Modern Rehabilitation

Reliability of center of pressure measures during dynamic balance performance

Ali Amiry

Background and Aim: Few studies have assessed the reliability of postural balance measures during dynamic balance performance that introduce additional challenging to postural control system. In addition sometimes in the static conditions some deficiencies of the postural control system may not be revealed obviously therefore the aim of this study was to assess the reliability of postural control parameters during functional performance on force plate in healthy subjects.
Materials and Methods: Ten healthy male subjects (mean age: 25.4 years, weight: 68.2 kg height:176.9cm) participated in this study. None of the subjects were involved in sport activities. Every subject performed three 15seconds trials of eyes open single leg stance on a force plate during dynamic balance task. Participants grasped object with hand at their waist level and release it at above shoulder level. The reproducibility of the center of pressure (COP) deviations (average speed &length of path) was assessed. All participants were tested on 2 sessions with an inter-measurement interval of 7 days. COP data was collected for each trial. The intraclass correlation coefficient (ICC) was used as parameter of intra-session and inter-session (Test-Retest) reliability.
Results: The ICCs for intra-session reliability of average speed and length of COP path were 0.89 and 0.91 respectively. The ICCs for inter-session reliability were 0.95 and 0.96 respectively.
Conclusion: The study showed high and very high reliability for center of pressure measures during dynamic balance task. Therefore this dynamic performance can be used as a balance pattern in postural control assessment. These can be used as reliable parameters in dynamic postural control assessment due to high reliability of average speed and length of COP path

Electromyographic analysis of shoulder impingement syndrome versus normal subjects

R Khanmohammadi

Background and aim: Altered muscle activity in the scapulothoracic and glenohumeral muscles is commonly believed to be a factor contributing to shoulder impingement syndrome (SIS), then, the aim of the study was to determine and compare the activity pattern of the shoulder muscles in subjects with and without SIS.
Materials & Methods: In this case-control study, 9 female subjects with shoulder impingement syndrome and 13 matched healthy female subjects were participated voluntarily by simple random sampling. Surface electromyography of serratus anterior, pectoralis major, upper trapezium, lower trapezium, posterior deltoid, anterior deltoid muscles of dominant side were recorded during D1ext and D1flex movement. Muscle activities were processed and compared in subjects with and without SIS. Non parametric test (Mann-Whitney Test)) was used for data analysis
Results: In both movement patterns, all muscles of the patient showed a greater normalized RMS than healthy group but this increase was statistically significant in anterior deltoid (p=0/003, p=0/04), pectoralis major (p=0/01, p=0/02), serratus anterior (p=0/01) and posterior deltoid (p=0/01) during D1ext and in lower trapezium (p=0/005,p=0/006) and pectoralis major (p=0/01) during D1flex.
Conclusion: The results of this study indicate that patients with impingement symptoms show abnormal muscle activity. The findings support the theory that shoulders impingement may be related to altered muscle activity in the scapulothoracic and glenohumeral muscles.

The relationship between isokinetic squat and vertical jump in anterior cruciate ligament reconstructed patients.

Ali Ashraf Jamshidi

Background and aim: For the rehabilitation program of the anterior cruciate ligament reconstructed patients (ACLR) strength and functional assessment and comparing with the uninvolved side is in great importance. Strength plays an important role in performing vertical jump moreover. It is performed in closed kinetic chain. Despite this importance, no information exists regarding the relationship on peak force of linear isokinetic and vertical jump score. The purposes of this study were1- To determine correlation between isokinetic squat and vertical jump in healthy and ACLR patients. 2- Comparing the peak force and vertical jump between the involved and uninvolved side of the ACLR patients.
Materials and Methods: Twenty two ACLR patients with 6 months post-surgery and 16 healthy men participated in this study. Their isokinetic squat strength at the testing velocity of 25.4 cm/sec and vertical jump was measured.
Results: ACLR patients' peak force and vertical jump were significantly different between the involved and uninvolved side P≤0.05. The findings showed low relationship )r=0.425) at the involved side between the vertical jump and peak force of squat, however, there was no relationship in the uninvolved side and the control group.
Conclusion: Findings of this study indicate no relationship between vertical jump and peak force of squat. Both testing methods should be used since strength not always correlate strongly with physical performance. Closed kinetic chain isokinetic testing should be used for testing lower extremity strength, while vertical jump should be used to determine performance levels.

The effect of verbal instructions on allocation of attention on postural control in young adults

Afsoun Hassani Mehraban

Background and aim: The importance of cognitive resources was shown in dual task studies of postural control. However, there was no definite evidence on how verbal instructions influence the allocation of attention to postural control. Therefore, the objective of this study is to explore the effect of verbal instructions on postural performance.
Materials and Methods: this Cross-sectional study was performed in 20 young adults (23.95 ± 3.31). Parallel standing/ hard surface, parallel standing/ foam surface, tandem standing/ hard surface were used as postural tasks and the choice reaction time task were conducted as cognitive task. Dual- task performance was measured under three different instructions including to pay attention to cognitive task, to postural task, and equal attention to both tasks.
Results: Comparing the performance of postural tasks under three different instructions were conducted by One-way ANOVA and showed in parallel standing on hard surface (p=0.831), parallel standing on foam (p=0.433), tandem standing on hard surface (p=0.912) for path length of COP and instructions in parallel standing on hard surface (p=0.308), parallel standing on foam (p=0.414), tandem standing on hard surface (p=0.867) for mean velocity were not significant. Postural performance in single and dual task conditions was significant only in parallel standing/ foam surface (p=0.046).
Conclusion: various instructions could not influence the amount of attention allocated to automatic postural tasks.

Translation of the test of childhood stuttering into Persian and investigation of validity and reliability of the test

Mohammad Shahbodaghi

Background and aim: The communicative functioning of children who stutter can be assessed in a variety of ways. Standardized tests are an important tool to assess communication skills particularly in stuttering children .The purpose of the present study was to translate the Test of childhood Stuttering (TOCS) into persian and investigation of validity and reliability of the test .
Materials and methods: In this research, 40 stutterers and 40 non-stutterer were evaluated. After the translation of the Test according to Protocol IQOLA and its equalization to Persian Language, Content validity and Face validity of it were determined by the opinions of experts. Then, for concurrent validity determination 80 stutterer and non-stutterer children were examined by TOCS and SSI3 .In order to test reliability, test -retest and Cronbach,s alpha were used.
Results: Entirely relevant items had simple translation. The translation items had content and face validity correlation between the marks of TOCS and SSI3 (p=0.000, r= %92). TOCS has high Test-retest ( p=0.000, ICC= %97) and internal reliability (p=0.000,α=%90).
Conclusion: Persian equalized TOCS (Test of childhood stuttering) have high validity and reliability. it might be useful to differentiate stuttering children among normal ones.

Gross Motor Development of low birth weight infants with the history of being in Aliasghar hospital Corrected aged 8 to 12 months

Sepide Nazi

Background and aim: The aim of this study was to compare the gross motor development between Low Birth Weight (LBW) infants and Normal Birth Weight infants (NBW) at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 (PDMS-2).
Material and Methods: This was a non experimental and cross sectional study which was conducted on 18 LBW infants with the history of being in Aliasghar hospital and 14 infants with the history of normal birth weight as a control group. Gathering the information was done by completing Questioner and then by using the Peabody Developmental Motor Scale-2 (PDMS-2). Finally the scores of the motor quotients were analyzed by independent T test statistical method.
Results: There was a significant difference (p= 0.002) between the mean gross motor quotient of LBW (90.83) and NBW ( 106.78).
Conclusion: This study showed that LBW infants attain low scores of gross motor skills in comparison with normal weight infants. It indicated that the LBW infants are more prone to motor development difficulties.

Effect of movement direction variation in relation to gravity on generalized motor program recruitment in fast single joint elbow movements by use of surface electromyography

Mahdi Rafeei Borojeni

Background and aim: The precise control of arm kinematics and kinetics as well as interaction of the arm with the external word, is an essential condition to perform skillful motor actions. Gravity has significant effect on spatial orientation, proprioception, displacement, start and stop of hand movements. The purpose of this research was to study the effect of movement direction variation in relation to gravity on generalized motor program recruitment in fast single joint elbow movement by use of surface electromyography.
Materials and methods: Fifteen volunteer students (mean age 24.8± 3.8 years) without sensory motor impairments participate in this study. Ninety percent of full range of motion at the elbow joint was used as goal degree. Subjects asked to do aimed elbow flexion as fast as possible in seven different direction in relation to gravity. While they were performing movements, surface electromyography was recorded from biceps and lateral head of triceps muscles. Relative timing, relative activity and sequence of contraction were derived from RMS. Data were analyzed by using repeated measure variance analysis.
Results: Muscle activation patterns were different in three positions from rest. There were significant difference between relative activity (p<0.001) and relative timing (p<0.003) in some positions. In fourth position, sequence of muscle contraction was different in seven subjects.
Conclusion: It seems that change in movement direction in relation to gravity is one of effective parameters in movement planning and execution and it can recruit different generalized motor program.

Effects of sensory retraining on recovery of the hemiplegic upper limb in stroke patients (A Single-System Design)

Akram Azad

Background and aim: Sensory deficits after stroke are common with prevalence rates variously reported to be 11% to 85%. In spite of the fact that Sensory deficits can decrease the quality of upper limb's movements and result in impairments in fine motor manipulation of objects, grasp and manipulative skills and finally decrease the patient's quality of life but commonly overlooked in stroke rehabilitation. The aim of this study was to investigate the effects of sensory retraining on upper limb recovery.
Materials and methods: In this study we studied 5 chronic stroke patients were participated using a single-system (A-B) design. During the baseline phase patient's function and motor impairment of upper limb were measured by Fugl-Meyer and Motoricity Index and their hand dexterity were measured by Box and Block test on three days intervals. When Patients reached to a stable pattern of changes, their treatment program began. In this phase they received sensory retraining intervention for 6 weeks. Based on sensory retraining principles and according to each patient's abilities, intervention began with detection and localization of constant and moving touch and followed by higher discriminatory tasks, suchas graphestesia. Then results of evaluations of two phases were analyzed.Results: Four patients showed significant improvements in upper limb function. The data showed significant improvements in motor impairments and hand dexterity in all of them.
Conclusion: Regarding of significant recovery of upper limb function, motor impairment and hand dexterity of patients, sensory retraining can be considered as a practical method in rehabilitation of stroke patients. However further research with larger sample size is needed.

Determination of facilitators and barriers in post stroke life, in Kerman city

Mahdieh Jafari

Background and Aim: Stroke is the third leading cause of death, second cause of long-term disability and one of the very important challenging in life. The aim of this research was to explain the barriers and facilitating factors affected on stroke patients' life, and to identify relationship among them with demographic factors and severity of disease.
Materials and methods: The descriptive-analytic technique was used. All patients who suffered from stroke were recruited in Kerman city. Finally 83 patients were selected, and data were gathered by demographic qualification questionnaire, proven questionnaire by researcher for studying barriers and facilitating factors (after testing validity and reliability), and NIHSS tools . Then, data were analyzed by using descriptive and referential statistics ANOVA test, T-Test, and Pearson coefficient correlation by SPSS software (ver. 16).
Results: The findings showed that patients had more problems in the domains of politics, environmental factors, physical, and economic status. Also, they introduced social support from friends, family and prayer as facilitating factors in their lives. There was a significant positive relationship between age and physical and economical problems. Women have used social support and religious coping more than men. Married patients received more social support and their physical and economic problems raised less.
Conclusion: Patients with higher severity of disease had more psychological problems such as depression and worry about future and Patients with lower socio-economic status more faced with barriers.