corticosteroid injection could be more long-lasting than physiotherapy alone in improving pain intensity, disability, QoL, and treatment effectiveness in patients with SAPS. TRIAL REGISTRATION NUMBER IRCT20201010048980N1.IMPLICATIONS FOR REHABILITATIONShoulder pain is common, persistent, and predominantly results from subacromial pain syndrome (SAPS).Physiotherapy and corticosteroid injections are effective interventions for this condition.Comprehensive physiotherapy alone can be as effective as corticosteroid injection combined with physiotherapy in the short term.A combined approach versus physiotherapy alone may have more medium-term effects on SAPS patients' pain, disability, quality of life, and treatment effectiveness.
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Affiliation(s)
- Javad Raeesi
- School of Physical Therapy, Health and Rehabilitation Sciences Department, Western University, London, Canada
- Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Science, Mashhad, Iran
| | - Hossein Negahban
- Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Science, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Kachooei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Daghiani
- Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Science, Mashhad, Iran
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Negahban H, Daghiani M, Raeesi J, Sayyed Hosseinian SH, Mousavian A, Varasteh Hajipour M, Sahebalam M. Comparing the effects of ankle integral and conventional physiotherapy on pain, range of motion, balance, disability, and treatment effectiveness in patients with chronic ankle instability: Randomized controlled trial. Clin Rehabil 2023; 37:362-372. [PMID: 36330694 DOI: 10.1177/02692155221134993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the effects of ankle integral and conventional physiotherapy on pain, range of motion, balance, disability, and treatment effectiveness in patients with chronic ankle instability (CAI). DESIGN Two-arm, parallel-group, randomized, double-blind, controlled trial. PARTICIPANTS 60 patients with unilateral CAI. INTERVENTION integral physiotherapy (n = 30) or conventional physiotherapy (n = 30). OUTCOMES Visual Analog Scale (VAS), dorsiflexion and plantarflexion range of motion, Star Excursion Balance Test (SEBT), Single Leg Hop (SLH) test, Foot and Ankle Outcome Score (FAOS), Lower Extremity Functional Score (LEFS), global rating of change, were gathered pre and post-intervention. RESULTS The ANOVA results revealed statistically significant interaction for FAOS, and LEFS outcome measures (P < 0.05) and the mean change results showed there were a favorable clinical difference incline toward the integral group (meanintegral = 20.14 (14.95-25.37), meanConventional = 29.46 (24.09-34.83)). There were no interactions between group and time among other outcome measures (P > 0.05). The group main effect did not show any statistical significance (P > 0.05). CONCLUSION Hip strengthening and balance exercises added to ankle rehabilitation could be more favorable on improving the patients' functional ability.
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Affiliation(s)
- Hossein Negahban
- School of Paramedical Science, 37552Mashhad University of Medical Sciences, Mashhad, Iran.,Orthopaedic Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Daghiani
- School of Paramedical Science, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Raeesi
- School of Paramedical Science, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Alireza Mousavian
- Orthopaedic Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohamad Sahebalam
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, 440827Iran University of Medical Sciences, Tehran, Iran
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Askarnia-Faal MM, Sayyed-Hosseinian SH, Nazari SE, Asgharzadeh F, Vahedi E, Eskandari M, Ghasemi H, Avan A, Alaei M, Naimi H, Daghiani M, Soleimani A, Alalikhan A, Mohammadzadeh R, Ferns G, Ryzhikov M, Khazaei M, Hassanian SM. Exploring new therapeutic potentials of curcumin against post-surgical adhesion bands. BMC Complement Med Ther 2023; 23:27. [PMID: 36721147 PMCID: PMC9887929 DOI: 10.1186/s12906-022-03808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Adhesion band formation is a common cause of morbidity for patients undergoing surgeries. Anti-inflammatory and anti-fibrotic properties of curcumin, a pharmacologically active component of Curcuma longa, have been investigated in several studies. The aim of this study is to explore the therapeutic potential of curcumin in attenuating post-operative adhesion band (PSAB) formation in both peritoneal and peritendinous surgeries in animal models. METHODS Bio-mechanical, histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin. RESULTS Results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. Curcumin may decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models. CONCLUSION These results suggest that protective effects of phytosomal curcumin against PSAB formation is partially mediated by decreasing inflammation and fibrosis at site of surgery. Further studies are needed to investigate the therapeutic potential of this molecule in preventing PSAB.
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Affiliation(s)
- Mohammad-Mostafa Askarnia-Faal
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayyed-Hadi Sayyed-Hosseinian
- grid.411583.a0000 0001 2198 6209Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Elnaz Nazari
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Asgharzadeh
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Vahedi
- grid.411583.a0000 0001 2198 6209Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moein Eskandari
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Haniyeh Ghasemi
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Human Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Alaei
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Naimi
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Daghiani
- grid.411583.a0000 0001 2198 6209Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atena Soleimani
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Alalikhan
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Mohammadzadeh
- grid.449862.50000 0004 0518 4224Department of Biology, Faculty of Basic Sciences, University of Maragheh, Maragheh, Iran
| | - Gordon Ferns
- grid.414601.60000 0000 8853 076XDivision of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex BN1 9PH UK
| | - Mikhail Ryzhikov
- grid.262962.b0000 0004 1936 9342Saint Louis University, School of Medicine, Saint Louis, MO USA
| | - Majid Khazaei
- grid.411583.a0000 0001 2198 6209Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- grid.411583.a0000 0001 2198 6209Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Daghiani M, Negahban H, Mostafaee N, Ebrahimzadeh MH, Kachooei AR, Moradi A, Vahedi E. Cross-cultural adaptation, validation and responsiveness of the Persian version of Western Ontario shoulder instability index questionnaire in Persian patients with shoulder instability. Physiother Theory Pract 2023:1-9. [PMID: 36637357 DOI: 10.1080/09593985.2023.2165425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/31/2022] [Accepted: 12/31/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION To translate, cross-culturally adapt, and psychometric testing the Western Ontario Shoulder Instability index (WOSI) into Persian. METHODS Seventy-two patients diagnosed with shoulder instability participated in reliability, construct validity, and responsiveness analysis. All the patients filled out the WOSI with an interval of two weeks to assess reliability. The shortened Disability of Arm, Shoulder and Hand (Quick-DASH), Shoulder Pain and Disability Index (SPADI), and the 36-Item Short-Form Survey (SF-36) were assessed to evaluate construct validity. In order to assess responsiveness patients filled out WOSI before and after the physiotherapy and global rating of change scale at last session of physiotherapy. Reliability was assessed by intra-class correlation coefficient (ICC (1,2)), construct validity by two tailed Pearson (r), and responsiveness by longitudinal validity and receiver operating characteristics (ROC) curve analysis. RESULTS The ICC (1,2) was 0.90 and correlation analysis revealed high level of correlation with: Quick-DASH (r = 0.82); SPADI (r = 0.72); physical SF-36 (r = -0.52); and mental SF-36 (r = -0.48). Responsiveness analysis demonstrated the area under curve was 0.90, with minimal clinical important difference 46.87. CONCLUSION We found the Persian-WOSI as a valid, reliable, and responsive questionnaire to evaluate quality of life of patients with shoulder instability.
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Affiliation(s)
- Maryam Daghiani
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Ahmad Abad St, Mashhad, Iran
| | - Neda Mostafaee
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
| | - Mohammad Hosein Ebrahimzadeh
- Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Ahmad Abad St, Mashhad, Iran
| | - Amir Reza Kachooei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Ahmad Abad St, Mashhad, Iran
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Ahmad Abad St, Mashhad, Iran
| | - Ehsan Vahedi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital, Ahmad Abad St, Mashhad, Iran
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Daghiani M, Negahban H, Mostafaee N, Ebrahimzadeh MH, Moradi A, Kachooei AR, Saidi A. Psychometric Properties of Full and Shortened Persian-version of Western Ontario Rotator Cuff Index Questionnaires in Persian-speaking Patients with Shoulder Pain. Arch Bone Jt Surg 2022; 10:668-676. [PMID: 36258749 PMCID: PMC9569145 DOI: 10.22038/abjs.2022.64227.3082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/17/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to translate the shortened Western Ontario Rotator Cuff (Short-WORC) questionnaire into Persian and determine the psychometric features of WORC and Persian-Short-WORC in patients with shoulder pain. METHODS A total of 130 patients completed Persian-WORC and -Short-WORC, Shoulder Pain And Disability Index (SPADI), shortened Disability of Arm, Shoulder, and Hand (Quick-DASH), WORC, as well as Short-Form health survey (SF-36), in the evaluation and re-evaluation sessions with an interval of 5-7 days to assess reliability and validity. To determine responsiveness, all patients completed questionnaires and a global rating of change scale before and after the 4-week physiotherapy. Intra-class correlation coefficient (ICC) was used for assessing reliability, two-tailed Pearson (r) for validity, as well as longitudinal validity, and receiver operating characteristics (ROC) curve analysis for responsiveness. RESULTS The ICC was 0.95 (confidence interval: 0.93-0.96) for Short-WORC. A strong correlation was found between Short-WORC, SPADI (r=-0.82), Quick-DASH (r=-0.79), WORC (r=0.92), SF-36 physical (r=0.76), and SF-36 mental (r=0.71). Floor and ceiling effects were not detected. The responsiveness of Short-WORC and WORC was proven with an area under the curve of >0.90, and their minimal important change was 28.56 and 26.28 points, respectively. CONCLUSION The Persian version of WORC has good psychometric properties to measure disability and health-related quality of life in patients with shoulder pain.
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Affiliation(s)
- Maryam Daghiani
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran ,Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Mostafaee
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir R. Kachooei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aref Saidi
- Faculty ember, University of Lahore, Pakistan
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Daghiani M, Negahban H, Ebrahimzadeh MH, Moradi A, Kachooei AR, Raeesi J, Divandari A. The effectiveness of comprehensive physiotherapy compared with corticosteroid injection on pain, disability, treatment effectiveness, and quality of life in patients with subacromial pain syndrome: a parallel, single-blind, randomized controlled trial. Physiother Theory Pract 2022:1-15. [DOI: 10.1080/09593985.2022.2044421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maryam Daghiani
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
- Orthopaedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Moradi
- Orthopaedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Kachooei
- Orthopaedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Raeesi
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
| | - Akram Divandari
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, East Door of Ferdowsi University, Mashhad, Iran
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Mostafaee N, Divandari A, Negahban H, Kachooei AR, Moradi A, Ebrahimzadeh MH, Tabesh H, Daghiani M. Shoulder and scapula muscle training plus conventional physiotherapy versus conventional physiotherapy only: a randomized controlled trial of patients with lateral elbow tendinopathy. Physiother Theory Pract 2020; 38:1153-1164. [PMID: 32975171 DOI: 10.1080/09593985.2020.1821417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous studies have suggested that weakening of shoulder and scapula muscles have been associated with increased pain, and decreased functional abilities in patients with lateral elbow tendinopathy (LET). PURPOSE To compare the effects of shoulder and scapula muscle training plus conventional physiotherapy with conventional physiotherapy only. METHODS A group of 48 patients with LET was randomly allocated into two groups: shoulder and scapula muscle training plus conventional physiotherapy (n = 24), and conventional physiotherapy (n = 24). All patients received 12 sessions of treatment for 4 weeks. Furthermore, both groups were instructed to continue their own exercise program at home until four months after the end of treatment. Pain intensity, grip strength, and functional status were measured preintervention, postintervention, and 4 months after the end of intervention (4-month follow-up). RESULTS The shoulder and scapula muscle training plus conventional physiotherapy group showed significantly more reduction in pain and greater improvement in functional status compared with conventional physiotherapy group, but there was no significant difference in pain-free grip strength for two groups. CONCLUSION Conventional physiotherapy combined with shoulder and scapula muscle training could be more effective in improving the pain and functional abilities of patients with LET compared with conventional physiotherapy only.
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Affiliation(s)
- Neda Mostafaee
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Akram Divandari
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.,Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Kachooei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamed Tabesh
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Daghiani
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Yosephi MH, Ehsani F, Daghiani M, Zoghi M, Jaberzadeh S. The effects of trans-cranial direct current stimulation intervention on fear: A systematic review of literature. J Clin Neurosci 2019; 62:7-13. [DOI: 10.1016/j.jocn.2019.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
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