Razi Journal of Medical Sciences

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Background and Aims: Psychiatric disorders are typically viewed as neuropsychological and neurobehavioral conditions that impair the ability to comprehend new or complex information. It is estimated that over 450 million people worldwide experience various mental disorders, with major depression anticipated to be the most disabling by 2030. Major depressive disorder (MDD), also known as unipolar disorder, is characterized by prolonged periods of depression across different situations and contexts, low self-esteem, and a lack of interest in activities that are normally enjoyable, lasting for at least two weeks. To diagnose MDD, it is essential to exclude any history of manic or hypomanic episodes. In children and adolescents, MDD may present as irritability. According to the DSM-5, other depressive disorders include persistent depressive disorder (formerly known as dysthymia), disruptive mood dysregulation disorder, premenstrual dysphoric disorder, substance/medication-induced depressive disorder, and depressive disorder due to another medical condition, and unspecified depressive disorder. Depression can impact both mental and physical health. Although the clinical cure rate for MDD is high, the treatment and recurrence rates are less favorable due to patients' lack of understanding and reluctance to adhere to regular treatment.
Globally, major depressive disorder (MDD) is consistently among the most prevalent mental disorders, affecting 322 million people worldwide. The average age of individuals with this disorder is 30.4 years. The prevalence of MDD is twice as high in women compared to men and affects one in six adults over their lifetime. The lifetime prevalence is estimated to be around 10-15%. The World Health Organization predicts that by 2030, MDD will account for 13% of the total global disease burden, surpassing cardiovascular disorders. MDD is a significant cause of suicide and morbidity among adolescents and young adults, making accurate diagnosis and effective care crucial for these age groups.
This disorder can cause significant suffering and poor performance in work, school, and home environments. While antidepressants can treat depression, their effectiveness varies. Most antidepressant medications, which primarily target monoamine pathways, are effective, but over 30% of patients do not achieve remission even after multiple treatment trials. Current interventions for MDD include behavioral activation, Acceptance and Commitment Therapy (ACT), problem-focused therapy, functional analytic psychotherapy, mindfulness-based cognitive therapy, and cognitive-behavioral analytic psychotherapy. Treatment for MDD often requires a combination of antidepressants, antipsychotics, psychotherapy, or electroconvulsive therapy. However, a lack of understanding about MDD or an unwillingness to seek formal treatment can negatively impact recovery rates. The complexity of MDD makes it difficult for most patients to fully understand the disorder.
Major depressive disorder (MDD) is influenced by both hereditary and environmental factors. Genetic contributions to MDD are well-documented through family, twin, and adoption studies. However, high discordance rates in studies of monozygotic twins suggest significant non-genetic influences, such as stressful life events, which can elevate the risk of developing depression. The heritability of MDD is estimated to be between 30% and 50%. The high prevalence, moderate heritability, and polygenic nature of MDD pose significant challenges for genetic mapping compared to other psychiatric disorders.
Environmental factors, such as sexual, physical, or emotional abuse during childhood, are significantly linked to an increased risk of developing MDD. Although no single mechanism can account for all aspects of the disorder, MDD is associated with changes in regional brain volumes, particularly the hippocampus, and functional alterations in brain circuits, including the cognitive control network and the affective-salience network. Additionally, disruptions in key neurobiological stress-responsive systems, such as the hypothalamic-pituitary-adrenal axis and the immune system, are observed in MDD. Treatment primarily involves psychotherapy and pharmacological interventions. For patients with treatment-resistant MDD who do not respond to multiple augmentation or combination therapies, electroconvulsive therapy has the strongest empirical support.
Major depressive disorder (MDD) is a complex, multifactorial disorder likely influenced by numerous individual genetic variations, similar to many other psychiatric disorders. The causes of MDD are intricate and involve a combination of genetic, immune system, and endocrine factors, often triggered by stress-related psychosocial conditions. Acute stress and major depression share similar pathophysiological changes, such as inflammatory states, metabolic alterations, and a prothrombotic state. The roles of genetic and epigenetic factors in the development and progression of MDD have been recognized, with nearly 200 genes associated with the disorder identified so far. By conducting genetic analyses to identify risk types, we can enhance our understanding of MDD's development, potentially leading to better prevention strategies and the creation of newer, more effective treatments.
Psychiatric disorders significantly impact patients' quality of life and impose substantial economic burdens on their families. The considerable phenotypic variability among patients complicates the investigation of their pathogenesis. However, bioinformatics is emerging as a promising tool for diagnosing psychiatric disorders by identifying sensitive biomarkers and exploring related signaling pathways. Bioinformatics studies now facilitate the discovery of key genes associated with diseases like depression. Advances in bioinformatics, coupled with high-throughput assessments of brain and behavior, have provided technologies for rapidly identifying and characterizing the roles of biological systems in behavioral processes. This progress has led to the identification of new molecular targets for research, diagnostics, and therapies. Although much of this research is in its early stages, significant advancements are being made, and practical applications are already emerging. This study utilizes bioinformatics data to investigate the genes contributing to depression. In molecular biology, techniques such as signal processing and 3D imaging generate abundant raw data that can be used for disease diagnosis and treatment. Bioinformatics is also crucial for analyzing gene and protein regulation and expression. By identifying genes that contribute to MDD, rapid and cost-effective computational methods can be employed to diagnose the disorder and develop effective treatment solutions.
Methods: In the present study, microarray was used from the Gene Expression Omnibus (GEO) database on 32 samples, including 10 samples from healthy individuals, 10 samples from patients with MDD and 10 samples from patients diagnosed with MDD but recovered. Data analysis was performed using R software. In addition, inflammation-related genes were extracted from the MSigDB database for further analysis.
Finally, protein-protein interaction (PPI) analysis and hub gene selection were analyzed using Cytoscape software.
Results: In the present study, a total of 1179 genes were identified as DEGs between MDD and healthy subjects, of which 648 were up-regulated and 531 were down-regulated. 18 genes are shared between DEGs and genes related to inflammatory processes, termed inflammation-related DEGs.
This study identified the genes IL-1β (interleukin 1 beta), TLR2 (toll-like receptor 2), IFNAR2 (interferon alpha and beta receptor subunit 1), TLR1 (toll-like receptor 1) and C5AR1 (complement receptor 1 C5a) as key genes in major depressive disorder.
Conclusion: This study had limitations such as lack of access to other databases and the inability to cite some articles. It is suggested that clinical and laboratory studies be carried out to confirm and complete the present study and to use this information for better diagnosis and treatment of this disorder. The key genes obtained by analysing the data in the present study provide important information for revealing the molecular mechanism and targeted treatment of depression disorder, and in the future, with more studies, the aforementioned genes can be used in the diagnosis and correct treatment of this disease. However, depression is still a major public health problem and governments should support the necessary research to develop interventions and better prevention and treatment.

 

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Introduction: Bacterial meningitis is an acute inflammatory phenomenon of the central nervous system, which is considered an emergency from the medical point of view, and if it is not diagnosed and treated, it will be associated with high mortality. It has been reported that it decreases with increasing age up to 25 years old. The complications of these diseases are relatively common and include blindness, deafness, neurological disorders, decreased level of consciousness, mental retardation, and paralysis. The death rate of bacterial meningitis is still high. Early diagnosis and treatment of bacterial meningitis can prevent serious complications. The diagnosis of bacterial meningitis is based on the combination of clinical and laboratory symptoms. Early treatment of bacterial meningitis can prevent serious complications such as hearing loss, memory problems, learning disorders, brain damage, seizures, and death. The diagnosis of bacterial meningitis is based on a combination of clinical and laboratory symptoms that indicate an inflammatory response in the cerebrospinal fluid. CSF).. Neonatal meningitis is divided into two categories, early and late, which are, respectively, due to the presence of signs of infection and isolation of the organism from cerebrospinal fluid culture in less than 72 hours or more than 72 hours of life. Analysis of cerebrospinal fluid through lumbar puncture is the most important laboratory diagnostic test. However, LP is invasive and painful and can pose challenges in its implementation and induce anxiety in the medical staff. This work is usually associated with side effects such as headache, back pain, and rarely with infection, brain herniation, and subdural, epidural, and spinal bleeding. The management of febrile infants aged 29 to 56 days in the emergency department has been discussed for decades. has taken. Although there is general agreement that these infants should have urine and blood tests, there is no such agreement for CSF testing. According to the said material, in this study we decided to take a step towards improving the sensitivity and specificity of diagnoses by examining and evaluating the accuracy of bacterial meningitis criteria in children who have undergone LP, which ultimately leads to more effective treatment and significant improvement. The quality of life of patients can be taken away.
Methods: In this descriptive-analytical study, the accuracy of bacterial meningitis criteria was investigated in low-risk children with fever of 28 to 56 days who underwent LP in the period of 2015 to 2019 at Hazrat Ali Asghar Hospital. After obtaining the necessary agreements, the approval of the ethics committee and permission to access the files were received from the hospital management. The information was completed through a checklist related to the criteria of bacterial meningitis and according to the files of the referring patients. The study questionnaire includes age, sex, gestational age, patient's appearance, history of chronic diseases and length of stay in NICU, history of antibiotic use in the last 72 hours, white blood cell count, tuberculosis band percentage, and LP test result. Completed questionnaires were randomly selected and analyzed from 73 checklists. It should be noted that the checklist was designed according to related articles and with the consultation and opinion of professors of Iran University of Medical Sciences. The implementation limitations of the plan included the time-consuming completion of the questionnaires and the incompleteness of the files and cases of loss to follow-up. After completing the data collection, the data were entered into SPSS and analyzed.
Examining  the accuracy of bacterial meningitis criteria: Using the central limit theorem and the finiteness of the mean and standard deviation, as well as the large number of observations, it was assumed that the data distribution was normal. Therefore, we no longer used common tests such as Kolmogorov-Smirnov, Anderson-Darling, etc. to check the normality of distributions. Because the predictor variables were quantitative or at least converted to quantitative and the response variable (LP) was also quantitative, we used multivariate regression design for data analysis. Of course, it is important that the linearity of the data was ensured before performing the regression method. This method was used to investigate the effect of LP on other mentioned cases with the aim of checking the accuracy of bacterial meningitis criteria in children with fever of 28 to 56 days who underwent LP in Hazrat Ali Asghar Hospital between 2015 and 2019. Considering that a suitable linear relationship was seen to express the relationship between the predictor variable and the response variables, we used linear regression transformations and obtained the results in a table. According to the obtained results, we found that the criteria for bacterial meningitis in febrile children can be defined under the components (38-week-old children, no long stay in NICU, negative AB, no evidence of infection on examination, normal CXR, no chronic medical problem, LP negative) modeled and obtained the optimal model.
Findings: SPSS version 22 software was used for statistical analysis of data. The results for quantitative variables were expressed as mean and standard deviation (Mean ± SD) and for categorical qualitative variables as percentage. Comparison between quantitative variables was done by t-test, and in case of non-normal distribution, using Mann-Whitney U test. Chi-Square Test and Fisher's Exact Test were used to check the relationship between qualitative variables. A significance level of less than 0.05 was considered.
In this study, among 84 patients, 57.14% of the patients studied were boys and 76.2% of the patients were born at a gestational age of more than 37 weeks. 88% of the patients had a happy appearance, and none of the patients had evidence of infection during the examination, and the results of the chest x-ray were reported to be normal in 98.8% of the patients. 81% of patients did not experience prolonged NICU stay and LP result was negative in all patients.
Conclusion: Considering that most of the patients looked happy and none of the patients had evidence of infection in the examination and these findings were consistent with the laboratory evidence, therefore, it is recommended not to perform LP in patients with this clinical picture.
Key words: Validity of Criteria  ، bacterial meningitis, fever, children aged 28 to 56 months


 

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ABSTRACT

There are numerous rehabilitation protocoles for Patello Femoral joint (PFJ) problems, but there is little objective data to determine the most effective treatment of this disorder. Increased VMO/VL activity ratio might be useful in treatment of patients with patellar tracking dysfunction. The purpose of this study was to investigate the EMG activty of the VMO and VL within seven angles of knee joint range of motion with isometric contraction in two commonly performed rehbilitation exercises: OKC, isometric holds(IS), and the CKC, vertical squat(SQ). The dominant knee of 44 healthy females(mean age:24.84 yearsrange:20-30 years) were analyzed. Surface electrode pairs were attached over the VMO and VL(Basmajian Method). The EMG biofeedback data were collected while the subject performed isometric contraction on IS and SQ exercises in 7 degrees from 0˚ to 90˚ (with 15˚ internals) of knee flexion. Paired t-test and Avova was performed between variables(p<0.001). This study demonstrates that there are significant differences: 1)Between OKC and CKC exercises in 0˚, 15˚, 30˚of knee flexion. 2)Between all Angles in CKC except:0-15˚, 0-30˚, 0-45˚, 15-30˚, 60-75˚, 75-90˚. 3)between: 15-60˚, 30-60˚, 45-60˚, 60-90˚ in OKC(p<0.001). A)In OKC and CKC respectively: 1/60˚ and15˚ of knee flexion was most sufficient position(increase VMO/VL activity ratios) 2/15˚ and 90˚ of knee were most insufficient position 3/The arc of movement between 45-75˚ and 0-30˚ was considered as most sufficient arc of movement. B)Because of some biomechanical & neurophysiological viewpoints that emphesized on the other literatures and also because of results of this research, our recommendations are: in early phase or in early session of treatment of PFJ dysfunction, treatment exercises done in CKC & sufficient position and after progression of patient condition OKC exercises also added.

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ABSTRACT

 Attention to high prevalence of inflammatory disease of upper gastrointestinal system and determination of Helicobacter pylori, “a great importance etiology of gastric disorders”, this study was performed for rapid diagnostic evaluation of Helicobacter pylori. This observational & cross-sectional study was performed in 100 cases who suffered from upper gastrointestinal symptoms. By an internist, at least two gastric biopsies with endoscope (From antrum region) were taken, one of the biopsies was used in H-E staining (reference for gold standard method) and its results compared with Giemsa stain result for determination of validity if Giemsa staining. Other biopsy was used in one minute rapid urease for rapid diagnosis in patient with H.Pylori infection and in statistical analysis of the results sensitivity, specificity, positive and negative predictive Values (PPV,NPV) and positive and negative likelihood ratio (PLR,NLR) were used. In Giemsa staining sensitivity was reported to be 95.9% and specificity was 44.4% and for rapid urease test sensitivity was 69.9% and specificity 85.2% PPV of Giemsa staining and rapid urease test were 82.3% and 92.7% respectively, and NPVof were 80% and 51% respectively. PLR in Giemsa staining and rapid urease test were 1.7 and 4.7 respectively and NLR were 0.09 and 0.35 respectively. Giemsa staining has a high sensitivity and its negative results is Valuable. Rapid Urease test has a high specificity, and its positive results are valuable but its negative results must be controlled with a sutiable reference test.

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 ABSTRACT

 The ability of controlling balance is an essential part for all movements. In recent years, new theories in movement and balance has become the basis of some research in evaluating balance. In one of this new methods ( which is used in this study ) controlling balance is evaluated by measuring body sway in standing position during different conditions in which, the availability of sensory information has been changed. This study has a Quasi – Experimental design, and the sample consisted of 90 females, categorized as children, adults and elderly. According to the results, in altered sensory conditions the adults could control their standing balance more effectively than the other two groups. Besides, it seems that in children the function of vestibular system in controlling balance was not as effective as in adults. The results also show that in elderly, the importance of visual information in controlling balance was less than somatosensory information. Key Words: 1) Balance 2) Sensory Information 3) Standing Position

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  This research was conducted to examin the effects of adding forward running and backward running training in a wobble board training program on some of functional static balance tests. In this research sixty-five young healthy males (13-17years) were selected by nonprobability sampling and assigned randomly into three groups.

  Group I included 25 subjects that performed 10 minutes forward running training first and then 15 minutes wobble board training.

  Group II included 25 subject that performed 10 minutes backward running training first and then 15 minutes wobble board training.

  Group III included 15 subjects that performed just 15 minutes wobble board training.

  Each group, was trained for six weeks and three times weekly. The functional static balance tests included the most possible time of standing on domminant leg in the straight posture on the firm support surface (A), standing on dominant leg in the straight posture on the foam support surface (B), standing on dominant leg in the semisquat posture on the firm support surface (C), standing on dominant leg in the semisquat posture on the foam support surface (D). All tests were performed with closed eyes. These teste were performed and 4 times in the training period. Results did not show any significant difference of the means among three groups after 6 weeks of training, but significant difference of the means of A, B, D tests was observed among three groups in the end of the second week. We have concluded that backward running for two weeks has a facility effect on the static balance by wobble training.

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  Peganum harmla L. (Zygophyllaceae) is one of the components of an ethnobotanical preparation used in the treatment of neoplasms in Iran. β -carboline alkaloids like harmaline and harmine are the major constituents of P. harmla L. seeds extract. MTT-colorimetric assay was used in this study to investigate cytotoxicity of P. harmala seeds extract and its β -carboline alkaloids against HFFF-P16, Hela and KB cell lines. In this method, the yellow tetrazolium salt MTT is converted by mitochondrial dehyrogenases of metabolically active cells to an insoluble purple formazan product. Absorbance of formazan after dissolving in dimethylsulfoxide (DMSO) can be measured at 570 nm. In cytotoxicity assays against HFFF-P16, Hela and KB cell lines, the order of potency was harmine>harmane>harmaline.extract. Harmine and harmaline content of the extract were determined using an HPTLC method and it appears that the biological activity of the extract can be explained by its harmine content.

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ABSTRACT The Patient is a 58 years old woman who admitted in Hazrat-Rasoul Akram Hospital because of enlargement of anterior of neck and signs of upper respiratory tract obstruction. By X-Ray, sonography and C-T scanning, a mass in pararetropharyngeal region (4.5×10 cm) was detected. After FNA and biopsy, plasmacytoma was suggested which confirmed by immunohistochemical staining. This uncommon case should be controlled and even cured by proper diagnosis and radiotherapy.

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ABSTRACT The aim of this clinical trial was to compare the effects of two techniques, forward & backward runningon the functional performances of lower exterimity. These functional performances were, (i) Vertical Jump, (ii) Single leg hop, (iii) Six Meters timed Hop & (iv) Shuttle Run. In a pilot study the reliability of these tests was confirmed. A convenient sample of 30 young & healthy men were selected and randomly assigned into two groups of 15 each. The testing period lasted 6 weeks with 3 sessions per week. Each session took 15 minutes. Measurements were taken at the beginning and every two weeks henceforward. Therefore we had between and within group analyses, using independent t-test and ANOVA. After the end of the 6th week, significant increase in functional performances of lower exterimity was observed in both groups. But these two techniques had similar effects,i.e. the observed difference between group performances was not statstically significant. That is, forward & backward running excersices have equal effects on the functional performances of lower exterimity.

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ABSTRACT The patellar stability is maintained by ligaments. Muscles and joint capsule. Due to vastus medialis atrophy patella is moving outward and finally causes lateral hyperpressure syndrome. Which is painfull. This is a common syndrome that too many patients suffered from it. The perpose of this study is to determine the level of activity of medial and lateral muscles of the patellofemoral joint that are critical for patellar dynamic stability. Twenty persons (10 healthy and 10 patients with patellar lateralization) participated in this study IEMG and IAV parameters were obtained by telemetric EMG instrument from vastus medialis obliques (VMO) and vastus lateralis (VL) during maximal voluntary isometric contraction in three different angels of knee flexion (15,30 and 45 degrees). While subjects sitted on Biodex machine. In conclusion the findings of this study demonstrate that during maximal voluntary isometric contraction in patients with patellar lateralization minimal VMO activity exists as compared with the highly ctive VL in selected degrees of range of motion. In addition in patients group VMO/VL ratio is less than 1. This is due to deficiency of nuero-muscular control system that decrease functional joint stability.

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This research was conducted to examine the effect of adding forward and backward running in a wobble training program on some of functional static balance tests. In this research 30 young male(15-35 years) with sprain of lateral ligaments (grade I,II) of ankle joint were selected by non-probability sampling and assigned randomly into three groups: Group 1 included 10 subjects that performed 15 minutes forward running training and then 15 minutes wobble board training. Group 2 included 10 subject that performed 15 minutes backward running training and then 15 minutes wobble board training. Group 3 included 10 subjects that performed just 15 minutes wobble board training. The functional static balance tests included the most possible time of standing on the injured leg in the straight posture on the surface by eye open(A), and eyes closed (B) and non-injured leg in the straight posture on surface by eyes open and eyes closed. The testing period lasted 6 weeks with 3 sessions per week. Measurments were taken at the beginning and every two weeks hence forward at 4 stages. At the end of 6 th week, the difference between 3 groups (A) statistically was not significant but there was significant difference of mean data between 2 and 4 weekstraining in 3 group (B). That is, backward running for 4 weeks has a good effect on the static balance by wobble board training.

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The purpose of this nonexperimental study was to compare 5 functional preformance tests between ACL deficients & healthy males. These tests includes co-contraction semicircular, carioca, shuttle run, timed hop and cross over hop. Functional tests are used to assess readiness of the subject to progress to another level of rehabilitation, to return to athletic practice, or to discharge. Selection of the appropriate battery of tests is important to maximize information about the patient’s functional capacities. Inthis study 16 males with ACL injury(group1) & 32 healthy males(group2) participated. Descriptive statistics for each parameter and variables measured in this research was done. Also two sample analysis for each functional tests between groups was done. Results: 1. Significant difference wasn’t seen in co-contraction semicircular test between two groups(P>0.05). 2. Significant difference was seen for carioca, shuttle run, timed hop and cross over hop tests between two groups(P<0.05). Above functional tests are objective measurment methods of functional instability which can be performed in a clinical setting, do not involve expensive equipment and require minimal time.

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  The purpose of this nonexperimental case-control study was to compare the postural control abilities in normal subjects (n=25) and patients with chronic low back pain (n=25), selected by nonprobability convenient sampling. The Biodex balance system was used to implement dynamic test in four positions including double-leg eyes-open (DEO), double-leg eyes-closed (DEC), single-leg eyes-open (SEO), single-leg eyes-closed (SEC) and dynamic limits-of-stability (LOS) test. Overall, anteroposterior and mediolateral stability indices as wall as the time percent of zone A (<5 ˚ inclination) were measured in dynamic balance tests while the completation time and overall directional control were measured in LOS test. Independent-t test ( α =0.05) were used to compare dependent variables between two groups. All dependent variables showed statistically significant difference (P<0.01) between the two groups except for AP stability index in DEO position. The most obvious differences were seen with eye closure and in ML indices. Based on these results, chronic low back pain patients had abnormalities in balance control both during body maintainance and weight shift. The patients had visual dependency and lateral instability. Balance problems, motor control abnormalities, proprioceptive deficits and muscular stabilizing systems of lumbopelvic region must be considered for successful evaluation and management in patients with chronic low back pain.

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Today, Isostation B-200 is one of the most familiar for assessing low back muscles function.This study that is a Quasi-Experimental design was done on 30 healthy men (mean age~26.4 years). The aim of this research is to determine the best and worst motor efficiency in standing and sitting position following torque measurement. In this research maximum torque of low back extensor muscles as measured in standing & sitting position & in four different degree of trunk flexion (0, 20, 40, 60). All date was analyzed by statgraphics plus software and concluded that in standing position with increasing of tunk flexion, and after extension of low back torque was increased continously and in sitting position, with increasing of trunk flexion, extension torque increased unitl 40 degree of trunk flexion, then decreased. The most prominent clinical point of this research is using of sufficient position & angle of low back spine in stabilization exercises, that in the early stage of training non specific standing position recommended and in the late & terminal stage specific standing & sitting position preferred.

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Musculoskeletal disorders which are introduced with back pain are now the most common cause of chronic incapacity in industrialized countries. One of the important causes of low back pain is, spinal instability. A recent focus in the physiotherapy management of patients with back pain has been the active spinal stabilization exercises of muscles surrounding the spine considered to provide dynamic stability and fine control to the lumbar spine with increasing endurance and coordination of spinal stabilizer muscles. On the other hand many studies have found that inadequate strength and endurance of the back muscles are significant risk factors and symptoms for low back pain. The aim of the current study was to evaluate the effectiveness of specific stabilizing exercises on the lumbar muscle performance in saggital plane in normal subjects with Isostation B200 and clinical endurance tests. In a randomized clinical trial(RCT) 30 young healthy females were assigned randomly to case and control groups. The case group underwent a 4 week specific exercise program. After intervention the case group showed a statistically significant increase in strength and endurance variables in all tests, but after 4 weeks follow up, strength decreased significantly. Improvement in trunk muscle strength and endurance after spinal stabilization training suggests that these exercises can be the best choice for low back pain. Key Words: 1) Active spinal stabilization exercise 2) Trunk muscle performance 3) Isostation B200

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New studies in neuromuscular control have indicated that the strength of muscle contraction isn’t the only important factor in a task. But the speed at which a muscle responds, preparation of muscle and synergistic pattern at which a group of muscles recruit to a task or respond to a condition are much more important in constant joint stabilization and potential injury prevention. The purpose of this study was to assess the timing and scaling of knee related muscles’ electrical activity. Included muscles were: vastus medialis, vastus lateralis, rectus femoris, gastrocnemius, lateral hamstring and medial hamstring. The electrical activity was collected with the use of surface electromyography during selected active and reactive movement patterns. This research was a quasi-experimental design on 30 healthy young men (assigned by the sample of convenience) between 20-30 years of age (avg: 25.36). Our subjects sequentially and randomly were asked to perform different movement patterns and during these tests EMG signals were collected from each muscle. These signals were collected to assess onset time and the amount of muscle electrical activity (IAV) in each task. All movement patterns were in three main categories. Active movements included forward step up and lateral step up abrupt movements included vertical jump and distance jump and reactive movements (angular perturbation of base of support) included anterior and posterior perturbation with knee straight and knee bend. In this research both muscles in reactive movement patterns were significantly activated before active movements. Vastus medialis in anterior perturbation was activated 182.6 ms sooner than FSU (P<0.0001), and medial hamstring was 279.5 ms earlier under the same situation. The gastrocnemius muscle activity was 23.154 µv in distance jump, but 5.46 µv in FSU. In anterior perturbation VM and VL were significantly activated faster than posterior limb muscles, for example, VM was 23.3 ms before medial hamstring. However, in posterior perturbation the findings were vise versa and posterior muscles were faster. In all reactive movements medial hamstring had greater level of muscle activity, related to lateral hamstring and itself, in active movements. In posterior perturbation MH was activated 7.2 µv more than LH. Results indicated that learned movements had more efficiency in CNS decision for choosing a pattern of movement among possible ways of doing a task, and unnecessary muscle activity was much less in learned movements. Gastrocnemius muscle had a great role in abrupt and posterior perturbation movements in comparison with VM and VL muscles. The role of medial hamstring in reactive movements was clear and this role was not seen in lateral hamstring. This muscle can act as a propericeptive and postural muscle trigger, especially in proximal stability for trunk and pelvic region, and in distal perturbation we don't expect to see an ascending muscle synergy all the time.