فصلنامه آرشیو توانبخشی
سال دوم شماره 1 (پیاپی 4، بهار و تابستان 1380)

A “hearing-impaired is defined as abnormal or reduced function in hearing resulting from auditory disorder” (Stach,1997). The goal of any preschool and school screening program should be to accurately identify those children whose hearing has impaired resulting from either conductive and / or sensory - neural pathology. Although some ear pathologies (e.g., middle ear effusion) might not produce a significant hearing loss, screening for these pathologies should be a part of the screening program because they may influence the potential to learn. This research was carried out in a cross-sectional descriptive study on 577 children (278 girls and 299 boys) among the 3-6 years old children of kindergartens in Welfare Organization of the Tehran Province from March to June 2001. The otoscopy examination, pure-tone screening and impedance screening was conducted after completion the parents awareness form of the hearing loss existence. In this study, there were 12.58% abnormal conditions of external ear canal, 23.7% abnormal tympanic membrane, 34.3% abnormal tympanograms, 35% no acoustic reflex, 12.6% hearing loss including 9.7% bilateral and 2.9% unilateral hearing loss (12.0% conductive hearing loss, 0.64% sensory-neural hearing loss and 0.36% mixed hearing loss), higher prevalence of left ear disorders and statistically meaning difference between two ears (P<0.05) in all of studied items, except of acoustic reflex condition. With respect to high prevalence of need to medical care and the negative effects of middle ear disorders in learning of preschool children, and also due to the importance of early identification and intervention of hearing loss in aural rehabilitation programs, awaring and teaching the people about the effects of hearing disorders and it's prevention and identification are very important.

The goal of the study was to investigate the major factors influencing knee osteoarthritis and to estimate its prevalence. This article is the outcome of an Ex Post Facto study on the files of 176 patients complaining of knee pain who referred to orthopedic clinics in Tehran within the period of 10 months from 1998 November to 1999 August. The selection of the files was implemented randomly. The prevalence of osteoarthritis in "only left knee" cases turned out to be 22.9%, in "only right knee" cases 39.4%, and in "both knees" cases 37.6%. The gender variable showed a significant effect on the prevalence of this condition (p<0.002) so that the prevalence in males is higher than that in females although the prevalence is higher in urban than in rural areas, this difference is not significant indicating that location does not influence this condition (p<1471). Other results showed that there is a significant positive go-togetherness between age and the prevalence of the condition (p<0.00l). There is also a significant positive correlation between occupations demanding physical labor and the prevalence of the condition. From factors aggravating pain in both "only right knee and both knees" cases, the highest effect belongs to sitting with entirely bent knees, and the lowest has to do with short distance walking, whereas in the case of "only left knee" cases long distance walking has the highest and rest the lowest effect on pain increase in all the three groups. Full rest leads to 40% decrease in pain, while sitting on a chair has the lowest effect on the relief of the pain, but in "only left knee" cases extending the lower extremities in sitting has the lowest effect on pain relief. Physical factors including apparent joint deformity in standing position, knee range of motion and meniscus laceration have a significant effects on this condition. Furthermore factors noticed through radiological observations such as joint atrophy, sub-cartilaginous bone sclerosis, cyst formation, osteophyte formation and biomechanical abnormality in the knee, all have significant effects on knee osteoarthritis. Factors including height, weight, knee trauma, knee infection record, using chairs, pharmaceutical treatment, health system type, doing exercises, and treatment non-pharmaceutical also have an impact on this condition.

Patients with facial palsy lose normal facial muscle movement in the paralyzed side. A condition which is treated using different methods of treatment. Over of a period of five years, a total of 80 facial palsy cases referred to the hospital. 22 were treated by high dose of prednisolon and physiotherapy. 58 cases were treated by different surgical procedures, that 38 cases had developed the condition due to trauma, and the remaining 20 due to bell's palsy, brain tumor, or congenital conditions. Surgical procedures used in treating these patients were end to end anastomosis, nerve graft between the severed nerve, neurotization of the contralateral healthy side to the paralyzed side, and nurotization with hypoglossal or accessory nerve of the paralyzed side. Muscle transplant to the paralyzed region, such as temporal or free gracilis muscle was also used in some patients. In acute phase of bell's palsy, after head trauma or facial palsy because of very cold weather, prednisolon in high dose and neuromuscular rehabilitation for some patients showed very good results. Operative technique using nerve graft or end to end anastomosis of the severed nerve showed very good results, and neurotization of the paralyzed side to the contralateral healthy side gave acceptable to good results. The use of muscles or hypoglossal nerve of the paralyzed region did not result in symmetric facial muscle movement. Our data shows the best operative technique for patients with chronic facial palsy is the use of free gracilis muscle. Patients treated with this method were able to regain their involuntary and symmetric facial muscle movement.

The impact of alcohol and other drugs increase dramatically in adolescent's lives when their parents are dependent drug users. Not only the children are at risk of developing drug users, but also they are at risk of developing drug related problems later in their life. They may also suffer other social and psychological problems.Matetials & The present study focusing on psychosocial problems of adolescents with addicted father, Uses the (s.c.l-90) and educational conditions Questionnaires. It is a "Case-control" study. Our samples include 40 adolescents with "addicted father" and 80 with "non-addicted father". The addicted fathers were chosen randomly from Gharchak rehabilitation center. The adolescents ages were between 12-18 years old chosen randomly and matched by variables such as sex, age, education. The result of the study shows a significant differences between the psychosocial problems of adolescents with "addicted father" and "non-addicted" ones, (p<0.05). So such that in our case group we see a higher drop in school subject anxiety and interactional disorders. It seems that there is a correlation between the addiction of father and psychosocial problems of their children.

Lower back pain is most prevalent during our young and middle adult lives. Eighty percent of the population will experience an episode of pain during their lifetime. Recently some exercises are prescribed by physical therapists based on the patient's lordosis. Therefore, the aim of this study is to investigate the relationship between LBP and lumbar lordosis in the students (21±2.3 years old). Lumbar lordosis with adjustable ruler, pelvic tilt with tilt-meter and scoliosis, flat foot and shoulder drop with clinical examination have been studied. For determining the reproducibility, each test has been repeated after 5 minutes. The results have been shown that there were 21.5% scoliosis, 34% shoulder drop, 25% flat foot and 12.5% lateral pelvic tilt. Also, 15.6% of subjects have been suffering from LBP. In addition, correlation between lumbar lordosis and pelvic tilt was 43% that supported the results of previous studies. The results of this study have not shown any significant differences of lumbar lordosis between normal and LBP subjects. On the other hand, mean of lumber lordosis in subjects with scoliosis was more than able-bodied subjects. Otherwise, in back pain subjects with shoulder drop and flat foot, hypolordosis has seen. Therefore, we concluded that to describe the exercise program based on lumbar lordosis needs more study.

In this survey spherical grip and tripod pinch strength in 200 normal right and left handed was evaluated in the children ages of 4-6 years with standard positioning and instructions that confirmed by American society of hand therapists and orthopedic surgeons, then hypothesis of this survey was evaluated. The instruments of this study were martin vigorimeter, kolis, meter, Balance scale. Summary of results was: There were no significant differences between means of right and left spherical grip strength of boys and girls, but there was significant difference between means of right and left tripod pinch strength of boys and girls. There were significant differences between means of right and left spherical grip and tripod pinch in right-handed children, but there were no significant differences between means of right and left spherical grip and pinch strength in left-handed children. There was a positive relationship between spherical grip and tripod pinch with weight, height, palmar width, middle finger length.

Many studies and researches have been done regarding elderly care health in countries with approved geriatrics as an independent branch. Because geriatrics is a new subject in Iran, this study was done in order to assess about social conditions and prevalence of elderly complaints and their rehabilitation services. This is a descriptive study. 150 elderly who were admitted ambulatory in the educational, research and rehabilitation center for older people in 1999, were assessed, and required information were taken. 150 elderly patients assessed, 58% female, 42% male, minimum age: 55 years. Maximum age: 100 years, 17.3% were illiterate, 19.3% had college studies. In female group 13% were widows and in male group 1.2% were widowers. 2 women and 1 man had never married. Cardio pulmonary disorders were the most common complaints (63.3%), then musculoskeletal disorders (55.6%), psychological disturbances (24.6%), neurological disorders (18%), 35% of above cases received physiotherapy, 13% occupational therapy and 2% speech therapy. It seems that in our community, rehabilitation services are given less than the countries with approved geriatrics medicine. Perhaps the role of rehabilitation in the quality of elderly life, for both, patients and their physicians is ignored. It is suggested that, rehabilitation disciplinary must be introduced more than before to physicians, especially who are working in the field of geriatrics.

The baby's first words producing is one of the most important index of development. Development of talking is through a complex process that is influenced by both neuromaturation and human relationships (environment). It is not an imitative function in which children learn to repeat what they hear, but also it is a creative process through which children master a rule based, symbolic system. Talking development can be evaluated in 5 important dimensions: phonology, semantics, morphology, syntax and pragmatic. The receptive and expressive abilities of the child must be evaluated also. This paper discusses about the epidemiology, etiology and pathogenesis, clinical manifestations, how to assessment and make early diagnosis, differential diagnosis, management (treatment and rehabilitation) and prognosis of delayed or atypical talking in addition to above definitions. This paper also emphasizes on early intervention for children who develop significant behavior problems secondary to their communication difficulties and for whom long-term problems in social development are a major concern.

Women have suffered from drug abuse for conturies, although formal Treatment assistance for women has been recognized as important only during the past few decades. The nature and underlying reasons for women's drug abuse differ from men’s behavior in many ways. It is finally understood that research on men will not simply translate into effective solutions for women as well. Here deal with the many issues that can arise in working with disabled women suffered from drug abuse because biologically, Culturally, and socially, their experience is different from that of men and other women and key theme For this discourse is that a woman who suffered from drug abuse is first and foremost a woman. Disabled women also have specific issues that must acknowledge and incorporate into the counseling, social work and other experince, so, here review is based on more than 25 years of the collective experience and firsthand knowledge of Monique Cohen and their Counselors at The CASPAR outpatient Clinic in Cambridge, Massachusett (2000) about women with drug abuse and alcoholism. The clinic Provides omprehensive substance abuse treatment to Individuals and Families struggling with either one or multiple addictions.

A 4 years old blind boy with leber's congenital amaurosis was referred for his severe expressive language problems. There was a considerable discrepancy between receptive and expressive language capabilities in favor of receptive ones. Behavioral problems such as temper tantrums, object dependency and cliche form movements, caused a referral to psychiatrist, which led to a short term drug prescription. Since it was revealed that he was able to perceive and reproduce rhythms presented to him, this capability was used for his speech training. This method of training have been appeared to be successful. His behavioral problems are controlled, he began to communicate vernally and his intellectual functioning is much better than prior to the therapy.