جستجوی مقالات مرتبط با کلیدواژه « توان بخشی » در نشریات گروه « پزشکی »

Auditory processing disorder (APD) tests, based on the deviation of results from standard benchmarks, can distinguish children suspected of having APD. Some of these tests directly relate to the ability to discriminate sound pitch, while others may be indirectly affected. Accordingly, this study investigates the impact of pitch discrimination-based rehabilitation on diagnostic indices of APD tests.

In this study, we selected 19 children suspected of APD who were identified based on tests of pitch pattern, dichotic digits, and monaural selective auditory attention as the intervention group. These children received pitch discrimination-based training, for about three months, two to three sessions a week, each session up to 1 h. After completing the rehabilitation phases, diagnostic tests were administered again. We also selected 26 children with similar diagnostic criteria for APD as the control group. No intervention was applied to this group, and after a comparable period to the intervention group, diagnostic tests were re-administered. The results before and after the interventions were compared within the intervention group and with the 26 children in the control group.

The rehabilitation showed significant improvements in the pitch pattern and monaural selective auditory attention tests. In the monaural selective auditory attention test, significant improvements were observed in both ears (P=0.001). In the pitch pattern test, effective improvements were also observed for both ears (P=0.001). The effects were such that nearly 37% of children suspected of APD, based on the diagnostic criteria used in the study, no longer met the criteria for this disorder. Hence, if the same tests are re-administered to them, these children will be diagnosed as having no auditory processing disorder.

Discrimination-based rehabilitation impacts the results of APD tests. Accordingly, some children who are classified as suspected auditory processing disorder with such tests, are removed from this subgroup after the intervention.

There is limited credible scientific evidence regarding the impact of functional training exercises on improving the shoulder position and performance of tennis players with Scapular Dyskinesia. Therefore, this study aimed to investigate the effect of a functional training program on improving the scapular-brachial rhythm and the performance of elite tennis players with scapular dyskinesia.  thirty top tennis athletes at the national level who were suffering from shoulder dyskinesia were selected purposefully and randomly and divided into two experimental and control groups of fifteen. Before and after 8 weeks of functional exercises, scapular-brachial rhythm and upper limb function were evaluated using an inclinometer and Y test. In the inferential statistics section, the analysis of the covariance test was used to compare the differences between groups, and the correlated t-test was used to compare the differences within groups.  The results of the paired t-test show the effect of functional exercises on the scapular-brachial rhythm at angles of zero degrees (P=0.004), 45 degrees (P<0.001), 90 degrees (P<0.001) and 135 degrees (P<0.001) and also upper limb function (P=0.002) in the experimental group.  Considering the changes observed in the shoulder position of the subjects of the present study, it seems that the changes in the neuromuscular system have occurred, and the results indicate that the implementation of a functional training program, in addition to improving shoulder posture, can be effective in improving the performance of tennis athletes.

Having a child with speech and language disorders, while creating a sense of great therapeutic responsibility towards them, will significantly affect the psychological dimensions of parents, especially mothers as the primary caregiver. They are more exposed to the pressures and stress that result from the sense of responsibility towards their children. The aim of this study was to compare the level of stress, depression, and quality of life (QoL) among mothers of children with speech and language disorders whose children have received rehabilitation services for different periods of time.

The current descriptive-analytical cross-sectional study was conducted on 185 mothers of children with speech and language disorders who needed to receive rehabilitation services. Data collection was done using: a short form of parenting stress index (PSI-SF) to measure stress, the Beck depression inventory-2nd edition (BDI-II) to measure maternal depression rate, a health survey questionnaire (a 36-item short form) (SF-36) to measure the QoL. Based on the duration of receiving rehabilitation services, mothers participating in this study were divided into four groups: 1) For less than one month, 2) Between 1 to 6 months, 3) Between 7 to 11 months, and 4) For more than 12 months. The data were analyzed by one-way repeated measures analysis of variance and multivariate ANOVA.

Comparing the mean scores of PSI, BDI-II, and SF-36 between four groups of mothers was significant (P<0.001). The results showed that mothers whose children had received rehabilitation services for a longer period of time had lower mean stress and depression scores and higher mean QoL scores (P<0.001). The factor of the type of child's disorder had a significant effect on the results (P<0.05).

The lowest score of stress and depression and the highest score of QoL in mothers who had received rehabilitation services for more than 12 months can indicate that mothers who receive rehabilitation services for a longer period of time see the improvement of their children. They are also better able to use stress coping strategies to deal with their child's problem.

Rehabilitation is one of the basic services for the elderly and people with disabilities and provides the possibility of equal opportunities and participation in the society. In fact, it is one of the main pillars of the health; however, less attention has been paid to this issue in Iran, and it does not have a specific place in the health system. The present study aims to find barriers and facilitators regarding rehabilitation programs for the elderly and people with disabilities in Iran.

This is a qualitative study using content analysis method. Participants were 13 experts in different fields of rehabilitation who were selected using a purposive sampling method which continued until the data saturation. The data were collected using a semi-structured in-depth interview from February 2021 to February 2022. The interviews were transcribed verbatim, and then were analyzed by using conventional content analysis method and using constant comparative analysis.

Two main categories of barriers and facilitators, each with 4 sub-categories were identified. The barriers were: High number of rehabilitation trustees, lack of awareness of officials and people, lack of attention to the role of the municipality in rehabilitation, and poor rehabilitation management. Facilitators were: Building culture in the field of rehabilitation and disability, improving the insight of officials, the role of rehabilitation specialists, benefiting from the experiences of other countries.

The identified barriers and facilitators can help officials and policymakers in Iran to improve the status of rehabilitation and provide better services to people with disabilities.

Low back pain is a syndrome with multifactorial etiology that affects 6.8% of the world population during life time. Therefore, the aims of this study was to examine the effect of rehabilitation with medicine ball on muscle activity in low back pain.
Patients during Walking

The present study was a clinical trial.  The statistical population of the present study included patients with low back pain that randomly divided into two intervention (age: 25.4±2.5 years, weight: 79.04±3.06 kg, height: 176.03±7.04 cm) and control (age: 25.8±2.09 years, weight: 79.00±3.01 kg, height: 176.06±7.01cm) group. The intervention group performed resistance training with medicine ball and the control group participated in pre-test and post-test only, without performing any training. were recorded muscle activities of the gastrocnemius lateral (GAS-L), biceps femoris (BF),semitendinosus (ST), vastus medialis (VM), external abdominal (ABD-L), rectus abdominal (ABD-R) and erector spinae (ES).

 The results of the present study showed an increase in the frequency spectrum of the rector femoris muscle during the heel contact and push off in experimental group in post-test compared to the pre-test, and indict a statistically significant difference, Also, the frequency spectrum of the right abdominal muscle in the experimental group has decreased in the post-test compared to the pre-test during the pushing phase, and indict a statistically significant difference .

Rehabilitation with a medicine ball leads to increase the activity the quadriceps muscles in low back pain patients, and it seems to be important factor in decrees the shock absorption during walking.

Because of the increasing number of people with disabilities and the lack of awareness of disability prevention methods in developing countries, creating a proper rehabilitation structure and providing appropriate services are among the important goals of every health system. Conducting comparative studies is one of the research methods for reviewing the structure of the rehabilitation system in the country’s health system. This study aimed to compare the rehabilitation structure in Iran with 5 other countries.

This research is a comparative study conducted in 2022. In this study, sampling was purposeful. Five countries of Germany, Japan, Canada, Turkey, and South Africa were compared in terms of organizational and health management, financial and legal components, and social policy components with Iran. Reliable databases and related resources in the rehabilitation structure were used to collect data. In this study, the obtained data were analyzed using the Bereday model containing four stages: Description, interpretation, proximity, and comparison. The findings were evaluated in a comparative table.

The findings indicated that in terms of organization and health management, the Ministry of Health should be responsible for health management and rehabilitation, but in Iran, in addition to the Ministry of Health, the Red Crescent, the Martyr Foundation, and Exceptional Education Organization are also involved in the management of rehabilitation. Financial issues and problems are significant barriers for people with disabilities to access rehabilitation services in these countries. In Iran, a large part of these costs is paid from the pockets of families. Regarding legal components in Iran, as in other countries, specific rules exist to provide services to people with disabilities. But sometimes, these rules are not properly implemented. From the sociodemographic perspective, Iran has an aging population, welcomes immigrants, and holds diverse cultures. The access of all people in need of rehabilitation in this diverse population to the services needed is limited. In terms of policy components, regulating national health policy requires review and, if necessary, changes in existing health system policies.

The existence of a specific position for rehabilitation in the Iranian health system, provision of services, and management of rehabilitation affairs by a single organization such as the Ministry of Health, as well as proper implementation of laws and policies, can lead to structural improvement and management of the health system and rehabilitation. Financial obstacles and problems to rehabilitation services should be reduced, and government and insurance must cover most of the costs of rehabilitation services. Also, a review of national health policies and legislation in the country should be done to improve the access of all people with disabilities to health and rehabilitation services. Therefore, it is necessary to fundamentally review and reform the structure, value, and process of providing rehabilitation services.

The purpose of the present study was to design occupational therapy interventions with therapeutic reasoning based on the model of human occupation (MOHO) to strengthen handwriting characteristics including readability and speed in Students with a specific learning disorder (SLD) and to compare its effect with common handwriting interventions.

This research was conducted as a semi-experimental interventional study. In this study, 16 children aged 8-10 years with SLD were selected by convenience sampling and assigned non-randomly in two experimental (n=8) and control (n=8) groups. Sampling criteria included studying in the second or third grade of elementary school, being a Persian speaker, having bad handwriting as a family and teacher complaint, and the absence of comorbid disorders. The experimental group received handwriting intervention based on the MOHO, and the control group received common handwriting interventions (sensory-motor and multisensory). The experimental group received 20 treatment sessions of 45 minutes, 7 weeks, and three sessions per week. The outcome measure was the Persian handwriting assessment tool.

The mean difference between the two experimental and control groups in terms of writing speed and variables related to readability, including word shape, word spacing, word alignment, and slope was significant (P≤0.05). Word size as the other readability variable showed no significant difference between the two groups (P<0.05).

The handwriting enhancement program with clinical reasoning based on the MOHO in students with SLD was an effective framework for handwriting intervention.

A proper hand function is essential for performing activities of daily living. Hand injuries can significantly affect participation in these activities. Therefore, any factors that interferes with the treatment of hand injuries and postoperative recovery such as smoking should be controlled. Smoking cigarettes use is a public health problem worldwide. The present study aims to investigate the relationship between smoking cigarettes and hand function after tendon repair in men.

This cross-sectional study was conducted on 40 men (20 smokers and 20 non-smokers) who had undergone at least 10 sessions of physiotherapy and 10 sessions of occupational therapy one and a half months after tendon surgery. In order to collect the information, a demographical form and the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) were used. The collected data were analyzed in SPSS software, version 22.

There was a significant difference in hand function after tendon repair between smokers and non-smokers (P=0.006). There was no significant relationship between the number of cigarette consumed per day and hand function (P=0.3)

It seems that there is a significant relationship between smoking and hand function after tendon repair, but there is no significant relationship between the number of cigarettes smoked per day and hand function. Individual counseling to smokers with hand injuries and expressing the possible negative effects of smoking on their hand function can increase the effectiveness of rehabilitation in them.

Low back pain is a musculoskeletal disorder with an annual prevalence of 18.6%. The aim of the present study was to evaluate the effect of rehabilitation with medicine ball on directed and general co-contraction of knee joint muscles in low back patients during walking,

The present study was a clinical trial. The statistical population of the present study included patients with low back pain in the age range of 20-30 years in Ardabil in 1399. Participants in the study included 20 men with low back pain, who were randomly assigned (names were placed in a bag and identified randomly and one among extracts and groups) in two The exercise group and the control group were divided. The training group performed 12 sessions of strengthening exercises of the central muscles of the body with the beta medicine ball. Selected muscle activity during walking was recorded in two groups during pre- and post-test

Findings demonstrated that general contraction during loading and mid-stance phases increased significantly at post-test than that pre-test. Paired wise comparison demonstrated that directed flexor/extensor knee joint contraction during push off phase increased significantly.

Exercise therapy with medicine ball improved directed and general co-contraction of knee joint muscles in low back pain patients during walking.

Objective:

 Despite the evidence that rehabilitation interventions are effective for spinal cord injury (SCI) patients, these interventions usually impose costs on the health system. Therefore, it is necessary to examine the cost-effectiveness of these interventions for the health system of countries through economic evaluation. In this study, we examined the cost-effectiveness and net financial benefits of rehabilitation services in treating spinal cord injuries in Iran.

Materials & Methods:

 Considering that this research is the first economic evaluation study related to spinal cord injury rehabilitation, the first stage of the economic evaluation was dedicated to designing an economic evaluation model. The model was designed based on disease groups, the natural course of the disease, the details of rehabilitation interventions for spinal cord injury patients in different disease groups, clinical outcomes, probability of occurrence of outcomes, and related costs. The structure of the economic evaluation model of this study is based on the design of a lifetime Markov model with a 1-year cycle length for each strategy and two groups of patients (paraplegia and tetraplegia). In this study, we also used the incremental cost-effectiveness ratio (ICER) to determine the cost of the most effective strategy. All findings were analyzed using Excel 2016 and TreeAge 2011 software.

Results:

 According to the annual incidence of spinal cord injury patients in need of rehabilitation services in the country, which is about 2000 people, based on public sector tariffs, the total annual cost of SCI rehabilitation in Iran in the paraplegia group ranges from 32997 to 40200 million Iranian Rials (IRR) and in the tetraplegia group from 25476 to 26119 million IRR in mild to very severe conditions. Also, the total rehabilitation costs of SCI patients based on public sector tariffs in one year were calculated to equal 256847 million IRR. Similarly, based on private sector tariffs, the total annual costs of SCI rehabilitation in the paraplegia group were estimated from 86374 to 103122 million IRR and in the tetraplegia group from 67509 to 68997 million IRR in mild to very severe cases. Meanwhile, the total rehabilitation costs of SCI patients were calculated based on private sector tariffs in one year, equivalent to 668847 million IRR. Also, the average lifetime of SCI patients undergoing rehabilitation is lower compared to non-rehabilitation and also has higher QALY (The quality-adjusted life year) values, which indicates the dominance of the rehabilitation strategy. The amount of ICER, in this case, is estimated based on public sector tariffs equal to negative 674 million IRR and based on private sector tariffs equal to negative 629 million IRR per QALY unit. Possible sensitivity analysis of the results and Monte Carlo simulation in both scenarios confirmed the initial analysis findings with high probability. Based on the public sector tariff, the net amount of incremental financial benefits of rehabilitation for the total annual incidence is estimated at 8991 billion IRR. These amounts were calculated based on private sector tariffs of 8579 billion IRR.

Conclusion :

Generally, the results of this economic evaluation showed that the rehabilitation of spinal cord injury patients in Iran, based on public and private sector tariffs, is quite cost-effective and has significant net positive financial benefits. The results of the sensitivity analysis also confirmed this finding.

There is little evidence of access to health services among people with disabilities (PWD) in low- and middle-income countries. This study aimed to examine access to physical rehabilitation services among PWD in Iran.

A population-based cross-sectional survey of 2177 PWD was conducted in all provinces of Iran using a multistage cluster sampling method in 2019. The number of sample zones was determined by dividing the country into four socioeconomic zones and considering the share of the population in each zone. Data were obtained by a valid self-administrated questionnaire and analyzed.

The frequency of need for physical rehabilitation services among PWD is %16.6. Among the types of physical rehabilitation services, the highest frequency of needs was related to physiotherapy services. About 28.1% of PWD did not have access to the required rehabilitation services. The third zone has more need and less access to required rehabilitation services. Lack of access to information and financial inability were the most common reasons for lack of access to services. Basic health insurance coverage, low disability rate, high level of education, and socioeconomic status were the determinants of access to rehabilitation services.

Given the gaps in the fair access of PWD to physical rehabilitation services, it is suggested that policies and programs be designed to increase the coverage of rehabilitation services and their costs to achieve the goal of universal health coverage in Iran. The implementation of these policies should be evaluated.

The present study aimed to investigate the effect of brain neuroplasticity on the incidence of anterior cruciate ligament (ACL) injury and on brain function and structure before and after ligament reconstruction and after a period of rehabilitation exercises.

In this review study, a search was conducted in PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, MedLine, Pedro, CINAHL, SPORTDiscus, and Cochrane Databases as well as national databases on related studies published from 1970 to 2021 using keywords in Persian and English related to the research topic.

The initial search yielded 65 articles. Based on the inclusion and exclusion criteria, 24 articles were selected for review of which 5 articles prospectively examined the effect of brain neuroplasticity on the incidence of ACL injury. Their results showed that the brains of people with ACL injury was different from the uninjured people, especially in the motor-sensory part of the cerebral cortex and cerebellum, which caused errors during movement planning of these persons. Ten articles examined the effect of ACL injury before reconstruction on brain function and structure and reported that changes occur in the level of motor-sensory cortex of the brain at least two weeks after the injury; after one year, these structural and functional changes were widely increased in injured people compared to healthy people. These studies also showed that the ligament dysfunction and the damage to mechanical receptors cause the reorganization of the central nervous system. In injured people, the control activity of motor-visual areas and their need for visual feedback have increased. Seven articles examined these changes after ligament reconstruction and showed that the brain neuroplasticity or functional and structural changes resulting from the injury not only did not return to normal conditions, but also increased after a while despite the reconstruction. Two articles examined these changes after a period of rehabilitation exercises and showed that functional and 

The changes in the brain after ACL injury not only persist after ligament reconstruction, but also increase after reconstruction. The common rehabilitation exercises whose main focus is not on eliminating these functional and structural changes in the brain cannot overdrive this negative neuroplasticity after injury which is one of the important causes of secondary injury and subsequent complications. In developing exercises to prevent ACL injury and for rehabilitation, it is better to use the new principles of motor learning and exercises related to visual feedback along with conventional exercises to overdrive negative neuroplasticity created in the brain and create positive neuroplasticity to support ACL.

One of the concepts raised in examining the job effectiveness of employees is professional self-efficacy, which refers to his skill level in facing job challenges. Establishing team cooperation is considered as a key component related to the self-efficacy of health and rehabilitation team members, which can improve health outcomes in patients as well as the quality of effective and safe rehabilitation services. This research was conducted with the aim of investigating the effect of implementing teamwork skills on the self-efficacy of the Red Crescent population rehabilitation team members in 1400.

The present study was conducted as a semi-experimental group in order to determine the effect of teamwork skills implementation on the self-efficacy of the rehabilitation team members of the Red Crescent Community Rehabilitation Center of Tehran in the year 2021. The statistical population in the present study included all the members of the rehabilitation team working in the comprehensive rehabilitation center of the Red Crescent Society of Tehran, totaling 42 people, who were selected by the full number method. The data collection tool includes a questionnaire and a scale: the first questionnaire was about the demographic information (made by the researcher) of the studied units. The second tool was the general self-efficacy scale. SPSS version 25 software was used for statistical analysis.

The participants of this study were 42 employees of the comprehensive rehabilitation center of Red Crescent population (29 women and 13 men) who were in the age range of 30 to 60 years. A positive and significant correlation was observed between work experience and self-efficacy level (P=0.0014). The results of the present study showed that the average score of the rehabilitation team specialists working in the Red Crescent Community Rehabilitation Center of Tehran in the area of general self-efficacy before and after the intervention was 30.12 and 34.51, respectively, which was at a high level and in terms of statistics was significant.

Considering that increasing the level of self-efficacy is a manifestation of effective and managed teamwork, it can be concluded that improving self-efficacy through the implementation of teamwork should be considered by rehabilitation team members and nurses.

Many studies have shown that after ischemic stroke, survivors experience motor dysfunction, memory impairment, and cognitive problems. Exercise is an effective and widely used factor in rehabilitation strategy to improve cognitive recovery and motor control following ischemic conditions caused by stroke, which is effective by increasing signaling pathways related to neurogenesis, synaptogenesis, etc. Recognizing and examining these factors as a result of exercise can be a principled solution to prescribe the most efficient and effective training method for the faster recovery of people suffering from stroke.Stroke is a type of injury related to blood vessels in different levels of the brain. A clinical study of people who had a stroke showed that over several years after the stroke, people who had different types of exercise in their rehabilitation program showed good functional results in neurological rehabilitation, but in groups Without exercise, most people developed aggravated neurological disorders, with mortality in this group being much higher than in the other group. Lack of blood supply to nerve cells in the CNS causes neurological and cognitive disorders, in which all parts of the nerve cell such as the cell body, axons, axonal terminus, and dendritic cavity in the penumbra region Deprived of blood affects the healing processes of various therapies, often involving neurogenesis and angiogenesis, which regenerate damaged cells in neural circuits. The neuroplasticity process in the central nervous system is divided into two parts: structural and functional changes, which have the ability to adapt to learning processes, and cognitive memory following neurological damage, which are dynamic processes that a number of centers Different parts of the central nervous system will undergo numerous changes and interactions. However, by natural mechanisms, the body produces simultaneous changes after ischemic brain injury, but these changes are not sufficient to reverse and repair the damage. In normal conditions or in conditions of brain injuries, rehabilitation can be created as a dynamic process in the nervous system with the aim of adapting to different conditions.Recently, exercise has been considered an effective and practical factor to increase cognitive function and motor function in rehabilitation conditions that increase dendritic branching and axonal myelination through neuroplasticity processes such as increased neural activity and postsynaptic stimulation ability. These phenomena can occur after a stroke. Due to the importance of recognizing and examining the effective factors in the rehabilitation period after stroke, exercise in recent years has shown a very effective role in improving the physical and cognitive condition of these patients. Therefore, the aim of this study was to identify the effective mechanisms in the neurogenic and angiogenic process and also to inhibit apoptotic processes due to exercise as effective factors in improving motor function and cognitive ability after stroke.

To conduct this study, search the Google Scholar, PubMed, Web of Science databases on the effect of various types of exercise on neuronal molecular and cellular changes in the post-ischemic stroke rehabilitation period from 2005 to 2021. Mainly in the title, abstract of articles, and keywords in the studied articles, the words, Ischemic stroke, Rehabilitation, Endurance training, cognitive training, Neuroplasticity, were searched. The inclusion criteria for the selected papers were to be published in Latin in international and prestigious journals, and in general to be about the effect of exercise on molecular cellular signaling in the post-stroke rehabilitation period. Finally, based on the standard principles and the title of the articles, the title of the present study was done with 65 articles

In this review, we discussed recent studies on the cellular and molecular mechanisms of exercise-induced neuroplasticity and Neuroprotective after stroke, analyzed the type of exercise rehabilitation. Studies from 2005 to 2021 have shown that exercise, depending on the type, can inhibit nerve cell-degrading factors and rehabilitate them, as well as the formation of new neurons in the penumbra region with cellular and molecular changes specific to neurogenesis. In general, among the various training methods, high-intensity interval training had more advantages, which was also very important considering the time to start training after a stroke. Finally, it was found that the types of exercise in post-stroke rehabilitation will vary greatly based on the type of exercise that should be used based on the type and amount of stroke, in order to determine the exact effects of different types of exercise, more research is needed in the future.

It seems that one of the effective strategies in designing exercises for rehabilitation and recovery disorders caused by stroke is to use incremental methods in duration and intensity levels that start with very low-intensity exercises and increase the intensity of exercises over time.

According to the conditions of the COVID-19 epidemic, one of the effective factors in the rehabilitation and recovery of patients with COVID-19 is physical activity. Physiologically, physical activities are divided into two categories: high-intensity exercises and low-to-moderate intensity exercises. According to the studies, low-intensity exercises can have a beneficial effect on the recovery of these patients. Therefore, it is possible to improve the existing research gap with suggestions, such as research in the field of comparing different types of exercises with different intensities during COVID-19 and their effects on inflammatory factors and factors affecting respiratory tract infections.

Considering that only about a year and a half have passed since the COVID-19 epidemic and the priority of the health care system has been to pay attention to symptoms and physical problems of this disease to prevent its further spread, there is insufficient evidence about psychological issues resulting from COVID-19. The purpose of this study was to partially review psychological problems caused by COVID-19 in patients and treatment staff and rehabilitation strategies to solve this problem. 

A search through in Medline, Web of Science, PubMed, and Scopus databases was performed by combining keywords related to COVID-19 (such as coronavirus), restrictive measures (such as quarantine, segregation, social distancing), and psychological outcomes (such as psychosis, depression) and instructions (such as guidance, management, rehabilitation). All articles were written in English and aimed at the psychological disorders and factors associated with the coronavirus. Given that only about a year and a half has passed since the introduction of COVID-19, the period of the reviewed articles was selected between 2019 and 2021.

Reviewing related studies, 18 original articles were considered. Overall, the literature showed that COVID-19 had changed the lifestyle. COVID-19, in addition to physical symptoms and mortality, has adverse psychological effects such as anxiety, depression, loneliness, stress, fear, and excitement. However, these symptoms are not very severe in most cases. Psychological problems can be more severe in specific groups, such as pregnant women or people with underlying issues. In countries with a history of epidemics, internet-based systems have been developed to assess and treat psychological problems in patients with COVID-19. Rehabilitation intervention can also positively improve the patient's breathing, thereby reducing psychological issues.

COVID-19 can cause psychological problems for the patient and physical symptoms. On the other hand, changes in people's lifestyles following the outbreak of COVID-19, such as travel restrictions, quarantine, social distancing, and business sluggishness, may also contribute to the psychological disorders following the COVID-19 pandemic. The psychological problems caused by COVID-19 in some special groups, such as pregnant women, health care providers, and children, need to be addressed. Rehabilitation interventions and raising public awareness can effectively improve the psychological situation.

 Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders in childhood. This study aims to assess the effect of cognitive rehabilitation combined with physical exercise on sustained, selective and alternating attention in ADHD children.

This is a quasi-experimental study with a Pre-test/posttest design. The study population consists of all primary school girls with ADHD in Yazd, Iran. Of these, 40 aged 9-12 years were selected and randomly divided into four groups of cognitive rehabilitation, physical exercise, combined (exercise + rehabilitation), and control. The Conners’ Teacher Rating Scale (CTRS) was used for initial assessment of children, Goodenough- Harris Drawing Test (GHDT) to measure intelligence score, Integrated Visual and Auditory-Continuous Performance Test (IVA-CPT) to assess sustained attention, Wisconsin Card Sorting Test (WCST) to measure alternating attention, and Stroop test to measure selective attention. For cognitive rehabilitation, My Brain application was used. The intervention was presented at 16 sessions, each for 60 minutes. Posttest assessment was performed 24 and 72 hours after the end of intervention. ANCOVA was used for data analysis. All analyses were performed in SPSS v. 20, considering a significance level of P<0.05.

 The results of ANCOVA showed that the combined group had significantly lower errors in sustained, selective and alternating attention tests compared to other groups. In the omission response variable, the mean score of the children in the combined group was significantly lower than in the control group (P<0.05).

 Cognitive rehabilitation combined with physical exercises can improve different types of attention in children with ADHD.