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. 

Background and Aim: Reading disorder is a neurodevelopmental disorder with deficits in cognition and motor skills. According to available studies, the brain structure in thesechildren is intact, but the brain function is abnormal. So, neurofeedback as a new treatment, can improve brain function in this disorder through regulating abnormalities of electroencephalogram (EEG). The purpose of this study was to investigate the effectiveness of neurofeedback balance protocol (to inhibit 4-7 Hz while reinforcing 15-18 Hz at electrode sites O1 and O2) on EEG and balance performance in children with reading disorder.

Materials and Methods: The study was conducted in a single subject design in 20 sessions. Participants were 4 children (1girl and 3 boys) aged between 8-12 years old who completed twelve 30-min neurofeedback sessions. Repeated measurements were performed during the baseline, treatment and follow-up by means of 2nd subtest of BOTMP for balance performance and EEG for brain waves changes.

Results: The results showed that the effect of treatment on balance performance was high (Cohen’d > 0.8) in all subjects but there were no significant changes in absolute power of brain waves.

Conclusion: The results of this study indicated that neurofeedback balance protocol can improve balance in children with reading disorder and may be more treatment sessions are needed for significant brain waves changes.

Background and Aim: One of the most common defects after stroke is deficit in trunk control and balance which can lead to disability or dependency in many functional activities in life. Many therapeutic approacheswere used in the stroke rehabilitation, but there is not any unique accepted approach in this field yet. However there are many evidences that show task-oriented practice for neuro-movement rehabilitation can be efficient. The purpose of this study was to examine the effect of intensive task-oriented balance practices on functional balance and mobility in patients with chronic stroke.

Materials and Methods: This was an interventional - quasi-experimental study on 13 patients (4 women, 9 men, mean age 55.07 ± 8.41) with chronic stroke which were selected according to inclusion criteria. The intervention included 10 days of intensive practice during 2 weeks ,5 days per week and 3 hours a day. The assessments (Berg Balance Scale, Time Up-Go) were performed before and after the intervention.

Results: Intensive task-oriented balance training in patients with chronic stroke significantly increased the functional balance (p=0.005) and reduced the time of functional mobility (p=0.001)

Conclusion: The results showed that intensive task-oriented balance training can improve functional balance and functional mobility. Because this study was done only in one group, conducting more studies with appropriate control group is suggested.it is recommended to follow up the long lasting effects of training.

Abstract

 Background and Aim: Regard with the importance of balance in daily activities especially in sport activities and understanding the important factor affecting it, the purpose of this study was to compare the role of vision system on dynamic postural stability of young women with men elite athletes.

Materials and Methods: Twenty six young women and men elite swimmer were chosen from the available society. They were divided in two groups according to body mass index. Each subject performed postural stability tests for 6 trials with open and close eyes (3 trials with open and 3 trial with close eyes) that each trial was taken for 30 seconds and with 10 seconds rest between each of them. Balance index in anterior- posterior and medial- lateral directions were calculated and independent t test was used to compare between groups.

Result: Results show that men swimmer are more depended to vision than women swimmer in maintaining retrieval postural stability (p= 0.001), while most impairment in maintaining postural stability in both groups occur in lack of vision status in anterior- posterior direction (p= 0.001).

 Conclusion: The findings of this study can be used to design training programs to prepare athletes.

Key words: balance, vision, athlete, control

Background and Aim: The aim of present study was to examine effect of attentional focus on balance performance and EMG activity of athletes.

Materials and Methods: The semi-dynamic balance task of 10 gymnasts (22.2±2.09 years old) with 3-5 years of experience in two periods, one in internal focus (focus on leg) and one in external focus (focus on stabilometer plate) was assessed. Postural sways were measuredby Biodexstabilometer and muscular activity of tibialis anterior and soleus muscles were recorded using ME6000electromygram device. Data were analyzed using paired t- test.

Results : muscular activity for controlling posture was reduced in external focus condition than internal focus. Postural sways is more in internal focus condition than internal focus.

Conclusion: Research findings (enhanced performance and reduced EMG) showed that antinational focus conditions (internal or external) have significant effect on athletes balance performance. In conditions that attention is focused on external feedback and information (rather than focus on body itself) balance is enhanced and requirement to muscular activity will reduce.

Key words: Attentional focus, Electromyography, Semi-dynamic balance

 Background and Aim: Total Hip Replacement (THR) is done comprehensively all over the world. Despite the effects of braces on control of THR complications , few studies have been performed on this subject. The purpose of this study was to evaluate immediate effect of hip abduction brace on mobility and functional balance of patients with THR.

 Materials and Methods: Eight men and nine women with THR participated in this study. Mobility and functional balance were assessed and compared with and without brace conditions by means of TUG, FR and Berg tests.

  Results : A significantly higher TUG, FR and Berg scores were seen in brace condition compared to without brace situation (P < 0.05).

  Conclusion: Hip abduction brace can increase mobility and functional balance in patients with THR.

  Keywords: Total Hip Replacement, Functional balance, Functional Mobility, Hip Abduction Brace

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

Background and Aim : One of the most common defects observed after stroke is deficit in trunk control and balance which can lead to disability or dependency in many functional activities in life. Many therapeutic approaches are used in the rehabilitation of stroke patients, but there is no any unique accepted approach in this field yet. However there are many evidences that show task-oriented practice for neuro-movement rehabilitation can be efficient. The purpose of this study was to examine the effect of intensive task-oriented balance practices on functional balance and mobility in patients with chronic stroke.

Materials and Methods: This study was an intervention - quasi-experimental with chronic stroke on 13 patients (study on 4 women, 9 men, mean age 55/07 ± 8/41)which were selected according to inclusion criteria. The intervention included 10 days of intensive practice during 2 weeks , 5 days per week for 3 hours a day. The assessments (Berg Balance Scale, Time Up and Go) were performed before and after the intervention.

Results: Intensive task-oriented balance training in patients with chronic stroke significantly increased the functional balance (p=0/005) and reduced the time of functional mobility (p=0/001)

Conclusion: The results showed that intensive task-oriented balance training can improve functional balance and functional mobility. Because this study was done only in one group, conducting more studies with appropriate control group is suggested. Follow up were recommended in order to show durability effect for future researches.

Key word s: Stroke, Functional balance, Functional mobility, Task- oriented approach, Intensive practice

Background and Aim: The aim of this research was to study spinal abnormalities ( kyphosis, lordosis and scoliosis ) and dynamic and static balance in mentally retardation with and without Down syndrome (DS) and relation between them in DS.

Materials and Methods: Thirty mentally retardation with DS (age 13.96 ± 1.77 yr) and 30 mentally retardation without DS (age 14.30±1.96 yr) that selected randomly participated in this study. Modified single balance test for the evaluation static balance and heel-to-toe test for evaluation dynamic balance were used. Continued spinal abnormalities included kyphosis, lordosis and thoracic & lumbar scoliosis were measured by spinal mouse.

Result: The results showed a significant difference between static and dynamic balance, kyphosis and thoracic & lumbar scoliosis in mentally retarded with and without DS . There was a significant relationship between static balance and kyphosis and thoracic and lumbar scoliosis and dynamic balance with kyphosis and thoracic and lumbar scoliosis in DS . There was not a significant relationship between balance and lordosis.

Conclusion: Due to relationship between postural and balance and special needs in mentally retardation particularly Down syndrome, for optimal performance of their daily activities, it should emphasis to recognize the structural profile and prescribe postural corrective programs and improving balance.

Key words : Down syndrome, Spinal deformities, Static balance, Dynamic balance  

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: Anterior Cruciate Ligament (ACL) is responsible for physical and somatosensory function. It is expected that additional sensory information improves dynamic balance of ACL reconstruction patients. This study is aimed to determine the effect of sensory information on knee dynamic balance after ACL reconstruction in comparison with normal people.

Materials and Methods: The study was designed as a randomized clinical trial. Thirty two men (16 men with unilateral ACL reconstruction and 16 healthy men), assigned in three groups: ACLR, reconstructed knee ACLR, non-reconstructed knee and normal. All participants received tactile information during functional tests. Dynamic postural stability was assessed by two functional tests including: Star Excursion Balance test and Cross over Hop for distance. The functional tests scores were conducted both pre and post applying sensory information in ACLR and normal people.

Results: The data showed that tactile information improves functional performance of ACLR patients. There were significant difference in reconstructed knee’s SEBT scores in medial (p=0.005) and posteromedial (p=0.034) directions by adding touch information. Significant difference in dynamic balance by addition of touch sense, in COH scores of ACLR people and normal population was found.

Conclusion: The findings of this study showed that additional sensory information improves dynamic balance in ACLR patients. The positive effect of tactile information supports to apply additional sensory information as a new method for increasing dynamic balance.

Key words: Anterior cruciate ligament, Sensory information, Dynamic balance.

Background and Aim : Vision plays an important role in maintaining balance in the body so that the visual defects produce some disturbances in the body balance. In order to establish balance, the first afferent signals to the brain are provided through the visual system. Therefor, diagnosis and treatment of visual disturbances are so most effective and important. This paper reviews the importance of the visual system in body balance control and visual disorders which affecting on balance.

Materials and Methods : In this study, the articles from 1989 to 2012 with issues of vision and body balance were reviewed. The research with medical subject heading terms and key words of “vision” and “balance” in Pub-med, Science Direct, Scopus, Iran Doc, Scholar Google, Iran Medex, Magiran were done.

Conclusion: Correction of visual disorders and improving vision in patients with balance disorders can hasten the healing process.

Keywords: Vision, Balance, Visual Disorders

Background and Aim: Physical and cognitive performance changes such as impairment in balance and reaction time occur with aging. In according to some studies, these disorders may be delayed by systematic physical activities. This study aimed to investigate the effect of Pilates training on the improvement of balance and reaction time of sedentary adulthood men in Kermanshah city.

Materials and Methods: In this study, 40 sedentary adulthood men, aged (72.15±6.74), selected and divided into two equal groups randomly. These old men lived in Elderly centers in Kermanshah. In order to measure the participants’ balance and reaction time, static balance test stork, timed up and go test and reaction time system was used. Participants participated in a course of 8-week Pilates exercise program such as stretching movements in the muscular joints balance practicing of legs, standing on one foot and deep breathing. After assurance of normality using K-S test, independent t-test was used

  for data analysis.

Results : The results showed in comparison with control group, participation in Pilates protocol, could improve balance and reaction time in elderly men significantly (p<.0.05).

Conclusion: According to results of this study , Pilates training can improve balance and reaction time of the elderly . So to improve the cognitive and motor functions of the elderly , it can be recommended to participate in physical activities such as Pilates training .

Key Words: Pilates training, Elderly, Static balance, Dynamic balance, Reaction time

Background and Aim: Knee osteoarthritis is one of the most common musculo-skeletal problems and can effect on patient's daily activity and produce dependency in their daily activity and functional disability such as including the balance of these patients. Therefore, the aim of this research is to investigate the effect of a period of therapeutic exercise and detraining after that on balance in the women with knee OA.

Materials and Methods: This research was a semi-empirical and applied on 24 inactive female patients with osteoarthritis of the knee with a physician's diagnosis and entering in Research. Subjects randomly classified into two groups, the therapeutic exercise and control. The Biodex Balance machine was used to determine static and dynamic balance in patients with pre-test and post-test in order to stabilize the situation and jeopardize. After pre-test in order to evaluate the durability of training, the tests were repeated after one months of detraining experimental group subjects. The therapeutic exercise protocols executed on subjects over 20 sessions (4 weeks and duration of each session about 60 minutes). During this time, the control group did not do any practice. The raw data was analyzed by SPSS version19. Friedman test and wilcoxon were used.

Results: Application of one course of treatment on the static balance: the overall stability and also dynamic balance of women with knee OA was significantly affected of (P &le; 0/05). Also, one month detraining after of the training period showed lasting improvement of balance (static-dynamic).

Conclusion: Based on the results of the present research, execution of period of 4 weeks in therapeutic exercise can significantly effect on balance improvement in women with knee OA. This change will be stable after one month of detraining. Therefore, therapeutic exercise even in a short period of 4 weeks can be advised to be effective way to cure and improve balance in patients.

Key words: Therapeutic Exercise, Detraining, Balance, Knee Osteoarthritis

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: Perceptual motor abilities are based on motor functions and conceptual growth. Therefore, regarding the weak perceptual motor abilities in mental retarded children, it will be an effective step in eliminating their learning problems and improving their functional activities at school, at home and in the society. The purpose of this study is to investigate the effect of instruction of balance exercises along with gross movement exercises on the balance function and gross movement in mental retarded children.

Materials and Methods: Using a simple non-probability sampling method, based on a pilot sample and the sample size formula were considered 10 children in the treatment group and 10 children in the control group. Inclusion criteria include educable children with mental retardation without significant skeletal, neurological and mental illness and the age group is between 4.5 to 14.5 years. Exclusion criteria include uncooperative child and absence of more than one session. Treatment group for 10 weeks, 3 sessions per week for 30-minute exercises; balance training and gross motor was taught. No intervention was done on control group. Then all subjects retested. The effectiveness of the treatment on balance and gross motor function were performed by statistical analysis.

Results: Before treatment, balance and gross motor scores were not significant (P&ge;0.05) between the intervention and control groups. In the interventional group, gross motor scores were significant (P&le;0.05) but balance scores were not significant (P&ge;0.05). Balance and gross motor scores between pre-and post-intervention in control group were not significant (P&ge; 0.05).

Conclusion: Lack of experience in the motor skills resulted poor motor skills in mental retarded children. Therefore, according to the findings of this study, we can provide requirements for gaining motor experiences with planning, targeted training and utilization of effective rehabilitation and occupational therapy.         

Keywords: Balance exercises, Gross exercises, Mental retardation

Background and Aim: Balance impairment in patients with stroke leads to dependence in activities of daily living. Appropriate, accurate and inexpensive tools are necessary to assess the severity of balance impairment. In order to identify individuals with chronic stroke who have balance impairment and to apply proper treatment, the aim of this study was to examine the sensitivity and specificity of Timed Up and Go (TUG) and Functional Reach (FR) tests, Bend Reach test (BRT) and Step test (ST) in functional balance assessment of patients with chronic cerebrovascular accident.

Materials and Methods: In this cross-sectional comparative study, eighty-one patients with chronic stroke by mean age of 58.82 (±13.48) years and the mean past duration of disease 36.33 (28.27) months were selected by simple non-probability method. Functional balance and mobility tests including TUG, FR, BRT and ST were used as index test and the Berg Balance Scale (BBS) was used as reference test.

Results: All of functional balance and mobility tests including TUG, FR, BRT and ST have a significant ability to identify individuals with chronic stroke subjected to the balance impairment compared with BBS(p<0.0001). Sensitivity of functional balance and mobility tests including TUG, FR, BRT and ST in intact and affected feet at the moderate or above threshold were 90, 90, 88, 88 and 90 percent respectively and at the sever threshold were 60, 85, 58, 88 and 60 percent respectively. Specificity of these tests at the moderate or above threshold were 56, 85, 65, 57 and 53 percent, respectively and at the sever threshold were 89, 90, 92, 30 and 92 percent respectively. TUG functional balance and mobility test had the highest agreement with BBS balance test.

Conclusion: TUG functional balance and mobility test are the best tool to identify chronic stroke patients with balance impairment in both moderate or above and severe threshold.

Keywords: Chronic stroke, Balance, Sensitivity, Specificity

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

Background and Aim: The purpose of this study was to investigate the effects of sensory-motor integration on Balance and Reaction time in children with Developmental Coordination Disorder( DCD). Motor developmental coordination disorder (DCD) is a statement that the American Psychiatric Association was described for children who have difficulty in implementing some of the skills and competencies necessary to deal with the needs of the motor suffering their everyday lives, proposed locomotors.

Materials and Methods: This study was a semi-experimental study. Twenty patients (mean age, 8.5years old) were randomly divided into two groups of experimental and control groups from the DCD children rehabilitation center in Kermanshah. Continuous performance test, test improved stork and test walk heel to toe were used. After the pretest, the experimental group had a protocol for 8 weeks, three sessions per week of 120 minutes exercise (Swinging, jumping on Trampoline, baby turn around, turn around and coach children). To investigate the differences between the groups and the effect of exercise, ANOVA with repeated measures design with 2 × 2 (two with double measurement) were used. Post hoc t-test and t-test was used to analyze differences within groups and between groups.

Results: The results showed that the experimental group showed a significant improvement in reaction time, dynamic and static balance. There was a significant difference at post-test in experimental group due to the extent of the practice.

Conclusion: Improvement in balance is more likely due to the increased proprioception and stability. It is also likely to reduce the reaction time of integrated activities due to the pre-movement or speed up of the processing of perceptual or cognitive.

Keywords:  Sensory-motor integration, Balance , Reaction time, DCD

Background and Aim: Whole body vibration (WBV) is a new therapeutic modality which improves muscle function, proprioception and postural control by creating an oscillatory mechanical stimulation. The aim of this research was to investigate the immediate effect of WBV on postural control in young adults.

Materials and Methods: In this quasi-experimental study, 22 healthy subjects were participated as a single group. Non-probability simple sampling method was used. Subjects were treated with 4 minutes WBV bout. The subjects repeated four times a 60-s light exercise program according to instructions which was shown by the therapist. During the vibration intervention, the vibration frequency increased in 1 minute intervals from 15 Hz for the first minute to 30 Hz for the last minute. Postural control indexes were recorded using the Biodex Balance system in situations of two leg standing with open and close eyes that included overall stability index (OSI), anterior-posterior stability index (APSI), medial-lateral stability index (MLSI) . In order to analyze the data, paired t-test was used.

Results: The results indicated that in the case of standing on two legs with eyes open, OSI and MLSI were statistically significant (P = 0.02; P = 0.01, respectively) and with eyes closed, OSI, APSI and MLSI were statistically significant (P = 0.000; P = 0.001; P = 0. 001, respectively).

Conclusion: Four minutes WBV bout can induce improvement of postural control and balance in young adults.

Keywords: Whole body vibration, Balance, Young adults, Stability