Modern Rehabilitation

The effect of cutaneous mechanical stimulations of medial plantar surface on the excitability of ipsilateral and contralateral motoneurons

MR Hadian

Background and Aim: Mechanoreceptors from the foot sole likely contribute in the reflex regulations. Stimulation of these receptors in the medial aspect of the foot is corresponded to the medial plantar nerve divisions in the tibial nerve. Therefore, it was hypothesized that repetitive low threshold afferents stimulation would have an inhibitory effect on the soleus H-reflexes.

Materials and Methods : sixteen normal subjects voluntarily, participated in the study. Subjects were remained in prone position. The Cutaneous Mechanical Pressure (CMP) (equal to 50% of leg and foot weight) was applied to the ipsilateral medial plantar surface by a designed instrument through a square plate (30 x 30 mm). H reflex as an indicator for excitability of motoneurones was bilaterally elicited before and after the application of the CMP.

Results: The amplitude of H reflex and H/M ratio showed significant differences before and after the Ipsilateral CMP stimulation of the medial side of the foot (p<0.05) furthermore, the latency of H reflex was also increased (p<0.05). In addition, the effect of CMP stimulation of the IPS stimulation showed more difference than the Contralateral side.

Discussion: The results highlights the modulatory effects of natural stimulation of cutaneous afferents on excitability of Ipsilateral and contralateral motoneurones. This in respect may have practical application in the management of muscle tone disorders in brain and spinal cord injuries.

A study of the ergonomics carpal tunnel syndrome (C.T.S)

M Abdolvahab

Background and Aim :It has been well established in the Literature that some jobs are associated with C.T.S. excessive Force, repetitive task, Lack of rest and problems in the work place setup and tools are among the most common causes of the injuries.

The purpose of this study was to investigate the relation ship between C.T.S Leading to pressure syndromes with the jobs.

Material and Method: In this retrospective study 253 patients were selected from among 3817 patients. The questionnaires were completed using the appropriate information extracted from the patients. The data were analyzed using special Statistical programs.

Results: The results indicated that there was a correlation between the jobs of house wife, construction worker and office employee and C.T.S Leading to pressure syndromes. The causes of the injuries were similar to those reported in the literature excessive force, repetitive task, lack of rest and problems in the work place setup and tool design.

Conclusion& discussion: It is, therefore, concluded that most of the C.T.S can be easily prevented by appropriate training of the work-force and taking the safety measures in to consideration when designing the tools. In addition, ergonomic principle should be observed while setting up the work places.

On the reliability and accuracy of measuring the angles, utilizing two methods of manual and AutoCAD analysis

MR Hadian

Background and Aim:Measuring the joint angles is used to assess joint position sense (JPS). The aim of this study was to introduce a fast, less expensive, objective and simple method of measurement.

In this study, the accuracy and reliability of a system, comprising digital photography, nonreflective markers and AutoCAD analysis (or manual analysis) were evaluated.

Material and Methods: For this purpose, the digital photos were taken from 9 angles of a standard goniometer whereas 4 square markers were been attached on its arms. The goniometer was placed at two locations on a calibration board. The angles were measured by using AutoCAD software via the markers^, corners. Furthermore, the markers were recorded at 72 angles of the knee joint positions in 24 healthy subjects.The knee angles were measured by 3 investigators and by using transparent sheets and goniometry.

Results:ICC was 1 for each location of the goniometer at each reference angle.The variability from the mean angles was approximately less than 0.2 degree. r² was 1 for each location. Intra & inter- rater reliability of the manual analysis were high.

Conclusion:It was noted that the new introduced system, was reliable and precise enough so it could be utilized to measure the joint angles, especially for evaluating the JPS.

Survey of charactristic of frequency spectrum in electromyographic signal in different lengths of Abd. policis brevis muscle in isometric and dynamic contractions.

GR Olyaei

Background and Aim: In this study, we investigated : 1) The effect of diferent lengths of Abd. policis brevis muscle on variations EMG frequency spectrum. 2) The effect of muscle contractions on frequency spectrum and 3) The effect of different lengths of muscle on local muscle fatigue.

Material and Method: 20 normal subjects participated in this study. (with range of 20 - 34 years old). Each test carried out in four steps. Every person performed 3 minutes of isometric contraction in Abd. policis brevis muscle and EMG signals were saved for 5 seconds before and after the test. Then the same procedure was performed while individual did 6 minutes free dynamic contraction and 6 minutes high speed dynamic contraction and 6 minutes forceful dynamic contraction respectively.

Results:This study showed that when the individual performed muscle contraction in short length, median and mean frequency increased (P = % 0) and fatigue test caused a decrease in frequency charactristics that was more in dynamic contractions in compare with isometric contraction (it was more obvious in forceful dynamic contraction). These parameters didn't change in different lengths (P = %9, P = %4, P= %3 for 0 - 45, 0 -90 and 45 - 90 degrees respectively).

Conclusion and discussion:This study showed that different muscle lengths and muscle contractions affect on frequency spectrum and it also showed the effect of different muscle lengths and muscle contractions on local muscle fatigue.

The flexion relaxation response of the erector spinae in females with different trunk flexibilitiy

S Talebian

Background and Aim: Several biomechanical and clinical studies have examined the apparent myoelectric silence of the lumbar spine extensor musculature during lumbar flexion from a neutral upright standing posture.

Objective: The purpose of this study was to investigate the relationship between trunk flexibilitiy and flexion relaxation response of the the lumbar erector spinae

Material and Methods: 30 female healthy students were participated in this study which They were arranged in three groups on toe touch test (low flexible, normal and high flexible).The surface electromyographic from the lumbar erector spinae muscles as well as flexion angle of the trunk, hip and lumbar were recorded. The angle in which electromyographic diminished during flexion and initiated during extension was determined and subjected to one way Anova to determine any significant differences in the flexion-relaxation response between three groups.

Results: The erector spinae muscles were relaxed in larger angles during flexion and initiated activity significantly earlier during extension in high flexible group (p<0/001). pearson correlation indicate that there were high correlation between trunk and hip angle during full flexion (r=0/88 p<0/001) and no correlation between trunk and lumbar angle (r=0/1 p< 0.3).

Conclusion: The results indicated that individuals with more flexible trunk , the erector spinae muscles gets relaxed in further angles of the trunk and the hip, furthermore while returing to the upright posture ,this muscle is recruiting sooner than two other groups .the biomechanical basis of this finding relies in ligamentous and passive tissues properties of individuals with different Flexibilities of the trunk which can effect there recruitment pattern of active tissues.

A Comparative Study on language Features and Educational situation of orphan versus non orphan children with 7 years old

M.R Shahbodaghi

Background and Aim: Language is one the most comprehensive human abilities that influenced by environment. Children learn language in different circumstances. Various circumstances and environments can influence on the development language rate. The purpose of this study is investigation of positive and negative influence of orphanage on language features and educational situation orphan children in first grade school.

Material and Method: This study was descriptive-analytic , case-control that performed on 21 girl & boys orphans( 8 girls and 13 boys) in Tehran city orphanages and 21 girls& boys non - orphans (8 girls and 13 boys)their classmates .

The average age of orphans group was 90months and control group was 87 months. The Told and reading test was performed for all children (orphan and non - orphan). then obtained the average of 10 last dictation scores .Then the scores of 2 test was analyzed. All data were analyzed using spss, version 13.10 for windows, appropriate descriptive statistics were used (mean, standard deviation and range) for duration of life in orphanage, Told and Reading scores .

We used Pearson correlation analysis for examining the association between duration of life in orphanage and Tests scores. We compared the average of Told and Reading tests scores and dictation scores between orphan children and non - orphan children using a Independent Samples T- test.

Results: independent-samples T- test was performed to compare mean Told and Reading tests and dictation Scores between orphan children and non - orphan children.. There were significant differences between their scores.

Conclusion& discussion: Findings suggests that orphan children in language features and educational situation were difference with non - orphan children. The orphanages couldn't prepare circumstances like family and must do changes in their conditions and care giving structures.

Inter-rater Reliability of Lateral Scapular Slide Test In patients with shoulder pathology

H Bagheri

Background and Aim: scapular position is one of the most important parts of a comprehensive approach to evaluation of patients with suspected shoulder dysfunction.Muscular imbalance has further been suggested to be a leading cause of asymmetrical motions and positions of scapula.

Kibler Introduced Lateral scapular slide test (LSST) quantitatively measures scapular symmetry, scapular stabilizer strength and shoulder girdle dysfunction threshold .

The literature recommends a further study on the reliability of LSST by using precise instrument such as caliper. Therefore, the main goal of present study was to determine the inter rater reliability of the LSST by using the caliper in comparison with the tape in patients with shoulder pathology

Material & Method: The LSST was administered to twenty men patients with a mean age 37.19 of years.(SD:12.42).The distances between the inferior angle of scapula &T7 were recorded. Subjects were tested with arm in neutral, hands on hips and 90 degrees of abduction full internal rotation. All data for tape and caliper in 0,45 and 90 degrees of shoulder abduction were analyzed with SPSS (V:11.5).

Results: The ICCs range of inter- rater reliability were respectively (0.56-0.76) and (0.73-0.88) for tape and caliper in 0,45 and 90 degrees of abduction. Differences between ICCs for caliper and tape are not statisticaly significant. The SEM range was from 6.78 to 9.29 mm for tape and from 4.33 to 8.19 mm for caliper.

Conclusion&Discusion: This study showed that inter rater reliability of LSST is questionable. Although ICCs for caliper are better than tape but in third position of the test in both measurement method ICC were low. Further research is needed.

Functional assessment of knee joint position sense following anterior cruciate ligament reconstruction

M.R Hadian

Bachground and Aim:The anterior cruciate ligament(ACL) has both mechanical and sensory function. Knee joint proprioception has been tested utilizing either reproduction of position or threshold to detection of passive motion in non-weight bearing positions. It has been suggested that more functional and dynamic/active tests of proprioception may clarify the effect of injury and reconstruction on the proprioceptive function of the ACL at the knee.

The purpose of this study was assessment of knee joint position sense (JPS) following ACL reconstruction in functional position.

Material and Method:12 patients who had undergone ACL reconstruction and 12 healthy control subjects participated in the study.

JPS was evaluated by reproduction of the angles in weight-bearing position with limb movement into flexion and extension.

The dominant-limb knee of healthy subjects and reconstructed and normal knee of the patients were selected for evaluation.

The knee angles were measured by using a system comprised of digital photography, non-reflective markers and AutoCAD software. Absolute error was considered as a dependent variable.

Results:There were no significant differences between the operated and normal knee of the patients and between the patients and healthy control subjects. These results were observed in two tasks of limb movement into flexion and extension. The position had no significant effect on the absolute error in both groups.

Conclusion and Discussion: The result of this study suggest that subjects who have undergone ACL reconstruction do not have a deficit in knee JPS when tested under functional weight bearing conditions. Knee JPS is maintained by muscle-tendon receptors providing primary and accurate sensory information for normal proprioceptive function, along with remaining capsular and ligamentous mechanoreceptors which provide additional and/or complimentary proprioceptive information.