Iranian Rehabilitation Journal
Volume:20 Issue: 50, Mar 2022

The present research aims to identify the assessment and treatment processes used by Iranian Speech-Language Pathologists (SLPs) for Childhood Apraxia of Speech (CAS) and investigate the impact of their knowledge level and experience on their choice of assessment and treatment.

This research is a cross-sectional study using a survey design conducted on 260 SLPs with a minimum of a Bachelor’s degree and at least one year of experience of working with preschoolers. The CAS assessment and treatment were measured by a validated questionnaire, which was completed in person or online. 

The tests of Diadochokinesis (DDK) (66%), single-word speech sampling (58.1%), oral-motor assessment (54.6%), and connected speech sample analysis (53.1%) were the popular tests chosen by the participants. The treatment approaches indicated that Oral Motor Exercises (OMEs) (57.7%) were the only treatment for which over half of the participants voted. The experts chose phonologically-based treatments and Integrated Phonological Awareness (IPA), but the less-experienced participants were more interested in PROMPT (prompts for restructuring oral muscular phonetic targets). The majority of the participants (70.8%) believed that children with CAS make very slow progress and 21.9% declared that speech problems of such children persist through the school years.

The participants’ choice of assessment tasks is in line with the results of recent studies. However, opting for outdated treatments such as OME indicates a gap between the clinicians’ knowledge and experience in using evidence-based treatments.

Premature neonates are at greater risk of developmental problems such as cerebral palsy, developmental delays, and hearing and vision problems. The challenge of healthcare professionals who support preterm neonates and their parents is not only ensuring neonates’ survival but also optimizing infant development. Interventions to reduce adverse health outcomes are very important. The present study was focused on exploring the effect of the Creating Opportunities for Parent Empowerment (COPE) schedule on the developmental outcomes of premature infants 

The randomization process was done using a randomized block design, and neonates were assigned randomly to the treatment (n=20) and control (n=20) groups. Neonates in two groups were matched in gestational age, birth height, head circumference at birth, birth weight, Apgar scores (1 min, 5 min), prematurity, and new Ballard score. So, there was not a significant difference between them at the baseline. In the intervention group, the parents received a COPE schedule in a set of CD’s in conjunction with written instruction and supplemental activities (guidebook). COPE schedule was performed in 5 steps. In the control group, neonates received only routine services and interventions, and the research therapist performed no additional interventions. New Ballard examination was done in all neonates at the time of enrollment, followed by administration of Ages and Stages Questionnaire (ASQ) by an occupational therapist, who was double-blinded for the study, to any available parent (mostly mothers) at 6 months of corrected age. 

The results showed more maturity in “communication”, “gross motor”, “problem-solving”, and “personal-social” in the intervention group, and the observed differences between the two groups in these outcomes were statistically significant (P<0.05).

This educational-behavioral intervention program could promote mothers’ knowledge about their neonates and improve the developmental aspects of premature infants during their first months of life.

Automated Auditory Brainstem Responses (ABR) peak detection is a novel technique to facilitate the measurement of neural synchrony along the auditory pathway through the brainstem. Analyzing the location of the peaks in these signals and the time interval between them may be utilized either for analyzing the hearing process or detecting peripheral and central lesions in the human hearing system.

In this paper, model-based signal processing is proposed to estimate the effective parameters of ABR signals. In this process, the biological parameters of the signal are assessed by utilizing a Finite Impulse Response (FIR) adaptive filter in which its adaptation procedure is performed based on the correntropy concept. The proposed method is applied on a set of ABR signals recorded in response to three stimuli of /da/, /ba/, and /ga/, and then its performances are compared with an existing state-of-the-art technique. 

The results show that the proposed method can significantly increase the accuracy of estimating the parameters in stable stimulations (/da/, /ba/) for major positive and negative peaks. This improvement is more significant (up to 2-3 times) for /ba/ stimulus and especially in major positive peaks. However, in other peaks, the improvements also occurred in smaller amounts. However, for unstable stimuli (/ga/), no significant improvement was achieved.

Increasing the accuracy performance of the proposed method for detecting the stable stimuli (while its performance remains unchanged) for detecting unstable stimuli indicates its effectiveness in automated clinical analysis of ABR signals.

As a severe mental health condition, schizophrenia presents a chronic and complex clinical manifestation and neuropathology. A large body of literature exists on the pharmacological treatment of schizophrenia. However, evidence on some dimensions of such interventions (e.g., eligible candidates, potential predicting factors of the therapeutic outcomes, safe implementation of these interventions, etc.) are notably scarce. Studies revealed superior influences of adjunct statin therapy over placebo among patients with schizophrenia. The study aimed to investigate the effects of aspirin and simvastatin as adjunctive therapy, compared to placebo on positive and negative symptoms and general psychopathology of patients with schizophrenia.

This is a double-blind, randomized clinical trial. The sample size was estimated to be 15 individuals for each one of the three research groups (n=45). The Positive And Negative Syndrome Scale (PANSS) and the Hamilton Rating Scale For Depression (HAM-D) were employed to collect the study data in the present study. The study patients were recruited from patients admitted to the psychiatric wards of Razi Hospital were identified. The study subjects were randomly divided into two test groups and one control group. All groups were initially treated with risperidone 4 mg daily for 3 weeks. Then, group A received aspirin (325 mg twice daily), whereas group B was prescribed 40 mg/d of simvastatin. However, the control group received a placebo. Psychiatric symptoms were recorded according to the PANSS at the beginning of the study and then at weeks 4 and 8. The results were analyzed using inferential statistics (repeated-measures analysis of covariance) and descriptive statistics in SPSS software v. 20.

Of 45 patients, 35(77.78%) were men (Mean±SD age: 45.8±10.5 years), and 10(22.23%) were women (Mean±SD age: 42.3±7.8 years). The mean scores of the positive symptoms of PANSS significantly decreased in the groups treated with aspirin and simvastatin (P=0.006 and P=0.005, respectively). However, no such difference was seen in the controls (P=0.447). Furthermore, the mean scores of the negative symptoms of PANSS significantly decreased in the intervention groups (P<0.001); in addition, no significant differences were seen in the controls after the end of the research program (P=0.18). In addition, the mean scores of the general symptoms of PANSS significantly decreased in the aspirin and simvastatin groups (P<0.001). There was an increase in the same value in the controls, but the increase was not significant (P=0.31). Finally, while the total mean scores of the PANSS increased in the control group (P=0.25), the corresponding scores significantly decreased in the test groups receiving aspirin and simvastatin (P<0.001).

The present study results indicate that either aspirin or simvastatin can reduce the symptoms of schizophrenia, including general psychopathology, negative symptoms, and positive symptoms in the explored patients. Also, the effectiveness of both drugs was similar, and no significant difference was detected between these medications in reducing the symptoms mentioned above.

The study aimed to explore the perceived burden and stress among mothers of autistic children.

This cross-sectional study was conducted at Riphah International University over 4 months, from October 2020 to January 2021. The samples were recruited using non-probability convenience sampling and comprised 84 mothers (23-60 years old) of children aged 3-16 years with Autism Spectrum Disorder (ASD) from different special education centers in Lahore. A demographic questionnaire, Parental Stress Scale (PSS), and Zarit burden interview (ZBI) were used to collect the study data, which were analyzed in SPSS v. 22 software. 

Forty-five Mothers (53.6%) suffered from moderate to severe burden with a high Mean±SD ZBI (41.75±10.62) and Parental Stress Scale (PSS) scores (48.67±8.04). Also, there is a significant positive correlation between the two scores (r=0.585, P=0.000). A significant association was noted between the mother’s stress and the severity of autism (P=0.006) and the child’s medication (P=0.008), also between the mother’s burden and the child’s age (P=0.019).

According to the current study’s findings, mothers of children with ASD perceived a high level of burden and stress. The association was seen with factors of children’s age, severity level, and child medication.

Most preterm infants experience oral feeding disorder. Sucking is the most appropriate way for oral feeding, but it may be immature in preterm infants. Regarding the increased risk of feeding problems in preterm infants, investigating and monitoring their sucking patterns to present appropriate and timely intervention is recommendedThe current research aimed to report the design of an instrument for measuring the suction pressure in preterm infants through a pilot study. We also checked the validity and reliability of the instrument.

A pilot study was conducted to measure the validity and reliability of this instrument. First, the instrument was developed, and in the next step, discriminant validity, test-retest reliability, and comparison in terms of sex were investigated by measuring the suction pressure of 20 full-term and 15 preterm infants. The Mann-Whitney U test and Wilcoxon test were used to establish the discriminant validity, comparison in terms of sex, and test-retest reliability in SPSS v. 23 software.

Two groups showed a significant difference in the suction pressure (P<0.001) to support the discriminant validity of the instrument. We obtained satisfactory values for the test-retest reliability in two groups (r=0.97, P<0.001). Boys and girls did not significantly differ between full-term (P=0.9) and preterm infants groups (P=0.5).

Performing the pilot study on 35 infants through an infant sucker tester proved the instrument’s discriminant validity and test-retest reliability. However, conducting the studies with a larger sample size is essential to make this instrument available commercially.

The main objective of this study was to culturally adapt the original English version of the Physical Activity Scale For Individuals with Physical Disabilities (PASIPD) for the Persian-speaking patients with Lower-Limb Amputations (LLAs) and to evaluate its reliability and construct validity.

This research was a multicenter cross-sectional and repeated measure study. The cultural adaptation process was conducted according to an accepted international guideline. A total of 197 Persian-speaking individuals with LLA were recruited to investigate the reliability and validity of the PASIPD. Reliability analyses were assessed by Cronbach α and the Pearson product-moment correlation coefficient. The Association between the PASIPD scores and the prosthetic limb user survey of mobility scores was examined to evaluate the convergent validity of the PASIPD. Known-groups validity was assessed based on sex, amputation causes, and amputation levels.

The PASIPD had an acceptable internal uniformity (the Cronbach α of 0.68) and test-retest reproducibility (r=0.70). There was a small correlation between the PASIPD and prosthetic limb user mobility survey (r=0.26; P<0.001). Some items of PASIPD could discriminate individuals with different causes of amputation and sex. Factor analysis extracted four main factors that explained 65.4% of the variance.

The Persian version of the PASIPD has acceptable reliability and validity for assessing the physical activity of persons with LLAs.

Neck roots lesions are among the etiologies of cervical and arm pain. A detailed patient evaluation could assist the diagnosis, reduce imaging requests, and promote the treatment of cervical pain. We tried to estimate the value of pronator teres reflex in C6 and C7 roots irritation.

The present study comprises 118 participants, including 56 patients with C6 and C7 lesions and 62 normal controls. The reliability and usefulness of this reflex in C6 and C7 roots lesions were compared to positive electromyography and imaging with magnetic resonance.

The sensitivity, specificity, positive predictive value, and negative predictive value for pronator teres reflex were 36.4%, 13.6%, 64.8%, and 4.6%, respectively.

This reflex can be considered an additional reflex during the physical examination for C6 and C7 nerve roots injury, but its diagnostic value for C6 and C7 radiculopathy is unreliable to be used for screening purposes.

As the elderly population increases, the need for their care and establishing nursing homes and hiring formal caregivers becomes more significant. Caregivers are under the pressure and burden of care due to the provision of services. The current study investigates the effect of Cognitive-Behavioral Therapy (CBT)-based social work intervention on the extent of care burden among the formal caregivers of the elderly.

This research was a quasi-experimental study with a pretest-posttest-follow-up design. The study’s statistical population comprised the formal caregivers of the elderly. The study sample consisted of 30 caregivers (15 men and 15 women), who were selected by convenience sampling method. The study participants received seven 90-min intervention sessions (CBT-based social work). The intervention protocol was validated by the Agree form using expert opinion evaluation. For data collection, the Zarit caregiver burden interview (short-form) was used. This scale has been validated by Rajabi Mashhadi et al. (2014) in Iran.

The care burden score of the explored participants was 24.20, within the average level. The repeated-measures analysis of variance revealed that the presented intervention provided a significant difference between the two stages of pretest and posttest in physical (P=0.004) and psychological (P=0.05) dimensions. Also, the changes in the study variables remained constant until the follow-up stage.

The obtained data indicate that the provided CBT-based social work intervention with the dimensions of identifying and accessing supportive resources, modifying attitude, and relaxation training can reduce the burden of care in physical, psychological, and general aspects among the study subjects. Therefore, more use of this intervention by specialists can affect the care burden of formal caregivers. The present research results also highlight the necessity for the attention of nursing home officials, social policymakers, and professionals active in the field of elderly care.

Real-ear measurements are critical in children for hearing aid fitting. This study aimed to evaluate the conformity of measured and predicted real-ear aided response of prescribed formula of desired sensation level (DSL) version 5, (Pediatric form) in children aged 4 to 7 years. Since there is limited information about the effect of degrees of hearing loss, ethnicity, gender, and ear on this conformity, the present study investigated the influence of the mentioned factors, too.

This study was conducted on 92 children aged 4-7 years (37 girls and 55 boys) with moderate to profound hearing loss. After auditory evaluations, the children’s hearing aids were fitted based on the DSL formula. Then, the hearing aid output was measured with a real-ear measurement system, and the difference between predicted and measured curves were compared.

This study showed a significant difference between the predicted values and the measured ones at three intensity level inputs (50, 65, and 80 dB SPL) and a frequency range of 0.5 to 6 kHz for both ears (P<0.05). However, there was no significant difference between predicted and measured values curves (predicted-measured) regarding the effects of the hearing loss degrees, gender, ethnicity, and ear (right or left) (P>0.05).

According to the difference observed between the predicted and measured curves, especially at the frequencies of 6 and 4 kHz, it is essential to conduct real-ear measurements in children.

To assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in young women with low to moderate Physical Activity (PA) levels.

Women with low to moderate PA, aged between 18 and 40 years, were enrolled in this study. A Thai version of the Kujala patellofemoral questionnaire (KPQ), history taking, and physical examination were used to screen and confirm the diagnosis of PFPS. Demographic features, including age, Body Mass Index (BMI), PA, knee alignment, and static foot posture, were recorded. Logistic regression analysis was conducted to determine confounding factors associated with PFPS.

A total of 1011 women with a Mean±SD age of 25.51±6.79 years participated in this study. The prevalence of PFPS was 15%. Age, BMI, PA, knee alignment, and static foot posture were not significantly associated with PFPS in this population.

Although the participants were young adults with low to moderate PA, the prevalence of PFPS was in the same range as the highly active groups. None of the factors investigated in this study could predict PFPS occurrence. Based on the findings, the risk factors of PFPS seem to be complex and individualized. The early diagnosis and treatment of PFPS should therefore be considered in this age group.

This study aims to measure the self-efficacy among women who have infertility in Al-Hilla City, Iraq.

We conducted a cross-sectional study in Al-Hilla City, Iraq, to measure the self-efficacy among infertile women. Using the non-probability purposive sampling method, 107 (Mean±SD age: 28.81±6.306 years) women with infertility were recruited. The study data were collected from the study samples using the infertility self-efficacy scale questionnaire. It is scored on a 3-point Likert scale to measure self-efficacy among infertile women.

The results show that the overall self-efficacy of infertile women is low. Also, there is a significant association between the self-efficacy of infertile women with all study parameters (P<0.05) except the age and level of education.

The highest percentage of the study samples were less than 30 years and lived in the urban area. The overall self-efficacy among infertile women was low, and the correlation between self-efficacy and their demographical data was significant except for the age and level of education.

Academic stress negatively affects the students’ mental state, leads to deterioration in academic performance, a decrease in the level of professional training and success in the future. This study has aimed to analyze the medical and psychological status of medical and pedagogical senior students to develop recommendations for the prevention of maladaptation associated with stressful influences.

This research is a descriptive and comparative study. It has investigated the mental health status of the senior students. A continuous sample of 192 fifth-year students was selected by convenience sampling. They examined by using the medico-sociological and psychometric methods. There were 137 students of medical and 55 pedagogical students aged 20-29 (21.8 ± 1.2) years, 142 females and 50 males. Participants competed the test for academic stress (Shcherbatykh, 2006), Social Phobia Inventory (Connor et al. 2000), Beck Depression Inventory-2 (Beck et al. 1996), Beck Anxiety Inventory (Beck et al. 1988), and depression anxiety, and stress sacle-21 (Lovibond, Lovibond). Data were analyzed by SPSS-16.

It was found that there are many differences between the mental health status of the participants of the study groups. It includes suicide ideation, suicide attempt, depression, and symptoms of social phobia; but there were no differences between anxiety, high academic load and disappointment in the profession, and manifestations of educational stress in both groups include fatigue and psychosomatic symptoms. Significant methods for overcoming stress were drinking alcohol (most often among medical students), smoking and taking non-prescription sedatives, which is a risk factor for addictive behavior.

It requires the development and implementation of psycho-correctional programs for medical and pedagogical students aimed at the formation of adaptive ways to overcome stress, reduce anxiety and depression, which will prevent the development of psychosomatic disorders and addictions.