Stroke is one of the main causes of disability and mortality worldwide. Most survivors experience impairments in their upper limb motor function. Methods: This experimental study was performed as a clinical trial on 30 chronic stroke patients who experienced stroke from 6 to 96 months ago. Patients were non-randomly divided into the intervention (Virtual Reality besides conventional occupational therapy) and control (conventional occupational therapy) groups. Each treatment session lasted for one hour which was divided into conducting conventional occupational therapy techniques and Virtual Reality (VR) for the intervention group, and routine techniques for the control group. The intervention effectiveness was evaluated by the Fugl-Meyer Upper Extremity Scale, Stroke Impact Scale, Chedoke Arm and Hand Activity Inventory, Motricity Index, Modified Ashworth Scale and goniometer. Results were analyzed by SPSS and one-sample Kolmogorov-Smirnov, Shapiro-Wilk test, Independent Samples t-test and Mann Whitney U test were applied to assess the normality of data and to detect significant differences between study variables. Results: The results suggested that investigated parameters such as upper limb motor function, muscle tone and the range of motion were significantly different in the intervention group, compared to control group; however, there was no significant changes in none of the group's daily living activities. Discussion: VR-based computer games in combination with routine occupational therapy interventions could improve upper extremities functional impairments in chronic stroke patients. However, it seems the mechanisms behind the effectiveness of video games and their impact on brain cortex as well as upper limbs function need to be further investigated.
Background: Nowadays, different types of exercise machines are being used in the field of athletic training, recreation, post-injury and post-operation rehabilitation. Leg press is a commonly-used one that retrains muscles and simulates natural functional activities. In this activity, feet are in contact with a footrest to exert muscular forces. In addition, the footrest inserts reactive forces to feet and from the feet load would transfer to structures that are more proximal. Any misalignment in foot structure may interfere its function. Objective: The aim of this study was to assess the effect of shoes and using a prefabricated medial arch support on the activity of Tibialis anterior and medial gastrocnemius muscles while doing leg press exercise in normal feet subjects. Method: 14 men with normal Medial Longitudinal Arch and normal Body Mass Index aged between 18-35 years old, with at least 6 months experience of doing leg press volunteered to participate in this study. Medial gastrocnemius and Tibialis anterior activity were measured by surface electromyography while doing leg press with 70% of subjects 1 Repetition Maximum. To increase accuracy, motion was divided into knee flexion and knee extension phases. Peak Amplitude, Time to Peak Amplitude and Root Mean Square variables were used for analysis. Wilcoxon nonparametric test was used to compare the results. Results: No statistically significant difference was found in the electromyographic parameters of Medial gastrocnemius nor Tibialis anterior in any phases of motion, except for an increase in Tibialis anterior time to peak amplitude in shod condition compared with barefoot in knee extension phase of motion (p-value=0.008) and Tibialis anterior RMS in knee flexion phase in orthotic condition compared to shod (p-value=0.03). Conclusion: It seems that in high loads shoes or medial arch supports cannot change electromyographic parameters in Medial gastrocnemius nor Tibialis anterior in any phase of motion while working with leg press device.
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