فصلنامه طب توانبخشی
سال دهم شماره 5 (آذر و دی 1400)

Visual impairment is accompanied by side effects and problems that can affect the person’s mental and physical health. The purpose of this study was to scan the studies on the effects of sensory-motor rehabilitation and space-perception with a focus on parent-child interaction and fear of movement in children with visual impairment.

The analysis of data in this project was done by the synthetic scan. The methodology was based on gathering, classifying, and summarizing data in studies on sensory-motor rehabilitation and space-perception with a focus on mother-child interaction and fear of motion in children with a visual impairment from 2007 to 2021 in articles found on databases, such as Eric, Ebsco, Google Scholar, Scopus, ScienceDirect, PubMed, Magiran, SID, Ensani, IranDoc, and Noormags with searching keywords, such as sensory-motor rehabilitation, space-perception, fear of movement, and children with visual impairment. In the primary search, 72 articles were chosen and then, 15 articles were chosen from them based on their title being sensory-motor rehabilitation and space- perception in children with visual impairment. 

The results showed that this treatment is suitable for decreasing motion fear in children with visual impairment. Also, sensory-motor rehabilitation and space-perception can improve motion fear factors, such as motivation, parent-child relationship, physical awareness, imitating others’ behavior, and orientation and mobility skills..

By evaluating studies, it is figured that sensory-motor rehabilitation and space-perception with a focus on mother-child interaction is one of the supplementary treatments for children with visual impairment and will eventually decrease motion fear in children so that they can commute independently.

Asthma is a chronic disease causing morbidity and reduced quality of life. Asthmatics are less active than their peers, inducing a more sedentary lifestyle for the patient. Asthma can cause postural changes in the spine. Shoulder girdles are suitable options for their correction and prevention. Another possible solution is corrective breathing exercises. Hence, this study’s objective was to investigate and assess the impact of combined corrective and home respiratory exercises on kyphosis angle and respiratory capacity in asthmatic children.

The present study was a clinical trial with a pretest and posttest design. For this purpose, with the approval of a pediatric pulmonologist, 30 mildly asthmatic children living in Rasht were voluntarily included in the study. The subjects were randomly divided into two groups: experimental (15 individuals with a mean age of 10.53±2.09 years) and control (15 kids with a mean age of 11.40±2.13 years). Written informed consent forms were obtained from the children’s parents. Respectively, a flexible ruler, spirometry, and bone caliper were deployed to evaluate the curvature of the thoracic spine, respiratory capacity, and the chest’s anthropometric indices. To analyze the study’s results, a dependent t-test and analysis of covariance were utilized (significance level: P<0.05).

The findings revealed a significant difference between the thoracic spine curvature (P=0.004), forced expiratory volume in 1 second (FEV1) (P=0/001), (FEV1)/ forced vital sapacity (FVC) (P=0/02), and chest anthropometric indices (P=0.001).

In line with the findings, it appears that combined corrective and respiratory exercises can positively influence the chest’s extensor muscles inducing improvements in lung function and postural correction in asthmatic children. Therefore, it is hereby recommended that therapists, coaches, and exercise teachers utilize combined corrective and respiratory exercises to improve the physical, postural, and respiratory conditions of asthmatic children.

Reduced balance and changes in posture are among the physical activity constraints in obese individuals. Devising techniques and methods for improving balance in obese women and preventing them from falling as well as its consequences are among the health system’s challenges. This article’s aim was to compare and evaluate the immediate effects of massage and mobilization of feet and ankles on balance among obese female nurses.

The current study assessed 45 female nurses in Tehran University Hospitals (age range: 35-45 years and body mass index [BMI] over 30-40). They were randomly divided into three groups consisting of 15 people: The massage group (age: 38.73±3.39 years), (height: 154.67±5.55 cm), (weight: 79.50±8.63 kg), (BMI: 33.28±1.82 kg/m2), the mobilization group (age: 40.87±3.09 years), (height: 155.33±6.72 cm), (weight: 80.83±8.34 kg), (BMI: 33.60±1.88 kg/m2) and control group (age: 40.00±3.00 years), (height: 155.80±4.06 cm), (weight: 80.63±4.55 kg), (BMI: 33.28±1.24 kg/m2). The therapeutic protocol included 20 minutes of foot massage in the massage group and 20 minutes of mobilization on the feet and ankles in the mobilization group. In the control group, no treatment was performed. In this study, the subjects in the three groups were analyzed by two clinical balance tests: “One-Leg Standing (OLS) Test” and “Time Up & Go Test (TUG)” Assessments were made before and immediately after the intervention. The data was statistically examined via Analysis of Covariance (ANCOVA) using SPSS software v. 21.

The analysis of Covariance findings indicated significant differences between the groups. Both massage and mobilization groups showed differences in the OLS scale score for both right and left legs and regarding the TUG test, significant differences were seen in the experimental groups compared to the control group (P=0/00). No significant differences were discovered between the efficacy of massage and balance mobilization (P≥0/05).

According to the findings, feet plantar massage and mobilization can improve functional balance in obese female nurses and no differences were detected regarding their effect and utilization.

Brain injuries are often induced by the linear and rotational acceleration of the head and neck. Head and neck orientation determines the type and severity of brain injury. The scant focus has been paid to this topic in previous studies. Therefore, this study aimed to assess and analyze the impact of head and neck orientation on linear and rotational acceleration in boxing.

In this study, a computer simulation method was utilized to investigate the impact of head and neck orientation on linear and rotational accelerations of the head during punching in boxing. A suitable head and neck and punch model was initially simulated using the Adams software. Then, the inverse kinematic method and Euler ZXZ angles were used to determine the orientation of the head and neck. 

The findings revealed that the maximum linear and rotational acceleration related to the reference state (anatomical position) was 75g and 4036, respectively. The head and neck orientation did not affect the magnitude of the linear and rotational acceleration in the sagittal plane. However, as the angle of the head and neck orientation increased in the frontal plane, the magnitude of the linear and rotational acceleration decreased.

In line with our findings, rotational acceleration was the sole cause of brain injury in boxing. Increasing the orientation of the angle of the head and neck in the frontal plane would reduce intensity. Therefore, by detecting biomechanical parameters associated with a head injury and influential factors affecting it, the severity of the damage, the pertinent risk factors, and relevant rehabilitation solutions can be projected and predicted.

Bilingual children are sometimes over-identified with language impairment and sometimes their language impairment under-identified that in either case, proper intervention is not possible. Accurate measurement of bilingual child language development involves assessing both of their languages. The purpose of this study was to identify a set of measures that would discriminate language impairment in bilingual Turkish-Persian children aged 5 to 7 years in Tehran.

In this descriptive-analytical study, the language sample of 24 bilingual children with no language impairment and 8 bilingual children with language impairment was analyzed according to the linguistic measures of mean length of Terminable-unit, number of total words, number of different words, and number of grammatical errors per Terminable-unit. Children without language impairment were selected from kindergartens and schools by multi-stage cluster sampling method. Language-impaired children were selected by the Speech-Language Pathologist with at least three years of bilingual speech and language pathology services from Tehran-based speech therapy clinics in an accessible manner. There was no significant difference between the groups in terms of nonverbal intelligence, age of exposure and duration of exposure to Persian. Parents responded to questions about their perceptions of their children’s speech and language skills and family history of speech and language problems.

Diagnostic analysis indicated that 3 measures discriminated the groups of children with sensitivity 87.5%: the Parent Report Questionnaire, number of total words, and mean length of T-unit.

According to the results, Indicators of parental reports and language criteria in identifying the language damage of Turkish-Persian bilingual children can be of diagnostic use for speech and language pathologists.

Working memory is among the essential components of executive function. Due to the different physiological and cognitive needs of open and closed motor exercises, this study aimed to investigate and assess the effects of open and closed exercises on the working memory of preschool children.

This study was quasi-experimental with pre-test and post-test design. Thirty preschool children in Kermanshah were randomly divided into two open and closed exercise groups. Before the exercise protocol, all participants underwent Wechsler Intelligence Test and working memory pre-test with N-back software. Each group performed their one-hour training sessions for 12 weeks (three sessions per week). The exercise intensity was set at (60±5%) of the heart rate reserve level (HRR), with HR being monitored by a heart rate monitor. Data analysis was performed using the analysis of covariance (ANCOVA) by SPSS software v. 23.

The findings revealed a significant difference between open skill training (OSE) and closed skill training (CSE) (P≤0.05). OSE compared to CSE had a more significant effect on increasing children’s working memory. 

The findings demonstrated that 12 weeks of OSE has a more significant effect on increasing the working memory of preschool children (compared to CSE). Therefore, it is recommended that preschool children participate in OSE (higher cognitive load) to improve their working memory.

Autism is a neurodevelopmental disorder, affecting the individual’s cognitive and language skills. Since human social life is highly dependent on cognitive and linguistic abilities, these abilities are essential factors in human growth and development. The production and perception of narrative discourse at a language level require the utilization of cognitive and linguistic abilities. Considering the fact that the timeline and the way it is expressed is one of the main components of narrative formation, the topic of time can be challenging in the narrative discourse for children with autism. Therefore, the aim of the present study was to investigate and assess the representation of some features of time, such as perfective and imperfective aspects and grounding, including foreground and background in the narrative discourse of children with high-functioning autism.

In the current research, the representation of grounding in narrative discourse aspects of Persian-speaking children with high-functioning autism disorder (HFAD) and normal children were studied, compliant with classifications by Hickman et al. To this end, 20 male children with high-functioning autism disorder (chronological age: 7-11) and 20 normal male children (chronological age: 7-11) participated in this study. Narratives were elicited based on “Horse” and “Cat” picture stories provided by Hickman. Pursuant to studying and describing the collected data, they were thereafter analyzed via the Mann-Whitney U Test.

The findings pointed out that there was a significant difference between HFAD and normal children in the representation of perfective aspect and grounding (P=0.05). Children with HFAD had a weaker representation compared to normal children. Similarly, the children with HFAD had a more anemic performance in representing perfective aspect and foreground as the core data in producing narrative, whereas children with HFAD produced more marginal data and background compared to normal children. Conclusion Consistent with the findings, it appears that poor performance by children with HFAD in comparison with normal children in the representation of certain features of time, such as aspect and grounding in narrative discourse can be related to their cognitive and linguistic weaknesses.

Since there is a direct relationship between achieving the best athletic performance and minimizing the damage and the potential injuries with people’s ability to perform the technique, this study aimed at comparing the selected biomechanical variables during consecutive jump-landings between professional and semi-professional karate athletes.

In the current study, using a force plate, the ground reaction force, changes of the center of mass to the center of pressure, and stabilization time during jump-landing of nine young members of the female karate national team (professional) and nine selected karate athletes of Mazandaran province (semi-professional), on their both right and left legs separately, were obtained and statistically analyzed.

In the information collected from the selected biomechanical variables, the average and standard deviation in the left foot of both groups were higher than in the right foot. There was a significant difference between the ground reaction force and the change of center of mass to the center of pressure (stress) in the internal-external non – professional karate athletes and the left foot of the professional and non-professional. There was a significant difference between the ground reactions force in the posterior-anterior direction between the right and left foot of the professional group and the right and left foot of the non – professional group and the right and left foot of both groups in the change of center of mass to the center of pressure between the right and left foot of these two groups. However, there was no significant difference in the stabilization time. 

According to the results, the variables of the ground reaction force and changes in the center of mass to the center of pressure, and the time needed to achieve stability for karate athletes can be used as an index to evaluate the level of ability to perform and detect the potential injuries occurrence in professional and semi-professional karate athletes.

The objective of this research was the assessment and evaluation of play and music’s effectiveness on the anxiety, depression, and self-esteem of elementary school students (second grade) with visual impairment. 

The present study was quasi-experimental with pretest and posttest design and with a control group. The statistical population included 60 students in the age range of 9-15 years (mean=11.74 years). The Cochran’s sampling method was performed after screening with the Spence anxiety tests, depression and children’s self-esteem assessment, and age-based peer-to-peer visualization. A total of 28 subjects were selected. The SPSS software and statistical methods of analysis of covariance, independent t-test, and even t-test were utilized for data analysis.

A comparison of pre- and posttest findings indicated that play and music do have a role in children’s anxiety, depression, and self-esteem of the subjects with visual impairment. However, the covariance analysis findings showed a significant difference only in the anxiety in the experimental group (P=0.002).

Play and music can reduce the anxiety of children with visual impairments.

Visual-spatial ability is a complex process involving several interconnected parts that develop with the development of working memory. These processes are performed by students with learning disabilities differently from normal students. The purpose of this study was to compare the visual-spatial perception of working memory between normal students and students with special learning disabilities.

The purpose of this study was to compare visual-spatial perception of working memory between normal students and students with special learning disabilities.

The research method was causal-comparative. The statistical population of the present study was all female and male elementary school students aged 10-12 years with math learning difficulties and dyslexia, and normal students in Khoy. The sample of this study consisted of 90 elementary school students, of whom 30 cases had math disabilities, 30 cases were dyslexic, and 30 cases were normal students. Students with learning disabilities were selected through available sampling in the Learning Disorders Center. Normal students were selected by random cluster sampling from Khoy schools. To diagnose and evaluate mathematical learning disability, the K-Mat test was used and the syndrome checklist was used to diagnose dyslexia. Corsi Blocks Task software was also used to measure the visual-spatial perception of working memory. The One-way ANOVA was used for data analysis. 

The results showed that the difference between normal students, dyslexic students, and those with visual-spatial abilities was significant (F=10.11, p<0.001). However, there was no significant difference between students with math disorder and dyslexia in the visual-spatial ability of working memory (P> 0.34).

Students with math learning difficulties and dyslexia had poor performance in the visual-spatial perception of working memory compared to normal students.

Depression is a common psychiatric disorder after a stroke. These patients often experience defective recovery despite intensive medication and psychotherapy. Transcranial Direct Current Stimulation (tDCS) of the brain is a technique used to stimulate different areas of the brain in neurological and psychiatric patients. One of the aims of this study was to investigate the psychological effects of color along with cerebral transduction direct electrical stimulation on stroke-induced depression.

This was a quasi-experimental study. Fifteen stroke patients hospitalized in the Shahid Sadoughi Hospital in Yazd (nine males and six females with a mean age of 55.76 years and mean post-stroke of 47.4 years) were selected and randomly divided into three groups of A, B, and C. Their Beck Depression Scale scores were compared in three occasions after treatment, after sham, and two months after the treatment. Each patient received ten sessions of sham electrical stimulation (20 minutes) with white, ten sessions of anodic stimulation and cathodic stimulation (2 mA-20 min) with white, and ten sessions of anodic stimulation and cathodic stimulation (2 mA-20 min) with green in left and right dorsal lateral prefrontal cortex, respectively. Data analysis was performed in two levels of descriptive (mean & standard deviation) and inferential (ANOVA with repeated measures) using SPSS software v. 21.

The findings of (ANOVA with repeated measures demonstrated that compared with a white color treatment, depression declined immediately after treatment with green and white color (P<0.001) and a follow-up period (P<0.001).

In line with the findings of this study, direct electrical stimulation with the green color can be utilized in the rehabilitation of stroke patients. However, electrical stimulation with the color green had a superior recovery than the white color.

With respect to the prevalence of chronic ankle instability and adverse consequences, such as neuromuscular dysfunction of the proximal joints, the implementation of preventive proceeding in the proximal limb of the ankle is very necessary. Therefore, the present study was done to investigate the effect of six weeks of plyometric training with feedback on maximum knee flexion and maximum vertical GRF on the drop landing technique of male basketball players with chronic ankle instability.

The present study has a quasi-experimental research design. Twenty-four male basketball players with chronic ankle instability participated in this study. After identifying individuals using the Cumberland Ankle Instability Tool, athletes were divided into two experimental groups (n=12) and a control (n=12) group. Evaluation of maximum knee flexion and maximum vertical ground reaction force was conducted using ten cameras and two distinct forces, respectively. The participants in the experimental groups performed plyometric training with feedback for six weeks. After examining the normality of data by the Shapiro-Wilk test, a paired t-test was used to compare differences within groups and an independent t-test was used to compare differences between groups.

The results showed that six weeks of plyometric training with feedback on maximum knee flexion and maximum vertical GRF on drop landing technique of male basketball players with chronic ankle instability significantly increased maximum knee flexion and reduced the maximum vertical GRF (P≤0.05).

Adding plyometric training with feedback to the chronic ankle instability basketball program to prevent subsequent damage later in the proximal limb is recommended.

Autism has multiple characteristics and dimensions making it very difficult to treat. Music therapy promises to overcome some of these challenges by creating an enjoyable healing process. However, studies on its effectiveness in Iran are scarce and how the treatment is accepted by children and mothers has not yet been studied. The primary objective of the present study was to examine the acceptance, effectiveness, as well as challenges in this treatment process.

The present study has a concurrent mixed-method design, conducted in the form of a multiple-case study. Thus, participants included five children with autism (without severe cognitive and learning disorders) aged 7-12 years. They were selected through purposeful sampling. One of them was ultimately excluded from the study process. Music therapy was performed individually for an average of eight one-hour sessions. Its effectiveness was assessed via the Matson Evaluation of Social Skills Scale and the Stirman Theory of Mind Scale as well as interviews with mothers and the therapist, plus observations of therapy sessions.

Participants demonstrated good compliance and even enthusiasm during treatment (in sessions and interviews with their mothers). Mothers also showed overall satisfaction with the treatment. The treatment had a significant impact on social and cognitive skills as well as mind theory. However, anxiety and repetitive behaviors did not appear to be reduced. Moreover, two significant challenges in the treatment process were a high level of anxiety and the children’s lack of concentration in the initial sessions, as well as a lack of passion and interest in practice at home.

Music therapy appears to be a potentially effective approach for children with autism, especially since participants revealed good acceptance and enthusiasm. Comparing this approach with a variety of psychological interventions for children with autism can be helpful.

Forward bending is a coupled movement combining lumbar flexion and pelvic rotation, the so-called lumbar–pelvic rhythm. Clinical observations have suggested that hamstring tightness influences the lumbar pelvic rhythm and may be associated with modifications in the sagittal spine curvatures during trunk flexion. Moreover, there is still no agreement on the best stretching techniques. Therefore, the aim of the present study was to compare the effect of six weeks of active and inactive static training on lumbar-pelvic rhythm in forward flexion in men with hamstring shortness.

This study was a quasi-experimental study with pretest/posttest with two groups. In this study, 26 men with hamstring shortness, with a Mean±SD age of 25.76±1.71 years were selected (via purposeful sampling). Hamstring muscle shortness was measured utilizing the SLR and 90-90SLR tests. Measurements of the lumbar pelvic rhythm were recorded in the three-phase forward bending by a spinal mouse. Variables included pelvic rotation and lumbar flexion. Active and passive static stretching were respectively jack-knife and kneeling hamstring stretching techniques. To compare pretest and posttest values of active and passive static stretching groups, the paired t-test and Wilcoxon test were utilized. Furthermore, to assess the difference between active and passive static stretching groups, the ANCOVA and Mann-Whitney U test were utilized.

After six weeks of active and passive static stretching, the total pelvic rotation significantly increased in contrast to total lumbar flexion (P<0/05). A comparison of pelvic and lumbar ROM output did not reveal a significant difference between active and passive static groups (P>0/05).

Compliant with the findings, active and passive static stretching could change the lumbopelvic rhythm to a pelvic-dominant motion, indicating that a flexible hamstring is important for preventing low back pain and other problems associated with the disturbance of the lumbo-lumbar rhythm.

Genu valgum is among the most common lower limb malalignments impacting people’s performance. The present study’s objective was to investigate the effects of a corrective exercise protocol utilizing TheraBand on muscle activity during running in individuals with genu valgum.

The present study was a semi-experimental and laboratory study, in which 24 male students (20-30 years old) were randomly divided into the control and experimental groups. Corrective exercises were performed on the experimental group for eight weeks using a thera-band. The electrical activity of selected muscles was recorded via the electromyography system. Statistical analysis was conducted utilizing measures, such as repeated measures Analysis of Variance (ANOVA) (significance level: 0.05).

The findings revealed a significant decrease (69.98%) in bicep femoris muscular activity during the stance phase of running posttest compared to pretest (d=1.88, P=0.002). Moreover, a significant decrease (33.77%) in the electrical activity of the semitendinosus muscle was detected in the posttest compared to the pretest (d=0.86, P=0.024). The electrical activity of other muscles did not indicate any significant differences in the posttest compared to the pretest (P>0.05).

Decline in bicep femoris muscle activity in individuals with genu valgus indicates the positive impact of rehabilitation via TheraBand as well as enhanced performance in their daily activities.

The Coronavirus disease 2019 (COVID-19) pandemic has created widespread and long-lasting impacts on human health. Infection induces harm and damage to various systems, including the respiratory, digestive, kidney, and central nervous systems. Hence, considering its effects on the central nervous system (CNS) and nervous disorders and the fact that the CNS can impact balance and “position sense”, the objective of this study was to compare static balance, dynamic balance, and knee joint position sense among women (with COVID-19 and healthy subjects).

In this study, 15 women infected with COVID-19 (age: 47.73±3.44 years, height: 162.53±4.17 cm, mass: 70.33±4.67 kg, and body mass index (BMI): 26.63±1.62 kg/m2) and 15 healthy women (age:47.53±3.27 years, height: 161.13±4.56 cm, and mass: 67.66±4.25 kg, and BMI: 26.11±2.10 kg/m2) were analyzed. Sharpendromberg and time up and go tests were utilized to respectively evaluate static and dynamic balance as well as knee joint position sense. The data were recorded by angular reconstruction and via a digital camera. Balance and sense of status tests were performed for both groups, and ultimately, the results were evaluated utilizing an independent t-test.

The findings revealed a significant difference between static and dynamic balance among the two groups of women (with COVID-19 & healthy) (P<0.05). Moreover, there was a significant difference between knee joint position sense (P<0.05), where the COVID group had 2.64 degrees more reconstruction error than the healthy group.

The static, dynamic balance, and knee joint position sense of the COVID group decreased, which can lead to an increase in the contingency of dropping/falling among these individuals.

Considering that in old age, the potential for musculoskeletal abnormalities and consequently changes in biomechanical function is probable, utilizing appropriate exercise programs with a prevention approach toward reducing the negative consequences of these changes is a concern for sports rehabilitation and occupational therapy specialists. The aim of the present study was to investigate the effect of dry, wet, and a combination of endurance training on selected biomechanical variables at the voluntary gait in men aged 60-75 years.

In this semi-experimental study, 60 elderly aged 60-75 years participated voluntarily and were randomly assigned to three groups of dry, wet, and a combination of endurance training. All three training protocols were performed weekly (three sessions per week) for eight weeks. A dependent t-test was used to compare pre-test and post-test and the analysis of covariance was utilized to compare the effect of three types of exercises on dependent variables.

The results of the present study showed that performing endurance exercises on dry, water and combination significantly increases the normalized stride length, displacement of the body mass center in the anterior-posterior and vertical axes, range of motion of the hip, knee and peak dorsiflexion of the ankle joints and the first normalized peak of Fz (vertical ground reaction force) during voluntary walking (P<0.05). Also, different types of endurance exercises had different effects on the variable of peak plantarflexion of the ankle joint (P<0.05) (between dry and combined exercises with P=0.007); but no significant difference was observed in the effect of various endurance trainings on other kinematic and kinetic variables during of voluntary walking (P>0.05).

Although it seems that using endurance training on dry, water and combination can have positive effects on the biomechanical variables of elderly during walking; due to more effect, combined endurance protocol can be recommended for the elderly to improve balance and gait performance and safe and secure movement. Future studies are necessary to more precisely examine differences among various types of endurance training methods.