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Background and Aim: Knee osteoarthritis is one of the most common musculoskeletal problems that can affect activity daily living of patients. Many studies have indicated postural control deficits in these patients but the effect of dual tasking on postural control has not been examined yet. The aim of this study is to investigat the effect of cognitive task on postural control in the female patients with knee osteoarthritis.
Materials and Methods: Postural stability in knee OA patients and healthy subjects (20 subjects in each group ) in four positions was measured using the Force plate. Positions included double leg stance with closed or opened eyes with and without cognitive task. Area of COP and mean velocity (Vm) were measured for as static postural stability.
Results: Area under the curve increased in the double leg stance position in the patients significantly (P<0.05). While mean velocity decreased by performing a dual task (P<0.05). The response to dual-tasking was not significant between the 2 groups(P>0.05).
Conclusion: Postural control deficits and increased of center of pressure’s sway were identified in participants with Knee osteoarthritis. Also performance of a cognitive task resulted in decrease of postural sway, but the dual- tasking did not change the postural performance of knee OA patients compared to healthy subjects.

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Background and Aim: Some studies indicated that training in elderly persons is very important for decrease of aging changes. Many investigations have reported the increase in muscular strength as a consequence of training performed on the contralateral limb. There are few clinical trials that quantify the effect of cross training in elderly adults .The aim of the study was to evaluate of unilateral biceps brachialis strength training on countralateral peak force in elderly persons
Materials and Methods: A total of 12 elderly females (age = 73.08) with no history of strength training and upper limb movement impairments enrolled in this study. Subjects performed unilateral elbow flexion exercises in dominant upper limb, using progressive resistance training three times a week for six weeks. After determining the maximal isometric force of elbow flexion , the subjects performed 3 sets of 10 repetitions of the 60-70% maximal force. The isometric force of elbow flexion were measured at the start and after 2 weeks by tensiometer. Paired t test was used to analysis the data
Results: The results showed that progressive unilateral elbow flexion training led to an increase in maximal isometric force of biceps brachialis muscles at two sides (P<0.05).
Conclusion: The increased muscle strength observed during training indicates positive effect of training in old adult. The increased muscle strength in untrained limb suggests the capacity of neuromuscular adaptation in old adult that it can be used in cases of limb immobility.

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Background and Aim: One of the risk factors in sports injuries is inappropriate flexibility of muscles, which leads to pain, decrease range of motion and functional limitation in sport or daily activities and affects the athletes’ quality of life. The aim of this study was to investigate the relationship between flexibility of calf muscles and functional status of athletes with ankle injuries.
Materials and Methods: Thirty male athletes with ankle injuries (mean age ± SD, 22.63 ± 3.94 range: 18-40 years) participated in this study. Ankle dorsiflexion of affected and non-affected sides were measured with a goniometer. FAOS (Foot and Ankle Outcome Score) questionnaire was used to evaluate the functional status of ankle.
Results: The relationship between flexibility of calf muscles in the affected extremity, and total score of the functional questionnaire, was not statistically significant (P>0.05). While the relationship between the flexibility of muscles and functional questionnaire's total score in the non injured extremity was significant (P = 0.004, r = 0.51).
Conclusion: This study revealed that although the athletes who have more flexibility of calf muscles, show better functional status of ankle but there is not necessarily a relationship between inflexibility of the muscles and lowered functional status.

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 Background and Aim: Family is the center and core of the care. Researchers who work with children with disabilities have shown that effective services are those that are focused on the role of families in treatment. The main aim of this study was an overview of family-centered approach (FCA).

  

 Material and Method: This study is a review of the national and international databases between 1985 and 201 2 .

  

 Result: Based on the exploration articles and documents, family-centered approach (FCA)

 has been advocated across a wide range of professions from health care (physician, nursing and midwifery), therapy services, early intervention, early childhood education, special and general education. The main essence of FCA includes parental involvement in decision making, collaboration and partnership, mutual respect (family and therapist), acceptance of the family’s choices, support, a focus on strengths, individualized and flexible service delivery, information sharing, and empowerment.

  

 Conclusion: family-centered approach (FCA) is effective, for children, parents, families, and the service provider. It enhances health care and increases family satisfaction of service delivery system. Perhaps because of the lack of sufficient knowledge and education about FCA, lack of educational materials and training in the medical model, there is limitation in implementation of FCA in Iran

  

  Keywords: Family centered approach, Rehabilitation, Occupational Therapy

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Background and Aim: The target tracking tests is a known method to quantify the performance of the neuromuscular system. It has been used in several studies for evaluation of neuromuscular control strategies. The purpose of the present study was to examine the effect of direction and speed of isometric trunk exertion on the trunk controllability during the target tracking tests in sagittal versus axial rotation torque plane.

  

Materials and Methods: Twenty- two healthy subjects (13 female and 9 male) randomly performed target tracking tasks at levels of 0% to 80% Maximum Voluntary Exertions (MVE) and seven different directions (0 ̊ , 30 ̊ , 60 ̊ , …, 180 ̊ ) in upright standing posture. In this study, the tracking system included a moving target circle, which moved on a straight line in specific direction from 0 to 80% of individual MVE with speed of 5, 6 and 7% MVE/s . The d irection of isometric trunk exertion was presented to participants in the real time visual feedback by a computer monitor positioned in front of them. Trunk controllability was determined by computing the control errors (Absolute Value Error from the Target [AVET], Error from the Target Path [ETP] and Error from the Target in the Target Path [ETTP]) during each performance. Analysis of variance was used to test the effect of speed and direction of isometric trunk exertion on trunk controllability.

  

Results: The results have shown that the direction of isometric trunk exertion had significant effect on the AVET and ETTP (p= 0.000) while the effect of speed and interaction between direction and speed were not significant. The error decomposition in to two independent parts showed that the only direction of exertion on ETTP was significant (p= 0.000) and speed of exertion on any of them ( ETP and ETTP ) was not significant. On the other hand, Borg scale (a simple method of rating perceived exertion) significantly affected by direction (p= 0.000) and speed (p= 0.000) of exertion during the target tracking tests.

  

Conclusion: According to the findings of the current study, the effect of d irection of isometric trunk exertion on the controllability was significant. Trunk controllability was significantly decreased during rotational exertions which may impair trunk neuromuscular coordination, increasing the risk of developing low back pain.

  

Keywords: Target t racking t ests , T runk controllability , Speed and d irectio n of isometric trunk exertion

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Background and Aim: Proprioception is one of the most precise and delicate senses of the human body. It plays an important role in coordination and postural control by protecting the body against trauma and accidents. Although many studies have assessed the effect of fatigue on proprioception in the limbs and the low back region, but a few studies have investigated its possible effect on the cervical region.

  

Material and Methods: Seventeen (8 women, 9 men) young and healthy volunteers were asked to perform the Cervicocephalic Relocation Test (CRT) to the neutral head position by relocating the head on trunk after actively rotating the head to right and left sides, in two conditions before and after muscular fatigue. Absolute, constant and variable errors were used to evaluate cervical joint repositioning accuracy.

  

Results: Fatigue had no effect on cervical joint position sense, Furthermore no considerable difference was seen between male and female subjects (p>0.05).

  

Conclusion: The results suggest that following isometric fatigue of upper trapezuis muscles, no change is produced in the repositioning accuracy of both sexes. Furthermore, sex had no effect on cervical joint proprioception.

  

Key Words: Cervical joint position sense, Fatigue, Proprioception, Cervicocephalic Relocation Test (CRT).

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Background and Aim: Muscle fascicle length and pennation angle can be non-invasively studied by applying methods like ultrasonography. The aim of this study was to introduce fascicle length and fascicle angle for the estimation of the strength of skeletal muscle by using ultrasonography.

  

Materials and Methods: The data of this study have been driven from pubmed and authoritative references available on the internet and in libraries. In all fifteen full text articles and 30 abstracts have been collected and reviewed. Keywords such as: muscle, fascicle, pennation angle, force and ultrasonography were searched to fulfill the purpose of this study.

  

Results : Detailed information about the angles of pennation and fascicles length are important to predict muscle force. It has been suggested that changes in muscle pennation angles are positively correlated to the length of fascicle in a muscle contraction. While muscle thickness may in some case be remained constant in this relation.

  

Conclusion: Real-time ultrasonography is a noninvasive procedure to monitor the architecture of the living muscle at rest and during static and dynamic sets. It is a valuable measurement tool to estimate muscle force by measuring the muscle architecture parameters such as angle of pennation and fascicle length.

 

Keywords : Muscle, Fascicle, Pennation angle, Force, Ultrasonography

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Background and Aim: The curves of the spine, especially lumbar lordosis, play an important role in the maintenance of an efficient upright posture and allow efficient absorption of the loads applied to the spinal column and increase the efficiency of the spinal musculature. Excessive lumbar postures, also called “hyperlordosis” and “hypolordosis” , are thought by some researchers to be indicative of altered muscle activity and stress patterns. Therefore tolerance of particular activities of daily living (ADL) of an individual with these postures is reduced. Despite the importance of neuromuscular control at spinal column maintenance and coordination, there are little investigations about the effect of thoracic and lumbar curvatures on trunk muscles activity. Therefore, the aim of this study was to investigate electromyographic behavior of trunk muscles in lordotic posture.

  

Materials and Methods: Twelve subjects with lordotic posture ( mean age 23.67 years, mean weight 56.67 kg, and mean height 162 cm) and eleven subjects with normal posture ( mean age 22 years, mean weight 59.36 kg, and mean height 164.91 cm) participated in this study. Subjects were asked to hold a load equivalent of 7% of her body weight.

  

Results: Data analysis indicated that there is not significant statistically difference in median frequency variable between two groups (p>0.05). But there is significant statistically differences at The percentage change in RMS of erector spinae and internal oblique muscles at three time periods between two groups. The percentage change in RMS of external oblique muscle has significant statistically difference at first and third time periods between two groups.

  

Conclusion: These finding reveal that excessive lumbar lordosis alter the activity levels of trunk muscles. Therefore, it seems that the use of posture correction exercises in therapeutic protocols is necessary for improvement of these changes. Also, it is recommended to do this research in dynamic tasks for attain of comprehensive information about the effect of postural deviation on electromyographic behavior of trunk muscles.

  

Keywords: Electromyography, Hyperlordosis, Posture, Prolonged load holding

  

  ^* Corresponding Author: Dr.AzadehShadmehr, Rehabilitation Faculty, Tehran University of Medical Sciences

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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

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Background and Aim: Reliability or unreliability of the results achieved from recording of surface electromyography of muscles has always been questioned. The aim of present study was to  measure the reliability of the delayed reaction time of muscle electromyography of the knee joints on the exposure of unexpected rotary turbulence in the transverse plane from the area of supporting surface.

Materials and Methods: Twenty healthy women from 19 to 30 years old and free from any clear deformities in the lower extremities were participated in the present study. Surface electromyography of the six knee musculature was carried out for every subject separately in 4 situations including: External Rotation (Ext Rot) from plantar area on the transverse plane with bent and straight knee, Internal Rotation (Int. Rot) with the same conditions, Single Leg Stance situation in 4 stages, and repeatability of Intra Session through intra-class correlation coefficients when the muscles are in action on the exposure of turbulence in four applied forms were analyzed.

Result: The results from 24 analyzed forms showed that 18 forms of muscles at the time of action had moderate to high repeatability (Monroe Classification)

Conclusion: Regarding reliability, the muscles indicated different amounts in onset latency time, on the exposure of rotary turbulence, according to joint angle and the direction of applying rotation on the transverse plane. In respect to direction of rotation, most of the muscles indicated more reliability on the exposure of external rotation turbulence (clockwise) in relation to internal rotation (anti-clockwise) and also regarding the joint angle in turbulences with straight knee in relation to turbulences with bent knee. 

Keyword: Knee muscles, Surface electromyography, Reliability, Rotational turbulence

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Background and Aim: The main cause of Myofascial pain syndrome is trigger point. The purpose of this study was to compare muscle energy technique (MET) with dry needling (DN) on latent trigger point of upper trapezius.

Materials and Methods: Fourty females, with diagnosis of latent trigger point of upper trapezius after adopting the inclusion and exclusion criteria were equally and randomly allocated into either the muscle energy technique or dry needling groups. Each patient received one treatment to the upper trapezius muscle. Outcome measures (visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) measured before and 48 hours after treatment.

Results: Two techniques which used in this study were effective for treating latent trigger point of upper trapezius (P<0/001) but no significant differences were found between the two groups in terms of the above variables (p>0/05).

Conclusion: This study demonstrated that muscle energy technique was as effective as dry needling in improvement of VAS, PPT and ROM in subjects with latent trigger point of upper trapezius muscle. But since muscle energy technique is safe and non-invasive method, therefore, if you want to select one of these two techniques, muscle energy technique is recommended.

Keywords: Dry needling, Muscle energy technique, Trigger points

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Background and Aim: Proprioception is a component of somatosensory system. One of the most important somatosensory receptors is muscle spindles. Neck area with high density of muscle spindle, plays a significant role in providing this sense. With repeated contact sports, with high trauma on head and neck region, it is likely that proprioception will be impaired. The present study was conducted to compare proprioception between wrestlers, taekwondo players and non-athlete subjects to determine the effect of trauma on proprioception of craniocervical region.

 

Material and Methods: This study was a case-control study of 75 male with the age range of 18-30 years (Including: 25 professional wrestlers, 25 professional taekwondo players and 25 non-athlete subjects). Participants were selected through simple non-probability sampling. To assess proprioception of craniocervical region, angular repositioning of two positions (neutral and 50% of range of motion) was evaluated by using the cervical range of motion device (CROM device). The statistical method which used in this study was one way ANOVA.

 

Results: Accuracy of target repositioning (50% of range of motion) of extension, right and left rotation were significantly different between three groups (p<0.05). Returning to neutral position from mentioned movement was associated with a significant error (p<0.05).

 

Conclusion: It is assumed that proprioception of craniocervical region has been affected by trauma in wrestlers and taekwondo players, so that the accuracy of head repositioning for both neutral and target positions were reduced in wrestlers. However, taekwondo players had more errors in repositioning of target angle.

 

Keywords: Proprioception, Repositioning error, Craniocervical, Wrestlers, Taekwondo players

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Background and Aim: Shoulder injury is one of the most common injuries in overhead sports. Impingement syndrome is most frequent cause of these injures. Scapular has important biomechanical role in normal shoulder function .Muscle imbalance changes normal scapular arthrokinematic and as a result the risk of injury is high. One of the treatment methods which is used in athletes with impingement syndrome is kinesio taping. Goals of this study was to investigate the effects of kinesio taping of trapezius muscles on pain , functional movements of shouhder joint and lateral scapular slide in athletes with impingement syndrome.

Materials and Methods: Fifteen athletes with a mean age of 30.53±3.56 with impingement syndrome participated in this study. Pain with visual analog scale , functional movements and lateral scapular slide test in 3 positions was  assessed . Then kinesio taping was used for trapezius muscles .Repeated evaluation was performed in 3 different periods of : 20 minutes , 72 hours , 6 days  after first session.

Results: Mean of  pain was reduced in 72 hours and 6 days after kinesio taping (p=0.003) .  Ext.rot + abd movement after kinesio taping was improved and the most improvement was 6 days after kinesio taping (p=0.004). Int.rot+add movement after kinesio taping was improved and the most improvement was 6 days after kinesio taping (p=0.001). Lateral scapular slide test in first position and second position improved significantly. In third position test did not change significantly after kinesiotaping.

Conclusion: Kinesio taping of trapezius muscles in athletes with impingement syndrome has effects on pain reduction, improvement of functional movement of shoulder and improvement of scapular kinematic. Therefore kinesio taping can be used as a treatment in athletes with impingement syndrome.

Keywords: Kinesio taping, Trapezius muscles, Impingement syndrome.

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Background and Aim: Different aspects of the motor control parameters of dominant and non-dominant legs are investigated but the effect of dominancy on motor control strategy is still unclear. The aim of the present study is to compare the pre- motor time, motor time and reaction time in dominant and non- dominant leg muscles of the non- professional healthy athletes in response to visual stimulus during forward jumping.

Methods and Materials: Eleven non- professional healthy athletes participated in this cross-sectional study determined by convenience non probability sampling. Surface electromyography were performed in the dominant and non-dominant leg muscles including  gastrosoleous , peroneus longus, peroneus brevis, and tibialis anterior in response to visual stimulus during forward jumping.

Results: There was no significant difference (P > 0.05) between the dominant and no-dominant legs with respect to the pre-motor time, motor time and reaction time of the gastrosoleus, peroneus longus, peroneus brevis and tibialis anterior.

Conclusion: Our findings suggest that limb dominancy is not an important parameter in the motor control studies.

Keywords: Motor control strategy, Visual stimulus, Forward jumping

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Background and Aim: Several studies have investigated the effects of angular velocity on mechanical and physiological variables such as joint net torque, muscle force and myoelectrical activity, but so far its effects on the control of the pattern of synergist muscle activation during isokinetic movements have not been studied. In this experiment, a computational method of identifying and analyzing muscle synergies were used which is based on the framework of the uncontrolled manifold hypothesis to determine the variability of muscle synergies following movement velocity alteration.

 

Materials and Methods: Twelve healthy females without any known neurological or motor disorders participated in the experiment. The participants were positioned on a Biodex dynamometer. They were asked to perform ten continuous knee extension and flexion motions with maximal strength at 45˚/s or 300˚/s. Electromyographic activity of the vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) were recorded and variance within the UCM (VUCM) and orthogonal to the UCM (VORT) with respect to an appropriate Jacobian matrix was computed. An independent t-test was used to compare VUCM between two velocities.

 

Results: Across subjects, VUCM was significantly higher than VORT (VUCM>VORT) in both tasks. There was no significant difference in VUCM between two velocities (p>0.05).

 

Conclusion: Our findings suggest that angular velocity is not an important parameter when a controller of a multi-element system wants to stabilize a particular value of a performance variable.

 

Keywords: Variability, Angular velocity, Muscle synergie, Externsor muscle.