Articles in Press

Review Article(s)

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    Objectives: A new coronavirus, called Covid-19, was discovered in December 2019 in Hubei, China. In just one year, Covid-19 reportedly infected more than 81 million people (as of December 29, 2020) worldwide. People with multiple sclerosis (MS) are a particularly vulnerable group during the course of this disease. In such a situation, telerehabilitation approaches provide the main solutions to improve the disorders caused by inactivity in people with MS. The purpose of this study was to review the studies performed in the field of telerehabilitation in people with MS and to evaluate the effectiveness and feasibility of using this method in the face of the prevalence of Covid-19 for people with MS.
    Methods: Research studies in 4 databases including PubMed, Science-direct, Scopus, and Web of Science were searched and reviewed in the period 1995-2020. Inclusion criteria included articles that used Telerehabilitation interventions in people with MS that used Telehealth interventions in people with MS that were published between 1995 and 2020. These articles have been published in peer-reviewed journals. Have used group or single-case intervention research.
    Results: 261 articles were found in the initial search by keywords. In these articles, descriptions of Telerehabilitation and Telehealth were given. Initially, after reviewing the searched articles, 223 articles were removed from the study process due to a lack of inclusion criteria. After that, the full texts of the remaining 38 articles were selected, at the end, 16 articles had inclusion criteria and were included in the study.
    Conclusion: Based on our findings on the benefits of using Telerehabilitation to improve the cognitive, physical, and quality of life of people with MS, as well as its cost-effectiveness, it is recommended that people with MS stay in quarantine under the Covid-19 pandemic. It is a good way to rehabilitate these people to prevent further progression of the disease and maintain their quality of life. Of course, this approach is growing and more research is needed due to the low quality of current studies.

Research Article(s)

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    Background: To investigate the effects of single session Intramuscular Electrical Stimulation (IMES) on pain and dysfunction following active trigger points in upper trapezius muscle.
    Materials and Methods: Volunteers (30 females) with active trigger points in upper trapezius muscle were randomly divided into two groups; 1) IMES group: needle was inserted into trigger point. Then, electrical stimulation was applied to generate a pain-free contraction. 2) Placebo group: procedure of intervention was exactly the same, but there was no electrical stimulation. Pain by Visual Analog Scale (VAS), Pain Pressure Threshold (PPT), Range of Motion (ROM) and disability by Neck Disability Index (NDI) were assessed as main outcome measures, before, immediately after and one week after conducting intervention by another blinded researcher.
    Results: The VAS scales were improved at both groups but was significantly lower at the IMES group one week after treatment. The PPT and ROM scores were substantially higher at the IMES group one week after treatment. NDI indexes were significantly reduced for both groups, while there were no significant differences between them. 
    Conclusion: IMES is effective to improve pain, PPT, ROM and disability, following trigger points in upper trapezius muscle. Further studies are required to investigate the IMES long term effects.

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    Background: The aim of this study was to assess the satisfaction of physiotherapy students about the general structure of Objective Structured Clinical Examination(OSCE).
    Material and Methods: Aresearcher-made questionnaire consists of eight items was conducted to 43 graduate and undergraduate physiotherapy students in order to evaluate the general structure of OSCE. Analysis of data was done through SPSS software version-20 considering significance level of P<0.05.
    Findings: Among 43 participants with a mean age of 23.7 ± 2.4 years old, The percentage of desirable attitude toward attractiveness of the OSCE was 46.6%, being fair was 21%, identify his/her strength and weaknesses was 53.5%, ability to assess knowledge and information was 11.7%, good assessment of practical skills was 30.3%, good assessment of clinical diagnosis skills was 34.9%, and appropriateness was 34.9%. 88.4% of the participants believed that OSCE increases the stress of the students. The total satisfaction of all the participants on the OSCE was 2.7 ± 0.8, which in the students at the last year was significantly less than in graduate ones (2.6 ± 0.9 vs. 2.9 ± 0.3).
    Conclusions: The findings showed that the satisfaction of physiotherapy students regarding general structure of the OSCE was not desirable, and OSCE was considered stressful. Therefore, due to the importance of OSCE in assessment of clinical skills, it is better to improve the quality of holding the OSCE by Fixing existent shortcomings, include shortness of time at each OSCE station, and establishing training sessions.

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    Background: Morphological awareness (MA) refers to the ability of conscious manipulation of morphemes (minimal meaningful units of language). There is no test for assessing MA in Persian. Therefore, this study aims to develop MA test (MAT) and determine its psychometric properties in elementary school students.
    Methods: This methodological research study was performed in 2 phases. The first phase of the current study involved studying articles to extract Persian morphemes for designing a MA test (MAT). A draft of MAT was developed. In the second phase, to determine content validity, the MAT was given to 7 experts. Content validity ratio (CVR) and content validity index (CVI) were calculated. Intra Class Correlation and Cronbach's Alpha were calculated for determining test-retest reliability and internal consistency, respectively. To determine discriminant validity, 20 dyslexic students were compared with 31 normal readers using Mann-Whitney U test.
    Results: CVI was reported 0.94. Test-retest reliability results showed that there was a statistically significant differences (P-Value<0.005) between two times in 7 subtests out of 10. Internal consistency was reported as 0.70. The results of discriminant validity showed that there was a statistically significant difference between normal and dyslexia groups in all MA subtests (P-Value<0.005).
    Conclusion: The amount of CVI showed that the test has the ability to examine MA skill. The inconsistency between test-retest results proved the influence of experience. The internal consistency of test was acceptable. The appropriate discriminant validity results showed that the test can distinguish between normal and dyslexic groups. Therefore, the Persian MAT is a valid and reliable tool for assessment of MA skill.

     

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    Background; Osteoarthritis is a chronic degenerative disabling worldwide disorder. In the knee osteoarthritis ROM is particularly reduced. Mobilization with movement (MWM) has shown rapid improvements in pain and functions. MET is claimed to be effective in muscles lengthening and strengthening and increasing joint ROM.
    Material and Methods: A clinical trial was conducted to compare between knee Mulligan (lateral, medial and rotational glides) techniques n=15, and Post-isometric relaxation Muscle energy techniques (Quadriceps, Hamstring and Tensor Fascia Lata) n=15, on Pain and function in Knee OA.
    Results; Twenty two subjects (73.3%) were grade-II of knee OA and 8 subjects (26.7%) with grade-III. Visual analogue scale showed significant changes for reduction of pain. In VAS score, the main effect of time of treatment shows that the mean value of VAS score has been statistically significant between at least two assessment stages (before 1st. session, after 3rd. session, and after a month) (P < 0.001) in each group. In KOOS score, the main effect of time of treatment shows that the mean value of KOOS score is statistically significant in increasing of KOOS between at least two assessment stages (before 1st. session, after 3rd. session, and after a month) (P < 0.001) in each group. KOOS showed significant changes for increasing of function.
    Timed up and go scored showed decremental significant changes in time). In TUG score, the main effect of time of treatment shows that the mean value of TUG score has been statistically significant between at least two assessment stages (before 1st. session, after 3rd. session, and after a month) (P < 0.008,). In ROM score, the main effect of time of treatment shows that the mean value of ROM score has been statistically significant in increasing of ROM between at least two assessment stages (before 1st. session, after 3rd. session, and after a month) (P < 0.002, observed power=0.927).
    Conclusion; Applying MWM is more functionally effective than applying PIR-MET, both interventions increase functional performance short termly in the patients with chronic knee osteoarthritis, but not effective functionally from a single session. The application of both techniques has the effect on reducing pain immediately and in short-term.

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    Background and Aim: The main purpose of this study was to investigate how words are retrieved in the picture naming tasks (retrieval is discrete serial or cascading and networked) by examining the effect of word cognateness on the ability to name. Obtain normal data on the ability to name of Mazandarani-Persian bilingual individuals with different genders, age and educational groups, was another goal of this study.
    Materials and Methods: In this cross sectional study, after completing the language proficiency questionnaire, 120 Mazandarani-Persian individuals named 109 nouns and 90 verbs in Mazandarani and Persian languages. Speed and voice of people were recorded by DMDX software.
    Results: The results show that the accuracy of naming of cognate nouns in Mazandarani, cognate verbs in Mazandarani and Persian, and the speed of naming of cognate nouns in Mazandarani is more than non-cognate (P = 0.000). Cognate status, gender (men), word type (noun), level of education and Persian language had a positive effect on naming accuracy.
    Conclusion: The results of this study are an example of the effect of cognate status on naming ability and thus confirming the cascaded activation model. Also, gender (men), word type (noun), level of education and Persian language has a positive effect on naming accuracy.

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    Background: In migraine headaches, motor control of muscles is impaired. In this research, thickness measurement of bilateral muscle thickness of Upper Trapezius (UT) and sternocleidomastoid (SCM) muscles was conducted and intra-rater reliability of the thickness measurement of these muscles was assessed in migraine headache and healthy subjects.
    Material and methods: This study was a cross-sectional study to measure bilateral ultrasound images of UT and SCM muscles in 15 migraine headache patients and 15 healthy controls. A linear array probe with a 50-mm footprint and frequency range of 7.5 MHz measured UT and SCM thickness, parallel to muscle fibers orientation. Intra-class correlation coefficients (ICC) and standard error of measurement (SEM) were used for data analysis.
    Results: The ICC and SEM for thickness measurement of left UT were 0.88 and 0.06 (excellent) and for right UT thickness was 0.87 and 0.07 (excellent). The ICC and SEM for left SCM muscle thickness were 0.88 and 0.06 (excellent) and for right SCM thickness was 0.85 and 0.08(excellent). Muscle thickness of right UT muscle was 13.38± 0.92 mm and 11.12± 1.00 mm, in migraine and healthy groups, respectively. Also, muscle thickness of right SCM muscle was 7.24± 0.70 mm and 9.16± 0.67mm in migraine and healthy groups, respectively.
    Conclusions: The present study showed that ultrasonography could be a reliable tool to measure cervical muscle thickness in migraine patients.  Additionally, the ultrasonography protocol of the current study, the position, and measurement level can be used with high reliability in future studies.

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    Introduction: Chronic neck pain (CNP) is of the most frequent symptoms of musculoskeletal disorder. Diaphragmatic exercises can reduce pain, disability, improves proprioception, and corrects forward head posture (FHP) in patients with CNP. The purpose of the present study is to determine the effect of the combination of diaphragmatic exercises with physiotherapy on pain, disability, active range of motions of cervical and forward head posture in individuals with CNP.
    Materials and Methods: Thirty women with the CNP were randomly divided into two groups of a combination of diaphragmatic exercises and physiotherapy (DEPT) and physiotherapy alone (PT). Each person received ten sessions of treatment over two weeks. The outcome measures were assessed in the first and tenth sessions and also two weeks later. There were including pain intensity by Visual Analogue Scale (VAS), disability by Neck Disability Index (NDI), Cervical Active Range of Motions (CAROMs) by goniometry, Forward Head Posture (FHP) by a lateral photograph.
    Results: The VAS, NDI, CAROMs, and FHP were improved after the tenth session and in a follow-up of two weeks (P<0.001). There was significant difference between the groups for average changes of VAS (P=0.04) and active extension (P<0.001) after the tenth session, while the average changes between the groups of cervical active left lateral flexion (P=0.82) and left rotation (P=0.11) in two weeks later is not significant.
    Conclusion: Both groups showed improvement in neck pain, disability, CAROMs, and FHP. However, it seems that DEPT has more lasting effects. Therefore, it is recommended to use evaluation and correction the breathing patterns in the first line of treatment programs for patients with CNP.

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    Introduction: The purpose of this study was to evaluate the adoption of yoga techniques as an alternative therapy in the management of physical and psychological occupational hazards among physical therapists.
    Materials and Methods: A validated closed-ended questionnaire was used to assess education and experience level, personal health and occupational hazards/habits, and treatment strategies used for the physical and psychological occupational hazards for participants in their current position. Via electronic mail, we invited 500 randomly selected physical therapists to participate.
    Results: We received completed questionnaires from 119 physical therapists. Musculoskeletal pain with stress was the most common occupational hazard reported followed by only stress, and only musculoskeletal pain. With regard to pain, the lumbar spine, cervical spine, thoracic spine, shoulder and knee were the body regions most commonly affected.  With regard to pain and stress, only a third physical therapists adopted yoga as an alternative treatment for these occupational hazards; physical therapists were more like to engage in other forms of exercise, listen to music or utilize massage to treat pain and stress. Lack of time and lack of training were the most commonly cited reasons by physical therapists for not practicing yoga. Interestingly, 85.7% of physical therapists would recommend yoga as a treatment for their patients.
    Conclusion: While musculoskeletal pain and stress were extremely common occupational hazards among physical therapists, only about a third of physical therapists adopted yoga as an alternative treatment for these occupational hazards.

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    Introduction: Balance screening has been identified as the key predictor of falls in geriatrics. The current study compares the diagnostic accuracy of various balance instruments in community-dwelling older people.
    Methods and Methods: In this cross-sectional study, 145 older adults were recruited. The Berg Balance Scale (BBS), Fullerton Advanced Balance (FAB) Scale, Dynamic Gait Index, Performance-oriented Mobility Assessment, Timed Up and Go Test, gait speed, step length, step test, and single item question were administered. The receiver operating characteristics curve analysis was used to calculate diagnostic accuracy.
    Results: All single-item tools had moderate diagnostic accuracy (AUC=0.76-0.89) and all multi-item tools had high diagnostic accuracy (AUC=0.91-0.95) when using the recommended cut-off point of 45 for BBS. All multi-item tools maintained high to moderate diagnostic accuracy (AUC=0.85-1.00) in all thresholds while using BBS severity cut-off points. The FAB Scale exhibited the highest diagnostic accuracy (AUC=0.95) among all assessment tools. Single item question scores (Wald=22.61, df=1, P=0.0001, Exp(B)=8.82) were significant as covariates in the regression model.
    Conclusions: For older persons with or without a history of falling, the FAB Scale demonstrated the highest diagnostic accuracy. Alongside single-item tools, FAB Scale may be a preferred multi-item tool.

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    Introduction: Pragmatics refers to how language is used in social communication. Pragmatics has different dimensions that in this study, the turn taking, topic maintenance and duration of topic maintenance in children with CIs and normal-hearing children matched with chronological age and language age has been investigated.
    Materials and Methods: In this cross-sectional study, pragmatics were compared in 15 CI children, 15 normal-hearing children matched with chronological age and 15 normal-hearing children matched with language age. Pragmatic skills of subjects such as turn taking, topic maintenance and duration of topic maintenance in verbal conversation were observed and measured in two groups including CI children with age matched peers and CI children with language matched normal-hearing children. The children's conversations were transcribed and the data were analysed based on the normlity of their distribution by Independent-Sample T-test and U-Mann Whitney tests.
    Results: Findings showed no significant difference between the mean of turn taking, topic maintenance and duration of topic maintenance skills of CI children with their hearing peer (P>0.05). Also, the results obtained by comparing the mean of  turn taking, topic maintenance and duration of topic maintenance skills in CI children with normal-hearing children matched with language age did not show significant difference (P>0.05).
    Conclusion: children with CIs achieved a level of skills in turn taking, topic maintenance and duration of topic maintenance, which was similar to age matched and language matched normal-hearing children. Probably, the duration of auditory experience after cochlear implantation, age of implantation of the prosthesis, age of diagnosis of hearing loss, age of rehabilitation intervention and family follow-up have been effective in achieving these skills.

Research Article(s)

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    Objectives: One of the most complex problems of elders is the balance problem and increase rick of falling. Body percussion is an effective treatment for various diseases with cognitive, physical, and psychological deficits and improves the memory, motor, and coordination skills, as well as social interaction of patients with neurological diseases. One of the problems in the elderly is the weakness in balance skills and falling. This study aimed to investigate the effect of body percussion exercises (BPE) on the balance of the elderly.
    Methods: This study was carried out as pretest-posttest research with two experimental and control groups. A 12-session therapeutic program was implemented 3 days a week each for 45-60 minutes. The subjects were evaluated using Berg balance scale, functional reach, and Timed Up and Go (TUG) tests. Data were analyzed by paired and independent t-test.
    Results: The results of the treatment group showed a significant effect of BPE on the balance (p < 0.005). Comparison of post-treatment results showed that the Berg balance scale (p-value = 0.00), and TUG (p-value = 0.023) were significantly different. The functional reach test (p-value = 0.174) was not significantly different.
    Conclusions: This study showed that BPE had a significant effect on the elderly`s balance.