مجله پژوهش در علوم توانبخشی
سال نهم شماره 1 (فروردین و اردیبهشت 1392)

Pelvic tilt is defined as pelvic inclination relative to the horizontal plane. The muscular strength and flexibility of lumbo pelvic region are effective factors in pelvic tilt. Studiesonthe relationship between muscle flexibility/strength and pelvic tilt have yieldedcontroversial results. The aim of this study was to examine this relationship in a larger sample and with more precise and sensitive instruments. 180 healthy women (20-65 years) participated in this study. Pelvic tilt was measured via inclinometer andmuscle function was determined throughisometric strength andendurance recordings for whicha dynamometer and a chronometer were used respectively. Muscles flexibility was evaluatedby special tightness tests. There was little relationship between pelvic tilt and hip external and internal rotators strength as well as the flexibility of iliopsoas muscle. Also، pelvic tilt and trunk flexors and side flexors endurance were weakly correlated. According to the lumbo-pelvic muscles connections، it seems that the flexibility and strength of these muscles canaffect pelvic tilt. However، this effect was not provedin this study. Many of these muscles act on two or more joints، so they can show the effect of strength and length changes in other areas. Also the subjects of this study were healthy without any pathology and، considering flexibility and strength، werenot in abnormal range. These reasons may explain why the above-mentioned was not observed.

Cleft lip/palate can affect such various aspects of children development as cognitive، auditory، speech and language skills. Delayed diagnosis and comprehensive assessment of these children may exert devastating effects on these domains. Therefore، developmental skills of children with cleft lip and palate were evaluated in this study. Seventy-two children (40 normal، 32 cleft lip/palate)، aged 3 to 6 years at the time of study، participated in this analytic-descriptive study for which a control-study design was adopted. All children were evaluated by Niyusha Developmental Scale. This scales targets the development of cognitive، auditory، speech، receptive and expressive language skills. Mann-Whitney’s U test was used to compare the mean scores between two groups and the Pearson correlation coefficient test was applied to examine the correlation between variables. This study revealed a statistically significant difference in mean scores of speech and expressive language skills between the two groups (P < 0. 05). The occurrence of middle ear infections in children with cleft lip/palate was greater than the normal group. Developmental skills in children with cleft palate and lip are affected by structural deficits. Comprehensive assessment of these children can help to design accurate interventional programs.

The balance and postural control impairments are current problems in people with multiple sclerosis، so much that the risk of fracture from falls in MS patients is 2 to 3 times higher than healthy subjects. The purpose of this study was to evaluate the correlation between lower extremity muscle strength and dynamic balance in women with Multiple Sclerosis. Thirty three female individuals with MS recruited in this study. Dynamic balance was assessed by the Berg Balance Scale، Timed Up and Go Test، and Functional Reach Test. Also bilateral lower extremity muscle strength was measured by dynamometer and 30 seconds sit to stand test. Data was analyzed by SPSS، version 16. There was a good correlation between lower extremity muscle strength and the FRT (P < 0. 05). Also the TUG test had a correlation with flexors and extensors muscles of knee strength (P < 0. 05) and 30 seconds sit to stand test (r = 0. 60، P < 0. 05). The correlation between BBS and extensors of knee muscle strength (Right: r = 0. 47 and left: r = 0. 46، P < 0. 05) and flexor of knee muscle strength was significant (Right: r = 0. 45، P < 0. 05 and left: r = 0. 37، P < 0. 05). While the correlation between this balance scale and 30 seconds sit to stand test was prominently significant (r = 0. 63، P < 0. 05). Generally the results of this study indicated that the loss of lower extremity muscle strength can influence on dynamic balance in subjects with multiple sclerosis. These results are beneficial to assess modality of rehabilitation program for patients with MS. It is recommended that increasing lower extremity muscle strength must be considered particularly to improve balance and reduce falls risk in these patients.

Chronic low back pain (LBP) is a growing problem in many communities، but there is no consensus regarding the most appropriate therapeutic intervention. Recently، Pilates exercises that is an approach to mind and body health، has been accepted as a rehabilitation method. Also، one of the other new therapeutic method is Kinesio Taping claimed to be able to reduce pain، swelling and muscle spasms and has been prevalent in orthopedic، sport medicine، and neuromuscular rehabilitation. Purpose of this study was to examine the effect of Pilates exercises and Kinesio Taping on intensity of pain and Functional disability in male subjects with non-specific chronic LBP.

Twenty four male with nonspecific chronic LBP (mean age ± SD; 54 ± 6/82 years old) were purposefully selected and assigned into two groups of twelve persons. For the first group، Pilates exercises were carried out and the second group were taped with Kinesio Tape. The duration of treatment was 6 week for two groups. VAS scale for the assessment of pain and Quebec functional disability scale for functional disability assessment were used. For data analysis Repeated measure ANOVA was applied at the significant level of 0. 05.

A significant improvement was shown in pain and functional disability in both groups after intervention (P < 0. 001). On the other hand، comparing data after intervention showed prominent difference in pain intensity between two groups (P < 0. 001). But، no significant difference in functional disability between two groups were notified (P = 0. 188).

It can be concluded that Pilates exercise have better effect than Kinesio Taping، in decreasing the pain and increasing function in men with non specific chronic LBP.

Parkinson''s disease (PD) is one of the most common disorders of the central nervous system. Laughter Yoga (LY) combines the complementary therapies، stretching، and breathing techniques. The aim of this study was to investigate the effects of LY training on motor function، balance and flexibility in subjects with Parkinson''s disease. Twenty four female participants with PD (stages 3-1 based on Hoehn and Yahr scale) voluntarily were recruited in this study. They were randomly assigned into two groups of experimental (mean age ± SD; 52. 6 ± 6. 8 years، weight ± SD; 61. 1 ± 7. 8 kg، height ± SD; 157. 8± 4. 3 cm) and control (mean age ± SD; 55. 5 ± 6. 7 years، weight ± SD; 67 ± 6. 8 kg، height ± SD; 158. 4± 5. 5 cm). In addition to pharmacotherapy، the experimental group received 8 weeks LY (3 sessions per week، each session; 45 minutes)، while the control group didn’t follow any effective physical activity. The patient’s motor function (Part 3 questionnaires UPDRS)، balance (Berg) and flexibility (sit and reach test) were evaluated at the beginning and the end of 8-week. All data were analyzed by SPSS، version16. The results of this study showed a significant improvement (P < 0. 05) in motor function after eight weeks LY in experimental group (12. 9 vs 12. 6)، as motor function improved about 2%. A significant reduction (P < 0. 05، 14. 3 vs 14. 7) was observed in the control group. Although balance increased in the experimental group but the differences was not prominent (P > 0. 05). An upward significant was observed in flexibility (P < 0. 05) in the experimental group (11. 1 vs 13. 3)، but it decreased in control group (P < 0. 05، 13 vs 12. 5). In all variables، significant differences were found between two groups. It can be concluded that LY has a positive effect on motor functional and flexibility in individuals with PD; therefore it should be suggested to organize some LY sessions for these subjects each week to improve their balance، motor function، and finally activity daily living.

It is common for parents with cerebral palsy children to expose further stress and affect all aspects of their quality of life. This study was carried out in order to determine the effectiveness of handling training program on the stress and quality of life of mothers with children with cerebral palsy.

This control trial study was performed with two groups of experimental (n = 29) and control (n = 25) were selected by randomized convenience sampling method. Data collection tools included demographic questionnaire، SF-36 quality of life، the Resource and Stress Questionnaires. All data collected before and after three months of intervention. Statistical analysis was carried out by SPSS، version 16.

The mother’s mean age in control and intervention groups were 32. 8 (SD = 4. 9) and 35. 3 (SD = 4. 4) years respectively. Also، children’s mean age in control and intervention groups were 6. 2 (SD = 2. 1) and 7 (SD = 2. 8) years. There was a significant difference in quality of life after intervention between two groups (P < 0. 05). However، difference was not significant in two dimensions of physical functioning and Emotional health (P > 0. 05). Also، there was a statistically significant difference between all dimensions of stress measures in two groups (P < 0. 05).

According to these findings، handling training program reduced stress and enhanced the quality of life of mothers with children with cerebral palsy in this study.

Mirror neurons are fired either by executing a motor task or by observing someone else performing it. The purpose of present study was to evaluate the postural control of balance-observers. In present cross-sectional study، the anteroposterior، mediolateral and overall postural sway of 20 students were evaluated by Biodex balance system while they did or did not observe postural balance status. Paired sample t test was used for the statistical analysis of the data. Mediolateral and overall sway enhanced by observing balance position (P = 0. 018، P = 0. 049). Antroposterior postural sway did not show any difference in two positions. Observing postural control increased postural sway. These findings could be best accounted for by the activity of mirror neuron that involved in managing postural control. It can be concluded that simultaneously executing the motor task at hand by therapist may serve as an overload during exercise therapy.

Neck pain is of the common musculoskeletal disorders. Physical maltreatment may have caused disability and socioeconomic repercussions. However، manual therapy techniques are less costly، with least side effects in treatment of neck pain، but there is a lack of evidence about the efficacy of these methods or a comparison of treatment to suggest the best technique. Thirty subjects with neck pain، aged 18-35 years old، were participated in this study. All individuals were randomly classified into two groups. One group received massage therapy and the other strain-counter strain technique. Participants had three therapy sessions every other day. Pain was accessed via pain numerical rating scale (PNRS) and neck disability index (NDI) questionnaire was used to measure the level of functional disability just before and immediately after each technique. Paired and sample t-tests were used to analyze the data. There was a significant improvement in pain intensity and disability level after massage therapy (PNRS = 0. 001، NDI = 0) and strain counter-strain (PNRS = 0، NDI = 0. 03). Nevertheless no significant differences were found just after intervention in NDI between both groups (P > 0. 05). Differences in NRS between both intervention groups were statistically found (P < 0. 05). Both massage and Strain-Counter strain alleviate pain and improved function in patients with neck pain، although massage therapy was more effective in these patients.

Shoulder internal and external rotator muscles play a critical role to provide stability and mobility for glenohumeral joint، particularly in the overhead athletes. Musculoskeletal adaptation and some special side effects due these physical demands and movement patterns are very important for these athletes. The purpose of this study was to compare shoulder strength ratio with shoulder internal to external rotation range of motion (ROM) in zurkhaneh athletes and non-athletes subjects. Twenty nine zurkhaneh athletes (mean age ± SD; 23. 51 ± 2. 04 years، sport history ± SD; 8. 75 ± 4. 47 years) and thirty non-athletes individuals (mean age ± SD; 24. 8 ± 1. 56) participated in this study. Data were collected through questionnaires and examination. Shoulder strength was measured by Hand-held dynamometer. Leighton flexometer was used to record ROM in both upper extremities internal and external rotations. Independent samples t-test was applied to analyze the data. There was a significant difference in internal/external rotation range of motion ratio among zurkhaneh athletes and non-athletes group (P ≥ 0. 05). Also، the results of this study identified a prominent difference in internal/external rotation strength ratio between zurkhaneh athletes and non-athletes group (P ≥ 0. 001). Repeated pattern of movements in the zurkhaneh sports for a long time causes muscle imbalance in strength and range of motion shoulder joint. It is known as a risk factor for shoulder injuries. Therefore; a design of corrective exercise and prevention strategies should be considered in training programs by athletic trainers and coaches.

The role and importance of dual task with right hemisphere in postural control has been reported in many previous studies but the effect of visual task levels on postural control in subjects with right and left hemi paretic is not yet known. This study was aimed to compare the effect of visual tasks on postural control in individuals with left and right chronic hemiparesis.

Participants were 6 rights and fourteen left hemiparesis selected by simple non probability sampling. Postural control tasks examined on force plate in different conditions; eyes open/close، visual inspection near/far، visual search near/far. Center of pressure sway parameters in this study were area، mean velocity، path length and phase plan total. All data were analyzed by SPSS، version 16.

The main effect of postural task were significant in all parameters، including mean velocity، path length، phase plan total except area، Also، main effect in affected side was prominently significant only at the area parameter (P ≤ 0. 05). There is no significant difference in interaction of affected side with postural task except in phase plan total (P > 0. 05).

Because of no difference between visual task effect on right and left hemi paresis postural control، it can be noted that these two groups use similar strategies for doing this task.

Complaints with low back pain are one of the most common work-related injuries. Despite of using in-person therapies، no other methods based on the new technologies have been yet introduced. Therefore، the aim of this study was to compare the effect of two therapeutic exercise methods and ergonomic based on virtual space in computer users with Low back pain. In this semi-experimental study one hundred and fifty subjects with low back pain were participated. They were randomly divided into two control (the ergonomic) and experimental groups (combination of exercise and ergonomic therapy). Both groups received their treatment via a virtual space. The control group carried out ergonomic therapy and experimental group in addition to ergonomic intervention performed exercise therapy. The pain and disability levels were assessed using Nordick questionnaire before and after 3 months intervention. Chi-Square (χ2) was used to analyze the data. The level of pain in the experimental group was reduced significantly than in control group in twelve month and 7 day evaluation (P < 0. 05). It can be concluded that the combination of ergonomic and exercise therapies may reduce low back pain in computer users، so this training program could be recommended for these people to increase their abilities to seat for a long time behind the computer.

It has been stated that adolescents are at greater risk of suffering sport injuries than younger children with peak injury rates occurring in the oldest adolescent age group. The purpose of this study was to evaluate the effects of strength، balance and combined (strength and balance) exercise programs on the dynamic balance of young male athletes. Sixty 14-to-17-year-old young male athletes (mean weight 62. 79 ± 3. 62 kg; mean height 171. 1 ± 4. 46 cm) without any lower extremity injury، vestibular and/or visual problems voluntarily participated in this study. The subjects were randomly assigned to one the following groups: 1) Strength exercise، 2) Balance exercise، 3) Balance exercise and 4) control group. The SEBT test was used before and after exercise programs in order to test dynamic balance. Descriptive as well as statistical analysis including repeated measure tests، paired t test and ANOVA with Tukey’s post hoc test were conducted (P-value was set at 0. 05). The study results showed significant increase in reaching distance in all directions after strength، balance and combined (strength and balance) exercise programs. It was also shown that increase in reaching distance following combined exercises was more than that resulting either after the balance or after strength exercises individually (P > 0. 05). This study showed that six weeks of balance training programs was able to produce a significant increase in dynamic balance in young male athletes. Because young male athletes are not initially able to stand pressure of exercise and special sport skills، it may be useful to trainers to provide their trainees with an adequate level of balance through combined exercises.

Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in both developed and developing countries. LBP affects 70% to 80% of adults at some time in their lives. Recent evidence suggests that psychosocial factors especially fear avoidance beliefs (FAB) have a critical role to predict disease progression from an acute to a chronic stage as well as the failure of intervention. The aim of this study was to review the relationship between pain، fear avoidance beliefs and postural stability in subjects with non specific chronic low back pain (CLBP). In this narrative research، two databases (pub med and Medline) were searched using key words such as chronic low back pain، fear avoidance beliefs، posture، stability، balance، motor control، center of pressure، and force plate. The inclusion criteria was being related to FAB and postural stability and adults with non specific CLBP، in English language، up to 2011، by the format of cohort and cross sectional studies. The results showed that psychological factors like FAB influence the chronicity factor of LBP but the relationship between pain and postural stability was different in these studies. The only study on relationship between postural stability and FAB did not find any significant relationship. It seems that the different results of these studies are due to different methods of data collection. More exact studies are needed for evaluating the relationship between FAB and postural control.

Lower limb amputations are usually performed in people suffering from trauma، vascular diseases، diabetes and/or congenital disorders. Amputees lose their ability to stand and walk depending to the level of amputation. Various types of prostheses can be used to improve the performance of amputees. The efficacy of lower-limb prosthesis is determined by the suitability of suspension method. In fact، using an appropriate fitting and suspension method plays an important role in the quality performance of prosthesis and patients’ comfort when using prosthesis. Although three decade shave passed since the advent of silicone liner prostheses، the effect of this prosthetic system on the performance of silicone liner prostheses has not been yet clearly determined. Moreover، the effect of silicone liner on such parameters as speed of walking، standing stability and gait confidence is not cleared. Therefore، the aim of this review was to clarify the effect of silicone liner on abovementioned parameters based on the available literature. An electronic search was done via the PubMed، Embase and ISI web of knowledge databases from 1960 to 2012. The quality of papers was assessed using the Down and Black evaluation tool. Following keywords were used: silicone liner، Icelandic roll on silicon socket (ICEROSS)، trans-tibial amputation، and trans-tibial prosthesis. Based Based on the used keywords، 100 papers were found from which 10 papers were selected in accordance with the selection criteria. The scores of reporting، external validity، internal validity (bias)، and internal validity (confounding) varied between 5-9، 1-3، 3-4، and 3-5، respectively. The results confirmed that this new system is better than the convention alone. It is worth mentioning that، no significant difference shave been found in quality of gait. Totally، we can say that more researches، such as clinical trials، are needed to understand the benefits of silicone prosthesis for below- knee amputees.