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Background and Aim: Academic evaluation is a systematic process for collecting, analyzing and interpretation of the obtained educational information. The purpose is that how many educational objectives can be achieved. The goal of education is creating effective & efficient changes in the outcome of this system (i.e. students), and finally, promotion of the quality of educational process. In the following study, internal evaluation in 8 educational domains of the Physical therapy Department of the Rehabilitation Faculty (TUMS) was performed.

Materials and Methods: Physical therapy Department of the Rehabilitation Faculty (TUMS) was evaluated using the opinion of the faculties, students and graduates in the academic year 2003-2005. The aim was to adjust the system according to the golden standard and community needs by using a cross sectional and descriptive method. This was done on the basis of 10 procedural steps, within 8 domains such as faculties, management, student's opinion, staff and logistic affairs, classes, library, clinics, equipments, laboratory, satisfaction of graduates and curriculum.

It is worthwhile to mention that there was no golden standard available in Iran for Physical Therapy Department. Therefore, by using the standards of prestigious universities of the world & opinion of Iranian experts, for the first time in Iran, a native golden standard was defined by the principal investigators. The results of the research were compared with the golden standard.

Results: The results of study showed that the mean of 8 domains based on SWOTs model was 76/2% which may be interpreted as a positive model. Among the 8 domains, the clinics, classes & library were rated the best (95%) and student's satisfaction was 65.3%.

Conclusion: The results of the current study showed that academic evaluation is the best indicator for representing the strength, weakness, opportunity & threats of the educational system. These results could be used for promotion, adjusting & remodeling of the academic system. 

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Background and Aim: The goal of this study is to determine the effects of comprehensive cardiac rehabilitation program (CCRP) on various domains of health related quality of life (HRQOL) in coronary artery bypass grafts (CABG) patients.

Materials & Methods: Forty- four post CABG patients aged 40 - 60 years (mean age = 52.95, SD = 6.02) participated in Phase II CCRP. The SF-36 health survey was used to assess the HRQOL before and after the CCRP and at three-month follow up. The data of patients were compared before and after the intervention and with the normal values of age matched (45-64 Yrs., 882 persons).

Results: The findings showed that there was a significant difference in seven domains of HRQOL between patients prior to CCRP and general population (P ≤ 0.05). There was a significant difference in all HRQOL domains after CCRP (P ≤ 0.005). Five out of 8 domains of HRQOL were unchanged at least 3 months after the CCRP, whereas there was an improvement in 3 domains of HRQOL (P ≤ 0.05).

Conclusion: The results of this study suggest that the physical and mental health interventions in CCRP are among  critical  keys to prevent and/or at least decrease the adverse effects of surgery on HRQOL.

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Background and aim: There is neuroplasticity in all of life time, from newborn to elderly and neuronal connections are being created and broken by experiences and states of health or disease. The recovery of people with stroke or cerebral palsy can be a sign of neuroplasticity.

The aim of this article is to detect significance of neuroplasticity and critical period of recovery in central nervous system after stroke and cerebral palsy.

Materials and methods: This study is based on review of internal and external articles that published about neuroplasticity in central nervous system after stroke and cerebral palsy from 1987 to 2007.

Results: According to review the articles the mechanisms of neuroplasticity after stroke and cerebral palsy consist of Axonal and dendrites Sprouting, cortical reorganization and neurogenesis.

The rehabilitation protocols have a direct effect on integration and reorganization in intact areas adjacent to injured motor areas of cortex.

Conclusion: This study showed that reorganization continually occurs in response to task, behavior and learning skills.

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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.

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Background and aim: One of the most important part of management and modification of CAD risk factor is to control the level of plasma lipid profile. Application of comprehensive cardiac rehabilitation in patient with CAD could decrease the level of CHL, TG, LDL and increasing of HDL .There are a lot of studies that discuss the effect of rehabilitation on different people with different races and life style
Material and Methods: Thirty six patients with the age (40-75) who were referred by cardiologist participated in this study. Fast walking on treadmill, biking on stationary bicycle and cycling with upper body ergometer were chosen as aerobic exercises. For assessing the short term and long term effects of this protocol, blood sampling were taken at three stages before exercise initiation, after 12 and 24 sessions of exercise.
Results: Following the cardiac rehabilitation protocol, the level of CHL, LDL and the ratio of LDL/HDL and CHL/HDL decreased significantly.
Conclusion: Cardiac rehabilitation could be used as means to improve lipid profile level in blood serum, prevention of cardiovascular disease and reducing mortality and morbidity rates.

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Background and aim: Human knee joints experience very large loads and motions during regular daily, occupational and sport activities. Consequently, they are at high risk of being exposed to injuries and degeneration. Osteoarthritis and ligament injuries often inflict knee joints causing considerable pain and loss of productivity involving thus significant human and economic costs. Hence, biomechanics of human knee joints has been the focus of many investigations with the primary aim to improve understanding of joint function in normal and perturbed conditions. The existing prevention and treatment programs have been based on such studies.
Material and Methods: Due to inherent costs, limitations, difficulties and ethical concerns associated with in vivo and in vitro cadaveric studies, finite element model studies have been developed as effective, powerful and complementary tools to investigate knee joint biomechanics subject to internal and external mechanical conditions affecting its normal function.
Results: The advantage of finite element method in study of joint biomechanics lies in its robustness to incorporate complex 3D joint geometry, intricate boundary and loading conditions and materials with nonhomogeneous and nonlinear properties.
Conclusion:This article reviews important model studies, presents their relevant results and discusses some of the promising future directions.

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Background and Aim: Anterior knee pain (AKP or AnKP) is one of the most common disorders of knee. Many studies have been implemented about anterior knee pain and effect of different treatments on this disorder. Todays, this general term has been divided and studied more closely. Knee extension syndrome is one of the common disorders in orthopedic and physical therapy that diagnosed with increased stiffness of quadriceps muscle and causes anterior knee pain. The purpose of this review article is to evaluate this disorder more closely.

Materials and Methods: A literature search was carried out using MEDLINE and SCIENCE DIRECT cite and JOSPT journal database to assess existing literature about anterior knee pain. Furthermore, literatures about the different standpoints of anterior knee pain and effectiveness of different treatments and interventions of anterior knee pain and knee extension syndrome have been identified.

 Results: Fifty articles have been surveyed: forty-two articles evaluated the effect of different treatments on anterior knee pain. Five articles evaluated the various aspects of anterior knee pain more closely and three ones related to knee extension syndrome.

Conclusion: According to these studies results, the causes of anterior knee pain can be classified in two categories: 1) anterior knee pain associated with patellofemoral disorders and 2) anterior knee pain non-associated with patellofemoral disorders. The knee extension syndrome is the cause for anterior knee pain but non-associated with patellofemoral disorders. In this disorder, the tilt angle of patella could be increased and this factor can increase the patients' pain. In contrast to general belief that focuses on tensor fascia lata- ilotiobial band complex (TFL-ITB complex), the rectus femoris muscle stretching should be focused more, because the ilotiobial band has a less effect on patellar tilt. 

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Background and Aim: One of the consequences of obesity is coronary artery disease (CAD) and diabetes. Effective exercise programs for patients with the coronary artery disease is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health. The purpose of this study was to compare the effectiveness of a physiotherapy and exercise based cardiac rehabilitation  on the anthropometric measurements of obesity in the diabetic and non diabetic men. 

Materials and Methods: Seventy one 45- to 75-years-old male volunteers with coronary artery disease (32 diabetic & 39 non diabetic patients) participated in 6-8 weeks of moderate intensity aerobic exercise training consisting of 45 min sessions of  treadmill, stationary bicycle and arm bicycle. Anthropometric measurements of obesity (body mass index (BMI), waist circumference, hip circumference, waist to hip ratio and waist to height ratio) were measured at the beginning, in the middle and at the end of exercise sessions in both groups.

Results: Following the cardiac rehabilitation program, all of the anthropometric measurements except hip circumference in diabetic patients decreased significantly (P<0.05). BMI, waist circumference and waist to height ratio  increased in non diabetic patients (P<0.05).

 Conclusion: Exercise training alone in cardiac rehabilitation program is not sufficient to reduce the anthropometric measurements of obesity in non-diabetic patients. 

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Background and Aim: One of the consequences of obesity is coronary artery disease (CAD) and diabetes. Effective exercise programs for patients with the coronary artery disease is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health. The purpose of this study was to compare the effectiveness of a physiotherapy and exercise based cardiac rehabilitation  on the anthropometric measurements of obesity in the diabetic and non diabetic men.

Materials and Methods: Seventy one 45- to 75-years-old male volunteers with coronary artery disease (32 diabetic & 39 non diabetic patients) participated in 6-8 weeks of moderate intensity aerobic exercise training consisting of 45 min sessions of  treadmill, stationary bicycle and arm bicycle. Anthropometric measurements of obesity (body mass index (BMI), waist circumference, hip circumference, waist the hip ratio and waist to height ratio) were measured at the beginning, in the middle and at the end of exercise sessions in both groups.

Results: Following the cardiac rehabilitation program, all of the anthropometric measurements except hip circumference in diabetic patients decreased significantly (P<0.05). BMI, waist circumference and waist to height ratio  increased in non diabetic patients (P<0.05).

Conclusion: Exercise training alone in cardiac rehabilitation program is not sufficient to reduce the anthropometric measurements of obesity in non-diabetic patients. 

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Background and Aim: Many key problems in autistic children are related to executive dysfunction. This dysfunction is usually occurred due to structural and functional dissociation between brain regions. So neurofeedback can be used as a new treatment procedure in improving children's executive function through modifying brain waves but behavioral changes are usually reflection of long-term changes in the brain level. Therefore the purpose of this study is to investigate the overall effect of neurofeedback training and behavioral effects caused by adding occupational therapy based on cognitive rehabilitation.
Materials and Methods: Single system (A-B-A-B+C-A) design was used in this study. Participants were 2 children with autism spectrum disorder who completed 41 sessions during the study. They received neurofeedback intervention alone (B) during 20 sessions and in the following 12 sessions neurofeedback with occupational therapy (B+C). In this study, Wisconsin card sorting and tower of london tests were used for collecting information on children,s executive functions.
Results: According to the obtained results, the effect size of neurofeedback training on executive function was high for both participants. The rate of shifting attention was improved as one of the executive function items after adding occupational therapy and also the increasing effect of neurofeedback in planning was maintained.
Conclusion: The results of this study showed that neurofeedback can improve executive function in autistic children and the effect of neurofeedback can be more obvious if occupational therapy will be added. But gaining more significant behavioral changes after receiving occupational therapy needs more sessions.

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Abstract

Background and Aim: Visual impairment affects people's quality of life. Since the effect of rehabilitation services is measured by improving in quality of life, this study was performed to evaluate the effect of rehabilitation services on quality of life in the blind.

Materials and Methods: 121 blind and low vision people who covered by Zahedan Welfare Organization were studied by census method in this descriptive analytical study. Data was collected using demographic questionnaire (including demographic information and rehabilitation services information in the people) and quality of life questionnaire for the blind. This questionnaire was translated to Persian by Tavakol et al wich its and validity and reliability was assessed with using content validity and test-re-test method, respectively (0.89

Results: T-test results showed the mean score of quality of life significantly higher in patients who had rehabilitation service than persons deprived of services (p=0.03). Mann-Whitney test showed these patients have significantly higher quality of life in mobility domain (p=0.01) and self-care (p<0.001).

Conclusion: According to the results, developing rehabilitation services and providing social programs for the blind is suggested.

Keywords: rehabilitation service, quality of life, blind people, low vision people

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 Background and Aim: Family is the center and core of the care. Researchers who work with children with disabilities have shown that effective services are those that are focused on the role of families in treatment. The main aim of this study was an overview of family-centered approach (FCA).

  

 Material and Method: This study is a review of the national and international databases between 1985 and 201 2 .

  

 Result: Based on the exploration articles and documents, family-centered approach (FCA)

 has been advocated across a wide range of professions from health care (physician, nursing and midwifery), therapy services, early intervention, early childhood education, special and general education. The main essence of FCA includes parental involvement in decision making, collaboration and partnership, mutual respect (family and therapist), acceptance of the family’s choices, support, a focus on strengths, individualized and flexible service delivery, information sharing, and empowerment.

  

 Conclusion: family-centered approach (FCA) is effective, for children, parents, families, and the service provider. It enhances health care and increases family satisfaction of service delivery system. Perhaps because of the lack of sufficient knowledge and education about FCA, lack of educational materials and training in the medical model, there is limitation in implementation of FCA in Iran

  

  Keywords: Family centered approach, Rehabilitation, Occupational Therapy

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Background and Aim: Importance-Performance Analysis (IPA) is a technique widely used in developing marketing strategies and improving products or service quality. The purpose of this study is to evaluate the quality of rehabilitation services in two aspects of importance and satisfaction with performance in four selected centers in Tehran by using IPA and also examine the relationship between demographic variables and dimensions of the service quality.

 

Materials and Methods: This is a cross-sectional study which was done among the 196 patients who visited four selected rehabilitation centers in Tehran (Helal­-e­-Ahmar, Molavi, Emam Khomeini and Shafa). A questionnaire was used to assess the quality of services in these centers. Data were analyzed using SPSS software version 17.

  

Results : According to the results, the quality of services in selected centers took place in the first quarter of Importance-Performance Analysis that means they are in desirable situation. In addition, no significant difference was observed among importance and performance of dimensions of service quality and age and sex variables (P>0.05). But there was a correlation between importance (P=0.04) and satisfaction with performance (P=0.03) in tangibles dimension and also between importance and level of education variable in assurance dimension (P=0.01).

  

Conclusion : Although the selected centers were in the favorable situation, but the managers should be aware of strengths and weaknesses of the organization so that they provide quality improvement and increase customer’s satisfaction.

 

Key words : Customer satisfaction, Quality of services, Rehabilitation services, Importance-Performance Analysis

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Background and Aim: The aim of the Community-Based Rehabilitation program is to enhance the quality of life of people with different disabilities including those affected by hearing impairment. The objective of this study was to explore the effect of CBR program on the quality of life of people of 15-65 years old with severe and profound hearing loss old who lived in the city of Sabzevar.

  

Materials and Methods: In this cross-sectional, the quality of life of people of 15-65 years old with severe and profound hearing loss who lived in the city of Sabzevar were assessed by using a standardized questionnaire SF36 in two groups consist of case group(those who were covered by Community Based Rehabilitation) and control group(those who were not covered by the Community Based Rehabilitation ). Data were analyzed by SPSS software version 17.

  

Results: The number of both groups of cases and controls was equal (each one 46 persons). In this study 63.04 percent of participants were hearing loss and 36.96 were deaf. There was a significant difference between case group and control group in general health perception, social functioning and role limitation due to emotional problems aspects. Overall quality of life scores in case group were higher than control group. Quality of life scores by age, gender, and education were not significantly different between case and control groups.

  

Conclusion: The results of this study confirmed that the effectiveness of community-based rehabilitation program on quality of life of people with hearing impairment.

  

Key Words: Quality of life, Community-Based Rehabilitation, Severe and profound hearing loss

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Background and Aim: The aim of this study was to investigate the structure of passive resistive moment of elbow joint acting against movement and also to apply it in order to create a similar moment mechanism for rehabilitation and practical equipment to perform joint movements according to sports medicine and rehabilitation scopes and notifications.

Materials and Methods: Eight healthy men were recruited in order to establish the subjects group which had no history of neurological or musculo-skeletal pathology. Five cyclic passive elbow flexions were performed by a Cybex isokinetic dynamometer at 15 and 45 deg/s through 0 to 130 degree of range of motion. The experimental data was exported to the MATLAB software for analysis.

Results: Investigation of the structure of the components of the passive resistive moment showed that the most compatibility with passive resistive moment observed in the combined use of weight and pneumatic resistive moments.

Conclusion: Finally it was concluded that the possibility of reaching optimized movement, reduction of damage to the tissues and joints and also reduction of energy dissipation due to inertia were provided by the use of the function of natural resistive moment of the limbs in order to create a resistive mechanism for rehabilitation and practical equipment

Keywords: Elbow joint, Passive resistive moment, Rehabilitation equipment, Viscoelastic