IntroductionReliable and valid tools must be used to assess spasticity in clinical practise and research settings. There is a paucity of literature regarding the validity of the Modified Modified Ashworth Scale (MMAS) and the Modified Tardieu Scale (MTS). No study, to date, has been performed to compare the validity of the MMAS and the MTS. This neurophysiological study protocol will compare the validity of the MMAS and the MTS in the assessment of poststroke wrist flexor spasticity.Methods and analysisThirty-two patients with stroke from the University Rehabilitation clinics will be recruited to participate in this cross-sectional, non-interventional study. All measurements will be taken in the Physical Medicine and Rehabilitation Department of Shafa University Hospital in Tehran, Iran. First, wrist flexor spasticity will be assessed clinically using the MMAS and MTS. The tests will be applied randomly. For the MTS, the components of R1, R2, R2−R1 and quality of muscle reaction will be measured. Second, neurophysiological measures of H-reflex latency, Hmax/Mmax ratio, Hslp and Hslp/Mslp ratio will be collected from the affected side. The results will be analysed using Spearman's ρ test or Pearson's correlation test to determine the validity of the MMAS and the MTS as well as to compare the validity between the MMAS and the MTS.Ethics and disseminationThe Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences (TUMS) approved the study protocol.  The study results will be disseminated in peer-reviewed publications and presented at international congresses.

BACKGROUND: Spasticity is a common impairment following upper motor neuron lesions such as stroke. The appropriate measurement of muscle spasticity using validated tools to evaluate the outcome of therapies is important in clinical and research settings. OBJECTIVE: To determine the concurrent criterion-related validity of the Modified Tardieu Scale (MTS) in assessing poststroke wrist flexor muscle spasticity based on its correlation with H-reflex tests. METHODS: A total of 20 adult patients poststroke underwent clinical and electrophysiological assessment of wrist flexor muscle spasticity on the affected side. The primary outcome measures were: R2−R1 of the MTS; and the H-reflex indices of H max /M max ratio and H slp /M slp ratio. The H slp and the latency of H-reflex were also measured. RESULTS: Correlations tests did not reveal significant associations between the clinical and H-reflex tests. CONCLUSIONS:This study suggests that the MTS may not be a valid tool to evaluate muscle spasticity in this sample of patients after stroke.

Objective Alteration of scapular position and motion is called scapular dyskinesis. Scapular dyskinesis is a common clinical problem. Strength of shoulder girdle muscles is important in shoulder motions and stability, so their weakness may lead to scapular dyskinesis. The aim of this study was to compare the maximum voluntary isometric force of shoulder girdle movements in subjects with and without scapular dyskinesis Materials & Methods A case-control study was designed where the participants were selected by nonprobability sampling; 30 subjects with scapular dyskinesis and an average age of 22.95±2.62 years and 30 subjects without scapular dyskinesis and an average age of 22.43±2.50 years. The subjects were instructed to stand with their arms resting on each side of the body. The examiner stood behind them at a distance of 1.5 meter and asked them to elevate their arms to the highest level possible. Scapular dyskinesis test was used to visually examine alteration in scapulohumeral rhythm during arm elevation in sagittal and frontal planes. The shoulder flexion and abduction were repeated for 5 times. At the same time, the examiner rated the scapular movement as normal or observable dyskinesis. The maximal voluntary isometric force of shoulder internal and external rotation on both sides, such as "scaption with external rotation", "scapular abduction and upward rotation", "scapular adduction and downward rotation", "scapular adduction" and "adduction and depression of scapula" were measured with manual Dynamometer. For determining the maximal shoulder isometric rotational force, subjects were positioned prone on tables, arm brought into 90º abduction in frontal plane with 90° elbow flexion and resistance given to distal forearm into shoulder external and internal rotations. The maximal isometric force of scaption (supraspinatus strength) was measured in seated position; shoulder elevated 70º into scapular plane abduction (scaption) with external rotation. The maximal isometric force of scapular abduction and upward rotation was determined in supine position while the arm was elevated to 90º flexion with elbow extension and resistance given against forward pushing. For determining the maximal isometric force of rhomboids and middle trapezius muscles, resistance was given against scapular adduction and downward rotation, and scapular adduction, respectively. The maximal isometric force of lower trapezius was determined in prone position while the arm was elevated to 135º shoulder elevation with elbow extension. Independent t-test was performed to compare the maximal voluntary isometric force of shoulder girdle motions in individuals with and without scapular dyskinesis. Results The mean±SD of age, weight and height of the participants without and with scapular dyskinesis were 22.43±2.50 years/ 22.95±2.62 years, 64.39±13.38 kg/ 65.67(±12.2) kg and 171.35(±11.29) cm/ 173.43(±8.66) cm, respectively. No statistically significant differences were found between the participants of the two groups with regard to the age, ...

Purpose: Osteoarthritis is a progressive disease and the most common form of joint inflammation. Moreover, it is the most common cause of functional disability in the elderly. Among the multiple and predisposing factors influencing the disease are demographic indicators and occupational factors. The present study aimed to investigate the relationship between age, pain severity, Body Mass Index (BMI), occupation, and educational level, and the severity of functional disability in patients with Knee Osteoarthritis (KO). Methods: This descriptive study was performed on 97 KO patients referring to the Novin private physiotherapy clinic of Semnan University of Medical Sciences from April to March 2017. The study participants were selected through a simple nonprobability sampling technique. Literate individuals with the educational level of guidance school and above and diagnosed with KO were included in the study. Individuals with a history of inflammatory arthritis diseases, such as rheumatoid arthritis, soft tissue rheumatoid arthritis, fibromyalgia syndrome, bursitis, tendonitis, the neurological and vascular conditions of the lower extremity, mental problems, and malignancy were excluded from this research. The data related to the variables such as age, gender, occupation, history of osteoarthritis, pain intensity, involved side, educational level, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee disability were collected by a self-report questionnaire. This study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences. Using SPSS, Spearman’s correlation coefficients were calculated to examine the relationship between the study variables. Results: Spearman’s correlation coefficients revealed no significant correlation between the KOOS scores and age, occupation, and educational level. The obtained results suggested a poor significant association between KOOS and BMI; however, there was a strong significant correlation between KOOS and pain intensity Visual Analogue Scale (VAS) (P<0.05). Conclusion: The severity of functional disability in patients with KO based on KOOS questionnaire scores, was well correlated with pain severity, but poorly associated with age and BMI. The obtained data indicated no significant relationship between disability and occupation and educational level.

In recent years, many people show interest to Paralympics competition because it is dedicated to athletes with disabilities. In order to affect the throwing, static stretching can be applied on the two muscles, i.e. pectoralis major and latissimus dorsi that play an important role in the arm acceleration phase. Normally, before sport activities, static stretching is applied. Stretching increases the flexibility that is effective in the throwing. The important point is the effect of this type of stretching on the throwing function, which is a combination of muscular strength, range of motion and productive torque. This study is going to examine this issue. Methods: In this study, 45 disabled male athletes (15 discus throwers, 15 shot put throwers, and 15 javelin throwers) participated. Before stretching, each athlete did 3 throws, then a static stretching session consisting of 5 sets of 30 seconds stretching followed by 30 seconds of rest between each set, was performed. One minute after the stretching, the athletes did throwing 3 more times. Static type of stretching is performed on pectoralis major and latissimus dorsi muscles. Results: Based on study results, no significant change was observed in the amount of throw before and after the stretching (Discus: P=0.47, Shot put: P=0.46, Javelin: P=0.14). Conclusion: Considering data analysis, one session of static stretching of pectoralis major and latissimus dorsi muscles does not create a significant change in the magnitude of throw in disabled athletes engaged in discus, shot put, and javelin throw.