فصلنامه طب توانبخشی
سال هفتم شماره 3 (پاییز 1397)

Exersices for improving the accuracy of proprioception, as a risk factor in the most common site of injury, i.e. knee, and rehabilitation to prevent further injury and improving function, is required. The purpose of the current study was to investigate the effect of plyometric hopping and box jump for six weeks on the knee joint position of male individuals with ACL reconstruction. A total of 40 males with ACL reconstruction (mean±SD; age: 27.88±1.62 year, weight: 79.9±10.28 kg, height: 1.77±0.05 meter) were objectively selected. Participants were randomly divided into three groups: hopping (n=14), box jump (n=13), and control group (n=13). Prior to and six weeks after the exercises (three sessions per week), at the same time and place, joint positions were recorded using a digital camera and the data was analysed using Auto CAD softwear. The control group did not perform any intervention program. Mixed repetead measure ANOVA was used for data analysis. The results showed significant improvement from pre-test to post-test in joint position at 45º (p=0.002) and 60º(p=0.046) in hopping group and at 45º (p=0.001) in box jump group. No significat improvement was observed in other angles (p>0.05). No differnces in the joint position was found between hopping and box jump training groups (P=1/001) either. But a significant difference was found between the two hopping and box jump groups and control group (P=0/001). It can be concluded that hopping and box jump exercises are useful to improve propriocpetion at 45º among male individuals with ACL reconstruction. However, it seems that hopping exercise is more benfitial compared with box jump exercise in improving joint position at 60º.

Real ear measurement is the most prevalent way of verifying hearing aids in children and adults. Recently, auditory evoked potentials have been used to assess the accuracy of fitting in infants and young children who could not present decent behavioral feedbacks. In the present study, the real ear measurement responses of hearing aids fitted with cortical responses are compared with NAL-NL2 formula. A total of 10 children suffering from moderate to severe hearing loss in the age group of 2 to 4 years were selected. At first, real ear measurement responses were obtained from hearing aids which were fitted with cortical responses and then they were compared with the target of NAL-NL2. Hearing aids which were fitted with cortical responses presented more gain in comparison with NAL-NL2 formula. The amount of P-value was lower than 0/005 in all frequencies and intensities except in the frequency of 500Hz in low intensity level and 4KHz in high intensity level. There was a significant difference in almost all frequencies and intensities between real ear measurement responses and the responses of NAL-NL2 formula (P-Value<0/05). In the current study, real ear response of hearing aids fitted with cortical responses and NAL-NL2 formula were compared. The results showed a significant difference in almost all frequencies and three levels of intensities between real ear responses of hearing aids, which was fitted with cortical responses, and NAL-NL2 formula.

Children with cerebral palsy require a constant care because of their long-term complications. Thus, taking care of them can affect physical and mental health of their caregivers. The aim of the present study was to investigate the effectiveness of handling training program on caregivers’ quality of life working in care centers for children with cerebral palsy. In the current semi-experimental interventional study, 60 caregivers were selected supervised by Welfare Organization of Tehran according to the related inclusion criteria and divided into intervention (30 participants) and control (30 participants) groups. Demographic questionnaire and SF-36 were used for data collection three months prior to and after presenting handling training program. The training session were conducted theoretically and practically in two days and each day with 15 caregivers. Statistical analyses were carried out using SPSS, version 22. The mean age and standard deviation of caregivers in intervention and control group were (43/57±10/84) and (42/50±9/22), respectively. The comparison of the mean scores between the two groups showed that the quality of life of the caregiver in the intervention group significantly increased three months after receiving handling training in all dimensions of SF-36 except for social function (p <0.05). Providing the caregivers with proper handling training program can decrease their job and physical stress and improve both their and the children’ quality of life, well-being, and health.

The present study aimed to investigate the effects of a-tDCS on pain score in women with Chronic Low Back Pain (CLBP). A total of 10 women with CLBP participated in the current double-blind sham-controlled cross-over study. Each participant received one session of a 20-minute, 0.3 mA tDCS with a current density of 0.1mA/cm2 on M1 and DLPFC, concurrently. Pain intensity and electrical pain threshold were assessed immediately prior to and after the treatment. In addition, the disability was assessed before and one week after the treatment. Shapiro-Wilks goodness-of-fit test was used for normality and dependent t-Test was used for data analysis. Values of p ≤ 0.05 were considered as statistically significant. The results showed no effect of active or sham treatment on the pain intensity, disability, and pain threshold (p>0.05). The mean difference between before and after active treatment were 0.9 (p=0.7) for pain, 5.6 (p=0.7) for disability, and-0/16 for pain threshold (p=0.1). These values were 0.4, 2.4, and -0.73 for sham treatment with p-value greater than 0.05. The method studied proved to have no significant effect on pain intensity of women suffering from CLBP; however, this finding may be related to the limited sessions of the treatment.

Ankle joint is known as one of the most vulnerable joints of the body. The aim of the present study was to compare the impacts and sustainabilities of NASM and combined excersices (neuromuscular and core stability) on the functional charactristics and balance of individuals with unilateral chronic ankle injury. A total of 36 male athlete students suffering from chronic ankle instability voluntarily participated in the present study and were randomly divided into three groups of 12: NASM excersices, combined training, and the control group. All the participants’ performance characteristics and dynamic balance were evaluated prior to, after, and four weeks after the exercises. To evaluate the functional characteristics, we used Side-to-Side Hop Test, Figure-eight Hop Test, Triple Hop Test, and questionnaires measuring the ability of the foot and ankle in sports and daily activities and to evaluate the dynamic balance, the balance test Y was used. Then, the NASM and combined groups performed the relevant exercises. The results showed that both NASM and compound exercises caused improvement in the dependent variables. Also, NASM exercises had lasting impacts four weeks after the exercise protocol in indicators of figure-eight hop test and the ability of ankle and foot test. Also, combination exercise had lasting effects observed in side-to-side hop test, figure-eight hop test, and the ability of ankle and foot scale. The results also showed that compound exercises, as compared with NASM exercises, were more effective as observed in the ability of the ankle and foot test. Doing eight weeks of combined training (neuromuscular and core stability) was observed to be significantly more effective, compared with NASM training, in the performance and postural control in patients with chronic ankle instability.

Developmental Coordination Disorders (DCD) is one of the most common disorders affecting 5-8 year-old children. The purpose of the present study was to investigate the effects of training and different background interference (blocked and random practice) on sensory-motor functions in children with growth coordination disorder aged 6-9 years in Mashhad city. Among all children with growth coordination disorder in Mashhad, 45 were selected using screening tests (Developmental Coordination Disorder Questionnare, IQ). After completing Conner neuropsychological testing questionnaire as pre-test, they were randomly divided into three groups of 15: block practice, random practice, and control groups. The three groups performed the relvant trainings for 8 weeks (3 sessions per week, each session 45 minutes). Then, post-test, i.e. Connors neuropsychological questionnaire was administered. Shapiro Wilk test was used to check the normality and t-test and analysis of covariance (ANCOVA) were run to determine intra-group and inter-group differences, respectively. The results showed that there is a significant difference between pre-test and post-test scores in the two groups' study variables. However, no significant difference was observed between the mean scores of pre-test and post-test for control group. The findings also showed that there is a significant difference between the two groups with different training contextualinterferences. Also, the training group with more background interference was observed to have further improvement in sensory-motor functions after training (P=0/04). However, it can be concluded that training with more background interference can further improve sensory-motor functions in children with developmental coordination disorder.

The aim of the present study was to determine the effectiveness of eight weeks of progressive jump-landing exercises on the performance and dynamic balance in young football players prone to anterior cruciate ligament injury. In the current study, 30 football players prone to the risk of anterior cruciate ligament injury (screened by functional movement screening tests) participated on a voluntary basis and were randomly divided into two groups of progressive jump-landing exercises (n=15; age 17.8±0.77 yrs; height 169.2±4.84 cm, weight 63.4±5.86 kg) and control (n=15; age 18±0.84 yrs; height 168.2±3.75 cm, weight 64.46±7.71 kg). The hoping (single leg hop, triple hop, triple diagonal hop, and timed hop) and Y balance tests were used for evaluation of performance and dynamic balance, respectively (at baseline and after 8-weeks of progressive jump-landing exercises). For statistical analysis, the mixed 2*2 analysis of variance and paired t-tests in SPSS, v. 22, were used. The results revealed that eight weeks of progressive jump-landing exercises led to significant effects on the scores of performance (P=0.001) and dynamic balance (P=0.001) tests in participants. According to the results, eight weeks of progressive jump-landing exercises could improve participants' performance and dynamic balance, so this type of exercise is recommended for improving performance and dynamic balance of young football players prone to the risk of anterior cruciate ligament injury.

The previous studies have reported controversial results on the shoulder muscles’ activity of individuals with shoulder impingement. The aim of the present study was to quantify the shoulder muscles’ activity during the cocking and acceleration phases of handball throwing with slow and fast speeds. A total of 12 controls (age: 23±3; weight: 64±12) and 12 patients with shoulder impingement (age: 27±4; weight: 60±13) were studied. The electrical activity of shoulder muscles in the right sides, including upper trapezius, anterior, middle, posterior deltoid, latissimus dorsi, pectoralis major, supraspinatus, and triceps muscles, were measured in both shoulders using an EMG system with surface electrodes. A mixed 2×2 analysis of variance was used at a significant level of p < 0.05. In cocking phase of the slow and fast throwing, in patients, higher activities of upper trapezius, supraspinatus, and latissimus dorsi muscles were observed, as compared with control group and in cocking phase of fast throwing, middle deltoid activity was lower in patient group (p<0.02). In the acceleration phase of the slow throwing, the activity of upper trapezius muscle was higher in patients compared with control group. However, in the acceleration phase of the fast throwing, in patients, lower activity in middle deltoid and higher activities in latissimus dorsi and trapezius muscles were observed (p<0.05). Shoulder pain syndrome results in altered shoulder muscle activity. These alterations are greater in fast throwing activity. The current study does not determine whether these changes are because of adaptation to the pain, or are caused by the injury. However, it appears that with pain present, fast throwing movements will put the shoulder in greater risk of injury. It is suggested that isometric or slow movements be used in the shoulder rehabilitation at the early stage of the treatment. Correct muscle enhancement is also recommended to prevent the shoulder pain syndrome.

Higher excessive hip adduction and internal rotation is one of the risk factors for lower limb injuries. The aim of the present study was to evaluate the immediate effects of hip external rotator and hip abductor muscular taping on three-dimensional lower limb joint kinematics during stance phase of running. A total of 24 healthy male participants (age: 24.6±2.5 year; Weight: 74.8±6.2; and Height: 177.1±7.9 cm) were volunteered to participate in the study. Three-dimensional lower limb kinematics were measured using a motion analysis system during running with and without femoral rotational and abductoral taping. Paired sample t-test was used for statistical analysis. Significant level was set at 0.05. Application of femoral tapes increased and decreased peak eversion angle during loading response (P=0.001) and mid-stance (P=0.001) phases, respectively. Compared with no tape, femoral tape significantly reduced peak knee adduction angle during the entire stance phase (P<0.05). Moreover, both peak hip adduction and internal rotation during taping condition were about 1° and statistically lower than that of no tape condition (P<0.05). Femoral rotational and abductoral taping could alter lower limb joint kinematics (reduction of ankle eversion during mid-stance, reduce peak knee adduction and peak hip adduction, and internal rotation during stance phase of running. However, effect size values in all cases were low. Therefore, further study is warranted in this field and on different patients.

During the development of the phonological system, gradually, some of error patterns decrease and speech intelligibility increase. The aim of the present study was to investigate phonological skills, including phonological processes and percentages of correct consonants and phonemes in the bilingual Persian-Arabic speaking children aged 4-5 in Ahvaz. In the current study descriptive-analytical cross-sectional study, 28 children aged 49-60 months were randomly assigned to two groups: Persian monolingual and Persian-Arabic bilingual (14 participants in in each group). All participants were recruited randomly based on inclusion criteria from Ahvaz kindergartens in Iran. The instrument used study was the Persian Phonological Test (PPT), a subtest of Persian Diagnostic Evaluation Articulation and Phonological test. In this test, phonological processes are investigated in two groups: structure and substitution processes. Data was analyzed using SPSS, running Mann-Whitney test. The results showed statistically significant differences between the two groups in proportion to the occurrence of substitution process (p <0/05), but there was no significant difference in the type of phonological processes between the two groups. Also, the results indicated a significant difference between the two groups in the percentages of correct consonants and correct phonemes (p <0/05). The present study showed that bilingualism has no effect on the type of phonological processes, but this can be effective on the frequency of processes. Since frequency of phonological processes was greater in bilingual children, it can be assumed that there are two phonological systems at work in bilingual children.

Children with Cerebral palsy need for caring at school because of their inability to perform daily occupations. The caregivers at physical disability schools provide care support for these children at school time. The caring is accompanied by physical and psychological tension and may affect the caregivers’ health and therefore quality of life. The aim of the present study was to evaluate the musculoskeletal pain and quality of life of caregivers of children with Cerebral Palsy at physical disability schools. In the present cross-sectional study, caregivers of children with cerebral palsy in Tehran, Isfahan, and Karaj who were willing to participate in the study and met the inclusion criteria were recruited. Finally, 92 participants took part in the study. The evaluations were done using the Persian version of the 36-item Short Form Health Survey (SF-36) questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), and Visual Analog Scale. The statistical analyses of data were done using exploratory factor analysis and Pearson correlation coefficient tests. The results indicated that the mean score for the study sample on physical component summary (PCS) and mental component summary (MCS) were 58.81 and 59.01, respectively. The greatest amount of pain and functional limitations were found in the lower back and knees, and the highest intensity of pain were found in the shoulders, neck, as well as upper and lower back. There were also a significant correlation between musculoskeletal pain and quality of life (r=0/523, P=0.001). Furthermore, there were significant correlations between work experience, insurance, working hours, income as well as Multiple job and physical pain (P<0/05). Permanent caring for many children with cerebral palsy and doing the heavy and repetitive caring tasks not only reduce the quality of life but also cause physical pain in the caregivers of children with cerebral palsy at physical disability schools. It is suggested that more support and pre-employment trainings about the principles of caring be provided to prevent physical pain in caregivers.

Visual perception is necessary for reception and application of environmental information; when it weakens, it causes disorders in learning. Spatial relationship is one of the dimensions of visual perception for improving of which limited number of programs have been designed. Hence, the present study was carried out to investigate the effect of spatial dots training program on the perception of spatial relationship in children with learning disabilities. The study adopted an A/B with follow-up design and active control group. The participant was selected using purposeful sampling from among students with learning disabilities who were in the educational and rehabilitation centers in Ahvaz city. The participant was a boy aged seven years and nine month without any sensory or motor handicaps with full IQ = 93. Frostig visual perception test was administrated as Baseline Data during 3 sessions. The participant was trained in 9 sessions and 3 follow-up assessment sessions using spatial dots training program. Data was analyzed using graphic displays visual analysis as well as Cohen’s coefficient effect size for statistical significance. Findings of the present study revealed that dots spatial intervention improves perception of spatial relationship with the mean effect size of 2/06. It seems that using structured exercise of spatial dots can positively affect treatment of visual perception difficulties in children with learning disabilities as this training program uses motor-playing training methods in a purposeful manner and with a special concern to the principles and functions of perception substructure.

Minor biomechanical changes within the reliance surface of feet could affect postural control strategy, which can be more and exacerbated under fatigue. Therefore, the aim of the present study was to investigate the effect of functional fatigue protocol on postural control in students with different foot arch. Statistical population of the current semi-experimental and cross-sectional study was 720 male students aged 10 to 13 years in the 6th district of Isfahan. A total of 60 students were selected as sample and were divided into 4 homogeneous groups of 15: natural foot, flexible flat foot, rigid flat foot, and cavus foot. Functional fatigue and standing with two feet for 20 seconds on a foot pressure was used for inducing fatigue and evaluating postural control, respectively. Independent T-test, analysis of variance, and tukey post hoc test were used at the 0.05 significance level. Fatigue resulted in significant decrease in all factors measured in all four groups (p≤ 0/05), but this decrease was significantly different among the four groups (p≤ 0/05). Also, prior to and after fatigue, there was a significant difference among the four groups in the measured factors (p≤ 0/05). Anatomical structure of the foot is effective in participants’ postural control. During fatigue, the balance in participants with abnormality in foot, especially in rigid flat foot, is further impaired. Therefore, due to a significant reduction in balance in individuals with different foot arches, it is suggested that corrective exercises of the foot arches and balance exercises in specific directions, in addition to the usual exercises, be considered in clinical and practice specific situations.

Non-alcoholic fatty liver disease is a public health problem in the world. Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease. Therefore, the present study was conducted to determine the effect of eight weeks of endurance training on serum levels of alanine aminotransferase, aspartate aminotransferase, and resistin in men with non-alcoholic fatty liver disease. A total of 23 patients with non-alcoholic fatty liver disease were selected following purposeful sampling in the present quasiexperimental study. Participants were randomly divided into two groups: endurance training group (n=12) and control group (n=11). The endurance training program included moderate intensity training with 60-75% of maximal heart rate for 45 min/session, 3 times/week for 8 weeks. At both baseline and completion of the eighth week, blood samples were obtained from all the participants. Data were analyzed running Shapiro-Wilk test and dependent and independent t-tests at the significant level of p In the current study, eight weeks of endurance training resulted in a significant decrease in serum levels of alanine aminotransferase, aspartate aminotransferase, and resistin in males with non-alcoholic fatty liver(α<0.05). According to the findings, endurance training may improve the serum levels of alanine aminotransferase, aspartate aminotransferase, and resistin in men with non-alcoholic fatty liver disease. Therefore, to reduce the dependent risk factors of non-alcoholic fatty liver disease, this therapeutic intervention seems to be beneficial.

Todevelop a Persian version of the diagnostic criteria for temporomandibular disorders (DC/TMD) Axis I and to assess its content validity The present study is a cross-sectional survey. To cross-culturally adapt the instrument, the DC/TMD Axis I was translated using a forward-backward method. Translation quality and cultural adaptation were assessed by a panel of five experts on a scale of 0 to 100. Then, the content validity of the Persian version was quantitatively evaluated by a panel of 10 experts calculating content validity index (CVI) and content validity ratio (CVR). Average values of translation quality were less than 90% in 7 items, which were rephrased. Average values of cultural adaptation of 2 items were less than 90% and they were omitted according to the experts' opinion. CVR values in all items of the questionnaire were between 0.8 - 1 and for the total instrument, the CVR values was obtained to be 0.94. All of the items of the questionnaire in terms of relevancy earned values higher than 0.75. CVI values in terms of clarity for 13 items and in terms of simplicity for 10 items were less than 0.75, which were candidates for revision in the second round. All these items received values higher than 0.75 in the second round. Evaluating contentvalidity of the Persian version of DC/TMD Axis I can be an introduction for assessing other psychometric properties of the questionnaire and will pave the way for including Iran in international studies on TMD.

Tennis elbows injury is one of the most common types of athletic upper extremity overuse injury which is accompanied by remarkable pain and functionality deficit in the injured limb. The aim of the present study was to investigate the effect of eight weeks of Powerball mediated resistance training on the wrist extensor muscle strength, wrist proprioception, grip strength, and upper extremity performance in volleyball players with tennis elbow. For the current quasi-experimental study, 30 volleyball players with tennis elbow were selected and randomly divided into two (control and experimental) groups. To measure wrist extensor muscle strength, grip strength, and performance before and after implementation of the intervention programs (eight weeks of resistance training using Powerball), the isokinetic dynamometer, hand held dynamometer, and Y balance tests were used, respectively. The results of the present study showed that the Powerball exercises have significant effects on wrist extension strength (P=0.009), wrist proprioception (P=0.011), grip strength (P=0.001), and upper extremity performance (P=0.001). Due to the significant effect of Powerball mediated exercises on wrist extension strength, wrist proprioception, grip, and performance of upper extremity, using this exercise program is recommended in the process of rehabilitation in patients with tennis elbow who have deficiency in the mentioned variables.

Children with reading disorder show problems in auditory attention and cerebral dominance that can be assessed using dichotic listening techniques. The aim of the present study was to assess and compare auditory attention (divided and selective) and language lateralization between normal and reading disabled children. The current cross-sectional study was performed on 30 normal children and 30 children with reading disability of 8 to 10 years old with normal peripheral hearing and strong right-handedness. First, participants were divided into three age groups of 8, 9, and 10 years old. Then, the mean scores of right and left ear responses and laterality index values were calculated and compared in three divided and selective attention conditions for all age groups using repeated measures test. Comparison of the scores showed statistically significant differences between the mean scores of right and left ears responses and laterality index values between the two groups in all age groups and three condition tests (p-value< 0/05). The results of the present study showed poor performance of children with reading disorder in dichotic digit test in both divided and selective attention conditions.

The aim of the present study was to compare the theory of mind in intellectually disabled and normal children and to determine the relationship between theory of mind and attachment style and mental health.
Materials and Methods The method of study was descriptive correlational and Ex post facto. The sample consisted of 74 children with intellectual disabilities and 100 normal children who were selected using census sampling and available sampling in Birjand city. Mothers completed General Health Questionnaire (GHQ) and Adult Attachment Style Questionnaire and the theory of mind in children was evaluated through the theory of mind Test. The results showed that there is a significant difference between children with intellectual disability and normal children in the first and second levels of acquisition of the theory of mind (p<0/05), but there is no significant difference between children with intellectual disability and normal children in the third level of acquisition of the theory of mind (p>0/05). Also, the result showed that there is no significant relationship between theory of mind with attachment style and mental health (p>0/05). Therefore, it can be concluded that there is a significant difference between the acquisition of the theory of mind in children with intellectual disability and normal children, but there is no significant relationship between the theory of mind as well as attachment style and mental health in mothers.

Cystic fibrosis is a genetic disorder that produces adhesive secretions along airway. Assisting the clearance of airway secretions plays an important role in treating these patients. The purpose of the present study was comparing mechanical cough assist and traditional chest physiotherapy in patients with cystic fibrosis. A total of 14 patients (mean age: 11/4 years) with cystic fibrosis participated in in the current study. Each patient was treated on two different days using two different methods, i.e. mechanical cough assist and traditional chest physiotherapy. Forced Vital Capacity (FVC), Forced Expiratory volume in one second (FEV1), Forced Expiratory Flow between 25% and 75% expired (FEF),and patient preference were evaluated. The results showed no significant difference in changing the FVC (P=0/83), FEV1(P=0/21), and FEF(P=0/74) after two treatment methods. Also, no significant difference was observed in patients adherence (p=0/66). Mechanical cough assist and traditional chest physiotherapy have the same effects on airway clearance in patients with cystic fibrosis and the patients prefer both of them at the same level.

Ankle is the most commonly injured area in sport, which accounts for 25% of all sports injuries. The relationship between injury occurrences in this joint with the anatomical alignment of the lower extremity is unclear. So, the purpose of the present study was to compare anatomical intrinsic risk factors between athletes with and without a previous history of ankle sprain. In the current cross-sectional study, 25 male athletes with previous history of ankle sprain and 25 healthy athletes were randomly selected and participated in the study voluntarily. Foot arch index, navicular drop, tibia vara, knee hyperextension, and tibia torsion were measured in samples. A comparison between the two groups was made using independent t-test for normally distributed variables, whereas the Mann–Whitney's U-test was used for non-normal distributed variables at a significance level of 0.05. Analysis of data using independent t-test and Mann–Whitney U test showed that there were significant differences in foot arch index (P=0.040) and tibia vara (P=0.0001) measures between the two groups. While there were no significant differences in navicular drop, knee hyperextension, and tibia torsion measures between the two groups. According to findings, it is possible that lower limb malalignments can be contributed in ankle injuries incidence as intrinsic risk factors. Therefore, port injuries prevention and rehabilitation professionals are recommended to consider leg and ankle malalignments in preventing and managing the risk factors of lateral ankle sprain.

Flat foot is associated with changes in the bone alignment and muscle activity. Yet, there is scarcity of information about kinetic and kinematic aspects of gait after exhaustion in flat foot people. The objectives of the present study were to evaluate the effects of exhaustion on temporal variables and kinetics of ankle foot during gait in flat foot people and control group.

A total of 10 flatfoot students at Bu Ali Sina University (Mean age, height, and weight, respectively: 24.4±2.16, 177.2±4.31, and 81.9±17.4) and 10 normal students with matched age, height, and weight participated in the study. A Vicon motion analysis system (100 Hz) with four cameras and as well as two Kistler force plates (1000 Hz) were used to measure the temporal variables and kinetics during the gait. For statistical analysis, independent student-t test, and repeated measure were used. The type one error was set at α

The inventory ankle moment of flat foot group was 0.16 N.m/BW and greater compared with that in control group. After fatigue protocol, walking speed (p=0.04), stride length (0.62 N.m/BW), and ankle plantar flexor moment of flat foot group (p=0.00) increased as compared with those of control group.

Plantar Flexor moment was lower in flat foot, compared with normal group. Maybe, weakness and malfunction of the plantar flexor muscles led to lower ankle plantar flexor. Higher inventor moment of the ankle joint may increase the pressure on the medial side of the foot during endurance activity. Fatigue change ankle Plantar Flexor moment and spatiotemporal gait variables, thus strengthening these muscles is recommended.

Depression is one of the most common psychological disorders in the world, with the prevalence of 13.6% in Iran among the population with 14-64 years old. The effectiveness of using antidepressants drugs is doubtful as the primary method of treatment and researchers are seeking alternative methods without side effects. In the present study, antidepressant effects of strength, aerobic, and combined exercise among adult men were studied. In the present semi-experimental study, 60 men aged 20 to 35, who were moderately or moderately to highly depressed, based on the diagnostic interviews and Beck Depression Inventory (BDI-2), were randomly placed into four groups of 15 individuals, including 1) strength group, 2) aerobic group, 3) combined group of strength-aerobic, and 4) control group, and participated in an eight-week exercise period (24 sessions of 45-60 minutes, 3 sessions per week, intensity of 60 to 75% of one maximum repetition/maximum heart rate). The data resulted from depression levels measurements in pre-test and post-test were analyzed using paired t-test and covariance analysis at 95 percent confidence level. Depression levels decreased significantly in all three experimental groups (strength, aerobic, and combined group). In addition, after controlling the effect of pre-test, the aerobic and combined and strength exercises groups experienced the highest reduction in depression levels, respectively. Based on the existing evidence, it seems that aerobic exercises can produce the most physiological adaptations associated with the regulation of emotions and levels of depression in men; however, other kinds of strength and combined physical exercises and sport activities can be used to reduce the symptoms of depression, as well.

Swayback abnormality is one of the most common abnormalities in the spine and is the most common abnormality in the age range of 18 to 25 years, with an outbreak in non-athlete individuals ranging from 10% to 62%. The aim of the present study was to investigate the effect of eight weeks of NASM exercises on sway back of Tabriz high school girl students. In the current semi-experimental research, among the non-athletic female students of Tabriz city, the lateral aspect of sway backs was identified using a primary screening by graph sheet to observe the spine status. Then, the researcher selected 30 students with the highest deviation in this anomaly. Next, they were randomly divided into two groups of 15 experimental participants with the mean age 14.23 ± 0.66 yrs, height 147.73 ± 27.27 cm, and weight 48.43 ± 4.44 kg, and 15 participants in control group with the mean age of 14.28 ± 0.63 yrs, height 147.33 ± 6.55 cm, and weight 48.53 ± 4.24 kg. Forward head, back kyphosis, lordosis, anterior tilt, and quality of life variables were measured and recorded using cervical donor, flexible ruler, tilt meter, and quality of life questionnaire SF-36 before and after the training period. The experimental group performed weekly three sessions of 50 minutes of NASM corrective exercises for eight weeks, while those in the control group performed their daily activities. Data were analyzed using ANOVA for repeated data at a significance level of P≤0.05. The results showed that eight weeks of NASM exercises had a significant effect on the forward head, back kyphosis, lordosis, anterior tilt, and quality of life variables of high school female students. According to the results, the new NASM series of exercises seems to be effective as a new approach to improving abnormality. Therefore, this exercise program is recommended for coaches, therapists, and specialists.

To compare the results of Photorefractive Keratectomy (PRK), surgery was performed using three Conventional, Iris Registration, and Spherical Equivalent methods in correcting astigmatism In the current cohort study, 72 myopic eyes (40 patients) with astigmatism less than 1.00 D were randomly divided into 3 groups (Conventional, Iris Registration, and Spherical Equivalent) and were respectively reviewed. In the first group, the excimer laser changed the corneal curvature regardless of the rotation of the eye. In the second group, a high resolution photo of the iris was provided before surgery and the amount of rotation of the eye in the lying state was measured related to the sitting. Finally, in the last group, half of power of the cylinder was added to the sphere and regardless of the rotation and axis of cylinder, the surgery was performed. Residual astigmatism and outcomes were compared with initial data six months postoperatively. The mean age of patients was 28.19±5.35. Preoperative BCVA was 10/10 in all patients. No statistical difference was noticed between the groups (p>0.05) in the preoperative astigmatism. In Conventional PRK group, the average astigmatism decreased from-0.48±0.30 D preoperatively to -0.19±0.20D postoperatively (p=0.002) and the average astigmatism in Iris Registration PRK group decreased from -0.54±0.19D preoperatively to -0.18±0.21D postoperatively (P<0.001), compared with the increased astigmatism in Spherical Equivalent PRK group from -0.55±0.12D preoperatively to -0.65±0.16D postoperatively (p=0.008). The average myopia decreased from -3.90±1.04 to 0.04±0.35D in Conventional group, decreased from -3.77±1.04 to 0.44±0.35 in Iris Registration group, and decreased from -2.58±1.11 to 0.14±0.28 in Spherical Equivalent group. According to the results, Conventional and Iris Registration PRK decreased the amount of postoperative astigmatism more than Spherical Equivalent PRK. The amount of postoperative myopia decreased in the three groups.

Urinary incontinence is one of the most important pelvic floor disorders affecting the patients' quality of life. Although natural delivery and pregnancy are the most important risk factors, less attention is paid to the other involved factors. The aim of the present study was to investigate the factors influencing urinary incontinence in women. A total of 195 obese women (91 cases with urinary incontinence and 104 without UI) were studied in the age range of 25 to 65 years old. After obtaining their consent to participate in the project, completion of the questionnaires and measurement of anthropometric characteristics were performed. SPSS software (version 18, USA) and ANOVA, t-test, and chi-square test were used for Data analysis (α≥ 0.05). There was a significant relationship observed between the mean age, menopause, as well as regular exercise and urinary incontinence. The mean age was higher in the affected group, and regular weekly exercise reduced the incidence of urinary incontinence. In general, the mean of anthropometric indices (height, weight, BMI, waist circumference, hip circumference, and waist to height ratio) was lower in participants with urinary incontinence Contrary to the popular belief, in obese women with urinary incontinence, low anthropometric indices appear to increase the incidence of urinary incontinence and regular exercise can reduce the incidence of urinary incontinence.

With regard to the importance of curing osteoporosis, the following study aims at investigating the effects of a period of HIIT exercises on BMD and BMC in male mature rats. In the present study, 27 adult male Wistar rats, with an average weight of 190±20 grams were used. Mice were divided into three groups with the same diet: high intensity interval training (HIIT) (n=9), continuous training (n=9), and control group (n=9). Then, 24 hours after six weeks of training sessions, and after using anesthesia, the rats were sacrificed. HIIT protocol was equivalent to an intensity of 95% to 100% of the maximum oxygen consumption. The first session of the continuous exercise was initiated with an intensity equal to 80% of the maximum consumed oxygen. After each training session, one minute was added to the time of the exercise and after each week, the speed was increased by one meter per second. The femurs of the animals were carefully extracted and placed in formalin solution. Evaluations of BMD and BMC were performed using DEXA method at the femoral neck site. After the exercise, in order to analyze the dates of one-way analysis of variance, the Scheffe’ test was used with the significance level of 0.5. The results in BMD indicated a non-significant increase in the bone density of the HIIT group and also a non-significant decrease in the continuation training group compared with the control group. Also, in the HIIT group, there was a significant increase in BMC compared with the continuation group and also compared with the control group. Considering that HIIT has led to an increase in BMC, it seems that this training method, after considering the scientific exercise principles (including age, sex, exercise records, access to good nutrition, etc.), can have a positive effect on the individuals exposed to the risk of osteoporosis.

Different training frequencies can affect the peoples’ physical fitness in different ways. The purpose of the present study was to evaluate the effect of exercise training with different sessions on some factors of physical and motor fitness in girls with mental retardation. In the current study, 31 girls with mental retardation (age: 12.06 ± 2.42 years; height: 136.2 ± 15.5 cm; weight: 30.48 ± 12.42 Kg; and IQ: 50-70) from Maryam Special Elementary School in Sabzevar were selected following purposeful sampling and randomly divided into three groups: 1) exercise training with 2 sessions per week, 2) exercise training with 4 sessions per week, and 3) control group. The experimental groups participated in selected trainings program for 8 weeks, with an intensity of 65-75% of reserve heart rate. Before and after the training period, physical and motor fitness tests, including static balance, dynamic balance, muscle force, agility, coordination, and endurance function, were administered. The data were analyzed using the Kolmogorov- Smirnov, one way ANCOVA, and dependent t tests at significance level of P<0.05. The results showed that there is no significant difference between the three groups in the static balance with closed eyes, agility, and endurance function parameters (P>0.05). Dynamic balance and muscle force of the group with exercise training of four sessions per week improved significantly moer than those of two sessions per week and control groups (P<0.05). Static balance with open eyes and coordination were not observed to be significantly different between the two experimental groups (P>0.05). According to the results, both training programs with two and four sessions of training per week improved the static balance with open eyes and coordination indices in girls with mental retardation. The indices of dynamic balance and muscle force improved through training volume with four sessions of training per week. The indices of static balance with closed eyes, agility, and endurance function were not affected by these training programs. Therefore, it may be suggested that girls with mental retardation may apply the selected trainings with frequency of four sessions per week for eight weeks to improve their physical and motor fitness indices.

Aging has apparent functional effects on auditory processing, such as spatial hearing processing, with the most apparent being speech in noise perception disorder. The aim of the present study was comparison of spatial hearing ability between young adults and elderly people. According to the inclusion criteria, 30 young adults with the age range of 18 to 28 years old with normal hearing and 20 elderly people with the age range of 60 to 70 years old with normal hearing and speech in noise disorder were included in study The comparison of mean scores using independent t-test showed that there was a significant difference in the mean scores of speech in noise-quite, lateralization, and total score between the two groups. Sex had no effect on the results obtained, Lower scores of elderly people with normal hearing in spatial hearing questionnaire, compared with young adults, can be defined as their weak performance in spatial hearing processing. The results of the present study reconfirms the effect of age on spatial hearing processing, such as lateralization and speech in noise.

Despite the recent advances in digital processing of hearing aids, a large number of users are not happy with their hearing aids. One of the major reasons for this is the lack of good recognition of speech in noisy environments. Digital noise reduction and directionality are some of the technologies that are helpful in this issue. The present study was conducted to evaluate the effects of these two technologies on listening comfort and speech recognition of individuals with moderate sensory-neural hearing loss. In the current study, we applied Acceptable Noise Level (ANL) and Farsi Auditory Recognition of Digit in Noise (FARDIN), as measures of listening comfort and speech intelligibility, respectively, on 18 participants (8 male and 10 female) who had moderate sensory neural hearing loss. We evaluated both these measures under six different hearing aid conditions: 1) Omnidirectional-DNR/off (baseline), 2) Omnidirectional-Broadband DNR, 3) Omnidirectional-Multichannel DNR, 4) Directional, 5) Directional-Broadband DNA, and 6) Directional-Multicellular DNR. Both the digital noise reduction technology and the directionality improved the ANL, but the effect of directionality was more than the other. None of the digital noise reduction or directionality could improve the score in FARDIN test, but it did not make the results even worse. According to the results, since these two technologies improve listening comfort and do not affect speech comprehension, it is recommended that these two options be activated for adjusting the hearing aid in clinics.

Previous studies showed that hearing loss is positively correlated with behavioral disorders and increases the risk of some problems. The purpose of the present study was to review articles on behavioral and emotional disturbances in hearing impaired children and to determine the prevalence and causes of these disorders. In the current study, articles published between 2005 and 2016 about the emotional and behavioral disorders, and hearing loss in Pubmed, SID, Sage, Springer link, Elsevier and Google databases were searched using the following keywords: behavioral disorders, emotional disorders, hearing loss, hearing impairment, and related terms. Language plays a key role in the development of the child's social development. Unfortunately, hearing impaired children, due to the lack of fluency in language skills, have fundamental problems in establishing the right relationship with others and social skills. The prevalence of behavioral disorders is more in hearing impaired children, as compared with normal children. The most important reasons that can be cited for these disorders include defects in the development of language and these individuals’ communication difficulties. In addition, parenting style and their acceptance rate are very important in this regard.

To investigate the relationship between recreational and professional sports and osteoarthritis

To carry out the present review article, we conducted a literature search in PubMed and Sportdiscus databases in the past three decades (1987 to 2017). The keywords used in the search process included ‘Osteoarthritis’, ‘Athletes’ and ‘Elite’, and ‘Sports’ with their related synonyms. Also, to search Persian articles, we used MAGIRAN, SID, and ISC databases.

Considering the inclusion criteria, 29 articles (28 English and 1 Persian) were selected: 13 articles were about the relationship between osteoarthritis and recreational sport and 16 articles investigated the osteoarthritis among elite athletes. Out of 13 articles on recreational sports, 5 prospective studies investigated OA among adult runners and 8 case control studies investigated OA in the knee and hip joint of other athletes. Out of 16 articles addressing professional sports, 7 articles investigated OA of lower extremity joints in former elite soccer players, 1 article investigated knee joint OA in former table tennis players, 1 article inspected shoulder joint among retired tennis players, 1 article investigated ankle joint OA in former volleyball players, and 1 article investigated OA among elite runners.

Recreational sport activities with moderate intensity, regardless of the sport, is not a risk factor for radiological and clinical OA and due to undeniable advantages of athletic activities, people should be encouraged to pursue them. Radiographic OA seems to increase among general population and elite athletes in certain team and power sports (football, rugby, wrestling, weightlifting, and racket sports) if the conditioning and competitions are intensive. Furthermore, it does not seem that elite endurance athletes are at the risk of OA. The risk of OA increases with repetitive and high-impact sports. This risk is highly associated with joint injury.

Constraint Induced Movement Therapy (CIMT) is one of the effective methods in improving motor function of upper extremity in children with spastic hemiplegic cerebral palsy, which has various types. The objective of the present integrated review was to investigate the effect of CIMT in children with spastic hemiplegic cerebral palsy and to create specific instruction for using this method for these children.

In the present combined and two-stage study, first, in an integrated review, all articles in Persian and English languages between 2000 and 2015 on children with spastic hemiplegic cerebral palsy were extracted using the following keywords: cerebral palsy, hemiplegia, Constraint Induced Movement Therapy, rehabilitation, and occupational therapy. Then, in the qualitative stage, the results were examined in the five-member expert panel of professional occupational therapists in the area of cerebral palsy.

In the conducted investigation, 36 articles were found related on cerebral palsy and upper extremity function. First, by examining the summary of articles, only 14 articles that met the inclusion criteria were selected. Then, full texts of articles related to interventions CIMT to improve hand function of patients with cerebral palsy were examined.

In the investigations conducted, the positive impact of CIMT in improving the motor function of children with cerebral palsy had been proven, but the results were not provided as an instruction. Therefore, with regard to the view of experts and specialists, a specific instruction for this treatment was developed. In addition, the impact of this treatment with a sling or splint for 14 days, 6 hours a day along with occupational therapy, and physiotherapy was more.

Some of the models in the evaluation of speech and language disorders have been based on the sequence of language development. Developmental-descriptive model supports the approach of following the sequence of natural language as the best training manual for teaching language to children who have a language disorder. The present study aims to investigate expressive vocabulary and lexical development of a Persian speaking child aged between15 to 34 months.
Case Report: In the current observational longitudinal study, expressive vocabulary and lexical output of a Persian speaking girl sampled from 15 to 34 months by daily scripting.

The first meaningful word was stated at the age of 15 months. Since about 22 months of age, when the vocabulary storage contained about 55 words, the child started to produce grammatical structures in the form of two-word sentences. In this period, names had the most frequency in child's lexicon. At 22 months of age, the highest frequencies of her vocabulary included names of persons, foods, objects, body parts, clothing and animals, respectively. The emergence of new verbs showed a remarkable growth at the age of 26 to 28 months. In this stage, the child started to use compound sentences. Scripting and evaluating the development of the child's vocabulary every 15 days showed vocabulary spurt at the age of 26 to 28 months.

According to the results, the present 20-month longitudinal study showed that the development of expressive vocabulary in the Persian speaking girl was similar those in other languages. It also follows a hierarchical process from simple to sophisticate. This information can hopefully provide useful evidence for clinical research and practice.