فصلنامه آرشیو توانبخشی
سال پنجم شماره 4 (پیاپی 14، زمستان 1383)

High risk infants are those who have a history of one or more risk factors in prenatal, perinatal or postnatal period in their developmental period, shown as developmental delay (DD). The incidence of DD in these infants is higher than normal. This study is done in order to determine the incidence of motor developmental delay (MDD) and effective risk factors in developing of it in high risk infants who have been refered to developmental disorders center of SABA. Study is a descriptive (incidence determination) and analytic case – control type (Effective high risk factors determination). The samples include 403 referred infants from health centers and pediatric clinics of Tehran that have the history of one or more risk factors. The infants with MDD defined as cases and infants who had refered to SABA center for other reasons as controls. The incidence of MDD in high risk infants was 30% that was significantly higher that of normal values. The most effective risk factors were prematurity (25.6), low birth weight (19%), neonatal seizures (7.4%), hyaline membrane disease (6.6%) systemic infections of mothers in pregnancy (5.7%) and severe neonatal hyperbilirubinemia (4.9%) in sequence. Regarding to effect of above risk factors in developing of MDD necessary and suitable attempts should be done for prevention of these factors in order to decreasing the incidence of DD. Developmental delayed infants also should be diagnosed early in order to early intervention rehabilitation & therapy in order to achieve a better results.

The main aim of this research was to set up Persian stimuli for diagnostic experimental analysis of speech in order to measure Nasality and Motor Speech Profile by two Speech Lab Systems: SNORS + & VISIPITCH III in native speakers of Persian. The linguistic stimuli of the two lab systems were standardized in accordance with the structural properties of Persian. Two groups of subjects (n=46) with an age range of 19 to 37 years were selected to test the reliability of the experimental analysis of the Persian stimuli. Based on the results the present linguistic stimuli can be used to measure nasality in SNORS + with standard deviation of %5 and MSP in VISIPITCH III with p=0 and STD=33.06 and mean of 38.165. Based on the statistical analysis of the present Persian stimuli¡ the data in both lab systems can be used to measure Nasality and Motor Speech Profile in the native speakers of Persian.

Increase of accidents in such industrial lifestyle, has resulted on increase incidences of Spinal Cord Injuriy (SCI). Research aims are updating knowledge of people about their SCI and to observe their qualty of life. In this design 1426 SCI patient were studied. A number of closed & opened questions which allocated 1 to 4 raws were sent to 24 provinces of Iran. This question about prevalence and causes of SCI, use of physiotherapy, Rehabilitation and social welfare services for their respected cases. Causes of SCI in 82.2% were due to accidents and war. 38.7% of the patients were deprived of physiotherapy services and only 12% of them received physiotherapy services for more than one year. 61.5% of them received Behzisty Organization services so that 36/2% of them received Welfare services, 33/9% rehabilitation aid equipments, 22/4% medical services and only 5% of them received consulting services. Accidents are the most common cause of SCI that some of them could be considered as preventable. Regardless of strong need for physiotherapy and rehabilitation services, some of SCI patients were deprived of such services. Behzisty Organization acts as guardian for disable persons and has an important role in social welfare and rehabilitation of SCI patients and we hope that government supports, enforce such role.

Tourette disorder composed of history of multiple motor tics and at least a vocal tic during a period of such disorder. Many reports have investigated in co– morbid major depressive disorder, and studies signify such importance of early diagnosis and treatment. So diagnosis of major depressive disorder when it is comorbid with Tourette disorder considered to be important in our society as well. 30 cases of Tourette disorder who refferred to a child psychiatry center were studied during a period of one year in a descriptive. Cross sectional study. At the same time” 30 cases matched by age and sex were chosen as our control group from Tehran public schools. There were 25 boys and 5 girls in each group “with age rang of 8 to 18 years. A semistructural questionnaire of kiddy Schedule for Affective Disorder and Schizophrenia was used to investigate the presence of major depressive disorder in both groups. Statistical tests including MC- Nemar exact test were used for statistical analysis. 23/3% of Tourette group patients were diagnosed as major depressive while 3.3% of the control group was diagnosed as major depressive disorder”. As given the high association rate for Tourette disorder and major depressive disorder. It is suggested to investigate all cases of Tourette disorder for possible major depressive disorder.

To collectively investigate the several clinical tests have been used to measure endurance of the trunk muscles in subjects with and without low back pain (LBP) and identify the sensitivity of each test to predict the probability of the occurrence of LBP. Testing the spinal muscle endurance seems to be very important in prediction, prevention and rehabilitation of LBP. Several types of methods of static endurance testing such as: Sorensen test, prone isometric chest raise test, prone double straight-leg raise test, Supine isometric chest raise test and Supine double straight-leg raise test, regarding their utilization have been reported in the literature. However, identification of the tests that have more dominant sensitivity on assessment of LBP has not yet been determined. Information regarding the sensitivity of each test is needed for effective prevention and appropriate treatment strategies. Total of 200 subjects participated in this study. Subjects were categorized into four groups: asymptomatic males (N = 50, mean age = 38±12 years), asymptomatic females (N= 50, mean age = 43±11 years), males with LBP (N = 50, mean age = 39±12 years), and females with LBP (N = 50, mean age = 43±12 years). Five clinical tests were measured in each group and the relative association of each test with on LBP was assessed. Among all the performed tests, prone double straight-leg raise test had the highest association with LBP. Other tests such as the, Prone isometric chest raise test, Supine isometric chest raise test and Supine double straight-leg raise test had low association with LBP in compare with Prone double straight-leg raise test. It seems that Prone double straight-leg raise test has more association with LBP than other tests and could be used to as an useful method for testing the spinal muscle endurance, prediction of the probability of the occurrence of LBP, prevention and rehabilitation of LBP.

In the world, stroke causes long-term complication and is considered an the important cause in these inability in patients. Therefore, nursing care is very important in this patient that must determine reachable and supportive goals. We can decrease the problems in these patients, their families and treatment-care system with implementation good program. This investigation is a semi-experimental study which its main goal has been to determine the effect of home care on complication resulting from immobility in musculoskeletal system of patients with stroke stayed at home. Association of investigation all the patients with stroke stayed at home which have been hospitalized at one of the hospitals of Semnan town in winter of 1381 and summer of 1382, among them 32 persons were chosen accidentally (16 person test group and 16 person witness group). Collection of data was instrument includes a questionnaire consisting of two parts. The first part demographic characteristic of patients with stroke and the second part as checklist which mentioned questions is in musculoskeletal system which completed by the researcher. After selection of samples and completion of questionnaire and graphic and checklist at the begining of the work, for patients of test group, nursing cares have been varried out by emphasising and focusing on musculoskeletal system for 12-18 session, each session 45 minutes to one hour (total 40 days) and for witness group no special care has given (But they were free in receiving care and if anyone had used this care, he/she expelled from samples). Research demographic profile indicated that 23 persons of samples are man (13 persons in test group and 10 persons in witness group) and 8 persons are woman (3 person in test group and 5 person in witness group). Mean of age is 63 in test group and 70 in withness group. Mean of weight is 67/5 kg in test group and 65 kg in witness group. In comparing immobility complication between two groups in muscloskeletal system (0.06) there were meaningful statical difference. Obtained finding in relation to the major goal of the investigation showd that the amount of complication resulting from immobility in test group, according to assumption has been lower than persons who don’t receive these cares, Nursing care was considered to be more effective on complication resulted from immobility of patients with stroke.

The purpose of this study was to assess impact of foot sensory modulation on inhibition of hypertonicity of the lower limb in children with diplegia spastic cerebral palsy. 24 selected children (aged 2.5 to 4.5 years) were randomly assigned to a control and experimental groups. Muscle tone was assessed using modified Ashworth scale, passive Range of motion by goniameter (Pedretti), neurodevelopmental level by Bobath scale. All children were pre-post tested in an interval of ten weeks. Significant reduction was observed in hypertonicity of hip extensor (p<0/1) and ankle planter flexor (P<0/05). Significant increase was observed in passive Range of motion of hip flexion (P<0/1), knee extension (P<0/05) and ankle dorsi flexion (P<0/05). There was found no significant difference of reduction in hypertonicity of knee flexor and improvement neurodevelopmental level. Meaningful relationship was observed between reduction hypertonicity of the hip extensor (P<0/05) and improvement of neurodevelopmental level (P<0/05). Impact of sensory modulation on children with diplegia spastic cerebral palsy reduces spasticity of lower limb and also extends joints domain of motion.

Hypertension is a chronic problem and most common cardiovascular disease. Whenever in this study carried out no drugs therapy and effect of progressive relaxation therapy on elderly hypertensive cliens. This study was a quasi experimental research that was conducted in two groups of control and experiment in order to evaluating efficacy and feasibility of progressive muscle relaxation on blood pressure of elderly subject with mild and moderate hypertension, residing at kahrizak charity foundation for elderly, in the year of 2005. fifty five elderly men and woman hypertensive (27 experiment and 28 control) were randomly studied Equipments for data collection were, client demographic questionnaire, check list of BP and recorder, sphygmomanometer, stethoscope. For then experimental group progressive musele relaxation was performed in 20 minutes sessions, three weekly for 6 weeks were calculated and compared with control group. Statically analysis was done help of SPSS. Mann- Whitney test showed that systolic blood pressure and diaatolic blood pressure in the both groups before the intervention was similar (p<0.05). Same test indicated that both stages of means, was significant differnce of systolic and diastolic blood pressure between both groups(p<0.05), and Wilcox on test also, showed a significant difference in decline of blood pressure after the intervention(p<0.05) in the experimental groups and reversely the same test showed a significant difference berween, before and after intervention in control group(p<0.05). Consequently the hypothesis of this study progressive musele relaxation (PMR) declines the blood pressure in subjects practieing this program. Comparing to the control group, such hyporthesis was confirmed.

Occupational accidents is considered as one of the sever dameage ocular structures which can produce permanent visual functionol impairment. 1048 occupational accidents files were reviewed from 1378-1381, randomly to analyze eye accidents caused at work and to present some plans and recommendation to reduce and prevent them. Demographic features and the way of the accidents happened were derived from the files of 63 ocular injuries from the industrial’s workshop of the social welfare organization and were analyzed by Excel software and Chi-square test. 6.05 per cent of occupational accidents was related to the ocular accidents. There was no significant relationship between age and the cause of ocular accidents. 28.8 per cent of the accidents caused by not caring and using safety wares were happened between the ages of 20 to 40 years. 25.7 per cent of accidents were related to the enter of foreign bodies to the eyes in the age of 20 to 40 years. There was a significant relationship between occupational shift and season with the eye accidents (P<0.05). There was no relationship between the accident type and the season of the year and 26.2 per cent of entering of the foreign bodies into the eye was happened in the morning. As the results show, teaching workers and promoting their knowledge level and occupational skills, proper using of personal and group safety equipments, avoid using improper equipments at work, abstain from over work shifts and using enough lights for decreasing occupational accidents can be the first to do.

The incidence of profound congenital hearing loss is about 1 in 1,000 live birth. There are more than 50 distinct genetic loci (known as DFNB loci) at which mutations can cause recessive hearing loss. DFNB4, one recessive locus for deafness, also maps to 7q31 considerably for nonsyndromic hearing loss and Pendred Syndrome which has been named PDS gene. Pendred syndrome (PS, MIM 274600) with an estimated frequency 1-8 per 100,000, is an autosomal recessive disorder and classically characterized by sensor neural hearing loss and goiter. Here, we reported a family with Pendred syndrome that in which a new mutation, T420I, in the homozygous state caused the condition. Also there was a 9-year-old boy in the related family with hearing loss and with no signs of thyroid dysfunction or goiter, whom was compound heterozygous for PDS mutations including 1197delT and T420I. Both of these mutations result to PDS syndrome. However we are not sure if the 9-year old boy show the goiter appearance in near future, but the results could be used as the prognostic factor. Consequently we should follow up the patient. Besides all, characterization of mutations in PDS gene can guide us to early diagnosis of Pendred syndrome and consequently early treatment of the patients maybe show the clinical features of hypothyroidism in later onset.