مجله پژوهش در علوم توانبخشی
سال نهم شماره 2 (خرداد و تیر 1392)

Multiple Sclerosis (MS) is the most common and progressive neurology sickness among young adults. Balance disorder is obviously seen with other symptoms. The purpose of this study was to examine the effects of a selected aquatic exercise program on the balance of subjects with multiple sclerosis. Thirty volunteer men with MS were participated from Isfahan Multiple Sclerosis Association in this study. They were randomly divided into two groups of fifteen people: control (Mean ± SD age; 35. 6 ± 4. 7 Years old، height ± SD; 176. 7 ± 5. 80 cm، weight ± SD; 73. 41 ± 8. 61 kg) and experimental (Mean ± SD age; 32. 4 ± 3. 8 years old، height ± SD; 174. 5 ± 4. 51cm، weight ± SD; 71. 8 ± 7/52 Kg). The experimental group carried out selected aquatic exercises three days a week for four weeks. Control group asked to continue their routine activities during this period. Balance levels were evaluated using Berg test in experimental groups before and just after the aquatic exercises. Descriptive statistics، independent and paired samples t test were used for statistical analysis (P < 0. 05). Between two groups in pre-test scores، finding showed no significant difference in balance status (P > 0. 05)، but in post-test، significant differences were seen between two groups (P < 0. 05). Paired sample t test showed that balance significantly differed between pre- and post- treatments for the experimental group while no differences observed in the control group (P > 0. 05). Aquatic exercise obviously improves balance in subjects with MS. Therefore، it could be considered as an effective intervention program in training sessions.

Speech sound disorder is one of the most prevalent developmental communication disorders affecting approximately 8. 7 percent of school-age children. Speech sound disorders require precise diagnosis and assessment which can be reached via formal and informal evaluations. Speech-language pathologists generally use the Phonetic Information Test to detect the disordered pronunciation of sounds. Unfortunately، the reliability and validity of this test have not been determined yet. The purpose of the present study was to test the reliability and validity of Phonetic Information Test as the first stage of its standardizing. At the first phase of this descriptive and methodological study، the content validity of the test was determined through quantifying the comments of 20 speech-language pathologists. Then، 150 children with the age range of 3 to 6 years were evaluated using the test and their scores were statistically analyzed by the two methods of Kuder-Richardson 20 and test-retest correlation to determine the reliability of the test. Data analysis was performedviaSPSS13. The CVR value for words was higher than 42percent except for /kæʧæ/. Kuder-Richardson20 and correlation coefficient results in the three age groups demonstrated that the test has appropriate reliability. The results of this study showed that the phonetic test meets validity and reliability requirements and، therefore، is sufficiently accurate to be used in the diagnosis and assessment of articulation impairments.

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder usually characterized by poor coordination and clumsiness. It seems that rhythmic aerobic exercise has the same effect on affected children’s balance as play therapy. The aim of this study was to compare the effect of an aerobic exercise program with that of group play therapy on the balance abilities of children with ADHD. In this study، 26 children with attention deficit hyperactivity disorder (4 girls and 22 boys) were assigned to 2 experimental groups (group-based play therapy and aerobic exercise groups) and one control group. Each experimental group received its respective intervention program 3 sessions a week، lasting 45 to 60 minutes each، over an 8-week period. Significant differences were observed between group-based play therapy group and aerobic group regarding dynamic balance. There was، however، no significant difference between experimental groups as long as static balance was concerned. Although group-based play therapy had greater impact on improving the balance of children with ADHD، aerobic exercise program had significant effects on improving static balance. Therefore adding aerobic exercise to routine group play therapy may bring more benefits to children with ADHD.

Increased muscle strength and resistance exercises are potential ways to improve the balance. In this study، we compared the effect of progressive resistive exercise versus combined resistance training with pulsed electromagnetic fields on muscle strength and balance in severe haemophilia A patients. Thirty two severe haemophilia A patients with osteoporosis (aged 18-35 years old)، were assigned randomly to a resistance training (RT)، resistance training with pulsed electromagnetic field (RTPEMF) and control groups. RT group performed trunk، upper and lower limb resistance exercises (progressively، as 50-60% 1RM) for approximately 30-40 min، and RTPEMF group was exposed to 30-minute PEMF with frequency of 30 Hz، and 40 Gauss as well as 30-minute resistance training with lower repetitions for 3 days weekly for 6 weeks. Muscle strength based on 1RM and balance tests (one leg standing، functional reach test، near tandem stand، timed up and go، timed sit to stand) were measured before and after 6 weeks of intervention. Muscle strength and balance tests improved significantly in the RT and RTPEMF groups related to control group and baseline values (P < 0. 05). RT and RTPEMF are effective to improve the muscular strength and balance in severe haemophilic A patients.

Reading impairment is a neurodevelopmental disorder with some deficits in cognition and motor skills. Neurofeedback، as a new treatment approach، can improve the functioning of individuals with the disorder through regulating electroencephalographic (EEG) abnormalities. The purpose of this study was to investigate the effectiveness of neurofeedback balance protocol on improving balance performance and attention shifting in children with reading disorders.

In this 20-session single subject study، 4 children (1 female) aging 8 to12 years completed twelve 30-miniute neurofeedback sessions. Repeated were performed during the baseline، treatment and follow-up stages of the study by means of the 2nd subtest of BOTMP for balance performance and the Posner Paradigm for shifting attention.

The results showed that the effect of treatment on balance performance was high (Cohen’s d > 0. 8) in all subjects but one and that attention shifting were improved only in some cases.

Consequently، neurofeedback balance protocol can improve balance and، to some extents، attention shifting in children with reading disorders.

Most daily activities require cognitive processing in addition to balance demands they exert on the nervous system. The purpose of the present study was to compare the interference of selective attention and attention-shifting tasks in balance among the youth. In this cross-sectional study، thirty male students (mean age 22. 47 ± 2. 27 years) were recruited from available research pools. Subjects were asked to perform single-foot standing task، which was measure by Biodex System، alone or coincidentally with either selective attention or attention shifting tasks. Selective attention and attention shifting were respectively evaluated via a “stroop test” and the Neurological Attention Shifting test. ANOVA with repeated measures was used for the statistical analysis of the data. Findings showed that both attentional tasks decreased balance performance on both frontal and sagittal plans and also overally (P < 0. 05). Similarly، attentional task scores were reduced by the balance task (P < 0. 05). The two attentional tasks interfere differently with balance task performance (P < 0. 05). Because same brain structures mediate attention shifting and selective attention processes and because these processes are interrelated، they may interfere with balance they combined with each other.

Pronated foot is one of the most common abnormalities associated with navicular drop and increased internal rotation of the hip and may be influenced by the hip muscles. The purpose of this study was to examine the affect of a selected exercise program on pronated foot correction. Thirty male subjects (Mean age ± SD; 21. 36 ± 2. 07 years، weight ± SD; 71. 93 ± 7. 62 kg، height ± SD; 177. 33 ± 7. 52 cm) with pronated foot participated in this study and randomly divided into two control and experimental groups. Pronated foot was measured by navicular drop test and medial rotation of hip was measured by goniometric method. The strength of hip abductor and lateral rotator muscles was assessed using hand-held dynamometer. The experimental group participated in strength training program three times a week for six weeks. Control group were asked to continue their daily activity. After 6 weeks، navicular drop، hip internal rotation and muscles strength were measured again. Data analysis with paired and independent samples t-test was performed. The results revealed that in experimental group، there was a hip internal rotation and navicular drop reduction with increase in hip muscle strength. The experimental group has significant decreased in the rate of hip internal rotation and pronated foot in comparison to control group (P £ 0. 05). The results indicated that increasing in hip abductor and lateral rotator muscles strength by a selected exercise program may prevent foot pronation and help to correct this deformity.

Attention deficit - hyperactivity disorder (ADHD) is a common childhood disorder which should be effectively treated in order to decrease the severity of its symptoms. In the present study، the effects of proprioceptive and vestibular sensory integration were aimed to be determined as a treatment approach for alleviating the symptoms of this disorder. In this study a quasi-experimental method with pretest، posttest، and control group was adopted. Participants were thirty-two 6-to-12 year-old students with ADHD studying at the schools of Semnan، Iran. They were randomly selected and assigned to either an experimental (n = 16) or control group (n = 16). The experimental group received a sensory integration intervention program (with an emphasis on Proprioceptive and Vestibular senses) that consisted of 12 sessions، lasting 2 hours each and held two times a week. The Child Symptom Inventory- 4 (CSI-4) was used to evaluate the symptoms of the disorder. The obtained data were statistically analyzed by Shapiro-Wilk test، and also by univariate and multivariate analysis of covariance. According to the reports of teachers، the experimental group had better scores for inattention and hyperactivity than did the control group (P > 0. 001). Impulsivity scores، however، was not significantly reduced in the experimental group compared to the control group (P < 0. 05). According to parents، the experimental group had better Performance than did the control group in the domains of inattention، hyperactivity and impulsivity (P > 0. 001). The intervention involving sensory- motor integration with an emphasis on proprioceptive and vestibular senses significantly improved attention deficits، hyperactivity and impulsivity in the studied population.

Postural control may be a key component in daily activities and sport exercises. Lower limb muscles have a critical role in to maintain postural stability. The purpose of this study was to investigate the relationship between proximal and distal lower limb muscles activities (gluteus medius، tibialis anterior) to reach stabilization time during single-leg jump-landing. Twenty male physical education students participated in this study. Subject’s muscles activities were evaluated and recorded via electromyography system. Time to stabilization was evaluated in anterior-posterior and medial-lateral directions on force plate system while jump-landing task. In order to analyze the data، the Pearson correlation test at a significance level of 0. 05 was used. The results showed that there is no significant correlation between tibialis anterior muscle activity and time to stabilization in three directions (P > 0. 05). Moreover، results identified no correlation between gluteus medius muscle activity and time to stabilization in Anterior - posterior and overall directions (P > 0. 05). However، significant correlation was found between gluteus medius muscle activity and time to stabilization in medial-lateral (P < 0. 05). Our findings suggest that less gluteus medius activity may lead to poor performance of functional balance tasks. Therefore; hip abductor strengthening can be considered to improve medial-lateral postural control.

Exercise and physical activity have the potential of improving the health status and quality of life of addicted people. The aim of this study was to compare the effects of an 8-week exercise therapy program with that of physioball on the correction of thoracic kyphosis، increasing balance (static and dynamic) and improving the quality of life of addicted men after withdrawing drugs.

30 men with kyphosis، who aged 20 to 40 years، were selected through convenient sampling method and then randomly divided into experimental and control groups. All subjects completed their addiction treatment two months prior to the initiation of the study. Kyphosis degree، dynamic balance، static balance and quality of life were respectively measured by flexible ruler، Star excursion balance test (STEB)، Romberg test and Quality of Life Questionnaire-Short Form (SF-36). Having signed a formal contest، subjects received their special training under supervision of a corrective and therapeutic exercise expert three sessions a week over 8 weeks. Each session lasted 30 to 90 min. Repeated measure ANOVA was used for statistical analysis with P ≤ 0. 05.

The changes and interactions of all three variables of balance and quality of life were significant in the exercise group upon comparing pre- and post-test results (P < 0. 05). This meant that applied exercise had brought about a positive effect. Between-group differences were not significant in any of variables (P > 0. 05).

According to the results of this study، the physioball program is competent in improving thoracic kyphosis abnormality and increasing balance and the quality of life of the addicted and it can be used as an effective and suitable complementary method for rehabilitating addicted people in addiction treatment centers.

Genuvarum and genuvalgum are the most prevalent of lower extremity alignment abnormalities. For assessment، prevention and treatment of these abnormalities exact assessment and presentation of statistics and indexes are necessary. The aim of the present study was to determine lower extremity alignment indexes (valgum and varum of knee) for normal men and women in Hamadan city.

In this research، five-hundred healthy subjects (250 female and 250 male) were randomly selected from 5 geographical regions of Hamadan (north، south، east، west، center)، and 5 age groups of 9-14، 15-24، 25-44، 45-64، and over 65. Intercondylar (IC) and intermalleolar (IM) distances were measured to assess genuvarum and genuvalgum، respectively. Vernier caliper was used as the measurement device. Data analysis was done by determining mean and standard deviation for desired ages and sexes، and an Independent t for measuring differences of distances in IC and IM in men and woman. All data were analyzed by SPSS، version 16 (P ≤ 0. 05).

Based on the results، IC distances in all age groups in men (P < 0. 001) and IM distances in all age groups in women (P = 0. 032) were more.

According to the results of this study normal indexes of lower extremity alignment in men and women were determined and also، in age 14 in girls and boys and 64 in women، a noticeable increase was seen in IC distances.

Stroke is one of the most common life-threatening neurologic disorders and is among the most important causes of disability in adult life. Unilateral upper limb motor impairment is one of the main causes of dependence in daily living activities. The aim of this study was to demonstrate the effects of simultaneously using both task-oriented exercise and constraint-induces movement therapy on adult hemiplegic patients’ upper limb performance. In this semi empirical-intervention study، 26 patients with CVA، who aged 40 to 65 years، were recruited from occupational therapy clinics and rehabilitation centers of Qazvin، Iran using convenience sampling. They performed task-oriented exercises 1 hour a day، while simultaneously under went 5 hours of CIMT، 3 days a week for 8 weeks. Fugl-Meyer test and Action Research Arm Test were used to evaluate upper limb motor performance. Paired t test was conducted for statistical analysis of data using SPSS 18 (α = 0. 05). Evaluation results showed significant improvements in upper limb functioning following the simultaneous use of task oriented training and CIMT. The results of this study indicate that simultaneous use of task oriented training and CIMT can be viewed as an effective way to improve the performance of the upper limb of stroke patients.

The purpose of this study was to compare laterality in the asymmetric transfer of strength and velocity in children with 11 to 13 years of age. In this semi-empirical study، 28 students (mean age، 11. 6 ± 0. 62 years)، who were recruited from junior high schools of Kashmar، Iran، were divided into two groups of 14 each. One group practiced strength training with the right hand and speed training with the left hand and in another group the usage of hands were reversed، meaning that strength training was practiced with the left hand and speed training with the right one. Participants had practiced for 3 sessionsaweek over a 4-weekperiod. The results of one-way ANOVA showed that there was significant difference in magnitude of strength transfer between the two groups. The magnitude of strength transfer from the left hand to right one was significantly greater than the vise versa (P = 0. 029). However in “Velocity” variable، there was no significant difference. According to results of this study and specialization of right hemisphere in control of strength، it seems that the magnitude of strength transfer from left hand to right hand is greater than the opposite direction.

The traditional and modified sit-and-reach tests (SRT) are commonly used to assess the flexibility of the spine and hamstring muscles. The aim of this study was to explore the relationship between traditional and modified sit-and-reach tests scores with some anthropometric variables in secondary boy students.

Ninety-two male students (Mean age ± SD; 13. 22 ± 5. 67 years) participated in this study. Anthropometric variables of weight، height، lower limbs length، trunk length and ratio of the lower extremity length to the upper body were measured. Then subjects performed traditional and modified flexibility tests. Linear regression was used to calculate the coefficient of determination and standardized B coefficient.

The results indicated that، coefficient of determination of modified test was less than the coefficient of determination of traditional test (P = 0. 081 and P = 0. 179، respectively). Also، the length of upper extremity and height had the most and the least impacts on the results of traditional (B = 1. 24 and B = 0. 80، respectively) and modified (B = 2. 61 and B = -1. 82، respectively) flexibility tests.

These findings show that the anthropometric variables affect on the scores of both traditional and modified sit and reach tests relatively. Therefore the individual differences should be considered while application of these selected tests.

Cerebral palsy (CP) is included a group of non-progressive disturbances that occur in developing brain and led to permanent movement disorders. Although Children''s participation is influenced by their movement disorders، environmental factors can be considered as barriers or facilitators to their participation. This study was aimed to investigate the influence of child''s disability on encountering environmental barriers to participation of children with cerebral palsy.

Seventy five parents of children with CP were participated in this study. They aged 5-12 years to include for this research. The Craig hospital inventory of environmental factors (CHIEF) and personal characteristic questionnaires were used to collect the data. Also children''s gross motor، manual ability and cognitive level were asked from parents by researcher.

Barriers to participation most commonly reported by parents found in services and assistance and policies subscales. Cognitive، gross motor functioning and manual ability levels were related to the parent perceived barriers.

Findings from this study indicated that the presence of multiple environmental barriers to participate these children in activities. With low function all children encountered more barriers. We can enhance participation by minimizing these barriers and providing more facilitators.

The human foot is a strong mechanical structure that can affect function of the feet. The aim of this study was to determine the immediate effect of foot insole on myoelectric activity and co-contraction of lower leg muscles in individuals with flatfeet in comparison with healthy subjects.

Thirty university male students participated in this study. Subjects were divided into two groups of flatfeet and control. Surface electromyography was used to record muscular activity of tibialis anterior، peroneus longus، medial gastrocnemius and soleus muscles. All subjects walked barefoot along a 15m walkway for three trials. Participants with flatfoot also walked on the walkway while wearing shoes with foot insole.

Findings of this study showed that individuals with flatfoot have more co-contraction ratio in midstance (P < 0. 05) and propulsion (P < 0. 05) sub-phases. The use of foot insole increased co-contraction ratio at heel contact sub-phase (P = 0. 009)، while co-contraction ratio decreased at midstance sub-phase (P = 0. 015).

Results of this study demonstrated using of foot orthotics could reduce the extra muscular activity. According to the effect of foot orthotics on co-contraction ratio at heel contact sub-phase، it could be concluded that excessive motion of rear foot has a non muscular source.

Depression can be an emotional reaction or as a part of biology of MS. Multiple sclerosis usually affects central nervous system which is in charge of limb muscle movements. As a result، most patients will lose muscle strength. The present study aimed to investigate the effect of Pilates training on motor function and depression in subjects with multiple sclerosis.

A quasi-experimental study was designed for this research. Participants were thirty three female individuals with MS (mean ± SD age; 33. 36 ± 9. 447 years، expanded disability status scale or EDSS ± SD; 2. 89 ± 1. 278) who referred to Isfahan multiple sclerosis centers in 2011. The patients were randomly assigned to two groups of experimental (18) and control (15). Depression Questionnaire، 30 seconds chairs stands، and timed up and go tests were used to record psychological and motor functions. The experimental group received an eight-week intervention (three sessions per week). The collected data were then analyzed through ANCOVA via SPSS، version16.

The results revealed a significant difference between control and experimental groups in 30 second chair stand test (F = 232. 394، P < 0. 001)، timed get up and go (F = 265. 199، P < 0. 001)، and depression (F = 92. 000، P < 0. 001).

The main goal of Pilates training is general body improvement and based on results has positive effects on motor function and depression. It seems that these results can just be achieved when this training is added to exercise therapy for MS as a supplementary treatment.

Stuttering is a communication disorder that، in addition to speech fluency، can affect all aspects of personal life. Through numerous researches and also from the experiences of People Who Stutter (PWS)، it is now evident that stuttering can cause an over all sense of life dissatisfaction. The aim of this study was to compare the quality of life in adults with stuttering versus their normal counterparts using the brief version of World Health Organization Quality Of Life Questionnaire. 25 adults with stuttering and 25 adults without stuttering، who were matched for age، sex and education level، participated in this cross-sectional analytic study. Tocollect data، World Health Organization Quality of Life Questionnaire was used. Independent sample t test was conducted for the statistical analysis of the data. The results of data analysis showed that، except for social relationships domain، the difference between the two groups regarding total scores of quality of life، physical health، mental health and environmental health were statistically significant. The results of the present study showed that people who stutter have lower quality of life based on WHOQOL-BREF questionnaire. Thus، it is better to pay appropriate attention to in the quality of life of people who stutter during the evaluation and treatment processes rather than attending solely to speech fluency needs.

Motor skills and functional mobility are mainly necessary for children to perform motor tasks especially their activity daily living. These skills are extremely essential for independence in self-care activities. Delays in self-care may be evident in children with motor problems. Treatment approaches are used by occupational therapists to improve motor function. In recent decades، cognitive orientation to daily occupational performance (also known as CO-OP) is one of the therapeutic approaches. CO-OP is a client-centered and individualized approach. This study reviews the evidence for the effectiveness of the CO-OP approach on motor function in children with developmental coordination disorder.

In this study، a comprehensive review of the literature was conducted via PubMed، Proquest، Informa، Scopus and Google Scholar data bases. The keywords used in this search were “motor-based occupational performance problems”، “CO-OP”. All articles were initially evaluated according to inclusion and exclusion criteria and then selected articles were reviewed.

Of 60 articles found، 8 articles met the inclusion and exclusion criteria and were considered as appropriate for this study.

The review of the studies showed that CO-OP approach is an appropriate approach to improving motor-based occupational performance of children with motor problems.

Many children and young people، who are born deaf or become so in the early months of life، have problems in reading and writing. So، we studied the reading skills of hearing impaired children living in Ahvaz to provide a base for encouraging better progress of reading skills in this population. In an analytical cross-sectional study، which was conducted in the first trimester of 2011-12 academic year، 35 second-graders (n = 23) and third-graders (n = 12) with sever to profound hearing impairment was recruited from two deaf schools of Ahvaz، Iran. Two subtests of the Diagnostic Test of Reading (Shirazi، Nilipur)، namely irregular word reading and nonword reading، were used for obtaining the data of interest. Data showed that the second-graders had better performance in whole-word reading skills than in phonic reading skills. In the third grade، the score of phonic reading was higher than that in the second grade. These differences، however، did not reach statistical significance. The results showed that reading skills in hearing-impaired children developed gradually as like normal children. Children in earlier stages of reading acquisition، use whole-word reading strategy more. As the age and literacy knowledge increase، children improve in phonic reading.