[Comparision of rehabilitation plus joystick versus routine rehabilitation treatment on hand muscles stiffness in hemiplegic patients]

Disabilities in upper limb due to stroke are the major problems in hemiplegic patients. Recently, joystick method as new method is applied for the improvment of upper limb disabilities. This study was carried out to compare the effect of joystick in combination verses routine rehabilitation and routine rehabilitation program on hand muscles stiffness in hemiplegic patients. In this clinical trial study, 12 hemiplegic patients were randomly divided into two control and interventional groups. Subjects in the control group were received rehabilitation program with placebo joystick. Patients in interventional group were received joystick treatment with routine rehabilitation program for 10 sessions, 3 times a week. Pre and post-treatment evaluation was performed based on Wrist Robo Hab method. Flexion and pronation muscle stiffness in control patients showed non significant improvement, but in the interventional group, significant improvement were observed [P<0.05]. At the end of study, there was not any significant difference between control and interventional group. According to this finding, there was not any significant difference between the combination of joystick and rehabilitation treatment and routine rehabilitation program on the hand muscle function in hemiplegic patients

Effect of low frequency repeatitive transcranial magnetic stimulation to improve motor function and grip force of upper limb in hemiplegic patients

Disability of upper extrimity from stroke are often permanent. Despite numerous functional problems, there is less attention to upper exterimity disabilitis than lower limbs. Some new methods of treatment focuses on using the magnetic stimulation as a means brain currents to produce therapeutic effects. This study was done to evalute the effect of low frequency repeatitive transcranial magnetic stimulation to improve motor function and grip force of upper limb in hemiplegic patients. This clinical trial study was done on 12 stroke hemiplegic patients in Firoozgar hospital in Tehran, Iran during 2009-10. Patients in group I, recieved rehabilitation program with placebo magnetic stimulation, and patients in group II, received magnetic stimulation with routine rehabilitation program for 10 session, 3 times in week. Pre and post were evaluated by Barthel and Fugl-Meyer indeces and dynamometer. Data were analyzed using SPSS-15, Kolmogorov-Smirnov, paired t-test, independent t-test and Wilcoxon signed tests. According to Barthel and Fugl-Meyer indeces both groups I, II showed significant improvement [P<0.05]. Using dynamometer, it was demenstrated that grip force of upper limb in group I was not significant but this index in group II was significant after intervention [P<0.05]. This study showed that low frequency repeatitive truscrianial magnetic stimulation has therapuetic effect on grip force of upper limb

[ comparison of shock wave therapy and corticosteroid injection on the treatment of plantar fasciitis]

Plantar Fasciitis is a common musculoskeletal disorder, which can reduce physical activity of the affected person. The usual treatments have short-term effects or they can cause adverse effects. In this study the injection of corticosteroid and shock wave therapy have been compared. This was a prospective, randomized and single blind clinical trial. In the physical medicine and rehabilitation clinic of two clinic in Tehran, through the year 2011, 37 feet were randomized to each treatment group. The first group received 40mg methylprednisolone and 2 cc lidocaine 2% and the second group was treated with 3 sessions of rESWT [2000 pulses, 10 Hz, 2.5 bar] weekly apart. The data was gathered by a questionnaire, 1 week, 1 month and 3 months after the intervention. Chi-square, T-test and mann-witney U test was used for data analyzing. In both groups 3 months after the intervention the severity of the symptoms were greatly improved. In short-term [1 month] corticosteroid effect was superior to shock wave's one [p<0.05]. This superiority declined through the time. In other words, the effects of the two treatments measured in the functional scale, didn't differ significantly 3 months after the initiation of the treatment [p>0.05]. Shock wave therapy can be an alternative treatment for plantar fasciitis

[Effect of low shoe heel height on the trunk muscular activity among young healthy females]

The reduction of shoe heel height can increase abdominal muscles activity. This study was conducted to evaluate the effect of low shoe heel height on the trunk muscle activity in young healthy females. In this quasi- experimental [Pre-post] study, 48 healthy females were evaluated at University of social welfare and rehabilitation at 2009-2010. Females were selected in a non probability sampling manner and divided randomly into two groups. Subjects in the first group [12 females] were used low heel height shoes[less than 3.4 cm] for six months. The second group [12 female] was used standard heel shoes height [3.5-5 cm] for six months. After the end of the first step of study, females in first group were used standard heel shoes height [3.5-5 cm] for six months. The Kinsiologic Electromyography instrument was used to test the Electromyography magnitude of rectus abdominal and external oblique activity. Data was analyzed with Paired and independent T student and Kolmogorrov-Smirnov tests. Muscle activity in first and second groups at external oblique was 9.72 +/- 3.15 microvolt and 7.87 +/- 2.47 microvolt and at rectus abdominal was 11.60 +/- 3.58 microvolt and 9.81 +/- 3.46 microvolt respectively. Muscle activity before and after using standard shoe heel height was significant [p<0.05]. It seems that using lower heel shoes height increase the trunk muscle activity

[ effect of "constraint induced movement therapy" on velocity and gait kinetics in hemiparetic patients]

Balance and gait disorders are common motor complications after stroke. Studies have revealed that conventional physiotherapy cannot manage these disorders efficiently; so more studies addressing the causes of these complications and presenting efficient treatment protocols are crucial. Thirty hemiparetic patients [age range 40-60 years old] participated in this experimental study. Patients were randomly divided in to 2 groups. One group received Constraint Induced Movement Therapy [CIMT] [group1] and the other Mass Practice [group 2] for 3 weeks. Experimental assessments included stride velocity and kinetic parameters of gait [amplitude and velocity of center of pressure sways of paretic and non-paretic limbs in sagittal and frontal planes] that were recorded and compared before and after treatment. For statistical analysis of data, if distribution of data was normal, parametric tests of t and pair t-tests were used. If distribution of data was not normal, non parametric tests of Wilcoxon and Mann-Whitney were used. SPSS V.11.5 was also used for data analysis. In both groups, stride velocity increased [p=0.03, p=0.01]. In CIMT group, COP sway for paretic and non-paretic limbs decreased in frontal plane [p=0.03, p=0.008]. COP sway velocity for paretic limb decreased in both planes [p=0.01, p=0.03]. For mass practice group, only COP sway amplitude for non-paretic limb decreased in sagittal plane [p=0.03]. Physical therapy based on "Constraint Induced Movement Therapy" can more efficiently manage dynamic balance gait disorders by overcoming "learned non-use" phenomena and improving somato-sensory deafferentation to central motor controllers

[Comparison of the effect of APS and TENS in reduction of pain and functional improvement of patients with mild to moderate osteoarthritis of knee]

Background: Osteoarthritis is the most common joint disorder in human. TENS [Trans Electrical Nerve Stimulation] is used for chronic pain such as those related to osteoarthritis. Recently, APS [Action Potential Stimulation] is widely used and said to be non-stimulant of skin. Therefore, it can be a suitable therapy in controlling the pain. The aim of this study is to compare the effects of APS with TENS in reducing pain and other symptoms of knee osteoarthritis

Materials and methods: This clinical trial was done through randomizing the patients in two therapeutic groups. Thirty-two individuals having mild to moderate arthritis in regard to radiological findings and Ahlback classifications entered to the study and treated in two groups [each group=16]. Group 1 received hot pad for 20 minutes, then, APS for 16 minutes and activity up to tolerance and group 2 received hot pad for 20 minutes, then TENS for 16 minutes and then activity up to tolerance. Each group was treated for 10 sessions. Data collection was performed through interview and patients examinations in four stages of the research

Results: Data was analyzed through SPSS-11. No significant differences were found in any four stages of evaluations, but in each group, most variables showed significant differences statistically in second stage from the first stage and second and four stages from third one

Conclusions: Nerve stimulation consisting of APS and TENS is useful in treatment of patients of osteoarthritis as improving of symptoms was seen with both APS and TENS after 10 days of treatment. Since the velocity of improving of pain was higher in group 1 than group 2, it seems that it is better to use APS in the beginning of the therapeutic course and to continue it with TENS

cut-off point of dual energy X ray and laser [DXL] of calcaneus osteoporosis diagnosis in postmenopausal women

Dual X-Ray energy Absorptiometry [DXA] is a method that can be used extensively for bone mineral densitometry [BMD]. A newer method is called DXL, associates dual X ray absorptiometry assisted by laserX-ray absorptiometry to the measures of heel thickness with a laser beam. In this study the cut off points for DXL of calcaneus in the diagnosis of osteoporosis in different bone regions in postmenopausal women were determined. In 268 postmenopausal women, BMD of the spinal and femoral regions was measured by DXA and the value for the heel calcaneous was measured by DXL. The agreement of the two methods in diagnosis of osteoporosis and optimal cut-off point for DXL in defining osteoporosis was obtained. DXA showed osteoporosis in 40.7% of cases with 35.2% in L2-L4, 16.2% in the femoral neck, and 11.7% for the femoral total region. The DXL found osteoporosis, considering -2.5 SD as a threshold, in 26.1% of cases. According to WHO criteria, agreementAgreement of the two methods in the diagnosis of osteoporosis [Kappa score] was 0.443 for the lumbar region, 0.464 for the neck, and, 0.421 for total femur regions [all P values were significant]. Using Receiver Operating Characteristic [ROC] curves, it was found that a T-score of -2.1, -2.6 and -2.4 as the optimal cut-off point of DXL in the diagnosis of osteoporosis in the lumbar spine, the neck and total region of femur, respectively. The results of this study showed a moderate agreement of the two methods in the diagnosis of osteoporosis. It seems that the DXL cannot be used as a substitute for the DXA method, but it can be used as a screening method for finding osteoporosis