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PURPOSE: This study examined the effects of a dynamic neoprene orthosis on kinematic variables of gait in children with spastic bilateral cerebral palsy (CP). METHODS: Five children (whose median age was 9.6 years and who ranged in age from six to 12) with spastic bilateral CP and flexed knee at levels I-III of the Gross Motor Function Classification System were examined using kinematic gait analysis in three different conditions: 1) with dynamic neoprene orthosis; 2) without dynamic neoprene orthosis (immediate effect); and 3) without orthosis after six weeks of intervention. RESULTS: The comparison between condition one (with dynamic neoprene orthosis) and condition two (without dynamic neoprene orthosis) demonstrated the existence of improvements in minimum hip and knee flexion variables. Moreover, the results indicated that the improvements remained constant in several key gait variables after six weeks. CONCLUSION: The results varied from subject to subject, and there were signs of improvement in some of the subjects. Therefore, it was not possible to draw conclusions at a group level. Nonetheless, a number of individuals may benefit from this type of orthosis. [ABSTRACT FROM AUTHOR]

Purpose: Pronation in the foot is a normal rolling movement occurring at the subtalar joint during running. The human foot, as the primary interface with our environment, presents morphological and postural changes following prolonged running. This study aims to identify running mechanics while training on the sand in runners with pronated feet. Methods: Thirty runners with pronated feet were in the control group, and 30 runners with pronated feet were in the experimental group. An experimental group conducted an 8-week corrective exercise program, while a control group did not exercise. A force plate was included to collect ground reaction forces in the walkway. An analysis of variance (ANOVA) with repeated measures test was conducted to identify the presence of an interaction between the within-and between-subject factors on the dependent variables. The significance level was set at P<0.05. Results: The experimental group displayed lower first peak vertical ground reaction force (P=0.026), peak mediolateral ground reaction force (P=0.000), anterior-posterior impulse (P=0.032), loading rate (P=0.004) and a larger last peak vertical ground reaction force (P=0.000) during training on the sand. Irrespective of the group under consideration, a lower first peak mediolateral ground reaction force (P=0.000), peak positive free moment amplitude (P=0.001), and a larger last peak mediolateral ground reaction force (P=0.003) observed in the post-test compared to the pre-test. Conclusion: We suggest that training on sand may be a suitable intervention to change running mechanics in male runners with pronated feet. [ABSTRACT FROM AUTHOR]

Purpose: Over-pronated foot (OPF) is a common abnormality of the foot. Sand can change lower limb muscle activities. Therefore, the aim of this study was to evaluate the effect of a sand exercise program on knee muscle co-contraction in runners with OPF. Methods: Thirty individuals (age range: 18-26 years) with OPF were randomly allocated to the equally sized control and experimental groups. The experimental group performed a sand running exercise protocol for eight weeks. Muscle activities were recorded using an electromyography system. Two variables, including directed co-contraction and general co-contraction, were calculated before and after training programs. Results: In the experimental group, lower directed vastus lateralis/vastus medialis co-contraction, greater general knee co-contraction, and directed medial/lateral knee co-contraction during the mid-stance and push-off phases were found at the post-test compared to the pre-test (P<0.017). Irrespective of the time, greater directed medial/lateral knee co-contraction during the push-off phase was observed in the experimental group (P=0.043). Conclusion: Sand can be used as a suitable surface for training, as increased muscle co-activation is required to make postural adjustments during running. [ABSTRACT FROM AUTHOR]

Gait disturbance is a common presentation of neurologic disease in children. Limping is a kind of gait dysfunction that occurs due to neurologic & skeletal diseases. Diskitis is an inflammatory process noted as one of the significant causes of limping especially in children aged less than 3 yr. Here we report case of diskitis and limping as the significant manifestation of Gait disturbance in A 22 months old boy from 17 Shahrivar Hospital in 2016, Rasht, northern Iran. Regarding normal neurologic exam, nervous system involvement was less possible. About 60% of gait cycle related to stance phase. [ABSTRACT FROM AUTHOR]

Purpose: Due to the paucity of information regarding the lower limb biomechanics in running at slow speed, as well as the concentration of most previous studies on a single movement plane, this study aimed to investigate lower limb joint kinetics with increasing running speed. Methods: Twenty-eight runners were asked to stay on the treadmill at a bent velocity which was incrementally increased to 2.5 m/s, 3.5 m/s, and 4.5 m/s speeds. The three-dimensional joint moment and sagittal mechanical muscle power of the lower limb were calculated during the stance phase of running. Repeated measures analysis of variance (ANOVA) with Bonferroni post hoc test was used to examine the variables during running at various speeds. Results: The results showed that at the hip joint in the frontal plane, an adduction moment developed in the middle of the stance phase, and the highest peak adduction moment was obvious at the highest speed condition (4.5 m/s). Also, the time elapsed to peak in the highest speed condition was less than the others. In the transverse plane, although the 3.5 m/s-speed condition experienced the maximum external rotation peak moment, the 4.5 m/s-condition speed reached the internal status earlier than the two other speeds. In the sagittal plane, the highest speed condition showed the highest extension and flexion moments. Conclusion: Increasing running speed in runners leads to more kinetic output and mechanical power gradient. [ABSTRACT FROM AUTHOR]

Objective This study was conducted to investigate the strategies used by visually impaired and blind people in Iran to cope with difficulty performing daily living activities. Materials & Methods This research is a qualitative study using a content analysis method. The participants were 18 visually impaired and blind people who were purposefully selected from those referred to the Visual Aid Research Center of Iran University of Medical Sciences in Tehran City, Iran. A semistructured interview was first used using general questions about some daily living activities to discover the participants' experiences. Attempts were made to allow participants to express their experiences independently without the help of the interviewer. The interviews were recorded as an audio file. After the interview, the audio files were transcribed and analyzed using thematic content analysis. The key sentences were extracted from the main texts, and the strategies or concepts extracted from those sentences were identified. Common strategies were put under one category. After the data saturation, when no new concept was found in the sentences, the interviews ended. By examining similar strategies in a category, subcategories were defined, and finally, similar subcategories were placed in a more general category, and the main themes or strategies were identified. Results The Mean±SD age of the participants was 39.5±11 years, ranging from 22 to 66 years. Of 18 participants, 7 were blind, 7 had severe visual impairment, and 4 had moderate visual impairment. Their duration of blindness or visual impairment was more than five years. In terms of education, 7 had no high school diploma, and 11 had a high school diploma or higher degree. Vision loss was congenital in some subjects and acquired in others. We extracted 8 main themes or strategies used by the subjects to cope with difficulty performing daily living activities. These themes are trust in others, use of alternative senses, efficient vision care, use of technology, optimization of the living environment, avoiding a specific activity, increasing emotional intelligence, and use of intelligence and memory. Conclusion The strategies used by the visually impaired and blind people in Iran are entirely personal and innovative and play an influential role in increasing their quality of life. According to their own statements, these strategies can solve their many problems in performing daily living activities. [ABSTRACT FROM AUTHOR]

Purpose To examine the effects of radial extracorporeal shockwave therapy (rESWT) on plantarflexor spasticity after stroke. Method Twelve patients with stroke were randomly included for this prospective, single-blind clinical trial. Patients received one rESWT session (0.340 mJ/mm2, 2000 shots) on plantarflexor muscle. The Modified Modified Ashworth Scale (MMAS), H-reflex tests, ankle range of motion (ROM), passive plantarflexor torque (PPFT) and timed up and go test (TUG) were measured at baseline (T0), immediately after treatment (T1) and one hour after the end of the treatment (T2). Results Patients had improved the MMAS scores for both the gastrocnemius and the soleus muscles, active and passive ROM, PPFT and TUG over time after rESWT. For the PPFT, it was greater at high velocity than at low velocity, and there was a significant three-way interaction between time, knee position (extended/flexed) and velocity (low/high). The H-reflex latency had decreased at T1, but there was no significant effect on Hmax/Mmax ratio. Conclusions The rESWT improved plantarflexor spasticity, and the effects sustained for one hour, whereas it was not effective in improving spinal excitability. One session radial extracorporeal shock wave therapy (rESWT) is safe and effective in improving post stroke plantarflexor spasticity, ankle active and passive range of motion, passive torque, and walking capability. The spasticity scores improved for both the gastrocnemius and the soleus muscles and persisted one hour after rESWT. The magnitude of resistive plantarflexor passive torque in the knee extended position and high velocity was larger over time suggesting greater gastrocnemius spasticity than soleus. The rESWT had no significant effects on alpha motorneuron excitability. [ABSTRACT FROM AUTHOR]

Falls in elderly people occur commonly and may result in significant morbidity and mortality. Prevention of falls is quite possible. The important point is to know and use interventions appropriate to each context. The aim of this study was to explore the facilitators and barriers of the process of falling in elderly people in an Iranian context. A grounded theory data analysis method (constant comparative analysis) was applied using semistructured interviews with15 older persons and seven formal and informal caregivers. According to the experiences of the participants of the current study, the main situation was “response to ageing,” and eight major concepts related to this situation have been explored. In reaction to ageing, older persons show three main responses including maladaptive, corrective adaptation, and unsuccessful or disruptive adaptation. Other related concepts include physical and mental condition, learning on aging, fall consequences, fatalism in falls, lifestyle, social factors related to falling, environmental factors, and restrictive care. Responses to ageing had the most important role in shaping the process of falls. Therefore, the type of interventions that lead people to respond appropriately to aging may be an effective factor in preventing falls in elderly people. It is also necessary to explore the process of fall in each context. [ABSTRACT FROM AUTHOR]

Falls in elderly people occur commonly and may result in significant morbidity and mortality in older individuals. Prevention of falls is quite possible. The important point is to know and use interventions appropriate to each context. The aim of this study was to explore the facilitators and barriers of the process of falling in elderly people in an Iranian context. A grounded theory data analysis method (constant comparative analysis) was recruited using semistructured interviews with 15 older persons and seven formal and informal caregivers. According to the experiences of the participants of the current study, the main situation was “response to ageing,” and eight major concepts related to this situation have been explored. In reaction to ageing, older persons show three main responses including maladaptive, corrective adaptation, and unsuccessful or disruptive adaptation. Other related concepts include physical and mental condition, learning on aging, fall consequences, fatalism in falls, lifestyle, social factors related to falling, environmental factors, and restrictive care. Responses to ageing had the most important role in shaping the process of falls. Therefore, the type of interventions that lead people to respond appropriately to aging may be an effective factor in preventing falls in elderly people. It is also necessary to explore the process of fall in each context. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the use of schoolbags and the prevalence of musculoskeletal symptoms among a sample of 307 Iranian primary school children aged 7–12 years. The average load carried by the children was 2.9 kg (representing on average 10.1% of the child's body weight). Most children chose to carry the schoolbag across two shoulders, although significant numbers also carried it on one shoulder or in the hand. Although the amount of load carried by school children was within the currently suggested load limit of 10% to 15% of the child's body weight, the prevalence of musculoskeletal problems was very high among the study population. Multiple logistic regression models indicated that the method of carrying the schoolbag was significantly associated with hand/wrist and shoulder symptoms, and that the time spent carrying a schoolbag was associated with hand/wrist and upper back symptoms. Schoolbag weight (expressed as a percentage of body weight) was only associated with hand/wrist symptoms. The results suggest that the current recommended weight limit may not be appropriate for school children in primary school, and that guidelines ought to consider factors other than relative schoolbag weight that influence the use of schoolbags among this age group. Practitioner Summary:The carrying of schoolbags by primary school children and their musculoskeletal symptoms were investigated. The results provide evidence that the current weight limit may not be appropriate for younger school children, and that such guidelines should consider a broader combination of the factors that influence the use of schoolbags. [ABSTRACT FROM PUBLISHER]