مجله پژوهش در علوم توانبخشی
سال ششم شماره 1 (بهار و تابستان 1389)

Colles’ Fracture is one of the most prevalent fractures among adults. For the cases of stable fractures, the standard treatment method is first close reduction under general, regional or local anesthesia and then casting. This study aimed to compare the treatment results of colles’ fracture under local anesthesia with those under general anesthesia. In this randomized clinical trial study, 100 subjects with stable colles’ fracture were selected from an accessible population of patients referred to Kashani Hospital (Isfahan-Iran) from December 2006 to December 2008. The subjects were randomly divided into two groups of A and B. In group A, subjects were treated under local anesthesia and in group B they underwent general anesthesia. The subjects’ data including demographic information, type of fracture, complication of reduction, costs of reduction and conditions of reduction, were obtained and subsequently compared on three different times for each of above-mentioned treatment before reduction, at the first, second and third week after treatment initiation and in the end of treatment. Statistical analysis of obtained data showed that there was no significant difference between complication in the two groups (P > 0.05). Furthermore, no statistically significant difference was found between the criteria of reduction in these two groups (P > 0.05). A statistically significant correlation was found between sex and colles’ fracture (P < 0.05). The cost of treatment in group B was significantly higher than group A (3 to 4 times more than group A) (P < 0.05). It can be concluded that the treatment method of fracture reduction under local anesthesia is more effective than general anesthesia for lower cost, acceptable reduction and without specific complication. It is suggested that local anesthesia be used in reduction of colles’ fracture.

Dentistry is one of the occupations which require a high concentration during treating the patients. There are many predisposing factors, such as head flexion during working on the patient's teeth, arm abduction and inflexible postural deficiencies which involves a dentist, leading him/her to some musculoskeletal disorders related to the neck. However, there is no evidence if dentists report neck pain before starting an abnormal condition in this region, including forward head posture (FHP). Understanding any alteration in the head posture in dentists before starting the pain might indicate one of the reasons of neck pain in these subjects. Fourty one dentists with no neck pain and 40 subjects having jobs rather than dentistry with no risk factors involving head posture were selected in the study as case and control groups, respectively. A standard method was used to measure cervical curve in these two groups. There was no significant difference between the mean values of cervical curve in dentists and control groups (P > 0.05). There was also no significant difference between cervical curve values in dentists, working in two different ranges of 5-8 and 8-12 years (P > 0.05). The only significant difference was found in the cervical curve mean values between men and women in the dentist group (P < 0.05). No alteration of cervical curve in the dentist group compared to controls might be due to no pain sensation in the dentists in the current study.

Stroke is the most important cause of disability among adults. Although most stroke patients regain the ability to walk independently, many will have persisting problems with mobility due to impaired balance, motor weakness and decreased walking velocity. It seems imperative to use effective therapeutic methods in order to improve disability conditions of stroke patients. In this nonrandomized clinical study-carried out from 2009 to 2010 in Isfahan-Iran- thirty patients with an average age of 60.1 years who were at least at six months poststroke were divided into three treatment groups. The subjects in each group underwent 12 therapeutic sessions which were held three times a week. Berg Balance Scale, Manual Muscle Testing and Motion Analyzer System were respectively used for measuring balance, muscle strength and gait. To compare the subjects’ status in different stages of treatment and across three aforementioned groups, Paired-t and ANOVA tests were applied on all data of interest. With regard to improvement of balance, there was a significant difference between FES and Exercise Therapy groups (P = 0.00) and between the FES and Biofeedback groups (P = 0.01) in both before- and after- treatment phases of the study. However, Exercise Therapy and Biofeedback groups did not show any significant difference (P = 0.23). Considering the improvement of quadriceps muscle strength, FES and Exercise Therapy groups significantly differed before and after therapy (P = 0.017). The FES and Biofeedback groups (P = 0.01) were also observed to have a significant difference but again, Biofeedback and Exercise Therapy groups (P = 0.98) did not show any significant difference. Upon walking evaluation, A meaningful difference between the three groups was only noticed in stride length and step length after the treatment (PGSt2 = 0.017, PGSL2 = 0.017). According to the results of this study, among various treatment methods suggested for stroke patients, biofeedback was more effective and the functional electrical stimulation was less effective than others.

Nasality is an important parameter needing to be considered in studying voice resonance pathology. The voice of normal adults typically shows varying degrees of nasality. It appears that nasality, like the other parameters of voice, is affected by loudness and this can be measured through experimental evaluations. The aim of the present study was to determine the effect of vocal loudness on vowel nasalance in a group of 18-28 year-old normal Farsi- speaking subjects. In this descriptive- analytic cross- sectional study, the voice samples of 65 randomly selected normal subjects (male and female) whose ages ranged from 18 to 28 years and who spoke Farsi as their native language were studied. All subjects were the students of Rehabilitation Faculty of Iran Medical Sciences University at the time of study. The mean score of nasalance for the vowels of Farsi language was captured through Nasal View software. Descriptive statistical analyses as well as one-way ANOVA were conducted on all data of interest. In both male and female subjects, the maximum and minimum amounts of nasalance were seen at the soft and the loud voice respectively. The statistical analysis results showed that the degree of nasalance in 3 levels of soft, normal and loud voices was significantly different (P < 0.05). In normal adults, vowel nasalance decreases as vocal loudness increases. This is a feature of normal speech mechanism. This finding can be explained with regard to the functioning of velopharengeal port. So, a raise in subglottal air pressure at loud voice results in an increase in muscular contraction of pharynx and palate.

Muscular fatigue (MF) is a phenomenon which commonly occurs in daily sports activities and results in the worsening of motor performance. The aim of the present study was to investigate the effects of muscular fatigue on functional stability among male athletes. Fourty two professional healthy athletes with a mean age of 25.2 ± 3.2 years and weight of 80.4 ± 8.4 kg were selected and subsequently divided into two groups: the experimental and the control. In this study the RUNING ANAEROBIC SPRINT TEST (RAST) was used for fatigue induction, the Biodex system (level 4) was applied for stability indices evaluation and a lactometer was utilized for blood lactate measurement. The independent- and paired-t tests were used for statistical analysis of data (α ≤ 0.05). The results indicated that muscular fatigue could affect the limit of stability (P ≤ 0.002) and the lateral stability index (P ≤ 0.003) but did not have any significant effect on the anterior-posterior index of the Biodex system (P = 0.310). With regard to the results, it can be concluded that while not having any significant effect on Ant-Post stability indices, fatigue protocol may affect the lateral functional stability index. This conclusion, however, needs further qualification.

Conversational repair strategies are among the most important pragmatic skills and are classified under the category of conversational skills. The importance of these skills has been specifically explored in hearing-impaired or specific language-impaired children who are prone to communicative breakdowns during interactions with others. Speech-language pathologist's knowledge about the conversational repair strategies (i.e., repetition, revision, addition and cue repair) and their normal application during communicative interactions is at best limited and tentative. The purpose of this study was to investigate and compare these strategies in children with 3, 4 and 5 years of age.

In this cross-sectional research, the employment of conversational repair strategies were evaluated across 72 speech samples derived from Farsi-speaking children resident in Isfahan-Iran. The subjects were divided into three age groups: 3, 4 and 5 years.

The results indicated that revision, cue repair and inappropriate responses had significant correlation with age whereas repetition and addition strategies did not show such relationship. With regard to gender of subjects, revision was the only strategy which was more applied by boys than by girls.

Repetition was the most frequently applied strategy in each age group. The employment of revision strategy was more common in younger children and, with increasing age, its application decreased. However, subjects used cue repair more frequently as their age increased. These results were in agreement with study results of foreign researchers.

The purpose of this study was to study the effects that sway back abnormality might have on structural changes of various body parts. To conduct the present study, 70 female students were randomly selected. A posture screen along with a plumb line was used for postural analysis. Other tools used in this study were as follows: a Goniometer for evaluating ankle, knee and hip angle, a flexible ruler for measuring the degree of lumbar lordosis and thoracic kyphosis and an inclinometer for measurement of pelvic inclination. T-test and Pearson correlation coefficient were performed on all variables of interest (P ≤ 0.05). Results showed that sway back abnormality is a prevalent abnormality among young girls (%35). Subjects with sway back abnormality had a greater thoracic kyphosis angle and pelvic anterior tilt than did normal subjects. In addition, the Subjects with sway back abnormality had relatively a greater extension in hip and knee joints. There was a statistically significant correlation between pelvic inclination and angles of knee (r = 0.02) and hip (P = 0.01). However, pelvic inclination did not significantly correlate with the ankle joint angle (r = 0.06). It can be concluded that there is a high prevalence of sway back abnormality among young females with the age range of 18 to 26 years. Moreover, we concluded that thoracic kypnosis, neck and lumbar lordosis, knee and hip angle in subjects with sway back abnormality would change during the life spam.

Considering schizophrenic patients’ problems with living skills, it seems necessary to evaluate these skills in this group of patients. In the present study, The Kohlman Evaluation of Living Skills (KELS), developed by Linda Thomson Kohlman at Seattle, Washington (1978), was first translated into Persian and then its reliability and validity was determined. To evaluate test- retest reliability, interrater reliability, and concurrent validity and construct validity of the Persian version of KELS, this cross- sectional analytical-descriptive study was conducted. The subjects who were assessed by the Persian version included 105 outpatients with schizophrenia, 35 inpatients with schizophrenia and 35 nonpsychiatric participants. The comparison of two sets of scores, gathered by two separate evaluators from 30 outpatients (r=0.997), as well as the results of test retest reliability in 24 outpatients (r=0.967) showed an acceptable reliability of the Persian version of KELS. The concurrent validity was determined by comparing the scores of 35 inpatients obtained via KELS and those obtained through Global Assessment Scale (r=0.886). The Persian version of KELS was found to be able to differentiate between living skills of nonpsychiatric participants and schizophrenic patients supporting construct validity. This study demonstrated that the Kohlman evaluation of living skills has an appropriate reliability and validity for being used with the population of schizophrenic patients.

Past research on the relationship between stuttering and different linguistic factors has shown that in children, non-fluent utterances are more complex than fluent utterances. This study, using an imitation task, investigated whether or not complex and simple sentences exert an influence on the amounts of speech disfluency among stuttering Farsi-speaking children, and then compared the results with those obtained from non-stuttering controls. The results could have some implications for clarifying the nature of stuttering and shed some light on the question of appropriate treatment methods. It was a cross-sectional descriptive-analytic study. The participants included 10 stuttering and 10 non-stuttering children between 4 and 6 years of age who spoke Farsi language as their native language. The participants in the two groups were matched by age and gender. The stimuli were two sets of sentences: one set consisted of 13 simple sentences and the other one included 10 complex sentences. The length of successive sentences was increased by adding one morpheme to each of them. Each participant was requested to repeat exactly what he/she had heard. To calculate the rate of disfluency in each utterance, the number of non-fluent words was divided by the total words of that utterance and the result expressed as a percentage. The disfluency percentages of simple and complex sentences, once among stutterers and non-stutterers separately and then between these two groups, were compared and analyzed using SPSS soft ware. In both stuttering and non-stuttering children, there was a significant difference between rates of disfluency on simple and complex sentences (P < 0.05). The result of this study showed that complex sentences caused more disfluency rates than did simple sentences and it was the case for both groups of participants. Moreover, stuttering children had more disfluency rates than did non-stuttering children as the syntactic complexity of stimuli increased.

Functional abnormalities are typically caused by non-standard use of body which has such consequences as various deformities and residual side-effects. The purpose of this study was to investigate types of skeletal abnormalities and their respective incidence among bodybuilders. 118 bodybuilders were examined for functional abnormalities through posture screening. Obtained data was first recorded on an assessment checklist and then statistically analyzed using Chi-square test. A total number of 874 Functional abnormalities were observed in all subjects participated in this study. On the average, each subject suffered from approximately 7.5 abnormalities. The most frequently observed abnormalities were as follows (arranged in a descending order): medial rotated shoulder (10.4%), lordosis (9.61%), anterior head tilt (8.65%), and kyphosis (7.78%). The observed number of trunk and head abnormalities was significantly different from that of upper extremities (χ2 = 12.28, p< 0.01) and lower extremities abnormalities (χ2 = 4.17, p< 0.05). There was no significant difference between abnormalities of lower extremities and upper extremities abnormality (χ2=2.14,P<0.05). It can be concluded that there is a high incidence of body abnormalities among bodybuilders and this should be regarded as a threatening situation on behalf of bodybuilding trainers. Thus instructors should design standard training programs to prevent their trainees from such abnormalities. Further studies may concentrate on the causes of these abnormalities.