Background and Aim: According to the further tendency of osteoporotic people to use the hip strategy to maintain stability, in present study, the relationship between hip, ankle and back extensor muscles strength and functional balance in healthy and osteoporotic postmenopausal women were evaluated.

Materials and Methods: Forty-five volunteer postmenopausal women were divided into two normal and osteoporosis groups according to their bone mineral density. Maximal isometric strength of hip, ankle, and back extensor muscles were assessed by a hand-held digital dynamometer. Functional balance was assessed by Near Tandem Stand (NTS), Star excursion (SE) and Figure of 8 walking (F8W) tests.

Results: In osteoporosis group, all muscle groups were significantly weaker than the normal group (P<0.05), and the time of F8W test was significantly more than normal group (P=0.031). Also, in osteoporosis group, hip adductors and extensors showed a significant correlation with three functional balance tests (P<0.05).

Conclusion: Regarding to decrease of muscle strength in osteoporotic women and its relationship to declining of functional balance in ADL, strengthening of hip and ankle muscle groups should be considered in their rehabilitation programs.

Keywords: Muscle strength, Functional balance, Postmenopausal women, Osteoporosis.

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

Background and Aim: Anterior cruciate ligament (ACL) injury is common in sports competition and training. Following ACL rupture, neuromuscular system performance is disrupted. Perturbation training can improve the function of patients with ACL reconstruction. The aim of the present study was to assess the effects of perturbation training on ground reaction force and functional status of these patients .

Materials and Methods: Twenty patients with ACL reconstruction were randomly assigned into intervention (mean age: 24/2 ±3/4 years) and control (mean age: 27/1 ± 2/5 years) groups. The intervention group performed ten sessions perturbation training with rocker board, wobble board and Bosu. Peak vertical ground reaction force (GRF) and time to peak vertical GRF were recorded by KISTLER force plate during single leg landing from a 30cm height step. In addition, cross hop test also was evaluated as a functional test.

Results: Before perturbation training, both GRF and time to peak vertical GRF in reconstructed knee had not significant difference between two groups (P>0/05). In addition, functional test score had not significant difference between the groups (P=0/62). Following perturbation training, peak vertical GRF in reconstructed knee was greater than that in control groups (P<0/003).Although time to peak vertical GRF in reconstructed knee increased, there was not statistically significant difference between two groups (P=0/50). Furthermore, functional test score was statistically greater in intervention group (P=0/03).

Conclusion: This s tudy showed that perturbation training can improve functional status in patients with ACL reconstruction. In addition, force plate findings indicated that the patients tolerated more forces at longer time in single leg landing.

Key words: Perturbation training, Ground reaction force, ACL reconstruction, Function

Background and Aim: One of the impaired senses in patients with chronic hemiparesis is the sole cutaneous sense. The role of this sense in maintaining the functional balance and mobility is still controversial in these patients. The aim of this study was to investigate the relationship between the threshold of sole cutaneous sense and functional balance and mobility tests in patient with chronic hemiparesis.

Material and Methods: In this correlational study, seventeen chronic stroke patients by mean age of 59.10 (13.31) years and mean time after injury of 31.70 (23.61) months were selected by simple non– probability method. Functional Reach with ankle and hip strategy (FR), Step Test (ST) in affected and non- affected foot, Bend– Reach test (BR), Timed Up and Go test (TUG) and Berg Balance Scale (BBS) were used for assessment of functional balance and mobility and Semmes- Weinstein monofilaments test was used to measure the cutaneous sense of seven different points of sole in affected and non– affected foot.

Results: The main effect of foot (affected and non– affected foot) and points (seven different points of sole) of cutaneous sense threshold was significant (P˂0.0001) and interaction effect of foot ˣ points not significant (P=0.2).

The cutaneous sense threshold in all seven points of affected sole showed significant (p˂0.05) low to high correlation (r= 0.24-0.81) with all of functional balance and mobility tests. There was not significant correlation between cutaneous sense threshold in seven points of non- affected foot and any of functional balance and mobility tests, with the exception of cutaneous sense threshold of the little toe floor with total, dynamic and static score of BBS, FR with ankle and hip strategy and TUG; cutaneous sense threshold of big toe with static score of BBS and FR with hip strategy; and medial border of sole with static score of BBS and FR with ankle strategy.

Conclusion: The cutaneous sense threshold of affected sole has a more correlation with functional balance and mobility tests. The cutaneous sense threshold of sole in big toe and medial border points has a significant role in functional balance and mobility tests in patients with hemiparesis.

Keywords: Functional balance and mobility, Cutaneous sense threshold, Hemiparesis

Background and Aim: Cerebral palsy is a common cause of inability in childhood that effects on posture and motor development and leads in activity limitation. One of the difficulty of cerebral palsy is impairment in arm and hand function. Splints and orthosis are used to improve position, range of motion and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on spasticity, range of motion, grip and pinch strength and function of affected hand of spastic hemiplegic children of 8-12 years old.

Materials and Methods: This is an interventional study. Twenty spastic hemiplegic 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 randomly divided into intervention and control group. Patients in intervention group used a static anti-pronation splint for two months, 6 hours daily. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of wrist, forearm and elbow, ROM of wrist, forearm and elbow were measured with goniometer and grip and pinch strength were evaluated with MIE.

Results: Results in intervention group showed a significant improvement in hand function (p<0.003), in wrist`s spasticity (p<0.005), forearm`s spasticity (p<0.003), wrist`s ROM (p<0.001), forearm ROM (p<0.003), grip strength (p<0.001) and pinch strength (p<0.003) in intervention group. The data did not show significant improvement on elbow`s joint ROM (p<0.343) and spasticity (p<0.157).In control group, significant improvement did not seen (p>0.05).

Conclusion: Information from present research shows that using static anti-pronation splint for 2 months ,6 hours a day, can be an effective method to improve hand function, wrist and  forearm spasticity and range of motion, strength of grip and pinch in hemiplegic CP children.

Keywords: Static anti-pronation splint, Hand function, Spastic hemiplegic, Cerebral palsy.

Background and Aim:  Diabetes mellitus comprises a group of disorders associated with hyperglycemia. Diabetes can cause many complications for the person which can affect various aspects of health. This study aimed to assess the function in diabetic patients based on the International Classification of Functioning, Disability and Health (ICF).

Materials and Methods: In this cross-sectional study, evaluation of function was based on selection of assessment tools from the components of the ICF system, including the hand function (strength, dexterity, sensation), the ability to perform instrumental activities of daily living, quality of life, ability to work, social support and their self-management on 94 patients with diabetes type 1 and 2(refer to the community support for diabetic patients in Shiraz) took place. Collected data were analyzed using SPSS.

Results: In this study of the 94 participants with diabetes, 39 were male (41/5 %) and 55 females (58/5 %). 40 patients (42/6 %) with type 1 diabetes and 54 (57/4 %) patients had type 2. The results show that the strength, dexterity, sensation, self-management and work ability were significantly associated with blood sugar levels (P <0/001).

Conclusion:Using the ICF as a framework for evaluating the function and determining the health status of diabetic patients, hand function and the ability to work in patients with diabetes was not desirable. Hand function and ability to work decreases with an increase in blood sugar levels.

Keywords: Diabetes, function, International Classification of Functioning, Disability and Health.

Background and Aim: People with multiple sclerosis (MS) suffer from respiratory disorders during the course of their disease .To express disability, much of the interest was devoted to their mobility and less attention has been paid on physiological aspects such as respiration. The aim of this study was to compare some of the important indices of breathing patterns in healthy individuals and people with MS. Furthermore the correlation between duration of disease and disability scores (EDSS) with pulmonary indices were investigated.

Materials and Methods: In this descriptive analysis study, there were 32 people with MS and 32 healthy subjects. Both groups were matched and selected by some of the demographic characteristics. We investigated biochemical parameters that were assessed by measuring end-tidal CO₂ pressure, saturation of O₂ and respiratory rate using Capnograph. Student’s t-test was applied for independent samples. The relationships between duration of disease and EDSS with pulmonary indices were analyzed by Pearson’s correlation.

Results: The end-tidal CO₂ index had significant difference between the two groups and was lower in people with MS, whereas saturation of O₂ and respiratory rate did not have significant difference. There was a significant positive correlation among the disease duration and the disability scores, but was not associated with abnormal breathing pattern.

Conclusion: Existence of disorders in some parameters of  respiratory pattern in people with MS are revealed that survey of respiratory system in people with MS can be effective in the early diagnosis and treatment process of breathing problems in physiotherapy centers.

Keywords: Multiple sclerosis, Breathing pattern, Biochemical parameter, Respiratory dysfunction

Background and Aim: Visually and hearing impairments are as the most common groups of physical disabilities. Due to limitation caused by these disorders, they can affect family functioning. The aim of this study was to compare the functioning of families with visual and hearing impairments with families without disorders.

Materials and Methods: In this descriptive – analytical study, 55 subjects with visually and hearing impairment from association of the blind and deaf of Ahvaz city, Iran and 55 subjects without disorders as the control group were selected by available sampling method and examined. Data collection tools include Family Assessment Device (FAD) inventory and the demographic  information questionnaire. Finally, the data were statistically analyzed using descriptive and analytical statistics in SPSS 20 software.

Results: The research findings showed that the mean scores values obtained from FAD inventory
in families with visual and hearing impairments and the controls had no statistically significant differences (P=0.1). Comparing the functioning dimensions in the three groups, the families with visual impairment had poorer functioning in dimensions of behavioral control (P=0.02), communication (P = 0.01) and overall functioning (P = 0.03) with respect to the two groups.

Conclusion: The results suggest that the families with visual impairment have lower performance compared to families with hearing impairment and the control group in some aspects.

Keywords: Family functioning, Visually impairment, Hearing impairment

Background and Aim: Fatigue is a factor that disrupts balance and leads to sport injuries. Female athletes have a much higher incidence of ligament injuries than men. The purpose of this study was to assess the effect of gender and functional fatigue on dynamic balance.

Materials and Methods: Thirty two non athletic healthy subjects (16 women and 16 men) aged between 18-35 year participated in this study. Star excursion balance test was performed pre and post functional fatigue at the posterolateral and posteromedial directions.

Results: Main effect of fatigue was significant (F=37.62, P<0.01). Both groups showed reduced reach distance after fatigue in posterolateral and posteromedial directions. Fatigue and group Interaction was not significant (F=0.045, P>0.05). The Interaction of fatigue and directions of star excursion balance test was not significant (F=1.169, P>0.05).

Conclusion: Fatigue reduced the dynamic postural control in both gender. However, this reduction was not different between the groups. It seems that other factors rather than the effect of fatigue on postural control contribute to the difference in the risk of injury between men and women.

Keywords: Functional fatigue, Balance, Gender