Journal of Paramedical Science and Rehabilitation
Year:2018 | Volume:6 | Issue:4 |Papers Count:10

Purpose: Central corneal thickness (CCT) as an anterior segment eye parameter, is an important factor for evaluation of patients with ocular disorders. The objective of this study was to Assessment of Age, Gender, and Refractive Errors on Central Corneal Thickness in Subjects Referring to Al-Zahra Eye Hospital of Zahedan using a robust statistical methodology. Methods: The present study was conducted on 755 eyes of qualified subjects referring to Al-Zahra eye hospital of Zahedan, the capital city of Sistan-and-Baluchestan provience from 2014 to 2016. After summarizing the data, linear quantile regression was fitted and normal values were estimated. SPSS (ver. 21) and R (3. 3. 0) were employed for analysis. Results: In this study, 422 subjects (56%) were female. Mean of age was 27± 7. 6 years old. According to the linear quantile regression model findings for subjects with a moderate CCT, age had a significant effect on CCT. Conversely, gender and spherical equivalence indicated no substantial effect on CCT. Normal limits of CCT were (489-602) μ m and (482-600) μ m for females and males, respectively. We also reported these limits by age and gender for comparisons. Conclusion: Normal limits of CCT can be used by ophthalmologists in examinations before refractive error operations and assessment of ocular pathologies like glaucoma.

Purpose: Phonation or the generation of audible sound energy is caused by muscular and aerodynamic activities that affect the vocal cords. The main objective of this study was to determine aerodynamic parameters in three categories of normal, spasmodic dysphonia and muscle tension dysphonia. Methods: Study population consisted of 30 individuals (ten subjects with spasmodic dysphonia, ten subjects with muscle tension dysphonia and ten normal subjects). Vital capacity of each individual was recorded by a spirometer and maximum phonation time was calculated with the help of stop watch. The data were analyzed with Spss 19 statistical software. Results: The maximum phonation time in muscle tension dysphonia was lower than two other groups and in spasmodic dysphonia group was lower than normal, the mean difference between groups was significant (p<0. 001). Vital capacity in the group of muscle tension dysphonia was lower than other groups and in spasmodic dysphonia was equal to the normal group, mean difference between groups was statistically significant (p<0. 001). Phonation quotient in muscle tension dysphonia was more than spasmodic dysphonia group and in spasmodic dysphonia group was higher than normal and again the mean difference between groups was statistically significant (p<0. 001). Conclusion: Maximum phonation time between three categories of normal, spasmodic dysphonia and muscle tension dysphonia was significantly different. Vital capacity in normal and spasmodic dysphonia group did not differ significantly and in muscle tension dysphonia group was different compared to other two groups. It seems that vital capacity reduction in this category of patients is an explanation for the occurrence of this type of dysphonia. The results showed that changes in the aerodynamic parameters in addition to separate the normal group from voice disorders, depending on the type of disorder as well. These differences must be considered in the process of assessment and therapeutic interventions.

Purpose: Increased forward head angle causes neck pain. The aim of this study was to compare the effect of traditional and National Academic of Sport Medicine (NASM) corrective exercises on the neck pain and forward head angle in college male students. Methods: Twenty male with forward head were selected within male students, and randomly divided into 2 groups (n=10 rats per group): Both groups performed traditional and NASM corrective exercises. First group performed traditional exercises and the second group performed NASM corrective exercises for 8 weeks that related to the forward head practices. Angle of head pain and head pain were measured by pain Visual Analogue Scale (VAS) and goniometer before and after the training period. Data were analyzed by paired t-test and independent t-test in P<0. 05. Results: The result of this study showed significant differences between pre and post-intervention conditions regarding the VAS, and head angle values in both groups (P<0/05). There is a significant difference between groups in pain scale VAS and head angle before and after the training period that the rate of healing in NASM group is higher than in the traditional group. Conclusion: NASM corrective exercises was more effective in improvement of the pain scale and head angle and it is recommended to the occupational therapist to the benefits of these exercises as a modern training methods in correction of the forward head angle.

Purpose: Despite various researches about identifying non-motor behaviors in Parkinson's patients, limited studies about cognitive and language problems have been found. According to this, it seems that the complex aspects of language has been impaired in this disease. Nonliteral language is one of the sophisticated areas related to this skill and the allusion is a subfield of that. The purpose of this study was to assess this aspect in Parkinson's patients at stage 1. Methods: Fifteen healthy subjects and 15 patients with stage 1 Parkinson's disease have been studied. As a tool, a questionnaire consisted of 14 allusions was made by the examiner. The content validity was suitable (CVR=0. 75) and the Cronbach's alpha was 0. 74 for this questionnaire. The allusion was presented orally to each individual and the subject should say what that means. According to the results of K-S test, the data distribution was Normal and Independent T-test was used in order to compare the means. Results: Mean scores that obtained by healthy subject are more than patient’ s scores, however, no significant difference was observed between the two groups. Conclusion: There was no difference between the healthy subjects and stage1 Parkinson patients in the allusion constructed test. If there is a difference in this aspect, more detailed and complex tests are needed to reveal the difference, or it could be observed at more severe stages of the disease (stage 2 or higher).

Purpose: Down syndrome is the most common chromosome abnormality and the most common genetic cause of intellectual disabilities in humans. The aim of this study was to investigate the effect of a selective combined training program on motor performances, balance and muscle strength in boys with Down syndrome. Methods: Twenty boys with Down syndrome aged ranged from 12 to 20 years were randomly assigned either into an experimental group (n=10) or control group (n=10). Subjects in the experimental group underwent combined training program for 45 and 60 minutes per day, 3 times a week, for 8 weeks. To evaluate the muscle strength and balance in subjects with Down syndrome, muscles force was measured with handheld dynamometer (MMT, North coast, USA) and balance with Sharped Romberg (r=0. 90-0. 91) with eyes both being open and close. Two-Way ANOVA with Repeated Measures was used to analyze the data (p≤ 0. 05). Results: ANOVA with repeated measures showed that knee flexion strength (p≤ 0. 05), Knee extension (p≤ 0. 05), hip flexion (p≤ 0. 05), hip extension (p≤ 0. 05), ankle plantar flexion (p≤ 0. 05), ankle dorsiflexion (p≤ 0. 05), and also static balance with eyes open (hard surface) (p≤ 0. 05), static balance with eyes being close (hard surface) (p≤ 0. 05), static balance with eyes being open (the software) (p≤ 0. 05), static balance with eyes being close (the software) (p≤ 0. 05) of the intervention group was significantly better than the control group. Conclusion: A combined strength and proprioceptive training improves postural balance in children with DS. This could be due to the enhancement in muscle strength and proprioceptive input integration.

Purpose: Spinal cord injury leads to changes in family structure and compatibility problems for individual adjustment. Family members who take care of the people are in close interaction with them will be adversely influenced. This research aims to investigate the relationship of family functioning with individual adjustment in spinal cord disabled covered by the welfare organization in Aligudarz city. Methods: The study is a descriptive-analytical type of correlation studies. Study population of this research was 50 spinal cord disabled individuals and their main related person of the family. The tools used in this study included Family Assessment Device, California individual adjustment questionnaire and two check-list includes demographic characteristics of disabled and family. Data were analyzed using Kolmogorov-Smirnov Test, Pearson Correlation Coefficient (R). Results: Statistical analysis showed a significant relationship (P<0. 01) between Problem Solving (Pearson=0. 455), role playing (Pearson=0. 327), Affective Involvement (Pearson=0. 465), Behavior Control (Pearson=0. 312) and General Function (Pearson=0. 330) family functioning and individual disabled adjustment. No relationship was observed among the demographic characteristics of the disabled with individual adjustment as well as demographic characteristics, family to family functioning, (p>0. 05). Conclusion: Family functioning can affect a disabled individual adjustment spinal cord. So with adhering to the ways in which family functioning, individual adjustment spinal cord disabled and consequently the health of their families and the disabled improve.

Purpose: During human life, language is important in social interaction and speech and language pathologists play a significant role in preservation and promotion of speech and communication in people. In adulthood, increasing age and particularly aging changes most cognitive functions that have impact on the ability of receptive and expressive language. As communication and discourse in aging can be improved by obtaining information on changing discourse features, studying language in different ages is crucial. Methods: This research is a descriptive-analytic cross-sectional study. In this study, 91 adult narrative discourses, with the age ranges of 19 to 74 years, divided into four age groups. First, each participant filled out personal information and consent form to participate in the research. Then cognitive assessment using Mini-Mental State Examination (MMSE) screening test was conducted. Finally, their capabilities of narrative discourse were evaluated using Persian narrative discourse assessment task. In order to check the normality of the data, the Kolmogorov-Smirnov test was used. For comparison of narrative discourse in different age groups, ANOVA and Kruskal-Wallis tests were used (for cohesion and coherence respectively). Results: Both cohesion and coherence variables were significantly different among aging group and all three other groups (p<0. 01). Conclusion: Results of the present study indicate that discourse abilities are affected by age and especially by aging. Therefore, it is necessary for speech and language pathologists to consider the cognitive and linguistic demands in their clinical applications.

Purpose: Urinary tract infections are the second most common human infection by family of the Enterobacteriaceae, particularly Escherichia coli. According to the increasing antibiotic resistance among strains of E. coli, the purpose of this study was to determine the current pattern and also to investigate changes in the antibiotic resistance patterns of Escherichia coli strains isolated from urinary tract infections in outpatients referring to Nabi-akram hospital in Zahedan city during the past years. Methods: This descriptive study was conductedon 87 cases of E. coli isolated from patients with urinary tract infections in a hospital in the city of Zahedan. The drug sensitivity test for antibiotics: imipenem (IPM), gentamicin (GM), ceftazidime (CAZ), nalidixic acid (NA), amikacin (AN), nitrofurantoin (FM) and cotrimoxazole (SXT) for isolates of Escherichia coli was performed. Results: Of a total of 87 samples, 70. 2% of isolates were women and 29. 8% of isolates were isolated from men. Patients' age range was of 12-45 years. The popular resistance to antibiotics: cotrimoxazole (66. 6%), nalidixic acid (63%), ceftazidime (44. 8%), nitrofurantoin (26. 1%), amikacin (19. 5%), gentamicin (13. 7%) and imipenem (4. 5%) were evaluated. Conclusion: Based on the results of this study, the antibiotics imipenem and cotrimoxazole had the highest resistance and susceptibility, respectively. Therefore, it is recommended to stop the administration of cotrimoxazole antibiotics to treat urinary tract infections and use Imipenem.

Purpose: Nowadays, there is an increasing interest in investigating the relation between language and theory of mind in children with autism. However, until now the nature of this relation is not fully understood, because findings of such an investigation in these children have been inconclusive, and even less is known about the direction of effect and the most effective component of language on theory of mind. The present study examined the relation between expressive grammar and theory of mind in 10 Persian children with high functioning autism between ages 6 to 9 years and 20 typically developing controls. Methods: In this study, research data were collected from 10 children with autism and 20 normal children (10 age-matched and 10 language-matched). Initially, we used screening and diagnosing test for diagnosing children with high-functioning autism. Then, expression of different structures of syntax and their ability in theory of mind were respectively assessed by using expressive grammar and theory of mind tests. Finally, data were analyzed with correlation tests using SPSS statistical software. Results: Our results showed that in language-matched group, significant correlation was found between total score of correct structure and correct tasks, and third level of theory of mind. However, in children with autism and age-matched normal children; no significant correlation was observed. For depth understanding of this relation in children with autism, we compared this relation in specific structures and found that there is a significant correlation between expression of adverbial relative clause and personal ending, and second level of theory of mind and total score of theory of mind. Conclusions: Therefore, for analyzing the relation between language and theory of mind in children with autism, it is necessary to compare different structures separately, and in cognitive therapy (treatment for improving the theory of mind), we should pay attention to grammatical structures such as relative clause and personal ending.

Purpose: According to the widespread application of vestibular stimulation in clinics, organized treatment protocols seem to be necessary. This narrative article aimed to investigate the evidence-based current protocols and to guide this clinical flow into structured direction. Methods: In this narrative study, valid sites and databases such as PubMed, Web of science, Scopus, Medline and Google scholar were searched from 1972 till 2014. The Key words were “ Mechanical Vestibular Stimulation” , “ Children” , “ Semicircular Canals” , “ Otolits” and “ Rehabilitation” . Results: 203 articles were found and finally, 34 studies were analyzed according to the inclusion criteria. Their treatment protocols were discussed. Most studies have proved vestibular stimulation to be an effective treatment method and the overall evidence suggests the efficacy of the vestibular interventions in improvement of children with disability. Additionally, suggested protocols are categorized and presented. Studies showed that treatment would be effective if all the vestibular receptors including utricle, saccule and all semicircular canals were stimulated in different positions such as prone, supine, side lying, quadruped, sitting, kneeling and standing. Conclusion: In the light of the present evidence about the efficacy of mechanical vestibular stimulation, organized vestibular stimulation with specialized protocol is strongly recommended to be as one part of children therapeutic schedule in order for empowering rehabilitation process. It is suggested to be careful about the age in which stimulation is received, type of diagnosis, intensity of deficits, history of receiving stimulation, head position control, type of stimulation, frequency, amplitude and sequence of stimulation. Direction of stimulation, length of stimulation, even the duration of each single stimulation during one session and number of sessions, body position during receiving the stimulation, the break and stop intervals immediately after each movement, the delay between two back to back stimulations, health of peripheral and central vestibular system itself along with suitable assessment tools are better to be considered in defining and designing clinical intervention protocol of vestibular stimulation.