فصلنامه علوم پیراپزشکی و توانبخشی
سال چهارم شماره 3 (پاییز 1394)

Factor XIII deficiency (FXIIID) is an extremely rare hemorrhagic disorder with an approximately 12 higher incidence in comparison with reported global incidence of the disorder. A standard diagnostic algorithm was proposed by the International Society of Thrombosis and Hemostasis (ISTH) for FXIIID, however, due to the lack of investments all parts of this algorithm cannot be applied in Iran. Thus, this study presented a national algorithm for diagnosis of FXIIID in Iran. For presentation of a national algorithm, all previously published data about Iranian patients with FXIIID as well as practical methods for diagnosis of FXIIID were collected using Science Direct, Google Scholar and PubMed databases. With available facilities, an algorithm with regards to the laboratory assessment, clinical presentations as well as family history can be suitable for an on time and less expensive diagnosis of FXIIID in Iran. Since ISTH diagnostic algorithm is expensive and time consuming, an economical and more suitable national algorithm with regards to available equipment may reduce the rate of misdiagnosis and its life-threatening consequences.

Evaluation of the corneal curvature, central thickness and volume three months after fitting the Rigid Gas Permeable (RGP) contact lens in keratoconic eyes. Corneal topography maps of 25 keratoconic eyes with a negative history of using the RGP lens were evaluated by Oculus Pentacam. Corneal curvature in both surfaces of the cornea, central corneal thickness and corneal volume were evaluated before and three months after fitting the aspheric RGP lens. Three months after using the contact lens, decrease in central corneal thickness (-3.43µm, P=0.127), decrease in flattest anterior corneal surface power (-0.43D, P=0.339), decrease in anterior corneal steep power (-1.54D, P=0.358), decrease in posterior corneal flat power (-0.1D, P=0.121), an increase in posterior corneal steep power (0.02D, P=0.710) and an increase in corneal volume (0.27 mm3 P=0.331) were not statistically significant. Lack of significant changes in corneal topographical parameters three months after using the RGP lens may indicate the non progressive nature of keratoconus in this period. Further studies with longer follow-up periods are suggested to obtain more accurate results.

Foot alignment has an effect on movements of proximal joints and bones. According to the kinematic chain theory, weakness in function of one motor segment can have an effect on other motor segments. Therefore, the purpose of this study is investigate the relation of pelvic tilt and lumbar lordosis with strength of lumbar-pelvic girdle muscles in athletes with ankle pronation deformity in standing position. In this study, 53 male with ankle pronation deformity were recruited with age of 23.2±2.27 years, height of 169±6.76 and weight of 67.2±6.47. Isometric strength of muscles by handle dynamometer, pelvic tilt by pelvic inclinometer, lumbar lordosis by flexible ruler and foot pronation by navicular drop were investigated. Data were analyzed by statistical methods of correlation between variables. There were significant relations between isometric strength of femur flexor muscles and lumbar lordosis angle (p=0.003, r=0.59) and also between pelvic tilt and lumbar lordosis angle (p=0.012, r=0.46) in participants with ankle pronation deformity. No significant relation was found between other variables of the research (p≥0.05). The positive and significant relation of femur flexor muscles strength with lumbar lordosis and also pelvic tilt with lumbar lordosis may be due to the postural compensatory strategy in persons with ankle pronation deformity. To further explore the relation between these changes in posture alignment and injury more investigations are needed.

Vocabulary assessment is one of the most important screening indexes and language evaluation. Receptive vocabulary has a strong correlation with verbal intelligence and it is a strong predictor of children future academic achievement specially in reading comprehension. The goal of the current study was to develop a picture receptive vocabulary test and to evaluate its validity & reliability for normal 30-71 months Persian children. The type of this study is test construction which was conducted in descriptive- analytic method. In this study, 91 normal Persian children aged between 30 and 71 months in 7 age groups, with a 6- month-age interval participated. For developing Persian picture receptive vocabulary test, words were extracted from books and dissertations which were related to our study, afterward one picture was selected for each word. In order to consider selected picture validity, test with a questionnaire was sent for professional speech and language pathologists. At the end, final edition of the test was administered to 7 age groups. Test retest reliability and correlation between A half and B half were calculated using Spearman Rank- order correlation. In order to consider the effect of age on total scores, Kruskal Wallis test was administered and to investigate the relation between gender and total scores independent sample t test was applied. The results of this study indicated that Persian picture receptive vocabulary test is valid and reliable. (CVI=1), test retest reliability=0.81 and split- half reliability =0.91. This study provided evidence that there is a significant difference (p=0/000) between different age groups scores, and there is no significant difference (p=0.08) in total scores between genders. Persian picture receptive vocabulary test can show differences in vocabulary comprehension ability in the study age groups.

Since joint kinesthesia is under the influence of glenohumeral joint capsule and range of motion, and significant capsular laxity and changed range of motion in throwing shoulder is determinant in their functional and dynamic stability; the objective of this study was to compare throwing influence on dominant and nondominant shoulder kinesthesia among volleyball, bowling players and nonathlete women before an injury. This non-experimental, cross sectional study included 45 women in 2 purpose groups of volleyball and bowling players and 1 nonathlete control group, with age range of 20 to 30 years old from the city of Tehran. Their shoulder kinesthesia was measured by Continuous Passive Motion device. For data analysis, descriptive statistic including mean, standard deviation, and for reliability analysis Correlation Coefficient, were performed. Kolmogorov-smirnov and Leven’s tests were performed for assessing the data normality and group variance equality. Chi-square test was used for comparing shoulder kinesthesia between dominant and nondominant sides and also for comparing between groups of volleyball, bowling players and nonathlete control group. Statistical significant was set at a level of p≤0.05. Kinesthesia error difference between dominant and nondominant shoulders in all three groups, were not statistically significant (p=0.33). Also, No significant difference was found in comparing shoulder in each group with the same sides of other group (p=0.21 nonathlete and volleyball, p=0.19 nonathlete and bowling, p=0.63 volleyball and bowling). Capsular laxity and changed range of motion in dominant shoulder, probably with produce microtruma, have negative influence on kinesthesia. However, on the other hand repetitive circumduction motions in dominant shoulder cause perceptual learning, therefore, probably has a positive influence on increasing accuracy in signal analyze and improve kinesthesia, hence, counteract the negative influence of capsular laxity and changed range of motion on kinesthesia. Probably, repetitive circumduction motions in rehabilitation can also reciprocate the influence of microtruma that cause stability disorder and pain in dominant shoulder by neuromuscular adaptations and it may not related to the kind of overarm or underarm rotation.

Stuttering is one of the most prevalent speech and language disorders. Etiology of stuttering has been surveyed from different aspects such as biological, developmental, environmental, emotional, learning and linguistic. Literature shows that word length and syllable structure as linguistic features may influence frequency of disfluency in this disorder. Therefore, the aim of this study was to determine the effect of non-word length and syllable structure on frequency of disfluency in adults with stuttering. This cross- sectional descriptive- analytic study was performed on 18 adults who stutter with the age ranged between 20 to 39 years. Disfluency frequency was evaluated by asking the subjects to read a list contained 24 non- words. The non-words were selected based on word length (two and five syllables) and syllable structure (simple and difficult). The obtained data were statistically analyzed through paired t-test using SPSS statistical software. The results showed that there was a significant difference between the frequency of disfluency in two and five syllable groups of non-words list (p=0.000). There was a significant difference in the frequency of disfluency between simple and difficult syllable structure in two and five syllable groups of non- words list (p=0.000). The findings of this study indicate that speech motor system performance in adults who stutter is affected by certain linguistic features such as word length and syllable structure.

Scoliosis is one of the musculoskeletal disorders which influences the energy expenditure of patients during walking. In previous studies, metabolic cost of walking measured by oxymetry. Therefore, the aim of this study was to evaluate the energy expenditure of walking of the adolescent idiopathic scoliosis patients by use of monitoring the heart rate. This was observational comparative cross sectional study. Ten scoliotic patients and 10 normal subjects with comparable age, height and weight were recruited for this study. Energy consumption of walking in scoliotic and in normal subjects was evaluated using polar Electro Finland heart rate monitor. The heart rate during resting and walking and the walking speed were the parameters used for energy consumption based on the physiological cost index. The energy consumption of scoliotic subjects during walking based on PCI and THBI was higher than that of normal subjects, however, the difference was not statistically significant (p>0.05). The results of this research showed that there was no significant difference between the PCI and THB index of normal and scoliotic subjects. Moreover, the walking speed of scoliotic patients did not influence by spinal deformation (p>0.05).

This study aimed to determine whether children with cochlear implant in comparison with normal hearing children have delay and disorder in nonverbal skills as well as speech. In addition, whether cochlear implant surgery impact on the progress of these skills. In this study, 60 children under 7 years old both boys and girls were examined via non-random sampling. This group comprises 20 children with cochlear implant (CLs), 20 children with hearing aids (HAs) and 20 age-matched normal hearing children. Communication skills were assessed using the Emory Dyssemia Index which includes verbal, nonverbal and paralinguistic aspects. Moreover, to assess and compare data, ANOVA Variance-analysis and Tukey test were employed. Statistical analysis with an error of less than one percent and significant difference of P<0/000 showed that nonverbal communication skills in hearing impaired children with cochlear implant are better than hearing aid users with severe to profound hearing loss, also in comparison with these children, they have better social communication and act the same as normal hearing children in some skills. By improving their hearing, children can be exposed to social communication and instruction. Therefore, their verbal and nonverbal skills will improve. Also, it is suggested that in a natural manner, parents should expose their hearing impaired children to appropriate verbal and nonverbal stimuli similar to normal hearing children.

Falls in the elderly cause a variety of injuries and may lead to dependency, lower self-efficacy, depression, limitation in daily activities, hospitalization, admission to a nursing home and cost to the individual and community. The present study was conducted to determine the types of injuries from falls in the elderly. In this cross-sectional study, all patients aged 60 years and older who were hospitalized due to fall in Shahid Beheshti Hospital in 2011 were investigated. External cause codes w00-w19 based on International Statistical Classification of Diseases and Related Health Problems (ICD-10) related to fall were selected from the hospital health information system, and the patient records, demographic variables, external causes of injury and type of injury were extracted. Data were analyzed using SPSS software. Relationship between duration of hospitalization and background variables were evaluated using chi-square test, t-test, ANOVA or nonparametric equivalents. A significance level of 0.05 was considered. A total of 251 patients aged 60 years and older were studied that 127 of them (50.6%) were women. The mean age of the patients was 76.82 ± 7.3 years. Fall on the ground was the most common type of injury (78%) and upper limb fractures (44.1%), lower limb fractures (28.9%) and head injuries (15.9%) were the most common types of injuries. The total number of hospitalization days was 1425 and mean of hospitalization was 5.68 ± 4.5 days. The most frequent injuries are fractures of the upper limb, lower limbs and head injuries that caused the greatest length of stay and cost of hospitalization in the elderly.

Color vision is one of the most important functions of visual system that has fundamental and considerable roles in visual data gathering, perceptual vision, visual information processing, correlation between different visual information and correlation with other senses. To investigate color vision, we need to understand color vision mechanism with respect to psychophysical findings. In this subject, retinal color vision mechanism and central nervous system play important function with each other, however, in different and parallel processes. For understanding this mechanism, we should focus on neuro-anatomy and neurophysiology of retinal cone cells, other retinal cells, color visual pathways, visual cortex, higher-order visual areas, and mechanisms that underlie the transformation from stimulus to perception. Most significant involved mechanism in color vision is the color opponency in visual system. Additionally, different types of neurons with its connections and other factors like contrast, luminance, brightness, boundary color and surround region color, color constancy, and etc., have many effects on color perception. In this systematic review, peer reviewed articles that published in PubMed from January 1970 to January 2015 have been searched, assessed and interpreted. Additionally, in this review, quantitative and qualitative peer reviewed evidences with regard to inclusion and exclusion criteria, have been gathered, summarized, discussed and concluded. The purpose of this study is to review the structure and function of visual system in color vision.