Investigating the effects of mechanical traction and high intensity laser therapy on pain, muscle activity, and functional balance in knee osteoarthritis Pardis Norouzi, Roya Ravanbod, Giti Torkaman Physiotherapy Theory and Practice, 2026 BACKGROUND: Mechanical traction (MT) is a noninvasive approach to unload the joint in knee osteoarthritis (KOA), however,its effects on co-contraction index (CCI) and balance remain unclear. PURPOSE: To investigate whether combining MT with high intensity laser therapy (HILT) yields greater improvements in subjective and objective outcomes among patients with KOA compared to HILT alone. METHODS: = 19) groups and received 10 treatment sessions over 2 weeks. Outcomes included pain (VAS), function (WOMAC), active knee flexion range of motion (AROM), CCI, and balance during curve tracking (CT) and sit-to-stand (STS) tasks. A two-way mixed-model ANOVA was used to assess the effects of treatment and time (pre - post). RESULTS: = 0.66 and 0.23). CONCLUSION: These findings suggest that the combined application of MT+HILT may serve as an effective conservative strategy to improve pain management, functional capacity, AROM, and balance, potentially contributing to a reduced risk of falls in individuals with KOA.
The silent predictor: Exploring the link between waist to hip ratio, fear of falling, and balance impairment in postmenopausal women Sanaz Mohebi, Giti Torkaman, Fariba Bahrami Women and Health, 2026 = .014), which explains the significant ability of the determined function for discrimination. A higher WHR value was associated with osteoporosis and an increased FES. The WHR value, a simple measure of visceral fat mass accumulation, exhibited a discriminative capability by accurately classifying 76 percent of the original grouped cases.
Effects of instrument-assisted soft tissue mobilization combined with exercise on knee joint muscle activity during walking in patients with moderate knee osteoarthritis: A randomized controlled clinical trial Bahare Jafarsalehi, Sahar Boozari, Giti Torkaman Scientific Reports, 2025 Knee osteoarthritis (KOA) is a degenerative joint disorder characterized by pain and stiffness, often leading to compensatory increases in muscle activity. Instrument-assisted soft tissue mobilization (IASTM) is an emerging manual therapy with potential benefits in soft tissue release and pain management. This study investigated the effects of IASTM combined with exercise therapy on muscle activity and clinical outcomes in individuals with KOA. Thirty KOA patients were randomly allocated to either an IASTM plus exercise group or a sham IASTM plus exercise group. The intervention consisted of four sessions over two weeks. Electromyographic (EMG) activity was assessed pre- and post-treatment using mean root mean square (RMS) amplitude values and co-contraction indices of selected lower limb muscles during preferred and fast walking. Pain intensity, knee and ankle strength, and self-reported disability were also evaluated. Significant group*time interactions were observed for the vastus medialis, semitendinosus, and tibialis anterior, with post-treatment EMG activity decreasing in the IASTM group and increasing in the sham group. All mean RMS values and co-contraction indices were significantly higher during fast walking. A significant speed*time interaction for the vastus lateralis revealed more pronounced post-treatment reductions during fast walking, with a trend toward decreased activity in the IASTM group and increased activity in the sham group. Both groups demonstrated significant improvements in pain, disability, and muscle strength; however, the IASTM group showed greater improvements, supported by significant interaction effects. Correlation analysis revealed that EMG activity in the rectus femoris, vastus medialis, and biceps femoris was moderately and positively associated with pain levels. The rectus femoris and medial gastrocnemius also showed inverse associations with muscle strength. Although both groups showed improvements in pain, strength, and disability, greater gains were observed in the IASTM group. Notably, IASTM combined with exercise therapy also reduced EMG activity. This reduction, alongside increased strength, suggests enhanced neuromuscular efficiency, which may decrease intra-articular loading associated with elevated muscle activation—commonly observed in KOA patients—while supporting joint stability. These findings highlight the potential benefit of incorporating soft tissue mobilization techniques alongside exercise therapy in KOA rehabilitation programs. Trial registration This trial was registered on 14 January 2022 at https://www.irct.behdasht.gov.ir with the registration code IRCT20201128049511N3. It is also accessible via the WHO trial search portal at: https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20201128049511N3 .
Comparing the impact of hyaluronic acid injections and exercise therapy alone and combined on the postural sway and base of support in individuals with knee osteoarthritis: A quasi-experimental study Giti Torkaman, Elham Rostami-Mehr, Noushin Bayat, Maryam Mofid International Journal of Therapy and Rehabilitation, 2025 Background/Aims Intra-articular hyaluronic acid injections and exercise therapy have been demonstrated to improve pain in knee osteoarthritis. The aim of this study was to evaluate the effectiveness of intra-articular hyaluronic acid injections and exercise both separately and in combination, on the centre of pressure sway and base of support in individuals with knee osteoarthritis. Methods In this quasi-experimental study, 36 participants with moderate knee osteoarthritis were divided into exercise therapy (n=12), intra-articular hyaluronic acid injection (n=12), and combined (exercise therapy and intra-articular hyaluronic acid injection) (n=12) groups. Intra-articular hyaluronic acid injections involved three consecutive weekly injections and exercise therapy was conducted three times a week for 5 weeks. The centre of pressure sway was measured in the medial-lateral and anterior-posterior directions, and the centre of pressure location on the base of support was also assessed using MATLAB software. Pain was assessed using a visual analogue scale. Physical function and postural balance were evaluated using the Lequesne Index, Timed Up and Go Test, Figure-of-8 Walk Test and Star Excursion Balance Test. Results All interventions were effective in reducing pain and improving function. In the medial-lateral direction, the combined group showed a significant decrease in centre of pressure velocity compared to the exercise therapy group (P=0.015) and a substantial reduction in centre of pressure displacement compared to the hyaluronic acid injection group (P=0.043). The base of support decreased significantly in the exercise therapy and hyaluronic acid injection groups (P=0.045 and P=0.007 respectively). The distance of the centre of pressure to the border of the base of support on the affected side significantly decreased in the hyaluronic acid injection group (P=0.001). Conclusions Using exercise therapy in conjunction with intra-articular hyaluronic acid injections is more effective in reducing centre of pressure sway than using intra-articular hyaluronic acid injections or exercises alone. However, the base of support parameters showed no significant difference for all groups, but intra-articular hyaluronic acid injections could lead to more weight loading on the affected knee joint. Without proper muscle strengthening, this could have negative effects that should be considered in future studies. Implications for practice Combining exercise therapy with intra-articular hyaluronic acid injections appears to provide superior control over the medial-lateral centre of pressure sway. This improvement in postural balance could be especially beneficial for patients with knee osteoarthritis.
Exploring the Impact of Instrument-Assisted Soft Tissue Mobilization on Functional Measures and Quality of Life in Knee Osteoarthritis Patients: A Randomized Controlled Trial Bahare Jafarsalehi, Sahar Boozari, Giti Torkaman Middle East Journal of Rehabilitation and Health Studies, 2025 Background: Knee osteoarthritis (KOA) is a prevalent disabling condition characterized by pain, stiffness, and functional limitations, significantly impacting quality of life, particularly among older adults. Instrument-assisted soft tissue mobilization (IASTM) is a technique that has shown promise in reducing pain and increasing the range of motion. Objectives: This study aimed to investigate the effects of IASTM on functional measures and quality of life in KOA patients. Methods: Thirty participants with unilateral KOA were randomized into IASTM and sham groups. The intervention consisted of four sessions over two weeks, combining IASTM with exercise therapy. Functional performance was assessed using the 6-minute walking test (6MWT) and the timed up and go test (TUG). Quality of life was evaluated using the 36-item short-form health survey (SF-36) and the Lequesne Algofunctional Index (LAI) Questionnaires. Results: A mixed ANOVA revealed significant improvements in functional performance in both groups after treatment in the 6MWT (P < 0.001) and TUG (P = 0.003) tests. Significant improvements were observed in the SF-36 subgroups for physical functioning (P = 0.002), role limitations due to physical problems (P < 0.001), energy/vitality (P < 0.001), pain (P < 0.001), and total score (P < 0.001). There was also a significant time*group interaction effect for role limitations due to emotional problems (P = 0.005), with the IASTM group showing improvement after treatment while the sham group experienced a decline. The LAI questionnaire also indicated significant improvements in both groups (P < 0.001) after treatment. Conclusions: Both IASTM and sham interventions, combined with exercise therapy, led to improvements in functional measures and quality of life. However, the IASTM group exhibited a more pronounced positive trend in the 6MWT and TUG tests, as well as a significant interaction effect for emotional role limitations. These findings suggest that while exercise alone can improve function and quality of life, the addition of IASTM may further enhance these outcomes, supporting its integration into KOA management strategies to improve activities of daily living and overall quality of life.
Comparative study on muscle-tendon stiffness and balance impairment in postmenopausal women: a focus on osteosarcopenia and osteoporosis Elham Bagheri Yekta, Giti Torkaman, Leila Aghaghazvini Aging Clinical and Experimental Research, 2024 Background and aims This study set out to examine the stiffness of the gastrocnemius medialis (GM) and Achilles tendon across postmenopausal women with osteosarcopenia (OS), osteoporosis (OP), and normal bone mineral density. Furthermore, we explored the relationship between muscle-tendon stiffness and postural sway during a curve-tracking task in both sagittal (AP) and frontal (ML) planes. Methods Seventy-three women volunteered to participate in this study. The participants were classified into OS (T-score ≤ − 2.5 and muscle mass below 5.5 kg/m2), OP (T-score ≤ − 2.5), and healthy (T-score >-1) groups. The shear wave elastography was used to determine GM and Achilles tendon stiffness during rest and activation. The postural sway was recorded using a force plate during the performance-based curve tracking (CT) task. Results The stiffness of the GM and Achilles tendon was found to be significantly lower in the OS group compared to the OP and healthy groups (P < 0.05). In the CT task, the OS group exhibited a significant decrease in the mean absolute (P = 0.011) and RMS error (P = 0.022) in the ML direction compared to the OP group. Additionally, a positive correlation was found between the ML mean absolute error and both GM and Achilles’s stiffness during rest and activation (P < 0.05). Discussion and conclusion The OS group exhibited the lowest muscle-tendon stiffness. The GM and Achilles stiffness was positively correlated with poor performance-based balance, particularly in the ML direction. This may increase the risk of falls and subsequent hip fractures during simple daily weight- shifting activities in women with osteosarcopenia.
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The effect of action observation on weight distribution and dynamic balance index improvement in hemiparetic patients based on mirror neuron theory Journal of Zanjan University of Medical Sciences and Health Services, 2015
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Effects of tripolar TENS on slow and fast motoneurons: A preliminary study using H-reflex recovery curve method Electromyography and Clinical Neurophysiology, 2008
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RECENT SCHOLAR PUBLICATIONS
The silent predictor: Exploring the link between waist to hip ratio, fear of falling, and balance impairment in postmenopausal women S Mohebi, G Torkaman, F Bahrami Women & Health, 1-9 , 2026 2026
Investigating the effects of mechanical traction and high intensity laser therapy on pain, muscle activity, and functional balance in knee osteoarthritis P Norouzi, R Ravanbod, G Torkaman Physiotherapy Theory and Practice 42 (2), 263-275 , 2026 2026
Effects of instrument-assisted soft tissue mobilization combined with exercise on knee joint muscle activity during walking in patients with moderate knee osteoarthritis: A … B Jafarsalehi, S Boozari, G Torkaman Scientific Reports 15 (1), 44743 , 2025 2025
Correlation of gastrocnemius muscle quality with balance, appendicular skeletal mass, and fall risk in osteoporotic women: A musculoskeletal sonography assessment during rest … EB Yekta, G Torkaman, L Aghaghazvini Journal of Clinical Densitometry, 101633 , 2025 2025 Citations: 3
Postural control investigation in postmenopausal women with and without osteoporosis: The relationship between the center of pressure variability and weight bearing asymmetry … S Mohebi, G Torkaman, F Bahrami Gait & Posture 122, 78-84 , 2025 2025
Validity and Reliability of the Accelerometer for Assessing Jump Performance Variables: Review Study M Nazari, S Boozari, G Torkaman, MA Sanjari International Journal of Musculoskeletal Pain Prevention 9 (4), 1121-1132 , 2025 2025
Transmissibility of whole-body vibration to lower limb joints and its immediate impact on the center of pressure sway in elderly women M Ahmadi, G Torkaman, S Dehghani, M Mofid Sport Sciences for Health 21 (2), 939-949 , 2025 2025
Comparing the impact of hyaluronic acid injections and exercise therapy alone and combined on the postural sway and base of support in individuals with knee osteoarthritis: a … G Torkaman, E Rostami-Mehr, N Bayat, M Mofid International Journal of Therapy And Rehabilitation 32 (4), 1-17 , 2025 2025 Citations: 1
Comparative study on muscle-tendon stiffness and balance impairment in postmenopausal women: A focus on osteosarcopenia and osteoporosis EB Yekta, G Torkaman, L Aghaghazvini Aging Clinical and Experimental Research 36 (1), 232 , 2024 2024 Citations: 7
The effect of whole-body vibration with medium and high frequencies in static and dynamic squats on jump performance in healthy non-athlete females M Nazari, S Boozari, MA Sanjari, G Torkaman Sport Sciences for Health 20 (4), 1455-1464 , 2024 2024 Citations: 1
Association of Flat Feet with Knee Moments and Western Ontario and McMaster Universities Arthritis Index in Knee Osteoarthritis M Sohrabi, G Torkaman, F Bahrami Journal of Modern Rehabilitation 18 (4), 461-470 , 2024 2024 Citations: 1
Effects of Low Intensity Pulsed Ultrasound on Healing of Denervated Tibial Fracture in the Rabbit SH Sadraie, GR Kaka, M Mofid, G Torkaman, MJ Monfared Iranian Red Crescent Medical Journal (IRCMJ) 13 (1), 1-8 , 2024 2024
Comparing knee kinetics and kinematics in healthy individuals and those with knee osteoarthritis, with and without flat feet M Sohrabi, G Torkaman, F Bahrami Journal of Applied Biomechanics 40 (3), 232-240 , 2024 2024 Citations: 6
Effects of photobiomodulation therapy on the expression of hypoxic inducible factor, vascular endothelial growth factor, and its specific receptor: a randomized control trial … G Torkaman, M Hoseini-Sanati, M Hedayati, M Mofid, ... Photobiomodulation, photomedicine, and laser surgery 42 (4), 275-284 , 2024 2024 Citations: 18
Exploring the Impact of Instrument-Assisted Soft Tissue Mobilization on Functional Measures and Quality of Life in Knee Osteoarthritis Patients: A Randomized Controlled Trial B Jafarsalehi, S Boozari, G Torkaman Middle East J Rehabil Health Stud 12 (1) , 2024 2024 Citations: 4
Virtual reality exergaming capability to change muscle strategy during the limits of stability test and reduce fear of falling in primary osteoporotic women M Gilani, G Torkaman, F Bahrami, N Bayat Games for Health Journal 12 (4), 310-322 , 2023 2023 Citations: 11
The Relationship Between Knee Moments and Function with Western Ontario and McMaster Universities in Moderate Knee Osteoarthritis S Gholami, G Torkaman, F Bahrami, N Bayat Journal of Modern Rehabilitation 17 (3), 306-318 , 2023 2023 Citations: 1
Different muscle strategy during head/knee level of functional reaching-transporting task to decrease falling probability in postmenopausal women with osteoporosis M Hatami, G Torkaman, MN Ashtiani, S Mohebi Archives of Physiotherapy 13 (1), 10 , 2023 2023 Citations: 2
The acute effects of 2 different intensities of resistance exercise on autonomic function in heart failure patients: a randomized controlled trial M Saeidi, R Ravanbod, MH Pourgharib-Shahi, H Navid, B Goosheh, ... Anatolian Journal of Cardiology 27 (5), 266 , 2023 2023 Citations: 10
The effect of six week virtual reality training on the improvement of functional balance in women with type-I osteoporosis: A preliminary study MK Rezaei, G Torkaman, F Bahrami, N Bayat Sport Sciences for Health 19 (1), 185-194 , 2023 2023 Citations: 13
MOST CITED SCHOLAR PUBLICATIONS
Effects of short-term aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis T Roghani, G Torkaman, S Movasseghe, M Hedayati, B Goosheh, ... Rheumatology international 33 (2), 291-298 , 2013 2013 Citations: 215
Evaluation of postural balance using the biodex balance system in subjects with and without low back pain S Kahrizi Pakistan Journal of… , 2008 2008 Citations: 180
Bacterial inhibition by electrical stimulation MR Asadi, G Torkaman Advances in wound care 3 (2), 91-97 , 2014 2014 Citations: 175
A home-based, transtheoretical change model designed strength training intervention to increase exercise to prevent osteoporosis in Iranian women aged 40–65 years: a randomized … KK Shirazi, LM Wallace, S Niknami, A Hidarnia, G Torkaman, M Gilchrist, ... Health education research 22 (3), 305-317 , 2007 2007 Citations: 154
In vivo study of non-invasive effects of non-thermal plasma in pressure ulcer treatment M Chatraie, G Torkaman, M Khani, H Salehi, B Shokri Scientific reports 8 (1), 1-11 , 2018 2018 Citations: 129
The effect of combined resistance-aerobic and aerobic training on the coagulative factors of young healthy men M Habibi, G Torkaman, B Goosheh, M Hedayati Physiology and Pharmacology 13 (1), 98-107 , 2009 2009 Citations: 121
Reliability and validity of the persian versions of the fear avoidance beliefs questionnaire and tampa scale of kinesiophobia in patients with neck pain A Askary-Ashtiani, I Ebrahimi-Takamejani, G Torkaman, M Amiri, ... Spine 39 (18), E1095-E1102 , 2014 2014 Citations: 102
Effects of boron and calcium supplementation on mechanical properties of bone in rats MR Naghii, G Torkaman, M Mofid Biofactors 28 (3‐4), 195-201 , 2006 2006 Citations: 100
Effect of sensory and motor electrical stimulation in vascular endothelial growth factor expression of muscle and skin in full-thickness wound. MR Asadi, G Torkaman, M Hedayati Journal of Rehabilitation Research & Development 48 (3) , 2011 2011 Citations: 89
The therapeutic effect of low-level laser on repair of osteochondral defects in rabbit knee F Kamali, M Bayat, G Torkaman, E Ebrahimi, M Salavati Journal of Photochemistry and Photobiology B: Biology 88 (1), 11-15 , 2007 2007 Citations: 79
Effect of anodal and cathodal microamperage direct current electrical stimulation on injury potential and wound size in guinea pigs. G Talebi, G Torkaman, M Firoozabadi, S Shariat Journal of Rehabilitation Research & Development 45 (1) , 2008 2008 Citations: 77
Anodal and cathodal pulsed electrical stimulation on skin wound healing in guinea pigs FG Mehmandoust, G Torkaman, M Firoozabadi, G Talebi Journal of Rehabilitation Research and Development 44 (4), 611 , 2007 2007 Citations: 72
Biotribological and biomechanical changes after experimental haemarthrosis in the rabbit knee R Ravanbod, G Torkaman, A Esteki Haemophilia 17 (1), 124-133 , 2011 2011 Citations: 69
The effect of short-term aerobic training on coagulation and fibrinolytic factors in sedentary healthy postmenopausal women T Jahangard, G Torkaman, B Ghoosheh, M Hedayati, A Dibaj Maturitas 64 (4), 223-227 , 2009 2009 Citations: 68
Angiogenic effects of low-intensity cathodal direct current on ischemic diabetic foot ulcers: a randomized controlled trial MR Asadi, G Torkaman, M Hedayati, MR Mohajeri-Tehrani, M Ahmadi, ... diabetes research and clinical practice 127, 147-155 , 2017 2017 Citations: 65
The effects of consecutive supervised stability training on postural balance in patients with chronic low back pain AM Arab Pak J Med Sci April-… , 2009 2009 Citations: 61
What is the effect and mechanism of kinesiology tape on muscle activity? R Bagheri, MR Pourahmadi, AR Sarmadi, IE Takamjani, G Torkaman, ... Journal of Bodywork and Movement Therapies 22 (2), 266-275 , 2018 2018 Citations: 58
Effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in severe haemophilia A patients with osteoporosis: a … B Parhampour, G Torkaman, H Hoorfar, M Hedayati, R Ravanbod Clinical rehabilitation 28 (5), 440-450 , 2014 2014 Citations: 58
Comparison between pulsed ultrasound and low level laser therapy on experimental haemarthrosis R Ravanbod, G Torkaman, A Esteki Haemophilia 19 (3), 420-425 , 2013 2013 Citations: 58
Effect of low-intensity direct current on expression of vascular endothelial growth factor and nitric oxide in diabetic foot ulcers MR Mohajeri-Tehrani, Z Annabestani Journal of Rehabilitation Research and Development 51 (5), 815 , 2014 2014 Citations: 56
