Journal of Modern Rehabilitation
Volume:11 Issue: 4, Autumn 2017

Speech sounds disorders are regarded as the most significant problems among children’s communication disorders. Employing the clinical experience and expertise alongside with preserving the patient’s virtue, a therapeutic approach should be adopted based on valid clinical evidence. The Cycles Approach is proposed by Hodson for the treatment of moderate to severe phonological disorders. Given that the results are sometimes controversy in the field of pathology of speech and language, to ensure that time and resources are used ethically is of considerable importance. Therefore, the research studies using this approach in the treatment of speech disorder are analyzed in this review study.
The keywords of Phonology, Evidence-based Practice and Cycles Approach are chosen. Databases include Science Direct, PubMed, ASHA, and Springer. Sixteen papers were extracted from 1983 to December 2017. After the initial review, nine papers were selected for this review study.
The reduction of all phonological processes as well as development of phonological awareness of the child and improvement in phonological production and phonological awareness are approved following the treatment. Production of non-irritable sounds showed a significant improvement in the succeeding group and individual combination therapy. Furthermore early intervention leads to an increase in the percentage of correct consonants as well as mean length of utterance. The Cycles Approach results in the reduction of the spelling errors patterns at phoneme, word, sentence and conversation levels.
Considering the research studies over the past three decades, Cycles Approach can be considered as an evidence-based treatment and the therapists can apply it as an appropriate method to interfere with the speech sound disorders in children having moderate to severe phonological disorders.

Headache is one of the prevalent health problems that impose huge costs on economy. One type of the headache is cervicogenic headache caused by bad posture of cervical spine. To know the effect of corrective exercises on cervical headache by improving range of motion in joints and retraining specific postural muscles like anterior and deep flexor muscles of the neck.
Based on inclusion and exclusion criteria, 30 individuals were randomly selected and divided into two groups; control (medicine) and interventional (exercises) groups with 15 participants in each group. A validated digital camera (Cannon A95 PowerShot) was used to determine Forward Head Posture (FHP). The landmarks of the FHP were marked by using white 12-mm markers that included earlobe, C7 spinous process, and acromion process. Patients performed stretching, strengthening, and corrective exercises after receiving training. The obtained data were analyzed by ANCOVA, Mann-Whitney U and Wilcoxon signed-rank tests.
The average difference in the scores of cervical headache in the experimental group was less than that in the control group which was statistically significant (P Corrective exercises had shown statistically significant effects on neck disability index, neck pain as well as on the pain intensity, its duration and frequency among office workers with FHP.

Smart phones and mobile devices are among the most important inventions of modern technology. Their physical and potential capabilities offer a wide variety of opportunities to software programmers for developing new applications. Of these applications, educational games can efficiently promote the learning goals. The speech therapy applications are educational games which can be more effective if they use interactive games running on mobile devices.
In this research, a mobile speech therapy application is designed to help children with Down Syndrome (DS) to improve their speaking skills. The application helps the children memorize the words and checks their pronunciation with an offline speech processing algorithm. The speech therapy application was tested on 5 children with different severity of DS. The application was assessed from two aspects of ease of use and efficiency by a Likert-type 5 item questionnaire under supervision of an expert. Also paired samples t test was performed to compare the efficiency of mobile application with the traditional speech therapy methods.
According to the paired samples t test results, the decision measure was 0.020 (less than 0.05), which shows that mobile application of speech therapy prefers to the traditional method.
The results show that the application is effective and easy enough for children with Down Syndrome to use. Also the comparing assessment with the traditional teaching method show that using mobile application as a means of education will improve learning efficiency.

Antonymy is a key feature of everyday conversation, mental organization of words and discourse. It is also known that the most important characteristic of children with intellectual disabilities is language delay. Therefore, such children may have difficulties in the perception of antonymy. The purpose of this paper is to provide a comparative study of the perception of various types of antonymy between Typically Developing (TD) and educable Persian-speaking children with intellectual disabilities. Specifically, whether the perception of various types of antonymy is similar in these two groups of children. This research may offer clues for the necessity of the investigation of antonymy to help perceive the semantic knowledge by children with intellectual disabilities because the semantic knowledge is in turn vital for language comprehension.
The study subjects included 15 TD children between 6 to 8 years of age and 15 educable children with intellectual disabilities with mental age of 6 to 8 years. Data were collected via a researcher-made test of perception of antonymy. A total of 30 questions were used to compare the perception of antonymy in terms of simple, gradable, reverse, converse, open and close taxonomy antonyms. Each question included three words.
Except for the gradable antonymy subcategory, the perception of various types of antonymy between two groups of children showed a significant difference (P The research findings indicated that children with intellectual disabilities had difficulties with antonymy perception.

Muscle fatigue is tiredness, in other words, loss of productive capacity of power in response to the activity. The development of fatigue during prolonged exercise may be evaluated by repeated assessments of maximal voluntary force. This study aimed to determine the effect of muscle fatigue on trans-tibial stump level in knee extensor muscles (vastus lateralis, vastus medialis, and rectus femoris) at 30 and 45 degree knee flexions by using surface electromyography.
Forty male amputees with trans-tibial amputation, aged between 18-50 years were assigned randomly in three groups; performed three isometric contractions with extended knee at 80% of the maximal voluntary contraction. Median Frequency (MDF) and Root Mean Square (RMS) values were obtained by surface electromyography from the knee extensor muscles at 30 and 45 degree knee flexions. Force values in stump and sound sides during knee flexion at 30 and 45 degree were also compared.
Median frequency on sound side showed more fatigue and MDF-RMS between stump levels was short, medium, and long for knee extensor muscles at 30 and 45 degree, before and after the fatigue. No significant effect between stump and sound side was found. Vastus lateralis muscle showed more power than vastus medialis and rectus femoris muscles before fatigue. But after fatigue, rectus femoris muscle showed more power than vastus medialis and vastus lateralis.
Results have confirmed that trans-tibial amputees with good functional ability showed more fatigability on the sound side while stump side showed more power. Vastus lateralis muscle had maximum power on both sides. Vastus medialis and rectus femoris of long stump levels and vastus lateralis muscle of short levels were more powerful.

This study aimed to investigate Phonological Awareness (PA) in children with Speech Sound Disorder (SSD). There are conflicting results about the pre-literacy skills of children with SSD. Previous studies have documented the heterogeneity within SSD children. The presence of a comorbid Language Impairment (LI) is an important factor for this heterogeneity.
The current study examined how a comorbid LI is related to phonological awareness as a pre-literacy skill in a sample of 5- to 6-year-old children with SSD. Participants were 46 children who divided into SSD and LI (n=13), isolated SSD (n=17), and normally developing peers (n=16). Speech production, language, and PA were assessed in these children.
PA scores were significantly lower for children with comorbid LI. The difference between children with isolated SSD without any LI and normally developing children on PA tasks was observed only in words with same final consonant (P=0.021). These two groups performed similar on other PA tasks. Phoneme blending was the only variable that not yielded significant differences between three groups of children (P=0.183). The study of relation between children’s skills on the percentage of consonants correct (PCC), oromotor abilities, language skills, and PA showed that only there was a relation between spoken language and rhyme in children with SSD and LI (r=0.63, P=0.021).
These results suggest that children with SSD and comorbid LI experience PA deficits. These results suggested that PA and spoken language should be assessed in preschoolers with SSD.

Evaluating the educational programs in various Medical Science disciplines is a highly sensitive matter and of great importance. Physiotherapy (PT) is an important field of Rehabilitation Sciences, which requires distinguished scientific and professional skills. One of the practical ways to assess the quality of clinical education in PT is to study the students’ perspective in this field, because they are the main target audience for education. Therefore, this study was conducted to determine the problems in clinical training of PT students, from the medical students’ perspective, in different universities of Tehran City.
The present study was conducted using a qualitative content analysis approach, through individual interviews with 13 PT undergraduate students in Tehran. They were recruited through targeted sampling with maximum variation.
After analyzing the obtained data, a total of 4 themes were derived, which included characteristics of clinical supervision, training schedules and training, setting of clinical training, and general characteristics of the learners. Furthermore, 22 subthemes were obtained; some of them included lack of clinical teaching experience among the faculty members, no supervision in clinical teaching, for example, theory and clinical courses being held in one day, short duration of clinical teaching, inappropriate facilities, and the disorganisation and laziness of some students.
Perhaps changing the clinical teaching methods, employing experienced and effective instructors, taking courses more seriously by students, establishing appropriate facilities for clinical training, supervision of the PT department over the performance of the teachers and the events during internships, and increasing the duration of theory and clinical courses, can all be effective in improving the quality of clinical training.

Increasing the prevalence and complexity of rehabilitation-related disorders has risen the responsibility of future therapists. Learning clinical skills is largely influenced by the effectiveness of the clinical education at university. Identifying the status of clinical education helps resolve or modify the weak points to attain the educational goals and educate skilled people. The purpose of this study was to determine the satisfaction of rehabilitation students with clinical education quality at Ahvaz University of Medical Sciences in 2017.
This descriptive-analytical study was carried out on 153 rehabilitation students. The relevant data were collected using a valid and reliable questionnaire of clinical education satisfaction. Then the obtained data were analyzed using descriptive statistics, the independent t test and ANOVA by SPSS.
The overall satisfaction of students (from different fields of Rehabilitation) with clinical education was reported to be between 50% and 63%. There was a significant difference between the students’ satisfaction with the quality of clinical education and the field of study (P=0.001)
Conducting ongoing education courses to promote the academic level of trainers, rehabilitating the educational environment based on strategic plans, setting up a specific tool and method for clinical evaluation of the students, and determining the minimum clinical qualifications based on the number of patients assessed during internship and apprenticeship can be of great assistance to increase students’ satisfaction.