فصلنامه طب توانبخشی
سال سوم شماره 3 (پاییز 1393)

Postural control is the basic part of body movement performance and is needed for many everyday activities, particularly sport activities. Several factors can adversely affect efficiency of postural control system and decrease postural stability which results in increased postural sway. Among these factors, musculoskeletal disorders such as low back pain can be mentioned. Thus the purpose of this study was to compare postural sway in athletes with nonspecific chronic low back pain and healthy athletes. Postural sway of 68 athletes (34 nonspecific chronic low back pain and 34 healthy individuals) was examined by Zebris force distribution system in two conditions of standing with open and closed eyes. The independent t-test was used to analyze the data and compare between groups. Results showed a significant difference between athletes with nonspecific chronic low back pain and healthy ones in standing with open and closed eyes (P≤0.05). According to the results of this study, athletes with nonspecific chronic low back pain showed increased postural sway in two conditions of standing with open and closed eyes in comparison with healthy athletes. Measuring postural sway of athletes with nonspecific chronic low back pain is recommended to identify one of the most important risk factors of sport injuries in these athletes.

Despite the fact that muscle stretching plays an important role in sport, therapeutic exercises and rehabilitation of musculoskeletal disorders, few studies have considered the effect of muscle stretching on joint proprioception. In addition, the studies report paradoxical results. Therefore, the aim of this study was to assess the effects of extensor and flexor muscles stretching on knee joint position sense in 15, 30 and 60 degrees of flexion angels. This quasi-experimental study with pre-test post-test control group design was done over 37 young healthy subjects in age range between 18-25 years.The subjects were randomly assigned to 3 conditions of extensor stretching, flexor stretching and control. Angular error was evaluated in 3 angles including 15, 30 and 60 degrees of knee flexion using digital photography, non-reflective markers and analysis with AutoCAD software. The results showed that when evaluating the proprioception during knee extention, the absolute angular error rate is significantly increased in flexor stretching condition in 15, 30 and 60 degrees of knee flexion (p<0.02), but in the extensor stretching condition, there was not any significant change. The results show that the minimum error occurs in 15 degrees and maximum error occurs in 60 degrees of knee. It seems that static stretching of antagonist muscles increases joint repositioning error.Also it seems that due to the stretching of soft tissues around the joints at the end of the range, there is less position sense error at the end range and more error at the middle range of motion. So in designing the stretching exercises for athletes and rehabilitation programs, the interference of stretching exercise with proprioception should be considered carefully.

Meticulous preoperative screening is one of the key factors that contribute to success in refractive surgery. The purpose of this study was to evaluate the Belin-Ambrosio and Rabinowitz indices as screening methods before refractive surgery to distinguish keratoconus suspects from normal patients. In this descriptive study, Pentacam data of 30 normal eyes (N) and 19 abnormal eyes with suspect keratoconus (KCS) were analyzed. Belin-Ambrosio and Rabinowitz indices were tested. Using SPSS Statistical Software (version17), an Independent T test was performed for statistical analysis. The mean age of patients was 25.51±3.97 years and the mean of myopia was -2.87±3.97 and the mean of astigmatism was -1.25±1.08 diopters. All tested variables had significant differences between N and KCS (Independent T-test, p< 0.001) except I-S value (p=0.22). The BAD-D and BAD-Dp had the greatest differences from Cutoff value. The Belin-Ambrosio indices provide additional information in diagnosis of suspect keratoconus compared to Rabinowitz criteria. In this study, the BAD-D and BAD-Dp were better approaches for detecting keratoconus.

Delayed onset muscle soreness normally appears right after an eccentric exercise and reaches its highest level between the first 24 to 48 hours after exercise. The symptoms totally disappear after 7 to 10 days. After recovery, power and efficiency of the muscle increase and this power raise, results in improvement of a sport skill like vertical jump. The aim of this article was to study the effects of eccentric exercise of quadriceps femoris muscle on vertical jump height in nonprofessional sportswomen. This study was performed on 10 amateur sportswomen. Quadriceps femoris muscle force, one repetition maximum (1RM), height of four types of single leg squat, double leg squat, countermovement, and drop jump, and the amount of muscle soreness were examined in two test sessions (right after and 10 days after the exercise). Using SPSS software, a paired T- test was done for statistical analysis. Isometric force of the quadriceps femoris muscle and the height of vertical jump decreased right after performing the eccentric exercise. The isometric force and the 1RM of quadriceps femoris muscle increased 10 days after performing eccentric exercise (P< 0.05). The jump that was mostly affected was single leg squat jump. Performing eccentric exercise increases the muscle force and this force raise can enhance sport skill efficiency like vertical jump. The eccentric exercise protocol in this study was new and although its intensity was medium, it had positive effects on muscle force and vertical jump height.

Cerebral palsy non Progressive abnormalities in the brain that motor and postural deficits in the child development. Used orthotics anti-spastic one of the ways to reduce motion complications in diplegia spastic. The purpose of this study was to investigate the effect of using of Anti spastic Orthosis on the Reduction of Spasticity and Gross Motor Function in Diplegic spastic children between 2 – 5 age group in Tehran. In the Utilizing Experimental study 20 diplegic spastic children age group (2-5) were selected randomly divided into two groups. The first lower limb spasticity was assessed before the intervention was evaluated by a physician, neurologist, and then by an experienced occupational therapist blind research process, evaluation and random into one & two groups were controlled In the One group Positioning and Neurodevelopment Treatment and the Two group treated only with the use of NDT. The research Instrument used was the Modified Ashworth scale (MAS) and the Gross Motor Function 66 (GMFM66). The findings of this study showed meaningful differences between two groups, scores of mean Gross Motor Function in One group was significantly greater than Two group (p=0/001) Application of Anti spastic Orthosis before rehabilitation exercises recommended for diplegic spastic children.

Individuals suffering from Autestic spectrum disorder are impaired in interpersonal and social skills highly due to deficiency in facial emotion recognition. The objective of this study was to compare this ability between children with High-Functioning Autism with Typical peers. Comparing recognition of neutral state was used for the first time. Twenty seven High-Functioning Autism and 27 Typical boys between 7 and 11 years of age who were matched based on age, and performance, verbal and overall IQ participated in this study. Comparison of neutral face and facial emotions, including fear and surprise was made using a computerized researcher-made test in MATLAB software. A repeated measures ANOVA and an independent t-test were used for statistical analysis using SPSS software version 19. There was a significant difference between the two groups in terms of facial emotion recognition (F (1,50) = 7.288, p = 0.009). The difference was significant in the recognition of neutral face with female gender (t = 2.574, p = 0.013). There was no difference in reaction time between groups (F (1,50) = 4.002, P =. 051). Differences in reaction time in both groups and in three facial expressions were observed in male targets (t = -2.305, p =. 025), (t = -2.160, p =. 035), (t = -2.654, p = 0.011). In recognition of neutral faces with female gender targets, people with High-Functioning Autism performed weaker than typical peers and their reaction time were increased in male gender targets.

Myofascial trigger points are one of the most common causes of musculoskeletal pain. Phonophoresis is the use of ultrasound to enhance drug absorption through the skin and may be useful for treating trigger point; however, there is little information about the mechanisms of it. Hydrocortisone is one of the corticosteroid medications that can be used for phonophoresis. As Dimethyl sulfoxide (DMSO) increases the permeability of drugs through the skin by changing the configuration of the horny skin cells and intercellular keratin, it may intensify the effects of hydrocortisone. The purpose of this study was to investigate the effect of phonophoresis of combined hydrocortisone and DMSO on pain intensity (VAS), pressure pain threshold of trigger points (PPT) and range of motion of neck (ILF, CLF) in participants with latent trigger points of upper trapezius muscle. Forty subjects with latent trigger point of upper trapezius were randomly divided into 2 treatment groups: Phonophoresis with hydrocortisone %1 and phonophoresis with combined hydrocortisone %1 and DMSO %10. The treatment consisted of 10 sessions and the outcomes were evaluated before the treatment, the end of the 5th and 10th sessions and 2 weeks after the last session. Both treatments showed improved intensity of pain (VAS), pressure pain threshold (PPT), ipsi-lateral flexion (ILF), counter-lateral flexion (CLF) (p<0.001), but there was no significant differences between the intervention groups. However, only the effects of the combined gel remained stable after 2-week follow-up (p<0.05). Results showed that there is no preference between the two gels, but adding DMSO may increase the long-term effects of hydrocortisone.

Auditory temporal processing is an important ability of central auditory nervous system which has a basic role in speech and language development. It seems that the ability of such processing is deficient in children with Attention-Deficit/Hyperactivity Disorder (ADHD) in comparison to normal children. So, the aim of this study was to compare the auditory temporal processing ability in children with ADHD and normal children using Gaps-In-Noise (GIN) test. In this cross sectional comparative study, 27 ADHD children aged from 7 to 12 years were selected using convenient sampling method. The control group was paired according to the age and sex. Gaps-In-Noise (GIN) test was administered to assess temporal processing and approximate threshold (A.th.) and the percentage of correct responses were calculated for all participants. Nonparametric (Mann Whitney) test was used to compare GIN test parameters between two groups. Paired t test was used to compare the result of two ears in each group. The mean approximate threshold and percentage of correct responses in ADHD group were7/9(2/55) ms, 53/21(12/87) % and in the control group were5/42(0/96) ms and 65/4(6/65) %, respectively. ADHD group performed worse than control group and there were significant differences between two groups in test parameter values (p<0.001). There was no significant difference between right and left ear performance in both groups (p>0.05). Based on the findings of the current study, it seems that auditory temporal processing in ADHD children is deficient that might be due to a Central Auditory Nervous System dysfunction. So GIN test can be useful in examining such processing in children with ADHD.

Nowadays, the issue of elderly people has been considered by governments from different aspects including medical, psychological, sanitarian and nursing, with regarding the increase of elderly people; thus, caring and keeping them are important. The present study was done to evaluate mediating role of spiritual intelligence with psychological well-being and elderly people satisfaction of Mehriz County (Yazd). The method used in this research is descriptive correlation, and statistical population was included all elderly people of Mehriz County in which 322 people were chosen through purposive sampling. The King’s spiritual intelligence, Diner et al life satisfaction, and Rif et al psychological well-being questionnaires were used for data measurement. Statistical tests such as mean (average), standard deviation, Pearson correlation coefficient, multiple regressions analysis and path analysis were performed for data analysis and determination of relationship between variables. Findings showed that there is a significant relationship between psychological well-being, spiritual intelligence and life satisfaction in 0/5 level, and psychological well-being can specify variance 39% on life satisfaction and also spiritual intelligence can specify variance 45% on psychological well-being. The results showed that the more the spiritual intelligence in elderly people is, the more the psychological well-being and life satisfaction will be; and also the personal build-meaning component in spiritual intelligence has the most impact on psychological well-being. In addition, spiritual intelligence can be as mediator between psychological well-being and life satisfaction.

Aging is a stage of human life which is naturally companied by reducing physical and psychological abilities. Exercise is one of the most effective ways to prevent aging disorders. Exercise and movement postpone aging processes. The elderly who exercise have better health and vitality. Considering the importance of life quality in these ages, this study compared depression, anxiety and stress between active and inactive old women. The research method was Descriptive Comparative. Statistical population was the old women who attend in Isfahan parks to exercise, as well as old women who attend to spend leisure time without any activity. Convenience sampling was used to select 170 old women as statistical sample. Personal information and activity and medical experiences interviews, demographic questionnaire and depression, anxiety and stress scale (DASS, Lovibond & Lovibond,1995) were used. The independent t-test was applied to compare depression, anxiety and stress between active and inactive old women. The results showed that depression, anxiety and stress are significantly different between active and inactive old women, and active old women compared to inactive ones have less depression, anxiety and stress. According to these results, exercise and physical activity can help old women reducing depression, anxiety and stress, and be applied as an effective complementary method along with other common curative interventions to reduce depression, anxiety and stress.

Epidemiological studies have shown that female athletes are vulnerable to ACL injuries 2 to 10 times more than male athletes. Neuromuscular and biomechanical factors in anterior cruciate ligament injuries are among modifiable risk factors. The high cost of treatment, increasing the potential loss of the competitive season and long-term disability and secondary damage have made the application of injury prevention programs more prominent. In this literature review, related research regarding modifiable risk factors and ACL injury prevention training was studied. To identify the research, databases such as Medline Pubmed, Science Direct, SPORTDiscuss and SCOPUS using the keywords "ACL", "Knee injuries", "modifiable risk factors", "neuromuscular risk factor", "biomechanical risk factor", "training prevention program " were used. Finally, 8500 studies were identified. After exclusion of non-English, duplicated, similar indexed studies, animal studies, studies with injured subjects, studies focused on clinical treatment, and studies without any intervention, 60 articles remained eligible for studying. Weakness and imbalance of the trunk and lower limb neuromuscular control increase prevalence of ACL injuries in female. Prevention training was categorized in two levels with the aim to modify the risk factors and reduce the rate of ACL injury. Majority of the effective intervention training exercises are multilateral program for at least 6 weeks in advance of the season and continued throughout the season with a repetition of at least once or twice a week with a trainer in the practice. Identifying neuromuscular imbalance can be used for screening the athletes at risk and designing the intervention training. However, a standard program aimed at preventing for a specific sport has not been introduced, yet.

Work is one of the key components in the life, as it brings financial benefits, social adjustment and affects health and well-being. Employment of people with mental illness not only is important as it is for general population, but also has a key role in their treatment. However, obtaining and maintaining a job for these people is considered as a challenge, and few of them can achieve their goals in this process. The aim of this paper was to review the resources to investigate job retention strategies in patients with severe mental illness. 25 relevant articles were selected and reviewed using key words employment, severe mental illness, sustain, tenure and coping strategy. Review of the articles showed that the strategies used by patients are divided into two categories: mental and practical strategies. Each of these focused on person (person –based strategy) or job (job –based strategy). The reviews highlighted that the most effective and practical strategy is “illness management” that is suggested to be added to the vocational rehabilitation programs.