فصلنامه علوم پیراپزشکی و توانبخشی
سال نهم شماره 2 (تابستان 1399)

Students with hearing loss experience some problems in reading comprehension skill as a component of language. This study aimed to examine the association between lexical knowledge and reading comprehension skill in fourth grade students with hearing loss and normal hearing.

This study was conducted on 30 fourth grade students in 3 groups including students with hearing aid, students with cochlear implant, and students with normal hearing. The lexical and reading comprehension skills were assessed by the persian version of test of language development (TOLD) and Nama Test. The data were analyzed by using SPSS software version 22, and  one-way ANOVA, Tukey's post hoc, and Pearson's correlation coefficient statistical tests. The significance level considered a  p

Mean scores of vocabulary comprehension and reading comprehension tasks were higher in normal hearing students than students with cochlear implants, but the difference was not statistically siginicant. There was a positive significant correlation between lexical knowledge and reading comprehension skills in the group of students with hearing aids.

Hearing loss has a negative impact on the development of lexical knowledgeand reading comprehension skills. It seems that increasing the size of the vocabulary can improve reading comprehension skill in this group of children.

Ankle joint proprioception and strength play an important role in its stability. Preventing ankle injuries in soccer functional movements requires accurate proprioceptive information and sufficient strength. Therefore, the purpose of this study was to compare the effect of eight weeks plyometric and theraband trainings on ankle proprioception and strength in adolescent soccer players.

Among Isfahan adolescent soccer players, thirty were purposively and conveniently selected and randomly divided into two groups of 15 namely plyometric (age=12.87±2.64 yrs, height=151.80±14.15 cm, weight=46.50±12.16 kg) and theraband (age=13.40±0.91 yrs, height=151.20±6.67 cm, weight=41.53±8.87 kg). Two groups performed their training programs for 8 weeks and 3 times per week. Each training session last for 45 minutes. Ankle angle restoring test in 15º for ankle inversion-eversion proprioception, and plantar and dorsiflexion strength tests were used before and after the training program. Repeated-measure analysis of variance was employed for data analysis with the significance level of (p≤0.05).

Within group differences results for plyometric group showed significant decrease in angle restoration error (p≤0.05) and increase in ankle dorsi and plantar flexion (p≤0.05). Also, the results of this study showed that theraband training decreased angle restoration error (p≤0.05) and increased ankle plantar and dorsi flexion strength (p≤0.05). However, there were no significant differences in ankle proprioception and strength between two groups (p≥0.05).

According to the results of this study, each two type of plyometric and theraband trainings improve ankle proprioception and strength and there was no differences in effectiveness of two training protocols. It is recommended to athletic trainers and clinicians to use these two training protocols in order to improve ankle proprioception and strength.

Today, cancer is one of the deadliest causes in the world and one of the top three causes of death in developed countries and Iran. Due to the importance of this issue, the present study aimed to investigate the incidence of cancer registration in Razavi Khorasan province between 2012-2015 using multilevel modeling.

The present study is a longitudinal study. The data used in this study were extracted from the cancer registration system of Razavi Khorasan province between 2012-2015. In this study, we investigated the incidence of brain and central, bladder, lung bronchus and trachea, breast, colon and anal canal, leukemia and blood, oesophagus, ovary, skin, stomach, thyroid gland nervous system cancers. MlwiN (version 2.2) and GIS software (version 10) were used to analyzed data and mapping the geographic map respectively.

Among the 11 cancers studied in this study were breast (37.42), skin (11.09), colon (8.54), stomach (8.33), esophagus (7.52), thyroid (5.30), leukemia and blood (4.35), lung bronchus (4.07), ovarian (3.65), bladder (2.51) and central and central nervous system (1.92) had the highest to lowest annual mean relative incidence of cancer per 100,000.

Given the high prevalence of the three types of breast, skin and colon cancers in Razavi Khorasan province, it is recommended that appropriate measures be taken to prevent, screen and treat these cancers.

Because of an altered walking mechanism in blind individuals compared to healthy ones, it is expected that using textured insoles in blind individuals change the mechanism and ground reaction forces encounter to the lower limbs and joints. Therefore, the aim of this study was to compare frequency domain of ground reaction forces during walking with and without textured insoles in blind individuals.

12 blind males (age: 29.66±4.39 years) volunteered to participate in this study. A foot scan system was used for measuring frequency spectrum of ground reaction forces during walking with and without textured insoles. Paired sample t-test was used for statistical analysis.

The findings indicated similar walking speed during walking with and without textured insoles in blind individuals (P>0.05). The frequency content with power 99.5% in the vertical ground reaction force component during walking with insoles were greater than that walking without it (p=0.039). Also, the frequency content with power 99.5% in the 3rd toe and 4th toe during orthoses condition were greater than that without it (p<0.05). In addition, frequency bandwidth in the 3rd toe region of the foot in insole condition was lower than that without insole condition (p=0.039).

Although there was similar walking speed during walking with and without textured insoles in blind individuals, there were lower frequency bandwidth and median frequency of ground reaction forces during orthoses condition compared to without.

Functional voice disorders are among the most prevalent voice disorders. In addition to voice involvement, patients experience psychological symptoms such as anxiety and depression. Speech therapy is the most effective therapy for these patients. The main aim of this study was to determine the effect of speech therapy on anxiety and depression status in patients with functional voice disorder.

Sixty patients (aged between 17 to 65 years), with functional voice disorder, who have referred to the ENT clinic of Amir Almomenin Hospital in Rasht, were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale. Thirty-six patients with the highest anxiety and depression score were selected and randomly divided into two groups of intervention (n=18) and control (n=18) in a form of quasi-experimental design. After speech therapy, both groups were investigated using Voice Handicap Index (VHI) and Hospital Anxiety and Depression Scale again.

  The experimental group found significant improvement in VHI and symptoms of anxiety and depression after intervention (p<0.001). However in control group, VHI scores were significantly decreased (p=0.008) and anxiety (p=0.222) and depression (p=0.213) were not significantly different. In addition, after the intervention, the experimental group exhibited better VHI scores and less anxiety and depression symptoms compared to the control group (p<0.001). However, these differences were not significant in the pre-test (p>0.05).

Speech therapy not only improved the voice status but also significantly reduced the symptoms of anxiety and depression in patients. Speech therapy, through improving the quality of the patient's voice, expands the social, emotional and occupational interactions of the individual and improves the psychological and emotional functioning of patients after passing through the effects of impaired voice.

Functional dysfunction has been reported as one of the most important consequences of functional ankle instability injury. One of the newest tools used to rehabilitate musculoskeletal injuries is suspension training with TRX )Total Body Resistance Exercise(. However, so far, its effect on the various functional factors in athletes with functional ankle instability has not been determined.  Therefore, the purpose of this study was to investigate the effect of 6 weeks of suspension training with TRX on the performance scores of athletes with functional ankle instability.

30 male athletes with functional ankle instability were selected and then randomly assigned into the control and training groups. The subjects were selected by inclusion and exclusion criteria. Subjects' performance was assessed by side hop test, figure 8 test, and three single-leg hop test. The training group performed 18 training sessions of 45 minutes during 6 weeks. During 6 weeks, control group were asked to not perform any special exercise. Then, the post-test was performed in both groups. In order to compare the scores of functional tests between two groups, paired t-test and covariance analysis were used. Significant level was considered as p≤0.05 in all statistical analyzes.

The results of statistical tests showed that there is a significant difference between the mean scores of each of the three side hop test (p=0.001) figure 8 test (p=0.001), and three single-leg hop tests (p=0.001) between the two groups in the post-test. Therefore, that subjects of the TRX training group had better performance in all three tests than those in the control group.

Since the results of this study showed that performing TRX suspension training can improve the performance of athletes in side-hop test, figure 8 test and triple hop test, therefore it recommended that all sport trainers use the exercises used in this study to improve the performance of athletes with functional ankle instability.

Functional ankle sprain is a common injury in different sports. Study of Ground Reaction Forces in different physical activity is associated with the risk of lower extremity injury and has a clinical importance. The objectives of this study were to analyze the GRF, and loading rate during running in ankle sprain compared with healthy subjects.

In this study, 10 healthy men and 10 soccer player with ankle sprain participated. Using two adjacent Kistler force plates (1000Hz) GRF during stance phase of running was measured. Then, maximum GRF, impulse, and loading rate, were obtained. MANOVA was used to analyze the data (α=0.05).

The results showed that there is a significant difference between two groups in ground reaction force of Fz1and Fz2 (p=0.01, p=0.01). On the other hand, there was a significant difference between the two groups in time to peak of components in Fz3 and Fx2 directions (p=0.02, p=0.004). Also, there was a significant difference between the two groups in time to peak of components in Fy1 and Fy2 directions (p=0.04, p=0.04).  The experimental group showed a higher loading rate than the control group (p=0.01).

The results showed that the values of initial reaction force and loading rate in the experimental group were higher than the control group. It seem less foot adaptability increases the loading rate in the experimental group. Since these forces are exacerbating the types of structural damage, therefore, therapists should pay particular attention to reducing these forces by modifying the motor strategy, strengthening the muscles and, even in some cases, prescribing a medical insole.

Vertigo and imbalance are common symptoms in patients with head trauma. In these patients, the vestibular system and especially saccule may damage. The saccular abnormalities cause more imbalance, especially in standing situations. The aim of this study was to evaluate the saccular system in patients with head trauma. For this aim, we focused on studies that used cVEMP and posturography.

In this study, related articles were searched in different databases including PubMed, Web of Science, Scopus, Magiran and SID from January 1980 to December 2018. The searched keywords were saccule, head trauma, vertigo and imbalance and finally after applying inclusion and exclusion criteria, 77 articles were evaluated.

There are vestibular and saccular abnormalities in many patients with head trauma. Results of cVEMP and posturography showed high frequency of these impairments.

Saccular abnormalities could greatly affect balance, especially in standing position. Other factors such as unilateral or bilateral or amount of abnormality, central compensation, and other supportive systems could affect these results.

People with Parkinson's disease (PD) often have walking difficulty in the advanced stages of the disease and also suffer from balance problems. They perform their functional movements in a smaller range and at a slower rate, which will cause difficulty in performing daily activities. Patients with PD face many difficulties in outdoor activities, community participation, personal tasks, and fine motor skills (e.g. writing). They usually need the help of others. For two decades, a new treatment called Lee Silverman Voice Treatment (LSVT) has been used by the speech therapists to treat speech and swallowing disorders in PD patients based on evidence and principles of neuroplasticity. The BIG protocol was added to this method in 2002 (LSVT-BIG). In this method, the whole body is involved and its main focus is on motor skills, which are guided by a physiotherapist and occupational therapist. The main goal of this new method is to improve patient’s skilled movement in PD, as opposed to the old methods that introduce muscle stiffness as the main problem in these patients. In this method, the patients will be required to perform a series of special exercises in sitting and standing positions in a larger range than usual with a specific schedule and in a one-month intensive period. Doing the BIG protocol correctly can make the range of motion softer and larger. The studies also show that the LSVT BIG method is very effective for improving patients' walking patterns and daily activities and significantly increases the quality of life in PD patients. Eventually, the PD patients will be able to perform their motor tasks automatically. Considering the useful results of this method and also the growing trend of its use around the world, it is necessary to able therapists with this new method and provide more complete services for PD patients.

Joubert syndrome with hypotonia and ataxia due to the defect in cerebellar vermis causes severe balance and coordination problems and this may prevent therapists to achieve functional goals. Therefore, one of the important purposes in rehabilitation is improving postural balance in these children. In this study, the effect of multi-sensory intervention on a child with Jubert's syndrome was investigated.

Subject was a 6-year-old girl with Joubert syndrome. The program for strengthening the sensory organization of balance using tilt-board was run in 16 30-40-minutes sessions. The outcome was measured by Pediatric Balance Scale (PBS) and Clinical Test of Sensory Interaction for Balance (CTSIB) at first, fourth, eighth, twelfth, and sixteenth sessions. Based on the assessments, the balance time of standing changed from 5.6 seconds to more than 5 minutes, 3.5 to about 12 seconds, 0 to 12 seconds, and 0 to about 5 seconds on the firm surface/opened-eyes, firm surface/closed-eye, foam surface/opened-eye, and foam surface/closed-eyes, respectively. The PBS score increased from 50% to 84% of the total score that shows 34% improvement in dynamic balance.

Sensory organization intervention for balance can play an effective role to improve postural balance in children with neurological deficits. Maintaining posture on the unstable surface/closed-eyes that there is no visual input and perturbed somatosensory input is the most difficult condition to process sensory information for postural balance. To enhance balance in children with Joubert syndrome, because of visual deficits, it is necessary to intervene in the visual system with greater accuracy and finer grading to facilitate the ability of the nervous system to process visual inputs.