مجله پژوهش در علوم توانبخشی
سال هشتم شماره 5 (آذر و دی 1391)

Consequences of cerebral palsy can cause significant influences on physical and psychological capabilities of adults with cerebral palsy and affect on their quality of life. The purpose of this study was to investigate the relationship between quality of life with hypertonia and ambulation status in young adults with spastic cerebral palsy.

In an analytical cross sectional study، 70 participants (40 women، 30 men، age range 20 to 40 years، mean age + SD، 26. 24 ± 5. 07) with spastic cerebral palsy were recruited in this study. They were selected from three Ra’ad Rehabilitation Goodwill Complexes in Tehran and Karaj cities. Quality of life (QOL)، ambulation status، knee extension، and ankle dorsi flexion range of motion were measured by World Health Organization Qualit of life questionnaire (WHOQOL- BREF)، functional ambulation category and manual goniometer، respectively. To analyze the data، Pearson and spearman correlation coefficient، Mann-Whitney U test، Independent sample T test were used.

We found no correlation between ambulation status and ankle dorsi flexion range of motion with quality of life domains. However، psychological and environmental domains showed low correlations with knee extension range of motion (respectively r = 0. 26 and r = 0. 28). Also، no significant difference was found between males and females in QOL domain scores.

Probably knee extension range of motion could affect on psychological and environmental domains in adults with spastic cerebral palsy. Also، impairments and physical limitations seems to have a less pronounced effect on health-related quality of life in adults with cerebral palsy.

There are two basic terms relating to hearing loss. One is Hearing Impairment which refers to the complete or partial loss of hearing function. Hearing Disability، on the other hand، mostly targets the mental and psychological effects of hearing loss. Questionnaires as one of the simplest tests known to audiologists are practical tools to evaluate hearing disability. Thirty Eight hearing impaired patients including 21 men and 17 women aged 20 to 65 years old participated in this study. Hearing loss was ranged from slight to profound. Basic audiology evaluations including otoscopy، pure tone audiometry، tympanometry، and speech discrimination score were performed for all subjects then Denver Questionnaire was completed by participants. To compare the data، the score of each questionnaire was then compared with Average Pure tone audiometric Thresholds. The results clearly showed that the hearing loss was positively related to the questionnaire score in each subject (P < 0. 05). Quantified Denver Scale of Communication Function has a great consistency with pure tone audiometry and it could be useful in evaluating hearing disability.

Voice onset time has been known to be the most reliable acoustic cue in differentiating voiced and voiceless stops. It can also be used in describing or categorizing various developmental، neuromotor and/or linguistic disorders. Values of voice onset time have been determined for many languages، and in the present study، voice onset time values were investigated for Persian language (Standard dialect). In this study، 44 healthy subjects، who were selected through convenient sampling method، produced each of 42 monosyllabic words twice. All stimuli contained 7 Persian stops in the initial position. Using Praat software، the voice onset time values were calculated in milliseconds according to waveform and wideband spectrograms. Vowel effect، sex differences، and the effect of place of articulation on VOT were analyzed. No significant difference was found for the voice onset times obtained from male and female Persian speakers (P > 0. 050). However، vowel and place of articulation had a significant effect on the voice onset times (P < 0. 001). The mean of voice onset time values for /b/، /p/، /d/، /t/، /g/، /k/، /G/ consonants and for [c] and [ɟ] allophones، along with their standard deviations، were 12. 41 (12. 7)، 78. 27 (18. 1)، 89. 44 (20. 9)، 16. 63 (9. 8)، 100. 73 (20)، 30. 34 (9. 1)، 23. 98 (8. 69)، 33. 6 (7. 7) and 103. 13 (18) ms respectively. It was revealed through this study that voice onset time values are the same for Persian-speaking men and women. However، like many other languages، back and high vowels and back place of articulation increased VOT values. Moreover، the results indicated that voiceless stops had long voicing lags and were aspirated in Persian language. On the other hand، voiced stops had positive VOT values and short voicing lags.

ACL Tearing is one of the most common injuries among athletes. In previous studies، the association between ACL injury and factors such as gender، age، type of sport activity، level of sexual hormones and joint laxity has been evaluated. Although diminished endurance of the lower trunk and core body muscles seems to play a potential role in ACL injury، these factors have not been evaluated adequately. The main objective of the present study is to assess the relationship between core stability and rupture of anterior cruciate ligament in soccer players. In this cross-sectional study، the endurance of trunk extensors، trunk flexors and trunk lateral flexors were measured in 30 professional soccer players among whom 15 persons had unilateral torn ACL (mean age = 23. 4) and the remaining had normal ACL (mean age = 21. 7). We performed the McGill and Biering-Sorensen tests to measure the endurance of these muscles in both groups utilizing a digital chronometer. The endurance of trunk extensors، trunk flexors and trunk lateral flexors were statistically lower in soccer players with torn ACL compared to the soccer players with normal functioning ACL (P < 0. 05). Diminished endurance of the trunk muscles is a possible factor that increases the chance of ACL rupture in soccer players. This certainly has to be proved with prospective comparative studies and، if it is the case، then increasing the endurance of these muscles can possibly decrease the risk of ACL injury.

The development of visual-perceptual skills in children with Down syndrome (DS) is usually significantly delayed. The aim of this study was to investigate the effects of fine motor activities on the development of visual-perceptual skills in individuals with DS.

In this experimental study، a convenience sample of 18 Down syndrome subjects، aged from 9 to 13 years، were first recruited from an accessible population and then randomly assigned to the intervention or control groups so that the two groups had an equal number of participants. The subjects in the intervention group completed a 24-session program of regular fine motor activities. The Test of Visual-Perceptual Skills-Revised (TVPS-R) was administered before and after the intervention phase. Kolmogorov-Smirnov، independent t، paired t and chi-square tests were used for statistical analysis of the obtained data.

Comparing the pre-treatment results with those achieved after the intervention phase، the intervention group but not the control group showed a significant difference (P < 0. 05 and P = 0. 095، respectively). Moreover، there was a significant difference between the two groups after intervention period (P = 0. 014).

Fine motor activities were effective in enhancing visual-perceptual skills in individuals with DS and this should be considered in the favor of the necessity of administering fine motor intervention programs for this population of children and of educating their parents.

The purpose of this study was comparison of three different methods of presenting TV programs and their impacts on receptive language of deaf people in two stages of consideration in Isfahanian population. (1- Providing program by sign language and lip reading method; presented by a deaf interpreter 2- providing program by lip reading method; presented by a TV broadcaster 3- providing program by combination method; presented by a TV broadcaster and an interpreter). An experimental design was used with a post-test control group. Forty eigth deaf subjects were randomly recruited in this sudy. Then، they devided in to 3 groups. To gather the information، validity and reliability receptive language scale was used. The data were analyzed by ANOVA and ANCOVA methods. SPSS، version16، was. Findings revealed that there is a significant difference between the performances of deaf people of all 3 groups in receptive scale of TV programs (P < 0. 5). Result showed presenting TV programs with combination method (TV broadcaster and interpreter) had the most effect on receptive language scale of deaf people.

Hypernasality refers to the perception of abnormal nasal resonance during the production of oral sounds. Perceptual judgment has been regarded to as the gold standard for rating hypernasality but it has been associated with poor reliability. Recently، there has been a significant interest in developing acoustic measures to augment perceptual judgment. The aim of this study was to apply one-third-octave analysis to the evaluation of hypernasality in children with cleft palate/lip during vowel production and to compare the results with those obtained from their normal peers.

This descriptive-analytic cross-sectional study was conducted on 10 cleft palate children with or without cleft lip who suffered from moderate to severe levels of hypernasality (7 males، 3 females; mean age 8. 01 ± 2. 7) and 20 normal controls (14 males، 6 females; mean age 8. 17 ± 2. 2). The speech material was the vowel /i/ produced by each speaker. The obtained samples were then acoustically analyzed using Praat software and the results were analyzed through independent t test using SPSS package version 16.

The results showed that the speakers with moderate to severe hypernasality had significantly higher energy levels for the one-third-octave bands centered at 630، 800، 1000، and 1600 Hz than those with normal resonance.

This study showed that one-third-octave analysis is an appropriate tool for quantifying perceived severity of hypernasality due to cleft palate with or without cleft lip.

The purpose of this study was to investigate the efficacy of Dohsa-hou psychic rehabilitation in reducing attention deficits and hyperactivity symptoms and in increasing social skills in a group of children with attention deficit hyperactivity disorder (named hereafter ADHD). A quasi-experimental method with pre-test، post-test and control group was adopted in this study. Twenty-four children with ADHD were recruited from the clients referred to Borna Occupational Therapy Center and were randomly divided into control and experimental groups. Prior to the initiation of the study، the parents of children completed the Conner’s Parents Rating Scale form، Children Symptoms Inventory-the 4th edition and Social Skills Questionnaire (parent form). At the termination of the study، they re-evaluated and completed these questionnaires once again. The Dohsa-hou was introduced to experimental group in twelve sessions held twice a week. The data from rating scales were statistically analyzed via ANCOVA and Independent t test using SPSS software program version 16. The results confirmed all hypotheses. The results of covariance analysis indicated the significant effect of Dohsa-hou psychic rehabilitation method on the social interactions and hyperactive signs of children suffering from ADHD. It was shown through the study that the application of Dohsa-hou techniques can increase the attention and decrease the hyperactivity and impulsiveness of these children (P = 0. 001). The findings showed that it is possible، through using psychological rehabilitation and preventive efforts، to enhance social skills and reduce the symptoms of over activity in ADHD children. This method can be introduced to exceptional education staff and also to the families to improve the social interactions of children with symptoms of hyperactivity.

Vitiligo is a systemic disease which leads to the destruction of melanocytes of the body. The hallmark of vitiligo is the formation of white patches in the affected skin but، because of the presence of melanocytes in the auditory and vestibular apparatuses، these systems may also be involved at some point in the course of the disease. 21 patients with vitiligo (12 females، 9 males) and 21 healthy controls (11 females، 10 males) were enrolled in this case-control study. Pure tone audiometry (PTA)، Auditory brainstem responses (ABR) and Vestibular evoked myogenic potential (VEMP) were carried out for all participants. High frequency sensory neural hearing loss was indicated in 8 (38. 09%) patients. ABR analysis revealed that 10 (47. 61%) patients had an abnormal increase in latency of the wave III، which was statistically meaningful in both right and left ears (P = 0. 024 and P = 0. 001، respectively) and that 6 subjects (28. 57%) had an abnormal prolongation of the IPL I-III. However، findings from the VEMP measurements showed no recorded responses in the left ear of 1 (4. 76%) patient and statistically significant prolongations in the latency of the p13 were shown in 5 (23. 80%) patients (P = 0. 001). Because of antioxidant، ion-recycling and protective roles of melanocytes in the auditory and vestibular systems، the involvements of these systems are possible in vitiligo vulgaris.

Trunk is a base for rotational movement patterns in shoulder and pelvic girdles and maintains the stabilization of spine، pelvis and lower extremities during movements. Dynamic trunk stability is provided by the muscles and dysfunction of them could cause musculoskeletal problems in other parts of the body. Patellofemoral pain syndrome (PFPS) is one of the most common knee disorders. Due to the prevalence of this disease in young people and the function of trunk muscles to stabilize the proximal joints for distal parts movement، it seems necessary to examine the importance of trunk stabilizers muscles on PFPS. The purpose of this study was to compare the strength and endurance in trunk stabilizer muscles between healthy people and subjects with PFPS. Fifteen participants with PFPS and fifteen healthy subjects were recruited in this study. Trunk muscles strength and endurance including trunk extensors، trunk flexors، right and left lateral trunk flexors were compared in two groups. The patient''s pain intensity was measured by Visual Analog Scale. Strength and endurance of trunk stabilizer muscles in patients with patellofemoral pain syndrome in flexor muscles (P = 0. 001)، extensor (P = 0. 005) and right (P = 0. 016) and left (P = 0. 058) lateral flexors was significantly lower than the healthy group. No significant correlation was determined between pain intensity and decreased trunk muscle endurance. It seems necessary to be considered trunk muscle strength and endurance exercise in common rehabilitation program for PFPS treatment.

Studding various aspects of stuttering is necessary for better understanding of the complex and multi- factorial nature of the disorder. Therefore، investigating stuttering from a linguistic point of view to determine how linguistic factors can affect it is of particular importance. The goal of this study was determine the frequency of word- and nonworddisfluencies in Persian-speaking adult stutterers. 15 Persian-speaking adult stutterers with the age more than 15 years were asked to repeat two separate lists of words and nonwords. 60 words containing 2-5 syllables with various frequencies of occurrence in Persian language were initially selected and 60 nonwords were made based on them so that at least 50 percent of their phonems were changed. Data was analysed via SPSS software. Study results showed that the frequency of disfluencies on words significantly differ from that on nonwords. Disfluencies over nonwords are remarkeablely more frequent that word disfluencies (P = 0. 05). The results of third study indicate a significant increased stuttering on nonwords than on real words when Persian speaking adult stutterers repeated these two kinds of words.

The rate of mild mental retardation is about 2 percent among school children. These children are able to satisfy their needs and meet the community expectations. Therefore، educational programs must be designed in such a way that they help this population develop suitable and effective social relations. The aim of the present study was to investigate the efficacy of drama therapy on adjusting the behaviors of mild mentally retarded girls with age range of 14 to 30 years. The rate of mild mental retardation is about 2 percent among school children. These children are able to satisfy their needs and meet the community expectations. Therefore، educational programs must be designed in such a way that they help this population develop suitable and effective social relations. The aim of the present study was to investigate the efficacy of drama therapy on adjusting the behaviors of mild mentally retarded girls with age range of 14 to 30 years. Data analysis indicated that the scores of adjusting behavior were significantly different comparing pre- and post-test condition and this difference was positive (P = 0. 002). In the studied sample، drama therapy improved adjusting behavior.

Musculoskeletal disorders cover a broad group of occupational clinical disorders. The purpose of this study was to analyze musculoskeletal disorder risk in tutors by QEC method and investigate the effect of 8 weeks selective and corrective exercise and occupational ergonomic interventions on their encounter. Nordic questionnaire and the quick analysis method (QEC) were used in four tasks of teachers. The Nordic questionnaires were distributed among 230 teachers، and then 30 teachers with musculoskeletal disorders were identified and participated in a selective corrective program and ergonomic interventions for duration of 8 weeks. The results indicated that %72. 7 of teachers reported job environment as a major factor in musculoskeletal disorders and %75 of teacher’s responsibilities were in the high level of risk. Significant differences were observed in teacher’s duties (P < 0. 05) according to our finding، teaching and، writing on the board (%57. 6)، and also sitting behind the desk (%56. 7) had the highest risks based on QEC results. After observation and student’s assignments (%54. 8)، teaching and observing the class in standing position (%43. 1) had more levels of risk. Musculoskeletal disorders were decreased in four duties after 8-week exercise intervention (P < 0. 05). It could be concluded that the workload was generally high in teaching environment. The general consensus was that teaching and practical sessions should be organized based on ergonomic principles and safe place. Also، selective corrective exercises could be an effective way to decrease the level of risk.

Mean length of utterance in morphemes (MLU) is widely used as a general index of language development in pre-school children. Because of insufficient data on Persian language development in Iran، this study examined the MLU of Persian-speaking children and its relation to their in an attempt to help improving clinical decision making. This cross-sectional study was conducted on 171 typically-developing children 2. 5-5. 5 years of age who were recruited from nursery settings of Isfahan، Iran. The sample was selected using a mixed method of sampling and divided into six age groups. After an informal conversation with each child to gauge whether the child appeared to be typically developing in terms of language and cognitive levels، speech therapists played with and tape-recorded them. Each child''s MLU was calculated for 75 complete and intelligible utterances longer than one word. The mean and standard deviation of MLU were computed for each age group within six-month intervals. The correlation between age and MLU was also investigated. The children’s mean MLU increased between 37-42 and 43-48 months and also between 43-48 and 49-54 months of age. The increase in MLU from the first age group onward was statistically significant. The correlation between age in months and MLU in morphemes was significant، r (171) = 0. 47، P < 0. 005. The average MLU of the children in this study-and similar studies of Persian-speaking children is much higher than that reported for English-speaking children، and the correlation with age lower; mainly because of morpho-syntactic differences between languages. Age sensitivity of MLU in Persian، however، indicates its capability as a developmental scale for monitoring syntax development in Persian-speaking children which needs to be deeply investigated in relation to Persian language-specific features، either.

Independence in bending and picking up an object from the floor has great importance in activities of daily living. Asymmetrical distribution of weight is effective factor in imbalance and postural instability in people with hemiparesis. This study aimed to investigate the correlation between symmetry index and postural sway in selected dynamic task and functional balance tests in people with right and left chronic hemiparesis. Seventeen hemiparetic patients (6 right، 11 left) were selected by simple non-probability sampling. Weight bearing symmetry was measured by two weight scales. Postural sway parameters of the dynamic tasks were examined by force platform and Functional Reach and Timed Up and Go tests were used to measure functional balance. Average for a value (standard deviation) for the months after stroke in right and left hemiparesis were 49. 33 (43. 06) and 75. 36 (91. 13) respectively. Symmetry index showed high to very high correlation (r = 0. 865-0. 925) with average COP velocity in right-far target and with total path excursion of COP in all near targets and right-far target in right hemiparesis and high correlation (r = -0. 716) with maximum COP displacement in anterior-posterior direction in left-near target in left hemiparesis. Similarly، high correlation (r = -0. 716) was found with maximum COP displacement in anterior-posterior direction in left-near target in left hemiparesis. Also it had no significant correlation with maximum COP displacement in anterior-posterior direction in right hemiparesis and with maximum COP displacement in medial-lateral direction in left hemiparesis. Symmetry index had a moderate correlation (r = -0. 623) with Functional Reach test in left-sided hemiparesis but had no correlation with balance tests in right-sided hemiparesis. Because of difference in symmetry index correlation with postural sway parameters in dynamic task and functional balance tests in right and left hemiparesis، it can be noted that these two groups use different strategies while doing this task.

Besides having major effects on the stability of lumbar vertebrae, Diaphragm and abdominal muscles play an important role in respiration. The function of these muscles may gradually change in patients with chronic low back pain leading to an inefficacious respiration. The aim of this study was to evaluate respiratory volumes in a group of patients with chronic low back pain and to compare these volumes with those of healthy subjects. Eighty subjects were recruited in this case-control study. Respiratory volumes were measured in 40 patients with chronic low back pain and in 40 sex- and age-matched healthy control subjects. Data on pain severity, previous physiotherapeutic intervention, duration of pain, was recorded. The respiratory volumes were measured by a spirometer. The t test was used for statistical analysis. The results showed that subjects in the case group had lower VC (in), VC (ex), FVC, FEV1, and F1V1 values than those in the control group (P £ 0.5). The two groups had no significant difference in terms of FEF 25%, FEF 50%, FEF 75%, PEF, PIF, and MEF (P > 0.5). A tendency toward altered contration in the diaphragm and abdominal muscles of patients with chronic low back pain may gradually result in muscle weakness and a changed respiratory pattern.

Parents play a crucial role in the success of their disabled children’s rehabilitation programs، by bringing them regularly for therapy sessions. However، not all of parents are always present at rehabilitation clinics at their appointment times. The purpose of this study was to determine which barriers the parents are mostly confronted with in compliance with the regular attendance to therapy sessions. In this survey، parents of ninety two disabled children were interviewed. These children were receiving occupational therapy، speech therapy or physiotherapy in rehabilitation outpatient clinics in Birjand، Iran. A questionnaire composed of closed and open ended questions was used for this purpose. The questionnaire was approved by using Lawshe method and based on the opinions of eleven experts، the content validity ratio was calculated to be 0. 73، and test-retest reliability was 0. 89. Data analysis was performed using Chi-square، exact fisher test or Independent sample t-test when appropriate. Among all parents، fourthy four subjects (47. 8%) were compliant with regular attendance to therapy sessions. According to parental responses to questions، «high cost of rehabilitation services»، «long distance between home and rehabilitation clinics»، «difficulties in carrying the child»، «poor weather conditions in some seasons» and «not having enough time» were the most important barriers to compliance. There was a significant correlation between «morning-only opening hours of rehabilitation clinics» and parental compliance (P = 0. 020، OR = 0. 181، CI = 0. 037-0. 879). Considering the benefits of regular attendance to therapy sessions on children''s improvement and considering the results of this study، we suggest future work should explore the effects of removal of each particular barrier on parent compliance with regular attendance to their children''s therapy sessions.

Visual impairment has an impact on all aspects of a child’s development. The purpose of this study was to compare motor speed among children and adolescents with blindness and their normal peers. In this cross-sectional study، 30 blind students and 30 normal counterparts were randomly recruited from the elementary schools of Tehran، Iran. Finger tapping task was used as a neuropsychological test of motor speed. The collected data were analyzed through independent t-test. Findings showed that there was a significant difference between the two groups regarding motor speed. When vision is impaired، difficulties are also arisen in motor abilities. The co-occurring of motor and visual deficits should be considered in the clinical assessment and intervention of blind persons.

In stuttering، the smooth flow of speech is interrupted by multiple and usually long hesitations which are perceived as blocks or prolongations. Various language impairments have been documented in stuttering including working memory which has recently attracted the interest of scientists. The goal of this study is reviewing the literature on this subject. A review of the latest literature on the subject of working memory in children with stuttering was performed using such keywords as “stuttering”، “working memory” and “nonword repetition” in ISI، Science Direct، PubMed، Google Scholar، Proquest، and Scopus databases. From the obtained articles، those which fulfilled the entry criteria were selected for the review. Furthermore، other resources that related to Speech and language pathology was used for writing this article. From a total of 50 articles، 24 most relevant studies were selected for a full review. It was evident from the review that children with stuttering had some deficits in the working memorywhen compared to normal children. When designing models to explainthe nature of occurrence and development of stuttering، it is suggested to pay more attention to the role of working memory.