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Background and aim: Swallowing disorder is one of the most important complaints of patients with upper motor neuron lesions.The rate of disphagia increases due to elderly subjects and brain injuries in our society Majority of these patients have hidden aspiration. Electromyographic assessment of swallowing can produce indicators of recovery and treatment effectiveness. This study tries to indicate pattern and recruitment of muscle activity in swallowing by surface electromyography.
Methods and Materials: Twenty healthy subjects (20-50) and ten subjects with swallowing dysfunction contribute at this study. Activities of bilateral orbicularis oris, buccinator, sternocleidomastoid and anterior region of throat muscles recorded during three stage of liquid swallowing include water, juice and honey by surface electrodes. Value of activity (RMS), duration of activity (Dur) , median (Mdf) and band (Banf) frequency of above muscles were measured.
Results: Healthy subjects indicated increase of RMS, Dur, Mdf and Banf of muscles, following increase of sweeten and viscose of liquid (P<0.05). Patients had more increase of this findings at oral muscles markedly, whereas Dur of throat muscle showed more increase in time (P<0.05). Comparison of between two groups indicated patients have more Dur time especially at throat muscles (P<0.05) and in contras reduce of activities and frequency parameters than healthy subjects (P<0.05).
Conclusion: Patients lean to keep liquid in oral phase and during throat swallow have more limitation. Patients may catch early fatigue and dysfunction for maintenance and keep of liquid particularly in throat region and it redound to change of trajectory of liquid to the respiratory tube. Therefore, rehabilitation protocols must enforce on coordination of oropharengeal muscles and recovery by movement therapy patterns.

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Background and aim: The aim of this review article is to study the effects of different positions & change of position on parameters of H- reflex.
Materials & Methods: changing position influence the excitability of motor neuron pools & can provide some evidence to resolve neurological and biomechanical problems as disk herniation & radiculopathies . One of the methods to assess these changes is H- reflex which described by German neurologist, Hoffman in 1918.It is a monosynaptic reflex with Ia fibers as afferent limb & α-motor neurons as efferent limb. To investigate the effects of changing positions on H reflex parameters, different databases, E-journals & thesis have been searched.
Result: Different positions & changing position influence different parameters of H-reflex .
Conclusion: Different H- reflex Parameters especially amplitude of H- reflex , show a wide range of varieties and this may explain that amplitude of H-reflex is not a reliable parameter.

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Background and aim: Knee osteoarthritis is one of the most common musculoskeletal problems, can affect on patient's daily activity and produce dependency in their daily activity and functional disability The aim of present study is to compare static balance in patients with knee osteoarthritis and healthy subjects using force plate. 

Materials & Methods: Postural stability in knee OA patients and healthy subjects (each group 20 subjects) were measured by force plate. Two positions were selected double stance with closed or opened eyes. Range of fore/aft (Rfa) and Range of side ways (Rsw), were measured as static postural stability.

Results: Rsw increased significantly in the double stance position in patients group (P<0.05). Also in both groups, Rsw and Rfa in the double stance with closed eyes were more than of open eyes position (P<0.05).

Conclusion: Postural control deficits and increase of center of pressure's sway were identified in participants with knee osteoarthritis. Therefore, one of the most important goals of rehabilitation is to improve balance control in knee OA patients.

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Background and Aim: Cerebral palsy is a non progressive disorder and the most common movement problem in children. Many children with cerebral palsy are of hemiplegic type. One of the important problems of this children is unilateral upper limb dysfunction, that not using the affected side causes forgetfulness and more problems on this side. In this study, effectiveness of Constraint-Induced Therapy(CIT) and the maintainance of this technique on spasticity and performance of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old have been investigated. 

Materials & Methods: In this pretest - posttest quasi experimental study, 20 cerebral palsy hemiplegic children 6 to 12 years old (15 boys and 5 girls) with  8.7   years mean age were selected. Interventions were performed about 8 weeks and patients were followed for 4 weeks. Spasticity on the affected side in wrist and elbow were tested by Modified Ashworth Scale and upper extremity function by the Box & Block test. The data were analyzed with the Wilcoxon and paired t- tests.

Results: Constraint-Induced Therapy in the affected limb decreases significantly the spasticity of wrist (p = 0.00) and elbow (p = 0.005) and significantly increases performance score (p = 0.00), and the recovery significantly maintained one month after the interventions.

 conclusion: Constraint-Induced Therapy of affected upper extremity could possibly decrease limb spasticity and increase function with two mechanisms: Fierstly, The reduction of not using the plegic side and secondly, neuroplasticity in CNS. This improvement may remain viable in the affected limb. 

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Background and aim: Spinal injury especially during occupational lifting is one of the most common neuromuscular disorders in the general population of the world. Asymmetric motions of trunk frequent bending and twisting, lifting and forceful activities contribute to spine disorders. Sport as a comprehensive activity might be able to cause less force to the spine and decrease spinal injuries. The purpose of present study was to determine the effect of lifting on motor control pattern during combined symmetric and asymmetric trunk motions on athlete and non-athlete subjects.
Materials and Methods: Seventeen non-athlete female subjects and seventeen athlete female subjects performed to lift four loads ( 5,7,9 ,12 kilogram ) at symmetric and asymmetric conditions. Under each condition temporal parameters of motor control were measured on flexor and extensor of trunk muscles.
Result: In two groups of athletes and non-athletes with increasing load , muscles begin their activity faster ( P<0.05 ). No significant change was found at asymmetric condition. Also, in athletes premotor time of muscles during lifting was less than non-athletes.
Conclusion: With increasing load, according to the feed forward control mechanism and awareness of subjects from amount of loads, muscles quickly prepared to contract for starting the movement. It seems that the response of movement on the neuromotor system of athletes is preprogrammed and automatic due to sport experience. Actually muscles have anticipation activity.

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

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

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

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

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

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

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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: 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: 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. 

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Background and Aim: Diabetes has world wide prevalence and it is estimated that up to ten years later, more than 300 million people would suffer from it. The disease has serious secondary complications. Physical activity can decrease the complications by altering the blood profiles. Patients with diabetes are unwilling to do physical exercise. Whole Body Vibration (WBV) might be a proper substitution for exercise. The effects of WBV on patients with diabetes have not been studied enough, so the aim of this study was to evaluate the effects of WBV on the blood profiles in patients with diabetes type 2.

Materials and Methods: Twenty patients with diabetes were assigned using matched assignment either into control (n=10) or intervention (n=10) group. Intervention group received the WBV with frequency of 30 Hz and amplitude of 2.5 mm for six weeks twice a week. The control group did not receive any intervention during this period. Blood profiles were measured in both groups at the baseline and the end of the study.

Results: FBS and HbA1C decreased in intervention group in comparison with the control group but the differences were not statistically significant (P=0.44).  There were not significant statistical differences in Cholesterol, HDL, LDL and TG before and after the treatment between the two groups.

Conclusion: The application of WBV with the above parameters might reduce FBS and HbA1C in patients with diabetes type 2. Increase in the amount of Glucose Transporter protein 4 (GLUT-4) is one of the contributing factors that these changes can be ascribed to.

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Background and Aim: Knee osteoarthritis is one of the most common musculoskeletal problems that can affect activity daily living of patients. Many studies have indicated postural control deficits in these patients but the effect of dual tasking on postural control has not been examined yet. The aim of this study is to investigat the effect of cognitive task on postural control in the female patients with knee osteoarthritis.
Materials and Methods: Postural stability in knee OA patients and healthy subjects (20 subjects in each group ) in four positions was measured using the Force plate. Positions included double leg stance with closed or opened eyes with and without cognitive task. Area of COP and mean velocity (Vm) were measured for as static postural stability.
Results: Area under the curve increased in the double leg stance position in the patients significantly (P<0.05). While mean velocity decreased by performing a dual task (P<0.05). The response to dual-tasking was not significant between the 2 groups(P>0.05).
Conclusion: Postural control deficits and increased of center of pressure’s sway were identified in participants with Knee osteoarthritis. Also performance of a cognitive task resulted in decrease of postural sway, but the dual- tasking did not change the postural performance of knee OA patients compared to healthy subjects.

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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. 

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Background and Aim: The curves of the spine, especially lumbar lordosis, play an important role in the maintenance of an efficient upright posture and allow efficient absorption of the loads applied to the spinal column and increase the efficiency of the spinal musculature. Excessive lumbar postures, also called “hyperlordosis” and “hypolordosis” , are thought by some researchers to be indicative of altered muscle activity and stress patterns. Therefore tolerance of particular activities of daily living (ADL) of an individual with these postures is reduced. Despite the importance of neuromuscular control at spinal column maintenance and coordination, there are little investigations about the effect of thoracic and lumbar curvatures on trunk muscles activity. Therefore, the aim of this study was to investigate electromyographic behavior of trunk muscles in lordotic posture.

  

Materials and Methods: Twelve subjects with lordotic posture ( mean age 23.67 years, mean weight 56.67 kg, and mean height 162 cm) and eleven subjects with normal posture ( mean age 22 years, mean weight 59.36 kg, and mean height 164.91 cm) participated in this study. Subjects were asked to hold a load equivalent of 7% of her body weight.

  

Results: Data analysis indicated that there is not significant statistically difference in median frequency variable between two groups (p>0.05). But there is significant statistically differences at The percentage change in RMS of erector spinae and internal oblique muscles at three time periods between two groups. The percentage change in RMS of external oblique muscle has significant statistically difference at first and third time periods between two groups.

  

Conclusion: These finding reveal that excessive lumbar lordosis alter the activity levels of trunk muscles. Therefore, it seems that the use of posture correction exercises in therapeutic protocols is necessary for improvement of these changes. Also, it is recommended to do this research in dynamic tasks for attain of comprehensive information about the effect of postural deviation on electromyographic behavior of trunk muscles.

  

Keywords: Electromyography, Hyperlordosis, Posture, Prolonged load holding

  

  ^* Corresponding Author: Dr.AzadehShadmehr, Rehabilitation Faculty, Tehran University of Medical Sciences

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Background and Aim : Trauma or micro-trauma over prolonged period of time can lead to

  pathoanatomical changes and passive instability of the sacroiliac joint. These subjects often reluctant to bear full weight through the impaired side of the pelvis. The aim of this study was to investigate the effect of exercise therapy on symmetric distribution of weight in sacroiliac joint instability in standing and walking through Alfoot device.

 

Materials and Methods : In this study, 17 subjects with sacroiliac joint instability with age range of 20-40 years were selected by simple sampling. Subjects performed a single session of training that involve five tasks in 3 sets, including sitting on gym ball, lying on gym ball, quadruped, standing near wall and standing on tilt board. Before, immediately after, 5 and 10 minutes after intervention , scanning the both feet were recorded during standing and walking.

 

Results : The amount of weight on both feet in bipedal stance position were significantly different before and immediately after the intervention. But this difference , 5 minutes (p =0.058) and 10 minutes (p =0.110) was not significantly different after exercise therapy. The pressure on the middle part of the foot during walking significantly increased immediately after the intervention and it continues up to 10 minutes .

  

Conclusion : The results of this study suggest that training of lumbopelvic muscles can be an effective way to improve weight distribution on the affected side in patients with sacroiliac joint instability .

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Background and Aim: Different aspects of the motor control parameters of dominant and non-dominant legs are investigated but the effect of dominancy on motor control strategy is still unclear. The aim of the present study is to compare the pre- motor time, motor time and reaction time in dominant and non- dominant leg muscles of the non- professional healthy athletes in response to visual stimulus during forward jumping.

Methods and Materials: Eleven non- professional healthy athletes participated in this cross-sectional study determined by convenience non probability sampling. Surface electromyography were performed in the dominant and non-dominant leg muscles including  gastrosoleous , peroneus longus, peroneus brevis, and tibialis anterior in response to visual stimulus during forward jumping.

Results: There was no significant difference (P > 0.05) between the dominant and no-dominant legs with respect to the pre-motor time, motor time and reaction time of the gastrosoleus, peroneus longus, peroneus brevis and tibialis anterior.

Conclusion: Our findings suggest that limb dominancy is not an important parameter in the motor control studies.

Keywords: Motor control strategy, Visual stimulus, Forward jumping

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Background and Aim: Several studies have investigated the effects of angular velocity on mechanical and physiological variables such as joint net torque, muscle force and myoelectrical activity, but so far its effects on the control of the pattern of synergist muscle activation during isokinetic movements have not been studied. In this experiment, a computational method of identifying and analyzing muscle synergies were used which is based on the framework of the uncontrolled manifold hypothesis to determine the variability of muscle synergies following movement velocity alteration.

 

Materials and Methods: Twelve healthy females without any known neurological or motor disorders participated in the experiment. The participants were positioned on a Biodex dynamometer. They were asked to perform ten continuous knee extension and flexion motions with maximal strength at 45˚/s or 300˚/s. Electromyographic activity of the vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) were recorded and variance within the UCM (VUCM) and orthogonal to the UCM (VORT) with respect to an appropriate Jacobian matrix was computed. An independent t-test was used to compare VUCM between two velocities.

 

Results: Across subjects, VUCM was significantly higher than VORT (VUCM>VORT) in both tasks. There was no significant difference in VUCM between two velocities (p>0.05).

 

Conclusion: Our findings suggest that angular velocity is not an important parameter when a controller of a multi-element system wants to stabilize a particular value of a performance variable.

 

Keywords: Variability, Angular velocity, Muscle synergie, Externsor muscle.

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Background and Aim: The aim of this study was to compare the neck and temporomandibular joint range of motion and muscle endurance in patients with temporomandibular disorders, referring to the dental school of tehran university of medical science and healthy individuals.

Materials and Methods: A total of 30 healthy men as control and 30 patients aged 20-40 years with temporomandibular joint disorders (TMD) were selected as patients. Range of motion in flexion and extension of the head and neck and mouth opening was measured and masticatory muscle endurance as well as the neck extensor muscles was measured and averaged values for each patient group were compared with the control group.

Results: Head and neck flexion range of motion and endurance of neck extensor muscles in patients with temporomandibular joint disorders (TMD) was lower than healthy controls. (P<0.001)

Conclusion: The results of this study showed that disorders of temporomandibular joint can change extensor muscle endurance and range of motion in neck. Pay attention to neck problems can be effective in improving patients with disorders of temporomandibular joint.

 Keywords: Range of motion, Muscular endurance, Temporomandibular disorder

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Background and Aim: The structure and function of the hamstring and quadriceps can contribute to the development and process of patellofemoral pain syndrome. As open and closed kinetic chain exercises have different effects on the knee joint, the aim of the current study was to investigate motor control of knee joint in both kinetic chains according to voluntary response index aspect.

 

Materials and Methods: 12 healthy knees and 12 injured knees (6 females in each group) were examined. Surface electromyography were performed in knee muscles including vastus medialis oblique, rectus femoris, vastus lateralis and biceps femoris while the subjects were doing flexion-extension of knee joint by isokinetic dynamometer system and one leg semi-squat movement. Then voluntary response index was calculated.

 

Results: There were no significant difference between the patients and healthy groups (p>0.05). In the patient group, correlation between similarity index and magnitude was seen.

 

Conclusion: Probably in the low intensity patellofemoral syndromes, voluntary response index could not differentiate between healthy and the patient groups. In the patients with patellofemoral syndrome group, correlation between similarity index and magnitude may represent co-contraction in their muscles.

 

Keywords: Patellofemoral pain syndrome, Motor control, Voluntary response index, Surface electromyography

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Background and Aim: Rotator cuff tendon rupture is the most frequent cause of shoulder pain and disability, especially in middle and old age. Physiotherapy is known as non-surgical or conservative treatment for it. The goal of this research was to investigate the effect of physiotherapy treatment in full-thickness tear of Supraspinatus tendon on shoulder pain and shoulder active range of motion.

Materials and Methods: In this before and after clinical trial, 17 patients (5 men and 12 women) with average age of 54.35±7.13 years old whom had full-thickness tear of Supraspinatus tendon were treated within 30 physiotherapy clinical sessions. The physiotherapy protocol for patients was included of heat, ultrasound and electrical stimulations modules and exercise therapy program was consisted of three components of stretching, strengthening and endurance. Patients in the first, twentieth and at the end of the thirtieth session were evaluated for pain and range of motion. Pain variable by visual analogue scale and range of motion variable by goniometer were evaluated.

Results: Within subjects ANOVA (parametric) and Friedman (nonparametric) tests showed a significant difference in pain and range of motion between before and after physiotherapy (P <0.01).

Conclusions: This study showed that physiotherapy may reduce pain and improve range of motion of shoulder in surgery candidate patients with full-thickness tear of Supraspinatus tendon and decrease client needs to surgery. However, studies with longer follow-up are recommended to evaluate this outcome.

Keywords: Supraspinatus tendon tears, Physiotherapy, Pain, Range of motion, Visual analogue scale, Goniometer