Aquatic Exercise Enhances Functional Movement and Sensorimotor Performance in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial Saeed Zarei, Sajad Bagherian, Mohammad Rabiei Journal of Sport Rehabilitation, 2026 Context: Chronic ankle instability (CAI) is prevalent among athletes and is associated with impaired sensorimotor function, reduced dynamic stability, and limited functional movement, increasing the risk of reinjury. Aquatic exercise offers a low-impact alternative to land-based rehabilitation by reducing joint loading and promoting neuromuscular adaptations. This study evaluated the effectiveness of an 8-week aquatic exercise program on functional outcomes in athletes with CAI. Design: Randomized controlled trial with preintervention and postintervention assessments. Methods : Forty male athletes (aged 18–30) with clinically diagnosed CAI were randomly assigned to an intervention group (n = 20) which completed an 8-week aquatic exercise program or a control group (n = 20) which continued regular activity without structured rehabilitation. The intervention included 3 weekly aquatic sessions targeting balance, proprioception, and strength. Primary outcomes were functional movement (Functional Movement Screen), dynamic balance ( Y -Balance Test), and self-reported ankle function (Cumberland Ankle Instability Tool, Identification of Functional Ankle Instability, Foot and Ankle Ability Measure, Foot and Ankle Ability Measure-Sport). Secondary outcomes included static balance, dorsiflexion range of motion, proprioception, and jumping performance. Repeated-measures analysis of variance and nonparametric tests were used, with P < .05 as significance. Results: The intervention group showed significant improvements in Functional Movement Screen scores, dynamic balance ( P < .001), dorsiflexion range of motion (+19.6%, P < .001), and self-reported ankle function (up to +46.9%, P < .001). Jumping performance significantly improved, with reduced completion times in the side-hop (–18.1%) and 8-line hop (–12.9%) tests, and increased distance in the triple-hop test (+8.5%; all P < .01). Static balance improved in eyes-open condition ( P < .001). No significant change occurred in proprioception ( P = .506). The control group showed no significant improvements. Conclusions: An 8-week aquatic exercise program significantly improves functional movement, balance, flexibility, jumping ability, and self-reported ankle function in athletes with CAI. These findings support aquatic therapy as a clinically effective, low-impact rehabilitation option for restoring sensorimotor performance and sport readiness.
Impact of National Academy of Sports Medicine Corrective Exercises on Gait and Postural Control in Individuals With Chronic Ankle Instability: A Randomized Controlled Trial Sajad Bagherian, Fatemeh Akbari, Mohammad Rabiei, Banafsheh Mohammadi, Erik A. Wikstrom Journal of Sport Rehabilitation, 2026 Context : Chronic ankle instability (CAI) is associated with altered gait mechanics and impaired sensorimotor function (eg, postural control). While corrective exercise programs are known to improve sensorimotor function in those with CAI, their impact on gait-related outcomes remains unclear. Design: A randomized controlled trial was conducted to investigate the effects of a corrective exercise program on gait kinetics and postural control in individuals with CAI. Methods : Seventy recreational and collegiate athletes with CAI (aged 18−35) completed the randomized controlled trial. Participants were recruited from the local sports community and randomly assigned to either a control group (n = 34) or an intervention group (n = 36). The intervention group participated in an 8-week National Academy of Sports Medicine (NASM) corrective exercise program, while the control group received no intervention. The NASM program targets muscle relaxation, lengthening, and activation, and finally, integration into functional movements. Gait kinetics, such as contact time, foot progression angle, and peak plantar forces, as well as postural control, were assessed at baseline and postintervention and submitted to 2-way repeated-measure analysis of variance to evaluate the effects of the intervention. Results : Significant interaction effects were observed for postural control ( P < .01) and gait contact time ( P = .001), indicating greater improvements in the NASM group compared to the control group. No significant group or interaction effects were observed for specific plantar force distribution regions or other gait outcomes ( P > .05). Conclusion : The findings suggest that an 8-week NASM corrective exercise program improves postural control but has limited effects on gait kinetics in individuals with CAI.
The effect of exercise therapy as a tool for preventing and treating musculoskeletal disorders among school-aged children: a randomised controlled trial Farhad Shourie, Behnam Ghasemi, Ali Shafizadeh, Sajad Bagherian, Evert Verhagen BMC Musculoskeletal Disorders, 2024 Background Children spend a lot of time in school, and there are many ergonomic hazards and postural malalignments that put children at greater risk of developing musculoskeletal disorders (MSDs). This study aimed to investigate the effect of exercise therapy on preventing and treating musculoskeletal disorders among school-aged children. Method This randomised controlled trial included 212 (121 boys and 91 girls) school-aged children aged 13–15 years assigned to treatment (n = 106) and prevention (n = 106) groups, where the treatment group contained individuals with MSDs and prevention group contained individuals without MSDs. In each group, half of the individuals received exercise therapy (50 min per session, four times per week, for an 8-week), and others continued their daily lives. MSDs and physical activity were assessed by the Teen Nordic Musculoskeletal Screening Questionnaire and the International Physical Activity Questionnaire-Short Form, respectively, at baseline and after the experimental protocol. Results There was a statistically significant reduction in the frequency of MSDs in the treatment group and occurring MSDs in the prevention group (P ≤ .05). Also, there was significant improvement in all variables of walking, moderate physical activity, vigorous physical activity, and total in intervention groups spatially in students who received exercise therapy (P ≤ .05). Conclusions This study demonstrated the effectiveness of exercise therapy in reducing and preventing MSDs and improving physical activity levels among school-aged children aged 13–15 years. Trial registrations Ethical Committee of Shahrekord University (IR.SKU.REC.1401.022) (registration date: 31/05/2022). Clinical Trail Registration (IRCT20220705055375N1), (registration date: 29/07/2022).
Effect of Eight Weeks of Corrective Exercises on Musculoskeletal Pain Level in 13-15 Year-Old Students: A Clinical Trial Ali Shafizadeh, Farhad Shourie, Behnam Ghasemi, Sajad Bagherian Journal of Gorgan University of Medical Sciences, 2024 Background and Objective: Restrictions imposed during the coronavirus disease 2019 (COVID-19) pandemic led to a decrease in physical activity levels across various age groups, particularly among students. This study aimed to determine the effect of eight weeks of corrective exercises on musculoskeletal pain levels in 13-15-year-old students. Methods: This clinical trial was conducted on 101 students (44 girls and 57 boys) aged 13 to 15 experiencing musculoskeletal pain in various body parts in Bandar Mahshahr, Khuzestan Province, during the second half of the academic year 2021-2022. Participants were selected based on the Adolescent Nordic Musculoskeletal Questionnaire (NMQ), considering only the first question regarding the presence or absence of pain in each of the nine body regions (neck, shoulder, elbow, hand, upper back, lower back, pelvis, knee, and ankle) in the past seven days. A score of 1 was assigned to the presence of pain and 0 to the absence of pain. Participants were randomly assigned to two groups of 60: A control group and an intervention group. The intervention group performed corrective exercises at home for eight weeks, with three sessions per week, each lasting 40 minutes. No intervention was provided to the control group. Musculoskeletal pain levels in the neck, shoulder, upper back, elbow-arm, wrist, lower back, knee, and ankle were then compared in the pre-test, post-test, and follow-up. Results: The mean and standard deviation of the total pain scores for the intervention and control groups were 1.32±0.41 and 1.33±0.46 in the pre-test, 1.01±0.08 and 1.34±0.46 at the post-test, and 1.17±0.36 and 1.11±0.31 at follow-up, respectively. Results revealed that eight weeks of corrective exercises significantly reduced musculoskeletal pain levels in the students’ neck, shoulder, upper and lower back, elbow, knee, wrist, ankle, pelvis, and thigh (P<0.05); however, this improvement was not sustained at the follow-up. Conclusion: Performing corrective exercises reduced musculoskeletal pain levels in the neck, shoulder, upper and lower back, elbow, knee, wrist, ankle, and pelvis and thigh of 13-15-year-old students; however, the benefits were not sustained when the exercises were stopped.
Postural Habits and Related Joint and Muscle Pain Among School-age Students: A Cross-sectional Study Sajad Bagherian, Khodayar Ghasempoor, Julien S. Baker Epidemiology and Health System Journal, 2023 Background and aims: Current lifestyles, with the growing use of contemporary technologies, have resulted in changes in people’s behavior, causing them to become increasingly sedentary and develop unhealthy body habits. Posture is an essential variable determining an individual’s physical and emotional well-being. The purpose of this study was to investigate postural habits and any related joint and muscle pain among school-aged students. Methods: An online questionnaire was utilized to measure participants’ postural habits and related joint and muscle pain. The questionnaire was completed by 43660 school-aged students (15532 boys and 28128 girls in the age range of 8-17 years) by a non-randomized convenient sampling method through Google Forms via social media on the schools’ platform in Chaharmahal and Bakhtiari province, Iran, in the middle of 2022. The questionnaire inquired about body postural patterns and any associated joint or muscle pain. Results: The majority of participants (77%) reported spending most of their time in the sitting position. Overall, 57% of the students reported that they did not maintain the correct posture during their daily activities. The majority of respondents (54%) reported feeling some joint or muscle pain. The greatest pain was reported in the neck (28%), upper back (14%), and lower back (13%). Conclusion: The findings indicated that schools and the medical profession may need to screen students for health risks such as poor postural status. Further, information related to bad posture should be provided to children, their families, and healthcare professionals to take care of them.
A cross-sectional study of functional movement quality in school-aged children Sajad Bagherian, Khodayar Ghasempoor BMC Pediatrics, 2022 Background During the growth period, before and after maturity, considerable biological changes occur. It seems that these changes are related to neuromuscular patterns and have significant differences in the functional movements performed of young boys and girls during the maturation process. The current study aimed to look at the movement quality scores of school-aged girls and boys. Methods This Cross-Sectional Study assessed the movement quality of 700 school-aged boys and girls aged 8 to 17, divided into 10 groups of 35 girls and 10 groups of 35 boys. Movement quality was evaluated by the Fusionetics scoring system, which includes 7 tasks: two-leg squat, two-leg squat with heel raise, one-leg squat, push-up, shoulder, trunk, and cervical movements that require a person to complete different movement patterns. The data was analyzed using the Wilcoxon signed-rank and McNemar tests (p <0.05). Results This is the first study to our knowledge to examine the movement quality scores in a large school age child with Fusionetics. The overall results showed that the most errors were recorded in all age groups during the double leg squat, double leg squat with heel lift, single leg squat, and push-up and school-age children showed less errors during the shoulder movements, trunk/lumbar spine movements and cervical spine movements. Furthermore, younger girls and boys made more errors than older girls and boys. In relation to gender, this study found that girls scored better on the total Fusionetics score than boys. Conclusions The Fusionetics scoring system explains how well school-aged children perform fundamental movements. Under the guidance of coaches and physical educators, students' movement compensation should be assessed and relevant training interventions implemented. Taking steps to address movement compensation could help to avoid injuries and improve school-age children performance.
Physical Activity Behaviors and Overweight Status among Iranian School-Aged Students during the COVID-19 Pandemic: A Big Data Analysis Sajad Bagherian, Khodayar Ghasempoor, Julien S Baker, Mohammad Mashhadi Iranian Journal of Public Health, 2022 Background: We aimed to investigate school-aged students' physical activity behaviors and overweight status during the COVID-19 quarantine.
 Methods: In this cross-sectional study, an online questionnaire was utilized to measure participants' physical activity behavior and overweight status during the COVID-19 quarantine in Iran (May of 2021). Participants self-reported their physical activity levels, types, amounts and locations, as well as whether or not they became overweight. The chi-square test was used to determine the differences in the distribution of the participant responses. The statistical significance level was set at P<0.05.
 Results: The questionnaire was completed by 43,660 school-aged students (15,532 boys and 28,128 girls). The age, weight, and height ranges were 8–17 yr, 18–144 kg, and 75–198 cm respectively. Half of the students reported changes in their body weight and became overweight during the COVID-19 pandemic (χ2=25514.4; P=0.001). Forty-one percent reported doing very little or no physical activity, 32% of students reported doing less than one hour of exercise per day (χ2=8547.7; P=0.001). The majority of students (72%) reported participating in physical activity at home (χ2=78851.2; P=0.001). Flexibility was the main kind of exercise performed, followed by walking or running, during the COVID-19 pandemic (χ2=24328.9; P=0.001).
 Conclusion: During the COVID-19 pandemic, half of the students became overweight, and the majority did not engage in regular physical activity. These findings can help guide efforts to protect and promote children's health during the COVID-19 outbreak, as well as influence policies to reduce the risk of future pandemics.
