Archives of Rehabilitation (Journal of Rehabilitation)
Year:2019 | Volume:19 | Issue:4 |Papers Count:10

Objective Spinal cord injury is one of traumatic events that has considerable impact on the quality of life of theinjured patients. Not all people react similarly in facing unpleasant event in life. This reaction cold be affectedby different factors. Some people after the traumatic event are unable to do normal functions for several yearsand show some chronic dysfunctions, while others try hard for months, reach some level of adaptation, andshow a model of recovery and improvement after tolerating some suffering. Individuals after spinal cord injurytend to adapt and cope with their injuries. However, there are differences in the level of compatibility and copingwith injury and some remain vulnerable to some psychological problems. This incompatibility, in additionto the experience of emotional distress can affect other functional areas such as physical health and increasethe risk of secondary complications. The purpose of this study was to explore factors affecting the acceptanceand adaptation with spinal cord injury based on the experiences of these patients. Materials & Methods This qualitative study was conducted using content analysis method. Content analysis is aqualitative method to associate data with the main subject and its final product is the concepts and categoriesof the study subject. The study participants comprised 23 patients with spinal cord injury in Tehran City, Iran, that were selected purposefully, with a maximum variation in age, levels of education and experiences androles in life. The inclusion criteria were spinal cord injury, over 18 years old, at least one year passed from thetime of injury, and their desire for sharing their experiences on the study subject. Purposive sampling wascontinued to reach the saturation point in every concept so that more new information could not be foundabout these concepts. The study data were collected through in depth semi-structured interviews during2016, and were analyzed using content analysis. Results The results of the data analysis were led to the extraction of the facilitators and obstacles of acceptanceand adaptation in patients with spinal injuries. Facilitators were classified in eight main categories, includingthe correct support, communication with peers, social participation, spiritual belief, positive attitude, motivators, access to facilities and contextual factors. The obstacles were classified also in two general categories orconcepts. Category of social and cultural incorrect beliefs with subcategories such as, pity, negative feedbackof relatives, and insufficient knowledge about correct support. The second category comprised structural andcontextual obstacles, including subcategories of health-related problems, urban handicap, financial problems, inefficiency of supporting organizations, and unawareness of disabled people. Conclusion The results obtained from the experiences of patients with spinal cord injury showed that a collectionof individual factors, environmental and social factors can affect the process of acceptance and adjustmentwith injury, and take the role of facilitator or inhibitor during the process of acceptance and adaptingwith the lesion. Identifying these factors that have been achieved with regard to social context and real experiencesof people from exposure to spinal cord injury, can have effective application in designing psychologicalrehabilitation programs for these people and their families. By promoting the individual and environmentalfacilitator factors, the process of accepting and coping with injury can be facilitated. In addition delays in acceptanceand compatibility and negative psychological side effects can also be prevented by reducing theimpact of inhibitory factors.

Objective Multiple Sclerosis (MS) as a progressive disease has remarkable consequences on thepatient’ s Quality of Life. According to the surveys, the Quality of Life in the people with MS is lowerthan the healthy people that is more prominent in physical, self-caring and daily performance activities. There are various reasons for this low Quality of Life such as lack of definitive treatment, relapsing-remitting periods, and unpredictable relapsing periods. Although, the effect of personal, social and economic factors on the Quality of Life has already been investigated, no study has beenconducted in order to survey balance and activity of daily living on the Quality of Life in people withMS, Thus, the present study aims to investigate the relationship between balance and activity ofdaily living with the Quality of Life in this group of patients...

Objective Work-related Musculoskeletal Disorders (MSDs) happen due to risk factors during work, acrossthe world, especially in developing countries. Multiple risk factors (physical, psychosocial and mental)have contributed in MSDs as with most chronic diseases. Several tools are used to evaluate these riskfactors. Quick Exposure Check (QEC) is one of the most accurate and quick-response tools for identifyingthese risk factors. The purpose of the present study is to translate cultural adaptation and to verify thereliability of the Persian-language rapid assessment evaluation checklist. Materials & Methods This study is a methodological study. In this study, the intercultural equivalence ofthe QEC questionnaire was performed using the international quality of life assessment project. For doingface validity, the questionnaire was completed by 12 ergonomic experts and 15 employees. In this study, (ICC), (SEM), (α Cronbach) The checklist was reviewed on 80 construction workers. They were divided intotwo groups of 30 and 50. The questionnaire was completed at intervals of 3-7 days in two rounds. Results The Persian version of QEC questionnaire was reported with easy terminology, wordage, andphrases. Interpreters were also unanimous about this, and the quality of translation was clearly translatable, the use of common language, conceptual equivalence, and the overall quality of translation wasdesirable. And the interpreter's agreement was satisfactory. In other words, the results of the formalvalidity check showed that all items were approved. High levels of internal consistency (α =0. 74), interraterreliability (r=0. 79-0. 93) and intra-rater reliability (r=0. 74-0. 89) were obtained, too. Face validity hadacceptable results from both workers and specialists’ perspective. In addition, SEM scale for inter-rater(4. 9-0. 4), intra-rater (2. 8-0. 73) showed low random errors. Conclusion Questionnaire was verbally verified in a way that all 16 questions were clear, simple, and understandablewith acceptable reliability. Therefore, The QEC can be applied as a specific risk assessmentinstrument for industrial and research studies in Persian language populations.

Objective In normal walking, the ground reaction forces pass through the medial compartment of theknee and produce an external adduction torque around the knee joint. External adduction moment ofthe knee can lead to medial knee osteoarthritis. Adjustment of the knee alignment and modifying thebiomechanical forces on the knee can reduce pain, increase performance, and parameters of walkingand improve the quality of life. The use of knee orthoses is recommended to remove weight from theaffected compartment and reduce pain in patients with knee osteoarthritis. However the effect of theknee orthosis height on external adduction moment and abduction force has not been measured in previousstudies, so the purpose of this study was to assess of the new three-point pressure knee orthosis(e-life) on the mentioned parameters in the patients with mild to moderate knee osteoarthritisMaterials & Methods The study subjects were 10 patients (9 females, 1 male) with mild to moderateknee Osteoarthritis (OA) that after receiving OA 2 or 3 degree by a specialist, were referred to the RehabilitationResearch Center of the Faculty of Rehabilitation. Each subject spent five different conditions inthe study. Ordering and sequencing of the process was done through randomization for each individual. These five stages included no orthosis, orthosis with long lift length, common-loaded orthosis, mediumangleabdominal orthosis, and maxillary abdominal orthosis. In this study, a three-dimensional QTM motionanalysis system (Version 7. 2, made in Sweden) with seven 100-kHz camera (Produced by Qualisys, USA) and one Kistler force detection plate (500×600 mm, model AA 9260, manufactured by Kistler, Switzerland)was used to collect the kinetic and kinematic data variables of walking at the MusculoskeletalResearch Center of Isfahan University of Medical Sciences. Visual 3D software (C-Motion USA Version 4)was used to musculoskeletal modelling of the lower limb. The temporal and spatial parameter, the momentsapplied to knee joint and knee range of motion were measured for each individual at all stages. SPSS (version 22) was used for data analysis and Shapiro-Wilk test to verify the normal distribution ofdata. The repeated-measures ANOVA test was used to compare the effect of orthosis on the parametersmentioned before and after the use of knee orthosis. Results Spatial parameters did not show significant differences (P>0. 05). There was no significant differencebetween the range of motion in all three pages in different orthodontic states (P>0. 05). The maximumextensor torque was applied to the knee joint without brace, but the results of statistical analysisdid not show any significant difference (P>0. 05). Adductor torque was significantly lower in orthosis witha lower lever arm than without brace (P<0. 05). Conclusion Orthosis did not cause any movement restrictions for the patients. Long-length orthosis has agreater effect on the reduction of external adduction moment. As a result, it may improve the treatmentprocess and improve the quality of life of the users.

Objective Parents face a lot of challenges with the birth of a child with disability. According to researchfindings, mothers of the children with disabilities have lower levels of mental health than mothers oftypically-developing children, and the presence of disabilities in family members creates mental andemotional problems for other family members, especially mothers. These mothers are unaware of theirphysical and mental health as compared to mothers of typically-developing children. These conditionscan lead to mothers’ losing interest in establishing relationships with their relatives that can end in depressionand worsening of mothers’ mental health. Therefore, it is necessary to pay attention to thepsychological status of mothers of children with disabilities and consider the essential role of parents inplanning any intervention program for people with disabilities. For this reason, the purpose of this studywas to investigate the effectiveness of psychological empowerment on the general health of mothers ofthe children with disabilities in a community-based rehabilitation program...

Objective Kyphosis is one of the common abnormalities of the spine. However, correct preservationof the posture can play an important role in preventing and treating kyphosis. Biofeedback systemsare among the methods used to prevent postural dysfunction. This study aimed to design a biofeedbacktool to prevent kyphosis and evaluated reliability and validity of this tool. Materials & Methods total of 17 students aged between 18 and 30 years participated in the studyas inappropriately. In this study, a flexible ruler was used as a golden standard to measure thekyphosis. First, a microcontroller-based kyphosis control biofeedback device was designed usinga flexural sensor. This device consists of a vibration generator that activates when microcontrollerdetects a kyphotic situation. In other words, by changing the physical condition, the flexural sensorresistance used in the smart biofeedback tool changes accordingly and the data collected by theflexural sensor are converted into a voltage variation with a simple resistance circuit. The output ofthe flexural sensor is input to the microcontroller so that as soon as the microcontroller detects anincorrect physical condition, it sends a control signal (based on the predefined threshold for the microcontroller)in a vibration feedback. If the curvature value is more than the threshold and lasts forat least 30 seconds, it will alert the user with vibration feedback. Vibration alert continues as long asthe user is in the kyphotic situation and stops as soon as the user leaves the kyphotic situation andreturns to the natural state. After installing the designed biofeedback tool on the target area of thebody, the tool error is evaluated by counting the number of warnings in the normal state and lackof warning in the kyphotic condition. In addition, to check the repeatability of the biofeedback tool, measurements were made in two neutral conditions and a tissue for each situation twice, with adistance of 2 hours. In this research, the tool validity was measured by Kappa coefficient based onsensitivity, specificity, and reliability...

Objective Empowerment is a process that helps the physically-handicapped people to break the povertyloop, achieve self-reliance and self-sufficiency, and join the mainstream of life. This study aimed to investigatethe empowerment (sense of meaningfulness, effectiveness, autonomy, self-efficacy and sense ofsecurity, and their related factors) of the physically-handicapped people (motor, visceral and sensory disabilities)under the support of Welfare Organization of Kohgiluyeh and Boyer-Ahmad Province in 2015. Materials & Methods The research method was survey-based; a type of cross-sectional and analyticalmethod. The data collection tool was a researcher-made questionnaire (including four demographicquestions (level of education, gender, disability type, and age) and 46 research-specific questions (10questions about social trust, 9 questions about social participation, 8 questions about sports activity, 4questions about sympathy behaviors and 15 questions about empowerment of people with disabilities)with 5-point rating Likert-type scale. The statistical population comprised all the physically-handicappedpeople (motor, visceral, and sensory disabilities) who were under the support of Welfare Organization ofKohgiluyeh and Boyer-Ahmad Province, Iran. They comprised about 10189 people in each city. A total of370 subjects were selected as a sample using Kokaran formula and then randomized sampling was usedbetween eight cities of Kohgiluyeh and Boyer-Ahmad Province. Therefore, in the first stage, 8 cities wereselected. In the second stage, the physically-handicapped people of each city were selected with thehelp of the welfare organization of the city. In the third stage, a group of physically-handicapped peoplewas randomly selected. In the final stage, they were visited personally...

Objective Cerebral Palsy (CP) is a group of non-progressive disorders in a developing brain that resultsin motor problems and other limitations in daily living activities. The presence of motor functions inthese children reduces their participation in daily activities. This is one of the important aspects of thechild’ s health and development, especially the child’ s physical and psychological development. Participationin social activities promotes life satisfaction. Besides, family has a prominent role in identifyingand supplying the child’ s needs. In other words, family plays an essential role in ensuring the health andwell-being of their children. Thus, provisions of growth-related health services has now changed froma child-cantered model into a family-cantered model. As a result, it is very important to understand theparents’ priorities about participation of their children in the daily activities and providing appropriateclient-center services. Materials & Methods In this descriptive-analytic study, 78 children and teenagers with CP aged 3-18 yearswithout psychiatric problems and their parents from Yazd City, Iran had participated. The samples wereselected by convenience sampling method, from clients of private and public rehabilitation centers inYazd Province. In this regard, one state and two private centers were randomly selected and the studysamples were selected from the clients referred to the centers. Parents' priorities for participation oftheir children in activities of daily living were found through semi-structured interviews. In these interviews, we used Canadian occupational performance measure to evaluate the child's level of occupationalperformance and parents’ satisfaction in the three areas of self-care, productiveness, leisure fromthe parents’ perspective. In addition, the level of gross motor performance was evaluated based on theGross Motor Function Classification System (GMFCS) at five levels. In the Iranian society, the validityof Canadian occupational performance measure for each of three areas of occupational performancehas been reported to be between 9. 75 and 3. 75 and the reliability level for the three domains reportedabove 0. 78. The statistical analysis of data was performed in SPSS V. 16. Descriptive statistics and oddsratio were used for analyzing the data. Results the children’ Mean± SD age was 8. 12± 4. 22 years. The first priority reported by the parents wasself-care. Mobility was known as the second important priority in everyday life for children. The resultsobtained from the statistical analysis showed no significant relationship between age and different motorlevels (P≥ 0. 05). Conclusion Parents reported functional priorities in similar performance aspects by all age groups andGMFCS levels in Cerebral Palsy children. The first priority was related to self-care. This reflects the desireof the parents to children’ doing self-care activities, which not only reduces care pressure, but also leadsto promotion in social participation and independence in individual life. The next priority was mobilityand the reason can be attributed to the fact that children with CP need mobility to manage their dailylife activities.