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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.

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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.

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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.

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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.

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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: 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: The lateral scapular slide test (LSST) is used to determine scapular position and scapular asymmetry with the arm abducted 0, 45, and 90 degrees in the coronal plane. This test was introduced by Kibler. Assessment of scapular position is based on the derived difference measurement of bilateral scapular distances and the distance of inferior angle of scapula to spinous process of T7 vertebra. The purpose of this study was to assess the reliability of measurements (intra rater, inter rater, sensitivity and specificity) of LSST in assessment of scapular asymmetry and scapular dysfunction in patients with shoulder impairments.

Materials and Methods: Subjects:  Fifty-seven subjects participated in this cross sectional study.

Twenty seven subjects in shoulder impairment group (X=47.66, SD=11.64) and thirty subjects in normal group(X=33.53, SD=11.72). Three examiners measured the distance of inferior angle of scapula to spinous process of T7 vertebra at two sides in three different positions by a caliper verneer (accuracy: 0.01 mm). Position 1 involves of the shoulder in glenohumeral joint neutral. In position 2, the humerus is placed in a position of medial rotation with 45 degrees of shoulder abduction. In position 3, the upper extremity is placed in a position of maximal medial rotation with 90 degrees of shoulder abduction. The data were analyzed with SPSS (version: 11.5). ICCs and SEMs were calculated.

Results: The ICCs for intra-rater reliability were 0.87 to 0.97 for subjects without and with shoulder impairments and 0.63 to 0.79 for inter-rater reliability in subjects with shoulder pathology (involved side). The SEMs ranged from 0.57 to 0.86 cm for intra-rater reliability and from 0.79 to 1.20 cm for inter-rater reliability. Sensitivity of the test was high(80% to 100%) but specificity  was low (4% to 26%).

Conclusion : The lateral scapular slide test has high sensitivity and good to high level of intra rater reliability at three different test positions. The test showed low specificity and poor to fair inter rater reliability at three different test positions particularly at position 3.

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Background and aim: Since 1998, the effect of traction on the H- reflex has been investigated by Hiraoka and the other researchers. Some of them have been done on lower extremity and the other on the upper extremity. The effect of traction was assessed by H reflex amplitude. Different results have been achieved. The new method which has been used since 2000, the effect of cervical traction on the H reflex was carried out by measuring H reflex slope .In this experiment the effect of manual cervical traction has been studied on the H slope of the upper extremity. Now we have sought to extend this work by examining the effects of cervical traction with 3 kg force on the H slope of the lower extremity 

Materials and Methods: This study was administered to sixteen healthy men with a mean age 23.12 of years and SD=2.55. The parameters of H reflex were recorded before and after of cervical traction .All data were analyzed with SPSS (V: 11.5).    

Results: The results showed that, there were no significant differences between before and after the application of cervical traction in H reflex parameters, ratio of H max/M max amplitude and M slope. But H slope and ratio of H slope /M slope were increased significantly after the application of traction (P<0.001).

Conclusion: The present study showed that traction with 3 Kg force can increase motor neuron excitability of soleus muscle and this result is against the previous study. This could be due to the application of the new method (H slope), which is more precise.

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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:The role of thoraco-lumbar muscles is important in spinal column stability. Following fatigue due to constant activity, these muscles encounter with variable control pattern and variations of median and mean frequencies are little in relation to torque of force. However these parameters are useful in the literatures, but due to complexity of neuromuscular interaction and variety of motor control, signal processing can determine a wide range of changes and measurements.     

Signal processing nonlinear techniques exploit in biologic signals. Variables of nonlinear techniques are recurrence, determinism, entropy and so on.

The purpose of this study was to determine changes of entropy as nonlinear parameter in comparison with linear parameter and applicability of entropic measurements of the erector spinae muscles during fatigue.   

Materials and methods: Ten healthy women and 6 women with nonspecific low back pain (NSLBP) with a range of 20-30 years old patticipated in this study. Surface electromyography of isometric activities recorded from trunk (T12), lumbar (L3) and biceps femoris muscles during modified Sorenson isometric fatigue test. Median and mean frequency and also nonlinear parameters such as entropy and trend measured in one second of muscles activities before and onset of fatigue. 

Results:  Following fatigue in healthy group, median and mean frequencies reduced at a range of 12-20% (p<0.05). This decrement in LBP group was little (4 - 20%, p<0.05). Entropy increased 120-200% and trend reduced 800-2000% in normal subjects (p<0.05), whereas subjects with LBP indicated increment of entropy 65-220% and decrement of trend 240-500% (p<0.05). Before and after fatigue there was a significance difference between two groups in entropy parameter (p<0.05), whereas median and mean frequencies differences were not significant.

Conclusion:Following static positions, fatigue occurred in three levels of above muscles particularly at lumbar region. Traditional fatigue indicators showed good differences, but percentage of variability was low in comparison to nonlinear parameters. It suggests that nonlinear variables especially entropy are more sensitive than traditional indicators and can explain these stochastic behaviors

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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: The presence of the flexion relaxation phenomenon (FRP) during trunk flexion represents myoelectric  silence consistent with increased load sharing of the posterior discoligamentous passive structures. A number of studies have shown differences in the FRP between patients with chronic low back pain and healthy individuals, Persistent activation of the lumbar erector spinae musculature among patients with back pain may represent the body's attempt to stabilize injured spinal structures via reflexogenic ligamentomuscular activation for protecting them from further injury and avoiding pain.

Materials and methods: Two groups of female subjects ((20 - 40 years old) were participated in this study. First group consisted of 10 subjects with chronic low back pain (CLBP) and second group consisted of 10 healthy ones as control group. Both groups have performed 5 cycles of trunk flexion - extension . The speed of the movement repetition controlled by an electronic metronome . The EMG signals recorded from T12 and L3 paravertebral muscles and bisepse femoris on the right side. The lumbar flexion motion degree has been measured by the digital flexible goniometry.  All subjects have done Sorenson Back Endurance test in prone laying position. The subjects have extended their trunk up to the horizontal position and sustained in this position up to fatigue level .The subjects leave the table and asked to do 5 more cycle of trunk flexion - extension.

Results:  In patients group there is an increment and significant differences in lumbar flexion degree at the time of muscle EMG off  in comparison with healthy subjects after fatigue test (p<0.05). In both groups, the myoelectric silence period showed a significant change with respect to the pre- fatigue (p<0.05). The median frequencies shifted to lower frequencies after fatigue protocol (p<0.05).

Conclusion: Muscle reflexive responses would change following fatigue protocol. Therefore, the muscle activity will increase after the fatigue period. In the other hand, in patient group the role of the muscles as a stabilizer seems to be increased to enhance the stability at the injured segment after fatigue protocol .This protects the segment against pain and disability.

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Background and aim: In physical evaluations, measuring the joint angle is one of the most important outcomes to assess the patient's progress, the effectiveness of various treatment techniques and to delineate the need for future treatments. The aim of this study is to study the reliability of a system consists of skin markers, digital photography, and AutoCAD software for measuring the knee joint angles.

 Materials and methods: In first section, reliability of markers placement was evaluated within three different intervals (five minutes, two days, and twenty days). At second section, reliability of digital photography was evaluated while position of the skin markers and subjects was the same. At the end, in third section, reliability of angle measurement by means of AutoCAD software was assessed.

Results: In first section, the ICC for test-retest reliability of markers placement between first and second sessions, first and third sessions, and also first and forth sessions were 0.97, 0.94, and 0.73, respectively. In second section, the ICC for test-retest reliability of digital photography was 0.99 and in third section, the ICC for intra-rater reliability of angle measurement by means of AutoCAD software was 0.99 (p=0.05).

Conclusion: It was noted that the introduced system was highly reliable, so it could be utilized to measure the knee joint angles.

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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: Asymmetric motions of trunk, external forces and other occupational factors such as frequent bending and twisting, lifting and forceful movement contribute to low back disorders. However, the dynamic and three-Dimensional motions of trunk at varying exertion levels were not addressed in literature. Hence, the aim of this study was to investigate the movement pattern and motor output during resisted trunk three-dimensional motion. 

Materials and Methods: Thirty healthy male subjects randomly performed dynamic asymmetric trunk motion at four resistance levels (nominal resistance, 25%, 50%, and 75% maximal voluntary contraction (MVC) torque) while positioned in standing with the L5-S1 interspinous space aligned with the flexion / extension axis of isostation B200. Under each resistance condition, movement patterns (range of motion), motor output (maximum torque) of the trunk were measured.

Results: In general, with increasing resistance from nominal to 75% MVC torque, the maximum torque of trunk in different directions of motion (flexion, extension, right & left lateral flexion, right & left rotation) increased significantly (p= 0.000). With increasing resistance from nominal to 50%  MVC torque, the range of motion of the trunk decreased significant (p<0.0083), but no significant change was found in this variable between resistance conditions of 50% and 75% MVC torque (p>0.0083).

Conclusion: When the resistance level is increased , the created external forces  must be balanced by internal forces generated by trunk muscles. Because the muscles have short lever arms compared with the external forces, they must generate large amounts of forces, placing compressive and shear loads on the structures of the spine. Under these conditions, spine injuries may be enhanced.

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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: The rapid growth of the athletic training profession has been accompanied by an equally rapid increase in focus on basic and clinical research. Lateral ankle sprain (LAS) is an extremely common athletic injury. Despite extensive clinical and basic science research, the recurrence rate remains high. Chronic ankle instability (CAI) following LAS is hypothesized to predispose individuals to re-injury because of neuromuscular control deficits which result following injury. No investigation has been carried out on the existence of joint position deficits in the knee joint of patients with CAI. In this study, joint position sense (JPS) was evaluated in patients with CAI.

Materials and Methods: Ten female patients with CAI and ten healthy control subjects participated in this study. JPS was evaluated by reproduction of the angles in two standing and sitting positions, and in each position two target angles were tested. The knee joints in both lower limbs of patients and the dominant knee-limb of healthy subjects were evaluated. The knee angles were measured by using a system comprised of skin markers, digital photography, and Auto CAD software. Absolute error was considered as a dependant variable.

Result: There were no significant differences between the knee JPS of dominant leg in healthy subjects and both knee joints of patients. There were also no significant differences between knee JPS in two standing and sitting positions and in two different target angles (p>0/05).

Conclusion: The result of this study suggests that subjects who have CAI do not have deficit in knee JPS when tested in sitting position and also under functional weight bearing conditions.  

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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.