Relationship between quality of life and hypertonia in young adults with spastic cerebral palsy

Background: The complications associated with spastic cerebral palsy can affect the physical ability and quality of life of individuals suffering from this motor disorder. The aim of this study was to assess the relationship between quality of life and hypertonia in adults with spastic cerebral palsy

Methods: In an analytical cross sectional study, 70 subjects with the diagnosis of spastic cerebral palsy from three Ra'ad Rehabilitation Goodwill complexes in Tehran and Karaj cities took part in this study through convenient sampling. The severity of spasticity and contracture of the knee flexors were measured by Modified Tardieu Scale. Also the quality of life was assessed through World Health Organization quality of life-BREF questionnaire. To analyze data, Pearson and spearman correlation coefficient were used

Results: Participants of this study were 42.9% male, 57.1% female with mean age 26.24 +/- 5 years. No correlation existed between quality of life with knee flexor muscles spasticity. However, psychological and environmental domains showed low correlations with knee extension range [respectively r=0.26 and r=0.28; p< 0.05]

Conclusion: The influences of the mechanical component of hypertonia [contracture] on the quality of life are more prominent than neural factors such as spasticity

comparison of the effect of deep and superficial heat on healthy ankle joint position sense

Background: Heat therapy is one of the natural treatments that can affect the information transferred by the proprioceptive receptors. Heat has an effect on the conduction velocity of peripheral nerves, but the exact effect of two kinds of deep and superficial heat on the joint position sense is not known clearly. The present study aimed to compare the effect of deep and superficial heat on ankle joint position sense

Methods: Thirty healthy male students aged between 18 to 30 y/o participated in this study. Deep heat by short-wave diathermy and superficial heat by water of 42 [degree]C were applied for 15 minutes in two sessions for all participants. In all of the tests, active and passive ankle joint position sense in dorsiflexion and plantarflexion were measured by pedal goniometers prior to and after heat application. The Non-Parametric-Paired T-test Wilcoxon and Non-Parametric- Paired T-test Mann-Withney were used to analyze the data

Results: The superficial heat does not have any positive or negative effect on the ankle joint position sense. After the deep heat, the absolute angular error of active dorsiflexion was increased, but passive plantarflexion was decreased significantly. Comparing the two types of heat, the results revealed that the deep heat increased the absolute angular error of active dorsiflexion significantly more than superficial heat

Conclusion: According to the results, deep heat therapy improves passive ankle joint position sense in plantar flexion, but it worsens the active joint position sense of dorsiflexion. Therefore, it seems that after applying deep heat therapy on an ankle joint, exercise prescriptions need to be cautious

Comparative evaluation of core and knee extensor mechanism muscle activation patterns in a stair stepping task in healthy controls and patellofemoral pain patients

Background: Patellofemoral pain [PFP] is a common affliction and complex clinical entity. Deficit in neuromotor control of the core may be a remote contributing factor to the development of PFPS. Comparative evaluation of core and extensor mechanism muscle activation patterns between healthy group and patients involved by patellofemoral pain syndrome [PFPS] in a stair stepping task is the aim of this study

Methods: In this non-randomized interventional study fifteen males with PFPS and fifteen asymptomatic controls participated. Electromyographic [EMG] activity of Vastusmedialisobliquus [VMO], Vastuslateralis [VL], Gluteus medius [GMED], Gluteus Maximus [GMAX], Internal oblique [IO] and Erector spinae [ES] were recorded and EMG onsets were assessed in both stepping up [SU] and down [SD]. The time of foot contact determined by a foot switch

Results: During SU: Onset times of all muscles except, VL and ES in the controls were significantly less than PFPS group [P<0.05]. In PFPS group the temporal sequence of ES, VL and VMO were different from control groups. During SD: Onset times of all muscles except, GMAX and ES in the control group were significantly less than PFP group [P<0.05]. The sequence of muscle activity in both healthy and PFP groups were the same

Conclusion: Our findings are in line with previous researches about the effects of core on function and control of lower extremity. Activation patterns of core and vasti muscles are different between control and PFPS group during stair stepping task. Designing exercises to correct inappropriate timing of core muscles may have a role in management of PFPS and it needs more future researches

Association between spasticity and the level of motor function with quality of life in community dwelling Iranian young adults with spastic cerebral palsy

Consequences of cerebral palsy in adulthood can affect physical, psychological capabilities and quality of life. The purpose of this study was to investigate the relationship between quality of life with spasticity and level of motor function in Iranian young adults with spastic cerebral palsy who were community dweller. In an analytical cross sectional study, 77 participants with spastic cerebral palsy [44 women¡ 33 men] with age range of 20 to 40 years; [mean age 26.19 +/- 5 yr] took part in this study. They were enrolled from three Raad Rehabilitation Goodwill complexes in Tehran and Karaj cities. All subjects were recruited through convenient sampling. Severity of Spasticity for knee flexors was measured with Modified Tardieu Scale. In addition, the level of motor function, and quality of life were assessed respectively through Gross Motor Function Classification System and World Health Organization Quality of life questionnaire [WHOQOL- BREF]. To analyze data, Pearson and spearman correlation coefficient was used. No correlation found between quality of life with knee flexor muscles spasticity and level of motor function [p> 0.05]. Quality of life as a multi dimensional concept has been impacted by many factors such as physical status, environmental issues and culture. Possibly, severity of spasticity and level of function have a less pronounced effect on quality of life in community dwelling adults with cerebral palsy