Journal of Paramedical Science and Rehabilitation
Year:2020 | Volume:8 | Issue:4|Papers Count:9

Purpose: It is important to recognize the mechanism of forces applied on lower limbs and back during walking with high heel shoes. Raising public awareness about the disadvantages of using these shoes is effective in reducing the incidence of related musculoskeletal disorders. Therefore, the present study aims to investigate the effect of high heel shoes on muscle forces and joint contact forces during walking. Methods: A total of 9 young girls with a mean age of 21. 34 ± 3. 83 years, height of 1. 49 ± 0. 14 meters, and a weight of 593. 25 ± 17. 24, were randomly included in this study. The Qualysis motion analyzer and Kistler's Forces Plate were used to record data. Open-SIM software was used to extract muscular force and joint contact force. Data were analyzed by paired sample t-test at the set point of 0. 05. Results: Gluteus medius muscle forces during walking with high heels was 46. 4 (N/BW) which was 1. 96 (N/BW) greater than walking without shoes (p=0. 02). The forces applied on the hip joint in mediolateral plane was significantly higher than walking with bare feet (p=0. 001). The vertical force applied on lumbosacral joint during walking with high heel shoes was significantly greater than walking without shoe (p<0. 001). Conclusion: Gletus medius muscle force, hip joint contact force on the frontal plane, and the vertical joint contact force of the lumbosacral joint was significantly increased while walking with high heel shoes. It can be said that continuous use of high-heeled shoes, not only affect the hip joint, but also affect the lumbosacral joint and can be a source of damage to theses joints, and may endanger at the risk of osteoarthritis. Therefore, it is recommended that these users avoid to wearing high heel shoes because of the traumatic consequences.

Purpose: According to several studies, people with childhood onset fluency disorder show differences in executive functions compared with normal peers. The purpose of this study was assessment of 7-12 years old children with childhood onset fluency disorder and in four areas of executive functions including sustained attention, Auditory working memory, reaction time and response control. Methods: This research was a comparative study. Twenty children with childhood onset fluency disorder and 20 normal children were selected through Speech Therapy Centers and schools in Tehran. They were tested by auditory (N BACK) to measure auditory working memory, continuous performance test (CPT) to evaluate sustained attention and reaction time and the go / no go test to measure response control. Also, the severity of non-fluency was measured by using the percent syllables stuttered. The results were analyzed by independent T-test and Walsh test. Results: The results showed the significant differences between children with childhood onset fluency disorder and normal peers in the areas of sustained attention (p=0. 019), auditory working memory (p=0. 038) and response control (p=0. 033). However, no difference was observed between the scores of children with childhood onset fluency disorder and normal children in the area of reaction time (p= 0. 329) (p>0. 05) Conclusion: The results showed that children with childhood onset fluency disorder are weaker in three areas of executive functions such as sustained attention, auditory working memory, and response control in comparison with their normal peers.

Purpose: Considering the increased population of elderly people, performing research on potential interventions to reduce the function drop is of central importance. Therefore, the purpose of this study was to compare the effect of three strength training programs (with and without blood flow restriction and traditional), on strength, hypertrophy and mobility function in elderly women. Methods: 33 elderly women (age ranged 60-70 years) were selected and randomly divided into three groups: resistance training with blood flow restriction (n= 11), resistance training without blood flow restriction (n= 11) and traditional strength training (n= 11). Functional tests were taken before and after the 12-week training period. One-way repeated-measures ANOVA was used to determine difference between groups. The significance level was set at p<0. 05. Results: There were no significant difference in hand grip strength (measured by hand grip dynamometer), lower body muscle strength (measured by leg extension machine), muscle hypertrophy (measured by anthropometric measures) and functional mobility (measured by TUG test) between groups. Conclusion: All three strength training programs i. e. resistance training with and without blood flow restriction and traditional resistance training have the same effect on muscle mass and strength, and functional mobility of elderly women. Therefore, resistance training with and without blood flow restriction with lower loads, which require less effort and possibly safer are recommended for elderly women.

Purpose: Multiple Sclerosis is a vascular disease in the central nervous system. There is evidence that Clostridium perfringens epsilon toxin causes damage to the myelin of the neuronal cells by increasing the permeability of the blood-brain barrier, and therefore contributes to the disease. Therefore, the aim of this study was the molecular identification of C. perfringens Epsilon toxin in samples isolated from multiple sclerosis patients using multiplex-PCR. Methods: In this descriptive cross-sectional study, 60 stool samples of patients with multiple sclerosis and 60 specimens of healthy individuals were studied. -toxin producing C. perfringens infection was examined by the M-PCR method after genomic DNA extraction. Results: of 60 fecal specimens obtained from patients with multiple sclerosis, 11 (18. 3%) and 2 (3. 3%) samples were positive for 16S rRNA and ε-toxin-encoding gene, respectively. Conclusion: The results of this study showed that the prevalence of C. perfringens toxigenic strains in MS patients are higher than in the control group, which can indicate the association between the presence of this toxin and MS disease.

Purpose: Postural control and balance take place through the central nervous system based on the system inputs involved in balance (visual, vestibular and sensory-motor). The aim of this study was to compare the postural control strategy in hearing elite with deaf elite wrestlers. Methods: This study was causal-comparative research, and samples were selected from elite hearing (10 subjects) and deaf (10 subjects) wrestlers present in the national’ s team. A computer dynamic Posturography device was used to measure the variables of the research including trunk sway and changes the center of gravity in the horizontal (X) and vertical (Y) axis using sensory organization test (SOT). To check the normality of the data, the Shaipro-wilk test was used and independent t-test was used for comparison of variables between groups at a significant level (p≤ 0. 05). Results: findings show that of the six positions related to the postural control, only variable of stability in the fourth condition was significantly different between hearing and deaf elite wrestlers (p≤ 0/05) in proprioception manipulation while visual and vestibular sensory signals were available between the groups difference. However, for the variables of the center of gravity in the horizontal axis (X) and vertical (Y) no significant differences were noted in any situations related to postural control between hearing and deaf elite wrestlers (p≥ 0. 05). Conclusion: According to the results of this study, it can be stated that a defect in one sense can be largely offset by other sensory inputs and other systems involved in postural control. In the fourth condition, while the visual and vestibular sensory signals are available and proprioception is manipulated, a significant difference is observed between the groups. So that it can be concluded deaf elite wrestlers are more dependent on the proprioception sense of hearing and deaf elite wrestlers.

Purpose: Word definition skill is one of the sophisticated language skills with linguistic and meta-linguistic knowledge play important role. Hearing impairment in children leads to delays in receptive and expressive language learning. This study aims to investigate and compare the growth of the content aspect of the word definition skill for hearing-impaired and normal-hearing children between 4. 5 and7. 5 years old. Methods: This study had a descriptive-analytic cross-sectional method. Statistical population included 37 hearing-impaired (by hearing aid and cochlear implant) and 37 normal-hearing children from 4. 5 to 7. 5 years old in Karaj. In both groups, there were 10 children from 4. 5 to 5. 5 years old, 12 children from 5. 5 to 6. 5 years old, and 15 children from 6. 5 to 7. 5 years old. The studied groups included 15 hearing-impaired girls and 22 hearing-impaired boys. Our test was the word-defining skill test that had made by Mehri Mohammadi for the first to third grade elementary school children, and then the validity of this test was confirmed by Maryam Malekian for the 4. 5 to 7. 5 age group. The data were analyzed using t-test statistics in SPSS software (version 22). Results: The results revealed that the performance of hearing-impaired children in the content aspect had a significant difference with normal-hearing children (p = 0. 007) and normal-hearing children showed better performance than hearing-impaired children. Conclusion: According to the results, there is a delay in content aspect of the word-definition skill as the other language skills in hearing-impaired children and then training and rehabilitation are needed.

Purpose: Genu varum is one of the most common mal-alignments of lower limb associated with dysfunction. However, little attention has paid to limb alignment and muscle activities while performing sport-specific tasks in persons with genu varum. The aim of this study is to compare the Effect of Genu Varum on the Pre-activation، Muscle Activation Pattern and Time to Stabilization During the Single Leg Jump-Landing Methods: In this cross-sectional study, 30 athletes (15 with and 15 without genu verum) participated. Genu varum was assessed with caliper with the accuracy of 0. 01 mm. The time to stabilization was measured using force plate in the jump-landing motion. The data obtained from electromyography that synchronized with the force plate and the onset of muscle activity were calculated and analyzed in MATLAB. For the statistical analysis, independent samples t-test with the significance level of p≤ 0. 05 was used. Results: The results showed that the activity of the gluteus medius muscle (p=0. 003) in genu varum knee is less than normal, and this difference was statistically significant. There were no significant differences in the activity of gluteus maximus, biceps femoris and semitendinosus between the two groups. In addition, no significance difference was observed in the onset of muscle activity between groups (p>0. 05). Moreover، the comparison of time to stabilization in the medial-latera (p=0. 003) and overall (p=0. 01) in participants with genu varum knee is higher than normal participants, and this difference was significant. Yet, in the anterior-posterior direction, there was no significant difference between the two groups (p>0. 05). Conclusion: It seems that genu varum is influential on the biomechanics of jump-landing and it is associated with reduced activity in the gluteus medius muscles. These changes may be associated with reducing lateral stability and increased risk of injuries in the athletes.

Purpose: Low-vision children face major challenges in educational settings. The aim of this study was evaluation of vision among these children in relation to their educational right. Methods: a clinical study was conducted at four exceptional schools for blind and partially sighted children in Tehran capital of Iran. These examinations included measuring distant and near visual acuities as well as refractive errors. These examinations were carried out at the low vision clinic in Iran University of Medical Sciences. Results: A total of 273 children were studied. of these, 40 individuals (14. 7 %) are able to study at normal school. 68 people (25 %) who studying with Braille are able to continue to study with their vision. 68 people (25 %) need spectacles. 26 people (9. 5 %) need dark room exercises, but these facilities are not available. 36 people (13 %) have special needs, such as cosmetic surgery, artificial eyes, contact lenses, and special sunglasses. Some of the students studying with Braille claim that they are able to read Braille with their eyes, but they are not allowed to use their vision. Teachers usually use the blindfold to avoid child to see in order to teach them Braille. Conclusion: The educational rights of low-vision children in the light of the general principles of law, such as the principle of justice and fairness, must be evaluated. The right of education is an example of the rights of citizenship and human rights. Therefore, it is necessary for the legislator to take special care and special attentions for particular groups, such as low-vision children. Growth and development during childhood have a great deal of dependence on vision. For infants and children creating visual memory is considered as a reference for future activities. In low vision rehabilitation, the residual of the vision should be used more effectively. Otherwise, the problem of growth and development will also spill over these children. It seems that the rights of visually impaired children in our country, Iran, needs serious reconsideration.

Purpose: The importance of foot position has been widely accepted for biomechanics of various functional movements including fundamental motions (like walking and running), sport performance and job tasks. The aim of the present review study was to assess the effect of change in foot position on electrical activity of human muscles during various movement tasks. Methods: Papers with Persian and English languages published in Google Scholar, PubMed, Science Direct, databases, SID, Magiran, and Irandoc databases were searched between years of 2000 and 2018. For extracting relevant papers, keywords of “ Foot position” , “ Foot wedge” , “ Electromyography” , and “ Muscle Activity” and a combination of them were used. Results: Among the relevant articles, twenty studies were selected for review. Generally, previous studies have shown that the application of wedge in back and front regions of the foot increases and decreases the level of muscle activity, respectively (mainly lower extremity area), but the effects of medial and lateral foot wedges are unclear. Since different analysis methods of raw free signals can have a significant impact on the output value of electromyographic variable signals; comparing the results of different studies should be undertaken with caution. Conclusion: It seems that the limitations of previous studies in examining the effects of changes in the foot position are related to the following issues. Non-use of people with various types of foot abnormalities; lack of assessment of the trunk muscles activation; lack of using appropriate electromyography signal processing methods; and application of the wooden wedges for changing the foot position instead of real foot orthotics. Therefore, there is a need for further studies on the above issues.