Function and Disability Journal
Volume:4 Issue: 1, Winter 2021

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The purpose of the present study was to examine the effectiveness of dry needling as local treatment of upper trapezius trigger points related to chronic neck pain on pain and pain pressure threshold in women with chronic nonspecific neck pain.

Thirty females with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the intervention for three weeks. The outcomes were pain intensity and pain pressure threshold. Every outcome was recorded at baseline and 2 days after the fifth session. 

Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. The results of the independent t-test showed a significant difference in measurements between the dry needling and passive stretch groups (P<0.05). 

Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in women with nonspecific neck pain.

Generally, spinal cord injuries can lead to functional limitations and restrict participation in different areas of occupations. One of the areas of occupations that are less considered is rest and sleep. The aim of this study was to investigate the relationships between physiological, emotional status and daily activities, and sleep quality in patients with spinal cord injury.

The present study was a cross-sectional analytical study that was conducted in 2019-2020. The statistical population of this study was patients with spinal cord injury referring to the occupational therapy clinics in Tehran and Karaj as well as hospitalized patients and daily patients referring to the Kahrizak care unit in Alborz province. The sample size was considered 100 spinal cord injury patients who were randomly selected. Data were collected using Pittsburgh Sleep Quality Questionnaire, STOP-BANG Respiratory Apnea Probability Questionnaire, Beck Anxiety and Depression Questionnaire, Pain Scale, and Barthel Questionnaire.

The results showed that there was a significant relationship between the risk factors of respiratory apnea, anxiety, depression, pain, the time elapsed after the accident and functional mobility, and sleep quality (P≤0.05).

Sleep quality in patients with spinal cord injury is low and is significantly associated with factors, such as the likelihood of respiratory apnea, pain, mood factors anxiety and depression, muscle tone, functional mobility, and independence in daily activities

Tecar therapy as a modality has been considered due to its reported effects on reducing pain and swelling and finally increasing range of motion and improving function. The aim of this study was to evaluate the effects of tecar therapy on acute symptoms of athletes following lateral ankle ligament sprain in the treatment and control groups between pre-treatment periods, after 6 sessions, and after 12 sessions of treatment.

In this study, 23 patients in each group including athletes with an acute lateral ankle ligament sprain in the acute stage in Tehran. The participant of this study were divided into 2 groups of control with normal treatment and the second group with normal treatment + tecar treatment. Participants were homogenized in terms of age, height, weight, and level of exercise. To evaluate the pain intensity of patients in the two groups and to measure the swelling of the ankle joint, a tape measure (mm) was used. A goniometer was used to measure the degree of ankle motions. The Foot and Ankle Ability Measure (FAAM) questionnaire was also used to collect data.

Statistical analyzes showed that the mean numerical visual criterion of pain in both groups was significantly lower after 6 and 12 sessions of treatment (P<0.001). The results of the analysis of variance showed that the mean swelling in the treatment group and in the control group after 6 and 12 sessions of treatment (P<0.001) was significantly lower than the mean swelling before treatment. Also, the mean swelling after 12 sessions of treatment was significantly lower than after 6 sessions of treatment (P<0.001). Regarding daily life activities and the percentage of athlete satisfaction in performing the activity, the test results showed that the athlete’s scores after 6 and 12 sessions of treatment (P<0.001) were significantly higher than before treatment. Also, their scores after 12 sessions of treatment were significantly higher than 6 sessions (P<0.001). The performance scores in both groups after 6 and 12 sessions of treatment (P<0.001) were significantly higher than performance scores before treatment. Also, the performance scores after 12 sessions of treatment were significantly higher than 6 sessions of treatment (P<0.001).

The results of the present study showed that tecar therapy in patients with lateral ligament sprain of the ankle joint improves the condition of symptoms after an injury, including swelling, pain, daily life activities, percentage of athlete satisfaction with daily activities, and finally his performance and it can be used as a complementary treatment along with common therapies.

Poor physical health can affect the performance of everyday life activities and integration into society. The extent of disability or its influence on the life of an individual is related to his/her physical and social environment. This study aimed to examine the psychological existential orientation and social integration of elders with physical disabilities.

Forty-six people with physical disabilities (with Mean±SD age of 73.7±10.6 years and age range of 53-93 years) were examined regarding psychological existential orientation, social integration, and health-related quality of life, using an extensive questionnaire set, including questionnaire on assistive technology, the Brief Symptom Inventory, and health-related quality of life.

The results showed that poor physical health can negatively impact the psyche and integration of the sample into society. Also, the subjects indicated a strong desire for more integration into society, however, they did not significantly participate in society in the last two weeks.

Poor health and dependence on the environment in daily life can negatively influence the psychological and social situation and also limit social integration.

Positional plagiocephaly is one of the most common skull deformities that ultimately lead to the asymmetry of the head and face in different ranges. This study aimed to estimate the prevalence of plagiocephaly and analyze the relationship between risk factors and the severity level of the deformities in children referred to the Mofid hospital.

In a cross-sectional study, the cranial vault asymmetry index was calculated from a routine head scan with a noninvasive laser shape digitizer. Data were recorded and categorized by the type and severity of deformation. Also, for the analysis of risk factors, data about sitting, feeding, and sleeping positions were gathered from parents.

The study participants included 90 children, and the prevalence of head deformity was 35% (32 infants) with mild to moderate severity. According to the risk factors, infant positions are significantly correlated with the severity of plagiocephaly.

Parents’ awareness of changing the head position plays an important role to reduce the risk of plagiocephaly in children.

Despite its many positive effects, having a job can expose people to stress and threats that negatively affect health and well-being, and consequently, upset their occupational balance. Occupational therapy is one of the most stressful jobs and always exposes therapists to health-related threats due to direct contact with patients and constant and repetitive movements. This study aimed to investigate burnout and occupational balance among occupational therapists in Tehran.

This cross-sectional study investigated 166 occupational therapists working in the public and private clinics and centers of Tehran. Sampling was conducted using the multistage method. The participants completed demographic questionnaires, the Maslach Burnout Inventory, and the Life Balance Inventory. Then, the Spearman Statistical Test was used to examine the relationship between burnout and occupational balance.

The results revealed a strong (r= -0.29) and significant (P=0.001) negative relationship between emotional fatigue and the total life balance list, a strong (r= -0.32) and significant (P=0.0001) negative relationship between depersonalization and total life balance and identity, and a strong (r= -0.32) and significant (P=0.0001) negative relationship between success and total life balance list.

According to the results of this study, burnout negatively affects the identity and interests of occupational therapists but does not affect their health and communication.

Bell palsy is the sudden lower motor neuron paralysis of the facial nerve, characterized by acute unilateral peripheral facial muscle weakness. Physiotherapy has been proven to be beneficial in the rehabilitation of patients with Bell palsy and is important to prevent permanent contractures of the paralyzed facial muscles. A physiotherapy technique includes electrical stimulation and mime therapy to help in restoring lost muscle functions. Also, sensory exercises include varied normality solutions administered. This study aimed to find the effects of mime therapy with sensory exercises on facial symmetry and functional abilities among Bell palsy patients.

A total number of 30 participants were recruited for an interventional study and conveniently assigned into three groups (n=10), where group A received electrical stimulation with facial exercises, group B received electrical stimulation with mime therapy, and group C received a combination of electrical stimulation, mime therapy, and sensory exercises. Each group received 18 sessions; each session was for 60 minutes per day, six days per week, for three weeks. Then, all the participants were assessed using the Sunnybrook facial grading system and the facial disability index.

Intragroup analysis showed a significant difference within all three groups (P<0.05). Besides, the intergroup comparison showed maximum recovery in group C followed by groups B and A.

A combination of mime therapy and electrical stimulation along with sensory exercises provides the most beneficial intervention to improve facial function and reduce facial synkinesis in Bell palsy individuals. Hence, sensory exercises are recommended as an adjunct to electrical stimulation and mime therapy for the line of treatment for individuals with Bell palsy.

One of the common disorders in Speech Language Pathology (SLP) is speech sound disorder. To increase students’ competence and objectively evaluate their clinical skills, we used the Direct Observation of Procedural Skills (DOPS) test in a clinical setting and examined its validity and reliability

This research is a non-interventional descriptive study. Twenty students who participated in this study were selected by the census method. Traditional treatment approach skill for speech sound disorder was selected. Then an evaluation checklist of DOPS was prepared. After obtaining the consent of students and professors, they entered the study. Two professors observed the work of all student during the procedure on a real patient. Results were recorded in a checklist, and feedback was given to the students about their strengths and weaknesses.

The content validity index of the DOPS test was more than 0.8, and its content validity ratio was more than 0.62. The correlation coefficients of questions indicate the optimal internal structure of the test and its structural validity. The results showed that the test questions were related to the predetermined subject. Results confirmed high face validity. The obtained Cronbach α coefficient (0.865) confirmed DOPS reliability. There was a significant inter-rater correlation coefficient (0.901) between evaluators (P<0.001).

According to the study, the use of DOPS for objective assessment of clinical skill has validity and reliability. This test can be used to evaluate the clinical work of SLP students, provide feedback, identify their strengths and weaknesses, and improve them.

Speech intelligibility is affected by vowel quality. Auditory feedback is an essential factor in vowel quality. The purpose of the current study was to compare vowel space and formant frequencies in Normal-Hearing (NH) and Cochlear-Implanted (CI) Persian-speaking children aged 4 to 6 years.

The participants were 10 CI children (5 girls and 5 boys) aged 4 to 6 years. All children had congenital hearing loss and received a multichannel CI before 2 years of age. The control group comprised 20 NH children (10 girls and 10 boys) aged 4 to 6 years. The two groups were matched by age. The participants were asked to produce six Persian vowels (/u/, /o/, /a/, /i/, /e/, /æ/) in /ChVCd/ context and then the average of formant frequencies (F1, F2,) was measured using Praat analysis software (Version: 5, 3, 27). The Independent samples t-test was conducted to assess the differences in F1 and F2 values between the two groups using SPSS 16.

The mean values of F1 and F2 of all 6 Persian vowels were not significantly different between CI and NH children (P>0.05). 

Findings of the present study implied that children who were implanted CI under 2 years of age are likely to produce Persian vowels similar to normal-hearing children.

With the pervasive use of digital devices, especially smartphones, concerns about their harmful effects on vision has increased. The aim of the present study was to evaluate the effect of long-term activity with a smartphone on the accuracy of lag of accommodation of two eyes.

In this cross-sectional study, 27(16 females and 11 males) students and staff (23 students and 4 staff) of the Iran University of Medical Science with a Mean±SD age of 25.29±4.72 years, with a visual acuity of 10/10, and emmetropic refraction with the available sampling method were selected. At first, the participants used a smartphone for an hour, and then, the lag of accommodation of two eyes was assessed with the monocular estimate method.

lag of accommodation of the right eye (P=0.001) and left eye (P=0.001) both statically increased significantly after one hour of smartphone use. However, no significant difference was found between the lag of accommodation of two eyes after near work with a smartphone (P=0.265).

The present study confirmed the relationship between long-term near work with a smartphone and increased lag of accommodation.

Cognitive and psychological disorders are among the most debilitating complications of Parkinson’s Disease (PD). Despite the high prevalence of these disorders in patients with PD and the important effect of psychological factors on cognitive factors in other neurological diseases, no study was found on the relationship between psychological factors and cognitive function in patients with PD who have chronic fatigue. The present study was conducted to investigate the relationship between psychological factors and cognitive function in patients with PD and chronic fatigue. 

In the present cross-sectional study, a total of 73 patients with PD who had chronic fatigue were selected by non-random convenience sampling method from those visiting Tehran’s rehabilitation centers in 2019. The following questionnaires were used: Fatigue Severity Scale (FSS) for fatigue, Beck’s Depression Inventory for depression, Beck’s Anxiety Inventory for anxiety, and Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) for cognitive function, as well as Unified Parkinson’s Disease Rating Scale (UPDRS-III) and Pain Visual Analog Scale (Pain VAS).

The regression models explained the cognitive function variance by a maximum of 1.43% in MMSE and 8.79% in MoCA. In all stepwise models of cognitive function, anxiety was the strongest predictor of cognitive function followed by age and UPDRS-III score. 

The results of this study indicated that anxiety as the strongest predictor can affect cognitive function in patients with PD who have chronic fatigue. Hence, therapeutic interventions focusing on psychological factors may be particularly important for improving cognitive function in these patients.

One of the most important areas in the rehabilitation of stroke patients is participation in meaningful activities. Participation of individuals with stroke in meaningful activities can increase their satisfaction and quality of life. The present study aimed to investigate the relationship between psychological factors and participation in meaningful activities as well as determining factors predicting participation in meaningful activities in patients with stroke.

In this cross-sectional study, 100 people with chronic stroke participated which were selected from four rehabilitation centers using a convenience non-probability sampling method. Participants were assessed using Meaningful Activity Participation Assessment (MAPA), Satisfaction with Life Scale (SWLS), Center for Epidemiological Studies of Depression Scale (CED-S), 36-Item Short-Form Health Survey (SF-36), Visual Analogue Scale for Fatigue (VAS ‐ F), and Visual Analog Scale for Pain (VAS Pain).

The severity of depression had the highest relationship with the level of participation in meaningful activities. Also, the severity of depression, cognitive status, pain intensity, and severity of fatigue were identified as significant factors predicting the rate of participation in meaningful activities of patients with stroke.

Participating in meaningful activities in people with stroke is an important issue and a major obstacle in the lives of people with stroke. As a result, identifying problems and making appropriate interventions to remove obstacles, such as fatigue, pain, cognitive problems, and most importantly depression should be a priority for professionals.

Analysis of gait parameters and energy expenditure in different walking speeds in trans-tibial amputees has been less investigated. This may provide an insight into how they respond to it. The main aim of this study was to investigate the effect of walking speed changes on gait parameters and metabolic energy consumption in unilateral trans-tibial amputees using the prosthesis. 

Thirty trans-tibial amputees fulfilling inclusion criteria were investigated for gait parameters using a ten-meter walk test while these subjects walked with three different walking speeds (comfortable, fast, and slow). Temporal-spatial gait parameters, such as step length, stride length, velocity and cadence, and Physiological Cost Index (PCI) for metabolic energy consumption were analyzed by repeated-measures ANOVA. 

Step length of a prosthetic side in the fast walking speed (0.67±0.10 m) was higher than the normal comfortable speed (0.56±0.13 m) and least in slow walking (0.42±0.06 m). A similar trend was observed for all gait parameters. PCI (beats/m) was least in normal comfortable speed (0.08±0.09), followed by fast walking speed (0.11±0.08). It was highest when patients walked at a slow speed (0.18±0.12). There was a significant difference in all temporal-spatial gait parameters and PCI in three walking speed conditions (p<0.05). 

Walking speed significantly affected all temporal-spatial and energy parameters in unilateral trans-tibial amputees.

Forgotten Joint Score-12 is a useful questionnaire to evaluate the level of joint awareness and patients’ ability to forget the involved joint. The objective of the present study was to obtain a tool to evaluate the level of joint awareness for use in Persian-speaking patients following anterior cruciate ligament reconstruction.

The present study was a methodological study in the field of psychometrics, in which after translation and cross-cultural adaptation of the FJS-12 questionnaire according to the ISPOR method, to examine its validity, the questionnaire was given to 114 participants who had passed between 1 and 3 years of their anterior cruciate ligament reconstruction. To evaluate reliability, participants were asked to complete and resubmit the questionnaire after a week. In this study, the intraclass correlation coefficient (ICC) was used to analyze the repeatability of the questionnaire and measure Cronbach’s alpha internal consistency. Structural validity was performed by calculating the correlation between the FJS-12 questionnaire and Western Ontario McMaster Osteoarthritis (WOMAC) and Knee Osteoarthritis Outcome Score (KOOS) questionnaires using Spearman’s correlation coefficient. The level of ceiling and floor effect of the questionnaire was also assessed.

Internal consistency and data repeatability were excellent for FJS-12 (Cronbach’s α=0.950 and ICC=0.845, respectively). In examining the validity, a weak to moderate correlation was obtained between the score of the FJS-12 questionnaire and the scores of the subscales of WOMAC (r=0.34) and KOOS (r=0.34). Also, a moderate correlation was obtained between the score of the FJS-12 questionnaire and the first question of the subscale of quality of life in the KOOS questionnaire (r=0.46), which indicates the validity of the average structure of the questionnaire. The floor (4.45%) and ceiling (3.50%) effect was low.

According to the results of this study, the Persian version of the FJS-12 questionnaire can be used by Persian speakers. Also, this questionnaire is a reliable and valid tool to evaluate the level of joint awareness in individuals following anterior cruciate ligament reconstruction.

This study was done to translate and evaluate the validity and reliability of the Persian version of the Sport Concussion Assessment Tool 5 (SCAT5) among Iranian martial arts athletes.

Translation and adaptation were performed in several stages with the instructions provided by Beaton et al. A total of 86 Persian-speaking martial arts athletes (42 males and 44 females) participated in this study. Descriptive statistics were reported for all items of SCAT5. For determining construct validity, the correlations between items of the Persian version of the SCAT5 and the Beck Depression Inventory (BDI) were all reviewed. The reliability of the questionnaire was determined from two different aspects of test-retest reliability and internal consistency.

The processes of translation and cultural adaptation were done by maintaining cultural adaptation through replacing appropriate words and terms, and finding semantic and perceptual equivalents. There was a significant difference between the results of male and female participants. For components of the SCAT5 in comparison with BDI, Spearman rank-order correlation coefficient (rho) was moderate with the Persian version of BDI 0.57 (p<0.001) in terms of the number of symptoms and severity of symptoms 0.50 (p<0.001). Regarding the test-retest reliability, the Persian version of the SCAT5 questionnaire showed excellent reliability for all items (ICC>0.75) and moderate reliability for the number of symptoms (ICC=0.48) and severity of symptoms (ICC=0.49). The coefficient of Cronbach’s alpha was more than 0.70 for all items of the Persian version of the SCAT5.

The Persian version of the SCAT5 is a valid and moderate reliable instrument for medical professionals and health care providers in concussion assessment. The ceiling effect was observed in three components, including orientation and two parts of concentration (backward recalling of digits+recalling of months in reverse order).

“Meaningful Activity Participation Assessment” (MAPA) questionnaire is a suitable tool for examining the frequency and meaningfulness of 28 activities. The aim of this study was to assess the face and content validity of the Persian version of MAPA for older adults.

The face validity was assessed qualitatively using interviews and quantitively using the item impact method (IIM) with 15 elderly aged 65-90 years old and MMSE≥21. They measured the suitability simplicity and comprehensibility of the items. To assess the content validity using CVR and CVI, 15 occupational therapists (eight PhD. Candidates, seven masters) who had more than five years of experience in geriatric rehabilitation and aged>30 years old took part.

All items of MAPA using IIM were more than 1.5. The CVR scores for each item were 0.6-1 (the cut-off base on Lawshe table 0.49). The average CVR value of MAPA was 0.84. The I-CVI of the Persian version of MAPA ranged from 0.86-1. All items scored higher than 0.79. The S-CVI/UA was 0.58 and the S-CVI/Ave was 0.96.

The Persian version of MAPA has acceptable content and face validity in the elderly. Investigation of test-retest and internal consistency reliability and construct validity (convergent, divergent, and factor analysis) is suggested.

The Severity of Stuttering Instrument-fourth edition (SSI-4) form can be used to assess the severity of stuttering. In this study, in order to increase students’ competence and objectively assess their clinical skills, the validity and reliability of the DOPS test in assessing the clinical skills of speech therapy students in using the SSI-4 form were assessed.

This study was a non-interventional descriptive study conducted in the School of Rehabilitation Sciences. Nineteen students were selected by the census method. An evaluation checklist related to the DOPS method was prepared. After obtaining the consent and training of students and examiners on the implementation of the DOPS assessment method, the student’s work was observed by the examiners and rated, and then the student’s strengths and weaknesses were given feedback.

The results showed that the questions are related to the measured subject and have high face validity. The content validity index was more than 0.9, and the content validity ratio was more than 0.6. The results confirmed the test's reliability and indicated the optimal internal structure of the test and its structural validity. 

According to this study, the use of the DOPS test to objectively assess the clinical skills of speech therapy students in the assessment of stuttering is appropriate and according to the results, DOPS has appropriate validity and reliability and this test can be used clinically.

We evaluated the intraocular lens power calculation (IOL) formulas in eyes with cataracts and irregular astigmatism who have undergone cataract surgery.

In a retrospective case series, 50 eyes with cataracts and irregular astigmatism who underwent phacoemulsification with IOL implantation were assessed. The IOL power was determined using the data of the keratometry of IOL master-derived keratometry in five formulas: Haigis, Hoffer Q, Holladay 1, SRK2  and SRKT. One month after surgery, refractive error and visual acuity were assessed.

The Mean±SD age of participants was 66.10±6.57 years (ranged 32-83). The percentage of male and female subjects was 45.8% and 54.2%, respectively. The axial length was 19.00mm to 23.00mm, which is a normal range. The most and least used formulas were SRKT and Haigis, respectively. Astigmatism and spherical refractive errors before and after surgery had significant differences (P<0.001). There was a decrease in astigmatism and hyperopic shift after surgery.

SRKT is a suitable formula for this group of patients. According to a decrease in astigmatism and hyperopic shift, an improvement in visual acuity can be expected.

The profile of occupational engagement in People with Severe Mental Illness (POES) is one of the time-use-based instruments, which can uncover the rhythm of activity and rest, as well as the variety and range of meaningful occupations. The current study aimed to report the translation process and assess the inter-rater reliability of the Persian version of POES.

In the present study, the translation process took place in three phases: forward-translation, backward-translation, and two expert panels review. To assess inter-rater reliability, all the POES forms were rated by the first and the third author.

The data achieved from 47 patients with schizophrenia were carefully analyzed. The inter-rater reliability analysis shows the intra-class correlation values were 0.86 in single and 0.92 in average measures.

The reliability results are entirely consistent with the previous studies on POES.

The present study was conducted to determine the effect of a family-based sensory diet program on children with attention-deficit/hyperactivity disorder (ADHD). In this program, parents were directed to use activities stimulating the vestibular, deep, tactile, visual, and auditory senses to maintain the children’s focus and organized consciousness.

This research was a quasi-experimental study with a Pretest-Posttest design with an experimental group. Wechsler Intelligence Scale for Children (WISC-IV) and Conners’ parent rating scale were used to measure the study variables. The study’s statistical population included all children with ADHD aged 6-12 years referred to Hasti, Bahar, and Masir-e Sabz health clinics in 2020. Of them, 30 participants were selected through a convenience sampling method. 

Based on the analysis of covariance (ANCOVA), the obtained F values of attention deficit and hyperactivity were significant at a level less than 0.05. So the test hypothesis is accepted, and family-based sensory diet sessions effectively reduce ADHD symptoms in these children.

According to the findings and the degree of effectiveness, implementing the sensory diet program by the child’s family can effectively reduce ADHD symptoms.

Currently, there is no standard way to check the optimal fitting of Progressive Addition Lenses (PAL) and visual acuity variations when looking at different objects according to PAL’s production mechanism. We need a standard method to control PAL subjectively according to research on its monitoring. These topics are checked in this study.

Two charts was designed for far and near distances using Persian letters and sentences with a logarithmic scale. Twelve subjects wearing PAL sat at 3 m and 30 cm distances, respectively, from far and near charts, and their visual acuity at Primary Position (Pp) and 15° up and down gazes, and 30° right and left gazes with single and progressive lenses were measured. To evaluate the stability of sharpness, measurements were repeated 5 minutes later. Also, to check the accuracy of vision, the measurements were compared to measurements recorded with a portable Rosenbaum pocket vision screener and E chart.

The correlations between Persian and E charts with PAL were confirmed in all gazes except pp. Mean visual acuity in all gazes except pp and 15° up gaze showed the difference in these charts. There are also mean differences in all gazes except 15° down gaze in near vision.

Persian and Electronic charts are helpful to evaluate the visual acuity of those wearing PAL and fix the above-mentioned problems.