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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: 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: Carpal tunnel syndrome is a common disorder, for which various conservative treatments have been suggested. The aim of this randomized clinical trial was to compare the iontophoretic effects of diclofenac and dexamethasone on patients with carpal tunnel syndrome.

Materials and Methods: Twelve hands from seven patients between 30 to 60 years of old (Mean=45.9 SD±8.3) were treated with pre-designed splint and iontophoresis. Four hands were treated with dexamethasone sodium phosphate and eight other hands had iontophoretic administration of sodium diclofenac. Cock-up splints were used for the patients during the course of treatment and 2 weeks follow up. Treatment continued for ten sessions during two weeks. They were advised not to take oral or parenteral anti-inflammatory drugs. Clinical symptom severity (SSS) and functional status (FSS) as well as visual analogue (VAS) scales were evaluated after iontophoretic treatment and two weeks follow up. Electrophysiological parameters such as distal sensory & motor latencies, amplitudes, nerve conduction velocities (NCV) were measured.

Results: Diclofenac group showed significant improvement in SSS score and sensory electrophysiological parameters of median nerve (P<0.05). Although, in dexamethasone group VAS and SSS scores decreased but there were no statistical significant differences in any intervals. With Comparison between two groups showed significant difference in distal motor latency after following up with more improvement in dexamethasone iontophoresis group (P<0.05).

Conclusion: Above findings showed efficacy of splint and iontophoretic administration of sodium diclofenac in treatment of patients with carpal tunnel syndrome. Although dexamethasone group showed no significant change, previous researches suggested the efficacy of ionophoretic administration of this anti-inflammatory medicine in clinical symptoms' improvement. Therefore, the lack of enough participants may be considered as a source for present results in this group. Although comparison between two groups, showed significant difference in distal motor latency after follow up (singnificant results in dexamethasone) but, due to small number of cases in follow up period, the validity of these results is questionable. Further researches are needed to confirm this difference.

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Background and aim: Knee osteoarthritis (OA) is one of the most common synovial joint diseases (i.e. weight bearing joints) of the human body. This problem probably is more common in Iranian society that is used to sit on the floor and carpet. Following knee OA, patients complain of pain, inflammation, decrease of range of motion and muscle weakness. Therefore, they can not independently do their activity of daily living (ADL). Consequently, the side effects of physical incapability may render to psychological problems and this in respect do affect on their quality of life.Various treatments such as pharmalogical, surgical and physiotherapy have been recommended at different stages of OA by specialist. In the present study, the effect of physical therapy agents (considering the point that physiotherapy has no or negligible side effects) have been studied on OA. 

Materials and methods: 40 patients participated in this study the patients were refereed by orthopedic surgeon to the physiotherapy clinic of the Faculty of Rehabilitation. University ethical committee approved the procedures. Patients were randomly divided in two groups and physiotherapy treatments were applied as following:

Group I.  Low Level Laser Therapy, heat, exercise.

Group II. Placebo (i.e. inactive Laser), heat, exercise.

Results: The result of current study shows that both methods of physical therapy were quiet efficient on 7 variables that measured in this study (p< 0.05).  However, the result of this study showed that in laser group, pain and speed of gait were more effectively influenced (p< 0.000 and p<0.048 respectively) in comparison with routine physiotherapy. Consequently, patients can fairly independently do their activity of daily living and this in respect may reduce the psychological side effects of illness. 

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Back ground and aim: Specific language impairment is one of developmental language disorders in children which have no known etiology. Very few researches have been done about children with this type of disorder in Persian language. The aim of this study is to detect whether there are similarity in language abilities between SLI children and their MLU -m matched group or not.

 Materials and Methods: In this case- control study, the results of speech samples analysis, quotients for composite scores and standard scores of subtests of TOLD, from 12(7 boys and 5 girls) 5-7 years old children with SLI were compared with the results obtained from 12 younger normal (8 boys and 5 girls) children who were matched according to MLU- m with SLI children.

 Results: results show that there are no obvious differences in percent- point average use of words and morphemes in speech between two groups. While the two groups were adapted according to m-MLU, but we found that children with SLI are significantly lower than their MLU matched children in quotients for composite scores of spoken language, organization and semantic and in standard scores of sentence imitation, relational vocabulary and oral vocabulary subtests of TOLD.

Conclusion: Our findings demonstrated that some language skills in children with SLI are lower than their MLU matched peers. Results of this study were not provided evidence to support the hypothesis that children with similar m-MLU have similar language skills too. So it is necessary for clinician to consider it when they work with these children. 

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Back ground and aim: The present study evaluated some language characteristics include: Semantic, Syntax and phonology in children with developmental dyslexia .          

 Materials and Methods: For this cross sectional/analytical study, 40 children between 7 and 8 years old were recruited by  non randomic sampling into 2 groups: 20 children with developmental dyslexia, with mean age of 8.04 years and 20 normal children with mean age 8.11 years. Data were collected using Parents Questionnaire,Teacher Questionnair and selected texts for informal evaluation, and we use Raven test of intelligence and Test of Reading and Dyslexia (NAMA) for diagnosing dyslexic children more carefully. At the end we use Test of Language Development-P:3 for comparing the language characteristics between 2 groups. Data were analyzed using t-test and Mann-Whitney.

 Results: Children with Dyslexia differ from the normal children in some language characteristics include : Semantic, Syntax and phonology. Comparing the means of Picture vocabulary,Oral vocabulary and Relational vocabulary tests were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Comparing the means of Sentence imitation, Sentence comprehension and Sentence completation tests were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Comparing the means of Phoneme analyze and Word discrimination tests were illustrated in 2 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Only in Word speaking Test there were no significant difference between 2 groups ( p>0.05 ).

Conclusion: In regard with these findings, accurate and deep evaluation of language by speech therapist is essential for dyslexic children and also speech therapy with focus on language skills can be clinical treatment, parallel to the traditional methods, in children with dyslexia.

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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: 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: Belts and back supports are frequently used to prevent low back pain. Despite many studies, there are not sufficient evidence and conclusive consensus about the effects of these supports. The purpose of the present study was to determine the effect of lumbosacral supports on motor control pattern during combined trunk motion.

Materials and Methods: 30 healthy young men were selected for the study. Temporal parameters of motor control and activity level of three pairs of trunk muscles were measured during combined trunk motion against minimum resistance and resistance equal to 50% of maximal isometric strength, under with and without back support conditions.

Results: By application of a lumbosacral support, movement response time was significantly decreased under minimum resistance (P=0/004). Application of support decreased reaction time and motor time under two resistance conditions significantly (P<0/05). No significant changes were found in trunk muscle activity levels following wearing a back support (P>0/05).

 Conclusion: By application of a lumbosacral support, individual reaction time was decreased. Although back support did not change the trunk muscle activity level, but the erector spinae muscle efficiency was increased to initiate desired movement.

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 Background and aim: The main problem of people with hearing loss is difficulty of hearing in background noise. One of the best tests that are used to evaluate speech perception in background noise is Quick Speech in Noise Test. The purpose of current study is to assess test-retest reliability and list equivalency of the Persian version of Quick Speech in Noise Test in young people with normal hearing. 

Material and methods: This cross-sectional study was performed on 36 young (18-35 years old) individuals with normal hearing. Materials were presented via compact disk of Persian version of quick speech in noise test with standard earphone. Almost one week after test session, re-test was performed. All of the correct words were scored and then signal to noise ratio loss was calculated.

Results: The mean SNR Loss was -1.5±0.74 dB. there was significant difference between test- retest scores for lists 1(p<0/05) and no significant difference between test- retest scores for lists 2, 3 and 4(p>0/05). There was significant difference between mean results of list 4 with list 1(p<0/05). There was significant difference for test- retest Pearson's Correlation in all lists.

Conclusion: Lists 2 and 3 of Persian version of Quick Speech in Noise Test are reliable and equivalent for determining signal to noise ratio loss.

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 Background and aim: Nowadays, importance of multidimensional approach in evaluating of stuttering  is obvious. Stuttering aspects evaluation provided by speech situation checklist. In this study, validity and reliability of this checklist is performed on stuttering and non- stuttering  (6-11 years old) pupils. 

Material and methods: In this research, 43 stutterer and 45 non-stutterer pupils were evaluated.

After equalization of questionnaire to Persian language, emotional reaction & speech disruption questionnaire were completed according to their attitude . In order to test validity, four methods were used. Data were analyzed by parametric and non-parametric statistical tests

Results: Comparison of score average of speech disruption and emotional reaction tests showed significant difference between stutter and non-stutter groups for Persian language children (p<0.05). Emotional reaction and speech disruption checklist (Persian version) has high test-retest (p=0.000,Icc>0.86) and internal validity (p=0.000,α >0.93).

Conclusion: Persian equalized speech disruption and emotional reaction tests have high validity and reliability. it might be useful to differentiate stuttering pupil among normal ones.  

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Background and aim: The aim of this study was to verify the relationship between pelvic tilt and lumbar lordosis with muscle tightness, muscle strength, BMI, and age in standing position.

Material and methods: In this study, 75 healthy female subjects participated with age range 20-70 years, mean (SD) = 40.66 (13.69). Pelvic tilt and lumbar lordosis were measured in standing position with pelvic inclinometer and flexible ruler respectively. The length of muscles, including: erector spinae, iliopsoas, rectus femoris, hamstrings, tensor fascia lata & ilio tibial band, and gastrocnemius were assessed by Schober, Thomas, Ely, 90/90 SLR, Ober tests and passive dorsiflexion of foot, respectively. The strength of muscles, including: rectus abdominis, transversus abdominis, left & right obliqus, Gluteus maximums & medius, and quadriceps were evaluated by manual muscle tests.

 Results: The relationship between pelvic tilt and lumbar lordosis with muscle strength, BMI, and age was poor. Muscle tightness and muscle strength had no significant effect on pelvic tilt and lumbar lordosis.

Conclusion: The results of this study indicated that the evaluated variables including: pelvic tilt and lumbar lordosis, have poor correlation with muscle tightness, muscle strength, BMI, and age. 

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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: Stuttering contains speech disruption or observed behaviors and inner reactions of speech- associated or emotional, disruptive, coping, and attitudinal reactions. Inner events can be reported by the person who stutters but can not be reliably defined by listener perceptions. Both the disorder's directly observable and inner elements and their interactive effects need to be fully assessed to achieve to clinically deals. This study investigates validity and reliability of the tests about inner events in stuttering children.
Materials & Methods: This descriptive and analytical study was performed on 96 stuttering and non stuttering students in 6-11 (similar in age and sex). After Persian equalization of questionnaire and verifying, tests validity are scored by 10 experts. In order to tests reliability, children performed tests in two stages (25 days interval). Three methods were used: 1.comparsion between the mean tests scores in two stage 2.Investigation of correlation between two stages. 3. Investigation of results reliability (ICC). The data were analyzed by parametric and non-parametric statistical tests (paired t-test, spearman and pearson).Independent t-test were used in order to compare the mean tests scores between stuttering and non- stuttering children.
Results: Although there was different between the mean BCL and CAT scores of stuttering and non stuttering children but this between group difference is not statistically significant (p>0.05) . The mean BCL and CAT scores between two group (stuttering and non-stuttering) was statistically significant (p<0.05).
Conclusion: Behavioral checklist and communication attitude tests changed in stuttering children at 6-11 age. Both are valid and reliable and these tests distinguish between stuttering and non stuttering children.

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Background and Aim: The standard tests are tools for quantifying different aspects of speech & language abilities and communicative skills. However developing and applying standard tests is necessary for assessing, screening, defining the speech & language abilities, diagnosing the speech & language disorders and attending to outcomes of treatment process. Therefore in this study for providing general view of speech & language assessment tests, we reviewed some of tests related to some important aspects of speech & language abilities.
Method: This research is a review study based on American speech-language and hearing association. We reviewed exactly the tests that are in this association site because it is one of comprehensive and reliable references for speech-language pathologists. Just four most practical aspects of them, from the first test developed to now (2010), are selected and then analyzed.
Results: In this study, 251 tests of assessment of speech and language are reviewed. 54 tests are related to articulation and phonological assessment. One hundred and forty tests are related to assessment of children expressive language. Forty three tests are available for assessing the expressive language in adult. 14 tests are presented for evaluating autistic children.
Conclusion: However there are widespread spectrum of standard tests but it is necessary to develop other tests in different aspects of speech and language pathology.

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Background and aim: One of the most important part of management and modification of CAD risk factor is to control the level of plasma lipid profile. Application of comprehensive cardiac rehabilitation in patient with CAD could decrease the level of CHL, TG, LDL and increasing of HDL .There are a lot of studies that discuss the effect of rehabilitation on different people with different races and life style
Material and Methods: Thirty six patients with the age (40-75) who were referred by cardiologist participated in this study. Fast walking on treadmill, biking on stationary bicycle and cycling with upper body ergometer were chosen as aerobic exercises. For assessing the short term and long term effects of this protocol, blood sampling were taken at three stages before exercise initiation, after 12 and 24 sessions of exercise.
Results: Following the cardiac rehabilitation protocol, the level of CHL, LDL and the ratio of LDL/HDL and CHL/HDL decreased significantly.
Conclusion: Cardiac rehabilitation could be used as means to improve lipid profile level in blood serum, prevention of cardiovascular disease and reducing mortality and morbidity rates.

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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: Intonation perception mainly relies on fundamental frequency changes perception that is not available for individual with profound to severe hearing loss. The aim of the present study is to investigate the perception of intonation in cochlear implanted children and compare with normal hearing children.

 Materials and methods: This study has been carried out on 25 cochlear implanted children and 50 children with normal hearing. An adult who her first language was Persian, expressed some questions and statement sentences. These sentences were playing for child and was asked him/her to determine whether it was in a question form or statement one.   

 Results: The results showed that perception of question and statement sentences intonation had significantly differences between two groups (P<0.05). Perception of question and statement sentences intonation had significantly correlation with age at implantation and duration of implant use (P<0.05).

 Conclusion: According to the findings of the current study and previous studies, cochlear implant has some deficits in facilitating the perception of intonation. However, this limitation has been compensated partly for early surgery. Thus, speech language pathologists should consider intervention of intonation in treatment program of cochlear implanted children.  

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Background and aim: Knee osteoarthritis is one of the most common musculoskeletal problems, can affect on patient's daily activity and produce dependency in their daily activity and functional disability The aim of present study is to compare static balance in patients with knee osteoarthritis and healthy subjects using force plate. 

Materials & Methods: Postural stability in knee OA patients and healthy subjects (each group 20 subjects) were measured by force plate. Two positions were selected double stance with closed or opened eyes. Range of fore/aft (Rfa) and Range of side ways (Rsw), were measured as static postural stability.

Results: Rsw increased significantly in the double stance position in patients group (P<0.05). Also in both groups, Rsw and Rfa in the double stance with closed eyes were more than of open eyes position (P<0.05).

Conclusion: Postural control deficits and increase of center of pressure's sway were identified in participants with knee osteoarthritis. Therefore, one of the most important goals of rehabilitation is to improve balance control in knee OA patients.

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Background and Aim: Cerebral palsy (CP) is the most common motor impairment in childhood and affects 2 in 1000 live births, in which postural and motor control involved. In hemiplegic type, two sides of the body have differences in postural tone that cause weight shift to the intact side. In these children postural disorders appear as postural stability disorder. The aim of this study is to assess the effect of lateral wedge insole on postural control in cerebral palsy children.
Materials and Methods:  Sixteen hemiplegic children attended in this program and stood in two conditions on the force plate with and without lateral wedge on the hard plate. Center of pressure displacement measured for medio-lateral and antro-posterio directions. Every test took 20 seconds. It was repeated 3 times.
Results: Range of sideways decreased significantly with use of 5º wedge. Also a shoe wedge of 5º provided symmetrical weight distribution.
Conclusion: The results represent that a 5º lateral wedge applied to the unaffected limb, can improve factors of postural control and gain the symmetry in hemiplegic children