Journal of Modern Rehabilitation is the official scholarly journal of the Rehabilitation Faculty at the Tehran University of Medical Sciences (TUMS). The purpose of publishing the MRJ is promoting depth of the relevant knowledge and providing the perfect platform to encourage researchers in the appropriate fields. The scope of the Journal emphasizes all aspects of the specialty of rehabilitation, including Physiotherapy, Kinesiology, Biomedical Engineering, Motion Control, Electrodiagnostic Medicine and gait analysis; and also relative rehabilitation specialties including Physical Medicine, Orthopedic Rehabilitation, Cardiac Rehabilitation, Respiratory Rehabilitation, Neurology Rehabilitation, Gynecology Rehabilitation, Speech Therapy, Audiology, Occupational Therapy, Optometry and  prosthetics and orthotics. The practice focus is on the clinical and administrative aspects of rehabilitation. The research focus emphasizes clinical inquiry and also explores basic science. The educational focus is on the application of modern teaching techniques/technology to graduate, undergraduate, and postgraduate rehabilitation instructional programs. 
 

Articles in Press

Current Issue

Vol 18 No 3 (2024)

Review Article(s)

  • XML | PDF | views: 249 | pages: 282-290

    Teaching foreign languages, such as, English as international language, to children with autism spectrum disorder (ASD) has been considered by the researchers of language instruction, language learning, and teachers of children with special needs. The population of children diagnosed with autism is rapidly growing and it is indispensable that they have similar opportunities for enhancing life skills, education, successful interactions and universal communicative skills. In the present research, we will review and discuss the findings of past studies that investigated effective ways and efficient methods for teaching English as foreign language to these children. Although the restricted literatures have been done throughout the world, the reviewed studies demonstrated improvement of the English language learning by suitable strategies and various methods including pictures representing, humanoid robots, Montessori-oriented methods, applied behavior analysis(ABA), cognitive method , the picture exchange communication system(PECS), well designed educational environment, mixed methods and strategies, speech therapy, media, total physical response (TPR) and individualized education plan (IEP). This narrative review, encourages various interventions and integrated methods for teaching English language to autistic children, taking into consideration their differences from diverse aspects.

  • XML | PDF | views: 112 | pages: 291-300

    Introduction: Grip strength is a vital hand function skill required to perform everyday tasks. Diseases and conditions deteriorate grip strength. Repetitive exercises can improve grip strength, but people are non-compliant with home exercise programs. Gamification of exercises can increase home exercise compliance. A device is needed to measure and rehabilitate grip strength and to deliver exercises remotely. A preliminary search on that topic did not provide any review literature on grip-strength devices. Accordingly, this scoping literature review (SLR) explores various electronic devices and sensors used to measure grip strength.
    Materials and Methods: Five electronic databases, namely PubMed, IEEE, Scopus, ACM digital library, and Web of Science, were searched. Modified preferred reporting items for systematic literature review and meta-analysis guidelines were used, with population/disease, intervention, comparison, and outcome framework employed to identify keywords and frame the research questions.
    Results: The results of the search yielded 3546 articles, and after elimination, 15 articles met the inclusion criteria for this review. Hence, this review has categorized various devices and sensors that measured grip strength, along with their wireless communication and gamification capabilities.
    Conclusion: The categorization presented in this review can help researchers use this information for future directions by emphasizing research gaps and designing telerehabilitation devices.

Research Article(s)

  • XML | PDF | downloads: 34 | views: 73 | pages: 301-309

    Introduction: This study quantifies the differences in individual scapular muscle strength in both arms along with obtaining a force couple ratio of scapula stabilizers to gain values in terms of the strength of muscles.
    Materials and Methods: A quantitative cross-sectional study was done on 30 stroke patients to assess the muscle strength of the serratus anterior, rhomboids, and upper, middle, and lower trapezius (in both shoulders) using a suspension scale. Meanwhile, the muscle force couple ratios were calculated.
    Results: The results showed significant strength differences between both arms for upper trapezius (P=0.0020), serratus anterior (P=0.018), rhomboids (P=0.001), middle trapezius (P=0.0068), and no difference for lower trapezius (P=0.1746). The mean muscle strength in the non-affected arm is greater than the affected arm. The middle trapezius strength is lowest in the affected arm (0.574 kgf) and the lower trapezius strength is lowest in the non-affected arm (0.767 kgf). The mean force couple ratio for upper trapezius versus lower trapezius was higher in the affected side (10.08) and the non-affected side (7.74). The remaining force couples were similar for both arms.
    Conclusion: Overall muscle strength of the scapula stabilizers is greater in the non-affected arm than in the affected arm. The strength of the force couple between the upper and lower trapezius is greater in both arms which shows considerable incoordination between the muscles.

  • XML | PDF | views: 70 | pages: 310-316

    Introduction: The amount of thoracic kyphosis and its mobility may be affected by gender in older adults. This study investigates gender differences in thoracic kyphosis and thoracic spine mobility in healthy older adults.
    Materials and Methods: In this cross-sectional study, 36 participants among which 21 were female and 15 were male with an age range of 65-80 years participated. The amount of thoracic spine kyphosis was measured in a relaxed standing position and the position of maximum correction of thoracic kyphosis using a flexible ruler between the spinous processes of T12 and C7. The difference between the thoracic kyphosis of the relaxed state and the condition of the maximum correction is used to determine the degree of thoracic spine mobility. Finally, men and women were compared in terms of thoracic kyphosis and thoracic spine mobility. The student t-test was employed to compare kyphosis and spinal mobility between men and women, and the paired student t-test was used to compare kyphosis angle in a relaxed posture and maximum kyphosis correction status. Meanwhile, the Pearson test was utilized to evaluate the relationship between variables.
    Results: Although there was no statistically significant difference in the mean thoracic kyphosis of relaxation (P=0.13) and maximal correction (P=0.18) status of healthy old men and women, there was a significant positive relationship between the rate of kyphosis angle and the amount of mobility of thoracic kyphosis (P=0.003; r=0.48).
    Conclusion: There is no difference in the degree of kyphosis and thoracic spine mobility in older men and women. In addition, people with more thoracic kyphosis had more spinal mobility.

  • XML | PDF | views: 85 | pages: 317-326

    Introduction: Stroke survivors are more likely to fall at home. A home hazard assessment may be beneficial to reduce the risk of falling; however, it is resourceful and time-intensive. This study examines the inter-rater reliability and usability of telehealth for a hazard assessment to address the risk of falls.
    Materials and Methods: Two occupational therapists accessed the telehealth platform from different locations and simultaneously rated participants’ home environment using the home falls and accident screening Tool. Stroke survivors and their caregivers answered the telehealth usability questionnaire.
    Results: A total of 36 stroke survivors and 31 caregivers participated in the study. Gwet’s AC1 was used for agreement analysis. The overall AC1 value for the inter-rater reliability was 0.93 (95% confidence interval [CI], 0.66%, 1.00%). There was a moderate correlation between the raters (r=0.57, P=0.000). Bland and Altman graph plot showed a mean difference of -0.61 and 97.2% of the difference score fell within the limits of agreement (95% CI, -5.67%, 4.39%). The overall mean score of the telehealth usability questionnaire was 5.62 out of 7.
    Conclusion: Telehealth technology is a potential medium that provides an opportunity for synchronous practitioner-client interaction in evaluating home hazards. Some challenges were noted during the telehealth sessions, thus requiring a brief protocol to navigate the system.

  • XML | PDF | views: 92 | pages: 327-337

    Introduction: Aging is associated with changes in the neuromusculoskeletal system, which can lead to impairments in balance. This study compares the effects of aerobic and core stability exercises on healthy older men’s static and dynamic balance.
    Materials and Methods: In this study, 30 adults aged 60 to 70 years were selected through purposive sampling and randomly divided into three groups as follows: aerobic exercises, core stability exercises, and a control group. The interventions were carried out separately for the two experimental groups over 6 weeks. Static balance was assessed using the Romberg and Sharpened Romberg balance tests, while dynamic balance was assessed using the functional reach and timed up-and-go tests. The data were analyzed using the one-way multivariate analysis of covariance test with the SPSS software, version 26.
    Results: The mean scores of post-tests for the balance tests in the two experimental groups improved compared to their pre-test scores and the post-test scores of the control group. Moreover, both aerobic and core stability exercises had a significant effect on the static and dynamic balance of the elderly (P=0.001). When examining the effects of exercises on dynamic balance, the findings showed a significant difference in favor of aerobic exercises compared to core stability exercises (P=0.017). However, no significant difference was observed concerning static balance (P=1.00) when comparing the effects of the exercises.
    Conclusion: Aerobic and core stability exercises have a positive impact on the static and dynamic balance of the elderly. Furthermore, for improving dynamic balance in older men, aerobic exercises appear to be more effective than core stability exercises.

  • XML | PDF | views: 100 | pages: 338-346

    Introduction: This study investigates the immediate effects of warm-up exercises, specifically static and dynamic stretches for the lower extremities, on strength, endurance, flexibility, motor control, and core stability function in young, healthy females.
    Materials and Methods: A total of 60 healthy, active women aged 19-30 years were randomly divided into three groups as follows: Static stretching (SS), dynamic stretching (DS), and a control group (CG), which received no exercises. Evaluation methods for core stability included strength, endurance, sit-and-reach, Y-balance, and bilateral squat tests. Meanwhile, these tests were conducted before and after the prescribed exercise protocols.
    Results: Both the SS and DS groups experienced significant increases in all core stability components compared to their baseline values (P<0.05). Meanwhile, the analysis of variance/analysis of covariance indicated that immediately after performing the stretching exercises, the SS and DS groups exhibited significantly greater improvements in parameters, such as strength, endurance, flexibility, and balance tests (except for the posterior-medial direction) when compared to the CG (P<0.05). Regarding functional parameters after the exercises, there were no statistically significant differences between the study groups (P>0.05). In addition, dynamic exercises demonstrated a higher effectiveness than static exercises for most parameters (P<0.05).
    Conclusion: Warm-up exercises, involving both static and dynamic stretches for lower limb muscles appear to have an immediate positive impact on core stability parameters. In sports that demand strong trunk muscles and balance, the dynamic protocol may be more effective.

  • XML | PDF | views: 105 | pages: 347-357

    Introduction: Various balance exercises have been employed to enhance functional stability and balance in individuals who have undergone anterior cruciate ligament (ACL) reconstruction; however, no study has explored the use of dual-task balance exercises for these patients. This study compares the effects of dual motor task balance exercises and single-task exercises on the static balance indices of individuals with ACL reconstruction.
    Materials and Methods: In a single-blind randomized controlled trial, 27 subjects who had undergone ACL reconstruction were randomly divided into two groups: Dual-task and single-task balance exercises. Both groups performed their exercises three days a week for one month. Static balance indicators were assessed at the beginning and end of the treatment.
    Results: The results demonstrated that after the treatment, there was a statistically significant decrease in various center of pressure variables, including mean displacement in the anterior-posterior and medial-lateral directions, total path length, mean velocity of displacement, root mean square of displacement, and velocity. Furthermore, the knee injury and osteoarthritis outcome score significantly increased in both groups (P<0.05). However, when comparing the two groups, no significant difference was observed after the treatment (P>0.05).
    Conclusion: Dual-task and single-task motor exercises improve static stability and knee function levels in patients who have undergone ACL reconstruction. Meanwhile, the effectiveness of these exercise types does not significantly differ from each other.

  • XML | PDF | views: 99 | pages: 358-364

    Introduction: There is little evidence regarding the relationship between gait performance and psychological factors in people with chronic neck pain. This study evaluates gait performance in patients with neck pain and explores the relationship between gait performance and kinesiophobia, pain catastrophizing, pain intensity, and disability.
    Materials and Methods: A cross-sectional study was conducted on 34 patients with chronic neck pain and 29 age- and sex-matched controls were recruited for this study. The participants performed timed up-and-go (TUG), and 10-m walk tests (TMW) with and without head-turning tests. The associations between clinical gait tests, kinesiophobia (Tampa scale of kinesiophobia (TSK), pain catastrophizing scale, pain intensity (visual analog scale), and disability (neck disability index) were assessed.
    Results: People with neck pain had significant differences in the TUG, and TMW with and without head-turning tests compared to controls (P<0.01). Kinesiophobia and pain catastrophism were significantly correlated with TMW tests (r range=0.45 to 0.71, and 0.40 to 0.47, respectively). Pain intensity and disability were not correlated with gait tests.
    Conclusion: The gait performance, as represented by TUG and TMWs test scores, altered in patients with chronic neck pain in comparison controls. Fear of motion and pain catastrophizing thoughts correlated with clinical gait test scores.

  • XML | PDF | views: 45 | pages: 365-370

    Introduction: Due to the prevalence of cognitive disorders, such as the behavioral variant of frontotemporal dementia (bvFTD) and the consequences that these disorders follow, early diagnosis and awareness of the deficiencies of these people in the cognitive and language areas is essential. Given that language is dependent on culture, examining the linguistic characteristics of such patients in different languages can provide valuable findings. Therefore, this study compares noun and verb naming abilities in individuals with bvFTD and non-patients Persian-speaking.
    Materials and Methods: In this cross-sectional study, 3 cognitive tests, including frontal assessment battery (FAB), Montreal cognitive assessment, and mini-mental state examination (MMSE), along with 2 noun naming and verb naming tests were performed on 15 patients with bvFTD and 30 homogeneous non-patient individuals.
    Results: The bvFTD group had significantly different scores for both noun and verb naming compared to the non-patient group (P<0.05). Meanwhile, the bvFTD group was more impaired in naming verbs than nouns, with the largest difference between groups in the verb naming task.
    Conclusion: the results showed that bvFTD patients have poorer noun and verb naming abilities than non-patients. In particular, in verb naming, they showed more deficits than nouns. One possible explanation is that the processing of verbs is more complicated than nouns and involves a more complex neural system and cognitive processes than noun processing. Another possibility is that verbs rely more heavily on frontal and temporal regions of the brain, which are typically affected by bvFTD.

  • XML | PDF | views: 102 | pages: 371-382

    Introduction: This preliminary study investigates the effects of adding exergame (EG) training to conventional exercises on the functional activities of newly fitted patients with unilateral transtibial amputation.
    Materials and Methods: A total of 22 newly fitted patients with unilateral transtibial amputation were equally and randomly divided into two groups as follows: the EG group who performed exercises and EG training and the control group who performed exercise only. The 2-min walk test, timed up and go test, amputee mobility predictor with prosthesis test, and physiological cost index were assessed at baseline and after 2 and 4 weeks of the intervention.
    Results: Both interventions effectively improved the 2-min walk test distance, timed up-and-go test, and the amputee mobility predictor with prosthesis test scores in patients with newly fitted transtibial amputation (P<0.001). Additionally, a significant improvement was observed in the timed up-and-go test time in the EG group versus the control group after the 4-week intervention (P=0.04, effect size=0.53).
    Conclusion: The findings of this preliminary study further support that adding EG to exercises significantly increases movement speed among amputee patients.

Case Report(s)

  • XML | PDF | views: 42 | pages: 383-391

    Introduction: Since hearing loss (HL) can lead to linguistic and especially morphosyntactic (MS) delay, creating a method for fostering and facilitating MS development is required. Accordingly, the auditory-based Sayeh Tahbaz Hoseynzadeh (STH)-method has been designed. Accordingly, the present article examines the effectiveness of this treatment.
    Case Description: Two hearing-impaired children (HIC) who used hearing aids, with moderately severe and severe HL and older than 3 years of age at the time of study, enrolled in the STH method for 24 weeks. The Persian developmental sentence scoring was used to analyze language samples together with some formal and informal assessments performed within a 12-week interval.
    Results: According to the Persian developmental sentence scoring used to analyze spontaneous language samples, the score of participant 1 changed from 0 to 10.6 and the score of participant 2 improved from 5 to 7.4 in the final assessment.
    Conclusion: The findings showed that STH-method helped in improving the MS skills of the participants.

  • XML | PDF | views: 113 | pages: 392-398

    Introduction: Erectile dysfunction (ED) is a common issue in men, often associated with various factors, such as obesity, diabetes, and more. This case study examines the impact of friction massage combined with pelvic floor exercises on ED in three patients, linked to prostatic adenectomy, aging, and diabetes.
    Case Description: Patients followed a one-month regimen of pelvic floor exercises and techniques. The technique’s progress was monitored via video calls twice a week. Exercises lasted for 10 min daily, along with a 10-min massage. We assessed improvement using the international index of erectile function 15 (IIEF15) questionnaire and erection hardness score (EHS), as well as ultrasound scans.
    Results: Following treatment, all three patients showed increased EHS and IIEF15 15 scores. Muscular thickness increased in the ischiocavernosus and bulbospongiosus muscles, while the cavernosal artery exhibited higher systolic velocity and lower diastolic velocity, although maximum blood flow velocity in the posterior vein decreased. Treatment had the most significant impact on the adenectomy patient, followed by the elderly patient and then the diabetic patient.
    Conclusion: Combining friction massage and pelvic floor exercises led to improved erection-related indicators and increased patient satisfaction.

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