Journal of Modern Rehabilitation
Volume:11 Issue: 1, Winter 2017

Computer modeling studies have shown that depolarization of the posterior and anterior root fibers can be achieved by surface tripolar electrical stimulation. This study investigated the soleus and gastrocnemius H-reflex recovery curve after applying tripolar electrical stimulation on the anesthetized skin of vertebral column. We emphasized on the early and secondary facilitation phases of the H-reflex recovery curve.
Material and A total of 15 healthy nonathletic female volunteers (mean±SD age: 27.20±3.17 years) were enrolled in this study. H-reflex recovery curves of the soleus and gastrocnemius muscles were recorded before skin anesthesia and then 15 minutes after it (with lidocaine 10%) and finally after application of Transcutaneous Electrical Nerve Stimulator (TENS) or placebo TENS (TENS on/off). Tripolar TENS with pulse width of 300 µs, frequency of 80 Hz and intensity of 1.5 times of the sensory threshold was used for 15 minutes at the level of T11. To record the H-reflex recovery curve, 34 paired stimuli were used with the intensity of 30% H max and interstimulus intervals between 1 and 202 ms. After drawing the H-reflex recovery curve, amplitude, slope, area under the curve, and threshold of the early and secondary facilitation phases were calculated.
After application of topical lidocaine, the sensory threshold of the skin vertebral column increased significantly. Fifteen minutes after applying local anesthesia, peak amplitude, slope, and area under the curve of the early facilitation phase significantly decreased in gastrocnemius and soleus muscles. After tripolar TENS application on the anesthetized skin of vertebral column, the slope of the early facilitation phase decreased significantly in the soleus (P=0.047). Also, area under the curve of the secondary facilitation phase significantly increased in both muscles.
These findings suggest the excitatory effect of skin anesthesia on the motoneurons activities. Changing the H-reflex recovery curve after application of tripolar TENS on the anesthetized skin may confirm deep penetration of this type of electrical stimulation.

Family is a social system and the most important unit of human social life. In every community, retarded children are born, and their needs should be considered to prevent negative consequences on their families and improve their quality of life. Mindfulness-based interventions are considered as the third generation or third wave of cognitive-behavioral therapy. The present study aimed to investigate the effect of mindfulness-based cognitive therapy on the quality of life and mental health of mothers with deaf children.
Material and Mothers of 24 deaf children were selected by convenience sampling method from special schools in Kermanshah and were assigned randomly to experimental (n=12) and control group (n=12). The experiment group received 8 sessions of mindfulness training, but the control group received no intervention. Both groups had completed short form questionnaire of the Minnesota Multiphasic Personality Inventory and the World Health Organization quality of Life questionnaire before and after the intervention. For testing the research hypotheses, multivariate analysis of covariance was used.
Analysis of the results showed that mindfulness-based practices have significant (P Because, mindfulness-based cognitive therapy improves mental health and quality of life, it is a suitable therapy to prevent problems of families with exceptional children.

Virtual reality is a novel technology which creates attractive environment using computer hardware and software. In these virtual realities people can actively participate and use their motor and cognitive abilities. Current study aimed at investigating effect of virtual reality on the balance of children with cerebral palsy.
Material and This research is a single subject study with ABA design conducted on three children with cerebral palsy (GMFCSΙ level). Basic phase and intervention phase of investigation lasted for 2 and 4 weeks, respectively. Intervention sessions were repeated 3 times per week like base line phase. In each intervention session, children performed different computer games for 21 minutes. These games require center of pressure displacement in the frontal and sagittal planes. Follow-up phase was implemented 2 to 3 months after completion of intervention phase. Changes were measured using following measurement tools: pediatric reach test (PRT), Timed Up and Go (TUG), 10-meter walking (10MW) and subtest of balance and lower limb strength test, including Bruininks-Oseretsky of Motor Proficiency (BOMP). Finally results were investigated using visual analysis and C Statistics.
Comparison of PRT tests and subtest of balance and lower limb strength test, including BOMP suggested significant improvement in static balance (P=0.000), jumping ability, and dynamic balance of children participating in the research and durability of this improvement in follow-up phase, though investigation of TUG and 10MW test results showed no significant improvement.
Results in this research showed that using virtual reality can improve balance in children with cerebral palsy.

Myofascial Pain Syndrome (MPS) is a common disorder of musculoskeletal system. About one third of the people with musculoskeletal disorders have been diagnosed as having MPS. It is a painful condition caused by trigger points. A variety of treatment approaches are used to cure MPS and its associated disorders. This study aimed to investigate the effects of single session Intramuscular Electrical Stimulation (IMES) through dry needling on pain and Range Of Motion (ROM) following trigger points in upper trapezius.
Material and Sixteen volunteers with active trigger points in upper trapezius were randomly divided into two groups: 1) the IMES treatment group (8 females) and 2) placebo group (8 females). In the IMES group, trigger points of the affected side were injected through dry needling, then a burst current (2 Hz) was applied on the muscle while the electrical stimulation steadily increases to form a pain free contraction for the patient. In placebo group, the procedure was exactly the same but there was no applied electrical stimulation through dry needling. Pain sensation by Visual Analog Scale (VAS) and cervical flexion ROM were measured before treatment, immediately after treatment and one week later by another blinded researcher.
VAS scores showed improvement in both groups at the end of the treatment session and also one week later. There was no significant difference between the groups; IMES and placebo in terms of the VAS after treatment session. However, the pain scores were substantially decreased in the IMES group one week after the intervention. The ROMs were significantly lower in placebo group one week after treatment. There was no significant correlation between improvement and duration of symptoms.
Both IMES and placebo methods might be effective in relieving symptoms of patients with the MPS in upper trapezius; however, patients following the IMES treatment showed higher level of improvement during one week after the intervention. Further relevant studies with higher number of volunteers and different treatment protocols are necessary to get high quality evidence.

It is believed that different components of our linguistic capabilities are not impaired to the same extent in aphasic patients. Moreover theoretical issues on aphasia can be researched on patients with different languages. Thus, we aimed to study the dissociation of inflectional and derivational morphology by assessing the performance of 8 Persian bilingual aphasic patients in producing Persian derivational and inflectional words.
Material and To explore the capability of patients in using derivational and inflectional words, in addition to obtaining a brief history from all patients and an image of the impaired regions of the brain, two types of tasks, word-repetition and spontaneous speech tasks, were administered to them. The results were then statistically analyzed to see which part of their word-formation competence, derivational or inflectional processes, was impaired more seriously.
The results of word-repetition and spontaneous speech tests indicated that patients did better at derivational morphology. In addition, a quantitative analysis revealed a gap between scores for derivational and inflectional words, confirming the dissociation of the two types of the process as claimed by generative linguists.
Based on the results patients had a better performance on derivational words as compared to inflectional ones confirming this linguistic theory that the two types of process take place in different sections, i.e. derivational process belongs to morphology whereas inflectional process is basically syntactic.

Tennis elbow (Lateral Epicondylitis) is one the most common elbow and arm musculoskeletal disorders. About 1% to 3% of active population in modern societies suffer from tennis elbow. Tennis elbow is usually caused by repetitive activities of hand and wrist, especially wrist extension and forearm supination. This research aimed to study high and also medium power gallium arsenide (Ga-As) laser irradiation on improving pain and grip strength (functional mobility) in patients with tennis elbow.
Material and Thirty female [Mean(SD) age: 49(2.3) y] patients with acute tennis elbow were recruited for this study. The patients were randomly divided into two groups based on random allocation table. Group A (15 patients) had been received 10 J/cm2 under a 0.5 W beam medium power Ga-As laser irradiation of 980 nm wave length. Group B (15 patients) had been received same energy density under 2 W beam high Ga-As laser irradiation with the same wavelength. Laser irradiation was performed on a 9 cm2 surface of lateral elbow epicondyle based on Grid laser application technique. The patients were under treatment for 10 sessions every other day. The outcome measures of pain at rest and ring finger extension against loading, grip strength and hand function were recorded and analyzed in a pre- and post-setting. The pain severity was measured by VAS (Visual Analog Scale) and McGill questionnaire and upper extremity function was measured by DASH questionnaire.
Significant pain reduction was observed in resting position and ring finger extension against loading after application of both high and medium power (980 nm, 0.5-2 W) laser therapy (P High and low power Ga-As laser irradiation may improve pain and grip strength in patients with acute tennis elbow.

The following study was carried out in order to translate, cultural adaptation, and determine the content and face validity of the “Patient-Rated Wrist Evaluation” questionnaire with the aim of evaluating the two components of pain and disability in patients with wrist injuries.
Material and The methodology of this survey was non-experimental study. After translation and cultural adaptation according to the Beaton method (approved by the American Surgeon Association), the pilot test was performed on patients with wrist injuries (fractures of the distal radius, scaphoid fractures and carpal tunnel syndrome). To assess content and face validity, the questionnaire was given to 10 specialists (6 of whom were occupational therapists, 2 were physiotherapists, and 2 were orthopaedic surgeons), and 20 patients with wrist injuries.
The qualitative content and face validity of the questionnaire for wrist injuries was appropriately reported good. Each item of the content validity ratio was slightly higher than 0.75 and this justified the necessity to include all items. Each item of the content validity index was slightly higher than 0.79. Therefore, all the items were approved in terms of their simplicity, clarity, and relevance. The impact score in order to evaluate the importance of each item was calculated and all were higher than 1.5. Therefore, in terms of face validity all the items were approved.
The results showed that the Persian version of the “Patient-Rated Wrist Evaluation” questionnaire for evaluating the pain and disability of wrist injuries was indeed satisfactory, in terms of it’s content and face validity, thus it can be used in patients by specialists and therapists.

Low Back Pain (LBP) is the most common cause of daily activities restriction and functional disability. Of various chronic LBPs, the most common type is chronic non-specific LBP. This study aimed to compare the effect of core stability exercises and electrotherapy on relieving symptoms of chronic non-specific LBP in mother assistants working in caring centers for mental-physical disabled children.
Material and A total of 42 mother assistants with nonspecific chronic LBP were randomly selected and put into three groups: the stabilization exercises (n= 15), the electrotherapy (n=15), and the control (n=12). Their mean(SD) age was 40.3 [1.8] years; mean(SD) work 15.8 [7.6] years, mean(SD) weight: 69 [11.8] kg, and mean(SD) height: 161.5 [6.3] cm. The first group underwent a 6-week training of core stability exercises every other day; the second group received a 10-session electrotherapy; however, the third group received no treatment at all. The three groups were given pretests and posttests via completing McGill Pain Questionnaire at the beginning of the study.
The 1-way analysis of variance to test all variables showed that all groups were matched in terms of job background, height, weight and age. The Shapiro-Wilk test results showed that the difference between the scores of pretest and posttest were normally distributed. To verify the hypotheses, ANOVA test was applied. All analyses were done at significance level of 0.05 using SPSS 22.
Results revealed a significant difference in the mean changes chronic LBP in working mother assistants in the electrotherapy group (-31.5), and control group (-1.7) (P=0.000). In other words, a course of electrotherapy led to a significant reduction in chronic non-specific LBP in mother assistants.
Electrotherapy compared to core stability exercises contributes significantly in reducing nonspecific chronic LBP in mother assistants working in units for caring children with physical or mental disabilities.