[Genu varum deformity may increase postural sway and falling risk]

Any disturbance in balance control procedures may increase the risk of injury during sport activities. Knee deformities such as genu valgum and genu varum may perturb the line of gravity passing the lower limb joints and so disturb dynamic and static balance indices. This study was designed to investigate the effects of genu valgum and genu varum deformity on the static and dynamic balance indices. A total of 90 non-athletic female university students were assigned in one of the three experimental groups; normal knee [n=30], genu varum [n=30] and genu valgum [n=30], according to their knee conditions. Static and dynamic overall stability index [OSI], anterior-posterior stability index [APSI], medial-lateral stability index [MLSI] and falling risk were evaluated three times by Biodex balance system, and the average of each index were recorded. No significant difference was seen between groups in term of dynamic and static OSI and APSI, while significant lower stability was found in the genu varum group compared to normal groups in term of dynamic and static MLSI [p<0.05]. A significant increased in falling risk was also seen in genu varum group, compared to the normal group [p<0.05]. The results showed that mechanical disturbance due to the genu varum deformity may perturb the medial-lateral balance indices in both static and dynamic situations. This may indicate that genu varum deformity may increase the normal postural sway in the medial lateral direction and increase falling risk as well

[Comparing the effects of iontophoresis and phonophoresis of dexamethasone on the treatment of carpal tunnel syndrome]

Using anti-inflammatory medicine injection such as dexamethasone acetate [DXA] is a common treatment for carpal tunnel syndrome [CTS]. Iontophoresis and phonophoresis of DXA are two other ways which may help to introduce DXA locally to inflammated tissues. This study has been deigned to compare the effect of iontophoresis and phonophoresis of DXA on the CTS treatment. 35 mild or moderate CTS patients [51 affected hands] were randomly assigned in one of the two experimental: iontophoresis [25 affected hands] and phonophoresis [26 affected hands] groups. Subjects in iontophoresis group received 10 sessions of iontophoresis of%0.4 DXA solution [DC, 0.2 mA/cm2, 20 min] over the wrist of the affected hands while the other group received 10 sessions of phonophoresis of%0.4 DXA jell with pulsed ultrasound [1 MHz, 1 W.cm-2, 5 min]. The strength of hand and thumb grips, paresthesia, pain, motor and sensory distal latency and evoked potential of median nerve were measured before and after intervention and after 4 weeks follow-up. Comparisons of the mean changes showed more increase in hand grip [P=0.006] and thumb grip [P=0.0002], less pain perception [P=0.001], shorter sensory [P=0.0001] and motor [P=0.0008] distal latency and higher sensory and motor [P=0.0001] action potential in the phonophoresis in compared with the iontophoresis group. Our results show that using phonophoresis of DXA is more effective for CTS treatment, than the iontophoresis method. More studies are needed to investigate the role of different parameters used during phonophoresis of DXA in the CTS treatment

Efficacy of low level laser on knee osteoarthritis treatment

Osteoarthritis [OA] is the most common disease in all joints that is generally treated with drugs such as non-steroidal anti-inflammatory drugs [NSAIDs] and physiotherapy. Although NSAIDs are widely used to treat the pain and stiffness associated with knee OA, the high incidence of serious upper gastrointestinal side effect with NSAIDs can limit their use. Therefore physiotherapy plays a vital role on OA treatments. One modality that has mostly used recently is low level laser. Despite its widespread usage, the results of the experimental and clinical studies are conflicting. However, very few controlled clinical studies of low-power laser applied for the treatment of knee OA have been reported and the findings of these studies are also contradictory. This study was performed to assess the effects of low level laser on knee OA. This single-blinded clinical trial was performed on 36 adult patients [45-75 years old] with knee OA. The patients were randomly divided into two groups of active laser with standard treatment and placebo laser with standard treatment. A Gal-Al-As diode laser device with a power output of 30 mW and a wavelength of 830 nm was used in the study. The standard treatment was ultrasound, transcutaneous electrical nerve stimulation, infrared, the straight-leg raise test in supine position, and the subjects were treated for ten sessions, 5 times per week and for a period of two weeks. Then pain at rest, duration of morning stiffness, active range of knee flexion and the quality of life with WOMAC index were assessed before and after the intervention. Although, there were significant differences before and after the intervention of all criteria in both groups [p<0.05], no significant differences were observed between two groups with respect to those criteria. This study revealed that application of low level laser is not efficient for the knee OA treatment

[Evaluation an altered neurophysiological functions of motor branches of deep peroneal nerve in lateral ankle sprain patients]

Inversion sprain is a result of abnormal forces of plantar flexion and inversion applied to the lateral side of the ankle. This injury recurs in 10% of non-athletes and 80% of athletes. It is believed that Changes in conduction of deep peroneal nerve following inversion sprain and instability occurred following it, to be a cause of recurrence of inversion sprain. Evaluation of the motor branches of deep peroneal nerve in inversion sprain in non-athletes persons is the base of this study. Mechanical instability is assessed through anterior drawer test and talar tilt test and electrical assessment is done first and four weeks after injury in 11 patients in each mechanical instability group of the ankle. All patients had the first incidence of unilateral inversion sprain and normal side was considered as control in the same patient. Electrical assessment of deep peroneal nerve included following: [1] Deep peroneal nerve motor conduction studies in three levels of knee, leg and ankle, [2] Electrical evaluation of tibialis anterior muscle both at rest and minimal contraction. Studies revealed significant changes in temporal dispersion in three levels of knee, below the head of fibula and ankle and motor latency in knee and ankle levels both at the first and second evaluation and motor nerve conduction velocity in leg at the first session in two extremities but no significant difference between mechanical instability was noticed. Also there was a significant difference in recruitment interval of tibialis anterior muscle in comparison of normal and involved extremity and mechanical instability at both sessions. Findings of this study indicated that in lateral ankle sprain deep peroneal nerve incurs is happened and its prognosis is dependent on severity of nerve involvement and grade of instability