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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: 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: Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Any functional disorder in the hand can cause a person's independence to be disrupted and therefore his or her social independence is threatened. The purpose of this study was to determine the effects of volar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic children.
Materials and methods: The design of this study was clinical trial and before_ after. Fourteen 8 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patient used a volar static splint (10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb) for 2 mounts (2 hours during day and 4 to 6 hours at night). In this study Jebsen Taylor Hand Function Test was used to evaluate hand function. Modified Ashworth Scale was used to evaluate spasticity. A Goniometer was used to measure range of motion.
Results: The results of this study showed significant improvement in hand function  ,significant reduction in wrist spasticity  and elbow spasticity  and significant increase in wrist range of motion The data did not show any significance in elbow range of motion .
Conclusion: Our findings suggested that 2 months using of volar static splint in children with spastic cerebral palsy can improve hand function, wrist and elbow spasticity and wrist range of motion.

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Background and Aim: Constraint-induce movement therapy is one of the treatment methods to treat those who have  stroke disorders. The aim of this study was to determine the effect of constraint-induced movement therapy(CIMT) on quality of life , function and range of motion of upper extremity of patients with stroke.

Materials and Methods: This study was conducted in 15 patients in accordance to random clinical trial during the treatment operation, the patients were asked to restrict their upper extremity movement with orthopedics sling for 3 days per week and each day for 8 hours. They were asked to practice on affected upper extremity for 2 hours
while their hands were restricted.  Additionally, the present study was conducted for 6 weeks.

Results: The statistical analysis illustrated that quality of life was significantly changed which measured by SF36 test (p=0.008). Furthermore,  the upper extremity function which was assessed by Box & Black test  was statistically analyzed by t-coupled in this regard, it showed a significant change when the treatment ended up (p=0.009). However, active range of motions in wrist extension and elbow extension did not significantly changed (p=0.227).

Conclusion: Based on the results, it can be implied that Constraint-induce movement therapy is an effective method for improvement of life quality and the upper extremity function .Three mechanisms are discussed: involvement of non used affected limbs, neural plasticity in CNS, and amelioration of mental and physical health of patients can be resulted in life quality and patients' hand improvement.

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Background and Aim: Cerebral Palsy (CP) children are the most clients referred to occupational therapy settings. Hand function is important in Activities of Daily living .There is a hand dysfunction in most cerebral palsy children. Orthosis and splints are commonly used to improve the position, range of motion, quality of movement and function of a person's arm or hand. The aim of this study was to investigate the effects of static cock up c-bar splint on strength,spasticity, range of motion, and dominant hand function in spastic diplegic children with 8 to 12 years old. 

Materials and Methods: This interventional study is in a before-after design. Thirteen spastic diplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients used a static cock up c-bar splint (wrist in 10 degrees of extension and thumb in palmar abduction and opposition) for two months, 2 hours daily and 4-6 hours at night. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of thumb, wrist and elbow, ROM of thumb, wrist and elbow were tested with goniometer and power grip was evaluated with dynamometer.  

 Results : Results showed a significant improvement in hand function (p<0.001), in wrist`s spasticity (p<0.001), elbow`s spasticity(p<0.008), palmar abduction of thumb spasticity (p<0.002), wrist`s ROM (p<0.001), Palmar abduction of thumb ROM(p<0.001) and power grip(p<0.001). The data did not show significant improvement on elbow`s joint ROM. 

Conclusion: Information from present research shows that using static cock up c-bar splint for 2 months, 2 hours a day and 4 to 6 hours nightly, can be an effective method to improve power grip, hand function, thumb, wrist and elbow spasticity and range of motion of thumb and wrist of spastic diplegic CP children.

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Background and Aim: Rehabilitation interventions have significant role in reducing the disabilities of Down syndrome. Due to great role of balance in the function of individuals particularly in Activity of Daily Living and the effect of strength on balance, the aim of this study was to investigate the effects of Progressive Resistive Exercise on functional balance in children with Down syndrome.
Material and Methods: Fifteen girls children aged between 8 and 12 years, with Down syndrome participated in this study by available sampling method. The subjects participated three times per week in a six-week progressive strengthening program. During intervention, 3 of them excluded. Balance were measured by Berg Balance Scale and right/left hip abductor and flexor, knee extensor and flexor muscles isometric strengths were measured by Nickolas hand-held dynamometer. Paired-sampled T-Test was used for data analysis.
Results: The results of this study showed that the mean of functional balance and muscles isometric strengths were significantly increased after intervention (P<0.001).
Conclusion: It seems that the results of this study confirm the effect of progressive resistance training on progressing functional balance, and 8-12 years old children with Down syndrome can benefit from these exercises.

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Background and Aim: Cerebral palsy (CP) is a neurodevelopmental disorder caused by nonprogressive lesions. This disorder produces motor impairment deficits in early infancy. Hand function is essential in performing activities of daily living for everyone, including individuals with cerebral palsy. Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function. The purpose of this study was to determine the effects of C-bar splint on hand function and strength and also wrist and thumb range of motion (ROM) of dominant hand of 8-12 years old children with spastic diplegic cerebral palsy.
Materials and Methods: The design of this study was before- after and quasi-experimental. According with inclusion criteria, 8 to 12 years old children with spastic diplegia from physical – motor special school at Tehran (8 boys and 5 girls), were studied. They used a C-bar splint (40 degree of palmer abduction of thumb) for 8 weeks (6-8 hours during day and 4-6 hours at night). In this study, hand function was evaluated by Jebsen Taylor Hand Function Test, hand strength by MIE dynamometer and thumb & wrist ROM by Goniometer. During intervention, they received routine occupational therapy program.
Results: The results of this study showed significant improvement in hand function (P=0.001), and thumb range of motion (P=0.02). The data did not show any significant improvement in wrist ROM and hand strength.
Conclusion: According to the result of this study, it seems that using C-bar splint can be an effective method in improvement of hand function and thumb ROM in 8-12 years old children with spastic diplegia. Key words: C-bar splint, Hand function, Diplegia cerebral palsy

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Background and Aim: Improving the affecting factors of balance could be a critical procedure in managing the elderly's balance dysfunction. The goal of this study is to find out how and to which amount a prolonged period of stretch and massage impact on elderly's balance. Materials and Methods: In this RCT study with a simple randomized case selection, 205 normal subjects screened and after that, 18 subject (74.6 5.45 Years) for intervention group and 17 (75.8± 4.27 Years) subjects for control group contributed for the study. The procedure was 15 sessions in 5 weeks (3 sessions per week). Each session last about 1 hour. Berg Balance Scale (BBS) and Timed Up and Go (TUG) were used for evaluation of balance.

Results: Using by SPSS-19 software and after independent T-test, significant differences in balance scales were found between the intervention and the control groups (p<0.05).

Conclusion: According to present evidence, stretch and massage are significantly effective on elderly's balance function. 

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Background and Aim : Cerebral palsy (CP) children are the most referral patients to occupational therapy centers. Hand function is important in activity of daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splint are commonly used to improve the position , range of motion, quality of movement, arm and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old.

  

Materials and Methods : This interventional study is in a before-after design for two group case and control. Thirty spastic diplegic cerebral palsy children with 8 to 12 years old who had the inclusion criteria, were randomly assigned to case and control group. Patients of case group used a static anti-pronation splint for 2 months, 8 hours daily. In this study the Jebsen Taylor test was used to evaluate upper extremity function, the Goniometer was used to measure ROM of elbow, forearm and wrist, the Modified Ashworth Scale was used to assess spasticity of elbow, forearm and wrist. Power grip and pinch were assessed with MIE device.

  

Results : In the case group results showed a significant improvement in upper extremity function (0.026), forearm supination ROM (0.007), wrist extention ROM (0.005), forearm muscle pronator spasticity (0.001), wrist muscle flexsor spasticity (0.009), power grip (0.001) and pinch (0.001). The data did not show significant improvement on elbow extention ROM (0.075), elbow muscle flexsor spasticity (0.164). In comparison with control group, the data showed a significant improvement in upper extremity function (P=0.001), forearm supination ROM (p=0.034), wrist extention ROM (P=0.042), forearm muscle pronator spasticity (P=0.009), power grip (P=0.001) and pinch (P=0.001). The data did not show significant improvement on elbow extention ROM (P=0.140), elbow muscle flexsor spasticity (P=0.638) and wrist muscle flexsor spasticity (P=0.105).

  

Conclusion : The findings show that using static anti-pronation splint for 2 months , 8 hours a day , can be an effective method to improve upper extremity function , range of motion of forearm and wrist , forearm spasticity and power grip and pinch in spastic diplegic cerebral palsy children with 8 to 12 years old .

  

Key word : Cerebral palsy, Static anti pronation splint, Upper extremity function, Spasticity, Power

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Background and Aim: Cerebral palsy is a common cause of inability in childhood that effects on posture and motor development and leads in activity limitation. One of the difficulty of cerebral palsy is impairment in arm and hand function. Splints and orthosis are used to improve position, range of motion and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on spasticity, range of motion, grip and pinch strength and function of affected hand of spastic hemiplegic children of 8-12 years old.

Materials and Methods: This is an interventional study. Twenty spastic hemiplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients randomly divided into intervention and control group. Patients in intervention group used a static anti-pronation splint for two months, 6 hours daily. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of wrist, forearm and elbow, ROM of wrist, forearm and elbow were measured with goniometer and grip and pinch strength were evaluated with MIE.

Results: Results in intervention group showed a significant improvement in hand function (p<0.003), in wrist`s spasticity (p<0.005), forearm`s spasticity (p<0.003), wrist`s ROM (p<0.001), forearm ROM (p<0.003), grip strength (p<0.001) and pinch strength (p<0.003) in intervention group. The data did not show significant improvement on elbow`s joint ROM (p<0.343) and spasticity (p<0.157).In control group, significant improvement did not seen (p>0.05).

Conclusion: Information from present research shows that using static anti-pronation splint for 2 months ,6 hours a day, can be an effective method to improve hand function, wrist and  forearm spasticity and range of motion, strength of grip and pinch in hemiplegic CP children.

Keywords: Static anti-pronation splint, Hand function, Spastic hemiplegic, Cerebral palsy.