فصلنامه طب توانبخشی
سال یازدهم شماره 1 (فروردین و اردیبهشت 1401)

 Sustained attention and working memory are the intertwined executive functions of the brain. Studies have shown that working memory training induce no far transfer effect to executive functions. Considering the importance of sustained attention in academic and occupational performance, this study aims to evaluate the effectiveness of computerized working memory (WM) training on sustained attention and WM of male students.

 Participants were 32 male middle-school students in the eighth grade, who were selected by a cluster random sampling method and assigned randomly to two groups of the training (n=16) and control (n=16). The computerized dual n-back task was used for WM training for 4 weeks at 12 sessions, each for 40 minutes. The computerized continuous performance test and the digit span test (forward and backward) were used for evaluating sustained attention and WM, respectively. The pre-test evaluation was performed one week before and the post-test evaluation was executed one week after the training course. 

 After the WM training, the sustained attention (P=0.043) and the backward digit span test score (P=0.033) in the training group were improved significantly compared to the control group, but no significant change was reported in the forward digit span test score (P=0.236).

 Improved sustained attention following WM training indicates the far transfer of the training effect to the sustained attention, and confirms the involvement of sustained attention in the central executive part of WM. On the other hand, no change in short-term verbal memory after training indicates that the mechanism of WM training effect is through strengthening the central executive, not through improving the phonological loop of WM.

 One of the treatment methods in the old age is to strengthen the sensory inputs. This study aims to evaluate the effect of knee brace on the electric activity of selected lower limb muscles during walking in older adults.

 The is a quasi-experimental and laboratory study. Participants were 30 older adults, 15 females (Mean age=62.66±3.84 years, mean height= 159.93±0.02 cm, mean weight= 73.86±11.56 kg, body mass index=28.82±4.17 kg/m2) and 15 males (Mean age= 68.93±5.88 years, mean height=175.07±0.03 cm, mean weight= 81.20±11.07 kg, body mass index= 26.44±3.19 kg/m2). The intervention was the use of a type of brace by restricting knee flexion and extension movements or knee support. Electromyography (EMG) data were analyzed in DataLITE and MATLAB applications using two-way ANOVA with repeated measures, and considering the significance level at P<0.05.

 The effects of braces on the electric activity of tibialis anterior, semitendinosus and erector spinae muscles were significantly different in the loading response, mid-stance, push-off and swing phases of walking. The effect of group on the electric activity of anterior tibialis and biceps femoris muscles in the loading response phase and for gastrocnemius medialis and biceps femoris muscles in the push-off and swing phases were significantly different. The interaction effect of group and brace was significant on the electric activity of the gastrocnemius and vastus medialis muscles in the push-off phase, and on the electric activity of the vastus lateralis and semitendinosus muscles in the swing phase.

 The knee brace improves the electric activity of selected muscles during walking in older adults. However, further studies are needed to prove this claim.

Knee genu varum is one of the lower limb abnormalities associated with biomechanical changes in lower limbs. The present study aims to compare the effects of shoe lifespan on ground reaction force (GRF) components in women with knee genu varum and healthy peers during running.

The is randomized clinical trial. Participants were 15 female college students with knee genu varum and 15 healthy peers. A new pair of sport shoes was given to each participant during to wear them for six months. Then, they were asked to run at a preferred speed in three trials with the new shoes (pre-test phase) and three trials with the used shoes (post-test phase) in a path where a force plate was installed. Statistical analysis was conducted by using repeated measures ANOVA. All analyses were done in SPSS v. 23 software. The significance level was set at 0.05.

 The results indicated the significant main (group) effect of shoes on peak anterior-posterior GRF during heel contact and on the anterior-posterior impulse (P<0.018, d>0.8). The values of these variables in the genu varum group were significantly higher than in the healthy group. Moreover, findings showed the significant main effects of shoes on the time to reach the peak GRF during heel strike and on the loading rate (P< 0.02, d > 0.9). The time to reach the peak GRF during heel strike with the used shoes was shorter than with the new shoes (P= 0.015, d=0.9), while the vertical loading rate during running with the worn shoes was greater than with the new shoes (P=0.019, d=0.9).

 Running with shoes having a lifespan >6 months is a risk factor for women with knee genu varum.

 Work-life balance refers to a person’s ability to effectively manage multiple responsibilities at work. Quality of life (QOL) is a person’s satisfaction with values in which they live. This study aims to investigate the relationship between work-life balance and QOL in dormitory and non-dormitory students

 This cross-sectional study was conducted on 230 students (dormitory and non-dormitory) of Shahid Beheshti University of Medical Sciences, Tehran, Iran, who were selected by a simple random sampling method. They completed the Life Balance Inventory and short form health survey (SF-36) questionnaire. The collected data were analyzed in SPSS v.18 software.

 The work-life imbalance in dormitory students (34.2%) was higher than in non-dormitory students (20.4%). The mean scores of physical health and mental health summary measures in non-dormitory students were higher than in dormitory students. There was a significant correlation between some domains of work-life balance and QOL (P<0.05).

Work-life balance, physical health, and mental health of non-dormitory students are higher than dormitory students. Given the relationship between work-life balance and QOL, educational and welfare planning should be made in universities to help improve the QOL of students.

The COVID-19 pandemic has affected the physical activity of the elderly because these restrictions have forced them to stay at home. This study aims to investigate the effect of eight weeks of Internet-based aerobic exercise on static and dynamic balance of older women during the COVID-19 pandemic.

 The study population consists of all older women in Kermanshah, Iran. Thirty inactive older women participated in the study voluntarily and were randomly divided into exercise and control groups. Static and dynamic balance of participants was measured using stork balance test and timed up and go test, respectively before and after the training protocol. The exercise group performed aerobic exercises provided to them via the Internet on their smartphones, for 8 weeks, three sessions per week. In order to increase the training intensity, the number of movements and repetitions were gradually increased such that the rhythm of aerobic exercises increased from 40 beats per minute to 90 beats per minute in last session. Paired t-test and analysis of covariance in SPSS v. 23 software were used to analyze the data.

 The balance changes from pretest to post-test phase were significant in the exercise group, but not significant in the control group. The internet-based aerobic exercise had a significant effect on static and dynamic balance of older women (P=0.001).

 Performing aerobic exercises provided via the Internet on smartphones can improve the static and dynamic balance of older women during the COVID-19 pandemic. Therefore, it is recommended that older women use Internet-based aerobic exercises to improve their balance skills during the pandemic.

The shoulder girdle is at higher risk of injury in overhead sports like volleyball. Repeated movements with high speed and power can cause changes in scapular position and lead to shoulder girdle dysfunction. This study aims to assess the effect of scapular movement impairment on functional stability of the shoulder girdle and the scapulohumeral rhythm in elite male volleyball players

In this descriptive-comparative study, 80 male volleyball players aged 18-35 years including 40 with scapular downward rotation syndrome (SDRS) (age=22±2.8 years, weight=82.50±1.3 kg, and height=193±3.2 cm) and 40 with scapular abduction syndrome (SAS) (age=24±2.1 years, weight=81.40±1.3 kg, and height=192±2.9 cm) participated who were selected purposefully. They underwent the scapular dyskinesis test and Kibler’s shoulder lateral slip test. The scapulohumeral rhythm was measured at four positions (0, 45°, 90°, and 135°) using two inclinometers. The Y-balance test-upper quarter (YBT-UQ), seated medicine ball throw test (SMBT), and closed kinetic chain upper extremity stability test (CKCUEST) were used to measure the functional stability of the upper extremity. Shapiro-Wilk test was used for examining the normality of data distribution, independent t-test was used to compare the differences between groups. 

There was a significant difference in the scapulohumeral rhythm at 45° (P=0.001), 90° (P=0.001), and 135° (P=0.001) between the two groups (Mean difference= 18.27, 21.27, and 27.87, respectively), where the SDRS group had lower scapular upward rotation than the SAS group. The results of YBT-UQ showed that the superior-lateral reach (P=0.001) and composite (P=0.001) scores of the dominant hand were significantly different between the two groups (Mean difference = 9.37 and 10.41, respectively), where the SDRS group had lower scores than the SAS group. No significant difference was found in the medial (P= 0.223) and inferior-lateral (P= 0.111) reach scores. Moreover, the results showed no significant difference between the groups in the SMBT (P=0.124) and CKCUEST (P=0.875) scores. 

 The occurrence of scapular movement impairment affects the YBT-UQ score and leads to scapulohumeral rhythm disturbance in volleyball players. Even if the activity is stopped, the ideal and optimal alignment will not be created unless efforts are made to improve the movement pattern.

Speech sound disorder (SSD) is a type of communication disorders in children where normal process of speech sound learning is disrupted. Children with SSD have errors in the expression of speech sounds that can make it difficult for others to understand what they say. The present study aims to assess the relationship of neuropsychological skills (language and attention skills) with SSD mediated by the parenting styles (authoritarian, authoritative, and permissive) and maternal depression.

 This is an analytical, descriptive, correlational study using structural equation modeling (SEM). A total of 117 preschool children agef 4–6 years with SSD and their mothers were recruited using a purposive sampling method from among those refereed to speech and language therapy clinics and kindergartens in Isfahan, Iran. The SSD was screened using the test proposed by Ahmadi et al. Conners’ neuropsychological assessment test, Baumrind’s parenting style inventory, and Beck depression inventory were completed by the mothers of children. The data were analyzed in AMOS software using the correlation test, regression analysis, path analysis, and SEM.

The statistical analysis showed that the correlation of language skills with SSD was significant (P=0.019 <0.05). However, the correlation was not significant when mediated by the parenting styles (P=0.665 for authoritarian style; P=0.306 for authoritative style; P=0.164 for permissive style) and maternal depression (P=0.546>0.05). On the other hand, the correlation of attention skills with SSD was not significant (P=0.361 >0.05), not even after medication by the parenting styles (P=0.686 for authoritarian style; P=0.315 for authoritative style; P=0.849 for permissive style) and maternal depression (P=0.393>0.05). However, in the attention model, the correlation of permissive parenting style with SSD was significant (P=0.026 <0.05).

 Language skills have a significant direct correlation with SSD in children, indicating that the increase of language problems in children can increase their errors in making sounds (phonemes). The attention skills has no significant correlation with SSD even after mediation by the parenting styles and maternal depression. The permissive parenting style has a significant negative correlation with SSD.

Ankle injuries are one of the most common musculoskeletal injuries in atheletes. Proper landing after jumping leads to the preparation for the next skill as well as prevention of various ankle injuries. This study aims to compare the electrical activity of selected ankle muscles in athletes duirng landing from different heights.

 This is a comparative study. Participants were 15 athletes (Mean age= 18.23 ± 2.3 years, mean height= 183.190 ± 6.3 cm, mean weight= 64.72 ±14.12 kg) with 3-5 years of experience in championship competitions. The landing skill was assessed from different heights (50%, 75%, 100% of maximum jump height). Electrical activity of selected ankle joint muscles (Gastrocnemius and Soleus) was recorded using an eight-channel BIOMED electromyography device with 96.34% validity and 91.29% reliability. Mean and standard deviation were used to describe the data, Shapiro-Wilk test was used to evaluate the normality of data distribution, and repeated measures analysis of variance was used to compare the collected data between groups followed by Bonferroni post hoc test. The significance level was set at 0.05.

 There was no significant difference in co-contraction of medial/lateral gastrocnemius and soleus muscles after jumping from three different heights. The peak contraction amplitude of the lateral gastrocnemius muscle was significantly different between the heights 50-75% (P= 0.006) and 50-100% (P= 0.002). The peak contraction amplitude of the medial gastrocnemius muscle was also significantly different between the heights 50-75% (P= 0.002) and 50-100% (P= 0.007). The peak contraction amplitude of soleus muscles was significantly different between the heights 75-100% (P=0.013) and 50-100% (P= 0.17).

 There is an increase in the contractile activity of selected ankle muscles in the anterior-posterior plane caused by the increase in jump height and subsequent landing due to the optimal use of appropriate strategies to control the eccentric muscle contraction and the extensor torque of the ankle joint by increasing the electrical muscle activity during the ground contact, resulted in the prevention of injury to the ankle joint. Coaches and athletes can use these results to adopt training methods to strengthen these ankle muscles by considering the optimal implementation of landing skills with an injury prevention approach.

 Decreased balance in the elderly is associated with an increase in the risk of falling. The present study aims to evaluate the effect of combining Cawthorne-Cooksey and Frenkel exercises on functional balance and risk of falling in the elderly with a history of falling.

 This is a quasi-experimental study. Participants were 28 eldery men and women with a history of falls living in nursing homes in Rasht, Iran. They participated voluntarily, were selected based on the entry and exit criteria, and were randomly divided into two groups: exercise (n=14) and control (n=14). The exercise group performed the combined Cawthorne-Cooksey+Frenkel exercise program for six weeks, three sessions per week, each for 60 minutes. The berg balance scale was used to evaluate the functional balance, and the timed up and go test was used for assessing the risk of falling. The paired t-test was used for within-group comparison and the analysis of covariance was used for between-group comparison. Statistical analysis was performed in SPSS v. 26 software. The significance level was set at 0.05.

 The results of paired t-test showed that the balance score (P= 0.007) and the risk of falling (P= 0.001) in the exercise group improved significantly after the intervention, while these scores were not significantly improved in the control group. The results of analysis of covariance showed that the two groups were significantly different in balance and risk of falling after the combined exercise.

 The combination of Cawthorne-Cooksey and Frenkel exercises can have a positive effect on functional balance and the risk of falling in the elderly. These exercises can be used to improve balance and reduce falling the vestibular and vision systems.

 Movement impairment is common among overhead athletes and can make them susceptible to shoulder injuries. This study aims to invesigate the effect of an eight-week corrective exercise program based on Sahrmann’s approach on scapulohumeral rhythm, isometric strength of shoulder girdle muscles, and functional stability in volleyball players with scapular downward rotation syndrome (SDRS).

 The is a quasi-experimental study with a pre-test/post-test design. Participants were 34 volleyball players with SDRS who were randomly divided into two equal groups of training (n=17) and control (n=17). Participants were selected based on observance of SDRS under the scapular dyskinesis test (SDT) in both flexion and abduction states, Kibler’s lateral scapula slide test (LSST), and scapulohumeral rhythm assessment. Before exercises, range of motion (ROM), isometric strength of shoulder girdle muscles, scapulohumeral rhythm, and functional stability were evaluated in both groups. Then, the training group performed the corrective exercises for eight weeks, three sessions per week. The control group performed no exercise and had their daily activities. At the end of training, post-test assessments were codncuetd in both groups. For the evaluation of isometric strength and ROM, a manual dynamometer and a goniometer were used, respectively. Scapulohumeral rhythm was measured at 4 positions (0, 45°, 90°, and 135°) with two inclinometers, and the Y-Balance Test Upper Quarter was used to measure the functional stability of the upper extremity. Paired sample t-test was used to compare the pretest and posttest means, and independent t-test was used to compare the differences between the two groups. The significance level was set at 0.05.

After 8 weeks of training program, there were significant increase in the strength of the isometric strength of shoulder external rotaion (P=0.003), upper trapezius (P=0.001), middle trapezius (P=0.027), lower trapezius (P=0.001), and serratus anterior (P=0.002) as well as scapulohumeral rhythm at 0-45° (P=0.012), 45-90° (P= 0.025), and 90-135° (P= 0.037) abduction; the ROM of the shoulder flexion (P=0.002), abduction (P= 0.001), internal rortation (P= 0.001) and external rotaion(P= 0.004); and pectoralis minor muscle length (P= 0.001) compared to pre-test scores in the training group. Moroever, the functional stability of the upper extremity after training program increased significantly in the training group (P=0.001), but the training program had no significant effect on the strength of shoulder internal rotaion (P=0.165), rhomboid muscule strength (P=0.283) and supraspinatus muscule strength (P=0.214). In the post-test phase, between group comparison showed a significant difference in scapularhumeral rhythm, functional stability, ROM, pectoralis minor length, and strength of trapezius, serratus anterior, and strength of shoulder external rotation between the control and training groups (P<0.05), but no significant difference was observed in the strength of supraspinatus and rhomboid muscles and strength of shoulder internal rotation (P>0.05).

 Eight weeks of corrective exercise program based on Sahrmann’s approach can improve the functional stability of the upper etermity, the scapulohumeral rhythm, and isometric strength of shoulder girdle muscles in volleyball players. This exercise protocol is recommended as an effective method to improve alignment and performance in athletes with SDRS.

 This study aims to evaluate the factor structure and validity of the electronic form of the Persian version of Behavioral Rating Inventory of Executive Functions (BRIEF) in male school students with learning disabilities.

 This is a psychometric study using the structural equation modeling. Participants included 100 male school students with learning disabilities in Kerman for assessing the validity and 430 male school students with learning disabilities for assessing the convergent validity. They were selected by a random sampling method. The data were collected electronically using the Persian BRIEF and Nejati’s Executive Functions Questionnaire (EFQ). The reliability was determined by assessing internal consistency and split-half reliability.

The results of exploratory factor analysis showed that the questionnaire had eight factors with good validity and reliability. The second-order confirmatory factor analysis confirmed the eight-factor model. The online Persian BRIEF score had a signifcant correlation with the EFQ score (P<0.001).

 The online Persian BRIEF can be used to assess the executive functions in male school students with learning disabilities in Iran.

Older adults with diabetic peripheral neuropathies (DPN) are at higher risk of motor control, slower reaction time, and increased postural sways. There is increasing evidence that exercise-based interventions have a positive impact on the health of older people. This study aims to assess the effectiveness of a selected multisensory training (SMST) program in improving the balance of older women with DPN.

In this study, 30 older women (Mean±SD age=62.35±1.87 years) were randomly assigned into the SMST and control groups. All participants underwent dynamic and static balance tests before and after the training. The SMST program included the balance training with eyes open and closed on different surfaces to stimulate visual, proprioception, and vestibular system. The intervention was conducted for 12 weeks, two times per week.

There was a significant difference in the dynamic balance between the SMST and control groups (t(28)=-6.74, P=0.000, ƞ2=0.61). The results of analysis of variance showed that the SMST program improved the static balance in the X direction (F(1,28)=14.16, P=0.001, ƞ2=0.33) and in the Y direction (F(1,28)=5.38, P=0.028, ƞ2=0.16) in older women with DPN.

The SMST can improve the dynamic and static balances of older women with DPN. Older women with DPN are at increased risk of falling. This program can be used to enhance their balance and postural control.