فصلنامه آرشیو توانبخشی
سال پانزدهم شماره 2 (پیاپی 58، تابستان 1393)

Neck pain is the second common musculoskeletal disorders in societies. According to studies، personal characteristics and school bags are predisposing factors for musculoskeletal problems in students. Due to the risk of neck pain، the aim of this study was to investigate the effect of risk factors on high school students. Methods and Materials: This study was carried out on 1000 high school students of Babol، Iran in 2012 and 2013. Students were chosen randomly. Student profiles and school bag characteristics and other information were collected by questionnaire. The VAS was used to assess pain intensity. Results were analyzed by SPSS software. The mean age of students was 15. 96±1. 13. Average bag weight and average bag weight to body weight ratio were 2. 76±0. 97 kg and 4. 47±1. 87%، respectively. Students with neck pain had lower age (P<0. 001)، lower height (P<0. 001)، lower weight (P=0. 002)، and more bag weight to body weight ratio (P=0. 001) than normal students. Use of backpacks was significantly more than other bag types in the students experiencing neck pain (P=0. 002). The results showed that the prevalence of neck pain was greater in students who had smaller physical dimensions. School bag characteristics can also be effective in causing neck pain. Given the importance of students as future adults، detailed investigation into the causes of neck pain prevalence in this age group is necessary. This study can also provide area for appropriate treatment.

A variety of evidence demonstrate altered perceptual functioning during visual processing in the brain of children with autism.it possibly is related to or the cause other diagnostic symptom in autism spectrum. In the present study visual perceptual organization in autistic children is studied. These processes require central coherence and typical functional connectivity among neural structure in the brain. 25 high functioning autistic and 25 neuro -typical boys were assessed in term of visual perceptual processing. Visual stimuli include fragmented (incomplete) and complete images of animate and inanimate objects which presented in a monitor. The subject’s task was rapid and accurate naming of images that have been seen. Responses compare by independent-T. Also the effect of completeness and image type factors on samples’ visual processing analyzed by repeated measure analysis of variance. Interaction effects of completeness, image type and group on subjects’ visual processing were significant (p<0.05). Also autistic children have lower performance in naming of incomplete image as well as inanimate object recognition (p=0.000); however, both groups were similar in recognition of whole image (p=0.597). On the other hand, all the samples perform better in detection of complete image than fragmented image (p=0.000). Failure to recognize the fragmented images of object in particular, inanimate, could be marker of impaired processes related to central coherence of visual information in the brain of autistic children. Detection of these images in these children was different from neuro-typical children significantly. That may be the indicator of impaired visual perceptual organization and an evidence for disrupted functional connectivity among the brain area in children with autism.

There is an increasing evidence that show fear of pain and fear of re-injury are fundamental mechanisms in progress of pain and disability in the patients. Cervical stabilization training is a method of exercise which is designed to improved the mechanisms by which the cervical spine maintains a stable, injury-free state. The aim of this study was to compare effectiveness of stabilization exercises with maximum Isometric exercises on fear avoidance belief in Chronic Non-Specific Neck Pain. In clinical trail study fifty patients with chronic neck pain were recruited. Subjects were randomly assigned to either a stabilization (n=25) or a maximum isometric exercise group (n=25). Before and after intervention (4,8,12 weeks) pain was assessed with visual analog scale (ordinal), disability (ordinal) with Neck Stability Index (NDI), Fear Avoidance of Belief with Fear Avoidance of Belief Questionnaire (FABQ. A 48 session exercise program which 8 weeks. six session per week, and per session was performed for both groups. Repeated measurement of analysis variance, Independent t-test and paired t-test were used for comparison between pretreatment and post treatment test results between groups and within groups, respectively. The mean neck pain decreased from 7/16±1/57 in first session to 0/92±0/70 in 12 session in the stabilization group and from 7/12±1/67 in first session to 1/28±0/94in 12 session in maximum isometric group (p=0/482). The mean disability (NDI) decreased from 22/60±3/20 in first session to 11/16±0/90 in 12 session in the stabilization group and from 21/88±2/76 in first session to 14/96±1/48 in 12 session in maximum isometric group (p<0/001). The mean FABQ-W decreased from 35/08±4/48 in first session to 9/08±1/44 in 12 session in the stabilization group and from 34/76±4/63 in first session to 17/44±2/18 in 12 session in maximum isometric group (P<0/001). The mean FABQ-PA decreased from 20/12±2/26 in first session to 9/26±1/01 in 12 session in the stabilization group and from 20/08±2/23 in first session to 11/16±1/14 in 12 session in maximum isometric group (p= 0/938). Decreased all variables in the stabilization group was more useful than maximum isometric group (p<0/05). This study showed that neck specific stabilization exercises and maximum isometric exercises decrease pain, disability, fear of pain and fear of re-injury. Also specific stabilization exercises was more useful than maximum isometric procedure.

The purpose of the present study was the meta-analysis of researches done on harm reduction and addiction treatment. In this study, researches done on harm reduction and remedy were collected by the meta-analysis method. This was done using related keywords, searching the sites and theses of postgraduate studies. Finally, studies which were consistent with the criteria for inclusion in the meta-analysis were selected and desired information which were prepared by the author for testing the hypothesis with a negative questionnaire were extracted. Out of the 11 studies selected, the appropriate statistics to calculate effect size and other required information were recorded and the effect size as well as hypothesis analysis were calculated by CMA2 software. The results of this study show that identified independent variables on harm reduction and remedy have been effective. The value of combined effect size is 0.8 (d =0. 8) and it is statistically considered significant. Since this value is in the range of 0.8 to 0.7, according to Cohen's classification, it is evaluated as average. Variables such as having a theoretical basis, the status of entry (New 6 months and more), the average of daily injection, integrated holistic therapy, medical interventions, quality of healthcare services, social esteem, methadone treatment and therapeutic interventions had statistically significant influence on harm reduction and remedy. In order to achieve harm reduction and remedy, the status of entry (New 6 months and more), the average of daily injection, integrated holistic therapy, medical interventions, quality of healthcare services, social esteem, methadone treatment and therapeutic interventions related to nations must be considered.

Chronic Pelvic Pain (CPP), a common health problem in women, characterized by any lower abdominal pain that lasted at least six months or more, with no relation to pregnancy, menstruation and intercourse. The pain can affects on activities of daily living negatively and lead to medical or even surgical treatment. According to our knowledge, there are limited studies related to CPP in Iran. Therefore, present study was aimed to survey on CPP in women attending Pelvic Floor Clinic at the Imam Khomeini University Hospital. Methods and materials: This cross-sectional study was conducted on 516 married women (who were not virgin). Participants completed a designed questionnaire, which included demographic information and questions regarding involvement of gynecologic, urinary, gastrointestinal, musculo - skeletal and psychological systems. After collecting data, binary logistic regression was used to analysis the data. Values of p<0.05 were considered to be significant. 27/9% of women reported current pain in the pelvic area unrelated to menstruation and sexual intercourse, while totally 17/6% suffered from pain over the past 6-12 months or CPP. There were a significant relationship between CPP, chronic low back pain and dyspareunia (p=0.04 and p=0.03 respectively). Our data did not show significant difference between the prevalence of CPP, types of delivery and history of having trauma to the spine and pelvis. This comprehensive study provided an extensive and multidimensional approach regarding to CPP in our society. As for to estimation 27.9% pelvic pain and 17.6% CPP and their relationship with gynecological, urinary, musculoskeletal and gastrointestinal systems, we suggest doing more population-based epidemiological studies, also emphasis on multidisciplinary approach for managing these patients.

speech sound disorders are among the most common speech disorders in children. Non-speech oral motor exercises have long been used as a facilitative activity throughout therapy sessions for a wide variety of speech disorders by speech-language pathologists. But there are few empirical controlled data to evaluate its effectiveness. This study aimed at comparing the effects of therapeutic intervention based on production training with non-speech oral motor exercises on improving speech of children with phonological disorders. This quasi-experimental interventional study with single subject design and multiple baselines recruited six 4-6 Farsi- speaking children with phonological disorders but normal oral motor status. Three therapeutic plans on two sounds with different distinctive features were conducted: production training, non-speech oral motor exercises and combined method. The results were analyzed using level, trend &slope analysis with excel software. Children who had received non-speech oral motor therapy, did not show any change in their speech pattern but children who received production therapy showed 91% improvement and those who received combined method showed 86% improvement in the target sounds. Findings of this investigation do not support the use of non-speech oral motor exercises in order to improve the speech of children with phonological disorders. This study seems to reveal production training as an effective method to improve speech production of children with phonological disorders.

The goal of this study is to compare the effects of the modified dynamic and conventional static splints on pain and functional abilities of hand in women with De Quervain syndrome. This quasi-experimental study was performed on 24 women (age between 35-55) with De‌‌ Quervain syndrome in orthotics and Prosthetics department of Tehran university of medical sciences, during 2012-2013. Patients assigned randomly in two groups using static and dynamic thumb spica splints for two weeks. Persian version of DASH (Disability of Arm, Shoulder and Hand) questionnaire was used to assess the pain and functional abilities of hand and VAS(visual analogue scale) was used to assess patient’s satisfaction of splint. Data were analyzed using SPSS-17 by independent and paired t-test. In both groups, an improvement in pain level and performance capabilities was observed after using the splints. In comparison of pain level and performance capability, there is no significant difference between two groups after using splints (p>0.05). On the other side, it was determined that the satisfaction level of the patients who had used dynamic splint was higher. Inserting a joint to the static thumb spica leads to patient's satisfaction and relief and also there is no significant difference between two groups in pain recovery and abilities improvement.

Autism is a pervasive developmental disability that impress on social interaction, verbal and nonverbal communication and stereotyped behavioral patterns. Regarding initiation difficulties of these children and weakness of interventions in creation of motivation,in this study we tried to examine effect pivotal response treatment method on initiation's ability of autistic children. In this randomized control trial (RCT) study, according to inclusion and exclusion criteria, 30 autistic participants (6 to 11 years old) that matched based on age, gender and mean length utterance, from especial clinics of Hamedan’s autistic persons selected and placed randomly in one of groups of intervention and control. Sessions was administered individually, lasting for 60 minutes and 2 days a week for 3 months. Both groups of children were tested before and after intervention by CCC (children’s communication checklist) to assess initiation’s ability. Data analysis was done through descriptive statistics tests and covariance analysis. Findings of study showed (according to covariance analysis between before and after of intervention in two groups) there is significant changes in initiation’s ability in intervention group. the result of these study indicated effect of pivotal response treatment on initiation’s ability in autistic children, therefore this method recommended for speech and language pathologist.

Accurate measurement of thoracic kyphosis has high value in the evaluation of patients with spinal kyphosis and in assessing the effectiveness of different treatment methods. Recently, Dual Digital Inclinometer (DDI) has introduced as a non-invasive tool that can measure the kyphosis angle. According to available information there is only one published study regarding the validity and reliability of this instrument in our country. Therefore, this study aimed to evaluate the Validity and reproducibility of DDI in measuring thoracic kyphosis in women over 45 years. In this methodological study, thorasic kyphosis was measured by DDI device three times on 20 women aged 45-70 years. The first two measurements were taken with an hour apart in same day to assess the within- day and the third measurement was taken one day later to assess the between-days reproducibility. Finally, the validity of obtained values of thorasic khyphosis by DDI compared with Cobb angle which measured by the same examiner on radiological films. ICC correlation coefficient test with 95% confidence intervals was used for data analysis. The validity of values obtained by DDI compared to the Cobb angle, as a gold standard, was high (ICC=0.86). Within-day and between-days thorasic kyphosis measurements using DDI were shown to be reproducible with high ICC values. (0.95 for within-day and 0.93 for between days respectively). According to the present study, the DDI is a valid and reproducible tool for non-invasive measurement of thoracic kyphosis in women over 45 years.