فصلنامه طب توانبخشی
سال دوازدهم شماره 3 (امرداد و شهریور 1402)

 The quick speech in noise (Q-SIN) test shows how difficult it is to perceive speech in noise by determining signal-to-noise ratio (SNR) loss. The lists with high-frequency words have a better ability to identify SNR loss which have been created in Persian. Although a Persian version of Q-SIN with emphasis on high frequency is available، but there is no Q-SIN lists with high-frequency words; therefore,this study aims to develop new lists and the lists with high-frequency words for Q-SIN test and determine their equivalency in normal-hearing people which was condcuted in Tehran University of Medical Sciences.

 The sentences were first developed. Then, their content validity and face validity were determined. In this regard، 36 sentences were used to make new Q-SIN lists and 36 sentences were used to make Q-SIN lists with high-frequency words. Based on the Q-SIN test development criteria، six regular lists (lists 1-6) and six lists with high-frequency words (lists 7-12) were tested on 46 people (23 males and 23 females) aged 18-35 with normal hearing

 The content validity index for new and high-frequency words lists were 0. 74 and 0. 736، respectively. The equivalency test results showed that among the first 6 lists، the lists no. 1, 2, 3, and 4 were equal. Among the six lists with high-frequency words, the lists no. 7, 8, 10, 11 were equal. There was no gender differences between six regular lists and high-frequency lists (P>0.05). 

 The Q-SIN word lists with equivalency can be used for normal-hearing people in clinical practice.

Nowadays, due to technological advances and sedentary or inactive lifestyle, non-communicable diseases have caused many health problems such as cardiovascular diseases. This study aims to examine the effect of two methods of aerobic training and concurrent training for cardiac rehabilitation on selected hemodynamic and biomechanical factors in older men with coronary artery disease.

This is a quasi-experimental causal-comparative study using the pre-test/post-test design. Participants were 24 older men with coronary artery disease, randomly divided into three groups of aerobic training, concurrent  training, and control. They first underwent cardiac assessment using the echo Doppler device as well as sports performance test. Then, they were referred to the biomechanics laboratory of the Physical Medicine Center to start cardiac rehabilitation training. After 8 weeks of training, they underwent post-test assessments. The mean and standard deviation were used to describe the data. The Shapiro-Wilk test was used to check the normality of data distribution and the Levene’s test was used to determine the homogeneity of variances. The paired t-test was used to assess between-group differences and independent t-test was used for assessing differences between pretest and post-test scores of the groups. The significance level was set at 0.05.

Significant improvement was reported in functional capacity, left ventricular ejection fraction (LVEF), and resting heart rate after both aerobic and concurrent training methods (P<0.05), but no significant difference in diastolic blood pressure and systolic blood pressure were observed (P>0.05). The improvements were more in the concurrent  training group.

Both cardiac rehabilitation methods (aerobic and concurrent  training) can improve functional capacity, LVEF, and resting heart rate of older mean with coronary artery disease, where concurrent  training is more effective.

having children with intellectual disability can cause psychological, emotional and social problems for the parents, especially mothers. The present study aims to examine the effect of dialectic behavior therapy (DBT) on self-conscious emotions and family quality of life (QoL) in mothers of children with intellectual disability.

This is a quasi-experimental study with a pre-test/post-test/ follow-up design. The study population consists of all mothers of children with intellectual disability in Ardebil, Iran in 2021. Of these, 37 were selected using a purposive sampling method and randomly divided into intervention and control groups. The mothers in the intervention group received eight sessions of DBT for two months. Tangney et al.’s test of self-conscious affect and the beach center family QoL scale were used in this study. The data were analyzed using mixed ANOVA.

The DBT had a significant effect on positive self-conscious affect (F=75.20; Eta squared=0.68; P=0001), negative self-conscious affect (F=45.19; Eta squared =0.56; P=0001) and family QoL (F=71.74; Eta squared=0.67; P=0001) in mothers.

The DBT can improve self-conscious emotions and family QoL in mothers of children with intellectual disability by employing techniques such as distress tolerance, mindfulness, and emotional regulation.

The increase in loading rate is associated with lower limb injuries such as tibial stress fracture. Quadriceps muscle activities absorb ground reaction force (GRF) shocks by eccentric activation. This study aims to evaluate the effect of aerobic training on the relationship between loading rate and quadriceps muscle activities in men with diabetic neuropathy (DN). 

In this double-blinded, randomized, controlled clinical trial, participants were 40 men with DN who were selected by a convenience sampling method and randomly divided into two groups of training (n=20, age: 54.9±7.3, body mass index: 28.4±5.4) and control (n=20; age: 54.1±7.3, body mass index: 28.5±5.1). The GRF data was recorded using a force plate system during walking. The electrical activity of selected lower limb muscles was recorded using electromyography method. The training group performed aerobic training for 12 weeks (three sessions per week). 

The results showed an increase in the negative relationship between vertical loading rate and vastus lateralis activities after training (P=0.028). The activities of vastus medialis and rectus femoris muscles showed no significant relationship with loading rate after training (P>0.05). 

Aerobic training can improve the relationship between vastus lateralis muscle activity and vertical loading rate in men with DN.

Adipokines have a major role in aging pathobiology and age-related diseases. The present study aims to evaluate the effect of 12 weeks TRX on irisin and chemerin levels in older men. 

In this randomized clinical trial, 16 older men (Mean age=62.06±1.53 years) were selected using a convenience sampling method and randomly divided into training and control groups. The training group performed TRX for 12 weeks, three sessions per week, each for 60 minutes. The training intensity was evaluated by the Borg rating of perceived exertion scale. Blood sampling was done 24 hours before and after training to measure irisin and chemerin levels. Statistical analysis was done by ANCOVA. The significant level was set at 0.05. 

In the training group, there were significant differences between pre- and post-test levels of irisin (P=0.001) and chemerin (P=0.001). The ANCOVA results showed a significantly higher level of irisin (P=0.001) a lower level of chemerin (P=0.001) in training group than in the control group. Also, the percentage of body fat and weight of people decreased significantly (P=0.001). 

It seems that TRX, by increasing irisin level and reducing chemerin level, can lead to improvement in body fat percentage, weight, and Body Mass Index (BMI) of older men.

Background and Aims

The present study aims to investigate the effect of a neuromuscular training program on knee valgus angle, and range of motion (ROM) and muscle strength of hip and ankle in male adolescent football players with dynamic knee valgus (DKV). Valgus knee is one of the most common neuromuscular abnormalities that is involved in causing non-contact damage to the anterior cruciate ligament (ACL).

This is a quasi-experimental study. Participants were 25 adolescent male football players with DKV who were purposefully selected from Shahin Football Academy in Amol, Iran and randomly divided into two groups of control and training. The existence of DKV was assessed by Squats test and the valgus angle were assessed by jump-landing test and Kinovea software. The abduction and external rotation strength and ROM of hip and the dorsiflexion and plantarflexion strength and ROM of ankle were evaluated with Manual Muscle Testing and a goniometer, respectively. After performing the pre-test assessments, the subjects in the training group performed neuromuscular training for 8 weeks, while the control group also participated in the physical fitness program of Shahin Football Academy. At the end, assessments were performed again in two groups. To examine the differences, repeated measures analysis of variance and Bonferroni post hoc test were used in SPSS software, version 24. The significance level was set at 0.05. 

The results showed a significant difference in knee valgus angle (P=0.001), abduction ROM of hip (P=0.01), external rotation ROM of hip (P=0.01), dorsiflexion ROM of ankle with knee extension (P=0.001), dorsiflexion ROM of ankle with knee flexion (P=0.001), hip abduction strength (P=0.002), hip external rotation strength (P=0.01), and plantarflexion strength of ankle (P=0.03) between the control and training groups. However, the results showed no significant difference in plantarflexion ROM of ankle and dorsiflexion strength of ankle (P>0.05). After one month, the results showed the sustainability of the effect of training on abduction and external rotation ROM of hip, dorsiflexion ROM of ankle with knee extension and flexion, and dorsiflexion and plantarflexion strength of ankle.

The neuromuscular training can reduce the risk of non-contact ACL injury in male football players with DKV by improving strength and ROM of hip and ankle.

Ai Chi is a new method of aquatic therapy and recommended in the rehabilitation of ankle injuries. Effect of the new Aichi method in the rehabilitation of ankle injuries is unclear. Therefore, the aim of this study was to investigate the effect of 8 weeks of Ai Chi exercises on balance, ankle joint proprioception and performance in elite female athletes with functional ankle instability.”

A total of 30 female volleyball, basketball, and handball players with functional ankle instability were divided into two groups of control (n=15; age: 21.9±1.22 years, height: 164.54±4.05 cm, weight: 61.19±7.40 kg, and BMI: 21.84±1.8 kg/m2) and training (n=15; age: 22.53±1.71 years, height: 165.07±5.18 cm, and weight: 59.45±8.82 kg, and BMI: 21.87±1.17 kg/m2). Before and after the exercise, the BIODEX balance system was used to evaluate the balance, a goniometer was used for proprioception evaluation, and the figure 8 hop test and side-to-side hop test were used to evaluate the performance. The training group performed Ai Chi exercises for eight weeks (twice per week, each for 30-60 min). Paired t-test and independent t-test were used to examine the between-group and within-group differences.

Ai Chi exercises improved between-group and within-group changes of static and dynamic balance, proprioception, and performance in female athletes (P˂0.05).

Female athletes’ balance, proprioception and performance can be improved by performing Ai Chi exercises in water. Therefore, the use of these aquatic exercises is recommended along with other training methods, since they challenges the physiological systems involved in balance.

Passion generally refers to the stimuli that shape a certain pattern of behavior. It can affects all aspects of a person’s life, including education and academic success. The present study aims to assess the predictability of school engagement based on communication skills, self-restraint, perceived parenting style, and sensory processing.

This is a descriptive-analytical study using the structural equation modeling (SEM).The study population consists of all secondary school students in Tehran (district 6). Sampling was done using purposive and convenience sampling methods. Using Cochran’s formula, the minimum sample size was obtained 385. Data collection tools were Baumrind’s parenting styles questionnaire, communication skills test-revised (CSTR), self-restraint scale, adolescent/adult sensory profile, and School Engagement Measure. To evaluate the SEM model, the significance level and path coefficients were investigated using the bootstrap method (re-sampling and sequential) and student’s t-test. 

Of 385 participants, 199 were girls (51.7%) and 186 were boys (48.3%), mostly aged 16 years (47.8%). Their mean age was 17.1±0.84 years. Results showed that the coefficient of determination (R2), Stone-Geisser’s Q2, and path coefficients were positive in all variables. The R2 value was 0.71, indicating that the independent variables together could predict 71% of school engagement.

Communication skills, self-restraint, perceived parenting style, and sensory processing are predictors of school engagement in students. Among these variables, communication skills have the highest effect.

Sleep after a new sequence memory training can enhance the explicit memory in children. However, children’s sleep-dependent motor memory consolidation particularly in implicit complex sequence tasks is unclear. Therefore, this study aims to investigate the role of night-time sleep and wakefulness on children’s motor memory consolidation following an implicit complex task.

In the current study, 26 boys aged 9-12 years were randomly assigned in two groups of sleep and awake. Acquisition phase included 10 blocks of 96 trials. The sleep group performed initial training at 8 (±1) PM while the awake group performed it at 8 (±1) AM by using the dynamic arm movement task. The participants were not aware of the sequence order. After training, the children’s performance was tested after 12 hours.

The results of 2×2 Mixed ANOVA in the consolidation phase showed the significant main effect of block on response time (P=0.000) and prediction error (P=0.023). However, the interaction effect of block and group were not significant on response time (P=0.566) and prediction error (P=0.887). 

The sequence memory consolidation in children under an implicit complex task can be improved offline regardless of having sleep between training and test sessions. Hence, sleep is not necessary for offline enhancement of motor sequence skills. Passage of time is effective for improvement in dynamic arm movement task. Therefore, the role of sleep in offline learning of motor skills depends on the nature of the task used in training.

Balance is an important factor in people with intellectual disability to have an independent life. These people are weak static and dynamic balance due to lack of development in their central nervous system, defects in the sensory-motor pathways, and having a sedentary life. This study aims to determine the effect of eight weeks of dynamic neuromuscular stabilization (DNS) exercises on static and dynamic balance of educable mentally retarded female students.

In this study, participants were 26 educable mentally retarded female students aged 15-20 years (Mean age: 17.19±1.50 years, IQ: 61.15±6.07, weight: 58.9±12.73 kg, height: 157.92±6.07 cm) who were selected using purposive and convenience sampling methods and randomly divided into two groups of training (n=13) and control (n=13). Before and after training, their static balance and dynamic balance on the right and left feet were evaluated using a foot scan device. Subjects in the training group performed DNS exercises at 24 sessions, each session for 40 minutes. No intervention was provided to the control group; they performed their routine activities. Repeated measures analysis of variance was used to analyze the data. The significance level was set at 0.05.

After eight weeks of DNS exercises, the results showed a significant improvement in static balance (F=72.54, P=0.001), dynamic balance on the right foot (F=90.90, P=0.002) and dynamic balance on the left foot (F=61.58, P=0.001) in the training group compared to the pretest scores and compared to the control group.

DNS exercises can be used as an effective method to improve static and dynamic balance of educable mentally retarded female students.

Despite the existence of various tools to assess such children’s educational and rehabilitation needs, there is no instrument in Persian for this purpose. The present study aims to develop a questionnaire to measure the educational and rehabilitation needs of children with Down syndrome in Iran from the perspective of their mothers.

This is a mixed method study with exploratory design-instrument development model. The phenomenological method was used in the qualitative stage, where the participants were 17 mothers of children with Down syndrome in Iran who were selected purposefully based on theoretical saturation. In this phase, semi-structured interviews were used. Hsieh and Shannon’s content analysis method was used to analyze the data. In the quantitative phase, participants were 100 mothers of children with Down syndrome who were selected using a random sampling method. In this phase, a researcher-made questionnaire of educational and rehabilitation needs of children with Down syndrome was used. Then, its validity and reliability were determined.

According to mothers, children with Down syndrome have four main needs: Communication skills, adaptive behaviors, language skills, and educational problems. These were considered as the subscales of the questionnaire. The content validity ratio (CVR) was in the range of 0.8-1, and the content validity index (CVI) value was 0.98. The Cronbach’s alpha for the overall scale was 0.93. The test-retest coefficient for the overall scale was 0.84.

The educational and rehabilitation needs scale for children with Down syndrome (parent form) in Persian has acceptable validity and reliability.

Fluency disorder or stuttering is a Speech disorder in humans whose prevalence is higher at the ages before puberty. Mind simulation may be effective in reducing the severity of stuttering and some associated problems such as negative attitude towards communication. Therefore, this study aims to investigate the effect of mind simulation method on reducing stuttering and improving communication attitude in children and adolescents with stuttering aged 7-16 years.

This is a quasi-experimental study with a pre-test/post-test/follow-up design. Participants were 30 children and adolescents with stuttering aged 7-16 years (9 females and 21 males) referred to a psychology clinic in 2020. They completed DeNil and Brutten’s communication attitude test-revised (CAT-R) and Riley’s Stuttering Severity Instrument- 4(SSI-4) in the pre-test stage. Then, they underwent treatment by the Mind Simulation method for three months. Immediately after and one month after treatment, they completed the CAT-R and SSI-4 questionnaires again. Repeated Measure Analysis of Variance and Friedman Test were used to analyze the collected data.

There was a significant difference between pre-test, post-test, and follow-up phases in stuttering severity (P=0.0001) and communication attitude (P=0.0001). The severity of stuttering decreased in the post-test and follow-up phases compared to the pre-test phase, while communication attitude improved in the post-test phase compared to the pre-test phase.

The mind simulation method can reduce stuttering and improve communication attitude in children and adolescents with stuttering.

 One of the neurological challenges of people with multiple sclerosis (MS) is balance. Different balance tests are used for this purpose. This study aims to measure the association between the scores of common balance tests for patients with MS. 

 In this descriptive retrospective study, participants were 41 patients with MS (27 females and 14 males) with an expanded disability status scale score of 4.5 or less (Mean= 4.02±0.61). The balance tests including Berg balance test (BBS), functional reach test (FRT), activities-specific balance confidence (ABC) scale, timed up & go (TUG) test, dynamic gait index (DGI), modified Romberg test-open eyes (RMTO), modified Romberg test-closed eyes (RMTC), and dizziness handicap inventory (DHI) were randomly performed in two days with sufficient rest interval between them. Pearson correlation test was used to measure the relationship between their scores. 

 The DGI score had a high and significant correlation with the scores of ABC scale, BBS, and FRT (P<0.001). Also, there was a high and significant correlation between the scores of ABC scale and BBS (P<0.001). The correlation between the scores of BBS and FRT test was also high and significant (P<0.001). 

 The BBS score، as one of the most widely used balance tests in patients with MS and other balance diseases، has a high correlation with the scores of DGI، ABC scale، and FRT. These tests are suggested as supplementary tests for BBS. The findings can help therapists and neurologists to choose valid balance tests at different conditions and levels of MS.

Balance control is needed to walk and function independently. Decreased balance accompanied by fear of falling can have a negative effect on the mental and physical health of older adults. In this study, we aim to assess the effect of group-based Fallproof program on balance and psychological aspects of health in the elderly with different ages.

In this quasi-experimental study, the study population consists of all healthy community-dwelling older people in Tehran, Iran. Based to the inclusion criteria, 60 people aged 65-85 years were selected using a convenience sampling method from public recreational centers. They were divided into three age groups: 65-71, 72-78, and 79-85 years. All groups received a group-based Fallproof program for eight weeks, three times a week. The Symptoms Checklist-90-Revised was used to measure psychological problems, and the Fullerton Advanced Balance scale was used to identify balance problems in the pre-test and post-test phases. Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, and analysis of covariance was used to measure the mean differences between groups The significance level was set at 0.05.

The results showed a significant improvement in balance and psychological health of all three groups after the intervention (P<0.001). The oldest group showed more significant improvement in all dependent variables when compared to other two groups. Therefore, older adults not only can benefit from exercise-based interventions, but also can achieve better physical and psychological results in short period by participating in group-based Fallproof program.

Eight weeks of group-based Fallproof program can be effective in improving balance and psychological health of the elderly and can be used along with other training protocols for improving balance problems of older adults.