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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.

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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.

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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.

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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.

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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.

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Background and aim: The present study evaluates spatial working memory and strategy use, that are from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy ( spastic diplegia ).

Materials and methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: twenty children with cerebral palsy ( spastic diplegia ), with mean age of 8.94 years and 20 normal children with mean age of 8.86 years. Data were collected using Strengths and Difficulties Questionnaire ( SDQ ), CANTAB and Raven test of intelligence. Data were analyzed using t-test.

Results: Children with cerebral palsy differ from the normal children in spatial working memory. Comparing of the means of errors, were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ),except in double error ( p>0.05 ) however there was no significant difference in function of strategy use between 2 groups ( p>0.05 ).

Conclusion: In regard with these findings, cognitive rehabilitation with focus on executive skills can be useful in clinical treatment, parallel to the traditional methods, for spatial working memory in children with cerebral palsy.

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Background and aim: Cerebral palsy (CP) is a common disorder in human society with many somatosensory problems that affects on functional capability. Dexterity affects activity of daily activity. The aim of this study was to investigate the effects of Progressive resistive exercises on strength and dexterity of cerebral palsy persons.

Materials and methods: Twelve CP persons between 8 to 16 years old (10 boys and 2 girls) with mean age of 11.9 years old participated in this study.

Progressive resistive exercises (PRE) protocols were done on upper extremity of  study group 3 times a week for 6 weeks.  Strength of shoulder abductors and extensors were evaluated by MMT NICHOLAS apparatus. Grip strength and dexterity were evaluated by Jammar Dynammometer and Purdue peg board respectively.

Results: Shoulder abductors and extensors strength increased %29.4 (p=0.0001) and %30.1 (p=0.014). Grip strength and dexterity improved %9.8 (p=0.048) and dexterity %23 (p= 0.016) respectively.

Conclusion: PRE increase muscle strength of upper extremity and may improve dexterity in children with cerebral palsy.

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Background and aim: Spasticity cause abnormal patterns in upper limbs of cerebral palsy children .It restricts hand function in grasp and release movement. In occupational therapy, neurophysiologic approaches include motor techniques, training and treatment for decreasing hypertonicity and biomechanical approach includes use of splint. In present study the effects of volar and dorsal splint were determined in decreasing of spasticity in upper limbs of quadriplegia cerebral palsy children with four up to six years old

Materials and methods: Twenty quadriplegia spastic children (4-6 years old) were participated in this study. They were classified in two groups. One group wears volar splint and the other group wears dorsal splint for two hours per days and four hours at night up to twelve weeks. Spasticity and passive range of motion were measured by modified  Ashworth scale and goniometry respectively

Results: The mean of wrist spasticity was 2.5 in volar splint group before intervention and 1.9 after intervention. The mean of wrist passive range of motion was 93.50 before intervention and 123.50 after intervention. Elbow passive range of motion was 113 in pre intervention and 135.50 in post intervention. The mean of wrist spasticity was 2.6 in dorsal splint group before intervention and 2.00 after intervention. The mean of wrist passive range of motion was 89.5 before intervention and 118.50 after intervention. Elbow passive range of motion was 110.50 in pre intervention and 135.50 in post intervention. Statistical Analysis of t-student and paired t-tests showed significant differences between the pre and post intervention in all parameters (p<0.05)

Conclusion:  The result of present study showed that both of the splints affected to decrease spasticity of wrist and increase wrist and elbow passive range of motion of hand. Based on this evidence, both of the splints would be suggested for spastic`s hand treatment. Due to major problem in making dorsal splint, we suggest volar splint for  reducing  spasticity in cerebral palsy children.

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Background and aim: Stroke is one of the main reasons that would cause disability in adult population. The patient prefers to use his non-involved limb for self-care activities that called disuse learning of involved upper extremity.Constraint-induced therapy is one of the rehabilitative intervention that seems to improve motor ability and functional use of involved upper extremity in some of patients with hemiparesis after stroke. The aim of this study was to investigate the time effects of constraint-induced therapy on functions, coordination and movements of upper extremity of adult patients with hemiplegia.

Materials and methods: In present study, 15 patients with stroke participated in structured therapy sessions (CIT) emphasizing more affected upper extremity in different activities five times a week for 12 weeks and 2 hours a day and non-involved upper extremity were also restrained five times a week for 12 weeks and 5 hours a day

Results: The data was analyzed with paired t-test. The scores  of different  subtests of Fugl-Meyer test  such as shoulder and forearm, wrist and hand movements, coordination and speed of involved upper extremities showed significant differences between pre and post interventions in different time periods (p>0.05). Test scores increased up to 8 weeks but no significant increase was seen after 8^th week .Dexterity measurements by Minnesota Manual Dexterity test  showed significant differences between pre and post intervention in different time periods ( p  < 0.05) with maximum increase up to 10 weeks

Conclusion: The present data showed that constraint-induced therapy could be an effective approach to improve function and overcome disuse learning. The results of this study revealed that scores of Fugl-Meyer and Minnesota Manual Dexterity test  would reflect functional skills improvement.

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Background and Aim: Internal Evaluation is an appraisal of abilitieshttp://mrj.tums.ac.ir/files/0allsites/wysiwyg_en.gif and potentials. The Internal Evaluation process, especially in an Educational Department, is an effective mechanism of the Departments quality process. The Aim of this research was to determine level of factors in the Occupational therapy Department and determining points of the strength, weaknesses, opportunities and threats of the Occupational therapy department in order to improve the programs and activities after this research.

 Material and Methods: This research was descriptive and analytical study. In this evaluation, nine important factors were taken into account. These include:  1- missions statement and goals 2- managerial and organization structure 3- faculty members 4- students 5- educational course and curriculum 6- graduate students 7- educational and research facilities and equipment 8- research 9- quality of treatment. Data were collected by questioner. Results were analyzed descriptively and were expressed as raw data and percentage. Scores of 49.9% was undesirable, between 49.9% and 74.9%, and more than 75% were desirable and very desirable, respectively.

 Results: The nine above factors were scored as follows: 1- missions statement and goals (very desirable 4.06, 81.2%) 2- managerial and organization structure(very desirable 3.95, 79%) 3- faculty members (desirable 3.63, 72.6%) 4- students(desirable 3.1, 62%) 5- educational course and curriculum (desirable 3.56 , 71.2%) 6- graduate student (undesirable 2.25 , 45%) s 7- educational and research facilities and equipment (desirable 3.18, 63.6%) 8- research (desirable 3.11, 62.2%)  9- quality of treatment(very desirable 4.22, 84.4%) The score of the Occupational therapy department, as the main factor is 3.44 out of 5 that is 68.1%.

 Conclusion: An analysis of the findings of this research study led to the understanding that the Department of Occupational therapy was desirable.

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Back ground and aim: The present study evaluates attentional set shifting, that is from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy (spastic diplegia).
Materials and Methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: 20 children with cerebral palsy (spastic diplegia), with mean age of 8.94 years old and 20 normal children with mean age of 8.86 years old. Data were collected using Strengths and Difficulties Questionnaire (SDQ), CANTAB and Raven test of intelligence. Data were analyzed using independent t-test.
Results: Children with cerebral palsy did not differ from the normal children in attentional set shifting. Comparing of the means of errors, trials and complete stages, with 18 outputs over all, demonstrated no significant difference between 2 groups (p>0.05).
Conclusion: In regard with these findings, it seems that children with cerebral palsy are not weak in attentional set shifting in comparing with peers, while in some other metacognitive functions such as spatial planning, working memory capacity and spatial working memory, these children are more retarded than normal children.

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Background and aim: Most of the rehabilitation treatments for hemiplegic patients focus on compensatory strategies to promote independence in ADL by any means for restoration of upper exterimity (UE) function . Patients were taught to use the unaffected UE and various assistive device for ADL. In contrast, Constraint-Induced Therapy (CIT) treatments discourage the use of unaffected UE and encourage the use of the hemiplegic arm . The aim of this study was to investigate the effect of constraint-induced therapy on ADL of adult hemiplegic patients.

 Materials and methods: This study is an interventional study. In present study, 15 patients who had hemiplegic arm following stroke, participated in constraint-induced therapy sessions emphasizing on more affected UE in different activities five times a week for 8 weeks and 2 hours a day. Noninvolved UE was restricted with a special sling for 8 weeks and 5 hours a day.

 Result: The measurements of self care activities, mobility and total score of stroke patients were evaluated with Barthel-Index. The date showed significant differences between mean score of pre and post interventions (p<0.001).

Functional measurements of upper extremity in ADL by using Arm Function Test showed significant differences between mean score of pre and post interventions (p<0.0001).

Conclusion: Presents data showed that constraint-induced therapy could be an effective approach to improve Activities of Daily Living of stroke patients and emphasis on more use of involved UE and overcome disuse learning. 

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Background and Aim: Muscle weakness can be a major problem for many young people with spastic diplegic cerebral palsy (CP). Strength affects on gross motor function. The aim of this study was to determine the effectiveness of loaded forward and lateral step up resistance exercises on Gross Motor Function in children with cerebral palsy of spastic diplegia.

Materials and Methods: Twenty CP persons between 5 to 12 years old (11 boys and 9 girls) with mean age of 8.15 years old were participated in this study. Loaded forward and lateral step up resistance exercises protocols were done 3 times a week for 6 weeks. Isometric strength of hip abductor, hip extensor, knee extensor and ankle plantar flexor were evaluated by MMT NICHOLAS apparatus. Gross Motor Function were evaluated by GMFM.

Result: The strength of Hip abductor, hip extensor, knee extensor and ankle plantar flexor increased (p < 0.05). The scores of GMFM dimensions D and E improved (p < 0.05).

Conclusion: Loaded forward and lateral step up resistance exercises increased muscle strength of lower extremity and improved scores in GMFM. 

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Background and aim: The elderly people are one of the most vulnerable people in any society. Falling in this group is accompanied with decrease of daily living activities. With regard of improvement of balance in perevention of falling, the aim of this study is survey about the effect of Cawthorne and Cooksey exercises on improvement of balance.
Material and Methods:36 elder men with age above 60 years old put in two groups (control group= 19 and exercise group= 17) who lived in the elderly center in city of Mashhad. The subjects in exercise group participated in the Cawthorne and Cooksey exercises during three months, three times a week, during sixty minutes. Balance status of subjects evaluated with Berg Balance Scale(BBS) in 4 stages ( befor exercise and one month, two months and three months) after exercises.
Result: Results showed that improvement of the balance in the different evaluation stages of BBS was significantly increased particularly in the first and second months (p< 0.05). The effects of exercise group were significantly different from control group(p=0.000).
Conclusion: Cawthorne and Cooksey exercises were effective on the balance improvement of elderly men in center of Mashhad and two months of these exercises were enough to improve balance in this group.

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Background and aim: Cerebral palsy is the most common motor disorder in childhood that affects on motor performance and functional activity. Impaired hand function is the secondary problem in children with spastic diplegia.

Individuals with hand dysfunction encounter with difficulties in self care, educational and recreational activities. The goal of this study is to investigate the effect of task oriented training on upper extremity function in children with spastic diplegia (8-12 years old).

Material and methods: Fifteen spastic diplegic children were participated in task oriented training three days weekly up to 8 weeks. The outcomes were measured with Jebsen-Ttaylor hand function test for upper extremity function, Purdue peg board test for hand dexterity, goniometer for range of motion and Ashworth scale for spasticity.

 Results: The data showed significant improvement in upper extremity function (P≤0.0001) , hand dexterity (P≤0.001) , wrist and elbow range of motion (P≤0.0001) and wrist and elbow spasticity (P≤0.05) after interventions.

Conclusion: Our findings suggest that task oriented training can improve upper extremity function in children with spastic diplegia.

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Background and aim: Rehabilitation treatments have significant role in reducing the disabilities of Cerebro Vascular Accident (CVA). Due to great role of upper limb in the function of individuals particularly in Activity of Daily Living and the effect of stability of shoulder girdle on hand function, the aim of this study was to study the effects of Progressive Resistive Exercise on shoulder extensor and abductor muscles isometric strengths in adult hemiplegic.                                                                                  

Material and methods: 17 adult hemiplegics patients (50-70yrs., mean =60.52, SD=7.22) with RT side dominancy and 6 months after stroke, participated in this study. All procedures were approved by ethical committee of TUMS and written consents were also taken. Patients were familiarized with the procedure and shoulder extensor and abductor muscles isometric strengths were measured by dynamometer.                                            

Results: According to results of our study, shoulder extensor and abductor muscles isometric strengths showed significant differences between mean scores of pre and post intervention (P<0.05). Progressive Resistive Exercise improved 34% in shoulder extensor muscles isometric strength and 27% shoulder abductor muscle isometric strength.                                 

Conclusion: Results of our research showed that progressive resistive exercise approach is a useful method for increasing the isometric strength of shoulder extensor and abductor muscles. Therefore, it might be concluded that improvement of strength of shoulder muscles could result in stability in shoulder girdle and consequently might affect on hand function in hemiplegic patients.                                                             

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Background and Aim: Aging is a natural phenomenon that affects on different systems of our body. This process is not due to diseases and accidents. Activity of Daily Living (ADL) is important for elderly persons. The aims of this study are to investigate the effects of progressive resistive exercises on Activities of Daily Living of elderly persons.
Material and Methods: Fifty elder men with age above 61 years old participated in this study. Twenty five elder men in exercise group with mean age of 69.45 and 25 elder men in control group whit mean age of 72.24. Strength of shoulder and knee extensors were evaluated by Tekdyne Incentive Dynamometers (TID). Activities of Daily Living were evaluated by Barthel - Index
Results: The measurements of shoulder and knee extensors of elder men were evaluated with TID. The data showed significant differences between mean score of pre and post interventions (p ≤ 0/0001). The measurements of self care activities, mobility and total score of elder men were evaluated with Barthel-Index. The data showed significant differences between mean score of pre and post interventions (p ≤ 0.0001).
Conclusion: Presents data showed that progressive resistive exercises could be an effective approach to increase strength upper and lower body and improve Activities of Daily Living of elder men.

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Background and Aim: in hemiplegic children Postural tone of the two sides of body is different. Once, asymmetric stance is a typical state in individuals' with unilateral pain and/or paresis and standing is with weight bearing on the stronger side. Obviously, an asymmetric stance with majority of weight bearing on the affected side can counter faces individual with the falling risk and causes instability. It seems coordinating of the two sides of body is the most vitally important therapeutic exercises in hemiplegic patients. Although stable stance is a simple postural task but it's controlled semi-automatically by cortical and spinal centers. It is established that stable standing, also demands cognition resources. So, postural control demands the interaction between musculoskeletal and nervous systems.
Material and method: In this clinical trial (before-after) 17 children 5-12 years old with spastic hemiplegia were participated. The subjects stayed in the center of force plate with the most stable standing position while using /not-using lateral wedge and in each state with/without doing cognition task. Short- memory test of digit span used as dual task condition. The mean range of fore-after and mediolateral sway and velocity and area as postural control independent variables and error measures in recalling of randomized digit chain as cognition task independent variables were registered.
Results: The wedge affected Rsw (P=0.015), Area (P=0.007) and Vm (P=0.005) significantly. Dual task also had significant effect on Rfa (P=0.014), Rsw (P=0.014), Area (P=0.002) and Vm (P=0.002). But the wedge declines its effect properly.
Conclusion: The results represent that a 5º lateral wedge applied to the unaffected limb, can improve factors of postural control even in Dual tasking thus The wedge can be used with a good effect on the posture of hemiplegic children.

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Background and Aim: Cerebral palsy is a non progressive disorder and the most common movement problem in children. Many children with cerebral palsy are of hemiplegic type. One of the important problems of this children is unilateral upper limb dysfunction, that not using the affected side causes forgetfulness and more problems on this side. In this study, effectiveness of Constraint-Induced Therapy(CIT) and the maintainance of this technique on spasticity and performance of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old have been investigated. 

Materials & Methods: In this pretest - posttest quasi experimental study, 20 cerebral palsy hemiplegic children 6 to 12 years old (15 boys and 5 girls) with  8.7   years mean age were selected. Interventions were performed about 8 weeks and patients were followed for 4 weeks. Spasticity on the affected side in wrist and elbow were tested by Modified Ashworth Scale and upper extremity function by the Box & Block test. The data were analyzed with the Wilcoxon and paired t- tests.

Results: Constraint-Induced Therapy in the affected limb decreases significantly the spasticity of wrist (p = 0.00) and elbow (p = 0.005) and significantly increases performance score (p = 0.00), and the recovery significantly maintained one month after the interventions.

 conclusion: Constraint-Induced Therapy of affected upper extremity could possibly decrease limb spasticity and increase function with two mechanisms: Fierstly, The reduction of not using the plegic side and secondly, neuroplasticity in CNS. This improvement may remain viable in the affected limb. 

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Background and Aim: The role of function of upper extremity in activity of daily living is critical and any impairment of function could cause major problems for diplegic spastic cerebral palsy (CP) patients. So, the application of rehabilitation protocols that could regain the hand function is very important.

The purpose of this study was to explore the effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic CP, 3-7 years old.

Materials and Methods: Thirteen CP patients (3-7 years mean: 4.92 years 4 boys and 9 girls) were participated in this study. Simultaneous activation of exteroception and proprioception were done 3 times a week (for 8 weeks). Function of upper extremity was evaluated by Quest Test and the degree of spasticity in wrist was evaluated by Modified Ashworth Scale.

 Results: The results of this study showed that after simultaneous activation of exteroception and proprioception, function of upper extremity was significantly improved (P<0.001). In addition, degree of spasticity in wrist muscles was significantly decreased (P<0.022).

Conclusion: Based on results of current study, it might be suggested that simultaneous activation of exteroception and proprioception could improve the function of upper extremity and decrease of spasticity. This in respect could reduce the disabilities of patients. So, the application of current protocols for the patients is suggested.