Archives of Rehabilitation (Journal of Rehabilitation)
Year:2009 | Volume:9 | Issue:3-4 (35-36)|Papers Count:13

Objective: Plantar Fasciitis is the common foot complaint that outbreaks as a result of an inflammation of plantar fascia. The purpose of this study was to compare the effectiveness of three orthoses, silicon heel pad, thermoplastic custom-made arch support and Tension Night splint, how they relived pain in plantar fasciitis.Materials & Methods: In this quasi experimental study that was done on 16 patients who were referred from Shariati Hospital Orthopedic ward to Saba Orthotics & Prosthetics Center; age, sex, BMI, occupationand activity level were not inclusion criteria, systemic diseases and also surgery on foot in past were as exclusion criteria. The patients were assigned one by one to three treatment groups who were ready to admit them. Subject's pain was assessed for 3 months, at 2nd, 6th and 12th week, by Numerical Rating Scale and Verbal Rating Scale through phone. Data were analyzed with ANOVA, Pierson's and Spearman's correlation coefficients, Kruskal-Wallis test and Repeated Measurement test. Results: The coefficient correlation of Numerical score pain and rating score pain were 0.80. The average of morning (P=0.87), evening (P=0.198) and the worse pain (P=0.113) before entering the study were similar in three groups. The repeated measurement test defined that all the three orthoses were effective for the morning, evening and as so for the worse pain (P<0.001).There was not significant difference among the three groups in decrease of morning (P=0.483), evening (P=0.462) and worse pain (P=0.948).Conclusion: Taking advantage of the three orthoses without any treatment was effective for the Plantar Fasciitis pain in this study.

Objective: Gestures of the hands and arms have long been observed to accompany speech in spontaneous conversation. However, the way in which these two modes of expression are related in production is not yet fully understood. So, the present study aims to investigate the spontaneous gestures that accompany speech in adults who stutter in comparison to fluent controls.Materials & Methods: In this cross-sectional and comparative research, ten adults who stutter were selected randomly from speech and language pathology clinics and compared with ten healthy persons as control group who were matched with stutterers according to sex, age and education. The cartoon story-retelling task used to elicit spontaneous gestures that accompany speech. Participants were asked to watch the animation carefully and then retell the story line in as much detail as possible to a listener sitting across from him or her and his or her narration was video recorded simultaneously. Then recorded utterances and gestures were analyzed. The statistical methods such as Kolmogorov- Smirnov and Independent t-test were used for data analyzing.Results: The results indicated that stutterers in comparison to controls in average use fewer iconic gestures in their narration (P=0.005). Also, stutterers in comparison to controls in average use fewer iconic gestures per each utterance and word (P=0.019). Furthermore, the execution of gesture production during moments of dysfluency revealed that more than 70% of the gestures produced with stuttering were frozen or abandoned at the moment of dysfluency.Conclusion: It seems gesture and speech have such an intricate and deep association that show similar frequency and timing patterns and move completely parallel to each other in such a way that deficit in speech results in deficiency in hand gesture.

Objective: Spasticity is one component of the upper motor neurone syndrome, which is characterised by a velocity dependent increase in the tonic stretch reflexes. This study aimed at investigating the interrater reliability of the Modified Tardieu Scale in the assessment of muscle spasticity in stroke patients.Materials & Methods: In this analytical and validity testing study 30 patients with spastic hemiplegia were selected by simple sampling from clients of central nervous system disorders clinic of Tehran University of medical sciences. The two muscle groups in affected upper limb were tested using a standardized procedure. These were elbow flexors and extensors. Assessment was done by the two occupational therapists during the same session. The order of assessment and the sequence of muscle testing by the two raters were random. The interrater reliability was calculated for the different subs ales of Modified Tardieu. The reliability was tested with the intraclass correlation coefficient (ICC). For the Modified Tardieu Scale scores, the Cohen's Kappa test was used to analyze the level of agreement between the raters.Results: The values of ICC for both muscle groups were high. The ICC for R2-R1 as main outcome measure for determination of spasticity severity was 0.99 and 0.95 in the flexors and extensors, respectively. The Kappa values in muscles reaction quality were 0.88 in flexors and 0.89 in Extensors.Conclusion: The Modified Tardieu Scale provides high interrater reliability in the assessment of muscle spasticity after stroke.

Objective: Nowadays computers are controlled by hand with some tools like mouse and keyboard generally, so people that can't use their hands aren't able to use these tools. This research was aimed to design a system, which help handicapped people to type by their eye movement.Materials & Methods: In this design, boarder between iris and sclera which is called limbus is tracked with the Infra Red transmitting and receiving system. Then software will process measured values, and will change them to proper values for moving cursor on characters. Since changing the user, unwanted head movements can affect on system operation, a calibration stage is considered which adjust the system in new condition. The system was implemented on 10 subjects (5 women & 5 men) and data were analyzed.Results: Distance resolution of system on 15" monitor's screen is about 4.11±3.38 centimeters. People with no experience can type a sentence with 14 characters in 3:30 minute by 28% error and an experienced person can type this sentence in 3 minute with 13% error. So the system with relatively high repeatability allows the user to communicate with computer by his eye movements.Conclusion: This system is able to recognize 12 points on monitor's screen. Each point is belonging to one character. Facility of using the system and no contact between system and eye are from the benefits of the system.

Objective: Reduction of attentional resources is readily apparent in cases of reduced or conflicting sensory information. The purpose of this study is to compare attentional demands of postural control between athletes with functional ankle instability (FAI) and healthy matched individuals.Materials & Methods: 15 functional unstable ankles college athletes and IS healthy matched athletes were selected conveniently. This case control, dual-task study was conducted using Biodex Balance System (BBS). To measure overall stability index while subjects experiencing 2 postural task difficulties (stability levels of 5 and 7 of BBS) and 2 cognitive loadings (no load and counting backward). In order to investigate the interactions of independent variables (postural task difficulty, cognitive task difficulty and health status) multi factorial mixed ANOVAs were used. T-Test was conducted to compare means in groups.Results: Mixed ANOVA showed interaction effects of health status with postural task difficulty and cognitive task difficulty on overall stability index are significant. Patients had significantly more increase in overall stability index when confronting cognitive task and less stable support surface than healthy subjects. (P=0.01, P=0.03).Conclusion: It seems that functional ankle instability (FAI) is associated with increased attentional demands to semi-dynamic postural control. Cognitive loading may be considered in any exercise program for FAI patients as an effective strategy.

Objective: Multiple Sclerosis (MS) is one of the most common chronic diseases of the central nervous system (CNS), which causes important changes patient's life, specially in adults life. MS decreases the quality of life (QOL) of patients severely and led to disability gradually.The aim of this study is to assess the effects of applying hydrotherapy on quality of life of Multiple Sclerosis patients.Materials & Methods: In this Quasi-experimental study, 50 Multiple Sclerosis patients were selected with no probability sampling according to specific criteria and then assigned to experimental and control groups (25 patients in each group) with balanced randomized allocation. Hydrotherapy performed for 24 sessions by experimental group during three months but no intervention was done for control group. Data collector tools included: demographic questionnaire, SF8- QOL questionnaire, Self report checklists. Statistical analysis was done by use of statistical tests such as: chi square, paired t-test, student t-test, ANOYA with repeated measurements and independent t-test.Results: There was no significant difference between two groups in physical and mental dimensions (P=0.04 & P=0.2) and whole (P=0.81) scores of QOL before intervention, but there were significant differences between two groups after intervention in these scores (P<0.001, P=0.003 & P<0.001). ANOYA test with repeated measurements showed that there is significant difference in mean score of whole (P=0.04) and physical (P=0.05) and mental (P=0.04) dimensions of QOL between two groups in 4 times.Conclusion: Hydrotherapy is practically feasible and is associated with increase of MS patients QOL; so that applying this technique can promote MS patient's QOL and offered to these patients.

Objective: Considering the fact that children with Down Syndrome have a severe delay in language development which does not appear being improved by language therapy leaning on auditory modality, this research was aimed to compare the traditional educational method and reading method effects on receptive and expressive language of 4 - 10 years old Down Syndrome children with 40 - 60 I.Q scores.Materials & Methods: In this quasi experimental and interventional research from Navide Asr Rehabilitation clinic in Tehran, Rezvan Rehabilitation clinic in Shahriar, Ehsan Rehabilitation clinic in Karaj and Down Syndrome Association of Karaj, 20 Down Syndrome children were selected by simple and convenient sampling from 96 Down Syndrome children and were allocated into two groups by balanced randomized method. The first group was educated by whole word reading method and the other group was educated by traditional method. Both groups had three IS-minute educational sessions per week for a period of 6-month.Languages of both groups have been examined by TOLD- P: 3 test as pre and post-test. The results were analyzed by statistical tests including Kolmogoroff - Smironoff (K-S), Independent-T-Test and Paired-T-Test. Results: Independent- T-Test in both groups revealed no significant differences before education in receptive (P=0.4S2), expressive (P=O.I) and speech (P=0.428) Language, but after intervention period, the groups have significant statistical differences in all language portions such as receptive (P=0.043), expressive (P<0.001) and Speech (P<0.001). Conclusion: Reading education has more effects on receptive and expressive language in children with Down syndrome than the other educational methods (traditional ones). Thus it seems that focusing on behavioral and cognitive phenotype of Down syndrome with emphasis on visual modality facilitates language development more than auditory modality, and aptitude training may have the best effects.

Objective: this research studied the relation between cluster B personality disorders and major depression disorder with relapse. Materials & Methods: In this analytical and comparative study, samples consisted of the major depressive disorders patients that had experienced major depression through 5 years ago and were experiencing partial remission in research time. Samples were selected by non probability sampling in outpatient centers. The patients with more than two relapses were assigned as case group and the patients without any relapse were assigned as control group (two groups on the base of demographic in formations were matched). They completed BDI_II and SCID_II to assess cluster B personality disorders, and a questionnaire made by researcher to gather information's. Results: Comorbidity of borderline personality disorder (P<0.001) and narcissitic personality disorder (P=0.016) with depression in patient with relapse of the depression is more significantly than patients with first episode of depression, but comorbidity of exhibitive personality disorder with depression and relapse had no significant difference between two groups (P=0.401).Conclusion: According to the relationship between narcissistic and borderline personality disorders and the role of them in relapse of depression, for making an effective psychotherapy for depression, it is necessary to consider personality beside special symptoms.

Objective: Among the traditional and modern drugs, appearance and spreading of ecstasy drugs is a new phenomenon that has affected different nations, among them Iranian youth. While, it seems that unawareness in society of these industrial drugs, has a great influence in spreading its use. This research was conducted to evaluate students' knowledge about the effects of ecstasy drugs.Materials & Methods: This study is a descriptive and cross-sectional research. 154 high school students, by simple random sampling, in district 9 of Tehran were selected and their awareness about research object was evaluated by researcher made questionnaire. The face validity of questionnaire was confirmed by specialists consideration and its rehabilitee was confirmed by Cronbach's alpha coefficient (r = 0.85). Data were analyzed by Correlation coefficient and Mann-Whitney U.Results: 14.7 percent of responses were incorrect, and 38 percent were don't know. Students' awareness of accidents and bad effects of ecstasy drugs is in a low level. There was no significant difference between boys and girls' knowledge about the effects of ecstacy (P= 0.573). Also, there was no significant relation between student sexuality and their awareness about Ecstasy side effects (P=0.572).Conclusion: Students' knowledge about the Effects of ecstasy drugs is in a low level (47.3 percent).

Objective: In this study clients' satisfaction in public and private rehabilitation centers in Kordestan province was assessed and compared.Materials & Methods: In this comparative and cross-sectional study, 415 people who were admitted for the first time to outpatient public and private rehabilitation centers in Kurdistan, during the six month period of autumn and winter 1383, were selected by simple randomized and stratified sampling. Using a Structured questionnaire, information was gathered through telephone interviews, and each client's satisfaction measured and scored by 1-20. The questionnaire's face validity was approved by experts. Using the test- retest method, the reliability was r = 0.83 and its ICC was 0.76 (Kronobakh alpha). Independent t- test and Chi- Square test were used to analyze of data.Results: The total satisfaction score of public sector clients (12.48±1.6) was more than that' of private sector clients (12.15±1.4) and their difference was significant (P=0.04). The private sector clients were more satisfied than public sector clients with physical conditions (P<0.001), time accessibility (P=0.018) and communication skills of the personnel (P=0.018), but the mean difference was not more than 1 point in either area. In public centers the physical accessibility (P=0.01), financial accessibility (P<0.001) and quality of services (P<0.001) caused significant higher satisfaction than private centers.Conclusion: Although the difference between clients' satisfaction in public centers and private ones was statistically significant, but the differences were not so prominent, except in the case of financial accessibility. Attaining a higher quality rehabilitation services and enhancing client satisfaction, is necessary for both public and private centers. For the private sector extension of insurance coverage is recommended.

Objective: Cardiac rehabilitation increases quality of life, decreases recurrence, and improves physical performance and psychological status. This report aimed to examine barriers to patients' participation in cardiac rehabilitation program.Materials & Methods: This paper is a party of a larger grounded theory study. Eighteen patients with first time myocardial infarction, three cardiologists, and three cardiac nurses were selected as purposeful and theoretical sampling. Semi-structure interviews were used for data collection. Using Strauss and Corbin's (1998) grounded theory approach, the data were analyzed. The trustworthiness of data is confirmed using Lincoln and Guba's criteria.Results: The majority of patients had not participated in cardiac rehabilitation programs. Barriers to patients' attendance in cardiac rehabilitation categorized in four main categories known as individual, sociocultural, economic, and health care system-related factors.Conclusion: The majority of the barriers to patients' participation in cardiac rehabilitation are modifiable that their alteration can facilitate patients' attendance in cardiac rehabilitation programs.