mahmoud jalili

Splinting is the most common conservative method of treating patients with mild and moderate Carpal Tunnel Syndrome (CTS). The aim of this study was to determine the effectiveness of the limited dynamic wrist splint on the symptoms, function, and strength of women with CTS. In this controlled trial study, the subjects wore a splint of a new design called the “limited dynamic wrist splint”, which allowed the wrist motion in the range (between 15-degree flexion and 15-degree extension) that exerts minimum pressure on the median nerve and prevents extra pressure on the nerve by limiting the range of motions out of the allowed range.
In this study, 24 women diagnosed with mild to moderate CTS were initially evaluated on the basis of the Boston questionnaire, the dexterity test of the Purdue pegboard, grip and pinch strength, distal sensory latency, and sensory nerve conduction velocity. The subjects were randomly divided into two groups, control and treatment. Both groups received routine rehabilitation treatment for six weeks. The treatment group received the limited dynamic wrist splint for about six to eight hours a day. After six weeks, the initial examinations were repeated. The SPSS-16, independent t, and paired t-tests were used for data analysis.
All the variables in the treatment and the control groups showed improvement. The function test of the Boston questionnaire, the Purdue pegboard test, and the pinch strength were significantly improved in the treatment group. The “severity of the symptoms” test of the Boston questionnaire and the pinch strength in the control group showed a statistically significant difference (P This study showed that the use of the limited dynamic wrist splint for about six weeks for six to eight hours a day could have a significant effect on the function, dexterity, and the pinch strength of patients with CTS. Not only can the patients receive treatment by this method, but they can also perform their daily activities to some extent.

Cerebral palsy (CP) children are the most referral patients to occupational therapy centers. Hand function is important in activity of daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splint are commonly used to improve the position، range of motion، quality of movement، arm and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old. This interventional study is in a before-after design for two group case and control. Thirty spastic diplegic cerebral palsy children with 8 to 12 years old who had the inclusion criteria، were randomly assigned to case and control group. Patients of case group used a static anti-pronation splint for 2 months، 8 hours daily. In this study the Jebsen Taylor test was used to evaluate upper extremity function، the Goniometer was used to measure ROM of elbow، forearm and wrist، the Modified Ashworth Scale was used to assess spasticity of elbow، forearm and wrist. Power grip and pinch were assessed with MIE device. In the case group results showed a significant improvement in upper extremity function (0. 026)، forearm supination ROM (0. 007)، wrist extention ROM (0. 005)، forearm muscle pronator spasticity (0. 001)، wrist muscle flexsor spasticity (0. 009)، power grip (0. 001) and pinch (0. 001). The data did not show significant improvement on elbow extention ROM (0. 075)، elbow muscle flexsor spasticity (0. 164). In comparison with control group، the data showed a significant improvement in upper extremity function (P=0. 001)، forearm supination ROM (p=0. 034)، wrist extention ROM (P=0. 042)، forearm muscle pronator spasticity (P=0. 009)، power grip (P=0. 001) and pinch (P=0. 001). The data did not show significant improvement on elbow extention ROM (P=0. 140)، elbow muscle flexsor spasticity (P=0. 638) and wrist muscle flexsor spasticity (P=0. 105). The findings show that using static anti-pronation splint for 2 months، 8 hours a day، can be an effective method to improve upper extremity function، range of motion of forearm and wrist، forearm spasticity and power grip and pinch in spastic diplegic cerebral palsy children with 8 to 12 years old.

Diagnosis of kidney scar could prevent vesico urethral reflax and its complications such as hypertension and renal failure. This study was conducted to determine average kidney length and volume in infants by sonography to accurate diagnosis of scars. This study was conducted on infants with the history of UTI who referred to Imam Reza Hospital, Kermanshah Iran, for DMSA scan. They underwent kidney sonography before DMSA scan. Difference in kidney length and volume were calculated and data was recorded and were analyzed using statistical tests. Right kidney length was less than left in 60% of right kidney scars this rate was 77.8% in nonscar patients (P=0.657). Left kidney length was less than right in 50% of left kidney scar and that was 22% in nonscar patients (P=0.241). Kidney volume was smaller than other side in 55.6% of right kidney scar and 62.5% of left kidney scar. Higher length detected in 100% and 47% of right and left kidney inflammation respectively. Higher volume detected in 40% and 76.5% of right and left kidney inflammation. In comparison with other studies suggesting kidney length as a valuble predictor for diagnosis of scar we did not find any relationship between scar and kidney length or volume.

Cerebral Palsy (CP) is a neurodevelopmental disorder caused by non-progressive lesions in single or multiple locations in the immature brain. Lesions of motor cortex and pyramidal tracts can lead to spasticity. Inhibition of spasticity is necessary to increase extremity mobilization, prevent postural abnormalities and provide independence in daily living activities. The purpose of this study was to determine the effects of volar static splint spasticity and range of motion of upper extremity in children with Cerebral palsy in threeperiods of time. The design of this study was experimental and repeated measurements. Ten children with Cerebral palsy aging 4-6 years old were non-randomly selected among children referred to occupational therapy Clinic of rehabilitation Faculty of Tehran University of Medical Sciences. Children used dorsal static splint for three months (2 hours at day and 4 hours at night). In this study, Modified Ashworth Scale was used to evaluate spasticity and a Goniometrewas used to measure passive range of motion. The results of this study showed significant reduction in the upper limb spasticity after 2 months (p≤0.0001) and significant increase in wrist passive range of motion after one, two and three months (p=0.007, p≤0.0001 and p≤0.0001, respectively) and significant increase in elbow passive range of motion after two (p=0.009) and three (p≤0.0001) months. This study shows that use of dorsal static splint in children with Cerebral palsy for 3 months has significant effects on reduction of upper limb spasticity and increasing passive range ofmotion of the wrist and elbow joints.

Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Any functional disorder in the hand can cause a person's independence to be disrupted and therefore his or her social independence is threatened. The purpose of this study was to determine the effects of volar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic children. The design of this study was clinical trial and before_ after. Fourteen 8 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patient used a volar static splint (10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb) for 2 mounts (2 hours during day and 4 to 6 hours at night). In this study Jebsen Taylor Hand Function Test was used to evaluate hand function. Modified Ashworth Scale was used to evaluate spasticity. A Goniometer was used to measure range of motion. The results of this study showed significant improvement in hand function, significant reduction in wrist spasticity and elbow spasticity and significant increase in wrist range of motion The data did not show any significance in elbow range of motion. Our findings suggested that 2 months using of volar static splint in children with spastic cerebral palsy can improve hand function, wrist and elbow spasticity and wrist range of motion.

Spasticity is one component of the upper motor neurone syndrome, which is characterised by a velocity dependent increase in the tonic stretch reflexes. This study aimed at investigating the interrater reliability of the Modified Tardieu Scale in the assessment of muscle spasticity in stroke patients. In this analytical and validity testing study 30 patients with spastic hemiplegia were selected by simple sampling from clients of central nervous system disorders clinic of Tehran University of medical sciences. The two muscle groups in affected upper limb were tested using a standardized procedure. These were elbow flexors and extensors. Assessment was done by the two occupational therapists during the same session. The order of assessment and the sequence of muscle testing by the two raters were random. The interrater reliability was calculated for the different subsales of Modified Tardieu. The reliability was tested with the intraclass correlation coefficient (ICC). For the Modified Tardieu Scale scores, the Cohen’s Kappa test was used to analyze the level of agreement between the raters. The values of ICC for both muscle groups were high. The ICC for R2-R1 as main outcome measure for determination of spasticity severity was 0.99 and 0.95 in the flexors and extensors, respectively. The Kappa values in muscles reaction quality were 0.88 in flexors and 0.89 in Extensors. The Modified Tardieu Scale provides high interrater reliability in the assessment of muscle spasticity after stroke.

Assessment of balance in children with neurological disorders is quite necessary in any rehabilitation therapy. There are various versions of balance tests for balance assessment of adults however, little has been done with regard to introducing a reliable test for evaluation of the balance in children with spastic cerebral palsy. The purpose of this study was to investigate the inter and intrarater reliability of Berg balance scale in children with spastic diplegia. In this descriptive and methodological study twenty spastic diplegia children with non probability selection participated. Children were in the range of 6-12 Yrs (Mean, SD, 7/35 &1/84 yrs, respectively). Parents were asked to sign an informed consent. Berg balance scale was tested in one session by two therapists for interrater reliability (inter-rating) and repeated tests were tested for intrarater reliability (intra-rating). Intraclass correlation coefficient (ICC) test was used for interrater (between two therapists, ICC= 0/985, P<0/001 and intra rater reliability repeated test by the same therapist, ICC= 0/994, P<0/001). The result of this study suggests that inter-rater and intra-rater reliability of Berg balance scale is acceptable. Therefore, it could be used in clinic for the assessment of children with spastic diplegia as a reliable scale.