dr boshra hatef

Disabilities of the upper limbs due to stroke can lead to more prolonged functional problems in comparison to lower limb disabilities, and fewer numbers of investigations have been performed on this problem. Use of magnetic stimulation to produce induction currents in the brain for therapeutic purposes is a new method. The aim of this study was to determine the effects of rTMS plus routine rehabilitation on hand stiffness, and compare them with pure routine rehabilitation program in hemiplegic patients. Method and material: 12 hemiplegic patients were assigned randomly to two groups. Control group, received rehabilitation program with placebo magnetic stimulation, and experimental group, received magnetic stimulation with routine rehabilitation program, 3 times/week for 10 sessions. Using Wrist Robo Hab,we assessed joint stiffness during flexion-extension of the wrist, and supination-pronation of forearm before and after treatment. In the control group we did not find any significant decrease in the resistance of flexor (p=0.207) and pronator (p=0.291) muscles. But in the experimental group the resistance of flexor (p=0.009) and pronator (p=0.035) muscles decreased significantly. rTMS can decrease stiffness of the upper limb joints and can be used in chronic hemiplegic patients, when conventional treatments are not effective.

Patients with type 2 diabetes mellitus (T2DM) are subject to progressive reduction of muscle strength especially in the lower limb. But the rate of progression of weakness is not clear yet. The aim of the study was to compare the isometric and concentric peak torque of knee extension and flexion in the T2DM more and less than 10 years of disease with healthy subjects that matched to patients with regards to sex، body mass index (BMI)، ankle to brachial pressure index (ABI)، and physical activity index (PAI). 30 T2DM patients categorized based on duration of disease in the two groups consist of 18 subjects with T2DM less than 10 years and 12 subjects with T2DM more than 10 years. The patients were compared with 20 sex، BMI، ABI and PAI - matched health subjects. Two- way ANCOVA analyzed the main and interaction effect of grouping and sex on the isometric maximum peak torque (IMPT) and concentric MPT (CMPT) of knee extension and flexion recorded by isokinetic instrument. The age was considered as covariate. The results showed that both knee extensor and flexor IMPT and CMPT were significantly greater in the health subjects than both patient groups (P value<0. 02). The amount of CMPT had also negative correlation with HbA1c percent (P value < 0. 002). There was no significant interaction effect of sex and grouping and different between two diabetic groups in the all MPTs. the women were weaker than men (P value < 0. 002). it is demonstrated that the T2DM patients in the both sexes had less knee strength than health subjects. The effect of duration of diabetes on muscle strength was seem very slowly overtime.