mahnaz hejazi-shirmard

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can lead to difficulties in various aspects of adult participation.

This present study aimed to investigate executive function, sensory processing, and participation in meaningful activities among adults with and without ADHD. Additionally, the study explored the relationships between executive function, sensory processing, and participation in meaningful activities in adults with ADHD.

In this cross-sectional study, 70 adults aged 18 to 40 with ADHD and 68 healthy peers were recruited from various clinics and centers across Tehran. Executive function and sensory processing were assessed using the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) and the Adolescent/Adult Sensory Profile Questionnaire (AASP), respectively. Participation in meaningful activities was evaluated using the engagement in meaningful activity survey (EMAS). Independent samples t -tests were used to compare adults with ADHD to healthy adults. Pearson and Spearman correlation coefficients were utilized to explore correlations. A stepwise linear regression model was applied to assess the predictive effects of various variables.

Significant differences were observed in executive function, sensory processing, and participation in meaningful activities between adults with and without ADHD. Significant correlations were found between participation scores and all subscales of executive function and sensory processing.

The findings indicate that individuals with ADHD exhibit significant differences in executive function, sensory processing, and participation in meaningful activities compared to their non-ADHD peers. Executive function and sensory processing in adults with ADHD appear to impact their participation in meaningful activities. Further studies are needed to confirm these findings.

Background and Aims:

 Cerebral palsy (CP) is one of the common disabilities in children caused by brain damage. Children with CP should receive rehabilitation suitable for their age and developmental stage. There are various treatment approaches to improve the condition of these children. However, there are a few approaches that specifically focus on both the upper and lower extremities. There is an approach called hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) that can affect the upper limb and the lower limbs of children with CP. The present study aims to review the clinical trials on the effectiveness of this method for children with CP.

Methods:

 This is a scoping review. A search was conducted in PubMed, Scopus and Web of Science databases using the keywords “CP”, “cerebral palsy”, “HABIT-ILE” AND “hand-arm bimanual intensive therapy including lower extremities”. A total of 82 were found by the initial search. Of these, 60 articles were excluded due to not being a clinical trial. Also, from the remaining 22 articles, 15 were excluded due to similarities in all three databases and one article was excluded due to lack of access to the full text. Finally, 6 articles were included in this research. 

Results:

Intensive two-handed hand-arm therapy including the lower limb has shown promising results in improving the function of the upper and lower limbs in children with cerebral palsy. In this study, 82 articles were found, and according to the inclusion and exclusion criteria, 6 articles were included in the study and reviewed.

Conclusion:

 The approach of intensive two-handed hand-arm treatment including the lower limb has been much appreciated by therapists due to its nature and the inclusion of the lower limb in addition to the upper limb. However, very few studies have been conducted in this field. It seems that larger and stronger studies are needed to investigate this approach in terms of the age range studied and the amount of time for interventions, as well as the generalization of this approach to other neurological problems.

There are ongoing debates among surgeons regarding the most effective surgical method for hip replacement, with varying preferences for the anterior and posterior approaches. Both methods have demonstrated excellent long-term outcomes, with clinical differences primarily observed in the early postoperative period.

This study aimed to compare the anterior and posterior methods of hip replacement after six months of surgery in terms of biomechanical and clinical indicators, as well as quality of life.

In this cross-sectional observational study, 42 patients who underwent hip replacement surgery using either the anterior (n = 22) or posterior method (n = 20) at least six months (and a maximum of 12 months) post-surgery, along with 20 healthy individuals, were evaluated. Biomechanical indices of the center of pressure (COP) were measured using a force plate during two-leg standing with eyes open and closed. Functional balance, independence, self-perception of performance, satisfaction, and quality of life were assessed using the timed up and go test (TUG), Barthel Index, Canadian Occupational Performance Measure (COPM), and the SF-36, respectively.

No significant differences were found between the anterior and posterior groups in terms of COP, clinical variables, and quality of life (P > 0.05). However, when compared to the control group, the anterior replacement group exhibited significantly higher COP displacement in the medial-lateral direction (P = 0.03) and COP velocity in the anterior-posterior direction (P = 0.02) during two-leg standing with eyes open. No significant differences in COP variables were observed in the posterior replacement group compared to the control group (P > 0.05).

The findings indicate no significant differences between the anterior and posterior approaches to hip replacement in terms of biomechanical and clinical indicators, as well as quality of life after six months. Therefore, the choice of surgical method can be based on the patient's condition and the surgeon’s expertise in the respective approach.

This study seeks to investigate how physical activities can help enhance static and dynamic balance in children with Autism Spectrum Disorder (ASD), who often experience difficulties with communication, cognitive abilities, and motor skills.

 The study is a randomized, double-blind clinical trial examining the impact of physical activities on improving static and dynamic balance in 6-12-year-old high-functioning ASD children from Tehran's treatment centers and special schools. Initially, 30 participants were chosen, then divided into two groups of 15 using block randomization. The experimental group underwent 24 sessions of physical activities, while their balance was assessed using force plate tools and the Walking heel to toe test before and after the intervention.

The results of the evaluation of center of gravity fluctuations using the power plate and also the Walking heel to toe test score showed that performing balance exercises for people with autism spectrum improves the static and dynamic balance of these people. More precisely, in the field of static balance, the center of gravity oscillation decreased in all parameters of lateral displacement, anterior-posterior displacement, average velocity of oscillation, and range of oscillation.

It seems that physical activities can improve static and dynamic balance in autistic children, so therapists can use physical activities to increase balance and improve movement disorders in autistic people.

Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients’ ability to perform daily occupations. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose potential for motor and cognitive recovery of patients with TBI has been investigated; however, its effect on functional outcomes following TBI is unknown. This study aims to determine the effectiveness of tDCS combined with routine occupational therapy on the activities of daily living in patients with TBI.

This was a single-blind, randomized clinical trial. A total of 24 patients with TBI were recruited using the convenience sampling method and were randomly assigned to the experimental (n=12) and control groups (n=12). Both groups underwent routine occupational therapy for 10 sessions (3 days per week), and the experimental group received tDCS (20 min) in addition to routine occupational therapy. Activities of daily living were assessed using the functional independence measure (FIM) at the baseline and the day after the end of the intervention.

After a 10-session intervention, both groups experienced significant improvements in the cognitive subscale and the FIM total score (P<0.001). Additionally, the findings showed that these improvements were significantly higher in the experimental group (P<0.001).

According to the findings, although routine occupational therapy can effectively improve the ability of patients with TBI to perform daily living activities, adding tDCS as a complementary intervention can accelerate recovery in these patients.

Physical exercise is a promising intervention to improve cognitive function and reduce the risk of dementia and other related neurodegenerative disorders. The present study aimed to investigate the effectiveness of an upper limb-focused physical exercise intervention on cognitive function and daily living activities in older adults. 

Forty older residents of a nursing home participated in this clinical trial and were randomly assigned to the experimental (n=20) or the control (n=20) groups. Participants in the experimental group received a physical exercise intervention for six weeks. This intervention included resistance training of the upper limbs using free weights. Evaluations were performed at baseline and after three and six weeks of the resistance training. Stroop test and Barthel index were used to evaluate cognitive function and daily living activities, respectively.

Upper limb resistance training significantly improved cognitive function in the experimental group, but there was no significant difference between the groups in the ability to perform daily activities.

The present study revealed that resistance training of the upper limb can yield cognitive improvement in older adults. Upper limb strengthening seems to have the potential to improve cognitive performance in the elderly and can be recommended as a regular exercise activity. However, further studies with more comprehensive outcome measures are needed.

Due to the climate changes and reduction of energy resources, the human-made environment and buildings should be more sustainable and use less levels of energy. In this regard, optimizing energy consumption and utilizing sustainable architecture approaches, especially in schools, can do a great help to the growth and development. The aim of the present study was to evaluate elementary schools in district three of Tehran based on indicators of sustainable schools.

This descriptive-cross sectional study included all elementary state schools in district three of Tehran in 2018. In this way, 28 schools were evaluated. The data collection instrument was a questionnaire containing 14 sub-criteria in terms of engineering-architectural and behavioral criteria. Data were analyzed using descriptive and inferential statistical tests by SPSS 23.

Findings of the research showed that most (82.1%) elementary schools of district three of Tehran are second-grade green schools and only 17.9% are first-grade. No significant relationships were found between the school officials’ concern about environmental issues with the school’s sustainability score. 

Elementary schools in district three of Tehran are at a relatively desired status based on the indicators of sustainability, but given the importance of designing ecosystem-compatible educational spaces, more attention should be paid to the design of schools based on the sustainability index.

Stroke is a primary cause of long-term disabilities. Impact of stroke on individuals can be devastating which include an increased dependency on others for activities of daily living, change in mood and cognition, and disruption of social interactions. Such changes have negative influences on the quality of life (QoL); however, it is commonly neglected. This study aimed to determine the functional independence and QoL in chronic stroke patients and the relationship between these factors.

In this cross-sectional study, QoL and functional independence of chronic stroke patients (n=63, aged 24-65 years) were assessed by World Health Organization Quality Of Life questionnaire (WHOQOL-Bref) and Barthel index. These participants had experienced only one stroke and had no other orthopedic, neurologic or psychological disorders.

The mean age of participants was 46.11±11.93. The mean score of total QoL was relatively low (58.91±12.21) and mean score of Barthel Index was 87.46±13.04. Psychological and environmental domains had lowest and highest scores respectively, and males had a higher QoL in comparison to females in all domains. There was a correlation between functional independence and overall QoL (r=0.001), functional independence was highly correlated with physical (r=0.000) and environmental (r=0.016) domains (P<0.001).

The results demonstrated that in the majority of participants the QoL was not favorable and is correlated with functional independence level, although further studies are necessary to confirm these findings. The results emphasize more attention to psychosocial aspects of stroke survivors.

Premature neonates are at great risk for cerebral palsy, developmental delays, hearing problems and visual impairments. Interventions to reduce the morbidities and adverse health outcomes in these neonates and improve parent-infant interaction are highly important. This study was conducted to determine the effect of the Creating Opportunitiesf or Parent Empowerment (COPE) program on the perceived mat ernal parenting self-efficacy of premature parents

This was a randomized controlled trial with equal randomization (1:1:1 for 3 groups) and parallel group design. Forty-five preterm neonates were randomly allocated into treatment (n=15), supervision (n=15), and control (n=15) groups. COPE program was provided for a 4-phase educational-behavioral intervention program to the treatment and supervision groups. Primary outcome was parental self-efficacy, which was assessed with the Perceived Maternal Parenting Self-Efficacy. All measurements were taken before and after completion of the study with the valid equipment and by the blind assessors.

COPE mothers reported significantly stronger beliefs regarding their parental role and have more confidence to their ability in caring of neonates compared with control mothers (P-value <0.001).

An educational-behavioral intervention program would strengthen mothers’ beliefs and knowledge about their neonates and would remove barriers to enhance their ability for caring of neonates and enhance parent-infant interaction.

The theories of occupational therapy always emphasize on the relationship between a person, his or her context, and occupations or tasks. Based on these theories, proper occupational performance results from appropriate interaction between these components. There is little evidence on the clinical practice of this theory in cardiac rehabilitation. So, this study aimed to investigate the implication of the Ecology of Human Performance (EHP) in a 50 years old man with cardiovascular disease. The participant was assessed and treated at home by an occupational therapist based on EHP principles. Results indicated that the intervention based on EHP was associated with improved performance and satisfaction of performance as well as independence in the activities of daily living. So, occupational therapists can use EHP to provide client-centered interventions and improve the occupational performance of clients with cardiovascular diseases. However, further studies with more methodological rigor are needed on this topic.

Occupation-based models can integrate the occupation into Occupational Therapy (OT) practice. These models offer a theoretical basis for OT interventions.  Person-Environment-Occupation (PEO) is one of these models, but there is limited evidence to outline the use of PEO to support OT in cardiovascular diseases. Therefore; the aim of this study is to investigate the usefulness of this model in a patient with a cardiovascular disease.  The participant was a 48-year old woman with cardiac disease (heart failure with NHYA 3). Results indicate that the application of PEO model significantly improved physical function and the quality of life. The findings of this study suggest that PEO can guide OT practice in cardiac rehabilitation.

Sensory deficits are common in stroke. These deficits can decrease quality of upper limb movements and result in impairments in manipulative skills and fine motor activities. In spite of the fact that skilled movements and independent function correlate closely with the ability of perception and discrimination of various sensory inputs, and full motor potential of sensory impaired limbs cannot be used, these deficits rarely addressed in stroke patients. The aim of this study was to investigate relations between sensory and motor functions in hemiplegic in chronic stroke patients.
Material and

In this descriptive-analytic study, twenty seven stroke patients were recruited through random sampling. Sensory function of upper extremity was measured by fugl-meyer (sensory section) and Stereognosis test, and motor function was measured by motor section of fugl-meyer test.

Significant correlation was found between motor function of upper extremity with stereognosis abilities (P=0.002), but no significant correlation was found between motor function with sensory section (light touch and properioception) of fugl-meyer test.

Regarding the significant correlation between motor function of upper extremity and stereognosis, it is essential to pay attention to sensory deficits in stroke patient during their rehabilitation.

Sensory deficits after stroke are common with prevalence rates variously reported to be 11% to 85%. In spite of the fact that Sensory deficits can decrease the quality of upper limb's movements and result in impairments in fine motor manipulation of objects, grasp and manipulative skills and finally decrease the patient's quality of life but commonly overlooked in stroke rehabilitation. The aim of this study was to investigate the effects of sensory retraining on upper limb recovery.

In this study we studied 5 chronic stroke patients were participated using a single-system (A-B) design. During the baseline phase patient's function and motor impairment of upper limb were measured by Fugl-Meyer and Motoricity Index and their hand dexterity were measured by Box and Block test on three days intervals. When Patients reached to a stable pattern of changes, their treatment program began. In this phase they received sensory retraining intervention for 6 weeks. Based on sensory retraining principles and according to each patient's abilities, intervention began with detection and localization of constant and moving touch and followed by higher discriminatory tasks, such as graphestesia. Then results of evaluations of two phases were analyzed.

Four patients showed significant improvements in upper limb function. The data showed significant improvements in motor impairments and hand dexterity in all of them.

Regarding of significant recovery of upper limb function, motor impairment and hand dexterity of patients, sensory retraining can be considered as a practical method in rehabilitation of stroke patients. However further research with larger sample size is needed.