Archives of Rehabilitation (Journal of Rehabilitation)
Year:2020 | Volume:21 | Issue:2|Papers Count:8

Objective Cerebral Palsy is one of the most common neurodevelopmental disorders in children. Due to the increase in the number of students with Cerebral Palsy (CP) entering ordinary schools and facing problems with independent functioning, there is a need for a valid and comprehensive assessment tool for their successful entry as well as providing a proper treatment plan. The School Function Assessment (SFA), by measuring many school-related functional skills, can identify the strengths and weaknesses affecting the students’ independence and participation in school assignments. It has 320 items and three main parts of participation, task support, and activity performance. The test score can be reported in general or based on each part, separately. The purpose of this study is to examine the validity and reliability of the Persian version of the SFA in children with CP. Materials & Methods This is a cross-sectional study with methodological design. The study population consists of all children with CP aged 7-12 years in Tehran. Of these, 120 were selected from exceptional public school using a convenience sampling method. The inclusion criteria were: CP diagnosed by a neurologist, age between 7 and 12 years, no other disabilities (e. g. deafness or blindness), and the willingness of children’ s parents to participate in the study. A demographic form and the Persian SFA were used for data collection through interview. In order to measure the content validity, Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated according to the standard protocol of International Quality of Life Assessment. In this regard, 8 experts in the field of pediatrics completed the Persian SFA. To determine the test-retest reliability, the questionnaire was completed by the parents of children with a 4-week interval. The internal consistency and test-retest reliability were examined by using Cronbach’ s alpha coefficient and Intra-class Correlation Coefficient (ICC), respectively. Data was analyzed in SPSS V. 22 software. Results Participants were 64 boys and 56 girls with CP (mean age= 9. 4 years). The distribution of CP was as follows: 10% hemiplegic CP, 27. 5% diplegic CP, 5. 8% monoplegic CP, and 56. 7% quadriplegic CP. Eighty hundred-eight percent of respondents were the mothers of students. The CVR and CVI values were in a range of 0. 7-1 and 0. 87-1, respectively indicating an acceptable validity. All the items had acceptable content validity. The Cronbach’ s alpha coefficient was obtained 0. 95 for participation, 0. 95-0. 99 for task support, 0. 83-0. 99 for activity performance, and 0. 92 in total. Moreover, the ICC value was reported 0. 90 for participation; 0. 84-0. 91 for task support; 0. 84-0. 97 for activity performance; and 0. 89 for the overall test. Conclusion The Persian version of SFA has acceptable content validity and reliability (internal consistency and test-retest) for children with CP. Therefore, it can be applied as a research and clinical tool to assess the school-related performance of these children.

Objective Brain trauma evidences suggest that the two grammatical categories of noun and verb are processed in different regions of the brain due to differences in the complexity of grammatical and semantic information processing. Studies have shown that the verbs belonging to different semantic categories lead to neural activity in different areas of the brain, and action verb processing is related to the activity of motor and pre-motor areas of the brain. Researchers use different tasks to evaluate action verb processing. The most common tasks are action naming and action fluency tasks. Although these types of tasks are sensitive to deficits in action verb processing, they do not specify the nature of the injury. To understand whether dysfunction in action verb processing is due to difficulty in lexical access or specific impairment in semantic processing, it is necessary to design a specific test to evaluate lexical-semantic processing. Semantic Similarity Judgment (SSJ) test targets the lexical-semantic encoding at a deep and controlled processing level. The purpose of the present study was to develop a SSJ test for Persian action verbs and non-action nouns and determine its content validity. Materials & Methods In this methodological study, 70 Persian action concrete verbs and 80 Persian nonaction concrete nouns were first selected. For each word, a semantically related word based on functional, physical, categorical features and similarity in action was selected according to the opinion of 4 experts (3 speech-language pathologists and one linguist) using a 7-point scale. For semantic similarity rating, only the pairs of words with a high semantic similarity score (5 to 7) remained and the rest were omitted. Then, for each pair of semantically related words, a semantically unrelated word was selected. After determining content validity qualitatively by three experts and removing inappropriate items, for matching the two sets of nouns and verbs, the lexical and psycholinguistic characteristics of the remaining words (207 nouns and 156 verbs) including frequency, number of syllables, phonemes, letters, phonological and orthographic neighbors, action association, imageability, familiarity and age of acquisition were extracted by 18 volunteers (13 speech-language pathologists and linguists and 5 parents selected by a convenience sampling method) based on a 7-point scale. The verbs with low action associations and the nouns with high action association were removed and then, the two sets of words were matched for other lexical and psycholinguistic characteristics. Finally, 34 triples of verbs with high action association and 34 triples of nouns with low action association were selected. In both noun and verb sets, the words were chosen in such a way that, in order to judge, the semantic features of the words need to be carefully considered. Data analysis was performed using descriptive statistics and independent t-test.

Objective Work-related musculoskeletal disorders are one of the major causes of lost working time, increased costs, human injuries and burnout. The International Labor Organization estimates that about 160 million work-related illnesses occur worldwide each year, where the highest prevalent illnesses are musculoskeletal disorders. Several studies have been conducted In Iran to investigate the prevalence of these disorders, each providing different statistics. Therefore, considering the importance of these disorders, it is necessary to obtain accurate results with high statistical power and validate them. The aim of this study was to investigate the prevalence of work-related musculoskeletal disorders in Iran in order to obtain more accurate results by conducting a meta-analysis. Materials & Methods For this meta-analysis, searching was conducted in SID, MagIran, IranMedex, Google Scholar, Scopus, Web of Science, and PubMed databases using the keyword “ work-related musculoskeletal disorders“ in both Persian and English on studies conducted during 2001-2016 in various cities of Iran. Inclusion criteria were: investigating the prevalence of musculoskeletal disorders in a period of one year, being a cross-sectional or descriptive-analytical study, publication in Persian or English, availability of full-texts, assessment using standard methods (e. g. Nordic Musculoskeletal Questionnaire) and considering the prevalence of musculoskeletal disorders throughout the body (upper and lower extremities). The heterogeneity of the articles was evaluated using the I2 statistics and the data were analyzed in STATA software using meta-analysis and random-effects model. Results In this study, 45 papers on work-related musculoskeletal disorders were studied. The overall sample size of these studies was 9813, with a mean number of 218 for each study. Most of studies were descriptive-analytical and cross-sectional. In all of them, the prevalence of musculoskeletal disorders in different parts of the body had been investigated. According to their results, the most prevalent workrelated musculoskeletal disorder in lower extremity was low back pain (0. 49%) and in upper extremity, it was neck pain (39. 3%). The prevalence of musculoskeletal disorders in other parts of the body were 39. 32% in the neck, 36. 9% in shoulders, 36. 8% in the back, 34% in the wrist, 26. 9% in legs, 20. 5% in thighs and hips, and 16. 2% in elbows.

Objective Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects the person’ life. The prevalence of ASD in Iran is increasing. The complicated nature of this disorder disrupts the balance and work routines in the family, which puts a lot of stress on the entire family, especially mothers. Mental health of the mother affects all family members, including a child with ASD. On the other hand, mothers’ confusion and failure in relation to their ASD child causes more stress and discomfort for them. In this study, we aimed to investigate the effect of filial therapy, as a play therapy, on the parenting stress of mothers with ASD children. Materials & Methods In this experimental study, participants were the mothers of 32 children with ASD (9 girls and 23 boys) aged 4-12 years referred to autism centers and occupational therapy clinics in Isfahan, Iran who were selected using a convenience sampling method. After obtaining an ethical approval from the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (code: IR. USWR. REC. 1396. 97), and necessary permissions, researchers referred to the clinics and after explaining the purpose of the study to the mothers, an informed consent was obtained from them. Then, they completed a demographic form, Gilliam Autism Rating Scale-2 (GARS-2), and Abidin’ s Parenting Stress Index-Short Form (PSI-SF). Participants were randomly divided into two intervention and control groups after matching for the child’ s age, GARS score, and the education of children and mothers. The intervention group received 10 sessions of filial therapy, once a week, each for two hours, while the control group continued routine treatment. After intervention, PSI-SF was completed by all mothers again. The collected data were analyzed by using ANCOVA, paired t-test and independent t-test. Shapiro-Wilk test was used to determine the normality of PSI-SF data distribution at Pre-test and Post-test phases. Results Paired t-test results showed that there was no statistically significant difference in the mean total parenting stress score between the two groups in the Pre-test phase (P= 0. 679) but it was significant in the Post-test phase (P= 0. 010). The results of independent t-test showed that the difference between the mean Pre-test and Post-test scores of total parenting stress in the control group was not significant (P= 0. 268) but it was significant in the intervention group (P=0. 001). ANCOVA results showed that the Pre-test score of parenting stress had an effect on the total parenting stress score after intervention such that it could explain 82% of variations in this variable. After controlling the Pre-test score, the total parenting stress was significantly different in two groups (P=0. 001). Eta squared value indicated that the intervention could explain 54% of changes in total parenting stress of mothers. Conclusion Filial therapy can help better acceptance of the ASD children by their parents and reduce parenting stress by improving child-parent relationships. This method can be taught as a complementary intervention to the mothers of ASD children.

Objective Communication can affect the personal and social life of people. According to International Classification of Functioning, Disability and Health (ICF), communication is one of the most important components of social participation and can have different functions such as behavior regulation (regulating the behavior of others to achieve a particular goal), social interaction (drawing attention of others to the self) and joint attention (attracting the attention of others to an event or particular object). Having knowledge of the development of communicative functions is so important in assessment, diagnosis, prognosis, and early intervention. Despite the importance and effect of communicative functions in language and communication development, no study has been conducted yet that examines the communicative function development of normal Persian-speaking toddlers. The purpose of this study was to investigate the development of communicative functions in normal Persian-speaking children from 12 to 18 months of age, regardless of communicative expressions (such as gestures, vocalization, and words). Materials & Methods This is a longitudinal observational study. The communicative function of 11 monolingual Persian-speaking 12-month-old children (7 boys and 4 girls) living in Tehran, Iran was investigated for 7 months. Sampling was done by using purposive and snowball non-probability sampling methods. All children had healthy medical history and normal growth, were from a family with a moderate socioeconomic status, and their parents had at least a high school diploma. The participants’ developmental status was assessed by Ages and Stages Questionnaire. A demographic form with acceptable content validity was also used to determine their demographic characteristics. For 7 months (once a month, each session for one hour), the examiner filmed the childmother interaction during a semi-structured play with a set of toys at the child’ s home. Afterwards, the recorded videos were coded according by the researcher and then entered into the SPSS V. 22 software. Descriptive statistics including mean and standard deviation were used to describe the data. The Shapiro-Wilk test was used to determine the normality of data distribution, and repeated measures ANOVA (within-subject comparison) was used to analyze the data. Two raters were taught about the coding and rating of the communicative functions. To verify the validity of the data coding, 20% of the recorded samples were given to them to code communicative functions. The coding validity was determined by calculating the Intra-class Correlation Coefficient (ICC). Results The mean frequency of behavior regulation and social interaction was constant from 12 to 18 months of age (P<0. 05), while the mean frequency of joint attention was constant from 12 to 15 months of age (P<0. 05) and then significantly increased at months 16 (P= 0. 019), 17 (P= 0. 023) and 18 (P= 0. 003) compared to the 12th month. The ICC value as the criterion for coding validity was reported 90%. Conclusion The mean frequency of joint attention increased significantly from 12 to 18 months of age, while it was constant for behavior regulation and social interaction. Our findings are consistent with the ICF’ s social participation, stating that a child uses a particular type of communicative function to increase its participation in the society.

Objective Dysphagia is commonly encountered in Multiple Sclerosis (MS). It can consequently cause severe complications such as the increased risk of dehydration, malnutrition and aspiration pneumonia that associated with an increased risk of death in the late stages of the disease. These complications can be prevented with an effective screening protocol. The Dysphagia in Multiple Sclerosis (DYMUS) is the only questionnaire developed specifically for patients with MS. The aim of the present study was translation and cross-culturally adaptation of DYMUS for the Persian population and estimation of the questionnaire's reliability and validity. Also, we investigated the frequency and severity of dysphagia in the patients referring to the Tehran MS Society and its association with the course of MS, disease duration, and Expanded Disability Status Scale (EDSS). Materials & Methods This is a methodological and descriptive-analytic study. The statistical populations consist of the patients with MS referring to the Tehran Multiple Sclerosis Society in 2018. The study sample consisted of 108 patients who were selected through a convenient sampling method. The research instruments consisted of 10-items DYMUS questionnaire (in the first part of the study, translated and its psychometric properties examined), Dysphagia Handicap Index and a demographic information questionnaire. In methodological section, translation and cross-cultural adaptation were fulfilled and the Confirmatory Factor Analysis (CFA) was used to assess the construct validity and to test the goodness-of-fit of the presented model. The association between the DYMUS and Dysphagia Handicap Index (DHI) scores investigated to convergent validity. The inter-item correlation matrix was calculated to assess the homogeneity of the questionnaire items. Kuder-Richardson (KR-20) was measured to assess the internal consistency of the questionnaire. Also, the test-retest procedure was conducted on the 19 subjects understudy to assess the reliability. Finally, the frequency and severity of dysphagia and its asso-ciation with the course of MS, disease duration, and EDSS was investigated. KR-20 reliability coefficient, Intraclass Correlation Coefficient (ICC), inter-item correlation matrix, Mann-Whitney U test and rank correlation coefficient or Spearman's were used to inferential statistical analysis. Results Analysis of the inter-item correlations matrix indicated a positive correlation between all items, exception item 10. Based on the results of the inter-item correlation, item 10 had the lowest correlation coefficient that was deleted from the questionnaire. CFA results confirmed the two-factor model of DYMUS, “ dysphagia for solids” and “ dysphagia for liquids” , and revealed that the item 10 was minimally contributing to the measurement of "dysphagia of solids" and internal consistency increased after the deletion of this item. Also, the solution of the 9-item Model was the best goodness-of-fit indicator forthe sample. The obtained results from the convergent validity indicated a positive significant correlation between the DYMUS and DHI (rs=0. 693, P<0. 001). A KR-20 reliability coefficient of the DYMUS was 0. 856, indicating high internal consistency of the Persian translation of the questionnaire items. Testretest reliability was excellent with 0. 965 value. The results also showed that 65. 7% of multiple sclerosis patients had a swallowing disorder. In terms of the dysphagia severity, 25. 9% of participants had mild dysphagia, and 39. 8% of participants had alarming dysphagia. DYMUS values were significantly correlated with disease duration (rs=0. 198, P= 0. 040), and EDSS (rs=0. 235, P= 0. 014) and significantly higher mean scores were observed in the patients with secondary progressive than the other subgroups of multiple sclerosis. Conclusion The Persian adjusted 9-item questionnaire was demonstrated to be a simple, consistent, valid and reliable tool for the detection of patients who need more specific instrumental evaluations of swallowing. Also, about the dysphagia is very frequent in these patients, it is important that clinicians monitor these patients carefully even in early stages of the disease for early detection and planning a rehabilitation program to the prevention of serious subsequence complications.

Objective One of the significant causes of foot pain is plantar fasciitis. The use of medical insoles is a conventional treatment for this condition. The purpose of this study was to compare the effect of the customized insole with the CAD-CAM and conventional insole on pain, symptoms, daily activity, exercise and recreational activity, and quality of life in patients with PF. Materials & Methods This quasi-experimental study was performed on 14 patients with plantar fasciitis (five women and nine men) with the mean age of 40 years. Fourteen patients have been diagnosed with orthopedic pain after being diagnosed with plantar fasciitis according to inclusion criteria. Diagnosis of the complication of plantar fasciitis by orthopedic physician, Patients with flexible flat foot. No neurological disorders or any foot pathology such as diabetes and osteoarthritis. Patients were randomly assigned into two groups of 7 using customized insole with CAD-CAM and conventional (prefabricated) insole. From the outset it was found to be one of two types of insole to be studied: first the patient was given a CNC insole, and the other 13 patients received the same insole and divided into two groups. The instrument of this study was the FAOS questionnaire (foot and ankle outcomes) which measures the five variables of pain, symptoms, daily activities, sports and recreational activities, and quality of life. Both groups completed the questionnaire before using the insole and again after six weeks. Compressive scan of both groups was accomplished using EMED foot pressure system. The custom-made insole was designed using Rhino Cross software and then shaved using EVA foam blocks with 50% shore using a CNC machine. In the conventional insoles group, patients received conventional polyurethane insoles based on the length measurements of the single leg. Patients completed the questionnaire again after six weeks. Data were analyzed by SPSS software v. 22. After checking the normality of the data by Shapiro-Wilk test, non-parametric Mann-Whitney and Wilcoxon tests were used to analyze the data. Results In the pre-intervention phase, there was no significant difference in pain, symptoms, daily activities, recreational-sports activities, and quality of life in the two groups, and the two groups were homogeneous. After six weeks, there was a significant difference between the two groups in the FAOS questionnaire (P<0. 05). There was no significant difference between the two groups in pain score, symptoms, daily activities, recreational-sport activities, and quality of life (P <0. 05). Conclusion According to the results of this study, both customized insoles with CAD-CAM and conventional insoles are effective in improving FAOS questionnaire subscales. There was no significant difference in the impact between the two types of insoles in foot and ankle.

Objective One of the parameters showing the correct phonetic and phonological development is the correct and clear articulation of vowels is achieved by changing the shape of vocal cords through altering the height and position of the tongue and the movement of the lips and jaw. The tongue’ s height and position are the basis of the production and difference of vowels. In other words, the raw sound produced by vocal cords, which has a base frequency, changes and intensifies according to the displacement of organs and vocal tract cavities which makes harmonies from the base sound called formats. These intensified harmonies depend on the shape, size, and material of the cavities, and can affect a person’ s speech clarity and, consequently, the listeners’ perception. Due to such effects and the significant role of vowels space and formants on communicative aspects in each language, they are considered as one of the most important acoustic characteristics of any spoken language. Therefore, determining a scale as a tool to assess vowel errors and speech disorders is necessary. This study aimed to investigate vowel space and formant structure of Mazani language in adults. Materials & Methods This descriptive-analytical study with a cross-sectional design was conducted on 60 adults (30 males and 30 females) with Mazani language aged 18-40 years who were selected randomly and based on the inclusion and exclusion criteria (no history of respiratory diseases, verbal and auditory disorders and having at least 5 years of experience in living in Babol county. After producing the vowels by participants, the first, second, and third formants (F1, F2, and F3) of all 6 vowels were obtained in PRAAT v. 6. 0 program, and analyzed finally using independent t-test in SPSS v. 18 software. Results In men, the highest mean value for the base frequency was related to the vowels /i/ and /u/ (136 Hz), and for F1, F2, and F3, it was related to the vowels /æ / (646 Hz), /i/ (2182 Hz), and /i/ (2888 Hz), respectively. On the other hand, their lowest mean values were related to the vowels /a/ (124 Hz), /i/ (283 Hz), /a/ (1150 Hz), and /e/ (2629 Hz), respectively. In women, the highest mean values of base frequency, F1, F2 and F3 were related to the vowels /u/ (222 Hz), /æ / (828 Hz), /i/ (2346 Hz), and /i/ (3151 Hz), while the lowest mean values were related to the vowels /æ / and /e/ (202 Hz), /i/ (364 Hz), /a/ (1167 Hz), and /o/ (2775 Hz), respectively. Conclusion There was difference in formants and vowel space between men and women with Mazani language. The /a/ was the lowest pitch vowel and /i/ and /u/ were the highest pitch the vowels in men, while /æ / and /e/ were the lowest pitch vowels and /u/ was the highest pitch vowel in women. Furthermore, the most open, closed, backward and forward vowels were /æ /, /i/, /i/ and /a/, respectively. The /e/ in men and /o/ in women were the most rounded vowels, while the /i/ in both genders was the most unrounded vowel. The results are somewhat different from the results of studies conducted on the production of vowels in standard Persian language. Since the speech clarity and fluency can be affected by the incorrect production of vowels, the results of this study can be used to evaluate and diagnose speech disorders in Mazani language for clinical and research purposes.