Iranian Rehabilitation Journal
Year:2015 | Volume:13 | Issue:4|Papers Count:22

Objectives: The purpose of the present study was to investigate the abnormalities observed in the oral narrative skills of late talkers mostly caused by mental disorders while they try to comprehend a wordless sequential picture story to create and narrate the relevant story.Methods: Totally 15 (10 male and 5 female) individuals were selected based on the purposive sampling.The participants were the students of a specialized school for physically and mentally retarded students.They were the students of grade one ranging in age from 6 to 13. All of them had language delay which was caused by mental disorder. Their narrations were observed and recorded in a semi natural setting by the researchers and their speech therapist.Results: Based on the data collected from the interview tackled by the researchers it was concluded that most of the students were not able to keep the sequence while narrating the picture.Discussion: With regard to syntactic patterns, all of the sentences were holophrastic or two-word utterances bearing a simple structure although some exceptions were noticed. An element which was mostly seen in the participants was their inability to name the objects because of their restricted lexicon; therefore they compensated this shortage through trying to define the function of the words they wanted to utter.

The holistic approach encourages the client to include rehabilitation strategies that support the general person condition. In this approach in every condition of physical and mental health, decreasing stress and increasing person’s immunity and psychological resilience can help the whole body cope better, rehabilitate more quickly, and maintain better health (1). Holistic treatment means that the rehabilitation treatment should offer recovery treatment that addresses the needs of the whole person body and mind (2, 3).

Objectives: There are some comorbidity between migraine, tension headaches, and some psychological factors including Early Maladaptive Schemas (EMSs). This research aimed to identify the EMSs associated with migraine and tension headaches.Methods: The present study was of cross sectional and correlational studies. The measures included Headache Disability Inventory and Young Early Maladaptive Schemas Questionnaire (Short Form). The population of the study was Tehran adult patients with migraine and tension headache aged 18 to 55 years. The final study sample included 69 participants with migraine or tension headaches and 86 nonclinical samples of both genders. After referring by psychiatrists, they were selected by convenient and targeted sampling. The two groups were matched based on sex and education.Results: Migraine and tension headache sufferers and non-clinical participants were significantly different in 9 schemas including Emotional deprivation, Abandonment/ instability, Mistrust/ abuse, Social isolation/ alienation, Failure to achieve, Enmeshment / Undeveloped Self, Subjugation, Self-sacrifice and Emotional inhibition. In addition, a series of EMSs could significantly predict 61 percent of the total change in position of tension headaches or migraine group correctly.Discussion: It seems that EMSs are important factors influencing migraine and tension headaches. The recognition and manipulation of these schemas along with other medical therapies can result in reducing the symptoms of the disorder.

Objectives: The aim of this study was to evaluate the effects of olfaction, audition and tactile senses in mobility and orientation of blinds.Methods: The statistical sample of this research included 100 blind persons aged between 16 and 75 years (61 males and 39 females) with different level of education (16 persons lower than the diploma, 26 persons diploma, 46 persons bachelor, 12 person MA), were randomly selected from most regions of the country. Analysis of obtained data were done by Friedman statistical method and using the SPSS software.Results: It showed the close relationship between the senses, and according to the null hypothesis, based on senses role from the blind's opinion, audition sense has a highest rating and tactile sense has a lowest rating in mobility and orientation of blinds.Discussion: Telemetry senses, especially audition, were more important in mobility and orientation of blinds. Thus, with proper training of blinds to use their existing capabilities and also with organizing the environments around in a way to increase their ability, they can have mobility and activity in environment easily.

Objectives: Joint attention is one of the most important prerequisite of language and social development. There are two types of joint attention, Initiating joint attention and Responding to joint attention. This study examined the development of responding to joint attention in typically developing children in 8-30 month.Methods: This study was cross-sectional.61 children (40 female and 21 male) were examined in age 9, 12, 15, 18, 24 and 30 month. Tasks of joint attention scale of Early Social Communication Scales (ESCS) were used to assess children. Colmogrov-Smirinov and Kruskal-Wallis were used for data analysis and mean scores were computed for all groups.Results: Data analysis showed that there was significant difference between mean ranks of groups.Children scores had an increasing pattern across 9 to 30 month.Discussion: Results of this study indicated that responding to joint attention is developing from 9 to 30 month by considering the individual differences between children in every group.

Objectives: The aim of present study was evaluation of saccular function in cochlear implant candidates with severe to profound sensory neural hearing loss. Before and after cochlear implantation Methods: In this study 35 Cochlear Implant (CI) candidates with bilateral severe to profound sensory neural hearing loss before and about 30 days after cochlear implantation and 20 normal-hearing cases as a control group underwent VEMP test. Both groups were matched based on gender and age.Results: VEMP responses were absent bilaterally in 10 out of 35 patients.4 patients were excluded from the study because they did not receive CI during present study. From 21 remaining patients, 5 cases lost VEMP response in their implanted ear after surgery. In control group, VEMP responses were present bilaterally.Discussion: The results of present study show that saccular dysfunction in CI candidates is extremely probable and this is possible that saccule get impaired after CI.

Objectives: Multiple Sclerosis (MS) is the most prevalent central nervous system diseases that due to chronicity, frequent recurrence, uncertainty about progression, and disability, can lead to various distresses as well as demoralization. Rehabilitation method based on Cognitive-Existential therapy is an integrated approach to decreasing demoralization syndrome in these patients. This study aimed to exploring effectiveness of rehabilitation method based on Cognitive-Existential approach on decreasing demoralization syndrome in patients with Multiple Sclerosis.Methods: Single subject design was used in this study. Among women who had referred to Tehran MS Association, 3 women (aged between 20-40) were selected through purposeful sampling and separately participated in 10 sessions (90 minutes). Participants were assessed during 7 phases of intervention (2 baselines, 3 measurements during intervention, 2 follow-up) through Demoralization Syndrome Scale and Cognitive Distortion scale. Data were analyzed by calculating process variation index and visual analysis.Results: Comparing patients with MS scores on the diagram during 7 time measurement and calculating recovery percentage, represent decreasing in demoralization syndrome score scale.Discussion: Findings showed that rehabilitation method based on Cognitive Existential approach can decrease demoralization syndrome in patients with MS.

Objectives: One of the problems in the process of assessment and evaluation, especially the evaluation of clinical training in rehabilitation disciplines, is the lack of an appropriate instrument for this purpose. Considering the effects of appropriate evaluation on quality assurance of clinical training, the aim of the present study was to design a valid and reliable tool for general evaluation of clinical training in rehabilitation disciplines.Methods: This study was carried out initially by literature review and then by holding a focus group discussion with the trainers and mentors of rehabilitation clinics whom were recruited by convenient purposive sampling. The main indicators for evaluation of training in these fields were determined. After classification of the indicators, evaluation tool was developed. The face validity and content validity of the tool were determined with the Lawasche's method. The reliability was determined with the test- retest method and Cronbakh's alpha coefficient.Results: Content analysis of the focus group discussion (FGD) resulted in determining 57 indices which were classified in 5 categories (including: the educator or trainer, the Trainees (students in these disciplines), administration of clinical training, fields of training and evaluation of clinical training). The final tool was adjusted in two separate questionnaires. The correlation coefficient for the questionnaire of the clinical trainers was 0.9, its Cronbakh's alpha coefficient was 0.88 and its content validity coefficient was 0.84. The correlation coefficient for the questionnaire of the students was 0.7, its Cronbakh's alpha was 0.92 and its content validity coefficient was 0.81.Discussion: The designed tool for the evaluation of clinical training in rehabilitation disciplines indicated acceptable validity and reliability and is appropriate for the assessment of trainings.

Objectives: In clinical practice, nurses who have shown consternation at the psychological well being are more motivated in practice. The stigma of needing mental health care remains a concern for most people.The purpose of the study was to predict the psychological well-being of rehabilitation nurses based on personality traits and defense mechanisms.Methods: In a co relational research, the participants consisted of all married female nurses in rehabilitation hospitals of the Qom city. The sample size estimated by Tabachnik and Fidel method 114 and with Overestimate attain to 120 people. The participants were selected by cluster random sampling method. Data collected by Ryff's Scales of Psychological well-being, Big Five Personality Inventory short form (NEO FFI) and defense style questionnaire (DSQ - 40). Data analyzed by Pearson correlation coefficient and multivariate regression by the use of SPSS software (V20).Results: Analysis of research data indicated that traits of extroversion (P≤0.01), neuroticism (P≤0.01), agreeableness (P≤0.01), mature defensive style (P≤0.01) and immature defense style (P≤0.01) could explain variance of psychological well-being of nurses significantly.Discussion: Considering to the findings of this research can concluded that personality traits and defense styles be able to predict the psychological well-being significantly.

Objectives: Stroke is the leading cause of long-term disability. Hand motor impairment resulting from chronic stroke may have extensive physical, psychological, economical, and social implications despite available rehabilitative treatments. The best time to start treatment for stroke is in sub-acute period. Repetitive Trans cranial Magnetic Stimulation (rTMS) is a method of stimulating and augmenting the neurophysiology of the motor cortex in order to promote the neuroplastic changes that are associated with motor recovery.The purpose of this study was to compare the effects of repetitive trans cranial magnetic stimulation protocols plus routine rehabilitation on hand motor functions and hand corticomotor excitability in stroke patients with hemiplegia with pure routine rehabilitation programs.Methods: This study was a randomized clinical trial which was performed on 24 patients with hemiplegia who were randomly divided in to three groups: received high frequency rTMS, received rehabilitation program with low frequency rTMSI, who were given only routine rehabilitation programs. The treatment was performed for 10 sessions, three times pre-post test and follow-up about neurophysiological contralesional hemisphere evaluations using record of MEP wave indices by single pulse TMS, and assessing functional wolf test and hand grip power of disabled hand by dynamometer.Results: The results demonstrated that the rest MEP threshold reduction in experimental group which received high frequency magnetic stimulation was not statistically significant (P=0.387). There was significant reduction for active MEP threshold in the within group (P=0.031). Also there were statistically significant between obtained results from WOLF test and grip test.Discussion: According to the results, it seems that HfrTMS combined with routine physiotherapy can significantly improve hand functions and brain neurophysiology via specifically increase of contralesional corticomotor excitability in sever stroke patients. It indicated the role of neuroplasticity in nonlesioned hemisphere; but the hypothesis of movement improvement related cognitive balance can' t be eliminated by exploring powerful approved effect of HfrTMS on mood regulation.

Objectives: Specific language impaired children, despite being normal in cognitive and neurological characteristics, and also normal levels of hearing, experience multiple problems in syntax comprehension.This study compared the passive comprehension in Persian-speaking typically developing children and Specific language impaired children.Methods: 10 children with Specific language impairment, 10 typically developing children matched for age with Specific language impaired children, and 15 younger typically developing children responded to passive sentence comprehension using picture identification task.Results: The results of study revealed significant differences in comprehension of passive sentences in Specific language impaired children and age-matched typically developing children. The difference in Comprehension of passive sentences was not statistically significant in Children with Specific Language Impairment and younger typically developing children. There were significant differences in the comprehension of passive sentences between two typically developing children groups.Discussion: While age-matched typically developing children comprehend passive structure completely, it seems that Specific language impaired children and younger typically developing children still have not come to a full comprehension of the passive structure. Specific language impaired children compared with age-matched and younger typically developing children interpreted passive sentences mostly as active sentences.

Objectives: Self-instruction training assists students to organize thinking patterns, learning, self-assessment, and self-awareness. This study was aimed to determine the effectiveness of verbal self-instruction training on math problem-solving of intellectually disabled male students in Tehran Provinces.Methods: This study was an experimental research with pre-test and post-test design with control group. 30 intellectually disabled male students were selected randomly through cluster sampling method from 9th grade students. They were assigned to experimental and control group equally. Experimental group participated in 8 sessions and were trained by verbal self-instruction program but control group did not. All students answered to a teacher-made math problem-solving test before and after the training sessions. Data were analyzed by analysis of covariance.Results: Findings showed that there was a significant difference between two groups according to math problem-solving performance (p<0.002).Discussion: As the performance of math problem-solving of experimental group promoted after the intervention sessions in comparison to control group, it seems that verbal self-instruction has led students to use thinking skills for acquiring and retention of fundamental mathematics facts. It can conclude that verbal self-instruction training probably leads to promote math problem-solving performance of intellectually disabled boy students.

Objectives: This paper describes further improvement and preliminarily evaluation of a novel viscoelastic ankle-foot prosthesis prototype. The objective was to control the ankle hysteresis at slow and normal walking speeds.Methods: Inspired by the ankle biomechanics, in which the hysteresis differs based on the gait speeds, a manually damping control mechanism imbedded in the prosthesis for adjusting the ankle damping at slow and normal walking speeds. The prototype was then preliminarily tested on an able-bodied subject wearing an adaptor which simulates the amputee walking. The ankle joint kinetics and kinematics were measured in a gait analysis lab at different walking speeds.Results: The results suggest that the viscoelastic ankle foot prosthesis prototype could provide a smooth normal-like walking for most of the measured gait characteristics in slow and normal speeds.Discussion: Therefore, it is suggested to apply a controllable damping mechanism based on the gait speeds in the design of new prosthetic feet.

Objectives: The aim of this research is designing a computerized program, in game format, for working memory training in mild intellectual disabled children.Methods: 24 students participated as test and control groups. The auditory and visual-spatial WM were assessed by primary test, which included computerized Wechsler numerical forward and backward subtests, and secondary tests, which contained three parts: dual visual-spatial test, auditory test, and a one syllable word recalling test.Results: The results showed significant differences between working memory capacity in the intellectually disabled children and normal ones (p-value<0.00001). After using the computerized working memory training, Visual-spatial WM, auditory WM, and speaking were improved in the trained group. The mentioned four tests showed significant differences between pre-test and post-test. The trained group showed more improvements in forward tasks. The trained participant’s processing speed increased with training.Discussion: According to the results, comprehensive human-computer interfaces and the aplication of computer in children training, especially in traing of intellectual disabled children with impairements in visual and auditory perceptions, could be more effective and vaulable.

Objectives: Adolescents are the most vulnerable group of the society when it comes to risky behaviors. As a consequence of their volatile behavior during adolescence they are more likely to behave in ways that threatens their ongoing physical and psychological health and their future. The current study was designed to examine the association between the emotional expressiveness style and addiction potential among male high school students.Methods: A cross-sectional study was conducted on 180 male high school students that had been selected through multi-stage random sampling from Karaj city’s at-risk high schools. The research tools consisted of: a) the researcher-made demographic questionnaire, b) addiction potential scale, c) emotional expressiveness questionnaire. Pearson’s correlation coefficient and multivariate analysis of variance (MANOVA) were used for data analyzing.Results: Based on the results, emotional expressiveness and its components were negatively and significantly associated with addiction: ‘expression of positive emotion’ (p=0.001), ‘expression of negative emotion’ (p=0.001), and ‘expression of intimacy’ (p=0.001). ‘Expression of positive emotion’plays a more significant role in predicting addiction potential. Addiction potential was significantly associated with familial economic status (p=0.024).Discussion: On the whole, our results underscore the significance of emotions and emotional expressiveness in predicting addiction potential in adolescents. Therefore, it is essential to educate adolescents during their schooling years to prevent this phenomenon.

Objectives: One of the most effective methods to describe speech disorders is the measurement of speech intelligibility. The speech intelligibility indicates the extent of acoustic signals that correctly speaker produces and hearer receives. The purpose of this study was to investigate the speech intelligibility in the Persian children with Down syndrome; age range was 3 to 5 years, who had spoken Persian.Methods: This cross- sectional study investigates 12 children (6 girls and 6 boys) with Down syndrome who had referred to speech therapy clinic in Hamadan city and 12 normal children (6 girls and 6 boys) who went to the kindergarten in Hamadan city. The pictures of speech intelligibility test (in Persian language) were used to collect speech samples of participants. The participant’s voice was recorded by voice recorder and was investigated in two age groups.Results: The results of this study indicated the means of speech intelligibility was 92.25 for normal children and 35.08 for children with Down syndrome. The correlation between age and speech intelligibility for normal children was 0.866 and for children with Down syndrome was 0.352. The mean of speech intelligibility 2 for normal boys was 93 and for normal girls 91.5 and for boys with Down syndrome 34.66 and for girls with Down syndrome 35.5.Discussion: The difference between normal children and children with Down syndrome was Significant. One of the factors that affect speech intelligibility for children with Down syndrome is difficulty with voluntarily programming, combining, organizing, and sequencing the movements necessary for speech.

Objectives: The aim of this study was to investigate the effectiveness of verbal self-Instruction on pessimistic attribution style about negative events in children with dyslexia.Methods: The study was semi-experimental with pre and post-test and control group. The statistical population consists of all dyslexic students of Maktab Ali School in Tehran City. Forty students were selected by convenience sampling method and randomly allocated to two groups: experimental and control. Experimental group received verbal self-instruction, Mychnbam and Goodman method in 8 sessions, two sessions per week, each lasting 45 minutes; while the control group received only the routine school training. The measurement was Children's Attribution Style Questionnaire, and data analysis using multivariate analysis of covariance.Results: Negative pessimistic attribution style (general, stable and internal) were significantly decreased (p<0.005) in the experimental group in comparison with control group after intervention.Discussion: Verbal self instruction can be applied in children with dyslexia for improvement of attribution style by psychologists, teachers, educators, special schools, parents and all those who are dealing with these children.

Objectives: Phonemic awareness skills have a significant impact on children speech and language. The purpose of this study was investigating the phonemic awareness skills of children with cochlear implant and normal hearing peers in primary school.Methods: Phonemic awareness subscales of phonological awareness test were administered to 30 children with cochlear implantation at the first to sixth grades of primary school and 30 children with normal hearing who were matched in age with cochlear implant group. All of children were between 6 to 11 years old. Children with cochlear implant had at least 1 to 2 years of implant experience and they were over 5 years when they receive implantation. Children with cochlear implant were selected from Special education centers in Tehran and children with normal hearing were recruited from primary schools in Tehran. The phonemic awareness skills were assessed in both groups.Results: The results showed that the Mean scores of phonemic awareness skills in cochlear implant children were significantly lower than children with normal hearing (p<.0001).Discussion: children with cochlear implant, despite Cochlear implantation prosthesis, had lower performance in phonemic awareness when compared with normal hearing children. Therefore, due to importance of phonemic awareness skills in learning of literacy skills, and defects of these skills in children with cochlear implant, these skills should be assessed carefully in children with cochlear implant and rehabilitative interventions should be considered.

Objectives: This study was designed to evaluate the effectiveness of a modified Floor Reaction Ankle Foot Orthosis (FRAFO) design on gait performance in children with cerebral palsy.Methods: Eight children with cerebral palsy wore a modified FRAFO bilaterally for six weeks. Motion analysis was used to assess the immediate effectiveness of the orthosis on improving gait and also following six weeks of gradual orthosis use. Primary outcome measures were walking speed, cadence and stride length, plus hip, knee and ankle joint ranges of motion. A paired T test was used to compare primary outcome measures.Results: Cadence, stride length and walking speed were all significantly increased when the children wore the modified FRAFO (P=<0.001for speed and stride length and p=0.005 for cadence). The children demonstrated a statistically significant reduction in ankle ROM when using the modified FRAFO. The mean knee joint ROM was increased from 36.5±13.32 degrees when walking with an orthosis at baseline to 43.5±1.19 degrees when walking with an orthosis after six weeks of use. Children with the modified FRAFO also had decreased hipflexion angle at initial contact and an extension shift during stance phase following 6 weeks of orthosis use compared to when initially donning it.Discussion: Children with cerebral palsy can benefit from an improvement in gait parameters when walking with a modified FRAFO.

Objectives: Stress level of families of children with autism is higher than moderate levels. Since the child with autism and the awareness of their disorders severely disappoint the parents, the problems, too much responsibility, and the attempts to improve the child’s situation, which usually fail, gradually increases the feelings of depression, anger, and guilt in parents. This study compared the effects of individual and group training on general health and stress of parents of children with Autism Spectrum Disorders.Methods: A number of 75 parents of children referring to Autistic Children Foundation (including 50 parents in two experimental groups and 25 parents in control group) were taken into account. Participated parents were selected through Accessible Sampling Method.Results: In order to diagnose Autism Spectrum Disorders, questionnaires such as Goldberg-Williams’, General Health, Abedin’s Stress, and Gars’ (Gilliam) were used; while in order to analyze the gathered data, the correlation method (comparison of pre-test and post-test means), independent t- (comparison of control and experimental groups) and one-way covariance (a survey of effects left by individual and group training methods on parents with emphasis being laid on control and experimental groups) were used.Discussion: There was no difference between parents receiving training in group and those receiving training in individual form. With respect to the correlation between general health and stress levels, both group and individual trainings resulted in a raise in general health and stress levels of parents.

Objectives: Stroke is one of the most common neurological diseases and it is the main cause of physical and mental disability and staying in house. Gait difficulties have high incidence in patients with stroke. So the aim of this study was to investigate the effect of gait retraining on balance, activities of daily living, quality of life and depression in stroke patients.Methods: This study was a clinical trial without control group. Sampling was performed by convenience sampling method and 18 patients participated. After recording demographic data, Berg Balance Scale, Barthel Index, SF36 questionnaire and Beck Depression Inventory-II used in pre-test and post-test to assess balance, activities of daily living, quality of life and depression, respectively. Data were analyzed using Pearson correlation coefficient and paired T-test.Results: The results showed statistically significant correlation in pre-test and difference between mean score of the all instruments before and after the intervention.Discussion: According to high prevalence of gait difficulties in stroke patients, it seems interventions in this area were necessary. Statistical results showed that the gait retraining intervention may have a positive effect on improving balance, activities of daily living, quality of life and depression of these patients. According to lack of information in this area, further research is needed.

This study was designed with the purpose of providing organized instructions on how to improve the psychological, medical, and social circumstances of street children with concurrent substance use disorders. Due to the special vulnerabilities of these children, customized guidelines are required in order to maximize the treatment outcomes. Systemic review of literature was applied on a large number of national and international journal articles available on the phenomenon of substance use among street children. The literature review was followed by a qualitative study using in-depth interviews in order to record and analyze the experience of experts working in this field. The preliminary draft was reviewed by the experts and final modifications were applied. The ultimate guideline presents practical recommendations for different stages of providing service for the target population including case finding, motivational interventions, assessment, care and intervention planning, and follow-ups. Street children face various physical, psychological, and social complications. Substance use disorders can exacerbate their circumstances and add to the complexity of their problems. The current guideline is an initial step to better understanding and treating street children who use drugs. Further research is required to investigate the effectiveness and long term results of this guideline. considering the fact that Iran is one of the many countries dealing with this phenomenon, adjustments should be made for application in different cultures.