فصلنامه طب توانبخشی
سال هفتم شماره 4 (زمستان 1397)

  Hypernasality is a frequently occurring resonance disorder in people with cleft palate. Nasometer measures the oral and nasal acoustical energy during the speech that is expressed as nasalance score and is a quantitative assessment. The aim of the present study was to obtain the normative nasalance scores for 7 to 20 year-old people and to investigate the differences between genders and age groups. The present descriptive-analytic study was perfromed in 2016 on 7 to 20 year-old participants in Isfahan City, following cluster sampling method for choosing schools and simple sampling method to choose participants. After completing the informed consent and according to the evaluations, individuals who did not have difficulties related to speech, resonance, voice quality, and hearing entered the study. Mean nasalance scores were obtained from 220 participants (120 participants from 7-14 year-old group (55 boys and 65 girls) and 100 participants from14-20 year-old group (50 boys and 50 girls)) using the Nasometer (model 6450) during the repetition of low pressure syllables and reading Rainbow text. The mean obtained nasalance scores for low pressure syllables and rainbow text were 14/09 ±5/65 and 33/65±5/13 in boys 7-14 years old, 15/30± 5/11 and 33/59±4/04 in girls 7-14 years old, 17/75± 10/17 and 35/44± 94/4 in boys 14-20 years old, and 22/42± 9/8 and 36/64± 5/79 in girls 14-20 years old, respectively. Normative nasalance scores for 7 to 20 year-old Persian speaking people in Isfahan city was obtained that can be used as a reference for the clinical diagnosis, evaluation, and treatment of resonance disorders in patients with cleft palate and velopharyngeal insufficiency along with the perceptual assessments.

  The aim of the present study was to examine the effects of regular exercise on the social interactions of educable mentally retarded children aged 8 to 14 years old in Shiraz. In the currentstudy, from among 75 educable mentally retarded students, 24 patients were randomly selected and assigned to two experimental (six boys, six daughters) and control (six boyd, six girls) groups. To assess their social interactions, Dadkhah Social Interactions questionnaire was used. The design chosen was quasi-experimental with pre-test and post-test and a control group. K-S test was run to determine the normal distribution of data and Levin test and covariance analysis were used to compare the means. Findings showed that after a period of regular exercise, social interactions of these children improved dramatically (P<0/05). According to the results, it can be concluded that regular exercise (Dunn and fait, 2010) is effective in increasing the social interaction of children with intellectual disability and, by its very nature, it can have a positive effect on social interactions, as a very important psychological component.

  Evidence shows that most of the learning disabilities are rooted in stress. The purpose of the present study was to compare the effectiveness of teaching self-regulation strategies of motivation and communication skills on academic stress of Tabriz talented female students. The research method was quasi-experimental with pre-test, post-test, and control group. The research participants consisted of 90 female high school third grade students from regions 1 and 4 of Tabriz in 2016-2017 who were selected using cluster random sampling method and were randomly assigned to experimental and control groups. The first group received a training course on motivational self-regulation strategies in 10 sessions and the second group trained 10 sessions of communication skills training, and the third group (control group) continued regular classroom programs. Cohen and Frazer Educational Stress Questionnaire was used as the instrument. Data analysis, using single-variable covariance, showed that self-regulation strategies motivation and communication skills had different effects on academic stress and communication skills were more effective in reducing academic stress. Effectiveness of communication skills to reduce stress versus self-regulation strategies of motivation is obvious in controlling the sources of academic stress. Therefore, by performing communication skills techniques, practically, the negative effects of stressors can be reduced

  The purpose of the present study was to investigate the effect of core muscles’ fatigue on landing mechanic and lower extremity function. In the present semi-experimental study, 18 female students were randomly selected from among the students at Razi University. First, pretests were administered. Y-test was used to measure dynamic balance, square & lateral hop tests was used to measure lower extremity function, and weight bearing dorsiflexion ROM and Landing Error Scoring System-Real Time as well as Kinova and AutoCAD Software were used to assess landing mechanic. After the pretest, we perfromed core muscles fatigue protocol and then the posttest was conducted. For data analysis, K-S and Levine’s test and paired sample t-test were run. The statistical significance was set at 0.05. The results showed that after core muscles fatigue, among studied factors, landing error scores (P=0.001), weight bearing dorsiflexion ROM (P=0.002), dynamic balance (P=0.02), and knee flexion angle (P=0.03) decreased in contact time. According to the results, it can be stated that the core muscles fatigue that accrues in sports competitions could result in the prevalence of lower extremity injuries. So, core strengthening protocol can be effective in preventing injuries in the lower extremity.

  Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. This disorder causes various problems such as impairment of visual and auditory attention that play important roles in everyday life. The aim of the present study was to investigate the effectiveness of yoga training on visual and auditory attention of children with ADHD. A total of 30 male students, aged 6-7 years, were randomly selected using the teacher form of Child Symptom Inventory-4 (CSI-4) from shiraz’s primary schools. Participants were assigned to two groups of experimental and control with the experimental group (n=15) receiving Yoga exercise practices for 12 sessions (4 weeks and 3 sessions per week, 60 minutes per session), while the control group did not receive any intervention. Before and after training, all participants were assessed using Continuous Performance Test (CPT). Multiple ANOVA were used to analyze the data. The results showed that yoga exercises were able to significantly increase visual (P=0.002) and auditory (P=0.003) attention performance in children with ADHD in comparison with the control group. Yoga practices can improve attention performance in children with ADHD.

  Scores above 14 in Functional Movement Screen (FMS) test are nowdays used to predict injury in the athletic population. According to title proposed, asymmetry or movement pattern limitation in functional movement screen test might predict musculoskeletal injuries. The objective of the present study was predicting musculoskeletal injuries in athletes using individual and composite scores on functional movement screening test. In the current study, participants included a total of 50 athletes (25 males and 25 females) with a mean age of 19±2.25. FMS tests were used to assess participants' performance. Occurrence of musculoskeletal injuries was diagnosed by an official physician of athletic teams in 2015-2016. Data analysis was carried out using SPSS running x2 statistical test and ROC curve with p. value set at 0.05. The results showed that the average composite score of FMS in injured group was lower than that of healthy group. Also, athletes who had a minimum of one asymmetry or limitation on the movement pattern in individual tests versus those without asymmetry or movement pattern limitation were more susceptible to musculoskeletal injuries. According to the results, athletes with scores lower than or equal to 14 experience more musculoskeletal injuries than those with scores more than 14. Thus, asymmetry or score one in functional movement screen individual tests along with composite score can be used for predicting occurrence of injury in athletes.

  Increased longevity affects quality of life and the ability to live independently which put others in need of care and protection. So, doing interventions that can enhance the quality of life in the elderly seems necessary. The current study aimed to investigate the effect of reminiscence therapy on the quality of life in the elderly of Jahandidegan Center in the city of Shiraz. The present study is a randomized clinical trial that was performed on 40 elderly people of Jahandidegan Center in Shiraz. For this purpose, a total of 40 of the elderly were selected using available sampling method and randomly assigned into two groups of control and experimental. The participants were evaluated in the two stages before and after the intervention, using the SF-36 quality of life questionnaire. For the experimental group, reminiscence therapy sessions were held in two groups of 10, for 6 weeks, 2 sessions a week (a total of 12 sessions) each session lasting for 90 minutes. The data were analyzed using SPSS and covariance analysis. The results of covariance analysis showed that reminiscence therapy in participants increased the score in some subsets of the quality of life (emotional, general health, and social functioning) and improved the limitations of the role of psychological reasons), while in other subsets of quality of life (physical functioning, bodily pain, and role limitations due to physical fatigue) did not make a significant difference. The results of the current study showed that there is a significant difference in terms of quality of life between the experimental and the control groups; in other words, reminiscence therapy improved the psychological aspects of the quality of life in the participants

  Chronic nature of MS, lack of prognosis and definitive treatment, and engaging the individuals at young age lead to many psychological problems in patients. The aim of the present study was to investigate the effectiveness of progressive muscle relaxation trainingon psychological distress of patients with multiple sclerosis. In the current quasi-experimental study with pre-test and post-test with experimental group and control group, from among all women with multiple sclerosis who were members of the M.S Society of Behshahr city, 30 were selected randomly and according to the inclusion criteria and then divided into two groups of control and experimental. The experimental group received 8 sessions of 30-minute progressive muscle relaxation training. All the patients were assessed in both pre-treatment and post-treatment stages using theHospitalAnxiety and Depression Scale (HADS) and Depression, Anxiety, and Stress Scale (DASS).Data were analyzed using covariance test. The results of data analysis indicated the effectiveness of progressive muscle relaxation training in decreasing psychologicaldistress of the experimental group compared with the control group (p<0/01). Progressive muscle relaxation techniques with relaxation through deep breaths on the autonomic nervous system led to a state of deep relaxation and increase in the individuals's ability to cope with stressors. Therefore, specialization and strengthening of the therapeutic programs for treatment and recovery of patients with M.S, considering the type of stress and anxiety and their resources in them, is essential.

  Disorders related to balance and falling are among the most important consequences of aging, which result in disturbing consequences such as bone fractures. The purpose of the present study was to determine the effect of TRX functional exercises on the balance of middle age men. In the current quasi-experimental study, 26 elderly men (mean age ± SD; 43.8 ± 3.44) were randomly divided into two groups of suspended exercises (n= 13) and control group (n= 13). The static, dynamic, and functional balance were evaluated using Sharp and Romberg, Corrected Star (Y), and Berg balance scales, respectively. The experimental group performed TRX exercises for 8 weeks, 3 sessions per week for 45 minutes. To analyze the data, t-test and ANCOVA statistical methods were used in SPSS, v. 2 with p-value set at ≤0.05. The results of t-test showed that the balance of the experimental group in all three groups was significantly different in post-test when compared with that in the pre-test (p≤0.05). In addition, the results of ANCOVA showed that performing TRX exercise significantly improved the balance in the experimental group as compared with the control group (p≤0.05). Since balance is a feature that is influenced by several factors, doing TRX exercises can well cover these capabilities and improve the balance of middle age men. Therefore, in order to prevent disorders related to balance and falling, it is recommended that these individuals take the benefits of functional TRX exercises during middle ages

  To diagnose developmental coordination disorder, a standard and accurate instrument for assessment of motor skills is required. The Movement Assessment Battery for Children - Second Edition is one of the tools developed for this purpose and is used in English-speaking countries (Britain and America). Therefore, it is necessary to examine the reliability of this test for use in Iranain society. The purpose of the present study was to determine the reliability of this test for age band two (7 to 10 years) children in Tehran. The statistical population of the study consisted of all 7-10 year-old children in Tehran. The sample consisted of 800 typical children with normal growth with a range of 0/7 to 10/8 years (mean 8.8 and 1.2 standard deviation) selected using multistage random sampling. The instrument used in the study was the Movement Assessment Battery For Children - Second Edition. We analyzed the inter-tester reliability and the test-retest and internal consistency for the Iranian sample. Inter-tester reliability was performed with two testers on 50 children, Test-retest reliability with two weeks interval between two tests and on 75 children, and internal consistency reliability was evaluated on 800 children. All steps of data analyses were performed using SPSS, version 23, and the significance level was set at p <0.05. Inter-tester reliability was calculated by calculating the intraclass correlation coefficient for manual dexterity to be 0/923, aiming and catching 0/999, balance 0/988, and the total score of test was calculated to be 0/985. Test-retest reliability was calculated by calculating the inter-class correlation coefficient for manual dexterity to be 0/926, aiming and catching 0/888, balance 0/967, and the total score of test was calculated to be 0/967. The Cronbach's alpha coefficient for the internal consistency of the test was 0/713 for manual dexterity, aiming and catching0/765, balance 0/603, and the total score was calculated to be 0/843. Based on the findings of the present study, it is concluded that The Movement Assessment Battery for Children - Second Edition is a reliable tool for diagnosing the developmental coordination disorder in children aged 7-10 years in Tehran

  Core stability is the ability to control the movement of the trunk for optimal production, transfer, and control of forces from the upper and lower extremities during functional activities. Limited evidence from literature provides a link between core stability, upper extremity, and prevention of injury of upper extremity and thus more investigation are needed. Therefore, the present study was conducted to determine the effect of core stabilization trainings on the function of upper extremity on physically active women with predisposition to injury. In the current study, 23 physically active women with the risk of upper extremity injury participated.Six-week programs, including core-stability exercises that progressed each week, were perfromed. Closed kinetic chain upper extremity stability test, shot medicine ball throw test for function, and error of active angle reproduction of 45 for dominant side for proprioception were used. Also, Shapiro Wilk test was used to examine the normality of the data and to assess the changes in the scores of the tests in each group, ANCOVA was used before and after the training period. The significance level wasα ≤ 0.05. A significant difference was observed between groups on function. Also, an increase was evident in all pretest-to-posttest results in the experimental group. According to the results, core stability training involves the neuromuscular system and increase dynamic stability in the core area. These functional exercises can affect the performance of the entire kinetic chain. The results showed that core stability training improved function and proprioception on upper extremity in physically active women with predisposition to injury. It is also be suggested that different tools be used to examine the function and proprioception in future studies.

  The information about individual time management is a good indicator of each person's quality of life. Given the high prevalence of cerebral palsy and the dependency of these children to their mothers due to their special needs, in the present study, we investigated the effects of time management consultation on satisfaction of time management and leisure time in mothers of children with cerebral palsy. In the current investigation, we chose participants from among the mothers of children who were admitted to Kimia Teb Clinique located in Varamin city. A total of 36 mothers were chosen and divided into two intervention and control groups. In the first session, both groups completed mothers time use questionnaire. The intervention group received four consulting sessions in a month. At the end of the month, both groups completed the questionnaire once again. The data of interest was statistically analyzed running ANCOVA and Wilcoxon tests in SPSS, version 18. The present study showed that there was a significant difference between the two groups in increasing leisure time variable before and after the intervention (p <0.05). Also, there was a significant difference between the two groups satisfaction of time use management variable before and after the intervention (p <0.05). According to the results, it was found that using consulting package of time has been effective in increasing the leisure time and increased the satisfaction of time use management in mothers of children with cerebral palsy

  Hormonal and physiological changes during puberty may lead women to generalized joint hypermobility followed by proprioceptive deficit. Limited studies have been conducted on the effectiveness of proprioceptive training in pre- and post-pubertal women with generalized joint hypermobility. The purpose of the current study was to evaluate the effect of proprioception training on pain and proprioception in pre- and post-pubertal women with hypermobility. A total of 28 female volunteers (8–16 years) with generalized joint hypermobility were randomly assigned in to two groups of 1) pre-pubertal and 2) post-pubertal groups. Pain and proprioception was evaluated using Visual Analog Scale and Photogrammetry methods, respectively. All measurements were performed both at the baseline and at end of the eighth week. To analyze the data, Kolmogorov–Smirnov test, paired t-test, and independent t-test were used. The within-group results of the study showed that eight weeks of proprioceptive training caused significant attenuation of pain (Ppre- puberty=0.001, Ppost- puberty=0.001) and improvement of proprioception (Ppre- puberty=0.001, Ppost- puberty=0.001) in pre- and post-pubertal hypermobile women as compared to their baseline. The results revealed changes from pretest (5.78±0.89) to posttest (1.64±0.74) in the pain parameter in pre-pubertal group, and changes in proprioception parameter from pre-test (4.85±0.66) to post-test (1.85±0.86) in pre-pubertal group. However, in post-pubertal group, the pain parameter changed from pre-test (5.35±1.33) to post-test (2.78±1.18) and in proprioception parameter, it changed from pretest (4.71±0.91) to post-test (2.35±1.00). These results were found to be significant too. Also, the pre-pubertal group showed higher difference between baseline and the eighth week in pain and proprioception as compared with post-pubertal group. The present study showed that eight weeks of proprioceptive training in pre- and post-pubertal women with hyper mobility result in decreasing pain and improvement in proprioception. But effectiveness of the proprioceptive training was more in pre-pubertal women; therefore, it is recommended that to lessen side effects of this impairment, proprioceptive trainings be used before puberty in women

  Natural hearing is essential for the acquisition of a phonemic system in any language. Children with hearing impairment have inappropriate or defective phoneme system. Even after healing of the hearing loss by cochlear implantation, an aspect of this problem remains that needs improvement. The present study was conducted to compare the phonological processes between Persian children with cochlear implantation and normal hearing children. The current cross-sectional study was performed on 28 children with cochlear implantation and 25 hearing 2-8 year-old children in Shiraz. The sample of the speech was obtained using the names of 106 images and then each phonological process was analyzed. Among phonological processes, reduplication, labialization, and glottal stopping (p=0/000) were seen only in cochlear implantation children. In hearing children, the phonological processes disappeared at the age of seven, but in cochlear implantation children, it disappeared after eight years of age. In hearing children (p=0/008) and in those with cochlear implantation (p=0/029), there was an inverse relationship between age and mean phonological process. According to the results, phonological processes in children with cochlear implantation disappeared later compared with hearing children and the frequency of phonological processes in cochlear implant children was more than that of the normal hearing group, which indicates a delay and divergence in their phonological development which is related to the relationship between the length of the growth process and hearing age. Phonological processes are reduced with the increasing age in both groups of hearing children and those with cochlear implantation.

  Hearing loss is associated with poor cognitive performance. Using hearing aids reduces the impact of hearing loss on cognitive problems. The aim of the present study was to evaluate the effectiveness of cochlear implant and hearing aid on the children's phonological working memory ability. In the current cross- sectional study, 63 Persian-speaking primary grade students (21 cochlear implant, 21 hearing aids, and 21 children with normal hearing) participated. The assessment tools used were Nonword repetition task of Sayyahi and forward and backward auditory digit spans from the Persian version of WISC-IV. The results showed that the means of scores for children with normal hearing in phonological working memory were significantly greater than those of children with severe-to-profound hearing loss with cochlear implants and hearing aids user (P<0/01). Mean scores of different skills in phonological working memory were not significantly different between the two groups of cochlear implant and hearing aid children (P>0/05). According to the results, a significant difference exists between children with hearing impairment and normal hearing children in phonological working memory. This represents the role hearing sense plays in the development of phonological working memory. So, it seems that in the present study, the type and use of hearing aids) hearing aids and cochlear implant (had no effect on working memory skills

 

Aggression is one of the most serious social threats in adolescents that disrupt their physical and mental health. Therefore, the present study aimed to compare the effects of physical exercises and anger control skill on male teenageers' aggression.

In the current quasi-experimental study (pre-test and post-test), 40 students at the school of Edalat in Arak city were selected through convenience sampling method. Participants were then non-randomly divided into two experimental groups (20 each). The first group received Physical Exercises (two sessions per week, each one hour) and the second group received Anger Control Skill training (two sessions per week, each one hour). Univariate and multivariate analysis of covariance (ANCOVA & MANCOVA) were used to analyze the data.

The findings of the present study showed that the effectiveness of anger control skill in reducing aggression and its components (physical aggression, verbal aggression, anger, and hostility) were significantly higher than doing physical exercises (p <0.001).

According to the results, anger control skill is more effective in reducing male teenagers' aggression compared with physical exercises.

  Patellofemoral pain syndrome, described as the black hole of orthopedics, is one of the most common musculoskeletal complaints in athlete and non-athlete populations. Altered kinematic, including dynamic lower extremity valgus, helps with the patellofemoral pain. Using a visual feedback device can help in correction of dynamics knee alignment. The purpose of the present study was to compare the effects of mirror, raw video, and real-time visual feedbacks on dynamic lower limb alignment and pain in individuals with patellofemoral pain syndrome. In the current study, 52 women with a mean age of 42±4.16 yrs with patellofemoral pain syndrome participated. The lower extremity dynamics and pain were measured using single leg squat and the Dartfish Pro Suite 7 software, and visual analog scale before and after correction of the dynamic lower limb alignment with three types of feedback: mirror, raw video, and real-time visual feedback. The results revealed that all three types of feedback mirror, raw video, and real-time visual biofeedback have a significant effect on lower extremity alignment, but the results for pain were not observed to be significant. According to the results, all the three types of mirror feedback, raw film and visual feedback influenced the dynamic lower limb alignment in individuals with patellofemoral pain syndrome, but there was no significant difference between the effects of immediate feedbacks.

  It is essential to consider balance as a modifiable risk factor to consequently prevent injury. The aim of the present study was to investigate the effect of six weeks of core stability and hopping exercises on balance among girls with ankle instability. A total of 36 female university students (age 22.08±7.1 year, height 1.61±0.05 m, and weight 58.77±9.89 kg) from among 90 individuals with an ankle instability were objectively selected from Shahid Bahonar University of Kerman and were randomly divided into three groups of 12: the core stability group, the hopping group, and the control group. The CIAT questionnaire was used to select people with ankle instability and the balance was measured using Biodex Balance System before and after six weeks of intervention program (3 times per week with 30 minutes duration per session) in the similar times and condition. The control group did not have any sport activities during this period. The results of mix repeated measure ANOVA test showed that there was a significant difference between core stability and hopping exercises groups in balance (p=0.001). The results also showed that balance was significantly different between pre-test and post-test in core stability group (P=0.000) and in the hopping group (P=0.001). The result of the current study showed that core stability and hopping exercises can be useful training programs for improving balance among girls with ankle instability.

Improving the quality of life in children and adolescents with disabilities is the primary goal of children's rehabilitation services and researchers. Reducing and identifying environmental barriers for children with disabilities are essential to create an inclusive society. The purpose of the present study was to determine the relationship between environmental barriers and quality of life of children with cerebral palsy. In the current descriptive/analytical cross-sectional study, 67 children with cerebral palsy were selected via the convenience sampling. Data were collected using demographic questionnaire, European Child Environment Questionnaire (ECEQ), and CP-QOL questionnaire (Primary Caregiver). The data were analyzed using SPSS software running Pearson correlation. The findings showed that there is a significant negative relationship between quality of life and environmental barriers (r = -0.36, p <0.05). Also, a significant negative correlation was found between the quality of life of children with cerebral palsy and physical environment of home, the physical environment of the community, transportation, and social support (p <0.05). However, there was no relationship between the quality of life and the components of the physical environment of the school, social support at home, attitude of family and friends, attitude of teachers and therapists, and attitude of classmates (p <0.05). The results of the present study showed that there is a significant relationship between quality of life and environmental barriers so that as environmental barriers around children with cerebral palsy decrease, the quality of life increases and vice versa.

  Reaching is one of the common daily life tasks. Most of daily life activities, such as reaching, are performed simultaneously by cognitive tasks, and thus result in decline in performance of the main tasks. The aim of the present study was to investigate the effect of constant (simple reaction time) and random variable (choice reaction time) trainings on anticipatory postural adjustment under dual task conditions. A total of 16 right handed young girls with an average age of (27.18± 3.18) participated in the current pre-test, post-test randomized group design research. To evaluate magnitude of anticipatory postural adjustment, center of pressure displacement and center of pressure mean velocity were measured using force plate before reaching movement initiation under dual task conditions. Data was analyzed using Matlab and SPSSS softwares. The results of independent t-test of pre-test and post-test scores showed that, in constant training, mean velocity of center of pressure was greater than that of random variable training. Also, 2×2 combine variance analysis in the center of pressure displacement did not show significant differences between the two groups According to the results, after constant training, anticipatory postural adjustment is improved under dual task conditions. This type of training leads to improvement of anticipatory postural adjustment after internal perturbation. Findings of the present study support Task-specific practice hypothesis evidence

  Using hearing aid is the main intervention in audiologic rehabilitation of hearing impaired elderly people. A suitable tool for evaluating auditory rehabilitation and hearing aid is using questionnaires. As a case in point, translation and psychometric evaluation of GHABP could provide a suitable and useful tool for Iranian Audiology Community. First the questionnaire was translated by two different translators and then the items were finalized. Next, face validity and content validity evaluations were condcted. To check th reliability, a total of 40 elderly filled out the questionnaire and 20 elderly people who had used the hearing aid for six months answered the questionnaire once again after 25 days for test-retest confirmation. After considering validity and content of Glasgow questionnaire, we found that this questionnaire enjoyed 89% validity index and also 0.89 cronbach's alpha coefficient demonstrating that using this questionnaire is benefitial to be used among the elderly.

GHABA is a valid, reliable tool for measuring the benefits of using hearing aid in hearing impaired elderly.

  The aim of the present study was comparison of participation of 4-6 year-old children with cerebral palsy in area of occupations (self-care, home participation, play, leisure, social participation, and educational environments) according to gross motor function level. In the current cross-sectional study, samples were randomly selected and to the two assessment strategies were used for sampling include: Gross Motor Function Classification System (GMFCS) and Persian version of Children participation questionnaire version (CPQ-P). Data analysis was performed using SPSS software (V. 21) and independent t-tests were used to evaluate significant differences with the significance point set at 0.05. The mean age of CP children in the study was 5 (min. 4 and max. 6 years) and 39 were male (78%) and 11 female (22%). The difference between participation mean of CP children in areas of occupations (self-care, participation at home, play, social participation, and educational environments) and levels of gross motor function (GMF) (1st and 2nd level) was found to be significant (P<0.05). On the other hand, between participation mean of CP children in leisure area and levels of GMF no statistically significant difference was found (P> 0.05). It was also found that no significant difference exists between participation and GMF, according to diversity and intensity dimensions (P> 0.05), but a significant difference was observed in the other dimensions of participation, including assistance, enjoyment, and parents satisfaction (P<0.05). According to the results, our study indicated that participation of CP children in area of occupations according to GMF level was trivial and had no noticeable efficacy; thus, in the evaluation and treatment of CP children, it should be noted that children's participation in occupations as an ultimate goal of rehabilitation cannot be achieved only by putting emphasis on improvment and motor function

  Abnormalities and muscular imbalance in lower limb can lead to poor performance in sports activities followed by injuries. The aim of the present study was comparison of the scores of functional lower extremity in active adolescents with normal and flexible flat foot. In the present study, 60 active students (16-18 years-old) with normaland flexible flat foot participated and were divided into two groups (30 each). The participants' navicular drop, using the method described by Brady, and lower limb function, using functional tests including control sequence, hop test sequence, and endurance sequence, were evaluated. To analyze the research findings, descriptive (mean and standard deviation) and inferential (t-tests) statistical methods were applied. The results indicated significant differences between the two groups with normal and flat foot in all functional tests of lower limb (p≤ /05) and, in comparison with the normal group, the flat foot group obtained lower scores. Based on the results, flexible flat foot as an abnormality can lead to poor performance in functional tests and sport activities that require balance, muscular endurance, and strength followed by sports injuries including plantar fascia inflammation, tibial stress fracture, anterior cruciate ligament rupture, and backache. So, it is recommended that flexible flat foot be considered as a risk factor in sports injuries.

  Today, considering the mechanical life, sitting behind the table and doing harmful movements make susceptible people prone to musculoskeletal abnormalities, the reason for which is remained unclear. The present study was conducted to investigate the relationship between flexibility and somatotype with abnormal lumbar lordosis among female students. A total of 92 female students of Ahvaz Islamic Azad University participated in the study. Research variables included the degree of lumbar lordosis measured using 30-cm flexible ruler and forward bending test using Youdas and Rate of flexibility method. Somatotype (endomorph, mesomorph, and ectomorph) was calculated using Heath and Carter somatotype method. The data were analyzed using Spearman, correlation, and multiple regression with the significance level set at α= 0.05. The results showed that there was no significant relationship between flexibility and lumbar lordosis (r=-0.11, p=0.3), but there was a significant negative relationship between endomorph and lumbar lordosis (r=-0.40 and p=0.0001). There was a positive relationship between mesomorph somatotype (r=0.18, p =0.09) as well as the ectomorph somatotype (r=0.07, p=0.48) and lumbar lordosis. Regression of predicted lumbar lordosis using variables of the flexibility and somatotype was significant only for endomorphy and mesomorphy components (f=4.35and p=0.003). According to the results and the possibility of predicting lordosis changes using somatotype components, it seems that physical conditions of the individual should be considered prior to any intervention in spinal abnormalities.

  Forward head posture is one of the most prevalent disorders in the cervical area. The objective of the present study was to investigate ground reaction force components during running in an able-bodied control group and in children with forward head posture. A total of 28 male children including 16 healthy controls and 16 children with forward head posture participated in the current study. Two Kistler force platforms were used to record the ground reaction forces during barefoot running. Peak ground reaction force components, their time to peak, impulses in all axes, and peak positive and negative free moments were assessed. Independent sample t-test was used for between-group comparisons. The significance level was set at p<0.05. The findings indicated that running speed in children with forward head was smaller than that in control group (P<0.001). Time to peak for vertical (by 11.2%; medium effect size; P=0.035) and lateral (by 76.3%; large effect size; P=0.009) ground reaction force components in forward head group were greater than those in healthy group. Peak ground reaction force components and peak positive and negative free moment amplitudes were not found to be statistically different between the two groups (P>0.05). Running speed in children with forward head posture was lower than that in healthy control group, while the peak ground reaction force components were similar to those in control group. This altered running speed and ground reaction forces are suggestive of a lower mechanical efficiency of running in children with forward head posture. Children with forward head posture need interventions such as sport exercises to reduce peak ground reaction force components and free moment values during running

  The knee joint is one of the most complex and largest synovial joints in the body, which is injured in sports injuries and accidents, due to its location and the type of physical stress it entails. Also, no previous research has reviewed the difference between the mechanics of patients' and athletes' tissue in the form of ultrastructural and nano analysis. The present study was carried out with the aim of comparing the nano-biomechanical structure of injured anterior cruciate ligament cell between athletic and non-athletic men to improve the science of cell biomechanics and to help better the knowledge in the field of human body mechanics. In the current study, statistical samples were seven athletes and seven non-athlete men with anterior cruciate ligament injury. Tissue samples were obtained by each participants' orthopedic surgeon and they were prepared to determine the number and diameter of fibrils, roughness, and cell topography by atomic force microscopy. Finally, the obtained images and data were calculated using the Dual Scope ™ / Raster Scope ™ (SPM) software. Statistical analysis of the data was done using SPSS software set at the significance level of 0.05 running independent samples T-test. The findings showed that the nano-biomechanical structure of damaged anterior cruciate ligament cell, including the level of roughness (nm), the number of fibrils per unit, and fibrils diameter (nm), were different between athletic and non-athletic men. Also, topographic images taken from different regions of two-dimensional and three-dimensional injured ligament tissue in longitudinal and transverse sections of these groups showed some irregular makeup areas of collagen fibers, and fibrils were not in the same direction. Regarding the relative mean of athletes in the present study and also considering that the muscles around the knee area in athletes are stronger than non-athletes, the adjacent muscles removed the pressure from the ACL and caused the differences between mechanical properties of the cell and the ACL tissue among athletes and non-athlete in the present study.

  Dynamic balance is a key element in everyday and sports activities and it is important to examine the factors that affect it. The present study focused on the relationship between arousal and activation with dynamic balance at different times of the day. A total of 30 male participants, aged 21.01±1.64 performed dynamic test at 10:00 a.m., 15:00, and 20:00 p.m. on a single day. Skin conductance level of participants was recorded continuously during performing balance task. ANOVA, Pearson correlation, and regression were used to analyze the data. The results indicated that dynamic balance based on reaching distance was higher at 15:00 p.m. than 20:00 p.m. and 10:00 a.m. It was also found that a linear relationship exists between activation and performance; the intensity of correlation was higher in the afternoon. These findings support the idea on separation of arousal and activation as separable aspects of the physiological and behavioral functions. In this approach, the activation was introduced for the afternoon as the factor causing superiority of dynamic balance, as compared with morning and evening

  Aggression is a phenomenon prevalent among children with ASD which makes the processes of training and rehabilitation difficult for them and can result in delays in acquiring developmental skills. The aim of the present study was to investigate the effectiveness of hydrotherapy on the degree of aggression in children with autism spectrum disorder (ASD). The present study used an A-B single-subject research design. The population consisted of all children with ASD in Alborz Province. Making use of the purposive sampling method three children were diagnosed to suffer from ASD. The research instruments were the Gilliam Autism Rating Scale (GARS) and a researcher-made checklist to measure aggression. Therapy sessions were conducted according to Halliwick instructions for two months (totally for 8 weeks and 16 sessions). To analyze the data, after drawing charts and the stability and process container, the effectiveness of the independent variable on the dependent variable was assessed applying intra- and inter-situational analyses. During visual analysis of the data chart, intervention was effective on all of the three participants. The Percentage of Non-Overlapping Data (PND) in the two baseline and intervention situations for the three participants were 100, 87.5, and 100%, respectively. The results indicated that hydrotherapy significantly results in reducing aggression in children with ASD. Thus, it is suggested that this method be used as a complementary method in training and rehabilitation of children with ASD.

  Postural changes in the lower limbs such as flat foot deformity can lead to abnormal changes in the axis of the lower extremities, the pelvic position, and the lower back. Since parts of the body are like a chain and each part affects the other parts, it is possible that changes in the balance of the foot with the use of insole and plantar exercise therapy improve the height of the medial longitudinal arch and correction of flat foot, which in turn can modify the axis of the lower extremities, pelvic tilt, and lumbar lordosis. Therefore, the aim of the present study was to evaluate the positive and negative effects of insole and exercise therapy on the flat foot, pelvic tilt, and lumbar lordosis. To search for related articles, IranMedex, Magiran, SID, PubMed, ScienceDirect, and Scopus databases were used. GoogleScholar was searched with both Persian and English language and keywords. The search was performed between August and September, 2016. In our study, based on the artcticles studied, it was found that insole has a positive effect on symptoms of the flat foot and correction of the axis lower limb. On the other hand, the articles related to the effects of exercise therapy on the flat feet showed that exercise therapy has a positive effect on the flat feet, except for one case. According to the results, using insole and exercise therapy can help support the plantar arch and leads to improvement in the flat foot, which can probably lead to alignment in the lower limb axis, pelvic tilt angle, and lumbar lordosis

  Attention to the phenomenon of aging, fall, consequences of falling, and finding methods to prevent falling in the elderly are points of interest to many researchers. On the other hand, choosing exercises that, in limited time, can bring about high effects with minimum facilities, are their ultimate goal. Therefore, the aim of the present review study was to investigate the consequences of falling and evolution of training in the elderly. In the current study by searching among related articles published from 1984 to 2017 in the field of elderly training and valid scientific databases, based on the research criteria, 55 articles were selected as the final articles for the present review study. Increasing age is associated with impaired systematicity of the human body and overall the ability to respond to perturbation decreases affecting the balance control and leading to increase in the chances of falling, which is one of the main causes of mortality in the elderly. Risk factors of strength disorder, balance, and reaction time are the most important causes of falls, and finally, balance disorder is one of the strongest and most important factors in the control of balance and falling in the elderly. In addition, various training protocols for improving balance and preventing falling have been shown to have conflicting outcomes. According to the results, if the main mechanisms of postural neurological control and balance are not properly strengthened, any perturbation such as glide, stinging to the edge of the carpet, and like can disrupt the balance and fall and result in irreversible problems. Therefore, further studies are needed to illustrate the effect of training focused on balance control mechanisms in preventing falls and persistence rate of this exercises

  The most common functional disorders in stroke patients are disabilities in reaching and manipulation tasks which are associated with many problems for doing daily activities. Despite multiple techniques in rehabilitation, the amount and rate of recovery of upper extremity motor functions are weak, so new strategies have been suggested for combining different therapy methods. With the assumption that further improvement achieved through the use of both cognitive and physical aspects in the reorganization of neural circuits in the brain, in the rehabilitation of affected limb, the combination of mirror therapy and electrical stimulation can be more effective than using each of these methods separately. In the present study, we compared electrical stimulation and mirror therapy and conventional therapy and combination therapy in a pre-test/post-test study. A systematic review with meta-analysis was performed on mirror therapy, electrical stimulation, and their combination from Pedro, Pubmed, and Rehabdata databases. A meta-analysis was performed based on random effect and effect size was obtained with the standard mean difference. The acute or sub-acute and chronic stroke, active/passive stimulation, and also protocol of training exercises in coordinated bilateral movement and other exercises are considered as affecting factors. In the present study, 35 articles with 903 stroke patients were studied. A significant difference was observed in comparing the efficacy of the two methods of mirror therapy and electrical stimulation and a conventional therapy. Also, a significant difference was confirmed between efficacies of pre-test/post-test in conventional therapy. Therewith, the existence of significant difference was confirmed between treatments of the early and late duration of the stroke. The type of active and passive stimulation, as well as bimanual or bilateral exercise movements in comparison with other exercise movements did not reveal a significant difference between the efficacy of electrical stimulation and mirror therapy, respectively. The hypothesis of improving brain reorganization for stroke patients is confirmed by simultaneously applying both cognitive aspects and physical functions. Electrical stimulation and mirror therapy can be more effective during the period early after the stroke. It can be concluded that other factors such as intensity of stimulation, duration, and frequency of excitation or even the active stimulation can be resulted in the lack of confirmation of the efficacy of the active stimulation method versus the passive stimulation. The reliability of the results in the meta-analysis could be increased if more articles are used