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Background and Aim: Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Any functional disorder in the hand can cause a person's independence to be disrupted and therefore his or her social independence is threatened. The purpose of this study was to determine the effects of volar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic children.
Materials and methods: The design of this study was clinical trial and before_ after. Fourteen 8 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patient used a volar static splint (10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb) for 2 mounts (2 hours during day and 4 to 6 hours at night). In this study Jebsen Taylor Hand Function Test was used to evaluate hand function. Modified Ashworth Scale was used to evaluate spasticity. A Goniometer was used to measure range of motion.
Results: The results of this study showed significant improvement in hand function  ,significant reduction in wrist spasticity  and elbow spasticity  and significant increase in wrist range of motion The data did not show any significance in elbow range of motion .
Conclusion: Our findings suggested that 2 months using of volar static splint in children with spastic cerebral palsy can improve hand function, wrist and elbow spasticity and wrist range of motion.

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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

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Background and Aim: Constraint-induce movement therapy is one of the treatment methods to treat those who have  stroke disorders. The aim of this study was to determine the effect of constraint-induced movement therapy(CIMT) on quality of life , function and range of motion of upper extremity of patients with stroke.

Materials and Methods: This study was conducted in 15 patients in accordance to random clinical trial during the treatment operation, the patients were asked to restrict their upper extremity movement with orthopedics sling for 3 days per week and each day for 8 hours. They were asked to practice on affected upper extremity for 2 hours
while their hands were restricted.  Additionally, the present study was conducted for 6 weeks.

Results: The statistical analysis illustrated that quality of life was significantly changed which measured by SF36 test (p=0.008). Furthermore,  the upper extremity function which was assessed by Box & Black test  was statistically analyzed by t-coupled in this regard, it showed a significant change when the treatment ended up (p=0.009). However, active range of motions in wrist extension and elbow extension did not significantly changed (p=0.227).

Conclusion: Based on the results, it can be implied that Constraint-induce movement therapy is an effective method for improvement of life quality and the upper extremity function .Three mechanisms are discussed: involvement of non used affected limbs, neural plasticity in CNS, and amelioration of mental and physical health of patients can be resulted in life quality and patients' hand improvement.

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Background and Aim: Cerebral Palsy (CP) children are the most clients referred to occupational therapy settings. Hand function is important in Activities of Daily living .There is a hand dysfunction in most cerebral palsy children. Orthosis and splints are commonly used to improve the position, range of motion, quality of movement and function of a person's arm or hand. The aim of this study was to investigate the effects of static cock up c-bar splint on strength,spasticity, range of motion, and dominant hand function in spastic diplegic children with 8 to 12 years old. 

Materials and Methods: This interventional study is in a before-after design. Thirteen spastic diplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients used a static cock up c-bar splint (wrist in 10 degrees of extension and thumb in palmar abduction and opposition) for two months, 2 hours daily and 4-6 hours at night. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of thumb, wrist and elbow, ROM of thumb, wrist and elbow were tested with goniometer and power grip was evaluated with dynamometer.  

 Results : Results showed a significant improvement in hand function (p<0.001), in wrist`s spasticity (p<0.001), elbow`s spasticity(p<0.008), palmar abduction of thumb spasticity (p<0.002), wrist`s ROM (p<0.001), Palmar abduction of thumb ROM(p<0.001) and power grip(p<0.001). The data did not show significant improvement on elbow`s joint ROM. 

Conclusion: Information from present research shows that using static cock up c-bar splint for 2 months, 2 hours a day and 4 to 6 hours nightly, can be an effective method to improve power grip, hand function, thumb, wrist and elbow spasticity and range of motion of thumb and wrist of spastic diplegic CP children.

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Background and Aim: Rehabilitation interventions have significant role in reducing the disabilities of Down syndrome. Due to great role of balance in the function of individuals particularly in Activity of Daily Living and the effect of strength on balance, the aim of this study was to investigate the effects of Progressive Resistive Exercise on functional balance in children with Down syndrome.
Material and Methods: Fifteen girls children aged between 8 and 12 years, with Down syndrome participated in this study by available sampling method. The subjects participated three times per week in a six-week progressive strengthening program. During intervention, 3 of them excluded. Balance were measured by Berg Balance Scale and right/left hip abductor and flexor, knee extensor and flexor muscles isometric strengths were measured by Nickolas hand-held dynamometer. Paired-sampled T-Test was used for data analysis.
Results: The results of this study showed that the mean of functional balance and muscles isometric strengths were significantly increased after intervention (P<0.001).
Conclusion: It seems that the results of this study confirm the effect of progressive resistance training on progressing functional balance, and 8-12 years old children with Down syndrome can benefit from these exercises.

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Background and Aim: Cerebral palsy (CP) is a neurodevelopmental disorder caused by nonprogressive lesions. This disorder produces motor impairment deficits in early infancy. Hand function is essential in performing activities of daily living for everyone, including individuals with cerebral palsy. Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function. The purpose of this study was to determine the effects of C-bar splint on hand function and strength and also wrist and thumb range of motion (ROM) of dominant hand of 8-12 years old children with spastic diplegic cerebral palsy.
Materials and Methods: The design of this study was before- after and quasi-experimental. According with inclusion criteria, 8 to 12 years old children with spastic diplegia from physical – motor special school at Tehran (8 boys and 5 girls), were studied. They used a C-bar splint (40 degree of palmer abduction of thumb) for 8 weeks (6-8 hours during day and 4-6 hours at night). In this study, hand function was evaluated by Jebsen Taylor Hand Function Test, hand strength by MIE dynamometer and thumb & wrist ROM by Goniometer. During intervention, they received routine occupational therapy program.
Results: The results of this study showed significant improvement in hand function (P=0.001), and thumb range of motion (P=0.02). The data did not show any significant improvement in wrist ROM and hand strength.
Conclusion: According to the result of this study, it seems that using C-bar splint can be an effective method in improvement of hand function and thumb ROM in 8-12 years old children with spastic diplegia. Key words: C-bar splint, Hand function, Diplegia cerebral palsy

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Background and Aim: Improving the affecting factors of balance could be a critical procedure in managing the elderly's balance dysfunction. The goal of this study is to find out how and to which amount a prolonged period of stretch and massage impact on elderly's balance. Materials and Methods: In this RCT study with a simple randomized case selection, 205 normal subjects screened and after that, 18 subject (74.6 5.45 Years) for intervention group and 17 (75.8± 4.27 Years) subjects for control group contributed for the study. The procedure was 15 sessions in 5 weeks (3 sessions per week). Each session last about 1 hour. Berg Balance Scale (BBS) and Timed Up and Go (TUG) were used for evaluation of balance.

Results: Using by SPSS-19 software and after independent T-test, significant differences in balance scales were found between the intervention and the control groups (p<0.05).

Conclusion: According to present evidence, stretch and massage are significantly effective on elderly's balance function. 

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Background and Aim: In recent years transcranial stimulations, action observation and motor imagery training have emerged as nonaggressive and attractive choices beside the common rehabilitation treatments for neurologic patients. Mirror therapy using visual feedbacks is one of these newfound methods that its therapeutic effects on impaired upper limb of stroke patients are still under investigation. In this case report, Impact of mirror therapy in treatment of the paralyzed upper extremity in 2 stroke patients will be described. Materials and Methods: Two adult patients with hemiplegia due to cerebrovascular accident and with 1 and 5 years passed since stroke went under 12 sessions of mirror therapy. Each session of mirror therapy lasted 45 to 60 minutes in which patients have been practicing specific exercises under direct supervision of therapist. Patients were evaluated for function and motor recovery level, spasticity, range of motion and power grip before and after one month of treatment. Results: In both individual, function and motor recovery level, active range of motion, and power grip were improved and spasticity just showed a decrease in one of the patient. Conclusion: Mirror therapy for 12 sessions can be beneficial to treatment of affected upper extremity in these two stroke patients

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Background and Aim: The number of elderly population in the world and also in Iran has increased due to health improvements and therefore, the quality of life has been focused in this group of population. Physical disabilities and particularly balance disturbances are among the consequences of the ageing process and hence, would affect the quality of life in elderly population. Mental practice is in fact the cognitive review of a physical skill without performing obvious bodily movements. The purpose of this study was to investigate the effect of mental practice of a movement skill on improvement of the quality of life in elderly men (60-80 yrs).

  

Materials and Methods: This was a Single blind Randomized controlled trial (RCT) study. The study was approved by the research ethics committee of the Tehran university of medical science (Irct ID: IRCT201107041722N3). The elderly population was 44 elderly men (60-80 yrs.) who were living in Kahrizak Nursing Home. They were randomly assigned in two groups and entered the study based on inclusion criteria. After baseline assessment, the quality of life of all of participants were assessed by SF36 test and also at 3 various stages (i.e. respectively, before the beginning of ,baseline assessment two weeks after intervention ,short term follow up and 3 months after intervention, long term follow up). Elderly population in the intervention group did mental practice of one movement skill for 4 weeks and during this periods, the control group did no mental practice.

  

Results: The results of our study showed the scores of SF36 in physical component, after the intervention of mental practice, have had a significant difference between the control and intervention groups. Although test scores in mental component and the whole test score showed no significant difference between the case and control groups at 3 stages of assessments.

  

Conclusion: The results of this study showed the significant effects of mental practices on physical component of SF36 in elderly population. However, these results also showed that this type of mental practice had no significant effects on mental component and total score of SF36.

  

Key Word: Quality of life, Balance, Mental practice, Elderly men

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Background and Aim : Cerebral palsy (CP) children are the most referral patients to occupational therapy centers. Hand function is important in activity of daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splint are commonly used to improve the position , range of motion, quality of movement, arm and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old.

  

Materials and Methods : This interventional study is in a before-after design for two group case and control. Thirty spastic diplegic cerebral palsy children with 8 to 12 years old who had the inclusion criteria, were randomly assigned to case and control group. Patients of case group used a static anti-pronation splint for 2 months, 8 hours daily. In this study the Jebsen Taylor test was used to evaluate upper extremity function, the Goniometer was used to measure ROM of elbow, forearm and wrist, the Modified Ashworth Scale was used to assess spasticity of elbow, forearm and wrist. Power grip and pinch were assessed with MIE device.

  

Results : In the case group results showed a significant improvement in upper extremity function (0.026), forearm supination ROM (0.007), wrist extention ROM (0.005), forearm muscle pronator spasticity (0.001), wrist muscle flexsor spasticity (0.009), power grip (0.001) and pinch (0.001). The data did not show significant improvement on elbow extention ROM (0.075), elbow muscle flexsor spasticity (0.164). In comparison with control group, the data showed a significant improvement in upper extremity function (P=0.001), forearm supination ROM (p=0.034), wrist extention ROM (P=0.042), forearm muscle pronator spasticity (P=0.009), power grip (P=0.001) and pinch (P=0.001). The data did not show significant improvement on elbow extention ROM (P=0.140), elbow muscle flexsor spasticity (P=0.638) and wrist muscle flexsor spasticity (P=0.105).

  

Conclusion : The findings show that using static anti-pronation splint for 2 months , 8 hours a day , can be an effective method to improve upper extremity function , range of motion of forearm and wrist , forearm spasticity and power grip and pinch in spastic diplegic cerebral palsy children with 8 to 12 years old .

  

Key word : Cerebral palsy, Static anti pronation splint, Upper extremity function, Spasticity, Power

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Background and Aim : Chronic non-specific low back pain is one of the important health problem in military and different factors have been reported in its emergence. The aim of this study is to determine the association between low back pain and education level, Body Mass Index (BMI), exercise, smoking status ,work status and bad postures in military men.

  

Materials and Methods : In this non-experimental case-control study, 92 subjects (mean age= 29.16 year, SD= 8.55 year) with chronic non-specific low back pain and 93 subjects (mean age= 26.80 year, SD=9.22 year) without low back pain were selected by simple non-probability method from military centers in Tehran. Evaluation tools of this study included a self-administrated questionnaire, weighting scale and metal tape measure.

  

Results : According to the results of bivariate logistic regression, risk factors of exercise (P= 0.003), smoking status (P= 0.042), grade of BMI (P= 0.034), bad posture grades including heavy objects lifting movements (P= 0.007), bending movements (P= 0.003), rotating movements from the lumbar (P= 0.011), carrying bulky objects (P= 0.034), carrying heavy objects (P= 0.05) and working in squatting position (P= 0.005) had a significant association with low back pain. Job status (P= 0.999), education level (P= 0.056) and bad postures grades movements like wringing clothes (P= 0.958) had not a significant association with low back pain.

  

Conclusion : Doing regular exercise and having normal BMI decrease the risk of suffering from low back pain in the military while smoking and doing injurious physical activities during work (lifting heavy objects, bending movements and rotating from the lumbar, carrying bulky and heavy objects, and working in squatting position for a long time) increase the risk of suffering from low back pain.

  

Key Words : Chronic non-specific low back pain, Military forces, Biomechanical risk factors, Exercise