Introduction
The elderly population is increasing; in this regard, having a long life alone cannot be considered the primary goal of the elderly, but multi-dimensional attention should also be paid to their physical, psychological, and social needs and quality of life [1]. One thing that depends on the quality of life (QOL) is sleep quality [2, 3]. A survey in 2012 showed that nearly 30% of men have an average of fewer than 6 hours of sleep per night [4]. Low sleep quality also causes skeletal-muscular problems, the most common of which is nonspecific chronic back pain [5]. 60% of patients with nonspecific chronic back pain have poor sleep quality [6]. In this regard, this study aimed to compare the effect of pre-sleep exercises on sleep quality parameters and nonspecific chronic back pain after sleep in elderly men.
Methods
The current study is semi-experimental, with a two-group design, exercise intervention, and pretest-posttest. The statistical population of the present study consisted of all employees and retirees over 60 years of age at the Isfahan University of Technology in the fall of 2018. Fleiss et al. [7] used the formula to determine the sample size. Finally, 40 male retirees over 60 years old of Isfahan University of Technology with an average age of 64.52±3.18 years, an average weight of 81.99±7.35 kg, and a body mass index of 27.91±2.21 as in were selected and randomly divided into two experimental and control groups of 20 people. 
An informed consent form and personal information questionnaire were received from all participants. And they were promised that their information would remain confidential and only the general results of all participants would be exploited. This article (Code: IR.IAU.KHUISF.REC.1399.071) was approved by the Isfahan University of Technology. Pittsburgh standard questionnaire was used to evaluate sleep quality parameters, the pain intensity questionnaire was used to check the back pain level, and the Oswestry questionnaire was used to assess functional disability.
The training intervention was applied for 15 minutes and 28 sessions while sitting and lying on the bed with the maximum preparation approach. The exercises before sleeping at home were explained and performed for each person in the training session. The pictures and videos related to these movements were provided to the participants, and they were reminded of the time of their execution three times every night through SMS. To determine normality without distribution, the Shapiro-Wilk test was used. The difference between the means and the homogeneity of the variances in the pre-test-post-test was investigated by analyzing the variance test with repeated measurements. Analysis of variance with repeated measures was used to analyze the data. All analyzes were used in SPSS software v. 24 at 0.05.
Results
After analyzing the data in the descriptive section and analysis of variance, it was found that both experimental and control groups are similar in terms of age, height, weight, body mass index, and other indicators. After that, the mean and standard deviation of the pre-test-post-test scores in the experimental and control groups were investigated for the parameters related to sleep quality, pain intensity, and the degree of nonspecific chronic low back pain disability. Finally, considering all the necessary preconditions, the ANOVA test with repeated observations was used.
The estimation of values ​​related to the analysis of variance for repeated measurements indicates that the outgroup and ingroup effects related to time stage and the interaction of group and time are statistically significant in all sleep quality parameters (P≥0.5) (Table 1).




The significance of the group effect means the overall difference in the average scores related to some sleep quality parameters among the studied groups (experimental and control). The significance of the time effect states that the average score of some sleep quality parameters significantly differs two times. Also, the interactive effect of group*time shows that the trend of changes in average scores in two groups during the pretest-posttest times is different. In other words, the effectiveness of pre-sleep exercises to improve sleep quality parameters has a significant effect on the subjective quality of sleep (P=0.001), delay in falling asleep (P=0.019), duration of falling asleep (P=0.006), efficiency and effectiveness of sleep (P=0.001), sleep disorder (P=0.016), use of sleeping pills (P=0.001), inappropriate performance during the day (P=0.002), and overall sleep quality (P=0.001) of male elderly. As indicated at the end of Table 1, exercises before sleep can also significantly affect nonspecific chronic back pain parameters such as pain intensity (P=0.039) and disability rate (P=0.014) in this age group. be

Ethical Considerations
Compliance with ethical guidelines
The present study was approved with the code IR.IAU.KHUISF.REC.1399.071 in the National System of Ethics in Biomedical Research of Iran and based on the Declaration of Helisenko.

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
Initial idea, submission of the article, modification of the initial and final version of the article and performing laboratory and field work: Mojtaba Babaei Khorzooghi; Writing and preparing the initial and final draft of the article and statistical analysis of data: Parinaz Sadat Sajjadian.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
All the participants in this study, the student vice president, the research vice president and the respected management of the Physical Education Center of Isfahan University of Technology are appreciated and thanked.


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