فصلنامه آرشیو توانبخشی
سال بیست و چهارم شماره 4 (پیاپی 98، زمستان 1402)

Cerebral palsy is a group of movement disorders caused by damage to one or more regions of the developing brain. Therapists use different treatment approaches for children with cerebral palsy. It is important to pay attention to the priorities of the parents of these children because they spend most of the time with their children and are fully aware of their needs. The present study aims to investigate the treatment priorities of parents of children with cerebral palsy.

In this scoping review study, a search was first conducted in national and international databases, including SID, PubMed, Scopus, Google Scholar, OT Seeker, and the Bank of Medical Theses of the country. The articles focused on the treatment priorities of parents of children with cerebral palsy and published in English or Persian from 2000 to 2022 were included. The review studies published in other languages were excluded. After assessing the found articles based on the inclusion and exclusion criteria, 12 articles were finally selected for the review. 

The parents of children with cerebral palsy have different priorities. Teaching elf-care skills to the child was one of their most important priorities, which is not dependent on the age and level of gross motor function in children. Other important priorities were mobility and having complete information about treatment services. It seems that all the mentioned priorities are related to each other and paying attention to each one requires checking other priorities.

The priorities of the parents of children with cerebral palsy are broad and unique. Not all of these priorities are dependent on the age and severity of disability in the children, and can be different per child. It seems necessary to pay attention to the treatment priorities of the parents of these children in the rehabilitation process.

Grammar is a key element of language knowledge and a factor in predicting language learning and success. Early diagnosis of grammatical errors in children before entering school is very important. So far, no tool has been designed to evaluate the Azerbaijani language grammar comprehension in Iran. The present study aims to design the Azerbaijani language grammar comprehension test for Iranian children aged 4-6 along and assess its validity.

This is a mixed-method (qualitative-quantitative) study. After searching in various databases and reviewing available articles, 42 grammatical structures of the Azerbaijani language were extracted, of which 8 were removed after preliminary examination by experts. Then, 204 items were formulated for the remaining 34 grammatical structures. To determine the content validity, the test was sent to 11 experts in the field of Azerbaijani language grammar to evaluate the items. According to their opinions, two more suitable items were selected from among four items for each grammatical structure and included in the initial version for the pilot study. The initial test version was conducted on 30 children aged 4-6 years with normal language development.

After calculating the content validity ratio (CVR), two grammatical structures were removed, and 32 structures with 128 items having CVR≥0.59 remained. After calculating the content validity index (CVI), the items with CVI≥0.79 were selected. The initial version had 32 grammatical structures and 64 items. None of the items were removed in the pilot phase, and only 10 items were modified. The CVR and CVI of the test were 0.91 and 0.87, respectively, indicating good content validity.

The Azerbaijani language grammar comprehension test has good content and face validity and can be used to evaluate the grammar comprehension of children with Azerbaijani language aged 4-6 years.

Swallowing disorder or dysphagia is one of the most common problems in old age and after brain vascular lesions. This problem has received a lot of attention in studies. However, Pain on swallowing (known as odynophagia) has been less discussed in the literature. The present study aimed to investigate the existence of pain on swallowing, its characteristics, the possible intervention, and the effects of this pain on the quality of life of affected people.

The present study adopted a qualitative approach. After purposeful sampling, we interviewed 11 speech therapists in the field of swallowing disorders (5 males) and 15 patients with dysphagia. All the interviews were transcribed and underwent content analysis using the Graneheim and Lundman method. Finally, the main themes, subcategories, semantic units, and examples related to each were obtained.

Out of 15 interviewed patients, only 6 reported pain on swallowing. In comparison, all 11 therapists in the field of swallowing disorders confirmed the presence of pain on swallowing. Seven main themes were obtained based on these interviews: The temporal pattern, duration, location, stimulating/provoking factors, type, intensity, and onset time. Each of these themes had its subcategories and items. All patients and therapists reported the negative impact of pain on swallowing on the quality of life. There was an agreement between therapists and patients to manage pain on swallowing.

This study showed that pain on swallowing is probably one of the characteristics of a swallowing disorder, and professionals must consider pain on swallowing during the clinical examination. Future studies can focus on different dimensions of pain on swallowing and develop proper evaluation scales.

Stuttering is one of the speech disorders that appears in childhood. Many studies emphasize early interventions for its treatment. Circumstances such as a lack of therapists and the COVID-19 pandemic have limited the access to face-to-face therapy. Studies show some problems with this type of treatment. A detailed understanding of these problems in a cultural context can help increase the quality of providing telepractice. This study was conducted to discover the telepractice treatment of stuttering in preschool children.

This qualitative study was conducted in Iran from November 2020 to February 2022 using the grounded theory method. In this study, in-depth, free, and individual interviews were conducted with 9 therapists and 5 parents of children who stutter. The data were analyzed using the Corbin and Strauss method, version 2015.

After analyzing the data of this study, 6 main categories, 17 subcategories, and 63 primary categories were extracted. The main categories include “hesitation in choosing telepractice”, “characteristics of family and clients”, “technology and the knowledge to apply it”, “therapist skills for telepractice”, “payment system for telepractice fees”, and “efficiency of telepractice”.

In this study, “efficiency of telepractice” was chosen as the central concept that all participants were concerned about in some way. According to this model, “hesitation in choosing telepractice”, “characteristics of family and clients”, and “technology and the knowledge to apply it” as the context have effects on the processes that are taking place in relation to the telepractice in preschool children who stutter. These processes include “therapist skills for telepractice” and “ payment system for telepractice fees”. In the end, all these things increase the efficiency of telepractice.

Proper physical activities play an important role in reducing disease and mortality in old age, and is one of the main causes of active aging; however, the fear of falling is a barrier to having proper physical activity. Due to the difference between the elderly living in urban and rural areas regarding the risk factors of fear of falling and the amount and type of physical activity, this study aims to investigate and compare the fear of falling, physical activity, and activities of daily living (ADL) in the elderly living in urban and rural areas of Konarak County, Iran.

In this analytical cross-sectional study, 350 elderly people  aged ≥60 years, who were under the coverage of comprehensive rural and urban health service centers in Konarak, Sistan and Baluchestan province (224 from rural areas and 126 from urban areas) were selected using a random sampling method and based on the inclusion and exclusion criteria. In addition to recording their demographic information, their fear of falling, physical activity, and ADL were measured by the Persian version of falls efficacy scale-international (FES-I), Rapid Assessment of Physical Activity (RAPA), ADL scale, and Instrumental ADL scale (IADL), respectively.

The mean overall age of the elderly was 68.48±7.84 years (69.53±8.29 years in the rural group and 66.62±6.61 years in the urban group), and there was a significant difference between the two groups in terms of age (P<0.001). Pearson correlation test results showed that the FES-I score had a statistically significant negative relationship with the scores of ADL, IADL, and RAPA1 in total and in each group (P<0.001), but there was no statistically significant relationship between the FES-I score and the RAPA2 neither in total (P=0.40) and nor in rural (P=0.38) and urban (P=0.81) groups.

The fear of falling is significantly higher in the elderly living in rural areas of Konarak county compared to those living in urban areas. The RAPA1 and basic ADL of the elderly living in urban areas are higher compared to those living in rural areas, but there is no significant difference between them in RAPA2 and IADL. In addition, fear of falling has a significant relationship with physical activity of the elderly in overall and in rural and urban groups.

In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the health system. This study aims to design and evaluate the validity and reliability of the Bayley-III examiner clinical performance scale.

this study, participants were Bayley-III test examiners from medical universities in Iran, who were selected using a purposive sampling method. First, in focused group discussion sessions with 10 Bayley-III test experts, the items of instrument were formulated. Then, to evaluate the face validity, the questionnaire was sent to a panel of expert consisting of 8 Bayley-III experts and examiners and they were asked to rate the items from 1 to 5 in terms of importance. The items with an impact score of less than 1.5 were deleted, and other items were revised, if needed. To evaluate content validity, the questionnaire was sent to 10 Bayley-III test experts, and then the content validity ratio (CVR) and content validity index (CVI) were measured. The items with CVR <0.6 and CVI <0.7 were deleted. The reliability of the instrument was assessed by calculating the inter-rater reliability, test re-test reliability, and internal consistency. Quantitative data analysis was done in SPSS software, version 22.

The instrument with 66 items, including 32 items for the cognitive domain, 22 items for the language domain (13 for receptive and 9 for expressive components), 12 items for the motor domain (9 for fine and 3 for gross motor skills), and 14 items for the general section, was assessed in stability and reliability. The intraclass correlation coefficient (ICC) for the test re-test reliability was obtained 0.83 for the specific section and 0.86 for the general section. The ICC for the inter-rater reliability was 0.80 (95% CI: 58-82). The highest correlation value was related to the cognitive scale (0.88), and the lowest value was for the gross motor skill subscale (0.76). The kappa coefficient for the inter-rater reliability of the general section was above 0.7. The kappa coefficient for the specific section ranged from 1 to 0.35. The Cronbach’s α for the internal consistency of the general section was 0.76. 

The designed questionnaire is a valid and reliable tool to evaluate the clinical performance of Bayley-III test examiners in Iran.

Patients with knee osteoarthritis (KO) commonly show quadriceps muscle weakness. One of the important reasons for this weakness is arthrogenic muscle inhibition (AMI), a process in which neural inhibition causes the failure of quadriceps activation. The present study aims to evaluate the effect of cross-education on the AMI and the maximum extensor force of quadriceps in women with unilateral KO.

this study, 21 women with unilateral KO (grade 2) participated. The AMI and the maximum extensor force of the quadriceps in the affected knee were measured before, immediately after, and 15 minutes after cross-education. The cross-education included isometric training of the contralateral quadriceps in 5 sets of 8 repetitions in one session. For measuring the AMI and maximum extensor force of the quadriceps, a burst of electrical stimulation was superimposed on the maximal voluntary contractions in 6 seconds.

Immediately after one session of cross-education, the AMI of the affected knee significantly decreased and the maximum extensor force of quadriceps significantly increased compared to the pre-test phase (P=0.001). Fifteen minutes after cross-education, AMI significantly increased compared to the post-test phase (P=0.018), but was still lower than that in the pre-test phase (P=0.001)

One session of cross-education can reduce AMI and increase maximum extensor force of quadriceps in women with KO, and this effect remains for at least 15 minutes.

Autism spectrum disorder (ASD) is a common disorder among children. The architectural design of the treatment environment can be effective in the quality of rehabilitation for these children. On the other hand, considering that an important part of treatment for children with ASD is to meet their sensory needs, there is a need for intervention and adaptation to the environment (sensory regime). The study aims to investigate the effect of the interior architecture of rehabilitation centers on the outcome of occupational therapy for children with ASD.

This is an observational cross-sectional study on 50 children with ASD aged 3-14 years, who were assigned into two groups of treatment in standard and non-standard environments, according to interior architectural factors. They were assessed before and after occupational therapy. To rank the physical space of rehabilitation centers, a researcher-made questionnaire was used with 30 criteria measuring natural light intensity, light quality (natural or artificial), visibility and view of the inside of the building, noise and visual pollution, and color of the walls. The criteria were based on the opinions of 32 occupational therapists and parents of 50 ASD children. The sensory profile 2 was used to measure sensory processing patterns (sensation seeking, sensation avoiding, sensory sensitivity, and sensory registration) of children with ASD. The paired t-test was used for within-group comparison, and the independent t-test was used for between-group comparison.

Both standard and non-standard treatment environments were effective in improving all four patterns of sensory processing (P=0.04). However, the rehabilitation center with standard design had a more significant positive effect on all four sensory processing patterns, including sensation seeking (P=0.001), sensation avoiding (P=0.001), sensory sensitivity (P=0.01), and sensory registration (P=0.001) compared to the non-standard environment.

The interior architecture of rehabilitation centers has a significant positive effect on the sensory processing patterns of children with ASD, which can affect the quality of rehabilitation services. Therefore, it is recommended to optimize the interior architecture of rehabilitation centers for ASD children.