Journal of Research in Rehabilitation Sciences
Year:2013 | Volume:9 | Issue:4|Papers Count:25

Introduction: The purpose of this research is to examine the influence of "speech therapy with cognitive behavior therapy" on reducing the severity of stuttering amongst stuttering patients of 18 years old and above in the city of Isfahan.Materials and Methods: The study used a quasi-experimental design with pretest - posttest control group. The sample group included 24 people suffering from stuttering who attended public speech therapy clinics of Isfahan. For the diagnosis and severity of stuttering, stuttering severity instrument (SSI4) was used. After doing the pre-test, subjects were placed into one experimental group of speech therapy with cognitive behavior therapy and one control group. Speech therapy for this research included ten 45-minutes sessions which was done for each individual subject and cognitive behavior therapy included ten 90-minutes group sessions. After finishing the therapy sessions, the post-test was done. In analyzing the data, Analysis of Covariance & Mann-Whitney U test were deployed.Results: Data analysis showed that speech therapy with cognitive behavior therapy has a significant impact on reducing the severity of stuttering.Conclusion: speech therapy with cognitive behavior therapy is effective in reducing stuttering.

Introduction: The proprioception protects the joints injuries. It acts to increase the joint stability and during movements its critical role, inter-joint coordinator, becomes more prominent. As the force sense reproduction is one of the common methods to evaluate the proprioception, its reliability is best to be evaluated. So the aim of this study was to investigate the reliability of evaluating the force reproduction error in dominant and non dominant sides of elbow extensor muscles in healthy young men.Materials and Methods: Twelve healthy young men aged between 18-30 years old were recruited for this study. They were all selected by simple convenient non probability sampling from students of rehabilitation faculty of Shahid Beheshti University of medical sciences in 1391. All participants read and signed the consent form. The intra-tester and inter-tester reliability were examined. The force meter was used to analyze the sense of force reproduction error in elbow extensor muscles. The specified percent (30%) of maximal isometric contraction was educated to subjects then asked them to reproduce the instructed force. The test was repeated just after two minutes and recorded in specific forms. The tests were measured randomly in dominant and non dominant. Relative reliability (ICC), absolute reliability (SEM) and, paired t-test were used in SPSS, version 16, to analyze the data.Results: The amounts of ICC for constant error, absolute error, and variable error in dominant (right) limb and non dominant (left) limb were in range from 0.76 to 0.94 which it shows a high reliability. The SEM measures were also in a range from 0.004 to 0.02.Conclusion: Based on the results of this study, it can be concluded that the method of evaluating the error of sense of force in both limbs of healthy young men has a high reliability. So it can be used as a reliable method in evaluating the force reproduction error.

Introduction: The purpose of this study was investigate the effect of Neoprene, lace-up and Aircast ankle orthosis on balance indexes of volleyball players with unstable ankle degree I and II.Materials and Methods: Thid article is original. Fifteen men volleyball players with unstable ankle grade I and II were recruited (18-23 years). They had at least 3 years experience of playing in different volleybal leagues. Four testing conditions included a no orthosis, Neoprene ankle orthosis, lace-up ankle orthosis, and Aircast ankle orthosis. Postural control test (single leg stability testing in difficult level of 12) was performed by Biodex Balance System. Data were analyzed using descriptive statistics and one-way repeated measures at the significance level of %95 or a£.05.Results: Data analyses showed that the overall index of postural control had a significant decrease while applying either types of ankle orthoses. According to the obtained results, all three types of ankle orthoses s could improve postural control (P<.05). Neoprene ankle orthosis was more efficient than lace-up and Aircast ankle orthoses (P<.05). Although the lace-up orthosis was more effective than Aircast ankle orthosis in ankle stability, but the difference was not prominently significant (P>.05).Conclusion: In athletes with unstable ankle, all three types of ankle orthosis, could prevent ankle sprain via improving the postural control index. Especially in volleyball players with unstable ankle grade I and II, Neoprene ankle support was more effective than other types of ankle orthosis.

Introduction: Job satisfaction considered as an important factor in increasing productivity, Workers belonging and attachment to the work environment and improving the quantity and quality of work. Therefore this factor is important in various careers.Materials and Methods: This is a descriptive-analytic study. It was done between Occupational therapists and speech therapists in the Karaj. In each group 16 individuals were randomly collected demographic and job satisfaction (JDI) questionnaires completed. Reliability and validity of questionnaire was approved by similar internal articles. Data analyzing has done by nonparametric tests and SPSS software.Results: Scores for job satisfaction in occupational therapists (76.0±31.3) were higher than the speech therapists (45.0±80.2. In Speech therapists group between job satisfaction with supervision, salary and promotion was a significant correlation. In occupational therapist be found a significant relationship between job satisfaction with nature of job, salary, promotion and colleagues.Conclusion: Scores in both groups indicates that corrective actions are necessary. Actions for increase job security, improved ergonomics, workplace conditions, career development and job enrichment can help to increase job satisfaction in these two groups.

Introduction: The purpose of this study was to assess what caregivers know about special caring practices for cerebral palsied children aged between one and five years and to what extent they apply such knowledge in their daily contacts with such children.Materials and Methods: To conduct this cross-sectional and descriptive-analytic study, a questionnaire was first designed and then validated through six phases. A sample of 70 caregivers in three rehabilitation centers of Tehran, Iran participated in the study. Descriptive statistics and Spearman's correlation coefficient were calculated for statistical analysis of the data using SPSS software version 16.Results: 61 participants (87.1% of total respondents) self-rated their knowledge about special caring as low to moderate. Actual testing of participants’ knowledge about special caring practices showed that sixty-six of them (94.3%) had low to moderate knowledge in this regard. Based on their reports, 27.1% of these participants had not had any training regarding special caring methods for above-mentioned children. They, as a whole, had not received any training for various aspects of such practices. Their educational history showed that the training had mostly focused on mobility (57.1%) with the least attention to toileting (20.0%).Conclusion: The majority of the participants had low to moderate levels of knowledge about how to take care of a child with cerebral palsy professionally. These results emphasized the need for revising training programs specific to professional caring methods. Moreover, caregivers should attend workshops and seek educational pamphlets to increase their knowledge about such methods. The workshops may focus on teaching toileting, mobility and carrying techniques.

Introduction: Language development and social behavior are considered as crucial aspects of initial development in children. One of the most common behavioral problems in childhood is relational aggression that is defined as behaviors that harm others through damaging to social relationships. Relational aggression is related to the different factors such as language development, which has been examined among normal preschool children in the present study.Materials and Methods: In a descriptive cross-sectional survey, 106 children of 4 and 6 years old (42 girls and 64 boys) who satisfied the inclusion criteria were recruited from Shiraz kindergartens by multi-stage random selection method. The Test of Language Development-Primary: 3rd Edition (TOLD-3) and Relational Aggression Questionnaire for Preschool Children were used to assess children. Data was analyzed by Pearson's correlation coefficient and independent t-test. Significance level was set at less than 0.05.Results: There was a positive and significant correlation between oral language development and relational aggression in the boys (p<0.01). Although the girls’ scores of language development and relational aggression were significantly more than the boys (p<0.01), there was no significant correlation in the girls (p>0.05).Conclusion: The better oral language skills among 4-to-6 year-old boys can be considered as a facilitative factor in expressing their relational aggressive behaviors.

Introduction: Multiple Sclerosis (MS) is an autoimmune disease which affects the skeletal muscles and optical neural networks. Weakness of ankle dorsi flexion and hip flexion muscles is commonly seen in consequence MS. The Ankle Foot Orthosis (AFO) is the most frequently prescribed orthoses to compensate for these weaknesses. It is generally believed that patients are commonly dissatisfied with AFOs. Hip Flexion Assist Orthosis (HFAO) is an orthosis which has been developed to address the shortcomings of the conventional AFO while it is neither manufactured nor prescribed in Iran earlier than the current study.Materials and Methods: Seventeen ambulatory MS subjects with unilateral lower extremity flexor weakness were participated in this study. All participants read and signed the consent form. Gait parameters including speed and step symmetry were evaluated after Two Minute Walk (2MW) test with and without AFO and HFAO interventions. The relation between BMI and the orthoses effectiveness was evaluated while and the participants' satisfaction was assessed by means of a valid questionnaire.Results: The average speed of walking and step symmetry was improved while using HFAO (P<0.001). The level of satisfaction was also significantly higher with HFAO. No significant relationship was found between the effect of body mass index (BMI) and effectiveness of the interventions.Conclusion: The results of the evaluations of this study indicate that the HFAO can immediately improve step symmetry and increase the speed of walking in MS subjects with hip flexors and ankle dorsiflexors weakness. It seems the BMI is not a determining factor in prescription of this orthosis.

Introduction: Noise exposure is the most common cause of tinnitus. A comprehensive assessment of tinnitus and its impact on the quality of life cannot be achieved merely by evaluating the psychoacoustic characteristics of tinnitus. This study aimed at exploring the potential relationship between tinnitus psychoacoustic characteristics and the resulting handicap.Materials and Methods: In this descriptive - analytical study, 20 industrial workers suffering from hearing loss and tinnitus completed the Tinnitus Handicap Index questionnaire (THI) and then underwent psychoacoustic evaluations.Results: The mean and standard deviation of THI was 53.7±25.8. The results indicated a positive significant correlation between the duration and loudness of tinnitus and THI scores (p-value˂0.05). No statistically significant correlations were observed between PTA, SDS and other psychoacoustic parameters and THI (p-value˃0.05).Conclusion: The psychoacoustic evaluations are not valid indicators of tinnitus impacts on patients’ quality of lives. Combined administration of psychoacoustic tests and questionnaires would provide a more comprehensive assessment of tinnitus.

Introduction: Low self–esteem has a long-lasting relation with chronic psychiatric disorders. Occupational therapy increases self- esteem by having patients perform purposive activities and develop deep-seated belief regarding the relation between occupation and health. This research, examines the effect of day-care occupational therapy services on patients’ self–esteem and the length of hospitalization in patients with chronic mental disorder.Materials and Methods: This was a quasi-experimental study through which 20 patients with chronic mental disorder received the psychiatric services in a day-care psychiatry center as the experimental group and 20 patients with chronic psychiatric disorder did not receive these services as the control group. The subjects voluntarily participated in the study. Day-care occupational therapy sessions were held 2 days a week for three months. Each session lasted for 5 hours. To assess their self-esteem, the participants were asked to complete the Coppersmith's Self-Esteem Scale. The mean of hospitalization days was calculated for one year before the initiation and one year after the termination of intervention. Chi-Square test and variance analysis were conducted for statistical analysis of the data using SPSS software, version 19.Results: Patients' self-esteem scores significantly increased after occupational therapy intervention (P=0.04). Also, the length of hospitalization decreased in the studied population after the intervention (P=0.03).Conclusion: The better oral language skills among 4-to-6 year-old boys can be considered as a facilitative factor in expressing their relational aggressive behaviors.

Introduction: Core stability is the ability to control the position and motion of the trunk over the pelvis and legs to allow optimum production and transfer the force to the terminal segment in sport activities. The role of core stability in lower extremity performance has been evaluated in some studies. However, results of such studies contradict each other. In this respect, it has been previously shown that studying the effect of core muscle fatigue on lower extremity performance can provide useful information about its critical role in lower extremity function. Therefore, the purpose of this study was to investigate the effect of core muscle fatigue on measurements of lower extremity functional performance in male athletes.Materials and Methods: Thirty-four healthy male physical education and sport sciences students participated in this experimental study. They all read and signed the consent form. Participants carried out the lower extremity functional performance tests including Y balance, side-to-side hop, figure-eight hop and triple hop in non-fatigued condition during first session. In the second session, at first, athletes participated in the core fatigue protocol consisting of seven exercises and immediately did the lower extremity functional performance tests. Paired t-test was used to compare the data in SPSS software, version 20.Results: Core fatigue protocol caused a significant reduction in the scores of all lower extremity functional performance tests including Y balance, side-to-side hop, figure-eight hop and triple hop (P=0.001 for all tests).Conclusion: Based on the results, it can be concluded that the core muscle function affects lower extremity performance, as core muscle fatigue resulted in decreased scores in all lower extremity functional performance tests in this study. Given the possibility that core muscles may become fatigued during long sporting events, training programs which increase core muscle endurance and improve their ability to resist fatigue, could probably be suggested as a way to prevent reduction of lower extremity performance during prolonged sporting activities.

Introduction: The purpose of this study was to investigate the effects of Beckman oral stimulation program on the time to achieve independent oral feeding in preterm infants.Materials and Methods: In this randomized clinical trial study, 21 preterm infants, whose gestational ages ranged from 26 to 32 weeks and were hospitalized in Kamali Hospital NICU (Karaj- Iran), were chosen according to inclusionary and exclusionary criteria. They were randomly assigned either to a control group or Beckman prefeeding oral stimulation program. Considering the high importance of continued practice in this prefeeding oral stimulation program, the researcher individually implemented this program for each infant allocated to the experimental group for 10 successive days. The subjects in experimental and control groups were compared on these variables: 1- chronological and gestational age at various oral feeding times and at discharge from NICU; 2- weight gained during the first and the second postnatal weeks; and 3- the discharge time from NICU.Results: Average chronological age at 8 oral feeding times was 18.2±9.1 days (mean±SD) in Beckman group and 24.27±10.42 days in control group. Therefore, the subjects in experimental group reached to the criteria 6.07 days sooner than the other group. The difference can be considered as a clinically important achievement. The mean chronological age at discharge time from hospital in Beckman group and control groups were 27.6±12.57 and 33.45±13.46 days respectively. That is, the experimental group discharged 5.85 days sooner from hospital, which is a clinically important benefit.Conclusion: The results of this pilot study implicate the need for more investigation on the efficacy of Beckman prefeeding oral stimulation program. Meanwhile, the program seems to increase oral feeding skills and decrease the length of hospitalization in NICU.

Introduction: the current state-of-art in designing electronic circuits in very small size and with very low power consumption has led to the development of wearable and implantable medical devices. However, the electronic circuits need power supply that is usually provided by relatively large and heavy batteries. The discharged batteries have to replaced or recharged for the long time operation of the circuits. A new promising approach to overcome these limitations is to harvest the required power from the human body itself.Materials and Methods: In this study, a harvesting system which implements a high performance piezoelectric transducer in the shoe was developed and evaluated for supplying the power required by a basic electronic circuit as a model of a wearable medical device.Results: The developed system was able to harvest 0.8mw of steady power with the use of only one piezoelectric transducer. The power was used to supply a basic micro-controller based electronic system steadily without the need for any batteries.Conclusion: The results demonstrate that low power monitoring or rehabilitation instruments may be supplied without batteries by harvesting the available energy in the walking process.

Introduction: Stuttering is one of the most prevalent speech and language disorders. Symptomatology of stuttering has been surveyed from biological, developmental, environmental, emotional, learning and linguistic viewpoints. Literature shows that "word meaning" as a linguistic feature may influence the frequency of disfluency. Therefore, the aim of this study was to determine the effect of word meaning on disfluency frequency in adult with developmental Stuttering.Materials and Methods: In this cross- sectional descriptive- analytic study, 14 adults who stutter (12 males and 2 females) with the mean age of 24.93 years participated. disfluency frequency was evaluated by asking the subjects to read two lists, one of which contained 60 words and the other 60 non- words. The words were selected based on various Persian syllable structures. The obtained data were statistically analyzed through paired t-test using SPSS software.Results: The results of this study showed that there was significant difference between the frequency of disfluency in word and non-word reading tasks (p<0.05).Conclusion: The findings of this study indicate a significant increase in frequency of disfluency on non- words than on real words. According to the results, it seem that the phonological encoding process of non- word reading must be much more complex than that of real-word reading in the sense that semantic content retrieval (word meaning) is missing in non- word reading.

Introduction: Identifying factors which cause the high incidence of ACL is of great importance. The anterior shear forces are the primary mechanism of load sustained on the ACL. During exercise, the activity of muscles and position of lower limbs may increase or decrease the anterior shear force. The purpose of this study is to investigate the relationship between the activity level of some lower extremity muscles and anterior shear force during single-leg jump landing.Materials and Methods: Twenty male-students of physical education participated in this study. EMG activity of the muscles of the gluteus medius, tibialis anterior and hamstring were evaluated via Electromyography system and ground reaction force was evaluated via force plate system in jump-landing task. There was used Pearson correlation test.Results: The results indicated no significant correlation between tibialis anterior and gluteus medius muscles activity with shear force, while there was found correlation between lateral hamstring muscle activity and anterior shear force (P<0.05.) Conclusion: The findings of this study showed that hamstring muscle activity during single-leg jump landing acts as a supporting muscle of ACL. This increased muscle activity leads to the reduction of the load on the ACL.

Introduction: Conductive hearing loss attenuates and delays sound transmission in the middle ear. It can lead to a variety of central auditory processing disorders which may persists even after the elimination of peripheral auditory system problems. Temporal processing, an aspect of central auditory processing, is important for understanding speech and involves temporal resolution, temporal ordering, temporal integration and temporal masking. This study aimed at assessing the effects of conductive hearing loss on the ability temporal resolution using the Gap In Noise test (abbreviated hereafter as GIN).Materials and Methods: This noninvasive analytic-prescriptive study was conducted on 13 persons with bilateral slight to moderate conductive hearing loss and 13 persons with normal hearing. Their age ranged from 20 to 50 years and they were matched for age and sex condition. Approximate threshold and percent of correct answers in GIN test obtained, then analyzed with nonparametric Mann-Whitney and Wilcoxon tests for between-group comparisons.Results: There was no meaningful difference in approximate threshold and percent of correct answers between two gender and the tested ear in each group (p>0.05). The mean approximate threshold of people with conductive hearing loss was significantly (P=0.003) higher than that of the normal group and, as expected, the mean percent of correct answers was lower than normal group (right ear P=0.000, left ear P=0.000).Conclusion: Increasing approximate threshold and decreasing the percent of correct answers, the conductive hearing loss has an adverse effect on some parts of central auditory pathway and reduces the ability of temporal resolution.

Introduction: Job satisfaction considered as an important factor in increasing productivity, Workers belonging and attachment to the work environment and improving the quantity and quality of work. Therefore this factor is important in various careers.Materials and Methods: This is a descriptive-analytic study. It was done between Occupational therapists and speech therapists in the Karaj. In each group 16 individuals were randomly collected demographic and job satisfaction (JDI) questionnaires completed. Reliability and validity of questionnaire was approved by similar internal articles. Data analyzing has done by nonparametric tests and SPSS software.Results: Scores for job satisfaction in occupational therapists (76.0±31.3) were higher than the speech therapists (45.0±80.2. In Speech therapists group between job satisfaction with supervision, salary and promotion was a significant correlation. In occupational therapist be found a significant relationship between job satisfaction with nature of job, salary, promotion and colleagues.Conclusion: Scores in both groups indicates that corrective actions are necessary. Actions for increase job security, improved ergonomics, workplace conditions, career development and job enrichment can help to increase job satisfaction in these two groups.

Introduction: Some evidence suggests that stuttering may be a temporal disruption of the simultaneous and successive programming of muscular movements required for producing speech sounds. According to this view, motor speech timing variables, including reaction time, may be different in people with stuttering (PWS) when compared to non-stutterers. Reaction time is a standard criterion that can show nature of these phonatory differences between stutterers and non-stutterers. The aim of this study was to determine the reaction times of phonation in PWS and to compare them with those of non-stutterers.Materials and Methods: In this descriptive-analytic study, 22 PWS and 22 normal counterparts, whose age ranged from 10 to 30 years (all subjects were divided into two age groups: 10-to-20-year olds and 20-to30-year olds), were asked to give the required response (a prolonged /a/) as soon as they heard an auditory stimulus. The intervals between stimuli and related responses were measured by Praat software.Results: The results of the study showed that the average of reaction times in PWS was higher than that of normal subjects and that this difference was greater in 20-to-30-year olds. These differences, however, did not reach statistical significance.Conclusion: The observed pattern of voice onset among stutterers may be resulted from such stuttering-related complications as struggling, avoiding, anticipatory behaviors, and neuromotor pathologies. It is also reasonable to propose that the voice onset delays are due to the time force perceived by older stutterers during the task.

Introduction: Neuro-occupation is one of the newest models in Occupational Therapy (abbreviated hereafter as OT). The nature of this model is based on the coexistence and dynamic interactions between brain’s neural system functions and engagement of an individual in occupations. The neuro-occupation model holistically views an individual as a blending of neuroscience and occupation. The human brain is perceived to be a self-organized, complex and adaptive system, which in order to achieve the ideal performance, must be in connection with the environment through occupations carried out by the individual.Materials and Methods: This paper introduces concepts and principles of the model in detail. Applying principles of this model, the behavior of a client with depression and diabetes was reviewed to demonstrate how this model guides thinking about the client differently when compared to other OT models. Since the studies adopting the model are in preliminary and basic stages and no experimental or observational studies have been made in this area to date, this article was a narrative review by which the neuro-occupational model in OT was introduced.Results: The structure of neuro-occupation model is based on the close relationship between neurological processes and occupation. The three stages of the model i.e. «Intention», «Meaning» and «Perception», show how the function of the brain’s neural system, through finding the meaning while participating in purposeful occupations, regulates emergence of new adaptive behaviors hence enabling the individual to cope with his/her life’s challenges.Conclusion: This model is applicable to a wide range of clients with diverse diagnoses. Therefore, with regards to the self-organization phenomena within the brain’s neural system functions, clients can be expected to pass through the distinct stages of Intention, Meaning and Perception.

Introduction: The purpose of this study was to investigate the effectiveness of client–centered model in form of Canadian Process Performance Framework in a client with schizoaffective diagnosis, in order to demonstrate its application in occupational base practice.Materials and Methods: In this case-study, a 38 schizoaffective woman was studied. Measures such as Canadian Occupational Therapy Measurement (COPM), Beck Depression Inventory II (BDI-II) and Lowenstein cognitive assessment were used to document the differences in performances of the client during therapy sessions. In all evaluations, twenty-one sessions of intervention and goal planning process, client had an active participation and the occupational therapist tried to respect her values and interests accordingly.Results: Results demonstrate that the amount of performance and satisfaction increased, according to COPM (5.3, 5.7) and the rates of depression decreased from sever to moderate (50 to 20).Conclusion: The results confirmed that current approach can be a useful approach to improve social skills and activities of daily living in patients afflicted with schizoaffective disorder.