- Tehran University of Medical Sciences, Physical Medicine and Rehabilitation, Department Memberadd
ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports that require running and jumping. A comprehensive training program can help athletes to prevent this injury. Among suggested exercises, the... more
ntroduction: Hamstring injuries are one of the most common tendon injuries, especially in sports that require running and jumping. A comprehensive training program can help athletes to prevent this injury. Among suggested exercises, the Nordic eccentric training can reduce the injury rate by up to 50%; however, it is a high-load exercise that cannot be prescribed in the first stages of rehabilitation. Here, we describe a football player who used low-load resistance exercise with blood flow restriction as an alternative method to strengthen their hamstring after nine months of anterior cruciate ligament reconstruction surgery.
Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week).
Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%).
Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
Case Description: A 19-year-old non-professional footballer with a body mass index of 22.18 kg/cm2 was invited to participate in this study. The variables examined included strength and cross-sectional area of the hamstring muscles (mean and maximum strength) and the cross-sectional area of the hamstring tendons at their origin. The treatment program included a seated hamstring curl with a load of 30% 1 RM with blood flow restriction for four weeks (thrice a week).
Results: The hamstring muscle strength improved by 6.54%, and the cross-sectional area of the muscles and tendons changed as follows: Semimembranosus (tendon=0.07%, muscle=2.57%), semitendinosus (tendon=0.00%, muscle=-4.04%), and biceps-femoris (tendon=5.5%, muscle=4.34%).
Conclusion: Low load resistance training with blood flow restriction in this athlete improved the strength and cross-sectional area of the hamstring muscles as well as the cross-sectional area of the tendons. The changes observed in tendon, and muscle cross-sectional areas were more prominent for biceps-femoris. This case showed that a training program with blood flow restriction may be a good alternative for people who cannot tolerate high-load exercises in the early stages of their rehabilitation. Doing more extensive studies with more cases and a control group in the future can help our knowledge in giving the best exercise prescription to our patients.
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Orofacial clefts are one of the most common congenital anomalies involving the craniofacial region. An isolated cleft palate is the rarest (33% of all orofacial clefts) among individuals with female predominance. Individuals born with... more
Orofacial clefts are one of the most common congenital anomalies involving the craniofacial region. An isolated cleft palate is the rarest (33% of all orofacial clefts) among individuals with female predominance. Individuals born with these clefts manifest craniofacial, functional, and psychological anomalies. Sometimes, patients cannot receive the required therapies due to a lack of awareness and lack of medical access or economic factors. Untreated clefts may adversely impact the patient's life both physically and psychologically. Case Description: This study presents a case report of a 45-year-old male with an untreated cleft palate since birth due to a low socioeconomic background, leading to several oro-dental anomalies, speech defects, and psychological and social challenges. Results: Extraoral examination revealed mild facial asymmetry, dry and incompetent lips, and underdeveloped philtrum. Intraorally, there was a cleft palate, macroglossia, soft and edematous gingiva with bleeding on probing, gingival recession, and periodontal pockets, along with various dental anomalies. Full mouth orthopantomogram showed discontinuity of the palatal line, collapsed maxillary arch, root stumps, and crowding. The final diagnosis of isolated cleft palate was made. The patient was advised for surgery regarding the cleft palate, dental treatment, speech therapy, and psychological counseling. However, the patient refused all treatments except a few dental aids due to economic difficulties. Conclusion: The present case report highlights the need for these patients to receive particular concerns. Patients must be motivated to get proper treatment at a suitable stage to prevent future complications. Cleft teams must be advised to initiate some encouraging steps in imparting treatment aids to such patients, especially in rehabilitation therapy, considering their surrounding environment, psychological makeup, socioeconomic status, and motivation. In addition, social groups should also treat these patients with a positive approach, helping them to live healthy and normal lives just like any other individual.
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Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients' ability to perform daily occupations. Transcranial... more
Traumatic brain injury (TBI) is one of the leading causes of long-term disability worldwide. Occupational therapy interventions in these patients are mainly focused on improving patients' ability to perform daily occupations. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose potential for motor and cognitive recovery of patients with TBI has been investigated; however, its effect on functional outcomes following TBI is unknown. This study aims to determine the effectiveness of tDCS combined with routine occupational therapy on the activities of daily living in patients with TBI. Materials and Methods: This was a single-blind, randomized clinical trial. A total of 24 patients with TBI were recruited using the convenience sampling method and were randomly assigned to the experimental (n=12) and control groups (n=12). Both groups underwent routine occupational therapy for 10 sessions (3 days per week), and the experimental group received tDCS (20 min) in addition to routine occupational therapy. Activities of daily living were assessed using the functional independence measure (FIM) at the baseline and the day after the end of the intervention. Results: After a 10-session intervention, both groups experienced significant improvements in the cognitive subscale and the FIM total score (P<0.001). Additionally, the findings showed that these improvements were significantly higher in the experimental group (P<0.001). Conclusion: According to the findings, although routine occupational therapy can effectively improve the ability of patients with TBI to perform daily living activities, adding tDCS as a complementary intervention can accelerate recovery in these patients.
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The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality of the muscle and any muscle damage caused by training or activity. To determine its reliability, a limited number of studies have... more
The skeletal muscle's echo intensity (EI) is a measurement that can be used to assess the quality of the muscle and any muscle damage caused by training or activity. To determine its reliability, a limited number of studies have investigated the measurement of cervical muscles' EI. This study determines whether the EI of the cervical muscles can be reliably quantified using the Adobe Photoshop software. Materials and Methods: The mean EI of the cervical muscles was measured using the standard histogram function of Adobe Photoshop CS6 in 20 healthy women. Results: The measurement of EI of cervical muscles using Adobe Photoshop CS6 is reliable in healthy women (intra-class coefficient >0.9). The values of the standard error of measurements of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 1.81, 2.09, 1.46, 2.02, 1.47 and 1.26, respectively. The values of the smallest detectable difference of longus coli, sternocleidomastoid, levator scapula, semispinalis capitis, rectus capitis posterior, and oblique capitis superior muscles were 7.11, 8.22, 5.74, 7.93, 5.79, and 4.97, respectively. Conclusion: Assessing the EI of the cervical muscles with Adobe Photoshop software is a viable method to determine the quality of the muscles.
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Introduction: As an essential factor affecting life prognosis and rehospitalization in patients with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation. Heart failure with preserved ejection... more
Introduction: As an essential factor affecting life prognosis and rehospitalization in patients
with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation.
Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has
recently increased among patients with chronic heart failure. This study evaluates the factors
indicating exercise tolerance in patients with HFpEF from various perspectives, including
cardiac and skeletal muscle functions.
Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac
rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical
function, physical activity, body composition test, baseline characteristics, blood data, and
echocardiography results were extracted from medical records to identify the indicators of
exercise tolerance.
Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75,
P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not
significantly different in brain natriuretic peptide levels and cardiac function.
Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its
pathological course differs from heart failure with reduced ejection fraction, suggesting that it
is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.
with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation.
Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has
recently increased among patients with chronic heart failure. This study evaluates the factors
indicating exercise tolerance in patients with HFpEF from various perspectives, including
cardiac and skeletal muscle functions.
Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac
rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical
function, physical activity, body composition test, baseline characteristics, blood data, and
echocardiography results were extracted from medical records to identify the indicators of
exercise tolerance.
Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75,
P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not
significantly different in brain natriuretic peptide levels and cardiac function.
Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its
pathological course differs from heart failure with reduced ejection fraction, suggesting that it
is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function.
Research Interests:
In 2008, Iran acceded to the convention on the rights of persons with disabilities (CRPD), including the right to health and rehabilitation. However, the goals of this convention have not yet been achieved in Iran. This study provides... more
In 2008, Iran acceded to the convention on the rights of persons with disabilities (CRPD), including the right to health and rehabilitation. However, the goals of this convention have not yet been achieved in Iran. This study provides solutions for implementing articles 25 (health) and 26 (rehabilitation) CRPD in Iran. Materials and Methods: This was a qualitative study conducted through content analysis. A total of 21 individuals were selected via the purposive sampling method. The data were collected through semi-structured interviews. The interviews continued until we reached information saturation. Data analysis was performed manually using the MAXQDA software version 10. Results: After the interviews, 860 initial codes were obtained. After removing the unrelated codes and merging the codes by overlap, 725 codes remained. The concepts were classified into four main categories and 15 subcategories: Development of a comprehensive rehabilitation program, culture and education, capacity building, and compliance with legal requirements. Conclusion: According to the results, because of severe problems in the field of health and rehabilitation of disabled people in Iran, taking necessary measures to solve these problems is essential. Hence, a comprehensive plan should be developed. Meanwhile, proper education, culture building, talents, and opportunities should be considered more carefully. Also, by facilitating services for people with disabilities and paying attention to the importance of being demanding, we can build capacity in the country. The findings of this research will provide a bright way for policymakers, administrators, and planners of the country.
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Introduction: Having a child with cerebral palsy (CP) is a stressful experience for the family, particularly mothers. Caring for these children occupies great time and energy from the family. The balance of life may be decreased by the... more
Introduction: Having a child with cerebral palsy (CP) is a stressful experience for the family,
particularly mothers. Caring for these children occupies great time and energy from the family.
The balance of life may be decreased by the influence of factors related to the child or mother.
Accordingly, this study investigates the predictive factors affecting the life balance of mothers
with CP.
Materials and Methods: This cross-sectional descriptive-analytical research was conducted
in Ahvaz City, Iran, in 2021. A total of 135 mothers (mean age=33.37 [7.93]) with at least
one child under the age of ten suffering from CP participated in this research. The data were
collected using the life-balance index, general health questionnaire, time management quality,
and demographic information checklists. The gross motor function classification system was
expanded and revised, and the manual ability classification system was used to determine the
gross motor and manual ability function levels. Generalized univariate linear models were
used to investigate the effects of predictor variables on the quantity of life balance.
Results: The life balance of mothers of children with CP was heavily unbalanced (45.2%) or
unbalanced (35.6%). Based on the regression coefficient of each variable, it was determined
that manual ability classification system (β=0.192), comorbidity in the children with CP
(β=0.187), gross motor function (β=0.137), general health (β=0.024), and maternal age
(β=0.01), respectively, contributed the most in the prediction of life balance variances.
Conclusion: Life balance is a seriously affected domain in mothers caring for CP children.
Child-related factors had a more effective role in predicting the life balance of mothers of CP
children than mother-related factors.
particularly mothers. Caring for these children occupies great time and energy from the family.
The balance of life may be decreased by the influence of factors related to the child or mother.
Accordingly, this study investigates the predictive factors affecting the life balance of mothers
with CP.
Materials and Methods: This cross-sectional descriptive-analytical research was conducted
in Ahvaz City, Iran, in 2021. A total of 135 mothers (mean age=33.37 [7.93]) with at least
one child under the age of ten suffering from CP participated in this research. The data were
collected using the life-balance index, general health questionnaire, time management quality,
and demographic information checklists. The gross motor function classification system was
expanded and revised, and the manual ability classification system was used to determine the
gross motor and manual ability function levels. Generalized univariate linear models were
used to investigate the effects of predictor variables on the quantity of life balance.
Results: The life balance of mothers of children with CP was heavily unbalanced (45.2%) or
unbalanced (35.6%). Based on the regression coefficient of each variable, it was determined
that manual ability classification system (β=0.192), comorbidity in the children with CP
(β=0.187), gross motor function (β=0.137), general health (β=0.024), and maternal age
(β=0.01), respectively, contributed the most in the prediction of life balance variances.
Conclusion: Life balance is a seriously affected domain in mothers caring for CP children.
Child-related factors had a more effective role in predicting the life balance of mothers of CP
children than mother-related factors.
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Simulation-based teaching is a technique for imitating a situation's behavior or process via a suitable analog situation for training or teaching purposes. Simulation-based teaching is widely used in various domains; however, there is... more
Simulation-based teaching is a technique for imitating a situation's behavior or process via a suitable analog situation for training or teaching purposes. Simulation-based teaching is widely used in various domains; however, there is limited literature on evaluating the role of simulated-based teaching in physiotherapy. This study investigates the effect of simulation-based teaching on learning domains for traumatic brain injury topics framed for final-year physiotherapy students. Materials and Methods: A total of 51 final-year physiotherapy students were randomly selected and allocated into two groups. Group A (n=25) includes didactic with PowerPoint presentation teaching session. Group B (n=26) includes simulated-based teaching sessions. There were eight simulators selected and trained for the Ranchos Los Amigos stages. The students were assessed using a self-designed pre-post multiple-choice questions (MCQ) test for knowledge and a clinical evaluation exercise for affective and psychomotor skills. Results: This study showed that group B significantly improved in the pre-post self-made MCQ test (t=17.34, P=0.00), and in the clinical evaluation exercise, group B performed 43.66% better than group A. Conclusion: The study concludes that simulation-based teaching significantly improves cognitive, affective, and psychomotor skills compared to traditional methods for traumatic brain injury topics framed for final-year physiotherapy students.
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Teamwork is an essential component of delivering successful physiotherapy services to patients; therefore, the education of physiotherapy students should be directed toward strategies that promote interaction between classmates. A flipped... more
Teamwork is an essential component of delivering successful physiotherapy services to patients; therefore, the education of physiotherapy students should be directed toward strategies that promote interaction between classmates. A flipped classroom (FC) is a pedagogical strategy that promotes active learning. The present study aimed to design, implement, and evaluate the FC for postgraduate physiotherapy students. Materials and Methods: A total of 44 postgraduate general and sport physiotherapy students participated in this study from 2016 to 2019. Two theoretical courses were designed and delivered based on the FC approach. The data were collected using a questionnaire that contained 12 items based on the 5-point Likert scale. The data were analyzed using descriptive statistics, Mann-Whitney, and Fisher exact tests. Results: The students' familiarity with FC was 2.52±1.51 (median=3). The total agreement with FC was 3.42±0.92 (median=3). Only 22.7% of the students reported no increase in motivation. Meanwhile, 71% of the students agreed with a blended classroom, while only 52% preferred to teach only with FC. Conclusion: Most students preferred a blended classroom combining in-class and home activities. Also, the FC could augment the interaction and motivation of the students. Accordingly, FC is a valuable teaching strategy for postgraduate physiotherapy students.
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Using personal protective equipment, especially face masks, in the COVID-19 pandemic era may make verbal communication difficult. Furthermore, acoustic changes in mask-wearing conditions may affect speech audiometry results. This study... more
Using personal protective equipment, especially face masks, in the COVID-19 pandemic era may make verbal communication difficult. Furthermore, acoustic changes in mask-wearing conditions may affect speech audiometry results. This study investigates the effect of wearing a face mask on the word recognition score and the role of speech frequency content in this effect. Materials and Methods: This study was planned and conducted in two phases. In the first phase, the validity and reliability of two speech material lists, high-pitch and low-pitch, were determined. In the second phase, the word recognition score was measured for "mask-wearing" and "covering mouth without a mask." Results: The statistical analysis showed that the content validity ratio was 0.92, and the content validity index was 0.8. Therefore, both speech lists were valid. For these lists, the mixed analysis of variance analysis showed that the scores for "mask-wearing" were significantly lower than "covering mouth without a mask," and there was more reduction in scores for the high-pitched list (F=8.7, df=1, P<0.005). Conclusion: In terms of the impact of a face mask on speech, explaining how speech audiometry is performed, especially in monitoring treatments, may help limit the probability of misinterpretation of speech test findings. Furthermore, understanding the impact of face masks on word recognition scores in adopting sufficient auditory rehabilitation procedures is necessary.
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This study compares the effect of postural restoration (PR) exercises with and without core stability exercises on the pain, intensity, function, quality of life (QoL), and passive range of motion (PROM) at lumbo pelvic-femoral complex in... more
This study compares the effect of postural restoration (PR) exercises with and without core stability exercises on the pain, intensity, function, quality of life (QoL), and passive range of motion (PROM) at lumbo pelvic-femoral complex in patients with nonspecific chronic low back pain. Materials and Methods: This was an interventional type of randomized clinical trial study. The participants were 45 female patients (48.1±6.11 years, 161.4±5.06 cm height, 65.08±6.9 kg weight, and 24.9±2.8 body mass index). They were randomly divided into three equal groups: Group 1=PR exercises and core exercises, group 2=PR exercises, and group 3=control group. Pain intensity, function, QoL, and PROM were measured with the visual analog scale, Oswestry disability index, short form-36 questionnaire, and goniometer. The analysis of covariance was used to compare the means in the study groups before and after the intervention. The intervention groups performed the exercises for six weeks. Results: The results showed a significant difference between the QoL, pain intensity, function, and PROM of left hip adduction in the group with PR exercises with and without core exercises and control (P=0.000). In the PR group with core exercises (P=0.001) and without core exercises (P=0.001), a significant increase was observed in the adduction of the left hip. There was no significant difference between the function (P=0.850), pain (P=0.120), QoL (P=0.328), and PROM (P=0.094) in the intervention groups. Conclusion: PR exercises with and without core stability are equally effective in reducing pain and improving function, QoL, and hip adduction range of motion in women with left anterior interior chain patterns.
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Broca and Wernicke's patients perform satisfactorily regarding the processing of canonical syntactic structures, as maintained by previous studies; however, there has been a gap in the literature because no particular research has yet... more
Broca and Wernicke's patients perform satisfactorily regarding the processing of canonical syntactic structures, as maintained by previous studies; however, there has been a gap in the literature because no particular research has yet investigated the performance of these patients in the Persian circumstances once they were required to analyze sentences which would demand extra-semantic processing. This study clarifies the role of two critical semantic operations demanding extra-semantic processing at the sentential level: Aspectual coercion. It complements to provide some evidence on the localist view of the brain. Our rationale for selecting these operations was their pure semantic nature, not relying on morphosyntactic properties. Materials and Methods: Having recruited two age-and education-matched Broca, two Wernicke, and four healthy controls, we conducted a semantic judgment task in which the participants were asked to express their correct semantic judgment in the two coercion and two normal conditions. Results: Our results showed an approximately above-chance performance of the Broca group for all conditions; however, in the Wernicke group, the same result was not observed due to their poor performance in coercion conditions, though in ordinary sentences, they performed much better. Conclusion: Our findings, along with similar off-line and imaging studies, corroborate the view of localism, based on which Wernicke's area is mainly responsible for the primary semantic operations while Broca's area predominantly takes over syntactic parsing.
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Forward head posture (FHP) is one of the most common positional deviations. Frequent users often exhibit incorrect posture because of the rising popularity of media devices, such as smartphones and computers. This posture leads to changes... more
Forward head posture (FHP) is one of the most common positional deviations. Frequent users often exhibit incorrect posture because of the rising popularity of media devices, such as smartphones and computers. This posture leads to changes in muscle activity in cervical flexion and extension. It is defined by hyperextension of the upper cervical vertebrae and forward translation of the cervical vertebrae. This study evaluates the effect of dry needles as a new method in the upper trapezius muscle on the neck's angles and range of motion (ROM) in individuals with FHP. Materials and Methods: In this quasi-experimental interventional study, 18 women with FHP underwent a dry needle session. The photogrammetry of the cranio-vertebral angle measured the degree of FHP. Visual analog scale (VAS), pain pressure threshold (PPT), cranio-vertebral angle (CVA) and cranio-horizontal angles (CHA), ROM, scapular index (SI), and forward shoulder translation (FST) were assessed before and after the intervention. Results: The results demonstrated that after the intervention, right and left PPT, flexion, and proper neck rotation, right and left SI, CVA, and CHA were significantly improved (P<0.05). Conclusion: The results showed that one session of dry needling with stretching exercises intervention could improve PPT, ROM, SI, CVA, and CHA and consequently improve FHP.
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Introduction: Competitive swimming is one of the most popular Olympic sports. Although studies indicate that explored flat feet improved running performance, research on foot types and their impact on swimming is scarce and unexplored.... more
Introduction: Competitive swimming is one of the most popular Olympic sports. Although studies indicate that explored flat feet improved running performance, research on foot types and their impact on swimming is scarce and unexplored. This study investigates the difference between flutter kicking speed among competitive swimmers with flat and standard feet.
Materials and Methods: A total of 78 competitive swimmers in the age range of 13 to 19 years were recruited from Pusat Akuatik Darul Ehsan swimming training using a purposive sampling method and a cross-sectional study design. Based on their navicular drop test scores, the participants were categorized as flat-footed (group A) and normal-footed (group B). An independent t-test was applied to compare the kicking speeds between flat-footed and normal-footed swimmers. The swimmers in group A and group B were instructed to perform a standard 50-m kicking front crawl performance with the upper limb placed over the sliding board individually in a swimming pool, and their reaching time was recorded using a stopwatch.
Results: The results indicated flat-foot swimmers’ front crawl kicking performance was faster than normal-foot swimmers’ (P=0.03) with a medium effect size (d=0.50).
Conclusion: This study concludes that flat-footed competitive swimmers have an advantage in reaching 50 m in less time than normal-footed swimmers.
Materials and Methods: A total of 78 competitive swimmers in the age range of 13 to 19 years were recruited from Pusat Akuatik Darul Ehsan swimming training using a purposive sampling method and a cross-sectional study design. Based on their navicular drop test scores, the participants were categorized as flat-footed (group A) and normal-footed (group B). An independent t-test was applied to compare the kicking speeds between flat-footed and normal-footed swimmers. The swimmers in group A and group B were instructed to perform a standard 50-m kicking front crawl performance with the upper limb placed over the sliding board individually in a swimming pool, and their reaching time was recorded using a stopwatch.
Results: The results indicated flat-foot swimmers’ front crawl kicking performance was faster than normal-foot swimmers’ (P=0.03) with a medium effect size (d=0.50).
Conclusion: This study concludes that flat-footed competitive swimmers have an advantage in reaching 50 m in less time than normal-footed swimmers.
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This study systematically evaluates the effect of telerehabilitation on improving physical activity, physical function, and quality of life (QoL) in individuals with multiple sclerosis (MS). Materials and Methods: Studies were obtained by... more
This study systematically evaluates the effect of telerehabilitation on improving physical activity, physical function, and quality of life (QoL) in individuals with multiple sclerosis (MS). Materials and Methods: Studies were obtained by searching the title, abstract, and keywords without time limit in the Scopus, PubMed, Embase, and Web of Science databases. The quality of the included studies was assessed using the Joanna Briggs institute checklist. The same checklist was used for data extraction. Results: A total of 16 eligible articles were found. In 12 studies, the results showed significant performance improvement, reduced fatigue, improved physical activity, and general balance in the telerehabilitation approach. Furthermore, of the 16 included studies, 5(31) reported an improvement in individuals' QoL, two of which showed a significant improvement in the individuals' QoL in the intervention group compared to the control group. Conclusion: The findings of this review showed that telerehabilitation services for MS individuals' precautions are comparable to or better than conventional services. Telerehabilitation is an effective educational instrument to restitute and maintain physical activity and balance in individuals with MS; however, no considerable improvement in individuals' QoL was reported.
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Ultrasonography is a common tool for assessing muscle morphology. This study aims to investigate the intra-rater reliability of ultrasonography measurements of the masseter and lateral pterygoid muscles (LPM) in subjects with and without... more
Ultrasonography is a common tool for assessing muscle morphology. This study aims to investigate the intra-rater reliability of ultrasonography measurements of the masseter and lateral pterygoid muscles (LPM) in subjects with and without temporomandibular disorder (TMD) and to compare the measurements between the two groups. Materials and Methods: A total of 30 individuals (15 subjects with TMD and 15 subjects without TMD) participated in the study. Imaging of the masseter muscle at rest and contraction, in addition to LPM, was performed using sonography in 2 sessions with a 2-day interval and the thickness of these muscles was measured. To assess the reliability, the intraclass correlation coefficient (ICC (3, 3)), standard error of measurement, minimal detectable change, and limits of agreement were used. Additionally, for the between-group comparison of measurements, the independent sample t-test was used. The Cohen d was used to determine the size of the differences. Results: ICC (3, 3) for intra-rater reliability of masseter thickness in rest and clenched positions and LPM were 0.89, 0.80, and 0.86 in the asymptomatic group, and 0.88, 0.80, and 0.90 in the TMD group, respectively. The values of absolute reliability parameters, such as standard error of measurement and minimal detectable change were in a small range. Additionally, compared to the asymptomatic group, the TMD group had thicker masseter muscle in the rest position and the effect size revealed a large difference between the groups. No significant differences were found between the groups for the thickness of the masseter muscle in contraction position and LPM. Conclusion: The results of the intra-reliability study revealed that ultrasonography is a reliable method to measure the thickness of the masticatory muscles in TMD subjects and asymptomatic subjects. Additionally, TMDs can change the thickness of the masticatory muscles.
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Musculoskeletal asymmetries are common and have important consequences for the individual and society. This study aims to determine musculoskeletal asymmetry in healthy adults. Materials and Methods: A total of 400 healthy individuals... more
Musculoskeletal asymmetries are common and have important consequences for the individual and society. This study aims to determine musculoskeletal asymmetry in healthy adults. Materials and Methods: A total of 400 healthy individuals with no musculoskeletal pain at the time of data collection were included in the study. Two custom-made wooden devices were used to assess the asymmetry in the participants by measuring their height from the base of the device up to different levels of the body. The modified Nordic pain scale was used to take the history of any regional pain in the last 6 months. Results: The mean age of male and female subjects was 21.69±2.19 and 23.49±1.72 years, respectively. The dominant side of the body in the majority of both genders was the right side. The most commonly reported painful site was low back with 47(23.5) males and 43(21.5) females affected, followed by neck pain in 40(20) males and 45(22.5) females. Out of 400 participants, only 31(15.5) males and 12(6) females had symmetrical shoulders and 41(20.5) males and 17(8.5) females had symmetry at the level of iliac crests. Conclusion: Musculoskeletal asymmetries are present in healthy adults at various levels of the body with a history of musculoskeletal pain relatively more prevalent in females compared to males.
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The world has been suffering from COVID-19 since 2020 and the disease continues up to now. COVID-19 patients are at high risk of dysphagia and dysphonia. Accordingly, this study aims to determine the prevalence of dysphonia and dysphagia... more
The world has been suffering from COVID-19 since 2020 and the disease continues up to now. COVID-19 patients are at high risk of dysphagia and dysphonia. Accordingly, this study aims to determine the prevalence of dysphonia and dysphagia and identify correlated factors to develop dysphagia and dysphonia in COVID-19 patients admitted to intensive care units (ICU). Materials and Methods: A total of 70 patients with COVID-19 (Mean±SD age of 63.1±18.6; males=39) hospitalized in ICUs were evaluated by an expert on speech and language. The patients were evaluated for swallowing disorder via the Mann assessment of swallowing ability and the Persian version of the functional oral intake scale. The consensus auditoryperceptual evaluation of voice was also used to evaluate voice disorders. Results: Overall, 58.6% of patients presented dysphagia and 74.3% of patients had dysphonia. Meanwhile, 34.3% of the patients were on mechanical ventilation. A correlation was detected between dysphagia severity and the number of mechanical ventilation days, the length of stay, and age (P<0.05). Dyspnea impacts the prevalence of dysphonia and dysphagia in COVID-19 patients (P<0.05). Vomiting has been effective on only the prevalence of dysphagia (P<0.05). Furthermore, a significant correlation was found between dysphagia and dysphonia (P<0.01). Conclusion: A high prevalence rate of dysphagia and dysphonia exists in patients with COVID-19 admitted to ICUs. An early evaluation by a speech and language pathologist is essential to identify the suspected patients and provide early intervention to prevent further complications and improve their quality of life.
Research Interests:
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with language, cognition, and social interaction. The diagnostic and statistical manual of mental disorder, fifth edition used "spectrum" to... more
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with language, cognition, and social interaction. The diagnostic and statistical manual of mental disorder, fifth edition used "spectrum" to show the variability in etiology and phenotypic levels. This study aims to compare nonverbal communication skills in normally developing and autistic children in Karbala City, Iraq. Materials and Methods: This was a cross-sectional study. Two sets of children (ASD and normal) were matched in terms of age and socioeconomic state. A total of 50 individuals were recruited with 25 ASD and 25 normally developing children without any history of psychological abnormalities. The child's parent/caregiver provided all the demographic information and medical history. The information was gathered from 10-min videos separately recorded for each child, regular contact with them, and continuous interviews with their parents and caregivers. The researchers developed a pre-designed data collection questionnaire according to the non-verbal skills of 3-5-year-olds, including body language, eye contact, and facial expressions. The questionnaire was filled out by the first author. Finally, the gathered data were analyzed by the SPSS software, version 25 (IBM Corp, Armonk, NY). Results: Comparing the total scores revealed a significant difference between the ASD and normal group in gestures (P≤0.001), phonetics (P≤0.001), body language (P≤0.001), and artifacts (P≤0.001). Normally developed children scored significantly higher than ASD children in all 4 variables. However, in the maladaptive behavior (P≤0.001), the significant scores were for ASD children compared to normal children. Conclusion: The results showed that ASD children experience difficulty in nonverbal communication skills. They also have maladaptive behaviors. The main reason for this behavior is their inability to communicate non-verbally.
Research Interests:
There is limited information on the status of international classification of functioning, disability, and health (ICF) framework in subjects with chronic stroke with varying duration of rehabilitation care. Accordingly, this study... more
There is limited information on the status of international classification of functioning, disability, and health (ICF) framework in subjects with chronic stroke with varying duration of rehabilitation care. Accordingly, this study investigates whether the duration of rehabilitation care affects the status of ICF in subjects with chronic stroke. Materials and Methods: This was an observational cross-section study on 58 individuals with chronic stroke. The number of subjects who received rehabilitation care for less than 3 months and more than 3 months were 22 (group A) and 36 (group B), respectively. The ICF components of impairment of body functions and structure were assessed using the clock drawing test, the Beck depression inventory, and the Fugl-Meyer assessment of motor recovery after stroke. The activity limitation and participation using timed up and go test, the community integration questionnaire, and environmental factors were assessed by the Craig Hospital inventory of environmental factors. Results: The Fugl-Meyer assessment and the policy components of the Craig hospital inventory of environmental factors showed a significant difference between the groups. Longer duration of rehabilitation care only showed a positive effect on the Fugl-Meyer assessment scores. No other components of ICF showed any difference between the groups. Conclusion: The duration of rehabilitation impacts the impairments of body functions and body structures of ICF components. The study findings are limited and further studies are required before generalizing the results.
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The use of the jump as a plyometric exercise is a way to improve jump performance. Additionally, as it requires abrupt stopping, starting, and changing directions, it might enhance agility. Thus, this study aims to find out the... more
The use of the jump as a plyometric exercise is a way to improve jump performance. Additionally, as it requires abrupt stopping, starting, and changing directions, it might enhance agility. Thus, this study aims to find out the relationship between drop jump variables and agility in contact sports. Materials and Methods: A total of 30 national-level male athletes (age=20.06±1.94 years; height=1.67±0.06 m; body weight: 58.02±8.40 kg) participated in this study. A drop jump test was performed on the Kistler force plate and agility was assessed by using the Illinois agility test along with the agility t-test. The Pearson correlation test was used to find the significant relationship between agility tests completion time and jump height from flight time, reactive strength index, average power, average force, and contact time for drop jumps. Results: The results indicate a significant moderate negative correlation between jump height from flight time and agility test time (r=-0.501 with Illinois agility test, P=0.005, and r=-0.601 with agility t-test, P=0.001). A significant weak negative correlation was observed between average power and Illinois agility test time (r=-0.477, P=0.008). Conclusion: These findings indicate that improved drop jumps will interpret better agility movements or vice versa; therefore, individuals who perform sports that require agile movement benefit from agility assessment and drop jump training.
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Language deficit is regarded as one of the most important hallmarks of primary progressive aphasia. This study aims to analyze the nature of verbal repetition ability in a group of patients suffering from the semantic variant of primary... more
Language deficit is regarded as one of the most important hallmarks of primary progressive aphasia. This study aims to analyze the nature of verbal repetition ability in a group of patients suffering from the semantic variant of primary progressive aphasia and investigate their cognitive capability. Materials and Methods: In this cross-sectional study, 12 patients of the semantic variant of primary progressive aphasia and 12 healthy individuals accomplished a set of tasks, including naming, word comprehension, digit span, repetition of multisyllabic single words, monosyllabic word span under similar or dissimilar phonological conditions, and sentence repetition. Results: The patients exhibited some degree of impairment with diverse patterns in each task, although the accomplishment of the sentence repetition task was the most challenging activity for the primary progressive aphasic patients of the semantic variant. However, the healthy individuals performed well in all tasks. Conclusion: The recognition of the quantity and quality of the cognitive deficit in the semantic variant of primary progressive aphasics can illuminate the nature of this disease and contribute to a better diagnosis of this disease. Furthermore, it can assist speech therapists and neuropsychologist to recruit appropriate therapies and employ better techniques for the diagnosis and cure of these patients.
Research Interests:
Flexibility or the ability of a muscle to increase in length is an integral part of musculoskeletal characteristics and is essential in preventing musculoskeletal injuries and increasing functional levels. Hamstring muscles rupture is a... more
Flexibility or the ability of a muscle to increase in length is an integral part of musculoskeletal characteristics and is essential in preventing musculoskeletal injuries and increasing functional levels. Hamstring muscles rupture is a common injury. One of the important factors in the occurrence of this injury is poor hamstring muscle flexibility, which because of its stiffened structure, has less ability to quickly increase in length. Some researchers have recently suggested that the dry needling technique could reduce the number of treatment sessions for hamstring muscle tightness and bring faster and more effective results. Accordingly, this study aims to investigate the effect of the application of dry needling through an acupuncture technique on hamstring muscle flexibility. Materials and Methods: The present study is a single-blinded randomized controlled trial in which 16 individuals with bilateral hamstring muscle shortness were randomly allocated into dry-needling and sham-needling groups. The sampling method was non-probability convenience. The outcome measures were the right and left active knee extension range of motion, assessed before and after the first, third, and fifth sessions of intervention. A 2-factor mixed analysis of variance was applied to determine the differences between and within the two groups. Results: Except for the group main effect, time main effect and interaction effect were statistically significant for the right and left active knee extension range of motion (P<0.001). There were differences in behavioral patterns in groups; accordingly, in the real dry-needling group, a significant difference was detected across times. However, in the sham dry-needling group, no significant difference was observed. Conclusion: The application of dry needling into motor points of hamstring muscles in individuals with bilateral hamstring muscles shortness could improve flexibility and increase the range of knee extension after 3 and 5 sessions of intervention because of the therapeutic effects of the dry needling technique in improving the muscle flexibility.
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Gesture is a form of non-verbal communication. Down syndrome (DS) is one of the most common congenital syndromes in which speech and language deficits are prominent. Earlier studies have revealed mixed results regarding the advanced use... more
Gesture is a form of non-verbal communication. Down syndrome (DS) is one of the most common congenital syndromes in which speech and language deficits are prominent. Earlier studies have revealed mixed results regarding the advanced use of gestures among children with DS in Western literature. Indian culture influences parent-child interactions and gesture use differently. This study aims to assess whether a gesture advantage exists among DS children in the Indian context. Materials and Methods: In this case-control study, 5 Tamil-speaking children with DS and 5 typically developing (TD) language-age-matched controls were observed. Their spontaneous interactions with their mothers were analyzed for type and frequency of gestures and gestureword combinations using a checklist. Results: Except for the frequency of deictic (requesting, giving) gestures, all the other gestures, namely deictic (pointing, showing), symbolic and representational gestures, and word-gesture combinations (equivalent, complementary, and supplementary) were observed much less frequently in DS children, although only pointing had a statistical significance. Also, fewer types of gestures were observed among DS children. Conclusion: Children with DS in the Indian context do not exhibit a gesture advantage. This study highlights the importance of gesture assessment and intervention among these children.
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Multiple sclerosis (MS) is one of the most common disabling neurologic diseases worldwide. Although occupational performance problems are reported in many people living with MS, there is little information on these problems in people with... more
Multiple sclerosis (MS) is one of the most common disabling neurologic diseases worldwide. Although occupational performance problems are reported in many people living with MS, there is little information on these problems in people with relapsingremitting MS (RRMS). This study aims to determine occupational performance problems in people with RRMS. Materials and Methods: The Canadian occupational performance measure was used to collect data from 58 participants in the age range of 20 to 50 years. The participants were recruited via the convenience sampling method from a neurology outpatient unit in a general hospital in Tehran City, Iran, in 2020. The data were analyzed using the Spearman, Man-Whitney, and Kruskal-Wallis tests. Results: A total of 91 activities in self-care, 96 activities in productivity, and 67 activities in leisure were identified by the participants as their priorities. No significant difference was observed between the mean scores of occupational performance with age, gender, employment status, and marital status. Still, there was a considerable difference between occupational performance and education level. Conclusion: People with RRMS suffer from many occupational performance problems, especially in productivity areas. Although occupational therapy interventions are essential in promoting self-care and activities of daily living, engaging in productive and instrumental activities of daily living is more cost-effective and valuable to promote independence in people with RRMS.
Research Interests:
A robust vocabulary improves all areas of communication. Vocabulary is critical to a child's success to think and learn about the world. Expanding a child's knowledge of words provides unlimited access to new information. This study... more
A robust vocabulary improves all areas of communication. Vocabulary is critical to a child's success to think and learn about the world. Expanding a child's knowledge of words provides unlimited access to new information. This study describes the early development of comprehension and production vocabularies in a group of Persian-speaking toddlers. Materials and Methods: The mothers of 33 typical, Persian-speaking toddlers during 6 months (from 12-14 months to 19-21 months) completed the Persian McArthur-Bates communicative development inventories 7 times per month. The collected data were analyzed via the SPSS software, version 21, through non-parametric tests. Results: The results indicated that the only significant increase for both vocabularies was between 15 and 16 months (P comprehension=0.045 and P production=0.027). The development of phrase comprehension showed significant increases during six months (P<0.001). Further analysis of production vocabulary growth demonstrated the word spurt in each child (in different months and with different word levels). According to the figures, the composition of vocabulary production was different during the selected 6 months. Nouns were the largest group during the 50-, 100-, and 200-word stages; however, verbs presented a faster rate of development. Both genders showed significant changes during follow-ups (P<0.001) and there were no significant differences between the vocabularies of different genders (P>0.05). Conclusion: Persian-speaking children follow commonalities of lexical development reported for different languages; however, few differences could be traced between these children and their peers from other languages.
Research Interests:
High-arch and flat foot deformities can negatively impact an individual's performance in different situations. They may also balance as well as disturb postural control, which is essential for performing optimal routine and port... more
High-arch and flat foot deformities can negatively impact an individual's performance in different situations. They may also balance as well as disturb postural control, which is essential for performing optimal routine and port activities, in addition to preventing injuries. This is a comparative meta-analysis of postural control in people with high-arch and flat foot deformities with normal feet. Materials and Methods: This is a systematic review of articles published from 2004 to 2021 in Medline/PubMed, Embase/Scopus, LILACS, CINAHL, CENTRAL (cochrane central register of controlled trials), Web of Science, PEDro, and Google Scholar databases. Results: The results revealed that the total balance score in people with high-arch and flat foot deformities was lower (P=0.001), compared to normal people. However, no significant difference was observed in the total balance of people with high-arch and flat foot deformities (P>0.05). Additionally, flat-foot people showed a weaker balance in the postural control test on a force plate, when compared to individuals with high-arch feet (P=0.001). Nevertheless, the results of dynamic balance were the same for all groups (P>0.05). Conclusion: Our findings indicate that people with high-arch and flat foot deformities suffer from weaker postural control when compared to their normal peers. Moreover, flat-foot people showed lower scores on postural control tests on force plates, compared to subjects with higharch feet, even though they had no significant differences for static and dynamic tests. There was no difference in the results of dynamic balance among the 3 groups.
Research Interests:
Identifying the currently-used outcome measures for clients with cerebral palsy (CP) in the Iranian occupational therapy (OT) research can declare the new trend of such researchers and identify the more focused domains regarding such... more
Identifying the currently-used outcome measures for clients with cerebral palsy (CP) in the Iranian occupational therapy (OT) research can declare the new trend of such researchers and identify the more focused domains regarding such individuals. Accordingly, this integrative review aims to define the utilized outcome measures for school-age children with CP in the Iranian OT research.
Research Interests:
Dear Editor in Chief The educational approaches have significantly changed and facilitated the teaching and learning process through the advent of novel technologies [1]. In the last years, learning through smartphones along with... more
Dear Editor in Chief
The educational approaches have significantly
changed and facilitated the teaching
and learning process through the advent
of novel technologies [1]. In the last
years, learning through smartphones along
with web-based learning has become 2 main types of
e-learning platforms, especially during the COVID-19
pandemic; however, smartphones are a more acceptable
approach compared to web-based learning because of
their availability and easy use. Accordingly, developing
smartphone-based learning packages may promote the
participation of students in learning procedures. Currently,
there are 16 billion mobile phones worldwide, of
which about 42% are smartphones [2].
The educational approaches have significantly
changed and facilitated the teaching
and learning process through the advent
of novel technologies [1]. In the last
years, learning through smartphones along
with web-based learning has become 2 main types of
e-learning platforms, especially during the COVID-19
pandemic; however, smartphones are a more acceptable
approach compared to web-based learning because of
their availability and easy use. Accordingly, developing
smartphone-based learning packages may promote the
participation of students in learning procedures. Currently,
there are 16 billion mobile phones worldwide, of
which about 42% are smartphones [2].
Research Interests:
Parkinson's disease is a chronic progressive neurodegenerative disorder causing impaired motor function and various non-motor symptoms. One of the most common problems in Parkinson's patients is occupational performance problems. The... more
Parkinson's disease is a chronic progressive neurodegenerative disorder causing impaired motor function and various non-motor symptoms. One of the most common problems in Parkinson's patients is occupational performance problems. The cognitive orientation to daily occupational performance (CO-OP) is one of the client-centered and problem-solving approaches in occupational therapy evaluations and interventions. This study aims to determine the effectiveness of the COOP approach on perceived satisfaction and occupational performance in a 62-year-old woman with Parkinson's disease. Case Description: The client was a 62-year-old woman with moderate cognitive impairment, stage 3 on the Hoehn and Yahr scale, and signs of depression. In our case study, the outcome measures were the Canadian occupational performance measure (COPM), functional independence measure (FIM), Montreal cognitive assessment (MOCA), and Beck depression inventory-II (BDI-II). We administered the COOP intervention for six weeks. Sessions were performed twice a week for one hour per session. Results: The results indicate that the COOP intervention improves the client's satisfaction, occupational performance, and functional independence. Although the results from this single case cannot be generalized, the findings suggest that COOP intervention may help improve satisfaction and occupational performance in adults with Parkinson's disease. Further investigation is necessary. Conclusion: These results suggest that COOP can be a valuable occupational therapy interventions for individuals with Parkinson's disease. We recommend that occupational therapists consider using this approach in their practice to improve the occupational performance of their patients with Parkinson's disease.
Research Interests:
We evaluated the effect of electromyography biofeedback on proprioception and functional balance in healthy young athletes. Materials and Methods: In this clinical trial, 24 athletes were randomly divided into two study (n=12) and control... more
We evaluated the effect of electromyography biofeedback on proprioception and functional balance in healthy young athletes. Materials and Methods: In this clinical trial, 24 athletes were randomly divided into two study (n=12) and control (n=12) groups. The study group received rehabilitation exercises, including one-foot standing, squatted standing, and isometric contraction of quadriceps muscle at different knee angles, including 30, 45, and 90 degrees of knee flexion along with electromyography biofeedback. The control group received only rehabilitation exercises without electromyography biofeedback. Exercises were performed by both groups for a 4-week period in three sessions per week. Functional balance and proprioception before and after exercises were measured using the star excursion balance test and a system consisting of digital photography non-reflective markers, respectively. The data of the center of pressure and time of vertical ground reaction force using a force plate was also collected to evaluate static balance and dynamic balance, respectively. Results: The absolute error in knee joint reconstruction for 30° (P=0.005), 45° (P=0.001), and 90° (P=0.033) angles significantly decreased after the intervention in the study group compared to the control group. Star excursion balance test scores in all directions did not show any significant differences between the two groups (P>0.05), except for the anterior-lateral direction (P=0.03). Moreover, all variables related to static and dynamic balance did not show a significant difference between two the groups after the interventions (P>0.05). Conclusion: The electromyography biofeedback intervention can probably be used as a rehabilitation protocol in recovering and healing proprioception injuries resulting from sports injuries.
Research Interests:
In individuals with anterior cruciate ligament deficiency (ACLD), defective sensory and motor neuroplasticity occurs in the central nervous system (CNS) due to defects in sensory afferents. To successfully restore ACLD individuals to... more
In individuals with anterior cruciate ligament deficiency (ACLD), defective sensory and motor neuroplasticity occurs in the central nervous system (CNS) due to defects in sensory afferents. To successfully restore ACLD individuals to pre-injury conditions, it is necessary to modify the neuroplasticity created in the CNS by prescribing more appropriate training. For this aim, in this study, we used perturbation training differently. Materials and Methods: Thirty athletes with unilateral anterior cruciate ligament (ACL) rupture were randomly assigned to the perturbation and standard training groups. The training program of two groups was performed in three intermittent sessions per week for one month. The relative power spectrum of alpha of quantitative electroencephalography (QEEG) was measured in three tasks: (1) the single-leg jump-landing, (2) the single-leg stance with opened eyes, and (3) the single-leg stance with closed eyes. Results: The perturbation training group only showed significant symmetry in the relative power spectrum of alpha between the two limbs in the single-leg jump-landing test (P=0.92, ES=0.04) in comparison pre-post test. Also, this group showed high symmetry in the alpha band in the single-leg stance test with closed eyes (P=0.53, ES=0.16). Conclusion: The results of the present study showed that both mechanical perturbation and standard training are suitable for transporting ACLDs back to sports. It also seems that mechanical perturbation training had higher effectiveness in modifying the CNS alpha power.
Research Interests:
The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics... more
The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics parameters and functional tests with Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores in people with moderate KOA. Materials and Methods: Twenty-three participants with moderate KOA participated in this study. Gait analysis involved the measurement of the external peak knee adduction moment (PKAM), peak knee flexion moment (PKFM), knee adduction moment impulse (KAM impulse), and knee flexion moment impulse (KFM impulse) during level walking. Functional tests included timed up and go (TUG) and figure of eight walkings (FO8W) tests. Pearson's correlation coefficient was used to investigate the correlation between kinetics parameters and functional test scores with WOMAC total scores and sub-scores. Results: There was a significant inverse correlation between the first PKAM and WOMAC total score and pain sub-score (r=-0.43 P=0.03 and r=-0.6 P=0.002, respectively). Also, there was a significant inverse correlation between the second PKAM and pain sub-score (r=-0.46 P=0.02). There was no significant correlation between functional tests and WOMAC scores. Conclusion: The low score of the WOMAC in the moderate KOA should not be attributed to the low level of joint knee moments.
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Diabetes mellitus (DM) is the most common metabolic disorder. The improvement of the quality of life (QoL) of people with DM is one of the goals in most health systems. This study was conducted to investigate the relationship between the... more
Diabetes mellitus (DM) is the most common metabolic disorder. The improvement of the quality of life (QoL) of people with DM is one of the goals in most health systems. This study was conducted to investigate the relationship between the QoL and social support in these individuals. Materials and Methods: Forty people with diabetes with lower limb amputation participated in this descriptive cross-sectional study. For data collection, the multidimensional scale of perceived social support (MSPSS), medical outcome study-social support survey (MOS-SSS), the diabetes quality of life (DQoL), and demographic questionnaires were used.To examine the relationships between the variables, an independent t-test, Pearson correlation coefficient, Spearman's correlation coefficient, and multivariate analysis were performed by SPSS software, version 22. Results: In this study, 56% of the participants (22 people) were male and the rest were female. The results of the linear regression analysis showed that there was a significant and direct relationship between QoL and social support resources (P=0.002, β=0.514) and dimensions (P=0.01, β=0.458). QoL was significantly correlated with marital status (P=0.015) and economic status (P=0.046). Conclusion: Increased social support enhances QoL in people with diabetes with lower limb amputation. Therefore, planning to improve social support is highly important in improving the QoL in these people.
Research Interests:
Stroke is the primary cause of functional dependency in daily activities leading to disability of the individual. It becomes an economic burden for the person and society. Post-stroke management in rehabilitation gives more emphasis on... more
Stroke is the primary cause of functional dependency in daily activities leading to disability of the individual. It becomes an economic burden for the person and society. Post-stroke management in rehabilitation gives more emphasis on improving functional performance. The improvement in functional activities of post-stroke survivors makes them independent in their daily activities at home but, still an impediment exists to participate in society and reintegrating into the community. The objective of the study is to find the association of community reintegration with the functional performance of one-year post-stroke survivors in eastern India and to compare their functional independence, community reintegration, and participation in instrumental daily living activities between stroke affection side and stroke subtype of the study group. Materials and Methods: A cross-sectional observational study was carried out on post-stroke survivors between 30 and 60 years of age without sex barrier. Ninety-four patients (mean age 54.38±12.06) were recruited for the study. The outcome was measured by the community integration questionnaire (CIQ), Lawton instrumental activities of daily living (LIADL), and functional independence measure (FIM). Results: Spearman rank order correlation was used and found a significant positive correlation persists between FIM to CIQ as the r=0.565 (P=0.01, 95% CI,-0.40%-0.70%) and LIADL to CIQ r=0.687 (P=0.01, 95% CI,-0.55%-0.79%) FIM to LIADL r=0.532 (P=0.01, 95% CI,-0.36%-0.67%). Mann-Whitney U test was done to compare FIM, LIADL, and CIQ between stroke affection side (right vs left) and stroke sub-type (ischemic vs haemorrhagic), and no significant difference was found. Conclusion: Functional independence, instrumental activities of daily living, and community reintegration are associated with each other. Hence, community reintegration should be incorporated into stroke rehabilitation to maintain a meaningful life as a part of society and family.
Research Interests:
The production of figurative expressions, particularly idioms, and proverbs, is negatively affected by damage to the left hemisphere and subcortical area of the brain. Alzheimer patients, thanks to the preservation of basal ganglia, can... more
The production of figurative expressions, particularly idioms, and proverbs, is negatively affected by damage to the left hemisphere and subcortical area of the brain. Alzheimer patients, thanks to the preservation of basal ganglia, can produce these expressions. In contrast, compared to Alzheimer's patients, Parkinson's patients cannot produce these expressions due to the malfunction of the basal ganglia. This study attempts to compare the linguistic and cognitive performance of Persian-speaking patients with Alzheimer's disease, Parkinson's disease, and healthy counterparts regarding the production and comprehension of these figurative expressions. Materials and Methods: In doing so, by selecting a sample of participants composed of 10 Alzheimer's patients, 10 Parkinson's patients, and 10 healthy individuals matched with each other regarding age and education. Then, different tests, including Arizona battery for communication disorders of dementia, famous names, and face test, structured conversation, figurative expression completion, elicitation of response based on situational context, Northridge evaluation of idioms and proverbs in situational context, conventional and figurative expression evaluation were condcuted to analyze their performance. Results: The results of Arizona battery for communication disorders of dementia indicated that Alzheimer's patients were in the middle stage of the disease while Parkinson's participants were classified as non-dementia patients. Although the result of the Renown face and name recognition test demonstrated a significant difference between Alzheimer's patients and the healthy group regarding cognition and confidence levels, the same result was not observed between healthy control and Alzheimer's patients. Furthermore, in the test of structured conversation, the proportion of produced words by Alzheimer's patients was more than that of Parkinson's patients. However, the results of sentence and figurative expression completion tests corroborated the weaker performance of Alzheimer's patients compared to their Parkinson and healthy counterparts. Furthermore, notwithstanding in the test of Elicitation of response based on Situational Context, Parkinson's patients performed more poorly than their Alzheimer and healthy counterparts, in the tests of conventional and figurative expression evaluation, Alzheimer's patients' pattern of performance was different from that of other groups as they performed more weakly than Parkinson patients. Conclusion: The observed dissociation in the performance of Alzheimer as well as Parkinson's patients in the linguistic production and comprehension tests shed light on the significant role of the subcortical area of the brain in the production of idioms and proverbs.
Research Interests:
Some accurate tools exist to assess fear-avoidance behavior, such as the Tampa scale for kinesiophobia (TSK) in individuals with musculoskeletal problems. The current research aims to compare the psychometric characteristics of the... more
Some accurate tools exist to assess fear-avoidance behavior, such as the Tampa scale for kinesiophobia (TSK) in individuals with musculoskeletal problems. The current research aims to compare the psychometric characteristics of the original 17-items TSK questionnaire and its 11-item brief version in chronic non-specific low-back pain (CNSLBP). Materials and Methods: In this test development study, 295 patients with CNSLBP referred to the physiotherapy clinic of Milad Hospital in Tehran city, Iran were evaluated. Confirmatory factor analysis (CFA) and α Cronbach was conducted to assess the validity and reliability of the original and brief version of the TSK, respectively. For goodness-of-fit, the Χ 2 /df, root mean square error of approximation (RMSEA), goodness-of-fit index (GFI), and comparative fit index (CFI) indices were used. Results: Internal consistency specified by Cronbach's α was 0.949 for the original version of the questionnaire and 0.927 for the brief one. Based on the CFA findings, the goodness-of-fit indices for the brief version were GFI=0.921, RMSEA=0.078 (90% confidence interval (CI), 0.062%-0.094%), comparative fit index (CFI)=0.981, and Χ 2 /df=2.791. These indices for the original one were 0.882, 0.066 (90% CI, 0.055%-0.076%), 0.983, and 2.270, respectively. A significant correlation was found between these two versions (P<0.001). These findings confirm the adequacy of the brief version of the TSK. Conclusion: The brief version of TSK can be considered a reliable and valid tool to evaluate somatic focus and activity avoidance in patients with CNSLBP.
Research Interests:
The study was conducted to compare the immediate effect of high-power pain threshold ultrasound (HPPTUS) and deep transverse friction massage (DTFM) as a traditional technique on the treatment of upper trapezius active myofascial trigger... more
The study was conducted to compare the immediate effect of high-power pain threshold ultrasound (HPPTUS) and deep transverse friction massage (DTFM) as a traditional technique on the treatment of upper trapezius active myofascial trigger points in male patients with mechanical neck pain. Materials and Methods: In this parallel single-blind randomized clinical trial study, 60 men with mechanical neck pain (mean age: 30.57±6.19 years) who met the inclusion and exclusion criteria were randomly assigned to HPPTUS and DTFM as the control group. A visual analog scale (VAS), pain pressure threshold (PPT), and range of motion (ROM) of cervical lateral flexion (CLF) were assessed before and after treatment. Results: Analysis of pre-and post-treatment findings showed that the VAS (P<0.01), PPT (P<0.01), and ROM of CLF (P<0.01) improved significantly in both groups while ROM of CLF increased significantly more in the HPPTUS group. An indirect correlation was found between the pre-treatment ROM of CLF and ROM of CLF improvement in both groups. A significant indirect correlation was observed between pre-treatment VAS and ROM of CLF improvement in the HPPTUS group. In the DTFM group a significant indirect correlation was found between pre-treatment ROM of CLF and VAS improvement. Conclusion: The results showed that HPPTUS can be used as an effective treatment for active trigger points (TP). It seems that this method is more effective than deep transverse friction massage.
Research Interests:
A few instruments are accessible for clinical estimation of the thoracic and lumbar curvatures. This methodical survey aims to identify the validity and reliability of noninvasive thoracic kyphosis and lumbar lordosis measurements.
Research Interests:
High prevalence of knee osteoarthritis (OA) in Iran and the subsequent disability have resulted in representing multifarious non-aggressive interventions with distinct influences on the disease. The aim of this study was to review... more
High prevalence of knee osteoarthritis (OA) in Iran and the subsequent disability have resulted in representing multifarious non-aggressive interventions with distinct influences on the disease. The aim of this study was to review previous domestic studies about the effects of conservative therapeutic options on patients with knee OA. Materials and Methods: Using search engines involving IranMedex, MedLib, ISC, Google Scholar, Magiran, SID, rehabilitation, and medical journals based on defined keywords, 98 Persian language articles were found, and 37 studies were finally included in our study after applying the exclusion criteria. The type of study, the pattern of choosing subjects, patient information, the measurements, interventions, and the results were exploited from each article, and the physiotherapy evidence database (PEDro) scale was administrated to evaluate the studies. Results: Based on analysis of PEDro scale results (Mean±SD for articles score: 5.89±1.29), the quality of most articles was as fair and good. The focus of conservative treatments was on exercise therapy methods, assistive devices, and physical therapy management. From a clinical perspective, the evidence indicates the appropriate effects of such treatment choices on alleviating pain, enhancing function, and improving quality of life in individuals with knee OA. Conclusion: Most conservative methods can reduce pain, and improve quality of life and physical performance in patients with knee OA. However, further high-quality studies with larger sample sizes and long-term follow-ups are required to determine whether knee OA can be managed by conservative methods.
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Antiviral drugs have been extensively used as a potential treatment during the COVID-19 pandemic. Based on previous studies, there were concerns about some of these drugs' ototoxic and vestibulotoxic effects. Still, these concerns were... more
Antiviral drugs have been extensively used as a potential treatment during the COVID-19 pandemic. Based on previous studies, there were concerns about some of these drugs' ototoxic and vestibulotoxic effects. Still, these concerns were exacerbated by the widespread use of these drugs at the beginning of the COVID-19 pandemic. Therefore, this article was done to comprehensively review the effects of ototoxicity and vestibulotoxicity of chloroquine (CQ)/hydroxychloroquine (HCQ) and remdesivir with different administration models and compare with the COVID-19 treatment guidelines in the world and Iran. Materials and Methods: This study collected the related published studies in PubMed, Scopus, Google Scholar, and Web of Science with the main keywords "chloroquine", "hydroxychloroquine", "remdesivir", "ototoxicity", "vestibulotoxicity", and "COVID-19". Results: The dose or duration of used HCQ/CQ drugs that caused ototoxic or vestibulotoxic effects in some diseases was reported mainly more than in COVID-19 guidelines, especially in Iran. These findings align with a recent study on slight HCQ-induced ototoxicity in patients with COVID-19 at low doses and short lengths of use. No evidence of possible cochlear damage after taking remdesivir is reported. Conclusion: It seems that the concern about the ototoxic effects of some drugs used in the COVID-19 pandemic should be according to some factors that affect the pharmacological effects of drugs, such as dose, length of use, and co-administration of drugs. Therefore, lower dosage and length of use in some administration models in COVID-19 treatment, such as Iran, are associated with limited and reversible ototoxicity effects. However, further studies are needed.
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A 15-year-old boy was diagnosed with Wilson disease and referred to a physiotherapy clinic for treatment. He received daily physical therapy exercises with resistance training three times a week for 70 minutes for 8 weeks. The performance... more
A 15-year-old boy was diagnosed with Wilson disease and referred to a physiotherapy clinic for treatment. He received daily physical therapy exercises with resistance training three times a week for 70 minutes for 8 weeks. The performance of daily activities was evaluated using the Persian version of the disabilities of the arm, shoulder, and hand (DASH) questionnaire. Upper limb muscle strength was assessed using a manual muscle strength test. The DASH questionnaire score decreased from 67.24 before treatment to 46.55 after 4 weeks and 36.20 after 8 weeks. In addition, shoulder flexion and extension are improved. The analysis of resistance exercises to facilitate distal muscles through the use of manual muscle tests showed an improvement in the strength of both hands. The present study suggests that regular physical therapy and exercise may help improve daily activity and muscle strength in Wilson disease.
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Blood flow restriction (BFR) training, in which an inflatable cuff partially occludes blood flow around the proximal portion of a limb, coupled with low-load resistance exercise (LLRE) has resulted in gains comparable with traditional... more
Blood flow restriction (BFR) training, in which an inflatable cuff partially occludes blood flow around the proximal portion of a limb, coupled with low-load resistance exercise (LLRE) has resulted in gains comparable with traditional progressive resistive exercise in healthy populations. The use of BFR with LLRE may help people with supraspinatus tendinopathy through proximal effects to improve strength and muscle size. The purpose of this case report is to describe the proximal effect of the LLRE+BFR program on a patient with supraspinatus tendinopathy. Materials and Methods: The patient was a 40-year-old man with a history of shoulder pain and weakness for the past months. He received an LLRE+BFR program for his right shoulder including rotator cuff and scapular strengthening exercises and lower limbs aerobic exercises based on protocols of strengthening and aerobic exercises of BFR. Outcomes measured at baseline and 4 weeks included the 4 items: 1) Strength of supraspinatus muscle and four scapular stabilizer muscles including serratus anterior strength, middle trapezius strength, and lower trapezius strength by dynamometer, 2) supraspinatus thickness by ultrasound, 3) pain pressure threshold of supraspinatus and deltoid muscles by algometer, and 4) pain reported bay in each session based on pain numeric scale. Results: After 6 weeks, the strength of supraspinatus and scapular stabilizers except for the lower trapezius increased. The supraspinatus thickness and pain pressure threshold in the supraspinatus and deltoid muscle also increased after 4 weeks. The mean of pain reported by the patient based on the pain numeric scale before and after each session was also decreased. Conclusion: The patient had measurable improvements following the use of an LLRE+BFR program. LLRE+BFR program may be an option for strength training in people with supraspinatus tendinopathy; however, more research is needed to determine effectiveness across the population of people with supraspinatus tendinopathy.
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Reaction time is an important indicator of good performance. Different types of exercises have been used by researchers to improve the reaction time of an individual. Other types of exercises still need more research to study their effect... more
Reaction time is an important indicator of good performance. Different types of exercises have been used by researchers to improve the reaction time of an individual. Other types of exercises still need more research to study their effect on simple reaction time, such as proprioceptive training. The purpose of this study is to examine the effect of a proprioceptive training program using the Huber machine on the simple reaction time. Materials and Methods: Twenty-one participants from the medical staff were assigned to two groups including the experimental group (1) composed of 5 male and 5 female participants and a control group (2) including 5 male and 6 female participants. A simple reaction time (SRT) test was assigned to all participants. Only the experimental group performed a proprioceptive exercise protocol on Huber motion's platform, while the control group was tested at identical periods without exercising before the training (T0), immediately post-exercise (T1), and twenty minutes after exercising (T2). The procedure was repeated for six sessions over two weeks. Results: The participants of the group (1) show a decrease in the mean of RT (-43 min) immediately after proprioceptive training (T1), but they reveal a little increase (at T2) in SRT after an interval of 20 minutes (-23 min). They still prove a retention effect, while few participants in the control group show improvement at T1 or T2. Paired sample t-test was significant for the group (1) at T1 and T2 (P<0.05) while it was not significant for the control group. Conclusion: Proprioceptive training may have a positive influence on reaction time with a retention effect. Clinicians can use proprioceptive training to improve the reaction time of their patients.
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Chronic constipation is one of the most common complaints of patients in developed countries, which affects 2 to 28% of the world's population and alters patients' quality of life extensively. This study aimed to determine the validity... more
Chronic constipation is one of the most common complaints of patients in developed countries, which affects 2 to 28% of the world's population and alters patients' quality of life extensively. This study aimed to determine the validity and reliability of the Persian version of the comprehensive constipation questionnaire. Materials and Methods: The comprehensive constipation questionnaire was translated into Persian, and its back-translation was confirmed after evaluating the content validity ratio index (CVR) based on Lawshe table (CVR≥0.62). The content validity of the questionnaire was assessed by the content validity index, followed by examining its reliability by Cronbach alpha and test-re-test reliability using the intra-class correlation coefficient (ICC). A total of 100 patients with chronic constipation completed the questionnaire. Results: Content validity was confirmed in the range of 0.84 to 1.00, and the Cronbach alpha values in the range of 0.90-1.00 were acceptable. In this questionnaire, was ICC in the range of 0.76-0.99 which indicates a level of good to excellent reliability of the questionnaire. Also, the results of the factor analysis were confirmed at a moderate level Kaiser Meyer Olkin test (KMO>0.6) and Bartlett test (P<0.05) by extracting a 1-factor solution. Conclusion: The Persian version of the comprehensive constipation questionnaire had acceptable validity and reliability and seems to be an effective tool to evaluate patients with constipation.
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This study investigated the effect of change in postural stability after applying static load during internal perturbation among professional athletes with and without anterior cruciate ligament (ACL) surgery. Materials and Methods: The... more
This study investigated the effect of change in postural stability after applying static load during internal perturbation among professional athletes with and without anterior cruciate ligament (ACL) surgery. Materials and Methods: The participants of the present study were 20 athletes with sixteen months post ACL reconstruction surgery and 20 healthy matched athletes. Each participant performed transitional tasks from double limb stance to single leg stance (SLS) and again to double limb stance on the force plate before and after the application of 10 minutes of constant loading. Area, fore-after range (the meaning of fore-after is anteriorposterior and in articles, this term has been used instead of anterior-posterior) range foreafter (Rfa), range sideway (Rsw), mean velocity (Mv) and confidence ellipse (Ce) of the center of pressure were measured. Results: Rsw (P=0.009) and area (P=0.009) in response to static loading in the healthy group showed a decrease and an increase of area (P=0.009) in response to static loading in the ACLR group was seen on the double limb stance phase. Mv (P<0.001) and area (P<0.001) were bigger in the ACLR group after static loaded on the integration phase. Conclusion: Decreased capacity of passive structures to maintain postural stability against perturbation was observed due to positional change among athletes with a history of ACL reconstruction surgery.
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Chronic pain is a serious secondary problem for many individuals with disabilities. Materials and Methods: A total of 231 disabled athletes invited to compete in a multisport national sports tournament for para-athletes in Ahvaz, Iran,... more
Chronic pain is a serious secondary problem for many individuals with disabilities. Materials and Methods: A total of 231 disabled athletes invited to compete in a multisport national sports tournament for para-athletes in Ahvaz, Iran, participated in the study to be investigated whether spinal pain (SP) prevalence and characteristics are different among different sports and disabilities. Athletes' demographic information, SP prevalence, characteristics, and disability using the athlete disability index questionnaire were obtained. SP prevalence, characteristics, and factors affecting SP intensity and disability caused by low back pain (LBP) were determined as primary outcome measures before data collection. Results: The mean (95% confidence intervals) disability percentage and LBP intensity score were 22.2% (19.2-25.3) and 2.14(1.84-2.47) of 10, respectively. The highest LBP intensity was among physical fitness participants and patients with spinal lesions. Weightlifting athletes and athletes with arm movement limitations had the highest disability. The mean (95% confidence intervals) neck pain intensity score was 2.16(1.80-2.54). Conclusion: A high prevalence of SP was observed among most disabilities and sports. Although its intensity is rarely severe among a population of any disability or sports, it is undeniably disabling among the vulnerable population of para-athletes.
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Although carpal tunnel syndrome (CTS) is an incident entrapment neuropathy disorder, there has been inadequate evidence about the effect evaluation of adding low-level laser therapy to ultrasound (US) plus median nerve glide exercises in... more
Although carpal tunnel syndrome (CTS) is an incident entrapment neuropathy disorder, there has been inadequate evidence about the effect evaluation of adding low-level laser therapy to ultrasound (US) plus median nerve glide exercises in these patients. Hence, this research investigated the trace of US plus median nerve glide exercises with and without low-level laser therapy (LLLT). Materials and Methods: Thirty-six patients with moderate CTS in two groups of intervention were assessed. One group received 10 sessions of adding LLLT to median nerve glide exercises plus US and the other group received median nerve glide exercises plus US without LLLT. Outcome measures were hand grip strength (HGS), visual analogue scale (VAS), Boston questionnaire (BQ), and cross-sectional area (CSA) of the median nerve. Results: Baseline analysis revealed similarities between the two groups in all parameters. Statistical analysis indicated significant improvement of HGS, VAS, BQ, and CSA of the median nerve in two groups of intervention. Conclusion: In patients with CTS, US and median nerve glide exercises with and without LLLT significantly improved without the superiority of adding LLLT to mentioned treatment.
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In addition to the instability of the knee joint, injury to the anterior cruciate ligament (ACL) leads to a functional deficit in the form of diminished proprioception of the knee joint. The purpose of this study was to compare knee... more
In addition to the instability of the knee joint, injury to the anterior cruciate ligament (ACL) leads to a functional deficit in the form of diminished proprioception of the knee joint. The purpose of this study was to compare knee proprioception in athletes with an ACL injury and healthy athletes. Materials and Methods: The participants in this cross-sectional study were 26 athletes with an ACL injury and 24 healthy athletes who were selected from the orthopedic clinic at Baqiyatallah Hospital in 2019, Tehran City, Iran. Cooper or non-Cooper subjects with ACL injury were identified via the knee injury and osteoarthritis outcome score (KOOS). The knee proprioception of all participants was recorded using a system consisting of digital photography, non-reflective markers, and Digimizer software. Results: The results showed that there was no significant difference between groups in the absolute error of knee joint reconstruction at both 45° and 90° angles. Conclusion: The data of the study showed that in comparison with healthy athletes, the knee joint proprioception of athletes with an ACL injury is not different and has the same function.
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Down syndrome (DS) as a chromosomal abnormality has different symptoms including cognitive problems and language delay. Studies showed a heterogeneous profile of language skills in this group of children. This study aimed to provide... more
Down syndrome (DS) as a chromosomal abnormality has different symptoms including cognitive problems and language delay. Studies showed a heterogeneous profile of language skills in this group of children. This study aimed to provide further information about the most vulnerable area of language-grammatical skills-regarding the unanalyzable utterances, clauses, phrases, grammatical morphemes, and mean length of utterances (MLU) in children with DS and compare them with those of non-verbal age-matched controls. Materials and Methods: The grammatical structures of 12 children with DS (non-verbal age=39 months) were compared to those of 50 non-verbal mental age-matched controls (non-verbal age=41 months). Clause, phrase, and grammatical morphemes were investigated through spontaneous language sample analysis according to Persian-language assessment remediation and screening procedure (P-LARSP). Results: Children with DS had higher percentages of unanalysable text units compared with typically matched peers (P≤0.001). The MLU, number of phrases and clauses structures, and inflectional morphemes were significantly lower in children with DS compared with typical children (P<0.001). Conclusion: Children with DS showed a noticeable gap in grammatical structures compared with typical children. The possibility of specific language problems in children with DS should be considered by future studies.