Archives of Rehabilitation (Journal of Rehabilitation)
Year:2019 | Volume:20 | Issue:1 |Papers Count:11

Objective Damage to parts of the vestibulocochlear nerve not only results in sensory-neural hearing loss and deafness but may also lead to balance problems. This is the reason why the hearing-impaired and deaf people are struggling with balance problems. Given the ever-increasing development of the adaptive sports, specific to the deaf, who are considered as part of the active individuals in the community, detailed studies are required on the balance of the deaf, which is an important part of routine activities and sports performances. Therefore, this study generally aims to investigate the balance skills of the deaf in comparison to their normal counterparts. Materials & Methods In this study, a comprehensive review on ‘ the balance of the deaf’ has been carried out by searching English databases, such as Science Direct, PubMed, Cochrane review, TRIP, PEDro, EMBASE, CINAHL, and Google Scholar, for the following keywords: “ Deaf” , “ Postural control in Deaf Hearing Loss” , “ Deafness” , “ Balance” and “ Balance in Deaf” . In addition, the Persian databases, such as Magiran, Irandoc, IranMedex, MedLib, Sid were searched for the following Persian equivalent keywords: Balance in the deaf, postural control in the deaf, deaf, congenital deafness and balance, from 1932 to June 2018. Moreover, manual searching and full reviewing of resources of the articles were carried out to find the respective articles. Articles were narrowed down and sorted out by the titles such as the English language, Persian language, Human, original article, and review article. After collecting the search results, the titles and abstracts of the articles were studied. If the articles met the inclusion and exclusion criteria, their results would be employed in the review study; otherwise, they would be excluded. Results Based on the criteria and objectives of the research, 51 articles were selected. Forty-eight papers were provided in full text and the rest were summarized. In general, the balance of the deaf was investigated in three different respects of 1) a comparison of the balance of the deaf with that of the normal counterparts, 2) the effect of age on the balance of the deaf, and 3) the effect of the training protocols on the balance of the deaf. Conclusion The deaf people appear to struggle with balance problems when the vestibular system information is the only sensory source available; however, when the information of the proprioception and vision systems is available, there can be no balance problem as compared to normal counterparts. Several studies have also shown that the deaf, as they age, make up for the balance impairment resulting from vestibular impairments with proprioception and vision systems; it also appears that their proprioception and vision systems are better than or equal to those of their normal counterparts. However, it has not been determined yet that by increasing age in the deaf people, which proprioception system dominates and contributes to maintaining the balance of the deaf better than other systems. Furthermore, a review of studies has shown that all training programs and rehabilitation protocols have positive effects on the balance of the deaf. However, it has not been determined yet which training programs have a long and lasting effect on the balance of the deaf, and few studies have been carried out in this area. In addition, the same balance tests are used in all community groups, which may be inappropriate for measuring the balance in deaf people, since it is still not clear which motion strategies have been employed by the deaf to maintain balance. Therefore, to reach the final conclusion about the balance of the deaf people, further studies should be conducted on the proper tests to measure the balance of the deaf so that accurate and high-quality reports on their balance can be obtained.

Objective Family is the center and core of the patient’ s care, so the most effective therapeutic programs are those that emphasize the role of the family in treatment. The purpose of this study was to evaluate the delivery of family-centered services by service providers for families and children in Iran based on the Persian version of the Measure of Processes of Care for Service Providers (MPOC-SP) Questionnaire. Materials & Methods In this study, 150 service providers participated including doctors, nurses, midwives, rehabilitation therapists, as well as graduates in public health. The Persian version of the MPOC-SP questionnaire was used to collect the study information. The collected data were then analyzed in SPSS 22. Results The results showed no significant difference between men and women providing the service regarding the components of the questionnaire for measuring the process of care. The mean of components in "providing general information" in the medical group was statistically significant and higher compared to the basic science group. The average score of "showing interpersonal sensitivity", "providing general information", and mean score of total services in different service centers were statistically significant. The average score of the "showing interpersonal sensitivity", "providing of general information" as well as the mean score of the whole questionnaire of the process of care in the private centers was statistically significant and higher than the governmental centers. The average components of "showing interpersonal sensitivity", "treating people respectfully", "providing of general information", as well as the average score of the total questionnaire of the process of care in different age groups of service recipients were statistically significant. The average of the same components in different service providers also had a statistically significant difference. Conclusion providers' responses showed that health and rehabilitation centers provided good services in terms of respectful behavior, but providing general information and showing interpersonal sensitivity were relatively weak areas. The average scores of these components as well as the average total score of the questionnaire were the highest in rehabilitation fields and then ranked by medical and other therapy personnel respectively.

Objective Intellectual Disability (ID) affects all aspect of life. Although children with ID have low intelligence, the educational environment, living environment, and relationships with their others, especially their parents, have an important effect on their potential actualization. With regard to the limitations and problems of children with ID in the working memory, it is very important to plan programs to improve their ability in working memory. One of the most important factors in the study of cognitive development and improvement of memory is active participation in the leisure time. Leisure time is an important issue and one of the main elements of human needs in today's life. The use of the rich and proportional leisure time program has been associated with effective outcomes. The present study aimed to determine the effectiveness of enriched and proportional Arsh leisure time program on the working memory profile of students with educable ID. Materials & Methods The present research was a quasi-experimental study with pretest, posttest and control group. The participants were 30 female students with ID from exceptional schools in Isfahan City selected by simple random method. Subjects were divided into experimental and control groups, each group consisted of 15 students. The experimental group received 16 sessions of Arsh leisure time program (two 60-minute sessions per week) and the control group did not. The instruments were working memory test battery for children (2001). The obtained data were collected through the scales before and after the training sessions. Multivariate analysis of covariance was used by SPSS (Version 23) for analyzing the data. Results First, the normality of the study variables and contingency of variance and covariance assumptions were tested. The Kolmogorov-Smirnov test showed that all variables were normally distributed (P>0. 05). Also, the Box test confirmed the contingency of variance-covariance assumption. So, assumptions of MANCOVA test were met and it can be used for analysis of data. The results showed that Arsh leisure time program had a significant effect on the working memory (P<0. 0001). The results also revealed that Arsh leisure time program had a significant effect on the central executive, visual-spatial sketchpad, and phonological loop subscales in these subjects (P<0. 001). It can be said that according to Eta2, respectively 63%, 61%, and 68% of variations in central executive, visual-spatial sketchpad and phonological loop subscales can be explained by the participation of subjects in Arsh leisure time program. Conclusion Arsh leisure time program improved working memory of students with educable ID. So, this program can be used to enhance cognitive rehabilitation of these students in the working memory domain. Finally, the planning for providing Arsh leisure time program for these children has particular importance.

Objective Besides their communication and socialization problems, many children with Intellectual Disability (ID) have difficulties with their parents, siblings, and teachers. The enduring nature of social reactions easily leads to social isolation. Thus, many children and adults with ID have few friends, even though they may desperately want to be liked. This can set up a vicious circle in which they attempt to win friends by latching onto the least chance for interaction with others. Regarding the characteristics of nonviolent communication program training, it seems that this program could reduce communication problems and improve mother-child interaction of children with ID. The nonviolent communication training program is one method for improvement of communication skills in parents of the children with ID because these parents are often facing problem in communication with their children. Nowadays, much effort is made for improving mother-child interaction, especially in mothers of children with ID. Therefore, the purpose of the present study was to investigate the effect of nonviolent communication program training on mother-child interaction in mothers of children with ID. Materials & Methods The present research was a quasi-experimental study with pretest-posttest and a control group. The study population included all of the mothers of children with ID who attend to Alborz Educational and Rehabilitation Institute which is located in Alborz Province, Iran under the supervision of welfare organization. The study sample included 30 mothers selected by convenience sampling method and assigned to two groups. The experimental group participated in a communication skills training program based on life language for 8 sessions (90 minutes for per session; twice a week), while the control group received no such training. The study instrument was the Pianta mother-child interaction scale (1992). The Pianta mother-child interaction scale was completed by mothers for all subjects in pretest and posttest. The study data were collected through the questionnaire before and after the training sessions. Multivariate analysis of covariance was performed in SPSS (Version 22) for analyzing the obtained data. Results First, the normality of study variables and contingency of variance and covariance assumptions were tested. The Kolmogorov-Smirnov test showed that all variables were normally distributed (P>0. 05). Also, the Box test confirmed the contingency of variance-covariance assumption. So, assumptions of the MANCOVA test were confirmed and MANCOVA test can be used for analysis of data. The results of MANCOVA revealed that posttest scores of experimental and control groups had a significant difference with regard to mother-child interaction (P<0. 001). Also, the results of MANCOVA revealed that posttest scores of experimental and control groups had a significant difference with regard to conflict, closeness, and dependency subscales (P<0. 001). It can be stated that according to Eta2, 67% of the variance in mother-child interaction can be explained by the subjects’ participation in the nonviolent communication training program. Also, according to Eta2, respectively 63%, 65%, and 66% of the variance in components of conflict, closeness, and dependency can be explained by the subjects’ participation in the nonviolent communication training program. Therefore, communication skills training based on life language has a positive effect on motherchild interaction of the mothers of children with ID. Conclusion Parents of children with ID has more problems in communication with their children than parents of any other kind of exceptional children. It doesn’ t take long that these children be ostracized from social activities. Unfortunately, the negative social status experienced by children with ID is difficult to overcome and usually long-lasting. Nonviolent communication program training improves mother-child interaction in mothers of children with ID. Therefore, providing nonviolent communication program training has particular importance for these mothers.

Objective The most effective and influential capital of any organization is its human resources. The promotion of financial and physical resources results from human resource development. Recognizing and identifying the factors affecting job performance is one of the important management tasks on the macro scale. Therefore, its related factors such as recruiting, training, educating, and maintaining employees, are planned and implemented in a better way by human resource management. If ethical values such as commitment to work, honesty, and integrity are observed, the organization's job performance and success will increase. The present study was conducted with the aim of explaining the relationship between work ethics and job performance of the administrative and medical staff of the University of Welfare and Rehabilitation Sciences and its affiliated centers in 2017. Materials & Methods This was a descriptive-analytic research study. The study population was the entire 1506 administrative and medical staff of the University of Social Welfare and Rehabilitation Sciences and its affiliated centers (Razi Psychiatric Hospital, Rofeideh Rehabilitation Hospital, and Mafi Rehabilitation Center) in 2017. Out of their staff, a total of 250 employees were selected by the straight randomized methodas the study sample. The research instrument consisted of a valid and reliable questionnaire with 15 questions about Patterson's job performance, 50 questions about Gregory's criterion work ethics that has 4 dimensions (attachment and interest, seriousness and perseverance, healthy relationships, and collective spirit and participation), and a demographic information questionnaire. To analyze the data, in the descriptive statistics section, indicators such as statistical tables, distribution indices, and percentage, and in the inferential statistics section (with regard to the abnormal distribution of data) non-parametric tests of Spearman's correlation coefficient and Mann-Whitney U test were used. Results The results showed a significant positive correlation between work ethics and its dimensions with the job performance of employees (P<0. 001, R2=0. 366). There is a correlation coefficient of 0. 566 between attachment dimension and the interest of work ethics with job performance. The correlation coefficient of the persistence of ethics with job performance is 0. 556. The correlation coefficient of the relationship of healthy work ethics with job performance is 0. 512 and the amount of the correlation coefficient of the collective spirit of work ethics with job performance was 0. 570. Therefore, there is a significant relationship between all aspects of work ethics and job performance (P<0. 001). Conclusion Regarding the direct relationship between work ethics and job performance, the promotion of employees’ morality is associated with an increase in employees’ job performance. For this purpose, it is suggested that the attention to work ethic in various aspects of epistemic programs and organizational learning be increased, in order to increase the performance and active participation of employees in organizational matters and to perform their responsibilities. The principals of the university and its affiliate health centers must also pay attention to the various ethical dimensions of the administrative and medical staff in order to increase the level of their employees' job performance and try to raise the moral level of employees by holding workshops, forming problem-solving teams, and setting up a reward system for their employees.

Objective Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disorder of the Central Nervous System (CNS) and it is also the most common cause of non-traumatic neurological disability in young adults. MS in women, especially young women, is about 1. 5 to 3 times more common than men all over the world. About 2. 5 million people worldwide are suffering from MS. The destruction of myelin in certain areas exhibits certain signs and symptoms. Balance disorders are particularly problematic because they are associated with difficulty in moving from one position to another, sustaining an upright posture, and performing functional activities such as walking and turning, all of which predisposes people with MS to the loss of equilibrium and falls. Isfahan City in Iran suffers from a high prevalence of MS that put it amongst the regions with the highest prevalence of MS in Asia and Oceania. This study aimed to use the holistic approaches of occupational therapy to investigate the physical and cognitive factors (attention, cognition and muscle strength of lower extremities) that affect the gait of MS patients in the city of Isfahan, Iran. Materials & Methods The present study was a descriptive-correlational one and convenience sampling method was used to recruit the samples. The study population consisted of all patients with MS in Isfahan City in August 2017. A group of 70 patients (24 males and 46 females with the Mean± SD age of 32. 20± 7. 55 y) met the inclusion-exclusion criteria and were enrolled in the study. To be eligible for the study, the patients had to meet the following inclusion criteria: having a neurologist-confirmed diagnosis of MS with MRI scan, being able to read and write, and walk at least 100 m independently. We excluded patients with cognitive impairments that might hinder understanding of the tasks to be accomplished, those with any comorbid neurologic condition other than MS, and those who are unwilling to collaborate with the research process. After providing sufficient information about the research process and getting informed consent of the patients, the questionnaires and tests were provided to the participants to be completed. The study tools were the Mini-Mental Status Examination (MMSE), 10 m Walking Test (10 MWT), Timed Up and Go test (TUG), Sit to Stand test, and Stroop test. For data analysis, the Pearson correlation coefficient and multiple regression analysis were performed in SPSS version 16. Results In this study, 70 patients suffering from MS participated. The results showed a significant negative correlation between the scores of walking speed test (10 m walking) and the scores of the functional strength of the lower extremities muscles (P<0. 001) and attention (P=0. 01). There is also a significant correlation between muscle strength of lower extremity and balance (P=0. 01). Regression analysis shows that the muscle strength of lower extremities has the highest contributions in predicting the speed of walking in patients with MS. Conclusion According to the study findings, among the physical and cognitive factors affecting gait and balance such as muscle strength of lower extremity or cognition and attention, the muscle strength of lower extremity is the most important factor affecting the balance and speed of walking in patients with MS that still can walk. In the process of rehabilitation, especially in occupational therapy, special attention must be paid to a muscle strengthening program for the lower extremities of patients suffering from MS.

Objective Multiple Sclerosis (MS) is a chronic autoimmune, demyelinating disorder of the central nervous system. Psychological well-being often declines as a consequence of this impairment. Application of neurological musical intervention to adapt with the limitation of neurological impairments has been under investigation. This study aimed to explore the effectiveness of neurological music intervention on the psychological wellbeing of women with MS. Materials & Methods Quasi-experimental study with pretest and posttest design was conducted. A total of 20 women from the Iranian MS Association, with a relapsing-remitting course, aged 20 to 30 years, were selected with the convenience sampling method. After grouping them with respect to variables such as education, age, marital status, occupation, and low Extended Disability Status (EDSS), they were randomly paired and assigned to experimental and control groups after obtaining their consent and taking the pretest. The exclusion criteria for the participants were as follows: psychological symptoms such as depression or taking other musical training during the intervention. Neurological music intervention was designed with the assistance of a musician based on Iranian culture and Musical Executive Function Training (Thaut, 2005) to affect the frontal and prefrontal lobes. The 8 designations of the training program included "executive function", "goal regulation support", "group motivation", "impulsivity control", "inhibition", "responsibility", "problem-solving creativity", and " decision making/creativity". The internal validity of program has been already validated. The experimental group received 30 sessions training, two times a week for three months in MS association center while the control group did not receive any training. Scores were gathered using Ryff (1995) 42-item psychological well-being scale in the pretest and posttest stages. Also, the Kurtke (1983) extended disability status scale was used to evaluate the physical disabilities of MS participants. Results The results, analyzed in ANCOVA and MANCOVA, indicated a significant improvement in psychological well-being (P<0. 05) and medium effect size (0. 38) according to the Cohen Scale. No significant improvement in 6 Ryff subscales was observed but a small effect was noted in self-acceptance (0. 02), personal growth (0. 02), the purpose of life (0. 01), environmental mastery (0. 07), autonomy (0. 09), and small to medium size effect in positive relation (0. 23). Conclusion According to experts, there is no cure for multiple sclerosis, there are, however, numerous treatments and rehabilitation interventions to slow down and reduce the physical and psychological symptoms. These findings suggest that neurological music intervention based on "Musical Executive Function Training” has a potential dual effect on cognitive and affective aspects of the brain. This kind of music intervention includes group and individual improvisation and composition exercises which improved the executive function skills such as organizing, problem-solving, decision making, and comprehending. Our results indicate that neurological music intervention improves psychological well-being in women with MS. Although there was no significant effect on the subscale of psychological wellbeing, a small to medium size effect was observed on different subscales of well-being. It appears that this intervention can be applied to clinical and rehabilitation settings.

Objective Mothers of children with Cerebral Palsy (CP) are susceptible to emotional problems like stress, anxiety, and depression which can lead to emotional schemas like rumination, not expressing emotions, lack of values, and feeling guilty. These negative beliefs about emotions cause ineffective thoughts and inappropriate behavior patterns that affect the mental health of the mothers. In this case, interventions such as mindfulness education can be effective in reducing their maladaptive emotional schemas by adjusting attention, developing metacognitive awareness, decentralizing, and accepting their mental contents. This study aims to investigate the efficacy of mindfulness training in decreasing emotional schemas (rumination, not expressing emotions, lack of values and feeling guilty) in mothers with children with CP. Materials & Methods The present study is quasi-experiment with pretest-posttest and control group. The statistical population consists of all the mothers with CP children referring to the rehabilitation center of Mashhad City. The study sample consisted of 20 volunteers who were selected based on the results of their pretest and study criteria. They were selected and randomly put into control and experimental groups. The inclusion criteria included having at least a guidance education level to do better teaching assignments and having a child with CP whose severity of disorder was moderate or severe on the basis of a doctor's diagnosis. The study instrument was Leahy Emotional Schema Scale (LESS) which was answered by mothers in the control and experimental groups before the intervention. The participants in the experimental group received “ Mindfulness Awareness” group intervention in eight 90-minute sessions for two months and the control group didn’ t receive any treatment. Results The data were analyzed through Analysis of Covariance (ANCOVA) and t-test. The findings indicate that mindfulness training for mothers in the experimental group leads to a decrease in schemas like rumination (t=2. 57; P<0. 05), not expressing emotions (t=8. 87; P<0. 05) and feeling guilty (t=2. 4; P<0. 05), but it doesn’ t have a significant effect on the lack of values (F=2. 73; P>0. 05). Conclusion Mindfulness can improve emotional schemas in mothers who have children with CP through raising awareness and concentration as effective training. Mindfulness education provides a model for reducing rumination and educates mothers to be aware of their mood fluctuations and to use mind-alert techniques to understand the information processing that makes emotions keep obsessing. Increasing calmness and consciousness along with a kind-hearted behavior creates curiosity and satisfaction at the present, which results in decreased rumination. The higher values in mothers are unchangeable beliefs, which are the function of culture and are unique to each individual. Therefore, the resistance derived from beliefs as a result of the education of mindfulness has a negative effect on the concept of higher-value inferiority. In sitting meditation, one can allow herself to express excitement with mercilessness and curiosity. Then he or she will be conscious of the gesture and state of the face and adapting it to its current state, and express her or his emotions and physical feelings without suppression and change. Feeling self-compassion in the mind of consciousness accepts the suffering of sin as part of life and leads to motivating the individual to reduce pain and suffering and feelings of guilt.