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Background and Aim: Several biomechanical and clinical studies have examined the apparent myoelectric silence of the lumbar spine extensor musculature during lumbar flexion from a neutral upright standing posture.

Objective: The purpose of this study was to investigate the relationship between trunk flexibilitiy and flexion relaxation response of the the lumbar erector spinae

Material and Methods: 30 female healthy students were participated in this study which They were arranged in three groups on toe touch test (low flexible,  normal and high flexible).The surface electromyographic from the lumbar erector spinae muscles as well as flexion angle of the trunk, hip and lumbar were recorded. The angle in which electromyographic diminished during flexion and initiated during extension was determined and subjected to one way Anova to determine any significant differences  in the flexion-relaxation response between three groups.

Results: The erector spinae muscles were relaxed in  larger angles during flexion and initiated activity significantly earlier during extension in high flexible group (p<0/001). pearson correlation indicate that there were high correlation between trunk and hip angle during full flexion (r=0/88 p<0/001) and no correlation between trunk and lumbar angle (r=0/1 p< 0.3).

Conclusion: The results indicated that individuals with more flexible trunk , the erector spinae muscles gets relaxed in further angles of the trunk and the hip, furthermore while returing to the upright posture ,this muscle is recruiting sooner than two other groups .the biomechanical basis of this finding relies in ligamentous and passive tissues properties of individuals with different Flexibilities of the trunk which can effect there recruitment pattern of active tissues.

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Background and Aim: In this study, we investigated : 1) The effect of diferent lengths of Abd. policis brevis muscle on variations EMG frequency spectrum. 2) The effect of muscle contractions on frequency spectrum and 3) The effect of different lengths of muscle on local muscle fatigue.

Material and Method: 20 normal subjects participated in this study. (with range of 20 - 34 years old). Each test carried out in four steps. Every person performed 3 minutes of isometric contraction in Abd. policis brevis muscle and EMG signals were saved for 5 seconds before and after the test. Then the  same procedure was performed while individual did 6 minutes free dynamic contraction and 6 minutes high speed dynamic contraction and 6 minutes forceful dynamic contraction respectively.

Results:This study showed that when the individual performed muscle contraction in short length, median and mean frequency increased (P = % 0) and fatigue test caused a decrease in frequency charactristics that was more in dynamic contractions in compare with isometric contraction (it was more obvious in forceful dynamic contraction). These parameters didn't change in different lengths (P = %9, P = %4, P= %3 for 0 - 45, 0 -90 and 45 - 90 degrees respectively).

Conclusion and discussion:This study showed that different muscle lengths and muscle contractions affect on frequency spectrum and it also showed the effect of different muscle lengths and muscle contractions on local muscle fatigue.

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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: Mechanoreceptors from the foot sole likely contribute in the reflex regulations. Stimulation of these receptors in the medial aspect of the foot is corresponded to the medial plantar nerve divisions in the tibial nerve. Therefore, it was hypothesized that repetitive low threshold afferents stimulation would have an inhibitory effect on the soleus H-reflexes.

Materials and Methods : sixteen normal subjects voluntarily, participated in the study. Subjects were remained in prone position. The Cutaneous Mechanical Pressure (CMP) (equal to 50% of leg and foot weight) was applied to the ipsilateral medial plantar surface by a designed instrument through a square plate (30 x 30 mm). H reflex as an indicator for excitability of motoneurones was bilaterally elicited before and after the application of the CMP.

Results: The amplitude of H reflex and H/M ratio showed significant differences before and after the Ipsilateral CMP stimulation of the medial side of the foot (p<0.05) furthermore, the latency of  H reflex was also increased (p<0.05). In addition, the effect of CMP stimulation of the IPS stimulation showed more difference than the Contralateral side.

Discussion: The results highlights the modulatory effects of natural stimulation of cutaneous afferents on excitability of Ipsilateral and contralateral motoneurones. This in respect may have practical application in the management of muscle tone disorders in brain and spinal cord injuries.

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Background and Aim: As the population of geriatrics increase, this group must be noticed from economical, vocational, therapeutic situations the majority of geriatrics has problems with their hands. These problems influence their activity of daily living, vocation and etc. The main goal of present study is to determine the relation between grip strength and dexterity in 25-45 and 65-85 years people.

Material and method: The grip strength and dexterity were administered to one hundred people aged between 25-45 and 65-85 years with a mean age of 53.61 years old (SD= 20.60). The grip strength and dexterity were evaluated 3 times, and data were analyzed with SPSS (V: 11.5).

Results: Mean of grip strength in group (25-45) year was more than group (65-85) year. In both groups the results of grip strength in men were more than women. We noticed that with increasing age the dexterity decrease and dexterity differences between group 25-45 and 65-85 years were statistically significant. Between men and women dexterity differences was not significant. The correlation between grip strength and dexterity was not statistically significant.

Conclusion: This study showed that dexterity is related with age and functional activities. Grip strength is related with age, occupation, gender. As the age increase these features of the hand decrease. But there isn't a correlation between grip strength and dexterity.

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Background and Aim: Academic evaluation is a systematic process for collecting, analyzing and interpretation of the obtained educational information. The purpose is that how many educational objectives can be achieved. The goal of education is creating effective & efficient changes in the outcome of this system (i.e. students), and finally, promotion of the quality of educational process. In the following study, internal evaluation in 8 educational domains of the Physical therapy Department of the Rehabilitation Faculty (TUMS) was performed.

Materials and Methods: Physical therapy Department of the Rehabilitation Faculty (TUMS) was evaluated using the opinion of the faculties, students and graduates in the academic year 2003-2005. The aim was to adjust the system according to the golden standard and community needs by using a cross sectional and descriptive method. This was done on the basis of 10 procedural steps, within 8 domains such as faculties, management, student's opinion, staff and logistic affairs, classes, library, clinics, equipments, laboratory, satisfaction of graduates and curriculum.

It is worthwhile to mention that there was no golden standard available in Iran for Physical Therapy Department. Therefore, by using the standards of prestigious universities of the world & opinion of Iranian experts, for the first time in Iran, a native golden standard was defined by the principal investigators. The results of the research were compared with the golden standard.

Results: The results of study showed that the mean of 8 domains based on SWOTs model was 76/2% which may be interpreted as a positive model. Among the 8 domains, the clinics, classes & library were rated the best (95%) and student's satisfaction was 65.3%.

Conclusion: The results of the current study showed that academic evaluation is the best indicator for representing the strength, weakness, opportunity & threats of the educational system. These results could be used for promotion, adjusting & remodeling of the academic system. 

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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: The present study evaluates spatial working memory and strategy use, that are from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy ( spastic diplegia ).

Materials and methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: twenty children with cerebral palsy ( spastic diplegia ), with mean age of 8.94 years and 20 normal children with mean age of 8.86 years. Data were collected using Strengths and Difficulties Questionnaire ( SDQ ), CANTAB and Raven test of intelligence. Data were analyzed using t-test.

Results: Children with cerebral palsy differ from the normal children in spatial working memory. Comparing of the means of errors, were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ),except in double error ( p>0.05 ) however there was no significant difference in function of strategy use between 2 groups ( p>0.05 ).

Conclusion: In regard with these findings, cognitive rehabilitation with focus on executive skills can be useful in clinical treatment, parallel to the traditional methods, for spatial working memory in children with cerebral palsy.

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Background and aim:The role of thoraco-lumbar muscles is important in spinal column stability. Following fatigue due to constant activity, these muscles encounter with variable control pattern and variations of median and mean frequencies are little in relation to torque of force. However these parameters are useful in the literatures, but due to complexity of neuromuscular interaction and variety of motor control, signal processing can determine a wide range of changes and measurements.     

Signal processing nonlinear techniques exploit in biologic signals. Variables of nonlinear techniques are recurrence, determinism, entropy and so on.

The purpose of this study was to determine changes of entropy as nonlinear parameter in comparison with linear parameter and applicability of entropic measurements of the erector spinae muscles during fatigue.   

Materials and methods: Ten healthy women and 6 women with nonspecific low back pain (NSLBP) with a range of 20-30 years old patticipated in this study. Surface electromyography of isometric activities recorded from trunk (T12), lumbar (L3) and biceps femoris muscles during modified Sorenson isometric fatigue test. Median and mean frequency and also nonlinear parameters such as entropy and trend measured in one second of muscles activities before and onset of fatigue. 

Results:  Following fatigue in healthy group, median and mean frequencies reduced at a range of 12-20% (p<0.05). This decrement in LBP group was little (4 - 20%, p<0.05). Entropy increased 120-200% and trend reduced 800-2000% in normal subjects (p<0.05), whereas subjects with LBP indicated increment of entropy 65-220% and decrement of trend 240-500% (p<0.05). Before and after fatigue there was a significance difference between two groups in entropy parameter (p<0.05), whereas median and mean frequencies differences were not significant.

Conclusion:Following static positions, fatigue occurred in three levels of above muscles particularly at lumbar region. Traditional fatigue indicators showed good differences, but percentage of variability was low in comparison to nonlinear parameters. It suggests that nonlinear variables especially entropy are more sensitive than traditional indicators and can explain these stochastic behaviors

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Background and aim: Muscle flexibility is an important component of physical fitness and injury prevention.

Passive Stretch can be effective in lengthening and making hamstring more flexible. Popliteal angle measurement is one of the most simple method in studying the efficiency of these methods however, in goniometry measurement, there is not any data about muscle tension and any proper judgment about flexibility.  The goal of this study is to evaluate length and stiffness of the hamstrings by Quick Release Movement before and after the passive stretch.

Materials and methods:14 men (20-30 years old) with shorted hamstring (20 degree or more ext lack in passive knee ext test by popliteal angle measurement) participated in this study. Before and after exercises, popliteal angle  and muscle stiffness  were evaluated with digital goniometer and  Quick Release Movement technique respectively. Evaluation of stiffness was performed in flexion and extension positions.

Results: A significant increase in hamstring length was observed. (P<0.05) There was decrease in stiffness in both position of flex and ext but it was significant when in extension state.(P<0.05)

Conclusion: Findings of this study demonstrate passive stretch's effectiveness in increase muscle length and lessening muscle stiffness. In addition Quick Release Movement can be a suitable method for measuring muscle stiffness.

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Background and aim: Spasticity cause abnormal patterns in upper limbs of cerebral palsy children .It restricts hand function in grasp and release movement. In occupational therapy, neurophysiologic approaches include motor techniques, training and treatment for decreasing hypertonicity and biomechanical approach includes use of splint. In present study the effects of volar and dorsal splint were determined in decreasing of spasticity in upper limbs of quadriplegia cerebral palsy children with four up to six years old

Materials and methods: Twenty quadriplegia spastic children (4-6 years old) were participated in this study. They were classified in two groups. One group wears volar splint and the other group wears dorsal splint for two hours per days and four hours at night up to twelve weeks. Spasticity and passive range of motion were measured by modified  Ashworth scale and goniometry respectively

Results: The mean of wrist spasticity was 2.5 in volar splint group before intervention and 1.9 after intervention. The mean of wrist passive range of motion was 93.50 before intervention and 123.50 after intervention. Elbow passive range of motion was 113 in pre intervention and 135.50 in post intervention. The mean of wrist spasticity was 2.6 in dorsal splint group before intervention and 2.00 after intervention. The mean of wrist passive range of motion was 89.5 before intervention and 118.50 after intervention. Elbow passive range of motion was 110.50 in pre intervention and 135.50 in post intervention. Statistical Analysis of t-student and paired t-tests showed significant differences between the pre and post intervention in all parameters (p<0.05)

Conclusion:  The result of present study showed that both of the splints affected to decrease spasticity of wrist and increase wrist and elbow passive range of motion of hand. Based on this evidence, both of the splints would be suggested for spastic`s hand treatment. Due to major problem in making dorsal splint, we suggest volar splint for  reducing  spasticity in cerebral palsy children.

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Back ground and aim: The present study evaluates attentional set shifting, that is from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy (spastic diplegia).
Materials and Methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: 20 children with cerebral palsy (spastic diplegia), with mean age of 8.94 years old and 20 normal children with mean age of 8.86 years old. Data were collected using Strengths and Difficulties Questionnaire (SDQ), CANTAB and Raven test of intelligence. Data were analyzed using independent t-test.
Results: Children with cerebral palsy did not differ from the normal children in attentional set shifting. Comparing of the means of errors, trials and complete stages, with 18 outputs over all, demonstrated no significant difference between 2 groups (p>0.05).
Conclusion: In regard with these findings, it seems that children with cerebral palsy are not weak in attentional set shifting in comparing with peers, while in some other metacognitive functions such as spatial planning, working memory capacity and spatial working memory, these children are more retarded than normal children.

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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: 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: 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: Neck muscles contract dynamically in the majority of daily activities. Athletes, agricultures and industrial labors are predisposed to muscular fatigue. Aim: The aim of the present study was to compare the effect of dynamic fatigue on power and frequency domains of EMG spectrum.
Material and methods: In this study 20 healthy young men contracted neck muscles dynamically, until muscular fatigue occurs. Surface electromyography was recorded of levator scapula, neck paraspinals and upper trapezius, as neck extensors. The effects of dynamic contraction on frequency (Median Frequency) and Power domains(RMS) were compared before and after fatigue.
Results: The results of the present study indicated that MedF decreases following dynamic fatigue (P<0.05). After dynamic fatigue, RMS of levator scapula and upper trapezius increased significantly (P<0.05). Regarding to significant decrease of RMS and increase of MedF, paraspinals encountered with force reduction .
Conclusion: Changes of MedF and RMS indicated that a continuous dynamic contraction tends to exhaust levator scapula and upper trapezius but decreases paraspinals force.

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Background and aim: Swallowing disorder is one of the most important complaints of patients with upper motor neuron lesions.The rate of disphagia increases due to elderly subjects and brain injuries in our society Majority of these patients have hidden aspiration. Electromyographic assessment of swallowing can produce indicators of recovery and treatment effectiveness. This study tries to indicate pattern and recruitment of muscle activity in swallowing by surface electromyography.
Methods and Materials: Twenty healthy subjects (20-50) and ten subjects with swallowing dysfunction contribute at this study. Activities of bilateral orbicularis oris, buccinator, sternocleidomastoid and anterior region of throat muscles recorded during three stage of liquid swallowing include water, juice and honey by surface electrodes. Value of activity (RMS), duration of activity (Dur) , median (Mdf) and band (Banf) frequency of above muscles were measured.
Results: Healthy subjects indicated increase of RMS, Dur, Mdf and Banf of muscles, following increase of sweeten and viscose of liquid (P<0.05). Patients had more increase of this findings at oral muscles markedly, whereas Dur of throat muscle showed more increase in time (P<0.05). Comparison of between two groups indicated patients have more Dur time especially at throat muscles (P<0.05) and in contras reduce of activities and frequency parameters than healthy subjects (P<0.05).
Conclusion: Patients lean to keep liquid in oral phase and during throat swallow have more limitation. Patients may catch early fatigue and dysfunction for maintenance and keep of liquid particularly in throat region and it redound to change of trajectory of liquid to the respiratory tube. Therefore, rehabilitation protocols must enforce on coordination of oropharengeal muscles and recovery by movement therapy patterns.

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Background and aim: The aim of this review article is to study the effects of different positions & change of position on parameters of H- reflex.
Materials & Methods: changing position influence the excitability of motor neuron pools & can provide some evidence to resolve neurological and biomechanical problems as disk herniation & radiculopathies . One of the methods to assess these changes is H- reflex which described by German neurologist, Hoffman in 1918.It is a monosynaptic reflex with Ia fibers as afferent limb & α-motor neurons as efferent limb. To investigate the effects of changing positions on H reflex parameters, different databases, E-journals & thesis have been searched.
Result: Different positions & changing position influence different parameters of H-reflex .
Conclusion: Different H- reflex Parameters especially amplitude of H- reflex , show a wide range of varieties and this may explain that amplitude of H-reflex is not a reliable parameter.

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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.