Modern Rehabilitation

The role of vision on the body balance

Ali Mirzajani

Background and Aim : Vision plays an important role in maintaining balance in the body so that the visual defects produce some disturbances in the body balance. In order to establish balance, the first afferent signals to the brain are provided through the visual system. Therefor, diagnosis and treatment of visual disturbances are so most effective and important. This paper reviews the importance of the visual system in body balance control and visual disorders which affecting on balance.

Materials and Methods : In this study, the articles from 1989 to 2012 with issues of vision and body balance were reviewed. The research with medical subject heading terms and key words of “vision” and “balance” in Pub-med, Science Direct, Scopus, Iran Doc, Scholar Google, Iran Medex, Magiran were done.

Conclusion: Correction of visual disorders and improving vision in patients with balance disorders can hasten the healing process.

Keywords: Vision, Balance, Visual Disorders

The effect of lumbar muscle fatigue on postural control in Athlete and non-Athlete Subjects

Mohammad Akbari

Background and Aim: Postural control is the ability of maintaining of the body posture in space. Peripheral and central factors have important role in muscle fatigue. Repetitive muscle contraction leads to muscle fatigue. If strength is educed up to 30% of maximum contraction can be disturbed stance control of subjects. The objective of the present study was to compare the effect of lumbar muscle fatigue on postural control in athlete and non-athlete subjects.

Materials and Methods: Fifteen men as athlete subjects and other fifteen matched men as non- athlete subjects participated in this study. Trunk extensor muscle fatigue was produced by dynamometer. Stance postural sways were evaluated by force platform device in bipedal stance with open eye.

Results: In pre-fatigue state there is no significant difference between two groups. Fatigue had significantly effect on postural sways in both group after Lumbar muscle fatigue specially in non-athlete group (P ≥ 0.05) .

Conclusion: The postural control of athletes after muscle fatigue was better than non athlete subjects probably due to better proprioception in athlete subjects.

Keywords: Muscle fatigue, Postural control, Force plattform.

Effect of Community-Based Rehabilitation program on quality of life for people of 15-65 years old with severe and profound hearing loss in the city of Sabzevar

Marzieh Mohammadi moghadam

Background and Aim: The aim of the Community-Based Rehabilitation program is to enhance the quality of life of people with different disabilities including those affected by hearing impairment. The objective of this study was to explore the effect of CBR program on the quality of life of people of 15-65 years old with severe and profound hearing loss old who lived in the city of Sabzevar.

Materials and Methods: In this cross-sectional, the quality of life of people of 15-65 years old with severe and profound hearing loss who lived in the city of Sabzevar were assessed by using a standardized questionnaire SF36 in two groups consist of case group(those who were covered by Community Based Rehabilitation) and control group(those who were not covered by the Community Based Rehabilitation ). Data were analyzed by SPSS software version 17.

Results: The number of both groups of cases and controls was equal (each one 46 persons). In this study 63.04 percent of participants were hearing loss and 36.96 were deaf. There was a significant difference between case group and control group in general health perception, social functioning and role limitation due to emotional problems aspects. Overall quality of life scores in case group were higher than control group. Quality of life scores by age, gender, and education were not significantly different between case and control groups.

Conclusion: The results of this study confirmed that the effectiveness of community-based rehabilitation program on quality of life of people with hearing impairment.

Key Words: Quality of life, Community-Based Rehabilitation, Severe and profound hearing loss

The effect of lumbar lordosis, pelvic tilt, type and number of labor in volleyball players suffering stress urinary incontinence

Behrooz Attar bashi Moghadam

Background and Aim : Pay attention to high prevalence of stress urinary incontinence (SUI) in women athletes and role of changes in lumbar lordosis, pelvic tilt and the type and number of delivery factors on the incidence of Urinary Stress Incontinence also lack of studies in this problem about risk factors (Predisposing factors) in Iranian population, this study was designed to investigate the relationship between changes in lumbar curvature and pelvic tilt with SUI and to determine the type and parity on the incidence of this problem .

Materials and Methods : In this cross - sectional study through easy and available sampling, 17 volleyball player with SUI and 15 healthy volleyball player, aged 20-40 years old. Females after interview and taking demographic information participated in the study. The Persian questionnaire of ICIQ-UISF (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form) used to confirm the SUI. A flexible ruler and inclinometer were used to measure lumbar lordosis and pelvic tilt .

Results: A statistically significant difference was seen between the two groups in terms of the lumbar spine curvature (p< 0.001) and pelvic tilt (p = 0.02) respectively. Based on the findings, the number of delivery was no significant effect on the incidence of Stress Urinary Incontinence but there was significant relationship between type of delivery and SUI .

Conclusion: With significant difference in the lumbar lordosis and pelvic tilt in athletic women with and without SUI, also advised to emphasize on the epidemiological and etiological investigation studies of lumbar lordosis and pelvic tilt in patients with Stress Urinary Incontinence.

Key words: Stress urinary incontinence, Women athletes, Lumbo-pelvic posture

Voice problems and its risk factors in primary school teachers

Seyedeh Maryam Khoddami

Background and Aim: Teachers are one of the groups at risk of developing voice problems in addition to communication problems.This problem affects on the quality of their professional activities. Therefore, purpose of this study is to survey voice disorders and its risk factors among primary school teachers.

Material and Methods: Fifty primary school's female teachers who had been chosen through simple sampling were recruited. Risk factors of voice problems questionnaire, VHI-10 questionnaire and symptoms questionnaire in voice problems were used in this study . To evaluate voice perceptually, vowel sounds, reading sentences and conversational speech were recorded and analyzed by three speech and language pathologists based on GRBAS profile.

Results: The results suggest that hoarseness was the most common (66%) and decreased phonational range (4%) was a rare voice complaint. Perceptual voice evaluation indicated that 80% of teachers have mild voice disorders. Teaching history, lack of curtain in the classrooms, teaching materials were found as risk factors of voice disorders (P<0.05).

Conclusion: In regard to high frequency of voice problems, even mildly severe in most of the teachers, it needs special attention. Various factors can exacerbate the risk of voice problems in teachers including of individual factors such as teaching experience as well as environmental factors such as physical conditions of classrooms and teaching conditions).

Keywords: Voice related symptoms, Teachers, Perceptual evaluation, Risk factors.

The immediate effect of stabilization training on improving weight distribution in patients with sacroiliac joint instability

Saeed Talebian

Background and Aim : Trauma or micro-trauma over prolonged period of time can lead to

pathoanatomical changes and passive instability of the sacroiliac joint. These subjects often reluctant to bear full weight through the impaired side of the pelvis. The aim of this study was to investigate the effect of exercise therapy on symmetric distribution of weight in sacroiliac joint instability in standing and walking through Alfoot device.

Materials and Methods : In this study, 17 subjects with sacroiliac joint instability with age range of 20-40 years were selected by simple sampling. Subjects performed a single session of training that involve five tasks in 3 sets, including sitting on gym ball, lying on gym ball, quadruped, standing near wall and standing on tilt board. Before, immediately after, 5 and 10 minutes after intervention , scanning the both feet were recorded during standing and walking.

Results : The amount of weight on both feet in bipedal stance position were significantly different before and immediately after the intervention. But this difference , 5 minutes (p =0.058) and 10 minutes (p =0.110) was not significantly different after exercise therapy. The pressure on the middle part of the foot during walking significantly increased immediately after the intervention and it continues up to 10 minutes .

Conclusion : The results of this study suggest that training of lumbopelvic muscles can be an effective way to improve weight distribution on the affected side in patients with sacroiliac joint instability .

The effects of static anti pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old

Mehdi Abdolvahab

Background and Aim : Cerebral palsy (CP) children are the most referral patients to occupational therapy centers. Hand function is important in activity of daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splint are commonly used to improve the position , range of motion, quality of movement, arm and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old.

Materials and Methods : This interventional study is in a before-after design for two group case and control. Thirty spastic diplegic cerebral palsy children with 8 to 12 years old who had the inclusion criteria, were randomly assigned to case and control group. Patients of case group used a static anti-pronation splint for 2 months, 8 hours daily. In this study the Jebsen Taylor test was used to evaluate upper extremity function, the Goniometer was used to measure ROM of elbow, forearm and wrist, the Modified Ashworth Scale was used to assess spasticity of elbow, forearm and wrist. Power grip and pinch were assessed with MIE device.

Results : In the case group results showed a significant improvement in upper extremity function (0.026), forearm supination ROM (0.007), wrist extention ROM (0.005), forearm muscle pronator spasticity (0.001), wrist muscle flexsor spasticity (0.009), power grip (0.001) and pinch (0.001). The data did not show significant improvement on elbow extention ROM (0.075), elbow muscle flexsor spasticity (0.164). In comparison with control group, the data showed a significant improvement in upper extremity function (P=0.001), forearm supination ROM (p=0.034), wrist extention ROM (P=0.042), forearm muscle pronator spasticity (P=0.009), power grip (P=0.001) and pinch (P=0.001). The data did not show significant improvement on elbow extention ROM (P=0.140), elbow muscle flexsor spasticity (P=0.638) and wrist muscle flexsor spasticity (P=0.105).

Conclusion : The findings show that using static anti-pronation splint for 2 months , 8 hours a day , can be an effective method to improve upper extremity function , range of motion of forearm and wrist , forearm spasticity and power grip and pinch in spastic diplegic cerebral palsy children with 8 to 12 years old .

Key word : Cerebral palsy, Static anti pronation splint, Upper extremity function, Spasticity, Power

Investigation efficacy of neurofeedback intervention on reduction aggression behaviors in adolescents

Morteza Shamohammadi

Background and Aim: Social psychologists defines aggressive act a conscious behavior that its aim is creation physical or mental pain and suffering. Aggression is relatively permanent inclination to expressing behaviors along with ruff from a person in different position.

Materials and Methods: The research is done in frame a quasi-experimental design (pre-test and post-test) with two test and control groups with t reatment protocol (t3-t4: s tructures and complex communication networks that there are in under cortex or cortical that to it called limbic system or lateral and is responsible emotions and memory ), on 30 adolescents 13-15 years old with aggression disorder. Sampling method was accessible. Treatment has been implemented during 20 sessions, for 2 months and 3 sessions, in every week (30 minutes). For data collection is used of Buss and Perry Aggression Questionnaire that iranian reliability reported for the total scale (0/82) and validity (0/73).

Results: The results of analysis of covariance about anger show that calculated F (14/55) is greater from table F with significant 0/01. Thus with confidence 0/99 can be claimed that use of neurofeedback method is causing reduction “anger”. The results of analysis of covariance about physical aggression show that calculated F (36/5) is greater from table F with significant 0/01. Thus with confidence 0/99 can be claimed that use of neurofeedback method is causing reduction “physical aggression”. The results of analysis of covariance about verbal aggression show that calculated F (5/77) is greater from table F with significant 0/01. Thus with confidence 0/99 can be claimed that use of neurofeedback method is causing reduction “verbal aggression”. The results of analysis of covariance about hostility show that calculated F (36/5) is greater from table F with significant 0/01. Thus with confidence 0/99 can be claimed that use of neurofeedback method is causing reduction “hostility”.

Conclusion: The results are expression that intervention with protocol (t3-t4) is causing reduction aggression behaviors in adolescents.

Key words : Neurofeedback , Aggression, Adolescents , I ntervention , Education

The effect of neoprene dynamic orthosis on postural control in children with cerebral palsy(pilot study)

Mahmoud Bahramizadeh

Backgrouna and Aim : Children with cerebral palsy have often movement and postural disorders. The purpose of this study is to evaluate the effect of new neoprene dynamic orthosis on balance in children with cerebral palsy.

Materials and Methods : This study is quazi experimental. Five children with cerebral palsy (spastic diplegia) with mean age of 9/6± 3.78 years old participated in this study. The degree of knee extension was measured using electrogoniometer. Center of Pressure(COP) displacement in anterior/posterior and medial/lateral planes and functional balance were also measured using kistler forceplate (BA, Kistler- Switzerland 9286) and berg test in two occasions, before and after wearing neoprene orthosis in a period of six weeks. Wilcoxon test was used for comparing data before and after 6 weeks.

Results : There was statistically significant difference in right knee extension before and after wearing orthosis (p<0/05). The result of this study show no statistically significant in COP parameters. However, functional balance of children with CP shows significant improvement using neoprene orthosis.

Conclusion : New neoprene orthosis can be effective in knee biomechanical alignment as well as functional balance

Keywords : Cerebral palsy, Lycra dynamic orthosis, Postural control

Reliability of the center of pressure parameters in patients with myofascial neck pain

Khadijeh Otadi

Background and Aim: The calculated parameters of the center of pressure (COP) are suitable indicators for evaluating balance in patients after rehabilitation. Therefore, determining the reliability level of each parameter is a matter of great importance. This study tried to determine the reliability of some parameters of the COP sway in patients with myofascial neck pain in different postural situations.

Materials and Methods: The present study is a test-retest reliability design. Twenty patients with myofascial neck pain performed a single and a double leg test with open and closed eyes on a force plate and with open eyes on foam in three sessions with a 30 minute intervals for 30 seconds. Antero-posterior and medio-lateral sway range, mean velocity and mean area of sway were calculated.

Results: The mean velocity showed high reliability (0.98) in all situations, but the other parameters were variable in different situations.

Conclusions: The results showed that some COP parameters are highly reliable in assessment of patients with myofascial neck pain.

Keywords: Reliability, Myofascial neck pain, Center of pressure, Force plate