Iranian Rehabilitation Journal
Year:2013 | Volume:11 | Issue:17|Papers Count:14

Objectives: To compare the effectiveness of two treatment methods of ‘combination pharmacological treatment and treadmill training’ and ‘pharmacological treatment’ on management of multiple sclerosis (MS) female patients.Methods: In this quasi experimental and interventional study a sample of 20 MS patients (mean age: 36.75 years) with Expanded Disability Status Scale scores (EDSS) 1.0 to 4.0 were randomly assigned to a ‘pharmacologic treatment’ (Ph) group and a combination group of ‘pharmacologic treatment& treadmill training’ (PhTT). All these individuals used the drugs of choice ‘Rebif’ and ‘Avonex’. The intervention consisted of 8-weeks (24 sessions) of treadmill training (30 minutes each), at 40-75% of age-predicted maximum heart rate for the PhTT group. The Ph group followed their own routine treatment program. Balance, speed and endurance of walking, quality of life and fatigue were measured by Berg Balance Score, 10 meter timed walk test, 2 minute walk test, and Fatigue Severity Scale (FFS). Data were analyzed by paired t test and one way ANOVA.Results: Comparison of results indicated that pre and post intervention led to significant improvements in the balance score (P=0.001), 10m walk time (P=0.001), walking endurance (P=0.007), and FFS (P=0.04) in the PhTT group. In contrast, no significant changes were observed in the Ph group's balance score, 10m timed walk and fatigue, while there was a significant decrease in the 2min walking distance (P=0.015) in this group.Conclusion: These results suggest that treadmill training in combination with pharmacological treatment improve balance and walking capacity and level of fatigue in women with mild to moderate MS.

Objectives: A large number of congenitally deaf children are born annually. If not treated, this will have destructive effects on their language and speech development, educational achievements and future occupation. In this study it has been tried to determine the level of language skills in children with Cochlear Implants (CI) in comparison with Normal Hearing (NH) age-mates.Methods: Test of Language Development was administered to 30 pre-lingual, severe-to-profound CI children between the ages of 5 to 8. The obtained scores were compared to a Persian database from scores of normally hearing children with the same age range.Results: Results indicated that in spite of great advancements in different areas of language after hearing gain, CI children still lag behind their hearing age-mates in almost all aspects of language skills.Conclusion: Based on the results, it is suggested that children with average or above average cognitive skills who use CI have the potential to produce and understand language comparable to their normally hearing peers.

Objectives: Psychotropic drug use in the elderly with chronic schizophrenia is an important issue in the field of psychiatry. The main goal of this study was to clarify the pattern of such drug use in these patients, in order to consider such therapy plan and focus on its cost attributing measures, for a more reasonable quality of care program.Methods: In this descriptive study, participants included 52 elderly patients at Tehran's Razi Mental Hospital who had chronic schizophrenia in the residual phase. Selected patients were taking at least two psychotropic drugs equivalent to 500mg Chlorpromazine. We prepared the list of the drugs used by completing the pre-designed questionnaire charts. Data were analyzed with SPSS 17.Results: In one case (1.92%) the entries were Risperidone, Chlorpromazine, Fluphenazine Decanoate, & Thiothixene). In 11 cases (21.2%) there were three entries and in 40 cases (76.8%) there were two. The Chlorpromazine equivalent dose in each group ranged from the lowest dose (750. mg) to the highest (5600.mg). The highest Chlorpromazine dose (5600. mg) equivalent per milligram belonged to the four entries of (Risperidone, Chlorpromazine, Fluphenazine Decanoate & Thiothixene). The lowest Chlorpromazine dose (750. mg) was seen in 3 entries of Risperidone, Chlorpromazine & Fluphenazine Decanoate.Conclusion: There was a high prevalence of using more than two psychotropic medications from the first atypical antipsychotic category. Less frequently, the second and the third typical antipsychotics were used. We recommend further research into more feasible patterns of psychotropic prescriptions, lowering the amount of medication use and considering their cost-benefits in the elderly with chronic schizophrenia.

Objectives: Nouns and verbs are the central conceptual linguistic units of language acquisition in all human languages. While the noun-bias hypothesis claims that nouns have a privilege in children’s lexical development across languages, studies on Mandarin and Korean and other languages have challenged this view. More recent cross-linguistic naming studies on children in German, Turkish, English and Korean demonstrate that all languages, including Korean show a noun advantage, however the degree of this discrepancy differs between languages. The aim of this study was to look at object and action naming in normal Persian children as a measure of conceptual development in preschool children and its possible use for screening and therapeutic procedures.Methods: In this analytical study, noun bias and processing dissociation of object and action naming in 64 three to six year old healthy monolingual Persian-speaking children was investigated. A black and white picture naming task, consisting of 36 nouns (natural and man-made), and 36 verbs (transitive and intransitive) was designed using DMDX software to measure response accuracy and reaction time of the subjects.Results: The results indicate a significant noun advantage with regard to accuracy and naming latencies. The results also reveal that transitive verbs are named more accurately than intransitive ones in Persian speaking children. Also, the data indicate that accuracy of object and action naming improve with age (p=0.000).Conclusion: Based on the results we recommended that a standardized Persian object and action naming battery be used. Such a tool would have the potential of screening lexical development delay and possible noun-verb performance gap in preschool children.

Objective: The aim of the study was to determine the effect of a selected exercise training on reducing symptoms of dementia caused by Alzheimer's disease in people with Down syndrome.Methods: 27 men with Down syndrome were randomized to intervention (n=13) and control (n=13) groups. All persons in experimental group followed 12 weeks selected exercise training, three times a week. Prior to the start of the study, and after three-month training, each member in both groups was assessed according to the DSQIID questionnaire filled by caregivers of these peoples. Data were analysed by independent T test.Results: The results indicated that the first questionnaire subscales that assess memory disorders and confusion in the experimental group between pre and post test showed a significant decrease (P=0.028). Also in third part of questionnaire that asked about the individual skills, social withdrawal, physical symptoms and speech abnormalities, the variable scores in post-test of experimental group were significantly lower than pre-test scores (P=0.047).Conclusion: These result showed that the combination of selected exercises training could cause a significant reduction in the incidence of initial dementia symptoms and can be an important step to prevent of the dementia in these people.

Objectives: The aim of present study was to determine the effectiveness of conceptual map training method on the achievement of social-economic skill course in male students with intellectual disability.Materials & Methods: This study was semi-experimental and 34 male students with intellectual disability who were educating in 3rd grade at pre-professional level in high school selected randomly from Talash Exceptional Center in Tabriz City. Their academic achievement in social-economic skill course were assessed by teacher-made and performance tests. Subjects were assigned in control and experimental groups randomly and equally. Experimental group participated in 8 sessions and were trained by conceptual map method for one month (8 sessions, 2 sessions weekly). At the end of eightieth session and one month later, subjects answered to teacher-made and performance tests again. Data were analyzed by analysis of covariance.Results: Findings showed that the conceptual map training method had positive effect on achievement of social-economic skill in students (p<0.01). But, its effectiveness wasn’t persistent after one month in follow-up test.Conclusion: Regarding to positive effects of conceptual map training method on meaningful learning, it seems as an effective method for intellectually disabled male students who require deep learning to understand the content of their lessons.

Objective: Some of the mothers of children with cancer suffer from reactive depression and confront existential crises, and benefit from their image of God in coping with it. The purpose of this study was to determine the effectiveness of spiritually-oriented cognitive therapy on reducing depression symptoms in mothers of children with cancer.Method: A single case experimental design and an A-B form were used in this study. The participants were selected through purposeful sampling. We studied three of the mothers of children who had been admitted to the pediatric ward of ‘Mofid Pediatric Hospital’. These children were aged under 12 years, they suffered from any kind of cancer except brain tumor, cancer had not metastasized to other parts of the body, the mothers themselves had no history of psychiatric illness prior to their child's illness, and had mild to moderate depression at the time of screening. These mothers were subjected to spiritually oriented cognitive therapy for 10 individual sessions, 90 minutes per week. The depression grade and the changes were measured with Beck Depression Inventory (BDI-II).Results: Comparing the mothers’ scores through 8 times of completing the inventory (three at baseline, three during the therapy and two follow-ups), and calculating the percent of recovery showed a decrease in depression scores.Discussion: It seems that spiritually-oriented cognitive therapy can enhance the spiritual experience and reduce depression in cognitive and existential contexts.

Objectives: The GALS (Gait, Arms, Legs and Spine) examination is a compact version of standard procedures used by rheumatologists to determine musculoskeletal disorders in patients. Computerization of such a clinical procedure is necessary to ensure an objective evaluation. This article presents the first steps in such an approach by outlining a procedure to use motion analysis techniques as a new method for GALS examination.Method: A 3D motion pattern was obtained from two subject groups using a six camera motion analysis system. The range of motion associated with GALS was consequently determined using a MATLAB program.Results: The range of motion (ROM) of the two subject groups was determined, the validity of the approach was outlined, and the symmetry of movement on both sides of the body was quantified through introduction of a dependency coefficient.Conclusion: Analysis of GALS examination and diagnosis of musculoskeletal problems could be addressed more accurately and reliably by adopting motion analysis techniques. Furthermore, introduction of a dependency coefficient offers a wide spectrum of prospective applications in neuromuscular studies.

Objectives: The purpose of this study was to determine the relationship between emotional intelligence and occupational stress among rehabilitation staffs in Tehran's training hospitals.Methods: A cross-sectional study was conducted on a sample of 169 staff members selected from a total of 300 rehabilitation staffs working in Tehran's training hospitals, recruited by random cluster sampling.Two questionnaires were used: The emotional intelligence questionnaire designed by Petrides and Furnham and HSE occupational stress questionnaire. Data obtained from this study were analyzed using Pearson's correlation and multiple regression tests.Results: An inverse significant relationship existed between occupational stress and emotional intelligence (P<0.001, r=-0.33). There are, also, significant relationships between subscales of emotional intelligence including self-awareness (P=0.031, r=-0.18), social skills (P<0.001, r=-0.302), empathy (P=0.006, r=-0.238) and occupational stress. The results of multiple regressions indicated that the two subscales of ‘understanding other's emotions’ and ‘social skills’ can be used for predicting occupational stress.Conclusion: This study confirmed the relationship between emotional intelligence and occupational stress. Promotion of emotional intelligence through implementing training courses may lower rehabilitation staffs occupational stress or prevent it.

Objectives: Multiple sclerosis (MS) is a disease of the central nervous system that results in many symptoms including mobility limitation, fatigue, cognitive dysfunction and redacted quality of life. The purpose of this study was to determine the effect of 8-weeks aerobic and yoga training on depression, anxiety and quality of life in individuals with MS.Methods: 31 women with MS (mean of age of 34.15years) with Expanded Disability Status Scale scores 1.0 to 4.0, were randomly assigned to one of three groups lasting 8 weeks: treadmill training, yoga or a waiting-list control group. Treadmill training consisted of 8 weeks (24 sessions) of treadmill training (30 minutes), at 40 -75% of age-predicted maximum heart rate. Yoga group subjects participated in a thrice weekly 60-70 minute sessions of Hatha yoga intervention for 8 weeks. The control group followed their own routine treatment program. Depression, anxiety and quality of life were measured by Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54) respectively. Data were analyzed by MANOVA, Tukey and paired T tests.Results: Results indicated that intervention has improved significantly BDI score, BAI score and some MSQOL-54 scale scores in the treadmill training group and yoga group. There were significant differences between treadmill training group and yoga group in BAI score and MSQOL-54 scale scores.Conclusion: These results suggest that treadmill training and yoga practice improved depression, anxiety and quality of life in people with mild to moderate MS.

The main goal of this report was to share with clinicians an atypical presentation of pulmonary thromboembolism (PTE) in a young male's post-appendectomy, whom he had no significant predisposing factors for such disease. The case also introduced for re-examining the challenges of PTE clinical manifestations which may mimic other differential diagnosis.PTE is an abrupt blockage of the pulmonary artery by a thrombus. Such thrombus is generated by a blood clot which has been formed, separated and migrated from the leg and/or pelvic veins toward the lung. The lung tissue's circulation is impaired which later episode results hypoxia and infarction. These events initiate a set of PTE clinical manifestations.

The aim of this review article is describing a research on spiritual and religious interventions in Iran. An integrative review was conducted to determine the state of the science in Iran. Iranmedex, Scientific Information Database, Irandoc, Noormags, Magiran and Google scholar were searched to find articles published in peer-reviewed journals from August 2002 to August 2012. A qualitative approach utilizing content analysis was used in the review. Overall, 21 articles on spiritual and religious interventions in Iran's health care system which met the search criteria were included from 800, 000 records in 438 journals. The review shows that there are at least four overarching themes of spiritual and religious interventions: spiritual and religious behaviours, spiritual care as part of a holistic caring approach, spiritual/religious therapy as an effective healing technique, and patients’ spiritual needs. These themes are linked and interrelated. The main concern for caregivers was “hanging on to spirituality” in spite of the eroding effects on spiritual beliefs caused by different factors in the health care system. Spirituality plays an important role in the way people live and die. The majority of the research on spiritual and religious interventions in Iran’s health care system focuses on patients’ need toward spiritual care and health professionals’ spiritual approach, as well as factors that influence their spirituality. More research is needed on the factors that influence patients’ spiritual needs, spirituality among health care providers, and interventions to engender spiritual and religious interventions in the health care system.

Objectives: To check and compare the effectiveness of modified agility and perturbation training over conventional physical therapy in patients with knee osteoarthritis.Methods: Subjects were screened on the basis of inclusion and exclusion criteria and a total of 50 subjects were recruited for the study. They were randomly divided into Group A and group B with n=25 each.Results: Group receiving conventional knee exercises with modified agility and perturbation training showed statistically significant results.Discussion: It was found that supplementing rehabilitation programs for people with knee OA with a modified agility and perturbation training program assist them in returning to higher levels of physical activity with less pain and instability following rehabilitation.

Objective: To report a case of somatoform disorder (not otherwise specified-NOS).Methods: The patient was an eight-year-old boy who complained of anxiety and seeing visual hallucinations of colorful shapes. He was administered ant migraine and antiepileptic drugs. However, no changes were observed. Psychotherapy was started, as well as fluoxetine (20 mg per day). Initial assessments included a behavioral interview, charting of daily activities, and recording visual hallucinations with a description of the patient's emotional and situational condition during the hallucinations.Results: The patient's visual hallucinations disappeared completely after two months of treatment.Conclusion: Somatoform disorders may respond well to a combination of behavioral therapy and antidepressant medication.