Modern Rehabilitation

A Comparison Between The Immediate Effects Of Two

KH khademi kalantari

Background and aim: The great amount of load tolerated by the knee joint during daily activities has made this joint the most vulnerable joint to osteoarthritis. Different types of knee orthosis are prescribed for treatment and among them neopran and 3 pressure points orthosis are the most common ones. Although these orthosis are used widely, little is known about their effects on the relief of patient's symptoms. In this study the immediate effects of two "4 spring-loaded neopran" and "3 pressure points corrective" knee orthosis on the pain reduction and functional improvement of the patients suffering from medial compartment knee orthosis were compared.

Materials and methods: Twenty patients (age 53±12) with medial compartment knee osteoarthritis, with severity of less than grade 4 (based on the Kellgren & Lowrence grading method and diagnosis of an orthopedist) and tibiofemoral angle of above 180º were recruited. The functional performance was assessed by 6 min walking test in the first day without orthosis and in the 2^nd and 3^rd day immediately after wearing one of the orthosis in random order. The intensity of pain was evaluated by 100 mm VAS test in the first day before and after 6 min walking test and in the 2^nd and 3^rd day only after the walking test.

Results: Both orthosis induced a significant reduction in patient's pain (p<0.01) and improvement in functional capacity (p<0.01). the comparison between the two orthosis regarding the pain reduction after the walking test revealed the dominance of the 3 pressure points corrective orthosis (p<0.007). The difference between the functional improvements of two knee orthosis was statistically not significant (average increase in walking distance of 15 m and 24 meters for neopran and 3 pressure point orthosis).

Conclusion: The 3 pressure point and neopran knee orthosis can induce significant reduction in pain and improvement in the functional capacity of the patients with medial compartment knee osteoarthritis. The 3 pressure point orthosis seems to dominate the neopran in pain reduction and functional improvement (however not statistically significant).

Body Part Identification in 1 to 4 years old children (East of Tehran)

SH Rafiee

Back ground and aim: The development of body parts identification is parallel with the development of sensory motor. The proper evaluation of developmental is done in western countries, but they are not designed for different races, therefore we decide to survey about body part identification in Tehran.
Materials and Methods: This study performed on 90 children (46 girls and 44 boys) of 1-4years old in east of Tehran with cross sectional design. The first demographic questionnaire was completed by chief nursery and then the second section of questionnaire which was consisted of self body and doll body parts identification, filled in order to determine the number of parts pointed for obtaining of total grade survey on the children and dolls bodies.
Results: The findings showed that there were significant difference between three group of age (P<0.0001). There was no significant differences between two gender groups (boys and girls) in scores mean of self and doll bodies identification in all age groups (P>0.05). In final there was no significant difference between body identification on self body and doll body (P=0.12).
Conclusion: Children who are unable to point to body parts may be at risk for delays in language, cognition, and body scheme development and should be screened or evaluated further.

A comparative study of core vocabulary frequency in children who Stutter and who do not stutter in primary school

Farhad Sakhaei

Background and Aim: Several recent studies have suggested that young children who stutter tend to show depressed lexical performance relative to peers. Children who stutter was produced fewer total verbs and fewer different verbs than peers did, but these differences can not be attributed to increased general all-purpose verb use. Production of gap verbs was similar between the groups. The fact that the children who stutter produce significantly fewer verbs in their samples relative to peers and overall lexical diversity would be impacted by children who stutter producing fewer total and fewer different verbs. Likewise, if children who stutter produced fewer verbs than peers did, mean length utterance should be impacted, as well due to challenge in learning verbs in children it is important to assess lexical diversity in children.

Material and Methods: This research was a descriptive-analysis study and cases was selected in speech therapy clinics that conducted on 57 non-stutter children and 13 stutter children (primary school).Due to effects of some distortion factors on the frequency of core vocabulary, we have some exclusion criteria such as: neurological disorders, language disorder, color blinded and etc. The qualified subject entered the test. Then stutter's children implemented 100 words test to access in percent and severity of stuttering. Comparison of frequency of core vocabulary implemented by word articulation test and word perceptive test and we register frequency of perceptive and expressive vocabulary in noun, verb and adjective category.

Result: The result of this study reveal that mean of frequency of expressive and receptive vocabulary in noun category in stutter children is lesser than non stutter children. There was significant difference between stutter children and non stutter children in frequency of expressive and receptive vocabulary in noun category. The mean of frequency of expressive and receptive vocabulary in adjective category in stutter children is lesser than non-stutter children. There was not significant difference between stutter children and non stutter children in frequency of expressive and receptive vocabulary in adjective category. The mean of frequency of expressive and receptive vocabulary in verb category in stutter children is lesser than non-stutter children. But there was not significant difference between stutter children and non stutter children in frequency of expressive vocabulary in verb category. There was significant difference between stutter children and non stutter children in frequency of receptive vocabulary in verb category.

Conclusion: :The results of this research indicate that frequency of expressive and receptive vocabulary in noun category in stutter children is significantly lesser than non-stutter children and stutter effect on frequency of expressive and receptive vocabulary in noun category. The frequency of expressive vocabulary in verb category in stutter children was not significantly lesser than non stutter children but frequency of receptive vocabulary in verb category in stutter children is significantly lesser than non stutter children and stutter effect on frequency of receptive vocabulary in verb category. The frequency of expressive and receptive vocabulary in adjective category in stutter children was not significantly lesser than non stutter children and stutter does not effect on frequency of expressive and receptive vocabulary in adjective category.

Reliability of a system consists of skin markers, digital photography, and AutoCAD software for measuring the knee angles

Nasrin Naseri

Background and aim: In physical evaluations, measuring the joint angle is one of the most important outcomes to assess the patient's progress, the effectiveness of various treatment techniques and to delineate the need for future treatments. The aim of this study is to study the reliability of a system consists of skin markers, digital photography, and AutoCAD software for measuring the knee joint angles.

Materials and methods: In first section, reliability of markers placement was evaluated within three different intervals (five minutes, two days, and twenty days). At second section, reliability of digital photography was evaluated while position of the skin markers and subjects was the same. At the end, in third section, reliability of angle measurement by means of AutoCAD software was assessed.

Results: In first section, the ICC for test-retest reliability of markers placement between first and second sessions, first and third sessions, and also first and forth sessions were 0.97, 0.94, and 0.73, respectively. In second section, the ICC for test-retest reliability of digital photography was 0.99 and in third section, the ICC for intra-rater reliability of angle measurement by means of AutoCAD software was 0.99 (p=0.05).

Conclusion: It was noted that the introduced system was highly reliable, so it could be utilized to measure the knee joint angles.

A comparison study in Test of Language Development (TOLD) and speech samples between children with specific language impairment and their MLU matched group

Toktam Maleki Shahmahmood

Back ground and aim: Specific language impairment is one of developmental language disorders in children which have no known etiology. Very few researches have been done about children with this type of disorder in Persian language. The aim of this study is to detect whether there are similarity in language abilities between SLI children and their MLU -m matched group or not.

Materials and Methods: In this case- control study, the results of speech samples analysis, quotients for composite scores and standard scores of subtests of TOLD, from 12(7 boys and 5 girls) 5-7 years old children with SLI were compared with the results obtained from 12 younger normal (8 boys and 5 girls) children who were matched according to MLU- m with SLI children.

Results: results show that there are no obvious differences in percent- point average use of words and morphemes in speech between two groups. While the two groups were adapted according to m-MLU, but we found that children with SLI are significantly lower than their MLU matched children in quotients for composite scores of spoken language, organization and semantic and in standard scores of sentence imitation, relational vocabulary and oral vocabulary subtests of TOLD.

Conclusion: Our findings demonstrated that some language skills in children with SLI are lower than their MLU matched peers. Results of this study were not provided evidence to support the hypothesis that children with similar m-MLU have similar language skills too. So it is necessary for clinician to consider it when they work with these children.

Internal Evaluation in the Department of Occupational Therapy Faculty of Rehabilitation Tehran University of Medical Sciences

Mehdi Abdolvahab

Background and Aim: Internal Evaluation is an appraisal of abilitieshttp://mrj.tums.ac.ir/files/0allsites/wysiwyg_en.gif and potentials. The Internal Evaluation process, especially in an Educational Department, is an effective mechanism of the Departments quality process. The Aim of this research was to determine level of factors in the Occupational therapy Department and determining points of the strength, weaknesses, opportunities and threats of the Occupational therapy department in order to improve the programs and activities after this research.

Material and Methods: This research was descriptive and analytical study. In this evaluation, nine important factors were taken into account. These include: 1- missions statement and goals 2- managerial and organization structure 3- faculty members 4- students 5- educational course and curriculum 6- graduate students 7- educational and research facilities and equipment 8- research 9- quality of treatment. Data were collected by questioner. Results were analyzed descriptively and were expressed as raw data and percentage. Scores of 49.9% was undesirable, between 49.9% and 74.9%, and more than 75% were desirable and very desirable, respectively.

Results: The nine above factors were scored as follows: 1- missions statement and goals (very desirable 4.06, 81.2%) 2- managerial and organization structure(very desirable 3.95, 79%) 3- faculty members (desirable 3.63, 72.6%) 4- students(desirable 3.1, 62%) 5- educational course and curriculum (desirable 3.56 , 71.2%) 6- graduate student (undesirable 2.25 , 45%) s 7- educational and research facilities and equipment (desirable 3.18, 63.6%) 8- research (desirable 3.11, 62.2%) 9- quality of treatment(very desirable 4.22, 84.4%) The score of the Occupational therapy department, as the main factor is 3.44 out of 5 that is 68.1%.

Conclusion: An analysis of the findings of this research study led to the understanding that the Department of Occupational therapy was desirable.

Comparison of some language characteristics between dyslexic children aged 7 & 8 years old and normal ones.

ahra Soleymani

Back ground and aim: The present study evaluated some language characteristics include: Semantic, Syntax and phonology in children with developmental dyslexia .

Materials and Methods: For this cross sectional/analytical study, 40 children between 7 and 8 years old were recruited by non randomic sampling into 2 groups: 20 children with developmental dyslexia, with mean age of 8.04 years and 20 normal children with mean age 8.11 years. Data were collected using Parents Questionnaire,Teacher Questionnair and selected texts for informal evaluation, and we use Raven test of intelligence and Test of Reading and Dyslexia (NAMA) for diagnosing dyslexic children more carefully. At the end we use Test of Language Development-P:3 for comparing the language characteristics between 2 groups. Data were analyzed using t-test and Mann-Whitney.

Results: Children with Dyslexia differ from the normal children in some language characteristics include : Semantic, Syntax and phonology. Comparing the means of Picture vocabulary,Oral vocabulary and Relational vocabulary tests were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Comparing the means of Sentence imitation, Sentence comprehension and Sentence completation tests were illustrated in 3 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Comparing the means of Phoneme analyze and Word discrimination tests were illustrated in 2 distinct features, demonstrated meaninngful difference between 2 groups ( p<0.05 ). Only in Word speaking Test there were no significant difference between 2 groups ( p>0.05 ).

Conclusion: In regard with these findings, accurate and deep evaluation of language by speech therapist is essential for dyslexic children and also speech therapy with focus on language skills can be clinical treatment, parallel to the traditional methods, in children with dyslexia.

Knowledge, Attitude and Practice of Osteoporosis among a group of Iranian Adolescent Females (2007)

Farideh Menshadi

Back ground and aim: Osteoporosis, a multifactor disease characterized by reduction of bone mass. It is a major cause of fractures especially femoral fractures leading to morbidity, mortality and decreased quality of life. Although there is no known cure, osteoporosis and related fractures are largely preventable. Knowledge, Attitude and Practice (KAP) are the important components of any effective preventive program.The purpose of this investigation was to determine the level of KAP of osteoporosis among a group of Iranian adolescent females.

Materials and Methods: A descriptive study was conducted to determine the KAP level of osteoporosis on 626 randomly selected school girls aged 10-19 (13.9±1.4) years coming from rural and urban regions of Tehran and other provinces to students' camp in north of Tehran. A designed questionnaire with four parts containing questions regarding demographic information, knowledge, attitude and practice was used in this study. Questions were made based on YES/NO and Don't Know in knowledge and attitude (this third option allowed the respondent a choice without guessing) and just Yes /No related to the practice. Students were asked to read the guidelines and then to complete the questionnaire when they were in the camp. We descript +2 for correct responses, 0 for incorrect responses and +1 for don't know answers. The ethical committee of the Iran University of Medical Sciences & Health services approved the study. The SPSS version 11.5 statistical software was used for analysis. ANOVA, Pearson and student t-test were performed to compare mean values and significant P- value was considered at P<0.05.

Results: The total score of KAP was 2-65(43.3±13.8) .In details a range between 14-30(23±2.9), 10-22(19.2±2.4) and 2-18(10.1±2.8) were seen in knowledge, attitude and practice respectively. There was a direct correlation between total score of KAP and parents' education. Students' Knowledge and attitude, and also attitude and practice had a positive correlation. There were no relationship between parents' occupation, family number and total score of KAP.

Conclusion: Iranian adolescent females would have relevant knowledge about osteoporosis but attitude and practice of them were less than knowledge. We recommend to perform further training programs to increase practice of Iranian young women about osteoporosis.

Percent Recurrence and non linear behavior of speech muscles by surface electromyography

Saeid Talebian

Background and aim: Muscles that contribute in production of sound have an important role in specific language. Knowledge of normal activities of these muscles is very important in language dysfunction and pathologic conditions. Needle electromyography is complementary approach in clinical evaluations of above conditions but it is a painful method for evaluating of the patient. Surface electromyography can be used to neurophysiological behaviors and effect of treatment interventions and is accepted by scientific academies. The purpose of this study is appointment of new approach in this area.

Materials and methods: Sixty eight healthy subjects (34 female and 34 male) in range of 20-30 years old were contributed after supplement of questioner form in this study. Subjects sat in a chair with arm rest and recording electrodes placed on muscles of Thyroarytenoid and Cricothyroid of both side (right and left) at middle and lower parts of throat, near of 1 cm from midline. Silent activity and fricative voice (z-zh) and voiceless (s-sh) activities recorded randomly at 10 second with interval rest between them for 5 repetition. All of signals processed and then compared in time, frequency and non linear measurements.

Results: Non linear values such as Percent of recurrence, Entropy were reduced significantly in fricative voice (P<0.05).

Conclusion: Surface activity recording of Thyroarytenoid and Cricothyroid muscles is possible and sensitive parameter is non linear values. Surface electromyography is new approach for assessment of above muscle in clinical evaluation of speech pathologic conditions.

Comparison of attentional set shifting in cerebral palsy children with normal in aged 7-12 years

Gholam Olyaei

Back ground and aim: The present study evaluates attentional set shifting, that is from the most important executive functions in performing the learning tasks and intellectual actions in children with cerebral palsy (spastic diplegia).
Materials and Methods: For this cross sectional/analytical study, 40 children between 7 and 12 were recruited by random sampling into 2 groups: 20 children with cerebral palsy (spastic diplegia), with mean age of 8.94 years old and 20 normal children with mean age of 8.86 years old. Data were collected using Strengths and Difficulties Questionnaire (SDQ), CANTAB and Raven test of intelligence. Data were analyzed using independent t-test.
Results: Children with cerebral palsy did not differ from the normal children in attentional set shifting. Comparing of the means of errors, trials and complete stages, with 18 outputs over all, demonstrated no significant difference between 2 groups (p>0.05).
Conclusion: In regard with these findings, it seems that children with cerebral palsy are not weak in attentional set shifting in comparing with peers, while in some other metacognitive functions such as spatial planning, working memory capacity and spatial working memory, these children are more retarded than normal children.