Journal of Research in Rehabilitation Sciences
Year:2012 | Volume:8 | Issue:8 (SUPPLEMENT)|Papers Count:19

Introduction: Flat foot is one of the most common disorders which not only influences the performance of the foot, but also affects the alignments of the ankle, knee and hip joints. The performance of flat arched differs from that of normal subjects during walking. However, there is not enough information in the literature regarding the difference between standing stability. Moreover, the influence of use of foot insole on standing stability has not been yet evaluated. This study was aimed to investigate the stability of subjects with flat foot with and without insole.Materials and Methods: Forty female students in Isfahan University of Medical sciences participated in this study. Then they classified into two equal groups of twenty normal and flat arched individual. Center of pressure (COP) was measured using Kistler force plate. The stability was evaluated by calculating the COP excursions, path length, and velocity in the mediolateral and antroposterior directions. The differences between stability of normal and flat foot subjects with and without insole were evaluated by use of sample and paired t-test, respectively (a=0.05).Results: There was a significant difference between the stability of flat arched and normal subjects based on COP velocity and total velocity (P<0.05). However, there was not a direct correlation between the severity of flat foot and instability during quiet standing (P>0.05). The mean values±SD of COP total velocity during standing with and without insole were 1645.42±160 and 2752±683 mm/min, respectively (P<0.001).Conclusion: The flat foot is more unstable compared with normal subjects during quiet standing due to miss-alignment of foot structure and a decrease in proprioception awareness of the foot ligaments and tendon. Insole can help to align foot structure and also reduce the exceed forces applied on the ligament and finally improves the standing stability.

Introduction: Despite the facilitatory effects after applied whole body vibration (WBV), results of some studies have shown the increase of muscle response depression. The purpose of this study was to investigate the acute response of H-reflex recruitment curve in soleus muscle after one session of WBV.Materials and Methods: Twenty six non-athletes volunteer healthy women (mean age±SD; 26.11±2.85 years) were participated in this study. All subjects received two different sham and test sessions. They stood on the vibration plate in semi squat position. In test session, WBV was applied with frequency of 30Hz and peak to peak amplitude of 3mm during 3 minutes. Soleus H-reflex recruitment curve was recorded before, immediately after, 5 and 10 minutes after WBV.Results: The intensity of H-reflex recruitment curve threshold and Hmax were significantly increased immediately after WBV in both sessions (P<0.05). Peak to peak amplitude of initial H-reflex were prominently decreased in both sessions whereas, peak to peak amplitude of Hmax was decreased only in sham session (P <0.05). The analysis of threshold and peak to peak amplitude, the parameters of H-reflex recruitment curve, between two sessions showed no significant difference (P>0.05).Conclusion: Considering the right shift of H-reflex recruitment curve and depression response in two sham and test sessions, it seems that maintaining of semi squat position and activated control mechanisms, such as extensor muscles contraction, affects this inhibitory response and WBV had no facilitatory effect on this depression response.

Introduction: Family caregivers of patient with psychiatric disorder are actually the base of health care systems. Caring patients with psychiatric disorder is a stressful responsibility for family members. The purpose of present study was to evaluate the efficacy of group psycho-educational interventions in general health promotion on family of patients with bipolar disorders.Materials and Methods: This research was a semi-experimental study with control group and random allocation. In this study, 6 subjects in experimental group and 9 individuals in control group were recruited. All participants were family members of patients with mood disorders. They completed general health questionnaire. Experimental group attended twelve sessions of group psycho-educational interventions, but control group received no intervention. Analysis of covariance was used for statistical analyses.Results: Our findings showed that patients significantly improved in general health (P<0.001).Conclusion: These results indicated that group psycho-educational interventions can promote general health in family of patients with bipolar disorders.

Introduction: Vestibular evoked myogenic potential is a novel and reliable test which provides diagnostic information about the saccule function and/or inferior vestibular nerve; it also completes the present vestibular tests, and evaluates the sacculocollic reflex. Vestibular evoked myogenic potential amplitude is proportional to the level of background EMG that it shows the necessitate of maintaining constant tonicity of muscles during test recording. Change in eye position results in change in sternocleidomastoid muscle activity and consequently change in vestibular evoked myogenic potential amplitude. Therefore, this study aimed to assess if eye open and closed has effect on vestibular evoked myogenic potential parameters.Materials and Methods: In this cross-sectional study, vestibular evoked myogenic potential was recorded for forty normal subjects, aged 18 to 30 years old, using 500 Hz-tone bursts (95 dBnHL).Results: Considering the results of both ears, there was no significant difference between mean amplitude, p13 and n23 latencies of the two situations (P>0.05).Conclusion: Eye open and closed has no significant effect on vestibular evoked myogenic potential. Therefore as necessary and for artifact rejection one can be recorded vestibular evoked myogenic potential with close eyes.

Introduction: Constraint-Induced Movement Therapy (CIMT) and bimanual approach (BIM training) are a promising treatment for upper limb function improvement in children with spastic hemiplegia. CIMT involved restraint of non-involved upper extremity and intensive practice with involved upper extremity. BIM training is complementary to other treatments of upper extremity and improves bimanual coordination using structured task practice embedded in bimanual play and functional activities. This study was aimed to evaluate the influence of combination of CIMT with BIM training on fine motor skills of children with hemiplegic cerebral palsy.Materials and Methods: In this study, twenty five children with hemiplegic cerebral palsy aged 5-10 years participated and randomly assigned into two intervention and control groups. Children in Control group received current occupational therapy intervention. Subjects in intervention group received a combination of CIMT and BIM training in addition to current occupational therapy. Each session was started with restraint on non-involved upper extremity and practicing with involved upper extremity for three hours. This was followed with BIM training for another three hours. This process lasted for 10 out of 12 consecutive days. Upper limb function and muscle tone were assessed by Jebsen-Taylor test of hand function and modified Ashwort scale, respectively.Results: Upper limb function in intervention group significantly improved (P<0.05) compared with control group, however the level of spasticity was not significantly different between two groups (P>0.05).Conclusion: Our findings suggest that combination of constraint induced movement therapy and bimanual intensive therapy improved upper limb Function in the hemiplegic cerebral palsy children.

Introduction: Rehabilitation is an ongoing process with a range of different specialties. Team working is one of the important aspects of this process. Rehabilitation team includes physiatrist, physiotherapists, occupational therapists, speech therapists and orthotic and prosthetic experts. So, the attitudes of these members towards team working will influence the quality of rehabilitation process. The purpose of this study was attitude survey of mentioned experts towards team working process.Materials and Methods: This is a descriptive and cross sectional study. The sampling method was enumeration and statistical population included physiatrist and residents, professionals of occupational therapy, speech therapy, physical therapy, orthotics and prosthetics whom working in public and private treatment centers in the city of Shiraz. Information gathering tool was a researcher-designed attitude survey questionnaire. Cronbach's alpha coefficient is applied to check the questionnaire reliability. Factor analysis is used for investigating the structural characteristics of questionnaire, and T-test is used to check the attitude status.Results: Cronbach's alpha coefficient of 0.87 confirms the good reliability of the questionnaire. Based on findings, all occupational groups have a positive attitude towards team working (P<0.05). Effective and risky factors within teamwork process were extracted from the members’ perspective with regard to estimate the percentage of answers to the items of questionnaire.Conclusion: Client-centered approach, sufficient knowledge to other members’ skills, and compliance with ethical and professional values are some of effective factors in teamwork improvement. On the other hand, personal disputes between members, poor communication within the group members, inappropriate deemed of requesting help and lack of sufficient knowledge to the team working process are risky factors.

Introduction: The effect of abnormal foot structure on dynamic function in lower extremity, particularly among children and adolescents has yet received little attention. The purpose of this study was to determine the electromyographic (EMG) activation patterns of selected lower limb muscles and plantar pressure characteristics during gait in teenage boys with normal and flat foot deformity.Materials and Methods: Twelve subjects with flat foot and twelve with normal foot defined by arch index method participated in this study. Surface electromyographic activity of selected lower limb muscles for tibialis anterior, peroneus longus, soleus, medial and lateral gastrocnemius were recorded. Plantar pressure characteristics were measured at their self-selected walking speed along a 10 m walkway. Independent t-test was used for statistical analyses.Results: EMG of medial and lateral gastrocnemius muscles were significantly greater in individuals with normal foot compared with flat foot group during loading response phase (P=0.001) While medial gastrocnemius showed a decreased activation in terminal stance phase (P=0.048). Peak pressure under foot regions including hallux and other toes, head of 2nd and 3th metatarsals and medial part of heel was greater in pes planus group. Center of pressure displacement was different between two groups during loading response, mid stance, and stance phase (P=0.011, P=0.015, and P=0.050, respectively).Conclusion: Abnormal foot posture could change the lower limb muscle activity and plantar pressure parameters during gait. The results of this study suggest that further studies can focus on the effects of foot abnormality on dynamic function in lower extremity to understand the underlying mechanisms and also set the suitable treatment manner.

Introduction: The number of subjects using ambulatory assistive devices during standing and walking is increasing. Various kinds of walkers and crutches have been designed to improve the performance of subjects. However, they have been prescribed based on some criteria which have not been tested clinically. Moreover, it is not clear what the difference between crutch and walker is which type of crutch is suitable; and also there is any difference between the new and traditional designs of walker and crutch. Therefore, the aim of this review is to answer to the above mentioned questions.Materials and Methods: An electrical search was performed in PubMed, ISI web of science, Embase, and Google scholar from 1960 to 2012.The abstract and title of papers were evaluated based on selected criteria. The quality of the papers was evaluated based on Black and down tool.Results: Nearly twenty four papers have been selected for find analysis. The quality of most of studies was poor. Many researches were done on normal subjects. Moreover, only some parameters like force applied on leg during walking and energy consumption were evaluated. The available evidence is not enough to distinguish between the performance of the crutch and walker.Conclusion: Based on the available research studies, the difference between various types of walkers, crutch and advantage of walker upon crutch is not cleared. The influence of crutch and walker length on the performance of subjects is controversial. Moreover, the sample size was not large enough to have a strong conclusion. Therefore, it is recommended to do a good research study with an acceptable sample size to test the various kinds of crutch and walker on the handicapped subjects.

Introduction: Rotatory chair test is used to evaluate the peripheral vestibular system and central compensation. It is also applied to follow up disease and evaluate specific management in some disorders. Analysis parameters are phase, gain, and asymmetry. This study was aimed to analyze previous researches based on rotatory chair testing protocol and its clinical application.Materials and Methods: The present study had a review design. To find and collect related articles some key words like rotatory chair, central compensation, and nystagmus were used. All searches performed on Google Scholar, Science Direct, EBSCO, Pubmed and Thieme.Results: Fifty eight original papers and 4 review articles were initially found. Finally, twenty of them were selected based on identified inclusion and exclusion criteria.Conclusion: Due to some advantages such as the use of physiological stimulus, the ability to evaluate central compensation with asymmetry, and the ease of performance, rotatory chair can today be easily utilized in evaluating vestibular protocol.

Introduction: Scoliosis is a common deformity of spinal column. Most previous researches have concentrated mainly on kinematic parameters. However, this spinal abnormality is also a structural deformity affects on the normally symmetrical vertebral column, alters the centre of mass position, and weight distribution on the lower limbs. Therefore, kinetic evaluation can lead to a better understanding of the etiology of scoliosis. The aim of this study was to evaluate kinetic parameters in scoliotic subjects and compare with normal participants considering previous studies.Materials and Methods: In this research, some key words like scoliosis, kinetic, ground reaction force, center of pressure, moment, and intervertebral force were used to find suitable articles. These researches were found on data bases such as Google Scholar, PubMed, Elsevier, Ovid, and Springer. Papers were selected based on identified inclusion and exclusion criteria. Then articles were scored by downs and black tool.Results: Among thirteen articles, eleven were selected from 1998 to 2012. For symmetric index, researchers indicated an asymmetry, but these asymmetries did not follow any special pattern with curves. Also, researchers showed that maximum displacement in center of pressure occurred on mediolateral direction. Another article investigated kinetic parameters evaluation during lateral steps, because in this gait pattern asymmetries were greater between two normal and patient groups.Conclusion: According to previous studies, there was an asymmetry in parameters. But, there is not any relationship between asymmetry and curves pattern in scoliotic subjects.

Introduction: The idiopathic scoliosis is a spinal deformity develops in three-dimensions mostly occurring in female adolescents. Untreated scoliosis can progress to where it results back pain, impaired vital capacity, and psychosocial disturbances. It seems that exercise-based therapies can be useful in the treatment of scoliosis; therefore the aim of this review is to clarify the effectiveness of physical exercises in the treatment of idiopathic scoliosis.Materials and Methods: We performed a search through different international databases (Ebsco, Medline (via PubMed), and ISI Web of Knowledge) with the following keywords: scoliosis combined with review, scoliosis combined with exercise, scoliosis combined with sport and scoliosis combined with rehabilitation. The inclusion criteria were both; patients treated solely by the physical exercises and systematic review of the study design.Results: Finally, Five articles fulfilled the inclusion criteria. Three of them had revealed poor quality evidence supporting the use of exercise in the treatment of idiopathic scoliosis. Two systematic reviews in 2008 and 2011confirmed the efficacy of exercises in reducing the progression rate and/or improving the Cobb angles.Conclusion: The encouraging results provided by the discussed studies can give birth to the hypothesis that physical exercises are effective in treatment of adolescent idiopathic scoliosis, a hypothesis that must be verified by a well-designed randomized controlled trial.

Introduction: Scoliosis, is a three dimensional deformity of the spine and ribcage that can lead to changes in the relationship between body segments, spinal anatomy, trunk symmetry and cause pathological gait pattern. Scoliosis also is a structural deformity, so it can alter center of mass (COM) position and weight distribution on lower limbs. It seems that individuals with scoliosis deformity have the poorer stability comparison with normal subjects.Materials and Methods: We conducted a Medline search via PubMed, Google scholar and ISI web of knowledge to identify studies on scoliosis field and the effect of this deformity on kinetic and kinematic parameters as well as the influence of bracing on mentioned parameters. The publication dates of the full-length articles were between 1998 and 2012. Some key words such as kinetic, kinematic, gait, and walking were used in combination with scoliosis to search in database.Results: Multiple Medline searches led to the find out fifty four papers that twenty six of which were relevant based on title and abstract. 6 more articles were retrieved according to their references. Finally, thirty two papers were considered in this literature review. A few studies performed the influence of brace on kinetic and kinematic parameters in scoliotic subject.Conclusion: There was no sufficient robust evidence to judge about the influence of scoliosis deformity on kinetic and kinematic parameters.

Introduction: Scoliosis is one the most common orthopedic problems in children and adults which is still idiopathic. Scoliosis is a three planar deformity and results in changes in anatomy of spine and pelvic that alters gait parameters. The purpose of this study was to evaluate changes in kinematic parameters in lower limb, upper limb, and trunk in scoliosis patients compared with normal subjects. Determining the exact pattern of these changes and the effect of it's severity on this parameters can be used to check the progression or improvement of scoliosis.Materials and Methods: To find and collect suitable articles some key words like scoliosis, gait, and kinematics were used in data bases such as Google Scholar, Pubmed, Elsevier, Ovid and Springer. Papers were selected based on identified inclusion and exclusion criteria. Then articles were scored by Downs and black tool.Results: Among of twenty five articles, 9 articles were selected on basis of inclusion and exclusion criteria from 1998 to 2012. Step length was the only temporospatial parameter that showed a significant reduction. Kinematic parameters in Lower limb identified reduced range of motion, but motion pattern did not show any significant difference. The most differences in data were observed in trunk and pelvic rotation. It was cleared only in person who has a large curvature of the thoracic spine and the same direction of pelvic rotation. Pelvic changes were not predicted in other cases. Pelvic also indicated some changes in x-ray and according to anatomical relation between pelvic and lumbar, thoracolumbar and lumbar curves had the most effect on the pelvic changes.Conclusion: The majority of these articles investigated walking parameters in different speeds. In order to achieve the comprehensive outcomes, the standard model should exist with regarding a curve type and test condition, especially in the upper limb that has been paid low attention, so far.

Introduction: Scoliosis is one of the musculoskeletal disorders which influence the performance of subjects during standing and walking. There is no enough information regarding the influence of orthosis on gait parameters and stability functions in scoliotic subjects, therefore the aim of this study is to investigate the effects of orthosis on the mentioned parameters.Case Report: An 8 years old scoliotic girl was recruited in this study. She walked and stood with and without Milwaukee orthosis. Joint movements and force applied on the leg were measured using motion analysis system and Kistler faceplate. The length of erector spine, external oblique and internal oblique abdominalis tendons was evaluated during walking with and without orthosis by use of Open SIMM software.Results: The orthosis seems to improve the performance of subjects during standing and walking. Moreover it stretches the contracted muscles on the concave side of vertebral column.Conclusion: The orthosis can align the vertebral column and improve subject abilities to stand and walk. As the length of vertebral column muscles increases following the use of orthosis, it can be concluded that it influences on the curve correction.