فصلنامه آرشیو توانبخشی
سال یازدهم شماره 2 (پیاپی 36، تابستان 1389)

Numerous studies showed increasing incidence of acute or recurrent dislocations of the shoulder joint in people with General Hypermobility Syndrome (GHS). Given the critical role of scapular orientation in function of shoulder, the aim of this study is to compare the parameters indicating position and orientation of scapula between females with and without General Hypermobility Syndrome in frontal and sagital plane in arm elevation. In this cross sectional and case-control study, 16 females with General Hypermobility Syndrome were selected simply and conveniently and 16 healthy females were selected and matched by age, body mass index and menstrual status. A three dimensional motion analysis system (vicon 460) was used to measure scapular position (upper-lower and medial-lateral translations) and orientation (upward rotation, posterior tilt and internal rotation angle). Measurement were taken with the arm placed in different angles of arm elevation. Date analysis was performed with Independent T test. Upward rotation angles in sagital plane in 90º (P=0.03), 120º (P=0.01) and full range of arm elevation (P=0.04) were lower in case group as compared to control group. Also patients with General Hypermobility Syndrome showed a lesser amount of lateral scapular translation in 90º (P=0.02) and full range of sagital plane arm elevation (P=0.02). In addition, lateral scapular translation in 120º (P=0.02) and full range of frontal plane arm elevation (P=0.01) was lower in case group compared with control group. Altered kinematics in General Hypermobility Syndrome has a greater role in shoulder injuries and neuromuscular defect seems to be an underlying cause of scapular kinematic's changes in people with hypermobility syndrome.

Sociocultural emphasis and increased interest in physical attractiveness and current attitudes body structure have increased body image dissatisfaction among women. The prevalence of body image dissatisfaction is linked with various psychological disorders and disturbances such as low self-esteem, depression and other disorders. The present study investigated the short program aerobic exercise effects on body image among women. In this interventional and quasi experimental study, 82 females among 150 women (18-45 years old) referred to Enghelab and Gol sports clubs in Tehran were selected by convenient and simple sampling based on inclusive and exclusive criteria and randomly divided into two intervention and control groups. They did not participate in any exercise in last 3 months and also they did not have any physical disease and meet criteria for deficit of body image attitudes. Data collection was done by using demographic and Multidimensional Body Self-Relation Questionnaire. The intervention group participated in aerobic exercise program. These sessions lasted 3 hours per week for 4 weeks. Data were analyzed by Chi–Square, Paired T and Independent T tests. There were significant differences between two groups after intervention in sub items of body image including: self-appearance evaluation (P<0.001), self-appearance orientation (P<0.001), health orientation (P=0.003), illness orientation (P=0.002), but their fitness evaluation (P=0.141), self-fitness orientation (P=0.888), health evaluation (P=0.072), self-body satisfaction (P=0.082), overweight preoccupations (P=0.167) and self-assesed weight (P=0.156) did not change clearly. Short periods of aerobic exercise can effectively promote body image attitudes among women, and exercise can be used as a method of treatment in occupational therapy of the disorder.

There is growing evidence for the idea that fear of movement may be as disabling as pain intensity in chronic low back pain patients (CLBP). The purpose of the present paper is to investigate the relation between fear of movement and pain intensity with physical disability in chronic low back pain patients and the role of pain duration, gender and age differences in these relations. In this analytical and cross-sectional study, 194 patients with chronic low back pain for more than three months, referred to seven rehabilitation clinics in Rasht city during four months, were selected consecutively. Data were collected by Numerical Rating Scale, Roland–Morris Disability Questionnaire, Tampa Scale for Kinesiophobia and Demographic questionnaire and analyzed by Pearson Correlation Coefficient and Multi Regression. Significant correlations were found between physical disability with fear of movement, pain intensity and age (P<0.001) and also pain duration (P=0.036). These relations were not different between males and females. In first Regression model, fear of movement and pain intensity, were the strongest predictors of physical disability. No differences were found between these factors. Then, prediction model was prepared adding age, sex and pain duration. Multiple regression analyses revealed that the fear of movement and pain intensity were superior in predicting disability. Among demographic variables, only the Beta Coefficient for age was significant in predicting disability (P=0.002). Fear of movement, pain intensity and age are important factors influencing physical disability in individuals suffering a chronic low back pain. Thus, for minimizing physical disability, alone with reducing pain intensity, patients showing fear of movement can be offered interventions that focus on reduction of the fear.

Parkinson’s disease (PD) is a common progressive neurodegenerative disorder, the onset is in later adulthood and its incidence increases in 55 to 60 years old. The purpose of this study was to determine the test-retest reliability and practice effects of the Purdue pegboard that is most used in dexterity testing and rehabilitation evaluation, in Parkinson’s patients. In this analytical study which is validation and methodological research, 24 Parkinson patients aging 50-89 were simply and conveniently selected from rehabilitation clinics and hospitals of Tehran. Patients’ general data were documented by demographic questionnaire and in order to determining the Purdue pegboard test each subtest was administered three times and was repeated one week later. Data were analyzed by Paired T test, Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). The rate of Intraclass Correlation Coefficient was above 90% in different items of Purdue pegboard test in single and mean of testes in off phase, thus indicates an excellent relative reliability in repeated measures. The rate of Standard Error of Measurement (SEM) was lower than 10% of maximum obtained scores at each subtest in one and three trials of test that indicates acceptable absolute reliability. The findings indicate that Purdue pegboard test is reliable enough in evaluating a manual dexterity of Parkinson patients in drug off-phase.

The aim of this study was to determine the effectiveness of Adeli Suit Therapy (AST) and Bobath approach on improvement of gross motor function in children with cerebral palsy aged 4 to 11 years of old. In this experimental and randomized clinical trial study, 24 children with cerebral palsy were selected simply according to inclusive and exclusive criteria from patients referred to ValieAsr rehabilitation center and then assigned into two Adeli Suit Thrapy and Bobath groups by simple random method. Period of therapeutic intervention was 36 sessions, 3 times per week for both groups. Assessment tool was Gross Motor Function Measure test (GMFM–66). Data was analyzed by Kolmogroff Smirnoff, Independent T-test and ANOVA for repeated measurements. After intervention, the gross motor function improved significantly in both groups (P<0.001). Follow up study revealed significant improvement of functions in Adeli Suit group (P=0.007) and significant regression of functions in Bobath group (P=0.004). There was no significant difference, just after the intervention, between two groups (P=0.598), but there was significant difference between two groups at follow up assessments (P=0.002). Both Adeli Suit and Bobath approaches are effective in improvement of gross motor functions in children with cerebral palsy during the therapeutic sessions. At follow up study, the Adeli Suit group, were still improving their function whereas the Bobath group regressed.

Transference interpretations have been considered as an important technique in models of short-term dynamic psychotherapy. The purpose of the cur rent investigation was to explore the role of transference interpretations on depression severity outcome of the 6 patients treated with short-term dynamic psychotherapy for major depression. Through single case study design 6 patients with major depression were selected conveniently and treated once weekly for 20 sessions. Severity of depression was measured through Beck Depression Inventory (BDI) in 3 phases and 27 points (3 session assessment as baseline, 20 sessions as treatment, and 4 sessions as follow up). Data were analyzed visually through charts and effect size analysis. The findings demonstrated that, 5 cases of 6 showed stable changes from moderate to mild severity in second half of treatment period. In treatment period compared with pre-treatment period, the effect of depression severity change in 4 cases was high and in 1 case was moderate. In one of patients, depression severity didn’t decrease. The results suggest that transference interpre tations should be used focal in sessions of short term dynamic psychotherapy with patients suffered from depression.

Objects: The purpose of this study was to determine muscle activation patterns of shoulder girdle during some selected functional exercises of upper Limb in healthy subjects. In this quasi-experimental study, 36 healthy women were selected by simple and convenient sampling. Surface bipolar electrodes were applied over the Pectoralis major, upper Trapezius, middle Trapezius, Infraspinatus, anterior Deltoid, middle Deltoid and posterior Deltoid. Subjects were asked to perform six functional exercises randomly. This exercises included abduction in scapular and frontal plane, D2F (Diagonal 2 Flexion), D2E (Diagonal 2 Extension), Tripod and push–up. Muscle activation pattern was studied in two temporal fields (onset and peak of muscle activation) and activity level of muscles using normalized integrated electromyography index (NIAV: Normalized the Integral of the Absolute Value). Statistical method applied in this research was analysis of variance for repeated measures (ANOVA). In the most of movement patterns evaluations, upper Trapezius was the first activated muscle in the movement with maximum level of activity in comparison with the other muscles. Pectoralis major muscle activity in both temporal and activity level fields was dependent on movement pattern. Activity of anterior and posterior Deltoid during some of the movement patterns, particularly oblique ones such as abduction in Scapular plane and D2F and D2E was also high. In all of the movement patterns, middle Deltoid acted as the prime mover and middle Trapezius and Infraspinatus showed the same level of activity. Upper Trapezius is not dependent on movement pattern, but Pectoralis major is. Activity of anterior Deltoid and posterior Deltoid is dependent on movement direction. Activity of middle Deltoid is dependent to displacement of target joint in movement patterns. Middle Trapezius and Infraspinatus as stabilizer–steerers muscles are independent to movement patterns.

The present study was designed to investigate language development in children with and without attention deficit hyperactivity disorder (ADHD). In this comparative and case–control research, 30 children with attention deficit hyperactivity disorder and 30 healthy matched children were selected simply and conveniently from the elementary first grade students of Qazvin city. Data collection tools included: test of language development– primary: 3th edition (TOLD-P:3), Connors’ rating scale – teachers form, and Raven color matrices. Data were analyzed by repeated measure analysis of variance. There was significant difference in profile of language development between ADHD children and healthy children (P<0.001), but there were no significant differences between boys and girls in both case group (P=0.254) and control group (P=1.00). The results of multivariate analysis showed that the ADHD children were significantly lower in some aspects of language development skills including picture vocabulary, relative vocabulary, oral vocabulary, grammatical understanding, grammatical completion, word discrimination, listening, organizing, speaking, semantics and syntax. No significant difference was found in sentence imitation, phonemic analysis and word articulation. The attention deficit hyperactivity disorder children have some problems in many but not all aspects of language development.

This research was aimed to investigate the relation between non-verbal imitation and naming ability and effect of non-verbal motor imitation exercises on ability of naming in autistic children.

In the first phase of this research which was done comparatively, 22 autistic and 22 normally developed children were selected conveniently and their ability of naming and non-verbal imitation was examined. In the second phase, which was an experimental-interventional study with a pretest-posttest and control group design, the autistic children were assigned into two matched groups by balanced randomized method. Then non-verbal motor exercises intervention executed in experimental group for 60 days (one hour a day). During this period the control group received routine educational program. Before and after intervention, naming ability of two groups was assessed by naming test. Data were analyzed by Independent T- test and Variance analysis.

Research findings showed statistically significant difference between autistic group and normal group in naming ability (P<0.001). In autistic group, there was a positive correlation between naming ability and non-verbal imitation ability (r=0/878). Furthermore findings showed significant difference in naming ability between control and experimental group after intervention (P<0.001).

This finding reveals that non-verbal motor imitation has a positive correlation with naming ability and non-verbal imitation exercises increases the naming ability in autistic children.