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 Background and Aim: Spasticity is a motor disorder characterized by a velocity dependent increase in tonic stretch reflex and tendon jerks, due to the hyper-excitability of the stretch reflex. Modified Tardieu Scale (MTS) is a clinical tool for assessment of spasticity. The purpose of this study was to investigate intra-rater reliability of the MTS for knee extensors and ankle plantar flexors muscles in adult subjects with chronic stroke.

 Materials and Methods: In an analytical cross sectional study, 17 participants (10 men ,7 women) with age range of 40-76 years and mean time post stroke of 20/79 (SD=20/55) in a convenient sampling took part in this test-retest study. Intra-rater reliability of spasticity with MTS was investigated by one un-experienced physiotherapist for knee extensors and ankle plantar flexors in two sessions over one week. 

 Results: Interclass correlation coefficient (ICC) values for R₂-R₁ as an indicator of spasticity in knee extensor and plantar flexors was good (ICC=0/66) and very good (ICC=0/87) and for knee extensors and ankle plantar flexors quality of muscle reaction was 0.80 and 0.92 respectively.

 Conclusion: The MTS has a good reliability in spasticity assessment of knee extensors and ankle plantar muscles after stroke. Probably MTS can be used as a reliable clinical tool to measure spasticity of lower extremity muscles in adult subjects with chronic stroke.

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Background and aim: Various studies indicate that background noise affects speech recognition ability of bilingual listeners (BL) more than monolingual ones (ML). However, no study has engaged in the speech recognition performance of Turkish-Persian bilinguals in the background noise. The purpose of the present study was to compare word recognition scores (WRSs) in the continuous and interrupted noises among ML Persian and BL Turkish-Persian young adults. 

Material and methods: The cross- sectional analytical study was conducted by presenting speech stimuli in quiet and in the background continuous and interrupted noises at signal to noise ratios (SNRs) of -20, -10, 0, +10 dB. Two groups of 33 ML Persian and 36 BL Turkish- Persian subjects with age ranging from eighteen to twenty-five years old participated   

Results: The degree of reduction in WRSs was significantly higher in the continuous noise relative to the interrupted one at four studied SNRs (p<0.0001) Moreover, the difference between WRSs of ML Persian and BL Turkish-Persian groups in the presence of both continuous (p≤0.001) and interrupted (p=0.002) noises was significant.

Conclusion: It seems that Persian-words recognition ability of Turkish-Persian BLs reduces more than Persian MLs in the background noises and continuous noise affects speech perception ability more than interrupted one. 

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Background and Aim: Spasticity is one of the symptoms that contributes to functional limitation in adults with cerebral palsy and characterized by a velocity dependent increase in tonic reflex due to the hyperexcitability of the stretch reflex. Modified Tardieu Scale (MTS) is a valid clinical tool for assessment of spasticity. The purpose of this study was to investigate Inter-rater reliability of the Modified Tardieu Scale (MTS) for hip adductors, knee extensors and ankle plantar flexors muscles in adult subjects with cerebral palsy.

 Materials and Methods: In an analytical cross sectional study, 30participants (11 men ،21 women, age range 20 to 40 years, mean age (26.57±4.8) with spastic cerebral palsy from Ra'ad Rehabilitation Goodwill Complexes in Tehran city in a convenient sampling took part in this study. Spasticity was measured by two physiotherapist for hip adductors, knee extensors and ankle plantar flexors with MTS during same session with ten minutes interval between assessment of two raters.

 Results: ICC values for R₂-R₁ as an indicator of spasticity in hip adductors, knee extensor and plantar flexors were 0.97, 0.88 and 0.81 respectively. Also ICC Values for quality of muscle reaction was 0.89 in hip adductors, 0.96 in knee extensors and 0.92 in ankle plantar flexors

Conclusion: MTS has a high reliability in spasticity assessment of adductors, knee extensors and ankle plantar flexors muscles, Probably MTS can be used as a reliable clinical tool to measure spasticity of lower extremity muscles in adult subjects with cerebral palsy.

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Background and Aim: Fatigue is one of the most common problem of multiple sclerosis. It is a sign of inefficiency in the physical, social, and cognitive function. It is a major factor in limiting the responsibilities of social work of patients.The aim of this study was to translate and culturally adapt the Fatigue Impact Scale (FIS) in Iranian and create an appropriate tool for measuring the impact of fatigue and effectiveness of treatment and also rehabilitation interventions on fatigue in Iranian patients. 

Materials and Methods: In order to use the FIS in Iranian patients, the forward  and backward translation and assessing the patient's perspective was done and the Persian version of the questionnaire was prepared.

Results: The questionnaire was completed by twenty patients with multiple sclerosis. The time duration of filling out of each questionnaire took ten to twenty minutes .The final corrections was carried out. All questions of patients was acceptable and understandable and questions of "sexual activity" was completed only by married patients. The question of "financial support" was completed only by employed person (working people). Finally, as much as possible, this questionnaire was adapted with Iranian culture and sentences were confirmed by MAPI Institute.

Conclusion: Persian version of the FIS is an appropriate tool for measuring the impact of fatigue, effectiveness of treatment and rehabilitation interventions on fatigue in patients with multiple sclerosis.

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Back ground and Aim: Some left brain- damaged stroke patients display both oral and verbal apraxia, while others may appear to have one or none of them. So the present study was focused on investigating the severity and relationship of oral and verbal apraxia in these patients.

  

Materials and Methods: In this cross sectional descriptive-analytic study, 20 left hemisphere damaged patients due to a single ischemic CVA (8 women, 12 men) with an average age of 60.68 years (range, 35-73) were recruited using convenience sampling. An oral apraxia task was applied to examine imitation of oral motor gestures, and the verbal apraxia was tested by a speech production task. Data were analyzed by U Mann-Whitney, Kruskal-Wallis and Pearson correlation.

  

Results: Analysis of data revealed that 4 patients showed prominent oral apraxia, 12 patients suffered from prominent verbal apraxia and 4 had a combination of both types with relative equal severities. No significant correlation between oral apraxia and verbal apraxia was observed (p= 0.899).

  

Conclusion: According to the findings, the co-occurrence pattern of oral and verbal apraxia seems not to be a predictable one. Despite of the fact that ischemic lesions lead to damage of neighboring neural substrates, half of the patients revealed dissociation of oral and verbal apraxia. This dissociation may be interpreted as an evidence of a modular task-specific neuromotor control system , which considers non-speech oral movement control independent of speech motor control .

  

Key words: Apraxia, Oral apraxia, Verbal apraxia, oral apraxia prominence, Verbal apraxia prominence

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Background and Aim: Oral feeding difficulties are common in children with cerebral palsy. Early oral motor interventions may improve oral feeding skills in these children. The purpose of this study is to evaluate the effect of intervention duration of oral motor stimulation on feeding skills in spastic cerebral palsy.

  

Materials and Methods: Twelve children with spastic cerebral palsy 2-7 years aged were participated into two groups A and B. Children in the group A received oral-motor stimulation for 12 session(3 days per week) and group B received stimulation program for 24 session(3 days per week).Feeding skills was assessed using Oral Motor Assessment Scale (OMAS). Data were analyzed using Friedman and Mann-Whitney tests.

  

Results : The results of the study revealed a significant improvement in feeding skills for both groups. The B group had significantly advanced in mouth closure, lip closure on utensil and sucking straw than children in group A (P<0.05). The difference between two group in control of food during deglutition, mastication and control of liquid during deglutition was not significant (P>0.05).There was difference in the total score of feeding skills was not significant between the two groups (P>0.05).

  

Conclusion: Oral-motor intervention might be improved feeding performance in children with cerebral palsy but continuation (increased duration) of intervention improved specific components of feeding behaviors.

  

Key Words: Spastic cerebral palsy, Feeding skills, Oral motor stimulation

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Background and Aim: There are many studies about differences between children who stutter and normal pairs in language and cognition domains. On the other hand, a variety of treatment approaches is suggested for stuttering therapy in children. One of them is prolongation (a fluency shaping approach). The aim of the present study is to investigate the effect of prolongation approach on phonological working memory in children with mild and moderate stuttering.

Materials and Methods: Twenty five children who stutter 4 to 6 years old were selected according to inclusion and exclusion criteria, and then non-word repetition test, pre and post treatment were conducted. Intervention process was based on Hedge’s treatment protocol (prolongation). Their score in non word repetition test and stuttering severity was calculated by SSI, pre and post intervention and compared by SPSS soft ware (version 18) And Wilcoxon singed – rank test .

Results: Severity of stuttering was diminished significantly after and before treatment (p<0.05). In non word repetition test, the number of correct non word including single syllable, two syllable and three syllable, pre and post treatment showed significant differences (p<0.05).  There was no relationship between children’s age and their improvement (p>0.05).

Conclusion: Results revealed that prolongation approach had significant effect on improving non word repetition ability and diminishing severity of stuttering. This approach as a form of fluency shaping which usually is based on motor theories had significant effect on increasing phonological working memory capacity.

Key words: Stuttering, Phonological working memory, Fluency shaping, Prolongation approach

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Background and Aim: Perception of words is one of the parameters that examine to assess the language skills, due to lack of appropriate test in this field, informal assessing was done and evaluating of Perception of words has been challenged. The aim of this study is to design and determine the characteristics of Picture perceptive Objective Vocabulary Test for normal Persian-speaking 6-13 years-old children in order to examine the perception of words accurately.

Materials and Methods: In this methodological study that was done cross-sectional, a list of words that had the ability to visualize, prepared. To determine the content validity index, 7 speech therapists were surveyed and were chosen 240 images of words, finally this test was done on 118 children (57 girls, 61 boys) in seven age groups. Reliability of this test was assessed by repeatability and internal consistency and correlation between children’s scores and their age was determined by Spearman’s correlation.

Results: Content validity index  for total of 240 words were 1. In assessing reliability of this test Spearman’s correlation and internal consistency were 0.87 and 0.83 obtained respectively. There was a significant correlation between children’s ability to respond and their age (p<0.0005).

Conclusion: Pictures test for assessing the ability for perception of words in different categories of 6-13 years old children have appropriate content validity and reliability. In the age range of the study, child's ability to perception of words increases with age.

Keywords: Picture Perceptive Objective Vocabulary Test, children, Validity and Reliability