فهرست مطالب azadeh riyahi

Objective Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disorder of the Central Nervous System (CNS) and it is also the most common cause of non-traumatic neurological disability in young adults. MS in women, especially young women, is about 1.5 to 3 times more common than men all over the world. About 2.5 million people worldwide are suffering from MS. The destruction of myelin in certain areas exhibits certain signs and symptoms. Balance disorders are particularly problematic because they are associated with difficulty in moving from one position to another, sustaining an upright posture, and performing functional activities such as walking and turning, all of which predisposes people with MS to the loss of equilibrium and falls. Isfahan City in Iran suffers from a high prevalence of MS that put it amongst the regions with the highest prevalence of MS in Asia and Oceania. This study aimed to use the holistic approaches of occupational therapy to investigate the physical and cognitive factors (attention, cognition and muscle strength of lower extremities) that affect the gait of MS patients in the city of Isfahan, Iran. Materials & Methods The present study was a descriptive-correlational one and convenience sampling method was used to recruit the samples. The study population consisted of all patients with MS in Isfahan City in August 2017. A group of 70 patients (24 males and 46 females with the Mean±SD age of 32.20±7.55 y) met the inclusion-exclusion criteria and were enrolled in the study. To be eligible for the study, the patients had to meet the following inclusion criteria: having a neurologist-confirmed diagnosis of MS with MRI scan, being able to read and write, and walk at least 100 m independently. We excluded patients with cognitive impairments that might hinder understanding of the tasks to be accomplished, those with any comorbid neurologic condition other than MS, and those who are unwilling to collaborate with the research process. After providing sufficient information about the research process and getting informed consent of the patients, the questionnaires and tests were provided to the participants to be completed. The study tools were the Mini-Mental Status Examination (MMSE), 10 m Walking Test (10 MWT), Timed Up and Go test (TUG), Sit to Stand test, and Stroop test. For data analysis, the Pearson correlation coefficient and multiple regression analysis were performed in SPSS version 16. Results In this study, 70 patients suffering from MS participated. The results showed a significant negative correlation between the scores of walking speed test (10 m walking) and the scores of the functional strength of the lower extremities muscles (P<0.001) and attention (P=0.01). There is also a significant correlation between muscle strength of lower extremity and balance (P=0.01). Regression analysis shows that the muscle strength of lower extremities has the highest contributions in predicting the speed of walking in patients with MS.  Conclusion According to the study findings, among the physical and cognitive factors affecting gait and balance such as muscle strength of lower extremity or cognition and attention, the muscle strength of lower extremity is the most important factor affecting the balance and speed of walking in patients with MS that still can walk. In the process of rehabilitation, especially in occupational therapy, special attention must be paid to a muscle strengthening program for the lower extremities of patients suffering from MS.

Background and Sleep disorders in children with cerebral palsy (CP) are complex and challenging. The aim of this study was to investigate sleep disorders in children with CP based on gross motor function levels.
This cross-sectional study was conducted in 76 children with CP (aged 6 to 15 years old) attending rehabilitation centers in Arak, Iran 2016. The participants were recruited by convenience sampling. The Sleep Disturbance Scale for Children (SDSC) was applied. Data analysis was performed in SPSS V.18 using descriptive statistics, T-test, and Chi-square test.
There were no significant differences between sleep disorders and sex and types of CP (P>0.05). But, a significant difference was found between sleep disorders and gross motor function levels (P The results showed that severe level of gross motor disability (the severity of motor impairment) is related to sleep disorders in children with CP. more training is suggested for children with CP and their caregivers for improving their sleep function.

With regards to importance of the role of parents in children's life, imbalance in the roles of parents can lead to serious mental, emotional and physical damages of the child. The purpose of this study was to determine how to do parenting role's tasks in parents of children with disability (physical- mental) younger than 7 years in the city of Arak in 2016.
In this study, the parenting role's tasks questionnaire for 120 parents of children with disability was completed. The effect of demographic characteristics on how to perform the role of parents was studied.
Based on data collected and analyzed using Pearson correlation coefficient for the relationship between the parents and other factors, we have found no significant relationship between role of parents with the child's age. In disabled children, between parent's role and maternal age was significant difference which its correlation coefficient was -0.18, represented the inverse association between maternal age and the parent's role with disabled children. In comparison of parent's role based on child's gender, significant difference was not seen in any of cases. The impact of the seizure on performance of parenting role's tasks implied no relationship between history of seizure and performance of parenting role's tasks. Economic situation as well as on how to do tasks was ineffective.
Imbalance in performance of parenting role's tasks in primary care, education, leisure and cognition promotion showed that existence of a disabled child in the family had negative impact on the parenting role's tasks in different aspects, for example further focus on one of the domains lead to ignorance of other domains. Total score confirmed the negative impact of disabled children on efficient implementation of parenting role's tasks.

Caregivers of children with cerebral palsy (CP) are faced with many challenges in self-care, treatment follow-up, educational care, and personal leisure time. Therefore, they should be trained for resolving their needs during caregiving. This study aimed to determine the priority of needs of mothering handling training for family caregiving of children and youth with CP at home based on the family-centered approach.
This cross-sectional study was performed on 186 children with CP (aged 4-12 years) from the rehabilitation clinics in the city of Arak. The participants were chosen by a convenience sampling strategy. Clinical tests such as the Manual Ability Classification System (MACS) and the Canadian Occupational performance measure were used to assess the level of fine motor function and determine the priority of needs of children with CP, respectively. The data were analyzed using statistical tests including two-way ANOVA.
In this study, there were 89 girls and 97 boys with CP with a mean age 7.52.38 years. The CP types were as follows: spastic (67.7%), dyskinetic (13.9%), ataxic (5.9%), and hypotonic (4.8%). The most important priority of needs of mothering handling training was self-care and care related to children with CP in the level of V of MACS. The results showed that the priority of needs of the mothering handling training based on occupational performance (self-care, productivity and play/leisure) were toileting in the level of IV of MACS. There were no significant differences in the priority of needs of the training in the areas of sex and level of fine motor function (P>0.05); however, there were significant differences in age and self-care (P The results showed that the highest priority of needs of mothering handling training was self-care, feeding, toileting, and functional mobility. However, the needs of mothering handling training enhanced with increasing severity of fine motor function lesions and age. The simultaneous relationships between age and MACS levels in children with CP have no effect on the priorities of mothering handling training. Organized training of families and caregivers about needs of mothering handling training and proper care of their children are facilitating steps in promoting the education of mothers of children with CP. It seems that the understanding and education of mothering handling for therapists responsible for managing children with CP and the education of their parents can open the way to effective caring and treatment.

To determine the reliability of the Persian translation of the Manual Ability Classification System (MACS) between parents and therapists in children with cerebral palsy (CP). After the forward and backward translation procedures and investigation of face and content validity, inter-rater reliability was assessed between parents and occupational therapists using the intra-class correlation coefficient (ICC) and the weighted kappa coefficient. 100 Children (4 to 18 years, mean age 85.15 months; 63 boys, 37 girls) with various types of CP were classified according to MACS by both parents and therapists. Additional data on the Gross Motor Function Classification System (GMFCS), intellectual delay, visual acuity, auditory acuity and epilepsy were collected. The inter-rater reliability was high; the ICC was 0.96 (ranged from 0.94 to 0.97) among occupational therapists and parents. Total agreement there was between the GMFCS and the MACS. The Persian version of the MACS is found to be reliable between parents and therapists, and is suggested to be appropriate for the assessment of manual ability within the Iranian population.