Abstract

Background and Aim: Patients with anterior cruciate ligament (ACL) deficiency are divided to coper and noncoper groups. The purpose of this study was to compare the efficacy of perturbation training with traditional rehabilitation on functional tests of lower extremity and knee muscles isokinetic peak torque ratio in two groups of patients with ACL-deficient: coper and noncoper

Materials and Methods: In this clinical trial study, 24 patients with ACL-deficient were divided to two groups: coper and noncoper. They participated in a management plan for 4 weeks, three times a week, including perturbation exercises and traditional rehabilitation (stretching, strengthening, and endurance exercises). Lower extremity functional tests through hop tests and knee muscles isokinetic peak torque ratio were evaluated.

 Results: After 4 weeks, all the functional tests improved significantly in both groups and timed 6-meter hop test showed significant improvement in coper group with respect to noncoper grouop (p< 0.05). There was no significant difference between two groups in knee flexors to extensors isokinetic peak torque ratio but this ratio was lower and close to normal values in coper group.

Conclusion: Perturbation training with traditional rehabilitation improves functional abilities of lower extremity in both groups of coper and noncoper of the patients with ACL-deficient. Probably, the patients of noncoper ACL-deficient have chance to return in some daily activities too.

Keywords: anterior cruciate ligament, perturbation training, functional tests, knee isokinetic peak torque

Abstract

Background and Aim: Proprioceptive problems, visuospatial deficits and muscle weakness are the main causes of weight bearing asymmetry and postural control impairment in chronic hemiparesis patients. The aim of this study was to investigate the correlation between center of pressure parameters in quiet standing with eyes open and closed and functional balance tests and symmetry index in these patients.

Materials and Methods: In this correlation study, 16 stroke patients (mean age: 52.937±10.109 years), were selected by simple non-probability sapling. Force plate, Functional Reach and Timed Up and Go tests and scales were used in order to investigate postural sway parameters in quiet standing, functional balance and symmetry index, respectively.

Results: Moderate to high significant correlation was obtained between Timed Up and Go test and symmetry index and most of the postural sway parameters in eyes closed condition, while Functional Reach test had only moderate significant correlation with standard deviation of velocity (anterior-posterior) and phase plane total. Also symmetry index showed moderate correlation with most of the postural sway parameters.

Conclusion: Current study demonstrates the role of vision and task in correlation between center of pressure parameters, balance tests and symmetry index.

Key words: Correlation, Symmetric weight bearing, Postural sway, Functional Reach, Timed Up and Go, Force plate, Quiet standing

Background and Aim: “Executive function” is a term describing the processes required for conscious control of thought, emotion, and action that have centered role in management of one's day-to-day life. The purpose of this study was to examine the relationship between executive function and performance on selected linguistic tasks in persons with aphasia (PWA) and left frontal lobe lesions.

Materials and Methods : Subjects were 12 right-handed, left hemisphere stroke patients and 12 normal adults as control group. Farsi aphasia test were administered to determine of persence and type of aphasia, as well as auditory comperehension(AC) and naming scors. Wisconsin Card Sort Test(WCST) and Tower Of London(TOL) were used to assess the executive function skills of planning, working memory, mental flexibility, self monitoring, inhibition irrelevant behavior, shifting between concept and action.

Results: The control group scored higher than the individuals with aphasia on the executive function tests (P<0/001). In WCST there was not a significant correlation between the AC and category completed (CC) as well as preservative errors(PE). There was a significant correlation between the AC and total errors (TE) (p=0/02) . There was a significant correlation between naming and CC (p=0/01) and TE (p=0/005). There was not a significant correlation when comparing the naming and PE (p=0/194). A comparison between naming scores and TOL showed a significant correlation (p=0/009). There was not a significant correlation between AC and TOL (p=0/113).

Conclusion: This study showed that individuals with aphasia have cognition disorder, other than language disorder. If they have a good naming ability, patients ' performance ontestsof executive function will be better.

 Background and Aim : Cerebral palsy is the most common physical disability in childhood. Children with cerebral palsy require long-term therapy for achieving improved motor function. It seems to be a need for treatment and training at home. The purpose of this study was to determine the impact of “handling training” for caregivers at home on the gross motor function of 15-72 months cerebral palsy children.

 Materials and Methods : In this experimental single-blinded study, 40 children with cerebral palsy (15-72 months old) were recruited from some of Tehran public or private rehabilitation clinics based on pre-determined inclusion criteria, and after matching for child age, type of clinic referred to (public or private), type of cerebral palsy, IQ score, GMFCS level and number of occupational treatment sessions already provided at the rehabilitation clinic. The children were allocated randomly into intervention and control groups. For data collection, a demographic information questionnaire, gross motor function measurement (GMFM66) test and gross motor function classification system (GMFCS) test were used. Data were collected on three occasions: before the intervention, 1.5 months and 3 months after intervention. For intervention, researchers went to the intervention group's homes and explained educations related to handling for caregivers in a 4-hours session. During 3 months, researchers would follow up to implement the intervention. Data were analyzed by one sample k-S, chi-square, independent sample t test, general linear model and analysis of Covariance.

 Results : There were significant differences in gross motor function of two groups in 1.5 months and 3 months after intervention than before intervention (p<0.001). There were significant difference in gross motor function improvement in pre-post (1.5 months after intervention) (p=0.006) and pre-follow (3 months after intervention) (p<0.001) between two groups and was greater in the intervention group.

 Conclusion : Handling training on caregivers in home improves gross motor function in 15-72 months old cerebral palsy children.

Keywords : Cerebra l palsy, Handling, Gross motor function

Background and Aim : Schizophrenia is a severe mental illness encompassing a spectrum of cognitive, social, and emotional impairments. One of the serious problems in schizophrenia is functional dysfunction. Emotional face recognition is an effective component of social functioning. The purpose of this study was to examine the relationship between negative emotional faces perception and global function in patients with schizophrenia.

Materials and Methods: The method of this study was analytical- descriptive. Using convenience sampling method 30 patients with schizophrenia (16 male/14female, 20-45 years old) were selected from Roozbeh Psychiatric Hospitalof Tehran University of Medical Science (TUMS) in Tehran, Iran. Their functionswere assessed by Global Assessment of Functioning (GAF), and responses to emotional face perception(N170) were recorded by Event Related Potential(ERP). Data were analyzed using Pearson correlation test and linear regression in SPSS software version 15.

Results: Results showed that the mean amplitudes of N170 responses to fearful and angry faces in patients with schizophrenia were significantly correlated with the GAFscores (P<0.001). Besides, the amplitudes of N170 responses to angry faces (as compared to fearful faces) could predicate the % 26 of the GAF scores changes by stepwise regression analysis.

Conclusion Findings suggested that the functional dysfunction in patients with schizophrenia is due to the deficit in the early stage of facial expression perception.

Key words : Schizophrenia, Emotional Face, Global Functioning, N170, ERP

Bachground and Aim: Ankle sprain is one of the most common injury among the athletic injuries. Around 70-80% of these injuries tend to be chronic. Despite extensive clinical and basic science research, the incidence of Chronic Ankle Instability(CAI) has not significantly reduced. Because the causes of CAI is not quite clear, the rehabilitation still deals with great challenges . one of the treatment methods which has been under special attention for this injuries is Kinesio Taping(KT). In this study, effects of three KT methods on performance in athletes with CAI was investigated .

Materials and Methods: Thirty male athletes (futsall, football) with CAI participated in this study. The KT was used in three distinct times with three different methods (mechanical, functional and ligament- Tendon Correction) for these people and their short- time effects on functional performance of lower limb was evaluated. This evaluation was done thorough two functional performance test (Star Excursion Balance Test and Figure of 8 Hop Test).

Results: In taping with the aim of functional and mechanical correction, functional performance after KT dramatically improved but in taping with the aim of Ligament-Tendon correction functional performance did not change significantly after taping.

Conclusion: The result of this study suggests that functional and mechanical correction have the significant effect on functional performance of futsaland football athletes with CAI , the ligament-tendon correction has not significant effect.

Keywords: Chronic ankle instability, Kinesio tape, Functional performance tests.

Background and Aim : Athletes from different sport fields are needed to lower extremity dynamic balance for their specific skills. The question can be raised is whether athletes from different sport fields are different in lower extremity dynamic balance? The aim of this study was to compare the dynamic balance of lower extremity of football, handball and taekwondo athletes with functional tests.

Material and Methods : Ten football, 10 handball, and 10 taekwondo healthy male athletes with the mean age of 23.83±0.06 years participated voluntarily in this study . The lower extremity dynamic balance was assessed by Shuttle Run test (SR), figure of 8 Hop test (FEH), Side to Side Hop test(SSH) and Agility Hop test (AH). All analyses were conducted using SPSS version 19.

Results : The scores of SR, FEH and AH tests were higher in taekwondo players compared to football and handball players (7.11± 0.26, 9.86±1.09 and 9.2 ±1.31, respectively). Football players gained the highest score in SSH test (7.52±0.84). The FEH test score in handball players was higher than football players (9.59±0.94). Statistical analysis showed significant differences between three groups on two tests (SR P=0/03 and AH P=0/01).

Conclusion : This study showed that lower extremity function of athletes from different fields of sport may be different. It seems that football and handball players need more agility and speed than taekwondo players for doing their own skills. This issue should be considered in designing the sport specific training protocol for athletes.

Key words : Functional test, Football, Handball, Taekwondo

 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: Many studies investigated the effect of ankle-foot orthosis on reducing the incidence of sprain. In this study the influence of elastic and semirigid stirrup type orthosis on the onset latency of peroneus longus muscle activity as the most important support of ankle- foot region in response to sudden perturbation was assessed in healthy group and athletes with functional ankle instability.

Materials and Methods: Thirteen healthy female athletes and 10 female athletes with functional ankle instability (17 to 27 years old) were perturbed unexpectedly by a custom made ankle perturbation system in frontal plane under three conditions of without orthotics, using elastic orthosis, and using semirigid stirrup-type orthosis. Simultaneous recording of electrical activity of peronus longus muscle was performed with surface electromyography.

Results: The results showed the significant differences between muscular latency of injured and control groups without orthosis (P=0.018). The onset latency reduced using each type of the orthoses in injured group but it was not significant (P>0.05).

Conclusion: Although the latency time of peroneus longus muscle response delay didn’t show significant reduction using orthoses in injured group, it seems that using orthoses leads to proprioception improvement and sensiomotor control increasement by stimulation of cutaneous mechanoreceptors.

Key words: Functional ankle instability, Invertory perturbation, Electromyography, Orthosis

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

  Abstract

Background and Aim: Cerebral palsy is a sensory and motor disease that affected control of posture and movement. Children with cerebral palsy show dysfunction in body such as spasticity, decreased muscle strength and selective control of movement that may limit functional activity and participation in daily life . The purpose of this study is to investigate effects of 8-Weeks progressive resistance training program on physical and motor status in children with hemiplegic cerebral palsy.

Materials and Methods: This study was semi-experimental with the interventional approachon16children of 4-12 years old with hemiplegic cerebral palsy in the first and second level of GMFCS classification that referred to rehabilitation center in Ilam city . Protocol of training was consisted of 16 one-hour sessions progressive resistance training in the case muscle group s ( 8 subjects) . Upper extremity muscles strength were measured by digita l dynamometer and gross motor function were evaluated by Gross Motor Function Measure (GMFM-88) at before and after intervention.

Results: The strength of dominant hand muscle groups was improved significantly after the intervention , also the scores of stand ing, walking , running and jumping were increased (p<0.05). There was no significant effect in strength of involved hand.

Conclusion: The results of this study indicate that progressive resistance training improve gross motor function and increase isometric strength in the dominant hand

Keywords: Hemiplegic cerebral palsy, Physical status, Motor function, Progressive resistive excercises (PRE).

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