Iranian Rehabilitation Journal
Volume:11 Issue: 18, Apr 2013

In this study, we examined the effect of botulinum toxin A (BTA) on chronic allergic rhinitis (CAR). We tested the effects of BTA, applied to an intranasal sponge, on patients who had CAR for a minimum of three years and had been treated unsuccessfully with conventional medications. The study was an interventional case-control single-blind randomized clinical trial. Forty-four male and female CAR patients who were referred to Tehran’s Saee & Pasargad Hospitals, and Saadat-Abaad, Sarv and Karimkhan Clinics in 2012; aged 20-40 years were selected on the basis of inclusion and exclusion criteria. The subjects were randomly assigned to the intervention (n=22) or control group (n=22). The intervention group received BTA (100 IU/ml; Dysport), on a 5cm nasal sponge retained in each nasal cavity for 30 minutes. The control group received normal saline. The groups were evaluated by the same examiner. Pre- and post-tests (1, 3, 6, and 12 weeks) were performed according to the authors’ pre-designed checklist, the validity and reliability of which was previously established. The symptoms scored from none (0) to severe (10) at the test points. The statistical analysis was conducted with SPSS-19, with a significance level of 0.05. Based on ANOVA, there was a significant difference (P<0.05) in symptomatic relief between the intervention and control groups. No marked adverse effects were observed during the study. An intranasal 5cm sponge impregnated with 100 IU/ml BTA, retained in each nasal cavity for 30 minutes, may alleviate CAR symptoms with no significant adverse effects.

Tourette syndrome is a disease with vocal and motor tics. This disorder is co-morbid with many psychiatric disorders, among which obsessive-compulsive disorder is the most common. During a one-year period, 30 patients with Tourette disorder were studied at an adolescent psychiatry referral clinic. It was an analytical-descriptive study. Subjects were selected by convenience sampling. The control group was selected from students in Tehran schools similar to the first group in terms of age and gender. K-SADS questionnaire was used to examine the existence of obsessive-compulsive disorder in both groups. The results were analyzed with SPSS software. The apparent co-morbidity of obsessive-compulsive disorder and Tourette syndrome was seen in this study, such that 53% of patients affected with it had obsessive-compulsive disorder. Statistics obtained was higher compared to earlier data. Although this co-morbidity was somewhat different in the two genders, it was not considered statistically significant (80% girls and 48% boys). More focus should be laid upon the co-morbidity between Tourette and OCD. It is recommended to study patients with Tourette syndromemore extensively in terms of co-morbidity with other psychiatric disorders, especially the obsessive-compulsive disorder.

Increasingly people are using the internet to find information about medical and educational issues and one of the simplest ways to obtain information is internet. Persian Cued Speech is a very new system to Iranian families with deaf child and the professionals and a few educators have enough knowledge about it, so the purpose of this study was to introduce Persian Cued Speech website to deaf educators and rehabilitation professionals and assess their views about the website and their accessibility to important information through its use. The sample group was randomly selected fromdeaf educators and rehabilitation professionals working in different educational settings for deaf children in Tehran, our capital. They completed a questionnaire which was adopted from different website assessing questionnaires. Researchers also completed an interview with the sample group. Our findings show that from the deaf educators and rehabilitation professionals point of view,the Persian Cued Speech website was a helpful and informing website. They also wanted more pictures and videos,bigger font sizes and more practical parts.So we decide to change some parts of the website to be more usable for them. Using informational websites can be a very helpful tool in the internet area. Helpful websites are those which are more accessible, readable and appropriately designed and are user-friendly.

The aim of this study was to determine the prevalence of flat foot in a population of 7-12 year old students and to investigate the relationship between flat foot and age and sex.In this cross-sectional study, a total of 945 students (460 girls and 485 boys) were examined. The presence of flatfoot and the degree of its severity according to Tachdjian''s system of grading for flatfoot was assessed. The data showed that the overall prevalence of flat foot was 74% out of which 23% were mild, 34% were moderate and 17% were severe. The prevalence of flat foot in girl and boy students were 75.2% and 72.6% respectively, but this difference was not significant. Moreover, no significant relationship was observed between the prevalence of flat foot and age. This study showed that flat foot is a common problem among primary school students and should be addressed by responsible organizations.

Wheelchairs are the prime mobility aid of persons with spinal cord injuries. Manual wheelchair propulsion puts a lot of demand on the cardiopulmonary as well as the skeletal system. The main purpose of the study was to compare the effects of both arm ergometry training and progressive resistance exercise training of upper limbs on resting heart rate and distance covered during wheelchair propulsion in paraplegics. A convenience sample of 30 male subjects took were randomly assigned to two groups. Participants were spinal cord injured patients recruited from the Indian Spinal Injuries Centre, New Delhi. Each group consisted of 15 subjects. Group 1 received arm ergometrytraining and group 2 received progressive resistance exercise training. The resting heart rate and distance covered during wheelchair propulsion in a 3 minutes task ofthe wheelchair circuit was measured before and after 4 weeks of training. The post intervention resting heart rate and distance covered during wheelchair propulsion after 4 weeks between the two groups showed significant differences. In group 1, resting heart rate was 77.53±3.52 beats/min and in group 2 resting heart rate was 82.33±3.69 beats/min (mean±SD). In group 1, the distance covered during wheelchair propulsion was 305.19±17.21 meters and in group 2 it was 250.71+20.59 meters. The arm ergometry training may be a better choice of exercise for improving the cardiovascular and functional aspect of spinal cord injury patients who are dependent on wheelchairs for mobility.

Stuttering is one of the most prevalent speech and language disorders. Symptomology of stuttering has been surveyed from different aspects such as biological, developmental, environmental, emotional, learning and linguistic. Previous researches in English-speaking people have suggested that some linguistic features such as word meanings may play a role in the frequency of speech non-fluency in people who stutter. The aim of this study was to determine the effect of word meanings on the frequency of dysfluency in Persian-speaking adults with developmental stuttering. This cross-sectional descriptive-analytic study was performed on 14 adults who stuttered. Their average age was 25 years. The frequency of non-fluency instances was evaluated upon reading two lists containing 60 words and 60 non-words. The words were selected on the basis of common Persian syllable structures. ‘Kolmogoro-Smirnov one sample test’ and paired t-test was used to analyze data; the significance level was set at P < 0.05. There was a significant difference between the dysfluency in word and non-word lists (p<0.05). The findings of this study indicate a significant increase in the frequency of dysfluency on non-words than on real words. It seems that the phonological encodingprocess of non-word reading is much more complex than for word reading, because, in non-word reading, the component of semantic content retrieval (word meaning) is missing when compared to word reading.

The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR) alters patients’ knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS) Questionnaire to ensure thateach subject was placed in the right group. The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.

This study aimed to investigate the level of problem-solving skills in 1-4 year-old children with early treated phenylketonuria (ETPKU). This analytic, cross-sectional study was conducted on 70 1-4 year-old children referred to phenylketonuria (PKU) clinics that had been diagnosed on screening at birth and had been treated. The measurements were a demographic questionnaire, Ages & Stages Questionnaire (ASQ) and clinical assessment by a pediatrician. One hundred children were also selected randomly from Tehran’s kindergartens as the control group, who also completed the above questionnaires. Data were analyzed by SPSS 19.0 software. The mean age of the children was 29.71 months in the control group and 28.51 months in the case group. There were no significant differences between the two groups regarding the type of delivery and the current and birth heights, weights and headcircumferences. There was a significant difference between the two groups regarding problem-solving developmental skills (P <0.000). The level of problem-solving developmental skills in the children with ETPKU was lower than normal children. It seems that Iranian children with ETPKU, regardless of being on a diet, have lower problem-solving skills. It is recommended to revise their diet and treatment and also to plan programs for early detection, and to carry out interventions for developmental delays in these children.

Falling is a common problem among the elderly. Falling indoors and outdoors is highly prevalent among the Iranian elderly. Therefore, identification of the contributing factors at home and their modification can reduce falls and subsequent injuries inthe elderly. The goal of this study was to identify the elderly at risk of fall, using the ‘Home Falls and Accident Screening Tool’ (HOME FAST), and to determine the reliability of this tool.

Sixty old people were selected from five geographical regions of Tehran through the Local Town Councils. Participants were aged 60 to 65 years, and HOME FAST was used to assess inter rater and test- retest reliability.

Test-retest reliability in the study showed that agreement between the items of the Persian version of HOME FAST was over 0.8, which is a very good reliability. The agreement between the domains was 0.65-1.00, indicative of moderate to high reliability. Moreover, the Inter rater reliability of the items was over 0.8, which is also very good. The correlation of each item between the domains was 0.01-1.00, which shows poor to high reliability.

This study showed that the reliability of the Persian version of HOME FAST is high. This tool can therefore be used as an appropriate screening tool by professionals to take necessary preventive measures for the Iranian elderly population.

This study used a quasi-experimental method inthe pretest-posttest to evaluate the efficacy of cognitive-existential group therapy on hopefulness in parents of children with cancer. Thirty parents (24 to 54 years old) of children with cancer were divided randomly into experimental and control groups. Both groups were assessed with Miller Hope Scale (1988), as pre-test. The experimental group received cognitive-existential group therapy in 12 sessions, each lasting 90 minutes (2 sessions per week), but no psychological intervention was applied to the control group. At the end of the intervention, both groups were reassessed through post-test. Data were analyzed by SPSS through analysis of covariance. Significant differences in hopefulness between the two groups (p<0.01) were observed in favor of the experimental group. Cognitive-existential group therapy can be effective in increasing hopefulness in parents of children with cancer.

The aim of this study was to examine the effectiveness of psychotherapy based on acceptance and commitment therapy (ACT) on the subscales of marital satisfaction; overall satisfaction, religious orientation, relations with children, sex, occasional conflicts, interpersonal conflicts and arrogance, by single case study in the spouses of veterans with spinal cord injuries. Participants completed Enrich marital satisfaction questionnaire at baseline (3 to 6 weeks), during six session’s psychotherapy and the two-month follow-up. Analysis method of charting and visual analysis of the results showed that the (ACT) is an effective therapeutic approach to 4 marital satisfaction subscales but second and third participant didn’t show any improvement.. Considering the above, (ACT) is an effective therapeutic approach to overall satisfaction, occasional conflicts, relations with children and interpersonal conflicts.

Hypertonicity is the most common type of cerebral palsy consists of 85% of the affected children. It has a very complex nature making intervention and management very difficult. This article tries to make reader familiar with various types of intervention and introduce a new intervention process to help clinicians decide better. Literature was reviewed with two criteria including: identifying various interventions and their effects on upper limb hypertonicity and level ofinvasiveness of each intervention. This paper suggested a new way of looking at hypertonicitybased on its two components (i.e., neural and biomechanical) and effectiveness of each intervention on these components. In the treatment and management of hypertonicity, clinicians are required tolook at all aspects of hypertonicity and then based on the provided decision tree, decide which kind of treatment to be used for the child.

The aim of this single case study is to describe a child with Landau Kleffner Syndrome who misdiagnosed as a child with autism spectrum disorder. We also explore occupational therapy`s role in correct process for diagnosis and treatment. Three times measurement with Autism Treatment Evaluation Checklist was performed to measure severity of symptoms and compare treatment outcomes. The outcome showed great improvements after pharmacotherapy. Results of this study indicated that correct diagnosis, early detection and early intervention in this disorder are essential to reach a proper treatment. Of course, therapeutic team work is crucial as well. Occupational and speech therapy interventions can also been recommended as a helpful treatment to improve social and sensory-motor and communicative skills. Parent`s consultation should not be ignored to decrease parental stress.