فصلنامه آرشیو توانبخشی
سال نهم شماره 2 (پیاپی 29، تابستان 1387)

Fatigue process in patients with neck pain was happened more quickly than healthy persons and neck muscle fatigue increased body sway during standing, but there is less evidence about the behavior of these muscles in dynamic conditions such as external perturbation, so this study was done to investigate the effect of muscle fatigue on onset latency of upper trapezius muscle in posterior-anterior perturbation among patients with chronic neck pain and healthy individuals.

In this quasi experimental and interventional study 16 patients with chronic neck pain (intervention group) and 16 healthy individuals (control group) were selected by simple and convenient sampling and based on inclusive and exclusive criteria. Data collection was done by using questionnaire and doing some tests and the main equipments were dynamometer, accelerometer and surface electromyography. The weight equal to 30% of maximum voluntary contraction used to produce fatigue process and 10% of body weight used to produce perturbation. Independent T test, Paired T test and Repeated ANOVA were used for data analysis.

There was significant difference in onset latency of upper Trapezius muscle in posterior – anterior perturbation between two groups, before (P=0.006) and after (P=0.026) fatigue. This means that the onset latency was increased in healthy individuals and decreased in patients after fatigue. Also, there was significant difference in onset latency of Trapezius muscle in posterior – anterior perturbation between before and after fatigue in patients group (P<0.001) and healthy persons group (P=0.04).

Pain can change the onset latency of trapezius muscle and possibly it can decrease muscle activity in deep muscle and change the pattern of muscle activation. Fatigue as an exaggerated risk factor can decrease onset latency of superficial muscle in patients with chronic neck pain to stabilize the system, that it can increase the risk of injury.

Hearing loss can affect on physical, mental and social health of deaf adults and lead to depression, anxiety, isolation, suspicion and stress of them. Cochlear implantation has positive effects on behavioral and emotional status of postlingually hearing impaired adults. This study is aimed to compare dizziness, depression, anxiety and mental health in adult cochlear implant recipients and candidates.

This case- control and comparative study was conducted on 49 patients, 24 cochlear implant recipients (as case group) and 25 severe-profound hearing impaired adults (as control groups) whom were selected by simple and convenient sampling. Beck Depression Inventory, Dizziness Handicap Inventory, Beck Anxiety Inventory and General Health Questionnaire were completed to determine and compare cochlear implant effects. Data were analyzed by MANOVA.

Mean depression and anxiety scores in cochlear implant candidates were more than cochlear implant recipients. This difference was significant in depression (P=0.001). There was no significant difference between two groups in general health (P=0.415). The results of this study also showed that dizziness is more in cochlear implanted group (P=0.004).

It seems that cochlear implant use leads to decrease of depression and anxiety. It leads to increase of dizziness.

Recent studies shown that related or common neuro-physiological processes are required for processing non-linguistic structures (e.g. cognitive sequencing) and some aspects of syntactic structure in language. As there has not been such research in Iran. this study surveys the relationship between the ability to process cognitive non-linguistic abilities and comprehension of non-canonical syntactic structures in broca aphasic patients.

A pre test and post test quasi experimental design was chosen in this study. The syntactic comprehension of 10 aphasic patients (6 men and 4 women) who according to the Farsi aphasic test (Nilipour.1993). Have been recognized to be broca aphasics. Was assessed before and after a training period of 10 weeks (a session every week) on cognitive sequencing. The syntactic comprehension was assessed using a test which was designed for Persian language on the basis of test for comprehension in aphasia. The ability to process cognitive sequences was assessed using lelekov test. The subjects were selected in a purposeful manner from among the broca aphasics who were under therapy in the state speech therapy centers in Tehran. The percent of the correct answers to every syntactic structure and to the cognitive sequence for each person was measured before and after a training period of 10 weeks data were analyzed by paired-t-test.

The findings showed that there is a direct relation between the ability of the patients for comprehending the non-canonical syntactic structures and their ability for processing cognitive sequencing.(R=0.50).After the training period. The ability of the patients for understanding syntactic structures with non-canonical word order improved significantly (p<0.05) there was no significant change in their ability for understanding syntactic structures with canonical word order (P>0.05).Their ability for processing cognitive sequencing increased significantly during the training period (P<0.05).

Reinforcement of the ability to process complex cognitive sequences in broca aphasic patients improves their comprehension of syntactic structures with non-canonical word order but it has no effect on their comperehension of structures with canonical word order.

The ultimate goal of this study is one of the discourse fields analysis, i.e. Grice's cooperative principles.

In this comparative and case - control study, two groups of normal individuals and schizophrenic patients were selected by simple method from sample of convenience and interviewed based on the spontaneous part of Persian Aphasia Test. All the answers were analyzed with respect to the percent rate of errors in the 4 "cooperative maxims", and the errors were collected. Data were analyzed by Independent T Test, ANOVA, Kruskal Wallis and Mann Whitney.

There were significant differences between two groups in respect to all the Grice’s cooperative principles (P<0.001), maxim of quantity (P<0.001), maxim of relevance (P<0.001) and maxim of manner (P=0.02), but in maxim of quality there was no significant differeance (P=0.07). The mean percent of errors in the course of illness, education and age varieties were not significant.

Schizophrenic patients have incoherence speech and this problem exists in the discourse field and social interactions, thus the patients frequently fail in observing the Gricean cooperative principles.

Children with Down syndrome have sensory integration dysfunction, and a range of physical problems and difficulties that may affect their motor development. The aim of present study was to determine effectiveness of sensory integration therapy on gross and fine motor skills of 5-7 years old children with Down syndrome.

Sixty 5-7 years old children were diagnosed as having Down syndrome, were selected by randomized sampling and participated in this experimental study. Each participant was assessed by researcher, that the assessment used was Peabody Developmental Motor Scales. The children were randomly assigned to the intervention (sensory integration therapy) and control groups. Sensory integration therapy was given to intervention group. Data were analyzed by Leven test, Independent T test and covariance analysis.

There was significant difference between pretest and post test scores of intervention and control groups in gross motor development (P<0.000), but in fine motor development there was significant difference between pretest and post test scores only in intervention group (P<0.001) and in control group it wasn’t significant (P=0.013). Also there was significant difference between two groups in gross and fine motor development (P<0.001).

The results showed the sensory integration therapy were effective in gross and fine motor of children with Down syndrome. It was concluded that sensory integration therapy should be applied for children with Down syndrome who have gross and fine motor difficulties.

Impaired postural control has been known as the main cause of fall in hemiparesis after stroke. Is Asymmetry of weight bearing on lower limb is one of the prominent characteristics of postural imbalance in these patients. The aim of this study was to evaluate the effect of symmetry improvement in weight bearing through therapeutic interventions on postural stability in hemiparetic patients.

In this quasi – experimental study which 27 hemiparetic patients were selected through sample of convenience by simple method from men and women who were referred to neurology clinic of Hazrat-e-Rasool hospital. For postural assessment patients stood quietly with open eyes and close eyes on force plates. Primary assessments included evaluation of asymmetry index (AI), RMS COP displacement (Root Mean Square of Center of Pressure) and RMS COP velocity in both frontal and sagital planes. Then a 10mm lift was inserted under the unaffected limb and primary assessments were repeated. Data were analyzed by repeated measure ANOVA test.

Simple main effect of lift on asymmetry index was significant (P<0/0001). There was no significant interaction between vision and lift. Simple main effect of lift on postural stability variables was also non significant (for RMS COP displacement in frontal and sagital planes P=0.186 and P=0.245, respectively and for RMS COP velocity P=0.259 and P=0.342 respectively).

Inserting a lift can improve symmetry by shifting center of gravity to midline. Since symmetry improvement did not decrease postural instability, asymmetric weight bearing can not be the primary cause of postural instability and may not be the principal target of rehabilitation programs aiming at restoring standing balance after stroke.

There are many reports about relations between stuttering and language development. Some studies reveal that bilingualism is a contributing factor to the development of stuttering. Main objective of this study was comparison of linguistic knowledge in Kurdish (L1) and Farsi (L2) between bilingual stutterers and their normal peers.

In this case-control and comparative study all of 31 Kurdish-Farsi bilingual stutterers from 4 and 5 grades in primary schools of Javanrood were selected as case group and 31 normal peers were selected as control group by Pairs Matching Method. The linguistic knowledge of two groups in L1 and L2 were evaluated and compared by analyzing the speech quality indices (speech fluency index, speech complexity index, type-token ratio) in a sample of their spontaneous speech in Kurdish and Farsi. Data were analyzed by Independent -T-test and Mann-Whitney U.

In both Kordish and Farsi Language, Speech unfluency was more in stutterd students than normal group. Also, speech complexity, speech fluency and lexical diversity of stuttered students were less than normal group and there were significant differences between two groups in all speech indices (P<0.05).

The linguistic knowledge of stuttered group was less than normal group in both Kordish and Farsi language. This finding confirms that level of language proficiency may be considered as a contributing factor to stuttering.

Elderly people often suffer from disturbed sleep and Traditional Chinese acupressure is a noninvasive technique that employs pressure and massage to acupoints in order to stimulate the balance of life energy that promotes health and comfort. The purpose of present study was to determine the effectiveness of acupoints massage in elders experiencing sleep disturbances.

In this quasi experimental study which was applied as single blind clinical trial, Pittsburgh Sleep Quality index (PSQI) questionnaire was used as a screening tool to select individuals with sleep disturbance by purposeful sampling. Then the individuals were assigned to three groups by balanced randomized method (an acupressure group, a sham acupressure group and control group). Each group had 30 subjects and gender ratio was equal in three groups. The same massage was used in the acupressure group and the sham acupressure group, whereas only conversation was employed in the control group. Time of interventions was limited to 15 min. One course of intervention lasted for 3 days per week. These interventions were carried out for 4 consecutive weeks. After intervention 77 persons completed the questionnaire. Repeated measure ANOVA, ANCOVA and Kruskal-Wallis tests were used for data analysis.

The analysis of data post intervention showed significant differences in PSQI subscale scores of the subjective sleep quality (P=0.025), sleep duration (P=0.012), sleep efficiency (P=0.022), sleep disturbance (P=0.025), daily performance (P=0.033), sleep latency (P<0.001) and global PSQI scores (P<0.001) among three groups. POST HOC comparison showed significant differences in PSQI subscales scores and global PSQI scores in the acupressure group compared to control group (P<0.05). Whereas, there was significant difference only in PSQI subscales scores of the sleep latency (P=0.006) and global PSQI scores (P=0.021) in the acupressure group compared to the sham acupressure group. Sleep log data showed significant decrease of awake time and improving the quality of sleep in acupressure group (P<0.001).

This study confirmed the effectiveness of acupressure in improving the quality of sleep of elderly people and offered a nonpharmacological therapy method for sleep-disturbed elderly people.

Age at implantation is one of the most important factors in improving speech and language skills in children with cochlear implants. Moreover, good vowel articulation is very important in the speech. So, the purpose of this research was to determine whether age at cochlear implantation influences the production of Persian simple vowels when cochlear implantation is undertaken below the age of 2 years as compared with cochlear implantation later in life.

This research was a comparative and cross-sectional study. Based on inclusive and exclusive criteria (i.e., have physical and mental health, monolingual or bilingual, have 9±1 months post-surgery rehabilitation, no hearing handicapped parents and no medical problems history), 140 children who cochlear implanted in Amir-Alam and Hazrate Rasool hospital of Tehran city were selected by convenient sampling and assigned to two groups, children implanted under the age of 2 years and those implanted above the age of 2 years Also 238 normally hearing children were selected for control group by randomized sampling. The first and second formant frequency (F1 & F2) of the Persian simple vowels /i, e, æ, a, o, u/ were evaluated by the version of 1.2 of SFSwin software. Data were analyzed by Independent T test.

The findings indicated that there were significant differences between two groups in the mean of F2/i/ (P=0.046), F1/e/ (P=0.011), F2/e/ (P=0.005), F2/æ/ (P=0.039), F2/a/ (P=0.012), F2/o/ (P=0.012) and F2/u/ (P=0.006), but there was no significant difference between then in the mean of F1/i/, F1/æ/, F2/a/, F1/o/, F1/u/ (P>0.05). According to these results, no significant difference was seen between normal group and children who received their cochlear implants under the age of 2 years in the mean of variables (P>0.05).

Observing significant differences in the quality of the production of Persian simple vowels between children implanted under the age of 2 years and children who received their implants after the age of 2 years, and no significant differences between children who implanted before 2 years of age and normally hearing children is in the favor of the positive effect of early cochlear implantation on speech sound development. Also, the results indicate that when performed under the ages of 2 years, cochlear implantation can prevent from vowels distortions in the speech flow of the receivers.

Disasters should never be considered as routine. Disasters of any kind—natural or manmade—clearly disrupt the normal functioning of any community and frequently overwhelm both personal and community resources. In the post-disaster context, following the initial shock of the disaster, returning lives and livelihoods to normalcy becomes a primary concern of the affected communities and nations. Traditionally, this has been known as the recovery and rehabilitation phase, where "normalcy" refers to the return of the community to the state it was in prior to the disaster event. Rehabilitation is this process of returning the community to “normal” that may extend for many years and involves the physical, social and economic components of the community. Disasters can take on a life of their own, therefore being prepared is the single most effective way to improve outcomes. Proper pre-event planning and providing mechanisms for resource coordination are critical which will be resulted a successful response. It should focus on increasing the participation of civil authorities in order to reestablish local authorities.In order to develop safer communities with fewer deaths, physical injuries, and psycho-social trauma following disasters, health systems must be capable of providing a coordinated response during disasters and of delivering effective mitigation and preparedness programs before disaster impact. The health sector has a vested interest and a key role in this process. In addition, prior to the occurrence of disasters, national, provincial, and local planning should be blueprinted by managers. The public must be educated regarding the importance of individual and family preparation for disaster.

Proximal Femoral Focal Deficiency (PFFD) is a rare congenital defect with prevalence of one in 50000 to 200000 live births. It affects the proximal femur and frequently the acetabulum and may occurs unilaterally and/or bilaterally. The side effects of PFFD vary in patients. These include: limb length discrepancy, instability of the hip and knee joint, contractures of the hip and knee muscles, unequal level of the knees, short stature and associated anomalies. Usually, children with PFFD and their families are faced with many treatment decisions, both surgical and non- surgical. Therefore, the treatment of PFFD has always been a challenge for the specialists. In this report, a 3-years-old boy with PFFD with dysplasia of hip and acetabulum and femur shortness in both side and delay in motor milestones has been reported who was referred by physician to the faculty of rehabilitation for occupational therapy and rehabilitation treatment.