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Background and Aim: Few studies have assessed the reliability of postural balance measures during dynamic balance performance that introduce additional challenging to postural control system. In addition sometimes in the static conditions some deficiencies of the postural control system may not be revealed obviously therefore the aim of this study was to assess the reliability of postural control parameters during functional performance on force plate in healthy subjects.
Materials and Methods:  Ten healthy male subjects (mean age: 25.4 years, weight: 68.2 kg height:176.9cm) participated  in this study. None of the subjects were involved in sport activities. Every subject performed three 15seconds trials of eyes open single leg stance on a force plate during dynamic balance task. Participants grasped object with hand at their waist level and release it at above shoulder level.  The reproducibility of the center of pressure (COP) deviations (average speed &length of path) was assessed. All participants were tested on 2 sessions with an inter-measurement interval of 7 days. COP data was collected for each trial. The intraclass correlation coefficient (ICC) was used as parameter of intra-session and inter-session (Test-Retest) reliability.
Results: The ICCs for intra-session reliability of average speed and length of COP path were  0.89 and 0.91  respectively. The ICCs for inter-session reliability were 0.95 and 0.96 respectively.
Conclusion: The study showed high and very high reliability for center of pressure measures during dynamic balance task. Therefore this dynamic performance can be used as a balance pattern in postural control assessment. These can be used as reliable parameters in dynamic postural control assessment due to high reliability of average speed and length of COP path

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Background and aim: Altered muscle activity in the scapulothoracic and glenohumeral muscles is commonly believed to be a factor contributing to shoulder impingement syndrome (SIS), then, the aim of the study was to determine and compare the activity pattern of the shoulder muscles in subjects with and without SIS.
Materials & Methods: In this case-control study, 9 female subjects with shoulder impingement syndrome and 13 matched healthy female subjects were participated voluntarily by simple random sampling. Surface electromyography of serratus anterior, pectoralis major, upper trapezium, lower trapezium, posterior deltoid, anterior deltoid muscles of dominant side were recorded during D1ext and D1flex movement. Muscle activities were processed and compared in subjects with and without SIS. Non parametric test (Mann-Whitney Test)) was used for data analysis
Results: In both movement patterns, all muscles of the patient showed a greater normalized RMS than healthy group but this increase was statistically significant in anterior deltoid (p=0/003, p=0/04), pectoralis major (p=0/01, p=0/02), serratus anterior (p=0/01) and posterior deltoid (p=0/01) during D1ext and in lower trapezium (p=0/005,p=0/006) and pectoralis major (p=0/01) during D1flex.
Conclusion: The results of this study indicate that patients with impingement symptoms show abnormal muscle activity. The findings support the theory that shoulders impingement may be related to altered muscle activity in the scapulothoracic and glenohumeral muscles.

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Background and aim:  For the rehabilitation program of the anterior cruciate ligament reconstructed patients (ACLR) strength and functional assessment and comparing with the uninvolved side is in great importance. Strength plays an important role in performing vertical jump moreover. It is performed in closed kinetic chain. Despite this importance, no information exists regarding the relationship on peak force of linear isokinetic and vertical jump score. The purposes of this study were1- To determine correlation between isokinetic squat and vertical jump in healthy and ACLR patients. 2- Comparing the peak force and vertical jump between the involved and uninvolved side of the ACLR patients.   
Materials and Methods: Twenty two ACLR patients with 6 months post-surgery and 16 healthy men participated in this study. Their isokinetic squat strength at the testing velocity of 25.4 cm/sec and vertical jump was measured.
Results: ACLR patients' peak force and vertical jump were significantly different between the involved and uninvolved side P≤0.05. The findings showed low relationship )r=0.425)  at the involved side between the vertical jump and peak force of squat, however, there was no relationship in the uninvolved side and the control group.
Conclusion: Findings of  this study indicate no relationship between vertical jump and peak force of squat. Both testing methods should be used since strength not always correlate strongly with physical performance.   Closed kinetic chain isokinetic testing should be used for testing lower extremity strength, while vertical jump should be used to determine performance levels.

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Background and aim: The importance of cognitive resources was shown in dual task studies of postural control. However, there was no definite evidence on how verbal instructions influence the allocation of attention to postural control. Therefore, the objective of this study is to explore the effect of verbal instructions on postural performance.
Materials and Methods: this Cross-sectional study was performed in 20 young adults (23.95 ± 3.31). Parallel standing/ hard surface, parallel standing/ foam surface, tandem standing/ hard surface were used as postural tasks and the choice reaction time task were conducted as cognitive task. Dual- task performance was measured under three different instructions including to pay attention to cognitive task, to postural task, and equal attention to both tasks.
Results: Comparing the performance of postural tasks under three different instructions were conducted by One-way ANOVA and showed in parallel standing on hard surface (p=0.831), parallel standing on foam (p=0.433), tandem standing on hard surface (p=0.912) for path length of COP and instructions in parallel standing on hard surface (p=0.308), parallel standing on foam (p=0.414), tandem standing on hard surface (p=0.867) for mean velocity were not significant. Postural performance in single and dual task conditions was significant only in parallel standing/ foam surface (p=0.046).
Conclusion: various instructions could not influence the amount of attention allocated to automatic postural tasks.

 

 

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Background and aim: The communicative functioning of children who stutter can be assessed in a variety of ways. Standardized tests are an important tool to assess communication skills particularly in stuttering children .The purpose of the present study was to translate the Test of childhood Stuttering (TOCS) into persian and investigation of validity and reliability of the test .
Materials and methods: In this research, 40 stutterers and 40 non-stutterer were evaluated. After the translation of the Test according to Protocol IQOLA and its equalization to Persian Language, Content validity and Face validity of it were determined by the opinions of experts. Then, for concurrent validity determination 80 stutterer and non-stutterer children were examined by TOCS and SSI3 .In order to test reliability, test -retest and Cronbach,s alpha were used.
Results: Entirely relevant items had simple translation. The translation items had content and face validity correlation between the marks of TOCS and SSI3 (p=0.000, r= %92). TOCS has high Test-retest ( p=0.000, ICC= %97) and internal reliability (p=0.000,α=%90).
Conclusion: Persian equalized TOCS (Test of childhood stuttering) have high validity and reliability. it might be useful to differentiate stuttering children among normal ones.

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Background and aim: The aim of this study was to compare the gross motor development between Low Birth Weight (LBW) infants and Normal Birth Weight infants (NBW) at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 (PDMS-2).
Material and Methods: This was a non experimental and cross sectional study which was conducted on 18 LBW infants with the history of being in Aliasghar hospital and 14 infants with the history of normal birth weight as a control group. Gathering the information was done by completing Questioner and then by using the Peabody Developmental Motor Scale-2 (PDMS-2). Finally the scores of the motor quotients were analyzed by independent T test statistical method.
Results: There was a significant difference (p= 0.002) between the mean gross motor quotient of LBW (90.83) and NBW ( 106.78).
Conclusion: This study showed that LBW infants attain low scores of gross motor skills in comparison with normal weight infants. It indicated that the LBW infants are more prone to motor development difficulties.

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Background and aim: The precise control of arm kinematics and kinetics as well as interaction of the arm with the external word, is an essential condition to perform skillful motor actions. Gravity has significant effect on spatial orientation, proprioception, displacement, start and stop of hand movements. The purpose of this research was to study the effect of movement direction variation in relation to gravity on generalized motor program recruitment in fast single joint elbow movement by use of surface electromyography.
Materials and methods: Fifteen volunteer students (mean age 24.8± 3.8 years) without sensory motor impairments participate in this study. Ninety percent of full range of motion at the elbow joint was used as goal degree. Subjects asked to do aimed elbow flexion as fast as possible in seven different direction in relation to gravity. While they were performing movements, surface electromyography was recorded from biceps and lateral head of triceps muscles. Relative timing, relative activity and sequence of contraction were derived from RMS. Data were analyzed by using repeated measure variance analysis.
Results: Muscle activation patterns were different in three positions from rest. There were significant difference between relative activity (p<0.001) and relative timing (p<0.003) in some positions. In fourth position, sequence of muscle contraction was different in seven subjects.
Conclusion: It seems that change in movement direction in relation to gravity is one of effective parameters in movement planning and execution and it can recruit different generalized motor program.

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Background and aim: Sensory deficits after stroke are common with prevalence rates variously reported to be 11% to 85%. In spite of the fact that Sensory deficits can decrease  the quality of upper limb's movements and result in impairments in fine motor manipulation of objects, grasp and manipulative skills and finally  decrease the patient's quality of life but commonly overlooked in stroke rehabilitation. The aim of this study was to investigate the effects of sensory retraining on upper limb recovery. 
Materials and methods: In this study we studied 5 chronic stroke patients were participated using a single-system (A-B) design. During the baseline phase patient's function and motor impairment of upper limb were measured by Fugl-Meyer and Motoricity Index and their hand dexterity were measured by Box and Block test on three days intervals. When Patients reached to a stable pattern of changes, their treatment program began. In this phase they received sensory retraining intervention for 6 weeks. Based on sensory retraining principles and according to each patient's abilities, intervention began with detection and localization of constant and moving touch and followed by higher discriminatory tasks, suchas graphestesia. Then results of evaluations of two phases were analyzed.Results: Four patients showed significant improvements in upper limb function. The data showed significant improvements in motor impairments and hand dexterity in all of them. 
Conclusion: Regarding of significant recovery of upper limb function, motor impairment and hand dexterity of patients, sensory retraining can be considered as a practical method in rehabilitation of stroke patients. However further research with larger sample size is needed.

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Background and Aim: Stroke is the third leading cause of death, second cause of long-term disability and one of the very important challenging in life. The aim of this research was to explain the barriers and facilitating factors affected on stroke patients' life, and to identify relationship among them with demographic factors and severity of disease.
Materials and methods: The descriptive-analytic technique was used. All patients who suffered from stroke were recruited in Kerman city. Finally 83 patients were selected, and data were gathered by demographic qualification questionnaire, proven questionnaire by researcher for studying barriers and facilitating factors (after testing validity and reliability), and NIHSS tools . Then, data were analyzed by using descriptive and referential statistics ANOVA test, T-Test, and Pearson coefficient correlation by SPSS software (ver. 16).
Results: The findings showed that patients had more problems in the domains of politics, environmental factors, physical, and economic status. Also, they introduced social support from friends, family and prayer as facilitating factors in their lives. There was a significant positive relationship between age and physical and economical problems. Women have used social support and religious coping more than men.  Married patients received more social support and their physical and economic problems raised less.
Conclusion: Patients with higher severity of disease had more psychological problems such as depression and worry about future and Patients with lower socio-economic status more faced with barriers.

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Background and aim: Human knee joints experience very large loads and motions during regular daily, occupational and sport activities. Consequently, they are at high risk of being exposed to injuries and degeneration. Osteoarthritis and ligament injuries often inflict knee joints causing considerable pain and loss of productivity involving thus significant human and economic costs. Hence, biomechanics of human knee joints has been the focus of many investigations with the primary aim to improve understanding of joint function in normal and perturbed conditions. The existing prevention and treatment programs have been based on such studies.
Material and Methods: Due to inherent costs, limitations, difficulties and ethical concerns associated with in vivo and in vitro cadaveric studies, finite element model studies have been developed as effective, powerful and complementary tools to investigate knee joint biomechanics subject to internal and external mechanical conditions affecting its normal function.
Results: The advantage of finite element method in study of joint biomechanics lies in its robustness to incorporate complex 3D joint geometry, intricate boundary and loading conditions and materials with nonhomogeneous and nonlinear properties.
Conclusion:This article reviews important model studies, presents their relevant results and discusses some of the promising future directions.

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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: During the past current decades, objective measurements in general and specialy dynamic measurements had been important aspect of evaluation of stuttering. Although these measurements can not replace with perceive judgements but these measurements help us to better diagnosis and treatment. Also we can use these for give feedback of treatment results to patient. Thereforee the purpose of this study was to measure and compare some dynamics characteristics between adult stutterers and nonstutterers.
Materials and Methods: Sample of  this study was 32 adult men including 16 stutterers and 16 nonstutterers. We used from Vowel /a/ prolongation was used for gathering the subjects voice sample.The data by were analysed by Dr. Speech software.
Results: According to this research there is not significant difference in average of vocal folds contact quotient and contact index among adult stutterers and nonstutterers. But there is significant difference in average of vocal folds contact quotient perturbation between adult stutterers and nonstutterers.
Conclusion: In this research we used vocal folds contact quotient and contact index as factors from occurrence and expanding of stuttering and therefore we concluded that these factors do not have significant role in stuttering occurrence and expanding.

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Background and aim: Grip strength (GS) is an important measure of general health to predict mortality, disability and function of the hand. The purpose of this study was to develop equations to predict grip strength based on several anthropometric measurements using a multiple regression analysis.
Materials and Methods: Four hundred and eleven males and 671 females college students, ages 18-30 years, in good health, participated voluntarily in this study. This sample was randomly assigned to the model-development (n=867) and cross-validation (n=215) groups. Four equations were developed by using data from the model development group, then cross-validated on the second group. A hand-held dynamometer was used to measure grip strengths. All anthropometric measurements such as hand anthropometry, forearm circumference (FC), lean body mass, skeletal muscle mass and arm muscle area were taken according to standard techniques.
Results: It was found that grip strength has a significant correlation with all anthropometric measurements. Forearm length (FL) was correlated to grip (68% explained variance) in a linear relationship, followed by upper limb length and SM. All four equations were confirmed by cross-validation. Because of simplicity and easy-to-measure the following equations were selected for prediction grip: Dominant hand, A) 0.464×Age(yr)+0.392×Height(cm)+0.681×BMI-13.035×Sex(0 for men and 1 for women)-46.160, B) 0.029×FC×FL-8.634×sex+13.872 Non-dominant hand: C) 0.347×Age+0.386× Height+0.657×BMI-13.313×Sex-44.243, D) 0.029×FC×FL-8.752×sex+13.788.
Conclusion: The six easy-to-measure cofactors sex, age, height, BMI, forearm length and forearm circumference provide a highly accurate prediction of normative grip strength.

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Background and aim: Virtual Reality is a computer technology with virtual environment and objects, which people manipulate virtual environment through active participation. The aim of this study was to determine the effect of practice in virtual environment on upper limb function of children with spastic hemiparetic cerebral palsy.
Materials and Methods: In this single blinded, randomized, controlled trial, 16 children with hemiparetic cerebral palsy were evaluated in a simple random sampling of Ahvaz city in 2 groups (virtual reality and control). Treatment protocol consisted of one and half hours sessions of practice in virtual environment for 4-week, every other day. Measures were conducted pre, post and 3-month after the treatment period by Pediatrics Motor Activity Log and Bruininks-Oseretsky Test of Motor proficiency. Sample randomization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in alpha level set at 0.05.
Results: Subjects in virtual reality group showed significant improvement (p<0.01) in post-test measures (bruininks-oseretsky test of motor proficiency, speed and dexterity: mean change from 0.25±0.06 to 1.22±0.23). Results were retained for both groups in follow up session.
Conclusion: Virtual reality technology through intensive and repetitive practice in an interactive and motivational environment is a promising method to improve upper limb function of children with hemiparetic cerebral palsy.

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Background and aim: Schizophrenia is a disabling condition which affects independent functioning in instrumental activities of daily living (IALDs). Due to their importance in mental health and rehabilitation planning, this study was designed to compare functional capacity and daily life performance in IADLs in patients with schizophrenia with healthy matched individuals. The relations between capacity and performance are also considered.
Materials and methods:  Thirty community dwelling patients with chronic schizophrenia and thirty healthy matched individuals were selected. After obtaining a written consent, IADLs were assessed using the Performance Assessment of Self-care Skills (PASS) and the Lawton's index of instrumental activities of daily living. Data analysis was done by SPSS, version 14.0.
Results: Comparing two groups, patients with schizophrenia scored significantly lower in independency, process, and quality in PASS, and in total score of Lawton's index (P<0.001 for all variables). No significant correlations were found between two measures.
Conclusion: It seems that functional capacity and performance in IADLs are limited in patients suffering from schizophrenia. Functional capacity was not related to daily life performance. However, further studies are needed to investigate factors affects functional outcome.

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Background and aim:   nowadays, comprehensive  developmental assessment of infants is highly considered. But, some assessments, especially those which use more manipulations on high risk infants, can cause more stress  on them. So sometimes it is necessary  to use one group of developmental assessments to predict another developmental aspect.  The aim of this study was to investigate the relationship between scores of behavioral scale and  motor performance.
Materials and methods:   In this  cross-sectional study that was conducted in neonatal intensive care unit and pediatric clinic of Shahid  Akbarabadi hospital, Tehran, 50 under 2 months low birth weight infants after met inclusion criteria were selected via convinence sampling method.  The Test of Infant Motor Performance (TIMP) and the Neonatal Behavioral Assessment Scale (NBAS) was used  for assessing motor performance and behavioral performance respectively. The TIMP consist of elicited and observational parts. NBAS was consisted  of habituation, social interaction, motor system, state organization, state regulation, autonomic system,  smile, supplementary items, and reflex items.
Results:  There was not any significant relationship between habituation part  of NBAS  and TIMP and also between autonomus system part  of  NBAS  and observational part of  TIMP (P<0.05).  Association between other variables was statistically significant (P>0.05).
Conclusion: Some items of behavioral assessment  can be used to predict  the motor performance in low birth weight infants. 

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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: Knee joint has a major role in various lower extremity activities. Among different elements of knee joint complex more interest was seen to anterior cruciate ligament because of its alignment, structural complications, more nerve receptors and susceptibility to injury. After injury of this ligament, knee extensor torque decreases but it is believed that this decrease compensated for by muscles of hip and ankle joints. This suggestion has not investigated by isokinetic studies. Therefore, the aim of this research was that if quadriceps muscle torque decreases in spite of rehabilitation process and if this decrease compensated for by hip extensors and ankle plantar flexors?

Materials and methods: 10 healthy men (age: 22-35 years old) and 10 patients with ACL deficiency (age: 23-42 years old) participated in this study. Plantar flexor muscle strength, quadriceps muscle strength and hip extensor muscle strength were tested by Isokinetic Biodex System 3 at 60 and 180 degrees of angular velocities. Also functional vertical jump test was done for each lower extremity.
Results: Will coxson test and Spearman correlation coefficient were used. Results showed that there was no significant difference between mean strength of gastrosoleus, hip extensors and sum of mean strength of gastrosoleus, quadriceps and hip extensors of patient's injured and sound limbs (P>0.05). Results showed that there was significant difference between mean strength of quadriceps of injured and sound limbs (P> 0.01). There was no relationship between gastrosoleus, quadriceps and hip extensor summation and vertical jump functional test in the patients and normal subjects (P>0.05).
Conclusion: The results show that compensation occurs in the ankle plantar flexors and hip extensors of injured lower extremity. Thus in spite of significant decrease in quadriceps strength in the injured limb, sum of mean strength of gastrosoleus, quadriceps and hip extensor muscles between injured and sound limbs was not statistically significant. Also there was no relationship between functional test and isokinetic parameters. Thus functional vertical jump test can not be used instead of isokinetic test.

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Background: Flexible flat foot is a congenital common deformity in lower extremity associated with ligamentus laxity. This deformity may cause hammer toe, heel spur, inflammation of achille tendon, early muscle fatigue during sport, foot imbalance and pain in leg, knee and hip. The use of insole with medial arch support considered as one of the common treatments for patients. The purpose of this study was to determine the effect of a composite insole, Ethyl Vinyl Acetate (EVA) with Poron layer on ground reaction force on subjects with flexible flat foot in comparison with common EVA insole.

Materials and Methods: Fifty two subjects (14 Male and 38 female) between 18-40 years of age with flexible flat foot participated in this study. Twenty six subjects received Poron insole (EVA with Poron layer) and 26 subjects received common EVA insole. After assessment each subject asked to walk with normal speed across two force plate in two conditions, walking with insole and shoe and walking without insole. Then each subject asked to use insole for forty hours during two weeks. Vertical ground reaction force in the first session and after two weeks was assessed.

Results: Impact force and first peak of vertical ground reaction force (F₁) with Poron insole in comparison with shoe significantly increased in second session (P<0.05). The second peak (F₃) with common insole in comparison with shoe significantly increased in second session (P<0.05). Significant reduction was noted in first peak (F1) with common insole in second session in comparison with first session (P<0.05). There was no observable significant difference in two groups before and after intervention.

Conclusion: The results of this preliminary study show that both insoles change vertical ground reaction force in comparison with shoe alone. But using a composite Poron Layer on EVA insole has not demonstrated a significant difference with common arch support insoles. Therefore application of Poron Silicon layer on EVA insole by itself can not show a significant reduction of ground reaction force.

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Backgroung and aim: Neck pain is one of three common complains of neuromuscular system. There are three subsystem to maintain stability of spine: passive subsystem, active (muscles) subsystem and control subsystem. Detection of postural muscle response during postural perturbation like fast arm movement can be utilized to analyse of postural control. Wearing cervical collars is a way to prevent or cure cervical pain. The aim of the present study was to investigate the effect of soft cervical collar on movement response and duration of activity and recruitment pattern of cervical muscles. 

Materials and methods: Twenty healthy young women participated in this study. They flex right shoulder in response to sound stimulus with and without wearing soft cervical collar. Surface Electromyography (EMG) used to assess postural muscle activity in following muscles: Deltoid , Trapezius , Cervical Erector spinae and  Sternocleidomastoid. The effect of soft cervical collar on reaction time, onset and duration of activity of cervical muscles was calculated.

Results: Wearing soft cervical collar increased reaction time of arm flexion  (P< 0.05) and decreased duration of activity of cervical extensor, trapezius and erector spinae (P< 0.05). During shoulder flexion with additional load, onset activity of trapezius muscle was significantly earlier than other neck muscles but cervical erector spinae and sternocleidomastoid exhibit coactivation pattern in response to perturbation .

Conclusion: During fast arm movement that leads to postural perturbation, soft cervical collar alleviates the response and reduce activity of muscles. The strategy of motor control centers in response to perturbation in cervical spine is coactivation of flexor and extensor muscles to maintain stability.