Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 114 124 EN Fatemeh Ashrafi Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Bahar Arshi Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Reyhaneh Mohamadi Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Bentolhada Zarei Faskhodi Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran. Mahboobeh Rasouli Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. 2021 06 02 2021 12 19 Introduction: Intellectual disability and specific cognition in down syndrome (DS) affect language development and processing. We assessed vocabulary and syntax reception among children with DS with typically developed (TD) Persian-speaking Iranian children. We also investigated the association between vocabulary and syntax reception in children with DS. Materials and Methods: Using the Stanford–Binet intelligence scales test, 18 TD children (4-6 years old) and 18 DS children were matched based on non-verbal mental age. Vocabulary reception was assessed using the receptive picture vocabulary test (RPVT) and syntax reception by the Persian syntax comprehension test. Results: Mean total vocabulary reception was lower in children with DS (P<0.001). Syntax reception was also impaired in children with DS compared to the normal values of the test. Among children with DS, vocabulary reception was positively correlated with syntax reception. Every unit increase in total vocabulary reception score was associated with 0.08 (95% confidence interval, CI: 0.04-0.12) improvement in syntax score in children with DS. Conclusion: Vocabulary and syntax reception in DS children, especially complex syntax structures, was impaired. The observed association between vocabulary and syntax reception shows that vocabulary reception improvement might result in progressing syntax reception in children with DS. https://jmr.tums.ac.ir/index.php/jmr/article/view/465

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 125 128 EN Hojjat Radinmehr Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Soulmaz Rahbar Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. 2022 03 30 2022 05 22 Duchenne muscular dystrophy (DMD) is a hereditary progressive neuromuscular disease of childhood. The survival rate of DMD patients is extremely low. In physiotherapy, electrical stimulation is frequently applied to rehabilitate these patients. The present study aimed to evaluate the effects of electrical stimulation on the muscles of patients with DMD. In this regard limited relevant studies were found, some of which reported the positive effects of low-frequency electrical stimulation on improving muscle strength. Conversely, there were reports of the detrimental effects of electrical stimulation on muscle fibers. Overall, there is no standard guideline for electrical stimulation in patients with DMD, and further research is required with adequate sample size and follow-up. https://jmr.tums.ac.ir/index.php/jmr/article/view/650

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 129 133 Haleh Kangari Department of Optometry School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Babak Masoomian Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Masoud Khorrami-Nejad Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sarah Fawzi Hasan Alshmailawi Department of Optometry School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faezeh Eidi Department of Optometry School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2021 08 25 2021 10 27 Introduction: The purpose of the present study was to determine the refractive profile of strabismic children under 8 in a tertiary referral center in Tehran, Iran. Materials and Methods: This retrospective cross-sectional study was conducted on the medical records of 357 patients under the age of 8 who had one type of strabismus in Farabi Hospital, Tehran, Iran, between 2015 and 2019. All routine ophthalmic examinations were done for all patients. Cycloplegic refraction was performed after the instillation of two drops of cyclopentolate 1% with an interval of 5 minutes, and the refractive error was measured after 30 minutes. The diagnostic criteria were based on cycloplegic refraction in which myopia, hyperopia, and astigmatism were defined when the refractive error was -0.25, +0.75, and -0.50 diopter (D) or more, respectively. The cycloplegic results were classified into different groups with an interval of 1.00 D, and astigmatism was also assessed separately. Results: In this study, the most common type of refractive error in esotropic patients was hyperopia, with the +2.00 to +4.00 D range having a higher prevalence. In exotropic patients, hyperopia was also prevalent; the most common range of hyperopia was between +0.75 to +1.00 D. Astigmatism had a prevalence of 37.8% in esotropic patients, and 17.2% in exotropic patients with the most common range from -0.50 to -1.00. Myopia was present in 2.8% of patients with esotropia and 3.2 % of patients with exotropia with the most common range from -0.25 to -1.00. Conclusion: In strabismic Iranian children, hyperopia was the most prevalent refractive error in both esotropic and exotropic patients, with higher degrees of hyperopia in esotropic patients. Low astigmatism was twice as prevalent in patients with esotropia as in patients with exotropia. Low myopia was the least prevalent in both esotropic and exotropia. https://jmr.tums.ac.ir/index.php/jmr/article/view/528

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 01 03 134 141 Monireh Aminian Department of Linguistics, Faculty of Literature, Humanities and Social Sciences, Sciences and Research Branch, Islamic Azad University, Tehran, Iran. Mahnaz Karbalaei Sadegh Department of Linguistics, Faculty of Literature, Humanities and Social Sciences, Sciences and Research Branch, Islamic Azad University, Tehran, Iran. Masoomeh Salmani Department of Speech and Language Therapy, Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran. Ali Jafari Naeemi Student research and Technology Committee, Semnan University of Medical Sciences, Semnan, Iran. 2021 08 09 2021 10 30 Introduction: 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. https://jmr.tums.ac.ir/index.php/jmr/article/view/519

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 142 148 Javad Naghizad Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mohamad Kazem Emami Meibodi Department of Orthopedic and Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Hamid Dalvand Department of Occupational Therapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Alireza Shamsoddini Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2021 08 23 2021 11 14 Introduction: 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. https://jmr.tums.ac.ir/index.php/jmr/article/view/526

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 149 155 Amirhossein Ghasemi Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Gholam Reza Olyaei Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Hossein Bagheri Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Hadian Rasanani Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Shohre Jalaei Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Khadijeh Otadi Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran 2022 03 03 2022 04 06 Introduction: 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. https://jmr.tums.ac.ir/index.php/jmr/article/view/641

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 17 2 2023 04 01 156 171 Ataollah Shahbandi Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Farzin Farahbakhsh Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Pardis Noormohammadpour Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Navid Moghadam Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Rostami Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Bahar Hassanmirzaei Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Ramin Kordi Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2021 10 27 2021 11 28 Introduction: 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 multi-sport national sports tournament for para-athletes in Ahvaz, Iran, participated in the study to be investigated whether spinal pain (SP) prevalence and characteristics are differol of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Movahed Haghjoo Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Amirhossein Shamsi Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Rasool Bagheri Department of Physical Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran. 2022 11 16 2023 01 23 Introduction: Clinical performance without documentation, assessment, and feedback may lead to an inefficient internship in the field. Logbooks are recommended to assess physiotherapy (PT) students’ clinical practice in the curriculum, therefore, this study aims to design, implement, and evaluate a logbook for undergraduate PT students. Materials and Methods: The present study includes three phases. In the first phase, a logbook was designed based on the existing evidence, undergraduate PT program curriculum, and opinions of clinical instructors of the relevant internships. After that, it was adjusted based on the topics of clinical rotations. In the implementation phase, students completed these logbooks during neurology, musculoskeletal inpatient, outpatient, and cardiovascular inpatient rotations. In the third phase, a 29-item questionnaire was used to assess the students’ and instructors’ perspectives on the logbook. Results: The designed logbook for undergraduate PT students consisted of two major sections, assessment of students’ clinical competencies and documentation of clinical experience. Sixty-nine students and 12 clinical instructors completed the questionnaires. Approximately 49% of the students and 87% of the instructors felt that the logbook’s quality was satisfactory. Nearly 53% of the students and over 90% of the instructors consider the use of the logbook and its content essential. Conclusion: A logbook was developed as a workplace-based assessment (WBA) method. It was designed to cover different internships, including PT in musculoskeletal, cardiovascular, and neurological conditions in outpatient or inpatient settings. Both students and instructors agreed on using the designed logbook to assess the student’s clinical performance. https://jmr.tums.ac.ir/index.php/jmr/article/view/793

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 2 2024 01 23 199 208 Maedeh Salehi Darjani Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Rahim Shahbodaghi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Shohreh Jalaie Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. 2022 07 03 2023 01 25 Introduction: Fluent speech requires executive functions to identify, inhibit, and modify speech interruptions to continuously regulate the speech process. The current study aims to examine the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity. Materials and Methods: This research is a cross-sectional descriptive-analytic study. The participants included 32 AWS (Mean±SD of age=28±6.79) divided into three groups of mild, moderate, and severe severity and 32 AWNS (Mean±SD of age=28.57±6.53). Selected tests from the Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains. Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (P=0.009), problem-solving and planning (P<0.001), verbal cognitive flexibility (shifting) (P<0.001), and verbal inhibitory control (P<0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, a significant relationship was observed between stuttering severity and executive function domains. Conclusion: This study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS. https://jmr.tums.ac.ir/index.php/jmr/article/view/699

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 2 2024 01 23 209 217 Shiva Panahiaboozar Department of Psychology, Faculty of Education and Psychology, University of Tehran, Tehran, Iran. Saeid Hassanzadeh Department of Psychology, Faculty of Education and Psychology, University of Tehran, Tehran, Iran. Masoud Gholamali Lavasani Department of Psychology, Faculty of Education and Psychology, University of Tehran, Tehran, Iran. Alireza Aghaz Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. 2022 10 14 2023 02 08 Introduction: The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infants’ early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aims to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for children with hearing loss (HL). Materials and Methods: In this study, due to the limitations of COVID-19 and the lack of access to samples, 23 available children with HL were sampled. The cause of participants› HL was 43.5% congenital, 30.4% acquired, and 26.1% unknown. The Mean±SD of the age of these children was 21.6±6.3 months. To evaluate the predictive validity and concurrent validity, the speech intelligibility rating (SIR) and categories of auditory performance (CAP) were used, respectively. Also, to assess the inter-rater reliability, both parents of each child completed the IT-MAIS-P. Results: A significant correlation (concurrent validity) was observed between the IT-MAIS-P and the CAP scores (r=0.87, P<0.001). Predictive validity was not confirmed by comparing it with the SIR (P>0.05). Also, the inter-rater reliability (kappa=0.44, P<0.001) of the IT-MAIS-P was confirmed. Conclusion: The IT-MAIS-P is a valid tool to investigate the progress of auditory skills in infants, although the predictive validity was not confirmed.  https://jmr.tums.ac.ir/index.php/jmr/article/view/770

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 2 2024 01 23 218 228 Masoud Khorrami-Nejad Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mustafa Abdullah Department of Optometry, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Babak Masoomian Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2023 01 21 2023 02 27 Introduction: Clinical manifestations of cranial nerve palsies are of great importance, and surgeons should consider them before planning surgical protocol. Materials and Methods: This retrospective study was conducted on preoperative hospital records of 598 Iranian patients with different types of extraocular muscle palsy, including third (90 patients), fourth (501 patients), and fifth (7 patients) nerve palsy at Farabi Hospital, Tehran Province, Iran. Results: In terms of fourth nerve palsy, the mean spherical equivalent (SE) in the right and left eye was 0.23±1.51 and 0.19±1.45 diopter, respectively. Also, the mean angle of vertical deviation was 15.54±8.85 Δ at near and 15.66±8.93 Δ at far. In patients with third nerve palsy, the mean SE in the right and left eye was -0.02±2.08 and 0.08±1.95 diopter, respectively. Also, the mean angle of vertical deviation was 17.8±17.4 Δ at near and 17.8±17.5 Δ at far. In terms of six nerve palsy, the mean SE in the right and left eye was -1.27±3.37 and -1.08±2.52 diopter, respectively. Also, the mean angle of esotropia was 32.4±7.7 Δ at near and 33±6.7 Δ at far. The frequency of amblyopia in patients with third, fourth, and sixth nerve palsies was 21 patients (23.3%), 70(14%), and 4(57.1%), respectively. Conclusion: The clinical characteristics of patients with different types of EOM palsy are remarkably different, which can be attributed to the different properties of these kinds of deviations. https://jmr.tums.ac.ir/index.php/jmr/article/view/823

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 2 2024 01 23 229 237 Masahiro Noguchi Department of Physical Therapy, Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan. Miho Tanaka Department of Physical Therapy, Mizuho Hospital, Tsubata, Japan. Yoshitaka Koshino Department of Internal Medicine, Mizuho Hospital, Tsubata, Japan. 2023 01 10 2023 02 28 Introduction: Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the best exercise regimen is ineffective if not sustained. This study aims to determine the dropout rate and factors influencing exercise therapy discontinuation during dialysis. Materials and Methods: This observational, retrospective, and descriptive study included 31 people who underwent exercise therapy during hemodialysis sessions between April 2015 and March 2018 at a hospital. The mean age of the participants was 59.29±11.12 years (range 36–78 years), and the male/female ratio was 24/7. The participants were divided into two groups, the continuation group (15 patients who continued exercise) and the discontinuation group (16 patients who discontinued exercise). Data on physical function history (knee extension muscle strength, one-leg standing time (OLS), and 6-minute walking distance (6 MD)) were collected from medical records. All participants were interviewed using a questionnaire on factors involved in exercise discontinuation from April 2018 to March 2022. Results: About half of the participants dropped out (51.6%). In particular, the results suggested that body pain was strongly associated with exercise discontinuation. In addition, 8 participants in the discontinuation group died during follow-up after exercise discontinuation (50%). Conclusion: The study results suggest that it is essential to increase self-efficacy and satisfaction by devising exercise content that meets the individual’s wishes to prevent dropouts during dialysis. In addition, measures against body pain are crucial to continue exercising. The relationship between exercise discontinuation during hemodialysis and mortality should be further examined. https://jmr.tums.ac.ir/index.php/jmr/article/view/818

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 2 2024 01 23 238 246 Zahra Chakeri Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Saeed Talebian Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Fariba Ghaderi Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. 2022 05 30 2023 03 15 Introduction: The application of Kinesio taping (KT) is a rehabilitation technique used to provide muscle and joint support and stability, without limiting the range of motion (ROM). No study evaluated the effects of KT on lumbar flexion relaxation phenomenon and kinematic details after static flexion. This study aims to find out the results of KT on erector spinae (ES) muscle activity, flexion relaxation pattern, and trunk, lumbar, and hip range of motion in healthy subjects during static flexion. Materials and Methods: This study used a two-factor within-group design. Twenty-two healthy female students participated in this study. We used surface electromyography (EMG) to assess ES muscle activity and measured kinematic information with data from the camera. Variables related to muscle activity and angles in forward bending movement before and after creep were investigated. The test was performed in two situations with and without the use of KT. Results: KT reduced the time of muscle activity during bending. Also, KT increased trunk, and hip angles at the end of forward flexion. In the lumbar extension phase, the ES muscles were activated later. Conclusion: KT can prevent the increase of lumbar spine flexion angle due to the creep effect. It can be used to protect the strained viscoelastic structures and increase the involvement of cutaneous receptors. KT