Background and Aim: Osteoarthritis is the most common joint disease in adults around the world and plays a great role in inducing disability in elderly. Patients suffering from severe knee osteoarthritis usually complain of pain and severe functional disability. For these patients, conservative treatments are often induces least remedy for pain and improvement of functional ability. This study evaluates the effects of knee mechanical traction on pain, edema, range of movement and functional ability in patients with severe knee osteoarthritis.

Materials and Methods: In this clinical trial, forty women with severe knee OA (grade 3 & 4 on the Kellgren-Lawrence grading scale) were recruited and randomly divided into two groups with different treatment protocols (common physiotherapy treatment and common physiotherapy treatment accompanied by knee traction). Functional capacity and level of pain were assessed by 6-minute walking test and visual analog scale respectively. A goniometer was used to measure knee range of movement and edema was also evaluated by use of measuring tape.

 Results: Common physiotherapy treatment accompanied by knee traction compared to common physiotherapy treatment leads to significant decrease in pain (P<0.01) and increase in functional capacity (P<0.05).

Conclusion: Common physiotherapy treatment accompanied by knee traction is a more effective treatment than common physiotherapy procedure in patients with severe knee osteoarthritis.

Background and Aim: An immaculate review of the literature reveals some changes on the vertical ground reaction force (VGRF) in ACL deficient knee subjects. However, the details are not clear yet. The current study aimed to study these changes in the ACL-deficient and apparently healthy knees of the coper and non-coper ACL-deficient knee subjects in comparison with the normal knees.

Materials and Methods: Sixteen unilateral ACL-torn subjects included 8 copers and 8 non-copers were recruited in this quasi-experimental study and were compared with 16 normal knee subjects (8 subjects matched to each coper and non-coper groups). All subjects walked barefoot and with their preferred speed in a 6-meter walkway and placed their wanted foot on the platform of a Zebris pedobarograph tool. The patients were asked to place their injured and healthy feet separately on the platform. The control group placed their foot matched to the ACL-deficient legs on the platform. The testes were repeated so much to have five acceptable trials. The outcome measures included the peak F1Z, F2Z, F3Z of the vertical ground reaction force values and the times to reach these peak values as well as total stance time of the tested feet.

Results: The results showed only a significant lower F₁Z value in the non-coper ACL-deficient knee subjects (p=0.008). No significant changes were shown in the F₂Z, F₃Z or the times reach to F₁Z, F₂Z and F₃Z values (p>0.05). The stance time of the coper ACL-deficient knee subjects increased significantly in the non-coper ACL-deficeint knee subjects when compared to the coper and healthy knees (p=0.005).

Conclusion: The reduced F1Z of the vertical ground reaction force at initial contact as well as increased total stance time seen only in non-coper ACL-deficient knee subjects reveals inadequate compensatory mechanism in these patients as a counter force stress at initial contact and weight bearing. However, the coper ACL-deficient knee subjects compensated these forces with good strategies and walked very similar to the control group.

Keywords: Vercial ground reaction force (VGRF), Time to peak vertical ground reaction force components, Coper & non-coper ACL-deficient knee subjects, Pedobarography.

Background and Aim: Despite the widespread use of whole body vibration (WBV),especiallyin recent years, its neurophysiological mechanism is still unclear and the results about the facilitatory or inhibitory effects of WBV widely vary in different studies. The aim of this study was to compare between immediate (one session) and short term (12 sessions) effects of WBV on the spinal motor neurons excitability in healthy young men.

Materials and Methods: Ten voluntary non-athlete healthy young-men (mean age:26.1±2.23) were participated in this study.In the sham sessions subjects stood on the turned off vibration plate while were maintaining the semi-squat position and then after 2 weeks wash-out, vibration training sessions were done on the same position with frequency of 30 HZ and peak to peak amplitude of 3 mm training sessions (sham & vibration) consisted of 12 sessions (3 sessions per week) and 4 set in each of them, weekly one set added to the training protocol. H reflex recruitment curve of soleus muscle was recorded before and after first and also 12th sessions in both sham and vibration training protocol. Ascending slope of recruitment curve, threshold and peak amplitudes and related intensities, amplitude of Mh and Hmax/Mmax ratio were determined.

Results: Immediate effects of vibration training 12th session caused a significant decrease of threshold amplitude and an increase of peak intensity (p=0.05 and p=0.05 respectively). Short term WBV training significantly decreased the threshold intensity of soleus recruitment curve (p=0.01).

Conclusion: The results suggest the inhibitory effect of acute WBV training on the spinal motor neurons excitability. It seems that short term WBV training may be effective to facilitate the motor neurons excitability or increase the muscle spindle sensitivity.

Key Words: Whole body vibration, H reflex recruitment curve, Soleus muscle, Short term training

Backgrouna and Aim : Children with cerebral palsy have often movement and postural disorders. The purpose of this study is to evaluate the effect of new neoprene dynamic orthosis on balance in children with cerebral palsy.

Materials and Methods : This study is quazi experimental. Five children with cerebral palsy (spastic diplegia) with mean age of 9/6± 3.78 years old participated in this study. The degree of knee extension was measured using electrogoniometer. Center of Pressure(COP) displacement in anterior/posterior and medial/lateral planes and functional balance were also measured using kistler forceplate (BA, Kistler- Switzerland 9286) and berg test in two occasions, before and after wearing neoprene orthosis in a period of six weeks. Wilcoxon test was used for comparing data before and after 6 weeks.

Results : There was statistically significant difference in right knee extension before and after wearing orthosis (p<0/05). The result of this study show no statistically significant in COP parameters. However, functional balance of children with CP shows significant improvement using neoprene orthosis.

Conclusion : New neoprene orthosis can be effective in knee biomechanical alignment as well as functional balance

Keywords : Cerebral palsy, Lycra dynamic orthosis, Postural control

Background and Aim: The main cause of Myofascial pain syndrome is trigger point. The purpose of this study was to compare muscle energy technique (MET) with dry needling (DN) on latent trigger point of upper trapezius.

Materials and Methods: Fourty females, with diagnosis of latent trigger point of upper trapezius after adopting the inclusion and exclusion criteria were equally and randomly allocated into either the muscle energy technique or dry needling groups. Each patient received one treatment to the upper trapezius muscle. Outcome measures (visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) measured before and 48 hours after treatment.

Results: Two techniques which used in this study were effective for treating latent trigger point of upper trapezius (P<0/001) but no significant differences were found between the two groups in terms of the above variables (p>0/05).

Conclusion: This study demonstrated that muscle energy technique was as effective as dry needling in improvement of VAS, PPT and ROM in subjects with latent trigger point of upper trapezius muscle. But since muscle energy technique is safe and non-invasive method, therefore, if you want to select one of these two techniques, muscle energy technique is recommended.

Keywords: Dry needling, Muscle energy technique, Trigger points

Background and Aim: ACL injury is one of the most common sport injuries which undergo reconstructive surgery. Electromyography or recording of muscles’ electrical activity is a suitable means to assess changes in motor control system output. The goal of this study is to compare the lower limb muscles EMG activity during drop landing in individuals after ACL reconstruction and healthy subjects.

Materials and Methods: Eleven men who had undergone ACL reconstruction 6 to 24 months ago (Age 29±6 years old) and 11 healthy men (Age 28±2 years old) participated in the study. Amount of electrical activity for tibialis anterior, vastus medialis, vastus lateralis, semitendinosus and biceps femoris muscles was recorded using surface electrodes during drop landing and calculated for two time intervals. The amount of activity was measured in -150 to +50 and +50 to +180 intervals in relation to the landing moment. Subjective IKDC questionnaire and cross-over hop functional test were used to determine the subjective and objective functional level.  Independent t test was used to determine between-group statistical differences.

Results: Feed forward activity of semitendinosus (P=.041) and biceps femoris (P=.008) muscles were significantly higher in ACLR group and feedback activity of vastus medialis (P=.03) muscles was significantly lower in ACLR group. Healthy individuals showed higher score on both the functional test and IKDC questionnaire. (P<.0005)

Conclusion: Individuals who had undergone reconstructive surgery of ACL showed different muscular activity compared to healthy subjects and closer to ACL deficient individuals 6 months after surgery and routine rehabilitation.

Keywords: Anterior cruciate ligament reconstruction, Electromyography, Neuromuscular control