Archives of Rehabilitation (Journal of Rehabilitation)
Year:2017 | Volume:18 | Issue:2|Papers Count:11

ObjectiveOppositional defiant disorder (ODD) is a behavioral disorder whose most important traits are constant negative repetitious behavior pattern, pertinacity, disobedience, and hostility against power symbols.It results in significant clinical disorders in educational, social, and occupational functions. Moreover, parents of children with ODD employ strict punitive methods against their behavioral problems, which worsens the children’s behavioral problems. As a result, parents have a hard time managing their children. The aim of the present study was to investigate the effect of parental behavioral education on mothers of children with ODD.Materials & MethodsThe research design was quasi-experimental with a pretest posttest and control group.The study population consisted of all mothers of children between 9 to 11 years from the city of Azna. Thirty mothers of children with ODD whose scores in the subscales of coping behaviors and aggressive behavior in Child Behavior Checklist were above the questionnaire cut-off point score were selected via at-hand sampling after homogenizing them in variables such as education, gender, severity of symptoms, age and maternal education.They were randomly paired and assigned into experimental and control groups after obtaining consent from the mothers. The inclusion criteria for the participants of this study were as follows: high aggression in children with the cut-off score in accordance with the Child Behavior Checklist. The age of the mothers was another inclusion criterion. All the mothers were between 33 to 37 years old. In this study, all of them were from two-parent families. The number of children with ODD was also considered for households having a child with ODD. Children’s age was another inclusion criterion in this study. All children between 9-11 years of age were included in the study. Mothers’ education level was also considered, with those included in the sample being diploma-educated. The research tools included the Child Behavior Checklist for parents (1991) and Child Symptom Inventory Parents’ form (1997). Parent’s behavioral training was accomplished across nine 90-minute sessions for the experimental group. In the end, the two groups completed the questionnaires. Analysis of covariance was used to analyze the data.ResultsThe results showed that the effectiveness of behavior management training among mothers with ODD children with regard to reducing their symptoms was more in the experimental group compared with that in the control group (P<0.001). The parents’ behavior training also reduced aggressive behaviors in the experimental group (P<0.012).ConclusionOverall, the findings suggest that mothers' behavioral training reduces the symptoms of ODD in children and prevents inappropriate behavior in family environment. Learning and applying principles such as avoiding punishment along with distinction between discipline and punishment, are the main principles of the training program that can reduce behavioral problems in children and increase their desirable behaviors.

ObjectiveMost children and adults with cerebral palsy do not have appropriate social competency and personality traits, which in turn leads to psychological problems in their life and negatively affects their interactions.The purpose of the present research was to investigate the effectiveness of mental immunization program training on social competency and personality traits of individuals with cerebral palsy in Tehran city.Materials & MethodsThe present research had a semi-experimental study with pretest and posttest design and control group. The study population included adolescents with cerebral palsy in the age group of 12-16 years in the academic year 2015-2016. Subjects were selected with the help of the convenient sampling method. In this study, 34 adolescents with cerebral palsy participated. They belonged to the middle socioeconomical class. The subjects were randomly divided into experimental and control group, each of which consisted of 17 adolescents. The experimental group received psychological immunization program training across 10 sessions (45 minutes for per session; twice a week) while control group did not receive any training.The instruments of present research were social competency questionnaire of Felner, Lease and Philips and big five factor personality inventory (NEO-FFI) of Costa and McCrae. The obtained data were analyzed by using mean, standard deviation and multivariate analysis of covariance (MANCOVA) test with the 21st version of the statistical package for social sciences (SPSS).ResultsThe normality of variables and contingency of variance and covariance assumptions were tested. The Kolmogorov Smirnov test showed that all variables were normal (P>0.05). The Box test confirmed contingency of variance-covariance assumption (P=0.28). Therefore, assumptions of MANCOVA test were confirmed and were used the MANCOVA test for analysis of data. The findings of this research showed that there was a significant increase in social competency mean scores of experimental group post intervention in comparison with control group (P<0.001). Also, personality traits mean scores of experimental group was significantly in neuroticism, extroversion, agreeableness and conscientiousness subscales (P<0.05). In other words, mental immunization program training had a significant effect on these subscales but not on openness (P>0.05).ConclusionThe results of the present research indicated a significant increase in social competency in adolescents with cerebral palsy. Also, desirable changes were found to be developed in the personality traits of these adolescents. In other words, there was a decreased level of neuroticism and significant increase in positive traits such as extroversion, agreeableness and conscientiousness. The overall results of the present research indicated that mental immunization program training led to improvement in social competency and personality traits of individuals with cerebral palsy. Therefore, paying attention to the mental immunization program training is essential, and planning for providing of psychological immunization program training is of particular importance. Cerebral palsy affects all aspect of an individual’s life and implementing the mental immunization program training has been associated with effective outcomes. Therefore, instructional interventions such as mental immunization program training are required. While a lot of research works have been conducted with regard to the effectiveness of mental immunization program training on social competency and personality traits of normal students, only a few investigations have been carried out for the same in relation to individuals with cerebral palsy. As far as present study used experimental method, could be cautioned in generalization of results. Another limitation of this study is the use of self-reporting questionnaires, wherein individuals do not feel the responsibility to answer correctly and honestly in order to avoid stigma or rejection by the community.It is recommended that the psychological immunization program training, which is very helpful in the instruction of teenagers with cerebral palsy, be used in primary schools and among various categories of exceptional students.

Objective: Lateral ankle sprains (LAS) are common among athletes and can result in a high rate of reinjury and Chronic Ankle Instability (CAI). CAI can affect dynamic stability in athletes. On the other hand, fatigue can disrupt dynamic stability in injured as well as healthy athletes. Recent studies support the use of taping and braces in subjects with chronic ankle instability. Nonetheless, it is not known if applying ankle taping can improve dynamic stability in fatigued people. So the goal of this research is to study the effect of ankle taping and fatigue on dynamic stability in female athletes with and without chronic ankle instability.Materials & Methods: Twenty female athletes including 10 subjects with chronic ankle instability (age 22.02±1.98 years, height 163.80±2.74 cm, weight 58.68±7.10 kg, FADI 80.78±1.03% and FADI Sport 65.10±1.75%) and 10 healthy subjects (age 21.70±0.67 years, height 162.90±5.06 cm, weight 59.10±7.04 kg, FADI and FADI Sport 100%) participated in two separate testing sessions. Different conditions (no taping and with closed basket-weave ankle taping) were applied at each session. Three trials of a jump landing task were performed under each condition before and after induced functional fatigue. The jump-landing task involved a single-leg landing onto a force plate from a height equivalent to 50 percent of each participant’s maximal jump height and from a starting position 70 cm from the center of the force plate. The functional fatigue protocol comprised three stations: Modified Southeast Missouri (SEMO) agility drill, stationary lunges, and quick jumps. The participants continued to run through each station until the time to finish the stations increased by 50% compared with their baseline timed runs.Time to stabilization was measured in the anterior-posterior (APTTS), medial-lateral (MLTTS) and vertical directions. Three separate repeated-measure analyses of variance with two within-subjects factor (condition and time) were performed for each dependent variable in each group..Results: The results of this investigation revealed that in healthy athletes group, the difference between MLTTS and vertical TTS was statistically significant {f=7.52, P=0.001}, {f=9.69, P=0.004}. Bonferroni post hoc testing revealed faster pretest MLTTS than posttest for taping condition and faster pretest vertical TTS than posttest for no taping condition. In injured athletes group, the difference between MLTTS and vertical TTS was statistically significant {f=10.57, P=0.001}, {f=14.27, P=0.001}. This testing also revealed faster pretest MLTTS than posttest for no taping condition, faster pretest vertical TTS than posttest for both conditions, and faster vertical TTS after taping than before taping.Conclusion: In the athletes with chronic ankle instability, taping without fatigue improved dynamic balance in the vertical direction. Taping after fatigue could not improve dynamic stability in the athletes with and without chronic ankle instability. Future researchers should examine injured and uninjured participants tested under these conditions to determine if these results are useful in selecting appropriate prophylactic method that can treat or prevent injury to the ankle during functional activities.

Objective: Hemipelvectomy amputation is a surgical procedure in which the lower limb and a portion of pelvic are removed. There are a few studies on the performance of this group of patients while walking.The aim of this paper was to evaluate the effect of hemipelvectomy amputation on kinematics and muscle force generation of the lower limb while walking with Canadian prosthesis.Materials & Methods: A subject who underwent hemipelvectomy amputation on his left side and whose mass, height, and age were 75 kg, 1.75 m, and 39 years, respectively, was involved in this study. Qualisys motion analysis system with seven cameras and force-plate system were used to record marker tracking and ground reaction forces. Twenty reflective markers were attached to the subject’s body. As the subject walked, the data was recorded. The mean of five trials was used for statistical computing. The data was collected with the frequency of 120 Hz and filtered with 10 Hz low-pass filter. Muscloskeletal modeling was conducted by Visual 3D and OpenSim software. All data were analyzed using the SPSS 19 software at α=0.05.Results: There were significant differences between knee and ankle joint kinematic pattern at Loading, Mid-stance, Terminal stance, and Pre-swing phases of gait (P<0.05).In weight acceptance phase and mid-stance phase, ankle plantar flexion and dorsi-flexion range of motion, respectively, were significantly lower in the patient compared to a healthy subject (P=0.00). At the end of the stance phase, ankle range of motion was significantly different in the patient compared to the healthy subject (P=0.00). In the pre-swing phase, ankle plantar flexion was 11.5 degrees greater than that of the healthy subject. In mid-swing phase, patients showed more ankle dorsi-flexion compared to the healthy subject. In weight acceptance phase, knee flexion of patient (P=0.00) was significantly greater than that of the healthy subject, and in mid-stance phase, knee extension of patient was significantly greater (P=0.04). In pre-swing phase (P=0.00) and initial swing (P=0.02), there were significant differences between knee flexion of patients and healthy subjects. The pattern of hip range of motion during gait cycle was the same for the patient and the healthy subject (P>0.05). Force generation of the hip abductor, hip extensor, and knee extensor along with tibialis anterior and posterior of the patients in the sound leg were significantly more than that of the normal subject (P<0.05).Conclusion: The kinematics pattern of the patient’s lower limb during gait is different. Kinematic changes are associated with a significant increase in lower limb muscle generation that can have a degenerative effect on the knee joint. So the importance of this subject should be considered by rehabilitation experts.

Objective: The present study was conducted with the aim to determine the relationship of personality traits with quality of life in spouses of patients with physical disabilities.Materials & Methods: The present study was a correlational study that was conducted in 2015-2016.The study population comprised all spouses of patients with physical disabilities under the purview of Kerman. Out of them, 100 participations were selected based on availability. To evaluate the research variables, Neo five-factor personality questionnaire and 36-item form of quality of life designed by Varosherbon were used. The data of the research were analyzed using descriptive statistical and correlational and regression methods. SPSS version 21 was used for data analysis.Results: Our findings indicated that there is a positive significant correlation between personality traits of extraversion, agreeableness and conscientiousness with the quality of life among spouses of patients with physical disabilities (P<0.01). Also, there is a negative significant correlation between the personality trait of neurosis with the quality of life of spouses of patients with physical disabilities (P<0.01).According to regression analysis findings showed that the personality traits of neurosis and extraversion predicted 17.6 and 5.2% of the variance in quality of life of spouses of patients with physical disabilities (P<0.01), and the personality traits of neurosis had the most contribution to the prediction of quality of life (P<0.001).Conclusion: According to chronic nature of physical disabilities, participation of patients’ wives in care programs can cause improvement in their quality of life and daily activities. Therefore; it is recommended to participant them in care plan through training.

Objective: Disability is a form of damage that limits one or more major life activities of an individual. It is also associated with psychological distress and depression in these individuals, which in turn also cause problems for the concerned families. Consequently, families with disabled children are socially isolated and experience a low-level of mental health and mood. As mothers of disabled children spend more time with them, their adjustment and physical and mental health are more threatened. They are more sensitive to emotional issues and family relationships outside the family. Thus, the present study was conducted to predict the perceived empathy based on emotional schemas and resilience in mothers with disabled children.Materials & Methods: This study is a descriptive one, and the statistical population consisted of all mothers with motor-physically disabled children. This study was conducted in 2015-2016 academic year in the city of Tehran. Through purposeful sampling method, 120 samples were selected. Thus among the multiple areas in Tehran, areas 2, 4 and 16 were selected and by referring to special schools with physical-motor disabilities, questionnaires were given to the students. To collect information, Jefferson Scale of Patient's Perceptions of Physician Empathy Questionnaire (JSPPPE) was used to assess communication skills, human relations, quality, and expertise and medical skills. Connor-Davidson Resilience Scale was designed to measure the strength to cope with stress, and Emotional Schema Scale Lee Hee (LESS) that is used to determine beliefs and attitudes toward emotion in individuals were developed in 2002 by Lee Hee. Based on emotional schema, these two scales were used to measure 14 schema dimensions.Results: Based on the analysis of results and with respect to the establishment of conditions for equality of variances with Levene's test (P≥0.05) and normal distribution of data with Shapiro test (P≥0.05), parametric tests were used. Given that research has predicted the relationship, the Pearson correlation test and multiple regressions by Enter method were used by using SPSS 23. The results of Pearson correlation showed that domains of emotional validation, superior values, stability, and consensus showed a significant positive correlation with perceived empathy of mothers having children with physical-motor disabilities (P<0.001). It was also found that resiliency has a positive and significant relationship with perceived empathy in mothers with children having physical-motor disabilities (P<0.02). Multiple regression analysis showed the shared variance emotional schemas and resiliency with perceived empathy is 0.46. The main findings of regression analysis, via the enter method, showed that the emotional schema validation, having superior values and resiliency factors have a significant effect in the prediction of perceived empathy of mothers of children with disabilities. Other emotional schemas are not significant impact factors in the prediction of perceived sympathy of mothers with disabled children.Conclusion: According to the results, the high resiliency and a positive emotional schemas such as having superior values and validation are predictors of perceived empathy in the mothers of disabled children. This means that the mothers of children with disabilities in dealing with situations when they have more resiliency and and interpret them as positive, are able to communicate more effectively with their surroundings. In this regard, one of the factors is perceived empathy that has a significant impact on the development of personal relationships between individuals and reflects the person's mental health. In addition, it can be used with resiliency and emotional schemas, so therapeutic intervention is implimented with respect to these two variables.

Objective: Stuttering is a disorder in fluency that is identified through involuntary interruptions in continuous speech. There are different types of the disorder, including growth stuttering with acquired and malingering origins. With respect to the law of exemption of stuttering individuals from military service, the issue of malingering is quite common. Since there is no standard tool to be used for deciding exemption, experts rely mostly on their personal knowledge and judgment, and because the measurements and perceptual judgments are made informally, it increases the likelihood of errors. Therefore, the preparation of a protocol to detect conscripts who are afflicted with malingered stuttering from those who suffer from real stuttering was the aim of the study, thereby, determining the conditions of exemption from military service.Materials & Methods: This study is of validation type. Accessible simple non-probability sampling was used. First, different sections of the detection protocol of malingering stuttering was prepared, which consisted of structured interview, questionnaire for malingering stuttering, MMPI test, facilitator techniques, SSI4 test, and analysis of reading and speech sample. Then, sampling was done on 20 exemption applicants who were suspected to be malingering and, at the same time, on 15 applicants who had visited a clinic for a real stutter. Then, the features of the protocol were investigated, and the profile of malingering was prepared based on the results obtained from the detection protocol of malingered stuttering.Finally, the data were analyzed using different statistical methods and SPSS.Results: Detection protocol of malingered stuttering was codified. With regard to Cronbach's alpha coefficient, which was equal to 0.76, for the detection questionnaire of malingered stuttering, the questionnaire was of good internal consistency. To determine the concurrent validity of the protocol (the results of the implementation of the protocol following the opinion of psychiatrists), Chi-square test was carried out, and no significant difference was found between the protocol and the comments of the psychiatrists (P>0.05). The protocol was of good construct validity. Finally, a profile was prepared to determine the status of conscription with respect to stuttering disorder based on the results for each participant.Conclusion: According to the results, the detection protocol of malingering stuttering is of good internal consistency and concurrent validity. However, considering that the sample population was not large in the present study, it can be said that this study is a preliminary evaluation to find the psychometric features of the instruments, with the aim of laying the groundwork for further studies.

Stroke occurs when the supply of blood to the brain is either interrupted or reduced. The clinical presentation varies from minor neurological symptoms to severe deficits, depending on the location and the size of the brain lesion. Hemiparesis is one of the most striking features in the acute phase. Many other deficits may also be present, including postural imbalance. All persistent neurological deficits may cause more or less severe activity limitations in several domains of human functioning. Regaining walking ability is a major goal during the rehabilitation of stroke patients. Therefore, using orthoses can be beneficial for them. Ankle-Foot Orthoses (AFOs) is one of the most common therapeutic approaches to control foot drop among stroke patients. AFOs prevent drooping or other unintended movements of the foot and ankle by providing stability in optimum conditions. It also helps in regaining normal walking posture in stroke patients. The aim of this review was to evaluate the efficiency of the AFOs on balance and examine the effectiveness of temporal spatial and kinetic gait kinematics in stroke patients with foot drop.Materials & Methods: Science Direct, Springer, Google Scholar, PubMed, Ovid databases were searched for articles published between 1996 and 2016 of studies on patients with drop foot wearing the AFOs.After reviewing and categorizing the articles, they were analyzed based on spatiotemporal parameters, gait kinetics, gait kinematics and stability. A total of 21 articles were selected for final evaluation.Results: Twenty-one articles were analyzed in relation to the effect of the AFOs on gait parameters in stroke patients. Spatiotemporal parameters were evaluated in 14 articles, and kinetics and kinematics parameters were analyzed in seven articles. AFOs have a significant impact on the length and width of the steps but had no significant effect on speed, cadence, symmetry of gait and balance. Also, AFOs improved kinetic parameters of gait, ankle kinematics and kinematics of the knee in the static phase but had no significant effect on knee joint kinematics and kinematics of the hip joint in the frontal and sagittal. There are a few studies with regard to the effects of AFOs on the moment of inertia and joints power, but the results of the present study showed no significant difference in these parameters.Conclusion: This study showed that the AFOs based on the models (static or dynamic) had a paradoxical effect on balance, kinetic and kinematic parameters of gait in the stroke patients. AFOs had a significant improvement in balance, kinetic and kinematic parameters of gait compared to those without orthosis situation in the stroke patients. According to the result of this study, depending on the patient's needs and situation, the best and the most suitable ankle foot orthoses should be designed and custom molded for them.