Iranian Rehabilitation Journal
Volume:21 Issue: 56, Dec 2023

Scapular-focused exercises are included in the rehabilitation of people with scapular dyskinesis (SD); yet, there is a noteworthy level of ambiguity concerning the comparative efficacy of different interventions in terms of their ability to enhance shoulder discomfort and function. This research analyzed the impact of a scapular-focused exercise schedule on shoulder pain and function of patients with scapular dyskinesia.

PubMed, Medline (Ovid), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Google Scholar, and Scopus databases were explored up until July 2021 for randomized controlled trials (RCTs) that considered the impact of scapular-focused training therapy in people with SD. Eleven RCTs, with a combined sample size of 890 participants encountered our inclusion criteria.

The results demonstrated a significant reduction in shoulder pain following exercise (therapy standardized mean difference [SMD]=-0.83; 95% CI, -1.44%, -0.22%; P=0.008). Moreover, exercise therapy significantly improved shoulder function (SMD=-0.62; 95% CI, -1.08%, -0.16%; P=0.008). Nevertheless, scapular-focused exercise had no significant effect on scapula positioning at any angle (0°: Mean difference [MD]=-0.44; 95% CI, -1.43%, 0.55%; P=0.38; 45°: MD=-0.17; 95% CI, -0.72%, 0.37%; P=0.53; 90°: MD=-0.25; 95% CI, -1.06%, 0.57%; P=0.56). 

Scapular-based exercise therapies are effective approaches among patients with SD. It is necessary to conduct additional high-quality studies with longer periods to evaluate and validate the results reported in this study.

Transcranial direct current stimulation and robotic therapy (RT) are two modalities in neurorehabilitation for the improvement of upper limb function in stroke patients. However, the additional effects of the concurrent application of these two techniques compared to RT alone on upper limb function in stroke patients have not been studied yet. We analyzed the effectiveness of concurrent tDCS and RT compared to RT alone on upper limb motor function in stroke patients.

A systematic search of PubMed, Scopus, Web of Science, CENTRAL, EMBASE, and Physiotherapy Evidence Database was performed from 2000 to January 1, 2021. The quality of the included studies was evaluated using the Cochrane risk-of-bias assessment tool. All statistical analyses were performed in STATA software, version 14, and the Mean±SD was used as the pooled statistics.

The result showed that concurrent tDCS and RT had moderate but non-significant pooled effect sizes for upper limb Fugl-Meyer assessment (SMD=0.31, 95% CI, -0.20%, 0.83%, I2=84.1%). 

According to the results of this study, no difference was obtained in the efficacy of concurrent tDCS and RT compared to RT alone on upper limb function in stroke survivors.

Limitations in the ability to perform manual functions decrease the individual’s participation in activities of daily living (ADLs). Thus, it is required to study the relationship between manual skills and self-care activities in children. This study aims to investigate the relationship between manual ability and self-care in children with spastic cerebral palsy at the ages of 1 to 8 years.

In this cross-sectional study, 125 children aged 1-8 years with spastic cerebral palsy who were chosen by the convenience sampling method from 8 occupational therapy clinics in Tehran City, Iran, in 2022 were studied. The evaluation tools were manual ability classification system (MACS), mini-manual ability classification system (Mini-MACS), pediatric evaluation of disability inventory (PEDI), and cognitive level form designed in the SPARCLE project. After collecting the data, Stata software, version 14 was used to analyze data using chi-square, Spearman correlation coefficient, Mann-Whitney, Kruskal-Wallis, and regression.

In this research, the mean age of the children was 54.2±15 months and 43.2% had a cognitive level >70. The mean self-care and mobility in children were 49.65±30.60 and 40.78±26.97, respectively. With increasing age, self-care and mobility of children showed a significant increase (P<0.001). No significant difference was observed between boys and girls in self-care and mobility (P<0.05). By changing the education level of the main caregiver, no significant difference was found in self-care and mobility (P<0.05). With the increase in children’s cognitive ability level and MACS level, self-care and mobility improved significantly (P<0.001). Moreover, the level of MACS and mobility with the highest beta values (-0.530 and 0.512, respectively) showed a greater contribution to the prediction of self-care.

The results showed that with increasing age, cognitive ability level, and MACS level, self-care and mobility improve significantly in children with spastic cerebral palsy. Therefore, it is suggested to pay more attention to manual ability to improve self-care and mobility in these children.

This study aims to determine whether health literacy, perceived stress, and anxiety sensitivity are correlated with self-care for COVID-19, focusing on the mediating role of health locus of control (HLOC) in Ardabil City, in northwestern Iran, in 2020.

This descriptive-correlational study was conducted using path analysis. The research population included households living in Ardabil city. The participants included 300 persons who were selected using the convenience sampling method. The data were collected via the health literacy instrument for Iranian adults (HELIA), perceived stress scale (PSS), anxiety sensitivity scale (ASS), self-care questionnaire, and locus of control scale (LCS). The statistical analysis of the collected data was performed with SPSS software, version 25 and AMOS software, version 24.

Data analysis showed that anxiety sensitivity had a negative relationship with the internal locus of control (ILOC) and a positive and significant relationship with the external locus of control (ELOC). Furthermore, health literacy has a positive correlation with ILOC and a negative and significant correlation with ELOC. The results also demonstrated that perceived stress had a direct and negative impact on ELOC and a direct and positive impact on the chance locus of control. Moreover, ILOC had a positive and direct relationship with self-care for COVID-19, and ELOC and chance locus of control had a negative and direct relationship. The data also indicated that HLOC played a fully mediating role in the relationships between the research variables, and health literacy and anxiety sensitivity were associated with self-care for COVID-19 mediated by the ILOC and the individual HLOC. However, the relationship between perceived stress and self-care was not confirmed mediated by HLOC.

The results revealed that health literacy and anxiety sensitivity are associated with self-care for COVID-19 and this relationship is mediated by HLOC. Accordingly, some interventions should be planned and implemented to strengthen and direct HLOC and enhance self-care behaviors in people during the COVID-19 outbreak.

This study aims to determine the prevalence of knee osteoarthritis (OA) and associated risk factors in the contralateral limb after lower limb amputation.

This cross-sectional survey included 500 lower limb amputees using prostheses for at least 1 year using convenience sampling from the Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS), Peshawar City, Pakistan rehabilitation services program (PRSP) and its satellite centers across Khyber Pakhtunkhwa. A sample included either gender aged 20 to 80 years. A basic demographic sheet and risk factors questionnaire and American College of Rheumatology (ACR) guidelines diagnostic knee OA criteria, such as using history, physical examination, and radiographic findings were used to collect data. Data were analyzed using SPSS software, version 21. T-test and analysis of variance (ANOVA) statistics were utilized to observe any relationship with P<0.05 as significant. 

The current study revealed the prevalence of OA in 131 people (26.2%) with a higher prevalence in 86 married men (65.5%) aged 51-80 years (99[75.6%] and 99[75.6%]) with the predominance of 87 trans-tibial amputees (TTA) (66.4%). Sustained knee bending was the most prevalent risk factor in 127 people (96.9%, 31.07), followed by the history of a painful knee injury in 117 people (89.3%, 12.00), sitting on the floor for home activities in 106 people (80.9%, 8.00) and occupation with knee use in 129 people (98.5%, 7.25).

The high prevalence of 26.2% of OA in the sound limb in lower limb amputees is more common in married men aged 51-80 years with trans-tibial amputation on the contralateral side. Common risk factors include sustained knee bending, a history of a painful knee injury, sitting on the floor for home activities, and occupations with knee use.

Reflective practice is a thinking method about experiences, learning from mistakes, identifying skills and strengths, and developing options and actions for change and future success. This practice empowers individuals to explore diverse methods of introspection, thereby enhancing their proficiency in applying reflective techniques within both personal and professional domains and ultimately fostering their learning skills and self-development.

This study aims to compare the reflective practice and self-assessment methods of novice practitioners who graduated from the governmental and private sectors.

A comparative cross-sectional study was conducted on 138 practitioners who graduated from the governmental and private sectors (69 from the governmental sector and 69 from the private sector). A random sampling method was used to collect data. Data were analyzed using SPSS software, version 20. Mean±SD was calculated for five main variables. Independent t-test was applied to calculate the reflective practice of novice practitioners. P≤0.05 was considered statically significant.

The study focused on investigating various factors related to the reflective practice of novice practitioners. All five main variables, namely reflection on events, reflection methods, others’ points of view, questioning of assumptions, and ability to reflect, were examined for potential differences between the graduates of private and governmental sectors. The results indicated no significant differences between these sectors, as evidenced by the P<0.05.

This study concluded that no significant difference is observed between reflective practice and self-assessment methods of novice practitioners who graduated from government or private institutes because reflective practice is the ability of a person to think and learn from experience in a way.

Reading impairments are the most prevalent problem at school. It is vital to have a valid and reliable test to assess the student’s reading skills. This study aims to develop the KHANA test as a valid and reliable test to evaluate reading skills in Persian-speaking students and study the accuracy, rate, and reading comprehension in different grades and genders

This study included 87 students from second to seventh grade (75 typically developing students [TDS] and 12 students with reading impairments [SRI]). First, two preliminary parallel forms of student books, A and B, were prepared, both including 12 reading passages organized based on increasing difficulty as the student moved from one passage to the next. All the passages contain five comprehension questions. Then, the content and face validity, descriptive statistics, construct validity, and reliability, including test re-test, inter-rater, and the correlation between passages A and B were measured. 

Based on the results, all the passages and questions were valid. The passages can make significant differences in reading skills between different grades, while gender differences are limited. However, according to the test re-test analysis, the inter-rater reliability, and the correlation between the two passages, KHANA is a reliable tool and can discriminate SRI from TDS.

According to the results, KHANA seems a valid and reliable test to assess reading skills in Persian-speaking students from second to seventh grade.

This study aims to determine the relationship between demographic data and self-esteem levels among school-age students.

A descriptive research design (correlational design) was conducted using probability random sampling included 240 participants. The study instruments were the index of self-esteem (ISE) and the bully scale. The statistical methods included a percentage test, normal distribution test, Mean±SD test, t-test and Spearman test using SPSS software, version 26.

The study results showed the analysis of the demographic characteristics of the target sample, a large number of the samples were in the age group of 10-11 years and boys. Also, the study results showed the evaluation responses for the study subject about bullying victims and self-esteem that most students suffer from strong bullying (65.5%) and most students have low self-esteem (81.2%). However, a significant relationship is observed between evaluation responses for bullying victims and self-esteem domains at a P<0.05.

The present study concludes that most students’ responses to bullying victims are strong bullying, the study highlights the potential effect of bullying on students’ self-esteem and raises potential problems. The results suggest that increasing students’ self-esteem may be an effective strategy to enhance student outcomes. The study recommends that further studies are required on the nature of this event that lead to defining the etiology of bullying victims. It should include family dynamics and other situations of vulnerability, as well as qualitative strategies for early detection and investigation of bullying behaviors.

This study aims to investigate the effects of lumbar stabilization exercise (LSE) and graded activity exercise (GAE) on concentrations of interleukin (IL) 1A (IL1A), IL18 receptor 1 (IL18R1), IL18 receptor accessory protein (IL18RAP), IL-6, cyclooxygenase-2 (COX2), and clinical outcomes of pain intensity, disability, catastrophizing, diverting-attention, cognitive-coping and pain-reinterpretation in patients with non-specific chronic low back pain (NSCLBP). 

This study was a single-blind parallel trial with an adaptive trial design. Fifty-four patients with NSCLBP were randomly assigned to LSE and GAE treatment groups. Demographic and anthropometric characteristics were measured. Treatments were administered twice a week for 10 weeks. The concentrations of IL1A, IL18R1, IL18RAP, IL-6, and COX2 of patients were assessed at four time points with enzyme-linked immunosorbent assay. Pain, disability, catastrophizing, diverting attention, cognitive coping, and pain reinterpretation were assessed at three time points with valid instruments. The responsiveness of the biochemical mediators to LSE and GAE was determined with a Bayesian one-way analysis of variance (ANOVA). Data were analyzed with descriptive and inferential statistics at P<0.05. 

The concentrations of IL1A, IL18R1, IL18RAP, and COX2 were unresponsive (Bayes factor [BF]<1) to LSE and GAE, while IL-6 concentrations were responsive (Bayes factor [BF]>1). The concentrations of IL-6 increased significantly (P<0.05) after LSE with a significant reduction (P<0.05) in pain, disability, and catastrophizing, while the concentration of IL-6 increased significantly (P<0.05) after GAE with a significant reduction (P<0.05) in pain, and disability. Effects of LSE and GAE on IL-6 concentrations, pain, and disability were comparable (P>0.05). Catastrophizing of patients with LSE was significantly less (P<0.05) compared to GAE. 

LSE increases IL-6 concentrations in NSCLBP patients while reducing pain, disability, and catastrophizing, while GAE increases IL-6 concentrations and reduces pain and disability. IL-6 concentrations, pain, and disability of patients were similar after LSE and GAE. Patients catastrophize less with LSE compared to GAE, hence LSE shows more beneficial effects for patients with NSCLBP than GAE.

Quadratus lumborum (QL) is included in the list of accessory muscles of expiration. This muscle contracts to depress the ribs. It stabilizes the diaphragm for respiration. A tight/stiff QL prevents the rib cage from fully expanding to take a deep breath and pulls over the diaphragm and surrounding tissues. This affects chest expansion and breathing patterns. This leads to faulty posture adaptation and disruption in breathing patterns. This study aims to assess the effect of muscle energy technique (MET) of QL on pain, and diaphragm activity in individuals with nonspecific low back pain.

This study was conducted using a quasi-experimental study and the research population included 65 individuals with non-specific low back pain. Two groups were formed based on the score of self-evaluation of the breathing questionnaire, SEBQ <11, and SEBQ >11 and pre-intervention assessment of numeric pain rating scale (NPRS), surface electromyography (EMG) of the diaphragm, maximum inspiratory pressure (Pimax) and chest expansion was assessed. MET to QL was given and immediate post-measurements of the same were assessed. Considering the normality, data were analyzed using paired t-test and Wilcoxon’s rank sum test using Medcalc software, version 22.017. 

Numeric pain rating scale (NPRS) of both groups was statistically significant (P<0.0001), amplitude in SEBQ >11 was significant (P<0.0166), and Pimax was highly significant in both groups (P=0.0001).

MET of QL affects pain and lung function in patients with nonspecific low back pain.

Patient falls are highly prevalent in hospitals, and are considered a complicated challenge. Thus, the present research assessed the prevalence of the fall risk assessment and the correlated factors among elderly inpatients.

The present analytical and cross-sectional research was conducted with 419 elderly patients meeting the inclusion criteria. The data collection instrument consisted of two parts including demographic information and the Johns Hopkins fall risk assessment tool (JHFRA). A convenience sampling method was used to select the elderly patients staying in the general wards of Allameh Bohlool Gonabadi Hospital, Gonabad City, Iran. The data analysis was done in SPSS software, version 23 using descriptive (frequency, Mean±SD) as well as inferential statistics (logistic linear regression analysis).

The Mean±SD of participants’ age was 72.09±9.46 and the prevalence of the fall risk was 85.9%. Statistically significant correlations were found between the elderly inpatients’ fall risk and their age (P=0.001), sex (P=0.012), and cardiovascular diseases (P=0.001).

Considering the high prevalence of fall risk among elderly inpatients, it is essential to plan for preventing and reducing the rate of elderly inpatients’ falls.

Aphasia is a language disorder caused by damage to a specific region of the brain that regulates the expression and comprehension of language. For many years, attempts to rehabilitate aphasic patients have been made. In this study, the efficacy of low-resolution electromagnetic tomography analysis (LORETA) z-score neurofeedback (LZNFB) training for enhancing language, working memory, and attention in a group of 13 non-fluent aphasic patients was investigated. 

The quantitative electroencephalography (QEEG)/LORETA and behavioral tests were administered at baseline and after 15 LZNFB treatment sessions. Using the NeuroGuide software, version 3.0.9, the LORETA analysis was conducted

The LORETA metrics revealed an increased high beta at the orbital frontal, beta at the medial frontal, and Alpha at the superior frontal, as well as decreased delta and theta at the cingulate gyrus. The behavioral tests revealed improved scores for language, working memory, and attention. 

These results are extremely encouraging, as they suggest that LZNFB training could provide a range of improvements and offer new hopes to individuals with aphasia who were unable to achieve satisfactory improvements with conventional therapies.

Recently, considerable attention has been paid to the field of positive psychology, and one of the variables that has been investigated in this field is narrative therapy. Therefore, this study investigated the effect of narrative therapy on the psychological capital of mothers of children with developmental and intellectual disabilities.

This study was an applied experimental research (pre-test-post-test with a control group). The study’s statistical population includes mothers of children with intellectual and developmental disabilities in Aliabad Katul City, Iran, in the academic year of 2021-2022 who volunteered to participate in the research. From this population, 30 mothers who scored low on the psychological capital questionnaire were purposefully selected and randomly assigned to two groups (experimental and control). Luthans psychological capital questionnaire was used to collect data. The intervention was a narrative therapy educational program implemented in eight 50-minute sessions in a group format. Data were analyzed using covariance analysis in SPSS software, version 22.

The results demonstrated that narrative therapy has a significant effect on increasing psychological capital (P=0.05). Also, the results showed that narrative therapy significantly affects dimensions of psychological capital including self-efficacy, hope, resilience, and optimism.

Therefore, a training program in narrative therapy can be used as a helpful treatment to increase the psychological capital of mothers of children with intellectual and developmental disabilities.

Aging is an inevitable period and the quality of life in older people has been a noteworthy issue for human societies. On the other hand, Coronavirus anxiety is one of the most important phenomena affecting the lives of older people during the Coronavirus outbreak. Therefore, the present study determined the effectiveness of cognitive-behavioral therapy on anxiety and quality of life in older people.

The statistical population of the present study included older people of the 3rd district of Tehran City, Iran, in the spring of 2022. The research method was quasi-experimental, which was carried out with a pre-test post-test, and one-month follow-up plan with the experimental and control groups. A total of 40 older people were selected by convenience sampling method. The experimental group participated in eight 90-minute sessions for two months and cognitive-behavioral training techniques were presented to them, and the control group did not receive any intervention. Older people responded to the Coronavirus anxiety scale and the quality-of-life questionnaire in three stages.

The results of the analysis of variance test with repeated measurements showed that cognitive-behavioral therapy affects the anxiety of corona and the quality of life in older people (P<0.05), and this effect remained stable in the follow-up phase. 

According to the findings of the research, cognitive-behavioral therapy can be used to reduce the anxiety of Corona and increase the quality of life in older people. Cognitive behavioral therapy is a pragmatic approach that empowers people to manage their problems more effectively through psychological treatment. This is accomplished by the emotional development of older people and making them more open to options and possibilities. It is also suggested that future research investigate the preventive and effective impacts of this treatment on the health of older people. Long-term follow-up evaluations of cognitive-behavioral therapy can help in understanding the long-term effects of this treatment on the quality of life and Corona anxiety.

This study aimed to detect the relationship between body mass index (BMI), selective voluntary motor control (SVMC), and functional independence in children with spastic diplegic cerebral palsy (CP) with levels II and III of gross motor function classification system.

A total of eighty-four children with spastic diplegic CP, aged 6-9 years with a mean age of 7.09±0.68 participated in this correlational study. BMI, selective control assessment of the lower extremity (SCALE), and pediatric functional independence measure (WEE FIM) were used for the assessment of BMI, SVMC, and functional independence, respectively.

The results demonstrated the presence of a positive strong significant correlation between SCALE and WEE FIM, a negative strong significant correlation between WEE FIM and BMI, and a negative moderate significant correlation between BMI and SCALE.

Functional independence is significantly correlated with BMI and SVMC in children with spastic diplegic CP. This study provides original evidence that BMI and SVMC are major factors that influence functional independence in these children. So, they are highly recommended to be part of the evaluation of their functional independence in clinical settings and research.

Withholding workers’ salaries for months as a punishment for engaging in a strike may natively affect and influence their psychological distress. This study assessed the correlation between physical activity, psychological distress, and socioeconomic status, and explored the factors influencing psychological distress among the striking workers in Nigeria.

This cross-sectional face-to-face and online study conveniently sampled a total of 234 lecturers aged 27-69 years. The sociodemographic, physical, socio-economic, and psychological distress was assessed by the university strike physical and psychological distress questionnaire (USPAPDQ). Data analysis includes descriptive statistics, multiple linear regression, Spearman’s correlation, and Man whiney U-test, using a p<0.05 as the level of significance.

The mean age, number of papers, and frequency/duration of exercise were 45.4±10.36 years, 4±5.82, 2.19±1.63 day/week, and 30.49±29.82 minutes/day, respectively. An inverse significant relationship was established between anxiety and age (r=-0.27; P<0.01), contemplating changing my job (r=-0.40; P<0.01), number of children (r=-0.19; P<0.01), academic rank (r=-0.27; P<0.01), frequency (r=-0.18; P<0.01), and duration (r=-0.16; P=0.02) of exercise. The significant predictors of anxiety were marital status (β=-0.207, P<0.01), contemplation on changing my job if the strike continues (P<0.01, β=-0.198), see anything positive about the strike (P<0.01, β=0.178), and numbers of children (P<0.01, β=-0.193). The significant predictors of depression were, an alternate source of income (P=0.04, β=0.126), contemplation on changing my job if the strike continues (P=0.03, β=-0.149), seeing anything positive about the strike (P=0.05, β=0.118), and time (hours) spent watching television (P=0.03, β=0.124).

Overall, the significant negative predictors of psychological distress include marital status, contemplating changing my job, and number of children. The positive predictors were seeing anything positive about the strike, alternate sources of income, and time spent watching television. The government may prevent the reoccurrence of strikes by honouring existing agreements.

Mortality from cardiovascular causes, including pulmonary embolism (PE), is the second most common cause of mortality in psychiatric patients. Signs and symptoms that are specific to PE include tachycardia and dyspnea. It rarely manifests as acute psychosis and other unspecific signs and symptoms. Many common treatment modalities for psychiatric disorders increase the risk of coagulopathies and conditions, such as catatonia are associated with an increased incidence of venous thromboembolism (VTE). PE is a preventable cause of death for psychiatric patients. Therefore, we present this case to emphasize the importance of VTE complications in psychiatric patients.

A 56-year-old woman was hospitalized a week before admission due to aggression, restlessness, and disturbance. She was hospitalized more than 6 times with the diagnosis of “bipolar spectrum”. Based on available information, a diagnosis of “unspecified and related bipolar disorder” with akathisia (possibly doxepin and selective serotonin reuptake inhibitor [SSRI] induced) was considered. Doxepin, citalopram, and olanzapine were tapered. Also, sodium valproate tablet 200 mg/qid and propranolol tablet 20 mg/bid were added to her drugs. After two weeks, with no progress in relieving symptoms, tachycardia was detected. Therefore, consultation with an internal medicine specialist and more evaluation was requested. With a high level of D-dimer, and low saturation, we considered thromboembolism, the patient was sent to a general hospital, and then the diagnosis of VTE was confirmed.

One of the vital causes of death in psychiatric wards is VTE. It is difficult to diagnose VTE in a psychiatric patient; therefore, it can increase the risk of mortality. Therefore, psychiatrists must perform essential assessments for patients with clinical suspicion. We publish this case to raise awareness of thromboembolic complications in psychiatric patients, especially hospitalized patients.