فصلنامه آرشیو توانبخشی
سال بیست و چهارم شماره 2 (پیاپی 96، تابستان 1402)

Aphasia is an acquired language disorder that can affect all representations of language (comprehension, expression, reading, and writing). This disorder is a communication disability that has a long-term effect on various aspects of the life of people with aphasia and their families. The most common cause of aphasia is stroke. The prevalence of this disorder is increasing in Iran. The evidence shows that the factors affecting the provision of speech therapy services to people with aphasia are different in various countries. Therefore, this study aimed to determine the barriers and facilitators of receiving speech therapy services from the perspective of the families of these people in Iran.

The study was conducted qualitatively with a content analysis approach. In this study, individual, semi-structured interviews with open-ended questions were conducted with 12 families of people with aphasia. Interviews were conducted by voice calls through WhatsApp or phone calls. Data analysis was done by Burnard’s approach. The duration of interviews with families was 25 minutes on average.

Barriers to receiving speech therapy services from the perspective of families of people with aphasia were divided into five categories and twelve subcategories, and facilitators of receiving services were divided into five categories and thirteen subcategories. There was an overlap between the identified barriers and facilitators, so the titles of the categories were the same and included: factors affecting clients’ attendance in speech therapy sessions, factors related to the patient, factors related to the place of treatment, factors related to the family, and factors related to speech therapist. All the participants pointed out a barrier and a facilitator related to the category of factors affecting clients’ attendance in speech therapy sessions. Also, all of them found a barrier related to the patient and a facilitator related to the family to be effective in receiving speech therapy services.

By examining the factors extracted from the interviewees, it is possible to make the necessary plans to reduce the barriers and strengthen facilitators with the help of people who have responsibilities in this field. Most of the participants considered the high severity of the impairment a barrier to receiving treatment. All of them agreed that the existence of a source to inform about speech therapy services has facilitated receiving these services. By considering the barriers and facilitators, people with aphasia and their families can receive more appropriate treatment according to their conditions and their quality of life will increase.

In the absence of an age normed developmental battery for Persian, the major objectives of this research are to develop a reliable and valid clinical linguistic battery to collect normative data from 3 to 7-year-old healthy Persian speaking children. The battery can also be used to measure severity of language impairments in 3 to 7-year-old Persian speaking children as compared with their aged matched peers.

Development of this battery is considered as a descriptive tool in which reliability and validity of the normative data were developed in 3 stages. The first version with 9 different sub-tests, 180 items and two descriptive pictures was developed after cultural and linguistic adaptations for the Persian language for different linguistic levels of phonology, morphology, syntax and pragmatics. The first draft was performed using 200 3 to 8-year-old healthy children in Tehran to measure the sensitivity of different tasks of the test for different age groups. This draft was not sensitive for 8-year-old children. The CVR of the first draft of the battery was checked by 3 Persian speaking clinical linguistic experts and 3 expert speech therapists and also was introduced to 20 SLP experts in a clinical linguistic workshop. In the second stage, based on the results and suggestions, necessary corrections were made in the test structure and items. Also, plural morpheme task of the previous version which was not sensitive enough, was removed and a new semantic task (word definition) as a sensitive semantic task used in other developmental language batteries was added to the battery. The results showed that the diagnostic sensitivity of the test for the 8-year-old age group is not satisfactory. The final version of the battery consisted of 9 subtests with 105 items and two descriptive pictures were used to collect normative data from 200 children. To evaluate reliability and validity of the final version, the opinions of 8 speech therapists and linguists were used.and to evaluate the construct validity, the correlation matrix and confirmatory factor analysis and for its validity Cronbach’s alpha were used. The final version of the battery was sent to expert speech therapists in 5 selected target group provinces (Tehran, Mazandaran, Fars, Esfahan and Khorasan) to collect normative data from 1200 3 to 7-year-old typically developement children in available kindergartens and schools. Finally, the collected data for task items and connected speech measures were processed and analyzed using SPSS software, version 20.

The content validity was 0.78 and test reliability was 0.76. In addition to confirm the construct validity and diagnostic validity of the test, the correlation between the sub-tests and the overall test scores were also significant at the level of 0.01 (with a correlation of 0.20 to 0.83). The norm for each age group was six months and one year and was calculated as a standard score and reported in the tables.

Finally, the results of the normative data of this battery are proved to be clinically normative as an indication of the level of linguistic development for each age group and also determine the severity of their language impairment. The battery can also be used to measure the efficacy of rehabilitation in 3 to 7-year old Persian speaking children.

Chronic obstructive pulmonary disease is one of the most common causes of death in the world, which affects the functional level of patients due to its progressive nature. disabilities caused by the disease lead to the dependence of these patients on family caregivers. Following the changes in caregivers’ lives, most family caregivers are exposed to psychological distress. Involving caregivers in pulmonary rehabilitation training for patients is one of the ways to reduce psychological distress. Considering the emergence of the digital age and the limitations of face-to-face training such as time and cost, mobile phone-based applications are available as one of the new methods for providing educational support to caregivers. Therefore, this study was conducted with the aim of determining the effect of the pulmonary rehabilitation application on the psychological distress of caregivers of people with chronic obstructive pulmonary disease.

This study is a field trial conducted on 70 family caregivers of people with chronic obstructive pulmonary disease. The samples were selected as available from the Sun Breathing Comprehensive Clinic and after checking the inclusion criteria, they were randomly assigned to intervention and control groups by minimization software. The intervention group used mobile phone-based pulmonary rehabilitation training application for 6 weeks. For the control group, face-to-face pulmonary rehabilitation training (routine) was provided in the form of 12 sessions during 6 weeks. The data collection tool included Kessler’s demographic information and psychological distress questionnaires, which were completed by caregivers before and after the intervention. Data analysis was done using SPSS version 24 software and Mann-Whitney, Chi-square and independent and paired t tests.

According to the findings, the two groups were homogeneous in terms of demographic characteristics. The average age of caregivers in the intervention and control groups was (44.1±14.8), (47.7±13.8) years, respectively. In the intervention group, 71.4% were female caregivers and in the control group, 82.9% were female caregivers (P>0/05). Before the intervention, there was no significant difference in terms of psychological distress between the test and control groups (P<0.05), but after the intervention, there was a significant difference between the two groups in terms of psychological distress (P=0.001). The average score of psychological distress before and after the intervention in the intervention group was (14.97±6.65) and (10.25±4.50) respectively, and there was a significant decrease (P<0.000), but the psychological distress in the control group was (15.68±7.91). 5.42±14.60) had no significant change (P<0.05). 

The results of this study indicate that training through a mobile-based pulmonary rehabilitation application may be useful in reducing the psychological distress of family caregivers of chronic obstructive pulmonary disease. Therefore, since the favorable mental state of caregivers has a significant effect on the quality of care provided , it is recommended to use this method in the training of caregivers of chronic obstructive pulmonary disease.

With the advancement of information and communication technology, the use of telepractice has expanded to provide speech, language, and swallowing services. In different countries, studies have been conducted in the field of telepractice of speech, language, and swallowing disorders, including stuttering, and these studies have confirmed the effectiveness of this method of providing treatment and have mentioned some problems. To present this method of treatment more effectively, the challenges of this treatment should be examined. The present study has been conducted to investigate the facilitators and barriers to the telepractice of stuttering in preschool children.

In this qualitative study, individual unstructured interviews have conducted using qualitative content analysis with 11 participants, including therapists with experience in stuttering telepractice in preschool children, therapists who were opposed to this treatment (n=7 people) as well as parents who have had successful telepractice and parents who have had unsuccessful telepractice (n=4).

Telepractice facilitators included cost reduction, therapist-client communication between sessions, greater parental cooperation and responsibility in telepractice, reduced stress and increased child-therapist collaboration in the natural environment, more time freedom, and time flexibility for the family and therapist. Barriers to telepractice in this group included lower trust in the therapist in telepractice, limited communication cues, spending more energy by the therapist, difficulty in educating parents, and lack of comprehensive protocols in telepractice.

When these cases are recognized, it is possible to provide higher-quality treatment to people who need these services by reducing barriers and strengthening facilitators. To achieve this goal, it is necessary to conduct studies to develop comprehensive and detailed protocols for providing this method of treatment, taking into account the existing facilitators and obstacles.

Social health, along with physical and mental health, is one of the pillars of health and represents one’s assessment of social life. Therefore, the purpose of this study was to investigate the social factors affecting the social health of the clients covered by the Nowshahr Well-being.

The research method in this study was the descriptive follow-up. The research community was formed by female clients 18 to 60 years old under the cover of the Nowshahr Well-being with 3951 people. 350 samples were selected using the Morgan table and simple random sampling method. The data collection tool consisted of two valid keyes social health questionnaires (1) and Babapour et al. (2010). The reliability of the questionnaires was calculated using Cronbach’s alpha method, according to which the coefficient of research variables and its dimensions were more than 0.7 and was evaluated as suitable. For research data analysis, correlation coefficient and regression analysis with SPSS software, version 24 was used.

According to the findings of the research, there is a positive and significant relationship between all the variables, that is, between the independent variables of the research, which include social integration, social skills, social participation, and social acceptance, with the dependent variable of the research, social health. Using regression, the effect of social integration variables (β=0.137), social skills (β=0.157), social participation (β=0.156), and social acceptance (β=0.120) on social health was determined. The value of the multiple correlation coefficient of the dimensions of social integration, social skills, social participation and social acceptance with the variable of social health and its estimated value under the final regression model is equal to (0.612). The value of the coefficient of multiple determination in the final model was equal to (0.567), which indicates that 57 percent of the changes in social health can be explained by the independent variables included in the model, namely the dimensions of social integration, social skills, social participation, and social acceptance. which indicates the good fit of the model. The estimation of the coefficients of the final regression model shows that the investigated variables are all significant and each of them has different weights. Also, the regression coefficients showed that the variable of social skills (β=0.157) has the greatest impact.

According to the findings of the research, social integration, social skills, social participation, and social acceptance is an effective factors in promoting social health and feeling good and improving the quality of life and social health of clients covered by Nowshahr welfare department, so with Increasing the level of awareness and social skills of clients will also provide the basis for improving their social health.

The present study aims to examine the effect of a play-based intervention on the anxiety of mothers of premature babies admitted to the neonatal intensive care unit (NICU).

This is a non-blinded randomized controlled clinical trial. The participants were recruited from among the mothers of premature babies (<37 weeks) admitted to the NICU of Hazrat-e Ali Asghar Hospital and divided into two groups of intervention (n=20) and control (n=20) using the block randomization method. They were 20-35 years old with at least a high school diploma. Their babies had stable physiological conditions with no physical disorders or specific diseases. The anxiety of mothers was measured by Spielberger’s State-Trait anxiety inventory (STAI) before study and two days after discharge. The intervention group received the play-based program for their babies at least once a day, for at least 5 days until discharge. The control group received routine hospital care.

Independent t-test results showed no significant difference in the scores of STAI and its domains between the two groups before and after the intervention. However, mean difference of pre- and post-scores of total STAI and state anxiety domain was significant in two groups (P<0.05), but it was not significant in terms of trait anxiety (P>0.05). The ANCOVA results showed that the effect size of intervention on state anxiety (P=0.001) and total anxiety score (P=0.004) was 27% and 20%, respectively.

The play-based intervention, can reduce the anxiety of mothers of premature babies admitted to the NICU and consequently affect the growth of children and mental health of family and society.

One of the most voice-related complaints in teachers is vocal tract discomfort (VTD) which can increase the voice handicap index (VHI) to different degrees. In teachers Muscle Tension Dysphonia (MTD), increases voice complaints and decreases the voice-related quality of life. The aims of this study were to evaluate and compare the frequency and severity subscales of the VTD score and total score of VHI and determine the relation between them in primary school teachers with and without MTD.

This study was cross-sectional and was performed on 80 primary female teachers with and without MTD. The participants in both groups were randomly selected after checking the inclusion criteria. Voice history, auditory-perceptual assessment of voice, palpation, and laryngeal video-stroboscopy were assessed on the teachers in two groups. Then, asked the participants to complete the Persian versions of the VTD and VHI scales. After determining the normal distribution of the data using the Kolmogorov-Smirnov test, the results of VTD, VHI, and their subscales were compared between two groups with an independent t-test. Also, the relationship between them was assessed with the Pearson correlation coefficient analysis.

The mean score of the frequency subscale of VTD in teachers with MTD was more than in teachers without MTD (30.17±5.11, 8.22±2.26), respectively. The score of severity subscales of VTD in teachers with MTD was 39.12±4.94 and in teachers without MTD was 7.89±2.13. Also, the total score of the VHI questionnaire in teachers with MTD was significantly higher than teachers without MTD (P<0.05). Moreover, there was a significant positive correlation between the frequency and severity subscales of VTD and the total score of VHI in the two groups (P<0.05).

This study showed the frequency and severity scores of the VTD and the degree of VHI experienced by MTD are remarkably higher than teachers without MTD. The authors emphasize on the use of VTD and VHI scales in screening teachers who are at risk of voice problems, and the researchers pointed out the importance of paying attention to the reduction of discomfort feelings in the vocal tract and voice handicap in the voice therapy sessions of teachers with MTD.

Due to the substantial prevalence of patellofemoral pain syndrome and the importance of quadriceps strengthening in knee rehabilitation, determining the best way to activate and strengthen the patella stabilizing muscles is considered as one of important keys of treatment. The aim of this study is to evaluate the effect of different hip rotations associated with ankle dorsiflexion during maximal straight leg raising (SLR) maneuver in the sitting position on thickness and fibers angle of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles using ultrasonography.

This quasi-experimental study was performed on 40 individuals (healthy group: 20, patellofemoral pain syndrome [PFPS] group: 20). VMO and VL thickness and fiber angle were measured using ultrasonography during maximal SLR in 6 positions: hip internal, hip external, and neutral rotations with and without ankle dorsiflexion. 

In between-group comparison, no significant difference was found for all variables with different SLR maneuvers (P>0.05). In the within-group comparison, hip external rotation compared to other hip positions without ankle dorsiflexion resulted in a significant increase in VMO thickness and fiber angle in both groups (P<0.05). Also, adding ankle dorsiflexion to different hip rotations during SLR significantly increased the thickness and fiber angle of VMO and VL.

By changing hip rotations with or without ankle dorsiflexion during SLR, the trend of changes in VMO and VL thickness and fiber angle in the two groups followed the same pattern. Moreover, performing SLR in hip external rotation with ankle dorsiflexion can be recommendable for the rehabilitation of PFPS.