---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

Background and Aim: Several stretching methods have been shown to increase flexibility of the short muscles. Previous research suggests muscle energy techniques produce increments in range of motion, but there are many variations of muscle energy techniques. The purpose of our study was to determine the efficacy of muscle energy techniques with 50% of maximal voluntary isometric contraction and 10 second hold in compared to control group.

Materials and methods: A sample of 30 female subjects (aged 20 -25 years) participated in this study. All subjects had limited hamstrings flexibility in degrees of passive knee extension. The subjects in experimental group (n=15) received 3 muscle energy techniques (50% MVIC, hold time=10 sec) for 4 weeks, whereas the control group (n=15) remained without treatment. Before and after range of knee extension was measured for all subjects.

Results: The paired t test revealed a significant differences in flexibility for experimental group (P<0.001). There was no significant difference in flexibility gains in control group (P<0.001). Treatment group had significant greater flexibility than the control group (P<0.001).

Conclusion: Muscle energy techniques with above protocol produce an increase of hamstring flexibility.

---

Background and Aim: Hamstring muscles are biarticular muscles, which conducted to pelvic and knee. Shortness of hamstring muscles can influence on the upper and lower joints of its attachment .With respect of the high prevalence of shortness of  these muscles, accurate assessment of these muscles is important. There are many tests for assessment of hamstring muscles length During using the straight leg raise (SLR) test, pelvic rotation can contribute to the angle of SLR, while pelvic movement in passive knee extension (PKE) is limited. This study was designed to measure the relationship between two alternative tests in order to use of simple and accurate PKE test for measuring of hamstring length.

Material & Method: 3308 healthy girls (3-17 years) were tested, and hamstring length were determined with using of two tests (SLR and PKE) for both side of lower limbs and measured of active SLR and popliteal angle (PA) with goniometer.

Results: Pearson che-squre analysis showed significant relationship(r = 0.529(R), r = -0.435(L), p< 0/05) between PKE and SLR .

Conclusion: Results demonstrated relationship between two tests, in all of ages and both side. SLR and PKE tests can use for assessing of hamstring muscles shortness, but PKE test may be a useful alternative in comparison with activeSLR for providing an indication of hamstring muscle length.

---

Background and Aim: Normal & skillful function of hand is an essential part of activity of daily living. Analysis of the function of hand shows the major contribution of fine movements.  Fine movement is also important in motor development. In this regard, any deficiency in fine movement may cause various problems for children. Hence, assessment of fine movement in children, particularly in mental retardation disorders is a prerequisite of any rehabilitation protocol. 

Material & Methods: 27 mental retarded children were participated in this cross sectional study.  Children were in the range of 7-10 Yrs (Mean & SD, 8/11 &1/09 yrs, respectively). Parents were asked to sign the informed consent. Purdue Peg board test was used for the assessment of hand skill. After fifteen sessions of intervention including eye hand coordination activities, Purdue Peg board test were repeated.

Results: Speed of movements (rates in 30 seconds) in dominant & recessive hand, coordination of both hands and hand skills were significantly differed (pre & post intervention, P≤ 0/05).

It was also revealed that hand skills are directly related with speed movement of dominant hand. ( P≤  0/05).  Furthermore, there was no difference in the eye hand coordination activities of male and female individuals. ( P≤  0/05). 

Conclusion: The results of this study showed that eye-hand coordination activities have positively affected the skill of hand movement in educable Mental retardation students in both sex.

Simple skills such as speed of hand improved in shorter time in comparison with complicated skills (e.g. coordination of tow hand).

Based on these evidences, a comprehensive rehabilitation program including eye hand coordination activities would be suggested for educable Mental retardation individual.

---

Background and Aim: Sports such as baseball, volleyball, and racquet sports demand skills that place substantial load upon the athlete's shoulder when his or her arm is in an overhead or abducted position. Athletes who participate in these sports are consequently at higher risk for overuse injuries of the shoulder. Infraspinatus syndrome is defined as a condition of frequently painless atrophy of the infraspinatus muscle caused by suprascapular nerve neuropathy. The syndrome typically causes symptoms that mimic those of rotator cuff tendinopathy, and the diagnosis is often overlooked until the condition fails to respond to a traditional rotator cuff treatment program.

In this study muscle timing and activities of shoulder rotator cuff compared between normal athletics and volleyball players with infraspinatus syndrome.

Materials and Methods: Thirty voluntary male professional volleyball players (20 healthy and 10 patient) in the range of 20 -30 years contributed in this study. Patients group in base of electroneurography had injury of suprascapular nerve at right side. Subjects lied prone on table and their shoulder were 90 degree of abduction and medial rotation with 90 degree of flexion in elbow with vertically position of forearm at the lateral side of table. Electromyographic activities of maximum voluntary contraction of infraspinatus, middle trapezius and teres minor . Muscles were recorded three times with monitoring of dynamometer for normalization of dynamic activities. Activities (RMS) of above muscles were recorded during three dynamic motions similar to spark skill and onsets of their activities determined by external synchronized apparatus.

Results: There was significant difference between normalized RMS of infraspinatus,. and middle trapezius of patients in dynamic motion (p<0.05). Whereas healthy subjects showed significant difference between infraspinatus. and two other muscles (p<0.05). Comparison of normalized RMS indicated different in all three muscles between two groups (p<0.05).  

The sequence of onset three muscle activities were different between two groups significantly (p<0.05). This sequence in patients was middle trapezius, teres minor and infraspinatus whereas in healthy subjects was middle trapezius, infraspinatus and teres minor. Duration of above muscle activities were different in two groups (P<0.05). In patients infraspinatus were active less than other two muscles.       

Conclusion: Professional volleyball players are candidate of suprascapular nerve and infraspinatus muscle weakness. Synergic and stabilizer muscles after this condition with more activities contribute and caused reduce of accuracy of motion and early muscle fatigue.

---

Background and Aim: Balance is an essential part of motor development. Assessment of balance in children with neurological disorders is necessary before any treatment. There are various versions of balance tests for adult assessment however, little has been done with regard to a reliable test for evaluating the balance in children with spastic cerebral palsy.      

The purpose of this study was to investigate inter and intra rater reliability of Berg balance scale in children with spastic hemieplegia.

Material & Methods: 20 Spastic hemieplegia children were participated in this study (cross sectional).  Children were in the range of 6-12 Yrs (Mean & SD, 7/10 &1/58 yrs, correspondingly). Parents were asked to sign the informed consent. Berg Balance Scale tested in one session by two therapist for inter rater and repeated tests by the same therapist for intra rater reliability after a week.

Results: Intraclass correlation coefficient (ICC) test was used for inter rater (between two therapists, ICC= 0.966, p<001 and intra rater reliability (repeated test by the same therapist, ICC= 0.988 , p<001 ).

Conclusion: The result of this study suggests that inter rater and intra rater reliability of Berg balance scale is acceptable. Therefore, it could be used in clinic for the assessment of children with spastic hemieplegia as a reliable scale.

---

Background and Aim: As the population of geriatrics increase, this group must be noticed from economical, vocational, therapeutic situations the majority of geriatrics has problems with their hands. These problems influence their activity of daily living, vocation and etc. The main goal of present study is to determine the relation between grip strength and dexterity in 25-45 and 65-85 years people.

Material and method: The grip strength and dexterity were administered to one hundred people aged between 25-45 and 65-85 years with a mean age of 53.61 years old (SD= 20.60). The grip strength and dexterity were evaluated 3 times, and data were analyzed with SPSS (V: 11.5).

Results: Mean of grip strength in group (25-45) year was more than group (65-85) year. In both groups the results of grip strength in men were more than women. We noticed that with increasing age the dexterity decrease and dexterity differences between group 25-45 and 65-85 years were statistically significant. Between men and women dexterity differences was not significant. The correlation between grip strength and dexterity was not statistically significant.

Conclusion: This study showed that dexterity is related with age and functional activities. Grip strength is related with age, occupation, gender. As the age increase these features of the hand decrease. But there isn't a correlation between grip strength and dexterity.

---

Background and Aim: Academic evaluation is a systematic process for collecting, analyzing and interpretation of the obtained educational information. The purpose is that how many educational objectives can be achieved. The goal of education is creating effective & efficient changes in the outcome of this system (i.e. students), and finally, promotion of the quality of educational process. In the following study, internal evaluation in 8 educational domains of the Physical therapy Department of the Rehabilitation Faculty (TUMS) was performed.

Materials and Methods: Physical therapy Department of the Rehabilitation Faculty (TUMS) was evaluated using the opinion of the faculties, students and graduates in the academic year 2003-2005. The aim was to adjust the system according to the golden standard and community needs by using a cross sectional and descriptive method. This was done on the basis of 10 procedural steps, within 8 domains such as faculties, management, student's opinion, staff and logistic affairs, classes, library, clinics, equipments, laboratory, satisfaction of graduates and curriculum.

It is worthwhile to mention that there was no golden standard available in Iran for Physical Therapy Department. Therefore, by using the standards of prestigious universities of the world & opinion of Iranian experts, for the first time in Iran, a native golden standard was defined by the principal investigators. The results of the research were compared with the golden standard.

Results: The results of study showed that the mean of 8 domains based on SWOTs model was 76/2% which may be interpreted as a positive model. Among the 8 domains, the clinics, classes & library were rated the best (95%) and student's satisfaction was 65.3%.

Conclusion: The results of the current study showed that academic evaluation is the best indicator for representing the strength, weakness, opportunity & threats of the educational system. These results could be used for promotion, adjusting & remodeling of the academic system. 

---

Background and Aim: Developmental coordination disorder is characterized by motor in-proficiency, resulting in significant impairments in social and academic functioning. We examine whether life style differences between elementary male students in two socio-economic different areas of Tehran may be reflected in developmental coordination disorder prevalence rates.

Materials and Methods: Two matched groups of 70 children were compared by use of BOTMP short form.

Results: The results show that the standard scores for children in the first area were significantly higher than the sixteenth area (P= 0.026).

Conclusion: Above findings suggest that different life styles may influence the motor skills and developmental coordination disorder prevalence in elementary children.

---

Background and Aim: The goal of this study is to determine the effects of comprehensive cardiac rehabilitation program (CCRP) on various domains of health related quality of life (HRQOL) in coronary artery bypass grafts (CABG) patients.

Materials & Methods: Forty- four post CABG patients aged 40 - 60 years (mean age = 52.95, SD = 6.02) participated in Phase II CCRP. The SF-36 health survey was used to assess the HRQOL before and after the CCRP and at three-month follow up. The data of patients were compared before and after the intervention and with the normal values of age matched (45-64 Yrs., 882 persons).

Results: The findings showed that there was a significant difference in seven domains of HRQOL between patients prior to CCRP and general population (P ≤ 0.05). There was a significant difference in all HRQOL domains after CCRP (P ≤ 0.005). Five out of 8 domains of HRQOL were unchanged at least 3 months after the CCRP, whereas there was an improvement in 3 domains of HRQOL (P ≤ 0.05).

Conclusion: The results of this study suggest that the physical and mental health interventions in CCRP are among  critical  keys to prevent and/or at least decrease the adverse effects of surgery on HRQOL.

---

Background and Aim: Rapid automatized naming test is the best tool for screening, assessment and early prevention of reading disorders. Therefore with regard to the importance of this test in anticipation and assessment of reading disorders and absence of valid test in this area in Persian language, the target of study was designing and measuring the validity and reliability of this test.

Materials and Methods: Based on foreign test, items of test have selected with regard to the criterions of Persian language. Then the suggestions of experts in this field were collected. Study was performed in two weeks time-out on fifty students of the governmental and nongovernmental schools of the 12th education area of Tehran and 12 dyslexic children of learning disability centers. Then, to measure the differential power and reliability of the test, the results were analyzed.

Result: Findings indicate high correlation between first and second test. There is also significant difference between two groups (normal and dyslexic) in total time of the test in two stages.

Conclusion: Rapid automatized naming test is valid and reliable in Persian language and is able to distinguish between two groups (normal and dyslexic).

---

Background and aim: Cryotherapy has long been introduced as a common method for preventing and reducing edema caused by traumatic injuries. Many studies have been conducted regarding other effects of cold such as its effects on muscle strength which provided controversial results over the past decades. The aim of this study is to investigate whether cold is capable of changing the muscle strength.

Materials and methods: The research was conducted on 30 volunteers with the mean age of 22 years. In a standard situation, the volunteers were asked to make their maximum grip force. Cold was applied over their anterior forearm using an ice pack for 15 minutes. The maximum grip force was measured before and within 1 to 120 minutes after cold application.

Results:The strength of the anterior forearm muscles decreased rapidly after cold application. The maximum reduction of muscle strength, in average 18% was observed after 10 minutes. This was followed by a gradual increase of grip force. After 120 minutes the force was increased to about 5% above the baseline force that was before cold application.

Conclusion: Regarding the slight increase in the muscle strength and its long delay, cryotherapy of muscles cannot be considered as a practical method in rehabilitation of patients. However, this method would be of great importance for athletes.

---

Background and aim:One of the common learning disability is dysgraphia that interferes academic progressive and/or activity of daily living in children.The aim of this study was comparative assessment of hand sensory - motor skills in 9 -11 ages
Materials and Methods: 20 dysgraphia and 40 normal children were selected for comparison. Participants were evaluated by Smmes-Weinstein Monofilaments (SWMs), The Minnesota Manual Hand Dexterity Test (MMDT), Power Grip Test with Dynamometer (GS), Pinch Strength with Pinch Guage (thumb to middle-thumb to index test) and Minnesota Hand Writing Test (MHT).They were divided into A (dysgraphia) and B (normal)Groups. In this research, dominant hand was right. All Data were analyzed by T-Test and Chi – square Tests with SPSS version13.
Results:The study showed that sensory-motor skills hand writing in dysgraphia children were significantly lower than normal children. There was a significant relationship between tactile threshold and dysgraphia. (P<0.05).In children with dysgraphia, the tactile threshold was high. Hand dexterity was significantly poorer in A group than B group. (P<0.05). Grip strength and Pinch strength were significantly poorer in A group than B group. (P<0.05 for G.S and P<0.05 for P.S). There was a significant relationship between handwriting skill and dysgraphia. (P<0.05).
Conclusion: Findings of this study, could be created in the mind of experts and therapists that perhaps with determination of suitable sensory-motor evaluations of precise Prpcedure to prevent and treat children who have dysgraphia problem,