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Evaluation the effects of dry needling on sonographic, biomechanical and functional parameters of spastic upper extremity muscles. Twenty-four patients (35–65 years) with spastic hand were randomly allocated into two equal groups: intervention and sham-controlled groups. The treatment protocol was 12-sessions neurorehabilitation for both groups and 4-sessions dry needling or sham-needling for the intervention group and sham-controlled group respectively on wrist and fingers flexor muscles. The outcomes were muscle thickness, spasticity, upper extremity motor function, hand dexterity and reflex torque which were assessed before, after the 12th session, and after one-month follow-up by a blinded assessor. The analysis showed that there was a significant reduction in muscle thickness, spasticity and reflex torque and a significant increment in motor function and dexterity in both groups after treatment (p < 0.01). However, these changes were significantly higher in the intervention group (p < 0.01) except for spasticity. Moreover, a significant improvement was seen in all outcomes measured one-month after the end of the treatment in the intervention group (p < 0.01). Dry needling plus neurorehabilitation could decrease muscle thickness, spasticity and reflex torque and improve upper-extremity motor performance and dexterity in chronic stroke patients. These changes were lasted one-month after treatment.Trial Registration Number: IRCT20200904048609N1 Upper extremity spasticity is one of the stroke consequences which interfere with motor function and dexterity of patient hand in activity of daily living Applying the dry needling accompanied with neurorehabilitation program in post-stroke patients with muscle spasticity can reduce the muscle thickness, spasticity and reflex torque and improve upper extremity functions [ABSTRACT FROM AUTHOR]

Purpose: Dynamic postural instability and subsequent functional movement dysfunctions are acknowledged as one of the primary reasons for intrinsic injuries. To prevent these injuries, individuals at risk should be diagnosed and involved in functional corrective interventions. This study was conducted to investigate the effectiveness of a six-week exercise intervention based on functional training on chest wall mobility, respiratory function, and the quality of functional movement patterns among female bodybuilders. Methods: The current study was a semi-experimental, conducted over six weeks, investigating the effect of a functional training protocol on chest mobility, respiratory function, and functional movement patterns in 40 female volunteers aged 19-39 years. The participants were assigned to two groups, an intervention group (n=20) and a control group (n=20), using a randomization technique. Upper chest mobility (UCM), lower chest mobility (LCM), inspiratory breath-hold time (IBHT), expiratory breath-hold time (EBHT), respiratory rate (RR), functional movement screen (FMS), and closed kinetic chain upper extremity stability test (CKCUEST) were measured at baseline and at the end of the study. Six weeks of functional training (three sessions per week) was implemented. The data were analyzed using repeated-measures analysis of variance (RMANOVA) by SPSS software, version 23. Results: A significant improvement was observed only in chest mobility (UCM: 3.74±1.26 vs 8.13±1.26, P<0.001 and LCM: 4.36±1.84 vs 7.63±1.53, P<0.001), CKCUEST (18.42±3.77 vs 21.67±3.23, P<0.01), and overall score of the FMS tests (14.55±1.93 vs 16.65±1.87, P<0.003), and the RR (18.00±3.43 vs 17.00±3.46, P<0.001) in the functional training group. Conclusion: It seems that doing the functional exercises program can improve chest mobility, respiratory function, and the quality of functional movements of female bodybuilders. It is recommended for coaches and athletes to use these exercises along with specific bodybuilding exercises. [ABSTRACT FROM AUTHOR]

Objective Musculoskeletal pain syndrome (MPS) is one of the main causes of functional disability. Although the symptoms and complaints of patients with MPS are often related to their musculoskeletal structures, repeated microtraumas and overuse (the main causes of musculoskeletal pain) may also lead to abnormal neurodynamics. Abnormal neurodynamics refers to mechanical dysfunction in the movement of nerve structures related to the surrounding tissues or disruption in the normal elongation of the nerve. Some recent studies have suggested the possibility of abnormal neurodynamics in patients with MPS. Therefore, this study aims to determine the frequency of abnormal neural tension and its association with functional disability in patients with MPS of the upper extremity. Materials & Methods A hundred participants with MPS (78 women and 22 men) participated in this study. Median, radial and ulnar nerve neurodynamic tests were performed according to Butler & Shacklock's approach. There was a five-minute rest between each test to avoid the therapeutic effects of neurodynamic maneuvering. To quantitatively measure the intensity of the abnormal tension in the peripheral nerves in case of a positive neurodynamic test, the angle of the elbow joint in extension (for the median and radial nerves) and the angle of the shoulder joint in abduction (for the ulnar nerve) were measured using a standard goniometer. The association between abnormal neural tension and functional disability was investigated using Pearson's correlation test. The statistical significance level was set a t 0.05. Results Regardless of the type of disorder, 112 patients had abnormal neural tension (some participants had more than one disorder) and underwent the neurodynamic test. Based on the results, 50 patients (50%) had at least one median, radial, or ulnar nerve tension dysfunction. There was no significant association between the degree of functional disability and the severity of abnormal neural tension according to the joint angle. Conclusion In many patients with MPS of the upper extremity with no obvious symptoms of neurological dysfunction, the nerve neurodynamic test is positive. Therefore, it is recommended that in all patients diagnosed with MPS, nerve neurodynamic test and, if necessary, neurodynamic therapy should be included in the routine physiotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Carpet weaving is one of the most common occupations in Iran. Studies have shown that the majority of workers in these industries are women and these people are exposed to high occupational risks such as musculoskeletal disorders (MSDs). This study aimed to evaluate the hands activity level and upper extremity work-related musculoskeletal disorders (UEWMSDs) symptoms in female carpet weavers (FCWs). Methods: This case-control observational study was performed on 150 FCWs of a carpet weaving workshop as a case group and 150 office staff as a control group. In order to assess the risk factors for UEWMSDs, the Hand Activity Level-Threshold Limit Value (HAL-TLV) method was used. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess the prevalence of UEWMSDs symptoms in the past year. Data were analyzed using SPSS-V 24. Results: The mean final scores of the HAL_TLV for the case and control groups were 1.04 and 0.15, respectively. The results of the statistical analysis showed a statistical significant difference between the mean of HAL, NPF, and HAL_TLV variables in case and control groups (P < 0.001). Also, the results showed a statistical significant difference between the mean scores of the incidence of discomfort in the Shoulder, Forearm, and Wrist areas in the case and control groups (P < 0.001). Conclusion: The results of this study show the effect of increasing the level of hand activity on UEWMSDs symptoms. To reduce the level of hand activity and UEWMSDs symptoms in FCWs, there should be increased focus on work time, work speed, and the use of ergonomic, lightweight hand tools. [ABSTRACT FROM AUTHOR]

Introduction: Avascular necrosis (AVN) is a rather common complication of scaphoid fractures, particularly scaphoid waist nonunion, which may occur even after surgical fixation. In the present investigation we aimed to evaluate the efficacy of Mathoulin technique in the surgical fixation of scaphoid waist nonunion with definite proximal AVN. Material and Methods: A total of 35 cases of scaphoid waist non-union with definite proximal AVN undergoing surgical fixation in a major tertiary referral orthopaedic hospital in northwestern Iran in 2021 were enrolled. Postoperative pain intensity, grip strength (based on modified mayo wrist score) and carpal range of motion (angles of movements) were evaluated at four time intervals, 1, 4.5, 6 and 9 months following Mathoulin surgical fixation. Results: A total of 35 patients, 28 (80%) male and 7 (20%) female, with a mean age of 28.96 ± 1.89 were investigated. By the end of the 9th month, no patients complained of severe pain, and 33 (94.28%) participants only reported mild pain. Carpal flexion, extension, supination and pronation angles significantly improved following surgery. Grip strength in 29 patients improved significantly. Wrist function Union as achieved in 33 (97.29%) patients. Conclusion: Mathoulin method in patients with proximal definite AVN with Scafoid Waist fusion leads to a reduction in pain intensity, improvement of motor angles, grip strength and satisfaction with surgery to a desirable extent. [ABSTRACT FROM AUTHOR]

Objectives: Fugl-Meyer Assessment (FMA) is the common scale for clinical and functional evaluation of sensorimotor conditions and related Upper Extremity (UE) dysfunction after stroke. This study was done to translate and cross-culturally adjust the original upper extremity FMA (FMA-UE) into Persian and to evaluate the psychometric properties of the translated version. Methods: A procedure of forward/backward translation based on the published guidelines was adopted and two independent bilingual translators performed the translations in each stage. The conceptual and semantic equivalence was obtained through a consensus between experts. Consecutive stroke patients (n=47, male=63%) with a mean age of 61.54±10.9 years were recruited. Content, face, and concurrent validity was calculated using the content validity index, a cognitive interview, and correlation with the Wolf Motor Function Test (WMFT). Internal consistency and intra-rater reliability were determined by calculating Cronbach's alpha and the Intra-Class Correlation coefficient (ICC2.1). Results: During the forward translation and cultural adjustment, some wording changes were performed. In the forward translation, the most challenging clarifications are related to anatomical terms and positions. The total FMA-Persian score demonstrated acceptable internal consistency (a=0.86) and intra-rater reliability (ICC2.1=0.96). Joint passive motion showed the lowest reliability among all domains. The FMA motor subscales showed a floor effect, while sensation, joint passive motion, and pain domains showed ceiling effects. The correlation between the FMA-UE score and the WMFT was 0.78 (P<0.001). Discussion: The FMA-UE translation and adjustment were performed successfully into the Persian language. The results of the current study found FMA-UE as an acceptable, reliable, and valid instrument for evaluating the upper limb function after stroke in Persian-speaking patients. However, it should be noted that floor and ceiling effects are respectively present in the domains of the motor subscales and for sensation, passive motion, and pain. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the effect of upper extremity coordination exercises based on fatigue prediction on fine and gross manual dexterity, upper limb motor function, shoulder and elbow proprioception, occupational performance, and activities of daily living in chronic stroke survivors. Methods: In this pilot double-blind randomized clinical trial, 24 chronic strokes were enrolled using the non-probability sampling method. Participants were randomly allocated to the control (received routine occupational therapy) and intervention (received upper extremity coordination exercises based on fatigue prediction using the Kinect) groups. Before and after the interventions (six weeks, three sessions/week, 45 min/session), as well as six weeks after completion of interventions, participants were assessed using the following tools: Box-Block Test, Purdue-Pegboard Test, Wolf-Motor Function Test, Action Research Arm Test, Manual Ability Measure-16, Grip Dynamometer, Shoulder Position Sense Test (SPST), Elbow Position Sense Test (EPST), Canadian Occupational Performance Measure, Shah-Barthel Index (SH-BI), and Multi-dimensional Fatigue Inventory. This project was carried out in the rehabilitation department of Shafa-Yahyaeian Hospital from May 2019 to June 2020. Results: The results showed a significant improvement in all assessments of both control and intervention groups (P=0.05), except for SH-BI. Further, the improvement of EPST and SPST scores in the intervention group was significantly greater than the control group (P=0.05). Also, a significant decrease in fatigue severity was observed in both control and intervention groups (P=0.05). Conclusion: These results suggest that upper extremity coordination exercises based on fatigue prediction in combination with routine occupational therapy could lead to improvement of upper extremity sensory-motor functions and power grip and caused a decrease in fatigue severity in chronic stroke. [ABSTRACT FROM AUTHOR]

BACKGROUND: Carpal tunnel syndrome (CTS) is a common disorder among occupations where upper extremities are actively involved in. Many occupational and non-occupational risk factors may contribute to this disorder. Knowledge regarding occupational risk factors can guide us to implement interventional programs. OBJECTIVE: The aim of the present study was to assess the prevalence and severity of CTS symptoms among butchers and their association with several occupational and non-occupational risk factors. METHODS: In this study, 152 butchers in Hamadan, Iran, were examined. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to investigate the severity of CTS symptoms among the individuals. Several risk factors such as body mass index (BMI), wrist ratio, active working hours per day, working experience, and the ergonomic quality of hand tools used by butchers were also investigated. Statistical tests such as the crude and robust regression were used to analyze the data. RESULTS: The prevalence of moderate and mild symptoms of CTS were 7% and 54%, respectively. Moreover, 39% of the butchers were free of CTS symptoms. Crude regression analyses showed that the severity of CTS symptoms had a significant relationship with age, work experience, active working hours per day, working hours per week, and ergonomic quality of the hand tools (p value <0.05). There was no significant relationship between the severity of CTS symptoms and wrist ratio and BMI. Results of the robust regression analysis showed a significant relationship between the severity of CTS symptoms with experience, active working hours, and quality of the hand tools. CONCLUSION: Occupational risk factors such as working experience, active working hours per day, and the ergonomic quality of hand tools are significant risk factors of CTS symptoms among butchers. Slippery handle is the main non-ergonomic feature of knives and cleavers used by butchers. There was no association between BMI and wrist ratio with CTS symptoms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Muscle weakness is the most common impairment in the upper extremity (UE) after a stroke. Understanding the relationship between hand strength and functional outcomes would be advantageous in clinical settings for the development of efficient rehabilitation programs. PURPOSE: To determine the relationship of hand strength with paretic UE function and activities of daily living (ADL) performance. METHODS: Twenty-six patients with hemiparetic stroke (mean age 51.38±12.64 years) participated in this cross-sectional study. Hand strength was assessed on both the more affected and less affected sides. An electronic dynamometer and isokinetic dynamometer were used to measure static grip and pinch strength, and dynamic grip strength, respectively. The relationships of hand strength with paretic UE function (Fugl-Meyer Motor Assessment, FMA) and ADL performance (Modified Barthel Index, MBI) were analyzed. RESULTS: Hand strength on the more affected side had a moderate to high correlation with UE function (r = 0.62–0.77, P < 0.001), in comparison hand strength on the less affected side had low correlation with UE function (r = 0.39–0.44, P < 0.05). Hand strength on the less affected side had a moderate to high correlation with ADL performance (r = 0.61–0.75, P < 0.001), while, hand strength on the more affected side had low correlation with ADL performance (r = 0.42; P = 0.03). Regression analysis showed that static grip and pinch strength on the more affected side contributed 71% of the variance in FMA scores, and static grip and pinch strength on the less affected side accounted for 73% of the variance in MBI scores. CONCLUSION: Hand strength on the more affected side is associated with paretic UE function and hand strength on the less affected side is associate with ADL performance. [ABSTRACT FROM AUTHOR]

Background: Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. Objective: The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. Methods: This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. Results: The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. Conclusion: The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of Same Arm Movement Therapy versus Constraint Induced Movement Therapy in improving upper-limb functions in patients of chronic stroke., Methods: The pilot, assessor-blind, randomised control trial was conducted from February to September 2020 at the Spine and Physiotherapy Rehab Centre, Riphah Rehabilitation Centre, Lahore, Pakistan, and comprised patients of either gender aged 30-60 years having any type of stroke for a minimum 3 months. They were randomised into group A which received same arm movement therapy for 8 weeks of mental rehearsal of upper limb movements during 45min supervised sessions three times a week and structured independent sessions twice a week, and group B which received constrain induced movement therapy for eight weeks of daily intensive training of the affected extremity for two hours per day, five days per week for eight weeks in association with restriction of the non-affected extremity for 10 hours a day. Measurements were taken at baseline and post-intervention. Data was analysed using SPSS 21., Results: Of the 22 patients, 5(22.7%) were male and 17(77.3%) were female. The average age in group A was 54.91±5.89 years compared to 53.18±6.61 years in group B. All 22(100%) patients had ischaemic stroke. Intragroup comparisons showed significant progress in both groups (p<0.05), but intergroup comparisons showed non-significant differences (p>0.05)., Conclusions: Both the study interventions had similar effect on upper limb functions among chronic stroke patients., Rct: Iranian Registry of Clinical Trials: RCT20200620047848N1 https://www.irct.ir/trial/49054.

Objectives. This study aimed to determine the types and frequency of pen-paper observational methods (OMs) used by Iranian practitioners and to identify their errors in selecting and implementing these methods. Methods. This was a systematic review and analytical study of papers in which the OMs had been used. Scientific databases were analyzed from September 1970 to September 2018. Errors were determined based on a list of wrong practices both in the selection and implementation of methods. Three ergonomists carried out the process of identifying errors independently. Results. The most frequently used methods were rapid upper limb assessment (RULA), quick exposure check (QEC) and rapid entire body assessment (REBA), respectively. Errors in selecting and implementing pen-paper OMs were 53.3 and 36.4%, respectively. Conclusions. Despite the abundant number of pen-paper OMs, Iranian practitioners use few of them. The high rate of errors can indicate a lack of knowledge and skills among practitioners for selecting and implementing OMs. The development of decision-making tools may help practitioners to select appropriate pen-paper OMs for assessing different types of tasks.

Background: Survivors of moderate and severe traumatic brain injury typically present with spasticity, an upper motor neuron lesion associated with hyperexcitability of the stretch reflex due to disinhibition of cortical influences on spinal cord circuits and structural and functional changes in skeletal muscle. There is growing evidence supporting the effectiveness of dry needling in abating spasticity., Case Presentation: The present case aims to quantify the effects of dry needling on upper limb spastic muscles in a survivor of severe traumatic brain injury in a 27-year-old Iranian man. The treated muscles were biceps brachii, brachialis, flexor digitorum superficialis and profundus, flexor carpi radialis, flexor carpi ulnaris, opponens pollicis, and adductor pollicis. Outcome measures were evaluated before and 1 hour after the intervention. Our results showed that the patient's upper limb recovery stage and hand function improved one grade according to Brunnstrom recovery stages. Spasticity assessed using the Modified Modified Ashworth Scale in all movements showed one-grade abatement, except in the forearm pronator. Passive resistance force decreased in all movements except in forearm supination. Active range of motion and passive range of motion increased in all movements except in active and passive forearm supination. Hand dexterity improved in both affected and unaffected hands., Conclusions: Results shown that dry needling could be a favorable option for reducing spasticity., (© 2022. The Author(s).)

Spasticity or increase in muscle tone is one of the problems following stroke. Due to this increase in muscle tone, patients are confronted to problems in motor control and difficulties in activities of daily living and complications such as shortness and contracture. The aim of this study is to compare the effects of using splint or botulinum toxin injection on spasticity, range of motion and upper extremity function in a 3-month period. The method of this research study was a two comparison design, done in rehabilitation clinics in Tehran. At first, 50 patients with chronic stroke were selected and based on the inclusion criteria, a total of 28 stroke patients after completing the consent forms were entered to intervention groups of splint or botulinum toxin injection and they were followed up about 3 months. At last, 18 patients completed the study. Goniometery was the method to measure range of motion, and Modified Ashworth scale was used to examine the spasticity and the upper extremity function was scored based on Fugl-Meyer assessment. All outcome measures improved in each group, but the differences between two groups were not significant (p value > 0.05). In this study, the effects of botulinum toxin injection and Volar-Dorsal Wrist/Hand Immobilization splint were not significantly different between the interventions in a 3-month follow-up. [ABSTRACT FROM AUTHOR]

Abstract: Background: Hydrocarbon injection, which mostly occurs in the upper extremity, is commonly seen in domestic and industrial accidents, or attempted suicide. Surgical approach to chemical cellulites and other complications in these patients is controversial. Method: This survey has been carried out on 21 patients admitted to general surgery unit of Loqman Hakim hospital, Tehran, Iran with the complaint of hydrocarbon injection in 2001–2005. Results: The most common injected material was petroleum (in 8 patients). Anterior forearm was the most common injection site (in 16 patients). All of the patients had inflammation, swelling, and localized tenderness. Leukocytosis was present in 18 of 21 patients. Compartment syndrome happened in 13 patients; 5 with necrotizing fasciitis. All of the patients with compartment syndrome underwent fasciotomy and debridement. Split thickness skin graft was done for 10 patients after 2 weeks of admission. There was no mortality or limb loss during the study period. Conclusions: Prevention of the systemic complications, hospitalization, close monitoring and treatment of chemical cellulites are the main parts of the management of patients with hydrocarbon injection. Surgical intervention is recommended when compartment syndrome or other local complications occur. [Copyright &y& Elsevier]

Background: Spasticity is a common motor disorder in adult stroke patients. Injury to the corticospinal tract (CST) is associated with spasticity. Dry needling (DN) has positive impacts on spasticity reduction and improvement in the range of motion (ROM) in stroke patients. This study aims to investigate the effectiveness of DN on the connectivity of the CST and the level of spasticity in adult stroke patients., Methods: This double-blind randomized controlled trial will enroll and randomly assign stroke patients to either the experimental group, for receiving three sessions of DN for the spastic wrist flexors, or the control group, for sham needling. The primary outcome measures will be diffusion tensor imaging and the Modified Modified Ashworth Scale score to assess CST connectivity and wrist flexor spasticity, respectively. The Box and Block Test and standard goniometry are the secondary outcome measures to assess hand dexterity and active and passive wrist ROM, respectively. Measurements will be taken both before and after the intervention., Discussion: The results of this study will provide important evidence of the effects of DN on CST connectivity, spasticity, and arm function in adult stroke patients., Trial Registration: This trial is registered in the Iranian Registry of Clinical Trials (IRCT) (https://www.irct.ir; IRCT20191208045649N1).

Background: Previous studies suggested that obesity and fat mass are associated with QT interval prolongation, but the role of different body parts' fat mass is unclear. The associations between total and regional fat mass (FM) and corrected QT interval (QTc) were investigated for the first time in this study., Methods: In this sub-analysis of Fasa PERSIAN cohort Study data, 3217 subjects aged 35-70 entered our study. Body fat mass was assessed by bioelectrical impedance analysis and QTc interval calculated by the QT interval measured by Cardiax ® software from ECGs and Bazett's formula. Uni- and multi-variable linear and logistic regression was performed in IBM SPSS Statistics v23., Results: In males, the fat mass to fat-free mass (FM/FFM) ratio in the trunk, arms, total body, and legs were significantly higher in the prolonged QTc group (QTc > 450 ms). Trunk (B = 0.148), total (B = 0.137), arms (B = 0.124), legs (B = 0.107) fat mass index (FMI) showed significant positive relationship with continuous QTc (P-value < 0.001). Also, just the fat-free mass index of legs had significant positive associations with QTc interval (P-value < 0.05). Surprisingly, in females, the mean of FM/FFM ratio in trunk and legs in the normal QTc group had higher values than the prolonged QTc group (QTc > 470 ms). Also, none of the body composition variables had a significant correlation with continuous QTc., Conclusion: Our study suggested that FMI ratios in the trunk, total body, arms, and legs were positively associated with QTc interval in males, respectively, from a higher to a lower beta-coefficient. Such associations were not seen in females. Our study implies that body fat mass may be an independent risk factor for higher QTc interval and, consequently, more cardiovascular events that should be investigated.

Background: Studies have demonstrated that upper extremity musculoskeletal disorders (UEMSDs) are highly prevalent among weavers. In Iran, little information is available regarding the prevalence of MSDs and their causal risk factors among hand-woven shoe workers. This cross-sectional study aimed to determine the prevalence of UEMSDs and to identify risk factors associated with UEMSDs symptoms among 586 Iranian hand-woven shoe workers., Methods: The data were collected using the Nordic Musculoskeletal Questionnaire and by direct observation of working postures via the Rapid Upper Limb Assessment (RULA) technique to determine ergonomic risks., Results: The prevalence of MSDs symptoms was high among the hand-woven shoe workers. The mean RULA grand score of 6.3 indicated that in most cases the workers' postures at their workstations needs to be investigated and changed immediately to prevent musculoskeletal injuries. The highest prevalence rates of MSDs were observed in the shoulders, wrists and arms. The result of multiple logistic regression modeling showed that risk factors associated with UEMSD symptoms were job experience, daily working hours, job satisfaction, working posture, work pressure, and discomfort at workstation, as well as individual factors, such as age, gender, BMI, material status, working conditions, education level, and lack of regular sport/physical activities., Conclusions: The findings of the present study emphasize that any interventional program in this industry has to focus on improving working conditions particularly by designing ergonomics-oriented workstations and hand tools.

Post-mastectomy chronic lymphedema as a complication of breast cancer treatment is primarily managed with Complete Decongestive Therapy (CDT). We examined various factors for correlating with results of Phase I CDT treatment in controlling the upper extremity lymphedema. Study population consisted of patients with lymphedema referred to the Lymphedema Clinic of the Iranian Breast Cancer Research Center for control of arm edema. After obtaining the demographic and clinical data, patients were treated with CDT for 2 - 3 weeks. One hundred and thirty seven patients (mean age +/- SD; 53.5 +/- 10 years) were studied. In 48.7% of patients, the affected arm was the dominant limb. Fifty percent of patients experienced lymphedema during the first year after surgery, and mean duration of lymphedema was 35 +/- 43 months. Mean volume reduction was 43% +/- 14.87% (p = 0.03). There was a significant relationship between the percent of volume reduction and initial lymphedema volume (p=0.003) as well as duration of lymphedema (p=0.002). Our results demonstrate that Phase I CDT treatment is very effective for post mastectomy lymphedema, and particularly if it is provided in earlier stages of disease. In addition, CDT also has an important role in reducing clinical symptoms and improving limb function. In the appropriate setting, Phase I CDT has been an effective method of controlling post mastectomy lymphedema in this Iranian population.

Objective: To translate and validate the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure (Persian DASH)., Design: Cultural translation and psychometric testing., Setting: Outpatient departments of orthopaedics surgery, primary care settings, rehabilitation medicine and physical therapy., Subjects: Two hundred and seventy-one consecutive Persian-speaking patients with upper extremity disorders including subacromial impingement syndrome, rotator cuff disease, epicondylitis, ulnar nerve entrapment, bursitis, instability, carpal tunnel syndrome, tenosynovitis and adhesive capsulitis., Methods: The translation and cultural adaptation of the original questionnaire was carried out in accordance with published guidelines. The participants were asked to complete a questionnaire booklet including the Persian DASH, the Short Form General Health Survey (SF-36) and a visual analogue scale (VAS) of pain. In addition, 31 randomly selected patients were asked to complete the questionnaire 48 hours later for the second time., Results: Cronbach's alpha coefficient for the Persian DASH was 0.96. The Persian DASH showed excellent test-retest reliability with intraclass correlation coefficient equal to 0.82 (P<0.01). The correlation between the Persian DASH and the functional scales of the Iranian SF-36 showed desirable results indicating a good convergent validity (Pearson's coefficients ranged from -0.25 to -0.72; P<0.001). The correlation between the Persian DASH and the visual analogue scale was 0.52 (P<0.01)., Conclusions: The Persian DASH is a reliable and valid instrument to measure functional status in Persian-speaking patients with upper extremity disorders in Iran. It is simple and easy to use and now can be applied in clinical settings and future outcome studies in Iran and other Persian-speaking communities.