Modern Rehabilitation

Quality of life among stroke patients in kermanshah city

ayub Fattahi

Background and aim: Health-related quality of life is an important index of outcome after stroke and may facilitate a broader description of stroke recovery. The objective of this study was to measure health-related quality of life in stroke patients in kermanshah city and determine of impact occupation status, gender and hemiplegics side of the body on the quality of life for stroke patients.

Materials and methods: The Method was descriptive-analytic and cross sectional. Fifty one stroke patients referred to comprehensive rehabilitation centers, occupational therapy, physical therapy ,speech therapy clinics and hospital centers of kermanshah city and there was an interview with all patient. Quality of life was evaluated by 36-item short-form health survey (SF-36).

Results: In attending to the results of recent study, quality of life affected by stroke in total subscales of the (SF-36) but this increased in Role-Physical. Quality of life in these patients is dependent to the age, level of education and post-stroke duration.

Conclusion: It seems that quality of life improves in stroke patients by passing the time.

Comparison of spatial working memory and strategy use in cerebral palsy children with normal subjects with 7-12 years old

mojtaba soltanlo

Background and aim: The present study evaluates spatial working memory and strategy use, that are from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy ( spastic diplegia ).

Materials and methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: twenty children with cerebral palsy ( spastic diplegia ), with mean age of 8.94 years and 20 normal children with mean age of 8.86 years. Data were collected using Strengths and Difficulties Questionnaire ( SDQ ), CANTAB and Raven test of intelligence. Data were analyzed using t-test.

Results: Children with cerebral palsy differ from the normal children in spatial working memory. Comparing of the means of errors, were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ),except in double error ( p>0.05 ) however there was no significant difference in function of strategy use between 2 groups ( p>0.05 ).

Conclusion: In regard with these findings, cognitive rehabilitation with focus on executive skills can be useful in clinical treatment, parallel to the traditional methods, for spatial working memory in children with cerebral palsy.

Comparison of the effects of heat, exercise therapy and combination of low level laser therapy on the side effects of knee osteoarthritis (women 40-65 years)

mohammad Reza Hadian

Background and aim: Knee osteoarthritis (OA) is one of the most common synovial joint diseases (i.e. weight bearing joints) of the human body. This problem probably is more common in Iranian society that is used to sit on the floor and carpet. Following knee OA, patients complain of pain, inflammation, decrease of range of motion and muscle weakness. Therefore, they can not independently do their activity of daily living (ADL). Consequently, the side effects of physical incapability may render to psychological problems and this in respect do affect on their quality of life.Various treatments such as pharmalogical, surgical and physiotherapy have been recommended at different stages of OA by specialist. In the present study, the effect of physical therapy agents (considering the point that physiotherapy has no or negligible side effects) have been studied on OA.

Materials and methods: 40 patients participated in this study the patients were refereed by orthopedic surgeon to the physiotherapy clinic of the Faculty of Rehabilitation. University ethical committee approved the procedures. Patients were randomly divided in two groups and physiotherapy treatments were applied as following:

Group I. Low Level Laser Therapy, heat, exercise.

Group II. Placebo (i.e. inactive Laser), heat, exercise.

Results: The result of current study shows that both methods of physical therapy were quiet efficient on 7 variables that measured in this study (p< 0.05). However, the result of this study showed that in laser group, pain and speed of gait were more effectively influenced (p< 0.000 and p<0.048 respectively) in comparison with routine physiotherapy. Consequently, patients can fairly independently do their activity of daily living and this in respect may reduce the psychological side effects of illness.

The effects of progressive resistive exercises on strength and dexterity of the hand of persons with cerebral palsy

hossein Bagheri

Background and aim: Cerebral palsy (CP) is a common disorder in human society with many somatosensory problems that affects on functional capability. Dexterity affects activity of daily activity. The aim of this study was to investigate the effects of Progressive resistive exercises on strength and dexterity of cerebral palsy persons.

Materials and methods: Twelve CP persons between 8 to 16 years old (10 boys and 2 girls) with mean age of 11.9 years old participated in this study.

Progressive resistive exercises (PRE) protocols were done on upper extremity of study group 3 times a week for 6 weeks. Strength of shoulder abductors and extensors were evaluated by MMT NICHOLAS apparatus. Grip strength and dexterity were evaluated by Jammar Dynammometer and Purdue peg board respectively.

Results: Shoulder abductors and extensors strength increased %29.4 (p=0.0001) and %30.1 (p=0.014). Grip strength and dexterity improved %9.8 (p=0.048) and dexterity %23 (p= 0.016) respectively.

Conclusion: PRE increase muscle strength of upper extremity and may improve dexterity in children with cerebral palsy.

Nonlinear behavior of lumbar extensor muscle activities following onset of muscle fatigue in women with nonspecific low back pain

saied Talebian

Background and aim:The role of thoraco-lumbar muscles is important in spinal column stability. Following fatigue due to constant activity, these muscles encounter with variable control pattern and variations of median and mean frequencies are little in relation to torque of force. However these parameters are useful in the literatures, but due to complexity of neuromuscular interaction and variety of motor control, signal processing can determine a wide range of changes and measurements.

Signal processing nonlinear techniques exploit in biologic signals. Variables of nonlinear techniques are recurrence, determinism, entropy and so on.

The purpose of this study was to determine changes of entropy as nonlinear parameter in comparison with linear parameter and applicability of entropic measurements of the erector spinae muscles during fatigue.

Materials and methods: Ten healthy women and 6 women with nonspecific low back pain (NSLBP) with a range of 20-30 years old patticipated in this study. Surface electromyography of isometric activities recorded from trunk (T12), lumbar (L3) and biceps femoris muscles during modified Sorenson isometric fatigue test. Median and mean frequency and also nonlinear parameters such as entropy and trend measured in one second of muscles activities before and onset of fatigue.

Results: Following fatigue in healthy group, median and mean frequencies reduced at a range of 12-20% (p<0.05). This decrement in LBP group was little (4 - 20%, p<0.05). Entropy increased 120-200% and trend reduced 800-2000% in normal subjects (p<0.05), whereas subjects with LBP indicated increment of entropy 65-220% and decrement of trend 240-500% (p<0.05). Before and after fatigue there was a significance difference between two groups in entropy parameter (p<0.05), whereas median and mean frequencies differences were not significant.

Conclusion:Following static positions, fatigue occurred in three levels of above muscles particularly at lumbar region. Traditional fatigue indicators showed good differences, but percentage of variability was low in comparison to nonlinear parameters. It suggests that nonlinear variables especially entropy are more sensitive than traditional indicators and can explain these stochastic behaviors

Prevalence of hamstring and calf mucles shortness

zahra Fakhari

Background and aim: With respect to attachment and mechanical relationship of hamstring and calf muscles, interaction between their function is unavoidable. Inspite of prevalence of hamstring and calf muscles shortness, there is not any statistical data about the relationship of shortness of above-mentioned muscles in Iran. The aim of this study was to verify of this prevalence.

Materials and methods: In this study 3308 healthy girls with age 3-17 years old participated. Length of calf muscles with dorsi flexion angle and hamstring with hip flexion angle (SLR) in both side were measured.

Results: The prevalence of hamstring and calf muscles shortness with together was20% in right and 25% in left side .The Prevalence of hamstring and calf muscles shortness with together in 20 district was greater than 3.The greatest amount was seen in secondary school(31.6%).

Conclusion:The results indicated that most of subjects who had hamstring shortness, they had also calf muscles shortness, so if there is any shortness in one of them, we shouhd pay attention to shortness of the another.

Introduction of Quick Release Movement in Evaluation of Immediate Effect of Passive Stretch in Terms of Length and Stiffness of Shorted Hamstrings

azade Shadmehr

Background and aim: Muscle flexibility is an important component of physical fitness and injury prevention.

Passive Stretch can be effective in lengthening and making hamstring more flexible. Popliteal angle measurement is one of the most simple method in studying the efficiency of these methods however, in goniometry measurement, there is not any data about muscle tension and any proper judgment about flexibility. The goal of this study is to evaluate length and stiffness of the hamstrings by Quick Release Movement before and after the passive stretch.

Materials and methods:14 men (20-30 years old) with shorted hamstring (20 degree or more ext lack in passive knee ext test by popliteal angle measurement) participated in this study. Before and after exercises, popliteal angle and muscle stiffness were evaluated with digital goniometer and Quick Release Movement technique respectively. Evaluation of stiffness was performed in flexion and extension positions.

Results: A significant increase in hamstring length was observed. (P<0.05) There was decrease in stiffness in both position of flex and ext but it was significant when in extension state.(P<0.05)

Conclusion: Findings of this study demonstrate passive stretch's effectiveness in increase muscle length and lessening muscle stiffness. In addition Quick Release Movement can be a suitable method for measuring muscle stiffness.

The effects of special two different types of splint , volar and dorsal, on reduction of spasticity of hand in spastic cerebral palsy 4 - 6 years old .

mahdi Abdolvahab

Background and aim: Spasticity cause abnormal patterns in upper limbs of cerebral palsy children .It restricts hand function in grasp and release movement. In occupational therapy, neurophysiologic approaches include motor techniques, training and treatment for decreasing hypertonicity and biomechanical approach includes use of splint. In present study the effects of volar and dorsal splint were determined in decreasing of spasticity in upper limbs of quadriplegia cerebral palsy children with four up to six years old

Materials and methods: Twenty quadriplegia spastic children (4-6 years old) were participated in this study. They were classified in two groups. One group wears volar splint and the other group wears dorsal splint for two hours per days and four hours at night up to twelve weeks. Spasticity and passive range of motion were measured by modified Ashworth scale and goniometry respectively

Results: The mean of wrist spasticity was 2.5 in volar splint group before intervention and 1.9 after intervention. The mean of wrist passive range of motion was 93.50 before intervention and 123.50 after intervention. Elbow passive range of motion was 113 in pre intervention and 135.50 in post intervention. The mean of wrist spasticity was 2.6 in dorsal splint group before intervention and 2.00 after intervention. The mean of wrist passive range of motion was 89.5 before intervention and 118.50 after intervention. Elbow passive range of motion was 110.50 in pre intervention and 135.50 in post intervention. Statistical Analysis of t-student and paired t-tests showed significant differences between the pre and post intervention in all parameters (p<0.05)

Conclusion: The result of present study showed that both of the splints affected to decrease spasticity of wrist and increase wrist and elbow passive range of motion of hand. Based on this evidence, both of the splints would be suggested for spastic`s hand treatment. Due to major problem in making dorsal splint, we suggest volar splint for reducing spasticity in cerebral palsy children.