جستجوی مقالات مرتبط با کلیدواژه "disability" در نشریات گروه "پزشکی"

Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL). The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.

A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.

The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).

Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune inflammatory disease predominantly affecting the central nervous system (CNS). Headaches, although common in patients with multiple sclerosis (MS), have been less studied in NMOSD. This study aimed to investigate the prevalence, characteristics, and associated symptoms of headaches in patients with NMOSD. This cross-sectional study included 120 patients with NMOSD recruited from MS clinics in Isfahan City, Iran, between 2023 and 2024. Patients were assessed for headache prevalence and characteristics. An expert neurologist conducted examinations to exclude secondary causes of headaches and classified headache types according to the International Classification of Headache Disorders (ICHD-3). Eighteen patients (15%) reported headaches, all of whom were women. The average age of these patients was 41.27 ± 11.33 years, and the average onset age of NMOSD was 34.60 ± 12.12 years. Of the 18 patients, 14 were diagnosed with migraine and 4 with tension headaches. Patients with migraine reported more severe pain (severity score: 6.00 ± 1.42) than those with tension headaches (4.20 ± 1.35). Headache onset was equally likely to occur before or after an NMOSD diagnosis. Significant associated symptoms included photophobia, phonophobia, and nausea in patients with migraine, with a substantial impact on occupational disability reported by 57% of migraine sufferers and 50% of tension headache sufferers. Headaches, particularly migraines, are prevalent in patients with NMOSD and significantly impact their quality of life (QOL) and occupational functioning. These findings emphasize the need for clinicians to recognize headache patterns in NMOSD for accurate diagnosis and effective management. Further longitudinal studies are warranted to explore causal mechanisms and develop targeted interventions.

Intravenous alteplase is a drug treatment administered as an emergency measure within the early hours of patient admission.

This study aimed to determine the role of hyperdense signal length in the middle cerebral artery on the degree of disability in patients with arterial ischemic stroke who exhibit evidence of vascular involvement.

In this cross-sectional study, patients with stroke who were referred to the emergency department of Imam Hossein Hospital in Tehran were included. The tools used were the demographic profile form and the Modified Rankin Scale (mRS). At the time of admission, the demographic profile form and the mRS tool were completed. The mRS tool was then administered again at discharge and 3 months after discharge. Following data collection, the patients' information was entered into SPSS version 16 software for analysis.

The results showed that there was no relationship between the patient's age and the disability score at admission (P = 0.11). However, at discharge and 3 months after discharge, the level of disability had a significant relationship with the patient's age, with younger patients reporting less disability. Additionally, after admission and thrombectomy, the patient's disability status significantly improved compared to the status at admission (P = 0.000). The mean ± SD mRS score at admission was 4.78 ± 0.44, while at discharge it was 3.94 ± 1.84. The mean ± SD disability score 3 months after discharge decreased from 4.78 ± 0.44 to 3.72 ± 2.25. This reduction compared to the discharge score was not statistically significant (P = 0.06).

Older patients and those with higher middle cerebral artery (MCA) levels reported greater disability. Therefore, it is necessary to implement preventive measures to address this issue.

Few low- or middle-income countries (LMICs) have prioritized the expansion of rehabilitation services. Existing scholarship has identified that problem definition, governance, and structural factors are influential in the prioritization of rehabilitation. The objective of this study was to identify the factors influencing the prioritization and implementation of rehabilitation services in Uganda.

A case study design was utilized. The Prioritization of Rehabilitation in National Health Systems framework guided the study. Data sources included 33 key informant interviews (KIIs) with governmental and non-governmental stakeholders and peer-reviewed and grey literature on rehabilitation in Uganda. A thematic content analysis and concept map were conducted to analyze the data.

Rehabilitation is an unfunded priority in Uganda, garnering political attention but failing to receive adequate financial or human resource allocation. The national legacy of rehabilitation as a social program, instead of a health program, has influenced its present-day prioritization trajectory. These include a fragmented governance system, a weak advocacy coalition without a unified objective or champion, and a lack of integration into existing health systems structures that makes it challenging to scale-up service provision. Our findings highlight the interactive influences of structural, governance, and framing factors on prioritization and the importance of historical context in understanding both prioritization and implementation.

Our findings demonstrate challenges in prioritizing emerging, multi-sectoral health areas like rehabilitation. Strategic considerations for elevating rehabilitation on Uganda’s policy agenda include generating credible indicators to quantify the nature and extent of the population’s need and uniting governmental and non-governmental actors around a common vision for rehabilitation’s expansion. We present opportunities for strengthening rehabilitation, both in Uganda and in similar contexts grappling with many health sector priorities and limited resources.

Children with disabilities need assistive technology (AT) to explore their surroundings, participate in social activities, and gain developmental skills. This study aimed to assess AT needs and barriers to access it for these children. 

The study participants comprised 217 children with disabilities aged 6-12 years, randomly selected from the registration list of Chaharmahal and Bakhtiari Welfare Organization, Chaharmahal and Bakhtiari Province, Iran, in 2022. After obtaining informed consent from their parents, study data were gathered by phone interview using the rapid assessment of AT (rATA) tool of the World Health Organization (WHO).

Among the 217 participants, 108(49.8%) used AT devices, and 102(47%) had unmet needs. Of the 55 AT devices named in the rATA, only 14 were used by the children. The most commonly used devices were hearing aids, glasses, and wheelchairs. Unmet needs of ‘chairs for bath/toilet,’ ‘wheelchairs,’ and ‘therapeutic footwear’ accounted for 50% of 132 unmet AT needs. The most common reasons for lacking AT were lack of financial resources (52%) and knowledge about AT devices (30.1%). Most clients were satisfied with AT-use training (92.3%), but only 20.2% were satisfied with AT device repair services.

This study highlights the need to improve AT device repair services, overcome financial challenges, and increase parental knowledge about AT devices as the most prevalent barriers to using AT devices. Developing a child-specific version of the rATA tool that includes questions about education and play engagement AT needs is suggested for better estimation of AT needs for children with disabilities in the future.

Low back pain is one of the most significant musculoskeletal problems, causing various functional limitations that adversely affect individuals' quality of life.

The effect of combined Pilates-Kinsey and Mulligan-Kinsey exercises in women with non-specific chronic back pain has not been investigated.

In the present quasi-experimental study, thirty women with non-specific chronic back pain with a range age of 35 - 65 years old were included in the study and were randomly divided into two Pilates-Kinesiotype (n = 15) and Mulligan-Kinesiotype (n = 15) groups. Exercise interventions were conducted for 6 weeks and 3 sessions per week. Pain, lumbar range of motion, hamstring stiffness and hip rotation were measured before and after the training intervention. Also, analysis of covariance (ANCOVA) test was used to analyze the data.

The results showed that there is a significant difference between the effect of Pilates-Kinesiotype training and Mulligan Kinesiotype training in the variables of pain, hamstring stiffness and hip rotation (P < 0.05) and the reduction of pain and hip rotation in the Pilates-Kinesiotype training group compared to The Mulligan-Kinesiotype group was better. But the hamstring range of motion was better in the Mulligan-Kinesiotype group than in the Pilates-Kinesiotype group. In addition, the results showed that there is no significant difference between the waist range of motion of the research groups (P < 0.05).

Due to the fact that mulligan and Pilate's exercises together with Kinesiotype have an effect on pain variables, hamstring stiffness and hip rotation, and each of mulligan and Pilate's exercises have different effectiveness. These exercises can be used in combination with Kinesiotype to help women with non-specific chronic back pain.

As a health vulnerable group, people with disabilities require more health-promoting behavior than non-disabled people. We aimed to identify the types of health behavior of disabled people and to track the trajectories of stress by the type of health behaviors.

Data came from the Panel Survey of Employment for the Disabled Second Wave by the Employment Development Institute (EDI) in Korea. We used dataset from the first 6 years of the 2nd wave of PSEDSW (2016-2021). The current study analyzed 3,991 subjects. The types of health behavior were identified through latent class analysis (LCA) and the trajectories of stress were estimated through multi-group latent growth modeling using Mplus 8.0.

Two types of groups in health behaviors, smoking-drinking group (SD), nonsmoking-less drinking group (NLSD) were derived. Depending on the types of health behavior, the trajectories of stress appeared significantly different: the NLSD had significantly lower stress than the SD in the first year, and this low-level stress trajectory was maintained continuously for 6 years.

Health behaviors could be suitable as a stress coping method for people with disabilities. This study suggests that it is necessary to make efforts to create an environment that supports people with disabilities to learn healthier ways to cope with stress.

The outstanding performance of Paralympic athletes improves their quality of life and resilience. The present study explores the role of mental toughness in predicting resilience and distress tolerance in Paralympic athletes.

This descriptive and correlational study was conducted on Paralympic athletes who were members of the Iran Sports Federation for the Disabled (IRISFD) and were invited to attend the Paralympic games. The participants were 128 Paralympic athletes (n=60 women and n=68 men) who were selected via the simple random sampling method. The data were collected using the mental toughness questionnaire-48 (MTQ48), the Connor-Davidson resilience scale (CD-RISC) and the distress tolerance scale (DTS). The collected data were analyzed using the multiple regression analysis by the SPSS software, version 26.

The results showed that mental toughness can predict resilience and distress tolerance in Paralympic athletes. Moreover, mental toughness accounted for 47.8% of the variances in resilience and 28.6% of the variance in distress tolerance. In addition, the analysis of the standard beta coefficients showed that mental toughness can positively and significantly predict resilience and distress tolerance in Paralympic athletes, with β coefficients equal to 0.69 and 0.53, respectively.

Mental toughness is a psychological construct that affects the performance and success of Paralympic athletes and increases their resilience and distress tolerance. Thus, a part of the preparation process, namely training and skill development programs for Paralympic games should focus on the mental toughness of athletes.

This scoping review allows a better understanding of current evidence regarding mirror therapy (MT) among children to help the future development of MT intervention protocol on children.

PubMed, Science-Direct, Web of Science and ProQuest databases were searched from January 2005 to January 2023 for interventions within the scope of MT for children. Google Scholar was also scanned for additional resources. The process of the present study was according to guidelines of the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. The main inclusion criteria were articles in English and Persian language and peer-reviewed empirical studies of MT for children. This study charted methodological information from articles according to participant characteristics, design, intervention, and outcome measures. 

Of 18 studies that were included in this scoping review, 17 studies were conducted in children with hemiplegic cerebral palsy, and only two studies were in other conditions. A total of 16 articles were randomized controlled clinical trials, one case study and one single subject. Meanwhile, 33 outcomes were in the body structures (BS) and functions level, and 10 outcome measures were in the activities and participation levels of the International classification of functioning. 

The review indicates that in future studies, it is necessary to pay more attention to other disorders beyond hemiplegic cerebral palsy; furthermore, levels of activity and participation as the outcome need to be used more.

Cerebral palsy is one of the most prevalent physical disabilities in childhood. Children afflicted with this condition face a myriad of challenges and potential disabilities, which complicate treatment efforts. Integrating scales with other diagnostic instruments is increasingly crucial for accurately assessing these children and devising effective treatment strategies. This study primarily aims to review functional classification systems based on the International Classification of Functioning, Disability, and Health (ICF) for children with cerebral palsy and explore the relationships among these systems. This study was designed to review the ICF-based functional classification systems. A comprehensive search was conducted across multiple databases, including Google Scholar, PubMed, ERIC, OVID, ProQuest, Scopus, Web of Knowledge, and OTseeker. Search terms related to cerebral palsy and various aspects of body function, activity, and participation were utilized. The search was conducted until September 2022 to gather relevant literature for analysis. The analysis of the reviewed articles revealed the existence of five valid and reliable classification systems. In most studies, the correlation among these systems was moderate. Owing to their simplicity and comprehensiveness, these classification systems have significantly impacted the depiction of the functional status of children with cerebral palsy and the quality of their care. However, additional classification systems remain needed to address other overlooked functions and complete the overall description. The outcomes of this review indicated the development of classification systems for certain functions in children with cerebral palsy. In conjunction with the classifications above, creating additional new systems for overlooked functions could offer a comprehensive and integrated understanding of children with cerebral palsy's crucial functional capacities and performances.

Chronic non-specific neck pain is one of the most common musculoskeletal disorders in modern society and is considered a cause of disability in many jobs, especially in office workers.

In this study, 36 female office worker with mean±SD age of 39.20±4.29 years, mean ± SD weight of 70.60±12.37 kg and mean±SD height of 163.15±6.23 cm were randomly divided into three groups: 1. Dynamic neuromuscular stability exercises 2. Stabilization Exercises and 3. Control group. Stabilization exercises with emphasis on the effect on deep neck muscles dynamic neuromuscular stability exercises with emphasis on the effect on cervical thoracic and lumbar pelvic chain coordination were performed for six weeks (3 sessions per week). Visual Analog Scale and disability questionnaire were used to measure the pain and disability of the subjects, respectively, and to measure muscle tolerance, two methods of assessing activation score and deep neck flexor muscle performance index were used by compression biofeedback device. Finally, data analysis was performed using SPSS software (version 22)at the significance level of P=0.05.

The one-way ANOVA test results showed a significant difference between the three groups in all variables (P<0.05). The Turkey post hoc test results showed no significant difference between the pain score and disability of the dynamic neuromuscular stability exercises and stabilization exercise groups (P>0.05). On the other hand, the results showed that after six weeks of training, there was no significant difference between muscle activation score and muscle performance index in the control and stabilization exercise groups (P>0.05).

Both training protocols had a significant effect on reducing pain and disability. However, dynamic neuromuscular stability and stabilization exercises substantially increased the tolerance of deep neck flexor muscles compared with the stabilization exercises group. It can also be a better approach to treat non-specific chronic neck pain.

There is little evidence regarding the relationship between gait performance and psychological factors in people with chronic neck pain. This study evaluates gait performance in patients with neck pain and explores the relationship between gait performance and kinesiophobia, pain catastrophizing, pain intensity, and disability.

A cross-sectional study was conducted on 34 patients with chronic neck pain and 29 age- and sex-matched controls were recruited for this study. The participants performed timed up-and-go (TUG), and 10-m walk tests (TMW) with and without head-turning tests. The associations between clinical gait tests, kinesiophobia (Tampa scale of kinesiophobia (TSK), pain catastrophizing scale, pain intensity (visual analog scale), and disability (neck disability index) were assessed.

People with neck pain had significant differences in the TUG, and TMW with and without head-turning tests compared to controls (P<0.01). Kinesiophobia and pain catastrophism were significantly correlated with TMW tests (r range=0.45 to 0.71, and 0.40 to 0.47, respectively). Pain intensity and disability were not correlated with gait tests.

The gait performance, as represented by TUG and TMWs test scores, altered in patients with chronic neck pain in comparison controls. Fear of motion and pain catastrophizing thoughts correlated with clinical gait test scores.