Iranian Rehabilitation Journal
Year:2016 | Volume:14 | Issue:1|Papers Count:10

The Iranian Rehabilitation Journal (IRJ) invites research papers on the genetic basis of single gene and complex disorders. This vastly dynamic branch of science will complement the multidisciplinary wealth of expertise in the fields of social welfare and rehabilitation.The past few years have witnessed outstanding research projects on the genetic causes of numerous debilitating disorders, such as intellectual disability, deafness, and blindness. Those achievements are largely indebted to the next generation exome sequencing technologies.Exome sequencing detects variants in coding exons, and can expand the target to include untranslated regions (UTRs) and microRNA to present a more comprehensive view of gene regulation. Whole-exome sequencing (WES) determines variations of all coding regions, or exons, of known genes. Once beyond imagination and reach, WES promises to revolutionize the perspective of a wide range of applications, including population genetics, medical genetics, and cancer studies.

The vestibular system is important for the development of normal movement reactions, motion tolerance, and motor control for postural alignment, balance, and vision. A vestibular system that is damaged by disease or injury in childhood can have a major impact on a child’s development. In addition, the emergence of vestibular lesions may also lead to cognitive deficits, including attention deficit. Despite the advances in testing and documentation of vestibular deficits in children, the vestibular problems continue to be an overlooked entity.Many children do not receive treatment that could significantly improve function and address the developmental delays caused by vestibular disorders.Vestibular rehabilitation therapy (VRT) has been defined as an effective modality for most individuals with disorders of the vestibular or central balance system disorders. The basis for the success of VRT is the use of existing neural mechanisms in the human brain for adaptation, plasticity, and compensation. The vestibular system cannot be considered as a separate entity ignoring other balance subsystems. Hence, a modified VRT program, named pediatric balance therapy with special modifications in exercises, was developed for children with vestibular disorders, in accordance to the whole balance system.

Objectives: Low back pain is one of the main health problems which affect many people worldwide. The daily course of life is highly disrupted due to the chronic back pain problem.This study aims to explore the occupational performance of individuals with chronic low back pain.Methods: Fifteen people with chronic low back pain were included in this study using purposeful sampling. The participants were interviewed, and a qualitative content analysis was employed to analyze the data.Results: The three main resulted themes were: 1) Occupational disturbance because of low back pain; 2) Difficulty in moving around and remaining in any given position; and 3) Permanent mind struggle owing to back pain. People with chronic low back pain experience difficulty in all areas of daily occupation including self-care, work, and leisure, plus having trouble with being physically active and being persistent in certain positions. Furthermore, mind struggle with back pain which implies preoccupation with back pain in addition to fear of movement are other findings of present study.Discussion: Chronic low back pain greatly influences the daily occupations of individuals.Mind struggle with back pain, which implies preoccupation with back pain, in addition to the fear of movement are significant findings of the present study. Occupational therapists can play an important role in re-engagement of people with chronic low back pain in their daily occupations.

Objectives: To investigate the clinical efficacy of physiotherapy with and without superficial dry needling on patients with knee pain; patellofemoral pain syndrome.Methods: A randomized clinical trial conducted in 2015, Tehran, Iran. Of patients with patellofemoral pain syndrome, thirty-four subjects were randomly divided into two groups (17 in each group). Group A was subjected to physiotherapy and group B to physiotherapy with superficial dry needling. Only for group B, superficial dry needling was applied during the ten-day sessions of physiotherapy, every other day. The needle remained for 6 minutes at three points of the quadriceps muscle, accompanied with needle rotation. Both groups received 10 therapy sessions. For both groups, in the first and tenth sessions, knee pain and quadriceps muscle strength was evaluated.Results: Statistical analysis showed the two variables in each group had significant improvements after the 10 sessions (P<0.05). Comparing the two groups, group B showed more pain reduction based on the visual analog scale (P<0.05). However, according to manual muscle testing method, the muscle strength between both the groups showed no significant difference (P<0.156).Discussion: Physiotherapy with and without superficial dry needling were seen to reduce pain and increase muscle strength of patients with patellofemoral pain syndrome. However, performing physiotherapy with superficial dry needling had a more significant effect on reducing knee pain.Superficial needling can cause many physiological and neurophysiological effects. Through stimulation of pain control mechanisms, it can help in further reduction of pain.

Objectives: Ankle Foot Orthoses (AFOs) are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO) on functional mobility in post-stroke hemiplegic patients.Methods: Fifteen hemiplegic patients (men and women) who were at least 6-months poststroke and able to walk without an assistive device for at least 10 meters voluntarily participated in this study. The patients were examined for three conditions: shoes only, with SAFO and with RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG) test. In addition, paired t-test was used to analyze the obtained data.Results: When the patients used RAFO, their gait speed significantly increased (P<0.05).Moreover, the time of performing TUG test experienced a significant decrease using RAFO compared with utilizing shoe only (P<0.05).Discussion: RAFO led to a significant improvement in functional mobility in hemiplegic patients post stroke. This may be due to the positive effect of rocker modification on improving push off and transferring weight during the stance phase of gait.

Objectives: This study examined the relationship between working and short-term memory performance, and their effects on cochlear implant outcomes (speech perception and speech production) in cochlear implanted children aged 7-13 years. The study also compared the memory performance of cochlear implanted children with their normal hearing peers.Methods: Thirty-one cochlear implanted children with a mean age of 121.52 months (~ 10 years) and SD=19.946 and 31 normal hearing children with a mean age 120.68 months (~ 10 years) and SD=18.137 participated in this study. Their memory performance was assessed by Working Memory Test Battery for Children (1), speech perception was measured by Categories of Auditory Performance (2), and their speech production was assessed by Speech Intelligibility Rating (3). Finally, the data were analyzed using SPSS through its descriptive variables MANOVA and Spearman Correlation Coefficient.Results: A significant and positive correlation was observed between working memory performance and cochlear implant outcomes. In addition, the children using cochlear implants had poorer performance compared to their normal hearing peers.Discussion: This study demonstrated that the memory performance of children using cochlear implants has a significant effect on their speech production.

Objectives: This study investigates the impact of neurofeedback on perceptual-motor skills of 5 to 12 years old children with Attention Deficit Hyperactive Disorder (ADHD).Methods: In this clinical study, 40 children between the ages of 5-12 years, who were patients of the Tavanesh Clinic and diagnosed with ADHD, were randomly chosen and divided into two groups of control and test.20-neurofeedback intervention sessions were performed.The tools utilized in this study included Bruninks–Oseretsky Test of Motor Proficiency and Child behavior checklist (CBCL) survey questionnaire. For evaluation after the intervention, Bruninks–Oseretsky Test of Motor Proficiency scale for children, along with CBCL questionnaire surveys were asked to fill up by the participants’ mothers.Results: After the intervention, the analysis of the scores in all perceptual-motor skills showed significant differences in both groups, but no significant difference was observed in the subtest of strength. The CBCL survey questionnaire revealed that the average scores on attention disorder, aggression, lack of attention and hyperactivity, externalizing and general problems in the test group is significantly less than that of the control group. However, in the confrontational behavior (internalization), there was no statistically significant difference between the test and control groups. There was a correlation between the change of motor skills and change of behavioral patterns in ADHD children.Discussion: Neuro feedback intervention can have positive effects on improving the perceptualmotor skills of children with ADHD.

Objectives: The Gradual Increase Length and Complexity of Utterance (GILCU) therapy method is a form of operant conditioning. This is a precise and controlled treatment that is done in 54 steps in 3 speech situations consisting of monologue, reading, and conversation. This study aimed at examining the effects of GILCU treatment method on the reduction of speech dysfluency of school-aged children with stuttering.Methods: In this quasi-experimental study, 32 children with stuttering (6-11 years old) who were referred to speech therapy clinics were selected using convenience sampling. Then, they were assigned into two groups. The first group was treated by GILCU therapy method by the researcher, and the second group was treated by traditional methods by another speech therapist. Both groups had fourteen 45-minute sessions that were conducted one to two times per week. Pre-test and post-test of both groups were assessed using the SSI-3 scores. The obtained data were analyzed using the Kolmogorov-Smirnov, t-test, and covariance test.Results: Both groups had statistically significant difference (P<0.005) in the stuttered syllables frequency. The average of moments of stuttering from the maximum moments of stuttering and the physical activity were examined according to the speech situations such as reading and conversation. The first group (GILCU therapy method) did not show any statistically significant improvement (P>0.005) with respect to parameters of SSI-3 scores.Discussion: These results suggest that a non-programming treatment for stuttering may be effective with school-aged children who stutter.

Objectives: All individuals need to have the ability of appropriate sensory processing for proper functioning in the environment and participation in daily activities. Moreover, behavioral functions can be affected by sensory processing problems. This study aimed to determine the relationship between behavioral problems and sensory processing in 7 to 10 years old children with Attention Deficit/Hyperactivity Disorder (ADHD).Methods: This descriptive (cross-sectional) study included 60 children with ADHD aged 7 to 10 years, who were referred to a comprehensive psychiatric center. Short Sensory Profile (SSP) and Child Behavior Checklist (CBCL) questionnaires were used for assessing the patterns of sensory processing and behavioral problems in the patients.Results: There was a negative correlation between internalizing behavioral problems (r=−0.426) and externalizing behavioral problems (r=−0.465), and the total score of sensory processing in ADHD children (P<0.05).Discussion: The findings of this study showed that some behaviors in children with ADHD could be due to certain defects in their sensory processing.

Objectives: New cognitive theories of delusions have proposed that deficit or bias in inference stage (a stage of normal belief formation) is significant in delusion formation. The aim of this study was predicting the severity of delusions based on jumping-to-conclusion bias in patients with schizophrenia.Methods: The sample consisted of 60 deluded patients with schizophrenia who were selected from the Ebnesina and Razi hospitals in Shiraz using convenience sampling method. The Similarity Task was used to measure the jumping-to-conclusion biases.Results: Its results have shown that the jumping-to-conclusion biases could predict a great part of the variance of delusions.Discussion: These results generally indicated that the jumping to conclusion biases may provide a more useful explanation for the delusion formation.