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Background and aim: Stroke is one of the main reasons that would cause disability in adult population. The patient prefers to use his non-involved limb for self-care activities that called disuse learning of involved upper extremity.Constraint-induced therapy is one of the rehabilitative intervention that seems to improve motor ability and functional use of involved upper extremity in some of patients with hemiparesis after stroke. The aim of this study was to investigate the time effects of constraint-induced therapy on functions, coordination and movements of upper extremity of adult patients with hemiplegia.

Materials and methods: In present study, 15 patients with stroke participated in structured therapy sessions (CIT) emphasizing more affected upper extremity in different activities five times a week for 12 weeks and 2 hours a day and non-involved upper extremity were also restrained five times a week for 12 weeks and 5 hours a day

Results: The data was analyzed with paired t-test. The scores  of different  subtests of Fugl-Meyer test  such as shoulder and forearm, wrist and hand movements, coordination and speed of involved upper extremities showed significant differences between pre and post interventions in different time periods (p>0.05). Test scores increased up to 8 weeks but no significant increase was seen after 8^th week .Dexterity measurements by Minnesota Manual Dexterity test  showed significant differences between pre and post intervention in different time periods ( p  < 0.05) with maximum increase up to 10 weeks

Conclusion: The present data showed that constraint-induced therapy could be an effective approach to improve function and overcome disuse learning. The results of this study revealed that scores of Fugl-Meyer and Minnesota Manual Dexterity test  would reflect functional skills improvement.

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Background and aim: Cerebral palsy is the most common motor disorder in childhood that affects on motor performance and functional activity. Impaired hand function is the secondary problem in children with spastic diplegia.

Individuals with hand dysfunction encounter with difficulties in self care, educational and recreational activities. The goal of this study is to investigate the effect of task oriented training on upper extremity function in children with spastic diplegia (8-12 years old).

Material and methods: Fifteen spastic diplegic children were participated in task oriented training three days weekly up to 8 weeks. The outcomes were measured with Jebsen-Ttaylor hand function test for upper extremity function, Purdue peg board test for hand dexterity, goniometer for range of motion and Ashworth scale for spasticity.

 Results: The data showed significant improvement in upper extremity function (P≤0.0001) , hand dexterity (P≤0.001) , wrist and elbow range of motion (P≤0.0001) and wrist and elbow spasticity (P≤0.05) after interventions.

Conclusion: Our findings suggest that task oriented training can improve upper extremity function in children with spastic diplegia.

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Background and Aim: The role of function of upper extremity in activity of daily living is critical and any impairment of function could cause major problems for diplegic spastic cerebral palsy (CP) patients. So, the application of rehabilitation protocols that could regain the hand function is very important.

The purpose of this study was to explore the effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic CP, 3-7 years old.

Materials and Methods: Thirteen CP patients (3-7 years mean: 4.92 years 4 boys and 9 girls) were participated in this study. Simultaneous activation of exteroception and proprioception were done 3 times a week (for 8 weeks). Function of upper extremity was evaluated by Quest Test and the degree of spasticity in wrist was evaluated by Modified Ashworth Scale.

 Results: The results of this study showed that after simultaneous activation of exteroception and proprioception, function of upper extremity was significantly improved (P<0.001). In addition, degree of spasticity in wrist muscles was significantly decreased (P<0.022).

Conclusion: Based on results of current study, it might be suggested that simultaneous activation of exteroception and proprioception could improve the function of upper extremity and decrease of spasticity. This in respect could reduce the disabilities of patients. So, the application of current protocols for the patients is suggested. 

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 Background and Aim: The translation, cultural adaptation and validation of the Persian version of the American shoulder and elbow surgeons (ASES) were carried out in accordance with published guidelines.

Materials and Methods: The study was conducted on 100 athletes (25.96±5.81 years), which suffered from different shoulder disorders. When the translation and cultural adaptation of the original questionnaire was carried out on the standardized method, the participants were asked to complete a questionnaire booklet including the DASH, the Short Form General Health Survey (SF-36) and ASES questionnaires. In addition, 30 randomly selected patients were asked to complete the ASES questionnaire 48 hours later for the second time. After data collection the Statistical analysis was performed by using SPSS software.

Results: The Cronbach's alpha was used to indicate internal consistency. Cronbach's alpha was 0.91 for ASES. Test-retest reliability was quantified by use of the intraclass correlation coefficient. It was 0.91 for ASES questionnaire. The Pearson Correlation Coefficient was used for the questionnaire validation study. The DASH questionnaire showed high correlation of ICC=0.78 with ASES. The ASES showed moderate correlation of 0.48 to 0.62 with those of the various scales of the SF-36.

Conclusion: The Iranian ASES showed good reliability and validity and can be used for shoulder-specific patient self-assessment.

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 Background and Aims: Oneimportant complicationof breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and cosmetic problems. The aim of this study was to evaluate the effects of Complex Decongestive Physiotherapy (CDP) on volume of lymphedema in patients with secondary lymphedema after breast cancer treatments.

Material and Methods: A total of 30 women with lymphedema after breast cancer treatments and according to inclusion and exclusion criteria were chosen. They were treated with complex decongestive physiotherapy. This protocol involved manual lymphatic drainage (MLD),Compression garments, remedial exercise and skin care. The women were taken 4-week therapy program once per day, 5 days per week. Absolute volume of the lymphedema and circumference of the limb were evaluated before and after treatment.

Results: After 4 weeks treatment, lymphedema volume, circumference in all of the evaluated points and severity of the pain are decreased after treatment.

Conclusion: In upper extremity lymphedema, the use of complex decongestive physiotherapy (CDP) can decrease edema.

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Abstract Background and aims: One of the complications of breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and disorder of Quality of life. The aim of this study was to evaluate the effects of Complex Decongestive Physical Therapy (CDP) on pain severity and quality of life in patients with secondary upper extremity lymphedema after breast cancer treatments. Material and methods: A total 30 women (age 29-70 yrs.) with secondary lymphedema after breast cancer treatments participated in this study. They were referred by general and cancer surgeons to Physical Therapy clinic based on inclusion and exclusion criteria. They were treated with complex decongestive physical Therapy. This protocol comprises of manual lymphatic drainage (MLD), compression garments, remedial exercise and skin care for 4-weeks, once per day, 5 days per week. Quality of life and severity of pain were evaluated before and after treatment. The quality of life was assessed with QLQ-C30 questionnaire. The severity of pain was also assessed by Visual Analog Scale (VAS). Results: After 4 weeks treatment severity of the pain are decreased after treatment. The physical and social roles of quality of life (QLQ-C30) were significantly increased (p<0000). Conclusion: Based on the results of this study, utilization of complex decongestive physical therapy (CDP) In upper extremity lymphedema is a useful method for pain relief and increment of quality of life. Keywords: Upper extremity lymphedema, Complex decongestive physiotherapy (CDP), Severity of pain, Quality of life

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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 : 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