Archives of Rehabilitation (Journal of Rehabilitation)
Year:2013 | Volume:14 | Issue:2 (57)|Papers Count:20

Objective: Low back pain (LBP) is one of the most common and costly health problems. Changes in muscle activity and recruitment of lumbar deep muscles which are responsible for lumbar spine stability have been reported in patients with LBP. Different exercise programs are used in the treatment of such patients to improve spinal stability. The purpose of this study was to systematically review the effect of stabilization exercises on objective outcome measures in patients with non-specific chronic LBP in previous randomized controlled trials.Materials & Methods: A literature search for the period of 2000-2012 was performed, using MEDLINE, PubMed, Google scholar, Science Direct, OVID and CINAHL databases. Low back pain, stabilization exercise, motor control exercise, segmental stabilization, transverse abdominis muscle, multifidus muscle, electromyography, ultrasound, ultrasonography, and randomized controlled trial were used as keywords. Muscle recruitment, postural balance control, muscle endurance, muscle size and lumbar range of motion were studied as objective outcome measures.Results: In total, of 158 articles, 13 articles were selected according to the inclusion criteria of the study. There was a wide variation among studies in terms of methodology, main outcome measures, sample size, procedure, etc. The results demonstrated that stabilization exercise was more effective than other interventions on activity pattern of deep muscles, postural balance control, muscle endurance and range of motion, while it was not significantly different with other interventions on deep muscle size.Conclusion: It seems that stabilization exercise has considerable effect on activity pattern of deep muscles, postural control, muscle endurance and range of motion and can be considered as an effective intervention in the treatment of patients with non-specific chronic LBP.

Objective: The aim of the present study was to determine the effect of "Community Re-entry Program" (CRM) on psychological condition in the patients with schizophrenia.Materials & Methods: In this quasi experimental design study that sampling was performed available and none randomized.24 patients with schizophrenia who had the inclusion criteria selected and were placed into two intervention (n=12) and control groups (n=12). Data were collected using the Positive and Negative Symptoms Scales (PANSS) questionnaires and interviews. Then intervention group were instructed Community Re-entry Program (CRM). The program was contained 16 sessions, which was administered every other day, 3 times a week, during run program were used only routine treatment of patients in psychiatric hospitals (medication therapy and occupational therapy). The data from this study were analyzed through the t-test for independent groups.Results: The findings indicated that the negative symptoms of schizophrenia patients in the intervention group, compared with the control group showed no significant change after the implementation of community re-entry program (P<0.05). Although it was evident that the change in the total average and other aspects but changes to the dimensions of (positive symptoms, general psychopathology and total score) were not significant (P>0.05).Conclusion: According the research findings community re-entry program could reduce negative symptoms in schizophrenia patients, this significant improvement can be attributed to the effect of the intervention, and the difference was not observed in the control group.

Objective: The goal of this study was to evaluate the lip reading ability and Speech perception of hearing impaired students of special schools for the hearing impaired in different speech levels.Materials & Methods: In this cross- sectional study, 44 deaf students (9-12 years old) were selected with multi-stage cluster sampling method, from two special schools for the deaf in Tehran. Tools were a demographics questionnaire, the Auditory Perception Test (APT-HI), Sara lip reading test (No 2) and Speech Discrimination Score Test (SDS). T test were used to analyze the data.Results: The lip reading ability and speech perception of 97.3% of deaf students was very poor and only 67% had degrees of speech perception. (Pvalue<0.001). There was the significant difference between Sara lip reading test scores (phonemes) with and without sound (P-value<0.001), but no significant difference between SDS test scores (words) with and without sound. Also there was no significant difference between male and female sample scores in all of tests.Conclusion: lip reading and speech perception, the first index of oral method, were not desirable in deaf students in special schools for the deaf in Tehran. More research is needed to explore solutions.

Objective: Assuming that cardiac rehabilitation and exercise significantly reduces mortality rate in coronary artery disease and has an important role in secondary prevention, the purpose of this study is to assess the effects of strength training and cardiac rehabilitation programs on biomechanical parameters of blood flow velocity and blood flow rate and these relationships with the brachial and femoral artery stiffness index in patients with coronary artery bypass graft (CABG) in past 2 months.Materials & Methods: This study was performed on 40 women and men, with 50 to 80 years old who were underwent CABG.Training group had 18 patients who participated in strength training and rehabilitation program for two months. There were three sessions in a week and patients trained according to determined level of each patient's functional capacity. The control group had 14 patients who did not participate in the training program. Variables blood flow velocity and arterial diameter in systole and diastole phases measured with Doppler ultrasound and the mean velocity of blood flow rate in arteries and arterial stiffness index was calculated for both groups. For statistical analysis dependent t-test was used in significance level of 0.05 and Pearson correlation coefficient was applied for measuring the relation between parameters in significant level of 0.01.Results: The significant changes in velocity, blood flow rate and decreased arterial stiffness index in arteries were observed in the training group.Conclusion: According to our results, we can say strength training and cardiac rehabilitation programs can be effective in improvement of peripheral vascular and bleeding tendency in these patients.

Objectives: This Study aimed to investigate the level of personal-social developmental skills in 1-4 years old children with early treated phenylketonuria.Materials & Methods: This analytic, cross-sectional study has been done on 40 children 1-4 years old referred to clinics of phenylketonuria (PKU) who were diagnosed through screening at birth and were treated. The measurements were a demographic questionnaire, ASQ (Ages & Stages Questionnaire) and clinical assessment by pediatrician. Forty children were also selected randomly as control group from kindergartens of Tehran and completed the questionnaires. Data were analyzed by SPSS 19.0 software.Results: The mean age of Children was 30.7 (±10.5) months in the control group and 27.7 (±11.0) months in the case groups. There was no significant differences between two groups in terms of delivery type and the current and birth height, weight and head circumference. There was a significant difference between two groups regarding personal social developmental skills (P<0.001).Conclusion: The level of personal-social developmental skills in the children with early treated Phenylketonuria is lower than normal children. Early diagnosis and intervention for all children with early treated Phenylketonuria is recommended.

Objective: People with spinal cord injuries (SCIs), are at risk for cardiorespiratory illnesses because sedentary life. The purpose of this study was to explore the effect of eight weeks of aerobic exercise on cardiovascular, respiratory and lipid profiles in spinal cord injured individuals.Materials & Methods: Twenty spinal cord injured individuals above 70% level of disability (49.9 ± 4.5 years old, and 25.9 ± 1.8 years of SCI, BMI 25.03 ± 3.9 kg/m2) randomly divided into two trained and sedentary control groups. Systolic and diastolic blood pressures, VC, FEVI, HDL-C, LDL-C and fasting blood glucose were measured before and after the program, 8-week exercise training program (aerobic exercise, 30 min/day, 3 days/week) for two groups.The collected data were analyzed using the Repeated Measure test at the significant level of P<0.05.Results: Systolic blood pressure and LDL-C decreased significantly after exercise in trained group (P=0.004, P=0.02). The levels of VC (P=0.01), FEV1 (P=0.031), HDL-C (P=0.004) increased significantly after exercise. There was no significant difference in these variables between two groups (P>0.05).Conclusion: Given the data obtained from current study, it seems that a course of exercise (8 weeks) could cause improvement in cardiovascular, respiratory and lipid profiles of individuals with spinal cord injury.

Objective: The developments of theory of mind are considered as one aspect of social cognition by researchers and have attracted their attention in recent years. The purpose was to determine the effect of theory of mind training on social skills in male students with intellectual disability in Meshkinshahr City.Materials & Methods: In present experimental study, pretest-posttest designs with control group were used. All intellectually disabled male students (aged 8-12 years old) who educating in Meshkinshahr (43 individuals) answered to theory of mind tests. Students who could not pass the tests (39 individuals) selected as a sample and their teachers completed Social Skills Rating Scale (SSRS; Gresham & Elliot, 1990) for them. They assigned randomly to experimental and control groups.Experimental group participated in 8 training sessions (for 2 weeks, 30 minutes per session). After last session, theory of mind tests and SSRS administered for all subjects again. Data were assesed with analysis of covariance.Results: Analysis of covariance showed that experimental group performed better than control group in social skills index, cooperation and self-control components significantly (P=0.001). But, two groups were not significantly different in assertion component.Conclusion: theory of mind training leads to improvement in social skills and its components of intellectually disabled students and will guarantee their success on these areas in adulthood.

Objective: The purpose of this study was studying of explicit motor learning in Relapse-Remission (RR) MS patients and compare with healthy subject.Material & Methods: A serial reaction time task by using software was applied for studying explicit motor learning in 15 RRMS patients and 15 matched healthy subjects. In this task four squares with different colors appeared on the computer screen and the subjects were asked to press 1 of 4 keys corresponding to the appropriately colored square immediately after observing it.In the first day subjects practiced 8 motor blocks with a retention test consisted of 2 patterned blocks, 48 hours later. Before test, the subjects were told the order of random and patterned blocks, and then RT values were calculated for each block and K-S test, paired T test and independent-samples t-test were used to analyse the measured blocks times.Result: The patient groups performed this task slower than healthy groups (P<0.05). Blocks time difference between the first block and tenth block, were significant in both groups (P<0.05). But Explicit motor learning in healthy subjects was higher than patient groups (P<0.05).Conclusion: although patient groups performed this task slower than healthy subjects, there was motor learning in RRMS patient but this explicit motor learning was less than healthy matched subjects.

Objective: the objective of the study was to assess and compare early active tension and immobilization protocols in rehabilitation of the hand, following zone 5-6 extensor tendon repair.Material & methods: from the 21 patients enrolled in a randomized controlled trial study, 18 cases with average age of 32.43 Years completed the protocol. A total of 41 extensor tendons from 27 fingers of the subjects were studied. A surgeon repaired all tendons in zone 5 and/or 6 by an end to end epitenon running technique using prolen 0.3. For rehabilitation, subjects were randomly assigned into two “immobilization” and “early active tension” group. Edema, metatarsophalangeal flexion, combined flexion and extension of wrist and fingers, total active motion of fingers and metacarpal extensor lag were assessed 6 weeks after surgery. All aforementioned variables and grip strength were reassessed 12 weeks after surgery.Results: compared to traditional immobilization protocol, early active tension could significantly improve hand edema, metacarpal flexion, combined flexion and extension of wrist and fingers, total active motion of fingers and grip strength (p<0.05). There was no significant difference in combined wrist and finger extension, and extensor lag between two groups (p>0.05).Conclusion: our results demonstrate that in compliant patients, early active tension could be an alternative method for traditional immobilization protocol, after surgical repair of extensor tendon injuries in zone 5 and/or 6.

Objective: Myofascial trigger point is one of the most common causes of musculoskeletal pain and disorders.Myofascial trigger point in upper trapezius has been reported as a frequent symptom in patients with neck and thoracic pain. The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on active trigger point in upper trapezius muscle.Materials & Methods: 32 women with active myofascial trigger point in upper trapezius muscle participated in this randomized clinical trial (RCT) study. The subjects were randomly assigned into two groups: dry needling (N=15) and ischemic pressure (N=17). The visual analogue scale (VAS) was used to assess the pain intensity before and after treatment in both groups. Paired t-test was used to determine any significant difference in pain intensity after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA) was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis.Results: Statistical analysis (paired t-test) revealed significant decrease in pain intensity after treatment sessions in control and experimental group (P=0.00) compared with pre-treatment score. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups (P=0.8).Conclusions: It seems that that both dry needling and ischemic pressure are effective in improvement in the pain intensity in subjects with myofascial trigger points. However, dry needling can be used by clinicians and therapist in physiotherapy clinics.

Objective: One of the most prevalent sensory problems in cerebral palsy is Astereognosis which has special importance in daily manual functions. The purpose of this study was to determine the level of hand stereognosis using common objects and geometric shapes in children with spastic hemiplegia and diplegia.Materials & Methods: In this cross sectional study, 20 children with cerebral palsy between 3-6 years old (9 males, 11 females) with mean age (hemiplegya: 55 months, diplegya: 57 months) were selected through nonrandomized convinience sampling referd to Occupational Therapy centers of Shahid Beheshti University of Medical Sciences. Stereognosis was evaluated using geometric shapes (square, circle, rectangular, triangle) and common objects (pencil, key, coin, nail, teaspoon and screw) and test special board. The data were analyzed by Mixed Analysis of Variance and Regression statistical tests.Results: There was no significant regression between common objects stereognosis score and age in hemiplegic children but this regression was significant for stereognosis score of geometric shapes (P=0.027).There was no significant regression between stereognosis score of common objects and geometric shapes in diplegic children. The Main effects of gender was not significant in stereognosis of children with spastic hemiplegia and diplegia, also main effects of hand were not significant in two groups.Conclusion: There was no significant difference between stereognosis of affected and unaffected hand in hemiplegic children and between right and left hands in diplegic children. Also There was no significant regression between age and stereognosis score of geometric shapes in diplegic children.

Objective: The present study examined the relationship of aggression and impulsiveness with readiness for addiction among the students of Allameh Tabatabai University.Materials & Methods: The methodology applied in this research was cross- analytical.170 male undergraduate students who study at Allameh Tabataba'i University were selected by two-stage random sampling. To measure the variables, Aggression Questionnaire of Ahvaz, Barrat Impulsiveness scale (BIS) and the readiness for addiction scale of Wade and Butcher were employed. To analyze the findings, the Pearson correlation coefficient and multiple regressions were used.Results: Results indicated that the variables of aggression and impulsiveness were significantly able to predict the readiness for addiction (P<0.001). Also, based on the coefficient of determination, aggression and impulsiveness variables together predicted 49 percent of variance of addiction readiness variable.Conclusion: Noting that the variables of aggression and impulsivity can properly predict readiness for addiction, university counseling centers can, through workshops, teach the students different ways of controlling these variables in a variety of situations and so they will be able to prevent the tendency towards drug use.

Objective: Today, due to the high growth rate of aging, protecting and improving the health and quality of life of elderly as a vulnerable group of the population are taken into more consideration. This study was performed to determine the relationship between social support and anxiety level in the elderly.Materials & Methods: In this descriptive-analytic study, 380 older adults of Hamedan city were selected through random sampling. To gather the data, Social Support Appraisals Scale and Geriatric Anxiety Scale were used as well as Demographic Variables Questionnaire. Data were analyzed by Correlation Coefficient and Independent T-test.Results: The sample consisted of 68.9% male and 90% were married.The mean age of the elders was 68.06 ± 6.72 years. Results showed that social support has significant relationships with anxiety and its subscales, of which cognitive subscale had the highest correlation (P-value<0.001, r=-0.494).Conclusion: Because of the increasing rate of aging, the importance of the social determinants of health such as social support is important in reducing anxiety in elderly.

Objectives: To translate and evaluate the test-retest reliability, internal consistency and construct validity of the Persian version of the IKDC questionnaire in Iranian patients after ACL and meniscal operations.Materials & Methods: After translation based on the Quality Of Life Assessment protocol, the IKDC, KOOS and SF-36 Health Survey were administered to a sample of 101 patients underwent for ACL and meniscal operations. The test-retest reliability was tested by use of an Intra-class Correlation Coefficient, the internal consistency by a Crohnbach’s alpha and the construct validity were tested by correlating the IKDC scores with KOOS subscales including pain, symptoms, ADL, recreations and sport activity, Quality Of Life and the physical and mental component summaries and the SF-36 Health Survey. In addition, the construct validity was measured by Pearson and Spearman correlation coefficient parameters.Results: A high test-retest reliability score was found with an ICC of 0.99. The Internal consistency was as 0.90. A moderate to good correlation was obtained between the IKDC total score and KOOS subscales, including pain (r=0.66, P<0.001), symptoms (r=0.55), ADL (r=0.68), sport and recreation activities (r=0.60) and Quality Of Life (r=0.50). A good correlation was found between the total scores of the IKDC and physical component summary (r=0.70) along with another fair association between the mental component summaries of the SF-36 Health Survey (r=0.44).Conclusions: Persian version of the IKDC is a reliable and valid instrument for designing any assessment or rehabilitation program in Iranian patients after ACL and meniscal Surgery.

Objective: Effectiveness of Constraint Induced Movement Therapy (CIMT) has been approved in adult persons, while it seems that we need many researches with higher levels of evidences in children. This research aimed to identify the efficacy of CIMT on unimanual and bimanual functions in children with Cerebral Palsy.Materials & Methods: In this interventional study, twenty eight participants were selected that had the inclusion and exclusion criteria and then divided into two groups of CIMT and control. The intervention was provided on 10 out of 12 consecutive days in CIMT group and another group was received occupational therapy services.Assessment tools which were utilized in the survey were Bruininks-Oseretsky Motor Proficiency Test, Caregiver Functional Use Survey (CFUS), Jebsen-Taylor Test in Hand Function. In order to compare two groups Independent t-test was used and to compare each group from pre-test to post-test paired t-test was utilized.Results: Data showed significant differences between two groups in dexterity, bilateral coordination, bimanual coordination, bimanual function, unimanual function and Caregiver Functional Use Survey (how well & how frequently) (P<0.05). Also comparison between pre-test and post-test in each group showed improvement in most of variables in research.Conclusion: protocol of child friendly Constraint Induced Movement Therapy was lead to improvement in either unimanual or bimanual hand functions in children with cerebral palsy.