فصلنامه طب توانبخشی
سال یکم شماره 1 (بهار 1391)

The present study was conducted to identify the effect of imaginary exercises on electrical activity of the shoulder muscles. Twenty three healthy subjects (17 females and 6 males) with no history of shoulder injury participated in this quasi experimental study. Surface EMG was recorded by bipolar electrodes that were applied over the supraspinatus, infraspinatus, posterior deltoid, middle deltoid, anterior deltoid and pectoralis major. Subjects performed 6 imaginary exercises including imagination of flexion, extension, abduction, adduction, external rotation and internal rotation. The amount of RMS obtained in EMG while exercising was compared with the one obtained at rest. Performing the imaginary exercises resulted in significant activation (P < 0.01) of the shoulder muscles. In the case of the supraspinatus muscle, a significant difference (P < 0.05) was found between exercise type and intensity of activation but no significant value was seen for infraspinatus muscle. In flexion, abduction, adduction & internal rotation imaginary exercises, correlation between muscles activation was also statistically significant (P<0.01). Imaginary exercises can be used as alternative means and the first step for shoulder muscles rehabilitation specialty when the movement of the joint is contradicted.

Different diseases can be the cause of low vision. In the case of low vision, visual acuity with conventional optical devices such as glasses and contact lenses is between” 20/70 to 20/200”. To improve the visual performance in these patients, low vision aids are prescribed.The types of prescribed low vision aids vary in different diseases. The purpose of this study is to determine the type and frequency of optical aids prescribed for low vision patients examined in optometry clinic of Rehabilitation faculty of shahid Beheshti University in 1387. In this retrospective cross-sectional study, 204 low vision patients went under investigation. In the present study variables including type and rate of refractive error, visual acuity with the best correction, type of diseases and type of prescribed optical low vision aids were investigated. The frequency of prescribed distance glasses in diabetic retinopathy was 97%, age related macular degeneration 86.2%, Stargarts 92%, retinitis pigmentosa 86.4% and albinism 88.2%, Also the frequency of prescribed microscope in diabetic retinopathy was 81.82%, age related macular degeneration 48.27%, Stargarts 40%, retinitis pigmentosa 35.3%, albinism 35.3% and the frequency of prescribed magnifier in diabetic retinopathy was18.18%, age related macular degeneration 24.12%, Stargarts 52%, retinitis pigmentosa18.18% and albinism 29.4%. In many low vision conditions, it is more suitable to prescribe distance glasses rather than telescope. In this study the distance glass with the frequency of 84.8% is seen more acceptable in comparison with the telescope with the frequency of 41.7%. Among near optical low vision aids, microscope with the frequency of 50.5% is more accepted by the patients compared to magnifier with the frequency of 26% and CCTV with the frequency of 0.50%.

Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS) Therapy and the routine physiotherapy (PT) protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis. 69 patients (62 females & 7 males) with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old) and the routine PT protocol (n=32, mean age: 61±14 years old) groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up). The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded. In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P<0.05). Visual Analogue Pain Scale (VAPS) indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P<0.05). It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P<0.05). A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4). The findings of this study showed significantly better results following the use of APS therapy protocol relative to the routine PT protocol in patients with knee osteoarthritis and hence are recommended to these patients.

Knee osteoarthritis is the most common cause of disability in many societies. Therapeutic measures such as using anti-inflammation drugs and physiotherapy programs have been used to suppress knee pain and improve knee joint function in patients with knee osteoarthritis. The aim of this study was to compare the effects of iontophoresis of piroxicam gel, galvanic current with or without piroxicam gel on pain, functional ability and knee muscle strength in patients with knee osteoarthritis. This study was a clinical trial conducted in Akhtar hospital. Forty two female patients (mean age 58.52 years old) with knee osteoarthritis participated in this study. The protocol was performed in Physiotherapy Clinic of Mazandaran Medical University, Mazandaran, Iran. All patients were randomly assigned to three groups. Iontophoresis of piroxicam gel was applied for group 1 (n=14), proxicam gel for group 2 (n=14) and galvanic current for group 3 (n=14). The procedure was carried out for 20-minutes, three times a week and for two following weeks. Knee pain and functional ability were estimated by knee injury and osteoarthritis outcome score (KOOS) questioner and the strength of knee extensor and flexor muscles by an isometric device just before the first treatment and immediately after the last treatment times. A significant decrease in pain and a significant increase in functional ability and the strength of knee extensor muscles were resulted in all studied groups (P < 0.05). According to ANOVA test, the level of the percentage difference which was computed for KOOS and knee muscle strength before and after treatments was significantly higher in group 1 than the other two (P < 0.01). Pain and knee functional ability were significantly improved in patients in all three methods. But iontophoresis of piroxicam gel appeared to be more effective in relieving pain and improving knee functional abilities than the application of galvanic current or piroxicam gel alone. Iontophoresis facilitated the transmission of piroxicam gel through the skin.

High levels of job stress experienced over time, as well as personal frustration and inadequate coping skills, can lead to the syndrome known as burnout. In it has been shown in several surveys that high job stress in occupational therapists could lead to the burnout syndrome. Since few studies have been conducted in Iran concerning burnout in occupational therapists, we felt the necessity of performing this study to make Iranian therapists more aware of the syndrome and its related factors. A cross sectional survey was carried out on 87 Iranian occupational therapists in the current study. A questionnaire consisting of two parts (demographic dates & maslach burnout inventory) was sent to all therapists who were members of medical organization. 80.4% of therapists reported mild to moderate symptoms of burnout, while nobody has reported severe burn out. Low job satisfaction (P value=0.038) and job experience less than 5 years (P value=0.049) were the two variables associated significantly with burnout. In the present study high rate prevalence of burnout shows that occupational therapists in Iran are not in a good health state and it can indicate that Iran health system should pay more attention to this group. According to our study the early years of a therapist’s carrier are the period when the therapist is at risk of burnout. So we believe that students should be given more information about burnout syndrome and its coping mechanisms during their education at the university.

Carpal tunnel syndrome is common among handicapped people using wheelchair, and repeated wrist movements increase the risk of incidence of this syndrome. In present study, performance, pain and range of motion of wrist were compared between the athletes and non-athlete handicapped people suffering from carpal tunnel syndrome. In this descriptive study, all members of handicapped basketball team in Tehran (35 persons) and 33 wheelchair-bound non-athlete handicapped persons residing in Tehran sanitariums were studied (similar with respect to age, weight, height, years of using wheelchair and level of disability).In this study, Clinical Questionnaire and Nerve Conduction Study were used for diagnosing carpal tunnel syndrome, VAS Scale for measuring pain, Goniometer for measuring range of motion of wrist, and Self-Administered Questionnaire for investigating severity of symptoms and performance. The finings of this study indicated that there was no significant difference between two athlete and non-athlete handicapped groups with carpal tunnel syndrome in prevalence of carpal tunnel syndrome, severity of pain, performance and range of motion of wrist (p>0.05). Among 35 athletes, 6 persons (mean age: 36±3.11, mean weight: 68±4.74 and mean height: 172±7) and among 33 non-athletes, 5 persons (mean age: 41±7.1, mean weight: 73±3 and mean height: 173±5) had carpal tunnel syndrome. Unlike what is supposed, repeated movements of wrist is not the only factor predisposing the athlete handicapped people to carpal tunnel syndrome, So other influencing factors should be considered.

The purpose of this study is to investigate the effect of group social skill training on drug abuse treatment prognosis.

To achieve this goal, 20 available subjects residing at Tehran Clinic were selected. These subjects were randomly assigned into two experimental and control groups. The experimental group participated in ten 2-hour sessions and were trained social skills, and the control group was in the waiting list. Measurement tools consisted of ACIS Questionnaire and laboratory test; Both experimental and control groups were subjected to pre and post tests. Data were analyzed using paired t test, independent t test, Mann-Whitney u test.

Results indicated that, the communication and interaction skills in experimental group had improved significantly in comparison with control group, also in the control group of a person suffering from lapse, but none of those two groups relapsed after 1- month follow up.

According to our results it can be concluded that social skills training can be used as a suitable tool to increase communication and interaction skills.

Slow handwriting speed is one of the major problems encountered by school-aged children having handwriting difficulties. These children are often referred to occupational therapy for assessment and intervention. However, to date, no norms of handwriting speed have been published for the Iranian writing system for school-aged children. The purpose of this study was to document handwriting speed performance of Tehran children from Grades 2 to 5. Participants were 400 children from Grades 2 to 5 from 20 elementary schools in Tehran. Participants were asked to copy text that was printed at the top of page on the writing lines below with normal speed at 5 minutes. Then, the sheets were gathered and number of letters written, were calculated by Two raters. There for, Scores of 120 students rated as fast, normal or slow by their teachers were compared to examine the test's construct validity Results showed that 50% of children were boys and 50% were girls. And 75% of children were studied in governmental schools and 25% of them were studied in nongovernmental schools. And 80% children were Right-handed and 20% were left-handed. Results showed that handwriting speed increased with age; and the rate of increase was found to be greatest among Grade 5. And handwriting speed assessment test has excellent inter-rater reliability (r=1, p=0.000) and construct validity (r=0/798, p=0.000).