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The Journal of Rehabilitation is the official scientific quarterly publication of the University of Social Welfare a... moreThe Journal of Rehabilitation is the official scientific quarterly publication of the University of Social Welfare and Rehabilitation Sciences (Tehran, Iran) with ISSN: 1607-2960. It is published in Persian language with abstracts both in Persian and English. This journal has been certified by Ministry of Culture and Islamic Guidance in 6/12/99 (Certification No. 124/12558) and was accredited as a scientific and research journal by HBI (Health and Biomedical Information) Journal Accreditation Commission in Summer of 2003 (Vol.13) and this grade has been extended in 26/8/2006. edit
Objective Cerebral palsy (CP) is the most prevalent motor disability during childhood, characterized by a range of movement and posture disorders that result in activity limitations. In children with CP, abnormal walking patterns are... more
Objective Cerebral palsy (CP) is the most prevalent motor disability during childhood, characterized by a range of movement and posture disorders that result in activity limitations. In children with CP, abnormal walking patterns are observed due to spasticity and contractures in the lower limb muscles. Also, an excessive flexion gait pattern of the knee presents in 66% of spastic diplegic CP children aged from 5 to 21 years. Accordingly, reducing excessive knee flexion during walking may decrease secondary compensations and enhance walking performance and quality of life. This study aims to design and evaluate a novel dynamic orthosis along with its impact on functional parameters of walking and occupation performance in a child with spastic diplegia CP. Materials & Methods This research was a fundamental and applied study of the design and fabrication. The study plan is a single subject, interaction design, conducted in two stages and implemented as A-B-BC-A. After the initial orthosis design, a second and final iteration was developed to address the limitations observed in the preliminary design. The study participant included an 8-year-old boy with spastic diplegic CP, classified as level II (according to the gross motor function classification system expanded and revised), exhibiting a crouch gait pattern. Functional variables, such as speed, balance in walking, spasticity, and occupation performance, were assessed in the study phases. Results The advantages and disadvantages of the final design were identified. Changes were made regarding manufacturing in less time, the ability to adjust the circumferential measures, ease of wearing and removing, and issues related to toileting. In comparing the baseline with intervention phases one and two regarding balance, the intervention demonstrated effectiveness (percentage of non-overlapping data [PND]=70%). According to PND values, functional speed in the second intervention phase showed significant results (PND=75%). The hamstring muscle spasticity graph analysis during intervention phases exhibited a reduction of 1 or 2 units. The occupational performance score and satisfaction with the child's performance increased significantly after the intervention phases. Conclusion According to the mechanism of dynamic movement orthoses, as long as they are worn during the day, they are effective in modulating the tonicity of spastic muscles by exerting pressure on hypertonic muscles. This modulation improves balance, movement speed, and overall task performance. Consequently, these findings suggest that dynamic orthotic interventions may enhance functional outcomes and occupational performance, and satisfaction in children with spastic diplegic CP.
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Objective This study aimed to investigate the validity and reliability of the Persian version of the "resilience assessment questionnaire" in patients with multiple sclerosis. Materials & Methods The statistical population of the present... more
Objective This study aimed to investigate the validity and reliability of the Persian version of the "resilience assessment questionnaire" in patients with multiple sclerosis. Materials & Methods The statistical population of the present study included all multiple sclerosis patients living in Tehran City in 2022. Of them, 250 people were selected through available sampling. The participants completed the questionnaires of Gromis et al. resilience and the hospital anxiety and depression scales. The validity of the questionnaire was investigated using the formal, content, construct, and predictor methods. Also, the reliability of the test was checked through the Cronbach α method and retesting. Data analysis was done using SPSS software, version 26. Results The face validity was confirmed by checking the content and solving the appearance problems. The content validity of the questionnaire was confirmed after correcting the questions. The results of exploratory factor analysis showed that the resilience questionnaire includes 5 components: Emotional and cognitive strategies, physical activity and diet, family and friends support, peer support, and spirituality. Also, the Cronbach α values of these components were 0.88, 0.79, 0.62, 0.76, 0.50, and 0.89, respectively. The eigenvalues of these components explained 47.49% of the variance. There was a significant relationship between the resilience and anxiety/depression questionnaire components. The correlation value between the first and second stages confirmed the retest validity of the resilience questionnaire. Conclusion The Persian version of the "multiple sclerosis resilience" scale is a valid and reliable tool for assessing resilience features in Iranian MS patients, which can be used in policymaking and research studies.
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Objective Communication skills have a principal function and value in health and treatment. These skills are essential for child experts, resulting in the clients' cooperation, satisfaction, and correct diagnosis. This study aims to... more
Objective Communication skills have a principal function and value in health and treatment. These skills are essential for child experts, resulting in the clients' cooperation, satisfaction, and correct diagnosis. This study aims to design a scale to evaluate the communication skills of health center experts in children's developmental tests. Materials & Methods The research community consisted of experts from health centers in Iran universities of medical sciences. The samples were recruited by purpose-based sampling. This group of experts was used in health centers due to the training of selected experts to perform the developmental Bayley test. First, the evaluation concepts were determined and discussed through a literature review and focused group discussion sessions with 10 experts; the experts were asked to express their opinions and suggestions regarding compiling communication items using the Delphi method. Suggested comments were collected and coded, and the study scale was designed. Then, the psychometric characteristics of the scale were determined with the participation of 16 experts through quantitative content validity and face validity. The scale's reliability was determined through the test re-test with a 2-week interval, the agreement coefficient in observations was compared between raters and the reference rater, and internal consistency was done. Quantitative data analysis was done in SPSS software, version 22. Results In this study, the communication skills scale was designed with 30 items: 13 for communication with children, 6 for communication with parents, and 11 for general items. The lowest content validity index value was related to one item in the communication with the children section. The rest of the items had acceptable validity. The Cronbach α value was 0.81 in communication with the children, 0.82 in communication with the parents, and 0.76 in the general section. The reliability level was 0.83, and the intracluster correlation coefficient was 0.77 in communication with a child, 0.88 in communication with parents, and 0.81 in general. The kappa coefficient for agreement between reference observer and other observers was above 0.7 in 5 cases and less than 0.4 in 2 cases. Conclusion The compiled evaluation scale has high validity and reliability and can be used as an evaluation scale of communication skills for child experts.
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Objective Insurance deductions are among the most important causes of hospital resource waste. Insurance deductions cause financial problems for hospitals and create tension between insurance organizations and hospitals. This study, done... more
Objective Insurance deductions are among the most important causes of hospital resource waste. Insurance deductions cause financial problems for hospitals and create tension between insurance organizations and hospitals. This study, done by the University of Social Welfare and Rehabilitation Sciences, investigates the reasons for deductions of inpatient bills covered by Social Security Insurance in Rofeideh Rehabilitation Hospital
Materials & Methods The study was conducted cross-sectionally on 776 cases admitted to Rofeidah Rehabilitation Hospital in 2021. All invoices for inpatient services sent to Social Security Insurance were reviewed using the census method. To collect data, invoices sent to Social Security, inpatient records and checklists, and a 31-question questionnaire of Mohammadkhani et al. were used. The collected data were analyzed by descriptive (frequency and percentage) and analytical statistics (the Spearman correlation coefficient) in SPSS software, version 23.
Results According to the findings, the highest frequency of inpatient prescriptions was related to November 2021 (7.48%). The most frequent deductions of inpatients’ bills were related to medicine and consumables to the amount of 310815448 Rails and surgeon’s fees in 187728448 Rails. Also, the most common reasons were requesting a surcharge and wrong coding. In this study, there was a significant relationship between the documentation of nurses and doctors and the amount of deductions (P<0.0001).
Conclusion Multiple causes affect the reduction of insurance deductions. By teaching insurance rules and the book on the relative value of health services to medical and nursing staff groups, electronic documents to Social Security Insurance and creating warning mechanisms in it, continuous interaction with Social Security Insurance to justify the managers of the organization regarding the way of providing services to rehabilitation patients and the reason for the prolonged hospitalization time of such patients could be the potential solutions for preventing patients records deductions and help hospitals achieve financial goals.
Materials & Methods The study was conducted cross-sectionally on 776 cases admitted to Rofeidah Rehabilitation Hospital in 2021. All invoices for inpatient services sent to Social Security Insurance were reviewed using the census method. To collect data, invoices sent to Social Security, inpatient records and checklists, and a 31-question questionnaire of Mohammadkhani et al. were used. The collected data were analyzed by descriptive (frequency and percentage) and analytical statistics (the Spearman correlation coefficient) in SPSS software, version 23.
Results According to the findings, the highest frequency of inpatient prescriptions was related to November 2021 (7.48%). The most frequent deductions of inpatients’ bills were related to medicine and consumables to the amount of 310815448 Rails and surgeon’s fees in 187728448 Rails. Also, the most common reasons were requesting a surcharge and wrong coding. In this study, there was a significant relationship between the documentation of nurses and doctors and the amount of deductions (P<0.0001).
Conclusion Multiple causes affect the reduction of insurance deductions. By teaching insurance rules and the book on the relative value of health services to medical and nursing staff groups, electronic documents to Social Security Insurance and creating warning mechanisms in it, continuous interaction with Social Security Insurance to justify the managers of the organization regarding the way of providing services to rehabilitation patients and the reason for the prolonged hospitalization time of such patients could be the potential solutions for preventing patients records deductions and help hospitals achieve financial goals.
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Objective The escalating challenges of drug and alcohol abuse underscore the critical need to prioritize Addiction-Affected Family members (AAFs), who face diverse health consequences and complex challenges. This study focuses on... more
Objective The escalating challenges of drug and alcohol abuse underscore the critical need to prioritize Addiction-Affected Family members (AAFs), who face diverse health consequences and complex challenges. This study focuses on Addiction-Affected Mothers (AAMs) and their coping strategies during their child’s substance abuse, aiming to explore their experiences during both the addiction and recovery periods.
Materials & Methods Using interpretative phenomenological analysis (IPA), nine AAMs, whose children had completed recovery, participated in semi-structured interviews. Purposive sampling ensured firsthand insights, with data analysis following IPA principles, including coding, categorization, and interpretation. Trustworthiness was maintained through member checking, peer debriefing, and ethical considerations.
Results The data analysis and the codes extracted from the interviews revealed four main themes and 14 subthemes. The four main themes extracted from the data included 1. Social Isolation, 2. The Swamp Trails, 3. The Continuum of Injuries, and 4. The Pursuit of Freedom. The first three main themes contained 11 sub-themes reflecting the mothers’ experiences caused by their child’s addiction, and the fourth theme, containing 3 sub-themes, comprised of countermeasures and effective mechanisms employed to overcome addiction-caused problems.
Conclusion The study provides evidence-based insights for enhanced services and policies targeting Addiction-Affected Mothers, who often initiate responses within families. Specialized interventions are crucial to address their unique needs and those of their families, minimizing the direct and indirect effects of addiction. Encouraging AAMs’ participation in support sessions is vital for ongoing coping. Effective resources and strategies can facilitate long-term recovery for both individuals with substance abuse and their families, contributing to a deeper understanding of familial dynamics affected by addiction.
Materials & Methods Using interpretative phenomenological analysis (IPA), nine AAMs, whose children had completed recovery, participated in semi-structured interviews. Purposive sampling ensured firsthand insights, with data analysis following IPA principles, including coding, categorization, and interpretation. Trustworthiness was maintained through member checking, peer debriefing, and ethical considerations.
Results The data analysis and the codes extracted from the interviews revealed four main themes and 14 subthemes. The four main themes extracted from the data included 1. Social Isolation, 2. The Swamp Trails, 3. The Continuum of Injuries, and 4. The Pursuit of Freedom. The first three main themes contained 11 sub-themes reflecting the mothers’ experiences caused by their child’s addiction, and the fourth theme, containing 3 sub-themes, comprised of countermeasures and effective mechanisms employed to overcome addiction-caused problems.
Conclusion The study provides evidence-based insights for enhanced services and policies targeting Addiction-Affected Mothers, who often initiate responses within families. Specialized interventions are crucial to address their unique needs and those of their families, minimizing the direct and indirect effects of addiction. Encouraging AAMs’ participation in support sessions is vital for ongoing coping. Effective resources and strategies can facilitate long-term recovery for both individuals with substance abuse and their families, contributing to a deeper understanding of familial dynamics affected by addiction.
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Objective Adolescents with visual impairments have less opportunity to adapt emotionally to the environment and, as a result, experience more social and academic problems. One of the most critical needs of adolescence is maintaining... more
Objective Adolescents with visual impairments have less opportunity to adapt emotionally to the environment and, as a result, experience more social and academic problems. One of the most critical needs of adolescence is maintaining emotional balance while confronting the stressful factors of puberty and environmental expectations. As visual impairment adversely influences adolescents' emotional maturity, helping teenagers adapt to challenging conditions is one of the main goals of a social and educational system. The purpose of the present study was to determine the effect of acceptance and commitment therapy (ACT) on the emotional maturity of female adolescents with visual impairment. Materials & Methods The current quasi-experimental study employed a pre-test and post-test and a follow-up design with a control group. A total of 82 females aged 14 to 18 from an educational community special for visually impaired individuals were assessed using the emotional maturity scale (EMS) in the academic year 2020-2021. Among the 33 volunteers who scored 180 and above in the EMS, 28 individuals were selected according to the inclusion criteria and matched based on their age and educational level via convenience sampling. All participants were randomly assigned to the experimental and control groups (14 individuals each). The experimental group attended 10 therapeutic sessions and received acceptance and commitment group therapy for two months (twice a week, 60 minutes per session). However, the control group only participated in the educational community's make-up empowering programs (including lessons curriculum plans and music training). All participants completed the EMS after the last intervention session and then 8 weeks later as a follow-up. The data were analyzed using the Shapiro-Wilk test, Levene test, M. Box test, multivariate analysis of covariance, and dependent t-test by SPSS software, version 22. Results The results of the Shapiro-Wilk test, Levene test, and M. Box test confirmed the normality of the distribution of scores, the homogeneity of variances, and the homogeneity of line slope, respectively. The results of multivariate analysis of covariance indicated that attendance of the experimental group in the acceptance and commitment group therapy sessions has led to a significant increase (P<0.05) in emotional maturity scores and its components: emotional stability, emotional progression, social adjustment, personality integration, and independence. Also, the ACT program changed the experimental group's emotional maturity and components as follows: 90%, 69%, 59%, 55%, 92%, and 68% for emotional stability, emotional progression, social adjustment, personality integration, and independence, respectively. In addition, the results of the dependent t-test to compare the emotional
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Objective The implementation of early rehabilitation programs based on evidence to improve the movement abilities of preterm infants is of particular importance. The evidence about rehabilitation interventions in improving the motor... more
Objective The implementation of early rehabilitation programs based on evidence to improve the movement abilities of preterm infants is of particular importance. The evidence about rehabilitation interventions in improving the motor development of preterm infants is diverse and scattered and there is heterogeneity in the type, dose and time of therapeutic interventions. Therefore, the purpose of this review study is to identify the types of rehabilitation interventions (occupational therapy and physiotherapy) in improving the motor skills of infants hospitalized in the intensive care unit. Materials & Methods This is a scoping review study. Research studies and indexed in scientific databases including were available in PubMed/Web of Science/Scopus or retrieved by Google Scholar search engine were searched and reviewed. Inclusion criteria included the report of studies in English and Persian papers published from 2000 to 2023 that were mainly focused and the main subject of early rehabilitation intervention studies (occupational therapy and physiotherapy) on the development of neuromotor skills of preterm infants in the neonatal intensive care unit. After selecting the keywords and organized search, the found articles were matched with the entry criteria and finally considered studies were selected. Results Among the reviewed studies, 15 studies met the inclusion criteria. Among the available studies, 7 studies related to multi-modal interventions and 2 studies related to multi-sensory intervention .2 studies related to neuro-developmental interventions. 2 studies related to interventions implemented by parents-administered. 2 studies related to interventions supporting play exploration and early developmental intervention. Conclusion Based on the findings of this research and the meetings held with experts in this field, we were able to organize early rehabilitation interventions for motor skills of preterm infants in 4 groups: 1) multimodal and multisensory interventions 2) neurodevelopmental interventions 3) parentsadministered interventions 4) supporting play exploration and early developmental intervention to categorize. In this way, all types of therapeutic interventions in improving motor skills of infants were identified. Most of the studies included interventions that were performed in a short period of time and reported short-term effects on motor improvement. Only the supportive play exploration intervention continued after discharge and bridged the gap of early NICU-to-home interventions and reported improved motor development in the short-and long-term (6, 12 months).
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Objective According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore,... more
Objective According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study was to determine the objectives and policies in the field of rehabilitation in middle-and high-income countries and compare them with Iran. Materials & Methods Based on available databases, a comprehensive review of documents, papers, and books was performed in the field of rehabilitation related to high-and middle-income countries. Results Due to a lack of coordinated services, inappropriate access, unplanned distribution, unclear service delivery levels, neglect of health promotion and prevention levels, lack of a transparent referral system, unclear insurance system, and weak financial resources, the need for a national program with a service integration approach is strongly felt. The review of the rehabilitation programs and documents in other countries help us to design a conceptual framework of the rehabilitation service model, which is based on three principles: Removing barriers and developing access to healthcare services and programs; strengthening and developing rehabilitation using technology, community-based support, and rehabilitation services; and promoting comparable international data collection on disability and supporting research on disability and related rehabilitation services. Conclusion The national rehabilitation program, with a service integration approach, provides a good platform for fair access to rehabilitation services for all people with disability. In this program, the health system is the most important reference to meet these needs. Therefore, it is suggested that this program pursue three main objectives: Fair promotion of the healthcare services of rehabilitation for recipients, improving the response to the needs of rehabilitation service recipients, and reducing the financial and social risks of service recipients.
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Objective Autism spectrum disorder (ASD) is a common disorder among children. The architectural design of the treatment environment can be effective in the quality of rehabilitation for these children. On the other hand, considering that... more
Objective Autism spectrum disorder (ASD) is a common disorder among children. The architectural design of the treatment environment can be effective in the quality of rehabilitation for these children. On the other hand, considering that an important part of treatment for children with ASD is to meet their sensory needs, there is a need for intervention and adaptation to the environment (sensory regime). The study aims to investigate the effect of the interior architecture of rehabilitation centers on the outcome of occupational therapy for children with ASD. Materials & Methods This is an observational cross-sectional study on 50 children with ASD aged 3-14 years, who were assigned into two groups of treatment in standard and non-standard environments, according to interior architectural factors. They were assessed before and after occupational therapy. To rank the physical space of rehabilitation centers, a researcher-made questionnaire was used with 30 criteria measuring natural light intensity, light quality (natural or artificial), visibility and view of the inside of the building, noise and visual pollution, and color of the walls. The criteria were based on the opinions of 32 occupational therapists and parents of 50 ASD children. The sensory profile 2 was used to measure sensory processing patterns (sensation seeking, sensation avoiding, sensory sensitivity, and sensory registration) of children with ASD. The paired t-test was used for within-group comparison, and the independent t-test was used for between-group comparison. Results Both standard and non-standard treatment environments were effective in improving all four patterns of sensory processing (P=0.04). However, the rehabilitation center with standard design had a more significant positive effect on all four sensory processing patterns, including sensation seeking (P=0.001), sensation avoiding (P=0.001), sensory sensitivity (P=0.01), and sensory registration (P=0.001) compared to the non-standard environment. Conclusion The interior architecture of rehabilitation centers has a significant positive effect on the sensory processing patterns of children with ASD, which can affect the quality of rehabilitation services. Therefore, it is recommended to optimize the interior architecture of rehabilitation centers for ASD children.
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Objective Patients with knee osteoarthritis (KO) commonly show quadriceps muscle weakness. One of the important reasons for this weakness is arthrogenic muscle inhibition (AMI), a process in which neural inhibition causes the failure of... more
Objective Patients with knee osteoarthritis (KO) commonly show quadriceps muscle weakness. One of the important reasons for this weakness is arthrogenic muscle inhibition (AMI), a process in which neural inhibition causes the failure of quadriceps activation. The present study aims to evaluate the effect of cross-education on the AMI and the maximum extensor force of quadriceps in women with unilateral KO. Materials & Methods In this study, 21 women with unilateral KO (grade 2) participated. The AMI and the maximum extensor force of the quadriceps in the affected knee were measured before, immediately after, and 15 minutes after cross-education. The cross-education included isometric training of the contralateral quadriceps in 5 sets of 8 repetitions in one session. For measuring the AMI and maximum extensor force of the quadriceps, a burst of electrical stimulation was superimposed on the maximal voluntary contractions in 6 seconds. Results Immediately after one session of cross-education, the AMI of the affected knee significantly decreased and the maximum extensor force of quadriceps significantly increased compared to the pretest phase (P=0.001). Fifteen minutes after cross-education, AMI significantly increased compared to the post-test phase (P=0.018), but was still lower than that in the pre-test phase (P=0.001) Conclusion One session of cross-education can reduce AMI and increase maximum extensor force of quadriceps in women with KO, and this effect remains for at least 15 minutes.
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Objective In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the... more
Objective In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the health system. This study aims to design and evaluate the validity and reliability of the Bayley-III examiner clinical performance scale. Materials & Methods In this study, participants were Bayley-III test examiners from medical universities in Iran, who were selected using a purposive sampling method. First, in focused group discussion sessions with 10 Bayley-III test experts, the items of instrument were formulated. Then, to evaluate the face validity, the questionnaire was sent to a panel of expert consisting of 8 Bayley-III experts and examiners and they were asked to rate the items from 1 to 5 in terms of importance. The items with an impact score of less than 1.5 were deleted, and other items were revised, if needed. To evaluate content validity, the questionnaire was sent to 10 Bayley-III test experts, and then the content validity ratio (CVR) and content validity index (CVI) were measured. The items with CVR <0.6 and CVI <0.7 were deleted. The reliability of the instrument was assessed by calculating the inter-rater reliability, test re-test reliability, and internal consistency. Quantitative data analysis was done in SPSS software, version 22. Results The instrument with 66 items, including 32 items for the cognitive domain, 22 items for the language domain (13 for receptive and 9 for expressive components), 12 items for the motor domain (9 for fine and 3 for gross motor skills), and 14 items for the general section, was assessed in stability and reliability. The intraclass correlation coefficient (ICC) for the test re-test reliability was obtained 0.83 for the specific section and 0.86 for the general section. The ICC for the inter-rater reliability was 0.80 (95% CI: 58-82). The highest correlation value was related to the cognitive scale (0.88), and the lowest value was for the gross motor skill subscale (0.76). The kappa coefficient for the inter-rater reliability of the general section was above 0.7. The kappa coefficient for the specific section ranged from 1 to 0.35. The Cronbach's α for the internal consistency of the general section was 0.76. Conclusion The designed questionnaire is a valid and reliable tool to evaluate the clinical performance of Bayley-III test examiners in Iran.
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Objective Proper physical activities play an important role in reducing disease and mortality in old age, and is one of the main causes of active aging; however, the fear of falling is a barrier to having proper physical activity. Due to... more
Objective Proper physical activities play an important role in reducing disease and mortality in old age, and is one of the main causes of active aging; however, the fear of falling is a barrier to having proper physical activity. Due to the difference between the elderly living in urban and rural areas regarding the risk factors of fear of falling and the amount and type of physical activity, this study aims to investigate and compare the fear of falling, physical activity, and activities of daily living (ADL) in the elderly living in urban and rural areas of Konarak County, Iran. Materials & Methods In this analytical cross-sectional study, 350 elderly people aged ≥60 years, who were under the coverage of comprehensive rural and urban health service centers in Konarak, Sistan and Baluchestan province (224 from rural areas and 126 from urban areas) were selected using a random sampling method and based on the inclusion and exclusion criteria. In addition to recording their demographic information, their fear of falling, physical activity, and ADL were measured by the Persian version of falls efficacy scale-international (FES-I), Rapid Assessment of Physical Activity (RAPA), ADL scale, and Instrumental ADL scale (IADL), respectively. Results The mean overall age of the elderly was 68.48±7.84 years (69.53±8.29 years in the rural group and 66.62±6.61 years in the urban group), and there was a significant difference between the two groups in terms of age (P<0.001). Pearson correlation test results showed that the FES-I score had a statistically significant negative relationship with the scores of ADL, IADL, and RAPA1 in total and in each group (P<0.001), but there was no statistically significant relationship between the FES-I score and the RAPA2 neither in total (P=0.40) and nor in rural (P=0.38) and urban (P=0.81) groups. Conclusion The fear of falling is significantly higher in the elderly living in rural areas of Konarak county compared to those living in urban areas. The RAPA1 and basic ADL of the elderly living in urban areas are higher compared to those living in rural areas, but there is no significant difference between them in RAPA2 and IADL. In addition, fear of falling has a significant relationship with physical activity of the elderly in overall and in rural and urban groups.
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Objective Stuttering is one of the speech disorders that appears in childhood. Many studies emphasize early interventions for its treatment. Circumstances such as a lack of therapists and the COVID-19 pandemic have limited the access to... more
Objective Stuttering is one of the speech disorders that appears in childhood. Many studies emphasize early interventions for its treatment. Circumstances such as a lack of therapists and the COVID-19 pandemic have limited the access to face-to-face therapy. Studies show some problems with this type of treatment. A detailed understanding of these problems in a cultural context can help increase the quality of providing telepractice. This study was conducted to discover the telepractice treatment of stuttering in preschool children. Materials & Methods This qualitative study was conducted in Iran from November 2020 to February 2022 using the grounded theory method. In this study, in-depth, free, and individual interviews were conducted with 9 therapists and 5 parents of children who stutter. The data were analyzed using the Corbin and Strauss method, version 2015. Results After analyzing the data of this study, 6 main categories, 17 subcategories, and 63 primary categories were extracted. The main categories include "hesitation in choosing telepractice", "characteristics of family and clients", "technology and the knowledge to apply it", "therapist skills for telepractice", "payment system for telepractice fees", and "efficiency of telepractice". Conclusion In this study, "efficiency of telepractice" was chosen as the central concept that all participants were concerned about in some way. According to this model, "hesitation in choosing telepractice", "characteristics of family and clients", and "technology and the knowledge to apply it" as the context have effects on the processes that are taking place in relation to the telepractice in preschool children who stutter. These processes include "therapist skills for telepractice" and " payment system for telepractice fees". In the end, all these things increase the efficiency of telepractice.
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Objective Swallowing disorder or dysphagia is one of the most common problems in old age and after brain vascular lesions. This problem has received a lot of attention in studies. However, Pain on swallowing (known as odynophagia) has... more
Objective Swallowing disorder or dysphagia is one of the most common problems in old age and after brain vascular lesions. This problem has received a lot of attention in studies. However, Pain on swallowing (known as odynophagia) has been less discussed in the literature. The present study aimed to investigate the existence of pain on swallowing, its characteristics, the possible intervention, and the effects of this pain on the quality of life of affected people. Materials & Methods The present study adopted a qualitative approach. After purposeful sampling, we interviewed 11 speech therapists in the field of swallowing disorders (5 males) and 15 patients with dysphagia. All the interviews were transcribed and underwent content analysis using the Graneheim and Lundman method. Finally, the main themes, subcategories, semantic units, and examples related to each were obtained. Results Out of 15 interviewed patients, only 6 reported pain on swallowing. In comparison, all 11 therapists in the field of swallowing disorders confirmed the presence of pain on swallowing. Seven main themes were obtained based on these interviews: The temporal pattern, duration, location, stimulating/provoking factors, type, intensity, and onset time. Each of these themes had its subcategories and items. All patients and therapists reported the negative impact of pain on swallowing on the quality of life. There was an agreement between therapists and patients to manage pain on swallowing. Conclusion This study showed that pain on swallowing is probably one of the characteristics of a swallowing disorder, and professionals must consider pain on swallowing during the clinical examination. Future studies can focus on different dimensions of pain on swallowing and develop proper evaluation scales.
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Objective Grammar is a key element of language knowledge and a factor in predicting language learning and success. Early diagnosis of grammatical errors in children before entering school is very important. So far, no tool has been... more
Objective Grammar is a key element of language knowledge and a factor in predicting language learning and success. Early diagnosis of grammatical errors in children before entering school is very important. So far, no tool has been designed to evaluate the Azerbaijani language grammar comprehension in Iran. The present study aims to design the Azerbaijani language grammar comprehension test for Iranian children aged 4-6 along and assess its validity. Materials & Methods This is a mixed-method (qualitative-quantitative) study. After searching in various databases and reviewing available articles, 42 grammatical structures of the Azerbaijani language were extracted, of which 8 were removed after preliminary examination by experts. Then, 204 items were formulated for the remaining 34 grammatical structures. To determine the content validity, the test was sent to 11 experts in the field of Azerbaijani language grammar to evaluate the items. According to their opinions, two more suitable items were selected from among four items for each grammatical structure and included in the initial version for the pilot study. The initial test version was conducted on 30 children aged 4-6 years with normal language development. Results After calculating the content validity ratio (CVR), two grammatical structures were removed, and 32 structures with 128 items having CVR≥0.59 remained. After calculating the content validity index (CVI), the items with CVI≥0.79 were selected. The initial version had 32 grammatical structures and 64 items. None of the items were removed in the pilot phase, and only 10 items were modified. The CVR and CVI of the test were 0.91 and 0.87, respectively, indicating good content validity. Conclusion The Azerbaijani language grammar comprehension test has good content and face validity and can be used to evaluate the grammar comprehension of children with Azerbaijani language aged 4-6 years.
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Objective Cerebral palsy is a group of movement disorders caused by damage to one or more regions of the developing brain. Therapists use different treatment approaches for children with cerebral palsy. It is important to pay attention to... more
Objective Cerebral palsy is a group of movement disorders caused by damage to one or more regions of the developing brain. Therapists use different treatment approaches for children with cerebral palsy. It is important to pay attention to the priorities of the parents of these children because they spend most of the time with their children and are fully aware of their needs. The present study aims to investigate the treatment priorities of parents of children with cerebral palsy. Materials & Methods In this scoping review study, a search was first conducted in national and international databases, including SID, PubMed, Scopus, Google Scholar, OT Seeker, and the Bank of Medical Theses of the country. The articles focused on the treatment priorities of parents of children with cerebral palsy and published in English or Persian from 2000 to 2022 were included. The review studies published in other languages were excluded. After assessing the found articles based on the inclusion and exclusion criteria, 12 articles were finally selected for the review. Results The parents of children with cerebral palsy have different priorities. Teaching elf-care skills to the child was one of their most important priorities, which is not dependent on the age and level of gross motor function in children. Other important priorities were mobility and having complete information about treatment services. It seems that all the mentioned priorities are related to each other and paying attention to each one requires checking other priorities. Conclusion The priorities of the parents of children with cerebral palsy are broad and unique. Not all of these priorities are dependent on the age and severity of disability in the children, and can be different per child. It seems necessary to pay attention to the treatment priorities of the parents of these children in the rehabilitation process.
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Objective Deafness is one of the most complex sensory disorders that leads to a major decline in auditory (listening) and preverbal skills. Research shows that reading books has provided patterns of communication and preverbal skills to... more
Objective Deafness is one of the most complex sensory disorders that leads to a major decline in auditory (listening) and preverbal skills. Research shows that reading books has provided patterns of communication and preverbal skills to deaf children. This study was conducted to investigate the effect of online dialogic parent-child book reading on the preverbal and listening skills of deaf children under three years old.
Materials & Methods This research was a one-group quasi-experimental study with a pre-test-post-test design. The study sample comprised 10 hearing parents with their deaf children under 3 years old who were members of the Deaf Family Association of Iran and the Deaf Center of Iran. First, the parents and their qualified children were purposefully identified (based on inclusion criteria). Then, from all the people who met the study criteria, the people who declared their readiness to participate were selected as study samples. Before starting the online dialogic parent-child book reading program, the preverbal skills test (pointing, joint attention, imitation, and take turns) and listening skills (little ears) were administered as a pre-test. Online reading sessions were held for 20 sessions, three days a week. Parents went online at a specific time (10 AM on Saturdays, Mondays, and Wednesdays). Each day a book with pictures and story-related content, book descriptions, questions, and more was posted in the WhatsApp group. After the online dialogic parent-child book reading program, the test of preverbal and listening skills (little ears) was performed as a post-test for the sample group. The paired t-test was used to analyze the obtained data.
Results The results of this study showed that the online dialogic parent-child book reading program caused a significant increase (P<0.005) in the post-test preverbal skills test score (imitation, joint attention, pointing and take turns) and listening skills (P<0.005) compared with the pre-test score of the sample group.
Conclusion Dialogic parent-child book reading is one of the parent-centered programs that is benefecial for deaf toddlers. The results showed the applicability of dialogic parent-child book reading in improving the listening and preverbal skills of deaf children.
Materials & Methods This research was a one-group quasi-experimental study with a pre-test-post-test design. The study sample comprised 10 hearing parents with their deaf children under 3 years old who were members of the Deaf Family Association of Iran and the Deaf Center of Iran. First, the parents and their qualified children were purposefully identified (based on inclusion criteria). Then, from all the people who met the study criteria, the people who declared their readiness to participate were selected as study samples. Before starting the online dialogic parent-child book reading program, the preverbal skills test (pointing, joint attention, imitation, and take turns) and listening skills (little ears) were administered as a pre-test. Online reading sessions were held for 20 sessions, three days a week. Parents went online at a specific time (10 AM on Saturdays, Mondays, and Wednesdays). Each day a book with pictures and story-related content, book descriptions, questions, and more was posted in the WhatsApp group. After the online dialogic parent-child book reading program, the test of preverbal and listening skills (little ears) was performed as a post-test for the sample group. The paired t-test was used to analyze the obtained data.
Results The results of this study showed that the online dialogic parent-child book reading program caused a significant increase (P<0.005) in the post-test preverbal skills test score (imitation, joint attention, pointing and take turns) and listening skills (P<0.005) compared with the pre-test score of the sample group.
Conclusion Dialogic parent-child book reading is one of the parent-centered programs that is benefecial for deaf toddlers. The results showed the applicability of dialogic parent-child book reading in improving the listening and preverbal skills of deaf children.
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Objective Myofascial pain syndrome (MPS) is a clinical disorder with a prevalence of 85%. It is characterized by the presence of trigger points, and all people experience it at least once in their lives. Different physiotherapy and... more
Objective Myofascial pain syndrome (MPS) is a clinical disorder with a prevalence of 85%. It is characterized by the presence of trigger points, and all people experience it at least once in their lives. Different physiotherapy and medical methods are used to manage MPS. Intramuscular electrical stimulation (IMES) is a relatively new treatment option for MPS. This study aims to examine the effect of IMES on clinical and ultrasound imaging parameters related to trigger points in patients with MPS. Materials & Methods This is a case series clinical trial. Twelve participants with trigger points in their upper trapezius muscles participated in this study. They were treated three times per week with IMES. Before and after the intervention, pain and cervical spine range of motion (ROM) were measured with the visual analog scale and goniometry. Ultrasonic parameters (longitudinal diameter and the area of trigger points, and the thickness of the upper trapezius muscle) were assessed with B-mode ultrasound imaging technique. The pre-test and post-test values were compared using the paired t-test. The significance level was set at 0.05. Results After three sessions of IMES, pain and cervical spine ROM improved significantly (P<0.05). All ultrasound imaging parameters, including trigger points' longitudinal diameter and area and upper trapezius muscle thickness, decreased significantly compared to baseline (P<0.05). Conclusion IMES seems to have promising effects on clinical and ultrasound imaging parameters of patients with MPS. Further studies with larger sample sizes are recommended to investigate the longterm effects of IMES with the inclusion of a matched control group.
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Objective Reviewing the literature related to the use of polysyllabic words in the assessment of speech sound disorders (SSD) in children have indicated the necessity of using these words for providing additional information such as... more
Objective Reviewing the literature related to the use of polysyllabic words in the assessment of speech sound disorders (SSD) in children have indicated the necessity of using these words for providing additional information such as prognostic information. Despite strong literature in other languages, there is scant research on examining the production of these words in the Persian language among children aged 4-7 years. Therefore, this study aims to design and assess the psychometric properties of the Persian version of the polysyllabic words test (PWT) for measuring production skills in Iranian preschool children. Materials & Methods In this cross-sectional study, First, 532 polysyllabic words with 3, 4, 5, and 6 syllables were selected from preschool children's books, which was reduced to 66 words after agreement among authors in three rounds. The content validity of the items was examined according to the opinions of five experts in typical speech development and SSD in terms of four criteria: Appropriateness for producing polysyllabic words, appropriateness for children aged 4-7 years, imageability, and cultural fit. After selecting pictures, face validity of items was examined by implementing the test on eight 4-7-year-old children (at least one child from each age group). Finally, 40 items were considered as the final words of PWT. For measuring psychometric properties, 120 children with normal development (60 males, 60 females), and 20 children with SSD (10 males, 10 females) participated. The control children were divided into 6 age groups with a 6-month interval (10 males and 10 females in each age group). Their inclusion criteria were age 4-7 years, not being bilingual, and passing the Persian diagnostic evaluation of articulation and phonology test (DEAP; Zarifian, 2014) and informal language screening test successfully. Because of the COVID-19 pandemic and the closure of most schools, the sampling of control children was done using a convenience method from two cities (Tehran and Karaj). The inclusion criteria for SSD children were: Inability to pass the DEAP test, not being bilingual, and having SSD. Their sampling was also done using a convenience method. For evaluating construct validity, the differences among six age groups, between males and females, and between control and SSD children were examined in terms of total score, percent consonants correct (PCC), percent vowels correct (PVC), and percent phonemes correct (PPC). Test-retest reliability was determined using 20 children at a one-week interval, and interrater reliability was determined by investigation of relations between scores of two independent raters for 20 children using the intra-class correlation coefficient (ICC). The internal consistency was determined by measuring the Cronbach's alpha coefficient. Descriptive statistics, ANOVA, independent t-test, Tuckey's post hoc test, were used for data analysis in SPSS software, version 26. Results In comparing the age groups, the results showed a significant difference in terms of total score, PCC and PPC (P<0.001), but not significant difference was found in PVC (P=0.23). No significant differences were found between males and females in total score, PCC, PPC, or PVC. In comparing control and SSD
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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... more
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.
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Objective Having a child with speech and language disorders, while creating a sense of great therapeutic responsibility towards them, will significantly affect the psychological dimensions of parents, especially mothers as the primary... more
Objective Having a child with speech and language disorders, while creating a sense of great therapeutic responsibility towards them, will significantly affect the psychological dimensions of parents, especially mothers as the primary caregiver. They are more exposed to the pressures and stress that result from the sense of responsibility towards their children. The aim of this study was to compare the level of stress, depression, and quality of life (QoL) among mothers of children with speech and language disorders whose children have received rehabilitation services for different periods of time.
Materials & Methods The current descriptive-analytical cross-sectional study was conducted on 185 mothers of children with speech and language disorders who needed to receive rehabilitation services. Data collection was done using: a short form of parenting stress index (PSI-SF) to measure stress, the Beck depression inventory-2nd edition (BDI-II) to measure maternal depression rate, a health survey questionnaire (a 36-item short form) (SF-36) to measure the QoL. Based on the duration of receiving rehabilitation services, mothers participating in this study were divided into four groups: 1) For less than one month, 2) Between 1 to 6 months, 3) Between 7 to 11 months, and 4) For more than 12 months. The data were analyzed by one-way repeated measures analysis of variance and multivariate ANOVA.
Results Comparing the mean scores of PSI, BDI-II, and SF-36 between four groups of mothers was significant (P<0.001). The results showed that mothers whose children had received rehabilitation services for a longer period of time had lower mean stress and depression scores and higher mean QoL scores (P<0.001). The factor of the type of child's disorder had a significant effect on the results (P<0.05).
Conclusion The lowest score of stress and depression and the highest score of QoL in mothers who had received rehabilitation services for more than 12 months can indicate that mothers who receive rehabilitation services for a longer period of time see the improvement of their children. They are also better able to use stress coping strategies to deal with their child's problem.
Materials & Methods The current descriptive-analytical cross-sectional study was conducted on 185 mothers of children with speech and language disorders who needed to receive rehabilitation services. Data collection was done using: a short form of parenting stress index (PSI-SF) to measure stress, the Beck depression inventory-2nd edition (BDI-II) to measure maternal depression rate, a health survey questionnaire (a 36-item short form) (SF-36) to measure the QoL. Based on the duration of receiving rehabilitation services, mothers participating in this study were divided into four groups: 1) For less than one month, 2) Between 1 to 6 months, 3) Between 7 to 11 months, and 4) For more than 12 months. The data were analyzed by one-way repeated measures analysis of variance and multivariate ANOVA.
Results Comparing the mean scores of PSI, BDI-II, and SF-36 between four groups of mothers was significant (P<0.001). The results showed that mothers whose children had received rehabilitation services for a longer period of time had lower mean stress and depression scores and higher mean QoL scores (P<0.001). The factor of the type of child's disorder had a significant effect on the results (P<0.05).
Conclusion The lowest score of stress and depression and the highest score of QoL in mothers who had received rehabilitation services for more than 12 months can indicate that mothers who receive rehabilitation services for a longer period of time see the improvement of their children. They are also better able to use stress coping strategies to deal with their child's problem.
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Objective One of the basic challenges of health care centers is the inflation of the costs of services. Rehabilitation services play a significant role in restoring disabled people's functional ability. Having knowledge of the unit cost... more
Objective One of the basic challenges of health care centers is the inflation of the costs of services. Rehabilitation services play a significant role in restoring disabled people's functional ability. Having knowledge of the unit cost of rehabilitation services can be useful in optimal allocation of resources and budget. This study aims to calculate the unit cost of outpatient rehabilitation services provided by the Nezam-Mafi Rehabilitation Center (NMRC) in Tehran, Iran. Materials & Methods This is a descriptive, retrospective study with a cross-sectional design. The time-driven activity-based costing (TDABC) method was used to determine the unit cost for 9 outpatient rehabilitation services related to speech therapy, occupational therapy, physiotherapy and audiology provided by the NMRC in 2019. In the first step, the sequence of each activity was mapped in one code (service). Then, the resources needed to perform each activity were identified and the source of cost for each activity was specified. In the next step, the cost driver for each specific sources and the amount of their use in each activity were determined. Due to the importance of personnel costs, this stage was done with more attention on the time required to provide each activity. In this regard, the cost of each minute of service compensation was calculated by considering the annual attendance time of personnel and their salary expenses. Finally, the costs of each unit of the production factor and the total cost for each code (service) were determined. Results In the NMRC, the costs of renting (47.9%), consumable materials and supplies (11.6%), and contracted services (10.5%) made up the highest percentage of costs. The costs of outpatient rehabilitation services (except for speech therapy) were higher than official tariffs for these services. The cost of specialized personnel for physiotherapy services and the cost of building in occupational therapy, speech therapy, and audiology services had the highest share in their unit costs. The total cost of staff personnel was estimated at 3.904 Rials per minute (RPM), which was higher than the specialized professional for pediatric occupational therapy (2046 RPM), occupational therapy (1929 RPM), speech therapy (1899 RPM), and audiology (1974 RPM). The high overhead costs of outpatient rehabilitation services (24.5% of the total cost(were one of the primary reasons for the gap between the average costs and tariffs. Conclusion There is a considerable gap between the cost of some services in the NMRC and the related tariffs. Due to the low capacity of service provision in the NMRC, overhead costs have led to the inflation of the cost of services in this center. Therefore, the consolidation of small institutions and improving the referral system for people with disabilities from medical centers can reduce the unit cost of services. Considering that most rehabilitation services are not covered by the social security insurance and are not affordable for patients, a national-level reform should be prepared in the healthcare system. In addition, using the TDABC method in rehabilitation service centers can be a solution to identify the main sources of costs and control price inflation in the health sectors.
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Objective Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged. The complex nature of the disease making the diagnosis more difficult for the patient to face. This study... more
Objective Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged. The complex nature of the disease making the diagnosis more difficult for the patient to face. This study explored the experiences of facilitators and barriers adjustment to MS by Iranian patients. Materials & Methods This study was conducted by using descriptive phenomenological approach. The participants included 14 patients (8 women and 6 men) referred to Rafideh Hospital in Tehran. The participants were selected by purposive sampling and maximum variety. Data collection continued through semi-structured interviews until theoretical saturation. The duration of the interviews was between 30-60 minutes. Data analysis was done with MAXQDA software and using the 7-step descriptive collaizzi,s method continuously and simultaneously with data collection. In order to check the robustness of the results, Lincoln and Goba criteria of validity, reliability, transferability and verifiability were used. Results The 5 main themes related to facilitators of adaptation that emerged included religious strategies, receive emotional and professional support, search and find information, psychological coping strategies, and life style (and 18 subcategories). Also the three main themes related to barrier of adaptation that emerged included health-related, patient-related and social-related barriers (and 8 subcategories). Conclusion These themes represent the perceived characteristics, facilitators and barriers of adaptation to Multiple Sclerosis by patients. Therefore, it is necessary to design or implement therapeutic interventions based on these findings by psychologists and counselors for patients to reduce psychological problems.
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Objective One of the important factors in choosing purposeful activities and defining the occupational performance of people is the cultural context in the society, which may have different effects in the lives of clients in Islamic... more
Objective One of the important factors in choosing purposeful activities and defining the occupational performance of people is the cultural context in the society, which may have different effects in the lives of clients in Islamic countries. This cultural structure in Islamic countries is largely influenced by the religious beliefs that govern the society. The effect of Islamic culture on the occupational performance of clients has been studied less. This study deals with the review of articles related to the relationship between the context of Islamic culture and the occupational performance of clients in Islamic countries using the explicit content analysis method. Therefore, the purpose of this study is to explain the effects of Islamic culture on the occupational performance of occupational therapy clients in Islamic countries. Materials & Methods The number of 46 studies using the keywords occupational therapy, Muslims and Islamic culture were initially selected until 2022 and the articles that were unrelated to occupational therapy and were not about Islam and Islamic culture were removed which finally reduced to 20 studies and then, they were subjected to qualitative analysis. Results The analysis of extractive studies has led to the emergence of different themes and categories, the theme of positive points has categories (importance of united family structure), (importance of religion in helping clients), (importance of pray as a purposeful activity) and theme challenges have categories (traditional treatments without clinical evidence), (importance of respecting the principle of Mahram in interpersonal communication), (specific beliefs in the cause of illness), (restrictions on praying), (cultural and local challenges), (hesitation in accepting occupational therapy philosophy). Conclusion In fact, Islam, with its influence on the family structure and the creation of positive beliefs and beliefs among the society, has been able to facilitate the process of occupational therapy and rehabilitation of clients to a great extent, but in the context of Islamic culture, there are many obstacles that unfortunately cause limitations. They are in interpersonal communication and acceptance of occupational therapy philosophy. Occupational therapists can use the opportunities to improve the client's performance, and in order to solve the challenges, it is necessary to do a lot of research to provide the necessary solutions.
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Objective Due to the substantial prevalence of patellofemoral pain syndrome and the importance of quadriceps strengthening in knee rehabilitation, determining the best way to activate and strengthen the patella stabilizing muscles is... more
Objective Due to the substantial prevalence of patellofemoral pain syndrome and the importance of quadriceps strengthening in knee rehabilitation, determining the best way to activate and strengthen the patella stabilizing muscles is considered as one of important keys of treatment. The aim of this study is to evaluate the effect of different hip rotations associated with ankle dorsiflexion during maximal straight leg raising (SLR) maneuver in the sitting position on thickness and fibers angle of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles using ultrasonography.
Materials & Methods This quasi-experimental study was performed on 40 individuals (healthy group: 20, patellofemoral pain syndrome [PFPS] group: 20). VMO and VL thickness and fiber angle were measured using ultrasonography during maximal SLR in 6 positions: hip internal, hip external, and neutral rotations with and without ankle dorsiflexion.
Results In between-group comparison, no significant difference was found for all variables with different SLR maneuvers (P>0.05). In the within-group comparison, hip external rotation compared to other hip positions without ankle dorsiflexion resulted in a significant increase in VMO thickness and fiber angle in both groups (P<0.05). Also, adding ankle dorsiflexion to different hip rotations during SLR significantly increased the thickness and fiber angle of VMO and VL.
Conclusion By changing hip rotations with or without ankle dorsiflexion during SLR, the trend of changes in VMO and VL thickness and fiber angle in the two groups followed the same pattern. Moreover, performing SLR in hip external rotation with ankle dorsiflexion can be recommendable for the rehabilitation of PFPS.
Materials & Methods This quasi-experimental study was performed on 40 individuals (healthy group: 20, patellofemoral pain syndrome [PFPS] group: 20). VMO and VL thickness and fiber angle were measured using ultrasonography during maximal SLR in 6 positions: hip internal, hip external, and neutral rotations with and without ankle dorsiflexion.
Results In between-group comparison, no significant difference was found for all variables with different SLR maneuvers (P>0.05). In the within-group comparison, hip external rotation compared to other hip positions without ankle dorsiflexion resulted in a significant increase in VMO thickness and fiber angle in both groups (P<0.05). Also, adding ankle dorsiflexion to different hip rotations during SLR significantly increased the thickness and fiber angle of VMO and VL.
Conclusion By changing hip rotations with or without ankle dorsiflexion during SLR, the trend of changes in VMO and VL thickness and fiber angle in the two groups followed the same pattern. Moreover, performing SLR in hip external rotation with ankle dorsiflexion can be recommendable for the rehabilitation of PFPS.
Research Interests:
Objective One of the most voice-related complaints in teachers is vocal tract discomfort (VTD) which can increase the voice handicap index (VHI) to different degrees. In teachers Muscle Tension Dysphonia (MTD), increases voice complaints... more
Objective One of the most voice-related complaints in teachers is vocal tract discomfort (VTD) which can increase the voice handicap index (VHI) to different degrees. In teachers Muscle Tension Dysphonia (MTD), increases voice complaints and decreases the voice-related quality of life. The aims of this study were to evaluate and compare the frequency and severity subscales of the VTD score and total score of VHI and determine the relation between them in primary school teachers with and without MTD.
Materials & Methods This study was cross-sectional and was performed on 80 primary female teachers with and without MTD. The participants in both groups were randomly selected after checking the inclusion criteria. Voice history, auditory-perceptual assessment of voice, palpation, and laryngeal video-stroboscopy were assessed on the teachers in two groups. Then, asked the participants to complete the Persian versions of the VTD and VHI scales. After determining the normal distribution of the data using the Kolmogorov-Smirnov test, the results of VTD, VHI, and their subscales were compared between two groups with an independent t-test. Also, the relationship between them was assessed with the Pearson correlation coefficient analysis.
Results The mean score of the frequency subscale of VTD in teachers with MTD was more than in teachers without MTD (30.17±5.11, 8.22±2.26), respectively. The score of severity subscales of VTD in teachers with MTD was 39.12±4.94 and in teachers without MTD was 7.89±2.13. Also, the total score of the VHI questionnaire in teachers with MTD was significantly higher than teachers without MTD (P<0.05). Moreover, there was a significant positive correlation between the frequency and severity subscales of VTD and the total score of VHI in the two groups (P<0.05).
Conclusion This study showed the frequency and severity scores of the VTD and the degree of VHI experienced by MTD are remarkably higher than teachers without MTD. The authors emphasize on the use of VTD and VHI scales in screening teachers who are at risk of voice problems, and the researchers pointed out the importance of paying attention to the reduction of discomfort feelings in the vocal tract and voice handicap in the voice therapy sessions of teachers with MTD.
Materials & Methods This study was cross-sectional and was performed on 80 primary female teachers with and without MTD. The participants in both groups were randomly selected after checking the inclusion criteria. Voice history, auditory-perceptual assessment of voice, palpation, and laryngeal video-stroboscopy were assessed on the teachers in two groups. Then, asked the participants to complete the Persian versions of the VTD and VHI scales. After determining the normal distribution of the data using the Kolmogorov-Smirnov test, the results of VTD, VHI, and their subscales were compared between two groups with an independent t-test. Also, the relationship between them was assessed with the Pearson correlation coefficient analysis.
Results The mean score of the frequency subscale of VTD in teachers with MTD was more than in teachers without MTD (30.17±5.11, 8.22±2.26), respectively. The score of severity subscales of VTD in teachers with MTD was 39.12±4.94 and in teachers without MTD was 7.89±2.13. Also, the total score of the VHI questionnaire in teachers with MTD was significantly higher than teachers without MTD (P<0.05). Moreover, there was a significant positive correlation between the frequency and severity subscales of VTD and the total score of VHI in the two groups (P<0.05).
Conclusion This study showed the frequency and severity scores of the VTD and the degree of VHI experienced by MTD are remarkably higher than teachers without MTD. The authors emphasize on the use of VTD and VHI scales in screening teachers who are at risk of voice problems, and the researchers pointed out the importance of paying attention to the reduction of discomfort feelings in the vocal tract and voice handicap in the voice therapy sessions of teachers with MTD.
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Objective The present study aims to examine the effect of a play-based intervention on the anxiety of mothers of premature babies admitted to the neonatal intensive care unit (NICU). Materials & Methods This is a non-blinded randomized... more
Objective The present study aims to examine the effect of a play-based intervention on the anxiety of mothers of premature babies admitted to the neonatal intensive care unit (NICU).
Materials & Methods This is a non-blinded randomized controlled clinical trial. The participants were recruited from among the mothers of premature babies (<37 weeks) admitted to the NICU of Hazrat-e Ali Asghar Hospital and divided into two groups of intervention (n=20) and control (n=20) using the block randomization method. They were 20-35 years old with at least a high school diploma. Their babies had stable physiological conditions with no physical disorders or specific diseases. The anxiety of mothers was measured by Spielberger’s State-Trait anxiety inventory (STAI) before study and two days after discharge. The intervention group received the play-based program for their babies at least once a day, for at least 5 days until discharge. The control group received routine hospital care.
Results Independent t-test results showed no significant difference in the scores of STAI and its domains between the two groups before and after the intervention. However, mean difference of pre- and post-scores of total STAI and state anxiety domain was significant in two groups (P<0.05), but it was not significant in terms of trait anxiety (P>0.05). The ANCOVA results showed that the effect size of intervention on state anxiety (P=0.001) and total anxiety score (P=0.004) was 27% and 20%, respectively.
Conclusion The play-based intervention, can reduce the anxiety of mothers of premature babies admitted to the NICU and consequently affect the growth of children and mental health of family and society.
Materials & Methods This is a non-blinded randomized controlled clinical trial. The participants were recruited from among the mothers of premature babies (<37 weeks) admitted to the NICU of Hazrat-e Ali Asghar Hospital and divided into two groups of intervention (n=20) and control (n=20) using the block randomization method. They were 20-35 years old with at least a high school diploma. Their babies had stable physiological conditions with no physical disorders or specific diseases. The anxiety of mothers was measured by Spielberger’s State-Trait anxiety inventory (STAI) before study and two days after discharge. The intervention group received the play-based program for their babies at least once a day, for at least 5 days until discharge. The control group received routine hospital care.
Results Independent t-test results showed no significant difference in the scores of STAI and its domains between the two groups before and after the intervention. However, mean difference of pre- and post-scores of total STAI and state anxiety domain was significant in two groups (P<0.05), but it was not significant in terms of trait anxiety (P>0.05). The ANCOVA results showed that the effect size of intervention on state anxiety (P=0.001) and total anxiety score (P=0.004) was 27% and 20%, respectively.
Conclusion The play-based intervention, can reduce the anxiety of mothers of premature babies admitted to the NICU and consequently affect the growth of children and mental health of family and society.
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Objective Social health, along with physical and mental health, is one of the pillars of health and represents one’s assessment of social life. Therefore, the purpose of this study was to investigate the social factors affecting the... more
Objective Social health, along with physical and mental health, is one of the pillars of health and represents one’s assessment of social life. Therefore, the purpose of this study was to investigate the social factors affecting the social health of the clients covered by the Nowshahr Well-being.
Materials & Methods The research method in this study was the descriptive follow-up. The research community was formed by female clients 18 to 60 years old under the cover of the Nowshahr Well-being with 3951 people. 350 samples were selected using the Morgan table and simple random sampling method. The data collection tool consisted of two valid keyes social health questionnaires (1) and Babapour et al. (2010). The reliability of the questionnaires was calculated using Cronbach’s alpha method, according to which the coefficient of research variables and its dimensions were more than 0.7 and was evaluated as suitable. For research data analysis, correlation coefficient and regression analysis with SPSS software, version 24 was used.
Results According to the findings of the research, there is a positive and significant relationship between all the variables, that is, between the independent variables of the research, which include social integration, social skills, social participation, and social acceptance, with the dependent variable of the research, social health. Using regression, the effect of social integration variables (β=0.137), social skills (β=0.157), social participation (β=0.156), and social acceptance (β=0.120) on social health was determined. The value of the multiple correlation coefficient of the dimensions of social integration, social skills, social participation and social acceptance with the variable of social health and its estimated value under the final regression model is equal to (0.612). The value of the coefficient of multiple determination in the final model was equal to (0.567), which indicates that 57 percent of the changes in social health can be explained by the independent variables included in the model, namely the dimensions of social integration, social skills, social participation, and social acceptance. which indicates the good fit of the model. The estimation of the coefficients of the final regression model shows that the investigated variables are all significant and each of them has different weights. Also, the regression coefficients showed that the variable of social skills (β=0.157) has the greatest impact.
Conclusion According to the findings of the research, social integration, social skills, social participation, and social acceptance is an effective factors in promoting social health and feeling good and improving the quality of life and social health of clients covered by Nowshahr welfare department, so with Increasing the level of awareness and social skills of clients will also provide the basis for improving their social health.
Materials & Methods The research method in this study was the descriptive follow-up. The research community was formed by female clients 18 to 60 years old under the cover of the Nowshahr Well-being with 3951 people. 350 samples were selected using the Morgan table and simple random sampling method. The data collection tool consisted of two valid keyes social health questionnaires (1) and Babapour et al. (2010). The reliability of the questionnaires was calculated using Cronbach’s alpha method, according to which the coefficient of research variables and its dimensions were more than 0.7 and was evaluated as suitable. For research data analysis, correlation coefficient and regression analysis with SPSS software, version 24 was used.
Results According to the findings of the research, there is a positive and significant relationship between all the variables, that is, between the independent variables of the research, which include social integration, social skills, social participation, and social acceptance, with the dependent variable of the research, social health. Using regression, the effect of social integration variables (β=0.137), social skills (β=0.157), social participation (β=0.156), and social acceptance (β=0.120) on social health was determined. The value of the multiple correlation coefficient of the dimensions of social integration, social skills, social participation and social acceptance with the variable of social health and its estimated value under the final regression model is equal to (0.612). The value of the coefficient of multiple determination in the final model was equal to (0.567), which indicates that 57 percent of the changes in social health can be explained by the independent variables included in the model, namely the dimensions of social integration, social skills, social participation, and social acceptance. which indicates the good fit of the model. The estimation of the coefficients of the final regression model shows that the investigated variables are all significant and each of them has different weights. Also, the regression coefficients showed that the variable of social skills (β=0.157) has the greatest impact.
Conclusion According to the findings of the research, social integration, social skills, social participation, and social acceptance is an effective factors in promoting social health and feeling good and improving the quality of life and social health of clients covered by Nowshahr welfare department, so with Increasing the level of awareness and social skills of clients will also provide the basis for improving their social health.
Research Interests:
Objective With the advancement of information and communication technology, the use of telepractice has expanded to provide speech, language, and swallowing services. In different countries, studies have been conducted in the field of... more
Objective With the advancement of information and communication technology, the use of telepractice has expanded to provide speech, language, and swallowing services. In different countries, studies have been conducted in the field of telepractice of speech, language, and swallowing disorders, including stuttering, and these studies have confirmed the effectiveness of this method of providing treatment and have mentioned some problems. To present this method of treatment more effectively, the challenges of this treatment should be examined. The present study has been conducted to investigate the facilitators and barriers to the telepractice of stuttering in preschool children.
Materials & Methods In this qualitative study, individual unstructured interviews have conducted using qualitative content analysis with 11 participants, including therapists with experience in stuttering telepractice in preschool children, therapists who were opposed to this treatment (n=7 people) as well as parents who have had successful telepractice and parents who have had unsuccessful telepractice (n=4).
Results Telepractice facilitators included cost reduction, therapist-client communication between sessions, greater parental cooperation and responsibility in telepractice, reduced stress and increased child-therapist collaboration in the natural environment, more time freedom, and time flexibility for the family and therapist. Barriers to telepractice in this group included lower trust in the therapist in telepractice, limited communication cues, spending more energy by the therapist, difficulty in educating parents, and lack of comprehensive protocols in telepractice.
Conclusion When these cases are recognized, it is possible to provide higher-quality treatment to people who need these services by reducing barriers and strengthening facilitators. To achieve this goal, it is necessary to conduct studies to develop comprehensive and detailed protocols for providing this method of treatment, taking into account the existing facilitators and obstacles.
Materials & Methods In this qualitative study, individual unstructured interviews have conducted using qualitative content analysis with 11 participants, including therapists with experience in stuttering telepractice in preschool children, therapists who were opposed to this treatment (n=7 people) as well as parents who have had successful telepractice and parents who have had unsuccessful telepractice (n=4).
Results Telepractice facilitators included cost reduction, therapist-client communication between sessions, greater parental cooperation and responsibility in telepractice, reduced stress and increased child-therapist collaboration in the natural environment, more time freedom, and time flexibility for the family and therapist. Barriers to telepractice in this group included lower trust in the therapist in telepractice, limited communication cues, spending more energy by the therapist, difficulty in educating parents, and lack of comprehensive protocols in telepractice.
Conclusion When these cases are recognized, it is possible to provide higher-quality treatment to people who need these services by reducing barriers and strengthening facilitators. To achieve this goal, it is necessary to conduct studies to develop comprehensive and detailed protocols for providing this method of treatment, taking into account the existing facilitators and obstacles.
Research Interests:
Objective Chronic obstructive pulmonary disease is one of the most common causes of death in the world, which affects the functional level of patients due to its progressive nature. disabilities caused by the disease lead to the... more
Objective Chronic obstructive pulmonary disease is one of the most common causes of death in the world, which affects the functional level of patients due to its progressive nature. disabilities caused by the disease lead to the dependence of these patients on family caregivers. Following the changes in caregivers’ lives, most family caregivers are exposed to psychological distress. Involving caregivers in pulmonary rehabilitation training for patients is one of the ways to reduce psychological distress. Considering the emergence of the digital age and the limitations of face-to-face training such as time and cost, mobile phone-based applications are available as one of the new methods for providing educational support to caregivers. Therefore, this study was conducted with the aim of determining the effect of the pulmonary rehabilitation application on the psychological distress of caregivers of people with chronic obstructive pulmonary disease.
Materials & Methods This study is a field trial conducted on 70 family caregivers of people with chronic obstructive pulmonary disease. The samples were selected as available from the Sun Breathing Comprehensive Clinic and after checking the inclusion criteria, they were randomly assigned to intervention and control groups by minimization software. The intervention group used mobile phone-based pulmonary rehabilitation training application for 6 weeks. For the control group, face-to-face pulmonary rehabilitation training (routine) was provided in the form of 12 sessions during 6 weeks. The data collection tool included Kessler’s demographic information and psychological distress questionnaires, which were completed by caregivers before and after the intervention. Data analysis was done using SPSS version 24 software and Mann-Whitney, Chi-square and independent and paired t tests.
Results According to the findings, the two groups were homogeneous in terms of demographic characteristics. The average age of caregivers in the intervention and control groups was (44.1±14.8), (47.7±13.8) years, respectively. In the intervention group, 71.4% were female caregivers and in the control group, 82.9% were female caregivers (P>0/05). Before the intervention, there was no significant difference in terms of psychological distress between the test and control groups (P<0.05), but after the intervention, there was a significant difference between the two groups in terms of psychological distress (P=0.001). The average score of psychological distress before and after the intervention in the intervention group was (14.97±6.65) and (10.25±4.50) respectively, and there was a significant decrease (P<0.000), but the psychological distress in the control group was (15.68±7.91). 5.42±14.60) had no significant change (P<0.05).
Conclusion The results of this study indicate that training through a mobile-based pulmonary rehabilitation application may be useful in reducing the psychological distress of family caregivers of chronic obstructive pulmonary disease. Therefore, since the favorable mental state of caregivers has a significant effect on the quality of care provided , it is recommended to use this method in the training of caregivers of chronic obstructive pulmonary disease.
Materials & Methods This study is a field trial conducted on 70 family caregivers of people with chronic obstructive pulmonary disease. The samples were selected as available from the Sun Breathing Comprehensive Clinic and after checking the inclusion criteria, they were randomly assigned to intervention and control groups by minimization software. The intervention group used mobile phone-based pulmonary rehabilitation training application for 6 weeks. For the control group, face-to-face pulmonary rehabilitation training (routine) was provided in the form of 12 sessions during 6 weeks. The data collection tool included Kessler’s demographic information and psychological distress questionnaires, which were completed by caregivers before and after the intervention. Data analysis was done using SPSS version 24 software and Mann-Whitney, Chi-square and independent and paired t tests.
Results According to the findings, the two groups were homogeneous in terms of demographic characteristics. The average age of caregivers in the intervention and control groups was (44.1±14.8), (47.7±13.8) years, respectively. In the intervention group, 71.4% were female caregivers and in the control group, 82.9% were female caregivers (P>0/05). Before the intervention, there was no significant difference in terms of psychological distress between the test and control groups (P<0.05), but after the intervention, there was a significant difference between the two groups in terms of psychological distress (P=0.001). The average score of psychological distress before and after the intervention in the intervention group was (14.97±6.65) and (10.25±4.50) respectively, and there was a significant decrease (P<0.000), but the psychological distress in the control group was (15.68±7.91). 5.42±14.60) had no significant change (P<0.05).
Conclusion The results of this study indicate that training through a mobile-based pulmonary rehabilitation application may be useful in reducing the psychological distress of family caregivers of chronic obstructive pulmonary disease. Therefore, since the favorable mental state of caregivers has a significant effect on the quality of care provided , it is recommended to use this method in the training of caregivers of chronic obstructive pulmonary disease.
Research Interests:
Objective In the absence of an age normed developmental battery for Persian, the major objectives of this research are to develop a reliable and valid clinical linguistic battery to collect normative data from 3 to 7-year-old healthy... more
Objective In the absence of an age normed developmental battery for Persian, the major objectives of this research are to develop a reliable and valid clinical linguistic battery to collect normative data from 3 to 7-year-old healthy Persian speaking children. The battery can also be used to measure severity of language impairments in 3 to 7-year-old Persian speaking children as compared with their aged matched peers.
Materials & Methods Development of this battery is considered as a descriptive tool in which reliability and validity of the normative data were developed in 3 stages. The first version with 9 different sub-tests, 180 items and two descriptive pictures was developed after cultural and linguistic adaptations for the Persian language for different linguistic levels of phonology, morphology, syntax and pragmatics. The first draft was performed using 200 3 to 8-year-old healthy children in Tehran to measure the sensitivity of different tasks of the test for different age groups. This draft was not sensitive for 8-year-old children. The CVR of the first draft of the battery was checked by 3 Persian speaking clinical linguistic experts and 3 expert speech therapists and also was introduced to 20 SLP experts in a clinical linguistic workshop. In the second stage, based on the results and suggestions, necessary corrections were made in the test structure and items. Also, plural morpheme task of the previous version which was not sensitive enough, was removed and a new semantic task (word definition) as a sensitive semantic task used in other developmental language batteries was added to the battery. The results showed that the diagnostic sensitivity of the test for the 8-year-old age group is not satisfactory. The final version of the battery consisted of 9 subtests with 105 items and two descriptive pictures were used to collect normative data from 200 children. To evaluate reliability and validity of the final version, the opinions of 8 speech therapists and linguists were used.and to evaluate the construct validity, the correlation matrix and confirmatory factor analysis and for its validity Cronbach’s alpha were used. The final version of the battery was sent to expert speech therapists in 5 selected target group provinces (Tehran, Mazandaran, Fars, Esfahan and Khorasan) to collect normative data from 1200 3 to 7-year-old typically developement children in available kindergartens and schools. Finally, the collected data for task items and connected speech measures were processed and analyzed using SPSS software, version 20.
Results The content validity was 0.78 and test reliability was 0.76. In addition to confirm the construct validity and diagnostic validity of the test, the correlation between the sub-tests and the overall test scores were also significant at the level of 0.01 (with a correlation of 0.20 to 0.83). The norm for each age group was six months and one year and was calculated as a standard score and reported in the tables.
Conclusion Finally, the results of the normative data of this battery are proved to be clinically normative as an indication of the level of linguistic development for each age group and also determine the severity of their language impairment. The battery can also be used to measure the efficacy of rehabilitation in 3 to 7-year old Persian speaking children.
Materials & Methods Development of this battery is considered as a descriptive tool in which reliability and validity of the normative data were developed in 3 stages. The first version with 9 different sub-tests, 180 items and two descriptive pictures was developed after cultural and linguistic adaptations for the Persian language for different linguistic levels of phonology, morphology, syntax and pragmatics. The first draft was performed using 200 3 to 8-year-old healthy children in Tehran to measure the sensitivity of different tasks of the test for different age groups. This draft was not sensitive for 8-year-old children. The CVR of the first draft of the battery was checked by 3 Persian speaking clinical linguistic experts and 3 expert speech therapists and also was introduced to 20 SLP experts in a clinical linguistic workshop. In the second stage, based on the results and suggestions, necessary corrections were made in the test structure and items. Also, plural morpheme task of the previous version which was not sensitive enough, was removed and a new semantic task (word definition) as a sensitive semantic task used in other developmental language batteries was added to the battery. The results showed that the diagnostic sensitivity of the test for the 8-year-old age group is not satisfactory. The final version of the battery consisted of 9 subtests with 105 items and two descriptive pictures were used to collect normative data from 200 children. To evaluate reliability and validity of the final version, the opinions of 8 speech therapists and linguists were used.and to evaluate the construct validity, the correlation matrix and confirmatory factor analysis and for its validity Cronbach’s alpha were used. The final version of the battery was sent to expert speech therapists in 5 selected target group provinces (Tehran, Mazandaran, Fars, Esfahan and Khorasan) to collect normative data from 1200 3 to 7-year-old typically developement children in available kindergartens and schools. Finally, the collected data for task items and connected speech measures were processed and analyzed using SPSS software, version 20.
Results The content validity was 0.78 and test reliability was 0.76. In addition to confirm the construct validity and diagnostic validity of the test, the correlation between the sub-tests and the overall test scores were also significant at the level of 0.01 (with a correlation of 0.20 to 0.83). The norm for each age group was six months and one year and was calculated as a standard score and reported in the tables.
Conclusion Finally, the results of the normative data of this battery are proved to be clinically normative as an indication of the level of linguistic development for each age group and also determine the severity of their language impairment. The battery can also be used to measure the efficacy of rehabilitation in 3 to 7-year old Persian speaking children.
Research Interests:
Objective Aphasia is an acquired language disorder that can affect all representations of language (comprehension, expression, reading, and writing). This disorder is a communication disability that has a long-term effect on various... more
Objective Aphasia is an acquired language disorder that can affect all representations of language (comprehension, expression, reading, and writing). This disorder is a communication disability that has a long-term effect on various aspects of the life of people with aphasia and their families. The most common cause of aphasia is stroke. The prevalence of this disorder is increasing in Iran. The evidence shows that the factors affecting the provision of speech therapy services to people with aphasia are different in various countries. Therefore, this study aimed to determine the barriers and facilitators of receiving speech therapy services from the perspective of the families of these people in Iran.
Materials & Methods The study was conducted qualitatively with a content analysis approach. In this study, individual, semi-structured interviews with open-ended questions were conducted with 12 families of people with aphasia. Interviews were conducted by voice calls through WhatsApp or phone calls. Data analysis was done by Burnard’s approach. The duration of interviews with families was 25 minutes on average.
Results Barriers to receiving speech therapy services from the perspective of families of people with aphasia were divided into five categories and twelve subcategories, and facilitators of receiving services were divided into five categories and thirteen subcategories. There was an overlap between the identified barriers and facilitators, so the titles of the categories were the same and included: factors affecting clients’ attendance in speech therapy sessions, factors related to the patient, factors related to the place of treatment, factors related to the family, and factors related to speech therapist. All the participants pointed out a barrier and a facilitator related to the category of factors affecting clients’ attendance in speech therapy sessions. Also, all of them found a barrier related to the patient and a facilitator related to the family to be effective in receiving speech therapy services.
Conclusion By examining the factors extracted from the interviewees, it is possible to make the necessary plans to reduce the barriers and strengthen facilitators with the help of people who have responsibilities in this field. Most of the participants considered the high severity of the impairment a barrier to receiving treatment. All of them agreed that the existence of a source to inform about speech therapy services has facilitated receiving these services. By considering the barriers and facilitators, people with aphasia and their families can receive more appropriate treatment according to their conditions and their quality of life will increase.
Materials & Methods The study was conducted qualitatively with a content analysis approach. In this study, individual, semi-structured interviews with open-ended questions were conducted with 12 families of people with aphasia. Interviews were conducted by voice calls through WhatsApp or phone calls. Data analysis was done by Burnard’s approach. The duration of interviews with families was 25 minutes on average.
Results Barriers to receiving speech therapy services from the perspective of families of people with aphasia were divided into five categories and twelve subcategories, and facilitators of receiving services were divided into five categories and thirteen subcategories. There was an overlap between the identified barriers and facilitators, so the titles of the categories were the same and included: factors affecting clients’ attendance in speech therapy sessions, factors related to the patient, factors related to the place of treatment, factors related to the family, and factors related to speech therapist. All the participants pointed out a barrier and a facilitator related to the category of factors affecting clients’ attendance in speech therapy sessions. Also, all of them found a barrier related to the patient and a facilitator related to the family to be effective in receiving speech therapy services.
Conclusion By examining the factors extracted from the interviewees, it is possible to make the necessary plans to reduce the barriers and strengthen facilitators with the help of people who have responsibilities in this field. Most of the participants considered the high severity of the impairment a barrier to receiving treatment. All of them agreed that the existence of a source to inform about speech therapy services has facilitated receiving these services. By considering the barriers and facilitators, people with aphasia and their families can receive more appropriate treatment according to their conditions and their quality of life will increase.
Research Interests:
Objective The physical and hormonal changes occur in pregnant women, which may cause skeletal and muscular discomforts and back and pelvic pain. If the pelvic muscles mechanism is damaged, pelvic joints may have less stability, and the... more
Objective The physical and hormonal changes occur in pregnant women, which may cause skeletal and muscular discomforts and back and pelvic pain. If the pelvic muscles mechanism is damaged, pelvic joints may have less stability, and the joint is more exposed to shearing force. As a result of this condition, the activity pattern of these muscles of the lumbar region may change, increased muscle activity compensates for the anterior forces, and bending moments may occur, especially when the abdomen volume is increased. In previous studies, the activity of pelvic muscles in the test of active straight leg raise (ASLR) was evaluated in pregnant women without using a pelvic belt. These belts are strapped at the level of the pelvic ring and do not fully support the lumbar region. The lumbar-pelvic belt can extend below the lower angle of the scapula, completely covering the lumbar region and supporting the waist and pelvis simultaneously. As a result, the whole body acts as a unit compared to a pelvic belt. The present study aims to compare the effect of the lumbar-pelvic belt with the pelvic belt in the activity of the pelvic muscles during the ASLR test of the lower limb in pregnant women with back and pelvic pain. Materials & Methods This was a clinical trial study on 48 pregnant women with pregnancy-related back and pelvic pain referred to the Kawsar Specialized and Subspecialty Clinic in Arak City, Iran. The sampling method was convenience sampling based on inclusion and exclusion. All participants completed the written consent form, and then they were randomly divided into three groups: lumbar-pelvic belt (14 women), pelvic belt (14 women), and control (20 women). First, a demographic questionnaire was completed by the participants. Then the pelvic muscles' muscle activity was evaluated using surface electromyography during the ASLR test at the beginning of the study and then three weeks later. Covariance analysis was used in SPSS version 26 software for data analysis, and the significance level was considered 0.05. Results After three weeks of using the devices, the activity of the right rectus femoris, left rectus femoris, right biceps femoris, and left biceps femoris muscles decreased in both groups who used the belts and increased in the control group during the ASLR test. The activity of the right biceps femoris and left biceps femoris muscles in the lumbar-pelvic belt group was significantly reduced compared to the pelvic belt group (P<0.001). Although the activity level of the right rectus femoris and left rectus femoris muscles in the lumbar-pelvic belt group decreased more than the pelvic belt group, this decrease was not statistically significant. Conclusion The activity of the rectus femoris and biceps femoris muscles during the ASLR test decreased in both groups using the pelvic belts and increased in the control group after three weeks. This finding shows the effect of both pelvic belts on improving pelvic muscle activity. However, the lumbar-pelvic belt had a greater impact on improving the activity of the biceps femoris muscles than the pelvic belt during the ASLR test.
Research Interests:
Objective Today transoral laser microsurgery is considered as one of the first options to control early laryngeal cancer, and voice disorder is one of the inevitable complications of this therapeutic component. This study aimed to compare... more
Objective Today transoral laser microsurgery is considered as one of the first options to control early laryngeal cancer, and voice disorder is one of the inevitable complications of this therapeutic component. This study aimed to compare the vocal function in patients with early-stage laryngeal cancer following laser surgery with healthy individuals with normal voice quality using acoustic analysis and the voice handicap index and to examine the correlation between the results of these two evaluations in each group.
Materials & Methods The current research is a descriptive-correlational and comparative study that was cross-sectioned using convenience sampling into two groups consisting of 60 men (Mean±SD of age 59.18±5.170 years) with early laryngeal cancer undergoing laser surgery as a patient group and 60 men (Mean±SD of age 56.68±5.491 years) with normal voice quality, and without any history of voice disorder as a control. The vocal function of participants was assessed using acoustic parameters (including jitter, shimmer, harmonic to noise ratio, fundamental frequency, smoothed cepstral peak prominence) and a 30-item Persian version of the voice handicap index questionnaire (including overall score and scores of physical, emotional and functional subscale). Then, data were analyzed using SPSS software, version 20, descriptive statistics, Kolmogorov-Smirnov, independent t-test, and Pearson correlation coefficient at the P<0.05.
Results The results show that the acoustic parameters and voice handicap index in the group undergoing laser surgery are significantly different from the control group (P<0.001). Also, a significant direct correlation between jitter and shimmer with total score and physical subscale of VHI, a significant inverse correlation between the harmonic-to-noise ratio and total score, functional and physical subscales of VHI, as well as between smoothed cepstral peak prominence with total score and all subscales of VHI (P<0.05). In addition, in the control group, there is no significant correlation between the acoustic parameters and the subscales of the voice handicap index (P<0.05).
Conclusion The findings of the acoustic analysis and the voice handicap index show impairment in vocal function and a decrease in voice-related quality of life (QoL) in patients with early laryngeal cancer after laser surgery. Furthermore, a significant correlation between the scores of the voice handicap index and acoustic analysis parameters, especially cepstral analysis indicates the necessity to pay attention to frequency-based analysis. Therefore the results of the present study emphasize the need for a comprehensive assessment of vocal function, providing voice therapy programs, and attention to psychological problems in patients with early laryngeal cancer after laser surgery.
Materials & Methods The current research is a descriptive-correlational and comparative study that was cross-sectioned using convenience sampling into two groups consisting of 60 men (Mean±SD of age 59.18±5.170 years) with early laryngeal cancer undergoing laser surgery as a patient group and 60 men (Mean±SD of age 56.68±5.491 years) with normal voice quality, and without any history of voice disorder as a control. The vocal function of participants was assessed using acoustic parameters (including jitter, shimmer, harmonic to noise ratio, fundamental frequency, smoothed cepstral peak prominence) and a 30-item Persian version of the voice handicap index questionnaire (including overall score and scores of physical, emotional and functional subscale). Then, data were analyzed using SPSS software, version 20, descriptive statistics, Kolmogorov-Smirnov, independent t-test, and Pearson correlation coefficient at the P<0.05.
Results The results show that the acoustic parameters and voice handicap index in the group undergoing laser surgery are significantly different from the control group (P<0.001). Also, a significant direct correlation between jitter and shimmer with total score and physical subscale of VHI, a significant inverse correlation between the harmonic-to-noise ratio and total score, functional and physical subscales of VHI, as well as between smoothed cepstral peak prominence with total score and all subscales of VHI (P<0.05). In addition, in the control group, there is no significant correlation between the acoustic parameters and the subscales of the voice handicap index (P<0.05).
Conclusion The findings of the acoustic analysis and the voice handicap index show impairment in vocal function and a decrease in voice-related quality of life (QoL) in patients with early laryngeal cancer after laser surgery. Furthermore, a significant correlation between the scores of the voice handicap index and acoustic analysis parameters, especially cepstral analysis indicates the necessity to pay attention to frequency-based analysis. Therefore the results of the present study emphasize the need for a comprehensive assessment of vocal function, providing voice therapy programs, and attention to psychological problems in patients with early laryngeal cancer after laser surgery.
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Objective Because of the increasing number of people with disabilities and the lack of awareness of disability prevention methods in developing countries, creating a proper rehabilitation structure and providing appropriate services are... more
Objective Because of the increasing number of people with disabilities and the lack of awareness of disability prevention methods in developing countries, creating a proper rehabilitation structure and providing appropriate services are among the important goals of every health system. Conducting comparative studies is one of the research methods for reviewing the structure of the rehabilitation system in the country's health system. This study aimed to compare the rehabilitation structure in Iran with 5 other countries. Materials & Methods This research is a comparative study conducted in 2022. In this study, sampling was purposeful. Five countries of Germany, Japan, Canada, Turkey, and South Africa were compared in terms of organizational and health management, financial and legal components, and social policy components with Iran. Reliable databases and related resources in the rehabilitation structure were used to collect data. In this study, the obtained data were analyzed using the Bereday model containing four stages: Description, interpretation, proximity, and comparison. The findings were evaluated in a comparative table. Results The findings indicated that in terms of organization and health management, the Ministry of Health should be responsible for health management and rehabilitation, but in Iran, in addition to the Ministry of Health, the Red Crescent, the Martyr Foundation, and Exceptional Education Organization are also involved in the management of rehabilitation. Financial issues and problems are significant barriers for people with disabilities to access rehabilitation services in these countries. In Iran, a large part of these costs is paid from the pockets of families. Regarding legal components in Iran, as in other countries, specific rules exist to provide services to people with disabilities. But sometimes, these rules are not properly implemented. From the sociodemographic perspective, Iran has an aging population, welcomes immigrants, and holds diverse cultures. The access of all people in need of rehabilitation in this diverse population to the services needed is limited. In terms of policy components, regulating national health policy requires review and, if necessary, changes in existing health system policies. Conclusion The existence of a specific position for rehabilitation in the Iranian health system, provision of services, and management of rehabilitation affairs by a single organization such as the Ministry of Health, as well as proper implementation of laws and policies, can lead to structural improvement and management of the health system and rehabilitation. Financial obstacles and problems to rehabilitation services should be reduced, and government and insurance must cover most of the costs of rehabilitation services. Also, a review of national health policies and legislation in the country should be done to improve the access of all people with disabilities to health and rehabilitation services. Therefore, it is necessary to fundamentally review and reform the structure, value, and process of providing rehabilitation services.
Research Interests:
Objective Knee osteoarthritis is one of the most common musculoskeletal disorders affecting balance. It is also a risk factor for falling in older people. People with a history of falling, whether being injured or not, acquire a fear of... more
Objective Knee osteoarthritis is one of the most common musculoskeletal disorders affecting balance. It is also a risk factor for falling in older people. People with a history of falling, whether being injured or not, acquire a fear of potential falling, so they limit their functional activities, leading to decreased mobility, muscle weakness, and increased risk of falling in the future. Evaluating the relationship between balance and fear of falling in these patients can detect the disability mechanisms and falling and also help find more effective therapeutic methods for these patients. Some previous studies evaluated the stability of patients by clinical methods in static situations and related it to fear of falling. However, the walking stability of patients was not assessed by laboratory-based systems in previous studies. Therefore, we aimed to evaluate dynamic (during walking and based on the center of mass sways) and static stability (based on the center of pressure sways) and their relationship with falling risk in patients with knee osteoarthritis. Materials & Methods This is a descriptive cross-sectional study. A group of 15 subjects with mild to moderate knee osteoarthritis with a Mean±SD age of 50±3.22 years and 15 normal subjects with comparable age, height, and weight participated in this study. The subjects' standing stability was evaluated using a Kistler force plate based on mediolateral (ML) and anteroposterior (AP) displacements of the center of pressure. Also, the dynamic stability of the subjects was evaluated during walking and based on the center of massbase of support relationship in AP and ML directions. Kinematic data were collected using a motion analysis system with 7 high-speed cameras and a Kistler force plate. To model the body segments, the output of Qualisys track manager software was exported to Visual 3D software. Fear of falling was assessed by the native version of the fall efficacy scale (FES-I). The normal distribution of data was checked by the Shapiro-Wilk test. The independent samples t-test was used to compare the stability of patients and normal subjects. The Pearson correlation coefficient was used to evaluate the relationships between static and dynamic stability parameters and fear of falling in patients with knee osteoarthritis. Results Patients with knee osteoarthritis had less stability during standing and walking than healthy subjects (P<0.05). Moreover, based on the results of this study, there was a linear relationship between the center of body pressure (COP) excursions in the AP direction and the fear of falling scale. Still, it was not significant (r=0.416, P=0.123), and there was no correlation between the other COP parameters with FES (r=0, P>0.05). The correlations between mean center of mass (COM) excursion in AP and ML directions and FES were 0.309 and-0.123, respectively; however, these correlations were also not statistically significant (P>0.05).
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Objective There are so many people with disabilities worldwide. This condition has led to taking various national and international measures regarding the rights of people with disabilities. Protecting the rights of people with... more
Objective There are so many people with disabilities worldwide. This condition has led to taking various national and international measures regarding the rights of people with disabilities. Protecting the rights of people with disabilities in the context of international methods is an important issue that has been explored for years. This study aims to explain the dimensions of the rights of people with disabilities in Iran. Materials & Methods In this study, the meta-synthesis method was used, and the statistical population of the research articles was extracted from various research databases, such as Magiran, Normgaz, Regional Information Center for Science and Technology, Science Net Database, Nematan, Civilica, and Humanities Portal were selected. In this study, based on the inclusion criteria, such as title, abstract, content, and quality assessment of studies, 14 articles were finally selected for study analysis. In addition, the time frame of this research is from 2009 to 2020. Also, this study used the 7-step method of Sandelowski and Barros (2007) to analyze the research data. Results The most important rights of the disabled are employment, human value and dignity, education, belonging, proper design of urban furniture, access to health services, elimination of social discrimination, recreation and leisure, social security, freedom, and transportation. By reviewing and integrating the initial findings in this study, after going back and forth between sub-fields, 7 main fields of disability rights were obtained: cultural, economic, political, architectural and urban rights, social, medical, and legal rights. This study examined the content validity ratio and content validity index. The opinions of 8 experts in this field have been used to calculate this ratio. Concerning the content validity ratio, it should be said that it was acceptable for all dimensions. The Kappa index has been used to measure the reliability of the designed model; the kappa coefficient is calculated to be 87%, which is at a high level of the agreement due to the status of the kappa index. Conclusion Legally, people with disabilities have cultural, economic, political, architectural, urban, social, medical, and legal rights. Different and negative views of managers and individuals in society have led to disregarding the rights of people with disabilities. Lack of proper knowledge about people with disabilities and subsequent marginalization will have negative consequences. Proper knowledge of this phenomenon and awareness of the capabilities of people with disabilities is an effective step toward developing a country. Most people with disabilities have been deprived of their basic social, economic, political, and cultural rights. In this regard, pervasive stereotypes, attitudes, and discrimination have reinforced this injustice. It is worthwhile that by changing the perspective of the international community, government, and citizens, able-bodied people can live a just life alongside others. The Iranian government can assist people with disabilities in enacting and enforcing various laws on the rights of persons with disabilities.
Research Interests:
Objective Osteoarthritis is one of the most common knee joint diseases. It is a multifactorial, inflammatory, and destructive disorder of the joint that involves the synovial tissues and joint cartilage and causes permanent pain,... more
Objective Osteoarthritis is one of the most common knee joint diseases. It is a multifactorial, inflammatory, and destructive disorder of the joint that involves the synovial tissues and joint cartilage and causes permanent pain, functional limitations, and a decrease in patients' quality of life (QoL). In advanced cases of the disease, total knee arthroplasty is performed to reduce pain and improve the function of the patients. The presence of pain after this surgery is a major concern that reduces the QoL of these people. One of the causes of pain after surgery is extra-articular pain and involvement of the musculoskeletal system, the most common cause of which is pain caused by active trigger points. Dry needling is one way to deactivate trigger points. This study aimed to investigate the effects of dry needling on the pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Materials & Methods This research was a before-and-after clinical trial study. In this study, 49 patients aged 55 to 80 years, with at least 3 months past their total knee arthroplasty and still having pain, were included by an orthopedic specialist after reviewing the inclusion and exclusion criteria. After the first researcher considered the inclusion and exclusion criteria and the presence of active trigger points in the muscles around the knee, including the quadriceps, hamstring, and gastrocsoleus, 27 patients were qualified. The amount of pain in these patients before, one week, and one month, after dry needling was measured and compared based on the linear visual analog scale. Also, the performance of the patients was assessed based on the knee injury and osteoarthritis outcome score questionnaire. This study aimed to investigate the short-term effects of dry needling on pain intensity and function of patients with active trigger points in the muscles around the knee after total knee arthroplasty. Results The results of this study show a significant difference (P<0.001) between the amount of pain before dry needling (57.2±8.9) and one week after dry needling (10.8±33.6). Also, there is a significant (P<0.006) difference between the performance of patients before dry needling (47.5±11.9) and one week after dry needling (42.3±10.6). No significant difference was observed regarding pain and performance between one week and one month after dry needling. Conclusion Performing one dry needling session on the active trigger points of the muscles around the knee after total knee arthroplasty reduces pain and improves patients' performance.
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Objective Post-traumatic stress disorder (PTSD) is one of the anxiety disorders caused by a specific event, which can be catastrophic events (natural disasters, war, imprisonment in a forced labor camp) or everyday adversities (death of... more
Objective Post-traumatic stress disorder (PTSD) is one of the anxiety disorders caused by a specific event, which can be catastrophic events (natural disasters, war, imprisonment in a forced labor camp) or everyday adversities (death of relatives, divorce, carrying bags). Since patients who have recovered from COVID-19 are exposed to such events, this research was conducted to determine the prevalence of PTSD in this group. Materials & Methods This study was cross-sectional. The statistical population included all patients who recovered from COVID-19 between November 2021 and February 2022 in Hamedan City, Iran; based on Krejcie and Morgan's sample size table, 185 patients were selected by simple random sampling method. The research tool was the demographic questionnaire and the Mississippi posttraumatic stress disorder questionnaire (Mississippi PTSD); the data were analyzed using the Mann-Whitney and Kruskal-Wallis tests. Results The results showed that the Mean±SD score of PTSD was 80.37±17.37 in the subjects who recovered from COVID-19. The relationship between the demographic variables of gender (P=0.01), education (P=0.039), occupation (P=0.24), marriage (P=0.62), age (P=0.048), weight (P=0.047), height (P=0.023) with PTSD were reported. Conclusion The results showed that 76.2% of people who recovered from COVID-19 were exposed to PTSD with moderate and high severity; therefore, techniques to reduce anxiety from the coronavirus are recommended.
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Objective Schizophrenia is the most debilitating psychiatric disorder with the highest psychiatric ward admission rate. Drug therapy is the first line of treatment. However, it does not result in appropriate therapeutic responses in many... more
Objective Schizophrenia is the most debilitating psychiatric disorder with the highest psychiatric ward admission rate. Drug therapy is the first line of treatment. However, it does not result in appropriate therapeutic responses in many patients, and they experience emotional regulation difficulties and psychosis symptoms after initial symptom resolution. Cognitive-behavioral therapy (CBT) is currently an adjuvant treatment besides drug therapy to target the persistent symptoms of psychosis. The present study aims to determine the effectiveness of CBT on the positive and negative symptoms and emotional regulation of those suffering from schizophrenia spectrum disorders. Materials & Methods The research design was single-subject and of the AB type (baseline and intervention) with a follow-up phase. Besides the routine therapy sessions, CBT sessions were held for the study participants. They were patients admitted to Razi Educational and Therapeutic and Research Psychiatric Center in Tehran City, Iran, who were selected based on the inclusion criteria. Thirty patients were selected with convenience sampling, and 5 were randomly placed in the CBT group. They were evaluated with the scales of positive and negative symptoms of Kay, Fiszbein, and Opler (1986) and difficulties in emotional regulation by Gratz and Roemer (2004) in the baseline, intervention, and follow-up phases. The treatment sessions were planned based on the CBT protocol developed by Laura Smith, Paula Nathan, Uta juniper, Patrick Kingsep, and Louella Lim (2003). Non-overlap of all pairs (NAP), percentage of non-overlapping data (PND), percentage of all nonoverlapping data (PAND), percentage of data points exceeding the median (PEM), Cohen's d effect size, and improvement percentages were used to analyze the data, and visual graphs were used for data presentation. Results The outcomes showed that in the intervention phase, compared to the baseline phase, the effect sizes of the positive and negative symptoms in the first to fifth participants were 1.6, 3.1, 3.2, 1.9, and 2.4, respectively. Only the effect sizes of the second and third participants were large. The effect sizes of the emotional regulation factor in the first to fifth participants were 2.8, 1.2, 1.1, 2.2, and 1.9, respectively. The effect size of the second participant was large, and the rest were average. The findings of this study showed that during the post-therapy and follow-up stages, while patients who had received CBT still experienced positive and negative symptoms of psychosis and difficulties in emotional regulation; these symptoms decreased in comparison with the baseline phase. Furthermore, their improvement percentages were not significant. Conclusion Data analysis showed that although CBT is effective in reducing positive and negative psychotic symptoms and improving the emotional regulation of patients, the data obtained from Cohen's d effect size and recovery indices showed that the results are not clinically significant. In other words, although the patients who received CBT showed a slight improvement in psychotic symptoms and difficulty in emotional regulation, they could not maintain the therapeutic gains in the follow-up phase.
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Objective The effectiveness of the Tipton chair on the thoracic and lumbar spine of students was evaluated in the straight upright position and careful study postures. Materials & Methods This study was performed on 30 students (20 women... more
Objective The effectiveness of the Tipton chair on the thoracic and lumbar spine of students was evaluated in the straight upright position and careful study postures. Materials & Methods This study was performed on 30 students (20 women and 10 men) who had no history of musculoskeletal disorders. Evaluation of changes in the angles of the thoracic and lumbar spinal was performed using an electrogoniometer on the normal and Tipton chair in the two postures of straight upright and careful study. The participants were evaluated in each posture on each chair for five minutes. Considering the resting time and questionnaire completion, the study took 30 minutes for each person. The data recorded by the electrogoniometer were analyzed through repeated measures statistical test and data of the system usability scale (SUS) questionnaire by the paired t-test in SPSS software, version 25. Results The mean range of changes in the angles of the thoracic spine in the sagittal plane showed that the variable of chair type was not significant (P=0.072), but the variable of posture was (P=0.013). Also, regarding the mean range of change in thoracic lateral flexion, the interaction of chair and posture (P=0.048) and the chair variable with (P=0.003) had a significant difference. This difference was about a 28% reduction in the mean range of changes in the lateral flexion of the thoracic spine in the upright posture and a 10% reduction in the careful study posture in the Tipton chair compared to the normal chair. While the posture variable had no significant difference (P=0.705). Also, the mean range of changes in lumbar flexion extension showed that the chair variable (P=0.003) had a significant difference. This significant difference was about a 16% reduction in the mean range of changes in the flexion extension of the lumbar spine in the upright posture and a 43% reduction in the careful study posture in the Tipton chair compared to the normal chair. While the variable of posture (P=0.162) did not have significant differences. The study's results on lateral lumbar flexion also showed that both variables of chair and posture had a significant difference (P=0.009). The mean range of changes in lumbar lateral flexion angles in both upright and careful posture in the Tipton chair was reduced by 28% compared to the normal chair. Analysis of SUS questionnaire scores for the Tipton and normal chairs showed a significant difference between these two chairs (P=0.000). In addition, the average scores of the SUS questionnaire were 78.6 for the Tipton chair and 65.9 for the normal chair, which shows an increase of 19%. Conclusion The results of the present study showed that the Tipton chair could reduce the average range of body angles in the thoracic and lumbar spine. Also, the study results indicated an increase in user satisfaction with the Tipton chair compared to the normal chair, in which the level of satisfaction of women is higher than men. It can be due to the difference in anthropometric dimensions between women and men.
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Objective Neurogenic bladder (NB) is one of the most common causes of urinary incontinence, and its many long-term problems negatively affect patients' quality of life, especially women, due to a lack of social roles. Due to the chronic... more
Objective Neurogenic bladder (NB) is one of the most common causes of urinary incontinence, and its many long-term problems negatively affect patients' quality of life, especially women, due to a lack of social roles. Due to the chronic nature of this disorder, the implementation of rehabilitation nursing interventions to improve the quality of life of these patients has been recommended. Therefore, this study aimed to evaluate the effectiveness of multidimensional rehabilitation nursing intervention of urinary incontinence on the quality of life of young and middle-aged women with neurogenic bladder. Materials & Methods The present research was a quasi-experimental study with a pre-test-post-test design that was conducted in Rofeideh Rehabilitation Hospital, Tehran, Iran, in 2021. Data were collected from 30 young and middle-aged women aged 18 to 60 years admitted with neurogenic bladder. The samples completed the demographic questionnaire and incontinence quality of life questionnaire (I-QOL) before and 6 weeks after the intervention during follow-up. Multidimensional rehabilitation nursing intervention of urinary incontinence included two-part training sessions: 1) clean intermittent catheterization and 2) behavioral therapy (Time voiding, delaying urination, diet, and medication) in 7 30-minutes sessions of training conducted daily and individually face-to-face in the first week and then a follow-up of patients in 5 weeks (second, third, fourth, fifth, and sixth weeks), one session per week in the form of virtual classes and online video calls in WhatsApp application. The collected data were analyzed in SPSS software version 25 using one-way ANOVA and paired t-test at a significance level of 0.05. Results Most participants were 20-30 years old (30%) and married (53.3%). Before and after the intervention, the quality of life of patients with neurogenic bladder disorder increased from 46.46±11.07 to 66.23±9.46, which was statistically significant (t=14.20, P<0.0001). Also, psychosocial impacts due to the disease were reduced based on one of the three subscales of the quality of life questionnaire. In addition, quality of life was significantly lower in younger, unemployed, single, spinal cord injury, body odor, and people with a neurogenic bladder disease diagnosis period of less than one year (P<0001). Conclusion According to our findings, clean intermittent catheterization and behavioral therapy could significantly improve patient's quality of life with NB. Therefore, it is recommended to investigate the long-term effectiveness of this intervention.
Objective Families with mentally-retarded children need more support than other families in overcoming crises and achieving social adjustment. So, it seems necessary to pay special attention to these families durinzg the COVID-19 pandemic... more
Objective Families with mentally-retarded children need more support than other families in overcoming crises and achieving social adjustment. So, it seems necessary to pay special attention to these families durinzg the COVID-19 pandemic and identify their experiences and challenges to provide more support for this vulnerable group. Therefore, the present study was carried out in care centers under the supervision of the Tehran state welfare organization of Iran (SWO) during the COVID-19 pandemic to identify the challenges of families with mentally retarded children. Materials & Methods The present study was conducted with a qualitative approach and contractual content analysis method of Granheim and Lundman (2004). The participants were 18 families with mentally-retarded children living in care centers under the supervision of the Tehran State welfare organization of Iran (SWO), who were selected by purposive sampling. Sampling was continued until data saturation. Data were collected and analyzed using in-person or online (telephone) in-depth semi-structured interviews from July 11 to September 22, 2021. To evaluate the data strength, four criteria of credibility, transferability, dependability, and confirmability of Guba and Lincoln were used. Results Based on data analysis, 6 main categories and 23 subcategories were obtained. The main categories and subcategories included 1) constant worry about their children getting COVID-19 (inability of the child to protect against coronavirus, not observing protocols by the staff, underlying diseases and deficiency in immune system, few preventive measure for under 18 years people, conflicting information about children and adolescents' infection), 2) disconnection and intensification of stress (agitation and irritability of the disabled, worry about the future, parent's mental confusion, fear of losing child), 3) conflict with family tensions and contradiction (intensification of family guilt, overlooking other children, couple's self-blaming, tension in family interactions, intensification of family melancholia), 4) non-supportive community (further social stigma, social exclusion, lack of supporting vulnerable groups, the limitations of social distancing), 5) family economic crisis (costs of keeping child in the center, losing job and lower income of the family head, poverty and intensification of unstable economic conditions), and 6) care and educational concerns (decreasing the quality of care for the disabled, suspension of rehabilitation and educational activities, restrictions on leisure activities and communication for the disabled). Conclusion The results showed that the families of mentally-retarded children had encountered many challenges and concerns during the COVID-19 epidemic, some of which were related to the intensification of psychological pressures and some due to insufficient support from governmental and non-governmental institutions for these families. The study findings can be used to provide services and design support programs and policies for children with mental disabilities and their families. In this regard, it is recommended to pay special living allowances, strengthen the communication system between parents and children living in care centers, prepare a care and health packages for parents, design and implement psychological interventions to reduce parents' anxiety and stress, and provide free counseling.
Objective Procedural memory is a key component of long-term memory that can be assessed in different modalities, such as verbal and motor. Learning through procedural memory occurs in three stages: initial learning, consolidation, and... more
Objective Procedural memory is a key component of long-term memory that can be assessed in different modalities, such as verbal and motor. Learning through procedural memory occurs in three stages: initial learning, consolidation, and retention. Several tasks evaluate procedural memory, but none have concurrently studied procedural learning in various modalities and learning stages. Besides, according to the declarative-procedural model, there may be an association between the performance of individuals in procedural learning and their state of the grammar of a language. Therefore, this study aimed to design a Serial Search Task (SST) for the simultaneous evaluation of procedural memory in motor and verbal modalities during three stages of learning and determine its reliability. Moreover, the relationship between procedural memory and grammar skills was examined. Materials & Methods This study is methodological research in the first stage and descriptive analytics in the second stage. First, based on the literature review and the opinions of three speech-language pathologists, some words with appropriate psycholinguistic features were chosen from the Persian picture naming set. Then, corresponding pictures were determined. The task was designed using Java programming language. The face validity of the task was evaluated, then after revisions, the reliability was determined. Face validity was assessed in 10 normal children, and the test-retest reliability was evaluated in 15 normal children aged 7-9 years; all of them were chosen using the convenience sampling method. In the second stage, to assess the relationship between grammatical skills and the SST, 20 normal children aged 7-9 years were selected by a mixed sampling method. Every child had exposed to a verbal modality in three stages: initial learning, consolidation (24 hours later), and retention (one week later). Then the same stages were performed in the motor modality. Each child's language skills were determined using the test of language development-primary (TOLD-P3), and the relationship between the two skills was determined. Statistical methods included the Pearson and Spearman correlation coefficients and repeated measures analysis of variance. Results The correlation values between two performances in the initial learning stage for the reaction time variable in verbal (r=0.84, P<0.001) and motor (r=0.80, P˂0.001) modalities and the variable of response accuracy in verbal (r=0.81, P=0.011) and motor (r=0.77, P=0.026) modalities were obtained. In the consolidation and retention stages, the correlation values for the reaction time variable in verbal (r=0.737, P=0.002) and motor (r=0.743, P=0.001) modalities and the variable of response accuracy in verbal (r=0.624, P=0.013) and motor (r=0.916, P<0.001) modalities were obtained. The relationship between grammar and procedural learning in the verbal modality was significant in the consolidation stage (P=0.045, CI:0.016-0.797, r=0.491). Conclusion SST is a reliable task to assess different stages of procedural memory in both verbal and motor modalities. Therefore, this task can be used to evaluate procedural memory in normal children aged 7-9 years. The current study's findings confirmed the predictions made by the declarative-procedural model during the consolidation stage in the verbal modality.
Objective Cerebral palsy refers to a group of postural and movement disorders that limit movements and can be related to a non-progressive disorder in the developing brain. The international classification of disability emphasizes the... more
Objective Cerebral palsy refers to a group of postural and movement disorders that limit movements and can be related to a non-progressive disorder in the developing brain. The international classification of disability emphasizes the child's functional abilities and routine performance. Some classification tools have been developed to describe and evaluate child's functions in daily activities such as walking, manipulating objects, and everyday communication. The present study aimed to investigate the relationship between classification systems (gross motor function, manual ability, communication function, and eating and drinking ability) in children with cerebral palsy. Materials & Methods This study was performed by cross-sectional correlation method and of descriptive analytical type. Children with cerebral palsy aged 12-144 months were recruited by convenience sampling from patients referred to clinics and public and private rehabilitation centers in Tehran and Arak cities, Iran, in 2019-2020. After completing the demographic information questionnaire by the child's primary caregiver, the gross motor function classification system (GMFCS), manual ability classification system (MACS), Communication function classification system (CFCS), and eating and drinking ability classification system (EDACS) were completed by a child therapist. Results In the present study, 154 children with a Mean±SD age of 49.45±32.22 months participated. also, 87 children (56.5%) were boys, and 67(43.5%) were girls. According to GMFCS, the highest percentage distributions at levels II and IV were 31.2% and 26%, respectively. In other words, more than 57% of children were distributed in these two levels. According to MACS, the distributions of the highest percentages at levels II, III, and IV were 28.6%, 22.1%, and 20.8%, respectively. In other words, more than 70% of the children were distributed in these three levels. According to EDACS, the distribution of almost all levels was equal except the V level, with 4.3% having the lowest percentage. According to CFCS, the distribution of the highest percentage at levels V and IV was 23.5%. In examining the relationship between functional systems, significant relationships were observed in all cases: MACS and GMFCS, r=0.672; CFCS and GMFCS, r=0.581; EADCS and GMFCS, r=0.593; CFCS and MACS, r=0.555; EADCS and MACS, r=664; EADCS and CFCS, r=0. 547 (P<0.01). Conclusion It seems that children with more motor function limitations show more limitations in other performance classification systems, too. Of course, the number of studies in this field is limited and needs further investigation.
Objective People's lives change after unfortunate events such as spinal cord injury, and the people with this injury, as a citizen, face various obstacles and challenges to participate in society. This study explores the barriers and... more
Objective People's lives change after unfortunate events such as spinal cord injury, and the people with this injury, as a citizen, face various obstacles and challenges to participate in society. This study explores the barriers and facilitators of social integration of patients with spinal cord injuries in Rofeideh Rehabilitation Hospital. Materials & Methods This research was conducted using Granheim and Lundman's (2004) conventional content analysis. The participants comprised 13 people with spinal cord injury, 4 family caregivers of patients, and 5 rehabilitation service providers in Rofeideh Rehabilitation Hospital, which were selected by purposive sampling. Sampling was continued until data saturation. Data were collected and analyzed using semi-structured in-depth interviews. To evaluate the stability of the data, four criteria of credibility, transferability, dependability, and confirmability proposed by Guba and Lincoln were used. Results Facilitators of social integration of people with spinal cord injury were identified in the 3 main categories and 8 subcategories. The main categories were "social support," "social participation," and "individual beliefs." The barriers to social integration were extracted from participants' experiences and consist of 3 main categories of "environmental and structural barriers," "physical and motor barriers," and "contextual factors" and 6 related subcategories. Conclusion According to the findings of this study, patients with spinal cord injuries face various barriers in order to re-integrate into the community. On the other hand, helpful factors at different levels of individual, family, and social facilitate their social integration process. Recognizing these factors, derived from the deep and rich experiences of people with spinal cord injury, family caregivers, and rehabilitation service providers, can be useful to patients, families, professionals, and policymakers. They can use these experiences to program, design, and implement related interventions to reduce barriers and strengthen facilitators to the social integration of the target group.
Objective The prevention of thumb joints flexion help cure de Quervain tenosynovitis. The thumb, therefore, is being immobilized in the abduction position by splinting. Thumb abduction can be away from the palm (palmar abduction) or from... more
Objective The prevention of thumb joints flexion help cure de Quervain tenosynovitis. The thumb, therefore, is being immobilized in the abduction position by splinting. Thumb abduction can be away from the palm (palmar abduction) or from the fingers (radial abduction), which are done in two different planes. To the authors' knowledge, the literature has not specified which kind of thumb abduction has better treatment outcomes and functions. This study aimed to compare the immediate efficacy of palmar abduction and radial abduction splinting on the severity of pain, handgrip, palmar and lateral pinch strength, and hand function in people with de Quervain tenosynovitis. Materials & Methods In this quasi-experimental study, 30 volunteer patients (24 females) with de Quervain tenosynovitis referred to clinical centers were selected via convenience sampling. The participants were randomly assigned to three study groups (without the splint, palmar abduction splint, and radial abduction splint). The splints' height was two-thirds of the elbow. The splints were designed to immobilize the carpometacarpal and metacarpophalangeal joint of the thumb but allow the interphalangeal joint to move. One splint immobilizes the thumb in palmar abduction, while another immobilizes the thumb in radial abduction. The outcomes were studied and measured immediately after the intervention and in a single session. The intended outcomes included pain severity, handgrip strength, palmar and lateral pinch strength, and hand function measured with a visual analog scale, hand dynamometers, and the Jebsen-Taylor test, respectively. The repeated measures analysis of variance was performed for statistical analysis using SPSS software, version 16. Results All participants completed all study assessments. The results showed a significant reduction of pain, handgrip strength, lateral and palmar pinch, and hand function after using a thumb splint compared to without the splint condition (P<0.05). The pain severity in gripping objects was lower after using a palmar abduction splint than the radial abduction splint. Also, the strength reduction in taking objects by gripping, lateral pinch, and palmar was lower after using the palmar abduction splint than the radial abduction splint (P<0.05). Still, both splints were not significantly different in slowing the hand function in the Jebsen-Taylor test (P>0.05). Conclusion The positioning of the thumb in palmar abduction with splinting could be more effective for pain reduction and manipulation of objects with the hand and fingers.
Objective Having a child with a disability profoundly affects the family and can impose many problems and challenges on parents. Children with Down syndrome (DS) are a large group with special needs at risk for chronic physical illness,... more
Objective Having a child with a disability profoundly affects the family and can impose many problems and challenges on parents. Children with Down syndrome (DS) are a large group with special needs at risk for chronic physical illness, developmental problems, and behavioral and emotional problems. These problems create more health and care needs in these children. Therefore, the present study aimed to investigate the caregiver burden and related factors in parents of 4 to 12 years old children with DS living in Tehran City, Iran, in 2020. Materials & Methods In this cross-sectional study, 150 parents (91 females and 59 males) of children with DS participated. They were referred to rehabilitation centers and Down Syndrome Center in Tehran City, Iran, and were selected using a convenience sampling method. The demographic information questionnaire and Novak caregiver burden questionnaire (1989) were used to collect the study data. The participants were asked to complete these questionnaires carefully. The non-parametric tests, including the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests, were used to analyze the data in SPSS v. 21 software. Results Based on data analysis, the Mean±SD age of the parents was 38.78±7.92 years. Sixty percent of children with DS were boys, and 40% were girls with a Mean±SD age of 7.14±2.38 years. The mean and standard deviation of the total parental care burden score and its subscales were as follows: overall care burden, 68.12±17.51; temporal care burden, 15.95±5.2; developmental care burden, 15.46±4.84; mental care burden, 12.22±4.85; physical care burden, 11.24±4.47; and social care burden, 11.18±4.94. There was a significant relationship between care burden and the following variables: age of parents (r=-0.66, P=0.001), parents' income (r=-0.6, P=0.001), number of children (r=0.55, P=0.001), and age of the child (r=0.6, P=0.001). While factors such as parents' gender, child gender, parents' marital status, receiving special education, care needs, and care status did not affect the amount of parental care burden (P>0.05). Conclusion The results of the present study showed that parents of children with DS experience moderate care burden in caring for their child. The findings of this study provide the opportunity for relevant government agencies, specialists, and health centers to understand the needs of children with DS and their parents at different stages of the disease, treatment, and care. So they can develop appropriate strategies to reduce the caring stress of their caring parents.
Objective Loss of all or part of the ear is one of the significant defects in the head and neck area (regardless of the cause) that can result from trauma, cancer, congenital diseases, or surgery to remove benign tumors. These defects can... more
Objective Loss of all or part of the ear is one of the significant defects in the head and neck area (regardless of the cause) that can result from trauma, cancer, congenital diseases, or surgery to remove benign tumors. These defects can be reconstructed with the help of surgical procedures or cosmetic prostheses. However, due to the complex structure of the ear, reconstructive surgery is one of the most challenging surgeries for plastic surgeons. Choosing between surgical methods and prosthesis use is problematic for those with a significant lesion and depends on the etiology and the patient's wishes. If the patient is a candidate for a silicone ear prosthesis, the most critical challenge is the suspension and ease of using the prosthesis. The conventional suspension method (unique adhesive) will present several challenges to the patient. Thus, we report using the implant suspension method for an ear prosthesis in this study. Materials & Methods A 35-years-old male patient with a congenital ear defect and no history of prosthesis use was referred to the Dentistry School of Shahid Beheshti University, Tehran City, Iran and was studied to make an ear prosthesis based on an implant. To make a prosthesis, the general steps were alginate molding from both healthy and involved parts of the patient, alginate molding from the donor, positive wax mold making, negative gypsum mold making, silicone casting, and prosthesis attachment using implants on the patient's stamp. Results In this method, we used silicone and implant-based reconstruction of ear defects. An attempt has been made to provide ease of wearing and removing the prosthesis, proper grip, natural appearance, and finally, patient satisfaction. Conclusion In this method, we used silicone and implant-based reconstruction of ear defects. An attempt has been made to provide ease of wearing and removing the prosthesis, proper grip, natural appearance, and finally, patient satisfaction
Objective Despite the evidence that rehabilitation interventions are effective for spinal cord injury (SCI) patients, these interventions usually impose costs on the health system. Therefore, it is necessary to examine the... more
Objective Despite the evidence that rehabilitation interventions are effective for spinal cord injury (SCI) patients, these interventions usually impose costs on the health system. Therefore, it is necessary to examine the cost-effectiveness of these interventions for the health system of countries through economic evaluation. In this study, we examined the cost-effectiveness and net financial benefits of rehabilitation services in treating spinal cord injuries in Iran. Materials & Methods Considering that this research is the first economic evaluation study related to spinal cord injury rehabilitation, the first stage of the economic evaluation was dedicated to designing an economic evaluation model. The model was designed based on disease groups, the natural course of the disease, the details of rehabilitation interventions for spinal cord injury patients in different disease groups, clinical outcomes, probability of occurrence of outcomes, and related costs. The structure of the economic evaluation model of this study is based on the design of a lifetime Markov model with a 1-year cycle length for each strategy and two groups of patients (paraplegia and tetraplegia). In this study, we also used the incremental cost-effectiveness ratio (ICER) to determine the cost of the most effective strategy. All findings were analyzed using Excel 2016 and TreeAge 2011 software. Results According to the annual incidence of spinal cord injury patients in need of rehabilitation services in the country, which is about 2000 people, based on public sector tariffs, the total annual cost of SCI rehabilitation in Iran in the paraplegia group ranges from 32997 to 40200 million Iranian Rials (IRR) and in the tetraplegia group from 25476 to 26119 million IRR in mild to very severe conditions. Also, the total rehabilitation costs of SCI patients based on public sector tariffs in one year were calculated to equal 256847 million IRR. Similarly, based on private sector tariffs, the total annual costs of SCI rehabilitation in the paraplegia group were estimated from 86374 to 103122 million IRR and in the tetraplegia group from 67509 to 68997 million IRR in mild to very severe cases. Meanwhile, the total rehabilitation costs of SCI patients were calculated based on private sector tariffs in one year, equivalent to 668847 million IRR. Also, the average lifetime of SCI patients undergoing rehabilitation is lower compared to non-rehabilitation and also has higher QALY (The quality-adjusted life year) values, which indicates the dominance of the rehabilitation strategy. The amount of ICER, in this case, is estimated based on public sector tariffs equal to negative 674 million IRR and based on private sector tariffs equal to negative 629 million IRR per QALY unit. Possible sensitivity analysis of the results and Monte Carlo simulation in both scenarios confirmed the initial analysis findings with high probability. Based on the public sector tariff, the net amount of incremental financial benefits of rehabilitation for the total annual incidence is estimated at 8991 billion IRR. These amounts were calculated based on private sector tariffs of 8579 billion IRR. Conclusion Generally, the results of this economic evaluation showed that the rehabilitation of spinal cord injury patients in Iran, based on public and private sector tariffs, is quite cost-effective and has significant net positive financial benefits. The results of the sensitivity analysis also confirmed this finding.