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 Background and Aim: Spasticity is a motor disorder characterized by a velocity dependent increase in tonic stretch reflex and tendon jerks, due to the hyper-excitability of the stretch reflex. Modified Tardieu Scale (MTS) is a clinical tool for assessment of spasticity. The purpose of this study was to investigate intra-rater reliability of the MTS for knee extensors and ankle plantar flexors muscles in adult subjects with chronic stroke.

 Materials and Methods: In an analytical cross sectional study, 17 participants (10 men ,7 women) with age range of 40-76 years and mean time post stroke of 20/79 (SD=20/55) in a convenient sampling took part in this test-retest study. Intra-rater reliability of spasticity with MTS was investigated by one un-experienced physiotherapist for knee extensors and ankle plantar flexors in two sessions over one week. 

 Results: Interclass correlation coefficient (ICC) values for R₂-R₁ as an indicator of spasticity in knee extensor and plantar flexors was good (ICC=0/66) and very good (ICC=0/87) and for knee extensors and ankle plantar flexors quality of muscle reaction was 0.80 and 0.92 respectively.

 Conclusion: The MTS has a good reliability in spasticity assessment of knee extensors and ankle plantar muscles after stroke. Probably MTS can be used as a reliable clinical tool to measure spasticity of lower extremity muscles in adult subjects with chronic stroke.

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Background and Aim: Spasticity is one of the symptoms that contributes to functional limitation in adults with cerebral palsy and characterized by a velocity dependent increase in tonic reflex due to the hyperexcitability of the stretch reflex. Modified Tardieu Scale (MTS) is a valid clinical tool for assessment of spasticity. The purpose of this study was to investigate Inter-rater reliability of the Modified Tardieu Scale (MTS) for hip adductors, knee extensors and ankle plantar flexors muscles in adult subjects with cerebral palsy.

 Materials and Methods: In an analytical cross sectional study, 30participants (11 men ،21 women, age range 20 to 40 years, mean age (26.57±4.8) with spastic cerebral palsy from Ra'ad Rehabilitation Goodwill Complexes in Tehran city in a convenient sampling took part in this study. Spasticity was measured by two physiotherapist for hip adductors, knee extensors and ankle plantar flexors with MTS during same session with ten minutes interval between assessment of two raters.

 Results: ICC values for R₂-R₁ as an indicator of spasticity in hip adductors, knee extensor and plantar flexors were 0.97, 0.88 and 0.81 respectively. Also ICC Values for quality of muscle reaction was 0.89 in hip adductors, 0.96 in knee extensors and 0.92 in ankle plantar flexors

Conclusion: MTS has a high reliability in spasticity assessment of adductors, knee extensors and ankle plantar flexors muscles, Probably MTS can be used as a reliable clinical tool to measure spasticity of lower extremity muscles in adult subjects with cerebral palsy.

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Background and Aim : Hemiplegic shoulder pain is a common problem that its prevalence varies from 48% to 84%. This disorder limits the patient’s ability to achieve the optimal function. The objective of study was to assess the relationship between hemiplegic shoulder pain with neuromusculoskeletal disorders in post stroke hemiparesis

  

Materials and Methods: This study was an observational-analytic that fullfilled on fifty patients with acute stroke. The post stroke period was 28 days. The following items were evaluated:shoulder subluxation with X-ray, shoulder spasticity with Modified Modified Ashworth Scale (MMAS), soft tissue injury with orthopaedic tests and RSD with clinical features.

 

Results: Hemiplegic shoulder pain was present in 28 patients(56%). Seventeen patients (85%) showed shoulder subluxation, 18 patients (72%) had supraspinatus tendonitis ,13 patients (65%) had biceps tendinits, 4 patients (14/2%) had ACJ involvement, 3 patients (10/7%) had elbow flexor spasticity, 2 patients (7/1%) had shoulder adductor spasticity ,2 patients (7/1%)had shoulder internal rotators spsticity , 4 (14/2%) patients had RSD.

  

Conclusion: Results from this study show that one factor does not play role in causing hemiplegic shoulder pain and this disorder is multifactorial. Prevention of shoulder pain and performing appropriate physiotherapy can play a role in improving stroke patients’ function.

 

Keywords: Stroke, Shoulder pain, Sublxation, Muscle tone, Shoulder –Hand syndrone

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Background and Aim: This study was conducted dueto the limited results of past studies in relation to postural control in children with developmental coordination disorders and the importance of postural control with the ability to integrate the vestibular, visual and somatosensory inputs. In this study the postural control of the children with Developmental Coordination Disorder (DCD) and their normal peers was compared under the reduced or the conflicted sensory input conditions.

Materials and Methods: Twenty two children with Developmental Coordination Disorder (16 males, 6 females with mean age of 7 years old and 9 months, SD 1 year and 5 months) and 19 children with normal motor development (13 males, 6 females, with mean age of 6 years and 11 months, SD 1 year and 1 month) were evaluated. Standing balance, sensory organization and motor control strategy were evaluated using the sensory organization test (SOT).

Result: The results showed that the children with DCD had poorer function than the normal children in the composite equilibrium (p&le; 0.001), visual ratios (p=0.005) and vestibular ration (p=0.002). There were no meaningful differences between groups in their average somatosensory ratio. Additionally, children with Developmental Coordination Disorder had lower motor strategy scores than the normal children when they were forced to depend on vestibular cues alone (p < 0.05). The children with Developmental Coordination Disorder had deficits in standing balance control in conditions that included reduced or conflicting sensory signals. The visual and vestibular systems tended to be more involved in contributing to the balance deficits than the somatosensory system. Moreover, children with Developmental Coordination Disorder were tended to use hip strategy excessively when forced to rely primarily on vestibular signals to maintain postural stability.

Conclusion: In order to improve the postural control in the patients, the rehabilitation protocols should focus on the sensory-motor deficits.

Keywords: Postural control, Postural stability, Developmental Coordination Disorder