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ckground and aim: Motor impairments, such as hemiparesis, incoordination and spasticity, are the most common deficits after stroke. Most patients show recovery in some of their lost motor function over time. Motor rehabilitation  are included mixed of combined movement therapy techniques in many occupational clinics. cerebral waves such as Theta wave can influence on patients function. There fore, the purpose of this study is to understand the influence of combined of occupational therapy and neurofeedback on motor recovery of stroke patients. 

Materials and methods :This study used a single-system (A-B) design. During the baseline phase patient's function of  upper and lowe limb were measured by Fugl-Meyer and Berg Test on three day intervals during 4 week and have occupational therapy every day. After this time, their treatment program began. In this phase they received combined of neurofeedback and occupational therapy for 4 week. Then results of evaluations of two phases were analysed. 

 Results: Both cases show significant recovery at upper limbs( case1 81.1% , case2 68.1%) and lower limbs( case1 73.1% , case2 75.4% ) in Fugel-Mayer test and Berg test( case1 51.6% , case2 68.1%).

Conclusion:Regarding the significant recovery of upper and lower limb function of patients, adding neurofeedback to routine occupational therapy  can be considered as a practical method in rehabilitation of stroke patients. However further research is needed.                                                         

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Background and Aim: Many of multiple sclerosis (MS) patients with normal pure tone thresholds complain from difficulties in their hearing, especially perception of speech in background noise. Many tests for evaluation of this dysfunction have been developed one of the best tests that are applied for evaluating the ability of individual to process and categorize brief, rapid changes in auditory stimuli is duration pattern sequence test (DPST). Accordingly, the purpose of this study was to compare between MS and normal 18-40-years-old participants by the duration pattern sequence test (DPST).

Materials and Methods: This analytic-descriptive non-invasive cohort study was conducted on 20 relapsing-remitting MS and 26 normal subjects 18-40-year-old with normal hearing. The finding data, percent of corrected answers, in two groups was evaluated by T-test. 

Results: The finding showed reduction of corrected answers percentage in DPST test between two groups (P<0.05). in addition, long periods of  the disease showed poor performance in DPST test in both ear.   

Conclusion: The findings of this study confirm that temporal resolution deficits in patient with MS may be related to involvement of central auditory processing nervous system.

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Background and Aim:Whole body vibration (WBV) has been regarded as an exercise training method and as a non-pharmacological supportive treatment option appearing to be efficient for chronic disease conditions, such as bone disorders and cardio-respiratory fitness. Since, data on the safety and efficacy of vibration on plasma parameters are lacking, therefore, the purpose of this study was to assess the effects of WBV on the plasma parameters in adult male Wistar rat model.

Materials and Methods: Male Wistar rats weighing 140-180 g were divided into control and the vibration group. Vibration training consisted of vertical sinusoidal whole body vibration for 8 weeks, followed by blood collection.

Results: The vibrated rats weighed more than the control group (approximately 14 % more). Plasma CK, E2 and IL-6 levels were significantly higher in the vibration group compared with the controls. The mean of Vit. D level was 15% higher hsCRP level was 11% lower and IL-6 level was 32% higher in the vibration group. No difference was observed for other selected plasma parameters.

 Conclusion: The potential effects of physiological responses of WBV on several physiological systems are without deteriorations in plasma parameters.

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Background and aim: Proprioception is a main component of somatosensory system that plays a protective role in acute injuries through reflex muscular splinting. Proprioception reduction could be a source of deficits in reaction time, postural control and postural stability. In chronic low back pain  patients (CLBP) the proprioception is decreased and leads to dysfunction in motor control and increased the risk of injury. Evaluation the repositioning of lumbar region could be an indication to measure the lumbar proprioception . The purpose of this study was to compare the lumbar repositioning in CLBP and healthy females. 

Material and Methods: Eighteen CLBP (22.83 ± 2.93 years) and 18 healthy females (23.33 ± 2.19 years) participated in this study. Lumbar repositioning error in 30% and 60% of lumbar full flexion and neutral position with closed eye in standing was evaluated with electrogoniometer. Absolute and constant error for 3 repositioning points were obtained and analyzed.

Results: Absolute error in patients with low back pain was significantly higher than control subjects in all 3 position points (P<0.05). Constant error did not show significant difference between two groups. (P>0.05)

Conclusion: Increased in absolute error of females with CLBP in lumbar repositioning implies that some aspects of proprioception may lose in patients with CLBP.

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Background and Aim:Set-shifting that is one of the most important executive functions in learning tasks and intelligence Quality (IQ) reactions was studied in high functioning children with autism. Mental ability can play an important role in learning tasks and activities of daily living. Assessment of this component is important in rehabilitation programs. The aim of this study is to compare set-shifting in high functoning children with autism and normal subjects between 6 to 12 years old. 

Materials and Methods: In this cross-sectional study, 30 children between 6 to 12 years old were participated and divided in two groups randomly. The mean age of autism and normal groups was 7.86(1.38) and 8(1.68) respectively. Cambridge neuropsychological test automated battery and wechsler for children were used. Data were analyzed by t-test.

Results: High functioning children with autism showed significant differences in set-shifting in comparison with normal subjects particulary in extradimensional stages (stages 8 and 9).

Conclusion: High functioning children with autism have poor capability in set-shifting in comparison with normal subjects. 

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Background and aim: One of the common problems in elderly people is falling. The effort to identify environmental risk factors at home and their modifications may control falls and injury in the elderly. Home FAST as a valid and reliable screening tool is used to identify elderly at risk of falling at home and in society.
Materials and methods : International quality of life assessment (IQOLA) was used for validity and reliability of Home fast. After forward and backward translation , the questionnaire was evaluated for content validity by 5 occupational therapists. Sixty participants aged over 65 were randomly selected through five geographical regions of Tehran. Inter-rater and test-retest with one week interval were conducted by two occupational therapists.
Results: Agreement among experts about the validity of screening tool of Home FAST (χ²= 25.008) were more than 96%.The correlations of test-retest with relative and absolute coefficients were high (ICC = 0.72 and SEM = 0.89). Also, the correlation coefficients between the raters with absolute and relative (ICC = 0.88 and SEM = 0.54) were significant, indicating the high reliability of this test.
Conclusion: This study shows the reliability and validity of the test are high. Since, test items are conformable to fall prevention goals, these results can be expected. The tool can be used by professionals.

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 Background and Aim: Optical blur due to refractive errors causes reducing retinal image quality and induces changes in how visual system responds. The purpose of this study is to evaluate the effect of myopic optical blur on visual cortex response by functional magnetic resonance imaging (fMRI). 

Materials and Methods: Five healthy volunteers with various degrees of myopia and age range 18-25 years (two females and three males) participated in this study. The results of functional magnetic resonance imaging of 18 emmetropic people (without refractive error) participated in a recent fMRI study with the same scanning conditions were applied as the control data. The functional scans were obtained by a Phillips scanner using a sine-wave grating visual task with spatiotemporal frequency of 2cpd/8Hz. The percentage of BOLD (Blood-Oxygen-Level-Dependent) signal change and number of activated voxels in different scan series were compared with each other after image processing.

Results: Non-linear reduction of visual cortex response due to increasing optical blur was observed in this study. The number of activated voxels and the percentage of BOLD signal change were both reduced in different amounts of myopia.

Conclusion: Considering the effect of optical blur on visual cortex responses in different amounts of myopia, it is better to provide the optimum optical correction during cognitive neuroscience fMRI research and FMRI study of neurologic diseases using patterned visual stimuli. 

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Background and Aim: In spite of massive knowledge increase and ergonomic correction, lumbar disorders extremely prevail in working environments. Efforts have been made in order to decrease prevalence of musculoskeletal disorders caused by lifting, carrying and pulling down objects by using some belts. The purpose of this research is to determine the effect of lumbo-pelvic belt in symmetrical load lifting on one of motor control indexes.
Materials and Methods: In this research twenty men were asked to lift objects with different weights of 5.5, 7.5, 9.5 and 12.5 kg in position of complete trunk and hips flexion and knees extension using and not using belt and put them on the target desk. Surface Electromyography has been recorded from two pairs of back muscles and three of abdominal muscles. 
Results: Lifting different loads with belt showed significant increase in symmetrical index (p<0.05). 
Conclusion:  Using belt brings about more coordination in trunk agonist and antagonist muscles activity while lifting the loads.  

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Background and Aim: Muscle fatigue is a factor that caused muscle injuries. Ability to perform movement without error and controllability has important role in reduction of injuries. Reproduce ability of motion is reduced after muscle fatigue. Evaluation of motor control can produce suitable conditions for assessment of these changes and help us treatment guide lines for prevention of injuries. The aim of this study was to evaluate motor control changes following onset of fatigue in patients with anterior knee pain as a physiological aspect.
Materials and Methods: Fifteen voluntary female (10 healthy, 5 patients with bilateral syndromes) participated in this study. During dynamic fatigue test (open and closed chain movements), muscle activities were recorded from bilateral vastus medialis, vastus lateralis and rectus femoris (20 healthy and 10 patients quadriceps muscles) by surface electromyography (sEMG). Five dynamic cycles of motions were selected before and immediately after fatigue and then average of three middle cycles were compared for Symmetry Index (SI) as motor control assessment.  Also Median Frequency (MDF) were computed as an indicator for onset of fatigue. 
Results: MDF reduced significantly in both groups. This reduction was markedly showed in patients group. Reduction of SI was significant after fatigue test. Comparison of SI between groups indicated that before fatigue there was significant difference but after fatigue test was not significant.  
Conclusion: Dynamic motions can produce muscle fatigue and reduction of MDF. High central control system used different synergies following pain and functional impairment. Synergy patterns change after dynamic motions fatigue and cause reduction of SI. This change is dependent to pain and functional impairment and has not a stable pattern. 

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Background and Aim: Whole Body Vibration (WBV), as a new exercise modality, can improve neuromuscular performance but, there is no study to assess the effects of WBV on the reaction time as an indicator of muscular performance especially in upper extremity muscles. Therefore, the aim of the present study is to investigate the immediate effects of WBV on timing parameters of upper extremity muscles. 

Materials and Methods: Forty healthy young women were randomly assigned in two groups of intervention (with WBV) and control (without WBV). In the intervention group, timing parameters (Reaction time (RT), Premotor time (PMT), Motor time (MT)) were measured by using EMG before and after the vibration (5 sets of 30seconds at 5 mm amplitude and 30 Hz frequency) session. The same protocol but without vibration was used for control group.

Results: Whole body vibration did not alter the RT significantly (P=0.253). Premotor time was increased significantly only in the triceps muscle (P=0.006). There was also a significant difference (P=0.003) in MT of the serattus anterior muscle between two groups.

Conclusion: It seems that WBV can induce different effects on upper extremity muscles. Whole body vibration has not any significant effects on the total RT 

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Background and Aim: Multiple sclerosis (MS) is a demylinating disease that due to the involvement of multiple areas in central nervous system, including sensorimotor system can impair the patients' balance. The aim of the present study was to determine the balance, extremities muscular strength and disability rate in Iranian patients with MS and to investigate the relationship between these parameters. 

Materials and Methods: Sixty eight patients with MS participated voluntarily in this study. The berg balance scale (BBS), Motricity index (MI) and self report patient determined disease steps (PDDS) were used for assessing the balance, extremities muscular strength and patients' disability rate, respectively 

Results: Fifty six of patients showed balance impairment. Balance values were significantly correlated with muscular strength of upper (p=0.011) and lower (p<0.001) extremities in patients with balance impairment. But, the relation between balance and muscular strength in patients without balance impairment was not significant (p>0.05).There was a negative correlation between balance and disability rate (p<0.001).

Conclusion: The results of this study showed that more than 50% of patients have balance impairment. Furthermore, the importance of evaluating muscle strength in order to predict the falling risk in MS patients were identified.

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 Background and Aim: The common mechanism for lateral ankle sprain is inversion, plantar flexion, or the combination of both, if untreated successfully can lead to chronic ankle instability. It seems that the foot position, while touching the ground, has an effective role to cause ankle sprain. Thus it is possible to prevent ankle sprain through limiting foot position. Therefore the aim of this research is to study the effect of plantar flexion and eversion on mediolateral ground reaction force while landing in individuals who suffering from functional ankle instability.

Materials and Methods: In this case-control research study 32 subjects (17 subjects with unilateral functional ankle instability (FAI) and 15 control subjects), aged from 18 to 35 years, were tested. All subjects in instability group were selected by the orthopedic physician, then the anterior drawer and talar tilt tests were  performed for diagnosis of functional ankle instability and other physical examinations. Control group were matched with instability group by age, weight, height, gender and body mass index. The subjects standing with single leg on a 40 cm high platform in 25 cm front of a force-plate while the test leg relaxed and non-weight bearing. The subject landed on the test leg on the center of the force-plate. The subjects landed according to four types of position: A: neutral position of ankle and lateral foot wedge, B: neutral position of ankle, C: positive heel and lateral foot wedge and D: positive heel. 

Results: Among control group, medial ground reaction force increased in the "C" position relative to "B" position (p=0.007) and "C" position relative to "D" position (p=0.018). In FAI group, lateral ground reaction force increased in "C" position relative to "B" position (p=0.001) and "C" position relative to "A" position (p=0.002). Also in FAI group medial ground reaction force decreased in "D" position relative to "A" position (p=0.014). 

Conclusion: According to the findings, applying lateral foot wedge, while the ankle is in plantar flexion, increases the mediolateral ground reaction forces. Based on the results, position of plantar flexion is more possibly effective than inversion in ankle sprain. According to the study, the lateral foot wedge in ankle plantar flexion position may be more effective than in neutral one to change mediolateral ground reaction forces. 

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

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

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

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

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 Background and Aim: Cerebral palsy is characterized by non-progressive abnormalities in the developing brain that creates a cascade of motor deficits and finally affects functional activities. Limited hand function is a characteristic of the movement disorders in children with cerebral palsy which leads to disability in performing activities of daily living, work and play. The purpose of this study was to investigate the effects of wrist Kinesio Taping on hand function of children with spastic diplegic cerebral palsy.

 Materials and Methods : In this randomized clinical trial and single-blind study, 26 children (3-6 years old) with spastic diplegic cerebral palsy were selected by convenient and simple sampling and randomly divided into two intervention and control groups. During the study for 12 days ,control group received only common occupational therapy treatment or Neuro-Developmental Treatment (NDT). Intervention group received both NDT and wrist Kinesio Taping for 24 hours a day on both wrists. Assessment tool was QUEST for evaluating quality of upper extremity skills and Modified Ashworth Scale for assessing spasticity of wrist before and after intervention in both groups. Data were analyzed by independent t-test and Wilcoxon rank sum.

 Results : The results showed significance increase of total QUEST score (P=0.029) and significance difference in domains of dissociated movements (P=0.003) and grasp (P=0.008) in Kinesio Taping group. However, there were no significant differences in weight bearing (P=0.46) and protective extension (P=0.89) domains. The data showed that wrist Kinesio Taping was effective in reducing spasticity of right wrist(P=0.004) but no significant difference for left wrist(P=0.06).

 Conclusion: Wrist Kinesio Taping technique revealed to be effective in increasing quality of upper extremity skills of spastic diplegic cerebral palsy children in domains of dissociated movements and grasp. Moreover, it was concluded that this technique can be effective in reducing spasticity of right hand due to more active use of dominant hand.

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Background and Aim: The effects of lateral wedge insole with and without sub-talar strap on pain, arthritic symptoms, functional performance, sports and recreational activities, and knee related quality of life in patients with medial compartment knee osteoarthritis were compared.

Materials and Methods: Community-dwelling men and women aged over 40 years with medial compartment knee osteoarthritis, grades I or II based on Kellgrene and Lawrence grading system were participated in this study. They were randomly allocated in two different groups lateral wedge insole with and without sub-talar strap. Both groups were required to wear the insoles at home for the duration of four weeks, approximately 5 to 10 hours per day. Participants were asked to complete the Farsi version of Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at baseline and at follow-up. The reliability of KOOS for measuring short term and long term symptoms and function in Iranian patients with knee injuries and osteoarthritis has been reported previously.

Results: The changes in KOOS subscales were significantly different in both groups over time. Contrary to our hypothesis, the interaction effect was significant between the two groups following our intervention in terms of symptoms, daily living functions, sports and recreational activities, and knee related quality of life, unless pain score. 

Conclusion: The result of this study suggests that both of the insoles improved pain, symptoms, function in daily living, sports and recreation activities and knee related quality of life in patients with mild medial compartment knee osteoarthritis. However, use of sub-talar strap with lateral wedge insole would be the better prescription for insoles in these patients. 

 

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Background and Aim: Constraint-Induced Movement Therapy (CIMT) is a new intervention in chronic hemiplegic patients. The aim of present study is to quantify of quality of movement (QOM) and amount of movement (AOU) that assessed by motor activity log (MAL) after modified CIMT in comparison with traditional physiotherapy (TPT).

Materials and Methods: Ten patients were randomized to modified CIMT or TPT group. Five patients received training of the more affected limb fort two hours daily, three times in a week during two months of treatment. The patients are encouraged to wear an arm- hand splint in less affected hand for five hours daily for maximal using of affected limb with shaping method. The patients in TPT group received physiotherapy treatment with same intensity with other group, for two hours daily during two months. Motor Activity Log (MAL) was used to determine QOM and AOU before- after two months treatment.

Results: The data showed significant improvements in AOU and QOM in affected extremity that clarified by Wilcoxon test. Mann- Whitney test used for comparison between two groups, revealed significant difference in modified CIMT group (p=0.02).

Conclusion: Although, modified CIMT was more effective than TPT in improving QOM and AOU but, TPT as an active rehabilitation can be effective on improving of these parameters. 

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Background and Aim: Work related injury (WRI) can cause problems such as change or loss in job, fatigue and burnout. Injury prevalence has increased from 10.2% to 13.5% in the U.S. therapists since 2004 to 2006. At least 3,700 physiotherapists and 900 occupational therapists membership in Iranian Medical Council and developments of occupational therapy and physical therapy domains are involved in our country and the growing trend of student admissions in these fields and also limited researches in work-related problems of therapists, there would be a challenge in research studies. The overall goal of this systematic review was to survey the prevalence of work-related problems, predisposing factors and causes of these problems among therapists and finally predict problems of Iranian occupational therapy and physiotherapy population. 
Materials and Methods: By performing the five stages of an evidence based systematic review with regard to the selection criteria obtained from related articles, looking for articles were done through using internet databases, reference books and Citation review. At first, 50 articles were obtained. Finally, this study reviewed 25 articles in the last two decades in different parts of Iran and the world (1990-2010)
Conclusion: It was clarified that muscular injuries were of the most common types of damages caused by these works. Injuries were seen in most particularly in public, orthopedic and acute settings. Low back pain was remarkably reported. Age under30 years, inexperience and heavy work were some of the risk factors. Improper handling was determined as the main cause of injuries in therapists. Besides musculoskeletal injuries, common psychosocial problems were depression, anger and job frustration. Finally, considering culture and job characteristics of the Iranian therapists, the data and results were compared and discussed to predict different aspects of WRI in Iranian therapists.

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Background and Aim: According to clinical observation, foot hyperpronation is very prevalent and may cause malalignment of the lower extremity in which can lead to structural and functional deficits in standing and walking. The aim of this study was to investigate of  foot hyperpronation effect on spine alignment in standing position.

Material and Method: Thirty-five healthy male ranging 18 - 30 years old were participated in this study. Evaluation was performed with two examiner in four standing positions (on the floor, on the wedges angled at 10, 15 and 20 degrees) using motion analysis system (zebris) and each one of measurement methods repeated three times. SPSS version 17.0 and paired t- test and repeated measures were used for statistical analysis.

Results: Significant difference was seen between all modes in sacral angle, pelvic inclination, lumbar lordosis and thoracic kyphosis variables (except between the first and second mode. Finally, with increasing wedge angle, a positive correlation obtained  for the examiners and all variables.

 Conclusions: The results of this study showed with increasing bilateral foot pronation, sacral angle, pelvic inclination, lumbar lordosis and thoracic kyphosis were increased. In fact, each one of them considered a compensatory phenomenon.

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Background and Aim: Forces which applied to ankle joint for control of stability can cause damage to joint if it does not have suitable control. Chronic ankle instability (CAI) is a current disability that can affect on activity daily living of the patients. The aim of this study is to evaluate forces which contribute to control of posture in difficult conditions.

Material and Methods: Postural control was measured by force plate in two groups of CAI and healthy subjects. Eight positions were selected , including of double stances with closed or opened eyes, and single stances with opened eyes (right/ left) with and without a cognitive task. Force changes in two direction medial/lateral and anterior/posterior were evaluated with fractal time series analysis.

Results: Fractal dimension of force in two groups, following dual task in all of conditions reduced significantly (P<0.05). There was not significant different between two groups in double stance with or without dual task. Single stance in patients indicated significant increase of fractal dimension in affected ankle joint (P<0.05) but comparison of two side in healthy subjects did not have difference. Also there was significant increase of fractal in affected ankle joint of patients in comparison with similar side of healthy subjects (P<0.05).

Conclusion: Patients with (CAI) have a problem in regulation of force for control of posture. This difficulty increased and clearly indicated by dual task condition, which can cause susceptible qualifications for recurrent injuries. Fractal dimension is a suitable factor for analysis of control of posture in difficult situations.

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Background and aim: Various studies indicate that background noise affects speech recognition ability of bilingual listeners (BL) more than monolingual ones (ML). However, no study has engaged in the speech recognition performance of Turkish-Persian bilinguals in the background noise. The purpose of the present study was to compare word recognition scores (WRSs) in the continuous and interrupted noises among ML Persian and BL Turkish-Persian young adults. 

Material and methods: The cross- sectional analytical study was conducted by presenting speech stimuli in quiet and in the background continuous and interrupted noises at signal to noise ratios (SNRs) of -20, -10, 0, +10 dB. Two groups of 33 ML Persian and 36 BL Turkish- Persian subjects with age ranging from eighteen to twenty-five years old participated   

Results: The degree of reduction in WRSs was significantly higher in the continuous noise relative to the interrupted one at four studied SNRs (p<0.0001) Moreover, the difference between WRSs of ML Persian and BL Turkish-Persian groups in the presence of both continuous (p≤0.001) and interrupted (p=0.002) noises was significant.

Conclusion: It seems that Persian-words recognition ability of Turkish-Persian BLs reduces more than Persian MLs in the background noises and continuous noise affects speech perception ability more than interrupted one.