Archives of Rehabilitation (Journal of Rehabilitation)
Year:2016 | Volume:16 | Issue:4|Papers Count:11

Education via smart mobile phone and mobile health applications is a key element in e-learning. For the first time and in cooperation with occupational therapists and Health Information management specialists, an applied educational smart phone-based program was designed and implemented for mothering handling of children with cerebral palsy (CP) by caregivers. For this purpose, InteliJIDe application version 13 for android was used. This application includes sections of acquaintance with children with CP, principles of motor development in children with CP, feeding, dressing, toileting, bathing, sleeping, lifting and carrying, playing, anticonvulsant drugs, and about us. It is free and can be installed on smart mobile phones and Android tablets via Bluetooth. This application is an important step in easy, fast, and free access of families of children with CP to daily care information. It is hoped that this software resolve some of these families’ problems.

Objectives: Musculoskeletal disorders are the most common childhood problems. The aim of the present study was to investigate the prevalence of head and upper extremity deformities in children with special needs.Materials & Methods: The present research is a descriptive cross-sectional study with stratified sampling method. Ten percent of students with mental retardation, hearing impairment and sight impairment in the academic year of 2012-13 were selected for this study. There were 1194 persons in Tehran, 1526 people in the cities of the Tehran Province and 559 students in Alborz Province. In total, 3279 people participated in the study. Demographic questionnaire and a plummet were used for data collection. Data was reported using descriptive statistics.Results: The results of the study revealed that "dropped shoulder" in girls of Alborz province with visual impairment with 100% had the highest rate and this abnormality in boys with visual impairment in the Tehran had the least prevalence. In the deformities of the head, lateral head bending with 76.6% in girls with visual impairment in Tehran, and forward head posture with 83.3% in boys with visual impairment in cities of Tehran had the highest incidence in comparison with others.Conclusion: The prevalence of upper extremity deformities is high in students with special needs including mental retardation, hearing impairment and sight impairment. It is necessary to diagnose these deformities in time.

Objective: Bracing along with exercising is the most effective protocol in patients with idiopathic scoliosis which have Cobb angles of 25 to 45 degrees. However, since the psychological aspects of scoliosis treatment may affect the quality of life, and the exact time for adjusting the pads of Milwaukee brace is unknown; therefore the aim of this study was evaluating the effect of exercising in a group, with adjusting the brace in shorter intervals, in compare to routine protocol, in the treatment of idiopathic scoliosis.Materials & Methods: Thirty-four patients with idiopathic scoliosis which had Cobb angles of 50 to 15 degrees were included in this study and were divided into experimental and control groups. The patients of two groups participated in an eleven-week treatment program, differ between the two groups. Quality of life scores of both groups were evaluated before and after intervention using SRS-22 questionnaire, as well as scoliosis angles before and after the intervention according to the primary and secondary radiographic X-rays.Results: Statistical analysis was performed using Paired T-Test in each group, and Independent T-Test between the two groups before and after treatment. The severity of scoliosis curvature and satisfaction domain of the experimental group was reduced significantly in compared with the control group, after intervention (P=0.04). Moreover in the case of the quality of life in patients with Cobb angles less than 30 degrees, compared with patients with Cobb angles greater than 31 degrees, in the domains of self-image, satisfaction, and total score, the difference was significant (P<0.05).Conclusion: Adjusting the brace at shorter intervals along with exercising as a group, during the eleven weeks of treatment, has increased satisfaction and reduced the scoliosis Cobb angles of patients.

Objectives: The purpose of the present study was to evaluate the reliability of Persian version of the “Cumberland Ankle Instability Tool (CAIT)” in Iranian athletes with lateral ankle sprain.Materials & Methods: The present study is a methodological and non-experimental study. After forward and backward translation of CAIT, 46 athletes were selected with convenient no probably sampling from Physical Education Faculty of Tehran University and Taekwondo Club. Questionnaire was given to participants who experienced at least one lateral ankle sprain based on doctor’s diagnosis. In the second phase (one week later) the questionnaire was distributed among the participants again to test the reliability of the measured between the two tests. After collecting the data, the test-retest reliability of Persian version of the questionnaire was evaluated by calculating the intraclass correlation coefficient, standard error of measurement, smallest detectable change and Cronbach’s alpha coefficients were calculated to assess the internal consistency of the questionnaire’s items.Results: Cronbach’s alpha was 0.64, which is close to acceptable level of internal consistency (0.7-0.95). Factor analysis showed that questionnaires’ items can be classified in 4 categories with maximum of 72% variance cover. The test-retest correlation coefficient ICC for the total score of CAIT was 0.95 (P>0.001), indicating excellent reproducibility of the Persian version of the questionnaire. The standard error of measurement (SEM) was 1 and the smallest acceptable change (SDC) was 2.76 with 95% confidence.Conclusion: The results show that the Persian version of the CAIT can be used in athletes with functional ankle instability as a reliable tool to detect instability and assess changes caused by therapeutic interventions.

Objective: Patellofemoral pain syndrome (PFPS) is one of the most common knee chronic disorders especially among females that is closely related to forces imbalance of vastus medial is oblique (VMO) and vastus lateral is (VL) muscles. The purpose of study was to examine the effect of knee isokinetic extension in maximum lateral tibia rotation on VMO and VL amplitudes in PFPS patients.Materials & Methods: Thirty-six women with PFPS participated voluntarily in this study and were randomly placed in one of three groups included the VMO selective isokinetic strengthening exercise, quadriceps general strengthening and control groups. Each exercise was performed for 8 weeks. Muscle RMS of VMO and VL and VMO/VL RMS ratio were recorded and calculated before and after training using of an 8-channels electromyography system. Data analysis was made by analyses of variance with repeated measures.Results: In baseline, VMO amplitude was less than VL in all groups (P£0.05), but after interventions, it was more than VL in selective group (P=0.01) and less than VL in general (P=0.001) and control (P=0.036) groups. Before interventions, there was no difference between groups in muscles amplitude (P>0.05). Yet, after interventions, VMO amplitude and VMO/VL amplitude ratio were more in selective group than in general and control groups (P£0.001), and VL amplitude was more in general group than in selective and control groups (P£0.01).Conclusion: According to the study results, isokinetic extension training with maximum lateral tibia rotation and in close to knee full extension can be recommended as an appropriate training for improving VMO/VL electrical activity ratio and decreasing imbalance between lateral and medial vastus muscles amplitudes in patients with PFPS.

Objective: In recent years, it has been focused much attention on gait analysis. Factors such as speed, age and gender affect gait parameters. The purpose of the present study was to compare the electromyographic activity pattern of knee two-joint muscles between younger and older subjects in different gait speeds.Materials & Methods: The method of current study was analytical cross-sectional method in which 15 healthy young men and 15 old men, were selected conveniently. Electromyographic activity of rectus femoris, biceps femoris, semitendinus and gastrocenemius were recorded during walking with preferred (100%), slow (80%) and fast (120%) speeds in a 10 meter walkway. Normalized RMSs of muscles were compared using RM-ANOVA and Tokey’s tests by SPSS 18 software.Results: According to results, RMSs of rectus femoris in midstance (P<0.01) and gastrocenemius in loading response (P=0.02) phases in all walking speeds were higher in older subjects than in younger ones, and it increased with speed in both age groups (P<0.01). Biceps femoris RMS in terminal stance at 80% speed, was lower in older subjects than in younger ones (P=0.01) and it increased with walking speed (P=0.01). Semitendinus activity in loading and midstance phases at 120% speed was higher in older subjects than in younger ones (P<0.01), and it increased with speed in both age groups in swing phase (P<0.05).Conclusion: According to the results, older subjects have more muscle co-contraction around knee at high speed in midstance phase than younger subjects. These age-related changes in muscle activity, leads to increase in joint stiffness and stability during single support, and probably play a role in reducing push off power at faster speeds.

Objective: The main purpose of the present study was to evaluate psychometric properties of Persian version of WHOQOL-DIS questionnaire in elderly people with disability.Materials & Methods: A classical psychometric method was used to evaluate validity and reliability of WHOQOL-DIS questionnaire in elderly people with disability. Lawshe, and Waltz and Bausell methods were used for assessing content validity. During convenient sampling, 205 elderly, whose score in WHOQOL-DIS questionnaire was more than 4, completed the SF-12 questionnaire in order to assess convergent validity and criterion validity (using known group's comparison). Reliability was estimated using internal consistency and test-retest reliability was determined by means of Intraclass Correlation Coefficients (ICC).Results: According to Lawshe, and Waltz and Bausell methods of content validity, acceptable scores were obtained for all items. Correlation between the WHOQOL-DIS questionnaire and the SF-12 scales was satisfactory except for social domain (P=0.13). The Intraclass Correlation Coefficients for score of questionnaire dimensions and total score was higher than 0.70. Cronbach's alpha for investigating Intraclass Correlation was higher than 0.70 except for social domain. Comparing known groups revealed distinctions in sex and health and disability status between elderly people (P<0.001).Conclusion: In general, the findings suggested that the WHOQOL-DIS questionnaire is a reliable and valid measure of health related quality of life among elderly people with disabilities. Therefore, the questionnaire can be used in the investigation on the quality of life of elderly people.

Objective: The aim of this study was the comparison of the functional stability of dominant and non-dominant shoulder in female volleyball players with and without anterior shoulder instability, using YBT-UQ.Materials and methods: In this descriptive study, 28 female university volleyball players (age=20 to 25 years) were categorized into healthy (n=14) and anterior shoulder instability (n=14) group. Upper quarter y balance test (YBT-UQ) was used for measuring functional stability of both dominant and non-dominant shoulder. After checking the normal distribution of the results with 1-s Kolmogorov-Smirnov, paired sample t-test and independent sample t-test were used for comparing the dominant and non-dominant shoulder’s functional stability and for comparing the results between groups, respectively.Results: Higher YBT-UQ composite score was observed in non-dominant shoulder and dominant shoulder of the healthy group and the non-dominant shoulder and dominant (injured) shoulder of shoulder instability group, respectively. No significant difference was observed between functional stability of both shoulders of the healthy group (p=0.144), while the functional stability of the non-dominant shoulders of the instability group was significantly higher than the dominant unstable shoulders (p=0.001). The results of functional stability of the unstable shoulders of the injured group were significantly lower than the results of the dominant shoulders of the healthy group, while in non-dominant side, all directions but the Super lateral direction showed significant difference.Conclusion: Based on the results of this study, functional stability of the unstable shoulder of female university volleyball players is lower than the functional stability of their non-dominant side or the functional stability of the healthy subjects; therefore, we suggest that the upper extremity stabilization exercises, specially the closed kinetic chain exercises should be added to the shoulder rehabilitation programs.

Objective: The aim of this work was the translation, cultural adaptation and validation of the Persian version of the Rapid Office Stress Assessment (ROSA) checklist.Material & Methods: This methodological study was conducted according of IQOLA method. 100 office worker were selected in order to carry out a psychometric evaluation of the ROSA checklist by performing validity (face and convergent) analyses. The convergent validity was evaluated using RULA checklist. Checklist face validity was performed in two stages, firstly by consulting specialists in the field of physiotherapy, occupational therapy, and ergonomics and then through evaluating checklist by 9 ergonomists. Data analysis were done using SPSS 19.Results: the results indicated that on the whole the translation of phrases and questionnaire sentences was easy and the quality of translation was good. Validation of the Persian version questionnaire was checked and major changes were made to the ROSA checklist. Spearman correlation coefficient between total score of ROSA check list and RULA checklist was significant (r=0.76, p<0.0001).Conclusion: The results indicated that the translated version of the ROSA checklist is acceptable in terms of face validity, convergent validity in target society, and hence provides a useful instrument for assessing Iranian office workers.

Objective: Neck pain is one of the most common musculoskeletal disorders. Structural and functional alteration of cervical muscles is a commonly-reported complication of chronic neck pain (CNP). Measurement of muscle thickness is an acceptable way to evaluate muscle morphological structure. Therefore, this study aimed to measure cervical extensor muscles thickness in individuals with chronic nonspecific neck pain and healthy controls using ultrasonography so as to evaluate structural differences between the 2 groups.Materials & Methods: A total of 30 female volunteers (15 individuals with nonspecific CNP and 15 controls) participated in this casual comparative study. Thickness of cervical extensor muscles, including multifidus, semispinalis cervicis, semispinalis capitis, splenius capitis, and upper trapezius at the level of the forth cervical vertebrae were measured using ultrasonography in resting position. Independent t test was performed to analyze the data by using the spss 20 software.Results: The thicknesses of cervical multifidus and semispinalis cervicis muscles in patients with CNP were smaller than those of controls with P=0.03 and P=0.01, respectively. There were no significant differences between two groups regarding the thicknesses of semispinalis capitis, splenius capitis, and upper trapezius muscles (P>0.05).Conclusion: Reduced multifidus and semispinalis cervicis thickness seen in the present study indicates deep neck extensor muscles atrophy and weakness in patients with neck pain. However, there were no differences between two groups with regard to superficial muscles thicknesses. Accordingly, exercise therapy for deep muscles should be considered in the management of patients with nonspecific CNP.

Objective: Speech and language disorders, when happening during childhood will ultimately lead to important negative outcomes in the life of the child. The farther we move from this critical period, that is, the first 3 years of life, the less will be the positive effects of environmental stimuli on the development of speech and language. Early detection of children at risk for or in the preliminary phases of developmental delays and provision of early intervention services for them is of utmost importance. The objective of this research was to compile and produce protocols for early intervention in childhood speech and language developmental disorders in Iranian children.Materials & Methods: This study was conducted in two main phases: review phase and qualitative phase. In the review phase, all accessible search engines and databases, especially those for systematic reviews and guidelines were searched. In the qualitative study phase, several focus group discussions and rounds of Delphi were carried out with 20 experts in 7 subgroups, who were selected purposively.Results: The result of this study is presented as 7 intervention packages, including the following domains of disorders: prelingual lingual hearing impairment, speech sound disorders, dysphagia, stuttering, and dysarthria.Conclusion: Most studies have confirmed the effectiveness and need for early interventions for children with speech and language impairment. However, most do not explain the details of these interventions. Before the present study, no systematic and evidence-based protocol existed for early intervention in childhood speech and language impairments, in Iran; and due to language differences, as well as possible differences in the speech and language developmental process of children of different communities, making direct use of non-Persian references was not possible and effective. Thus, there was a clear demand for the production of such a protocol.