Journal of Modern Rehabilitation
Volume:12 Issue: 3, Summer 2018

Autism spectrum is a lifelong neural growth disorder, manifested as problems in social interaction, communication, and imagination along with limited and repetitive behaviors and interests. Furthermore, autistic children show clear defects in imitation skill. Acquiring imitation skill plays a vital role in the growth of social communication such as language, common attention, and play. Given the increasing prevalence of autism in advanced societies and lack of speech therapies for language enhancement and the role of imitation in the development of language, the purpose of this study is to evaluate recent studies in the field of mimicking effects on the different aspects of language in autistic children and determining the most effective and appropriate way of teaching imitation to improve the language and communication skills in these children. This research is a review study aimed at collecting the relevant data from 2000 to 2017 in the field of imitation and its impact on language and communication in children with autism by searching the Google Scholar, Science Direct, Scopus, PubMed, SID, and IranMedex databases. In this article, 13 related studies were found from 2000 to 2017. Out of these studies, two studies were carried out in Iran, and 11 other studies in other countries. Two research studies compared imitation ability of autistic children with other disorders, and other studies examined the effect of imitation on different aspects of language acquisition. All studies have shown that imitation influences on different aspects of language acquisition and enhances pre-lingual communication, such as the infant’s gaze at mother’s eyes, development of perception and expression language, improvement of understanding language application skills and syntax, including the number of verbs and the increase of the verbal production of vocabulary and the phrase.

Employment of braces can increase the standing stability by external support of the joints. Examining the effects of different braces, specifically in numerous static postures is practically difficult; therefore, the current parametric study aimed at modeling the alterations of the muscular recruitment patterns during static postures caused by wearing different braces. A biomechanical model of the musculoskeletal system was employed to simulate over 27,000 standing postures with different joint angles and brace conditions. Activation of the muscles in standing posture was calculated using optimized inverse dynamics. The postures with muscle efforts beyond the physiological limit were considered as the feasible postures. Braces increased the number of feasible postures. However, their effects depended on the joint angles. Knee flexion assisted in providing balance for more postures. The maximum number of feasible postures occurred in midrange knee flexion (30 degrees). High and low stiffness braces caused relatively similar outcomes. Wearing the upper joint braces (knee or hip) relieved the ankle joint muscles and prominently recruited the knee muscles to maintain the balance. Results also suggested that if an individual, in practice, intended to wear only one brace to have the most efficient support in balance, the ankle brace was the best choice. Braces can assist in providing balance for the quiet standing condition. It is better to let knee joint rotate and support the ankle by braces.

Type 2 diabetes is one of the major causes of progressive microvascular and macro vascular complications leading to retinopathy, nephropathy, and neuropathy as well pulmonary complications due to changes in collagen, elastin, and micro angiopathy. The current study aimed at assessing some respiratory indices in patients with type 2 diabetes and the possible relationships between these parameters and the level of blood glucose control and duration of diabetes. In the current descriptive-analytical study, 20 patients with type 2 diabetes were compared with 20 matched healthy subjects. The information of the respiratory system was collected using a chronograph. Parameters for assessment were respiration rate, heartbeats, and oxygen saturation percentage. The results of the study showed a significant reduction in end-expiratory carbon dioxide pressure and increased respiratory rate in the patients compared to the control group. The results also showed a strong and inverse relationship between hemoglobin A1c (HbA1c) and respiratory indices. The duration of having diabetes had a negative significant relationship with respiratory indices. In general, the results of the study indicated that lung function is impaired in people with type 2 diabetes. According to the results of the current study, a proposal for a program to facilitate or prevent lung function impairment for these patients is suggested.

The current study aimed at determining the feasibility of using Blended Learning in the curriculum of speech therapy at Tehran University of Medical Sciences. The subjects consisted of 48 undergraduate students, 25 undergraduate students, 22 PhD. students, and six faculty members selected by random sampling method using Morgan table. Faculty members were also counted. A researcher-made hybrid learning questionnaire was employed to collect data. In the descriptive section, frequency distribution tables, charting, and calculation of central and distribution indices were employed. In the inferential statistics, the Kolmogorov-Smirnov test was employed to investigate the normal distribution of the variables, and the single-sample t-test to evaluate the research hypotheses. The results of the evaluation showed that Blended Learning speech therapy curriculum was very important in the combination of speech learning, but from the point of view of speech therapy respondents, the Blended Learning is less used now. In this regard, the students of the Department of Speech Therapy, Tehran University of Medical Sciences, believed that the combination of high-quality learning speech therapy was of high importance. On the other hand, the highest importance from the viewpoint of the students and faculty members of the Faculty of Rehabilitation, Tehran University of Medical Sciences, was related to educational goals.

In 1996, American Speech-Language-Hearing Association (ASHA) introduced the need for an appropriate screening tool for Auditory Processing Disorder (APD). Questionnaires are one of the tools to screen APD, of which the most frequent one is the Fisher auditory checklist. The current study aimed at translating and determining the validity and reliability of the Persian version of the Fisher checklist. The current checklist developing study was conducted on 25 children (12 males and 13 females) aged 8 to 12 years (Mean±SD=9.4±1. 3) with APD as the case group, and 25 normal children (14 males and 11 females) aged 8 to 12 years (Mean±SD=9.5±1.4) as the control group. The translation process was performed according to international guidelines. Indicators of formal validity, test-retest reliability, and internal consistency of the questionnaire were assessed. Then, to check the effectiveness of the questionnaire to identify children with APD and normal children, the checklist was examined along with paired Dichotic Digit Test (DDT) and Word in Noise Tests (WNT). The average score of the Persian version of the Fisher checklist was 46.6±16.7 in the case group and 94.7±12.5 in the control group. The Cronbach’s alpha for the Fisher checklist at the test stage was 0.827 and in the retest stage, the Cronbach’s alpha in the patient group was 0.845 and in the control group was 0.709. The Intraclass Correlation Coefficient (ICC) values in the case and control groups were 0.708 and 0.744, respectively. According to the results of DDT and WNT, the Persian version of the Fisher checklist had face validity (face value: 3.4) and intrinsic reliability of APD detection.

Osteoarthritis (OA) is one of the common causes of disabilities in adults. The prevalence of Knee Osteoarthritis (KOA) is approximately 4.9% among people over 26, 16.7% among people over 45, and 12.1% among people over 60 years old. This study aims to determine the effects of Low-Level Laser Therapy (LLLT) and laser acupuncture in decreasing pain and increasing functional activity in patients with subacute and chronic KOA. In this randomized, single-blind, controlled study, the patients with grades 2 and 3 primary KOA were assigned into two experimental groups (active low-level laser and acupuncture laser) and one control group (infrared & exercise). The patients in the experimental group I (n=23) were under low-level Ga-Al–As diode laser, 830-nm continuous waves, and received laser irradiation of 30 mW/cm2 power density, 3 mW output power, 0.1 cm2 spot size, with a total dose of 18 J and for 10 minutes on 6 acupuncture points (SP10, ST34, ST35, GB34, Xiyan, SP9) around the knee in each session. The patients in the experimental group II (n=23) received 3 J power irradiation in each cm2 in a gridding technique over a triangle-like surface of 15 cm2 over the medial, lateral, and anterior sides of the knee with a total energy density of 45 J/15 cm2 for each session. Laser therapy was applied 5 times per week for a period of two weeks (10 sessions in total). The patients in the control group (group III) were under conventional physiotherapy (superficial heat therapy and isometric knee exercises for 15 minutes every day for a similar period (10 sessions in 2 weeks). The outcome study measures were pain level at rest rated by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and Short Form of McGill Pain Questionnaire (SF-MPQ). In addition, active knee flexion and extension Range of Motions (ROMs) were measured too. These variables were evaluated at the baseline time, before the intervention, and after the intervention, on the final day of the intervention. Based on statistical outcomes, a significant pain reduction by NRS and McGill, an increase in functional activity by WOMAC as well as an increase in the Range of Motion of the knee were observed in three study groups after 10 sessions. However, the result of ANOVA test showed significant difference in pain reduction among three groups and the post hoc Least Significant Difference (LSD) test showed the significant difference between laser acupuncture and conventional laser groups with the control group; the largest improvement was found in Group I. In terms of functional activity, the post hoc LSD test showed the significant difference between conventional laser and laser acupuncture groups with the control group; the largest improvement was found in Group II. No significant difference was observed among the three groups with regard to the mean values of active knee flexion and extension. Laser acupuncture and conventional laser are more effective in reducing pain and increasing functional activity in patients with KOA compared to conventional treatment. Clinically, laser acupuncture would appear to be superior in pain reduction.

Flexibility is considered as one of the most significant components of rehabilitation protocols including two definitions: static flexibility measured by the Range of Motion, and dynamic flexibility measured by stiffness. Generally, a normal flexibility is necessary for an appropriate posture and flawless activity in daily life. With regard to various methods that contribute to increasing flexibility of hamstring muscles, the current study aimed at investigating immediate effects of Muscle Energy Technique (MET) on hamstring flexibility and stiffness in healthy young females Ten healthy young females with the mean age of 22.5±2.67 years old participated in the study. Flexibility was measured via active knee extension and modified sit-and-reach test, and stiffness was measured based on the ratio of torque to angular changes via Biodex System 3 before and after MET interventions by post-isometric relaxation method. The amounts of active knee extension and modified sit-and-reach tests significantly increased after MET intervention; the amounts of active knee extension and modified sit-and-reach increased significantly (P<0.001). Moreover, the estimated hamstring stiffness decreased significantly in comparison with its values before treatment (P<0.001) The results of this study indicated that MET may improve hamstring flexibility as well as its stiffness.

Developmental disorders consist of a broad spectrum of chronic and life-long disorders resulted from mental or physical deficits; therefore, they may affect daily experiences. The current study aimed at evaluating parental stress modeling based on self-conscious affect (shame and guilt) of parents and family performance. It was considered a correlational study based on structural equations modeling. Statistical population consisted with all mothers of children with autism spectrum disorders studied in the autistic schools in Tehran. In the current study, 250 mothers of children with autism spectrum disorders were selected by random convenience method, then they were evaluated by parental stress index-short form, test of self-conscious affect, and family performance questionnaire. Data were analyzed with SPSS version 24 and AMOS 23. Findings of the study suggested that 51% of parental stress was explained by self-conscious affect (shame and guilt) of parents as well as family performance. Also, indirect way of self-conscious affect (shame and guilt) of parents, with mediating family performance on parental stress, was supported given to maximum leveling and as general, this model was supported. The current study results showed that focusing on self-conscious affect (shame and guilt) of parents as well as family performance and also emphasizing on parental stress of parents with autistic child and coping strategies may have significant effects on decreasing the stress and vulnerability of this population.