SCIENTIFIC JOURNAL OF REHABILITATION MEDICINE
Year:2015 | Volume:4 | Issue:3|Papers Count:20

Background and Aim: Anterior cruciate ligament injury is a common knee problem that could affect balance. The purpose of this study was to investigate whether the additional sensory information could improve dynamic balance in individuals with anterior cruciate ligament (ACL) injury in comparison with healthy adults.Materials and Methods: 15 young patients with unilateral anterior cruciate ligament injury (mean age 28.9±4.7, male) and 15 healthy volunteers (mean age 26.1±3.8, male) participated in this study. Participants were completed the star excursion balance test under two sensory conditions: with and without using light touch. The force sensor that was placed on the light touch device transferred the sensory informations from index finger to the microprocessor and proper feedback was produced.Results: The results showed significant differences after using light touch in anterior cruciate ligament deficiency patients in compared with control group in these directions : medial, posterior, lateral, anterolateral, Poster olateral and posteromedial (P=0.001).There was also significant differences between the patients and healthy controls in posterior (P=0.005),lateral(P=0.004) and medial(P=0.003) directions.Conclusion: Based on these results, we suggest that the reduction in dynamic test in patients with anterior cruciate ligament deficiency would be due to the reduction of sensory information provided by this ligament, but when sensory information is enhanced, dynamic performance improves. The results have implications for a new method to improve stability in these patients.

Background and Aim: Kinesio-Taping is a new therapeutic method for musculoskeletal disorders including low back pain. The purpose of this study was to examine the effect of six weeks kinesio taiping on pain and disability in male subjects with non-specific chronic LBP.Materials and Methods: Twenty four patients diagnosed with non-specific chronic low back pain underwent a six week treatment with Kinesio-Taping by a sports therapist. The amount of pain and functional disability were measured using visual analogue scale (VAS) and Oswestry disability index (ODI) questionnaire respectively before, after and Four months after the intervention. Data were analyzed using independent T and paired T. Statistical significance was set at p£0.05.Result: Our finding showed that immediately after six-week kinesio-taping, the amount of pain and functional disability was improved in participants with non-specific chronic low back pain (p<0.01). The results obtained from Four-month follow-up did not indicate any significant reduction in pain and improvement in functional disability in patients compared to the baseline (p>0.05).Conclusion: Based on current results, Kinesio-taping could have temporary and short-term effect in rehabilitation of subjects with chronic low back pain.

Background and Aim: Increasing age increased the risk of acute and chronic diseases, but decreased functional capabilities of individuals and the power of the senses and perception. The changes in the areas of biological, psychological and social threatened quality of life for older persons, as far as keeping them from performing daily activities. The purpose of this study was to evaluate the effect of neurofeedback training on the quality of balance control under dual tasks conditions motor- balance and cognitive-balance in elderly men.Materials and Methods: The research method is quasi-experimental that is conducted by Pre-test/ post-test method. subjects were 60 years and older in Tabriz, Iran and were selected on a voluntary basis. Thirty elderly volunteers were randomly divided into two groups: experimental and control groups. The TUG was measured under conditions of dual-task motor-balance (Run the test with a full cup of water transport) and Dual Task balance-cognitive (Countdown test with random numbers); before and after the neurofeedback training (Up to 15 sessions in 30-minute 3 times a week for 5 weeks).Results: The results showed that neurofeedback training was significantly increased performance in elderly motor dual-task (p=0.001). But in dual-task cognitive performance, although the improvement had taken place, not statistical significant differences were observed (p=0.051).Conclusion: The results suggest that the balance neurofeedback protocol improves balance performance under dual-task conditions, especially dual-motor task.

Background and Aim: Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are used in people with motor problems. The current study conducted to investigate the effectiveness of videogames on balance and fear of falling in patients with chronic stroke.Materials and Methods: This experimental study organized in a single subject system, A-B design for four patients with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, Step test, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess the fear of falling. The results were considered using C-statistic, Bayesian factor, Mann Whitney U, and visual analysis.Results: The results were significant for balance skills, the maximum force produced by lower extremities at different directions and fear of falling parameters but the deviation from center did not show distinct pattern.Conclusion: The results related to balance skills, the maximum force produced by lower extremities and also fear of falling confirmed the efficacy of videogames, however the deviation from center did not show any improvement.

Background and Aim: Oscillatory devises like Body blade and Flexi-bar have been popular in USA and Europe as a kind of exercise therapy. Many controversial researches have been done to find out the activation pattern differences of some muscles during oscillation with these devices. In this study we compare erector spine muscle EMG activity in lumbar, thoracic and cervical region during Flexi-bar unilateral oscillation at 3 different weight bearing positions.Materials and Methods: Surface EMG signal were bilaterally collected from erector spine muscles from 12 healthy volunteers during double stance and single stance on the right and left leg. We compared regular EMG activity of muscles which was normalized by maximal voluntary contraction during Flexi-bar oscillation.Results: Repeated measures ANOVA revealed significant deference between muscular activity of left and right side in cervical reign (P=0.012 ), in thoracic (P=0.008 ) and in lumbar reign (P<0.001). The comparison across different standing positions were not statistically significant.Conclusion: Flexi bar oscillation in position of this study resulted different level of activity in Erector spine muscles. Studies on another postures and muscles can help us to choose the most appropriate position of exercise for our patients.

Background and Aim: Cleft palate is a congenital malformation. The structural defects causes disturbances in speech clarity due to incomplete closure of the or opharyngeal ring. Previous studies of speech and language disorders (including cleft palate) suggest impaired diadochokinesis skill. We thought that there is a relationship between diadochokinesis and intelligibility of speech. The purpose of this study is to examine the relationship between oral diadochokinesis with intelligibility of speech.Materials and Methods: The present study is a descriptive, cross-sectional study. Thirty children aged between 5 to 6 years with cleft palate (15 boys and 15 girls) were randomly recruited from hospitals in Mashhad, Iran. 30 normal children of the same age were selected as controls. The resolution capability of Weiss and Fletcher criteria were used for clarity of speech and speed of diadochokinesis respectively.Results: Between diadochokinesis in patients with cleft palate, and their intelligibility of speech a negative correlation was observed (- 89% in male, -92% in girls), But no correlation was found in normal children (-0.009 and -0.046 in boys and girls respectively). There was ot significant differences in both diadochokinesis and intelligibility of speech between two groups (p>0.05).Conclusion: According to the findings in patients with cleft palate; diadochokinesis speed and intelligibility of speech can be significantly reduced compared to normal children of the same age that significantly related with each other. This relationship was not found in normal individuals.

Background and Aim: Tension-type headache (TTH) is the most common type of headache in different societies. TTH is a prototypical headache in which myofascial pain of neck muscles can play an important etiological role. Weakness of upper posterior muscles of neck is a common accompaniment of myofascial pain in this region. Thus the purpose of this study was to compare the strength of upper posterior neck muscles in women with chronic tension headache and healthy women.Materials and Methods: The strength of superior-posterior neck muscles in 33 women (16 chronic tension headache and 17 healthy individuals) were examined by The Power meter. An independent t-test was used to analyze the data and compare the groups.Results: Results showed a significant difference between women with chronic tension headache and healthy ones (p=0.021). The results also showed inverse relationship between intensity of pain and the strength. (r=-0.65 ،p=0.006).Conclusion: According to the results of this study, women with chronic tension headache had lower posterior upper cervical muscles strength than healthy controls. These results may reflect a disturbance in the upper posterior neck muscles musculoskeletal system in the patients which may be primary to TTH or secondary and as a result of TTH. Further studies are required to extend our knowledge in this area.

Background and Aim: According to importance of healthy posture and high prevalence of all kinds of faulty postures among young population, study of etiological factors is necessary. The aim of this study was to evaluate the relationship between lumbar lordosis and pelvic inclination with ultrasonic thickness of abdominal wall muscles in healthy young females.Materials & Methods: 76 healthy young female, ages ranged 18-30 years participated in this study voluntarily. After collecting demographic information, flexible ruler and inclinometer were used for measuring the degree of lumbar lordosis and pelvic inclination respectively. Then, the rest thickness of abdominal wall muscles were measured in two different positions of crook lying and standing by using ultrasonography. The Pearson correlation coefficient was used for statistical analysis.Results: Results revealed significant statistical relationship between lumbar lordosis and pelvic inclination (p=0.03(. Among abdominal muscles, only transverse abdominis muscle showed a negative correlation with lumbar lordosis during standing (p=-0.02). There was not statistical relationship between abdominal muscle thickness and pelvic inclination.Conclusion: Based on the findings of this study, there is a direct relationship between lumbar lordosis and pelvic tilt, but rest thickness of the abdominal wall muscles except the transverse abdominis muscle, has no significant effect on lumbar lordosis.

Background and Aim: The purpose of this study was to evaluate the reliability of the vestibular evoked myogenic potential (VEMP) response in clinics where only a feedback method is available for monitoring background EMG.Materials and Methods: forty healthy young subjects (mean age of 23.62 years old) participated in the investigation of the within-session reliability. They were retested again after 2 to 3 days for the between-session reliability. VEMPs were recorded in air and bone conduction procedures using 500 Hz tone bursts with durations of 4 and 7 milliseconds and use of feedback method for control of muscle contraction.Results: The intraclass correlation coefficient value for air conduction was found to have fair-to-good reliability and for bone conduction (4 millisecond) the correlation was found to be fair-to-good. For bone conduction (7 millisecond) the correlation was found to be poor-to-good. The latency of n23 was more reliable than the latency of p13. For AC procedure amplitudes were more reliable than the latencies but for BC procedure latencies were more reliable than amplitudes. Overall air conduction procedure was more reliable than bone conduction procedure.Conclusion: Overall, VEMP response parameters were found to have fair to good test-retest reliability. The feedback method revealed that the results of this study are comparable to other data in the literature where different test conditions were applied. Clinicians should consider these findings when interpreting VEMP responses

Background and Aim: To prospectively investigate the physical function and falls among elderly patients who underwent total knee arthroplasty (TKA).Materials and Methods: A total of 30 patients (3 male, 27 female) over 60 years of age who underwent TKA and were living independently were enrolled. Patients with UTKA (n 15) and BTKA (n 15) were evaluated before, 1, 2, and 3 months after TKA. They were assessed using Berg Balance scale Test. All the patients received standard rehabilitation programs during this period.Results: One month post operation, both groups of patients experienced significant losses from preoperative levels in all outcomes (P<.05) .Unilateral TKA Patients recovered to preoperative levels after 3 months postoperatively in all measures. Compared to bilateral TKA, unilateral TKA patients did not perform significantly different for Berg Balance scale test (P=0.47).Conclusion: The persistent impairments and functional limitations 3 months after TKA with standard rehabilitation protocol suggest that more intensive therapeutic approaches may be necessary to restore function of patients following TKA. Individuals with unilateral knee OA have deficits in balance, and function compared to bilateral TKA.

Background and Aim: Functional constipation is a widely prevalent anorectal condition. The most commonly used instrument to evaluate constipation is the Rome III criteria .Clinical diagnostic techniques such as anorectal manometry is also performed to assess constipation. Issues of cost, accessibility, requirement for specialized skill and denial of patient comfort, makes its use waned. Rome III criteria can be used as an assessment tool easier than the other modalities, such as manometry. Therefore, this study aimed to investigate the relationship between clinical symptoms based on Rome III criteria with manometric findings in women with functional constipation.Material & Methods: 35 female patients with a mean age of 38.51±10.24 years and functional constipation diagnosed by specialist were included in this study. After complication of Rome III criteria and background information questionnaire, digital evaluation and anorectal manometry were assessed. For data analysis SPSS software version 22, Pearson and Spearman correlation coefficient was used.Results: Our results indicated significant negative correlation between the severity of Rome III criteria pressure of upper anal during squeeze and push maneuver, between rectal, upper anal resting pressure and level of gas or fecal incontinence and between rectal pressure of squeeze with number of delivery and also between severity of Rome III criteria and strength and endurance of pelvic floor muscles by digital assessment. Positive correlation between lower anal pressure during push and resting tone was observed (p<0.05).Conclusion: According to this study, the clinical assessment of patients with functional constipation, Rome III criteria and manual pelvic floor muscle examination such as strength and endurance, as a non-invasive and low cost method is recommended. However, to achieve an accurate diagnosis, in addition to the mentioned methods, the use of anorectal manometry is recommended.

Background and Aim: Given the importance of core stability exercises as well as the high incidence of ankle sprains and functional instability and Subsequently, increasing of postural sway as a risk factor for the occurrence of ankle sprain, Core stability exercises aimed at stabilizing the central area of the body can have a significant role in reducing postural sway. Therefore the purpose of this study is the immediate effect of core stability exercises on postural sway in athletes with functional ankle instability.Materials and Methods: Thirty male college athletes with functional ankle instability participated in this study. After Primary screening and identification of eligible athletes with ankle joint functional assessment tool (AJFAT), subjects were divided into the experimental (n=15) and control group (n =15). Athletes’ experimental group did two types of core stability exercises in a session. Postural sway measured in both groups before and after the test.Results: Statistical test results showed that the core stability exercises affected the postural sway in athletes with functional ankle instability in the short-term with the closed eyes and significantly reduced their postural sway (p<0.05). But this exercises had no effect on postural sway with open eyes (p<0.05).Conclusion: It seems that core stabilizer muscles are important in control of proximal and distal joints for reduction of postural sway in athletes with functional ankle instability when their eyes are closed and doing this exercises in the short-term can be useful in reduction of postural sway in athletes with functional ankle instability.

Background and Aim: The standard method to measure the base curve radius of hard contact lenses (RGP) is to employ a tool namely Optical Spherometer which is also called Radioscope. As Radioscope is an expensive and not easily accessible tool compared to keratometer, using the keratometer clamps seems to be more reasonable. In order to remove these problems, in this research a small clamp was designed and built which is a combination of the two above-mentioned clamps and the name Contacheck was selected for it. The purpose of this research is to find an answer to this question that whether or not the sizes of radius of the base curve of hard contact lenses resulting from Contacheck are reliable and valid compared to the standard device of Radioscop.Materials and Methods: In this study 43 hard contact lenses in different sizes were randomly selected and their curve which had been specified based on the manufacturing company were measured two times by an optometrist; once by a Radioscope device and then by the Contacheck. Another optometrist had gone through the same measurement procedure. The correlation of the values resulting from two devices (Inter-rater reliability coefficient), the equality of the values obtained from the observations by two independent evaluators were also tested. Bland –Altman method was employed to determine the approximate agreement of 95% in all mentioned stages.Results: The mean and Standard deviation of curvature of hard contact lenses were 6.75±0.75 & 6.76±0.73 by radioscope and contachek respectively. Intraclass correlation coeffitiont (ICC) was 0.998 and the confidence interval for the mean differences between the average values of both devices by the Bland-Altman plot was (-0.11, 0.12).Conclusion: The contachek is a valid and reliable instrument for measuring the Base curve radius of hard contact lenses.

Background and Aim: Regarding the importance of addiction in our societies, this study has been carried out to investigate the relationship between personality disorders and addiction severity.Methods and materials: 248 addicts (135 opiate dependents and 113 stimulant dependents) chosen by convenient sampling method in 2013 were participated in this study. All participants were from patients referred to Addiction Treatment Clinics in Tehran, Iran. Data collecting process was accomplished by means of clinical interview based on DSM-5 criteria for Substance Use Disorders, Iranian version of Addiction Severity Index, and Millon Clinical Multiaxial Inventory – III. Data were analyzed by Pearson correlation using SPSS version 21.Results: There was a significant correlation between cluster A and legal status (p<0.05), cluster B and alcohol use, drug use, legal status, and psychiatric status (p<0.05), and cluster C and alcohol and drug use (p<0.05).Conclusion: Personality disorders in cluster B are stronger predictors for addiction severity and suggests specified treatment requirements in comparison with other groups.

Background and Aim: Uncontrolled diabetes can lead to diabetic foot ulcers and if it is not treated can lead to amputation. With suitable plantar pressure distribution, by changing material and arrangement of constituent layers for multi-layer insoles, the foot ulcers can be prevented or improved. In this study, single-layer and three-layer insoles made by Silicone Gel, Plastazote Foam, Polyfoam and Ethyl Vinyl Acetate foam have been compared.Materials and Method: the materials behavior determined using a uniaxial pressure test. Then a custom-made insole was prepared and by a digitizer device, a scatter file obtained from machined sample. This file was imported in Catia software and the volumes and surfaces has been created by using a three dimensional nonlinear FEM model, for 4 single-layer and 18 combinations of three-layer insoles during dynamic test. For verification of FE results, experimental test has been done by using Pedar system.Results: The results showed that among single-layer insoles, the Silicon Gel and Plastazote and between three-layer insoles arranging Plastazote, Silicone Gel and Ethyl Vinyl Acetate (from top to bottom) were recognized as the best combination.Conclusions: Three-layer insole stress concentration and strain can reduce 31% Von Mises constrain stress and 30% strain with respect to one layer insole. Experimental tests using Pedar system verified this result. In dynamic mode using Pedar system, Silicon Gel one layer insole and three-layer PLZ-SG-EVA decrease plantar pressure by 30% and 54% respectively in comparison with bare foot. The method used in this research can show suitable performance of these materials when used as insole. Also this research can be helpful for analyzing insoles using finite element method.

Background and Aim: This study aimed to investigate the relationship of expressed emotion, codependency and coping styles for stress and the symptoms of obsessive-compulsive patients. Material and Methods: This study included 40 patients suffered from obsessive-compulsive, which were referred to Imam Hossein hospital and several health clinics. The scale of maternal expressed emotion was assessed by Cole and Kazarian Level of Expressed Emotion Scale and Holyoake Codependency Index and Parker and Andler Coping Inventory for Stressful Situation questionnaire.Results: Among the components of expressed emotion, subscale of disturbance and intervention P=0.013, emotional responses P=0.002 and a negative attitude towards the disease P=0.023 and total score expressed emotion by P=0.002 in relatives of patients showed a significant relationship with severity of obsession. All subscales of self-devotion P=0.041, external focus P=0.047, and the reaction P=0.039 and the total score (P=0.038) showed the same relationship with the obsession severity. Among coping styles, focused coping styles P=0.017 and the severity of the obsession showed a significant relationship.Conclusion: Family expressed emotion, codependency and emotional coping style are related with the symptoms of obsessive-compulsive patients.

Background and Aim:Since sleep has an important impact on life of students and their mental health, this study designed to investigation of the relationship between quality of sleep and mental health of students in school of rehabilitation sciences, of shahid beheshti university of medical sciences.Material & Methods:In this cross-sectional study 239 students from four field of study in rehabilitation were randomly selected. The used questionnaires were as following; demographic, mental health (GHQ-28) and pittsburgh sleep quality index (PSQI). ANOVA test was performed for data analysis. (a=0.05).Result:36.6% of all students had satisfactory sleep quality and the rest 63.6% had poor sleep quality. 46.2% had physical symptoms, 50.2% showed stress, 65.7% had social function disorder and 33.1% showed depression, according to mental health minor scales. There was significant relationship between sleep quality and mental health (P<0.001).Conclusion:There is a significant relationship between sleep quality and mental health. So, lack of sleep can affect on students’ academic performance, daily function, physical and mental health.

Background and Aim: Osteoporosis is a systemic skeletal disease with its associated fractures 8 times higher in women than men. Doing physical activity to maintain bone mass and strength are vital and help individuals in prevention of osteoporosis-related fractures. Although some studies have shown a positive relationship between physical activity and bone mineral density (BMD), some revealed physical activities are ineffective on BMD. Thus a systematic study to clarify the contradictions and determine the effect of physical activity on bone mineral density is required. The purpose of this study was to review the effects of physical activity on bone mineral density, pain and quality of life in patients with osteoporosis.Materials and Methods: In this review, articles that were published in international and Iranian journals of Pub med, Springer, Elsevier, Science Direct, Magiran, Noor mags, SID with standard keywords were used.Results: Most of the findings from various studies, indicated positive effects of physical activity on bone mineral density, reduced pain and improved quality of life for people with osteoporosis.Conclusion: although compounded exercises and researches that have been done on young people suggested a positive effect on bone mineral density, in the researches on which the exercise period was similar, a positive effect did not show in elderly. Sports activities for people with osteoporosis should be selected according to the characteristics such as age, purpose (treatment or prevention) and limits of patient. Since there is a significant positive effect of exercise on bone mineral density, It is recommended to study the exercise effects in various environments (land, water, and mixed).

Background and Aim: Stroke is a major cause of disability in adults and functional disability of upper limb. It is the most important difficulty that makes the person unable to perform activities of daily living. Rehabilitation interventions in the guidelines format can result in integrated therapists’ performance and increases the process of recovery and decrease the level of functional disability after stroke. The purpose of this study was to make an integrative review and localization of occupational therapy practice guideline in rehabilitation of upper limb function in stroke patients according to available evidences and experts’ opinions.Materials and Methods: This study is a combination of two steps. In the first phase, the integrated review was done in all domestic and foreign published articles and practical guidelines of the previous ten years. The key words of Clinical practice guide, stroke, occupational therapy interventions and of upper limb function were used and the found articles were extracted. In the second phase, the quality of the results were analyzed and discussed in the expert panel that included of 10 occupational therapists in CVA area. Then final results were presented in a booklet format.Results: In this study 268 articles in the field of stroke and upper limb function and 11 clinical practice guidelines were found. Initially, abstracts and then 70 full texts of articles relating to hand function interventions in stroke patients which had inclusion criteria were investigated. Robotic aids interventions, induced constraint movement therapy, splinting, mirror therapy, sensory training, mental training, task- oriented approach, resistive exercises, bilateral exercises and electrical stimulation of the upper extremities in stroke patients were enrolled in these articles.Conclusion: The results of the study and the experts were focused on induced constraint movement therapy, robotic assistive devices, mirror therapy, sensory re-education, mental practice and task-based approach in the rehabilitation of hand function in stroke patients. Results were presented in the field of occupational therapy in improving upper extremity function of stroke patients in booklet format.

Background and Aim: Auditory and speech processing is based on bottom – up (data – driven) processing which in turn depends on acoustic signal input and integration of central auditory pathways. Moreover interpreting auditory information involves top- down (concept – driven) processing, which is dependent on higher central resources such as working memory capacity and attention. Working memory has important function in auditory perception process and deficit in working memory causes auditory processing disorder. This study was aimed to introduce importance of working memory in auditory information processing and evaluate its role in CAPD children according to recent clinical researches Materials and Methods: For reviewing of the latest literature about function of working memory in auditory information processing from 2000 till now, articles were selected from Pubmed, Science Direct, Google Scholar, Proquest data sources.Results: Detecting auditory processing disorder needs complete approach which consider assessment of cognitive factors such as working memory and central executive function. It should be emphasized, that in addition to central auditory processing tests, assessment of bottom-up and top-down processing should be considered.