Archives of Rehabilitation (Journal of Rehabilitation)
Year:2002 | Volume:3 | Issue:8-9|Papers Count:21

A cross sectional study of the prevalence and etiologic factors of limb paralysis and amputation was performed in Iran. Using systematic cluster sampling (each cluster consists of 15 families) 59678 people have been evaluated. The sample size was 1 per 1000 of total population. The prevalence of different kinds of paralysis and limb defects was 7 per 1000 population. Hemiplegia and paraplegia were the most prevalent, accounted for 2.8 per 1000 population. The prevalence of disabilities due to cerebral palsy, limb amputation and poliomyelitis per 1000 were 2.0, 1.3 and 0.9 respectively.Prevalence of poliomyelitis was zero in age group 0-4, which supports the recent reports declared that incidence rate of poliomyelitis is very low, and it is the consequence of vaccination done all over the country. 24.5% of all kinds of paralysis and limb defects were congenital, Other etiologic factors were physical injury, infectious disease, non-infectious disease and aging which accounted for 25.6%, 15.6%, 28.8% and 3.1% respectively. Most of the cases of cerebral palsy were congenital (67.2%). The main cause of hemiplegia and paraplegia was non-infectious disease (54.8%) and the main cause of amputation was physical injury. (73.7%), prevalence of disabilities due to paraplegia, hemiplegia and limb amputation considerably increased with age so it was most prevalent among people of 65 years old and over (29.0 per 1000). The prevalence of the above-mentioned disabilities was 6.3 per 1000 among men and 2.8 per 1000 among women. So male female ratio was 2:1 (p<0.000). Overall, the prevalence of hemiplegia, paraplegia and limb amputantion were 4.9 per 1000 in urban and 4.1 per 1000in rural areas, but after adjusting for "age" difference between urban and rural areas was not significant (P=0.059).Logistic Regression analysis declared that variables "age", "sex" and "living area" have separately significant effect on odds of hemiplegia, paraplegia and limb amputation. Considering these variables concurrently, "age" and "sex" again showed significant effect but "living area" effect sthrough age. (p<0.000)

ALS is a progressive degenerative fatal disorder of motor neuron. In this, research course of functional disability and possible underlyingfactors affecting disability were studied. First 59 patients with definte ALS were selected and for each patient ALSFRS (ALS functional rating Scale) was determined at Initial and the end of a six month peroid. During this period 9 patients expired. Bulbar onset localization showed a more rapid course than non-bulbar onset group. There was no meaningful relationship between the age group or gender with progression of disability.In expired group, mean survival in bulbar onset and older patients were significantly less than those with non-bulbar onset and younger ones. There was no meaningful relationship between survival and gender.

The purpose of the present study was to compare adaptive behavior among mental retarded and normal subjects. 246 normal and 74 mental retarded subjects between 7 and 18 years of age participated in the study.Their adaptive behavior scores were obtained by means of "Adaptive Behavior Scale-Residential and Community" (ABS-RC:2) It is consisted of two parts and 18 domains. Significant differences were found for independent functioning, economic activity, language development, number and time, prevocational / vocational activity, self-direction, responsibility, disturbing interpersonal behavior, domestic activity, socialization, social engagement, conformity and trustworthiness. Mental retarded subject showed lower performances in these domains. No significant differences were found for physical development, stereotyped and hyperactive behavior, sextual behavior, self-abuse behavior and social engagement.

Work accidents and injuries are important issues because it usually happens for the young and active population in the society. Every year, lots of workers in the country loss their productivity and health because of work accident. The aim of this study is finding the main causes of accidents and injuries at work and suggesting the possible prevention solutions. In fayyazbakhsh hospital which is the most active hospital in referring work injuries, the study was done. For one month, 320 patients related to work injury participated in the study. Most injuries were related to the hand and they were severe. The most important factors in work accidents were psychic problems, past illness history, lack of education, budget problem and not using safety tools and helmet during the work.

Suspected Scaphoid Fractures are common problems in medical practice, which account for countless work-hours losses each year. This was a prospective study that was performed on 51 patients with suspected scaphoid fracture in Doctor shariati and shahid Moaieri hospitals within eight months. The patients were treated with removable thumb splint and weekly physical examination. We found that 90% of immobilizations were unnecessary and removable brace and weekly examination and early rehabilitation can reduce the immobilization time in more than half of our patients.

Among different epileptic syndrome infantile spasm in one of the most malignant form which causes irrepairable brain damage in the child.Consequently the longer this type of epilepsy lasts the more harmful results will follow. The majority of children with infantile spasm are younger than one years age and only 5 present of affected children are in the age group above one year.This descriptive study was done on 60 (36 male and 24 female) infant 2-24 month age in pediatric neurology department of mofid children hospital during two years. From 60 patients (36 male and 24 female). 48 case (80%) symptomatic and 12 case (20%) cryptogenic and idiopathic. Based on clinical manifestation 35 case (58%) were flexor type. 6 case (10%) extensor and 19 case (32%) mixed. In EEG hypsarrhythmia in all patient was seen. Brain CT scan in 11 case showed brain atrophy and in remainder was normaL So in our study ethiologically symptomatic and clinically flexor type were more common. Hysparrhythmia in all patient was seen adn brain CT scan in 80% of patient was normal.

Exsistence of neurological soft signs in psychological disorders is considered by researchers. Since these signs are applicable in the medical diagnosis discrimination when there is a doubt, so the aim of this study is to find out the prevalence of these sings in different kind of psychological patients who are reffered to Shahid Beheshti psychological hospital, and also this prevalence is compared in different patients with different disorders. Therefore 213 patients who had the final discrimination are selected as a simple systematic sample. This sample size based on a pilot study (with prevalence 32%, d=6%, and confidence coeffictient 93%) Six tests of neurological soft signs were used on this sample. The results showed that the relation between age and four of these tests were significant, (standing on one foot, heel walking, toe walking, tandem walk) and the relation between psychological disorders and two of these tests," two-point discrimination PV=0.01 "and "Tongue extrusion p.v.=0.02," were significant. In the first test depression and in the other test schizophemia were above normal and in the remaining tests the relations were not significant.The results of this research showed that neurological soft signs are the same in different psychological disorders or the difference in negligible.

One of the first identified age-associated functional changes in immune response was decreased DTH responses. In fact the DTH response is an example of a T.h response mediated primarily through th-1-type cytokines although many events are required before proliferation, assessment of lymphocyte proliferation often has been used as an indicator of the cell-mediated immune potemial of on individual Therefore, many studies have utilized the proliferative response to assess age-associated changes in T-cell response. A decreased ability of PBMCs to proliferate in response to T-cell stimuli is among the most consistent age-associated of the immune system. It has been reported that 40 percent of individuals over age 70 demonstrate decreased reactivity to askin test panel regardless of their overall health status.A decreased DTH response can result from change in the initial activation of T cells. a shift in cytokine production by the activated cells, or altered reactivity by macrophages.Also, multiple age-associated changes have been observed in vitro. (respond to antigens: dinitrochlo robenzen. streptokinase or streptodomase) including decreased proliferative responses, modified activation signals. and altered cytokine prodution protiles.In addition numerous studies over the last two decades have examined whether phenotypic changes in the T-cell compartment accompany human aging and it is generally accepted that healthy aging is accompanied by a slight decrease in circulating lymphocytes, number of total T cells. In end. aging is accompanied by many moditications of immune reactivity, with the most significant changes being observed in the T-cell compartment. Therefore, these changes merit close attention by health care professionals.

The purpose of this study was to assess the effect of cronisacral techniques on chronic headache. We used a A-B-A single subject design which consisted of one week of baseline (pre-treatment), four weeks of treatment, and follow up period.The subject of this study was a 47 years old female who complained of sever headache during the last five years. patient had received multiple medical and physical therapy. treatments without success. began starting craniosacral therapy.After treatment patients headache decreased from 7/5 to 1 (0-10 scale), and her sleep disorder improved by 50% and the vertigo and tinnitus that patient complained removed. Although this study showed the positive effect of craniosacral techniques on chronic headache in a singl subject. more studies are needed in this area.

Chronic calf pain may have various etiologies including stress fracture, chronic compartment syndrome, accessory soleous muscle, and muscle sprains. An uncommon cause of chronic calf pain is entrapment neuropathy. Because entrapment neuropathies are uncommon, they are often underdiagnosed. A 15-year-old adolescent developed progressive calf pain 10 months before his presentation. Physical examination and paraclinical studies revealed no abnormality and electrodiagnostic study was reported as normaL 2 months nonoperative the superficial sural aponeurosis treatment and one surgical intervention were failed. Reexamination was revealed positive Tinels sign and paresthesia in distribution of the sural nerve. Surgical exploration revealed entrapment of the medial sural cutaneous nerve localized in the passage of the nerve resulted in complete resolution of symptoms and full recovery. Several location for entrapment of the sural nerve were reported, but we couldnt found any report in english language literature about sural nerve entrapment in the superficial sural aponeurosis in no athletics.

Gluteal intramuscular injection in newborns and children is one of the most common causes of sciatic palsy. Two factors are important to cause this palsy: kind of injection material and injection side. In this article we reported 28 cases of sciatic palsy (complere or incomplete) after gluteal region injection of diclofenac during years of 1368 to 1380 referring to Imam Khomeini. hospital. Ten of these patients underwent surgical release that all of them got satisfactory results.