فهرست مطالب

Iranian Rehabilitation Journal
Volume:19 Issue: 46, Mar 2021

  • تاریخ انتشار: 1400/03/04
  • تعداد عناوین: 12
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  • Sepideh Dadkhah*, Jamshid Jarareh, Firoozeh Akbari Asbagh Pages 1-12
    Objectives

    Infertility presents extensive psychological effects on infertile couple’s marital life, especially in women during infertility treatment. Studying the essential psychological factors and their correlations on a large scale could rehabilitate the mental health of infertile women and facilitate the stressful process of infertility treatment. This systematic review aimed to study the literature and relationships among self-compassion, positive and negative affect, and marital quality in infertile women.

    Methods

    To examine the considered association, a comprehensive literature search was performed to identify relevant articles in English and Persian published from 2000 to May 2020 and indexed in Pubmed, Google Scholar, Scopus, Science Direct, Jstore, Cochrane Library, Medline, SID, Irandoc, Civilica, and Magiran. The study eligibility criteria included only infertile couples/women who were clinically diagnosed with infertility. The measurement tools used by studies consisted of at least one of the following: Self-Compassion Scale (SCS); Positive and Negative Affect Schedule (PANAS); Revised Dyadic Adjustment Scale (RDAS), and infertility-related questionnaires. The search strategy of this review was per PICO (Population, Intervention, Control, and Outcomes) and included the terms Self-Compassion (SC), Positive and Negative Affect (PANA), and Marital Quality (MQ) in infertile women. To identify further eligible studies, the bibliographies of primary articles were manually searched to meet the inclusion criteria. The quality of studies was graded by GRADE from the Cochrane handbook. The studies were investigated concerning design, risk of bias, inconsistency, indirectness, imprecision, and publication.

    Results

    SC could play a mediating role in the relationship with PANA, and MQ in infertile women undergoing infertility treatment.

    Discussion

    This systematic review highlighted the importance of addressing psychological characteristics which can affect the biopsychological health of infertile women undergoing infertility treatment.

    Keywords: Self-compassion, Positive, negative affect, Marital quality, Infertile women
  • Mahta Alsadat Aarabi, Kianoush Abdi*, MohammadSaeed Khanjani Pages 13-22
    Objectives

    One of the most essential needs of children with Autism Spectrum Disorder (ASD) is using rehabilitation services. However, these services are associated with numerous challenges. The present study aimed to identify the perceptions of the parents of children with ASD and rehabilitation service providers about the challenges of using rehabilitation services in Iran.

    Methods

    This was a qualitative study. In total, 27 participants were selected from the parents of children with ASD and rehabilitation service providers to these children, based on purposive sampling method; we considered maximum variation and sampling continued until data saturation. The necessary data were collected by semi-structured and in-depth interviews. The interviews lasted from July to December 2020 and MAXQDA was used for data analysis.

    Results

    The challenges of children with ASD in accessing and using rehabilitation services were identified and categorized into 6 main classes, as follows: the lack of a systematic support system; the lack of commitment to observing professional ethics; neglecting the structure and policy of rehabilitation; the lack of comprehensive ASD diagnostic and rehabilitation protocols; inadequate knowledge and attitude, and the lack of feasible access to services.

    Discussion

    Policymakers, service providers, and managers must be aware of the challenges of rehabilitation services for ASD; subsequently, they are expected to pay special attention to this issue. This study provided evidence for the above-mentioned groups for accessing and using rehabilitation services among ASD. Besides, the obtained data could help to improve the services they receive and their living conditions; ultimately, they help improve their quality of life.

    Keywords: Autism Spectrum Disorder (ASD), Challenge, Rehabilitation services, Healthcare, Qualitative
  • Leila Safarpour, Nahid Jalilevand*, Ali Ghorbani, Mahboobeh Rasouli, Gholamreza Bayazian Pages 23-30
    Objectives

    Cleft Palate (CP) with or without Cleft Lip (CL/P) are the most common craniofacial birth defects. Cleft Lip and Palate (CLP) can affect children’s communication skills. The present study aimed to evaluate language production skills concerning morphology and syntax (morphosyntactic) in children with CLP.

    Methods

    In the current cross-sectional study, 58 Persian-speaking children (28 children with CLP & 30 children without craniofacial anomalies=non-clefts) participated. Gathering the language samples of the children was conducted using the picture description method. The 50 consecutive intelligible utterances of children were analyzed by the Persian Developmental Sentence Scoring (PDSS), as a clinical morphosyntactic measurement tool.

    Results

    The PDSS total scores of children with CLP were lower than those of the non-clefts children. A significant difference was found between the studied children with CLP and children without craniofacial anomalies in the mean value of PDSS total scores (P=0.0001). 

    Discussion

    Children with CLP demonstrate a poor ability for using morphosyntactic elements. Therefore, it should be considered how children with CLP use the grammatical components.

    Keywords: Cleft lip, palate, Expressive language, Morphology, Syntax, Persian Developmental Sentence Scoring (PDSS)
  • Mahsa Fadavi Ghaffari, Akram Azad*, Ghorban Taghizade, Noureddin Nakhostin Ansari, Hooman Shariatzadeh, Sina Aminizadeh Pages 31-40
    Objectives

    It is essential to have a suitable instrument for the accurate assessments of pain and disability outcomes during interventions; such tools also help to guide hand surgery and rehabilitation programs in distal radius or scaphoid fracture. This study aimed to evaluate the psychometric features of the Patient-rated Wrist Evaluation (PRWE) questionnaire in Iranians with a history of scaphoid and distal radius fractures.

    Methods

    One hundred and fifty subjects with a history of scaphoid and distal radius fractures were recruited from hospital-based outpatient hand clinics and completed the PRWE, 2 and 7 days after the occurrence of fracture. Additionally, the Quick-Disabilities of Arm, Shoulder, and Hand (Quick-DASH), the percentage of Wrist Range of Motion (%ROM), Visual Analog Scale Pain/Disability (VAS-P, VAS-D), Short-form Health Survey (SF-36) questionnaires, and pinch and grip strength (%) were conducted in the study participants. Cronbach’s alpha (α) coefficient and Intraclass Correlation Coefficient (ICC) were used to evaluate the internal consistency and test-retest reliability of the scale, respectively. Pearson or Spearman correlation coefficient was calculated for assessing the test’s construct validity.

    Results

    No floor or ceiling effect was found. A very high test-retest reliability was obtained for the PRWE’s total score and subscores (ICC≥0.92). Cronbach’s α coefficient was obtained as ≥0.78 for the PRWE and its subscales. The PRWE total score presented a weak to strong (0.24-0.74) correlation with the average values of %ROM, %power grip, %pinch strength, VAS-P, VAS-D, SF-36, and Quick-DASH. The standard error of the measurement of PRWE total score equaled 3.93; its smallest real difference was 10.86. 

    Discussion

    The PRWE presented acceptable validity and excellent reliability for measuring disability and pain in individuals with the scaphoid and distal radius fractures in Iran.

    Keywords: Disability evaluation, Fracture, Pain, Validation, Wrist
  • Talieh Zarifian, Maryam Malekian*, Tabassom Azimi Pages 41-50
    Objectives

    Alternative and Augmentative Communication (AAC) provides a means of effective communication to individuals with severe impairments in speech comprehension and production. The present study aimed to examine the awareness of Iranian Speech-Language Pathologists (SLPs) of AAC services.

    Methods

    In total, 111 SLPs who were selected by convenience sampling method participated in this cross-sectional study. Using a researcher-made questionnaire, information on SLPs’ familiarity with the term AAC and its methods; patients who can benefit from AAC methods; the kind of AAC method that could be used per patient, and the effectiveness of each method were obtained. This research was conducted at rehabilitation clinics in Tehran City, Iran.

    Results

    The obtained results revealed that only 8.1% of the respondents were familiar with the concept of AAC; however, 92.8% of SLPs had contact with Patients With Communication Problems (PWCP). Only 0.9% of SLPs were familiar with high-tech devices. Additionally, 88.3% of the respondents were willing to further educational opportunities concerning AAC.

    Discussion

    Iranian SLPs had little familiarity with AAC and the target population of these services. Overall, there appeared to be a lack of AAC expertise within the profession in Iran. Therefore, training these professionals, both theoretically and clinically, is essential.

    Keywords: Augmentative, alternative communication, Awareness, Speech-language pathologist, Communication aids
  • Nastaran Ghotbi*, Mohsen Bayat, Kazem Malmir, Shohreh Jalaei Pages 51-58
    Objectives

    Lower extremity muscles are critical for maintaining dynamic balance and athletic performance. Fatigue of these muscles may affect dynamic balance. It is unclear whether fatigue in a particular muscle group can affect dynamic balance more than that in other groups. This study was conducted to evaluate and compare the effects of fatigue in 5 muscle groups on dynamic balance in volleyball players.

    Methods

    Fifteen healthy male volleyball players separately performed the Star Excursion Balance Test before and immediately after the occurrence of fatigue of ankle Plantar Flexor (PF), knee extensor, knee flexor, hip abductor, and hip adductor muscles. Composite reach distance and distance in anterior, posteromedial, and posterolateral directions were recorded, accordingly.

    Results

    Repeated-measures Analysis of Variance (ANOVA) data indicated that fatigue of all muscle groups significantly decreased the mean score of composite (P<0.001). Anterior, posteromedial, and posterolateral distance scores decreased following muscle fatigue of knee extensors and ankle PFs (P<0.05).

    Discussion

    This study suggested that regarding composite reach score, fatigue of ankle, knee, and hip muscles similarly decreased dynamic balance. However, evaluating three main directions revealed that knee extensors and ankle PFs muscles fatigue presented more prominent effects on the explored volleyball players’ balance, compared to the other muscles.

    Keywords: Muscular fatigue, Dynamic balance, Star Excursion Balance Test (SEBT), Volleyball, Lower extremity
  • Shahrbanoo Bidari, Maryam Jalali*, Mohammad Kamali, Batoul Bagheripour Pages 59-68
    Objectives

    Foot disorders, especially pain and deformities, are common patient complaints. Foot Health Status Questionnaire (FHSQ) was developed to assess general and foot health specifically in chronic foot disorders. The purpose of the current study was the cross-cultural adaptation of the FHSQ to Persian and evaluating the psychometric properties of the translated version.

    Methods

    As per the International Quality of Life Assessment guideline, the forward and backward translations of the questionnaire were conducted by two independent translators. Accordingly, the final version was approved by a committee and confirmed by the developer. The psychometric properties of the Persian version of the FHSQ were tested in 101 participants (Mean±SD age: 42.98±15.03 y) with chronic foot disorders. Face validity by impact score calculation; criterion validity through correlation to the Manchester-Oxford Foot Questionnaire (MOXFQ) scores; internal consistency by Cronbach’s alpha coefficient, and test-retest reliability by calculating intra-class correlation were tested to describe the psychometric features of its Persian version.

    Results

    Face validity was confirmed by impact scores of >1.5 for all items. The FHSQ was significantly correlated with the MOXFQ domains, supporting the criterion validity of the instrument, except for the shoe domain of the Persian FHSQ, i.e., not correlated with the pain domain of the MOXFQ (r=0.26). Cronbach’s alpha coefficients for pain, function, shoe, and general foot health were measured as 0.93, 0.92, 0.90, and 0.96 respectively. Thus, it suggested an excellent internal consistency for all domains. The intra-class correlation coefficient ranged from 0.73 to 0.93 for all domains, reflecting its good to excellent reliability.

    Discussion

    The Persian version of the FHSQ is a valid and reliable patient satisfaction measurement instrument for evaluating foot conditions. Moreover, the current study results supported the potential of applying it as an appropriate instrument in research and clinical setting. Implementing this tool could help to evaluate the effects of an intervention or estimate the prevalence of a disorder in Persian-speaking populations.

    Keywords: Foot, Foot Health Status Questionnaire (FHSQ), Translation, Cultural adaptation, Psychometric evaluation, Persian
  • Budiman*, Sri Garnewi Pages 69-74
    Objectives

    The present study aimed to determine the effect of diaphragmatic breathing exercises on the degree of breathlessness among patients with Chronic Obstructive Pulmonary Disease (COPD) in West Java Province, Indonesia.

    Methods

    This was a quasi-experimental study with a pretest-posttest and no control group design. In total, 33 patients with COPD participated in this study using a consecutive sampling technique. The Modified Medical Research Council was used to measure the degree of breathlessness. A portable spirometer was used to assess Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC).

    Results

    The Mean±SD age of the study subjects was 44.5±3.17 years; 54.4% of the study participants were male, with healthy a body mass index. Approximately 42.4% of the studied patients experienced the fourth degree of breathlessness before the intervention. There was a reduction in the Mean±SD score of breathlessness from 3.42±0.53 to 1.64±0.13 after the intervention (P=0.001). There were improvements in the breathing frequency (Mean±SD: 11.8±4.9 vs 9.5±1.6), oxygen saturation (93.39±3.20 vs 95.47±4.21), and FEV1/FVC (0.5±0.12 vs 0.3±0.45) in the study subjects.

    Discussion

    It is expected for the hospital, educational institutions, nurses, and patients to be able to apply diaphragmatic breathing exercises as one form of nursing care measure. This is because it is proven effective to reduce the degree of breathlessness.

    Keywords: Breathlessness, Diaphragmatic breathing exercises, Chronic Obstructive Pulmonary Disease (COPD)
  • Younes Amiri Shavaki, Arezoo Saffarian*, GholamAli Shahidi, MohammadReza Keyhani Pages 75-84
    Objectives

    In the early stages, most Parkinson’s patients display some degrees of voice and speech disorders. Speech disorders can negatively affect individuals’ social interactions and life; thus, treatment plans for the disorders in the early stages might be further beneficial than the late stages. Therefore, we aimed to investigate the effects of an intervention on Persian-speaking patients with early mild Parkinson’s Disease (PD). The intervention was the Lee Silverman Voice Treatment (LSVT).

    Methods

    This was an interventional study and included 23 patients with PD. The study participants were randomly assigned into one of two groups; 13 patients in the intervention group (PD-I), and 10 in No-Intervention (PD-NI) group. Normal Persons (NP) or the control group included 13 healthy participants who were neurologically normal and presented no speech and voice disorders. Besides, they were matched with the PD-I group concerning education, age, gender.

    Results

    There was a significant impairment in Maximum Phonation Time (MPT), vocal loudness in vowel /a/, in reading, and during a monologue speech in the PD group, compared with the NP group (P≤0.001). The LSVT resulted in a significant improvement in all measures in the PD-I group (P≤0.001); however, no significant change was observed between the PD-I and PD-NI groups’ scores in first assessment (P≥0.201). In contrast, the PD-NI group’s results in all measurements of final assessment were significantly lower than those in the PD-I (P≤0.001) and NP (P≤0.001) groups. The MPT also exhibited a considerable improvement in the PD-I group, compared with the controls.

    Discussion

    The LSVT, as a therapeutic technique based on the motor learning theory was beneficial in improving the vocal loudness of Persian-speaking patients with PD in the early stages of their disease.

    Keywords: Voice, Treatment, Loudness, Voice disorders, Parkinson disease
  • Mohd Mukhtar Alam, Abid Ali Khan* Pages 85-98
    Objectives

    This study presents a method of assessing muscle fatigue during endurance testing at 50% maximal voluntary contraction (MVC) using electromyography (EMG) information as indirect indices of fatigability in the forearm muscles, namely, flexor digitorum superficialis (FDS); flexor carpi ulnaris (FCU); extensor carpi ulnaris (ECU) and extensor carpi radialis brevis (ECRB)." This study presents a method of assessing muscle fatigue during endurance testing at 50% maximal voluntary contraction (MVC) using electromyography (EMG) information as indirect indices of fatigability in the forearm muscles, namely, flexor digitorum superficialis (FDS); flexor carpi ulnaris (FCU); extensor carpi ulnaris (ECU) and extensor carpi radialis brevis (ECRB).

    Methods

    A randomized comparative experimental design was used during endurance test with 8 VT protocols; based on different combinations of vibration frequency (35 & 45 Hz), amplitude (3±0.5g & 9±0.5g), and exposure duration (30 & 60 seconds), i.e., were given to the study participants for 4 days. A random sampling of participants was conducted from two groups (n=56/group), as follows: individuals with a Sedentary Lifestyle (SL) and a group of Construction Workers (CW). 

    Results

    Multivariate Analysis of Variance (MANOVA) results indicated a significant increase in EMG rms, median frequency, waveform length, mean absolute value (P<0.001), and the variance of EMG signal (P<0.05) (except in ECU for the SL group and ECRB for the CW group on the variance of EMG signal) after VT in all muscles of both research groups. Therefore, an increase in the EMG parameter value after a grip endurance task revealing an elevation in EMG signal amplitude is indicative of muscle fiber fatigue. Furthermore, the strongest correlation was found between grip endurance and WL (r=0.471, P<0.001), and EMG rms (r=0.401, P<0.001) of the ECU muscle in the SL group only.

    Discussion

    The patterns of EMG signal represented the amplitude and spectral parameters of the signal, enabling real-time fatigue analysis. Additionally, surface EMG information is useful for indirectly evaluating performance fatigue during the endurance test.

    Keywords: Vibration therapy, Muscle fatigue, Surface electromyography, Endurance training
  • Karim Mohammad Jabbar, Farzaneh Gandomi* Pages 99-110
    Objectives

    Flexed posture with Hyperkyphosis (HKP) and Forward Head Posture (FHP), due to changes in the spine alignment, lead to the displacement of the center of pressure and increased postural sways; ultimately, this condition disrupts the distribution of foot pressure. Therefore, the present study aimed to compare the effects of 8 weeks of National Academy of Sports Medicine (NASM) and Sharman training on Foot Pressure Distribution (FPD) in flexed posture students.

    Methods

    In this double-blind randomized clinical trial, 30 students with HKP and FHP were randomly assigned in two groups of NASM and Sahrmann (n=15/group). The angle of HKP and FHP were evaluated by Spinal Mouse and Image J software. FPD was also assessed by a Payatek foot scaner (PT-scan) device. The obtained data were analyzed in SPSS using one-way Analysis of Covariance (ANCOVA).

    Results

    The present research results suggested that both intervention groups presented significant differences in reducing the angle of HKP (P<0.001) and FHP (P<0.001), COP minor axis length (P<0.05), COP major axis length (P<0.001), COP path length (P<0.001), the standard deviation of internal-external sways (P<0.001), and standard deviation of anterior-posterior sways (P<0.001); however, t there was no significant difference concerning the COP area (P>0.05) and symmetry index between the two legs (P>0.05). 

    Discussion

    Both provided corrective exercises reduced HKP and FHP angles and reduced postural sways. However, Sahrmann intervention with adjusted muscle stiffness and reduced electromechanical latency was more effective than NASM exercises in improving postural control and foot pressure symmetry index.

    Keywords: Hyperkyphosis, posture, exercise, foot, kyphosis, postural control
  • Hrishikesh Yadav Korada, G Arun Maiya*, Sharath Kumar Rao, Manjunath Hande Pages 111-116

    A 49-year-old male patient with type 2 diabetes mellitus and Diabetic Foot Syndrome (DFS) was evaluated by comprehensive diabetic foot assessment. A 10-session photobiomodulation therapy (low-level laser therapy) was prescribed for neuropathic pain and symptoms applying the scanning and probe method. Customized insoles were recommended for redistributing the plantar pressures and reducing stress on the diabetic foot’s plantar surface for 4 weeks. Dynamic plantar pressure distribution, lower limb kinematics, and postural sway were evaluated using WinTrack dynamic pressure platform. Photobiomodulation therapy with customized insoles is useful in the redistribution and treatment of plantar pressure and gait kinematics. This approach should be extensively used in DFS as preventive and treatment measures.

    Keywords: Laser therapy, Biomechanics, Gait, Diabetes, case reports