Archives of Rehabilitation (Journal of Rehabilitation)
Year:2014 | Volume:15 | Issue:2|Papers Count:12

Objective: Neck pain is the second common musculoskeletal disorders in human societies. According to studies, personal characteristics and weight of school bags are predisposing factors for musculoskeletal problems in students. Due to the risk of neck pain, the aim of this study is to investigate the effect of risk factors on high school students and also to provide proper therapeutic solutions.Materials & Methods: This study was carried out on 1000 high school students of Babol in year 2012, 2013. Students were chosen randomly. Student personal variables and school bag characteristics and other information were collected by questionnaire. The VAS was used to assess pain intensity. The balance and meter were used to measure the height and weight. Results were analyzed by SPSS software.Results: The mean age of students was 15.96±1.13. Average bag weight and its relation to body weight were 2.76±0.97 kg and 4.47±1.87%, respectively. Students with neck pain had lower age (P<0.001), lower height (P<0.001), lower weight (P=0.002), and the relation of bag weight to body weight was higher in them (P=0.001). Students suffering from neck pain used backpack more than others (P=0.002).Conclusion: The results showed that the prevalence of neck pain was more in students who had smaller physical dimensions. School bag characteristics can also be effective in causing neck pain. Given the importance of students population as future adults of country, it is necessary to do detailed investigation into the causes of neck pain prevalence in this age range.

Objective: A variety of evidence demonstrated altered perceptual functioning pattern in the brain of children with autism. This can be related to or the cause of other diagnostic symptoms in autism spectrum. In the present study, the visual- perceptual organization in autistic children is studied. These processes require central coherence and typical functional connectivity among neural structure in the brain.Materials and Methods25 high functioning autistic boys and 25 neuro - typical boys were assessed in terms of visual perceptual processing. Visual stimuli include fragmented (incomplete) and complete images of animate and inanimate objects which were presented in a monitor. The subject’s task included rapid and accurate naming of images that have been seen. Responses were compared in two groups by independent- T test. The effect of completeness and image type factors on samples’ visual processing were also analyzed by repeated measure analysis of variance. Statistical analysis was performed using spss software seventeenth edition.Results: Interaction effect of completeness, image type and group on subjects’ visual processing was significant (p<0.05). Also autistic children have lower performance in naming incomplete images as well as recognizing inanimate objects (p=0.000); however, both groups were similar in recognition of whole image of animate and inanimate objects (p=0.597). On the other hand, all the samples perform better in detection of complete images than fragmented images (p=0.000).Conclusion: Failure to recognize the fragmented images of objects, in particular, inanimate, could be marker of impaired processes related to central coherence of visual information in the brain of autistic children. Detection of these images in these children was significantly different from neuro- typical children. This may be the indicator of impaired visual perceptual organization and an evidence for disrupted functional connectivity among the brain area in children with autism.

Objective: There is increasing evidence that show fear of pain and fear of mechanical injury result in progress of pain and disability in the patients. Cervical stabilization training is a method of exercise designed to treat the spinal injuries and causes the stability of cervical spine and reduces its vulnerability. The aim of this study was to compare effectiveness of stabilization exercises with maximum Isometric exercises on fear avoidance belief in chronic nonspecific neck pain.Materials & Methods: This clinical controlled trial was done randomly on fifty patients with chronic neck pain who attended physiotherapy research center of Tehran University of social welfare and rehabilitation sciences during 2012-13. Subjects were assigned to either a stabilization (n=25) or a maximum isometric exercise group (n=25). Before and after intervention (4, 8, 12 weeks) pain was assessed with visual analog scale (ordinal), disability (ordinal) with Neck Stability Index (NDI), Fear Avoidance Belief with Fear Avoidance Belief Questionnaire (FABQ). A 48 session exercise program during 8 weeks, six session per week, and each session with repeating specific exercises was performed for both groups. Repeated measurement of analysis variance, independent t-test and paired t-test were used for comparison of results before, during and after the treatment of between and within groups.Results: The mean neck pain decreased from 7.16 ± 1.57 in first session to 0.92 ± 0.70 in 12 session in the stabilization group and from 7.12 ± 1.67 in first session to 1.28 ± 0.94 in 12 session in maximum isometric group (P=0.482). The mean disability (NDI) decreased from 22.60 ± 3.20 in first session to 11.16 ± 0.90 in 12 session in the stabilization group and from 21.88 ± 2.76 in first session to 14.96 ± 1.48 in 12 session in maximum isometric group (P>0.001). The mean FABQ-W decreased from 35.08 ± 4.48 in first session to 9.08 ± 1.44 in 12 session in the stabilization group and from 34.76 ± 4.63 in first session to 17.44 ± 2.18 in 12 session in maximum isometric group (P>0.001). The mean FABQ-PA decreased from 20.12 ± 2.26 in first session to 9.26 ± 1.01 in 12 session in the stabilization group and from 20.08 ± 2.23 in first session to 11.16 ± 1.14 in 12 session in maximum isometric group (p=0.938). Decrease in pain and disability as well as fear avoidance belief was higher in stabilization exercises than in isometric exercises (P<0.05).Conclusion: This study indicated that both stabilization exercises and maximum isometric exercises decrease pain, disability and fear avoidance belief while stabilization exercise was more useful than maximum isometric procedure.

Objective: The purpose of the present study was the meta-analysis of researches done on harm reduction and addiction treatment.Materials & Methods: In this study, researches done on harm reduction and remedy were collected by the meta-analysis method. This was done using related keywords, searching the sites and theses of postgraduate studies. Finally, studies which were consistent with the criteria for inclusion in the meta-analysis were selected and desired information which were prepared by the author for testing the hypothesis with a negative questionnaire were extracted. Out of the 11 studies selected, the appropriate statistics to calculate the effect size and other required information were recorded and the effect size as well as hypothesis analysis were calculated by CMA2 software.Results: The results of this study show that identified independent variables on harm reduction and remedy have been effective. The value of combined effect size is 0.8 (d=0.8) and it is statistically considered significant. Since this value is in the range of 0.8 to 0.7, according to Cohen’s classification, it is evaluated as average. Variables such as having a theoretical basis, the status of entry (New 6 months and more), the average of daily injection, integrated holistic therapy, medical interventions, quality of healthcare services, social esteem, methadone treatment and therapeutic interventions had statistically significant influence on harm reduction and remedy.Conclusion: In order to achieve harm reduction and remedy, the status of entry (New 6 months and more), the average of daily injection, integrated holistic therapy, medical interventions, quality of healthcare services, social esteem, methadone treatment and therapeutic interventions related to nations must be considered.

Objective: Chronic Pelvic Pain (CPP) is any pelvic pain with no relation with pregnancy menstruation and intercourse that lasts at least for six months or more and has no known structural reason. This pain can disturb daily activities and lead to medical or even surgical treatment. According to our knowledge, there are limited studies related to CPP in Iran. Therefore, the present study was designed and performed with the aim of surveying the amplitude of CPP in women attending Pelvic Floor Clinic at Imam Khomeini Hospital.Materials and Methods: This cross-sectional study was conducted on 516 married women attending pelvic floor clinic. Participants completed a designed questionnaire which included demographic information and questions regarding the symptoms of any problems in gynecologic, urinary, gastrointestinal, musculoskeletal and psychological systems. After collecting the data, binary logistic regression was used to study the relation between the qualitative and quantitative variables and chronic pelvic pain.Results: It was reported that 27.9% of women had pain in the pelvic area unrelated to menstruation and sexual intercourse, while totally 17.6% suffered from pain over the past 6-12 months or CPP. There were a significant relationship between CPP, chronic low back pain and dyspareunia (p=0.04 and p=0.03 respectively). No significant relation was observed between the prevalence of CPP, types of delivery and history of having trauma to the spine and pelvis.Conclusions: This comprehensive study provided an extensive and multidimensional approach on CPP in our society. With regard to the prevalence of 27.9% pelvic pain and 17.6% CPP and their relationship with gynecological, urinary, musculoskeletal and gastrointestinal systems, it is strongly recommended by health and treatment system to do more population-based epidemiological studies.

Objective: Speech sound disorders are among the most common speech disorders in children. Nonspeech oral motor exercises have long been used as a facilitative activity before or simultaneaously with treatment of wide variety of speech disorders by speech pathologists. But there are few empirical controlled data to evaluate its effectiveness. Therefore, this study is aimed at comparing the effect of therapeutic intervention based on production training with non-speech oral motor exercises on improving the speech of children with phonological disorders.Materials & Methods: This quasi-experimental interventional study was done while using single subject design with multiple baselines on six Farsi-speaking children (aged 4-6) having phonological disorders with normal oral-motor status. Data were collected using phonetic information test and Robbins-Klee oral-motor protocol. In this study, three therapeutic plans (production training, non-speech oralmotor exercises and combined method) and two sounds with distinctive phonological features were considered.Each plan was carried out on two children. The results were analyzed using level, trend & slope analysis with excel software.Results: Children who had received non-speech oral motor therapy, did not show any change in their speech pattern but children who received production therapy showed 91% improvement and those who received combined method showed 86% improvement in the target sounds.Conclusion: Findings of this investigation do not support the use of non-speech oral motor exercises in order to improve the speech of children with phonological disorders. This study also refuses the applicatiojn of this execises before production training with the aim of facilitating speech production and considers production training as the most effective method to improve speech production of children with phonological disorders.

Objective: The goal of this study is to compare the effects of the modified dynamic and conventional static splints on pain and functional abilities of hand in women with De Quervain syndrome.Materials and Methods: This quasi-experimental study was performed on 24 women with De Quervain syndrome in orthotics and prosthetics department of Iran University of medical sciences, during two weeks in year 2012-2013. The patients were divided randomly in two groups of 12 persons. One group of patients were given modified dynamic splint and the other conventional static splint, both of which were custom-built. Persian version of DASH (Disability of Arm, Shoulder and Hand) questionnaire was used to assess the pain and functional abilities of hand before and also two weeks after using splint and VAS (visual analogue scale) was used to assess patient’s satisfaction of splint at the end of the 2nd week. Data were analyzed using SPSS-17 and by independent and paired t-test.ResultsIn both groups, an improvement in pain level and performance capabilities was observed after using the splints. In comparison of pain level and performance capability, there is no significant difference between two groups after using splints (p>0.05). However, the satisfaction of the patients who had used dynamic splint was higher.ConclusionInserting a joint to the static thumb spica leads to patient’s satisfaction and relief while there is no significant difference between two groups in pain recovery and abilities improvement.

Introduction: Autism is a pervasive developmental disability that impress on social interaction, verbal and nonverbal communication and stereotyped behavioral patterns. Regarding initiation difficulties of these children and weakness of interventions in creation of motivation, in this study we tried to examine effect pivotal response treatment method on initiation’s ability of autistic children.Materials & Methods: In this randomized control trial (RCT) study, according to inclusion and exclusion criteria, 30 autistic participants (6 to 11 years old) that matched based on age, gender and mean length utterance, from especial Hamedan clinics for autistic persons were selected and placed randomly in one of groups of intervention and control. Sessions were administered individually, lasting for 60 minutes and 2 days a week for 3 months. Both groups of children were tested before and after intervention by CCC (children’s communication checklist) to assess initiation’s ability. Data analysis were done through descriptive statistics, Independent t-test, Chi-squared and covariance analysis.Results: Findings of study showed (according to covariance analysis between before and after of intervention in two groups) there is significant change in initiation’s ability in intervention group (p<0.001).Conclusion: The result of these study indicated effect of pivotal response treatment on initiation’s ability in autistic children, therefore this method is recommended in therapeutic interventions.

Objective: Accurate measurement of thoracic kyphosis has a great value for both evaluating patients and monitoring the effect of different treatments. Dual Digital Inclinometer (DDI) has been introduced as a non-invasive devise that can measure the kyphosis angle. However, according to available information, there is only one published study regarding the estimation of validity and repeatability of this device in our country. Therefore, the purpose of this study was to determine the validity and repeatability of the thoracic kyphosis angle measurement using DDI in women over 45 years.Materials and Methods: In this methodological study, thoracic kyphosis was measured by DDI device three times on 20 women aged 45-70 years. The first two measurements were taken with an hour apart in same day to assess the repeatability within-day and the third measurement was taken one day later to assess the between-days repeatability. Furthermore, the value of kyphosis angle was measured by calculating Cobb angle on radiological films with an examiner and the validity of obtained angle was studied by DDI ICC correlation coefficient test with 95% confidence intervals for data analysis.Results: The validity of values obtained by DDI compared to the Cobb angle was high (ICC=0.86). This revealed that the DDI was reasonably valid for women over 45 years. Within-day and between-days thoracic kyphosis measurements using DDI were shown to be reliable with high ICC values. (0.95 for within-day and 0.93 for between days).Conclusion: According to the findings of the present study, the DDI is a valid and reliable tool for non-invasive measurement of thoracic kyphosis.