Iranian Rehabilitation Journal
Volume:19 Issue: 47, Jun 2021

N/A

Telerehabilitation (TR) is an alternative approach for providing rehabilitation services in some situations, like Coronavirus Disease 2019 (COVID-19) pandemic. There exist some obstacles, especially during the pre-implementation phase of TR, necessitating an investigation of existing local evidence. This research aimed to investigate the challenges of TR.

Five electronic databases (Scopus, PubMed, Google Scholar, SID, & Magiran) were searched for studies published in English and Persian language from 2011 to February 2021. Search results in all databases provided a total of 598 articles. After reviewing the titles of the articles, we excluded 574 articles as they were duplicated and/or irrelevant. Finally, based on the inclusion and exclusion criteria, 11 articles have remained.

Most extracted articles were published in 2020 (n=4). The remaining articles disturbed between 2013 until 2021. These articles were mostly reviews, case reports/series, or qualitative studies and surveys. Geographically, 27% of the final selected papers belonged to the USA, 46% to Asia, and 27% to Europe. Outcomes in studies mostly included TR advantages and disadvantages, facilitators, challenges, and barriers.

Studies specified numerous challenges for TR implementation. The main challenges in the technologies used in TR were the awareness and culture of individuals and the TR infrastructure. Despite these barriers, TR could be a better treatment selection in some patients. Therefore, it is necessary for health policymakers, and especially rehabilitation managers, technology developers, scientists, and clinicians to cooperatively make serious efforts to remove these barriers.

The present study evaluated the inter-rater and intra-rater validity and reliability of posturography by Kinovea software to measure the thoracic kyphosis and lumbar lordosis.

Eighteen subjects (10 females & 8 males) referring for radiographic imaging were included in this cross-sectional study. For evaluating the validity, the thoracic kyphosis and lumbar lordosis were measured according to the Cobb method and Kinovea in standing position. The inter-rater and intra-rater reliability of Kinovea were tested by 3 evaluators and one expert evaluator, respectively.

Pearson correlation coefficient data suggested that the validity of measuring the thoracic kyphosis depends on the evaluator’s expertise. Besides, the correlation was not significant in measuring the lumbar lordosis angle (P>0.05). The inter-rater and intra-rater repeatability revealed that the correlation was significant in all angles by the intraclass correlation coefficient (P<0.001).

Posturography by Kinovea, as a noninvasive method presents an excellent inter-rater and intra-rater repeatability for measuring thoracic kyphosis and lumbar lordosis. This reliable method is simple, efficient, and inexpensive.

Computer usage has rapidly grown. This is because it helps to resolve problems, i.e., encountered in daily life by individuals. Various monitor screens that have been developed affect the user’s eyes. Screen size is one of the relevant impacts. Thus, this study compared the immediate effects of two computer screen sizes on visual fatigue in Video Display Terminal (VDT) users.

Twenty female VDT users participated in this study. Using a randomized block design for the study, the study participants randomly drew a ballot to determine the order of using an 18.5-inch and 23-inch computer screen size. The research participants were assessed by a visual fatigue score, critical flicker frequency, and dry eye score before and after using both computer screen sizes. They were tested in an ergonomic computer workstation for 2 hours. Besides, where they rested between each workstation for ≥30 minutes or until presetting no eye fatigue symptoms. The relevant data were compared between before and after using the computers and between the two different screen sizes. 

The collected results suggested no significant difference in the visual fatigue score, critical flicker frequency, and dry eye score between using either computer screen sizes (P>0.05). However, there were significant differences in the visual fatigue score, critical flicker frequency, and dry eye score between before and after computer screen usage (P<0.05).

Using both computer screen sizes resulted in increased visual fatigue, reduced critical flicker frequency, and increased dry eyes. The present study results can provide information in determining how to reduce risk factors and prevent visual fatigue from continuous computer use for a long time.

Handwriting dysfunction may harm children’s wellbeing. Therapists and elementary school teachers help to identify and improve children’s handwriting performance. The present study aimed to assess the relationship between therapists’ assessment and teachers’ perception of handwriting performance in first graders.

This cross-sectional study involved (n=31) first-grade students, aged 6-8 years from an international school in Riyadh City, Saudi Arabia. Teachers evaluated the handwriting proficiency using the Handwriting Proficiency Screening Questionnaire (HPSQ), and the explored students were rated as proficient and non-proficient hand writers. Furthermore, therapists assessed students’ handwriting proficiency using the Minnesota Handwriting Assessment (MHA) (manuscript & D’Nealian styles) scores. The Mann–Whitney U test was used to assess the differences in MHA scores between proficient and non-proficient hand writers. Moreover, Spearman’s correlation coefficient was used to assess the relationship between the scores of MHA and HPSQ.

There was a significant difference in all component scores of MHA (except the rate) and both writing styles between the proficient and non-proficient writers (P<0.05). There was also a significant relationship between the MHA and the HSPQ scores (P<0.05). However, further analysis of these scales’ components suggested no significant association between teachers’ and therapists’ evaluation of the handwriting speed domain.

There was a significant relationship between the teacher’s and therapist’s evaluation of handwriting performance using standardized measures. Thus, therapists should work in collaboration with teachers to identify and treat handwriting difficulties in school children.

Menopause is the termination of a woman’s menstrual cycle for a year. In this condition, women’s health status declines due to hormonal changes and aging. Physical Activity (PA) is among the best available alternatives for managing menopause-related symptoms without any adverse effects. This study aimed to assess the relationship between PA and symptoms, such as fatigue, depression, and insomnia in Saudi menopausal women.

This cross-sectional study involved 60 menopausal women; they were divided into physically active and inactive groups. The group allocation was conducted based on their PA level determined by the International Physical Activity Questionnaire Short-Form (IPAQ-SF). Menopausal symptoms, such as fatigue, depression, and insomnia were assessed using the Fatigue Severity Scale (FSS), Beck Depression Inventory-II (BDI-II), and Insomnia Severity Index (ISI), respectively, in the study groups. The association between PA and fatigue, depression, and insomnia was assessed using the Pearson correlation coefficient. The significance level was set at P≤0.05.

Fatigue, depression, and insomnia were more prevalent in physically inactive post-menopause women than the active women. A significant difference was observed in the outcome variables between the study groups. Furthermore, a significant association was detected between PA and fatigue, depression, and insomnia in the study participants.

Half of the explored menopausal women were physically active. Physically active menopausal women presented less fatigue, depression, and insomnia, compared to their inactive counterparts. This study suggested that PA positively impacted menopausal symptoms (fatigue, insomnia, & depression). Besides, the collected results highlighted the importance of physical activity among menopausal women.

This study aimed to assess the knowledge and perception of the role of speech therapists by other medical professionals in public hospitals.

This cross-sectional study recruited 200 healthcare professionals with >1year of job experience at the workplace of both genders and any age. Besides, the study subjects were selected using a non-probability convenience sampling approach. The study sample was recruited from 25 District and Tehsil Headquarter Hospitals from April 1, 2019, to September 30, 2019. A basic demographic datasheet and the Knowledge, Attitude, and Practices (KAP) survey were used for data collection. Statistical analysis was performed in SPSS.

Out of the total 200 eligible professionals from different departments, the Mean±SD scores of the responses were highest (75.14±24.87) in pediatric medical professionals. Moreover, the lowest scores (46.70±0.01) concerned Intensive Care Unit (ICU) experts; this difference was statistically significant (P<0.001). Similarly, a significantly higher Mean±SD score of 74.05±20.04 was noted for those working day shifts, compared to that of (35.01±8.52) those working in night shifts (P<0.001).

The knowledge and perception of different healthcare professionals serving in public hospitals vary regarding the role of SLPs. Such differences concern their profession, with pediatrics presenting the highest level of understanding, followed by general medicine. However, psychiatry and ENT professional provided the least understanding in this area. The professionals working in day shifts suggested better knowledge and perception, compared to night shifts staff.

Chronic Obstructive Pulmonary Disease (COPD) impacts the quality of life of the affected patients. The present study aimed to determine the effects of home-based self-care program follow-up on re-hospitalization frequency and quality of life in COPD patients.

This quasi-experimental study was performed on 44 COPD patients at Masih Daneshvari Hospital in Tehran City, Iran, in 2018. For collecting the necessary data, we used demographic data checklist, COPD Assessment Test, and the St. George’s Quality of Life questionnaire. We used SPSS v. 22 for analyzing the obtained data. 

The present study revealed that the highest age frequency was in the 61-70 years age group. Moreover, the male gender had the highest frequency and most research participants had elementary school education; the highest frequency regarding the disease duration was >5 years. Besides and the hospitalization frequency was once a year. The present study findings indicated that the provided self-care program follow-up reduced the re-hospitalization frequency and increased the quality of life of the explored COPD patients (P<0.001). 

The obtained results revealed that implementing a course of home-based follow-up self-care program could reduce re-hospitalization and increase the quality of life of COPD patients; thus, it is suggested that such follow-up programs be included in COPD treatment plans.

Flexible Flat Foot (FFF), a common foot deformity decreasing medial longitudinal arch height is often comorbid with subtalar joint pronation causing physical activity difficulties in this population. Among the orthotic insoles prescribed for improving foot function, foot orthoses with medial heel skive technique have a limited research background. The present study aimed to investigate the effects of the custom-mold insole with medial heel skive technique on physical function in FFF.

Eighteen adults with FFF from the University of Social Welfare and Rehabilitation Sciences students and staff participated in this study. Custom-Mold insole with medial heel skive was fabricated for all research participants. Physical function in the activities of daily living and sports was assessed by the Foot and Ankle Ability Measure (FAAM), Activities of Daily Living (ADL) subscale (ADL-FAAM), and SPORT-FAAM questionnaires at the beginning of the study and 6 weeks after. Paired Samples t-test and nonparametric tests were used to compare the collected results.

After 6 weeks of using the insole with medial heel skive technique, scores in both ADL and SPORTS activities were significantly improved.

Foot function improvement was not found in all of the studies assessing foot function in flat feet after using different orthotic insoles, by different questionnaires or other systems. In this study, foot and ankle function was significantly improved per FAAM questionnaire- which had highly limited use in orthotic interventions in flat feet population- using medial heel skive technique; however, further studies are required to accentuate medial heel skive technique effect on flat feet function by comparing this technique with other positive cast modifications to control the flat foot. According to the present study results, custom-mold insole with medial heel skive may improve physical function in FFF and can be prescribed in this group.

A common concern in some cochlear-implanted children is the lack of desired progress in auditory and listening skills. Such a concern remains despite proper verbal processor programming, additional disabilities, and continuous participation in hearing rehabilitation programs. A more detailed assessment of pathways and centers of the auditory processing at the lower end of the brain stem by measuring the time of the Electrical Stapedius Reflex (ESR), and investigating its relation to auditory perception skills can provide significant information about choosing the appropriate rehabilitation method.

In total, 20 unilateral cochlear-implanted children (3-7-year-olds) participated in this research. All of them were implanted for ≥2 years and participated for ≥1 year in the auditory-verbal rehabilitation program. The ESR reaction time was measured for 3 electrodes in the apex, middle, and basal areas. The Categories of Auditory Performance (CAP-II) test score was used to assess the progress of auditory skills. Then the correlation between CAP-II test score and ESR reaction time was investigated per each electrode.

There was a significant inverse correlation between the ESR reaction time and the CAP II test scores in the apex electrodes (r=-0.5, P<0.05). However, no such correlation was observed in the middle (r=0.34, P>0.05) and basal (r=-0.06, P>0.05) electrodes. 

There was a significant correlation between the shorter reaction time of ESR in the apex electrode and the higher scores in the CAP-II test for auditory skills in children. Therefore, examining the ESR reaction time can be useful for prediction of the benefits of cochlear implantation as well as choosing a better rehabilitation approach for cochlear-implanted children.

Ankle-Foot orthoses are used to minimize the impact of weakness in ankle dorsiflexion muscles. The study on different orthotic types defines the optimal design, which effectively improves the users’ mobility. This study investigated the potential benefits and risks of a Dictus-band (flexible orthotic), compared with a thermoplastic (fixed) ankle-foot orthosis on the mobility of individuals with Multiple Sclerosis (MS).

Fifteen subjects with MS and dorsiflexion ankle weakness volunteered in this randomized crossover study. The study participants received either a Dictus-band or a thermoplastic ankle-foot orthosis worn on the weaker leg, compared to barefoot as the control condition. Postural stability during standing, forward reach test, timed up and go test, and walking speed in the 10-meter walking test were compared between the study conditions.

There were no significant differences in the postural stability and forward reach tests between study conditions (P>0.5). When the research participants used a Dictus-band, compared to the fixed ankle-foot orthosis, the time required to complete the timed up and go was significantly reduced [P<0.01; Mean±SD difference: 6.4±1.4; 95% Confidence Interval (CI): 2.7-10.2], and walking speed was increased in the 10-meter walking test (P<0.01; Mean±SD difference: 0.46±0.8; 95%CI: 0.23-0.69). There was no difference in the timed up and go and 10-meter walking test data between the barefoot and Dictus-band conditions (P>0.5). No adverse or safety events were sustained in this research. 

The present study data provided initial evidence for the lack of detrimental effects of using the Dictus-band in subjects with MS and ankle dorsiflexion deficiencies.

Postoperative physiotherapy is routinely prescribed for patients after thoracic surgeries. There are no established guidelines for exercise prescription after pleural resection surgeries. The present study aimed to determine the effect of an individualized postoperative physiotherapy program on a patient who underwent pleurectomy.

A 19-year-old female patient was admitted to Kasturba Medical College, Mangalore in February 2019. She was diagnosed with right spontaneous pneumothorax; then, she underwent bullae repair and pleurectomy and was given a 7-day individualized postoperative physiotherapy. The severity of dyspnoea, chest expansion, and right shoulder range of motion was recorded on postoperative day 2 and the day of discharge; the six-minute walk distance was measured on postoperative day 4 and the day of discharge.

Significant improvements in all the outcomes were found after the individualized post-operative physiotherapy program in the reported patient.

The provided individualized 7-day physiotherapy program improved the chest expansion, shoulder range of motion, rating of perceived exertion scores, and functional capacity in the reported patient who underwent bullae repair and pleurectomy.

Central Pontine Myelinosis (CPM) and Extra Pontine Myelinosis (EPM) are debilitating conditions, resulting from the rapid correction of hyponatremia. The outcome and prognosis of this medical condition are variable; mainly involving functional decline from neuro-musculoskeletal upset. An intensive, multidisciplinary rehabilitation has played an essential role in facilitating and hasten recovery, promoting a favorable outcome. We reported our experience in rehabilitating a patient with a rare condition of comorbid CPM and EPM. The reported patient presented with disabling Locked-in Syndrome (LIS) and Parkinsonism movement disorder. We highlighted the stepwise rehabilitation approach according to Patterson and Grabois Motor Recovery scale for LIS in preventing and reversing the complications and disabilities caused by CPM and EPM that may facilitate favorable therapeutic outcomes.