Iranian Rehabilitation Journal
Volume:21 Issue: 54, Jun 2023

Postconcussion syndrome (PCS) results from an injury to the head, leading to loss of consciousness. It includes symptoms like fatigue, headache, dizziness, and difficult concentration. PCS is frequently seen among athletes, and its treatment is still controversial. This systematic review aims to study the impact of manual therapies on recovery from postconcussion syndrome.

A systematic search was performed using three databases (PubMed, Google Scholar, and Research Gate) from 2011 to 2021. GRADE approach (grading of recommendations assessment, development, and evaluation) was utilized to evaluate and appraise the quality of studies deemed eligible for this study.

A total of 5489 articles were identified. After undergoing the process of screening and review, only 7 articles were used in the systematic review. Data were extracted from these 7 articles (GRADE rating very low to low).

Manual therapy is an intervention for treating postconcussion symptoms. More studies especially controlled trials with randomization with greater sample sizes, are required to confirm the existing findings.

This review aimed at exploring the effect of the Holy Qur’an recitation (HQR) therapy in patients admitted to intensive care unit (ICU).

The relevant articles in the last 10 years were reviewed to obtain data about the application of the HQR and its effects on physiological parameters and neuropsychological functions. Twenty-four articles were relevant to the topic, which consisted of 9 review articles, 14 original articles, and 1 web page.

HQR therapy is a non-pharmacological therapy given to ICU patients to improve their physiological and psychological parameters that disturbed due to stressors in the ICU. The form of therapeutic intervention for listening to the HQR varies based on the time of administration, the length of therapy, and the chapter (Surah) read. The HQR therapy had a therapeutic effect by relieving the discomfort caused by the treatment and creating a peaceful mind. The average duration of listening to the HQR therapy is about 30 minutes, with the administration time during spontaneous breathing trials or while the patient is still on mechanical ventilation. 

The HQR could change the physiological parameters of the cardiovascular and respiratory systems. Listening to HQR involves religious and spiritual characteristics associated with stress, anxiety, and depression. Spirituality is related to cognitive and emotional functions such as belief, motivation, and feeling close to God, so this therapy was used to improve cognitive and psychological functions. The HQR therapy decreases the degree of pain. After receiving the HQR therapy, the psychological function is enhanced by reducing stress levels, anxiety, depression, or other emotional disorders.

Social anxiety disorder (SAD) is one the most prevalent psychiatric disorders and generates severe negative effects on patients' mental, individual, and social health. Decreased responsibility, absenteeism, and poor life quality can be the consequences of this disorder. Considering the effective empirical background of both therapeutic approaches in reducing social anxiety symptoms and the lack of research on combining both interventions to reduce anxiety, this study was performed to determine the effects of acceptance-commitment therapy (ACT) and psychodrama therapy on nurses' social anxiety.

This randomized trial research was conducted at Torbat Heydarieh University of Medical Sciences in 2017 with a pre-test-post-test design. A total of 48 nurses with SAD who were referred to the university counseling center were chosen at random and entered into 4 equal groups (12 subjects) (an intervention group and 3 control groups). The intervention group received a combination of psychodrama and ACT therapies in twelve 90-minute treatment sessions (2 meetings every week). The control groups were provided with psychodrama therapy, ACT, and no treatment. The study data were collected by Connor's social anxiety questionnaire (2000). The collected data were analyzed by analyses of variance and covariance.

A decrease was observed in the social anxiety scores in the four groups of the study after psychological therapies. The Mean±SD of the social anxiety score in the treatment group based on psychodrama was 64.75±13.37 before the study period and 49.08±6.71 after that. While in the ACT group, it was 59.65±12.21 and 42.66±8.05 before and after the study, respectively, and in the group provided with a combination of both therapies, it was 62.75±13.49 before the study period and 35.75±7.19 after that. A lack of significant difference (P=0.86) could be detected in the mean anxiety score in the group of control. However, the social anxiety score of the group with a combination of both therapies significantly decreased (P<0.001) compared to other studied control groups. 

The data analysis showed that a combination of ACT and psychodrama therapies significantly reduced the social anxiety of nurses.

Lung cancer is the deadliest and the costliest cancer in the world. In this study, we compared the situation of this disease in several countries by considering the most important risk factor of lung cancer (smoking).

This is a comparative study, a comprehensive one which was done on lung cancer rates in four countries: Iran, Turkey, England, and the USA, during the past twenty years (2002-2021). Age-standardized rate (ASR) index and the percentage of smokers were extracted from available information in the World Health Organization (WHO) databases, The Organization for Economic Co-operation and Development (OECD) Health Statistics 2021, and other valid related articles. After comparison, control procedures were examined.

England, with an ASR of 46, has the highest rate of lung cancer, and Iran, with an ASR of 21, has the lowest rate. Turkey has the highest percentage of smokers (29.3%), and the lowest percentage belongs to Iran (20%). Regarding the increasing trend of the ASR index, lung cancer in Iran and Turkey has had an upward trend, and England and the United States have a downward trend. Taxes on cigarettes are a significant factor in smoking reduction. Among these 4 countries, the lowest cigarette tax belongs to Iran (4.83%).

The result of this study shows that the incidence of lung cancer in Iran is rising, so following successful countries in imposing cigarette taxes can be an effective step to reduce smoking. Training programs, cultural improvement, and new diagnostic methods can also be useful in reducing lung cancer ASR.

Individuals should have good sensory processing ability to function appropriately and participate in daily activities. This investigation aimed to evaluate the sensory processing characteristics of children aged under 14 years.

This is a descriptive cross-sectional study. The study population comprised all children aged >14 years referred to child’s developmental centers and elementary and middle schools in Tehran City, Iran. After considering the inclusion criteria, 1272 children were selected using multistage cluster sampling. The research tool was sensory profile-2, completed by children’s caregivers and teachers. Their sensory processing characteristics were measured according to the cut-off scores of the separate questionnaires of Sensory profile-2 in the section, school, and quadrant factors. 

The research samples scored just like the majority of others on most sensory processing areas, with only two quadrants, one sensory section, and one school factor score indicating “less than others” or “more than others.”

According to the findings, a high sensory sensitivity leads to intolerance of children in schools. Also, the low level of sensory seeking in toddlers is associated with less than other scores in movement items.

Feeding problems can occur in early-term infants born at 37 weeks. Early-term and full-term infants may benefit from oral motor therapy to attain successful breastfeeding. The present study aims to determine the impact of the 5-minute premature infant oral motor intervention (PIOMI) and the 15-minute oral stimulation program (15-minute oral stimulation program) on 37 to 41 weeks infants in attaining successful breastfeeding.

This clinical trial was conducted on early-term and full-term infants in the neonatal intensive care units (NICUs) of two hospitals in Mashhad City, Iran. They were randomly divided into two intervention groups (5-minute PIOMI or 15-minute oral stimulation program) and one control group (17 infants in each group). These three groups were then compared to each other after the intervention by pediatricians and speech and language specialists regarding their breastfeeding. All statistical analysis was performed using R software, version 4.0.2, and the significance level was set at 0.05.

Infants in both intervention groups attained different levels of breastfeeding compared to pre-intervention. This outcome could be due to our interventions or natural growth and development (P<0.05). However, the longer the infants’ oral motor therapy time was, the more likely they were to breastfeed successfully. The 15-minute oral stimulation program group had a significantly higher number of male infants attaining breastfeeding after treatment than the control and PIOMI groups (P=0.03). 

The PIOMI has been confirmed as an effective early intervention for small preterm infants as young as 29 weeks, and the short 5-minute therapy time is accepted in the preterm infant population. The program affects the brain’s plasticity and improves neurosensory and motor skill development for feeding. The current study indicates that PIOMI remains effective versus the control group in the full-term babies. However, the longer 15-minute oral stimulation program, is more effective in full-term infants. This finding shows that full-term infants can endure and benefit from longer than 5 minutes per day of oral motor therapy.

A proper function of hands is critical for doing daily activities and work, especially when using electronic devices. This study determined the effect of mirror therapy on individuals with asymmetrical hand function. 

Forty-two men with asymmetrical hand function were recruited. All participants were randomly divided into sham control (n=21) and mirror therapy (n=21) groups. Both groups were tested before and after training using the 9-hole peg test (9HPT). The sham control group received pegboard training, and the mirror therapy group received mirror therapy using the pegboard. During training, hand muscle activities were recorded using surface electromyography. The obtained data were analyzed using the t-test and Mann-Whitney U test. 

Non-dominant hand function on the 9HPT showed significant improvement in the mirror therapy group compared with the sham control group (P=0.021). The asymmetric hand function was also improved in the mirror therapy group. Muscle activities of the non-dominant hand were not significantly different between groups. 

Mirror therapy using the pegboard had an immediate effect on improving non-dominant hand function. This finding has implications for possible preventive strategies against common hand problems and improving the efficient use of both hands.

Disability is a social problem with multiple interrelated aspects, including medical, psychological, social, and rehabilitative. The number of people with disabilities has increased recently, despite the great advances in the medical field. This study aims to assess the quality of life (QoL) among amputees and its relations with some independent variables.

A descriptive cross-sectional study was conducted on 250 amputees registered in the Babylon Rehabilitation Facility, Babylon Province, Iraq. In light of some independent variables, we examined the QoL of these amputees. An empirical study was conducted to measure the reliability of the study questionnaire before it was given to professionals for validation. Interview techniques were used to collect data, which were then evaluated using descriptive (frequency and percentage) and inferential statistics (analyses of variance and the independent t test).

The Mean±SD age of the participants was 50±13.47 years (ranged 50-59 years). The characteristics of participants were as follows: male, 68.8%; married, 61.2%; secondary school graduate, 38%; employed, 34%; with insufficient monthly income, 41.2%; amputation due to diseases, 48.4% or accidents, 16.4%; amputation in lower extremities, 56.4%, and for more than 10 years on amputation, 48.8%. The results show differences in QoL concerning amputees’ age, marital status, occupation, monthly income, reasons for amputation, duration of amputation, gender, and sites of amputation.

Individual demographic characteristics should be considered in programs aimed at improving the QoL of amputees. Quality of life assessment and early inclusion should always be considered.

This study aims to investigate the impact of impaired upper limb motor function on trunk control and mobility in chronic post-stroke survivors so that the upper limb function should be enhanced as a core component of rehabilitation.

This analytical cross-sectional study was conducted from March 2021 to August 2021 at the Rehabilitation Center for the Physically Disabled in Peshawar, Pakistan. A total of 166 chronic stroke patients in the age range of 35 to 70 years and greater than 6 months post-stroke were included. To assess the impaired upper extremity, the Fugl-Meyer assessment upper extremity scale was used, and the trunk control and mobility were checked through functional reach test and timed up and go test, respectively.

Among 166 stroke survivors having upper extremity impairment, 109(65.7%) participants’ upper extremity was severely affected. Mobility levels measured through the timed up and go test were categorized and scored; accordingly, the participants showed a low risk of 22(13.3%), moderate 32(19.3%), high 72(43.4%), and very high risk of falls of 40(24%). Among 166 patients, 147(88.6%) had no trunk control which resulted in 8 times greater fall risk in 65(39.2%) participants. Thus, upper limb impairment is significantly associated with impaired trunk control and mobility (P=0.001).

This study found about one-third of stroke survivors have a risk of falling, two-thirds have upper extremity impairment, and two-thirds have no trunk control. This study showed a significant reduction in mobility level, balance, and posture balance in stroke survivors having upper extremity impairment. These findings suggest that stroke survivors with upper extremity impairment may use therapeutic intervention to minimize falls and enhance postural balance and trunk control.

This study aims to evaluate the prevalence, severity, and nature of adverse events (AEs) and provide suggestions on how to prevent AEs recurrence in an inpatient rehabilitation hospital in Iran.

This retrospective descriptive-analytical study was conducted in 2021 at Rofaydeh Rehabilitation Hospital in Tehran City, Iran. AEs associated with rehabilitation services and nursing care, which were reported in the hospital’s voluntary reporting system from 2018 to 2021 were evaluated. A standard checklist codified by the Ministry of Health of Iran was used to collect the data from the medical error documentation. The data were analyzed by the SPSS software, version 21, using descriptive statistics, the chi-square, and the Fisher exact tests.

A total of 5642 patients had been hospitalized in the study setting and 517 AEs had been documented during the 4 years of the study. The most common AEs in descending order were as follows: falls 288(55.7%), pressure ulcers 57(11.02%), medication errors 50(9.67%), clinical process 49(9.47%), clinical administration (issues with admission process 10(1.93%) and wrong patient identification 5(0.96%). Among 58(11.21%) cases of hospital-acquired infections, 45(77.58%) cases were urinary tract infections. There was a significant relationship between age and fall (P=0.026), pressure ulcer (P=0.006), and hospital-acquired infection (P=0.001), and between gender and fall (P=0.01), pressure ulcer (P=003), and hospital-acquired infection (P=0.01). The severity of identified AEs was categorized into mild 431(83.36%), moderate 61(11.79%), and severe 25(4.83%). The most common causes of AEs were limited supervision of patients by healthcare providers.

This study showed that patient fall, pressure ulcer, and hospital-acquired infection were the most prevalent AEs in the rehabilitation hospital. Future efforts to improve patient safety in these settings should focus on reducing such AEs along with removing barriers to voluntary incident reporting.

Considering the prevalence and importance of depression, it is necessary to study the new psychological variables involved in its formation, persistence, and recurrence. Accordingly, this study aims to investigate the relationship between psychological flexibility (PF), mindful ability (MA), and self-compassion with the severity of depression in patients with mood disorders.

This cross-sectional study was conducted from October to January 2018. A total of 80 patients with various mood disorders were selected via a purposive sampling method based on the inclusion and exclusion criteria from the psychiatric wards of Noor Hospital and clinics affiliated with Isfahan University of Medical Sciences. They completed the self-compassion scale, acceptance and action questionnaire, Freiburg mindfulness inventory–short form, and the Beck depression inventory-II. The data were analyzed using the SPSS software, version 24. Meanwhile, the Pearson correlation coefficient and multiple regression were applied as well.

The correlation coefficient between PF and depression was -0.79. This coefficient was -0.91 and -0.87 between self-compassion and depression and MA and depression, respectively. This indicates a strong inverse relationship between depression scores and these variables. Stepwise regression analysis showed that gender and MA were respectively the best predictors of depression (P<0.05).

Based on the results, there was a significant relationship between low self-compassion, PF, and MA and depression in patients with mood disorders.

Chronic non-specific low back pain (CNSLBP) is described as pain whose pathoanatomical cause cannot be determined. The current study aims to evaluate the impact of retro-walking on pain, flexibility, and physical functions in patients with CNSLBP.

A randomized controlled trial was conducted in the Physical Therapy Department of District Head Quarter Hospital Nankana Sahib, Punjab, Pakistan from September 2021 to March 2022. The trial was conducted on 36 patients, randomly divided into 2 groups of 18 patients. Conventional treatment and retro-walking were given to the experimental group and the conventional treatment alone was provided to the control group for 1 month with 3 sessions per week. The outcome variables were pain, the flexibility of hamstrings and lumbar region, and physical function assessed by numeric pain rating scale, sit and reach test, modified Schober test, and modified Oswestry disability index, respectively. The data were assessed at pre-treatment after the sixth and twelfth sessions.

This study showed a significant difference in the numeric pain rating scale, sit-and-reach test, and modified Oswestry disability index with a P<0.05 in both groups after intervention. However, in the group comparison, these variables showed better results in the retro-walking group compared to others with a P<0.001 after both the sixth and twelfth sessions.

The current study suggested that when added up to conventional treatment, retro-walking was more beneficial in reducing pain and enhancing the flexibility and physical function in patients with CNSLBP when compared to conventional treatment alone; therefore, it should be added to the treatment protocol for chronic non-specific pain in the lower back.

Alzheimer is the most prevalent cognitive disturbance with a high spread rate among the elderly. The current research aims to investigate the impact of cognitive rehabilitation on the memory improvement of Alzheimer disease patients.

This was a semi-experimental design with pre-test and post-test designs. The statistical population in Baghdad City, Iraq, in 2021 included 60 patients with Alzheimer and was divided into an experimental (n=30) and a control group (n=30). The patient’s cognitive abilities were assessed before the intervention (pre-test), promptly after the intervention (post-test), and 2 months later (follow-up). The experimental group had twenty-eight 45-min sessions of training based on the Montessori method (2 sessions per week). The data were analyzed via the SPSS software, version 19, using the independent t-test and repeated measures analysis of variance. The results had a P<0.05.

The findings of the independent t-test demonstrated no significant difference between the scores of both groups during the pre-test stage (P>0.05); however, the difference was significant during the post-test and follow-up stages (P<0.001). In addition, the findings of the repeated measure analysis of variance indicated a significant difference between both groups’ mean scores in the post-test and follow-up (P<0.001).

Cognitive rehabilitation can help patients with memory disorders and positively affect their memory performance.

The present study aims to design and test a model of factors affecting the acceptance of cosmetic surgery in Iranian female students. 

A sample of 600 female students aged 18 to 35 were selected from Kharazmi University using cluster random sampling. The participants completed six questionnaires: The short version of the attitude toward women scale, the beliefs about appearance scale, the body areas satisfaction scale, the body image coping strategies inventory, the rhinoplasty outcome evaluation, and the acceptance of cosmetic surgery scale. A structural model was used to examine the relationships among research variables.

Results showed a good level of fit to the data and proposed that gender role attitudes can facilitate cosmetic surgery in women by mediator roles of dysfunctional appearance beliefs, body dissatisfaction, coping strategies, and outcome expectancy. 

The study highlights the importance of traditional gender role attitudes in body dissatisfaction and cosmetic surgeries among Iranian women. Indeed, traditional gender role attitudes can encourage women to conform to beauty standards and undertake cosmetic procedures. These procedures can expose them to risks and unwanted consequences. Therefore, future research and prevention programs should be paid more attention to these traditional beliefs.

Patients with borderline personality disorder (BPD) often develop a certain depression that may be accompanied by “mental pain.” A negative self-concept, aversive chronic emotions, and pervasive helplessness characterize mental pain. This research aims to explore the pathology of BPD symptomatology in a nonclinical sample. Also, the role of mental pain, cognitive emotion regulation, self-compassion, and depression are assessed.

Following a correlational study, 300 university students were selected via the multi-stage random cluster sampling method. The study data were collected by the personality assessment inventory-borderline features scale, Orbach and Mikulincer mental pain questionnaire, cognitive emotion regulation questionnaire, self-compassion scale (SCS-SF), and Beck depression inventory version 2.

Multiple regression analyses indicated that components of putting into perspective, rumination, loss of control, refocus on planning, catastrophizing, irreversibility, somatic, and isolation (ΔR2=0.507, P<0.001) significantly predicted BPD symptomatology.

The results support the biosocial model dimensions in an Iranian context. In addition, it shows a strong association between mental pain, cognitive emotion regulation, self-compassion, depression, and BPD symptoms.

Although the Microsoft Kinect has compelling potential for gait analysis in medicine, data available to compare it with observational gait analysis (OGA) is scarce. This study compared the Microsoft Kinect and the OGA in assessing the gait parameters of apparently healthy adults.

Ninety-seven apparently healthy young male adults participated in this comparative study. First, the participant’s age, height, weight, and body mass index were obtained. Afterward, gait parameters involving the number of steps, cadence, stride length, and step length were assessed concurrently following OGA standard procedures and the Microsoft Kinect during a 6-m walk down the hallway. The obtained data were analyzed using descriptive and inferential statistics. The significance level was set at P<0.05. 

The Mean±SD walk time, steps, cadence, velocity, and stride length were 8.07±1.39 s, 14.0±2.96 counts, 72.9±11.9 steps/min, 0.8±0.13 m/s, and 0.77±0.13m, respectively. Step length was significantly higher (P<0.05) with Microsoft Kinect than OGA, whereas stride length and walk speed values were significantly (P<0.05) lower with Microsoft Kinect. A moderate but significant (P=0.001) positive correlation existed between Microsoft Kinect and OGA regarding walk speed. In contrast, regarding the step length, a weak but significant (P<0.05) positive correlation was found between Microsoft Kinect and OGA.

Step length values of Microsoft Kinect were significantly higher than OGA values, whereas stride length and walk speed values of Microsoft Kinect were significantly lower than OGA values. Walk speed and step length measured by Microsoft Kinect and OGA were positively correlated.

Income poverty is one of the most common problems of old age. It varies among older adults living in different societies. This study aims to investigate the predictors of income poverty in older adults based on the data from Organization for Economic Cooperation and Development (OECD) countries.

The secondary data analysis method was used in the present study. The income poverty rate and its associated variables were extracted from 36 members of OECD countries and entered into the SPSS software, version 22. For data analysis, descriptive and inferential statistics, including the Pearson correlation coefficient test and multiple linear regression analysis were employed.

The results showed that in the studied countries, the mean of income poverty among older adults was higher in women (11.48±16.2), and the elderly aged 75 years or above (12.57±16.1). The income poverty of older adults was significantly correlated with older adults’ share in the gross domestic product (r=-0.376, P=024), targeted pension coverage (r=-0.505, P=0.003), income sources based on public transfers (r=-0.460, P=0.005), income sources from work (r=0.697, P=0.000), mandatory pension contribution rate (r=-0.343, P=0.040), and net pension replacement rate (r=-0.424, P=0.010). The results of regression analysis also revealed that variables of income sources from work and targeted pension coverage explained 66% of the variance in income poverty among older adults.

It is important to pay attention to the variables of age and gender of older people to overcome economic vulnerability in social policies. It is also necessary to consider the role of the share of public transfers and basic old-age pensions to reduce older adults’ poverty. The lessons to be learned from OECD countries in this research are useful for the social rehabilitation of older adults in Iran.

Attention is one of the cognitive functions that can be enhanced through cognitive rehabilitation. Play therapy is a treatment option for cognitive impairments. This study aims to investigate the use of rehabilitation based on play therapy to increase the attention of medical students.

The present research is a randomized controlled clinical trial. The statistical population included all 162 third-year students of the College of Medicine in 2022 at the University of Baghdad City, Iraq. Using simple random sampling, the statistical population of 70 people was selected and then divided into intervention (n=35) and control (n=35) groups. Play therapy was provided to individuals in the intervention group, while subjects in the control group did not receive any intervention. We used the IVA-2 CPT software, version 2019.1 to assess visual and auditory attention as well as response control performance. The pre-test and post-test stages were separated by a 15-week interval. The data were analyzed via the multivariate covariance analysis in the SPSS software, version 23. The significance level was set at 0.05.

The results indicated a statistically significant difference between the intervention group’s mean pre-test and post-test scores (P<0.001); thus, the rehabilitation based on play therapy significantly enhanced attention in the intervention group. Also, the post-test results revealed a statistically significant difference between both groups (P<0.001).

Rehabilitation based on play therapy is an effective way to increase people’s attention.

The unanticipated lockdown following the COVID-19 outbreak significantly impacted the field of rehabilitation, compelling the professionals to switch to tele-mode to continue providing their service without interruption. This article aims to highlight the steps taken to overcome the various challenges that were encountered in this period and to strengthen the opportunities in telerehabilitation services at a tertiary care center in Kerala, India. An average of 1000 clients were served monthly through telerehabilitation in various units at the selected institute during the COVID-19 pandemic. The telerehabilitation services included assessments, intervention, and counseling for clients of all ages with various types of disabilities. A high literacy rate and better access to technology among the general population in Kerala, India were identified as advantages for the rapid implementation of telerehabilitation as a viable form of service delivery.