مجله پژوهش در علوم توانبخشی
سال هفتم شماره 4 (بهمن و اسفند 1390)

Human hand is a complex and fine structure whose function and strength can be affected by even a mild injury. Hand dynamometry is one of the most accepted methods for evaluating the integrity of hand function. Nerve conduction velocity (NCV) is a noninvasive procedure to ensure neuromuscular integrity of the hand.

In a cross-sectional study, 39 women with an age ranging from 30 to 60 years who attended the Vahid Electrodiagnostic Center (Isfahan-Iran) during the fall of 2009 were studied. Informed consent was signed by all subjects. All participants were asked to perform grip and all types of pinch grip with a dynamometer. Nerve conduction velocity was conducted for both hands. All data obtained from the dynamometer and NCV were statistically analyzed via Pearson correlation test using SPSS software version16.

There were significant differences between sensory and motor NCV of median nerve for Pinch strength (maximum correlation was noted for Motor NCV with Palmar Pinch1, P < 0.001, r = 0.379) versus Grip strength (maximum correlation was with Motor NCV, P < 0.002, r = 0.342). There were significant differences between Median Severity Scale for different types of Pinch strength (max correlation with Palmar Pinch1, P < 0.001, r = -0.613), different types of Grip strength (P < 0.001, r = -0.563) and NCV (max correlation with Sensory NCV, P < 0.001, r = -0.562)

Dynamometer may be a prognostic tool to determine the amount of median nerve involvement since it measures the strength of thenar musculature. Also Median Severity Scale is a good clinical means to prognosticate median sensory and motor NCV.

Vocal nodules are non-malignant lesions of vocal cords caused by vocal misuse and abuse. Nodules can be viewed as the reaction of vocal tissue to a constant stress induced by frequent and severe movements. Acoustic signs of people with vocal fold nodules somehow differ from those with normal voice. However, there is no universal agreement on the exact amount difference between acoustics of normal voice and pathologic voice heard at the presence of vocal nodule and this, in turn, has resulted in different reported acoustic measurements. In this study, we used the standardized Rangin Kaman passage for vocal assessment of normal people and patients with voice nodule. In a cross-sectional descriptive– analytical study, 20 people with normal voice (10 males and 10 females) and 20 patients with vocal nodules (10 males and 10 females) with an age range of 40 to 59 years were randomly assigned into two age groups of 40 to 59 and 50 to 59 years. Each of these age groups included 10 subjects with normal voice (5 males and 5 females) and 10 ones with bilateral vocal nodules (5 males and 5 females). Thus, 20 voice samples were obtained from each age group. These voice samples were acoustically compared to each other on the basis of fundamental frequency and fundamental frequency variation range. Results showed that the differences in fundamental frequencies was significant when all samples were considered (P = 0.043). For detecting local differences, repeated analysis of variance was performed for men and women separately. In men, significant differences of fundamental frequency were neither observed between normal and pathological samples nor between two age groups as a whole (P = 0.59). In women, differences of mean in fundamental frequency between two age groups were significant (P = 0.007). Mean fundamental frequency analysis can discriminates between normal voice and voice with nodules only in 50 to 59-year age group. Although nodules were recognizable through stroboscope, acoustic signs varied depending on the amount of influence exerted by the nodule on the voice.

Based on the crucial role of muscle strength in performance and injury prevention, insufficient muscle strength has been implicated in injuries to soccer players’ lower limbs. This study investigated the effects of an injury prevention training program on knee isometric strength of young professional male soccer players. Twenty-four young professional soccer players with at least five years of experience in playing soccer professionally on a regular schedule were divided into two groups: experimental group (12 players) and control group (12 players). Participants in experimental group underwent a knee preventive intervention program (called “HarmoKnee program”) three times per week for eight successive weeks. A Biodex Isokinetic Dynamometer used to study the hamstring and quadriceps strength at 30˚, 60˚ and 90˚ knee angles. Paired t-test, independent sample t-test and two way repeated measures were used for statistical analysis of data (P < 0.05). The results of this study showed that in experimental group, quadriceps peak torque (PT) increased significantly at 60˚ and 90˚ (P < 0.05). Significant differences were found between hamstring's PT at 30˚ and 60˚ in the experimental group (P < 0.05). Quadriceps muscles PT of the experimental group were significantly different at different angles (P = 0.000). For all cases, quadriceps PT was highest at 90˚ (292.1 Nm). For the hamstring muscle's PT, significant differences were found among three angles in the experimental group (P = 0.000). The most hamstring PT was revealed in 30˚ of the knee joint (155.1 Nm). It is concluded that the HarmoKnee prevention program is a useful program for improving knee muscle strength in young male professional soccer players. Data from this research can help trainers to decide whether players need physical therapy to improve their balance and strength and also are helpful in designing injury prevention programs for young professional soccer players.

Substantial delays in spoken language acquisition have been documented for children with severe to profound hearing loss. Accordingly, areas of linguistic research in this population have shifted from measuring vocabulary size to studies designed to understand word learning processes including semantic development. The purpose of this study was to determine the differences between students with hearing loss and their normal peers on the grounds of synonym comprehension. 78 fifth graders who were all resident in Isfahan participated in this descriptive-analytic cross-sectional study. Of this number, fifty-two students had normal hearing ability and remaining twenty-four ones had hearing loss attending special education classes. The data of interest were gathered via two paper-based tests in which synonyms of each word should be written once in the context of a sentence and once out of such context by each subject. Hearing-loss and normal-hearing groups significantly differed from each other in both tests (P < 0.05). All students in both groups had significantly higher ability in understanding synonyms when words were embedded in the context of a sentence than on the occasions in which target words represented out of the context (P < 0.05). Due to differences between hearing and hearing-loss students, it seems that the semantic category of synonym words is affected by hearing impairment as are other language areas. In addition, the different performance of subjects in two tests implies that synonyms extracted from the context are more difficult than synonyms embedded in a semantic context.

It is estimated that 84% of population experience low back pain at some stage in their life. Given the pivotal role of women, especially rural women, in family management and economic activities and also their key role in society from a national point of view, it is of special importance to find and subsequently prevent the risk factors related to low back pain. So the aim of this study was to compare the prevalence of low back pain risk factors between rural and urban women in Shiraz and surrounding villages. 646 women with the age range of 18-60 years were selected through convenient sampling. All of them were resident of Shiraz or its surroundings and suffered from low back pain. The data of interest were gathered via a reliable and validated custom-made (Cronbach's Alpha coefficient =0.70). The obtained data were statistically analyzed using SPSS software. There was no significant statistical difference between urban and rural groups on the basis of following variables: age, BMI, number of children, pregnancy, osteoarthritis and allergy, typical spinal condition during work, how to sleep, typical time of doing most of work, the average work time, sitting or standing during activity and resting during work time. However, marital status and level of education, doing regular exercise, daily smoking, how to transport heavy objects, bed type, working more than eight hours daily during the past six months, the total resting time during activity and the number of seeking medical advice for spinal discomfort during the past six months showed significant differences between two groups (P = 0.0001). Despite of demographic similarities between urban and rural women evaluated in this study, the existent difference in such factors as bed type, regular exercise, amount of smoking and amount of standing position time among these two groups can lead to more reports of low back pain in rural women.

Cleft palate is one of the most common congenital birth defects. Individuals with cleft palate have certain speech characteristics that can be identified perceptually by speech-language pathologists. Perceptual assessment has been regarded to as the gold standard for evaluating cleft palate speech. Considering the prevalence of cleft palate and its related speech characteristics, it is necessary for clinicians to use a reliable test for perceptual assessment of cleft palate speech errors. The aim of this study was to evaluate Intra- and inter-rater reliabilities for a recently developed assessment tool named "Cleft palate speech assessment test based on universal parameters system– Farsi version". In this descriptive-analytic cross-sectional study, speech samples obtained from 34 five-to-nine-year-old Farsi-speaking children with cleft palate who were referred to Isfahan cleft palate clinic were rated by two speech-language pathologists (one of them was considered as a naive and the other one as an expert rater). Two months later, 30% of the same speech samples were randomly selected and rerated by the same raters. Speech materials included 40 single words and 17 sentences along with a sample of connected speech. Intra- and inter-rater reliability measures were calculated via Intraclass Correlation Coefficient (ICC). Mean Intra-rater reliability measured by ICC was found to be 0.967 and 0.971 for the naive and expert raters respectively. Mean Inter-rater reliability was 0.957 as measured by ICC. This test has an acceptable Intra and inter-rater reliability to be used in assessment of cleft palate speech and can be applied in those studies aimed at evaluating different aspects of speech in Farsi-speaking children with cleft palate aged from 5 to 9 years.

Most people with spinal cord injury (SCI) use wheelchair to move around in living areas. In order to improve their health status, however, these people do need to stand and walk with orthosis. Although lots of orthoses have been designed for paraplegic subjects, they still experience various problems using them. A new type of reciprocal gait orthosis was designed in the Bioengineering Unit of Strathclyde University to solve the problems of the available orthoses. Since there has been no research so far on the effectiveness of this new orthosis for paraplegic subjects, the present study was aimed to evaluate the new orthosis during standing of paraplegic subjects. Five paraplegic subjects whose lesion levels ranged from T4 to T12 participated in this clinical trial study. A control group including normal subjects matched with spinal cord injured individuals was also considered in this study. The stability of subjects was evaluated during quiet standing and when they were standing with either the new orthosis or the knee ankle foot orthosis (KAFO) performing hand tasks. Differences between the performances of paraplegic subjects while standing with each of these orthoses and between the functioning of normal and paraplegic subjects were compared via paired and two-sample t test respectively. The stability of paraplegic subjects in standing with the new orthosis was better than that with the KAFO orthosis (P < 0.05). Moreover, the force applied on the crutch differed between the two types of orthoses. The functional performance of paraplegic subjects was better with the new orthosis and also as compared to that of normal subjects. The ability of the new orthosis to change the alignment of the components, the higher structural stiffness of the orthosis and better fitting was the main reasons for better operation of the new orthosis comparing to the KAFO.

Exposure to undesired and unfamiliar treatment spaces may lead to increased stress and intensified illness in sick and disabled children. Since investigating the experiences and environmental needs of this group of children can improve the quality of these spaces and consequently create more comfort on the behalf of children during treatment sessions, the findings of this study are worth considering. It was a qualitative phenomenological study based on Criterion-based purposive sampling. The study population was comprised of 35 children with the age range of 6 to 12 years suffering from head injury, spina bifida, spinal cord injury and other kinds of lower limb deformations. The children were asked to depict their desired treatment environment and needs based on their experiences. In addition, the researcher helped the subjects to complete their paintings and express their needs using deep open semi-structured conversation. Narrative analysis and subjective coding by Atlas Ti6 were used to analyze the paintings and obtained texts. The codes extracted from the paintings were subsequently categorized into 5 basic themes including entertainments and amusement functions, furniture, decorations, social – emotional communications and sense of security. Study results showed that paying attention to children’s experiences have an important role in enhancing quality of treatment environments. Expressed needs and desires of children regarding natural settings, room decorations, lively colors and natural proper light can be incorporated into designing favorite treatment environments so that they feel relaxed while they are in such settings. These modifications would have the eventual effect of accelerating children’s rehabilitation process.

Hemiparetic cerebral palsy refers to an impairment caused by non-progressive damages to premature brain which is more sever in one side of the body than the other side. The aim of the present study was to determine the effects of combining constraint-induced movement therapy (CIMT) with virtual reality (VR) on upper limb functioning of children with hemiparetic cerebral palsy. In a single blind randomized, controlled trial, 16 children with hemiparetic cerebral palsy, who were selected through a simple random sampling method in Ahvaz city, were divided into 4 groups of CIMT, VR, CIMT+VR, and controls. Subjects in experimental groups participated in one-and-half-hour therapeutic sessions which were held every other day during a four-week period. Measures were conducted pre, post and 3-month after the treatment period using Pediatrics Motor Activity Log and Bruininks-Oseretsky Test of Motor proficiency (BOTMP). Sample randomization and statistical analysis of data through analysis of variance with repeated measures were conducted via SPSS-16 software in which alpha level was set at 0.05. Data analysis for measurement tools was indicative of significant difference of combined group compared to VR, CIMT, and control groups (P < 0.01) (mean amounts of BOTMP, speed and dexterity changed from 0.15 ± 0.08 to 1.89 ± 0.33 in post-test). Data analysis for follow-up session revealed the retention of results for 4 groups (P = 0.32). Incorporating VR and CIMT may improve upper limb functioning of children with hemiparetic cerebral palsy through combining the advantages of both protocols and implementing them in an integrated program.

Muscle strength is one of the most important and effective factors in movement disorders of spastic diplegic children with cerebral palsy. Respecting the fact that strength can influence gross motor functions, the aim of this study was to measure the effects of loaded sit-to-stand resistance exercises on such functions in this group of children with cerebral palsy. 20 cerebral palsy children with spastic diplegia (12 boys and 8 girls), aged between 5 and 12 years (mean, 8.30 years), participated in this study. Loaded sit-to-stand resistance exercises were performed 3 times a week for 6 weeks. Isometric strength of hip extensor, knee extensor and ankle plantar flexor were evaluated by MMT NICHOLAS apparatus. Gross motor functions were measured via GMFM. Data were statistically analyzed through paired t test. The strength of hip extensor and knee extensor increased significantly (P < 0.0001). Moreover, the scores of GMFM dimensions D and E improved significantly (P < 0.0001). Loaded sit-to-stand resistance exercises may enhance muscle strength of lower extremity and increase scores of GMFM.

Health- related quality of life (HRQOL) is an important factor to evaluate the effects of different interventions on cardiovascular diseases. Improvement in HRQOL is an important goal for individuals participating in cardiac rehabilitation (CR) programs. In Iran, however, published data are lacking in this regard. The purpose of this study is assessing the impact of cardiac rehabilitation (CR) on HRQOL in patients with coronary artery disease (CAD). In this queasy-experimental study the files of 100 patients with coronary artery disease (CAD) who were referred to rehabilitation department of Isfahan cardiovascular research center were studied using a randomized sampling method. Demographic data, height, weight and waist circumference were measured. To determine the risk of the disease and designing exercise program, all patients performed an exercise test so that their echocardiography, exercise capacity and ejection fraction were defined before cardiac rehabilitation (CR). Exercise intensity was obtained based on 60 - 80 percent of maximum heart rate during the exercise test. A validated questionnaire called Short-Form 36 Health Status Survey (SF-36) was applied by a trained person to evaluate HRQOL. Cardiac rehabilitation (CR) consisted of 24 sessions each of which included a warm-up, aerobics, a cool-down and relaxation as well as 8 sessions to educate risk factor modification under supervision of rehabilitation team. Finally all the exams were repeated and data was analyzed based on sex and age groups (≥ 65 and < 65 years) using SPSS12 at level of P < 0.05 via independent t test. To compare the quality of life (QOL) score before initiation and after termination cardiac rehabilitation (CR), paired t-test was used. After cardiac rehabilitation (CR) program, scores of all physical domains of the SF-36 including physical problems, role limitations due to physical problems, vitality and bodily pain improved significantly (P < 0.05) compared to the baseline data. There was not any difference between age groups (≥ 65 and < 65 years) but women had significantly greater improvement regarding physical problems and mental health (P < 0.05). These results indicate that cardiac rehabilitation (CR) improves the quality of life (QOL) in cardiac patients, especially in women. It was also noted that elderly patients can gain same benefits as other patients.

Studies have showed that although Constraint Induced Movement Therapy can lead into improvement of hand function in children with Cerebral Palsy, it has several important limitations. Charles and Gordon introduced Hand-Arm Bimanual Intensive Therapy (HABIT) in an attempt to compensate for such deficits. This study aimed at evaluating the efficacy of HABIT on unimanual and bimanual functions in children with Cerebral Palsy.

The participants of this single-blinded randomized control study were twenty-eight children with CP who were divided into two groups of HABIT and controls according to a set of inclusionary and exclusionary criteria. Subjects in HABIT group received the intervention 6 hours per day over 10 successive days and the members of the other group were provided with occupational therapy services. Assessment tools administered in this study were Bruininks-Oseretsky Test of Motor Proficiency, Caregiver Functional Use Survey (CFUS), and Jebsen-Taylor Test in Hand Function. Independent and paired t tests were respectively used for comparing the two groups and to compare each group with regard to pre-test and post-test conditions.

Study results showed significant differences between two groups concerning dexterity, bilateral coordination, bimanual coordination, bimanual function, unimanual function and Caregiver Functional Use Survey (how well & how frequently) (P < 0.05). Also comparison of pre-test and post-test results for each of the two studied groups indicated improvement in most of domains evaluated.

The protocol of Arm-Hand Bimanual Intensive Therapy may result in improvement of either bimanual or unimanual hand functions in children with cerebral palsy.

The purposes of this study were first to examine the relation between social skills and personality characteristics in elementary school children with stuttering and their normal peers and second to compare these variables in these two groups. 30 normal students and 30 students with stuttering recruited from elementary schools of Isfahan city were evaluated via Personality Assessment Questionnaire and Social Skills checklist. Data analysis through one way analysis of variance showed that of six factors of personality evaluated in this study, self-esteem was significantly different in two groups. The results of Pearson correlation in stuttering group revealed that there was a significant positive correlation between emotional control and dependency. However, self-esteem and self-adequacy correlated negatively with each other in this group of students. With regard to the normal group, Pearson correlation results were indicative of a significant correlation between negative world view and participation. In general, the results of this study indicated that because of lower communicative performance of students with stuttering as compared to normal group, they evaluate themselves negatively, and thus their self-esteem decreases. On the other hand, increased emotional control of students with stuttering through participating in various social situations may promote independency, self-esteem and self-efficacy in these children. Considering normal children, negative world view caused by whatever reason can predict their efficiency in interpersonal relationships.

It has been hypothesized that speakers with velopharyngeal disorders exert stronger forces on their laryngeal structures in order to minimize hypernasality and to reach appropriate voice intensity. Several studies have investigated the voice characteristics in subjects with a velopharyngeal insufficiency. The resulting findings appear to be inconclusive and even contradictory. The main purpose of the present study was to determine the fundamental frequency (f0), jitter and shimmer in children with velopharyngeal insufficiency (VPI) and to compare them with normal peers. 32 children with VPI and 48 healthy children (grouped as controls) with the age range of 4 to 8 years participated in this study. All children with VPI were assessed via universal parameter test and those who had either moderate or severe hypernasality were asked to prolong vowel /a/ at normal voice loudness. All subjects in the control group were also required to do this task. The obtained samples were then acoustically analyzed using Dr. Speech software. The following acoustic parameters were assessed: f0, jitter and shimmer. The results were analyzed through descriptive and inferential (students t- test) statistics. Considering average f0, jitter and shimmer, there were no significant differences between children with VPI and normal controls. The results of the present study showed no relationship between VPI and f0, jitter and shimmer in children aged 4 – 8 years. This may be accounted for by the low age range of the subjects.

The aims of this study were to develop a culturally-adapted Farsi version of the SIS (SIS-P) and to evaluate the reliability of the SIS-P in a sample of Iranian patients with Stroke. SIS –P was developed following a forward – backward translation procedure and cultural adaptation based on IQOLA guidelines. A sample of 70 people with Stroke participated in this study. Participants were recruited from outpatient rehabilitation clinics of Kashani and Alzahra Haspitals (Isfahan-Iran) between 2006 and 2008. The Stroke Impact Scale (SIS) consists of 64 items and 8 domains which have been developed to measure and assess strength, hand function, ADL/IADL, mobility, communication, emotion, memory and thinking, and life participation. The participants were asked to answer SIS items. The SIS was re-administered 3 weeks after the initial assessment. Test-retest reliability and internal consistency were assessed via Intraclass Correlation Coefficient (ICC) and Cronbach α respectively. All the participants found the SIS-P items to be clear and unambiguous in this pilot study. The ICC and the Cronbach α were respectively above 0.78 and above 0.69 for each domain. The Farsi version of the SIS is a culturally adapted and reliable instrument to assess disability in Iranian patients with CVA (Cerebral vascular accident).

Considered as a common childhood disease, Perthes disease is resulted from the necrosis of femoral head which in return is a consequence of impaired blood supply in this bone. Through the course of the disease, the replacement of bone tissue by recently formed necrotic tissue changes the shape of affected bone. The aim of this study was to determine the prevalence of causative factors involved in the occurrence of the disease. Patients referred to Red Crescent specialist clinics were retrospectively studied. Two questionnaire were used to obtain and document data considering medical, demographic and biographic status of participates and also to record such measurements as the degree of bone shortening in the affected bone. All data of interest were statistically analyzed using correlation test, frequency test and chi- square. A total of 77 subjects with Perthes disease were admitted to aforementioned clinics during the time this study was in progress. Male-to-female ratio was 4 to1 and subjects had an age range of 1 to 13 years with the mean age of 7 years. 61% of subjects had concurrent pain and lameness, 29% of them had only lameness and remaining 10% of studied sample just reported pain. Left and right side of the body was equally affected and in 11% of studied population both legs were affected. Most participants were from urban areas than rural regions. Only 5% of subjects reported a familial history. The mean number of off spring was 3. The results of this study replicated those of other studies with regard to the male–female (%82 to 18%) ratio, type of involvement (left: %44, right: %43 and bilateral: %11), pain and lameness (%61), urban- to – rural ratio, amount of shortening (1/6 cm) and familial predisposition. It is worth mentioning that prevalence of the disease and urban life were significantly correlated with each other.

Recently, researchers have increasingly interested in learning about the relationship between stuttering and utterance length. The aim of this study was to investigate the effect of utterance length on the amount of speech dysfluency in Farsi-speaking adults who do and do not stutter through an imitative speech task. The obtained results can pave the way for reaching a better understanding of adulthood stuttering as well as developing more appropriate treatment methods. 15 people who do stutter and 15 fluent controls (age range, 15 to 50 years) who spoke Farsi as their native language and were matched by age and gender participated in this cross-sectional study. All participants were assessed by ten sets of simple and complex sentences. In order to assess the impact of syntactic complexity on dysfluency, each sentence in a given set had one morpheme more than the previous one. The obtained data were statistically analyzed through paired t test using SPSS software. Neither in the stuttering nor in the nonstuttering groups, simple and complex sentences did not differ significantly from each other on the basis of the amounts of dysfluency produced (P > 0.05). The results of this study showed that during sentence imitation tasks, syntactic complexity did not affect dysfluency amount neither in people who stutter nor in those who do not. It is imperative to attend to linguistic factors when dealing with children and adults who stutter and to consider syntactic complexity throughout the treatment process at the sentence level.

Nowadays, the advantages of participating in physical activities are so well proved that many statements recommend them in preventing chronic diseases such as osteoarthritis. The purpose of this study was to examine the effects of Pilates exercises on the knee pain and its symptoms as well as on motor problems associated with daily living activities (ADL), doing sports, recreation activities, and the quality of life among elderly male athletes. The study group consisted of fifteen physical education teachers with mean age (years) 57 ± 6.47, mean height (cm) 176.43 ± 8.49, and mean weight (kg) 76.21 ± 8.81. They all suffered from knee osteoarthritis. The world-known Knee injuries and Osteoarthritis Outcome Score questionnaire was used for data collection. Pilates exercises were carried out under the supervision of a Pilates expert for eight weeks. Obtained data were statistically analyzed through t test at significance level of P ≤ 0.05. No significant difference was observed between pre- and post-test conditions concerning knee pain (P = 0.144) and symptoms (P = 0.367). However, motor functions of daily living (P = 0.001), sport and recreation activities (P = 0.007) and subjects’ quality of life (P = 0.002) were significantly improved subsequent to the termination of the training program. The results showed that Pilates, as a safe and effective exercise method, should be considered in improving motor functions of elderly males with knee osteoarthritis and their quality of lives.

Considered as an important factor in communication, prosody is composed of a number of features including intonation, pitch, stress, rhythm and duration, among others. Intonation is the variation of pitch in the course of producing a sentence. In this study, fundamental frequency range was defined as the minimum and maximum amounts of fundamental frequency one can produce when speaking a sentence. The aim of the present study was to evaluate two aspects of prosody, namely, fundamental frequency range and intonation contour in declarative sentences expressed by normal Farsi-speaking adults through laboratory procedures. Participants of this cross-sectional descriptive-analytic study were 134 males and females, aging between 18 to 30 years, who natively spoke Farsi. Voice samples obtained by having each subject produce 2 declarative sentences were analyzed by Dr. Speech program (real analysis software). Data were statistically analyzed via unilateral analysis variance and intonation contour was drawn for each of these sentences. The intonation contour was similar among two sex groups. However, fundamental frequency range of males during speaking the sentences significantly differed from that produced by female subjects (P ≤ 0.001). The intonation contour of declarative sentences was characterized by a falling status at the end of the sentence. Females showed much more changes in fundamental frequency in order to transfer declarative state in their expressions than males did.

Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders affecting young active adults. The pathology of PFPS is not clearly understood because of its mixed pathologies however, some researchers believe predisposing factors including; soft tissue deficits, muscle imbalances and biomechanical disorders in the knee and joints proximal and distal to the knee, may result in PFPS. Considering the high prevalence of PFPS among the young adults, this paper tries to consider probable pathologies and current physical therapy protocols for subjects with PFPS based on the studies performed during last two decades. Using the last treatment findings for this syndrome, physiotherapists can efficiently treat their patients individually, based on different pathologies during their assessment. So, the current researcher tried to gather and present the data using the articles published in the data bases of pubmed, science direct, web of knowledge and google scholar.