SCIENTIFIC JOURNAL OF REHABILITATION MEDICINE
Year:2018 | Volume:7 | Issue:2 |Papers Count:31

Background and Aim: Fatigue is thought to affect the anterior cruciate ligament injury risk; thus, the present study was conducted to investigate kinematics, kinetics, and active muscle control strategies of the knee joint in fatigue conditions during a landing task. Materials and Methods: A total of 15 healthy active male individuals (age: 22. 09± 3. 18 years; height: 58/7 ± 177 cm; weight: 72/7 ± 71 kg) participated in the current quasi-experimental study. Sit to stand fatigue protocol was used for lower limb fatigue and kinematic and kinetic and muscle activity during normal gait before and after fatigue protocol were collected. Shapiro-Wilk test was used to ensure the normal distribution of data and paired t-test was run to compare variables at p≤ 0. 05 level. Results: Increased knee flexion velocities (P=0. 004), increased knee flexion angle at initial foot contact (p=0. 016), and peak knee flexion angle (p<0. 02), decreased ground reaction force (p=0. 001), increased time to peak force (p=0. 02), decreased pre-activation of biceps femois (p=0. 00), semitendinosus (p=0. 00), and medial gastrocnemius before landing and decreased biceps femoris after landing (p<0. 002) were observed. Conclusion: According to the supportive role of gastrocnemius and hamstrings muscles and contribution of this muscle with ACL ligament at knee joint stability, it seems that lower limb fatigue can lead to ACL injury and reduction of the stability of the knee. Increased flexion angle at foot contact, reduced ground reaction force, and increased time to pike may be related to the nervous system strategy to shock absorption and reduce injury of lower limb joints.

Background and Aim: Anterior Cruciate Ligament (ACL) injury occurs frequently among athletes during single-leg landing and identifying factors which cause the high incidence of ACL injury is of great importance. The biomechanical factors and anterior shear forces are the primary mechanisms of load sustained on the ACL. The lower extremity position during activity may increase or decrease the anterior shear force. Therefore, the objective of the present study was to evaluate the effect of eightweek stabilization training on knee flection and anterior shear force during a drop landing task to prevent ACL injury. Materials and Methods: A total of 30 basketball athletes were randomly assigned into a training group (n = 15), and a control group (n = 15). Training group performed the Core stability training during eight weeks but control group did not perform these exercises. Lower extremity kinetics and kinematics variables were calculated in pretest and posttest during single leg drop landing using motion analysis and force plat. Data were analyzed using mixed ANOVA repeated measure with the significance level set at P< 0. 05. Results: The results revealed that the amount of knee flexion in the training group significantly increased after eight weeks of training (P< 0. 05), but there were no significant reduction in anterior shear forces (P> 0. 05). Conclusion: Based on the findings of the current study, core stability training with increasing core stability has probably improved muscles recruitment strategy during drop landing. Therefore, according to the results of the present study, we can conclude that stabilization training can result in the reduction of risk factors of ACL injury including biomechanical and factors during dynamic movement.

Background and Aims: Today, the benefits of balance exercise and taping are considered in the prevention and improvement of sports injuries, especially in sprains and dislocations in imbalance as well as defects of proprioceptive. The purpose of the current study was to evaluate the effect of six weeks of balance exercises protocol, taping, and mixed on proprioception and functional performance in teenager male volleyball players with chronic ankle instability. Materials and Methods: A total of 45 teenager male volleyball players with chronic ankle instability participated in the study. Eligibility of ankle instability was assessed using Cumberland Ankle Instability Tool (CAIT) and anterior drawer test. The Biodex system was used for measuring proprioception (ICC=0/99) and Eight Hop Test was used for conducted functional performance. The covariance (ANCOVA) and post hoc Sidac tests were used for statistical analysis at P=0/05. Results: The results in all groups showed significant differences between pre-test and post-test in proprioception 10 ° dorsiflexion, 20 ° plantar flexion, and functional performance (p<0/05). Also, the results showed significant differences between balance exercises and combined groups compared with taping group in post-test (P<0/05), while there was no significant difference between two groups (combined and balance exercise) (P<0/05). Conclusion: Considering the extremely large effect size of the balance and combined groups, it is recommended that these program be used to improve ankle proprioception and functional performance of teenager male volleyball players with chronic ankle instability.

Background and Aims: Cardiovascular diseases are a leading cause of mortality in developed and in developing countries. The purpose of the present study was to determine the effect of whole body vibration training and detraining on selected cardiovascular risk factors in inactive middle-aged women. Materials and Methods: Cardiovascular diseases risk factors (Fasting blood sugar, total cholesterol, triglyceride, High-density lipoprotein, low-density lipoprotein, systolic and diastolic blood pressure, and heart rate) were measured before, after one month (30 session’ s vibration training) and after three months detraining in 9 inactive middle-aged women. Results: Significant difference was detected in concentration of fasting blood sugar, total cholesterol and LDL-C (P≤ 0. 05) between three intervals (before, after 30 session’ s vibration training, after three months detraining) which concentration decreased after training. In contrast no significant difference was observed in concentration of triglyceride, HDL-C, systolic and diastolic blood pressure and heart rate (p≥ 0. 05) between all measured time units. Conclusion: In summary, following one month of whole body vibration training there was a significant decrease of some of the cardiovascular diseases risk factors compared to baseline, but its effect didn’ t remain after three-month detraining. It seems that whole body vibration training may have the potential to use as an alternative training for middle-aged women, who lacking tendency for attending exercise gym, to reduce some cardiovascular risk factors during performing this kind of training.

Background and Aims: The ability to anticipate the injury is as important as its assessment and treatment; thus, it is recommended to include the analysis of performance in pre-season screening tests. Using the functional assessment prior to participating in the event could be reducing the incidence of injury and act as a preventive factor. One of the vulnerable regions of the body is shoulder and the method for assessing upper extremity and shoulder is using shoulder functional assessment test. The aim of the present study was to compare the scores of shoulder screening test between overhead and non-overhead athletes. Materials and Methods: Participants were 100 girl athletes (with the age range 15-25 years) who volunteered to participate. The participants included overhead (volleyball) and non-overhead (futsal) athletes. Both groups of athletes were assessed using shoulder functional tests (Howe, 2015). Each item of the test was measured three times and the average was considered as an ultimate score. Also, participants' forward head and round shoulder was measured using the photogrametry. Independent Ttest and k-squared test were used for data analyses. Significant level was set at 0. 05. Results: T-test showed a significant difference between functional scores obtained from volleyball players and those of futsal players (p₌ 0. 003). However, the results of k-squared test showed significant differences in pectoralis minor and levator scapula muscles length test. Also, the results showed that the futsal players had more dysfunction compared with volleyball players. Conclusion: Upper quarter screening in pre-season trainings can be an appropriate guide for the trainer for diagnosis and correction of athletic movement disorders. In the current study, the results of screening test between futsal and volleyball groups indicates weakness in both of them, but the group that has more forward head and shoulder disorder (futsal) had weaker performance. It is therefore concluded that in shoulder function, the presence of abnormalities with high intensity is probably more important than the type of sport.

Background and Aims: The hemiplegic children use the affected hand less, so improvement of the affected hand function is considered by treatment programs. The aim of this study was to investigate the effect of Xbox-kinect bimanual games on using the affected hand in hemiplegic children aged 4 to 14 those referred to rehabilitation centers of Tehran. Materials and Methods: In this current randomized clinical trial, 34 children with hemiplegic cerebral palsy randomly divided into control and intervention groups. The upper limb performance was evaluated by using QUEST test. Both groups received the occupational therapy in a similar way In addition, children in the intervention group played Xbox-kinect bimanual games half an hour twice a week for eight weeks. Then the upper limb performance was evaluated again. Results: The results of ANCOVA indicated a significant difference between control and treatment groups (P< 0/001). Conclusion: The results indicated that participation of hemiplegic children in virtual games, such as xbox kinect games, has significant effects on upper limb function improvement in children with hemiplegic cereberal palsy.

Background and Aims: Background and Aim: Localization in horizontal plane is one of the consequences of binaural hearing. It is based on interaural time difference at low frequencies and interaural intensity difference at high frequencies. Stimulus spectrum and its frequency must be considered as an interfering factor in localization studies, as warble tone is used in free field tests instead of pure tone. The present study was designed to investigate the difference between warble tone and narrow band noise in horizontal localization. Materials and Methods: The present study was conducted on 30 normal hearing and right handed adults (22 female, 8 male) (Mean age: 25, SD: 3. 16). Horizontal localization was tested using four loudspeakers at ± 30 and ± 60 degrees azimuth with 1 meter interval at 35 dB SL. The localization test was performed using Narrow Band Noise and Warble tone separately at 500, 1000, 2000, 4000, and 6000 HZ and the results were compared. Results: There was no significant difference observed between localization error for warble tone and NBN stimulus at low frequencies (500, 1000, 2000, HZ) at ± 30 degree (P>0. 05). For 4000 HZ, localization with NBN was more accurate at all azimuths except for +30 degree. At 6000 Hz, the localization accuracy was better with NBN stimuli at all azimuths. Conclusion: The current study showed that as the frequency and azimuth of loudspeaker increased, the accuracy of localization with Warble Tone stimulus decreased. The NBN is a preferred stimulus for horizontal localization studies.

Background and Aims: Individuals with flat foot may have sensorimotor impairments that affect coordination at the lower limb joints. The purpose of the present study was to compare joint coupling angles of the lower limbs during walking with and without arch support foot orthoses in children with flexible flat foot. Materials and Methods: A total of 15 male teenagers (age: 10. 3± 1. 5 year) with flexible flat foot, after obtaining their parents’ permission, volunteered to participate in the study. Three-dimensional kinematic data were collected while subjects walk with and without arch support foot orthoses. The intra-joint coupling angles were calculated using a vector coding technique. Paired sample t-test was used for statistical analysis. Alpha level was set at P<0. 05. Results: The results demonstrated that there are significant differences in ankle-knee intra-joint coupling angles in both sagittal (P=0. 002) and frontal (P=0. 035) planes between the control and experimental groups during loading response phase, while the results also demonstrated that foot orthotic device reduce horizontal knee– hip coupling angle significantly during loading response (P=0. 008), mid stance (P=0. 009), and push off (P<0. 001) phases of walking. Moreover, horizontal ankle-hip coupling angle significantly increased during foot orthoses condition in both loading response and midstanc phases (P<0. 05). Conclusions: During orthoses condition, knee flexion angle was greater than that of sagittal ankle joint motion. This indicated positive effects of orthoses in injury prevention. The arch support foot orthoses that was used in the present study in male children with flat foot caused the highest alterations in lower limb intra-joint coupling angles in loading response phase. However, further study is needed to prove thie claim.

Background and Aims: Overweightness and obesity is significantly increasing in developing countries including Iran. Childhood obesity can affect self-efficacy in various aspects of life including academic achievements and quality of life. The present study was conducted to compare peer interaction self-efficacy of school-aged obese, overweight, and normal children in Shiraz city. Materials and Methods: An analytical cross-sectional comparative study was carried out. The sample size consisted of 72 primary school girls and boys (8-12 y) in Shiraz city. The sample was categorized into three groups (normal, overweight, and obese) based on Body Mass Index (BMI). Data were collected using "Children self-efficacy for peer interaction scale" (Wheeler & Ladd) and analyzed in SPSS running ANOVA with the significance level set at <0. 05. Results: The results showed that there was a meaningful difference between the three groups studied in self-efficacy (P<0/05). Also, a significant difference was observed in the children's self-efficacy considering different areas of Shiraz city (P<0/05). Conclusion: Based on the findings, obesity and lack of self-efficacy are related to each other. The results were congruent with some previous studies. It is suggested that more research be conducted with regard to the general mental health level, IQ, and EQ.

Background and Aims: Clinical competence is one of the most controversial topics in the field of health care, which has a great importance in various areas of therapy, including education, clinical, and management. The present study was conducted to explore the skills required for obtaining the clinical competency of occupational therapists. Materials and Methods: The current qualitative study was conducted following content analysis. The participants included 13 occupational therapists with a minimum of two years of clinical experience. The information was obtained through a focus group with four attendees and an individual interview with nine other graduate occupational therapists. Data was analyzed based on Graneheim method (2004). Results: Three categories emerged from the data, including reflection (with subcategories of selfjudgment and critique of others), communication (with subcategories of communication with client and colleagues), and technical skills (with subcategories of disease recognition, assessment and comprehensive planning, and time and energy management). Conclusion: The findings of the present study suggest that occupational therapists need different skills to obtain clinical competence and, according to the participants, improvement of supervisory, support, and educational systemas well as individual interest in the profession can help them to acquire skills and use them. Yet, more studies are needed to shed more light on this area.

Background and Aims: Non-specific chronic low back pain is one of the subgroups of low back pain. Pain, functional disability, and reduced muscle endurance are common in such patients. The objective of the present study was to compare the effects and durabilities of isolated and combined stabilization exercises and reflexology massage on pain and muscle endurance in patients with low back pain. Materials and Methods: A quasi experimental study was carried out on 47 patients aged between 30-35 years who had low back pain. They were divided into four groups: the control group underwent routine exercises only, while the core stabilization group performed stabilization training, reflexology group underwent a reflexology, and combined core-reflexology group underwent complex intervention for eight weeks. The pain and muscle endurance were evaluated three times (before, post treatment, and after one month detraining). The data were analyzed using repeated measure ANOVA, analysis of covariance (ANCOVA), sample, and paired t tests. Results: The results revealed that after treatment, the pain and trunk muscle endurance, improved significantly in core and core-reflexology groups and demonstrated durability, but reflexology has only effect on pain. Conclusion: Considering the positive effects and durability of stabilization exercises on the reduction of pain intensity and increase in muscle endurance, it is recommended that this method be used in the treatment of patients with LBP.

Background and Aims: Velopharyngeal dysfunctions are frequently reported in patients with repaired cleft palate. For patients with small gap in velopharygeal sphincter, behavior therapy has been suggested to treat their velopharyngeal dysfunction. CPAP therapy, as a behavior therapy, can be used to increase palate muscles strength and to make VP closure complete using a continuous positive airway pressure during speech tasks. The aim of the present study was to determine the effect of CPAP therapy on hypernasality and nasal turbulence in repaired cleft palate patient with small velopharyngeal gap. Materials and Method: A single-subject study was conducted with multiple baselines to study the effect of CPAP therapy on the speech of an eight-year-old boy with repaired cleft palate, small gap in velopharyngeal valve, hypernasality, and nasal turbulence. The participant received CPAP therapy for 48 sessions during two months. Perceptual assessment was done at baseline, during intervention, and in follow-up phases. Visual analysis and Improvement Rate Difference (IRD) were used to analyze data. Result: The patient showed one-point decrease in the severity of hypernasality on intervention phase and another point decrease occurred on the follow-up phase. This reduction maintained by the end of the study. Also, nasal turbulence was shown to decrease by two points during the intervention phase and therefore normal level was achieved. The achievements were remained unchanged on follow-up phase. The IRD for both parameters were found to be 0/75. Conclusion: The present study showed that CPAP therapy seems to reduce the severity of hypernasality and nasal turbulence due to strengthen palatal muscles in patients with small velopharyngeal gap.

Background and Aims: Proprioception affects muscle reflexes, joint dynamic stability control, and motion planning for neuromuscular control. The aim of the present study was to determine the effect of knee cooling after local fatigue on proprioception in athletic women. Materials and Methods: The current study was done using semi-experimental method with pretestposttest. Participants included 40 healthy athletic women divided into four groups (control, cooling, fatigue, cooling after fatigue). Cooling with ice pack on knee was used for both groups of cooling and cooling after fatigue. Also, fatigue and cooling after fatigue groups performed neuromuscular local fatigue protocol including a variety of plyometric exercises. Knee proprioception before and after cooling (immediately after fatigue in fatigue group) and 20 minutes after cooling was evaluated by measuring angle error 30, 45, and 60 degree knee joint using isokinetic dynamometer. Data obtained was analyzed using SPSS software and running repeated measure ANOVA, independent T-test, and bonferroni correction. The significance value was set at α ≤ 0. 05. Results: The results showed that despite significant decrease in skin temperature after cooling, there was no significant difference in the groups in different time period neither was any significant difference between the groups studied. Conclusion: It seems that cooling protocol used in the present study only affects the skin receptors. Muscle and joint receptors that play a role in joint position sense are not affected. Therefore, it can be concluded that this method of cooling, even in case of fatigue, will have no danger for athletes to continue their activities.

Background and Aims: Children suffering from Developmental Coordination Disorders (DCD) have weak situation control and are more subject to falling and damaging as compared with their health peers. Doing exercise may improve balance capability in this population. The aim of the current study was to examine the impacts of taekwondo on children suffering from DCD. Materials and method: In the present semi experimental study, 20 boy children in the age range of 7-11, who were referred to two private and public psychological centers, were randomly chosen and divided into two groups (experimental and control). A pretest was administered using improved test of Stroke Stand for measuring standing balance and tandem walk test for measuring dynamic balance. Experimental group participated in a selected program of taekwondo for ten weeks (three sessions in a week, 45 minute each session). At the end, items related to balance test were given to the two groups again. Kolmogorov Smirnov statistical test and related T test were run to analyze the data. Results: The results of the pretest revealed that there is no meaningful difference between average score of experimental and control children, but in posttest, the means of the static and dynamic balance in the experimental group were more than those of the control group (P< 0/01). Conclusion: The present study showed that doing taekwondo can improve the balance in children with DCD.

Background and Aim: Caregiving a child with cerebral palsy effect on general health status of parents. The purpose of this study was to evaluate the effect of having a healthy child on the general health status of parents of children with cerebral palsy. Materials and Methods: Twenty eight parents with healthy/cerebral palsy children (age range 36. 67± 7. 09) and 30 parents with cerebral palsy children (age range: 33. 11± 6. 7) filled general health questionnaire (GHQ-28) including 28-items regarding somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression. Results: General health score of parents with healthy/cerebral palsy children was significantly higher than parents with cerebral palsy children (P≤ 0. 05). There was no significant difference between mothers in the case of somatic symptoms and also fathers in the case of anxiety/insomnia (Between two groups) (P>0. 05). Conclusion: Having a healthy child can also be advised to parents of children with cerebral palsy as a factor in promoting physical, mental and social performance. Medical and genetic counseling and examinations and obtaining approval from a specialist before the birth of another child are emphasized to parents.

Background and Aims: In patients with Chronic Ankle Instability (CAI), biomechanical alterations and sensorimotor dysfunctions have been reported. However, little is known about the relationships between functional movement patterns and sensorimotor function in people with CAI. The purpose of the present study was to examine the relationships between movement dysfunctions associated with functional movement patterns and sensorimotor function in collegiate athletes with CAI. Materials and Methods: A total of 40 male collegiate athletes with CAI volunteered to participate in the study. Three functional movements including double limb squat, double limb squat with heel lift, and single limb squat were conducted for assessing movement dysfunctions and scored using Fusionetics algorithms. Sensorimotor function was assessed using static and dynamic postural control, ankle dorsiflexion ROM, ankle joint proprioception, and ankle muscle strength. Pearson product correlations and multiple linear regression were used to examine the relationships between functional movement assessments and sensorimotor function. Results: The results showed that collegiate athletes with CAI had poor (20. 1± 14. 1%), moderate (52. 3± 17. 4%), and good (80. 1± 19. 4%) movement efficiency in single leg squat, double limb squat, and double limb squat with heel lift, respectively. Specific movement errors such as ‘ Heel of Foot Lifts’ (50 %) and ‘ Knee Valgus’ (70 %) were common among CAI participants during the double limb squat and single leg squat, respectively. There were significant correlations between functional movement errors and sensorimotor functions (p<0. 05). Similarly, the presence of specific movement dysfunctions were predicted by select sensorimotor outcomes (p<0. 05). Conclusion: Collegiate athletes with CAI had movement dysfunctions during functional movement patterns. There were correlations between functional movement errors and select sensorimotor outcomes. Some specific movement dysfunctions can be predicted by examining sensorimotor outcomes.

Background and Aims: Students with special needs might face a variety of educational and rehabilitation needs. The present study was conducted to develop a rehabilitation and educational needs assessment tool for mainstreamed primary school students with hearing loss. Materials and Methods: The first draft of the tool was designed according to a review of four tools designed for assessment of rehabilitation and educational needs for hearing impaired and deaf students in other countries. A total of 14 experts were invited and their viewpoints were obtained to assess the face and content validity of the instrument. To determine the clarity of the text, internal consistency and test-retest reliability, 51 mainstreamed primary school students with hearing loss in the cities of Eslamshahr, Robat Karim, Qarchak, and Varamin as well as their teachers were asked to complete related parts of the questionnaire. Lawasche Method was used to calculate Content Validity Index. Cronbach's alpha coefficient was used to examine internal consistency, and test-retest reliability was examined using calculating Intra-class Correlation Coefficient. Results: The tool was designed in two parts; ‘ student replying’ and ‘ teacher replying’ with 35 questions in six subscales. The face validity was confirmed by the experts’ opinion. Content Validity Ratios of all questions were more than 0. 71 and Content Validity Index was 0. 93. Cronbach's alpha in subscales of needs for rehabilitation of hearing, speech, psychology, educational needs, self-advocacy in cognitive problems, and self-advocacy in hearing aids were 0. 831, 0. 840, 0, 819, 0. 851, 0. 823, and 0. 785, respectively. In calculating test-retest reliability, Intra-class Correlation Coefficients scores in all sub-scales were more than 0. 940. Conclusion: Rehabilitation and educational needs assessment tool for mainstreamed primary school students with hearing loss is a valid and reliable tool and after determining cut of points, it can be used in determining the needs of mainstreamed primary school students with hearing loss.

Background and aim: Low Back Pain (LBP) is one of the most common skeletal disorders, with an incidence possibility of up to 80% during one's life. Before planning a rehabilitation program, an accurate evaluation seems to be necessary in people with LBP. With regard to the kinetic chain of human body, any problem or dysfunction in any part of the chain can cause abnormal function in other parts. Abnormal hip kinematics and impaired hip muscle performance have been associated with LBP. So, the purpose of the current study was to compare electric activity ratio of gluteal muscles to tensor fascia lata in males with and without non-specific chronic LBP. Materials and methods: A total of 15 healthy males and 15 males with non-specific chronic LBP participated in the present semi-experimental study. Electromyography signals were obtained from the gluteus medius, superior gluteus maximus, and TFL muscles at 1000 Hz frequency as participants performed some selected exercises and the gluteal-to-TFL muscle activation indices were calculated. Repeated measures analysis of variance and independent t-test were run for data analysis. Results: The results of the present study demonstrated that, compared with the low back pain group, in launch, squat, hip abduction, clam in side lying, lateral step down, hip extension with extend knee, hip extension with flexed knee, one-side bridge, two-side bridge, and cutting maneuver with elastic resistance, gluteal muscles were significantly more active in healthy group (P<0. 05). Conclusion: The result of the present study shows that the electromyography activity index differs between the gluteal muscles and the tensor fascia lata in people with non-specific chronic LBP and healthy people. In order to plan rehabilitation exercise, the clam in side lying, cutting maneuver with resistance elastic, unilateral, and bilateral bridge exercises can be suggested to people with LBP, with the exception of lunch and squat exercises.

Background and Aims: Given that children spend a significant portion of their time with their parents, they are a rich source of information about their children. Therefore, it is essential to use some instruments to get informed about parents' ideas and experiences for clinical and research purposes. Accordingly, the present study aimed to evaluate the psychometric properties of the Persian version of Parents' Views and Experiences with pediatric Cochlear Implant Questionnaire (PVECIQ). Materials and Methods: The present study is a test development and descriptive-analysis conducted with a non-interventional and cross-sectional design. Statistical population included all children who were undergoing cochlear implant in Azzahra Hospital. A total of 73 children (28 boys and 45 girls), who had at least one year of experience of using cochlear implant, were selected from this population using convenience sampling. The Parents' Views and Experiences with pediatric Cochlear Implant Questionnaire (PVECIQ) was used for data collection. After making sure about the content validity, the data were analyzed using the correlation of PVECIQ sub-sections, Cronbach's alpha coefficient, and test-retest reliability in SPSS22. Results: The Content Validity Indices in all items were higher than 0. 75. The minimum and maximum CVI were 0. 76 and 0. 1, respectively. The correlations among sub-sections were positive and significant in most cases. Cronbach's alpha coefficient for the sub-sections of the questionnaire ranged between 0. 74 and 0. 83 and the Cronbach's alpha coefficient for the total questionnaire was found to be 0. 77. The test-retest reliability of the sub-sections of PVECIQ also ranged between 0. 85 and 0. 97. Conclusion: According to the results of the present study, it seems that the Iranian version of Parents' Views and Experiences with pediatric Cochlear Implant Questionnaire (PVECIQ) has adequate reliability and validity.

Background and Aims: The most important problem in hearing impaired children is difficulty in communication, because hearing loss prevents them from hearing the others' speech or results in incomplete hearing of other' speech. The current study examined the impact of the intervention program based on creative drama on the language skills of 4-6 year-old children with hearing impairment and cochlear implant. Materials and Methods: An interventional experimental study with pre-test and posttest and control group was carried out. Participants consisted of 30 hearing impaired children with cochlear implant who were selected using convenience sampling and were divided into two experimental and control groups. The language skill of both groups before and after intervention was assessed via a story retelling test. Results: Comparing the average of seven subscales of retelling story test in the two experiment and control groups, using multivariate regression analysis, it was found that in all the seven subscales, there were significant differences between the experiment and control groups and in terms of syntactic complexity subscale, due to the differences in the pretest of the two groups, the observed difference in the posttest between the two groups cannot be explained by the treatment. These findings suggest that the creative drama was effective on the language skills of hearing impaired children. Conclusion: Rehabilitation of hearing impaired children, including speech therapy and auditory training, are always performed in formal meetings and often these children are not excited enough to use these trainings. That is why the education process is very time-consuming and energy-intensive. Based on the findings of the present study, a demonstration and training opportunities for indirect teaching of language structures has a noticeable impact on the children's language skills and these children demonstrated good progress in using correct forms of language structures after this intervention.

Background and Aims: The present study aimed at investigating the relationship between coping style strategies, big five personality traits, and social support perception and depression among women with breast cancer. Materials and Methods: In the present correlational study, 175 women with breast cancer were selected using convenient sampling. The participants completed the perception social support questionnaires (1998), Beck depression inventory (1998), coping with stressfully situation inventory (coping style) (2002), and Big five personality trait scale (1992). Results: Findings of the correlation indicated that neuroticism had a positive relationship with depression (P=0/01). There was also a significant negative relationship between openness to experience, agreeableness (P=0/01), and extraversion (P=0/05) depression. In addition, no statistically significant relationship was observed between consciousness and depression (P=0/05). Moreover, there was a negative and significant relationship between social support and problem-oriented coping style and depression (P=0/05). Furthermore, a significant and positive relationship was observed between problem-solving coping style and avoidance and depression. Conclusion: Based on the findings of the present study, women with more severe neuropathic breast cancer who are more likely to use emotion-focused problem solving styles experience mood symptoms more severely.

Background and Aims: Problems increase with age, which affects the older people at different levels. Old age is associated with reduced physiological capacity that can lead to increased disability, loss of balance and falling. The purpose of the present study was to evaluate the effect of the combination training (strength and stretching) on balance, the risk of falls, and quality of life for older men. Materials and Methods: In the current quasi-experimental study, participants were healthy elderly men in Rasht (age: 65/64± 6/95). The experiments were 28 men who met the criteria for research and were available for sampling. In the present study, we used the Sharpend-rumberg test (with eyes open and closed) as well as get up and go time test to measure the static and dynamic balance. These tests were conducted after the training sessions. Data analysis was done using independent t-test (at a significance level of 0/005> R). Results: The results showed that combined training for eight weeks in comparison with the control group has a significant effect on static balance with open eyes (P = 0/009), static balance with eyes closed (P = 0/001), dynamic balance (P = 0/025), and the risk of falls (p = 0/004). Conclusion: It seems that combined training (strength and stretching) can positively affect the balance and risk of falls in older people, but it does not have a significant impact on the quality of their life.

Background and Aims: Bina color vision test was devleoped by a local company in Iran. There was no information available about the quality and the accuracy of this test and no decision could be made about its clinical application. In order To determine its accuracy, this test was compared with Ishihara’ s Pseudo Isochromatic Plates and H16 Panel test. Materials and Methods: The participants were selected from the previous screenings in Tehran and Ghom provinces and were referred to an optometry practice. After performing a routine eye exam, the participants were tested under the same luminance condition using Bina panel test (developed in Iran), Ishihara’ s PIPs (developed in Japan), and H16 panel test (developed in UK), in random order. Similar to H16 test, the procedure for Bina test was based on the manual. Bina test was repeated 30 minutes after completion of the final test. Results: A total of 94 participants with no color vision defects, and 76 with color vision defect (detected by Ishihara’ s PIP), with no other pathology, participated in the study. With H16, 94 individuals showed no defects, 57 were diagnosed with color vision defect, and in 19 participants the type of defect could not be diagnosed. With Bina test, 94 individuals showed no defects, 61 were diagnosed with color vision defect, and in 15 individuals the type of defect could not be diagnosed. In diagnosing the type of defect, Bina test and H 16 showed 87. 9% agreement (Kappa= 0. 897). In diagnosing the type of defect, Bina test showed repeatability of 72% (Kappa=0. 72). Conclusion: The accuracy of diagnosis of color vision defect with Bina color vision panel test is adequate.

Background and Aims: Pattern of time use refers to a branch of social science and science studies in occupational therapy and occupational science that focuses on "What was it? " and "Why do we use time? " Children's growth is the result of a set of their experiences. Study of how to use the time helps us to understand these children’ s experiences. A balance among different areas of occupation is also very critical to support this growth and provides an opportunity to grow wider life skills for mental health, and physical well-being. It appears that children are at the risk of imbalance in their occupation within which they spend less time in activities associated with the movement. The aim of the present study was to investigate the activity patterns of children with Cerebral Palsy (CP) compared to those with typical development using a use-of-time approach. Materials and Methods: A cross-sectional design study was carried out on 28 children with CP and 28 typically developed children who were matched for age, sex, and socio-economic status. Participants were interviewed using a time use diary. Independent t-test and analysis of variance were run to analyze the values obtained in SPSS22. Results: Statistically significant differences were observed in sleeping and playing as well as education and play areas on weekdays, leisure activities on holidays, and everyday life activities on both weekends and holidays (P < 0. 05), but in other areas, there was no significant difference (P> 0. 05). Children with CP were observed to spend more time on the activities of daily living and leisure; they also found to spend less time on play and sleep (P>0/05), yet there were no significant differences in other areas between the two groups. Conclusion: By and large, the activity patterns of children with CP were observed to be similar to those of their Typically Developed peers. The results highlight the activities of daily living, in children with CP, which can an area for future interventions.

Background and Aims: In the auditory system, tinnitus and superior speech perception in noise are examples of negative and positive plasticity that can result from sensory neural hearing loss and life experiences dealing with more complex stimuli and learning, respectively. Positive plasticity occurs as a result of learned skills and sensory stimuli; plasticity involves specific neural pathways and can be observed in auditory ascending or descending pathways. Materials and Methods: In the present study, we document a form of plasticity in top-down auditory pathways through the measurement of Acceptable Noise Level (ANL) in 60 adults (27 females and 33 males) with normal hearing. Individuals were assigned to one of the two groups: the groups with and without occupational experience of speech perception in noise. Results: The results showed that the test group had statistically significant lower ANL scores and significantly higher background noise level scores compared with the control group. Conclusion: Using ANL test, we attributed differences in individuals’ abilities to tolerate varying amounts of background noise and speech perception in noise function to the auditory efferent system. We therefore concluded that working in crowded locations due to job nature can influence differences in speech perception in noise function.

Background and Aims: . Adolescence has been considered as an era with rapid changes in so many aspects of life, like corporal, cognitive, and social aspects. The hearing impaired teenagers face a lot of complications in the struggle to gain identity, independence, and developmental self-actualization. Deaf people mostly face a biased interaction with their society and, as a result, instead of being considered teenagers with special needs, they are considered as deaf disabled people. The present paper is an attempt to address different parameters which affect the life of deaf adolescents including identity, independence, and loneliness. Materials and Method: We investigated most of the studies which were conducted on challenges of deaf teenagers during their adolescence. Both English and Farsi papers were collected and investigated since 1981 using search engines SID, SAGE, WILEY, SCOPUS, SCIENCE DIRECT, EMERALD, and ERIC PUBMED. In so doing, the following keywords were used: hearing, deafness, hearing disorders, hearing loss, adolescence, adulthood, puberty, identity, independence, and loneliness. Results: Different parameters can affect the identity, independence, and the loneliness of the deaf teenagers which should be investigated to first prevent and then minimize their problems and psychosocial issues to facilitate their growth. Conclusion: By conducting more goal oriented studies and collecting more data, we can gain more information, so better programs can be set for the future of the deaf teenagers. Parents’ decision on using cochlear implant or hearing aids, choosing an appropriate school, access to effective communication inside and outside the home, having a supporting group with which the deaf teenager can coordinate themselves, and etc. can all be powerful means by which a deaf teenager can develop a meaningful identity and reduce possible negative effects of deafness.

Background and Aims: Many kinds of daily living activities and sports require a combination of eccentric and concentric contractions. Mechanical stress caused by the contraction, especially eccentric contraction, can increase congestion and muscle fiber damage. Thus, reducing muscle soreness may decrease the risk of damage to the tissues and help the individual start activities soon. A variety of methods may be used in order to prevent the damage. One of these methods is using the Whole Body Vibration (WBV). The purpose of the present study was evaluateing the effect of WBV on muscle damage indicators. Materials and methods: Articles published between 2000-2016 in GoogleScholar, PubMed, Elsevier, IRANDOC, SID, and Research gate databases were searched using “ Whole Body Vibration” , “ Muscle Injury” , and “ Delay Onset Muscle Soreness” keywords. A total of 19 articles relevant to the topic were selected and studied according to inclusion criteria. The study was conducted using the evidence-based Duffy method. Results: According to the literature review, delayed muscle soreness causes pain and decreased muscle strength and range of motion. There are many interventions that reduce delayed muscle soreness. Also, the review of the literature showed that time, frequency, athletic or non-athlete, type of activity performed (type of contractions and their duration), frequency of exercise, rest time between therapy, and WBV individually or concurrently with other treatments are the effective factors demonstrating the effectiveness of WBV on muscle injury indices in healthy persons. Conclusion: The results of the study demonstrated that WBV increases the blood flow and range of motion, improves strength, reduces pain, and can be an effective method to decrease delayed muscle soreness considering the effective factors. This is while, more research in this area can lead to better understanding of the effects of WBV on parameters of muscle damage following the delayed-onset muscle soreness.

Background and Aims: Using the real ear measurement, in addition to accurately fitting of the hearing aids, can reduce the frequent referral of patients to hearing-related clinics. Therefore, audiologists can save time and energy. Currently, real ear assessments are conducted at two general forms in clinics: 1. Real ear based verification, and 2. Coupler based verification. In the present review article, the focus is on coupler based verifications. Because the test of the RECD is one of the main components of the coupler based verifications, we made an attempt to outline the role of this test, based on the new standard of ANSI S3. 46-2013, at fitting of hearing aids. Then, using the suggested coupling method, we tried to solve the challenge of mismatch between different RECDs. Materials and Methods: We searched the subject of hearing aids verification based on coupler in databases of GoogleScholar, Proquest, Pubmed, and Sciencedirect among the publication between 1980-2017. In this search, we used the following keywords: Hearing Aid Verification, Real Ear to Coupler Difference, RITE hearing aids, and coupling of hearing aids. A total of 45 papers were found and 35 were selected. The present paper is based on these original articles and three related text books. Conclusion: Using foam instead of silicone domes in receiver of RITE hearing aids, in addition to maintaining the benefits of RITE hearing aids, can result in more gain at low and middle frequencies for patients. Also, in accordance with ANSI S3. 46 2013 standard, we can use the same coupling method for both coupler based and real ear based verifications.

Background and Aims: In linguistic studies, the word definition task is used for surveying organization of concepts in the mental lexicon. The aim of the present study was to review the literature related to the developmental processing of concepts and organization of them using word definition task. Materials and methods: Published articles on the subject of the development of word’ s definition in children were surveyed using the folowing keywords: word definition, definitional skills, and children within the timeframe of 1965-2014. Databases of ScienceDirect, Springer, GoogleScholar, Elsevier, PubMed, ASHA, and related Iranian studies were used. Conclusion: In the word definition task, the children were asked to define words. The answers expressed in this task are scored based on content and form. Age, literacy, and meta linguistic awareness are effective factors at presenting the best kind of definition. As the age increases, noun definitions are developed from functional and concrete responses into more abstract and conceptual responses, and also using superordinate terms increases. Increased use of super ordinate terms in definitions indicates that by increasing the age, concepts are organized into hierarchies of connections and superordinates have connection with subordinates.

Background and Aims: Early years of life are of great importance, because what happens during childhood affects mental and physical health during life. Therefore, the objective of the current study was to briefly present protective and risk factors affecting children’ s growth. Materials and Methods: In the present review study, some mentioned issues related to child protective and risk factors were searched and explored in Scopus, Springer, ScienceDirect databases as well as Google search engine for publications between 1980-2016 using risk factors, protective factors, normal growth, child, mental pathology, behavioral issues, and emotional issues keywords. Conclusion: In the period between infancy and childhood, the quality of children's relation with their parents and caretakers, and all the environments in which they live and learn, has significant effects on their cognitive, emotional, and social growth. Therefore, it is essential that governments, health organizations, and families provide a secure supportive environment and also stable relationships that children need.

Background and Aims: A prevalent but neglected symptom of vestibular disorder is experience of difficulties in cognitive skills, such as short term memory, concentration, calculation, and reading. This assumption that cognitive and emotional symptoms do not specifically result from vestibular injures may cause some physicians to ignore such symptoms among vestibular patients or even misdiagnose vestibular injury when such symptoms are primary indicators of disease. Vestibular information has an important role in maintaining accurate spatial awareness. In brain, head direction and self-motion information combine to define Self-location. The aim of the present review article was evaluating vestibular system role in spatial representation as one of the cognitive functions and illuminating cognitive effects of vestibular disorder and moreover scientific attending to cognitivevestibular interaction. Material and Methods: we studied the previous literature on the relationship between vestibular system and spatial representation and effects of vestibular injury on ability to performing specific cognitive functions by dual tasks. Articles in this area published in GoogleScholar, Ovid, PubMed and Sciencedirect databases were searched using vestibular system, spatial representation, hippocampus, cognitive dysfunction, and dual tasks keywords in publication reported between 1990-2017. Conclusion: Cognitive deficiencies such as poor concentration and reduced short term memory were frequently seen in vestibular disorders. Indeed, vestibular signals are involved in personal and extra personal perception, sensations related to the whole body position and motion in space, and the displacement of the environment relative to the person.