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ABSTRACT: Despite the large body literature focused on the modified Ashworth Scale (MAS), validity of the scale for measuring spasticity is still questionable. The purpose of this study was to investigate the validity of the MAS by using both the conventional (Hmax/Mmax ratio) and the new indicators (Hslp/Mslp) of motoneuron excitability. Main outcome measures were the MAS and electrophysiologic assessments. The latter was performed using both conventional and new indicators of alpha motoneuron excitability. Data on 20 hemiplegic patients (17 men and three women) were analyzed. Correlation between the MAS and either soleus Hmax/Mmax or soleus Hslope/Mslope was not significant. In 10 patients whose H-reflex could be evoked bilaterally, only new spinal excitability indicator showed significant difference between the affected and non-affected sides. Based on the results of this study, there is no relationship between the MAS and the indicators of alpha motoneuron excitability. This research suggests that the MAS is not a valid measure for the assessment of spasticity in ankle plantar flexors. Acta Medica Iranica 2007; 45(4): 290-294.
05/2012;
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ABSTRACT: The anterior cruciate ligament (ACL) has both mechanical and proprioceptive (sensory) functions. Knee-joint proprioception has been assessed using either reproduction of position or threshold to detect passive motion in non-weight-bearing positions. It has been suggested that a more functional and dynamic/active assessment of proprioception might clarify the effects of injury and reconstruction on the proprioceptive function of ACL at the knee joint.
To assess knee joint position sense (JPS) following ACL reconstruction in functional positions.
Twelve male patients who had undergone ACL reconstruction and 12 male healthy control subjects participated in the study.
JPS was evaluated by reproduction of the angles in weight-bearing position with limb movement into flexion and extension. The dominant knee of healthy subjects and both (reconstructed and uninjured) knees of the patients were tested. Absolute angular error was used as a dependent variable.
There was no significant difference between the operated and uninjured knees of patients or between patients and healthy controls (p>or=0.05). These results were measured during two tasks of limb movement into flexion and extension.
We found no evidence of impaired JPS in weight-bearing positions in subjects with ACL reconstruction at a mean follow-up of 11 months after surgery compared with subjects with healthy knees.
British journal of sports medicine 04/2008; 42(4):300-3. · 2.55 Impact Factor
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ABSTRACT: Low back pain (LBP) is a very common problem in primary care and a major cause of disability. There is no evidence for the efficacy of therapeutic modalities such as ultrasound in LBP In a randomized, single blind placebo controlled clinical trial, we aimed to evaluate the effect of continuous ultrasound (US) in patients with non specific LBP Of the fifty eight patients recruited, 10 patients (8 women and 2 men) randomly allocated to ultrasound (n=5) or placebo controlled (n=5) groups. The patients were treated by either US or sham-US for ten sessions, three days per week, every other day. The outcome measures were Functional Rating Index (FRI), Hmax/Mmax ratio and range of motion (ROM), which were measured at baseline, after 5 treatment sessions and at the end of treatment. To analyze the data, The Mann Whitney U test and Wilcoxon Signed Rank test were used. After treatment, both US and placebo groups showed statistically significant decrease in FRI scores indicating improvement in functional ability (p = 0.042 and p = 0.043, respectively). The mean changes of FRI during the second five treatment sessions and after the end of treatment was significantly better in the US group than in the placebo group (p = 0.016 and p = 0.032, respectively). Before and after treatment, the mean H reflex latency and Hmax/Mmax ratio, right and left side were similar in the groups (p > 0.05), and no significant changes were observed in the treatment groups (p > 0.05). After treatment, the extension and lateral flexion range of motion significantly increased in the US group (p = 0.04), but the back movements in the placebo group did not show significant changes (p > 0.05). The present study supports the significant effect of US on LBP, and suggests that US may improve the functional ability of patients with non specific low back pain.
Electromyography and clinical neurophysiology 12/2006; 46(6):329-36.
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ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 01/2006; Volume 31, 2C. · 0.24 Impact Factor
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ABSTRACT: Background: The purpose of this study was to measure isokinetic maximum and average peak torque of internal and external rotators of glenohumeral joint in volley ball and tennis players Methods: This study was performed on 17 professional female athletes (7 tennis players &10 volleyball players) with age ranged 18-28 years. The subjects had played in a skilled team for more than 3 years. They were free from injury to their dominant shoulder in the past year. Subjects performed a five minute warm up by shoulder wheel and Maximum average Peak Torque (APT) were obtained unilaterally by a Biodex System 3 with the arm of players in 90 degree abduction at 120,180 & 210 o/s. Players performed five trails of concentric movements with 30 second rest between them. Results: Maximum and average of maximum torques of shoulder rotator, in both groups, expect for internal rotators of tennis players, reduced by increase of movement speed (P<0.05). There are not significant difference between two groups in maximum, average of maximum torques and normalized data (ratio of maximum torque to weight). There is significant difference between two groups in percentage of APT of External rotator / Internal rotator ratio at 210 o/s (P<0.05). Conclusion: Volleyball and tennis have no effect on isokinetic strength of shoulder rotators. In high speed, ratio of External rotator / Internal rotator is reduced. This indicates that increase in movement speed increase internal rotator in comparison to external rotator in these professional female athletes.
Tehran University Medical Journal 01/2006;
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ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 01/2006; · 0.24 Impact Factor
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ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 01/2006; 31. · 0.24 Impact Factor
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ABSTRACT: Although many studies provide insight into the possible muscle strength and functional deficits in patients with osteoarthritis (OA), they had not controlled or matched the subjects for various variables The aim of study was to investigate and compare the concentric torque of Quadriceps and Hamstring muscles and Timed-Walking test in two groups. Thus, one group of healthy subjects and one group of patients with low grade of tibiofemoral OA were selected. Concentric torque of Quadriceps and Hamstring were measured in both groups. Besides, pain measurement, Timed-Walking test, range of motion and the muscle bulk of thigh were assessed in both groups. The independent t-test revealed significant differences between the two groups with regard to concentric torques and Timed-Walking test. However, no significant difference in range of motion and the muscle bulk was seen. In conclusion, patients with low grade of osteoarthritis and minimum clinical signs had weaker muscles and functional limitation in comparison with the matched healthy individuals. Acta Medica Iranica 2007; 45 (4): 295-300.
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ABSTRACT: The aim of present study was to determine whether combination of transcutaneous electrical nerve stimulation (TENS) and acupuncture inhibits sympathetic nerve activity in healthy humans. Multiunit efferent postganglionic sympathetic activity was recorded with Toennies set. In this study, the aim was to obtain latency, amplitude and duration of sympathetic skin response (SSR) and skin temperature (ST) from both hands in 15 healthy subjects. Subjects randomly assigned and everybody participated in all the three groups [Control Group (CG), Acupuncture Group (AG) and Nerve Stimulation Group (NSG)]. TENS (2 Hz, 250 microsecond) was applied over the median nerve of the right elbow in NSG for 20 min, either, TENS was applied over (HE-7) point of the right hand in CG (TENS off) and AG (TENS on) for 20 min. SSR (lat, amp, dur) and ST data was recorded before TENS and for immediate, 5 min and 10 min post--TENS. ST was recorded in distal phalanx of index finger of both hands and SSR was recorded from both hands. TENS in CG did not affect ST and SSR following stimulation. TENS applied at AG and NSG caused a significant increase in ST (P = 0.001), significant increase in latency of SSR (P = 0.001), significant decrease in amplitude of SSR (P = 0.001) and no significant changes were observed in duration of SSR (P > 0.05). Then statistical analysis showed differences between both of groups (AG & NSG) for ST and SSR post--TENS. Transcutaneous electrical nerve stimulation inhibits sympathetic nerve activity in healthy humans.
Electromyography and clinical neurophysiology 44(1):23-8.
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ABSTRACT: Mechanoreceptors from the foot sole likely contribute in the reflex regulations. Therefore, it was hypothesized that repetitive low threshold afferents stimulation would have an inhibitory effect on the soleus H-reflexes.
Sixteen normal subjects voluntarily, participated in the study and were randomly allocated. Subjects were remained in prone position. The Cutaneous Mechanical Pressure (CMP equal to 50% of leg and foot weight) was applied to the ipsilateral lateral and Medial plantar surface by a designed instrument through a square plate (30 x 30 mm). H reflex as an indicator for excitability of motoneurones was bilaterally elicited before and after the application of the CMP. The H-reflex parameters were estimated.
Mechanical pressure significantly depressed soleus H-reflex excitability in ipsilateral and contralateral feet in all subjects.
The demonstration of a decrease in H-reflex excitability as a result of applied pressure to the foot sole suggests that the change in reflex excitability is the result of a common spinal mechanism. The results highlight the modulatory effects that natural stimulation of afferents can have on reflex excitability.
The placement of a small flat plate, in order to apply pressure to the plantar eminence, may be useful for modulation of muscle tone. In addition, these findings might be useful for reducing spasticity; because spasticity is at least partially caused by hyperexcitability of the motorneuron pool.
Electromyography and clinical neurophysiology 50(5):251-6.
