Journal of Paramedical Science and Rehabilitation
Year:2018 | Volume:7 | Issue:2 |Papers Count:10

Purpose: The aim of this study was to evaluate and compare ocular wavefront characteristics in bilateral keratoconus (KCN) patients with unilateral corneal Vogt`s striae. Methods: In this prospective cross-sectional contralateral eye study, fifty patients diagnosed with bilateral KCN with unilateral corneal Vogt`s Striae with age ranged 20-38 years were recruited. All subjects underwent a comprehensive ophthalmic examination, including monocular uncorrected distance visual acuity, monocular corrected distance visual acuity, refraction (converted to Vetcor component), slit lamp biomicroscopy, Scheimpflug-based tomography (Pentacam HR, Oculus, Germany), and placido disc-based topography (TMS-4, Tomey, Erlangen, Germany). Following pupil dilation, ocular wavefront aberrations were measured by means of iTrace (Tracey Technologies, Houston, Tx). All the ocular wavefront aberrations were evaluated and compared between the KCN eyes with and without Vogt`s striae. Wilcoxon signed rank test was used to compare the parameters. P-value <0. 05 considered statistically significant Results: A total of 50 bilateral KCN patients with the mean age of 27. 43± 5. 46 years were enrolled in this study. The results of this study showed that there were significant differences in the sphere, cylinder, spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity, and J0 (P <0. 05), except for J45 (P=0. 58) between two groups. Also, there were significant differences between two groups for some parameters measured by iTrace, including root mean square (RMS) total, RMS low-order total, RMS defocus, RMS Astigmatism, RMS High-order total, RMS Coma, RMS Spherical, and RMS Trefoil (P <0. 05), but there was no significant difference for RMS Secondary Astigmatism (P=0. 054) between the two groups. Conclusions: The iTrace measurements for ocular wavefront showed a significant increase in the majority of ocular HOA and LOA aberrations in the keratoconic eye with corneal Vogt`s striae compared to the eyes without Vogt`s striae. These results should be noticed in clinical evaluations and treatments of KCN patients with Vogt`s striae.

Purpose: Knowledge about inter-segmental coordination (ISC) during challenging walking conditions provides insight into the adaptability of central nervous system for controlling human gait. Particularly, this is an important issue in elderly people who are a large population of the society and are at risk of multiple falls while walking. The aim of our study was to evaluate the effects of speed of walking on variability and phase dynamics of inter-segmental coordination in elderly people with and without a history of falls. Methods: Twenty non-faller and 12 faller people participated in this study. They were asked to perform three walking trials on a treadmill, including walking at three paces (preferred, slower and faster). Deviation phase (DP) and mean absolute relative phase (MARP) values (indicators of variability and phase dynamic of ISC, respectively) were calculated. Results: The results showed that the main effects of walking speed were significant on pelvis-thigh, thigh-shank and shank-foot DPs. DP values were significantly higher during slower walking speed compared to preferred and fast walking speeds (p<0. 05). Furthermore, the main effects of walking speed were significant on the aforementioned ISC relationships, where MARPs of thigh-shank and shank-foot ISC were significantly higher during slower walking speed compared to fast walking speeds (p<0. 05). Conclusion: Our findings indicated that aging leads to increased ISC while falling and faster walking could result in a decreased ISC variability. Furthermore, falling and faster walking could make the dynamic of ISC more in-phase which may be a possible strategy to reduce the control effort by the controller system.

Purpose: Formant structure is the most important acoustic characteristic of vowels and the vowel is the main center of syllables. Therefore, an investigationof their formants structure is of great importance. The aim of the present study was to investigate the nine Azeri vowel's formants. Methods: The present study was a cross-sectional and descriptive-analytic study. The participants of this study were 50 (25 males-25 females) students of Tabriz University of Medical Sciences with their age ranging from 18-24 years old. The fundamental frequency (F0) of /a/ and /i/ vowels and the first, second, and third formants (F1, F2, F3) of nine Azeri vowels were determined with using Praat software. Statistical analysis was performed with SPSS software. When the data were normally distributed, independent t-test was used. Otherwise, Mann-Whitney test was used. Results: F0 of /a/ and /i/ vowels are significantly higher in females than males. /æ / and /i/ vowels in the both sexes, respectively, have the most and least F1. The most F2 in the both sexes is /i/ and the least F2 in male /æ / and in females is /o/. Also, in both sexes, the most F3 is /i/ vowel and the least F3 is /ø / vowel. Conclusion: /æ / and /i/ vowels in the both sexes, respectively, are the most open and closed vowels. /i/ vowel in the both sexes and /æ / in males and /o/ in females respectively, are the most front and most back vowels. The roundest vowel in Azeri is /ø / and the most spread vowel is /i/.

Purpose: This study aimed to quantitatively assess the color vision in patients with relapsing and remitting multiple sclerosis with and without visual symptoms using D15. Methods: In this study, 100 eyes of 50 patients with Multiple Sclerosis including 30 patients with visual symptoms and 20 patients without visual symptoms were compared with 50 eyes as the control group. Patients were divided into 4 groups: An involved eye of the patient with unilateral visual symptoms (group 1), fellow eye of the patient with unilateral visual symptoms (group 2), patient’ s eye without visual symptoms (group 3), and eyes of the comparison group (group 4). Visual acuity was measured in log MAR. Color vision was evaluated using D15. The results were quantitatively recorded based on Color Confusion Index (CCI). Results: The mean CCI of color vision was 131. 17± 19. 69 in the first group, 126. 39± 15. 31 in the second group, 123. 62± 10. 03 in the third group, and 117 in the fourth group. There was a significant difference between three groups and the control group. (p<0. 0001, p<0. 0001 and p=0. 01). No significant difference was observed between first and second groups (p=0. 149). There was no significant difference between second and third groups (p=0. 393). There was a significant difference between first and third groups (p=0. 01). Conclusion: Color vision disorder has been observed in patients with and without visual symptoms; however, the severity of the defect was different between groups. Quantitative assessment of the color vision test provides useful information of the natural history of the disease for examiner. In addition, there are appropriate clinical criteria to identify subclinical defects along with other diagnostic methods in patients with MS.

Purpose: Knee osteoarthritis is one of the most prevalent musculoskeletal disorders causing joint destruction and consequently, the proprioceptive deficits, hence decreased balance and falling. The aim of the present study is to investigate the effect of core-stability exercises on knee osteoarthritis. Methods: This study used a quasi-experimental with the pre-test and post-test. Twenty-five women with knee osteoarthritis were selected via the purposive and convenience sampling technique. Afterwards, they were divided into two experimental groups (groups 1 & 2). Participants performed exercises for 8 weeks, each of which consisted of three sessions. At the beginning and at the end of the research, their static balance, dynamic balance, and fear of falling were tested by the One Leg Stance Test (OLST), Y balance test, and Falls Self-Efficacy Scale (FES-I), respectively. For analyzing statistical data, descriptive statistics, and repeated-measures ANOVA (type II) were used at the significance level of 5%. Results: A significant increase was observed in the static and dynamic balances in the experimental group 1 and experimental group 2 (P<0. 001). Overall, no significant difference was observed between the two groups for dynamic and static balance scores (p>0. 05). Regarding the score of fear of falling in the experimental group 1 and experimental group 2, a significant difference was observed (p<0. 001). In general, no significant difference was observed between the two groups for fear of falling (p>0. 05). Conclusion: It could be concluded from the findings of the research that the addition of core-stability exercises to strengthening and balanced ones which focus only on knee joints can be effective on the improvement of balance and the reduction of the risk of falling for patients with knee osteoarthritis.

Purpose: Refractive errors are the fourth cause of blindness in the world, and if they are not recognized or corrected, they can expose the child to amblyopia and blindness. Epidemiological information is needed to prevent and detect refractive errors. . Due to the limited researches on refractive errors of children in Fars province, this study aimed to determine the prevalence of refractive errors and anisometropia in 6-7 years old children in the city of Fasa. Methods: In this cross-sectional study, we used two-stage cluster stratified random sampling and selected 633 preschoolers. A total of 601 preschoolers were referred to clinic but 596 cases of all were examined. Results of cycloplegic refraction were recorded for statistical analysis. Results: In this study, the prevalence of myopia, hyperopia astigmatism and anisometropia were 6/54%, 10/57%, 32/55%, 3/02%, respectively. Also the rates of the prevalence of astigmatism were 24/16%with the rule, 7/21 % against the rule and 1/17%. oblique Prevalence of refractive errors in boys and girls respectively: myopia 8/01% and 5/17%, hyperopia 10/1% and 11%, astigmatism 31/35% and 33/65%, anisometropia 2/78% and 3/23 %. According to the chi-square test, there was no significant difference between girls and boys in refractive errors and anisometropia. The prevalence of astigmatism according to thewith the rule, against the rule and oblique in boys and girl were as follows: (27/17% and 21/35%), (11/32% and 2/78%), (1/39% and 0/97 %). According to chi-square test, against the rule astigmatism were significantly more prevalent in girls than boys (p<0. 001). Conclusion: According to the result of the present study, astigmatism was the most prevalent refractive error in preschoolers in Fasa province. In comparison to the other studies the prevalence of hyperopia was average amount but myopia was almost high. Anisometropia was not a serious problem. According to the high level of astigmatism and myopia in this study, we recommend other studies should be accomplished in preschoolers in Fars.

Purpose: Coronary artery bypass graft is associated with numbers of physical and psychological problems. One of the aims of the cardiac rehabilitation program is to improve health related physical fitness factors and quality of life. Therefore, the objective of the present study is to investigate the effect of eight weeks pilates exercise on the strength and quality of life in heart patients after coronary artery bypass grafting. Methods: Twenty-two women with cardiac problem under coronary artery bypass grafting were selected and divided randomly into two equal groups: experimental (mean ± SD, age 60. 4± 8. 8 years, height 157. 5± 6 cm, weight 77. 5± 13 kg) and control groups (mean ± SD, age 62. 8± 8. 1 years, height 154. 4± 3 cm, weight 77. 4± 9. 5 kg). Experimental group performed pilates exercise for eight weeks, three sessions per week and each session took an hour, while the control group did not perform any exercise. The hand grip strength (hand-held dynamometer) and the quality of life (MacNew questionnaire), were measured before and after the pilates exercise intervention in all of patients. The data were analyzed with repeated measures analysis of variance (p<0. 05). Results: Strength of experimental group showed significant improvement after the pilates exercises (p<0. 05, 14. 9 vs 20. 2), however, no significant difference was observed between pretest (17. 1) and posttest (16. 8) in the control group, (p>0. 05). In total, significant differences were observed in strength between experimental and control groups (p<0. 05). Quality of life of experimental group showed significant improvement after the pilates exercises (p<0. 05 4. 3 vs 5. 3), but no significant difference was seen in the control group between pretest (4. 5) and posttest (4. 5), (p> 0. 05). In total, significant differences were observed in quality of life between experimental and control groups (p<0. 05). Conclusion: It can be concluded that Pilates exercise improve strength and quality of life in women with heart disease after coronary artery bypass surgery, so it can be recommended as a part of rehabilitation program for these patients.

Purpose: Understanding the condition of internal environment of a hospital offers a starting point plan to improve hospital performance. The present study aimed to assess the internal environment of hospitals at Mashhad University of Medical Sciences based on Wiseboard model. Methods: This cross-sectional study was conducted in 2016 on 360 employees from hospitals at Mashhad University of Medical Sciences selected through stratified-random sampling method. Standardized Wisebord questionnaire was used for data collection. The status of each of the seven dimensions of the internal environment of hospitals was evaluated using 35 questions with seven options in Likert scale. The mean less than four was evaluated as weak, equal to four as neutral, and above four as strong status. Data were analyzed using descriptive statistics methods and Spearman, Mann-Whitney and Kruskal-Wallis tests. Results: The condition of internal environment of the studied hospitals was evaluated as weak in terms of communication, neutral for structure, and strong for purposing, rewards, leadership, coordination, and attitude for change. There was a statistically significant relationship between structure and type of employment, purposing, coordination and field work, and coordination, rewards and marital status. Conclusion: Generally, the condition of internal environment of the studied hospitals was strong. The status of relationship and structure which were in weak and neutral conditions could be improved by modifying the organizational structure of hospitals and reinforcing internal relationships/communications.

Purpose: Since characteristics of specific language impairment (SLI) are not well known yet, and several hypotheses have been proposed in different investigations, periods and languages, it seems necessary to investigate it in different languages. There are some hypotheses about dependency of impairment to language characteristics and these hypotheses are other reason for necessity of examining the SLI in different languages. To investigate SLI, the first step is to identify and understand the various assumptions in the field. Therefore, the aim of the study was to explain different hypothesis about SLI. Methods: For this purpose, special articles related to SLI was gathered by using Science Direct, Elsevier and Google Scholar, data bases, between 1970-2014 and 58 article reviewed. Conclusion: Studding different hypotheses indicate that development in linguistic theories, result in changes in hypotheses and develop new hypothesis. Additionally, it has been shown that we can classify and study hypotheses with different view points, or choose and study one of them that is language-specific.

Purpose: As the population of older people grows, the rate of falling among them increases significantly. This may lead to serious damage to the health status of the older people, their families and the society. One of the conditions that may result in falling in older people is when they walk and simultaneously perform another cognitive or motor task, known as dual-task walking (DTW). DTW is an interesting issue in the fields of geriatrics, cognitive and motor sciences and it is important for the researchers to decide how to design their studies on DTW paradigm. Thus, the aim of this study was to review the methodologies of DTW studies in older people. Methods: We searched Scopus, PubMed, Embase and Index Copernicus since, 1998 till 2016. The keywords were a combination of three categories: 1) Elderly/ Older people/ aged people/ Aging; 2) Walking/ gait and 3) Cognitive/ executive function/ Memory/ Working memory/ Attention/ Processing speed/ Visuospatial/ Language/ Psychomotor speed. Results: Sixty-four articles met our inclusion criteria. The cognitive, motor and/or cognitive-motor tasks as the concurrent task while walking, the instrumentation for evaluating gait performance and the effects of dual-tasking on both gait properties and the quality of performing the concurrent task, were considered in our study. Conclusion: While several cognitive and motor tasks are available to be used in the DTW and they need to be chosen based on the objectives of the studies, cognitive tasks are more prevalent. It may be attributed to the safety of the tasks since the hands are free to protect the elderly from possible falling during walking. Moreover, the speed of walking and other linear properties of walking were assessed in most of the studies.