Modern Rehabilitation

Inter-rater reliability of goniometric measurements of the pronation and supination movements

Mohammad Amozadeh Khalili

Background and aim: The goniometric measurement is a simple and common method for assessment of movements and joints in the rehabilitation clinics that the survey of sensitivity and reliability level has an important role for the therapists. The aim of this study was to investigate inter-rater reliability of goniometric measurements of the pronation and supination movements
Material and methods: In this descriptive cross-sectional study twelve healthy student boys were participated. The candidates were asked to sign an informed consent.Goniometric measurements were carried out by the two experienced physiotherapists to assess the forearm supination and pronation. The dominant limb was evaluated in supine position during the test. The correlation coefficient test was used for inter rater reliability.
Results: The coefficient correlation was high between the two raters, (for supination, r=0.931 and for pronation r=0.875). The results showed that the coefficient correlation of supination was higher than pronation.
Conclusion: The results of the study indicated that the inter-rater reliability of goniometric measurements of the pronation and supination movements were high, also the level of reliability for supination was higher than pronation.

Providing a picture verb naming test and determine its validity in Persian aphasia patients

A Mehri

Background and Aim: Naming test is an appropriate tool for assessing, diagnosing and treating word finding difficulties in Aphasic patients. Considering the importance of this test and lack of such kinds of tests in the field of verb in Farsi, the purpose of this research is to provide a verb-naming test in Persian.
Materials and Methods: In order to provide the tool based on the foreign samples, the common traits are exploited according to selection the verbs and based on the frequency criteria, Acquisition age, length of word, and investigating the inferior studies, 132 Persian verbs were chosen and picture of the selected verbs were drawn. They were offered to 15 experts to give points to the pictures based on the previous criteria of our research including familiarity, imagination and beauty of viewing. The mean score of obtained points was computed and 50 verbs were selected out of 132 suggested verbs.
Results: Findings of this study showed that the selected verbs were of high frequency verbs. Also they are those verbs which have lowers acquisition age. Most of the verbs were compound and it indicates that in Persian language compound verbs are of high frequency. Moreover, it appeared that high objectivity degree caused to high scores of imagination. Then most of the verbs were objective verbs.
Conclusion: Finally 50 verbs with their related pictures made this naming test. It is worth mentioning that remaining verbs were ranked based on their scores.

The effect of home based lovaas approach on social interaction, Speech and language, Play and behavior skills, and intensity of autism in young children with Autism

Leila Dehghan

Background and aim: The aim of this study was to determine effect of home based lovaas approach on social interaction, Speech and language, Play and behavior skills, and intensity of autism in young children with Autism

Materials & Methods: This study was a quasi-experimental, interventional pre/post design. Thirty children with Autism were selected by convenience sampling in a rehabilitation center by matching closely, 8 years old, in Tehran city.

The impact of lovaas approach was evaluated in children with Autism. For evaluation total scores and dimension of social interaction skills speech and language play a behavior before and after therapeutic intervention we used The PDD assessment scale/screening questionnaire. The results were analyzed with paired T test and wilcoxon signed and multivariate T² Hotteling and SPSS software edition 17.

Results: After intervention PDD assessment scores decreased (P<0/001). Significant progress were observed in social interaction skills (P<0/001).Speech and language (P=0/001), play (p<0/001) and behavior (P= 0/002). Significant decrease wasn't seen in the intensity of PDD after intervention (P> 0/05).

Conclusion: The result showed that home based lovaas approach increased the social interaction, Speech and language, Play and behavior skills in children with Autism

Survey of Transferrin level changes in healthy subjects following a session of exercise program: A preliminary study

Behrooz Attarbashi Moghaddam

Background and aim: Coronary artery disease is the most common cause of mortality in adult with atherosclerosis. Based on recent studies decrease of transferring level is very important in coronary vascular disease development. The main goal of this study was to survey the effects of endurance, resistance and combination training on the transferring level.

Materials and methods: Forty three volunteers with 18- 25 years old participated in this study. Transferring, heart rate and blood pressure assessed before & after one session of exercise. Subjects randomly put in to one of the four groups (control, endurance, resistance and combination).

Results: There was no significant difference between transferring before and after in endurance & combination groups; But there was a significant difference between transferrin before and after one session of resistance exercise group (P= 0.04).

Conclusion: The results of this pilot study showed that one session of resistance exercises decreased the transferrin level whereas endurance and combination exercises were ineffective upon it.

Movement pattern & motor output during resisted trunk three dimensional motion

Mehdi Sadeghi

Background and aim: Asymmetric motions of trunk, external forces and other occupational factors such as frequent bending and twisting, lifting and forceful movement contribute to low back disorders. However, the dynamic and three-Dimensional motions of trunk at varying exertion levels were not addressed in literature. Hence, the aim of this study was to investigate the movement pattern and motor output during resisted trunk three-dimensional motion.

Materials and Methods: Thirty healthy male subjects randomly performed dynamic asymmetric trunk motion at four resistance levels (nominal resistance, 25%, 50%, and 75% maximal voluntary contraction (MVC) torque) while positioned in standing with the L5-S1 interspinous space aligned with the flexion / extension axis of isostation B200. Under each resistance condition, movement patterns (range of motion), motor output (maximum torque) of the trunk were measured.

Results: In general, with increasing resistance from nominal to 75% MVC torque, the maximum torque of trunk in different directions of motion (flexion, extension, right & left lateral flexion, right & left rotation) increased significantly (p= 0.000). With increasing resistance from nominal to 50% MVC torque, the range of motion of the trunk decreased significant (p<0.0083), but no significant change was found in this variable between resistance conditions of 50% and 75% MVC torque (p>0.0083).

Conclusion: When the resistance level is increased , the created external forces must be balanced by internal forces generated by trunk muscles. Because the muscles have short lever arms compared with the external forces, they must generate large amounts of forces, placing compressive and shear loads on the structures of the spine. Under these conditions, spine injuries may be enhanced.

The effect of constraint-induced therapy on Activity of Daily Living of adults hemiplegic patients

Mehdi Abdolvahab

Background and aim: Most of the rehabilitation treatments for hemiplegic patients focus on compensatory strategies to promote independence in ADL by any means for restoration of upper exterimity (UE) function . Patients were taught to use the unaffected UE and various assistive device for ADL. In contrast, Constraint-Induced Therapy (CIT) treatments discourage the use of unaffected UE and encourage the use of the hemiplegic arm . The aim of this study was to investigate the effect of constraint-induced therapy on ADL of adult hemiplegic patients.

Materials and methods: This study is an interventional study. In present study, 15 patients who had hemiplegic arm following stroke, participated in constraint-induced therapy sessions emphasizing on more affected UE in different activities five times a week for 8 weeks and 2 hours a day. Noninvolved UE was restricted with a special sling for 8 weeks and 5 hours a day.

Result: The measurements of self care activities, mobility and total score of stroke patients were evaluated with Barthel-Index. The date showed significant differences between mean score of pre and post interventions (p<0.001).

Functional measurements of upper extremity in ADL by using Arm Function Test showed significant differences between mean score of pre and post interventions (p<0.0001).

Conclusion: Presents data showed that constraint-induced therapy could be an effective approach to improve Activities of Daily Living of stroke patients and emphasis on more use of involved UE and overcome disuse learning.

The effect of chronic ankle instability on knee joint position sense

Nasrin Naseri

Background and Aim: The rapid growth of the athletic training profession has been accompanied by an equally rapid increase in focus on basic and clinical research. Lateral ankle sprain (LAS) is an extremely common athletic injury. Despite extensive clinical and basic science research, the recurrence rate remains high. Chronic ankle instability (CAI) following LAS is hypothesized to predispose individuals to re-injury because of neuromuscular control deficits which result following injury. No investigation has been carried out on the existence of joint position deficits in the knee joint of patients with CAI. In this study, joint position sense (JPS) was evaluated in patients with CAI.

Materials and Methods: Ten female patients with CAI and ten healthy control subjects participated in this study. JPS was evaluated by reproduction of the angles in two standing and sitting positions, and in each position two target angles were tested. The knee joints in both lower limbs of patients and the dominant knee-limb of healthy subjects were evaluated. The knee angles were measured by using a system comprised of skin markers, digital photography, and Auto CAD software. Absolute error was considered as a dependant variable.

Result: There were no significant differences between the knee JPS of dominant leg in healthy subjects and both knee joints of patients. There were also no significant differences between knee JPS in two standing and sitting positions and in two different target angles (p>0/05).

Conclusion: The result of this study suggests that subjects who have CAI do not have deficit in knee JPS when tested in sitting position and also under functional weight bearing conditions.

Determining of the effectiveness of loaded forward and lateral step up resistance exercises on Gross Motor Function in children with cerebral palsy of spastic diplegia

Hossein Bagheri

Background and Aim: Muscle weakness can be a major problem for many young people with spastic diplegic cerebral palsy (CP). Strength affects on gross motor function. The aim of this study was to determine the effectiveness of loaded forward and lateral step up resistance exercises on Gross Motor Function in children with cerebral palsy of spastic diplegia.

Materials and Methods: Twenty CP persons between 5 to 12 years old (11 boys and 9 girls) with mean age of 8.15 years old were participated in this study. Loaded forward and lateral step up resistance exercises protocols were done 3 times a week for 6 weeks. Isometric strength of hip abductor, hip extensor, knee extensor and ankle plantar flexor were evaluated by MMT NICHOLAS apparatus. Gross Motor Function were evaluated by GMFM.

Result: The strength of Hip abductor, hip extensor, knee extensor and ankle plantar flexor increased (p < 0.05). The scores of GMFM dimensions D and E improved (p < 0.05).

Conclusion: Loaded forward and lateral step up resistance exercises increased muscle strength of lower extremity and improved scores in GMFM.

Efficacy of Cawthorne & Cooksey exercise on balance improvement in elderly persons in Mashhad

Gholam Olyaei

Background and aim: The elderly people are one of the most vulnerable people in any society. Falling in this group is accompanied with decrease of daily living activities. With regard of improvement of balance in perevention of falling, the aim of this study is survey about the effect of Cawthorne and Cooksey exercises on improvement of balance.
Material and Methods:36 elder men with age above 60 years old put in two groups (control group= 19 and exercise group= 17) who lived in the elderly center in city of Mashhad. The subjects in exercise group participated in the Cawthorne and Cooksey exercises during three months, three times a week, during sixty minutes. Balance status of subjects evaluated with Berg Balance Scale(BBS) in 4 stages ( befor exercise and one month, two months and three months) after exercises.
Result: Results showed that improvement of the balance in the different evaluation stages of BBS was significantly increased particularly in the first and second months (p< 0.05). The effects of exercise group were significantly different from control group(p=0.000).
Conclusion: Cawthorne and Cooksey exercises were effective on the balance improvement of elderly men in center of Mashhad and two months of these exercises were enough to improve balance in this group.

The effect of lumbosacral support on motor control pattern during combined trunk motion

Saeid Talebian

Background and aim: Belts and back supports are frequently used to prevent low back pain. Despite many studies, there are not sufficient evidence and conclusive consensus about the effects of these supports. The purpose of the present study was to determine the effect of lumbosacral supports on motor control pattern during combined trunk motion.

Materials and Methods: 30 healthy young men were selected for the study. Temporal parameters of motor control and activity level of three pairs of trunk muscles were measured during combined trunk motion against minimum resistance and resistance equal to 50% of maximal isometric strength, under with and without back support conditions.

Results: By application of a lumbosacral support, movement response time was significantly decreased under minimum resistance (P=0/004). Application of support decreased reaction time and motor time under two resistance conditions significantly (P<0/05). No significant changes were found in trunk muscle activity levels following wearing a back support (P>0/05).

Conclusion: By application of a lumbosacral support, individual reaction time was decreased. Although back support did not change the trunk muscle activity level, but the erector spinae muscle efficiency was increased to initiate desired movement.