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Background and aim: Spinal injury especially during occupational lifting is one of the most common neuromuscular disorders in the general population of the world. Asymmetric motions of trunk frequent bending and twisting, lifting and forceful activities contribute to spine disorders. Sport as a comprehensive activity might be able to cause less force to the spine and decrease spinal injuries. The purpose of present study was to determine the effect of lifting on motor control pattern during combined symmetric and asymmetric trunk motions on athlete and non-athlete subjects.
Materials and Methods: Seventeen non-athlete female subjects and seventeen athlete female subjects performed to lift four loads ( 5,7,9 ,12 kilogram ) at symmetric and asymmetric conditions. Under each condition temporal parameters of motor control were measured on flexor and extensor of trunk muscles.
Result: In two groups of athletes and non-athletes with increasing load , muscles begin their activity faster ( P<0.05 ). No significant change was found at asymmetric condition. Also, in athletes premotor time of muscles during lifting was less than non-athletes.
Conclusion: With increasing load, according to the feed forward control mechanism and awareness of subjects from amount of loads, muscles quickly prepared to contract for starting the movement. It seems that the response of movement on the neuromotor system of athletes is preprogrammed and automatic due to sport experience. Actually muscles have anticipation activity.

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Background and aim: Many studies have been carried out about bedrest and its effects on different systems including musculoskeletal,neuromuscular,cognition and vascular systems throughout the world.The purpose of this paper is to review systematically all Berlin Bedrest Studies on musculoskeletal system.The focus of this review is  mainly Second  Berlin Bedrest Study (2^nd BBRS) supported by European Space Agency(ESA).Such studies provide a chance to study the specific effects of immobilization without interference of other diseases.
Materials and Methods: A literature search was carried out using MEDLINE and ESA database to assess existing literature about the effect of bedrest on musculoskeletal system published by Berlin Bedrest Studies.It has been searched for efficacy of interventions  as high load resistive exercise and whole body vibration,as well.
Results: Fourty six articles have been found from 2000 to 2011year: 2 articles in 2000 and 2003,the other ones  between 2005 to 2011. Seventeen  articles were related to muscle and intervention on it,three ones about bone and related intervention on it,four  ones related to both bone and muscle and twenty two ones about the other systems  such as heart,vesseles,sleep and cognition.
Conclusion: According‏‏‏ to study results,bedrest has widespread effects on musculoskeletal system specially in early bedrest . These  effects remain up to 180 days  after bedrest course.Thus,high load resistive exercise and vibration should be prescribed in early stage of bedrest to reduce the detrimential effects of prolonged bedrest.

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Background and aim: One of the main problems in learning is ignoring the teaching in small group discussion.So, today, teaching in student-based methods such as work in small group is emphasized. Nevertheless, this method is not used for teaching physiotherapy students. This study was performed to determine the effect of teaching in small group on satisfaction and learning level of second- year students in physiotherapy in comparison  with lecture teaching.
Materials and methods: An experimental study was performed on 29 physiotherapy students. The students were randomly classified into two groups lecture (14 people) and work in small group (15 people). Students were educated for 4 sessions. Two separate questionnaires were used to assess learning and satisfaction levels.
Results: Overall satisfaction in small group was significantly greater than lecture group (P<0.0001). However, there was no significant difference between learning levels of the methods (p>0.05). 86.7% of students in small groups preferred to be educated in the future semesters using this teaching method.
Conclusion: This study showed the role of small group teaching on increasing students' satisfaction level. Due to increased satisfaction in small group, despite the lack of significant difference between the two methods of learning, learning process can be facilitated .Thus this method is recommended for education of the undergraduate students.

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 Background and Aim: The translation, cultural adaptation and validation of the Persian version of the American shoulder and elbow surgeons (ASES) were carried out in accordance with published guidelines.

Materials and Methods: The study was conducted on 100 athletes (25.96±5.81 years), which suffered from different shoulder disorders. When the translation and cultural adaptation of the original questionnaire was carried out on the standardized method, the participants were asked to complete a questionnaire booklet including the DASH, the Short Form General Health Survey (SF-36) and ASES questionnaires. In addition, 30 randomly selected patients were asked to complete the ASES questionnaire 48 hours later for the second time. After data collection the Statistical analysis was performed by using SPSS software.

Results: The Cronbach's alpha was used to indicate internal consistency. Cronbach's alpha was 0.91 for ASES. Test-retest reliability was quantified by use of the intraclass correlation coefficient. It was 0.91 for ASES questionnaire. The Pearson Correlation Coefficient was used for the questionnaire validation study. The DASH questionnaire showed high correlation of ICC=0.78 with ASES. The ASES showed moderate correlation of 0.48 to 0.62 with those of the various scales of the SF-36.

Conclusion: The Iranian ASES showed good reliability and validity and can be used for shoulder-specific patient self-assessment.

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Background and Aim: Diabetes has world wide prevalence and it is estimated that up to ten years later, more than 300 million people would suffer from it. The disease has serious secondary complications. Physical activity can decrease the complications by altering the blood profiles. Patients with diabetes are unwilling to do physical exercise. Whole Body Vibration (WBV) might be a proper substitution for exercise. The effects of WBV on patients with diabetes have not been studied enough, so the aim of this study was to evaluate the effects of WBV on the blood profiles in patients with diabetes type 2.

Materials and Methods: Twenty patients with diabetes were assigned using matched assignment either into control (n=10) or intervention (n=10) group. Intervention group received the WBV with frequency of 30 Hz and amplitude of 2.5 mm for six weeks twice a week. The control group did not receive any intervention during this period. Blood profiles were measured in both groups at the baseline and the end of the study.

Results: FBS and HbA1C decreased in intervention group in comparison with the control group but the differences were not statistically significant (P=0.44).  There were not significant statistical differences in Cholesterol, HDL, LDL and TG before and after the treatment between the two groups.

Conclusion: The application of WBV with the above parameters might reduce FBS and HbA1C in patients with diabetes type 2. Increase in the amount of Glucose Transporter protein 4 (GLUT-4) is one of the contributing factors that these changes can be ascribed to.

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Background and Aim: With regard to importance of the role of balance in performance of daily activity especially in exercise activity and necessary to identify the factors that influence the balance, the purpose of this study was to survey the effect of lower limb muscle fatigue on balance in elite young athletes.
Materials and Methods: For this purpose, 15 young elite swimmers with a mean age and body mass index 17±0.7 and 21.62±0.5 during the two test phase, were studied. All participants performed the postural Stability and limit of stability tests in six for each test (three repetitions before and three repetitions after fatigue protocol by Wingate test)on the balance Biodex system. Values obtained by the system of the total , anterior - posterior, medial - lateral, anterior, anterior - right, anterior- left, posterior, posterior - right and posterior left index, were analyzed using paired sample t-test(P0.05).
Results: Results showed that fatigue caused a significantly influence the anterior - posterior, medial - lateral, posterior, left and posterior –left index.
Conclusion: With considering the specificity of training principle, the results can be helpful in the design of exercises involving the lower limb muscles in the specific direction. Keyword: Balance, Limit of stability, Fatigue, Athlete.

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 Background and Aims: Oneimportant complicationof breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and cosmetic problems. The aim of this study was to evaluate the effects of Complex Decongestive Physiotherapy (CDP) on volume of lymphedema in patients with secondary lymphedema after breast cancer treatments.

Material and Methods: A total of 30 women with lymphedema after breast cancer treatments and according to inclusion and exclusion criteria were chosen. They were treated with complex decongestive physiotherapy. This protocol involved manual lymphatic drainage (MLD),Compression garments, remedial exercise and skin care. The women were taken 4-week therapy program once per day, 5 days per week. Absolute volume of the lymphedema and circumference of the limb were evaluated before and after treatment.

Results: After 4 weeks treatment, lymphedema volume, circumference in all of the evaluated points and severity of the pain are decreased after treatment.

Conclusion: In upper extremity lymphedema, the use of complex decongestive physiotherapy (CDP) can decrease edema.

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Background and Aim: Accurate control of movement is one of the multiple components in skillful motor performance that can be impaired by disease. Trackingtests quantify the effects oftreatments designed toimprovecontrol of movement and they are considered as anideal protocol forimproving motor control. The purpose of the present study was to examine reliability of the control error during target tracking tasks in trunk region in sagittal transverse torque plane in healthy subjects.

Materials and Methods: Nine healthy subjects (4 females and 5 males) randomly performed target tracking tasks at levels of 0% to 80% Maximum Voluntary Exertions (MVE) and twelve different directions (0 ̊, 30 ̊, 60 ̊, …, 330 ̊) twice in upright standing posture. In this study, the tracking system included a moving target circle, which moved on a straight line in specific direction from 0 to 80% of individual MVE with speed of 6% MVE/S.The direction of isometric trunk exertion was presented to participants in the online visual feedback by a computer monitor positioned in front of them. Trunk controllability was determined by computing the control errors (Absolute Value Error from the Target [AVET], Error from the Target Path [ETP] and Error from the Target in the Target Path [ETTP]) during each performance. Relative reliability (Intra-class Correlation Coefficient [ICC]) of the control error in each direction was determined. Also absolute reliability (Standard Error of Measurement [SEM]) and Minimal Detected Change (MDC95) were computed.

Results:The results have shown that ICC for AVET, ETP and ETTP ranged from 0.81 to 0.99, 0.71 to 0.98 and 0.7 to 0.99, respectively. Also SEM for these variables ranged between 0.003- 0.013, 0.001- 0.009 and 0.003- 0.011, respectively and finally MDC95 ranged between 0.008 to 0.036 for AVET, 0.003 to 0.025 for ETP and 0.008 to 0.03 for ETTP.

Conclusion: The study showed high and very high reliability for control error measures during target tracking tasks in sagittal transverse torque plane in asymptomatic subjects. Therefore this performance may be used as a test in trunk controllability assessment.

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Background and Aim: Since utilization of different patterns to perform voluntary movements influence human function, the aim of this study was to compare the selected kinematic parameters of active males in voluntary and involuntary gait initiation.

Materials and Methods: In this quazi-experimental study 13 young male subjects with age (23.3±3.1) years, height (1.75±.13) m, weight (68.9±7) kg and body mass index (22.4±1.8) k/m2, performed initiation of gait in 6 trials included three voluntary and three involuntary. Kinematic parameters measured by motion analysis system. K-S test was used to ensure the normal distribution of data and dependent T- test to compare within group variable at P0.05 level.

Result: The results showed that use of perturbation that leads to the initiation of motion, increased distance (p: 0.00) and velocity (p: 0.00) and reduced the time of gait initiation (p: 0.00), swing time (p: 0.00), stance time (p: 0.00) and double support time (p: 0.00), increased the amount of hip (p: 0.00) and knee flexion (p: 0.00) and decreased the amount of ankle dorsiflexion (p: 0.00). In addition, the displacement of the center of mass in the medio-lateral and vertical directions was decreased (p=0.03) and increased (p=0.01) respectively. Conclusion: The results indicate significant changes in most of the spatio-temporal parameters of gait initiation as a result of using Perturbation that leads to the initiation of motion. The results of this study can be recommended to be used in the field of gait initiation studies as well as in clinical cases to diagnose the normal and abnormality.

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Abstract Background and aims: One of the complications of breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and disorder of Quality of life. The aim of this study was to evaluate the effects of Complex Decongestive Physical Therapy (CDP) on pain severity and quality of life in patients with secondary upper extremity lymphedema after breast cancer treatments. Material and methods: A total 30 women (age 29-70 yrs.) with secondary lymphedema after breast cancer treatments participated in this study. They were referred by general and cancer surgeons to Physical Therapy clinic based on inclusion and exclusion criteria. They were treated with complex decongestive physical Therapy. This protocol comprises of manual lymphatic drainage (MLD), compression garments, remedial exercise and skin care for 4-weeks, once per day, 5 days per week. Quality of life and severity of pain were evaluated before and after treatment. The quality of life was assessed with QLQ-C30 questionnaire. The severity of pain was also assessed by Visual Analog Scale (VAS). Results: After 4 weeks treatment severity of the pain are decreased after treatment. The physical and social roles of quality of life (QLQ-C30) were significantly increased (p<0000). Conclusion: Based on the results of this study, utilization of complex decongestive physical therapy (CDP) In upper extremity lymphedema is a useful method for pain relief and increment of quality of life. Keywords: Upper extremity lymphedema, Complex decongestive physiotherapy (CDP), Severity of pain, Quality of life

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Abstract

 Background and Aim: Regard with the importance of balance in daily activities especially in sport activities and understanding the important factor affecting it, the purpose of this study was to compare the role of vision system on dynamic postural stability of young women with men elite athletes.

Materials and Methods: Twenty six young women and men elite swimmer were chosen from the available society. They were divided in two groups according to body mass index. Each subject performed postural stability tests for 6 trials with open and close eyes (3 trials with open and 3 trial with close eyes) that each trial was taken for 30 seconds and with 10 seconds rest between each of them. Balance index in anterior- posterior and medial- lateral directions were calculated and independent t test was used to compare between groups.

Result: Results show that men swimmer are more depended to vision than women swimmer in maintaining retrieval postural stability (p= 0.001), while most impairment in maintaining postural stability in both groups occur in lack of vision status in anterior- posterior direction (p= 0.001).

 Conclusion: The findings of this study can be used to design training programs to prepare athletes.

Key words: balance, vision, athlete, control

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Background and Aim: The target tracking tests is a known method to quantify the performance of the neuromuscular system. It has been used in several studies for evaluation of neuromuscular control strategies. The purpose of the present study was to examine the effect of direction and speed of isometric trunk exertion on the trunk controllability during the target tracking tests in sagittal versus axial rotation torque plane.

  

Materials and Methods: Twenty- two healthy subjects (13 female and 9 male) randomly performed target tracking tasks at levels of 0% to 80% Maximum Voluntary Exertions (MVE) and seven different directions (0 ̊ , 30 ̊ , 60 ̊ , …, 180 ̊ ) in upright standing posture. In this study, the tracking system included a moving target circle, which moved on a straight line in specific direction from 0 to 80% of individual MVE with speed of 5, 6 and 7% MVE/s . The d irection of isometric trunk exertion was presented to participants in the real time visual feedback by a computer monitor positioned in front of them. Trunk controllability was determined by computing the control errors (Absolute Value Error from the Target [AVET], Error from the Target Path [ETP] and Error from the Target in the Target Path [ETTP]) during each performance. Analysis of variance was used to test the effect of speed and direction of isometric trunk exertion on trunk controllability.

  

Results: The results have shown that the direction of isometric trunk exertion had significant effect on the AVET and ETTP (p= 0.000) while the effect of speed and interaction between direction and speed were not significant. The error decomposition in to two independent parts showed that the only direction of exertion on ETTP was significant (p= 0.000) and speed of exertion on any of them ( ETP and ETTP ) was not significant. On the other hand, Borg scale (a simple method of rating perceived exertion) significantly affected by direction (p= 0.000) and speed (p= 0.000) of exertion during the target tracking tests.

  

Conclusion: According to the findings of the current study, the effect of d irection of isometric trunk exertion on the controllability was significant. Trunk controllability was significantly decreased during rotational exertions which may impair trunk neuromuscular coordination, increasing the risk of developing low back pain.

  

Keywords: Target t racking t ests , T runk controllability , Speed and d irectio n of isometric trunk exertion

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Background and Aim: The calculated parameters of the center of pressure (COP) are suitable indicators for evaluating balance in patients after rehabilitation. Therefore, determining the reliability level of each parameter is a matter of great importance. This study tried to determine the reliability of some parameters of the COP sway in patients with myofascial neck pain in different postural situations.

  

Materials and Methods: The present study is a test-retest reliability design. Twenty patients with myofascial neck pain performed a single and a double leg test with open and closed eyes on a force plate and with open eyes on foam in three sessions with a 30 minute intervals for 30 seconds. Antero-posterior and medio-lateral sway range, mean velocity and mean area of sway were calculated.

  

Results: The mean velocity showed high reliability (0.98) in all situations, but the other parameters were variable in different situations.

  

Conclusions: The results showed that some COP parameters are highly reliable in assessment of patients with myofascial neck pain.

  

Keywords: Reliability, Myofascial neck pain, Center of pressure, Force plate

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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

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Back ground and Aim: Feeding is the most essential behavior in infants for vitality, learning and interaction. Because of feeding importance in developmental process and its primary role in infant’s vitality, the study of dysphagia has an important role. Diagnosis, assessment and treatment of this disorder are primary professional action for speech therapists. Therefore, basic information about prevalence of such disorders can be effective in treatment planning. In this study, the number of infants with oral feeding disorders is determined in NICU .

Materials and Methods: In this descriptive-sectional study, all infants that were in NICU at Tehran University of medical sciences hospitals were evaluated in three first months of 1390 year through information from medical history, interview and observation. The data were analyzed with SPSS 16.

Results: Data analyzing of this study showed that 45 infants (27.10%) from 166 cases in NICU had oral feeding disorders. The incidence in male is more than female (91.11% versus 8.88%). Twenty two of cases feed normally, 18 cases feeding with NGT and 5 cases with OGT. The rate of difficulty in oral phase and esophageal phase were 88.88% and 2.22% respectively. No infants have difficulty in Pharyngeal phase.

Conclusion: Feeding disorder assessment by speech therapist provides essential information about feeding intervention and so early diagnosis can prevent later speech problems. Therefore, the role of a speech therapist in NICU is important.

Keywords: Incidence, Oral feeding disorders, Infants, NICU

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Background and Aim: Proprioception is a component of somatosensory system. One of the most important somatosensory receptors is muscle spindles. Neck area with high density of muscle spindle, plays a significant role in providing this sense. With repeated contact sports, with high trauma on head and neck region, it is likely that proprioception will be impaired. The present study was conducted to compare proprioception between wrestlers, taekwondo players and non-athlete subjects to determine the effect of trauma on proprioception of craniocervical region.

 

Material and Methods: This study was a case-control study of 75 male with the age range of 18-30 years (Including: 25 professional wrestlers, 25 professional taekwondo players and 25 non-athlete subjects). Participants were selected through simple non-probability sampling. To assess proprioception of craniocervical region, angular repositioning of two positions (neutral and 50% of range of motion) was evaluated by using the cervical range of motion device (CROM device). The statistical method which used in this study was one way ANOVA.

 

Results: Accuracy of target repositioning (50% of range of motion) of extension, right and left rotation were significantly different between three groups (p<0.05). Returning to neutral position from mentioned movement was associated with a significant error (p<0.05).

 

Conclusion: It is assumed that proprioception of craniocervical region has been affected by trauma in wrestlers and taekwondo players, so that the accuracy of head repositioning for both neutral and target positions were reduced in wrestlers. However, taekwondo players had more errors in repositioning of target angle.

 

Keywords: Proprioception, Repositioning error, Craniocervical, Wrestlers, Taekwondo players

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Background and Aim: Semantic test “pyramids and palm trees” (PPT) are the most common tests for assessing memory. Since this test is related to language and culture, normative data in different populations are needed. This study was done in Persian language.

Materials and Methods: Current study was cross-sectional and was done in 270 male and female from 20 to 69 years old. After performing Mini-Mental Status Examination test, Persian version of PPT was done. Subjects must select a picture or word between two pictures or words that was closer to target. First picture version was performed and then word version was carried out after 10 to 14 days. Data was analyzed by Spss16 software and the statistic tests were included of T-Test and a Paired T-Test and ANOVA.

Results: The Results show that difference between picture and word scores increased with rising age. There were significant differences in gender between scores of picture and word version (male P<0.001, female P=0.003). It also points out the difference increases between picture and word scores with education. 

Conclusion: Both versions are affected by demographic variables and so the scores should be interpreted accordingly.

Keywords: Persian normative data, Pyramids and palm trees, Adult

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Background and Aim: Measures of oral diadochokinesis are widely used in the assessment and detecting motor speech disorders and functional abnormalities of speech performance. Preschoolers have great difficulties with this clinical task. One reason for this problem is application of using of non-words in the test. Since, such words were not designed in Farsi; therefore we compared some words and non-words repetitive articulatory rate in preschool children.

Materials and Methods: In this analytic cross-sectional study design, 142 children (65 boys & 77 girls) aged 4 to 6 years old were participated. We compared timing for 10 fast repetitions between two meaningful words /motæk&Lambda;, gol&Lambda;bi/ and tri-syllabic sequences /p&Lambda;t&Lambda;k&Lambda;/. Data was analyzed by repeated measures of ANOVA test.

Results: In children aged 4 to 5 years old, mean ± SD of timing for 10 repetitions of /p&Lambda;t&Lambda;k&Lambda;, motæk&Lambda;, gol&Lambda;bi/ were 7.72±1.02, 6.58±1.68 & 6.65±1.13 seconds respectively, and in children aged 5 to 6 years, were 7.57±0.95, 6.35±1.38 & 6.30±1.01 seconds respectively. This Analysis showed that regardless of all factors, the main effect of type of words on oral diadochokinesis was significant (p=0.0001). There were no other significant main effects or interactions.

Conclusion: Children aged 4 to 6 years old could repeat meaningful words /motæk&Lambda;, gol&Lambda;bi/ faster than non-word /p&Lambda;t&Lambda;k&Lambda;/. Sex and age group factors had not significant effect on oral diadochokinesis function. Finally, it is suggested that speech therapists can examine this ability with meaningful words.

Keywords: Oral diadochokinesis, Word, Non-word

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Background and Aim: Theory of mind as a cognitive component is the foundation of our ability to explain or predict the behavior of ourselves and others which is done through the attribution of mental status. This ability damaged in deaf children and its development is fast in girls. The aim of this study was to study theory of mind in 5-6 years cochlear implant children and its relation with gender and age of cochlear implant (CI).

Materials and Methods:  This study is descriptive and cross-sectional. Eighteen Farsi speaking children CI children and 18 normal development children aged 5-6 were participated in this study. The normal children were selected from living area of CI children. They were selected through available and easy sampling method. These children had no sensory or speech disorders. The basic theory of mind was tested in these children.

Results: Theory of mind was significantly different in both groups (p = 0.00). The comparison between girls and boys did not show significant difference in normal (p= 0.321) and CI children (p =0.231). There was no significant relationship between the age at CI and theory of mind scores (p=0.100).

Conclusion: Hearing impairment has influence on basic theory development in CI children. Age of implantation and gender had no effect on development of theory of mind.

Keywords: Theory of mind, Cochlear implant, Farsi language.