Document Type : Research Paper


1 shahid beheshti university/master of scince sport injury and corrective exercise/tehran/iran

2 Associate Professor, Department of Health and Rehabilitation in Sport, Faculty of Sport and Health Sciences, Shahid Beheshti University, Tehran, Iran

3 Assistant Professor, Department of Sport Injuries and Corrective Exercises, Sports Medicine Research Center, Sport Sciences Research Institute


Spinal cord injuries are one of the most serious physical injuries. People with spinal cord injury generally suffer from one or more types of pain. Neuropathic pain is the most common of these and can lead to functional impairment as it is associated with loss of mobility. The aim of this study was to evaluate the effect of reflexology massage and virtual reality on improving the function of paraplegics. The sample of this study consisted of Athletic men paraplegics who are members of the Veterans and Disabled Board of Tehran Province. Forty-five paraplegic athletes were randomly divided into three groups of control, virtual reality and reflexology, using the letters of the alphabet in the medical record. The two experimental groups performed three sessions of intervention per week for 6 weeks and the control group did not receive any intervention. Performance-related shoulder girdle strength and range of motion were evaluated by Mobe MMT dynamometer and Mobee Electrogonometer, respectively. Data were analyzed using SPSS 23 software at a significance level of 0.05. The results of statistical tests showed that the strength and range of motion of the shoulder girdle In different movements of Outward rotation, inward rotation,extention and flexion after selecting 6 weeks of training according to available research, intervention in both massage and virtual reality groups increased. (P=0/003, P=0/001, P=0/02, P=0/003). The increase in strength and range of motion According to the means of change was also more significant in the virtual reality group. The results showed that the application of reflexology massage as well as the virtual reality system was effective in improving the range of motion and strength of the shoulder girdle in people with paraplegia; therefore, people with paraplegia and the educators and nurses who work with them can use the benefits of these interventions to improve their performance.


  1. Mohsen hamidi Lnj. The pattern of development of educational sports in education in the event of health crises: A case study of a pandemic Covid-19. 2020(persian).
  2. K Postma HJGB-Evd, J B J Bussmann, T A R Sluis, M P Bergen & H J Stam. Validity of the detection of wheelchairpropulsion as measured with an Activity Monitor in patients with spinal cord injury. 2005
  3. TN B. Spinal cord injury. Demos Medical. 2010
  4. Sances Jr A, Myklebust JB, Maiman DJ, Larson S, Cusick JF, Jodat R. The biomechanics of spinal Critical reviews in biomedical engineering. 1984;11(1):1-76.
  5. Gardner MB, Holden MK, Leikauskas JM, Richard RL. Partial body weight support with treadmill locomotion to improve gait after incomplete spinal cord injury: a single-subject experimental design. Physical therapy. 1998;78(4):361-74
  6. Jayaraman A. Skeletal muscle adaptations following incomplete spinal cord injury and exercise training: University of Florida; 2008.
  7. K Postma HJGB-Evd, J B J Bussmann, T A R Sluis, M P Bergen & H J 7. Stam. Validity of the detection of wheelchair propulsion as measured with an Activity Monitor in patients with spinal cord injury. 2005.
  9. Tator CH. Update on the Pathophysiology and Pathology of Acute Spinal Cord Injury. 1995
  10. Center NSCIS.Spinal Cord Injury Facts and Figures at a Glance. The Journal of Spinal Cord Medicine. 2013;36(1):1-2.
  11. Farhad fatehi mk. perceived experience of unemployed people with spinal cord injury in the process of returning to work. 2012(persian)
  12. Calmels P, Mick G, Perrouin-Verbe B, Ventura M. Neuropathic pain in spinal cord injury: identification, classification, evaluation. Annals of physical and rehabilitation medicine. 2009;52(2):83-102.
  13. Finnerup NB, Baastrup C. Spinal cord injury pain: mechanisms and management. Current pain and headache reports. 2012;16(3):207-16.
  14. Votrubec M, Thong I. Neuropathic pain: A management update. Australian family physician. 2013;42(3):92.
  15. Shojaei H, JAFARI A, Valaei S. Frequency of phantom pain among patients with spinal cord injury. 2009(persian)
  16. Michailidou C, Marston L, De Souza LH, Sutherland I. A systematic review of the prevalence of musculoskeletal pain, back and low back pain in people with spinal cord injury. Disability and rehabilitation. 2014;36(9):705-15.
  17. PJ Siddall DTaMC. Classication of pain following spinal cord injury. 1997.17.
  18. Budh CN, Hultling C, Lundeberg T. Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain. Spinal Cord. 2005;43(2):85-95.
  19. Rose M, Robinson J, Ells P, Cole J. Pain Following Spinal Cord Injury: Results From A Postal Survey. Journal of Tissue Viability. 1991;1(4):95-8
  20. Widerström-Noga EG, Duncan R, Felipe-Cuervo E, Turk DC. Assessment of the impact of pain and impairments associated with spinal cord injuries. Archives of physical medicine and rehabilitation. 2002;83(3):395-404.
  21. Siddall PJ, Finnerup NB. Pain following spinal cord injury. Handbook of clinical neurology. 81: Elsevier; 2006. p. 689-703.
  22. New PW, Cripps RA, Lee BB. Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository. Spinal cord. 2014;52(2):97-109.
  23. Akyuz G, Kenis O. Physical Therapy Modalities and Rehabilitation Techniques in the Management of Neuropathic Pain. American Journal of Physical Medicine & Rehabilitation. 2014;93(3):253-9.
  24. Ravenscroft A, Ahmed Y, Burnside I. Chronic pain after SCI. A patient survey. Spinal cord. 2000;38(10):611-4.
  25. Putzke JD, Richards JS, Hicken BL, DeVivo MJ. Interference due to pain following spinal cord injury: important predictors and impact on quality of life. Pain. 2002;100(3):231-42.
  26. Widerström-Noga EG, Felipe-Cuervo E, Yezierski RP. Chronic pain after spinal injury: interference with sleep and daily activities. Archives of physical medicine and rehabilitation. 2001;82(11):1571-7.
  27. Jensen MP, Kuehn CM, Amtmann D, Cardenas DD. Symptom burden in persons with spinal cord injury. Archives of physical medicine and rehabilitation. 2007;88(5):
  28. Summers JD, Rapoff MA, Varghese G, Porter K, Palmer RE. Psychosocial factors in chronic spinal cord injury pain. Pain. 1991;47(2):183-9.
  29. Feyzioğlu Ö, Dinçer S, Akan A, Algun ZC. Is Xbox 360 Kinect-based virtual reality training as effective as standard physiotherapy in patients undergoing breast cancer surgery? Supportive Care in Cancer. 2020;28(9):4295-303.
  30. Park D-S, Lee D-G, Lee K, Lee G. Effects of virtual reality training using Xbox Kinect on motor function in stroke survivors: a preliminary study. Journal of Stroke and Cerebrovascular Diseases. 2017;26(10):2313-9.
  31. yosefi b. Reflexology: Hand and foot massage techniques for maximum energy, health and vitality2006(persian)
  32. Santavirta N, Björvell H, Solovieva S, Alaranta H, Hurskainen K, Konttinen YT. Coping strategies, pain, and disability in patients with hemophilia and related disorders. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2001;45(1):48-55.
  33. Rodrigues EV, Valderramas SR, Rossetin LL, Gomes ARS. Effects of video game training on the musculoskeletal function of older adults: a systematic review and meta-analysis. Topics in Geriatric Rehabilitation. 2014;30(4):238-45
  34. Abdelaziz KhS BA, Ebrahim HH, Gab AA. Ebrahim and Amir, A. Effect of reflexology on knee osteoarthritis patients: A randomized clinical trial. Gab World JSport Sci. 2019.
  35. Chatchawan U, Jarasrungsichol K, Yamauchi J. Immediate effects of self-thai foot massage on skin blood flow, skin temperature, and range of motion of the foot and ankle in type 2 diabetic patients. The Journal of Alternative and Complementary Medicine. 2020;26(6):491-500.
  36. Karrouf G, El-Gendy SR, Al Saif A, Mamdouh K. Impact of Reflexology on Mechanical Low Back Pain. Int J Physiother. 2015;2(5).
  37. Carrougher GJ, Hoffman HG, Nakamura D, Lezotte D, Soltani M, Leahy L, et al. The effect of virtual reality on pain and range of motion in adults with burn injuries. Journal of Burn Care & Research. 2009;30(5):785-91
  38. Daneshmandi H. The effect of virtual reality training program on the Functional Fitness of the elderly. Journal of Gerontology(persian). 2021;6(1):0-.
  39. Harber MP, Konopka AR, Douglass MD, Minchev K, Kaminsky LA, Trappe TA, et al. Aerobic exercise training improves whole muscle and single myofiber size and function in older women. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2009;297(5):R1452-R9
  40. Eom M-R, Kim SK, Park MH, Namkim O. The Effects of Foot Reflexology on Sleep Quality, Pain and Muscle Strength in Community Dwelling Female Elderly. Indian Journal of Public Health Research & Development. 2019;10(5).
  41. Samira Beigmoradi  EN, Fatemeh Movafegh , Mehdi Ramazanpour ، Ehsan Soltani Nejad , Amin Shakouri. Effects of reflexology on chemotherapy-induced peripheral neuropathy in patients with colorectal cancer referred to selected
  42. hospitals of Kerman University of Medical Sciences, Iran, in 2019. 2019(persian).

Mohammadreza ramezan pour Arl, Mohsen hesari. Comparison of the effect of three methods of returning to the original state (gentle swimming, sitting and massage) on heart rate and blood lactate of adult swimmers. Sports and life sciences. 2010(persian)