Journal of Research in Rehabilitation Sciences
Year:2011 | Volume:7 | Issue:5 (SUPPLEMENT)|Papers Count:26

Introduction: Various methods are used to address the foot structure however, the most common and easy to use method is foot print method which is capable to detect the wide variation of foot morphology and providing information about the distribution of foot type. Most of the studies regarding foot print indexes have been reported during static condition and in a single limb support. However, there is no enough evidence regarding the foot print indexes in dynamic condition and also in static equal weight bearing condition. The aim of this research was to find the mean values of the foot print indexes in static condition, equal weight bearing condition, and during walking. Moreover, it was aimed at finding the correlation between static and dynamic indexes.Materials and Methods: Two groups of 30 normal and flatfoot subjects were recruited in this clinical trial study. They were selected from the staff and students of Isfahan University of Medical Sciences. The footprint indexes were collected during static and dynamic conditions. Arch index, footprint index and footprint angle were the parameters determined via Solid Work software. The difference in footprint indexes between normal and flat-arched subjects was evaluated through two-sample t test. The Pearson correlation test was used to determine the relationship between the static and dynamic conditions.Results: The footprint indexes of normal and flat footed subjects differed significantly from each other (P<0.05). In addition, there was a correlation between the static and dynamic indexes (r>0.808).Conclusion: Footprint index can be used to monitor the foot misalignment in flat arched subjects. As there was a significant correlation between static and dynamic conditions, it is suggested to monitor foot alignment during walking with regard to those indexes measured in the static condition.

Introduction: Learning phonological awareness skills plays a very important role in the course of speech and language development and throughout academic education in that these skills help children express their mental concepts more precisely. The aim of the present research was to determine levels of phonological awareness competency among educable children with Down’s syndrome whose mental age ranged between 7 and 12 years and were resident of Isfahan, Iran.Materials and Methods: In this descriptive-analytic study, all Isfahanian children with Down’s syndrome were individually assessed by a phonological awareness test and their scores on different subtests of this test were recorded on a separate sheet exclusively designed for this purpose. Data were statistically analyzed via t-test using SPSS software version 16.Results: Although a superior performance was found in girls, there was no significant difference between boys and girls as far as phonological awareness skills were concerned. In both genders, the highest average score of phonological awareness competency across 12 areas, which were covered by the abovementioned test, pertained to phonemic synthesis and the lowest average score of such competency was observed in the awareness of middle phoneme. Ranked from simplest to most complex, the following order of competency in phonological skills was observed for both male and female subjects: recognition of the first phoneme, recognition of the last phoneme, awareness of the last phoneme, rhyme detection, alliteration and omission of the first and the middle phoneme.Conclusion: Study results showed that, as a group, phonological awareness skills of girls were superior to those of boys but there were not statistically significant differences between them regarding these skills.This superiority can probably be explained by faster speech and language development in girls and their relatively more advanced use of speech and language skills as it is the case in normal population.

Introduction: According to International Classification of Functioning, Disability and Health (ICF), children with Cerebral palsy may have considerable impairments and limitations in all levels of body structure and functioning, activity, and participation in social roles. The purpose of this study was to evaluate the efficacy of adapted constraint induced movement therapy (CIMT) on outcome measurements based on ICF levels.Materials and Methods: In a single-blinded randomized controlled trial, 28 participants who met preset inclusion and exclusion criteria were divided into two groups: CIMT and the controls. Subjects in CIMT group were provided with the intervention for 10 out of 12 consecutive days and another group received routine occupational therapy services. Independent-sample t test and paired-sample t test were used for statistical analysis of data.Results: At ICF level of body structure and function, significant differences in shoulder muscle tone and forearm and wrist passive range of motion (PROM) were found between the two studied groups. At activity and participation levels, similar differences were also indicated in dexterity, bilateral coordination, bimanual coordination and Caregiver Functional Use Survey (how well & how frequently) (P<0.05).Conclusion: Implementing the adapted constraint induced movement therapy protocol through a child friendly approach was proved to improve hand functions and activities of daily living.

Introduction: According to the studies from 1999 to 2008, 50% of pregnant women suffer from low back pain. Physiological variations that occur during pregnancy cause postural changes which in turn can result in low back pain. In spite of these facts, the exact cause f pregnancy-associated low back pain has not known yet. It cannot be solely accounted for by hormonal factors. So far, study results have been inconclusive on documenting the efficacy of isometric exercises in alleviating low back pain. The aim of present study was to evaluate the effects of isometric exercise in low back and pelvic pain reduction among pregnant women of Isfahan city.Materials and Methods: In a randomized clinical trials study, 58 women (age range, 20-35 yrs) who were pregnant for 3 to 7 months were evaluated. All participants attended our Obstetric and Gynecologic Clinic complaining low back and pelvic pain. They were randomly assigned into the treatment (n=29) and the control (n=29) groups. Subjects in the former group received therapeutic exercises while those in the latter group had no intervention program. All of the penitents completed the first questionnaire (number 1) designed to obtain information about low back pain and ability to do daily activities at the initiation of the study. One month later, all of them completed the second questionnaire (number 2). All data of interest were statistically analyzed using SPSS software version 14.Results: We found that there was a significant difference between treatment and control groups regarding all daily activities (P<0.05). Also, there was a significant decrease in pelvic and low back pain in treatment group as compared before and after program. However, no significant difference was observed in control group in this regard (P>0.05).Conclusion: Isometric Exercises can decrease the low back and pelvic pain during pregnancy and increase the pregnant women's quality of life.

Introduction: Cleft lip and/or cleft palate comprise a group of the structural disorders that can affect speech intelligibility and communicative functions. Velopharyngeal insufficiency and compensatory misarticulations (CMAs) are considered as common problems among children with Cleft lip/ palate. This research aimed at determining the prevalence of compensatory misarticulations in preschoolers in order to establish a foundation for future studies on the subject.Materials and Methods: In a cross-sectional descriptive study, 31 affected children with an age range of 3 to 7 years were recruited from speech therapy clinics of Isfahan-Iran according to entrance criteria. To determine frequent CMA types, a word- repeating task was used. The task's items were selected from an articulation test that has been frequently used in speech therapy clinics. All voice samples were tape recorded and then errors were transcribed by repeated listening to the samples. Data were statistically analyzed via SPSS software.Results: The prevalence of compensatory errors (in percent) in the studied population are as follows: glottal stop: 58.1%, pharyngeal stop: 48.4%, pharyngeal fricative: 61.3%, pharyngeal affricative: 38.7%, posterior nasal fricative: 22.6%, and mid-dorsum palatal stop: 74.2%.Conclusion: The prevalence of compensatory misarticulations, as obtained in this study, was somehow different from that of the other studies. This may be due to the difference in number of samples, age groups and the different methods of categorizing articulatory errors in those researches.

Introduction: Autism is a complicated developmental disability that typically appears during the first three years of life as a result of a neurological disorder affecting performance. The present study aimed at studying significant developmental events happening to autistic children compared to those occurring for normal ones.Materials and Methods: 50 autistic children and 50 normal children with an age range of 4 to 11 years participated in this descriptive-analytic study which was conducted in Isfahan-Iran. Important developmental factors related to pre-, peri- and post-natal periods were collected from literature and a tailor-made questionnaire was designed to be later completed by children's mothers. The data was statistically analyzed via Chi-Square, Fischer Exact and Mann-Whitney test.Results: The results indicated that the factors which occurred significantly more frequently among children with autism were as follows: advanced maternal and paternal age, maternal stress, allergic signs during pregnancy, familial marriages, having a history of communication and/or speech-language disorders in the family, cesarean delivery, high fever after birth, seizures and head trauma (P<0.05).Conclusion: Although this study cannot determine decisive causes of development of autism in children, it can introduce possible risk factors. In fact, our findings suggest that pre-natal, neonatal and post-natal factors contributing to deviant growth are important in the pathogenesis of the disorder.

Introduction: The human foot contains one of the most variable structures of the body, namely the medial longitudinal arch. Decreasing the height of this arch is called flat foot. Although there is some evidence regarding the influence of flat foot on gait performance of subjects with flat arch, there is no strong evidence to support the effect of flat foot on energy consumption. Therefore, the aim of this study was to evaluate the contribution of flat foot in energy consumption.Materials and Methods: Two groups of 25 normal and flat-footed subjects were recruited in this research project. They were selected from the female staff and students of Isfahan University of Medical Sciences.The foot indexes of both groups were obtained using footprint method through Solid Work software. The physiological cost index of the subjects was measured by use of heart rate monitoring system (Polar Electro Finland). The difference between the PCI of subjects in the two studied groups was statistically determined via t-test. In addition, the influence of using insole was evaluated by use of paired t-test.Results: The energy consumption of flat foot subjects differed significantly from that of normal subjects (the PCI of normal and flat arch subjects was 0.357 and 0.368 beats/m, respectively). Usage of foot insole improved the performance of the flat foot subjects during walking.Conclusion: The PCI of subjects affected by flat foot is more than that of normal subjects due to the misalignment of foot structure. Moreover, the application of foot insole improved foot alignment and decreased energy consumption.

Introduction: The purpose of the present study was to evaluate the effects that a set of selected primary school games may have on elementary children's perceptual – motor as well as social growth.Materials and Methods: In a randomized clinical trial, 48 female second- and third-graders were randomly selected from a larger sample of elementary students matched by a personal questionnaire. At pretest, all subjects were administered Bruininks-Oseretsky Test of Motor Proficiency and Vineland Social Maturity Scale test and then they were randomly assigned to experimental and control groups.Subjects in the experimental group played selected elementary games for 8 successive weeks (3 sessions a week). At the end of the program, all subjects in both groups were re-evaluated. Subsequent to recording and classifying data obtained from above-mentioned questionnaire and tests, they were statistically analyzed via depended and independent t tests using SPSS software version 16. Significance level was set at less than or equal to 0.05.Results: The results of this study showed that selected primary school games are significantly more effective than usual activities in improving speed and agility of upper limbs and also on perceptual-motor growth (P=0.000). However, the effect of such games on static and dynamic balance, bilateral coordination, strength, response rate, visual-motor control and social development was not significant (P≥0.05).Conclusion: Although elementary games have the potential for enhancing children's perceptual-motor abilities, the maturity of social skills requires planned and structured group activities.

Introduction: Mild cognitive impairment can be considered as an intermediate clinical state between normal cognitive aging and mild dementia. Subjects with MCI represent an at-risk group for development of dementia. As younger groups of population become older, the need for developing tools that are capable of identifying suspected cases of the disorder in an easy and confident manner is strongly felt. The purpose of this study was to investigate the agreement between MMSE and MOCA regarding the identification of cognitive impairment in healthy elderly.Materials and Methods: In this cross-sectional study, 47 healthy elderly subjects (25 women and 22 men) were examined. All subjects were resident in Shiraz and aged 60 years or more. MMSE and MoCA were taken within a 2-month interval (test-retest). Coronbach alpha coefficient and regression analysis were respectively used for determining the reliability of MoCA and its agreement with MMSE.Results: The average age of studied sample was 69.43±2.5 years. Intraclass correlation coefficient (ICC) for MoCA was 0.780 at the first time of application and 0.721 on repeated measurement. Pearson correlation coefficient (r=0.69, P<0.0001) showed positive relation between test and retest conditions for this test. Lack of consistency between the MMSE and MoCA test was indicated through simple regression analysis (r=0.602 and R2=0.362).Conclusion: Results showed that there is not reasonable agreement between the two tests. In other words, although we can use MMSE instead of MoCA in other situations, it is not the case for diagnosing MCI in a healthy elderly. It seems that Montreal Cognitive Assessment's high internal consistency and target population of this study which involved only healthy elderly individuals are the factors that account for the inconsistency observed between the two test's scores hence inability of the Mini Mental Status in diagnosing mild cognitive impairment.

Introduction: The acquisition of the lexicon is a central and complex component of language development. The ultimate goal of this study was to survey the expressive lexicon size of 18-to-36-monthold children growing up in Farsi-speaking families.Materials and Methods: In a descriptive cross-sectional study, expressive lexicon size of 42 normal children with the age range of 18 to 36 months was evaluated by CDI (form II). Subjects were divided into three age groups, each of which covered a six-month period. The forms were completed individually by each subject's mother. Size of expressive lexicon was compared across the three age groups.Results: Generally speaking, the difference of expressive lexicon size was significant among the three studied age groups (P<0.01). Moreover, the categories of common nouns and grammatical function words comprised the maximum (P=0.001) and the minimum (P=0.02) proportions of lexicon respectively.Conclusion: Study results showed that as children grew older, their respective size of expressive lexicon increased. Also, the variation of the vocabulary size for different lexical categories was wide at this age range.

Introduction: The aim of this study was to evaluate the reliability and validity of the Persian version of Stroke Impact Scale (SIS-P) among patients with stroke.Materials and Methods: A Sample of 80 people with Stroke was included in this study. The participants were patients diagnosed with stroke who were attended Kashani and Alzahra hospitals in Isfahan-Iran from 2005 to 2007. The Stroke Impact Scale (SIS) is a self-report measure that includes 64 Items and assesses 8 domain (strength, hand function, ADL, mobility, communication, emotion, memory and thinking and participation). A Sample of 90 were asked to complete (SIS) and subscale of SF-36 and HADS, BI, MMSE, FMA, FAT questionnaires. Dimensionality and construct validity was assessed, using item-scale correlation after correction for overlap and convergennt validity, using a priori hypotheszed correlations with the SF-36 and HADS, BI, MMSE, FMA, FAT.Results: All the participants found the SIS-P items to be clear and unambiguous in a pilot testing. The total score for each domain and other golden instrument were significantly corolated between 0.67 to 0.96. The correlation between each item and total score for 8 domain were reported above 0.70.Conclusion: The Results of the study revealed that the SIS-P is a psychometrically appropriate instrument to assess the people with Stroke.

Introduction: Investigation of strategies and methods of therapy in stuttering regarded to its characteristics and length of treatment and relapse of stuttering is very important. Acupuncture was introduced as a therapeutic method for treatment of stuttering. The aim of the present research was identification of the results of intervention of laser acupuncture compare with speech therapy in treatment of the persons who have stuttering.Materials and Methods: This research was a clinical- trial and case control research and the subjects were 20 stutterers and 20 non-stutterers. In the present research speech therapy and laser acupuncture on 10 persons who had developmental stuttering was used. Then the results compare with the data of speech therapy and placebo laser in 10 control subjects. All of subjects were followed 12 weeks after intervention.The data were analyzed by Independent t-test and repeated measure ANOVA and SPSS10.Results: The data showed that speech therapy accompany by laser acupuncture result to increasing of maintenance and therapeutic effects of stuttering treatment and decreasing of relapsing. The speech rate and percent of stuttered words before and after intervention in A and B groups was decreased but following the results after 12 weeks showed that the results were stable in laser group more than another group and there was a significant difference between two groups.Conclusion: The results of the present research showed that use of laser acupuncture therapy accompany by speech therapy has many effects on treatment of stuttering and prevents of relapsing of stuttering that is very common.

Introduction: Nowadays cardiovascular disease is a major problem in the world which is known as a leading cause of morbidity and morality. Since, physical activity and exercise training have beneficial role in prevention and treatment of cardiovascular disease, so, cardiac rehabilitation units on the basis of exercise training were established in 1960. Therefore, with attention to scientific evidence, researchers want to review the effects of various exercise training during cardiac rehabilitation program to facilitate return to an active lifestyle in patients with coronary heart disease.Materials and Methods: Comprehensive cardiac rehabilitation consists of medical measurement, exercise prescription, cardiac risk factors modification, education and consultation with the purpose of primary and secondary prevention.Conclusion: These interventions have been designed to limit the progression of cardiac diseases and their related symptoms, to improve psychological status, to increase functional capacity and above all, to reduce cardiovascular mortality. Also, exercise training which has been identified as an integral component of cardiac rehabilitation has useful effects on cardiac disease by decreasing cardiac work load, reduction oxygen in use, improvement myocardial function and endothelial vessels flexibility and increasing maximum oxygen consumption.

Introduction: Tinnitus, a common symptom in patients with otologic and/or neurologic problems, is a medical term describing acoustic perceptions in the ear or in the head that are not caused by or related to environmental stimuli. It is usually not considered as a disease by itself but rather as a part of an underlying medical condition including sudden hearing loss, acoustic trauma, cochlear dysfunction, Meniere’s disease, and neurological disorder. The neuroscientific analysis of tinnitus has been led to the development of a new theory on its origin which will be discussed in detail as the neurophysiologic model of tinnitus.Materials and Methods: A review of the latest literature on the subject of neurophysiological model of tinnitus was conducted in science direct, Pubmed, Google scholar, Proquet, Scopouse databases using the following key word "tinnitus", "neurophysiologic model" and "mechanisms of tinnitus".Results: Of 35 original and 7 review articles initially found, 18 articles were finally selected having studied original articles on the bases of their title, introduction and discussion and read review articles completely. The selected articles were used to carry out this review on the neurophysiologic model of tinnitus.Conclusion: The neurophysiologic model of tinnitus proposes that auditory and nonauditory processes are involved in it. Tinnitus loudness perception and the rate of its annoyance are depending on the limbic system's activity.

Introduction: Occupation includes daily tasks and purposeful activities in which we are involved because of peculiar personal meanings and values they have to each of us. These activities can be influenced by cultural backgrounds, certain interests or those aspects of life considered to be meaningful by an individual. The concept of occupation is central to occupational therapy since it has been developed on the basis of the idea that occupation can be used as a therapeutic method. In addition to the fact that occupation has a complex structure, it includes many complex concepts. Due to various definitions attributed to the term, it seems occupational therapists need a comprehensive definition of occupation that can be used to specify their role in rehabilitation teams and to define occupational therapy services.Materials and Methods: A phenomenological method was adopted in this study because its main goal was to achieve a comprehensive definition of occupation. In the first stage, all definitions were gathered and then an integrated definition was developed that encompassed all aspects. That definition was summarized by of a group of expert occupational therapists and then data gathered through Delphi method. A detailed explanation of all these steps will be presented in this article.Results: Occupation contains widespread concepts. According to participant's comments, purposefulness and meaningfulness are two main concepts in definition of occupation. We should concern the act of doing or occupational performance and also the context of doing in occupation definition.Conclusion: According to the established definition of the term in this study, occupation has such features as purposefulness and meaningfulness. Occupation results from collaboration between developmental structure and occupational form and can be described as a physical or mental performance evident in areas such as activities of daily living, sleep and rest, education, play and leisure, social participation, or combination of these areas. Compared to other definitions, this definition is more comprehensive and objective and includes all main concepts. So, occupational therapists can use this definition for describing occupational therapy services and specifying their role in team work and determining their position relative to other members of rehabilitation team.

Introduction: Multiple Sclerosis is one of the most common diseases of the human’s nervous system affecting mostly young adults. In addition to common sings of body weakness, vertigo and diplopia, motor speech disorders characteristic of dysarthria can be seen in 40% to 50% of patients. Because of subcortical nature of lesions observed in the disease, intact language performance has been assumed for affected people resulting in ignorance of assessment and subsequent treatment of linguistic functions in intervention plans developed for MS patients. Due to the importance of language in human communication and quality of life, this research has been conducted with the aim of studying presence and types of language disorders in MS patients.Materials and Methods: A review of the literature on the subject of language performance in Multiple Sclerosis patients was performed using ISI, Ebsco, Pubmed, Elsevier data bases and library sources. Initial searching was done via following key word: language, speech, rehabilitation, cognition and multiple sclerosis. Having collected sufficient amount of data, inclusion criteria concerning the method of research was set for evaluating of search results. Through studying abstracts, those articles in which speech and language abilities or cognition abilities related to language have been studied were only selected.Results: Of 78 articles found in the first step of study, 28 articles were finally selected for further evaluation.Conclusion: The results of this study indicated that there were different types of language disorders including naming and verbal fluency impairments, high – level language impairments and problems of discourse structure that should be attended during assessment and treatment of MS patients.

Introduction: Memory impairments have been increasingly recognized as an important neurocognitive feature of schizophrenia. Dysfunctioning of Working memory as a system for short- term storage and manipulation of information may relate to a number of core symptoms observed in schizophrenia. This review study investigated different aspects of working memory and its related methods of evaluation in schizophrenia.Materials and Methods: A comprehensive search of literature published between 1990 and 2011 using several databases (including Pubmed, Proquest Science Direct, Black Well and Scopus) as well as library resources was carried out. The following keywords were used both independently and in combination: "schizophrenia", "memory", "Working Memory" and "Evaluation". It should be noted that only studies matching inclusion criteria concerning originality of studies, types of review, date of publication, adoption of a comparative approach and usage of valuable evaluation methods were finally reviewed.Conclusion: Significant deficits of working memory were demonstrated in schizophrenia groups across all three working memory domains. Most of studies indicated that some negative and positive symptoms can be affected by working memory impairments. Most of evaluations and tasks were specialized depending on the specific working memory area. However the results of evaluation can be changed along with the severity of symptoms.

Introduction: Cochlear dead zones are defined as areas where the inner hair cells have been destroyed.Thresholds on the audiograms show the integrity of those parts of the ear that are tested. Care must be taken in interpretating audiograms. Thanks to the advances in understanding of cochlear functions, it is now possible to spot false responses that come from dead zones of the cochlea. Recently, cochlear dead regions have been detected via TEN (Threshold Equalizing Noise) test in which ipsilateral broadband noise and threshold shifting are used.Materials and Methods: A review of the literature on the subject of dead zones published from 1993 to 2003 was performed using Pubmed, Ebsco, Science Direct, Google Scholar Thieme ProQuest databases and library sources. key word: were "cochlear dead zone", "traveling wave", "ten (threshold equalizing noise) test", "ipsilateral noise" and "real-ear measurement for hearing aids prescription".Conclusion: Hearing aids fitting process for patients with severe and sloping sensory neural hearing loss must be noted specially by amplifying active zone and avoiding amplification for dead region i.e., offering amplification to the transition frequencies that have better hearing than others, those among the fine regions and the dead zones. Dead zone detection may help in hearing aids fitting and fine tuning.

Introduction: Children with cerebral palsy may receive various rehabilitative intervention programs aimed at facilitating their development and improving their functional independence in such areas as movement, self-care, playing, leisure and school activities. Occupational therapists working with children with Cerebral Palsy (CP) employ a variety of therapeutic approaches among which neurodevelopmental treatment approach has been traditionally the most common. Considering the expansion of family centered therapy approaches, the importance of obligation to the International Classification of Functioning, Disabilities and Health principles (ICF, WHO, 2001), limitations of current therapy approaches and recent advances from dynamic systems theory, there is an urgent need to develop a new approach in occupational therapy at the present time. The aims of this study were to present a brief description of CP with an emphasis on the role of occupational therapy in it and to explore the benefits of family-centered approach, dynamic systems theory and family-centered functional therapy in the rehabilitation process of children with cerebral palsy.Materials and Methods: In this study, a comprehensive review of the literature published from 1966 to 2011 was conducted via PubMed, Scopus, ProQuest and Google Scholar data bases. The keywords used in search were "cerebral palsy", "functional", "therapy", "family-centered". All articles were initially evaluated according to predefined inclusion and exclusion criteria and then selected article were reviewed.Results: Of 128 articles found, 22 articles met the inclusion and exclusion criteria and were considered as appropriate for this study.Conclusion: Family-centered functional therapy, which combines theoretical principles of occupational therapy, family centered approach and dynamic systems theory of motor development, is an optimal response to developmental needs of children with cerebral palsy. However, the efficacy of this approach has not been proven empirically.

Introduction: Diagnosis and management of balance disorders is more difficult in young patients than in adults since children are frequently unable to explain the nature of their complaint. The symptoms of vestibular disorders in children may easily be mistaken for behavioral or other medical problems, leading to wrong diagnosis and inappropriate evaluation and treatment. This review summaries the most common causes of childhood vestibular disorders and suggests the need for a multidisciplinary approach to their assessment.Materials and Methods: The present study was a review of the latest literature on the subject of neurophysiological model of tinnitus using Science Direct, PuBmed, Google Scholar, ProQuet, Scopus databases. The following keywords were used to perform the search "vestibular disorders of children", "dizziness" and "vertigo".Results: Of 85 original and 87 review articles initially found, 26 articles were finally selected having studied original articles on the basis of their title, introduction and discussion and full reading of review articles. The selected articles were used to carry out this review on vestibular disorders in children.Conclusion: The results of this study indicated that childhood vestibular disorders may be more common than what previously thought. Attacks of vertigo may be severe and poorly tolerated in children, thus management of this aspect is important and both the child and his/her parents should to be counseled.