Archives of Rehabilitation (Journal of Rehabilitation)
Year:2003 | Volume:4 | Issue:14-15|Papers Count:16

Introduction:Acute inflammatory demyelinating peripheral neuropathy (Guillain-Barre-Syndrome) is by far the most common cause of immune -mediated peripheral nerve disease in children and with the near disappearance of poliomyelitis, is responsible for the great majority of cases of acute flaccid paralysis. Several controlled studies have done with corticosteroids, plasma pheresis and IVIG in pediatric patients.IVIG treatment can be done in two types of treatment:1- High dose that means 1gr/kg/day for 2 days.2- Low dose that means 400mg/kg/day for 5 days.Several studies in another countries have shown faster rate of recovery in patients who received total dose of IVIG in 2 days as opposed to 5 days.Material & methods: Because we have not any study about this two types of treatment in IRAN we decided to comparison this two types of IVIG treatment. So the patients that referred to Mofid children hospital for weakness and we diagnosed GBS (with history, physical examination, laboratories and EMG - NCV) are divided in two groups:1-High dose IVIG treatment (experimental group).2-Low dose IVIG treatment (control group)Then the results evaluated.Results & conclusion: Our findings included that in high dose IVIG therapy we have faster rate of recovery and the Hospital stay is shorter than low dose IVIG-therapy.Also in this type of treatment "because the patients cure faster", so complications are decreased in them. In the group of high dose IVIG therapy, lower and upper extremities weakness decreased in time. We did not receive any relationship between side effects of drugs and the type of treatment. The relationship between high dose IVIG therapy and drug side effects was not significant.

Despite numerous advances in our understanding of the anatomy, Biomechanics, nutrition and Healing, the result Following Fiewor Tendon repair Shiow relatively high rate of failure the purpost of this study was to compare the result of 50 digits treated by either Early active mobilization or controlled passive mobilization re gimen in Ivan hand rehabilitation center. Mathod: Pationt being matched for gende, age, injuries hand, technique of srgery ( all with eqitenon first, four strand) in two groups. They Were assessed 8 week postoperatibg in respect of total active motion, flexion gap and extension lag. Outcome were defined using “Strickland” and “Buck – Gramko” criteria. Findings: The result were 80% excellent and good, 20% fair and no poor in early active motion group and in second group 40% excellent and good, 44% fair and 16% poor due to Strickland criteria. In buck-grancko criteria 52% extension and good, 32% fair and 16% were poor. Mean of total active motion was significantly greater in early active motion group (in E.A.M.150.2, in passive group: 116.41).conclusion: Actively mobilized tendon underwent intrinsic healing without large gap formation. Active motion generated bith tension and motion and offer several advantage over passive motion: improved tendon nutrition , less adhission, higher rate of healing, increased ultimate rang of motion. So early active motion is the best protocle for treating tendons in zons 2 Our result is comparable with theory.

Introduction: Increased normal thoracic kyphosis due to postural reasons is one of the conditions which needs accurately be measured for better evaluation and treatment .Flexible Ruler is a tool which measures the amount of kyphosis non-invasively but there is not any study about its validity and reliability in postural hyper Kyphotic subjects. The objective of this study was investigating the validity and reliability of measurement taken by flexible ruler in quantifying the amount of thoracic kyphosis in postural hyper kyphotic patients. Materials & Methods: In 25 patients with postural hyper- kyphosis and 15 healthy subjects we measured the amount of kyphosis twice using flexible ruler by a single tester. In kyphotic subjects also the amount of kyphosis was measured as Cobb angle on radiographic films in two times by one tester and repeated in one time by another tester. The Reliability of measurements in two subject groups and validity of measurements compared with radiology in kyphotic group was studied.Results & Conclusions: In both of the groups we found excellent Intratester reliability in measurement of kyphosis using flexible ruler. The measurement of kyphosis on radiological films also had excellent Intratester and intertester reliability. The validity of the measurement of kyphosis angle using flexible ruler was very good but the"Index of Kyphosis" on the curve taken by flexible ruler had poor validity. Based on our results, the flexible ruler can be used as a valid and reliable tool for non - invasive measurement of thoracic curve in healthy and postural kyphotic subjects.

Introduction: Results of some studies suggest that Baclofen (a GABA receptor agonist) maybe effective in detoxification of opium dependency. Thus we have done this study in order to identify possible efficacy of Baclofen for detoxification of opium dependency. Materials & methods: This study is a double - blind randomized clinical trial. We selected 52 patients with opium dependency and with other criterias that we have designed on the basis of DSM-IV TR. Then we randomly assigned patients to two outpatient groups. The first group received Baclofen (40 mg/day) and second group received placebo for two weeks accompanied by similar drugs. The severity of the opium withdrawal symptoms was measured by SOWS (short opiate withdrawal scale) and two other questionnaires for measuring mental and physical symptoms of opium withdrawal in days of 0, 2, 4, 7 and 14.Results & Conclusion: Baclofen group showed a superiority over placebo in the management of withdrawal symptoms of opium dependency, but there was not a significant statistical relationship.Baclofen maybe considered as an effective adjuvant agent in the management of mental and physical symptoms of opium withdrawal. However further studies to confirm our results is warranted.

Introduction: Muscle weakness and atrophy due to immobilization and disuse are most common problems that clinicians specially physiotherapists encounter with them. There are many approachs for overcoming these problems, the more intresting of them is cross transfer effect of uninvolved limb exercises . The aim of this study was to investigate the bilateral effect or cross transfer effect of unilateral quadriceps exercises in terms of strength, endurance and electromyographic activities on contralateral homologue muscle.Materials & Methods: 46 healthy male student ( 22.5 yrs, SE =4.5) participated in this study , 23 of them were in experimental group who undergone 3 weeks of strengthening exercises , and 23 control group continued their usual life . Variables including MVC, ( Maximal Voluntary Contraction ) , END ( Endurance ) , IEMG ( Integrated Electromyography ) were measured before and after 3 wks in all subject.Finding: Data analysis (Paired T Test ) revealed that in experimental group all variables of both trained and nontrained quadriceps muscles had been significantly changed (P<0.001).Result & conclusion: Having no change in control group, these findings approve cross transfer effect of unilateral exercise on homologue muscle. Since changes were same in both trained and contralateral nontrained limbs, so the most probable mechanism of this phenomena in neural adaptation and magic CNS interaction to establish symmetry and equilibrium in the body.

Introduction: to investigate whether a neoprene sleeve and elastic bandage around the knee joint of subjects with knee osteoarthritis (OA) would, in short term (a) reduce pain (b) improve knee joint position sense and comparison of their effect with each other if they have. Materials & Methods: In a semi-experimental study, 30 subjects (11 men, 19 women, age between 33-75) with unilateral knee OA. Subjects had to have at least 2cm from 10cm visual analogue scale (VAS) of knee pain for study entry. All patients were randomly assigned to either an elastic bandage or a neoprene sleeve. One week later they were assigned to the opposite selection. Joint position sense was assessed in the sitting position using an electrogoniometer and pain by VAS where 0cm equals no pain and 10 cm equals worst pain. Knee pain and JPS were assessed for each selection one week apart. During each visit assessment were performed at baseline and after 20 min of bandage/neoprene sleeve application.Finding: the mean of scores for knee variables JPS and VAS was taken and paired-t test and Wilcoxon signed rank test was employed to calculate the different between two trails. Neoprene sleeve had significant effect on knee JPS (P=0.037). But elastic bandage had no effect (P=0.631). Both of them had significantly reduced knee pain. (P=0.000).Results & Conclusion: In subjects with both neoprene sleeve and elastic bandage reduced knee pain with more effect of neoprene sleeve. Only the neoprene sleeve had effect on knee JPS.

Introduction: Early Diagnosis and intervention of primary stuttering is the key for prevention of chronic developmental stuttering. Normal nonfluency of children under 5 years old is an important differential diagnosis of primary stuttering. The goals of this research are finding accuracy of diagnoses on children referred to Saba speech therapy Clinic labeled as normal nonfluency and introducing move precise methods of differential diagnosis.Materials & methods:The research method is case series study in which through simple sampling procedure stuttering children referring to SabA Clinic during 1382 & 83 were studied. 10.Research tools and data collection consist of: questionnair, spontaneous speech sample recording and determining VOT using laryngograph processor.It should be noted that because normative date of stutteres VOT the lack of the normal subjects VOT are analysed and comared with stutterers.Findings:Based on numerical criteria, our findings indicate that only one of stutterers was normal nonfluent and the others were stutteres. VOT data of stutteres also were compared to that of normal matched children. The results revealed that all of stutterers had significantly (p< 0.05) longer VOT than normal subjects.Result & Conclution:v This study provides a good numeric and clinical index for speech language pathologists for diagnosis of primary stuttering and normal nonfluency. Morover,. using VOT would help accurate diagnosis.

Introduction: Multiple sclerosis (MS) is a neurological disease that causes sudden deaf. In this research auditory disorders were studied in the patients with multiple sclerosis (MS).Material & Method: This cross sectional descriptive-analytical study was performed on 107 patients with multiple sclerosis in the range of 20-45 yrs. There were not history of trauma and middle ear disease in all cases. Sampling was randomized. A complete auditory evaluation including pure tone audiometry, speech audiometry, imittance audiometry and brainstem Auditory Evoked Potential were performed on patients. Finding: In pure tone audiometry 62,19% of cases had sensory neural high tone loss. In speech audiometry and imittance audiometry 18 and 31 cases were abnormal, respectively. 14,55% of cases had abnormality in BAEP. The most of abnormalities were prolonged latency of V, decrease of V/I amplitude ratio and poor reproducibility, respectively. With high rate of stimulation 57,77% of cases were abnormal. Statistical analysis showed significant difference between latency of V and stimulation rate. result & conclusion: According to findings of this research it seems that hearing evaluation is very important for follow-up and early rehabilitation of auditory disorder in patients with MS. Also auditory test battery especially BAEP with high stimulation rate are useful in the diagnosis, BAEP, High stimulation rate.

Introduction: Scapulothoracic muscles weakness or fatique can result in abnormal scapular positioning and compromising scapulo - humeral rhythm and shoulder dysfunction. The scapula moves in a -3 Dimentional fashion so the use of 2-Dimentional Techniques cannot fully capture scapular motion. One of approaches to positioining markers of kinematic systems is to mount each marker directly on the skin generally over a bony anatomical landmarks. Howerer skin movement and Motion of underlying bony structures are not Necessaritly identical and substantial errors may be introduced in the description of bone movement when using skin - mounted markers. Objective :evaluation of Influence of marker movement errors on 3- Dimentional scapular position and orientation Materials & Methods: 10 Healthy subjects with a mean age 30.50 participated in the study. They were tested in three sessions A 3-dimentiional electro mechanical digitizer was used to measure scapular position and orientation measures were obtained while arm placed at the side of the body and elevated 45,90,120 and full Rang of motion in the scapular plane. At each test positions six bony landmarks were palpated and skin markers were mounted on them.This procedure repeated in the second test session in third session Removal of markers was not performed through obtaining entire Range of motion after mounting the markers. finding: The intraclass correlation coefficients (ICC) for scapulor variables were higher (0.92-0.84) when markers were replaced and re-mounted on bony landmarks with Increasing the angle of elevation. Results & Conclusions: our findings suggested significant markers movement error on measuring the upward Rotation and posterior tilt angle of scapula.

Thanks to new techniques in Pediatric Neurology, nowadays we are more able to detect and differentiate different diseases of the nerves and muscles in children. Although these techniques are sometimes more sensitive and specific than EMG in children, but EMG and NCV study has its specific role in pediatric neurology and this is because of more availability and feasibility of these tests in children. One of the main Limitations of EMG techniques especially in pediatric age group is the pain induced by the insertion of needle electrodes into muscle as well as electrical stimulations needed to do NCV and other studies. So, all the experts in the field are trying to find some methods to reduce the pain induced by this technique. I have tried to introduce some of these methods after a brief explanation about pediatric EMG technique.

Introduction: Hereditary Hearing loss (HHL) affects one in 2000 netborns and more than 50% of these cases, the loss has a genetic basis. About 70% of HHL is non-syndromic with autosomal recessive mode of inheritance accounting for ~85% of the genetic load and more than hundred loci have been estimated for this kind of deafness. Materials and Methods:A 4-year-old boy and her sixteen-year- old sister, both suffering from congenital deafness without any other clinical symptoms were referred to Genetics Research Center to be screened for molecular basis of their phenotype. Bases on clinical observation, autosomal recessive non-syndromic hearing loss was dignosed for both of them. Using linkage analysis their phenotype localized to 6p21-3 chromosome in which COL11A2 has been located Several mutations have been reported in this gene associated with stickler syndrome type3 and non-syndromic hearing loss, both with autosomal dominant form of inheritance. Finding:In this study linkage between COL11A2 gene in DFNA13 locus, causative for autosomal dominant hearing loss, and phenotype of autosomal recessive non-syndromic hearing loss in and Iranian family was analyzed and Pro621Thr mutation was found in this family.Result & Conclusion:Pro 621 Thr mutation found in this study is the first report of COL11A2 mutation associatied with autosomal recessive non-syndromic hearing loss.