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

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

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

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

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Background and Aim: In recent years transcranial stimulations, action observation and motor imagery training have emerged as nonaggressive and attractive choices beside the common rehabilitation treatments for neurologic patients. Mirror therapy using visual feedbacks is one of these newfound methods that its therapeutic effects on impaired upper limb of stroke patients are still under investigation. In this case report, Impact of mirror therapy in treatment of the paralyzed upper extremity in 2 stroke patients will be described. Materials and Methods: Two adult patients with hemiplegia due to cerebrovascular accident and with 1 and 5 years passed since stroke went under 12 sessions of mirror therapy. Each session of mirror therapy lasted 45 to 60 minutes in which patients have been practicing specific exercises under direct supervision of therapist. Patients were evaluated for function and motor recovery level, spasticity, range of motion and power grip before and after one month of treatment. Results: In both individual, function and motor recovery level, active range of motion, and power grip were improved and spasticity just showed a decrease in one of the patient. Conclusion: Mirror therapy for 12 sessions can be beneficial to treatment of affected upper extremity in these two stroke patients

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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