فهرست مطالب

Rehabilitation Journal - Volume:13 Issue:23, 2015
  • Volume:13 Issue:23, 2015
  • تاریخ انتشار: 1394/01/24
  • تعداد عناوین: 15
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  • Asghar Dadkhah Pages 4-5
    The current issue of the Iranian Rehabilitation Journal contains original research evaluating the efficacy of addiction rehabilitation; an evaluation of a child rehabilitation system for community based research, reading program for children with down syndrome, auditory stream segregation in auditory processing disorder, speech and language disorders, quality of life of adolescents with hearing loss, and diagnostic criterion of schizophrenia. The concerns of articles were mainly on children with down syndrome, patients with rheumatoid arthritis, pregnant woman with obsessive and compulsive disorder, chronic stroke patients, students with learning disability, people with bipolar-I disorder, auditory processing disorder children, children with speech and language disorders, and adolescents with hearing loss.
    Keywords: Rehabilitation approaches, drug abuse, addiction, pediatric issues
  • Farideh Dehghani, Fariba Yadegari *, Enayatollah Bakhshi, Mehdi Dehghan Pages 6-9
    Objectives
    Reading is a language skill based on visual modality which recently is addressed as a facilitator of expressive language in children with Down syndrome. The aim was designing a whole word reading protocol and examining its effects on the language skills of children with Down syndrome.
    Methods
    A whole word reading protocol was developed and was examined through a single- subject study with time-series design. The protocol was made up of 50 pictures of nouns which were used through assessment and treatment. The vocabulary stimuli were selected from the receptive lexicon of each child. Three children with Down syndrome (trisomy 21) participated in the study (3 Females, mean age=6. 1 years, mean IQ=44), and each participant received an individualized treatment up to 20 sessions. Visual graphs and C-statistic test were used for data analysis.
    Results
    As a result of the treatment, naming ability of treated words was increased statistically in all children (Z= 2.46>1.64; Z=1.75>1.6; and Z=2.37>1.64).
    Discussion
    Whole word reading protocol seems to be effective in improving expressive vocabulary in children with Down syndrome.
    Keywords: whole word reading, Down syndrome, expressive vocabulary
  • Fatemeh Rahemi Noushabadi, Narges Adib Sereshki *, Firoozeh Sajedi, Mohammad Rostami Pages 10-15
    Objectives
    Verbal self-instruction strategy is one of the useful techniques for treating individual with learning disability. The purpose of the present study was to determine the effect of Verbal Self-instructional Package on the social competence of students with learning disability.
    Methods
    The study was done in a quasi-experimental research and pre-test, post-test design with control group. The population included all male students with learning disability who were studying in two learning disability centers of Hamedan City from 3rd grade to 5th grade. The participants included of 40 male students diagnosed with learning disability who were selected through convenience sampling method and were placed in control group and experimental group (20 students in each group). The verbal Self-instructional Package was held for 8 sessions in a month (2 sessions per week) for experimental group. To collect data, the pre-test and post-test scores of Social Competence Questionnaire were used.
    Results
    The findings of multivariate analysis of covariance showed that Verbal Self-instructional Package significantly affects social competence and it’s components; cognitive skills and abilities, behavioral skills, emotional competence and set of motivations and expectations in students with learning disability.
    Discussion
    Using verbal self-instruction can enhance the social competence of students with learning disability, Thus it is recommended to use this adjusted package in schools and psychological clinics for these students.
    Keywords: Verbal Self, instruction, learning disability, social competence
  • Roshanak Vameghi, Mahnaz Bakhtiari, Peymaneh Shirinbayan *, Nikta Hatamizadeh, Akbar Biglarian Pages 16-21
    Objectives
    Speech and language development is one of the main aspects of evolution in humans and is one of the most complex brain functions such that it is referred to as one of the highest cortical functions such as thinking, reading and writing. Speech and language disorders are considered as a major public health problem because they cause many secondary complications in the childhood and adulthood period which affect one’s socioeconomic status overall.
    Methods
    This study was conducted in two phases. The first phase was to identify all potential factors influencing delay in referral of children with speech and language disorders for receiving rehabilitation services, based on literature as well as the families’ and experts’ points of view. In the second phase of the study which was designed in a case-control manner, actual factors influencing the time of referral were compared between two groups of participants.
    Results
    Parental knowledge of their children's problems related to speech and language had no significant impact on the on-time referral for treatment for children with speech and language disorders. After the child definite diagnosis of speech and language disorders, parents’ information about the consequences of speech and language disorders, had a significant influence on early referral for speech and language pathology services.
    Discussion
    In this study family structure plays an important role in the early identification of children with developmental disorders. Two-parent families had access to more resources than single-parent families. In addition, single-parent families may be more involved in the work and business of life.
    Keywords: Speech, language development, early identification, child, rehabilitation
  • Abdollah Moossavi, Saeideh Mehrkian *, Yones Lotfi, Soghrat Faghih Zadeh, Hamed Sadjedi Pages 22-27
    Objectives
    This study investigated the efficacy of working memory training for improving working memory capacity and related auditory stream segregation in auditory processing disorders children.
    Methods
    Fifteen subjects (9-11 years), clinically diagnosed with auditory processing disorder participated in this non-randomized case-controlled trial. Working memory abilities and auditory stream segregation were evaluated prior to beginning and six weeks after completing the training program. Ten control subjects, who did not participate in training program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Differences between the two groups were measured using a repeated measures analysis of variance.
    Results
    The results of this study indicated children who received auditory working memory training performed significantly better on working memory abilities and auditory stream segregation task than children do not received training program.
    Discussion
    Results from this case-control study support the benefits of working memory training for children with auditory processing disorders and indicate that training of auditory working memory is especially important for this population.
    Keywords: working memory, working memory training, auditory stream segregation, auditory processing disorders
  • Gita Sadighi *, Mohammad Reza Khodaei, Farboud Fadaie, Arash Mirabzadeh, Alireza Sadighi Pages 28-32
    Objectives
    Psychiatric stigma refers to systemic and internalized stereotypical negative attitudes against individual with mental illness. This article describes the level of self stigma, stereotype endorsement and perceived discrimination experienced by patients with Bipolar-- I disorder in Tehran.
    Methods
    Data were collected from a total of 126 patients with Bipolar-- I disorder who responded to acute phase treatment using the Internalized Stigma of Mental Illness scale. The ISMI scale has five subscales: Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance.
    Results
    In this study 26.7% of participants reported moderate to high levels of self stigma, 57.49% moderate to high levels of stigma resistance and 18.3% moderate to high levels of Perceived discrimination.
    Discussion
    The results suggest that, self stigma appears in over one fifth of individuals with Bipolar-- I disorder in Iran. The symptoms of Bipolar-- I disorder has profound impacts on the quality of life of affected patients. Psychosocial functioning and self-esteem is impaired in people with Bipolar-- I disorder. Interventions are required to reduce the negative effects of internalized stigma in this group.
    Keywords: self stigma, Bipolar, I disorder, stereotype endorsement, perceived discrimination
  • Nafiseh Alebouyeh, Roshanak Vameghi *, Kianoush Abdi, Pouria Reza Soltani Pages 33-37
    Objectives
    Regarding the type of service receivers as well as the technicality of the services provided, these services often bear high complexity and difficulty which can eventually lead to job burnout and shortage of motivation in the staffIn this study, the factors affecting job motivation from the viewpoints of staff and managers of Semnan Welfare Organization have been identified and possible differences have been analyzed.
    Methods
    In the present study, based on Herzberg’s model of job motivation and considering several assessment tools produced according to this model, a draft of a researcher-designed questionnaire was prepared in order to determine the factors affecting job motivation in the staff and managers of the State Welfare Organization in Semnan province. The content and face validity of the questionnaire was determined and approved by 10 experts, 5 managers and 15 staff members of the Semnan Welfare Organization who were selected purposefully, using the Lawsche’s method. The reliability of the questionnaire was assessed and approved by test-retest correlation coefficient determination. After informed consent was obtained, all staff and managers conforming to the inclusion criteria were invited to participate in the study and to complete the questionnaire.
    Results
    In contrast to Herzberg’s theory which considers intrinsic factors as more important than extrinsic factors in causing motivation, our results demonstrated that staff and managers of Semnan Welfare Organization believed extrinsic factors provoked higher motivation.
    Discussion
    The major motivation factors for staff and managers of Semnan Welfare province were somehow related to management practices of managers and staff, both of which are categorized as extrinsic factors.
    Keywords: Job motivation, factors affecting job motivation, staff, managers, Welfare Organization
  • Saeideh Saadati Borujeni, Nikta Hatamizadeh *, Roshanak Vameghi, Adis Kraskian Pages 38-43
    Objectives
    Quality of life, when referring to an individual’s health, is called health-related quality of life. The purpose of this study is to assess self-perceived hearing loss related quality of life of adolescents with hearing loss and its relationship with sex, age sub-groups or school settings with domains of quality of life.
    Methods
    A school based survey was conducted in Tehran city. Using stratified sampling, 255 7th to 12th grade students with hearing loss, aged 11-19 years, studying in main streaming and special school sitting, were participated in the study by completing the health-related quality of life adolescent’s questionnaire. Physical, Emotional and Social health-related quality of life domain scores as well as Total health-related quality of life scores was calculated in a 0-100 scoring system.
    Results
    As a whole, health-related quality of life of adolescents calculated to be 64.7 ± 16.5. Students with milder hearing loss reported their quality of life (physical, emotional and social domains, as well as total quality of life) better than those with more severe hearing loss. Girls reported their physical and total health-related quality of life better than boys, and adolescents who were studied in mainstreaming reported better physical, social and total health-related quality of life. No significant differences were seen between reported health-related quality of life in early, mid or late adolescent age sub-groups. Nevertheless the power of tests was not enough to exclude differences between groups.
    Discussion
    Findings of this study could be readily used to focus interventions on domains with more weakness in each group of adolescents. Beyond that the results could be helpful as a base line for detecting effectiveness of interventions in future.
    Keywords: Quality of Life, health, related quality of life, hearing impaired, adolescent
  • Omid Massah, Fardin Farmani *, Reza Karimi, Hourieh Karami, Fatemeh Hoseini, Ali Farhoudian Pages 44-50
    Objectives
    Substance abuse is one of the most outstanding socio-psychological hazards that can easily wreck one’s personal, family and social life. Reality Therapy is a type of Cognitive rehabilitation (known as psychosocial rehabilitation), and the application of this method in the treatment of different disorders has recently been the topic of research. The objective of this study was to examine the effectiveness of group reality therapy on the reduction of stress, anxiety and depression in addicts.
    Method
    A quasi-experimental study of pretest-posttest design, with a control group was conducted. The study population consisted of all addicts attending Tehran’s ‘Neda’ Rehab Clinic. First, the DASS-21 questionnaire was administered and then 40 people were selected from those who had scored average and higher. They were then randomly assigned to two test and control groups of 20 each. Analysis of co-variance was used to analyze the data, with which pretest scores were controlled, and the effect of the independent variable on posttest scores was evaluated.
    Results
    Following the intervention, there were significant decreases in the mean scores of all three variables, i.e. stress, anxiety and depression in the test group (p<0.05).
    Conclusions
    Psychosocial rehabilitation based on reality therapy can be considered as an effective method for reducing stress, anxiety and depression in addicts and also as an adjunctive therapy in treating other ailments.
    Keywords: Psychosocial rehabilitation, Reality therapy, Stress, Anxiety, Depression, Addiction
  • Yousef Azami, Younes Doostian, Abdollah Motamedi, Omid Massah *, Naser Heydari Pages 51-55
    Objectives
    From the psychological point of view, coping strategies and attitudes have considerable effects on people’s tendency towards risky behavior, including opioid substance abuse. Dysfunctional attitudes are attitudes and beliefs that predispose the individual toward depression and psychological disorder, generally speaking. Usually, people use three types of coping strategies when confronting stressful situations; problem-focused, emotion-focused and avoidance strategies. This study therefore aimed to compare dysfunctional attitudes and coping strategies in substance-dependent & healthy individuals.
    Methods
    A causal-comparative study was conducted. The population under study consisted of 100 addicts attending Robat-Karim’s addiction rehabilitation centers who were selected through simple random sampling. Another 100 ordinary individuals were matched with the addicts. The dysfunctional attitudes scale and the coping strategies questionnaire was used to collect data. Multivariate analysis of variance was used to analyze data.
    Results
    The two groups differed significantly in their dysfunctional attitudes and problem-focused and emotion-focused coping strategies. Substance-dependent individuals applied emotion-focused coping more and had greater dysfunctional attitudes than the healthy ones, and the latter applied problem-focused strategies more.
    Discussion
    Based on our results, addicts have greater dysfunctional attitudes than non-addicts. Therefore, better treatment and rehabilitation results may be obtained by preparing grounds for appropriate psychological interventions and coping strategies in substance-dependent individuals.
    Keywords: Dysfunctional attitude, Coping strategy, Addict
  • Bahareh Amirabadi, Neda Alibeigi, Mohammad Nikbakht, Omid Massah, Ali Farhoudian *, Younes Doostian Pages 56-60
    Objectives
    According to the gateway drug theory, tobacco use is a predisposing factor for future substance abuse. This study was conducted to compare nicotine and opiate dependents to identify the differences between their personality traits and psychopathology that makes them turn to other substances after cigarette smoking.
    Methods
    A causal-comparative study was conducted. Three groups were randomly selected: nicotine dependents, opiate dependents and ordinary individuals (non-dependent population). Cloninger’s Temperament and Character Inventory-Revised, the Fagerstrom Test for Nicotine Dependence, Maudsley Addiction Profile, the Beck Depression Inventory, and Beck Anxiety Inventory were used to collect data. Analysis of variance was used to analyze data.
    Results
    Opiate dependents had higher ‘novelty seeking’ and lower ‘cooperativeness’ scores as compared to the other two groups. They also had higher anxiety and depression scores than the other two groups.
    Discussion
    Higher ‘novelty seeking’ and lower ‘cooperativeness’ scores are important personality traits predicting.
    Keywords: Opiate substances, Nicotine, Temperament, Character
  • Masumeh Bagherzadeh Cham *, Zahra Safaeepour, Mohammad Sadegh Ghasemi, Bijan Forogh, Mohammad Ali Sanjari, Mozdeh Zabihi Yeganeh Pages 61-67
    Objectives
    Foot and ankle problems are common complications in rheumatoid arthritis disease. Gait pattern such as normal foot and ankle rocker is impaired in patients with rheumatoid arthritis. Rocker sole as an external shoe modification is commonly prescribed in this pathology. The aim of this study was to investigate the effect of rocker shoe on vertical ground reaction force parameters during walking in patients with rheumatoid arthritis.
    Methods
    Sixteen female participants with rheumatoid arthritis were recruited in this study. All patients were prepared with a pair of high-top, heel-to-toe rocker shoe and were asked to wear the shoes for one month. Ground reaction force parameters including peak forces and peak force times were evaluated in the first session, and after seven days and thirty days follow up were carried on.
    Results
    first maximal vertical force was significantly increased with rocker shoe compared to barefoot after 7 days follow up. Walking with rocker shoe reduced the minimal vertical force after 7 days. The second maximal vertical force showed to be statistically lower with rocker shoes than barefoot after 7 and 30 days. Furthermore, stance time decreased with rocker shoe after one month.
    Discussion
    Results of this study revealed that vertical ground reaction force parameters changed in rheumatoid arthritis patients with heel-to-toe rocker shoe, both immediately and after one month follow up. This might suggest the effectiveness of rocker shoes in improving gait in rheumatoid arthritis patients.
    Keywords: Rheumatoid arthritis, Rocker shoe, Gait, Ground reaction force
  • Neshat Rahimi S.Monfared, Samira Boroumand, Afsoon Hassani Mehraban * Pages 68-74
    Objectives
    Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are newly used in people with motor problems. It is very important to use different interventions for balance issues. The aim of this study is to determine the effectiveness of videogame on balance and fear of falling in one participant.
    Methods
    This experimental study was done in a single subject system, A-B design for one patient with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess fear of falling. Analysis of results was done by C-statistic, Bayesian factor, Mann Whitney U, and visual analysis graphs.
    Results
    The results showed significant improvement for balance skills, the maximum force produced by lower extremities and reducing fear of falling parameters. But the deviation from center graphs did not showed distinct pattern.
    Discussion
    All analysis confirmed the efficacy of videogames on balance skills and fear of falling improvement. However, the deviation from center did not show improvement and it seems to need more studies.
    Keywords: stroke, balance, fear of falling, videogames
  • Morteza Nouri Khajavi, Susan Afghah *, Abbas Azizi, Khoei Pages 75-77
    Objectives
    Rapid and fast growth of Methamphetamine in Iran has posed a new challenge for Iranian health sector. The objective of this study was to report a case of Methamphetamine psychosis (not otherwise specified-NOS).
    Methods
    The patient was an 48-year-old married male who complained of suspiciousness and delusion of control, he started using Methamphetamine 5 years ago, Two days after hospitalization and before drugs taking effect, he took a spoon during a meal, broke it in half and stabbed into his right temple, in an attempt to take out the imaginary device implanted in his head controlling him.
    Results
    It was revealed that the patient is weak at social interactions and is under peer pressure and that he cannot withstand the pressure. Therefore, strategies of improving social skills for establishment of social relationships and interactions as well as assertive training were considered for him. The patient underwent an emergency surgery and during which the object entered his brain was removed.
    Discussion
    Methamphetamine psychosis may respond well to combination behavior therapy and rehabilitation programs and pharmacotherapy medications.
    Keywords: Methamphetamine, psychosis, Self injury
  • Sanaz Khomami *, Reza Rostami, Reza Kazemi Pages 78-81
    In this study, the authors reported a case of woman with severe compulsion who became pregnant during the Repetitive transcranial magnetic stimulation. We carried out Repetitive transcranial magnetic stimulation and behavior therapy simultaneously after repeated medications'' refraction. The patient received 20 sessions 1 Hz Repetitive transcranial magnetic stimulation in right dorsolateral prefrontal cortex and behavior therapy at the same time in repetitive transcranial magnetic stimulation room. We asked the patient to exposure her fear and without permission of doing usual behavior (washing), she was receiving repetitive transcranial magnetic stimulation. Repetitive transcranial magnetic stimulation and Behavior Therapy could reduce her symptoms significantly. Although her baby was healthy physically but some areas of Age and Stage Questionnaire were below than the average. Repetitive transcranial magnetic stimulation with an additional psychotherapy as behavior therapy could accelerate the improvement of Obsessive compulsive disorder''s symptoms. Furthermore, using Repetitive transcranial magnetic stimulation during the first of trimester probably couldn’t be safe for pregnant woman.
    Keywords: Obsessive compulsive disorder, Behavior therapy, Repetitive transcranial magnetic stimulation