فصلنامه آرشیو توانبخشی
سال هشتم شماره 4 (پیاپی 27، زمستان 1386)

Exercise training has assumed a major role in cardiac rehabilitation, mostly because of its positive effects on myocardial perfusion in patient with coronary artery disease. Improvement of peripheral vascular system and myocardial contractile function have been suggested as potential adaptations. The purpose of this study was to determine the effect of concurrent training on hemodynamic responses in patients with coronary artery disease. In this interventional and experimental study twenty four patient (50-75 years old) with coronary artery disease were selected by sample of convenience and through a directive goal oriented sampling and were randomly divided to two subgroups, experimental (n=12) and control (n=12) groups. The experimental group participated in 3 months concurrent training, 3 times/week for 60 to 80 minute at 70% to 85% of MHR and 40% to 60% of 1RM. Investigation variables were assessed at baseline and at the end of the protocol by the impedance cardiography method. Data were analyzed by T test. A significant training effect was documented by an decrease in heart rate and blood pressure at rest. Stroke volume (SV) increased from 60±8 to 81±13 ml/beats, Stroke index (SI) increased from 33±4 to 44±6 ml/beat/m2, Cardiac output (CO) increased from 4±1 to 5±1 l/min and Cardiac index (CI) increased from 2±0.5 to 3±0.5 l/min/m2 (P<0.05). Systemic vascular resistance (SVR) decreased from 1782±361 to 1540±294 dynes/sec/cm5 and Systemic vascular resistance index (SVRI) decreased from 3212±662 to 2751±558 dynes/sec/m2/cm5 (P<0.05). We conclude that concurrent training may improve myocardial hemodynamic responses in some patients with CAD.

Research is designed to determine speech respiratory measures in spastic cerebral palsied children versus normal ones, to be used as an applicable tool in speech therapy plans. Via a comparative cross-sectional study (case–control), and through a directive goal oriented sampling in case and convenience approach for controls twenty spastic cerebral palsied and twenty control ones with age (5-12 years old) and sex (F=20, M=20) were matched and identified. All possible inclusion and exclusion criteria were considered by thorough past medical, clinical and para clinical such as chest X-ray and Complete Blood Counts reviews to rule out any possible pulmonary and/or systemic disorders. Their speech respiratory indices were determined by Respirometer (ST 1-dysphonia), made and normalized by Glasgow University. Obtained data were analyzed by independent T test. There were significant differences between cases and control groups for "mean tidal volume", "phonatory volume" and "vital capacity" at a=0/05 values and these values in patients were less (34%) than normal children (P<0/001). Measures obtained are highly crucial for speech therapist in any speech therapy primary rehabilitative plans for spactic cerebral palsied children.

The purpose of the present study was to assess the effect of local muscle fatigue induced at proximal and distal segments of lower extremity on sagittal plane mover on visual dependency in quiet standing postural stability. In this Quasi–experimental study (before – after comparison) sagittal plane prime movers of the ankle and hip musculature were fatigued using isokinetic contractions at two test sessions with a randomized order and one week interval. Twenty five healthy young female students were َselected by using non probability selection and sample of convenience and asked to maintain single leg upright posture as immobile as possible. RMS and SD of Center of Pressure displacements were assessed in 30 seconds and consequently, the eyes were closed after 15 seconds. A analysis of variance (ANOVA) for repeated measures was used to analyze the effect of the following factors over two periods of 5 seconds immediately before and after eye closure: (1) fatigue, (2) vision, (3) segment of fatigue. The main effects of each within-subject factors (fatigue, vision and segment of fatigue) were significant (P<0. 05). The analysis of RMS and SD of Center of Pressure demonstrated a significant interaction between fatigue and vision, and fatigue and segment of fatigue so that the effects of Fatigue on Proximal segment and eye closed conditions were increased. The visual dependency for control of postural stability incremented following muscle fatigue. Proximal muscle fatigue lead to exaggeration of visual dependency for control of postural stability. Based on the present results, emphasis on the proprioception of proximal segment of lower extremity may be recommended for postural stability training.

This study has done in order to provide a test to examine the selection of grapheme kind and location on spelling errors. This study is a descriptive and cross- sectional and validity assessment research. The children were selected from the 8th territory of ministry of education (two classes from girlish school and two classes from boyish school) by non probability sampling from sample of convenience. At the first grade the words of Farsi book were analyzed based on the grapheme kind and location and some of them were selected. Different experts like speech and language pathologist, linguists and teachers scored those words. Finally 93 words were selected as words of test. They were dictated to students at first grade by the tester during 2 stages separately in one stage and the other stage the tester and the teacher do it for another group during 2 stages separately. The dictation errors were determined and data were analyzed by correlation coefficient and paired T test. Findings showed that there was no significant difference between spelling test errors of first and second stage of test performance by the tester neither in kind of grapheme selection (P=0/12), nor in location of grapheme (P=0/16). There was significant difference between spelling test errors of tester and teacher test performance in kind of grapheme selection (P<0/01), but no significant difference was seen in location of grapheme (P=0/12). These findings show that this test has intra rater reliability either in kind of grapheme selection or location of grapheme, but it has inter rater reliability just in location of grapheme.

Lumbar curvature is an important factor in posture and body movement that help us to understand low back pain problems. The aim of this study was evaluation of external load and trunk posture effect on lumbar curvature under static condition.

This study is an interventional, quasi-experimental and case-control study. Ten women with non specific chronic low back pain and ten matched without low back pain women were participated in this study. We used simple and non random method for sampling. Two clinometers sensors were used to evaluate lumbar curvature. Six static tasks while holding three levels of load (0, 6, 12 Kg) and two levels of trunk position (neutral and 30 degree of flexion) were simulated for subjects. Data were analyzed by using Kolmogroff-Smirnoff, ANOVA (Repeated Measurement) and independent T-test.

Findings revealed lumbar lordosis in patients with low back pain does not change to kyphosis while increasing external load from 0kg to 6kg and 12kg in neutral trunk position (P<0.05).

Dysfunction in passive system due to soft tissue disorder, afraid of pain, changes trunk muscles recruitment and reduction of moment arm are likely reasons for increased lumbar lordosis in patients with low back pain during loading.

Hereditary hearing loss (HHL) is a very common disorder. When inherited in an autosomal recessive manner, it typically presents as an isolated finding. Interestingly and unexpectedly, in spite of extreme heterogeneity, mutations in one gene, GJB2, are the most common cause of congenital severe-to-profound deafness in many different populations. In this study, we assessed the contributions made by GJB2 mutations and deletion in a portion of GJB6 to the autosomal recessive non-syndromic deafness genetic load in Iran. In this descriptive and cross – sectional study1605 probands from 1605 different nuclear families with autosomal recessive non-syndromic hearing loss were investigated. Hearing loss tests and clinical examination were done and 10 ml blood was drawn as DNA source. After study of 35delG mutation by ARMs PCR, negative or heterozygote individuals were sent to IOWA University for detection of other GJB2 mutations. GJB2-related deafness was found in 243 families (15.1%). Varient geographic pattern for GJB2-related deafness has considerable results in Iran in comparable with other study in Europe and our neighboring countries and deletion in GJB6. [∆ (GJB6-D13S1830)] hasnt been detected in our studied population.

Cerebral palsy is a nonprogressive disorder in body posture and movement, due to different etiologies. Different medical and rehabilitation interventions include massage have been used in these children. This study has been done to determine the effect of adding massage to occupational therapy on muscle tone of children with spastic cerebral palsy. This study was a double blind clinical trial. The children were recruited from clinics of University of Welfare & Rehabilitation Sciences. The individuals were divided to intervention and control groups. The routine rehabilitation techniques were done in 3 months in both groups. The intervention group received massage for 30 minutes before rehabilitation. Muscle tonicity was evaluated at the beginning of the study and 3 months later by Ashworth test. The data analysis was done by parametric (t test, paired t test) and nonparametric (Mann Whitney, Wilcoxon) tests. Thirteen subjects of case (intervention) group and 14 subjects of control group were studied. The average age in case group and control group was 49.5, and 42.1 months respectively. There were no statistically significant differences in Tonicity of upper and lower limbs, trunk and neck between intervention group and control group (P>0/05). In general based on the results of this study, adding massage to occupational therapy had no effect on tonicity of spastic cerebral palsied children. Regarding to some effects of massage mentioned in different articles on physical abilities of children with C.P. as well as executive limitations in this research, it is not possible to reject the effects of homeopathy on physical abilities of children with C.P.

The purpose of this study was the investigation of relationship between muscle imbalance syndrome in the lumbo-pelvic area (Pelvic Cross Syndrome) which includes the combination of weakness of phasic muscles and tightness of postural muscles, lordosis and chronic low back pain. This study was a comparative - cross-sectional and case – control research. A convenience sample of 600 subjects participated in this study. The size of lordosis, strength of abdominal and gluteal muscles and the extensibility of iliopsoas and back extensor muscles were measured in each group. The best cut-off values obtained from Receiver Operating Characteristic (ROC) curve analysis were used to categorize subjects as having weak or tight muscles in accordance with the assumptions. The lumbar lordosis in subjects with and without patterns of muscle impairments, and the association between lordosis and low back pain was assessed. Data were analyzed by using statistical methods such as: ICC, Kolmogroff – Smirnoff, Independent T test and ANOVA. The Findings of this study showed no significant difference in the degree of lordosis in subjects with and without patterns of muscle impairment in pelvic cross syndrome (P=0.38) and no significant difference in the lordosis between subjects with and without low back pain among those with specific patterns of muscle impairment in pelvic cross syndrome (P=0.62). Data also showed no significant association between degree of lordosis and low back pain (P=0.25). The findings of this study did not support the Pelvic Cross Syndrome theory, which indicates certain patterns of muscle impairment would lead to exaggerated LL and LBP. Our data show a relationship between muscle impairment and occurrence of LBP, but probably not via changing the degree of lumbar lordosis as it has been proposed in PCS theory.

Schizophrenia is one of the complex psychiatric disorders. Although the antipsychotic agent is the main treatment for this disorder, but psychological interventions are effective on clinical symptoms and poetry therapy as one of those interventions may be effective on psychosocial aspect of schizophrenia. The purpose of present study is investigation of poetry therapy effect on mental and behavioral state of schizophrenic patients. In this interventional and experimental study 29 schizophrenic patients were selected by sample of convenience from Razi psychiatry center and were assigned probability to poetry therapy group (n=14) and control group (n=15). For experimental group, poetry therapy was held in one hour session, twice weekly for 6 weeks. The brief psychiatric rating scale and behavioral problem scale were used as questionnaires. Statistical analysis of data was done by Independent T test and paired T test. The findings showed that there was significant difference between mental and behavioral state of before and after intervention in poetry therapy group (P<0/001). There was no significant difference before and after intervention in control group (P=0/774). We found significant differences between poetry therapy and control group after intervention (P<0/05), but there was no difference between two groups before intervention (P=0/812). The study confirmed the effectiveness of poetry therapy on mental and behavioral state of schizophrenic Patients.

Plantar fasciitis is one of the most common foot complications. Pain appear at the inside part of the anterior margin of calcaneous bone. The goal of this study was a comparative between the effect of medial heel wedge and lateral forefoot wedge on improvement of Activity daily living, Sport and pain in these patients. In this interventional and quasi experimental study, 30 patients with plantar fasciitis including 12 male and 18 female with 36 involved extremities were selected by non probability sampling. The patients were allocated in two groups with 15 patients in each group by random assignment. First group used medial heel wedge and second group used lateral forefoot wedge. Variables including activity daily living, sport and recreational activity, step length were measured in 3 stages. In order to evaluating of the variables FAOS questionnaire was used. 3 stages included: once before intervention and the second and third stages after 2 weeks and the third stage 4 weeks after intervention. Alpha cronbach in all subscales were more than 0/71 and test retest correlation in all subscales were more than 0/80. Data analysis has been done with T-Test, Smironov-Kolomogrov, Alpha Cronbach and Correlation Coefficient. In both follow up stages, the change of variables including activity daily living, sport and recreational activity and pain was significant (P<0.05). But there was no significant difference between two patient groups in step length variables in both follow up stages (P=0.518 for the first follow up stage and P=0.502 for the second follow up stage). According to finding of this study, medial heel wedge was more effective on improvement of activity daily living, sport and recreational activity and pain in both follow up stages than the lateral forefoot wedge. But medial heel wedge wasn’t more effective on step length increasing than lateral forefoot wedge.

Considering the late complications of eye due to mustard gas in warfare patients, this study was performed to evaluate the late complications of eye. In this descriptive study, 500 male patients (aged between 35 and 55), whose mustard gas injured period is more than 15 years were selected by non probability sampling. The patients were examined by an ophthalmologist. The complications were divided in 3 grades, mild, moderate and severe. The data were analyzed by x2 and spearman correlation coefficient. Out of 500 warfare patients, 48% aged 35-40, 82.2% once injured with mustard gas, 12.2% twice injured with mustard gas, 1.8% three times injured with mustard gas and 3.8% more then 3 times injured with mustard gas. The degrees of complications: 80% mild Eye Complications, 13.2% moderate Eye Complications and 6.8% sever Eye Complications. There were significant relationships between Eye Complications degrees with using the drugs, the times of injury and the times of hospitalization (P<0.05). Having reached the mentioned conclusions, it is recommended to perform more comprehensive study to evaluate the complications of the other parts: eye, lung, skin … as well.

The purpose of present research was the comparison of mothers irrational believes with severe or profound mentally handicapped child and mothers with normal child from 6 to14 years old in Tehran city. This study was an analytical, cross – sectional and comparative (case – control) research. From mothers with severe or profound mentally handicapped child who had refered to Tehran welfare services centers, 80 mothers were selected by regular randomized sampling from two rehabilitation centers and 80 mothers with normal child were selected for peering with the group of testimonial from schools areas of east, west, south, north and center of Tehran, through multi - stage cluster sampling in for variables of: age of mothers, educational levels, the location of living and the number of children. They answered to questionnaire of irrational believes of jons (IBT). Analysis of data was done by descriptive and infringing statistics methods (Independent T test, U Mann Whitney, Chi-square and fisher). The findings showed that: there are significantly differences in total irrational believes and irrational believes of blame proneness, frustration reactive, anxious over concern, problem avoiding and dependency, perfectionism between two groups of mothers (P<0/05). There was no significant difference in irrational believes between mothers who had mental handicap daughter and mothers who had mental handicap son (P=0/314). There was no significantly difference between two groups of mothers in four believes of demand for approval (P=0/737), high-self expectation (P=0/126), emotional irresponsibility (P=0/727), helplessness for change (p=0/283). Irrational believes and many its sub scales. In mothers of severe or profound mental handicap children were more than mothers with normal child. But believes of demand for approval, high self expectation, emotional irresponsibility, helplessness for change in mothers with handicap child was not more than mothers with normal child. Also sexuality of handicap child doesnt effect in mothers irrational believes.

However rehabilitation and disability in their modern concept are found in ancient world and medical textbook to a limited rate, the background of treatment and rehabilitation is obviously found in the history of the most ancient territories to coincide with religious beliefs. The aim of this research is study of the effects and reliable documentations remained from ancient times regarding the abovementioned title so that we can evaluate and determine the role of Iranian civilization in the formation of rehabilitations and empowering in the world today on the basis ofAWT IMAGE scientific evidences and proofs. In this qualitative research, reviews in historical documents has been used. After defining the objective and making given hypotheses, data has been collected form reliable sources which were then verified through internal and external critic. In ancient Iran, Ahuramazda is the source and origin of all goods while all pains, suffering, disabilities are Devil temptations. Iranian civilization is among the earliest civilizations using scientific methods and herbal drugs for treatment and empowering. Gondi Shapor University was among the first medical universities proceeding to treatment and rehabilitation. As well there had been some places at that time where disabled people were maintained and kept. At the time western world and other nations involved ignorance and unawareness, frightening from hard diseases, threw disabled people to the sea, Iran was the cradle of civilization, wisdom and the biggest medical university. As there are very limited documents and evidences with discrete subjects on the matter, any point and statement in this research work indicate important, critical and undeniable facts the interpretation and description of which is put for the future researches and readers.