SCIENTIFIC JOURNAL OF REHABILITATION MEDICINE
Year:2018 | Volume:6 | Issue:4 |Papers Count:32

Background and Aim: Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder. Executive functions defect is considered as a general feature of the disorder. The aim of the present study was to examine the effectiveness of motor based cognitive rehabilitation on the improvement of sustained attention and cognitive flexibility in children with ADHD. Materials and Methods: The present study followed a quasi-experimental randomized clinical trial design (pretest-posttest with control group). A total of 30 children aged 7 to 12 referring to the clinics in Tehran were diagnosed by a psychiatrist with ADHD. Participants were selected using convenience sampling and then randomly divided into control and experimental groups. Sustained attention and cognitive flexibility were evaluated using recording attention tests and tracking A and B. Data were analyzed running independent t-test and mixed ANOVA in SPSS, version 20. Results: The results of the study showed that sustained attention (P<0/01) and cognitive flexibility (P<0/01) of the experimental group improved after the intervention, meaning that in the pretest, little difference was observed between the control and experimental groups in sustained attention and cognitive flexibility, but in post-test, scores of experimental group were significantly higher than those of the control group. Conclusions: The results of the statistical analysis showed that with regard to the control group, gesture-based cognitive rehabilitation therapy improved sustained attention and cognitive flexibility in children with ADHD.

Background and Aim: Vital benefits of breast-feeding for mother and child's growth and immunity against diseases are indubitable; however, the effects of mother's physical activity on breast milk during breast-feeding is not clearly known. Thus, the present study was carried out to investigate the effects of long-term submaximal aerobic exercises on homemaker mothers' breast milk factors. Materials and Methods: A total of 30 non-athlete healthy and convenient mothers voluntarily participated in the study. Participants were randomly divided into two control and experimental groups. The first milk samples from both groups were taken 24 hours before the exercise and the second samples were obtained from the experimental group right after the excersise finished. Samples were also taken 24 hours after the 12-week exercise program from the experimental group. A third sampling was also conducted for both groups. In order to study the effects of exercising on milk factors, t-test and two-factor variance test were run. Results: One hour of aerobic exercises with 60 to 70% HRMAX were observed to have significant effects on breast milk factors of mothers for an hour: fat percentage and protein increased, lactose and water content decreased, and conductivity remained unchanged. Moreover, the study failed to find any significant difference between the effects of 12-week aerobic exercises on milk factors in control and experimental groups. Conclusion: Findings revealed that long-term and average-intensity aerobic exercises, aiming to improve breast-feeding function, do not have a significant effect on homemaker mothers' breast milk factors.

Background and Aim: Auditory temporal processing may be defined as the perception of the temporal envelope or the alteration of durational characteristics of a sound within a restricted or defined time interval and it likely underlies, at least in part, most other processes, such as localization, discrimination, pattern processing, binaural integration, and binaural separation. Temporal resolution is a component of the recommended minimal central auditory processing test battery. The Gap in Noise (GIN) test is a valuable tool in identifying temporal resolution deficits. Using appropriate speech stimuli, the auditory brainstem responses appear to reflect processing of the temporal features of speech in addition to documenting brainstem activation in response to stimulus onset. As the GIN test and complex ABR (cABR) evaluate temporal resolution of auditory stimuli in different aspects, the purpose of the present study was to investigate the correlation between the two tests and the possibility of using cABR as an electrophysiological test for temporal processing in central auditory processing disorder test battery. Materials and Methods: A total of 20 CAPD children, within the age range of 8– 12 years, diagnosed with four auditory processing tests, participated in the study. GIN test was administered for all of the participants and nine children underwent ABR and cABR tests. Then, the results of the tests were compared between the two groups. Results: Based on the results of GIN test, these children had temporal processing impairment; the results were also confirmed using cABR. There was also a correlation between the gap detection threshold in GIN test and the slope of V-A in cABR. Conclusion: Both GIN and cABR can evaluate temporal processing, but since there is no need for active participation of the individuals in cABR, this test can be used in younger children and those who cannot take behavioral tests.

Background and Aim: Developmental Coordination Disorder (DCD) is a serious defect in the development of motor coordination. This disorder affects educational achievement and activities of daily living to a considerable amount. The purpose of the present investigation was to study the correlation between motor proficiency with executive function and educational performance of 7-11 year-old children with DCD in Ilam province, Iran. Materials and methods: A descriptive-analytic study was conducted on 53 DCD children, who met the inclusion criteria conditions, randomly selected from the pool of all children in Ilam primary schools. Next, the childrens' motor proficiency, executive function, and educational performance were evaluated using Bruininks Oseretsky test, Behavior Rating Inventory of Executive Function (BRIEF), and a researcher-made test, respectively. Results were analyzed using SPSS software (version 16) and pearson correlation coefficient. Results: Significant correlations were found between the total scores of Bruininks Oseretsky test with the total scores of BRIEF (p <0/01). The correlation between total scores of Bruininks Ossietzky test with spelling test (p <0/01) and math test (p <0/05) was also significant. Conclusion: The present study showed that there is a significant correlation between the motor proficiency with executive function and academic performance of children with DCD, which could be used by clinicians for early intervention to improve executive function and educational performance of children with DCD.

Bachground and Aim: The sense of hearing is an important sense that helps the development of speech and language and cognitive skills. One of the oral manifestations is reading which is based on the spoken language. Reading is an important skill to learn lessons for children and the auditory defects or any sensory impairment can limit learning and experience in a way that auditory defects in hard-of-hearing children affects their thought, imagination, and perception. There is a direct correlation between reading ability and level of hearing loss and the greater the hearing loss, the weaker the reading ability and comprehension. The present study aimed to assess the efficacy of music therapy on increasing the ability to read in primary school children who had cochlear implants. Materials and Methods: An experimental study with pretest-posttest and control group was conducted. The sample consisted of children aged 8 to 10 years old with the hearing disorder who had cochlear implant surgery selected using convenience sampling method. Data was collected using a reading disorder test designed by Dr. Mostafa Tabrizi, which can be administered within three minutes and in which the words read and the number of mistakes are checked in a list and disorder is diagnosed. Results: According to the findings, it can be stated that music therapy improves reading skills in school children with cochlear implant. Conclusion: As a rule, the reading process is a very important tool for students to learn and is used as a means to extend the capabilities of the student during the learning process. Variance analysis of repeated measures showed that music therapy can significantly influence reading skills in primary school children with the cochlear implants.

Background and aim: Sensory processing in humans involves reception of a physical stimulus, transduction of the stimulus into a neural impulse, and perception, or, the conscious experience of sensation. These sensory disorders can negatively affect development and functional abilities in behavioral, emotional, motoric, and cognitive domains. The present study was designed to investigate the prevalence of parent's perceptions of sensory processing disorders among 5 to 11 year-old children in Tehran, Iran. Materials and methods: The current study was a descriptive and cross sectional study performed on 5 to 11 year-old children. Data collection instruments were a demographic and a sensory profile questionnaire. Data were analyzed using Kolmogorov-Smirnov, Mann Whitney Welch, and ANOVA tests. Results: In the present study, 2191 cases were evaluated in terms of sensory processing factors. According to the findings, morbidity from sensory processing disorder in boys is higher than that in girls. Also, the most common disorder was observed in sensory sensitivity factor and the lowest was related to fine movement and perception. The results of Mann Whitney showed that the medians of sensory sensitivity, emotional reaction, and oral sensory sensitive, inattention and destructibility, sensory sensitivity, and fine movements/perception were significantly different between males and females (P < 0. 001). In addition, findings of the present research showed that there exists significant relationships between age and all nine factors except for emotional response (P <0. 001). Conclusion: Due to the impact of the disorder on the children's quality of life and their adverse effects on the children's personal and social life, screening school-aged children and making attempts to treat it is necessary.

Background and Aim: The present study aimed to investigate the effect of mothers' training behavior modification methods, on reducing oppositional behavior and enhancing behavioral performance of their 8-10 year old children with hearing impairment. Materials and Methods: The research design employed was quasi-experimental with pre-test and post-test and control groups. To do so, 30 mothers of children with hearing impairment were selected using available sampling. The participants were divided into two experimental and control groups after being matched. The research tools included CSI-4 and behavioral performance questionnaires. The training behavior modification methods were performed in nine 90-minute sessions in the experimental group. Data were analyzed using analysis of covariance in SPSS, version16. Result: The results of covariance analysis showed effectiveness of behavior modification training on reducing oppositional behavior scores in children of mothers in the experimental group compared with those of the control group (F= 28/79, P=0/001). The results also showed enhancement of behavioral performance in experimental group (F= 5/85, P=0/05). Conclusion: Generally, the findings demonstrated that training behavior modification methods improve behavioral problems in deaf children and prevention of behavioral problems in family environment; thus, using parents training, symptoms of behavioral problems in these children can be managed.

Background and Aim: Alexander Technique and Massage Therapy are considered as two efficient interventions for rehabilitation. The purpose of the present study was to compare the effectiveness of Alexander Technique and Massage Therapy on improvement of happiness, hope, and mental health in patients with Parkinson's disease. Materials and Methods: The statistical population of the study consisted all of patients with Parkinson's disease who were clients of therapeutic centers in Isfahan City in 2015. Among this population, 28 patients were selected through convenience sampling as the sample of the study. Oxford Happiness Questionnaire (OHQ), Adult Hope Scale (AHS), and General Health Questionnaire (GHQ-28) were used as the instruments of the study. Data was analyzed using Mixed ANOVA. Results: The results showed that both interventions of the present study significantly improved happiness and hope in patients with Parkinson's disease, and there are no differences between effectiveness of the two interventions. Conclusion: Alexander Technique and Massage Therapy can be considered as efficient interventions for improvement of happiness and hope in patients with Parkinson's disease.

Background and Aim: Breast cancer is the most common cancer type among women and one of its complications is ipsilateral upper extremity lymphedema. Lymphedma is a chronic condition of lymphatic system that leads to swelling of the involved extremity and, if left untreated, leads to limitation in shoulder range of motion, dysfunction, and feeling of heaviness in the upper limb. The aim of the present study was to compare the effect of complex decongestive physical therapy with combination of intermittent pneumatic compression pump and complex decongestive physical therapy on shoulder range of motion, heaviness and upper extremity circumfference in patients with secondary upper extremity lymphedema post. Materials and Methods: A total of 20 female participants with scondary upper extremity lymphedema were selected after breast cancer treatments, reffered by general and cancer surgeons, according to inclusion and exclusion criteria. After the initial assessment, participants were randomly divided into two groups. Participants in the first group were only treated with complex decongestive physical therapy techniques and patients in the second group, in addition to complex decongestive physical therapy techniques, were trated with intremittent compression pump. These techniques include manual lymphatic drainage, bandaging, therapeutic exercise, and skin care and intremittent compression pump. Patients were treated for 2 weeks, 5 days per week. Involved extremity circumference, intensity of limb heaviness, and shouldre range of motion were measured prior to and after the treatment. Also, limb heaviness was evaluated using Visual Analog Scale. Results: No significant difference was found in the demographic characteristics between the two groups. Following two weeks of treatment, the mean of affected limb circumference in total areas showed statistically significant decrease after treatment compared to that priro to the treatment and heaviness intensity showed statistically significant decrease after treatment compared to that before the treatment. The means of shoulder abduction and flexion showed statistically significant increase after treatment compared to those before treatment in both groups. In addition, there was no significant difference in the means of affected limb circumference and shoulder range of motion between the two groups. However, a statistically significant difference was found in the mean of heaviness intensity between the two groups. Conclusion: The results of the current study showed, the combination of complex decongestive physical therpy and intremittent compression pump are useful as a means of improving affected limb circumference, intensity of heaviness, and shoulder range of motion.

Background and Aim: Forward Head Posture (FHP) is one of the most common postural abnormalities in the cervicothoracic region that can lead to muscle imbalance and probably future pain. However, there is no study available assessing muscle strength in these patients compared with healthy individuals. Materials and Methods: A total of 18 FHP and 16 healthy individuals were recruited after signing the informed consent. The strengths of cervical flexor and extensor muscles were assessed using handheld dynamometer in supine and prone lying positions, respectively. Three 5-second trials of maximum voluntary isometric contraction of cervical flexion and extension were performed with 1-minute rest interval between them and the mean value of the trials was considered for further analysis. Results: FHP group demonstrated significantly lower cervical muscle strength in both flexion (P=0. 001) and extension (P=0. 000) directions as compared with those of healthy participants. There was no significant difference between flexor and extensor muscles in either FHP or healthy participants (P<0. 05). Conclusion: FHP individuals exhibited flexor and extensor muscles weakness in comparison with participants. Findings of the present study intensify the necessity of muscle strengthening program for FHP individuals as well as all asymptomatic computer users or people that have prolonged driving or sitting habit in their routine lifestyle.

Background and Aim: In children's speech disorders, assessing the percentage index of speech intelligibility is important. Expression of single words and sentences in some ways, such as the effect of voices on eachother, is different, that may affect speech intelligibility. In the present study, attempts were made to answer the question whether the percentages of speech intelligibility are different in these two tests. Materials and Methods: In the present cross-sectional study, 120 healthy children (60 girls and 60 boys) were chosen among all kindergartens in Ghaemshahr city, Iran. Children's speech samples were collected by means of calling pictures and repeating sentences. The voices were tape-recorded and children's speech intelligibility was studied in four age groups within six months. Comparison of the intelligibility of the two speech samples was carried out using Wilcoxon Tests and the correlation between children’ s scores in the expression of words and sentences was determined using Spearman correlation. Results: The mean score of the speech intelligibility was 94% (SD=10. 66) in the words test and 96/02% (SD=9. 65) in the sentence test. A significant difference was observed between age groups in both tests (α =0/05). Also, there was a significant correlation between the intelligibility of words and sentences (p=0. 000). However, no statistically significant difference was found between boys and girls. Conclusion: The significant difference found in the speech intelligibility percentages of words and sentence test shows that language and communication factors affecting the listener's understanding of others' speech are different. So, in measuring the speech intelligibility using these two tests, we should not expect similar results. Increase in the speech intelligibility percentage in sentence test may be due to the abundance of semantic clues, which can increase the listener's guessing capability.

Background and Aim: Hemiplegia after stroke is the most common cause of dexterity disorder in adults, which is associated with impairment in daily life activities. The aim of the present study was comparative assessment of the effects of movement therapy and electrotherapy on dexterity. Materials and Methods: In the present clinical trial with before-after design, 16 patients with post-stroke hemiplegia received 36 sessions of treatment. Hand gross dexterity was measured using Minnesota instrument prior to, and 18th and 36th sessions after the intervention. Shapiro Wilk test, paired t-test, and Pierson correlation were used to analyze the data. Results: The significant increase of hand gross dexterity was noticed between before and 18th, 18th and 36th, and also before and 36th sessions after intervention in movement therapy group (p<0. 0001), but in electrotherapy group only the means between before and 18th (p<0. 002) and 18th and 36th sessions (p<0. 001) were significant. Conclusion: The present study showed that movement therapy is effective in increasing hand dexterity all the time. But the continuation of electrotherapy has reverse effects on it.

Background and Aim: Behavioral problems are common in educable intellectual disability students. The purpose of the present study was comparison of the effects of direct instruction and cognitive method on social skills in individuals with mild intellectual disability. Materials and Method: A semi-experimental study was conducted with pretest-posttest and control group. A total of 30 students with mild intellectual disability were selected based on available sampling and were randomly divided into three groups (two experimental groups and one control group). First, behavioral problems and social skills scores were collected using Gresham and Elliott social skills questionnaires (1990). Next, participants in the experimental group were individually trained for 20 sessions: one group received cognitive approach and the other group received direct instruction. After trainings, the Social Skills Questionnaire was administered again among teachers and parents. The data were then analyzed using analysis of covariance method in SPSS19. Results: The results showed that from teachers' perspective, social skills training through cognitive approach and direct instruction did not significantly decrease behavioral problems, but from parents' perspective, cognitive approach significantly decrease behavioral problems and direct instruction did not. Conclusion: According to the findings, it can be stated that training programs that focus on understanding total situation and social cue encoding have more impacts on behavioral problems in educable intellectual disability students.

Background and Aim: Ocular biometry parameters are important factors which have valuable roles in diagnostic and therapeutic procedures in ophthalmology. The aim of the present study was to determine the relationships between height, weight, and Body Mass Index (BMI) and Ocular biometric parameters. Materials and Methods: A total of 123 participants underwent ocular examination in Noordidegan eye clinic. Inclusion criteria were spherical refractive error ranging between plano to ± 2. 00 diopter, astigmatism between plano to-2. 00 diopter, and best corrected visual acuity of 20/20. Also, exclusion criteria were diabetes, blood hypertension, thyroid problems, keratoconus, corneal scars, pterygium, cataracts, glaucoma, and any ocular surgery history. Ocular biometric parameters were analyzed using Lenstar, and height and weight were measured according to the standard protocol. Results: Ocular biometric data were collected from participants with an average age of 36. 10± 8. 41 including 61 women (49. 6%) and 62 men (50. 4%). The average value of height, weight, and BMI were 170. 40± 9. 81 cm, 79. 84± 18. 91 kg, and 27. 54± 6. 18 kg/m2, respectively. Also, the averages of eye axial length, central corneal thickness, anterior chamber depth, crystalline lens thickness, and corneal power were 23. 59± 0. 82 mm, 538. 60± 36. 84 μ m, 3. 57± 0. 32 mm, 3. 79± 0. 35 mm, and 43. 67± 1. 42 D, respectively. It was observed that height correlated positively with axial length and anterior chamber depth (p<0. 001, p=0. 003 respectively). However, it was negatively associated with corneal power (p<0. 001). Also, BMI positively correlated with crystalline lens thickness (p<0. 05). In addition, weight positively related with axial length (p=0. 005) and anterior chamber depth (p<0. 05) Conclusion: Our results indicated that eye axial length and anterior chamber depth increase with increase in height and weight and corneal power decrease with increase in height. Also, a direct association was observed between BMI and crystalline lens thickness.

Background and Aim: One of the effects attributed to Kinesio tape is increasing muscle strength. Several studies have been conducted in this area providing conflicting results. Perhaps one of the reasons for the variety of results is the difference in using Kinesio tape. Due to the fact that the effects of Kinesio tape depend on factors such as level of tension and the amount of its coverage, we aimed to investigate the effect of these factors on the immediate increase of muscle strength. Materials and Methods: Participants of the study included 30 healthy non-athlete female randomly examined with nine different modes of Kinesio tape. The Kinesio tape was applied by three levels of tension (0, 30, and 60 percent) and also three different levels of contact on the Quadriceps muscle of the subdominant leg, and the extents of torque were measured prior to and after applying the type. The mean of the maximum extension of three extensor contractions was calculated before and after applying the Kinesio tape. Result: Applying Kinesio tape increased the knee extensor torque (P<0. 05). The net effect of the two factors of tension and coverage of Kinesio tape on the increase of muscle strength was not found to be statistically significant, but the interaction of tension and breadth of coverage does create a significant effect (P<0. 05). Conclusion: Although the Kinesio tape causes a slight increase in the Quadriceps muscle’ s strength, changing the tension and extension of Kinesio tape stretch did not have an immediate impact on the increase of knee extensor torque.

Background and Aim: Caring for children with Cerebral Palsy (CP) is hard, energyconsuming, and long-term, and can lead to caregivers’ burnout. The present study aimed to identify reasons for and consequences of occupational burnout among caregivers working in institutes for children with CP in an Iranian context. Materials and Methods: The present study was carried out using qualitative approach and content analysis methodology. Nine caregivers, two managers, and one physiotherapist participated in the study. Purposive sampling method was used to select participants and in depth, semi-structure interviews were used to collect the data. All interviews were conducted in institutes. The interviews were recorded, transcribed verbatim, and overviewed. Constant comparative analyses were used to analyze the interviews. Results: A total of 623 initial codes were extracted from the interviews. Then, the codes were categorized into three main categories and nine sub-categories. The main categories were as follows: care-related stress, nature of caring occupation, and managerial and organizational challenges and shortcomings. Conclusion: Identifying the barriers and challenges can lead to betterment of managers’ knowledge and, consequently, adoption of more proper organizational policies to increase the quality of caring services in the institutes.

Background and Aim: During the recent years, a great progress has been made in identifying hearing loss in adolescents and prompt intervention. The effectiveness of rehabilitation approaches can be verified in various aspects including reducing the disability, acceptance, usefulness and satisfaction. The aim of the present study was to investigate the beneficial relationship between hearing aids and the quality of life in impaired adolescents. Materials and Methods: In the present descriptive-analytical study, adolescents aged 12 to 18 with severe sensor-neural hearing loss, who had used smart digital hearing aid a minimum of one year, were targeted. Accordingly, a total of 61 patients were selected for the investigation. To collect data, two questionnaires were used: The Abbreviated Profile of Hearing Aid Benefit (APHAB) has 24 items and includes four subsets of optimal conditions, reverberation, and background noise and sound persecutors, and Quality of Life Questionnaire of hearing loss for adolescents with 38 questions divided into three parts: physical, emotional, and socio-emotional. Data were analyzed in EXCEL and SPSS 16 software. One-sample t-test, paired t, Spearman correlation coefficient, independent t-tests, one-way analysis of variance, and Kruskal-Wallis tests were used along with the corresponding post hoc test. Results: In the average score of all four sub-categories and the average rating of total scores before and after using hearing aids, there was a significant difference (P=0/0005). In terms of the quality of life, the emotional-excitement, physical, and social classifications had the highest average, respectively. No significant relationship was then observed between the effectiveness of hearing aids and quality of life in hearing-impaired adolescents in Tehran (P=0/5). Conclusion: The results indicated that what means as quality of life for adolescents is not only influenced by the effectiveness of hearing aid. Also, the results showed that hearing aids is effective in reducing disability caused by hearing impairment.

Background and Aim: Duration of stretching in the muscles around the joint can have different effects on the accuracy of sense of position. However, since the accuracy of the joint's position sense is one of the important factors in subtle movements and prevention of injury, the present study was conducted to compare the immediate effects of static stretching of quadriceps with different times (10, 20, and 30 seconds) on the knee joint position sense in Collegiate female athletes. Materials and Methods: A total of 33 Female student-athletes (average age: 22. 15± 2. 48 years, average weight 60. 72± 8. 36 kg, and average height of 165. 15± 6. 40 cm) were purposefully selected. Absolute error was evaluated in the reconstruction of the knee joint flexion angle at 45° and 60° in three days with three different times during static quadriceps stretching using photogrammetric method. Results: The results of the analysis of variance with repeated measures showed no statistically significant difference between the absolute errors of reconstruction of the knee joint flexion angles (P>0/05). Conclusion: Considering the results obtained in the present study, it seems that athletes and coaches can use these three static stretching times without worrying about differences in their negative effects on the accuracy of their knee joint position sense.

Background and Aim: Assessment of auditory processing in children is performed via special tests with confirmed sensitivity. For any adapted or developed test, there should be evidences to demonstrate acceptable test-retest reliability. Recently, two dichotic listening and two recognition of speech-in-noise tests of auditory processing have been developed in Persian language. The present study aimed to assess test-retest reliability of these tests in normal children. Materials and Methods: The present observational and analytic study was performed on 40 children, aged 6-12 years old, selected from two elementary schools in Tehran. Inclusion criteria were right-handedness, normal peripheral hearing sensitivity (< 20 dB HL in frequencies of 500-4000 Hz), and normal school performance. Farsi Auditory Recognition of Digits-in-Noise (FARDIN), Persian Auditory Recognition of Words-in-Noise (PARWIN), Persian Pediatric Competing Words (PPCW), and Persian Pediatric Competing Sentences (PPCS) tests were administered in two sessions with the same conditions 45 days apart. Both relative and absolute reliability indices were calculated. Results: The mean score of FARDIN and PARWIN did not show a significant difference between tests and retest sessions. Dichotic listening tests scores showed a significant improvement in retest session. Intra-class correlations for tests of recognition of speech-in-noise and dichotic listening tests were 0. 6-0. 65 and 0. 6-0. 9, respectively. FARDIN and PPCW showed higher absolute reliability compared with PARWIN and PPCS tests, respectively. Conclusion: Although children' performance for dichotic tests in retest session was slightly better, it seems that auditory processing tests used in the current study have adequate test-retest reliability in normal children.

Background and Aim: Retinitis Pigmentosa (RP) is a group of hereditary retinal degenerative diseases, causing blindness among individuals younger than 60 years, and patients have to continue with visual impairment for their entire lives, which can cause changes on their quality of life. The purpose of the present study was to determine the vision-related quality of life using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) in patients with RP, and to examine the relationship between quality of life and visual acuity. Materials and Methods: The present cross-sectional study included 35 patients with RP (18 male, 17 female) with the mean age of 37. 57± 11. 42 and 35 normal participants for control (18 male, 17 female) with the mean age of 36. 11± 9. 32. Best Corrected Visual Acuity (BCVA) sores were measured in distance and near. Participants answered the Persian version of the NEI VFQ-25. The difference between RP and normal group and the correlation between quality of life and visual acuity were determined. Results: The mean NEI VFQ-25 scores were 47. 59± 18. 72 in RP patients and 92. 29± 5. 48 in normal controls. This difference was highly significant (P<0. 001). Also, among RP patients, there was a significant correlation between the mean NEI VFQ-25 score and BCVA, according to Log MAR scale (r=-0. 704, P<0. 001). Conclusion: Retinitis pigmentosa and decreased visual acuity have a great impact on the quality of life.

Background and Aim: Canonical babbling is a crucial stage in speech and language development. Researchers have suggested that preterm infants show delay in canonical babbling plus speech and language development in future. Beckman Oral Stimulation is a sensory non-speech oral approach. Gender is one of the risk factors for delay and language impairment in preterm infants. In the present study we made an attept to investigate the effects of Beckman Oral Stimulation approach on the frequency of canonical babbling in preterm infants after six months. Material and Methods: A randomized clinical trial was performed on preterm infants with 28-34 weeks gestational ages in "Imam Reza" and "17th of Shahrivar" NICU hospitals in two groups. After visiting the inclusion-exclusion criteria, the recruited infants were randomly assigned to Beckman oral stimulation (n=13) and control (n=13 per group) groups. We compared and studied the infants' sensory stimulation and the effects of gender and canonical babbling between the two groups. Results: The findings revealed that the babbling frequency was more in girls (p: 0. 021) than in boys (p: 0. 029). Conclusion: It seems that Beckman sensory stimulation has more effects on canonical babbling in preterm girls than in preterm boys.

Background and Aim: Heart disease patients need rehabilitation programs after surgery. The aim of the present study was to survey the effect of aerobic continuous training versus aerobic interval training on some heart morphological factors in Coronary Artery Bypass Graft Surgery (CABG) patients. Materials and Methods: A total of 33 (30 men, 3 women with the mean age: 58. 33± 9. 50 and mean BMI: 27. 05± 3. 55 kg/m2) POST CABG patients were divided into three groups of selected aerobic continues training (ACT, n=12), aerobic interval training (AIT, n=12), and control group (C, n=9) and participated in this training program three times a week for eight weeks. Echocardiography was used to investigate morphological factors such as Left Ventricle Diastolic Diameter (LVDD), Left Ventricle Systolic Diameter (LVSD), and Ejection Fraction (EF). Paired T test and One-way ANOVA were used to compare the means. Results: The results showed that AIT and ACT have significant effects on LVSD (ACT: p=0. 013, AIT: p=0. 014). Also LVDD and EF had accretion as a result of AIT and ACT, but this increase was not found to be significant (LVDD: ACT: p=0. 331, AIT p=0. 138, EF: ACT= 0. 487, AIT: P=0. 186). Conclusion: ACT and AIT for eight weeks cause identical and minor optimal changes in left ventricle structure and functional (contractility) after CABG.

Background and Aim: Injury is an inseparable part of athletic trainings and competitions and athletes are always subject to the risk of injury. The present study was conducted to investigate the effect of six weeks of neuromuscular warm up program on the scores of injury incidence and functional movement screen in male basketball players disposed to injury in Iran Basketball Super League. Materials and Methods: A total of 50 basketball players prone to injury were identified in a Functional Movement Screen (Age 25. 33 years, high 197. 56 cm, Weight 97. 1 Kg, BMI 24. 59) and divided into two groups of control and experimental. Experimental group performed six weeks of neuromuscular exercises while control group only performed conventional team exercises. In the end, similar pre-season and pre-test Functional Movement Screen tests were administered and also injury reports of players prone to injury were examined. Data analysis was done using t test and repeated measures of ANOVA test. Results: The results of the present study showed that protocol of neuromuscular exercise, in comparison to control group, had a significant effect on decreasing injury in upper extremity, waist, central body (P=0. 500), and lower extremity (P=0. 001). Investigating scores of the three step tests of pre-season competitions, pre-test, and post-test after six weeks of neuromuscular exercises showed that these exercises increased scores of Functional Movement Screen more than conventional exercises did. Conclusion: Functional Movement Screen can be used to identify players prone to injury in preseason and even mid-season competitions. Also, use and implementation of neuromuscular exercises might help to decrease probability of injury incidence in identified individuals disposed to injury and increase Functional Movement Screen scores.

Background and Aim: Due to the variability of the Electromyography (EMG) signals in different individuals, the signals need to be normalized to a reference signal in order to enable comparisons between individuals. The aim of the present study was to determine the reliability of EMG of lower extremity muscles in five signal normalization methods. Materials and Methods: A total of 14 healthy individuals ascended and descended a set of stairs and a ramp. Each task was repeated six times. Surface EMGs of the Vastus Medialis (VM), Vastus Lateralis (VL), Rectus Femuris (RF), and Tibialis Anterior (TA) muscles were recorded during each exercise and the isometric Maximum Voluntary Contraction (MVC) of the muscles. Electromyography signals were normalized using five different methods. The reference signal for the normalization was corresponding signal of each muscle in MVC, Mean Dynamic Task (MT), Peak Dynamic Task Activity (PT), Mean of Raw Signal (MT-raw), and Peak of Raw Signal (PT-raw). Results: The MVC method showed the highest reliability and the lowest standard measurement error (SEM). The averages obtained for ICC and SEM for the MVC method in different activities were 0. 74 and 4. 8, respectively. Also, the MT method showed the lowest reliability and the highest error. The averages obtained for ICC and SEM in different exercises were found to be 0. 15 and 88. 43, respectively. Although PT, PT-raw, and MT-raw methods showed a similar and average reliability (0. 33< ICC<0. 39), the MT-raw method showed a low error (high absolute reliability). Conclusion: In conclusion, MVC demonstrated the highest reliability; therefore, it is suggested as the best normalization method for young healthy people during stair up and ramp walking.

Background and Aims: The present study was conducted to evaluate the intra-rater reliability of synchronization software so as to measure the Tibialis Anterior Muscle (TAM) structural parameters and force during contraction in healthy-nonathletes using ultrasonography and dynamometery in a synchronized way. This software was used in order to increase the ability of recording of pictures and data from ultrasonography and dynamometry synchronizingly. Materials and Methods: In the present cross-sectional study, the reliability of measuring the TAM structural parameters and force with the synchronization software was evaluated on 15 healthy nonathletes, aged 18-35 years, with BMI (23± 1/8). An Ultrasonography B mode and a Dynamometer were used during three states of contractions: maximum voluntary contraction, electrical stimulation, and the combination of both in healthy non-athlete individuals. The Pennation Angle (PA), Fascicle Length (FL), and Muscle Thickness (MT) and Force (F) of TAM were measured in three states of contraction and then the measurements were repeated one hour later in order to determine intra-rater reliability. Interclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and Smallest Detectable Difference (SDD) were used to evaluate the relative and absolute reliability, respectively. Results: The synchronization software was found to be highly reliable in measuring the TAM structures and force in three states of contraction (MVC), (ES), and (MVC+ES) in healthy-non athletes. The ICCs for muscle thickness of TAM were 80%, 98%, 93%, respectively. For PA, the ICCs were 88%, 77%, and 75% respectively and ICCs for FL force in the three states of contraction (MVC), (ES) and (MVC+ES) were 95%, 97%, and 91%, respectively. Also, the ICCs for F in three states of contraction (MVC), (ES), and (MVC+ES) were 82%, 97%, and 91%, respectively. Conclusion: Ultrasonographic measurement and dynamometry of TAM using synchronization software has proved to be reliable for measuring the structural parameters of TAM and force in healthy-non athletes in three states of contraction in a synchronized manner.

Background and Aim: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental type disorder. Executive functions disorder is a universal characteristic of ADHD including negative outcomes on the children with this disorder. The purpose of the current study was to determine the effects of PARS cognitive rehabilitation program on the improvement of inhibitory control and risky decision-making in children with ADHD. Material and Method: A randomized clinical study (pretest, post-test with control group) was carried out on 30 children with ADHD, aged 7-13-year-old. The participants were divided randomly into two control and intervention groups (15 each). During the treatment, three children from the experimental group left the study. Balloon Analogue Risk Task (BARAT) was used to assess risky decision-making, and the Go/ Nogo and Stroop Tests were used to assess the inhibitory control. The data were analyzed using mixed-design variance analysis in SPSS. Result: The results showed that after the treatment, inhibitory control (P<0/01) of the treatment group improved, but there was no significant difference in risky decision-making between the two groups after the intervention. Conclusion: The results of the study demonstrated that inhibitory control in children with ADHD improved after using PARS cognitive rehabilitation, while there was no significant difference in risky decision-making between the two groups. Also, the results showed that this program has an effect on other parts of executive functions.

Background and Aim: Attention Deficit Hyperactivity Disorder (ADHD) is an inherited neurological disorder which has not disappeared in adulthood and is known as an important disease. This disease especially causes a lot of emotional, social, educational, and employment problems in students. So, the present study was conducted to examine the symptoms of ADHD in adults at Shahid Beheshti University of Medical Sciences, Tehran. Materials and Methods: The sample was 230 students at Beheshti University of Medical Sciences, Tehran, selected based on convenience sampling method. All the participants filled out a demographic questionnaire and the Conners questionnaire to determine their Adult ADHD. Results: The overall prevalence of ADHD was 31% with the score ≤ T 55 and 8. 9% with the score≤ T65. The level of ADHD in the subscale C (Nshanhhaykly hyperactivity/inattention), with a frequency of 29% for cut-off point ≤ T 55 and 9. 5% for cut-off point ≤ T65, had the highest frequency. Conclusion: Due to the significant amount of this disorder in the students, it seems that screening programs should be considered among students. Also, further investigations are necessary in order to help improve their performance and relationships.

Background and Aim: Delayed neuromuscular responses is among the most important lesions in individuals with Functional Ankle Instability (FAI), which indicates using the compensatory mechanisms. Since most of body movements occur in closed-kinetic chain, the distal lesions can affect the proximal sections leading to the use of compensatory strategies. The aim of the present study was to investigate the compensatory strategies during gait in individuals with FAI using inversion perturbation. Material and Method: Seven healthy individuals (age 23. 40± 1. 70 years; weight 72. 25 ± 6. 14 Kg; height 176. 32 ± 6. 41 cm) and seven individuals with FAI (age: 24. 31± 0. 81 years; weight: 71. 15 ± 7. 21 Kg; height: 175. 12 ± 4. 28 cm) volunteered in the present semi-experimental investigation. Electrical activation of the peroneus longus, tibialis anterior, gluteus medius, and erector spine muscles during gait on the inversion perturbation system was measured using the wireless EMG system. Response Time to Perturbation (RTP) in electrical signals of the muscles was extracted using MATLAB and analyzed running independent T-tests (p<0. 05). Results: FAI group, as compared with the healthy group, indicated a significant longer RTP in the peroneus longus and erector spine muscles (p<0. 05), whereas RTP in gluteus medius muscle was significantly less in FAI group (p<0. 05). Although RTP in tibialis anterior muscle was longer in FAI group, as compared with the healthy group, no significant difference was observed between the two groups. Conclusion: The results of the current study showed that RTP differ in FAI group compared with that in the healthy group. Early recruitment of gluteus medius muscle in FAI group is indicator of using the hip-based strategy to control posture. Since the FAI individuals have lesions in muscle surrounding the ankle, ankle-based strategy is not enough to response the perturbation,; therefore, the dominant strategy for controlling the posture is hip-based strategy. Alterations in RTP are reported due to variation in the central neuromuscular control, so it is suggested that practitioners focus on detecting the compensatory mechanisms.

Background and Aim: Autism Spectrum Disorder (ASD) is a pervasive developmental disorder of nervous system which results in deficiencies in thinking, feeling, emotion, speaking, and social communication abilities. Considering the outbreak of this disorder in Iran, the present study was conducted to predict the construction of specialized educational and therapeutic spaces in the coming years that can be an effective step towards the treatment of autism children. Material and Method: In the current descriptive analytical research, a questionnaire was designed by the researcher through a qualitative investigation in existing documents and resources. The questionnaire was also confirmed by 10 proficient occupational therapists in autism and later handed to 19 parents of the suffering children in Autism rehabilitation centers and Specialized Autism Clinic (Zehn-e-Ziba). The questionnaire was designed based on the observations of the sufferers’ parents with the spectrum of slight and intense autism and Asperger’ s, relevant to educational, therapeutic, and service spaces. Result: Considering 15 designed questions, the needs and medical charachteristics of therapeutic spaces for autistic children, such as environmental stimuli, sounds, lights, colors, safety, and health conditions, were stated by autistic children's parents and were investigated accordingly; the results were obtained using the psychological approach of architectural spaces. According to the studies investigated, among the therapy methods, educational methods, such as physical and mental occupational therapy, speech therapy, play therapy, etc., were prevoiusly investigated. The significance and role of using specialized spaces by the architects indicates that the diverse forming of the spaces and construction of details as well as creation of dynamic and diverse spaces are among the effective architectural factors for educating autistic children. Effective elements like color, light, and appriopriate sounds in these spaces must also be considered since they can dramatically influence the performance improvements of autistic children. Conclusion: According to the researches and field observations, using light colors and avoiding stimulant colors may stimulate or interrupt children’ s concentration while education, thus we can create a spectrum of light or use a space as a dark room to strengthen their concentration. This can decrease these children’ s stress level, which plays a positive role in their therapy procedure. It can be suggested that architects design flexible spaces contractually with regard to children’ s needs so as to help both autistic children and their parents.

Background and Aim: One of the requirements of safe driving is having good and strong vision. Some vision disorders, can increase the risk of traffic accidents. The present article was conducted to examine the role of decreased visual acuity, contrast sensitivity disorder, and visual field defect in accidents. Also, some recommendations are provided to improve these factors. Materials and Methods: In the present review article, three databases of Google scholar, PubMed, and Scopus were search for articles in English and without time limitation using some keywords (Contrast sensitivity, visual field, inappropriate glasses, traffic accidents, and vision impairment) individually and in combinations. Findings: If there is a correlation between visual acuity and accidents, it is very weak. There was a positive correlation between contrast sensitivity disorder and traffic accidents. The risk of traffic accidents can be increased if the visual field defect is binocular and severe. The main considerations to improve these factors have been in the form of recommendations to drivers and changing screening processes. Conclusion: Impaired visual acuity has a poor relationship with car accidents. Researchers do not have consensus over the direct relationship between vision disorder and traffic accidents and some believe this issue is inconclusive. But among the factors studied, contrast sensitivity has a greater impact on car accidents compared with the other two factors. Therefore, more studies should be performed to identify and reduce the causes of impaired contrast sensitivity.

Background and Aim: The effects of music training in relation to brain plasticity have attracted many researchers, which is evident from the popularity of books on this topic among scientists and the general public. Neuroscience research has shown that music training leads to changes throughout the cortical and sub-cortical pathways of auditory system that prime musicians for listening challenges beyond music processing as seen in the processing of speech stimuli. In the present study, we have focused on the effects of music training for development of auditory skills especially in children and their education system in school. Materials and Methods: In order to review the latest literature about the effects of music training on the development of auditory processing and brain plasticity since 2000, selected PubMed, Science Direct, Google Scholar, ProQuest databases were searched. Results: At one glance, we may assume that speech and music processing are so different because they are processed in separate brain areas (speech in the left hemisphere and music in the right hemisphere). But the truth is something else. We use the same cognitional and comprehension features of cortical and subcortical pathways to process speech and music. Music training induces changes in the auditory system, which is not specific to music processing only, it also improved speech processing. Music training can be used for those children suffering from disease affecting speech processing.

Background and Aim: Myelomeningocele is a congenital central nervous system abnormality. Myelomeningocele children suffer from different aspects of the problem, including difficulty in mobility and behavioral disorders, especially aggression, but most of the time the behavioral disorders of these children are ignored. The aim of the present study was to assess the effect of painting therapy on reducing the aggression of a child with Myelomeningocele. Case Report: The current case report was conducted to assess the effect of 12 session of structured painting therapy on reducing the aggression of a 10-year-old Myelomeningocele child. In the present study, two questionnaires, The Aggression Questionnaire – AQ (Buss and Perry) and Children Aged 11-7 Year-Old Aggression Questionnaire, were used. Result: The scores obtained showed that this child's aggression reduced and painting therapy had good effects on reducing the aggression. The painting therapy can be used as an effective method for reducing the aggression of children with disability.