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Background and aim:The knee joint is one of the most important joints of human body, witch tolerates many forces while the subject is standing up or walking especially during close chain and squat positions.

Muscle fatigue may causes some modifications on effects of forces and accordingly some changes on strategy of movement, therefore the concentration in thigh muscles impression on continuous movements is a guidance that makes the investigation on these changes so important.

Materials and Methods: Fifteen healthy women in the range of 20-30 years were contributed in this study. Muscle fatigue were applied in separate sessions by maximal voluntary contraction (MVC) in both open and close chains.

Subjects were done five dynamic repetitions of flexion / extension motion of knee before and after fatigue tests. Surface electromyography (sEMG) recorded from vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL) muscles during all conditions of tests. Normalized electromyography (NEMG) of muscles activities in two conditions of concentric (Con) and eccentric (Ecc), also median frequency (MF) were calculated for fatigue index. Muscle timing or recruitment pattern indicated by onset of muscle activities for both dynamics chains.

Results:  There are significant different of fatigue indexes between before and after fatigue tests (p<0.05).  After fatigue muscle timing delayed in open chain (p<0.05) and recruitment patterns changed from VL- VM- RF to VL-RF-VM. Fatigue test in close chain caused increment of muscle timing (p<0.05), but it did not change recruitment patterns.

Conclusion: After fatigue tests MF reduced little than NEMG. Significant difference occurred in muscle timing. These variations were increase and delay of timing with change of recruitment in open chain. These findings suggest that motor control strategy is will change at different condirions of with and without load situations.

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Background and aim: Knee osteoarthritis (OA) is one of the most common synovial joint diseases (i.e. weight bearing joints) of the human body. This problem probably is more common in Iranian society that is used to sit on the floor and carpet. Following knee OA, patients complain of pain, inflammation, decrease of range of motion and muscle weakness. Therefore, they can not independently do their activity of daily living (ADL). Consequently, the side effects of physical incapability may render to psychological problems and this in respect do affect on their quality of life.Various treatments such as pharmalogical, surgical and physiotherapy have been recommended at different stages of OA by specialist. In the present study, the effect of physical therapy agents (considering the point that physiotherapy has no or negligible side effects) have been studied on OA. 

Materials and methods: 40 patients participated in this study the patients were refereed by orthopedic surgeon to the physiotherapy clinic of the Faculty of Rehabilitation. University ethical committee approved the procedures. Patients were randomly divided in two groups and physiotherapy treatments were applied as following:

Group I.  Low Level Laser Therapy, heat, exercise.

Group II. Placebo (i.e. inactive Laser), heat, exercise.

Results: The result of current study shows that both methods of physical therapy were quiet efficient on 7 variables that measured in this study (p< 0.05).  However, the result of this study showed that in laser group, pain and speed of gait were more effectively influenced (p< 0.000 and p<0.048 respectively) in comparison with routine physiotherapy. Consequently, patients can fairly independently do their activity of daily living and this in respect may reduce the psychological side effects of illness. 

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Background and aim: The great amount of load tolerated by the knee joint during daily activities has made this joint the most vulnerable joint to osteoarthritis. Different types of knee orthosis are prescribed for treatment and among them neopran and 3 pressure points orthosis are the most common ones. Although these orthosis are used widely, little is known about their effects on the relief of patient's symptoms. In this study the immediate effects of two "4 spring-loaded neopran" and "3 pressure points corrective" knee orthosis on the pain reduction and functional improvement of the patients suffering from medial compartment knee orthosis were compared.

 Materials and methods: Twenty patients (age 53±12) with medial compartment knee osteoarthritis, with severity of less than grade 4 (based on the Kellgren & Lowrence grading method and diagnosis of an orthopedist) and tibiofemoral angle of above 180º were recruited. The functional performance was assessed by 6 min walking test in the first day without orthosis and in the 2^nd and 3^rd day immediately after wearing one of the orthosis in random order. The intensity of pain was evaluated by 100 mm VAS test in the first day before and after 6 min walking test and in the 2^nd and 3^rd day only after the walking test.

 Results: Both orthosis induced a significant reduction in patient's pain (p<0.01) and improvement in functional capacity (p<0.01). the comparison between the two orthosis regarding the pain reduction after the walking test revealed the dominance of the 3 pressure points corrective orthosis (p<0.007). The difference between the functional improvements of two knee orthosis was statistically not significant (average increase in walking distance of 15 m and 24 meters for neopran and 3 pressure point orthosis).

 Conclusion: The 3 pressure point and neopran knee orthosis can induce significant reduction in pain and improvement in the functional capacity of the patients with medial compartment knee osteoarthritis. The 3 pressure point orthosis seems to dominate the neopran in pain reduction and functional improvement (however not statistically significant).

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Background and aim: In physical evaluations, measuring the joint angle is one of the most important outcomes to assess the patient's progress, the effectiveness of various treatment techniques and to delineate the need for future treatments. The aim of this study is to study the reliability of a system consists of skin markers, digital photography, and AutoCAD software for measuring the knee joint angles.

 Materials and methods: In first section, reliability of markers placement was evaluated within three different intervals (five minutes, two days, and twenty days). At second section, reliability of digital photography was evaluated while position of the skin markers and subjects was the same. At the end, in third section, reliability of angle measurement by means of AutoCAD software was assessed.

Results: In first section, the ICC for test-retest reliability of markers placement between first and second sessions, first and third sessions, and also first and forth sessions were 0.97, 0.94, and 0.73, respectively. In second section, the ICC for test-retest reliability of digital photography was 0.99 and in third section, the ICC for intra-rater reliability of angle measurement by means of AutoCAD software was 0.99 (p=0.05).

Conclusion: It was noted that the introduced system was highly reliable, so it could be utilized to measure the knee joint angles.

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Background and Aim: The rapid growth of the athletic training profession has been accompanied by an equally rapid increase in focus on basic and clinical research. Lateral ankle sprain (LAS) is an extremely common athletic injury. Despite extensive clinical and basic science research, the recurrence rate remains high. Chronic ankle instability (CAI) following LAS is hypothesized to predispose individuals to re-injury because of neuromuscular control deficits which result following injury. No investigation has been carried out on the existence of joint position deficits in the knee joint of patients with CAI. In this study, joint position sense (JPS) was evaluated in patients with CAI.

Materials and Methods: Ten female patients with CAI and ten healthy control subjects participated in this study. JPS was evaluated by reproduction of the angles in two standing and sitting positions, and in each position two target angles were tested. The knee joints in both lower limbs of patients and the dominant knee-limb of healthy subjects were evaluated. The knee angles were measured by using a system comprised of skin markers, digital photography, and Auto CAD software. Absolute error was considered as a dependant variable.

Result: There were no significant differences between the knee JPS of dominant leg in healthy subjects and both knee joints of patients. There were also no significant differences between knee JPS in two standing and sitting positions and in two different target angles (p>0/05).

Conclusion: The result of this study suggests that subjects who have CAI do not have deficit in knee JPS when tested in sitting position and also under functional weight bearing conditions.  

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Background and aim: Fatigue is the inability to generate the maximal force that can be produced by the muscle . Fatigue is a subject that patients and athletes frequently encounter. Fatigue is one factor that limits muscle function and may lead to various pain and injury conditions. It is most commonly caused either by repetitive motion or by sustained muscular
contractions. Massage has been used for rehabilitation and relaxation for thousands of years. Massage is widely believed to have a beneficial effect on treating muscle fatigue and has been used in clinical and sports setting for that purpose. There is limited scientific evidence, however, to support the use of massage for enhancing performance and recovery from injury, or for preventing injury. The comparison of massage and rest on the knee extensor muscles fatigue after maximal isokinetic contractions is the main objective of this research.
Materials and methods: Fifteen healthy female aged between 20-30 volunteered to participate in this research. They did at least once a week some non-professional light sporting activities. Each of volunteers was evaluated in 3 different times. The first session was in order to familiarize the volunteers with the test and Isokinetic. For the main test, each of the volunteers was evaluated twice with one week interval. At the start of each session after warm up, the following parameters were measured: Perceived fatigue by Visual Analog Scale ¸average peak torque and average power maximal concentric of quadriceps at the velocity of 60 degrees per second by Isokinetic apparatus. Then in order to fatigue protocol ¸ the subjects were asked to perform successive and maximal quadriceps contractions until three subsequent quadriceps torque output reaches below 50 percent maximal torque output. Afterwards average peak torque and average power was measured. The extent of perceived fatigue was evaluated as before. Subjects then either received massage on the knee extensors or rested for 15 minute duration. Recovery from fatigue was quantified using average peak torque (APT), average power (AP) and perceived recovery scale (VAS).
Results: After maximal fatigue and decrease in torque output, below 50 percent maximal torque, 15 minutes of massage could change APT after fatigue from mean 56.70 (Nm) to 91.53 (Nm)) , AP from 38.64 to 63.62 (Nm) and VAS from 90.06 to 10.20 (mm). After 15 minute rest could change APT from 55.36 to 68.10 (Nm), AP from 37.69 to 48 (Nm) and VAS from 90.06 to 20.73 (mm).
Conclusion: There was significant difference between rest and massage conditions for recovery of fatigue. Massage was an effective intervention for enhancing muscle performance and recovery from fatigue but rest didn`t have such an effect. In both cases, recovery stage (massage or rest) caused significant change in perceived fatigue but massage is more effective on the decrease of perceived fatigue. Therefore, massage has been more effective than rest as a strategy to return to normal state and has caused more relief in perceived fatigue.

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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: Biomechanical conditions of limbs can affect on motor unit recruitment (MUR) markedly. Surface Electromyography (SEMG) is an approach for evaluation of muscle activities and onset time during different functions. The purpose of this study is to use SEMG for detection of central motor control in different functions of knee extensor muscles.

Materials and Methods: Ten healthy subjects contributed in this study. They were done five repetitions of knee flexion/extension in open and close chain separately during recording of SEMG simultaneously. Integrated EMG (iEMG) of three middle repeated cycles were detected according to chain (open- close) and kind of contraction (concentric- eccentric).then the Average of three slope of iEMG compared to each other. 

Results: There were not significant differences in MUR of three extensor muscles for concentric and eccentric contractions in open chain but vastus medialis and lateralis muscles showed significant changes in close chain (P<0.05). Result showed that there were significant differences of MUR for two kind of muscle contractions between open and close chains (P<0.05).  

Conclusion: Recruitment of motor units has not shown difference in open chain between concentric and eccentric contractions. This process indicates representative similarity of control pattern in two kind of contraction in open chain. Concentric contraction at close chain cycle has more MUR in comparison with eccentric contraction. It is equal to more interference of contractible compartment in concentric to eccentric contraction. This happens due to the nature of two kind of contraction particularly in close chain cycle. Comparison between two chains indicated that more motor units contribute in close chain (concentric and eccentric). It means that motor unit recruitment increased due to effect of increase of load in close chain. 

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Background and aim: Human knee joints experience very large loads and motions during regular daily, occupational and sport activities. Consequently, they are at high risk of being exposed to injuries and degeneration. Osteoarthritis and ligament injuries often inflict knee joints causing considerable pain and loss of productivity involving thus significant human and economic costs. Hence, biomechanics of human knee joints has been the focus of many investigations with the primary aim to improve understanding of joint function in normal and perturbed conditions. The existing prevention and treatment programs have been based on such studies.
Material and Methods: Due to inherent costs, limitations, difficulties and ethical concerns associated with in vivo and in vitro cadaveric studies, finite element model studies have been developed as effective, powerful and complementary tools to investigate knee joint biomechanics subject to internal and external mechanical conditions affecting its normal function.
Results: The advantage of finite element method in study of joint biomechanics lies in its robustness to incorporate complex 3D joint geometry, intricate boundary and loading conditions and materials with nonhomogeneous and nonlinear properties.
Conclusion:This article reviews important model studies, presents their relevant results and discusses some of the promising future directions.

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Background and Aim: Muscle fatigue is a factor that caused muscle injuries. Ability to perform movement without error and controllability has important role in reduction of injuries. Reproduce ability of motion is reduced after muscle fatigue. Evaluation of motor control can produce suitable conditions for assessment of these changes and help us treatment guide lines for prevention of injuries. The aim of this study was to evaluate motor control changes following onset of fatigue in patients with anterior knee pain as a physiological aspect.
Materials and Methods: Fifteen voluntary female (10 healthy, 5 patients with bilateral syndromes) participated in this study. During dynamic fatigue test (open and closed chain movements), muscle activities were recorded from bilateral vastus medialis, vastus lateralis and rectus femoris (20 healthy and 10 patients quadriceps muscles) by surface electromyography (sEMG). Five dynamic cycles of motions were selected before and immediately after fatigue and then average of three middle cycles were compared for Symmetry Index (SI) as motor control assessment.  Also Median Frequency (MDF) were computed as an indicator for onset of fatigue. 
Results: MDF reduced significantly in both groups. This reduction was markedly showed in patients group. Reduction of SI was significant after fatigue test. Comparison of SI between groups indicated that before fatigue there was significant difference but after fatigue test was not significant.  
Conclusion: Dynamic motions can produce muscle fatigue and reduction of MDF. High central control system used different synergies following pain and functional impairment. Synergy patterns change after dynamic motions fatigue and cause reduction of SI. This change is dependent to pain and functional impairment and has not a stable pattern. 

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Background and Aim: The effects of lateral wedge insole with and without sub-talar strap on pain, arthritic symptoms, functional performance, sports and recreational activities, and knee related quality of life in patients with medial compartment knee osteoarthritis were compared.

Materials and Methods: Community-dwelling men and women aged over 40 years with medial compartment knee osteoarthritis, grades I or II based on Kellgrene and Lawrence grading system were participated in this study. They were randomly allocated in two different groups lateral wedge insole with and without sub-talar strap. Both groups were required to wear the insoles at home for the duration of four weeks, approximately 5 to 10 hours per day. Participants were asked to complete the Farsi version of Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at baseline and at follow-up. The reliability of KOOS for measuring short term and long term symptoms and function in Iranian patients with knee injuries and osteoarthritis has been reported previously.

Results: The changes in KOOS subscales were significantly different in both groups over time. Contrary to our hypothesis, the interaction effect was significant between the two groups following our intervention in terms of symptoms, daily living functions, sports and recreational activities, and knee related quality of life, unless pain score. 

Conclusion: The result of this study suggests that both of the insoles improved pain, symptoms, function in daily living, sports and recreation activities and knee related quality of life in patients with mild medial compartment knee osteoarthritis. However, use of sub-talar strap with lateral wedge insole would be the better prescription for insoles in these patients. 

 

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Background and Aim: Anterior knee pain (AKP or AnKP) is one of the most common disorders of knee. Many studies have been implemented about anterior knee pain and effect of different treatments on this disorder. Todays, this general term has been divided and studied more closely. Knee extension syndrome is one of the common disorders in orthopedic and physical therapy that diagnosed with increased stiffness of quadriceps muscle and causes anterior knee pain. The purpose of this review article is to evaluate this disorder more closely.

Materials and Methods: A literature search was carried out using MEDLINE and SCIENCE DIRECT cite and JOSPT journal database to assess existing literature about anterior knee pain. Furthermore, literatures about the different standpoints of anterior knee pain and effectiveness of different treatments and interventions of anterior knee pain and knee extension syndrome have been identified.

 Results: Fifty articles have been surveyed: forty-two articles evaluated the effect of different treatments on anterior knee pain. Five articles evaluated the various aspects of anterior knee pain more closely and three ones related to knee extension syndrome.

Conclusion: According to these studies results, the causes of anterior knee pain can be classified in two categories: 1) anterior knee pain associated with patellofemoral disorders and 2) anterior knee pain non-associated with patellofemoral disorders. The knee extension syndrome is the cause for anterior knee pain but non-associated with patellofemoral disorders. In this disorder, the tilt angle of patella could be increased and this factor can increase the patients' pain. In contrast to general belief that focuses on tensor fascia lata- ilotiobial band complex (TFL-ITB complex), the rectus femoris muscle stretching should be focused more, because the ilotiobial band has a less effect on patellar tilt. 

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Background and Aim: This study was performed to compare the stiffness of hamstring and rectus femoris muscles in subjects with anterior knee pain and normal subjects.

Materials and Methods: In this non experimental and case-control study, 20 persons with anterior knee pain were selected simply from convenient sample and 20 healthy persons were selected by matching method. proximal and distal stiffness of hamstring and rectus femoris muscles were measured using an isokinetic device in the passive mode. Also, maximal concentric peak torque during flexion and extension movements of hip and knee, in two groups were compared by independent T-test and correlation analysis.

Results: There was no significant difference between anterior knee pain and proximal compartment of rectus femoris(P=0.320) and hamstring(P=0.125) stiffness, but there was significant difference between anterior knee pain and distal compartment of rectus femoris and hamstring stiffness (P<0.001). Significant relationship was found between anterior knee pain and muscles strength (P<0.001). No correlation was found between strength and stiffness of rectus femoris (P=0.356) and hamstring muscles (P=0.643) in patients group, but in healthy subjects this relationship was found (P<0.001). 

Conclusion: In patients with anterior knee pain, hamstring and rectus femoris muscles stiffness increased and muscle strength decreased. Increasing of muscle strength was effective on stiffness in healthy subjects, but there was no relation between them in patients group. Also rectus femoris and hamstring muscles possibly have different proximal and distal neuromuscular compartments.

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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: Osteoarthritis is the most common joint disease in adults around the world and plays a great role in inducing disability in elderly. Patients suffering from severe knee osteoarthritis usually complain of pain and severe functional disability. For these patients, conservative treatments are often induces least remedy for pain and improvement of functional ability. This study evaluates the effects of knee mechanical traction on pain, edema, range of movement and functional ability in patients with severe knee osteoarthritis.

Materials and Methods: In this clinical trial, forty women with severe knee OA (grade 3 & 4 on the Kellgren-Lawrence grading scale) were recruited and randomly divided into two groups with different treatment protocols (common physiotherapy treatment and common physiotherapy treatment accompanied by knee traction). Functional capacity and level of pain were assessed by 6-minute walking test and visual analog scale respectively. A goniometer was used to measure knee range of movement and edema was also evaluated by use of measuring tape.

 Results: Common physiotherapy treatment accompanied by knee traction compared to common physiotherapy treatment leads to significant decrease in pain (P<0.01) and increase in functional capacity (P<0.05).

Conclusion: Common physiotherapy treatment accompanied by knee traction is a more effective treatment than common physiotherapy procedure in patients with severe knee osteoarthritis.

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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

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Background and Aim: Genu varum and genu valgum are two most common deformities of the knee joint in children and adults. In these deformities knee muscles function maybe affected by the alteration in mechanical axis of lower limb. The aim of this survey was to provide some basic knowledge about the function of knee muscles in patients with genu varum and genu valgum deformities.

  

Materials and Methods: Studies were identified by searching in the Pub-Med, Science Direct, Google Scholar databases and authoritative references available on the internet and library for articles and books published after 1990,with the key words such as genu varum, genu valgum, knee muscles, bow leg, knock knee and knee frontal angle.

  

Results: Among 102 papers and 10 books resulted from the first search, only 30 papers and 5 books were related to this literature review and just10 papers and 2 books among them were about changes in knee muscles.

  

Conclusion: The results of this survey indicated that patients with genu varum and genu valgum deformities have architectural and functional alteration in their knee muscles. According to the results most of these studies have noticed the basic changes in quadriceps muscle function and architecture. It is necessary to study more about the function of other knee muscles.

  

Key words: Genu varum, Genu valgum, Bow leg, Knock knee, Knee muscles.

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Background and Aim: Reliability or unreliability of the results achieved from recording of surface electromyography of muscles has always been questioned. The aim of present study was to  measure the reliability of the delayed reaction time of muscle electromyography of the knee joints on the exposure of unexpected rotary turbulence in the transverse plane from the area of supporting surface.

Materials and Methods: Twenty healthy women from 19 to 30 years old and free from any clear deformities in the lower extremities were participated in the present study. Surface electromyography of the six knee musculature was carried out for every subject separately in 4 situations including: External Rotation (Ext Rot) from plantar area on the transverse plane with bent and straight knee, Internal Rotation (Int. Rot) with the same conditions, Single Leg Stance situation in 4 stages, and repeatability of Intra Session through intra-class correlation coefficients when the muscles are in action on the exposure of turbulence in four applied forms were analyzed.

Result: The results from 24 analyzed forms showed that 18 forms of muscles at the time of action had moderate to high repeatability (Monroe Classification)

Conclusion: Regarding reliability, the muscles indicated different amounts in onset latency time, on the exposure of rotary turbulence, according to joint angle and the direction of applying rotation on the transverse plane. In respect to direction of rotation, most of the muscles indicated more reliability on the exposure of external rotation turbulence (clockwise) in relation to internal rotation (anti-clockwise) and also regarding the joint angle in turbulences with straight knee in relation to turbulences with bent knee. 

Keyword: Knee muscles, Surface electromyography, Reliability, Rotational turbulence

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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

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Background and Aim: Standing stability is resulted by normal functioning of various neuro-muscular and musculo-skeletal systems. Patients with below knee amputation cannot use ankle strategy due to limb loss and they have to rely on other mechanisms to improve their standing stability. The effect of prosthesis foot on standing stability of patients with below knee amputation is not well understood. Therefore, the aim of this study was to evaluate the stability of below knee amputees and determine the influence of prosthesis foot on stability

Materials and Methods:  Fourty subjects participated in this study. Participants were divided into three groups including:  (a) normal individuals, (b) amputees using SACH foot and (c) amputees using single axis foot. The stability of subjects was evaluated by use of a Kistler force plate. The subjects were asked to stand on the force plate for one minute and look forward with their hand at their sides. The stability was evaluated by use of some parameters such as excursion of Center of Pressure (COP) and path length and velocity of COP in mediolateral and anteroposterior directions. The difference between the stability of the subjects was determined using One-way ANOVA and Post Hoc test.

Results: There was a significant difference between stability of the three groups during standing with regard to path length and velocity of COP in mediolateral and anteroposterior directions (P < 0.05). No significant difference was reported with regard to all of the measured parameters when comparing normal individuals and amputees with single axis foot (P >0.05).

Conclusion: Below-knee amputees standing stability who are using single axis foot have the same standing stability compared to normal subjects; moreover, stability of amputees who are using SACH foot was surprisingly better than normal subjects in some of the parameters including path length and velocity of COP in mediolateral and anteroposterior directions.

Keywords: Standing stability, Below knee amputation, SACH foot, Single axis foot, Force plate