Giti Torkaman
@modares.ac.ir
Physical Therapy Department, Faculty of Medical Science
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Sanaz Mohebi, Giti Torkaman, and Fariba Bahrami
Elsevier BV
Mina Ahmadi, Giti Torkaman, Sedigheh Dehghani, and Maryam Mofid
Springer Science and Business Media LLC
Giti Torkaman, Elham Rostami-Mehr, Noushin Bayat, and Maryam Mofid
Mark Allen Group
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.
Bahare Jafarsalehi, Sahar Boozari, and Giti Torkaman
Brieflands
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.
Pardis Norouzi, Roya Ravanbod, and Giti Torkaman
Informa UK Limited
Elham Bagheri Yekta, Giti Torkaman, and Leila Aghaghazvini
Springer Science and Business Media LLC
Abstract 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.
Maryam Nazari, Sahar Boozari, Mohammad Ali Sanjari, and Giti Torkaman
Springer Science and Business Media LLC
Maryam Sohrabi, Giti Torkaman, and Fariba Bahrami
Knowledge E DMCC
Introduction: Flat feet are prevalent among individuals with medial compartment knee osteoarthritis (KOA), showing a correlation with elevated knee pain and cartilage degeneration. This study investigates the relationship between calcaneal eversion angle (CEA) and medial longitudinal arch angle (MLAA) with knee kinetics and pain.Materials and Methods: This analytical observational study included 30 volunteers with moderate KOA. The Vicon motion analysis system and two synchronized force plates were employed to capture level walking and the static standing position to measure CEA and MLAA. The study assessed the first and second peaks of the knee adduction moment, knee adduction moment impulse, peak knee flexion moment, and the peak knee flexion angle at heel strike (PKFA-HS). The Western Ontario and McMaster Universities arthritis index (WOMAC) pain and physical function were evaluated.Results: A significant positive correlation was found between CEA and the knee pain sub-score (Pearson correlation [PC]=0.446, P=0.011) and WOMAC total score (PC=0.363, P=0.049). Additionally, a significant negative correlation was observed between CEA and peak knee flexion moment/PKFA-HS (PC=-0.418, P=0.022, and PC=-0.479, P=0.001, respectively). The results also indicated a negative significant correlation between MLAA and WOMAC pain sub-score (PC=-0.389, P=0.034).Conclusion: Increased CEA and decreased MLAA are associated with elevated WOMAC pain sub-score and decreased PKFA-HS in individuals with moderate KOA. Addressing flat feet should be considered in KOA management to enhance pain relief and functional outcomes
Maryam Sohrabi, Giti Torkaman, and Fariba Bahrami
Human Kinetics
Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.
Giti Torkaman, Mahsa Hoseini-Sanati, Mehdi Hedayati, Maryam Mofid, and Manouchehr Iranparvar Alamdari
Mary Ann Liebert Inc
Background: Impaired angiogenesis is a significant factor contributing to delayed healing in diabetic foot ulcers (DFUs) due to inadequate oxygenation. Objective: This study aimed to investigate the impact of photobiomodulation (PBM) using a Ga-As laser on the release of serum hypoxia-inducible factor 1-α (HIF-1α), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2, and nitric oxide (NO) in diabetic patients with DFUs. Materials and methods: In this double-blind RCT, a total of 30 patients with grade II DFUs were enrolled. The patients were randomly divided into two groups: the PBM (n = 15) and the placebo (n = 15). In the PBM group, a Ga-As laser (904 nm, 2 J/cm2, 90 W) was given for 3 days/week for 4 weeks (11 sessions). In the placebo group, the power was turned off. Both groups received similar standard wound care. Before and after interventions, the levels of serum HIF-1α, VEGF, NO, and sVEGFR-2 were measured. In addition, the percentage decrease in the wound surface area (%DWSA) was measured. Results: Following the intervention, the results revealed that the PBM group had significantly lower levels of VEGF than the placebo group (p = 0.005). The %DWSA was significantly higher in the PBM group compared to the placebo group (p = 0.003). Moreover, VEGF showed a significant negative correlation with %DWSA (p < 0.001). Conclusions: The observed decrease in serum levels of VEGF and an increase in %DWSA, compared to the placebo group, suggests that PBM effectively improves angiogenesis. Furthermore, the significant correlation found between VEGF levels and %DWSA emphasizes the importance of evaluating wound surface in patients as a dependable indicator of enhanced wound angiogenesis. Clinical Trial Registration: NCT02452086.
Marzie Hatami, Giti Torkaman, Mohammad Najafi Ashtiani, and Sanaz Mohebi
Springer Science and Business Media LLC
Abstract Background The reaching-transporting task as an essential daily activity impacts balance control and falling in older women. This study investigated the different muscle strategies during the head/knee level of the functional reaching-transporting task in postmenopausal women with osteoporosis. Methods 24 postmenopausal volunteers were classified into two groups based on the lumbar T-score: osteoporosis (≤ -2.5, n = 12) and non-osteoporosis (> –1, n = 12). Using a custom-designed device, participants randomly performed 12 reaching-transporting tasks at the head and knee levels. Electromyography signals were collected while reaching and transporting phases with a wireless system. The peak of the root means square (PRMS) and time to PRMS (TPRMS) were measured. In addition, the isometric muscle strength and the fear of falling were assessed. Results The isometric muscle strength in the osteoporotic group was significantly lower than in the non-osteoporotic group (P < 0.05), except for vastus lateralis (VL). The PRMS of VL, (P = 0.010) during the reaching phase and VL (P = 0.002) and gastrocnemius lateralis (GL) (P < 0.001) during transporting phase was greater than the non-osteoporotic group. The PRMS value of the muscles was greater for reaching-transporting at the knee level than the head level; this increase was significant just for VL and biceps femoris during the transporting phase (P = 0.036 and P = 0.004, respectively). Conclusion Osteoporotic women have more muscle activities during the reaching-transporting task, especially at the knee level, compared to the head level. Their muscle weakness may lead to insufficient stability during the task and cause disturbance and falling, which requires further investigation.
Mohammad Gilani, Giti Torkaman, Fariba Bahrami, and Noushin Bayat
Mary Ann Liebert Inc
Objective: Muscle strength and balance impairment change the control strategy and increase the probability of falling. This study aimed to investigate the effect of 6-week strength-balance training through virtual reality exergaming (VRE) on muscle strategy during the limits of stability (LOS) test, fear of falling, and quality of life (QOL) in osteoporotic women. Materials and Methods: Twenty volunteer postmenopausal women with osteoporosis were randomly allocated to the VRE (n = 10) and traditional training (TRT as control, n = 10) groups. The VRE and TRT strength-balance training was performed for 6 weeks and three sessions per week. Before and after exercise, the muscle activity (onset time, peak root means square [PRMS]) and hip/ankle activity ratio were assessed by the wireless electromyography system. The muscle activities of the dominant leg were recorded during LOS functional test. The fall efficacy scale and QOL were assessed. Paired t-test was used to compare results within groups, and an independent t-test was used to compare the percentage changes in parameters between the two groups. Results: The VRE improved the onset time and PRMS. The VRE significantly reduced the hip/ankle activity ratio in the LOS test's forward, backward, and right directions (P < 0.05). No significant change was seen in all directions of the LOS functional test in the TRT group (P > 0.05). VRE reduced the fall efficacy scale (P = 0.042). Both VRT and TRT improved the total QOL score (P = 0.010). Conclusion: VRE was more effective in decreasing the onset time and hip/ankle ratio of muscle activation. The VRE is recommended to induce a better ability to reduce the fear of falling and control balance during functional activity in osteoporotic women. Clinical Trial Registration number: IRCT20101017004952N9.
F. Khun Schimanko, S. Gholami, and G. Torkaman
Edra SpA
Samaneh Gholami, Giti Torkaman, Fariba Bahrami, and Noushin Bayat
Knowledge E DMCC
Introduction: The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics parameters and functional tests with Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores in people with moderate KOA.
 Materials and Methods: Twenty- three participants with moderate KOA participated in this study. Gait analysis involved the measurement of the external peak knee adduction moment (PKAM), peak knee flexion moment (PKFM), knee adduction moment impulse (KAM impulse), and knee flexion moment impulse (KFM impulse) during level walking. Functional tests included timed up and go (TUG) and figure of eight walkings (FO8W) tests. Pearson’s correlation coefficient was used to investigate the correlation between kinetics parameters and functional test scores with WOMAC total scores and sub-scores.
 Results: There was a significant inverse correlation between the first PKAM and WOMAC total score and pain sub-score (r=-0.43 P=0.03 and r=-0.6 P=0.002, respectively). Also, there was a significant inverse correlation between the second PKAM and pain sub-score (r=-0.46 P=0.02). There was no significant correlation between functional tests and WOMAC scores.
 Conclusion: The low score of the WOMAC in the moderate KOA should not be attributed to the low level of joint knee moments.
Marzieh Saeidi
Kare Publishing
Background: Although a wide spectrum of resistance exercise intensities was recommended in the guidelines, none of them investigated the acute effects of different intensities of the resistance exercise on cardiac autonomic function in patients with chronic heart failure. This study aimed to investigate the acute effects of the low and high intensities of the resistance exercise on heart rate variability in chronic heart failure. Methods: This randomized controlled trial was performed between October 2019 and December 2020. Fifty-seven patients with chronic heart failure (New York Heart Association class II and class III) underwent hemodynamic, functional capacity, and heart rate variability (time and frequency domains) assessments. They were randomly divided into R1, R2, and control groups. The intervention consisted of performing a short aerobic exercise including 15 minutes of walking at an intensity of 50% reserved heart rate for all 3 groups and additional resistance exercise with the intensity of 50% 1-repetition maximum and 75% 1-repetition maximum for R1 and R2 groups, respectively. Results: The standard deviation of normal to normal intervals and standard deviation of average NN intervals became significantly lower in R2 (P = .031), and both high-frequency power and low-frequency power were significantly higher in R1 (P = .039 and P = .004, respectively) after the intervention. No significant changes were observed in the control group. Between-group changes were not significant for hemodynamics and functional capacity after treatment. The between-group comparison demonstrated a significant increase in root mean square of successive differences of the NN intervals in R1 in comparison to the control (P = .035). Conclusions: These findings indicate that resistance exercise in 50% 1-repetition maximum in comparison to 75% 1-repetition maximum had more favorable effects on the heart rate variability in chronic heart failure.
Mohammad Kazem Rezaei, Giti Torkaman, Fariba Bahrami, and Noushin Bayat
Springer Science and Business Media LLC
Marzieh Saeidi, Roya Ravanbod, Mohammad Hossein Pourgharib-Shahi, Babak Goosheh, Abdolvahab Baradaran, and Giti Torkaman
Elsevier BV
M. Mofid, S. Mohebi, M. Darbani, Z. Basiri, H. Naderifar, and G. Torkaman
Edra SpA
Jalal Tavakoli, Giti Torkaman, Roya Ravanbod, and Saeid Abroun
Elsevier BV
Behrouz Parhampour, Vahid Alizadeh, Giti Torkaman, Roya Ravanbod, Rasoul Bagheri, Behnoosh Vasaghi‐Gharamaleki, Mehdi Dadgoo, Seyed Mehdi Mohsenipour, and Zohreh Alsadat Sadat
Wiley
Muscular atrophy and overweightness develop arthropathy in persons with haemophilia (PWH), and exercise increases their muscle strength and decreases their body weight. Musculoskeletal ultrasonography may be a non‐invasive, safe, valid, and reliable tool to investigate muscle thickness (MT) and pennation angle (PA) after exercise training.
Samaneh Gholami, Giti Torkaman, Fariba Bahrami, and Noushin Bayat
Elsevier BV
Mahmoud Ahmadi Fakhreh, Giti Torkaman, and Roya Ravanbod
Knowledge E
Introduction: Knee Osteoarthritis (OA) is one of the most important etiologies of pain and disability among adults. The effects of pulsed Ultrasound (US) on pain reduction and joint function have been proven, but its role on joint friction and inflammatory mediators is still unclear. Therefore, this study was designed to investigate the effects of US on knee joint friction and inflammation in non-traumatic experimental knee OA.
 Materials and Methods: Forty-eight guinea pigs were randomly assigned into four groups: OA+US, OA+US sham, 30 days after OA induction (OA30), and normal control (n=12 for each group). OA was induced by intra-articular injection of 3 mg/kg of Mono-Iodoacetate (MIA) in the animal’s left knee. Joint circumstance and weight of the animals were measured at baseline, before (i.e., after 30 days of MIA injection), and after US treatment. Joint friction was evaluated by a pendulum friction tester system. Cytokine levels, including Tumor Necrosis Factor (TNF)-α and Interleukin (IL)-1β, were measured by the ELISA method. The Pearson correlation coefficient was calculated to study the relationships between friction and inflammation variables.
 Results: Joint circumference was increased in the OA30 group. Joint friction variables, including exponential curve fitting, cycle number, and friction coefficient, were significantly better in the US group (P<0.05). TNF-α and IL-1β cytokine levels were significantly lower in the US group. A significant positive correlation was observed between joint friction indices and TNF-α and IL-1β cytokine levels (P<0.05).
 Conclusion: US was an effective approach for reducing joint friction and inflammation in OA30. Moreover, the relationship between knee joint friction and inflammation could help us better understand the etiology, mechanism, and treatment strategies of this disease.
Mohammad Kazem Rezaei, Giti Torkaman, Fariba Bahrami, and Noushin Bayat
Elsevier BV