Effect of slow stroke back massage on anxiety in patients with stroke- A randomized clinical trial

زمینه و هدف: سکته ی ‌مغزی یک بیماری ناتوان کننده می‌باشد که استقلال بیمار را در انجام فعالیت های روزمره به شدت محدود نموده و باعث اضطراب بیمار می شود. ماساژ درمانی به عنوان یک هنر مفید و مؤثر در حرفه پرستاری شناخته شده است که یکی از انواع آن، ماساژ استروک سطحی پشت (SSBM) می باشد. لذا پژوهش حاضر به منظور تعیین تأثیر ماساژ SSBM بر اضطراب بیماران مبتلا به سکته ی مغزی انجام شده است. روش بررسی: در این پژوهش کارآزمایی بالینی که به صورت نیمه تجربی انجام شد، تعداد 34 بیمار از میان 70 بیمار مراجعه کننده به مرکز توانبخشی تبسم شهر تهران در سال 1389 انتخاب شدند و به روش تصادفی در دو گروه مداخله و شاهد قرار گرفتند. ابزار گرد آوری داده ها شامل پرسشنامه های مشخصات دموگرافیک و اضطراب آشکار اسپیل‌برگر بود. میزان اضطراب قبل و 24 ساعت پس از آخرین جلسه ماساژ SSBM در گروه ها ارزیابی و مورد مقایسه قرار گرفت. یافته ها: میانگین نمره اضطراب قبل از مداخله در گروه آزمون 8/25±61/40 و در گروه شاهد 3/85±61/80 بود که از لحاظ آماری تفاوت معناداری را نشان نداد (P>0/05). پس از مداخله میانگین نمره اضطراب گروه آزمون 4/62±34/60 و گروه شاهد 3/44±58/80 بدست آمد که تفاوت معناداری را نسبت به قبل از آزمون نشان داد (0/001>P). نتیجه گیری: بکارگیری ماساژ SSBM توسط پرسنل درمانی و مراقبتی می‌تواند گام مؤثری در پیشگیری یا کاهش اضطراب مبتلایان به سکته ی مغزی محسوب گردد

Cervical Position Sense in Forward Head Posture versus Chronic Neck Pain: A Comparative Study

Introduction: Chronic Neck Pain (CNP) and Forward Head Posture (FHP) are two common musculoskeletal problems of the modern society. Previous studies reported several complications both in CNP and FHP including Joint cervical position sense dysfunction, sensorimotor disturbance, and altered muscle function. However, still, the extent of cervical proprioceptive dysfunction in FHP and CNP is not well known. Therefore, the aim of the present study was to investigate the cervical position sense in individuals with FHP and patients with CNP. Method and Materials: A total of 25 individuals with FHP and 25 patients with CNP participated in the present study. Craniovertebral Angle (CVA) was measured to identify individuals with FHP. Participants’ cervical position senses were calculated performing Head Repositioning Error (HRE) test. Also, independent t-test was run to compare the HRE between the two groups. Finally, in order to evaluate the association between pain and CVA with HRE, Spearman correlation was conducted. Results: The results of the present study revealed a significant difference between the two groups in terms of HRE (p=0.02), with higher HRE in patients with CNP. A moderate positive correlation was observed for CVA and HRE. No significant relationship was found between pain and HRE. Conclusions: The results of the present study showed that patients with CNP have higher HRE, indicating more cervical proprioceptive dysfunction in such patients compared with those in individuals with FHP. This finding may be of interest for those researchers investigating the effects of pain and mechanical loads on cervical position sense.Key words: Joint position sense; Forward head posture; Chronic neck pain; Proprioception; Repositioning Erro

Kliničko značenje povišene razine olova u krvi u ovisnika o opijumu s jakom boli u području abdomena

There are inconsistencies regarding the association of blood lead level (BLL) in opium addicts with severe abdominal pain. In present study, we aimed to assess BLL in opium addicts presented with severe abdominal pain. This cross-sectional study was conducted on 60 opium-addicted individuals admitted to our rehabilitation center in Zabol city during February-October 2016. BLL was measured using potentiometric-stripping analysis (PSA) method. Statistical analysis was conducted in SPSS 20 software. From 60 addicts re-cruited, 47 (78.3%) were males. The mean age was 40.3±18.1 years old. The mean BLL was 43.1±117.4 µg/ dl. Considering a threshold of 18 µg/dl, 22 (37.6%) of the addicts had elevated BLL. The mean BLL in addicts with oral, inhalation and mixed method of consumptions were 54.9±1.5 µg/dl, 47.4±9.2 µg/dl, and 10.1±95 µg/dl respectively (P=0.5). No differences were found regarding the mean BLL among different age groups or between different genders. Furthermore, there were no significant difference in neither hematological pa-rameters or liver enzyme in addicts with normal and elevated BLL. The BLL was not of significant difference in addicts with different methods of opium usage and severe abdominal pain. It is recommended to investigate the effects of factors such as the duration of opium usage and the concentration of lead in opium to influ-ence BLL.Postoje nedosljednosti u vezi povezanosti razine olova u krvi (OUK) u ovisnika o opijumu s jakim bolovima na području abdomena. U ovome radu nam je bio cilj odrediti OUK u ovisnika o opijumu s jakim bolovima u trbuhu. Provedeno je presječno instraživanje na 60 ovisnika o opijumu primljenih u naš rehabilit-acijski centar u gradu Zabol od veljače do listopada 2016. OUK je mjereno metodom potenciometrijske strip-ing analize. Statističke analize su učinjene programom SPSS 20. Od ispitanih 60 ovisnika, 47 (78,3 %) su bili muškarci. Srednja dob je bila 40.3 ± 18.1 godina. Srednja vrijednost OUK je bila 43.1 ± 117.4 μg/DL. S obzirom na prag od 18 μg/DL, 22 (37,6 %) ovisnika imalo je povišeno OUK. Srednje vrijednosti OUK u ovisnika koji su sredstvo konzumirali peroralno, inhalacijski i mješano su iznosile 54.9 ± 1,5 μg/DL, 47.4 ± 9,2 μg/DL i 10.1 ± 95 μg/DL (P = 0,5). Nisu pronađene značajne razlike srednje vrijednosti OUK među različitim dobnim skupinama ili između spolova. Nadalje, nije bilo značajne razlike ni u hematološkim parametrima ili jetrenim enzimima u ovisnika s normalnim i povišenim OUK. OUK se nije značajno razlikovalo u ovisnika s različitim načinima konzu-miranja droge i jakim bolovima u trbuhu. Preporuča se istražiti kako čimbenici kao što su trajanje konzumacije opijuma i koncentracija olova u opijum utječu na razinu OUK

The Effect of Unihemispheric Concurrent Dual-Site Transcranial Direct Current Stimulation of Primary Motor and Dorsolateral Prefrontal Cortices on Motor Function in Patients With Sub-Acute Stroke

It is believed that unihemispheric concurrent dual-site transcranial direct current stimulation (tDCSUHCDS) of the primary motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC) causes an increase in motor cortex excitability. However, the clinical effect of this type of stimulation on patients with neurological conditions is not yet known. The aim of the present study was to assess the effect of anodal-tDCSUHCDS (a-tDCSUHCDS) on upper limb motor function in subacute stroke patients. Fifteen patients participated in this sham-controlled crossover study. The main outcome measures were the reaction time (RT) to visual stimuli, completion time of a nine-pin pegboard (9-PPB), and the scores from the Fugl–Meyer assessment (FMA) for the upper limb of the involved side before and after three brain stimulation conditions. For a-tDCSUHCDS, the anodal electrodes were placed on the M1 and the DLPFC, while for a-tDCS, the anodal electrode was placed on the M1. For the sham stimulation, the tDCS was turned off after 30 s. For brain stimulation, the selected current was 1 mA for 20 min. After a-tDCSUHCDS, there was a significant reduction in the RT and completion time of the 9-PPB compared with the times after a-tDCS and the sham stimulation: p = 0.013 and p = 0.022, respectively). However, there was no significant difference in the FMA scores after the three types of stimulations (p = 0.085). Compared with a-tDCS, a-tDCSUHCDS temporarily improved the RT and dexterity of the involved hand in subacute stroke patients.Clinical Trial Registration: Iranian Registry of Clinical Trials (IRCT), identifier IRCT2015012520787N1

Rapamycin protects testes against germ cell apoptosis and oxidative stress induced by testicular ischemia-reperfusion

Objective(s):Rapamycin is an immunosuppressant compound with a broad spectrum of pharmaco-logical activities. In recent years, it has been used successfully to decrease ischemia-reperfusion injury in several organ systems. The purpose of the present study was to examine the effect of rapamycin on testicular ischemia-reperfusion injury. Materials and Methods: Seventy-two adult male Wistar rats were divided into six groups: control (group1), sham-operated (Group2), T/D + DMSO as vehicle group (group3), and groups 4–6; respectively received 0.5, 1, and 1.5 mgkg-1 of rapamycin , IP 30 min before detorsion. Ischemia was achieved by twisting the right testis 720o clockwise for 1 hr. The right testis of 6 animals from each group were excised 4 hr after detorsion for the measurement of lipid peroxidation, caspase-3, and antioxidant enzyme activities. Histopathological changes and germ cell apoptosis were determined by measuring mean of seminiferous tubules diameters (MSTD) and TUNEL test in right testis of 6 animals per group, 24 hr after detorsion. Results: Testicular T/D caused increases in the apoptosis, malondialdehyde (MDA), and caspase-3 levels and decreases in the superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities in ipsilateral testis (

Cross Transfer Effect of Unilateral Quadriceps Muscle Exercises on Contralateral Limb

Objective: Muscle weakness and atrophy due to immobilization and disuse are most common problems that clinicians especially physiotherapists encounter with them. There are many approachs for overcoming these problems the more intresting of them is cross transfer effect of uninvolved limb exercises. The aim of this study was to investigate the bilateral effect or cross transfer effect of unilateral quadriceps exercises in terms of strength, endurance and electromyographic activities on contralateral homologue muscle. Materials & Methods: 46 healthy male student (yrs=22.5, SE=4.5) participated in this study , 23 of them were in experimental group who undergone 3 weeks of strengthening exercises, and 23 control group continued their usual life . Variables including MVC, (Maximal Voluntary Contraction), END (Endurance), IEMG (Integrated Electromyography) were measured before and after 3 wks in all subject Finding: Data analysis (Paired T Test) revealed that in experimental group all variables of both trained and nontrained quadriceps muscles had been significantly changed (P<0.001) Results: Having no change in control group, these findings approve cross transfer effect of unilateral exercise on homologue muscle. Conclusion: Since changes were same in both trained and contralateral nontrained limbs, so the most probable mechanism of this phenomena in neural adaptation and magic CNS interaction to establish symmetry and equilibrium in the body

Study Cause of SCI in Client User of Rehabilitation Services

Objective: Increase of accidents in such industrial lifestyle, has resulted on increase incidences of Spinal Cord Injuriy (SCI). Research aims are updating knowledge of people about their SCI and to observe their qualty of life. Materials & Methods: In this design 1426 SCI patient were studied. A number of closed & opened questions which allocated 1 to 4 raws were sent to 24 provinces of Iran. This question about prevalence and causes of SCI, use of physiotherapy, Rehabilitation and social welfare services for their respected cases.  Results: Causes of SCI in 82.2% were due to accidents and war. 38.7% of the patients were deprived of physiotherapy services and only 12% of them received physiotherapy services for more than one year. 61.5% of them received Behzisty Organization services so that 36/2% of them received Welfare services, 33/9% rehabilitation aid equipments, 22/4% medical services and only 5% of them received consulting services. Conclusion: Accidents are the most common cause of SCI that some of them could be considered as preventable. Regardless of strong need for physiotherapy and rehabilitation services, some of SCI patients were deprived of such services. Behzisty Organization acts as guardian for disable persons and has an important role in social welfare and rehabilitation of SCI patients and we hope that government supports, enforce such role

Inter-rater reliability of the modified Tardieu scale for the assessment of knee extensor spasticity in patient with multiple sclerosis

Introduction: Spasticity is a common motor disorder in multiple sclerosis (MS). The modified Tardieu scale (MTS) is one of the most widely used test for assessing muscle spasticity. The aim of this study was to investigate the inter rater reliability of MTS in measuring of Knee Extensor muscle spasticity in MS patients. Materials and Methods: Knee extensors of 20 MS patients with mean age of 41.50(SD =11.95) were assessed by two inexperienced physiotherapists. The order of assessments by the two raters was randomized. The inter rater reliability of MTS was determined by ICC two-way random effects model. Results: Inter-rater reliability for quality of muscle reaction and R2-R1 as dynamic component of spasticity in knee extensors muscle was high and moderately high respectively (ICC= 0.89, 0.77). Conclusion: The results indicated MTS can be used as a reliable measurement for assessing knee extensors spasticity

Study of Explicit Knowledge Effects on Implicit Motor Learning in Older Adults

Objective: The motor skill performance and learning in older adults are of a great importance. The primary purpose of this study was to determine whether older adult’s explicit knowledge effect on implicit learning and motor performance and which are typical for rehabilitation and skills acquired in older adults. Materials & Methods: In this comparative study a serial reaction time task by using software was applied for studying implicit and explicit motor learning in 15 older adults received intentional and 15 older adults received incidental instruction in a randomly chosen. In this task 4 squares with different colors appeared on the monitor and subjects were asked to press its defined key immediately after observing it. In the first day subjects practiced 8 motor blocks (4 patterned blocks, then 2 random blocks and finally 2 patterned blocks). Two next day subjects practiced a retention test consisted of 2 patterned blocks. Implicit group were not provided with any explanation about the sequence of squares and explicit group receive explanation about the sequence of squares and blocks. All subjects were right handed and no history of neurologic disease or musculoskeletal dysfunction. Date was analyzed by Independent T test and ANOVA. Results: The results indicated that Block time differences of second block with eight and tenth blocks (two next days) were significant and similar in both groups. Final stage of Task (7-10 blocks) was significant slower in explicit than implicit groups that show significant higher learning in implicit groups but no difference in performance improvement with explicit groups (P<0.001). Conclusion: High motor learning (defined as stable decrease of block times) in implicit older adults group shows explicit knowledge was enabled negative effects on implicit learning, although implicit and explicit groups wasn’t significant difference performance