Iranian Rehabilitation Journal
Volume:17 Issue: 42, Dec 2019

Flexion contracture in fingers of hands is a complication of Dupuytren’s contracture and cannot be stopped by the progressive course. The aim of this study was to review the effect of splinting in the correction of contracture after Dupuytren’s contracture operation.

To carry out this research, a kind of systematic evidence-based review process (Duffy 2005) was used. For data gathering, we used electronic database and Persian- and English-language specific journals between 1990 and January 2019. The keywords were related to examine the effect of various splinting after Dupuytren’s contracture operation.

After data gathering, 26 articles about Dupuytren’s contracture were found; after checking and deep reviewing of those articles, 17 articles were removed from the study and 9 articles were included in the study for reviewing. The results of a review article based on using splint in Dupuytren’s contracture after operation were classified into 6 categories, including static splint, dynamic splint, day splint, night splint, the time duration of splinting, and prescribed time of splinting.

Splint alone has been ineffective in reducing contracture. Static splint and hand therapy (exercise) are together the most effective way for the treatment of Dupuytren’s contracture. Occasional and irregular use of splint also has no effect on pain relief and the reduction of contracture. The pressure and force of splint will be gradually increased, and the splint should be used at least for 3 months, too.

Comparing time use patterns and self-efficacy in two groups of mothers, including mothers of children with Cerebral Palsy (CP) and mothers of children with typical development, is the main objective of this study.

This study was carried out in 2017 in Arak, Iran, on 200 mothers. Multiple sources of the evaluation, including Mothers’ Time Use Questionnaire and Sherer General Self-efficacy Questionnaire, were used. SPSS v. 22 software was used to analyze the data.

The Mean±SD age of children was 4.64±1.46 years in the group of children with CP and 4.64±1.47 in the group of children with typical development. Significant differences were found between groups in the amount of time spent in various occupations, including self-care, childcare and household, leisure, rest/sleep, and work. Mothers of children with CP significantly spent a bigger proportion of time on “rest/sleep” and “childcare and household” areas (P<0.001). However, mothers of children with typical development spent significantly more time in “Self-care” (P=0.01), “Leisure” (P<0.001), and “Work” (P<0.001) areas. Also, significant differences were found between groups in the level of satisfaction.

Lower total score of the time use questionnaire in the group of mothers of children with CP might be because of the nature of limitations and the negative burden of this type of disease in terms of socio-cultural and fewer health system services.

Methamphetamine (MA) use disorder is a new health problem among Iranian female methadone patients that needs special treatment and rehabilitation services. However, few describe their baseline characteristics, their reasons for MA use while in treatment, and their treatment needs and success. The study aimed at investigating these research gaps.

The participants were 70 women with MA use disorder in two large women-only methadone treatment services in Tehran, Iran. A researcher-made checklist, the Severity of Dependence Scale, the Contemplation Ladder, and the General Health Questionnaire-28 were completed by women in a baseline interview.

The mean±SD age of the participants was 35.84±8.62 years. The participants reported high severity of MA dependence (mean±SD = 6.88±3.19), poor motivation to change (mean±SD = 4.0±2.31]), and impaired psychological well-being (mean±SD = 16.35±4.04) in the treatment. The most important reasons for MA use while undergoing methadone treatment included self-treatment (55%) and pleasure-seeking (43%). The most important MA treatment needs included effective psychological treatments (75%), continued family support (72%), and life skills (68%). Stable living and financial conditions (90%), drug-free living and working places (86%), continued family support (78%), and psychological counseling (69%) were the most important reported factors associated with MA treatment success.

The current study indicated that participants reported a number of MA-related problems. This issue needed a comprehensive treatment program at individual, social, psychological, and professional levels. The findings have important implications for delivering psychosocial treatments, as well as gender-specific research.

To determine the role of child factors in the prediction of parental attitudes toward children and adolescents with CP in Iran.

The cross-sectional study design was used. A total of 152 children and adolescents with CP aged 7-17 years (Mean±SD = 10.93±3.46) with a mother aged at least 25 years were selected, using a systematic random sampling method. The Mother-Child Relationship Evaluation questionnaire was used to assess the parental attitude. Simple and multiple linear regression analyses were performed to determine the predictive role of child factors (eg, age, gender, type of CP, dependency in gross and fine motor functions, and IQ) in parental attitudes.

Overindulgence and overprotection attitudes were the most common attitudes among mothers. The acceptance attitude was best predicted by the type of CP (r2=0.151). Diplegia, being fully dependent in gross motor functions, and adolescence predicted greater overprotection attitude (r2=0.101). Girls were predicted to be treated more overindulgent (r2=0.045). Femininity predicted lesser rejection attitude while being fully dependent in fine motor functions predicted greater rejection attitude (r2=0.006).

Child factors influence only a small proportion of parental attitudes toward children and adolescents with CP. Contrary to expectation, child factors, including the child’s disability status, are not the most prominent determinants of the parental attitudes toward children and adolescents with CP in Iran.

Knee osteoarthritis is one of the most common musculoskeletal problems that is associated with impaired balance. This study was conducted to determine the result of balance and strengthening training in static stability indices in females with knee osteoarthritis.

In this single-blind randomized controlled study, 13 patients were determined through the available sampling method and randomly assigned to strengthening exercises and balance exercises groups. Strengthening exercises were based on quadriceps strengthening and in the balance exercises group, it included balance exercises. Anterior-posterior, overall, and medial-lateral stability measures were performed by Biodex before and after the treatment in the static situation at the status of open and close eyes on one and two feet. The treatment was performed 15 sessions for 3 weeks. The data were analyzed by paired t-test and independent t-test.

In strengthening exercises group, at the static status, overall and anterior-posterior stability index on two feet at the status of open eyes reduced from 1.26±0.82 to 0.76±0.48 (P=0.02) and from 0.87±0.53 to 0.56±0.37 (P=0.02), respectively. In the balance exercise group, in the static status, overall lateral stability index on the involved foot at the status of close eyes reduced from 9.15±3.18 to 7.53±2.81 (P=0.00) and from 8.27±3.32 to 6.77±2.95 (P=0.00), respectively. There was no significant difference between the groups (P>0.05).

There was no difference between them regarding the impact on static stability indices. However, strengthening exercises caused improvement in the greater number of stability indices compared to those in the balance exercises group.

For children with Attention Deficit Hyperactivity Disorder (ADHD), different types of play therapy may have different effects. This study aimed to compare the effect of two play therapy intervention methods including a child-parents therapy named as Filial Therapy (FT) and a child therapist therapy known as Adlerian Therapy (AT) on attention and hyperactivity of these children.

In this randomized clinical trial which lasted from February 20 to May 5 of 2014, 51 boys and girls aged 6-12 years with ADHD were selected and allocated randomly by blocked blocks to three groups of 17 subjects in each one. From three groups, two ones received FT and AT intervention and one group remained as a control group. Participation’s parents in the FT group received one session training play therapy per week for 10 weeks and played with their children at home every day during this time. The AT group acquired three sessions play therapy for 10 weeks in the clinics. Attention and hyperactivity of the subjects were gathered in pre and post-test and three months after that as a fallow-up time by Child Symptom Inventory-4 (CSI-4) and Test of Everyday Attention for Children (TEA-Ch). The Mean, standard deviation and frequency were used as descriptive statistics and the Chi-squared, one-way ANOVA, Man-Whitney, Kruskal-Wallis tests, and Generalized Estimating Equation (GEE) were utilized as analytical statistics in the SPSS version of 22. The alpha of 0.05 considered as the significant level.

50 percent of the subjects were male and the mean ± SD of the age of the subjects were 8±2 years old. The mean ± SD of hyperactivity in the FT group were 23.94 ± 13.44, 20.82 ± 11.64, and 20.76±11.13, in the AT group were 17.70 ± 3.70, 15.20 ± 3.33 and 15±3.50, and in the control group were 24.25 ± 10.32, 25.38 ± 11.48 and 24.81±11.96,  respectively. The mean ± SD of attention in the FT group were 8.47 ± 5.33, 15.60 ± 2.79 and 15.80±2.50, in the AT group were 6.71± 5.31, 12.24± 3.33 and 12.90±3.12, and in control group were 9.71± 5.36, 10.41± 3.24 and 9.92±4.89,  respectively. As the result showed, hyperactivity of the subjects had significantly decreased in the intervention groups (p <0.05) compared with the control group. Also, the attention of the subjects had significantly increased in the intervention groups (p <0.05) compared with the control ones.

Although both methods reduced the severity of hyperactivity and increased the attentional performance of the subjects, but the effectiveness of FT method was more enormous. The founding indicated that participating of parents in the treatment process could exceed the rehabilitation procedure of children with ADHD.

Dysmorphic disorders of the body are one of the most common abnormalities in women with breast cancer. Women with this disorder seem to be over-represented, which affects their individual and social life. In this regard, the present study aims at assessing the effectiveness of group psychotherapy based on admission and commitment to the Obsessive-Compulsive Disorder of Body Dysmorphic Disorder in women with breast cancer.

The present study is a quasi-experimental research with a pre-test-post-test-follow-up design with the control group. For this purpose, 30 patients with breast cancer, who were referred to Khansari and Shariati Hospitals in Arak in 2016, were selected through convenience sampling method; they were randomly assigned to control and experimental groups (15 patients in each group). This study used a correctional scale for Obsessive-Compulsive Disorder (Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder); the experimental group was treated for 8 sessions (each session 60 minutes), but no intervention was received in the control group. For data analysis, descriptive and deductive statistics were used to analyze covariance.

The results of covariance analysis showed a significant difference between the two groups in improving the Obsessive-Compulsive Disorder of the body during the post-test (F=16.53, P<0.0001) and follow-up (F=11.56, P=002) stages.

Acceptance and commitment therapy can be effective in recovering the Obsessive-Compulsive Disorder of women with breast cancer.

The effect of metformin on weight changes and some metabolic parameters in patients with schizophrenia and schizoaffective disorder was investigated in this study.

As a randomized double-blind controlled clinical trial, this study was performed from 2018 to 2019. A total of 66 obese patients (BMI≥27) with schizophrenia and schizoaffective disorder, hospitalized in the departments of Razi Psychiatric Hospital, entered the study; then, they were randomly divided into intervention and control groups after completing the informed consent form. The patients received metformin or placebo for 12 weeks. The dose of metformin was gradually increased and in case of a patient’s tolerance, was prescribed up to 500 mg twice daily. During the study, all patients received their previous therapies. The variables included BMI, weight, waist circumference, lipid profile, and fasting blood glucose, which were studied at the beginning of the study and at weeks 4, 8, and, 12. The data were analyzed, using a post hoc test by SPSS software.

The results showed a significant decrease in weight (3.5 kg) and BMI (1.30) at the end of the week 12, and there was a significant reduction in waist circumference (5.9 cm) at the end of the week 8 compared to the placebo group (P<0.05). Moreover, metformin had no significant effect on fasting blood glucose and lipid profile in comparison with the placebo group.

Based on the findings of this study, by reducing the weight, waist circumference, and BMI, metformin can have a significant role in decreasing the complications of obesity and metabolic disorders in patients with schizophrenia and schizoaffective disorder. Therefore, given that the complications of metformin are low and transient, it can be recommended as a safe and tolerable drug in obese patients with schizophrenia and schizoaffective disorder.

Schizophrenia is a chronic psychiatric disorder, which reduces the patient’s quality of life. Although a minimum dose of medications has been recommended for treating this disorder, antipsychotic polypharmacy has been used experimentally leading to an increase in drug interactions. Aripiprazole is associated with a lower risk of metabolic side effects and is recommended as a first-line treatment for schizophrenia. Biomarkers can serve as predictive of treatment response in patients with schizophrenia. The aim of this study was to compare the efficacy of antipsychotic medication polypharmacy with Aripiprazole monotherapy in patients with long-term schizophrenia, using blood biomarkers.

Nineteen patients with long-term schizophrenia, who had received at least 2 types of antipsychotics with daily doses of more than 500 mg of chlorpromazine, were included in the study. The response rates to the treatment based on the Brief Psychiatric Rating Scale (BPRS) score and the blood level of Interleukin 2 (IL-2), Interleukin 6 (IL-6), Interleukin-1 Receptor Antagonist (IL-1RA), and Brain-derived Neurotrophic Factor (BDNF) biomarkers were compared in antipsychotic polypharmacy and 6 months after monotherapy with Aripiprazole.

The mean concentrations of IL-6, IL-1RA, and IL-2 significantly decreased after the intervention. The mean changes in the BPRS scores and also the relationship between changes in blood biomarkers and BPRS scores after intervention were not significant.

The conversion of the antipsychotic polypharmacy state to monotherapy with Aripiprazole has been accompanied by a significant decrease in the serum levels of IL-2, IL-6, and IL-1RA. These biomarkers can be used for evaluating the response rate of schizophrenia treatments in the future.

Dementia is the fifth cause of death in older adults with the most significant financial, social, and caring burden on health systems across the world. The aim of this study was to determine the most common medical risk factors for dementia in the retired population.

A case-control methodology was used for this study, within which 180 patients with dementia were compared to 371 controls for medical risk factors in the National Iranian Oil Company (NIOC) in 2017. Participants in the case and control groups were matched in terms of age, educational level, and sex. The logistic regression was employed to estimate Odds Ratios (OR), using SPSS software.

The majority of the participants were male (55%) and married (69%) with a mean age of 73.14 (SD=9.11) and high school education (38%). The results of the adjusted logistic regression showed a significant association among dementia and chronic and acute vitamin D3 deficiency (more and less than 1 year) (OR=4.73, P<0.001, OR=7.50, P<0.001, respectively), cancer history (OR=15.31, P<0.001), and chronic anemia (OR=5.95, P<0.001).

The results of this study suggest vitamin D3 deficiency, cancer, and anemia history as probable risk factors for dementia. Thus, managing or controlling these risk factors may effectively delay or prevent the onset of dementia for the individuals.

The modulation of the dorsolateral prefrontal cortex (DLPFC) activity enhanced the prospects of substance use disorders rehabilitation, using non-invasive brain stimulation, such as transcranial Direct Current Stimulation (tDCS).

We carried out a randomized sham-controlled clinical trial to assess the effect of repeated tDCS at DLPFC on drug craving in 30 abstinent male methamphetamine users. The participants underwent 5 sessions of 20 minutes bilateral real or sham 2 mA tDCS (anode right/ cathode left) of DLPFC. The Desire for Drug Questionnaire (DDQ) was used for assessing instant craving. The cue-induced craving was rated on a Visual Analog Scale (VAS) after the verbal induction of craving.

The findings of this study indicated that cue-induced craving reduced significantly in tDCS related to sham (P<0.05), but tDCS did not significantly alter instant craving.

The results indicated that repeated bilateral tDCS over DLPFC was not effective in reducing self-report instant craving, but reduced self-reported craving in the craving induction condition.