---

Back ground and aim: Osteoporosis, a multifactor disease characterized by reduction of bone mass. It is a major cause of fractures especially femoral fractures leading to morbidity, mortality and decreased quality of life. Although there is no known cure, osteoporosis and related fractures are largely preventable. Knowledge, Attitude and Practice (KAP) are the important components of any effective preventive program.The purpose of this investigation was to determine the level of KAP of osteoporosis among a group of Iranian adolescent females.

Materials and Methods: A descriptive study was conducted to determine the KAP level of osteoporosis on 626 randomly selected school girls aged 10-19 (13.9±1.4) years coming from rural and urban regions of Tehran and  other provinces to students' camp in north of Tehran. A designed questionnaire with four parts containing questions regarding demographic information, knowledge, attitude and practice was used in this study. Questions were made based on YES/NO and Don't Know in knowledge and attitude (this third option allowed the respondent a choice without guessing) and just Yes /No related to the practice. Students were asked to read the guidelines and then to complete the questionnaire when they were in the camp. We descript +2 for correct responses, 0 for incorrect responses and +1 for don't know answers. The ethical committee of the Iran University of Medical Sciences & Health services approved the study. The SPSS version 11.5 statistical software was used for analysis. ANOVA, Pearson and student t-test were performed to compare mean values and significant P- value was considered at P<0.05.

 Results: The total score of KAP was 2-65(43.3±13.8) .In details a range between 14-30(23±2.9), 10-22(19.2±2.4) and 2-18(10.1±2.8) were seen in knowledge, attitude and practice respectively. There was a direct correlation between total score of KAP and parents' education. Students' Knowledge and attitude, and also attitude and practice had a positive correlation. There were no relationship between parents' occupation, family number and total score of KAP.

 Conclusion: Iranian adolescent females would have relevant knowledge about osteoporosis but attitude and practice of them were less than knowledge. We recommend to perform further training programs to increase practice of Iranian young women about osteoporosis.

 

---

Background and aim: Fatigue is the inability to generate the maximal force that can be produced by the muscle . Fatigue is a subject that patients and athletes frequently encounter. Fatigue is one factor that limits muscle function and may lead to various pain and injury conditions. It is most commonly caused either by repetitive motion or by sustained muscular
contractions. Massage has been used for rehabilitation and relaxation for thousands of years. Massage is widely believed to have a beneficial effect on treating muscle fatigue and has been used in clinical and sports setting for that purpose. There is limited scientific evidence, however, to support the use of massage for enhancing performance and recovery from injury, or for preventing injury. The comparison of massage and rest on the knee extensor muscles fatigue after maximal isokinetic contractions is the main objective of this research.
Materials and methods: Fifteen healthy female aged between 20-30 volunteered to participate in this research. They did at least once a week some non-professional light sporting activities. Each of volunteers was evaluated in 3 different times. The first session was in order to familiarize the volunteers with the test and Isokinetic. For the main test, each of the volunteers was evaluated twice with one week interval. At the start of each session after warm up, the following parameters were measured: Perceived fatigue by Visual Analog Scale ¸average peak torque and average power maximal concentric of quadriceps at the velocity of 60 degrees per second by Isokinetic apparatus. Then in order to fatigue protocol ¸ the subjects were asked to perform successive and maximal quadriceps contractions until three subsequent quadriceps torque output reaches below 50 percent maximal torque output. Afterwards average peak torque and average power was measured. The extent of perceived fatigue was evaluated as before. Subjects then either received massage on the knee extensors or rested for 15 minute duration. Recovery from fatigue was quantified using average peak torque (APT), average power (AP) and perceived recovery scale (VAS).
Results: After maximal fatigue and decrease in torque output, below 50 percent maximal torque, 15 minutes of massage could change APT after fatigue from mean 56.70 (Nm) to 91.53 (Nm)) , AP from 38.64 to 63.62 (Nm) and VAS from 90.06 to 10.20 (mm). After 15 minute rest could change APT from 55.36 to 68.10 (Nm), AP from 37.69 to 48 (Nm) and VAS from 90.06 to 20.73 (mm).
Conclusion: There was significant difference between rest and massage conditions for recovery of fatigue. Massage was an effective intervention for enhancing muscle performance and recovery from fatigue but rest didn`t have such an effect. In both cases, recovery stage (massage or rest) caused significant change in perceived fatigue but massage is more effective on the decrease of perceived fatigue. Therefore, massage has been more effective than rest as a strategy to return to normal state and has caused more relief in perceived fatigue.

---

Background and Aim: Muscular fatigue is common problem that an athlete faces repeatedly during sport competition or therapeutic exercise. Undoubtedly¸ fatigue affects the precision of subjects’ performance and limits the range of physical and sport activities. Muscle fatigue advantages and disadvantages have been reviewed in many previous studies. To challenge this controversy fatigue evaluation requires reliable, stable and precise methods of analysis itself. Researches on muscle strength and subject’s perception of fatigue have been done in many studies. Therefore researchers in this study focus on temporal stability of both subjective perception of fatigue and produced muscle torque after fatigue.
Materials and methods: Fifteen healthy female between 20-30 years of age, who at least had some nonprofessional light sporting activities once a week, volunteered in this research. Each of volunteers was evaluated in 3 different sessions. The first session was to familiarize the volunteers with the Isokinetic tests. For the main test, each of the volunteers was evaluated once and then after one week interval. At each session after warm up, perceived fatigue was measured using Visual Analog Scale. Then Average peak torque and average power maximal concentric Isokinetic of quadriceps were measured at the velocity of 60 degrees per second. To perform the fatigue protocol, subjects were asked to perform successive maximal quadriceps contractions until the three subsequent quadriceps torque output drop below 50 percent of maximal torque output. Afterwards, for re-measurement average peak torque, average power and perceived fatigue were evaluated similarly.
Results: The interaclass correlation coefficient (ICC) of average peak torque¸ average power and visual analog scale before performing fatigue protocol were calculated %81.6, %87.4 and %47.9 respectively. The repeated ICC after fatigue has estimated %59.9 ¸%64.4 and %96.6 respectively.
Conclusion: This research demonstrated that Isokinetic temporal stability parameters were high before fatigue. In other words, both torque and power are reliable in two repetition times in a session, as well after one week interval between. After fatigue the stability rate of torque and power recorded by Isokinetic were repeatable and this repeatability has been moderate to high. However VAS showed a completely opposite results, in which before fatigue the stability of imagined local fatigue perception has been very low and was not significant, although after fatigue the VAS showed high repeatability.

---

Background: Flexible flat foot is a congenital common deformity in lower extremity associated with ligamentus laxity. This deformity may cause hammer toe, heel spur, inflammation of achille tendon, early muscle fatigue during sport, foot imbalance and pain in leg, knee and hip. The use of insole with medial arch support considered as one of the common treatments for patients. The purpose of this study was to determine the effect of a composite insole, Ethyl Vinyl Acetate (EVA) with Poron layer on ground reaction force on subjects with flexible flat foot in comparison with common EVA insole.

Materials and Methods: Fifty two subjects (14 Male and 38 female) between 18-40 years of age with flexible flat foot participated in this study. Twenty six subjects received Poron insole (EVA with Poron layer) and 26 subjects received common EVA insole. After assessment each subject asked to walk with normal speed across two force plate in two conditions, walking with insole and shoe and walking without insole. Then each subject asked to use insole for forty hours during two weeks. Vertical ground reaction force in the first session and after two weeks was assessed.

Results: Impact force and first peak of vertical ground reaction force (F₁) with Poron insole in comparison with shoe significantly increased in second session (P<0.05). The second peak (F₃) with common insole in comparison with shoe significantly increased in second session (P<0.05). Significant reduction was noted in first peak (F1) with common insole in second session in comparison with first session (P<0.05). There was no observable significant difference in two groups before and after intervention.

Conclusion: The results of this preliminary study show that both insoles change vertical ground reaction force in comparison with shoe alone. But using a composite Poron Layer on EVA insole has not demonstrated a significant difference with common arch support insoles. Therefore application of Poron Silicon layer on EVA insole by itself can not show a significant reduction of ground reaction force.

---

Background and Aim: Constraint-Induced Movement Therapy (CIMT) is a new intervention in chronic hemiplegic patients. The aim of present study is to quantify of quality of movement (QOM) and amount of movement (AOU) that assessed by motor activity log (MAL) after modified CIMT in comparison with traditional physiotherapy (TPT).

Materials and Methods: Ten patients were randomized to modified CIMT or TPT group. Five patients received training of the more affected limb fort two hours daily, three times in a week during two months of treatment. The patients are encouraged to wear an arm- hand splint in less affected hand for five hours daily for maximal using of affected limb with shaping method. The patients in TPT group received physiotherapy treatment with same intensity with other group, for two hours daily during two months. Motor Activity Log (MAL) was used to determine QOM and AOU before- after two months treatment.

Results: The data showed significant improvements in AOU and QOM in affected extremity that clarified by Wilcoxon test. Mann- Whitney test used for comparison between two groups, revealed significant difference in modified CIMT group (p=0.02).

Conclusion: Although, modified CIMT was more effective than TPT in improving QOM and AOU but, TPT as an active rehabilitation can be effective on improving of these parameters. 

---

Background and Aim: According to clinical observation, foot hyperpronation is very prevalent and may cause malalignment of the lower extremity in which can lead to structural and functional deficits in standing and walking. The aim of this study was to investigate of  foot hyperpronation effect on spine alignment in standing position.

Material and Method: Thirty-five healthy male ranging 18 - 30 years old were participated in this study. Evaluation was performed with two examiner in four standing positions (on the floor, on the wedges angled at 10, 15 and 20 degrees) using motion analysis system (zebris) and each one of measurement methods repeated three times. SPSS version 17.0 and paired t- test and repeated measures were used for statistical analysis.

Results: Significant difference was seen between all modes in sacral angle, pelvic inclination, lumbar lordosis and thoracic kyphosis variables (except between the first and second mode. Finally, with increasing wedge angle, a positive correlation obtained  for the examiners and all variables.

 Conclusions: The results of this study showed with increasing bilateral foot pronation, sacral angle, pelvic inclination, lumbar lordosis and thoracic kyphosis were increased. In fact, each one of them considered a compensatory phenomenon.

---

Background and Aim : The tracking tests are a known method to measure and quantify the performance of the neuromuscular system. They are also one of the accurate and flexible methods for measurement of the performance capacity of sensory-motor control or sensory-motor coordination. The purpose of the present study was to examine reliability of the torque error during trajectory tracking tasks in trunk region in torque-time plane in healthy subjects.

  

Materials and Methods: Twenty healthy subjects (7 female and 13 male) randomly performed target tracking tasks with two patterns (sinusoidal and saw shape). The sinus and saw tracking tasks had two periodic cycles included 10 seconds (3 cycles) and 15 seconds (2 cycles). The amplitude of the signal was set at about 30% to 70% of Maximum Voluntary Exertions (MVE) of each participant. The tracking tasks were performed in 6 directions of uniaxial exertion (flexion, extension, left and right rotation, and left and right lateral bending). Absolute error mean and the performance of the tracking task were determined by calculating Relative Root Mean Square Error (RRMSE) for each participant during each trial. Relative reliability (Intraclass Correlation Coefficient: ICC) of the error mean and RRMSE for all participants was determined. Also absolute reliability (Standard Error of Measurement: SEM) and Minimal Detected Change ( MDC₉₅ ) were computed.

  

Results: The results have shown that ICC, SEM and MDC₉₅ for error mean ranged from 0.5 to 0.87, 0.002 to 0.006 and 0.007 to 0.016, respectively. Also these variables for RRMSE ranged between 0.5- 0.86, 0.05- 0.024 and 0.065- 0.139, respectively.

  

Conclusion: The repeatability analysis showed high and very high reliability for torque errors ( Error Mean, RRMSE ) measures during trajectory tracking tasks in torque time plane in asymptomatic subjects. Therefore this performance can be used for quantification of trunk controllability and also mentioned variables as reliable parameters in researches.

  

Keywords: Reliability, Trajectory tracking tests, Torque error, Isometric trunk exertion

---

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

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

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

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

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