مجله پژوهش در علوم توانبخشی
سال هشتم شماره 4 (مهر و آبان 1391)

Stuttering Severity Instrument-Fourth Edition (named hereafter SSI-4) is one of the most wildly recognized and reliable measures of stuttering severities to date. This instrument has been used for describing some aspects of stuttering and also for measuring treatment outcomes. Considering the importance of outcome measurement in evidence- based practice and the paucity of reliable instruments to make such estimates in Iran، it was decided to determine the reliability of SSI-4 through this study.

After being translated in to Persian according to IQOLA protocol، the reliability of instrument was evaluated in a sample of 35 adults who stutter. 5 experienced raters scored each subject''s stuttering severity using SSI-4.

Inter- and intra-rater reliability was determined using Cronbach''s alpha coefficient، Intra-class correlation coefficient (ICC)، and one way ANOVA. ICC values ranged from 0. 93 to 0. 98 for inter-rater reliability and from 0. 85 to 0. 98 for intra-rater reliability. One way ANOVA with repeated measures did not provide any evidence of mean difference between the severity scores obtained from weekly assessments.

Regarding to the high reliability of SSI-4 reported in this study، it can be concluded that the Persian version of SSI-4 is an appropriate instrument for evaluating stuttering severity in adults who stutter. However، the point that has to be made here is that SSI-4 address only one aspect of stuttering، namely its severity، and cannot cover all complicacies of the disorder.

This study was a quasi-experimental، case-control design to investigate the effect of fatigue on postural stability during repetitive trunk bending motion in subjects with chronic low back pain and healthy adults. Fourteen healthy volunteers and thirteen subjects with low back pain participated in this research. They performed repeated trunk bending motion in mid sagittal plane until exhaustion. All data were divided into three parts then first and third parts were compared together. Some variables like standard deviation of amplitude، standard deviation of velocity in anterior-posterior and medial-lateral directions mean total velocity and path length were calculated. Paired and Independent T-test were used to explore the pre/post fatigue and the between groups difference. The results showed that fatigue had a significant effect on the mean total velocity and amplitude standard deviation in anterior-posterior direction in healthy subjects. There was no effect in low back pain participants. Also، no difference was observed between two groups at the beginning of the test in postural stability. Results suggested that the Postural control system of chronic low back pain patients is distinguishable from the healthy adults’ one، just in an induced perturbation condition. Also healthy subjects showed the different strategies in response to fatigue compared to low back pain subjects.

Knee joint osteoarthritis (OA) is one of the most incapacitating diseases affecting older population، which is associated with pain and functional limitation. Its prevalence is significantly higher among women than men. Osteoarthritis is a degenerative disease usually involves medial intra-articular space. Various kinds of conservative treatment have been used in order to decrease knee pain and to improve the quality of life for subjects suffering from OA. Although one of the first conservative mechanical treatments is the use of laterally wedged insole، there are discrepancies regarding to clinical effects reported for the use of this method. Thirty six subjects with medial knee compartment osteoarthritis were recruited in this study. Participants were randomly classified into two groups to receive 3 and 7mm lateral wedge insoles. Pain and the quality of life were measured by WOMAC scale and radiologic method was used to record and calculate OA severity and tibiofemoral angle. The use of both 3 and 7mm lateral wedge insole significantly improved the quality of life and knee pain (P < 0. 5). There was no difference in OA severity before and after using the lateral wedge insole (P > 0. 5). Also، result showed 7mm laterally wedged insoles were more effective than 3mm in pain improvement (P < 0. 5). Using lateral wedge insole could be a simple and inexpensive method to decrease pain and correct tibiofemoral angle، and also، improve knee joint function.

Osteoporosis is the most common type of bone disease that affects the skeletal system especially in older people. In elderly population، reduction in bone mineral density (osteoporosis) is often associated with a reduced health-related Quality of Life. The present study aimed to investigate the effect of a selected exercises program on quality of life in elderly women with osteoporosis. Twenty- seven women with osteoporosis (Mean age ± SD، 58 ± 6 years) who were referred to Isfahan osteoporosis diagnostic center divided into two groups: intervention (n = 14) and control (n = 13) groups. The experimental group received the following intervention: balance، strength training and range of motion exercises for 8- weeks (three sessions per week). Control group did not receive any intervention. Quality of life was measured using the QUALEFFO-41 questionnaire just before and after exercise program. Independent and paired sample t-test were used to analyze the data. In experimental group، a significant difference (P < 0/05) was observed before and after exercise program in pain (30/7 ± 17 vs. 15/4 ± 11)، mobility (23/1 ± 8 vs. 17/6 ± 7)، social activities (27/9 ± 13 vs. 20/16 ± 8)، general health perception (51/2 ± 21 vs. 35/1 ± 16)، mental function (20/8 ± 6 vs. 15/1 ± 5). There is no significant difference (P > 0/05) in household activities and ADLs. Also، no significant difference was observed in control group (P > 0/05). Although، in pre test، the observed difference was not statically significant between control and experimental groups (P > 0/05)، but significant difference was found in post test (P < 0/05). It seems that an exercise program could improve health-related quality of life in elderly women with osteoporosis، therefore this exercise program can be considered as an appropriate treatment regimen for such patients.

Using conventional methods of vestibular rehabilitation such as adaptation and habituation exercises is a management strategy for patients with bilateral vestibular loss due to aminoglycoside ototoxicity so far. Previous studies shown EVSS- electrotactile vestibular substitution system- might have an important role in the rehabilitation process for these patients. This study investigated the effect of this therapeutic modality as a pilot study. In this study، 10 cases (6 males، 4 females) with bilateral vestibular loss were rehabilitated by EVSS. This approach was conducted in 10 sessions، 20 minutes per session (two sessions per day). Sensory organization test (SOT) and Dizziness handicap Inventory (DHI) were performed before and after treatment (at the first day of post-treatment period). Difference between the groups before and after treatment was analyzed by t-test using SPSS software (ver. 16). After 10 treatment sessions، all subjects had significant difference in score of SOT and DHI (P < 0. 05). Less falling (5th stage of SOT) was seen after treatment sessions (P < 0. 05). Subjects could maintain their straight posture in Romberg position، with closed eyes and on a soft surface (P < 0. 05) and their movements were also more uniform and their gait was more stable (P < 0. 05). The results show recuperation of subjects following EVSS that indicate probable sensory systems substitution in order to manage vestibular disorders.

In investigation of job satisfaction، paying attention to humanitarian motivation of employee subjects is of high priority. The aim of this study was to explore the role of locus of control and personality dimensions in the prediction of job satisfaction of occupational therapists employed in governmental organizations in Tehran. 75 occupational therapists (23 males and 52 females) aged between 23 to 50 years (Mean age = 32. 37 ± 7. 00) who employed in governmental organizations were selected to participate in this study. NEO Five Factor Inventory، Rotter''s Locus of Control Scale، and Herzberg''s Scale of Job Satisfaction were used to collect the data. By use of SPSS 18، data were analyzed by Spearman correlation and multiple regression analysis. Pearson correlation test showed a significant relationship between locus of control (P = 0. 001)، and four personality dimensions including neuroticism (P < 0. 001)، extraversion (P = 0. 009)، agreeableness (P = 0. 012)، consciousness (P = 0. 024) and job satisfaction of occupational therapists. No significant correlation was observed between openness (P = 0. 061) and job satisfaction of occupational therapists. Results of regression analysis showed that extraversion (P = 0. 009)، and locus of control (P < 0. 047) had significant role in the prediction of job satisfaction of occupational therapists. Paying attention to neuroticism and locus of control of occupational therapists، have the most important role in the improvement of their job satisfaction.

Lateral ankle sprain accounts for 10-28% of all sport injuries. Most of the people with lateral ankle sprain never fully recover and almost 80% of basketball players suffer from repeated ankle injuries. Balance will be distributed in most cases. In addition، athletes can become fatigued physically during competition; this can lead to recurrent ankle sprain when (s) he suffers from previous sprain as one of the orthosis functions is injury prevention، the aim of present study was to examine the effect of prefabricated ankle orthoses on balance in athletes with chronic ankle instability in fatigue condition.

Twenty basketball players with chronic ankle instability (CAI) and fifteen non-injured athletes participated in this study. Balance was measured for all subjects in normal and fatigue conditions using Biodex Balance System. The three testing conditions included a soft ankle support، spiral spring ankle support، and no orthosis. Analysis of variance (ANOVA) was used to analyze the data and the significance level was set at P < 0. 05.

this study investigated that the pre-fabricated orthoses could improve balance in healthy athletes and athletes with CAI، in fatigue condition (P < 0. 05).

As the prefabricated orthoses has a positive influence on balance ability in experienced athletes these assistive devices can be used to prevent further sport injuries.

There are many hypotheses about cognitive deficiencies in students with dysgraphia and one of these hypotheses is deficiency in visual memory. The purpose of this study was to determine efficacy of improving visual memory through play therapy on reducing spelling errors in students with dysgraphia. In a quasi-experimental study (pre and post test design)، 30 students with dysgraphia were selected form referrals to Learning Disability center، using Wechsler Intelligence test، Fallahchai writing test and evaluation test of learning. Then they were randomly divided into two groups of experimental (15 students) and control (15 students). The experimental group was trained for improving visual memory through play therapy in 20 sessions during 3 months، while the control received no interventions during the similar period of time. One way ANOVA، Pearson correlation and t-tests were used to analyse the data. F ratio (visual memory: P < 0/05، cubes test: P < 0/05) of the post test of the experimental and control group showed a statistical difference in visual memory and Wechsler cube sub-test. The result of the independent t-test showed there was no statistical difference between gender in in their average scores of visual memory and cubes test in the post test (P > 0. 05). improving visual memory in students with dysgraphia revealed reduction of spelling errors. This intervention might result in these students controlled their writing process; purposefully perform their activity، in addition to gain correct writing of the word.

Syntactical characteristics of hearing-impaired (named here after HI) children have been one of the main focuses of interest in speech and language pathology. In This study، HI children were compared with their normal counterparts in terms of MLU and the type and the number of error patterns in two types of speech samples (namely، free and descriptive speech). Sixteen Persian-speaking normal-hearing and 9 HI children aged from 48 to 72 monthswere evaluated in this cross-sectional descriptive-analytic study. All subjects were recruited from either nursery or rehabilitation centers of Tehran، Iran through the convenience sampling method. Story-retelling and complex-picture description tasks were used to obtain descriptive speech samples while free speech samples were collected via asking complementary questions. All samples were tape recorded for future quantitative and qualitative analyses. For statistical analysis of the data، Mann-Whitney''s U and student''s t tests were conducted. Data analysis demonstrated a significant difference between the two groups with regard to the Mean length of utterance calculated inmorphemes (MLUm) in both free and descriptive speech samples (P < 0. 001 and P = 0. 002 respectively). The total mean of errors in both free (P < 0. 001) and descriptive speech was significant different among the studied groups (P = 0. 003). The most frequent syntactical errors in the descriptive speech of HI and normal children was incorrect deletion (48. 5%) and incorrect selection (38. 2%) respectively. Incorrect syntactical deletion had the highest frequency of occurrence in the free speech samples of both normal-hearingand hearing-impaired children (47. 4% and 38. 8% respectively). Beside their shorter MLU (especially in free speech)، the nature of morphosyntagmatic errors of hearing-impaired children are different from typical children.

The purpose of this study was to determine the effect of two different age groups (children and young adult) to learning of temporal-special coordination hand movement pattern. Sixty subjects according to the age (children-young adult) and receiving feedback (100%، omitted، self-control) were randomly divided in to six groups. This study was done in three days. All subjects practice 100 trails of movement task in each day of first and second days. Retention tests were done in second and third days and reacquisition test was done in the third day. Analysis of variance (ANOVA) with repeated measures and two way ANOVA was used to data analysis. All participants in the first day improved their accuracy across practice trials. In the second day children did not improve their accuracy but young adult experienced improvement across practice trials. There was no significant difference between retention children tests but that was significant about young adult. During the retention tests children who received 100% feedback was significantly better than other children feedback groups and there was no significant between young adult feedback groups. During the reacquisition test children who received 100% feedback was significantly better than other children feedback groups and there was no significant between young adult feedback groups. Results from this study showed young adult were better than children in the learning of this pattern، receiving more feedback can improve motor learning in children (in contrast with guidance hypothesis) and we must not expect motor skill acquisition occur in fast rate like young adult in children.

Psychomotor skills have an important role on academic learning and developmental aspects of children. The purpose of present research was to investigate the effectiveness of a selected psycho-motor rehabilitation program on psycho-motor skills improvemnet in educable mentally retarded students. The statistical population was comprised all educable mentally retarded female students in Isfahan city. 30 students were randomly selected by cluster sampling method. Lincoln-Oseretsky motor developmental scale was used to measure variables. SPSS، version16، was applied to analyze the data. The results showed that the selected psycho-motor rehabilitation program was significantly effective on psycho-motor skills improvmenet in students with mental retardation (P < 0. 001). Also، this program could prominantly effect on some psychomotor subtests such as: finger skills and backward movement (P < 0. 05). According to results، appending some psychomotor activities as the main and essential part in daily schedule for students with special needs could improve their function and help them to be more active.

Asthma is one of the most common disorders of respiratory system. Exercises are the main part of pulmonary rehabilitation program. This study designed to investigate the effects of selected rebound therapy and aerobic training program in men with Asthma. Twenty six asthmatic male participants among all patients referred to Alzahra respiratory clinic in Isfahan، Iran، were selected randomly and divided to two Rebound therapy and Aerobic groups. All subjects were aged between 20 to 40 years. Exercise capacity (VO2max) was measured using a modified Bruce test، endothelin level was tested in blood sample by Elisa method، and quality of life was recorded by standard Asthma quality of life questionnaire (AQLQ). After signing a formal contest، subjects started their special training under the supervision of an exercise specialist for 8 weeks، two sessions a week. Data were analyzed with repeated measures analysis of variance (ANOVA). Alpha was set at 0. 05. The within-group changes and change of slope were prominently significant for all variables in rebound therapy (P < 0. 05). Although، Two groups did not differ in aerobic capacity and plasma endothelin level (P = 0/8 and P = 0/06)، But there was significantly difference in quality of life (P = 0/01). It seems that the rebound therapy exercise could be used as an useful complementary method to reduce some problems in patients with asthma.

Narrative assessment is an important evaluative tool for determining literacy outcomes، academic performance and social appropriateness. It can be viewed as rich approach for the description of how language develops in early childhood environments. The aim of this study was to report some language structures in narrations produced by 4-year-olds and to explore any association that may be observed between those structures and the sex of these children according to Narrative Assessment Protocol (NAP). In this cross-sectional descriptive study، NAP method was used to evaluate particular language structures in spontaneous narrations of 126 Persian-speaking children that had been produce while they were describing a picture book. Intra-rater، inter-rater and online- offline reliabilities were also calculated. Target language structures were evident in the most of narratives. The most commonly used structure was possessive noun and the least common one was tier-two noun. Agreement percentage for each of the NAP items ranged from 53% to 100% of accuracy. The final NAP score for each subject and the scores obtained for each structure were not significantly different between girls and boys. The results were in agreement with the past results about the Mean Length of Utterance (MLU) in various ages and the relationship between MLU and the development of language structures in this age range.

Autism Spectrum Disorders (ASDs) are associated with various abnormalities of cortical areas resulting in motor learning deficits. Motor learning can be categorized into two main types: implicit motor learning and explicit motor learning. The main goals of this study was to investigate the possible differences between implicit and explicit motor learning in children with high functioning autism including those with Asperger Syndromes and a matched group of typical children and to evaluate the extent of learning consolidation in these two groups after 24 hours.

30 boys with autism spectrum disorder، diagnosed via ASSQ، and a matched group of 32 typical boys were recruited from elementary schools of Najaf Abad، Isfahan، Iran، and then were compared with each other. At the first day of the study، participants in both groups performed a serial reaction time task with 10 blocks by the right hand. A similar task with 4 blocks and by the same hand was performed after 24 hours. Repeated measure ANOVA was conducted for the statistical analysis of the data using SPSS 19.

Concerning explicit motor learning، the two study groups showed a significant difference which implicated an explicit learning deficit in the subjects with ASD (P = 0. 009). Results also indicated no significant difference in implicit learning between these two group (P = 0. 385). Intact implicit consolidation (P = 0. 160) and deficit in explicit consolidation (P = 0. 046) was also observed in the ASD group.

Deficits in explicit motor learning and consolidation among subjects with ASD may be due to left hemisphere dysfunction which is specialized for motor learning. Since explicit consolidation is sleep-dependant and children with ASD usually suffer from sleep disorders، deficit in explicit consolidation was expectable. Intact implicit learning and consolidation can be attributed to the effect that right hemisphere has on implicit motor learning.

Several studies have shown various deficits in linguistic، auditory، and speech-motor processing of people who stutter. The Diversity of pathological findings makes it hard to suggest a comprehensive hypothesis to explain the nature of stuttering. However it seems possible to integrate heterogeneous findings in terms of maturity hypothesis which has been recently proposed on the basis of an electro-encephalographic study. This narrative review article was an attempt to integrate diverse findings on stuttering into the frame of brain maturity hypothesis. Literature review was performed using “neurophysiology of stuttering” and “brain maturity hypothesis” as keywords in PubMed، Science Direct، Proquest databases، and Google Scholar search engines and also among library sources from 1990 to 2012. Thirty-two papers and 4 books were selected according to subject relevance and their respective citation numbers. Records on neurogenic or psychogenic stuttering were excluded so that only those papers on developmental stuttering with a citation number of at least 10 (for papers published from 1990 to 1999) or 2 (for those published from 2010 to 2012) were selected. Three papers were obtained in abstract form. Results the present article focused on the pattern of spontaneous recovery as an evidence for maturity hypothesis. To be more specific، spontaneous recovery was considered as an index of slow neural maturity، which in return، results in linguistic، auditory and motor ability deficits in stuttering. Diversity of deficits in stuttering may imply slow neural maturity of linguistic-motor system. It seems that، this slowness causes disturbances in the laterality of linguistic-motor processes in people who stutter. More research about hypothesis is possible via using techniques which can facilitate neural maturity generally or specificly.

Down syndrome is one of the most common genetic causes of mild-to-moderate mental retardation. The main signs and symptoms of the disorder are the loss of mental functions and physical abnormalities that affect motor activities. The purpose of this research was to determine the possible relationship between flexibility، body composition and skeletal abnormalities in student with Down syndrome. 50 mentally-retarded female students with Down syndrome (age: 13. 96 ± 1. 77 yr، height: 135. 40 ± 8. 19 cm، weight: 42. 86 ± 9. 21 kg، IQ: 59. 12 ± 3. 73)، were randomly selected and enrolled in the study. Demographic and health-related information including age، height، weight، IQ and medical histories were obtained from the students’ medical records. Flexibility and body composition were respectively assessed through asking subjects to complete “sit and reach” test and calculating their body mass index (BMI). Continued spinal abnormalities (kyphosis، lordosis، thoracic and lumbar scoliosis) were measured through Spinal mouse. The results showed a significant correlation between BMI and lordosis (P ≤ 0. 05) but there was no significant correlation between flexibility and skeletal abnormalities in the sample studies. Considering the interaction between postural، physical fitness and Special needs among patients with Down syndrome، it would be reasonable to provide affected students with postural corrective exercises، physical fitness and weight control programs in order to ensure that they perform their daily activities optimally.

The Incidence of hearing loss in neonates with hearing loss risk factors is 10 to 20 times higher than that of normal neonates. The main purpose of the current study was to evaluate the risk factors of neonatal hearing loss among those newborns who were brought to Ahvaz Hearing Screening Program and to assess their impacts on hearing loss occurrence. In This descriptive-analytic and cross-sectional study، the hearing evaluation documents of the newborns who had failed in the first stage of in Ahvaz Hearing Screening Program and exhibited at least one hearing risk factor were reviewed. This program was initiated in 2008 and continued through 2011. Chi-square and odds ratio tests were used for the statistical analysis of data using SPSS software package. Four hundred and seventy-eight infants (16 percentages) out of 2940 neonates were identified with one or more hearing loss risk factors. Totally، 52 hearing-impaired infants were diagnosed. There was a statistically significant difference for the occurrence of hearing loss between neonates who had risk factors and those who did not (P < 0. 05). Syndromes associated with hearing loss، craniofacial malformation and meningitis were the most common causes of hearing loss. According to high impact of risk factors on incidence of neonatal hearing loss، hearing screening in infants with these risk factors is highly recommended.

The effects of brain lesions on the ability to sequence auditory stimuli have been documented in numerous studies. Some investigations have demonstrated that for almost all people، left hemisphere is specialized in temporal processing، especially the temporal ordering. The Aim of this study was to evaluate the temporal processing abilities of patients with unilateral temporal lobe epilepsy by means of “duration pattern sequence«test. In this cross-sectional study، 25 temporal lobe epileptic subjects (11 patients with right temporal lobe epilepsy and 14 ones with left temporal lobe epilepsy) and 18 normal controls with the age range of 15 to 50 years were assessed by duration pattern test. All subjects were evaluated in rehabilitation faculty of Tehran University of Medical Science. The mean scores of correct answers were statistically compared between the three groups using one-way ANOVA. Tukey’s HSD test revealed significant differences between controls and patients with left temporal lobe epilepsy and also between patients with right and those with left temporal lobe epilepsy (P < 0. 05). Difference subjects between right temporal lobe epilepsy and normal groups، however، were not significant (P > 0. 05). Difficulties in processing of temporal ordering among the patients with left temporal lobe epilepsy can be considered as a proof for the specialization of the left temporal lobe in the processing of temporal ordering.

Radiography is a common، highly reliable and valid method of measuring spinal kyphosis. However، it may be considered unsuitable for regular use because of radiation exposure and particular cost. Other clinical methods may provide safe and rapid assessment of spinal curvature. The purpose of this study was، therefore، to verify the reliability and validity of the flexicurve to measure thoracic kyphosis. One hundred and five subjects with hyperkyphosis were enrolled in this study (aged 10-80 years). The Cobb angle was measured on a posterior-anterior x-ray by a spine specialist. Two other examiners، blinded to the results of previous measurement، evaluated thoracic kyphosis using the flexicurve. Finding showed that the validity of flexicurve was in poor range while compared with established radiologic measurement. There was an acceptable reliability on the intra-rater evaluation with flexicurve measurement method in participants aged < 30 and > 50 years. However، it was poor on inter-rater reliability evaluation in subjects aged < 30 years but an acceptable option in those aged > 50 years. The flexicurve is barely valid for thoracic kyphosis measurement. So، despite it has been identified as a safe، non-invasive and cost-effective method، but because of its low reliability and validity could not be recommended for regular screening.

Drop foot is a neuromuscular disease that arises due to genetic defects، war injuries، accidents، tumors and brain stroke that foot neuron damages permanently or temporarily. For improving this gait disorder، patients need to use an ankle-foot orthosis. Intelligent robotic orthosis consists of a sole foot pressure sensor plate، calculator software and a robotic part. In accordance with developed model and based on data of drop foot patient gait it has been defined that there is need of robotic system for improving the amount of torque required for patient therefore a new orthosis is needed to recognize the required compensated torque for robotic system which is supplied by electric energy. For making connection between torque supply system and pressure measured by force plate artificial models were used. This system improves the gait of a drop foot patient and enhances the ability of patient for walking. Other anticipated aims of this research are reducing the pressure and damage on tendons، reducing impact on joints using robotic system and compensating the deficiency of muscles.