فصلنامه علوم پیراپزشکی و توانبخشی
سال هشتم شماره 3 (پاییز 1398)

 In recent years, the evaluation of voice disorders has traditionally moved into a more comprehensive approach that includes quality of life. The quality of life related to Singing Voice Handicap Index (SVHI) is one of the most widely used self-assessment tools in the area of ​​voice disorder for singers. The aim of this study is to investigate the voice handicap index in singers who are suffering from voice disorder and healthy singers by the Persian version of the singing voice handicap index (SVHIP).  This is a descriptive-analytic study. In this study, 115 singers (48 singers with voice disorder and 67 healthy singers) were participated, and their demographic information was recorded. By completing the Persian version of SVHIP and using Independent T-test and Pearson correlation coefficient, total score and score of each SVHIP index subset (functional, physical and emotional domain) were calculated.  There is a significant difference between the total score of singing voice handicap index and the scores of its subset in both healthy and voice disorder groups. (p≤0.05). There is also a strong correlation between each SVHIP subset with each other in each group of participants 0/6<r<0/8.  Voice impairment in singers affects the quality of life related to their voice in all aspects of physical, functional and emotional.

An ankle sprain produces two-way defects that increase the risk of secondary damage to the non-injured limb. Hence, the purpose of this study was to investigate the effect of plyometric training (PT) on lower extremity functional symmetry of soccer players with a history of lateral ankle sprain. In this semi-experimental study, 20 male soccer players with a history of one and two-grade external ankle sprain were selected by using sampling method. PT were performed for 6 weeks. To evaluate the functional asymmetry between the lower extremities functional tests including single hop test, triple hop test, crossover hop test, 6m hop test and multiple test were used. The lower extremity symmetry index (LSI) formula was used to assess the degree of asymmetry in healthy and injured leg. Paired t-test was used to compare the performance between the lower limbs and compare the average percentage of lower extremity symmetry. The results of this study showed that there was a significant difference between two legs in the pre-test. A healthy leg had a better performance than the injured leg in single hop test (p=0.011), triple hop test (p=0.017), crossover hop test (p=0.001), 6m hop test (p=0.001), and multiple hop test (p=0.001); while the post-test showed no significant difference between the lower extremities. The results of paired t-test showed that there was a significant difference between the average of LSI in the pre and post-tests in single hop test (p=0.024), triple hop test (p=0.039), a crossover hop test (p=0.031), 6m hop test (p=0.004) and multiple hop test (p=0.001). The results indicated that injured and dominant leg function led to functional asymmetry in two legs, which PT could compensate for this functional asymmetry.

Approximately three-fourths of women experience an episode of vaginal candidiasis. One of the virulence factors, is the ability of attachment of C. albicans to the host tissue through factors such as sticky molecules and proteins that accelerate this connection. The aim of this study was to investigate the frequency of biofilm formation genes in C. albicans strains isolated from vaginosis and to compare the expression of als gene in strains treated with iron nanoparticles in the in vitro using real time -PCR. In this descriptive cross-sectional study conducted in Shariati Hospital during a 6-months period, 100 isolates Candidafrom vaginal specimens were evaluated. After identification of C. albicans strains using standard biochemical and microbiological tests, genomic DNA extraction was performed using the CinnaGen Company Kit. Multiplex-PCR assays were performed to detect als, hwp1 and hyr genes. Also, to investigate the effect of iron nanoparticle on expression of als gene, RNA, all isolates containing this gene were extracted using Cinnapure kit. After cDNA synthesis, real time PCR test was performed. Molecular analysis results showed that from the total of 60 isolates of C. albicans, 34 isolates (56.66%) had the hwp gene, 46 isolates (76.66%) had Als gene and 33 isolates (55%) had Hyr gene. The results of the asl melting curve in clinical strains of C. albicans and treated with iron nanoparticles showed that the main peak for this gene occurs at 85.34 ° C. Als expression in the treated isolates was lower than untreated, which indicates the positive role of the treatment in reducing Als gene expression in these isolates.

with regard to the nature of cognitive and perceptual aspects, dyslexia is believed to be a defect in the development of brain cells in the visual and auditory areas. So significant evidence has confirmed the origin of dysfunctional neurology, one of the new interventions for a group of children with dyslexia is the use of approaches such as sound therapy, which little research has been conducted in Iran. Therefore, the present study was conducted with the aim of evaluating the effectiveness of sound therapy by Tomatis method on executive functions in dyslexic students.
 
This study is an experimental study. From students who had been diagnosed with dyslexia admitted to counseling and rehabilitation clinics in Tephran, 14 students were selected via convenience sampling. Afterwards, they were divided into two experimental groups, experimental (sound therapy by the Tomatis method) and control group (without intervention). In the next stage, the Stroop Test, N-Back test, Wisconsin card sorting test (WCST) and tower of London (ToL) test were performed on the subjects of each of the two groups and the obtained scores were considered as pre-test scores. Then, an independent variable was applied, in other words, the experimental group received 30 sessions of treatment 3 times a week, about 2 hours in length led to the intervention of "sound therapy by the Tomatis method", while control group were just followed. At the end of intervention post-test was performed and then groups were followed up after 1.5 months. The data were evaluated using repeated measures ANOVA by statistical software SPSS-22 with p<0.05 considered as statistically significant.
The results showed that sound therapy had an impact on improving executive functions (selective attention, cognitive flexibility, abstract reasoning, change in relation, cognitive function, ability to plan and organize) in dyslexic students (p<0.005).
According to the findings, considering the usefulness of sound therapy on improving the performance of dyslexic students and considering the short duration of these interventions and their attractiveness for children, it seems that applying this method can be beneficial to learning disabilities and other disorders that are caused by imperfections in executive functions.

Changing strength ratio of internal to external rotator muscles is a common condition in overhead athletes with shoulder impingement syndrome. The purpose of this study was to investigate the effect of traditional and TRX (total-body resistance exercise) suspension training on the strength ratios of internal and external shoulder muscles. Thirty-three athletes with shoulder impingement syndrome in Kerman city were selected and grouped into two groups of training (traditional and TRX Suspension training) and control group. To assess the strength, the subject sitted at the edge of the table with arm position located near the body and elbows at 90 degrees of flexion. The subject was applied the maximum pressure to hand-held dynamometer for 5 seconds, each person performed three attempts and an average performance of the person was based on statistical work. The results showed that after the training period, improvement in the strength ratio in shoulder rotator muscles were observed (p=0.004). The results showed that there was a significant difference between the traditional and TRX group with the control group (p<0.001, p=0.009 respectively), but there was no significant difference between the traditional and TRX training groups (p=0.58). Furthermore, the average score changes in the TRX group was higher. Since traditional exercises require several training tools, however, TRX exercises only one tool is needed, as well as the TRX exercises execute in the closed-kinetic chain, it can be concluded that TRX exercises can be used as a substitute for traditional exercises in places with restricted exercise space.

The anterior corneal curvature has important role in diagnosis and management of keratoconus. The purpose of the present study is to determine the repeatability of anterior curvature of 5 corneal rings (1-5 mm from the corneal center) in keratoconus patients obtained by the Orbscan and Eyesys instruments and to determine the level of agreement of curvature measurements between two instruments. In this prospective study, anterior curvatures of 5 corneal rings were measured using Orbscan and Eyesys in 48 right eyes of 48 keratoconic patients. The mean age of patients was 31.6±4.7 and the grades of keratoconus of patients according to the maximum keratometry were mild (≤50 D), moderate (50-55D) and severe (≥55D). Statistical analysis was performed using Intraclass Correlation Coefficient and Repeated measures ANOVA for repeatability of each device. Pearson’s correlation coefficient, paired t test and Bland-Altman plot were also used for comparison of two techniques. In this study, the ICC showed high repeatability for measurements of each devices (ICC Eyesys=0.99, ICC Orbscan≥0.95, p<0.0001) in all corneal rings. According to repeated measures ANOVA, there was no significant difference between the repeated measurements of each device in all corneal rings. The Pearson’s correlation analysis showed high correlation between the measurements of Orbscan and those of Eyesys (r≥0.84, p<0.0001) in all rings. According to the paired t test, there was a significant difference in curvature measurements of Eyesys and those of Orbscan in all corneal rings (p<0.001). Also, the Bland-Altman plots showed low agreement between curvature measurements of two devices in all corneal rings. The present study showed that the anterior curvature measurements obtained by each of Orbscan and Eyesys instruments were repeatable in all corneal rings. Anterior curvature measurements of 5corneal rings obtained by Eyesys were steeper than those obtained by Orbscan and the two devices could not be replaced for anterior corneal curvature measurement in keratoconic eyes.

Propose:Hand function is essential to activities of daily living for everyone, including individuals with cerebral palsy (CP). Individuals with hand dysfunction experience difficulties in self-care as well as educational, recreational, and fitness activities.Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function activities. Hand dysfunction may have effects on quality of life. Dysfunction of the upper extremity is a common and debilitating consequence of cerebral palsy. The purpose of this study was to determine the effects of short thumb Splint on hand function, and wrist and thumb range of motion of children with age range of 8 to 12 years with spastic cerebral palsy.
The design of this study was before- after clinical trials on fifteen cerebral palsy children selected from special school based on inclusion criteria. Patients used a short thumb Splint (40 degrees of palmar abduction of thumb) for 2 months (6-4 hours during a day and 6 to 8 hours at night). In this study box & block Hand Function Test was used to evaluate the hand function. Goniometric measurements of thumb were obtained in degrees to calculate the passive range of motion.
The results showed significant improvement in hand function (p=0.001), thumb range of motion (palmar and radial abductions) after Splinting (p=0.02) but did not reach statistical significance in wrist range of motion (p=0.054).
Our findings suggested that application of short thumb Splint in cerebral palsy children can improve hand function and enhance dominant hand thumb range of motion.

Previous studies have indicated that vitamin D3 deficiency is common in mentally disabled. This study aimed to determine Vitamin D3deficiency among mentally disabled patients city of Kashmar. In this descriptive cross-sectional study, 72 mentally disabled people (10-60 years old) who were in a rehabilitation center in Kashmar city were selected through a census. Sampling was done by a researcher for subjects who had inclusion criteria. Serum levels of D3  were measured using HPLC method. The vitamin D3 deficiency was defined as serum 25-hydroxyvitamin D3 level ≤ 12 ng/ml. Data was analyzed using SPSS software. 47.2% patients were classified as deficient in Vitamin D3. Age and 25-hydroxyvitamin D3 level was significantly correlated. 65 percent of disabled from age 20 to 39 years were severe and moderate deficient in Vitamin D3. The physicians, responsible for the treatment of patients with multiple complex developmental disorder, incorporate Vitamin D3   supplementation in their practice. In addition, screening for vitamin D3 deficiency should be integrated in the health assessment of patients with mental disorders.

Chronic back pain is one of the problems of today's societies, that its treatment reduces the economic, social and psychological consequences of society. Regarding the role of physical activities and exercises in improving back pain, the purpose of this study was to compare the effect of Barreausol and Pilates on pain, functional disability and quality of women with chronic back pain.
Thirty patients with chronic back pain were selected as convenience and randomly in three 10-patients groups Barreausol (average age of 42 ± 7, height 160 ± 8, and weight 62 ± 5.5 kg) Pilates (average age of 42.5 ± 5 years, height 159 ± 10 cm, and weight 61 ± 6 kg) control (average age of 42 ± 6 years, height 161 ± 11 cm, and weight 59.5 ± 7 kg) among the referred patients. The intervention group received 8sessions per week and three 60 minute sessions each week. The pain was evaluated by the visual scale of functional pain and functional disability in patients with osteoporosis questionnaire. For analysis, inferential statistics of variance for repeated data were used.
The findings showed that both of the interventions reduced pain and functional disability in patients compared with the control group (p≤0.05) Also, the findings did not show a significant difference between the two training methods in the dual variables of the research (p>0.05).
Based on the findings of this study it can be concluded that Barreausol exercises and Pilates exercises can reduce the ' pain and adverse effects of women with chronic low back pain so it can definitely be recommended as a suitable medicine for the treatment of chronic low back pain.

New research techniques and theories on fetus/infant have suggested that language learning begins in the fluid world of the uterine and it continues throughout the life. This study is a review on studies that examine the fetus response to auditory stimulus, evidence of language learning during the fetal life, and methods for examining these cases in the fetus. The title and abstract of all published articles from 1980 to 2018 in databases including Web of Science, Google Scholar, Scopus and PubMed were searched to find the articles that were related to the existence, formation, and development of pre-linguistic skills in the fetuses and infants. As a result of this comprehensive search, 106 articles were found. After careful investigation of their abstracts, 52 articles that were completely compatible with the study objectives were included and used to write the article. Methods including change in the pattern of sucking and heart rate of the infant/fetus, and other types of behavioral scales have shown that the human fetus can remember and recognize the previously exposed human voices and language. In fact, by developing auditory skills during the second half of pregnancy, the first fetus experiences of the spoken language are formed. Prosody and rhythm of speech have a central role in early language learning, and such information are available to fetus and is processed by the auditory system. Therefore, the fetal brain can really understand and learn most of the main aspects of the language at near-birth.