شیوا موسوی

Breast cancer is the most common cancer type among women and one of its complications is ipsilateral upper extremity lymphedema. Lymphedma is a chronic condition of lymphatic system that leads to swelling of the involved extremity and, if left untreated, leads to limitation in shoulder range of motion, dysfunction, and feeling of heaviness in the upper limb. The aim of the present study was to compare the effect of complex decongestive physical therapy with combination of intermittent pneumatic compression pump and complex decongestive physical therapy on shoulder range of motion, heaviness and upper extremity circumfference in patients with secondary upper extremity lymphedema post.

A total of 20 female participants with scondary upper extremity lymphedema were selected after breast cancer treatments, reffered by general and cancer surgeons, according to inclusion and exclusion criteria. After the initial assessment, participants were randomly divided into two groups. Participants in the first group were only treated with complex decongestive physical therapy techniques and patients in the second group, in addition to complex decongestive physical therapy techniques, were trated with intremittent compression pump. These techniques include manual lymphatic drainage, bandaging, therapeutic exercise, and skin care and intremittent compression pump. Patients were treated for 2 weeks, 5 days per week. Involved extremity circumference, intensity of limb heaviness, and shouldre range of motion were measured prior to and after the treatment. Also, limb heaviness was evaluated using Visual Analog Scale.

No significant difference was found in the demographic characteristics between the two groups. Following two weeks of treatment, the mean of affected limb circumference in total areas showed statistically significant decrease after treatment compared to that priro to the treatment and heaviness intensity showed statistically significant decrease after treatment compared to that before the treatment. The means of shoulder abduction and flexion showed statistically significant increase after treatment compared to those before treatment in both groups. In addition, there was no significant difference in the means of affected limb circumference and shoulder range of motion between the two groups. However, a statistically significant difference was found in the mean of heaviness intensity between the two groups.

The results of the current study showed, the combination of complex decongestive physical therpy and intremittent compression pump are useful as a means of improving affected limb circumference, intensity of heaviness, and shoulder range of motion.

Proprioception is a component of somatosensory system. One of the most important somatosensory receptors is muscle spindles. Neck area with high density of muscle spindle, plays a significant role in providing this sense. With repeated contact sports, with high trauma on head and neck region, it is likely that proprioception will be impaired. The present study was conducted to compare proprioception between wrestlers, taekwondo players and non-athlete subjects to determine the effect of trauma on proprioception of craniocervical region.
Material and This study was a case-control study of 75 male with the age range of 18-30 years (Including: 25 professional wrestlers, 25 professional taekwondo players and 25 non-athlete subjects). Participants were selected through simple non-probability sampling. To assess proprioception of craniocervical region, angular repositioning of two positions (neutral and 50% of range of motion) was evaluated by using the cervical range of motion device (CROM device). The statistical method which used in this study was one way ANOVA.
Accuracy of target repositioning (50% of range of motion) of extension, right and left rotation were significantly different between three groups (p It is assumed that proprioception of craniocervical region has been affected by trauma in wrestlers and taekwondo players, so that the accuracy of head repositioning for both neutral and target positions were reduced in wrestlers. However, taekwondo players had more errors in repositioning of target angle.

The purpose of the present study was to determine the influence of demographic variables and disease characteristics on the quality of life scores and the distribution of the scores at different stages of Chronic Obstructive Pulmonary Disease (COPD). One hundred patients with COPD participated in this cross-sectional study. Interview and the validated Persian version of the clinical COPD questionnaire (PCCQ) were used for data collection. The method of data collection for the study was interview with a demographic and validated Persian version of the clinical COPD questionnaire (PCCQ). Six percent of patients were revealed as mild COPD, 34 percent of patients as moderate COPD, 49 percent of patients as severe COPD and 11 percent of patients as very severe COPD. Significant differences were observed for total score and the component scores of the PCCQ among four stages of the disease. The age and length of the disease correlated significantly with the total PCCQ score (P<0.05). In order to compare between the CCQ total score and three domains of male and female groups, the results showed that women compared to men had lower quality of life in CCQ total score and functional areas (P<0/5). Distribution of the quality of life scores in patients with different stages of COPD patients showed that there is an overlap quality of life scores in the mild, moderate, severe and very severe stages of COPD patients. As a result, classifying the disease using spirometry cannot distinct patients with COPD according to impairments in their health status. In adittion, the age, sex and length of the disease are the main factors that may affect the quality of life.

The calculated parameters of the center of pressure (COP) are suitable indicators for evaluating balance in patients after rehabilitation. Therefore، determining the reliability level of each parameter is a matter of great importance. This study tried to determine the reliability of some parameters of the COP sway in patients with myofascial neck pain in different postural situations. The present study is a test-retest reliability design. Twenty patients with myofascial neck pain performed a single and a double leg test with open and closed eyes on a force plate and with open eyes on foam in three sessions with a 30 minute intervals for 30 seconds. Antero-posterior and medio-lateral sway range، mean velocity and mean area of sway were calculated. The mean velocity showed high reliability (0. 98) in all situations، but the other parameters were variable in different situations. The results showed that some COP parameters are highly reliable in assessment of patients with myofascial neck pain.

One of the complications of breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and disorder of Quality of life. The aim of this study was to evaluate the effects of Complex Decongestive Physical Therapy (CDP) on pain severity and quality of life in patients with secondary upper extremity lymphedema after breast cancer treatments. A total 30 women (age 29-70 yrs.) with secondary lymphedema after breast cancer treatments participated in this study. They were referred by general and cancer surgeons to Physical Therapy clinic based on inclusion and exclusion criteria. They were treated with complex decongestive physical Therapy. This protocol comprises of manual lymphatic drainage (MLD)، compression garments، remedial exercise and skin care for 4-weeks، once per day، 5 days per week. Quality of life and severity of pain were evaluated before and after treatment. The quality of life was assessed with QLQ-C30 questionnaire. The severity of pain was also assessed by Visual Analog Scale (VAS). After 4 weeks treatment severity of the pain are decreased after treatment. The physical and social roles of quality of life (QLQ-C30) were significantly increased (p<0000). Based on the results of this study، utilization of complex decongestive physical therapy (CDP) In upper extremity lymphedema is a useful method for pain relief and increment of quality of life.

Oneimportant complicationof breast cancer treatment is ipsilateral upper extremity lymphedema. Secondary lymphedema is a chronic condition that leads to loss of function and cosmetic problems. The aim of this study was to evaluate the effects of Complex Decongestive Physiotherapy (CDP) on volume of lymphedema in patients with secondary lymphedema after breast cancer treatments. A total of 30 women with lymphedema after breast cancer treatments and according to inclusion and exclusion criteria were chosen. They were treated with complex decongestive physiotherapy. This protocol involved manual lymphatic drainage (MLD)، Compression garments، remedial exercise and skin care. The women were taken 4-week therapy program once per day، 5 days per week. Absolute volume of the lymphedema and circumference of the limb were evaluated before and after treatment. After 4 weeks treatment، lymphedema volume، circumference in all of the evaluated points and severity of the pain are decreased after treatment. In upper extremity lymphedema، the use of complex decongestive physiotherapy (CDP) can decrease edema.

The translation، cultural adaptation and validation of the Persian version of the American shoulder and elbow surgeons (ASES) were carried out in accordance with published guidelines. The study was conducted on 100 athletes (25. 96±5. 81 years)، which suffered from different shoulder disorders. When the translation and cultural adaptation of the original questionnaire was carried out on the standardized method، the participants were asked to complete a questionnaire booklet including the DASH، the Short Form General Health Survey (SF-36) and ASES questionnaires. In addition، 30 randomly selected patients were asked to complete the ASES questionnaire 48 hours later for the second time. After data collection the Statistical analysis was performed by using SPSS software. The Cronbach''s alpha was used to indicate internal consistency. Cronbach''s alpha was 0. 91 for ASES. Test-retest reliability was quantified by use of the intraclass correlation coefficient. It was 0. 91 for ASES questionnaire. The Pearson Correlation Coefficient was used for the questionnaire validation study. The DASH questionnaire showed high correlation of ICC=0. 78 with ASES. The ASES showed moderate correlation of 0. 48 to 0. 62 with those of the various scales of the SF-36. The Iranian ASES showed good reliability and validity and can be used for shoulder-specific patient self-assessment.

Hyperkyphosis can lead to reduced respiratory capacity, postural disturbance and increased risk of falling. Despite the evidences about the more postural stiffness and kyphosis in elderly compared with young subjects and despite the known role of sex hormones and menopause in lowering the bone density, there is not any study about the effect of sex on the amount of thoracic kyphosis. The objective of this study is measuring and comparing the amount of spinal thoracic kyphosis and postural stiffness between the old females and males.Methods and Materials: In this descriptive-analytical study, in 36 healthy old subjects (21 female and 15 male) the amount of spinal thoracic kyphosis was measured by flexible ruler mounted between the spinous process T12 and C7 during, relaxed and erect postures. The difference of the kyphosis in relaxed and erect posture was used as an index of postural stiffness. The kyphosis and postural stiffness was compared between the females and males. The average amount of kyphosis in relaxed and erect standing didn’t have statistically significant difference between females and males. The subjects in both groups could decrease theirs kyphosis in standing erect position (P=0.0001), but the amount of this decrease (postural stiffness) was not different between the females and males. In old women (which aren’t osteoporotic) hormonal changes due to menopause didn’t induce a statistically significant difference compared to old men in kyphosis and postural stiffness.Postural stiffness was increased by increasing the BMI that could suggest the BMI as an efficient factor in reducing the mobility of the spine

One of the main problems in learning is ignoring the teaching in small group discussion.So, today, teaching in student-based methods such as work in small group is emphasized. Nevertheless, this method is not used for teaching physiotherapy students. This study was performed to determine the effect of teaching in small group on satisfaction and learning level of second- year students in physiotherapy in comparison with lecture teaching. An experimental study was performed on 29 physiotherapy students. The students were randomly classified into two groups; lecture (14 people) and work in small group (15 people). Students were educated for 4 sessions. Two separate questionnaires were used to assess learning and satisfaction levels. Overall satisfaction in small group was significantly greater than lecture group (P<0.0001). However, there was no significant difference between learning levels of the methods (p>0.05). 86.7% of students in small groups preferred to be educated in the future semesters using this teaching method. This study showed the role of small group teaching on increasing student's satisfaction level. Due to increased satisfaction in small group, despite the lack of significant difference between the two methods of learning, learning process can be facilitated. Thus this method is recommended for education of the undergraduate students.

One of the most important part of management and modification of CAD risk factor is to control the level of plasma lipid profile. Application of comprehensive cardiac rehabilitation in patient with CAD could decrease the level of CHL, TG, LDL and increasing of HDL. There are a lot of studies that discuss the effect of rehabilitation on different people with different races and life style. Thirty six patients with the age (40-75) who were referred by cardiologist participated in this study. Fast walking on treadmill, biking on stationary bicycle and cycling with upper body ergometer were chosen as aerobic exercises. For assessing the short term and long term effects of this protocol, blood sampling were taken at three stages; before exercise initiation, after 12 and 24 sessions of exercise. Following the cardiac rehabilitation protocol, the level of CHL, LDL and the ratio of LDL/HDL and CHL/HDL decreased significantly. Cardiac rehabilitation could be used as means to improve lipid profile level in blood serum, prevention of cardiovascular disease and reducing mortality and morbidity rates.

Abnormal joint mobility is an important factor in movement dysfunction and physical disability. A general lack of descriptive details exists for measurements of hip rotation range of motion (ROM). This study was designed to establish the influence of hip position on active and passive range of motion of the hip in external and internal rotation(Ext & Int Rot). Sixty healthy female college-age (22.17 +/- 1. 8 years) subjects were studied. Hip rotation of the legs of each subject was measured in the prone (hip near 0 degree of extension) and seated (hip near 90 degrees of flexion) positions using a standard goniometer. Data were analyzed using an analysis of paired-t-test and Wilcoxon, Mann-Whitney model. Pearson's r statistics were used to determine the reliability of measurements of hip rotation made in ext vs. flex (P<0.05, r>0.90). A statistically significant difference (p < 0.05) was found between mean hip Ext & Int Rot, active range of motion measured in ext vs. flx. Conversely, mean hip Ext & Int Rot, passive range of motion measured in ext or flx was not statistically different. Our data indicate that measurement position had a significant effect on the amount of active range of motion of the hip in Ext & Int Rot. Discussion & These findings are clinically significant for they stress the importance of documenting measurement position. They also stress the need for representative normal valves to be established for each hip position and gender. Our normal valves ROM values for the Int & Ext Rot of the hip calculated from this population based sample were found to differ from estimate found in textbooks. This may be due to young age and female groups and lifestyle of Iranian population, too.

The changes that occur in all of the motor unit recruitment following the central and peripheral lesions of motor nerves can be effective on individual's disability. Following the low back pain (L.B.P) with any known cause, the effective role of muscles in providing postural or dynamic stability will be reduced. Today in rehabilitation of these patients, except of medical treatment for reduction of pain, a great attention is given to assess the motor control and its efficiency in order to prevent reappearance of the disease symptoms. The aim of this research is to determine the amount of changes in motor planning at motor control level in order to provide an appropriate setting for movement of lumbar spine following postural responses and peripheral stimulation. Ten healthy women (24.3+2.32 year) and five women with L.B.P (27.34+4.67 years) without any structural disorder of lumbar spine have participated in this study. The test stages included flexion and extension in sagital plan with/ without external hearing stimulation in the 30 degree of flexion and 10 degree of extension, with 5 repetition. By measuring the amount of individual's reactions and computation of range of motion (R.O.M), the velocity, torque and delay time for showing any reaction prior to reaching stimulation point and its post time as well as comparing them with each other in both groups and also comparing these two groups. There are a significant differences between R.O.M changes, velocity and torque in similar times before and after hearing stimulation in both types of movement (P<0.05). In such a way the said values before hearing the external stimulation was much greater than after hearing the external stimulations and appearance of postural responses (P<0.05). Also in comparing with the conditions that external stimulation and postural response imposing was loosed, the time of appearance the postural response has shown a meaningful reduction (P<0.05). The group consisted of patients with L.B.P in compare with normal group, during the period that the movement were without any external stimulation, has shown no significant difference, while in stages with external stimulation and occurrence of postural responses, the R.O.M, time, velocity and torque have shown a significant difference (P<0.05). In healthy cases the percentage of functional performance reduction following external stimulation was more than the patients (P<0.05). This shows that the patients with history of L.B.P will have problems in setting up motor planning or in feedworward process.

In this study the effects of continuous and pulsed ultrasound (3 MHz) on the parameters of hoffmann's reflex (H reflex) were compared with each other. In order to do this, 14 healthy female subjects aged between 25 and 35 years old (mean = 26.64, SD = 2.71) were tested. Ultrasound (U.S) was applied on the sciatic nerve of right lower limbs on the posterior aspect ofthe thighs at two different sessions. The area oftreatment was 20 square em (2*10). Duration ofthe treatment was 5 minutes and the intensity ofthe U.S. was 1 watt per square em, The duty cycle was 10% for the pulsed ultrasound. -,Parameters ofM wave and H reflex of the soleus muscle (amplitudes of Y2 Hmax, duration and latency) were measured and recorded before the application ofthe U.S. (TO) and immediately (TI), 5 minutes (T5), 10 minutes (TIO) and 15 minutes (TI5) after the U.S. Statistical analysis of the data (ANOVA repeated measurement and paired t-test) showed that the continuous ultrasound increases the amplitude ofH-reflex significantly (P < 0.01). There was no significant difference in the latency before and after the application of U.S.These results may' be due to thermal effects of continuous U.S. on the reflex arc and it seems that the continuous U.S. (3 MHz) increases the excitability ofthe alpha motoneurone.