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Background: Stroke is one of the causes of long-term morbidity. Despite rehabilitation strategies, most survivors live with motor deficits in the upper limbs. Objectives: The aim of the study was to compare the effect of contralateral cross education (CE) and high-frequency repetitive magnetic stimulation (HF-rTMS) on the function of upper extremity in subacute phase of stroke. Methods: Forty patients were randomly assigned into 4 groups. Group "A" received physical therapy (PT) for 10 sessions, 3 times per week. Group "B" received PT and HF-rTMS as follows: stimulation of 20 Hz for 5 s, intertrain interval for 50 s, 20 trains, 2000 pulses at 90% resting motor threshold, and conventional PT. Group "C" was treated with CE and PT. In group "D," HF-rTMS, CE, and PT were administered. Results: Significant differences were found in the Fugl-Meyer scale between "A" and "C" (P = 0.01), "A" and "D" (P = 0.02), and "B" and "C" groups (P = 0.01). In the box-block test, there were significant differences between "A" and "B" (P = 0.01), "A" and "C" (P < 0.001), "B" and "D" (P = 0.001), and "B" and "C" groups (P = 0.01). Statistical differences were observed in grip strength between "A" and "B" (P = 0.01) and "A" and "C" groups (P = 0.02). Conclusions: It is suggested that clinicians select the therapeutic methods in line with their expected goal. When the goal is to improve upper extremity function, CE+PT could be more effective than HF-rTMS+PT. Also, CE+PT and HF-rTMS+PT were more effective than CE+HF-rTMS+PT at improving grip strength. Therefore, combining several methods would not always lead to better results.
RESUMO
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is a novel technique that may improve recovery in patients with stoke, but the role of rTMS as an applied and practical treatment modality for stroke rehabilitation has not been established yet. OBJECTIVE: This study was conducted to determine the effects of a rehabilitation program (RP) in conjunction with rTMS on functional indices of the paretic upper limb in the subacute phase of stroke. MATERIAL AND METHODS: In this experimental study, twenty patients in the subacute phase of stroke were randomly assigned into two groups: The high frequency rTMS (HF-rTMS) in conjunction with RP (experimental group), and the RP group (control group). The experimental group received 10 sessions of 20 Hz rTMS on the affected primary motor cortex and the other group received 10 sessions of RP. In experimental group, RP for the paretic hand was conducted following rTMS session. Box and block test (BBT), Fugl-Meyer Motor Assessment for upper limb (FMA-UL), grip strength and pinch strength were used to assess motor function before the first session and after the last session of treatment. RESULTS: Significant improvement in BBT, FMA-UL, grip strength and pinch strength was observed in both groups. Improvement of BBT and grip strength was significantly greater in the experimental group rather than the control group (p<0.05). FMA-UL score and the pinch strength were greater in the experimental group, although the differences were not statistically significant. CONCLUSION: HF-rTMS in conjunction with RP is effective to improve the function of upper limb. It seems HF-rTMS is a novel feasible and safe technique for hemiparesis patients in the subacute phase of stroke.
RESUMO
BACKGROUND: It is well documented that cigarette smoking has negative impacts on body health, as well as social health, economy, culture, etc. Nowadays, there is a large body of evidence that smoking is the cause of numerous life-threatening diseases like cardiovascular and pulmonary diseases along with different kinds of cancer. The aim of this study was to compare the physical fitness of smokers and non smokers. METHODS: This cross-sectional study was conducted on 64 non-sportsmen (34 non-smokers and 30 smokers) aging 19-27 years. Both groups were matched for age, weight, height and body mass index (BMI). The smokers used cigarettes at least 5 cigarettes a day for 2 years. None of them had a musculoskeletal disease. We used a questionnaire and physical fitness tests for data gathering. The tests were used to measure muscle strength, endurance, speed, agility and flexibility in both groups. FINDINGS: The muscle strength was significantly different in smokers and non-smokers (P = 0.012). Moreover, smokers had less agility (P = 0.004) and speed (P = 0.008) than non-smokers. However, although smokers were weaker than non- smokers, the differences in muscle endurance (P = 0.066) and flexibility (P = 0.095) were not the statistically significant. CONCLUSION: According to these results, the smokers were less powerful than nonsmokers. In addition, physical activity skills in young smokers were decreased. Therefore, smoking will cause a gradual loss of physical strength and active personal and social power.
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BACKGROUND: The rising trend of smoking cigarettes, especially among the youth, has become a great concern in Iranian society. Not only does smoking cigarettes harm one financially, but also it will cause immense damage to the smoker as well as the society. This paper investigated the prevalence of musculoskeletal pain and the factors affecting it in young smokers. METHODS: The research has been conducted on 400 men smokers aged 18-30 studying at Shiraz University of Medical Sciences. Data was collected through a questionnaire containing information about age, history and amount of smoking, existence of pain and its severity according to the visual analog scale (VAS). The subjects were randomly selected while making sure the proportion of subjects from each department was appropriate. The subjects were smokers for more than two years and smoked more than five cigarettes a day. Data was analyzed by analysis of variance (ANOVA) and the least significant difference (LSD) test. FINDINGS: Among all studied subjects, 129 (32.25%) suffered from musculoskeletal pain. Most of the subjects (31.25%) had pain in their backs. The relationship between the duration of smoking and musculoskeletal pain, as well as that between the number of cigarettes smoked per day and the pain, was direct and significant. However, no significant relationship was found between age and pain. CONCLUSION: The occurrence of musculoskeletal pain in male students was relatively high. This fact can bring irrecoverable damages to the society and would put its health at risk. It also decreases the socioeconomic improvements.
