SCIENTIFIC JOURNAL OF REHABILITATION MEDICINE
Year:2018 | Volume:7 | Issue:1 |Papers Count:31

Background and Aim: The aim of the present study was early and accurate diagnosis of preschoolers at risk for dyslexia through designing an intelligent diagnostic system. Materials and Methods: The current research was a “ research and development” type of investigation, in terms of its goal, and a descriptive research, assessment, and diagnostic type study, in terms of data collection method. The Neuro-cognitive program designed by Delavarian et al. was used for evaluation of the children. The efficacy, accuracy, validity, and reliability of this program were proven in many previous studies. Participants were selected following cluster random sampling method and their neuro-cognitive functions were saved for two years until the definite diagnosis of each individual was determined and then the data was applied in designing the diagnostic system. Multilayer perceptron and radial basis function artificial neural networks were applied in designing the system and they were compared according to their accuracy and sensitivity. Results: The average accuracy of the system in early diagnosis of preschoolers at risk for dyslexia, designed by multilayer perceptron neural network, reached to 94. 40% and the network’ s sensitivity and specificity were obtained to be 90. 27 and 95. 28%, respectively. Conclusion: According to the high validity and reliability of the neuro-cognitive program and the high accuracy and sensitivity of the designed decision support system, the mentioned system could be used in early detection of at risk preschoolers, prior to entering the elementary school.

Background and Aim: Although the internal and external risk factors of anterior cruciate ligament (ACL) injury have extensively been studied, biomechanical and neuromuscular risk factors that put women at risk for this injury are unclear. Since muscle weakness is a contributing factor in ACL injury, the current research was conducted to study how weakness or strength of muscle, especially core muscles, can affect lower limbs performance and injury. Fatigue is also a negative contributing factor to the performance of core muscles. In this regard, the present study aimed at evaluating the effect of core muscles fatigue on some kinematic parameters associated with ACL injury during single-leg stop-jump maneuver in female athletes. Materials and Methods: A total of 30 female athletes were selected and divided into two groups of control and experimental. We used a protocol for recorded fatigue to exhaust the core muscles and the Vicon Motion Analysis device to analyze kinematic parameters. Results: The flexion angle and knee valgus at the moment of initial contact of the foot with the ground and the maximum amount of flexion and knee valgus during single-leg stop-jump maneuver were measured. A significant difference was observed between flexion angle of the knee at the moment of initial contact of the foot with the ground before (6. 82) and after (2. 36) intervention and knee valgus before (3. 10) and after (5. 80) intervention in the experimental group (p<0. 05). Also, a significant difference was observed between the maximum amount of knee flexion before (12. 45) and after (23. 35) and maximum amount of knee valgus before (13. 06) and after (16. 68) intervention in the experimental group (p<0. 05). Conclusion: It is concluded from the results of the present study that core muscles fatigue can influence the flexion angle and knee valgus and the maximum amount of flexion and knee valgus.

Background and Aims: One of the main components of somatosensory system is proprioception, which can be measured via position sense, movement sense, and sense of force. Although local investigation of proprioception is important, its influences in a kinetic chain particularly between spine and extremities should not be ignored. Therefore, the purpose of the present study was to compare knee joint proprioception in Chronic Nonspecific Low Back Pain (CNSLBP) and heathy people in different lumbar posions. Martials and Methods: A total of 25 healthy and 20 female participants with CNSLBP took part in the current study. Knee joint reposition error in lumbar flexion, neutral position, 50% of rotation to left (Lt Rot), and 50% of rotation to right (Rt Rot) with closed eyes in sitting were evaluated using inclinometer. Also, absolute and constant errors were obtained and analyzed. Results: Absolute and constant errors in flexion and neutral positions in CNSLBP patients were significantly higher than those in healthy subjects, but they were not significantly different in 50% rot to either sides. Conclusion: Knee joint repositioning error increased in CNSLBP patients compared with healthy participants. This finding suggests that proprioception and sensory-motor training programs can improve joint position sense in the lower limb specifically in the knee joint as well as the low back in CNSLBP patients.

Background and Aim: Eyes are very sensitive to Sulfur Mustard gas (SM) because they have wet surfaces. Considering the late complications of eye due to mustard gas exposure in warfare patients, the present study was conducted to evaluate the late complications of the eye. Materials and Methods: In the current descriptive study, we evaluated 300 male patients aged between 40-75 years old whose mustard gas injury period was about 27-32 years before. A complete eye examination by an ophthalmologist was done. The complications were divided in 4 grades: normal, mild, moderate, and severe. The results were reported as x2 and relative frequencies. Results: Out of 300 warfare patients, 37. 5% were aged 46-50 years old, 79% were injured with mustard gas once, 13. 4% twice, 6. 6% three times, and 1% more than 3 times, 42% had hospitalization, and 77. 6% used drugs. The most common symptoms were itching (42. 3%), burning (38. 3%), and dryness (37%) and the most prevalent complication of the lid was MGD (39. 4%). Also, the most prevalent complication of Conjunctiva was vascular anomalies (46. 6%), the most common complication of limbus was ischemia (12%), and the most common complication of cornea was epithelial defect (13. 4%). Among the prevalent ocular surgeries were punctual occlusion (19. 4%), penetrating keratoplasty (PK) (0. 33%), tarsoraphy (0. 66%), conj. flap (1%), amniotic membrane transplantation (0%), stem cell graft (2. 66%), and lamellar keratoplasty (LK) (0. 66%), in the order of frequency. The degrees of complications were 53. 34% for normal, 33. 33% for mild, 9. 33% for moderate, and 4% for severe cases. Conclusion: Conjunctival vascular abnormalities and epithelial defect were the most significant signs among the sulfur mustard chemical war victims. Having reached the mentioned conclusions, it can be stated that mild complications were more than moderate and severe ones.

Background and Aim: Osteoporosis (OP) is the most common metabolic bone disease described by loss of bone mass and micro architectural deterioration of bone tissue, which causes serious problems for women. In Iran, more than 70% of women and 50% of men over age 50 are osteopenic. The most common conditions associated with OP are pain, mobility restrictions, functional reduction, psychological consequences, and secondary chronic disorders due to fracture which lead to reduced quality of life. The purpose of the present study was to assess the effects of balance exercise program on pain and quality of life in women with postmenopausal osteoporosis. Materials and Methods: In the present randomized, double-blind trial, a total of 48 postmenopausal osteopenic women, aged 48-65 years (-1

Background and Aim: Some of the psychological and personality characteristics are very influential in human beings’ selection and decision-making. These psychological characteristics can be also related to chosing the type of delivery. So, the present study aimed to compare personality characteristics (Neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) and anxiety (overt and covert) in pregnant women according to the type of delivery (natural or cesarean) inTarom city. Materials and Method: In the present descriptive and causal-comparative study, 90 pregnant women who had referred to health centers in Tarom city in 2015 were selected. Cluster sampling was used to select two centers of the city, and then from among pregnant women who had referred to these two centers, 90 were randomly selected. Participants responded to Personality Inventory Questionnaire (NEO-FFI) and Speilberger State – Trait Anxiety Inventory (STAI). To analyze the data, descriptive statistics (mean and standard deviation) and Multivariate Analysis of Variance (MANOVA) were used. Result: The results showed that pregnant women’ s preferances for the two types of delivery (normal and caesarean section) were significantly different in overt anxiety and personality traits, such as neuroticism, extraversion, openness to experience, and conscientiousness (p<0. 01). Conclusion: The results showed the importance of psychological issues in the preferred type of delivery and also suggest that to reduce the number of caesarean sections, anxiety and personality characteristics in pregnant women must be considered.

Background and Aim: Auditory processing disorder and dyslexia are shown to be related in many researches and they are known to have high comorbidity. Most of dyslexic students have some problems in auditory perception. The purpose of the present study was to investigate the effectiveness of central auditory processing rehabilitation program on the dyslexic students’ auditory perception. Materials and Methods: A controlled clinical trial was conducted. The population involved dyslexic elementary school students studying in a learning disorder center in Tehran. Using convenience sampling method, 30 dyslexic students with central auditory processing disorder were selected and were divided into experimental and control groups. Central auditory processing rehabilitation program was designed in 12 steps together with different practices for dyslexic students. Auditory perception test for hearing impaired was conducted in the pretest. The experimental group received 15 sessions of central auditory processing rehabilitation program. Auditory perception test for hearing impaired was conducted in the posttest again and follow up was administered five weeks later. Results: The data analysis using the multi-variable variance analysis with repeated measures indicated a significant difference between the mean scores of auditory perception in the experimental and in control groups in posttest (P= 0. 05). Conclusion: According to the results, the effectiveness of the rehabilitation program on dyslexic students’ auditory perception was confirmed and follow up showed that effectiveness was stable.

Background and Aim: Up to 45 to 96 percent of children with autism suffer from sensory processing disorder. Considering the high prevalence of sensory processing disorder and reduced participation in activities of daily living in children with autism, the present study was conducted with the purpose of studying the relationship between sensory information processing and participation of autistic children of normal intelligence. Materials and Methods: A cross-sectional study was conducted on 10 primary school autistic children with normal intelligence and 10 normal peers. In order to collect data from parents, two standard questionnaires of life habit and Dunn sensory profile assessment were used. Data analysis was performed using SPSS21 software and spearman correlation test was run at a significance level below 0. 05. Results: The results showed that the average participation in daily activities in autistic children and normal children were 4. 08 and 8. 16, respectively. Average sensory processing in children with autism was 131. 30 (obvious impairment of sensory processing) and in normal children 145. 1 (possible impairment in processing of sensory information). Based on the data, no significant relationship was found between the sensory information processing and participation in high-functioning children with autism (P-value=0. 06). In addition, there were no significant relationship between sensory information processing and participation in normal children (P-value= 0. 85). Conclusion: The findings emphasized that children with high-functioning autism have sensory processing disorder, and their participation in the activities of daily living has decreased. There was no significant relationship between the sensory information processing and participation in children with autism and their normal peers. This could be due to the attendance of high-functioning children with autism in our study.

Background and Aim: The lower extremity pronation syndrome involves foot hyper pronation, knee internal rotation, and adduction. When sport exercises are properly designed and integrated, using a multifaceted training approach can help achieve goals without the need for other interventions. Ankle balance strategy restores balance by moving the body around the ankle joint. The aim of the present study was to investigate the effect of eight-weeks of combined corrective exercises on the activity of of involved muscles in girls’ ankle strategy with lower extremity pronation syndrome. Materials and Method: In the current semi-experimental study with pretest-posttest design and control group, 30 students, aged 13-16 years old, with lower extremity pronation syndrome were randomly divided into two groups of experimental (n=15) and control (n=15). Prior to and after eight weeks of training for 60 to 80 minutes, three times a week, we evaluated flat foot using Navi drop test, knee valgus using tibiofemoral angle measurement, tibialis anterior and medial gastrocnemius muscles Electromyography (EMG) activity on Biodex Balance while standing on dominant. Results: Covariance analysis showed a significant difference in tibialis anterior and medial gastrocnemius muscles EMG between the two groups in the posttests. Also, corrective exercises was found to be significantly different on tibialis anterior and medial gastrocnemius amount of muscles activity at posttest compared with pretest and had approximately 94% and 62%, respectively, effects on the EMG of these muscles in girls with lower extremity pronation syndrome (p=0, 001) (p=0, 026). Conclusion: It seems that corrective mixed exercises led to changes such as increased muscles activity in those responsible for balance control such as increase in the tibialis anterior muscle activity and decrease in the gastrocnemius muscle activity, which are related to the ankle strategy. So it is recommended that specialists and researchers consider corrective exercises in order to improve balance strategies in people with pronation syndrome.

Background and aims: A common complaint of dyslexic children is difficulty in understanding speech in the presence of background noise. Previous studies have suggested that the Medial Olivocochlear Bundle (MOCB) may play a role in speech hearing in noise. The MOCB function can be evaluated by the suppression effect of the Transient Evoked Otoacoustic Emissions (TEOAE) in response to Contralateral Acoustic Stimulation (CAS). The present study was conducted to investigate the suppression effect of TEOAE in dyslexic children. Materials and Methods: The study groups comprised 32 dyslexic children aged 8– 13 years with normal hearing and 32 controls matched for gender and age. The suppression effect of TEOAE was evaluated comparing the TEOAE levels with and without CAS. The dyslexic children were screened by screening inventory reading test. Results: There were no significant differences in TEOAE inhibition between normal and dyslexic groups. TEOAE amplitude in right ear was higher than that of left ones in dyslexic children while this finding was not observed in the normal group. Conclusion: The greater amplitude of right TEOAE in dyslexic children can be due to asymmetric performance of MOCB. This pattern was not observed in normal children.

Background and Aims: Studies in the recent years have shown that corneal astigmatism changes occur after trabeculectomy and emphasis on steeping of vertical meridian and inducing With the Rule Astigmatism (WTR) have regulations. The present study was conducted to study the changes in rate astigmatism and its axis, myopia, and hypermetropia in trabeculectomy and shunt surgery. Materials and Methods: In the present comprative study, two groups of 16 patients with average age of 52. 4± 8. 9 and 94. 6± 6. 7 respectively under trabeculetomy and shunt surgery were recruited. They were studied and compared for changes of refractive error before, 1 week, 1 month, and 3 months after surgery. Data were analyzed using Friedman and Mann-whitney tests. Results: Averages of Intraocular Pressure (IOP) before, 1 week, 1 month, and 3 were 31. 31± 7. 6, 9. 8± 2. 8, 10. 5± 1. 29, 10. 9± 1. 26 (P<0. 05) months after trabeculectomy and 36. 06± 10. 32, 13. 5± 3. 3, 11. 68± 2. 21, 11. 18± 1. 27(P<0. 05) after shunt. Also, averages of astigmatism were-1. 00± 0. 59,-6. 00± 1. 9,-2. 21± 1. 18,-1. 37± 0. 62 (P<0. 05) in trabeculectomy and-0. 89± 0. 46,-1. 56± 1. 62,-1. 51± 1. 46,-1. 07± 0. 85(P>0. 05) in shunt. The percentages of WRT astigmatism in trabeculectomy were 37. 5, 100, 37. 5, 31. 25 and these values in shunt were 43. 75, 50, 50, 56. 25. In addition, the averages of Equivalane sphere (Es) in trabeculectomy were-0. 31± 1. 49, 1. 43± 1. 94, 0. 27± 1. 74, 0. 04± 1. 46(P<0. 05), whereas these values were 0. 65± 1. 5, 1. 03± 2. 03,-. 70± 1. 64, 0. 62± 1. 54 (P<0. 05) in shunt. Comparison of astigmatism and axial between trabeculectomy and shunt using Mann-whitney test showed significant changes (P<0. 05), but Es was not found to be significantly different (P>0. 05). Conclusion: Both surgery methods induced hypermetropia which decrease with time, but the amount of astigmatism and percentage of WTR astigmatism in trabeculectomy were more than those for shunt surgery.

Background and Aims: Due to the growing population of the elderly and the high prevalence of mental disorders in this population, mental health professionals should take measures regarding the treatment of mental disorders, especially depression. Today, bibliography is used for the treatment of common mental disorders. So, the aim of the present study was to investigate the effects of audiobooks on the mental health of the elderly at the State Welfare Organization of Iran. Materials and Methods: In the present quasi-experimental study, 30 elderly from welfare organization participated in eight sessions of audiobooks and the aspects of their mental health were investigated using the Standard Mental Health Questionnaire (SCL-90-R) before and after participating in the audiobook sessions. Data were analyzed in SPSS using descriptive methods (Mean and standard deviation) and inferential tests (kolmogorov-Smirnov test). Results: Data analysis showed that audiobook resulted in significant desensitization in mutual relationships, physical complainants, obsession, depression, anxiety, aggression, phobia, and paranoid disorder in the elderly population of the State Welfare Organization of Iran (p<0/05). Conclusion: Considering the growing number of the elderly population in the country, taking care of their health is a necessity. The findings suggest that using books and bibliotherapy can have beneficial effects on the mental health of the population. This is one of the low-cost options for the treatment and mental health officials can use for prevention and treatment purposes.

Background and Aims: Persian Pediatric Competing Words (PPCW) and Persian Randomized Dichotic Digit (PRDD) tests were previously developed and adapted for use in Persian language. The present study aimed to investigate the effect of age on the results of these tests in children. Materials and Methods: The current observational and descriptive-analytic study was performed on 241 schoolchildren, including 122 (50. 6%) male and 119 (49. 4%) female children with an age range of 6 to 12 years. All children had a hearing level of 15 dB HL or lower in frequencies of 250-8000 Hz. Inter-aural hearing threshold asymmetry was less than 10 dB. Children’ s handedness was determined using Chapman and Chapman handedness questionnaire. Ear advantage was calculated in two methods: right ear advantage and dominant ear advantage. The effect of age, gender, and handedness on the ear advantage was investigated. Results: The results showed that as the children's age increased from 6 to 12 years, the ear scores for both of the tests increased. In general, the dominant ear advantage for the both tests was significantly greater than that for the right ear advantage. Also, it was found that the mean of the right ear advantage for both of the test was not significantly different between males and females and between right-handed and left-handed children. Conclusion: The ear scores of PRDD and PPCW tests increased with age independent of the effect of gender and handedness of 6-12 year-old children. Dominant ear advantage is a more conservative method for reporting ear advantage.

Background and Aims: The evaluation of probe microphone is the only gold standard to confirm the performance of hearing aids. In children, due to the fitting positive impact with real ear measurement on the children's communication skills and also considering that children are not able to express their hearing aid functional problems, the importance of the use of real ear measurement is felt more. Therefore, the present study was conducted to determine the difference between hearing aid output fitted by DSL prescriptive targets with approaches of real ear measurement and 2 cc coupler among 3-7 year-old hearing impaired children to understand the impact of earmold on these measurements. Materials and Methods: In the present descriptive-analytical cross-sectional study, 3-7 year-old hearing impaired children with moderate to profound hearing losses were studied. For children’ s assessment, after doing audiometerical tests, the children's hearing aids were planned in accordance with the DSL using relevant software formula, then hearing aids output was once measured using real ear measurement and once more using the 2 cc coupler. The obtained values were then compared. Results: A significant difference was found between the sound pressure level average of target curve and that of hearing aids in the real ear measurement and 2 cc coupler in different intensity levels (p>0/05). The average difference betweeen sound pressure level of target curve and measured curve by real ear measurement compared with that of sound pressure level of target curve and measured curve by 2cc coupler was less than 10. Conclusion: According to the findings of the present study, using real ear measurement in children seems a necessity. Also, the cause of the difference between the target and measure in real-ear measurement is the poor performance of various factors other than earmold (hearing aid, measurement, lack of correct prediction values in the settings application hearing aids, etc) and this issue is not related to the quality of the earmold.

Background and Aims: Sport skills include landing from high-risk activities. Single-leg landing is a common movement in many sports and is known a major cause of non-contact Anterior Cruciate Ligament (ACL) injuries, and increase in knee external motion in the frontal plane can also aggravate it. The present study was carried out to analyze the effects of different degrees of insole hardness (soft, medium-hard, hard) on joint kinematics of knee in single-leg landing from different heights including 20, 40, and 60 centimeters. Materials and Methods: A total of 20 male individuals (mass mean: 75. 30± 1. 03 kg; height: 180. 1± 4. 19 cm; age: 25. 30± 4. 29) were selected. Participants were asked to do single-leg landing from different heights (20, 40, and 60 cm) on different kinds of insole in terms of hardness placed inside the shoes in front of a three-dimensional motion analysis system. After data processing using cortex software, maximum parameters of knee flexion and knee valgus were measured. Statistical analyses of data were done using repeated measures test considering a significant level lower than 0. 05. Results: In landing from 20 cm height, soft insole showed the maximum level of knee flexion and minimum level of knee valgus. In landing from 40 cm height, semi-hard insole showed the maximum level of knee flexion and minimum level of knee valgus. Finally, in landing from 60 cm height, hard insole showed the maximum level of knee flexion and minimum level of knee valgus. Conclusion: The results showed that different degrees of insole hardness influence the knee joints kinematics. More knee flexion and less knee valgus brought about by these insoles can reduce ACL injuries.

Background and Aims: Background and Aim: Speech intelligibility depends on different segmental and suprasegmental speech parametrs, such as accuracy of production, intonation, voice quality, and resonance. The investigation on speech intelligibility evaluation is performed using two methods: perceptual and acoustic. In perceptual method, speech intelligibility is investigated based on the listeners' judgement and in acoustic method, acoustic parameters related to speech are studied. The purpose of the present study was to obtain the correlation between average frequency in words and percentage of speech intelligibility in children with cochlear implant. Materials and Methods: The present study was carried out on 18 children, aged 4-6 years, with cochlear implant. Perceptual evaluation was performed by the judgment of the listeners who were not familiar with the speech of the hearing impaired children. The evaluation was carried out based on the speech intelligibility words test in Persian language. Calculation of the frequency was done using Praat software, 5. 2. 25 version. Results: The results of the acoustic analysis showed that the average of the frequency in population studied was 294/2± 45/05 and the average of the percentage of speech intelligibility was 47/87+20/33. According to the obtained correlation factor, there is an inverse relationship between these two factors. However, considering the significance level more than 0. 5, the correlation was not found to be significant. Conclusion: Due to the lack of correlation between the percentages of perception of speech intelligibility and fundamental frequency, as one of the suprasegmental features of speech, according to the findings of the present study, it can be concluded that despite the effect of chain factors, such as production, as shown in some studies, this parameter does not have a significant effect on these children's speech intelligibility.

Background and Aims: Visual perception disorders are one of the most important deficits in individuals with stroke that causes limitation in daily living activities and learning self-maintenance skills and balance. The present study aimed to compare the visual perception, visual acuity, contrast sensitivity, and depth perception among three groups of healthy persons and right and left sided stroke pateints. Materials and methods: A total of 31 individuals with stroke (16 left sided and 15 right sided) and 16 healthy persons participated in the present study. Freiburg Vision Test software was used for assessing visual acuity and contrast sensitivity. Depth Perception Peg Board Set test and Developmental Test of Visual Perception-Adolescence and Adult test were used to assess depth perception and visual perception, respectively. Results: The analysis of visual perception, depth perception, visual acuity, and contrast sensitivity using ANOVA revealed that there are significant differences among the three groups (p<0. 05). Furthermore, with contrast sensitivity as a covariance, analyzed by MANOVA, it was shown that there was a significant difference among the three groups with both eyes (p<. 0/05). Conclusion: Patients with stroke, in comparison with healthy persons, have difficulties in visual perception, depth perception, visual acuity, and contrast sensitivity, but there is no difference between left sided and right sided stroke.

Background and Aims: The previous studies showed that exercise training has been shown to benefit diverse medical and behavioral conditions. The purpose of the current study was to investigate the effect of resistance training on the level of cortisol, testosterone hormone, and some physical fitness factors of males washed out from methamphetamine addiction in rehabilitation period. Materials and Methods: A total of 19 washed out males (Age 29. 8± 4. 5 yr) from methamphetamine were randomly divided in to two resistance group (n=10) and control group (n=9). The training group performed eight weeks of training at 50-80 percent of one repetition maximum. Before and after the eight weeks of training, blood sample were obtained to measure serum cortisol and testosterone. Also, participants' muscle strength and endurance and body composition were measured. One-way covariance test and dependent t-test were run to analyze the hypothesis. All data were analyzed using statistical software of SPSS, version 20, and a P-value of P≤ 0. 05 was considered statistically significant. Results: The results showed that the levels of cortisol has a significant decrease in experimental group (p=0. 05), while cortisol levels were not found to be significantly different between the two groups (p>0. 05). Testosterone was slightly increased in training group but the increase was not found to be significant (p>0. 05). Moreover, the results demonstrated that there were no significant differences between experimental and control groups in testosterone levels (P=0. 24). The muscle strength of the upper extremity and muscle endurance, and the circumference of the chest, arm, and waist of the experimental group had a significant increase compared with those of the control group, too (P=0. 01). Conclusions: It seems that a period of resistance training for eight weeks can be effective as a non-pharmacological treatment strategy in wash out period related to addiction of previously metamphetamine dependent individuals. Also, it could improve physical and functional status of these persons.

Background and Aim: Stroke is a major cause of disability. Upper extremity motor impairment is one of the most common consequences after stroke. The purpose of the present study was to investigate the effect of Kinesiotape (KT) on hand function dexterity and activities of daily living as well as spasticity in stroke patients. Materials and methods: Eight individuals with stroke, and the mean age of 50-63 years, participated in the present clinical trial and pretest-posttest study. An I strip taping was placed on extensor muscles of the participants' forearms. Spasticity, activities of daily livings, and hand function dexterity were evaluated immediately and one month after kinesiotaping using the Modified Ashworth Scale (MMAS), Barthel Index, and Nine Holle Peg test. Results: At the immediate assessment, there were significant differences between hand dexterity function and Barthel Index in the pre-test and post-test (P-value ≥ 0/001). Secondary assessment was done after one month and the results showed similar significant differences but there was no significant change in flexor muscles spasticity of the hand after the intervention. Conclusion: The current preliminary study indicated that KT in the direction of the extensor muscle could result in better hand function and recovery activities of daily living.

Background and Aim: Patients with chronic mechanical low back pain experience disorder in proprioception and sensory acuity and these disorders are associated with pain in these patients. The aim of the present study was to compare the effectiveness of motor control exercises, exercise in water, and combined exercises on proprioception, sensory acuity, and pain in patients with chronic mechanical low back pain. Materials and Methods: In the current study, patients with mechanical low back pain were selected using Oswestry Questionnaire. They were randomly assigned into four groups of motor control exercises (n=12), exercise in water (n=12), combined exercises (n=11), and control group (n=13). All three exercise groups performed eight weeks of determined exercise but the control group did not perform any exercise. To assess proprioception, sensory acuity, and pain in the patients, goniometer, caliper, and the Visual Analog Scale were used, respectively. For intra-group comparison of pre-test and post-test variables, paired t-test was used, and for inter-group comparison of variables, ANOVA test was used (Alpha ≤ 0. 05). Results: The results of the present study showed a significant difference between the pre-test and post-test of exercise groups compared with those of the control group in the variables of pain (p=0. 007), proprioception (p=0. 005), and sensory acuity (p=0. 008). However, no significant difference was found among the three groups. Conclusion: As a result, exercise in water, motor control exercises, and combined exercises were effective in alleviating the pain and increasing proprioception and sensory acuity of patients with mechanical low back pain, and all the three exercise methods were effective in the treatment of non-specific chronic low back pain.

Background and Aim: The reliability of manual tests of the Sacroiliac Joint (SIJ) is important in that they are frequently used in the assessment of this region for which there is no successful paraclinical exam. The aim of the present study was to measure the diagnostic stability of some of the SIJ manual tests as well as to compare it between symptomatic and asymptomatic individuals. Materials and Methods: A total of 17 examiners assessed the symmetry of the position of bilateral ILAs and PSISs in prone lying, PSISs in standing as well as the motion of PSISs in standing flexion test on two individuals (one symptomatic and one asymptomatic). The diagnostic stability of the landmarks was computed using X2 and Bayes factor. Examiners were blinded about participants' symptoms. Results: The results revealed that X2 and Bayes factor were 4. 76 and 12. 28 for ILAs, 9. 94 and 277. 52 for PSISs in prone lying, and 9. 30 and 241. 15 for PSISs in standing and standing flexion test, respectively. Conclusion: The diagnostic stability of the PSIS in prone lying was the highest and the diagnostic stability of the ILA was the lowest. The diagnostic stability of symptomatic participant was higher than that of the asymptomatic participant. Accordingly, the probability of false postive outcome of the tests is high in asymptomatic individual. Therefore, prior to static palpation tests in the physical examination, it is better to perform pain provocation tests in order to confirm the existence of the SIJ dysfunction.

Background and Aim: Over activity of Bladder (OAB) is a syndrome with symptoms in urinary storage phase and it appears with the increase of the frequency of urination or emergency condition. During the recent years, using Posterior Tibial Nerve Stimulation (PTNS) has been introduced as a simple, noninvasive, without-the-side-effect method for the treatment of OAB. The purpose of the present study was evaluation of the effect of PTNS with kegel exercises on women with over activity of bladder. Materials and Method: The current study was a randomized, double-blind, placebo controlled trial including 67 female participants with OAB syndrome divided in two groups of test and control. During 12 sessions, kegel exercise was taught to patients and PTNS was performed for the two groups but the flow rate was zero for the control group. The perineometry device was used to evaluate the pelvic floor muscles strength and three questionnaires of 1-assess quality of life 2-ICIQ-OAB, and 3-ICIQ-UI SF, as well as voiding diary form was used to evaluate the symptoms and severity of the disease, before and after the intervention. Results: Analysis of the results with paired sample t test in the two groups showed that the strength of pelvic floor muscles increased and the quality of life improved (P≤ 0/05). The use of the independent samples t-test showed increase of the pelvic floor muscles strength and improvement of quality of life and the decrease of scores of urinary symptoms in the test group was significantly greater than those of the control group (P≤ 0/05). Conclusion: According to the results of the study, the PTNS with kegel exercises caused increase of the pelvic floor muscles strength and the improvement of the quality of life in women with OAB syndrome.

Background and Aim: Chronic low back pain is one of the most common clinical problems for which various treatments have been carried out so far. Considering the abdominal drawing maneuver effects on the performance of lumbopelvic muscles and the effect of these muscles themselves on the lumbar lordosis, and also having in mind the relationship between lumbar lordosis and low back pain, the present study was carried out to investigate the effect of ADIM on the lumbar lordosis angle in patients with chronic low back pain. Materials and Methods: A total of 15 women with chronic low back pain and lumbar hyperlordotic posture took part in the study. To measure the lumbar lordosis angle in standing posture, we used the Cobb method in radiographies with lateral view. Results: The mean difference between the lodosis angles (before and after applying the maneuver) was 11. 276, meaning that prior to applying the ADIM, the lordosis angle was more than that after applying it (P<0. 05). Conclusion: According to the findings, applying ADIM in standing position in patients with chronic low back pain and lumbar hyperlordotic posture can result in lordosis decrease and lumbar alignment improvement and it also decreases the chronic pain in this region.

Background and Aim: According to the modern life style that includes lack of adequate physical activity, incorrect position while working with computer, and long term driving, forward head posture is a whidespread problem. As forward head posture can change the vertebral column position in sagittal plane and muscle lengthtension and it may change kinematic of scapula and incorrect scapular kinematic can lead to shoulder pathologies and shoulder pain, it is important to recognize the scapular kinematic in patients with forward head posture. The aim of the present study was to evaluate scapular kinematic in patients with forward head posture using lateral scapular slide test and the compare it with that in healthy individuals. Materials and methods: A total of 45 women with forward head posture and 45 matched healthy individuals participated in the present study. To evaluate and diagnose the forward head posture, photography method was used and to evaluate scapular kinematic, lateral scapular slide test was used. Results: There was a significant difference in the asymmetry of scapula in all test positions of lateral scapular slide test between the two groups. Conclusion: Our results indicated that the forward head posture can cause more asymmetry of the scapula and so it is important to evaluate scapular kinematic in these patients.

Background and purpose: Anatomy and biomechanics of the spine have been changed because of modern life style and working in unhealthy environments; therefore, diagnosis of postural deviations and their kinematic relationship has particular importance in detection, prevention, and treatment of these disorders. One of the most common postural abnormalities is forward head posture which could be created independently or after other postural disorders. The aim of the present study was to evaluate spine curves in patients with forward head posture and to compare it with healthy individuals. Materials and methods: In the current study, 51 patients and 50 healthy participants, matched height, weight, and age, were recruited. To evaluate and diagnose the forward head posture, photography method and calculation of craniovertabral angle were used and to measure the spinal curvatures, flexi curve, as a noninvasive and valid method, was used. All measurements were performed in both standing and sitting positions. Results: Statistical results showed that by reducing the craniovertabral angle, thoracic kyphosis and lumbar lordosis increased and also there is a significant difference in craniovertabral angle, head tilt angle, thoracic kyphosis, and lumbar lordosis between the two groups and also between sitting and standing position (p<0. 05). Conclusion: Our results indicated that the increase of forward head posture in standing position is associated with the increase of thoracic kyphosis and also lumbar lordosis and in sitting position it is associated with the increase of thoracic kyphosis.

Background and Aim: According to the previous studies regarding the role of fatigue on performance, the aim of the present study was to investigate the effect of lower limb muscle fatigue on spatio-temporal, ground reaction forces and selected muscle activity of the gait in active young men. Materials and Method: A total of 15 healthy active male individuals, aged 22. 09± 3. 18 years, height 58/7± 177 cm, and weight 71± 7. 72 kg, participated in the present quasi-experimental study. Sit to stand fatigue protocol was used for lower limb fatigue and kinematic and kinetic and muscle activity were collected during normal gait before and after fatigue protocol, 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: Changes in gait variables, such as increased step width (p=0. 003) and heel contact velocity (p<0. 001), reduced ankle dorsiflexion (p=0. 005), increased knee flexion (p<0. 001), and first peak vertical ground reaction force (p=0. 004) as well as a significant reduction in tibialis anterior, vastus medialis, vastus lateralis, rectus femoris, semitendinus, and biceps femoris muscle activity (p<0. 05) were observed after fatigue. Conclusion: The results confirmed the effectiveness of muscle fatigue on gait variables. Increased step width and heel contact velocity and reduced activity of selected lower limb muscles may increase the need for dynamic balance during fatigue and increase the risk of injury. The results of the present study may have clinical values. Falls in the elderly and children may create physical and mental effects. Hence, in designing associated exercises with these groups, it is recommended that intensity of exercises be maintained at fatigue threshold.

Background and Aim: Bilinguals constitute the group of individuals who talk in two languages with competency equal to the native speakers of both languages, especially at verbal aspects. According to the recent studies, language information is processed differently in the presence of noise. Receptive performance of the second language is affected more in noisy places. The aim of the present study was to investigate the effect of bilingualism on temporal fine structure ability in young normal hearing adults. Materials and Methods: In the present cross-sectional descriptive analytic study, 30 bilingual adults were compared with 30 monolinguals. Temporal fine structure test was performed at 250-500-700 Hz frequencies. Data analysis was completed running two factor repeated measure analysis of variance, while the age was controlled. Results: The average of phase change threshold was higher in bilingual group (p=0/02). The difference between the averages of change threshold at different frequencies was found to be significant (p<0/001). Conclusion: The results of the present study indicated that the TFS ability is stronger in monolinguals. This might be considered as one of the causes of reduced speech recognition ability in noise for bilinguals.

Background and Aims: Due to the increasing trend of high-heeled shoes usage among women, investigation of their effects on the body and especially lumbar lordosis and pelvic alignment seems necessary. Some studies have previously been conducted in this field but it seems that there is little convergence about the effects of wearing such shoes and, in some cases, even contradictions exist. These contradictions are more pronounced where lumbar lordosis is under investigation. Therefore, the aim of the present review article was to investigate the results of existing studies on the effects of shoe heel height on the magnitude of lumbar lordosis and the pelvic tilt. Materials and Methods: The current article focused on reviewing the results derived by the articles published between 2000-2016 on the effects of high heeled shoes on lumbar and pelvic alignment in sagittal plane. By searching the relevant resources, six articles including two review articles were chosen for evaluation and investigation. Results: According to the limited number of studies examined and the distinction between them, a certain conclusion about the effects of shoe heel height on the magnitude of lumbar lordosis and the pelvic tilt cannot be presented. According to the results of articles examined, loss of multilateral investigation on the vertebral column and pelvis, loss of using proper and validated measurment tools in some cases, and neglect in the compensatory effects are the common reasons for divergence in the results. It seems that a more comprehensive study is necessary to shed more light on the areas unknown.

Background and Aims: Tinnitus is one of the most common symptoms of otological diseases and hearing disorders that has traditionally been regarded as a disorder of ear structures. However, the recent perspective tends to the central origin. Now, the world is trying to develop appropriate management strategies based on neuroscience of tinnitus. The present study provided the new and comprehensive explanation about neuroscience, management approaches, and rehabilitation of tinnitus. Materials and Method: The current article reviewed the latest articles and books published between 2005-2016, on tinnitus, its neural correlates, and management approaches selected from Science direct، Google scholar، PubMed, Proquest, and Scopus databases. Conclusion: Tinnitus is often caused by abnormal changes in the central nervous system after auditory deprivation and negative emotions. Currently, this disorder cannot be cured definitely, but its severity can be reduced by drug therapy, neural modulation, and rehabilitation based on counseling. Also, new therapies are being developed that directly target the neural mechanisms of tinnitus.

Background and Aims: About 13% all of children suffer from disabilities. Maltreatment of children and adults with disabilities is a common practice. The identification of the nature and risk factors for maltreatment helps identify the children and families at risk and facilitate intervention to prevent and treat these children. The present study was conducted to identify the nature of and risk factors for maltreatment of children with disabilities. Materials and Methods: In the present narrative review, the keywords including: maltreatment, abuse, neglect, disability, children, and risk factors were searched among databases including Springer, Elsevier, ProQuest, Scopus, Ovid PubMed, Cochrane, and the search engine Google Scholar, in the period between 1960-2015. Empirical studies, meta-analysis, and systematic reviews with the emphasis on maltreatment of children (below 18 years) with mental, physical, and psychological disabilities were selected. Results: Totally, 822 potentially relevant studies were found and 79 abstracts were examined. Finally, 26 full texts were included. Almost all studies confirmed that children with disabilities are at a significantly greater risk of maltreatment compared with those without disabilities. According to the literature, the nature of and risk factors for maltreatment can be examined under three categories: maltreatment characteristics, victim characteristics, and perpetrator characteristics. There is sporadic data in this field and different studies have reported different results on the subject. Probably behavioral disabilities are the most important risk factor for maltreatment. Low level disabilities that have not outward appearance may cause increaseed risk of maltreatment, especially sexual abuse. Parents, school staffs, peers, and strangers were identified as perpetrators of maltreatment. Conclusion: Different definitions of disability and maltreatment as well as different research methodologies used in the studies have made it impossible to reach a decisive conclusion about risk factors for maltreatment of children with disabilities; however, there is the probability that lack of parenting skills as well as young age and less serious disabilities of children, regardless of the type of disability, are among the risk factors for maltreatment. A few studies conducted in Asian countries indicated that they are not prepared to deal with this social issue.

Background and Aims: Modern hearing aids are often nonlinear and they have dynamic features such as noise reduction and feedback cancellation. Thus, these hearing aids will react to speech differently compared with sinusoidal and none modulated stimulants. Speech is the most important stimulus encountered by hearing aid wearers. For this reason, the use of static stimulus such as pure tone sweeps and non-modulated noises in the assessment and verification of hearing aids is not appropriate. The purpose of the present article was to introduce the new method of Percentile Analysis in verification of hearing aid using International Speech Test Signal (ISTS) to reduce the differences between clinical, improve fine tuning of hearing aids, prevent annoyance caused by loud portion of speech, and not hearing the soft portion of speech. Materials and Methods: We searched the subject of hearing aids verification in Google scholar, Proquest, Pubmed, and Sciencedirect databases among the studies published between 1990-2017 using the following keywords: Verification, Speech Mapping, International Speech Test Signal, and Percentile analysis. A total of 40 papers were found among which 32 were selected. The Application of Percentile Analysis in Verification of Hearing Aid Using International Speech Test Signal (ISTS) was reviewed based on these original articles and three related text books. Conclusion: ISTS is known as a common speech stimulus. Because this stimulus has all the features of a live speech, it can be used in audiology clinics as a common stimulus for assessment and verification of hearing aids. Therefore, the time and spectral characteristics of speech stimulus will be stable between audiology clinics. In this case, we can use Percentile Analysis to obtain dynamic range of the input and output sounds of hearing aids, gain, and amount of hearing aid compression from one clinic to another. Also, because speech is a dynamic stimulus, Percentile Analysis will allow us to fit the gain and compression features of hearing aid in a successful way. Therefore, that loud portion of speech does not exceed from uncomfortable loudness levels and the soft portion of speech will be above hearing thresholds.