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Background and Aim: Balance is an essential part of motor development. Assessment of balance in children with neurological disorders is necessary before any treatment. There are various versions of balance tests for adult assessment however, little has been done with regard to a reliable test for evaluating the balance in children with spastic cerebral palsy.      

The purpose of this study was to investigate inter and intra rater reliability of Berg balance scale in children with spastic hemieplegia.

Material & Methods: 20 Spastic hemieplegia children were participated in this study (cross sectional).  Children were in the range of 6-12 Yrs (Mean & SD, 7/10 &1/58 yrs, correspondingly). Parents were asked to sign the informed consent. Berg Balance Scale tested in one session by two therapist for inter rater and repeated tests by the same therapist for intra rater reliability after a week.

Results: Intraclass correlation coefficient (ICC) test was used for inter rater (between two therapists, ICC= 0.966, p<001 and intra rater reliability (repeated test by the same therapist, ICC= 0.988 , p<001 ).

Conclusion: The result of this study suggests that inter rater and intra rater reliability of Berg balance scale is acceptable. Therefore, it could be used in clinic for the assessment of children with spastic hemieplegia as a reliable scale.

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Background and aim: The lateral scapular slide test (LSST) is used to determine scapular position and scapular asymmetry with the arm abducted 0, 45, and 90 degrees in the coronal plane. This test was introduced by Kibler. Assessment of scapular position is based on the derived difference measurement of bilateral scapular distances and the distance of inferior angle of scapula to spinous process of T7 vertebra. The purpose of this study was to assess the reliability of measurements (intra rater, inter rater, sensitivity and specificity) of LSST in assessment of scapular asymmetry and scapular dysfunction in patients with shoulder impairments.

Materials and Methods: Subjects:  Fifty-seven subjects participated in this cross sectional study.

Twenty seven subjects in shoulder impairment group (X=47.66, SD=11.64) and thirty subjects in normal group(X=33.53, SD=11.72). Three examiners measured the distance of inferior angle of scapula to spinous process of T7 vertebra at two sides in three different positions by a caliper verneer (accuracy: 0.01 mm). Position 1 involves of the shoulder in glenohumeral joint neutral. In position 2, the humerus is placed in a position of medial rotation with 45 degrees of shoulder abduction. In position 3, the upper extremity is placed in a position of maximal medial rotation with 90 degrees of shoulder abduction. The data were analyzed with SPSS (version: 11.5). ICCs and SEMs were calculated.

Results: The ICCs for intra-rater reliability were 0.87 to 0.97 for subjects without and with shoulder impairments and 0.63 to 0.79 for inter-rater reliability in subjects with shoulder pathology (involved side). The SEMs ranged from 0.57 to 0.86 cm for intra-rater reliability and from 0.79 to 1.20 cm for inter-rater reliability. Sensitivity of the test was high(80% to 100%) but specificity  was low (4% to 26%).

Conclusion : The lateral scapular slide test has high sensitivity and good to high level of intra rater reliability at three different test positions. The test showed low specificity and poor to fair inter rater reliability at three different test positions particularly at position 3.

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Background and aim: The function of deep neck flexor muscles is very important in physiotherapy assessments. The purpose of this study was to examine the reliability of sphygmomanometer device to measure the strength of deep neck  muscles.

Materials and methods: Thirty healthy non-athlete females aged 18-24 years old voluntarily participated in this study. The maximal contraction of deep neck muscles were measured in different times, different days and by two different testers using a sphygmomanometer device. At each session subjects performed three maximum voluntary contractions and the maximum strength was chosen for data analysis. The Interclass Correlation of Coefficient (ICC), Pearson product moment and CV% were used to assess the reliability of different measurements between times, days and two different examiners.

Results: The results of ICC, Pearson product moment and CV% indicated that the strength measurement of cervical stabilizer muscles were highly repeatable between different times, days and testers (ICC ≥ 0.90, CV% ≤ %3.8 and r ≥ 0.91).

Conclusion: The sphygmomanometer and the method which was used in this study appeared to be a reliable and useful method to measure the force of deep neck flexor muscles. It can also be suitable for the assessment of physiotherapy or rehabilitation programs.

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Background and aim:The current research provides a word association test and determine its validity and reliability in Persian (farsi) language.
Materials and methods: A word association test was administered to a group of twenty girls and twenty one boys that were similar in age and education. Based on Goldfarb's word association test , word stimuli were balanced according to frequency of occurrence (frequent, infrequent), word length (short, long), abstraction level (low , medium, high) ,and grammatical class (noun ,verb, adjective ) . Based on "Recognition basic word's Iranian student in primary school"(nemat zade,1384),180 words were selected. This words scored by experts. Seventy two words were selected . The test administered in oral on the first grade students .Then responses were coded as paradigmatic or sytagmatic . Results were analyzed by Maknamar and Capa test.
Results: Findings show high correlation between first and second test in three grammatical Class (noun, verb, adjective, p=0/001).High correlation exists between two stages of test.
Conclusion: These findings show word association test is valid and reliable .This is usable in assessment of semantic development and language development.

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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.

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Background and aim: The goniometric measurement is a simple and common method for assessment of movements and joints in the rehabilitation clinics that the survey of sensitivity and reliability level has an important role for the therapists.  The aim of this study was to investigate inter-rater reliability of goniometric measurements of the pronation and supination movements
Material and methods: In this descriptive cross-sectional study twelve healthy student boys were participated.  The candidates were asked to sign an informed consent.Goniometric measurements were carried out by the two experienced physiotherapists to assess the forearm supination and pronation. The dominant limb was evaluated in supine position during the test. The correlation coefficient test was used for inter rater reliability.
Results: The coefficient correlation was high between the two raters, (for supination, r=0.931 and for pronation r=0.875).  The results showed that the coefficient correlation of supination was higher than pronation.
Conclusion: The results of the study indicated that the inter-rater reliability of goniometric measurements of the pronation and supination movements were high, also  the level of reliability for supination was higher than pronation.

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 Background and aim: The main problem of people with hearing loss is difficulty of hearing in background noise. One of the best tests that are used to evaluate speech perception in background noise is Quick Speech in Noise Test. The purpose of current study is to assess test-retest reliability and list equivalency of the Persian version of Quick Speech in Noise Test in young people with normal hearing. 

Material and methods: This cross-sectional study was performed on 36 young (18-35 years old) individuals with normal hearing. Materials were presented via compact disk of Persian version of quick speech in noise test with standard earphone. Almost one week after test session, re-test was performed. All of the correct words were scored and then signal to noise ratio loss was calculated.

Results: The mean SNR Loss was -1.5±0.74 dB. there was significant difference between test- retest scores for lists 1(p<0/05) and no significant difference between test- retest scores for lists 2, 3 and 4(p>0/05). There was significant difference between mean results of list 4 with list 1(p<0/05). There was significant difference for test- retest Pearson's Correlation in all lists.

Conclusion: Lists 2 and 3 of Persian version of Quick Speech in Noise Test are reliable and equivalent for determining signal to noise ratio loss.

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 Background and aim: Nowadays, importance of multidimensional approach in evaluating of stuttering  is obvious. Stuttering aspects evaluation provided by speech situation checklist. In this study, validity and reliability of this checklist is performed on stuttering and non- stuttering  (6-11 years old) pupils. 

Material and methods: In this research, 43 stutterer and 45 non-stutterer pupils were evaluated.

After equalization of questionnaire to Persian language, emotional reaction & speech disruption questionnaire were completed according to their attitude . In order to test validity, four methods were used. Data were analyzed by parametric and non-parametric statistical tests

Results: Comparison of score average of speech disruption and emotional reaction tests showed significant difference between stutter and non-stutter groups for Persian language children (p<0.05). Emotional reaction and speech disruption checklist (Persian version) has high test-retest (p=0.000,Icc>0.86) and internal validity (p=0.000,α >0.93).

Conclusion: Persian equalized speech disruption and emotional reaction tests have high validity and reliability. it might be useful to differentiate stuttering pupil among normal ones.  

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Background and Aim: Stuttering contains speech disruption or observed behaviors and inner reactions of speech- associated or emotional, disruptive, coping, and attitudinal reactions. Inner events can be reported by the person who stutters but can not be reliably defined by listener perceptions. Both the disorder's directly observable and inner elements and their interactive effects need to be fully assessed to achieve to clinically deals. This study investigates validity and reliability of the tests about inner events in stuttering children.
Materials & Methods: This descriptive and analytical study was performed on 96 stuttering and non stuttering students in 6-11 (similar in age and sex). After Persian equalization of questionnaire and verifying, tests validity are scored by 10 experts. In order to tests reliability, children performed tests in two stages (25 days interval). Three methods were used: 1.comparsion between the mean tests scores in two stage 2.Investigation of correlation between two stages. 3. Investigation of results reliability (ICC). The data were analyzed by parametric and non-parametric statistical tests (paired t-test, spearman and pearson).Independent t-test were used in order to compare the mean tests scores between stuttering and non- stuttering children.
Results: Although there was different between the mean BCL and CAT scores of stuttering and non stuttering children but this between group difference is not statistically significant (p>0.05) . The mean BCL and CAT scores between two group (stuttering and non-stuttering) was statistically significant (p<0.05).
Conclusion: Behavioral checklist and communication attitude tests changed in stuttering children at 6-11 age. Both are valid and reliable and these tests distinguish between stuttering and non stuttering children.

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Background and aim: This study was aimed to examine the reliability of a developed device measuring "arch height ratio" index.

Materials and Methods: 40 feet (the right and left foot of 20 subjects) were measured. Foot length was measured from posterior aspect of calcaneus to the tip of longest toe and dorsum height was measured at the midpoint of total foot length. All measurements were assessed in three weight bearing conditions of 10, 50 and 90 percent of total body weight on three occasions (10 minutes and five days after the first measurement) by a single rater. Finally the arch height ratio index was calculated.

Results: The ICC values in different conditions of 10, 50 and 90 percent of total body weight in 10 minutes after the first measurement were calculated 0.96, 0.97 and 0.92 and in five days after the first measurement were calculated 0.97, 0.97 and 0.91. Minimal detectable change values of arch height ratio index in all conditions of measurement were 0.01.

Conclusion: Simplicity of usage, low cost and high reliability of this device is highly recommended for clinical and research use. 

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Background and aim: Assessment of hip strength needs a reliable method. Hand-held dynamometers are appropriate alternatives for manual muscle testing and isokinetics. Stabilizing the dynamometer with hand will increase error in measurements. The purpose of this study was to compare the test-retest reliability of hand-held dynamometer fixed by hand and fixed to a new stable frame for measuring hip extension, abduction and external rotation strength in healthy female athletes.
Materials and Methods: Normalized average and peak values of torque of three successive trials for each muscle group were calculated in two sessions one week apart in ten healthy female athletes. Strength was measured with hand-held dynamometer fixed by hand and fixed to the stable frame in each session. Intra-class correlation coefficients (ICC), coefficients of variation (CV) and standard error of measurement (SEM) were calculated to determine the reliability.
Results: For hip extension, abduction, and external rotation strength measured by hand fixation. The ICC ranged from -1.22 to 0.6, the CV ranged from 8% to 33% and the SEM ranged from 0.007 to 0.04. For strength measurements with stable frame, the ICC ranged from .93 to .96, and CV ranged from 5.26% to 7.94%. The range of the SEM was from .004 to .08.
Conclusion: Measurements of hip muscles strength with a dynamometer fixed to a stable frame showed higher reliability than fixation by hand in young female athletes. These findings support the error within hand fixation of dynamometers and the necessity for providing better fixation.

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Background and Aim: Few studies have assessed the reliability of postural balance measures during dynamic balance performance that introduce additional challenging to postural control system. In addition sometimes in the static conditions some deficiencies of the postural control system may not be revealed obviously therefore the aim of this study was to assess the reliability of postural control parameters during functional performance on force plate in healthy subjects.
Materials and Methods:  Ten healthy male subjects (mean age: 25.4 years, weight: 68.2 kg height:176.9cm) participated  in this study. None of the subjects were involved in sport activities. Every subject performed three 15seconds trials of eyes open single leg stance on a force plate during dynamic balance task. Participants grasped object with hand at their waist level and release it at above shoulder level.  The reproducibility of the center of pressure (COP) deviations (average speed &length of path) was assessed. All participants were tested on 2 sessions with an inter-measurement interval of 7 days. COP data was collected for each trial. The intraclass correlation coefficient (ICC) was used as parameter of intra-session and inter-session (Test-Retest) reliability.
Results: The ICCs for intra-session reliability of average speed and length of COP path were  0.89 and 0.91  respectively. The ICCs for inter-session reliability were 0.95 and 0.96 respectively.
Conclusion: The study showed high and very high reliability for center of pressure measures during dynamic balance task. Therefore this dynamic performance can be used as a balance pattern in postural control assessment. These can be used as reliable parameters in dynamic postural control assessment due to high reliability of average speed and length of COP path

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Background and aim: The communicative functioning of children who stutter can be assessed in a variety of ways. Standardized tests are an important tool to assess communication skills particularly in stuttering children .The purpose of the present study was to translate the Test of childhood Stuttering (TOCS) into persian and investigation of validity and reliability of the test .
Materials and methods: In this research, 40 stutterers and 40 non-stutterer were evaluated. After the translation of the Test according to Protocol IQOLA and its equalization to Persian Language, Content validity and Face validity of it were determined by the opinions of experts. Then, for concurrent validity determination 80 stutterer and non-stutterer children were examined by TOCS and SSI3 .In order to test reliability, test -retest and Cronbach,s alpha were used.
Results: Entirely relevant items had simple translation. The translation items had content and face validity correlation between the marks of TOCS and SSI3 (p=0.000, r= %92). TOCS has high Test-retest ( p=0.000, ICC= %97) and internal reliability (p=0.000,α=%90).
Conclusion: Persian equalized TOCS (Test of childhood stuttering) have high validity and reliability. it might be useful to differentiate stuttering children among normal ones.

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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: Developmental dysgraphia is a kind of learning disabilities in school students. Evaluation of the sensory and motor skills in hand  of these persons by appropriate, functional and real tests demonstrates that their fine and complex hand sensory-motor abilities are prerequisites of intervention planning.  Purdue Pegboard and Two-Point Discrimination Tests are used for evaluation of the hand motor and sensory skills respectively. This study was aimed to evaluate the test-retest reliability of these tests in students with developmental dysgraphia.

Materials and Methods: In this descriptive-analytic study hand sensory-motor skills were evaluated in 23 students with developmental dysgraphia (8-11 years) in Tabriz city by Purdue Pegboard and static and moving Two-Point Discrimination tests. Test-retest reliability of mentioned tests was done between and within examiners via intra-class correlation coefficient and independent t-test  was done for the comparison of the skills between girls and boys and right and left-handed students and Pearson correlation coefficient was calculated for the relationship between motor and sensory skills.

Results: Intra-class correlation coefficients of Purdue Pegboard, static and moving two-point discrimination tests for inter-session and intra-session reliability were ranged from 0.77 to 0.94 and 0.69 to 0.92 respectively. There was no significant relationship between motor and sensory skills (p>0.05).

Conclusion: Because of high reliability of these tests, it can be used them for evaluating the sensory-motor skills and intervention planning in students with developmental dysgraphia. Loss of relationship between motor and sensory skills can be related to the pathology of dysgraphia that needs further researches. 

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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: The translation, cultural adaptation and validation of the Persian version of the American shoulder and elbow surgeons (ASES) were carried out in accordance with published guidelines.

Materials and Methods: The study was conducted on 100 athletes (25.96±5.81 years), which suffered from different shoulder disorders. When the translation and cultural adaptation of the original questionnaire was carried out on the standardized method, the participants were asked to complete a questionnaire booklet including the DASH, the Short Form General Health Survey (SF-36) and ASES questionnaires. In addition, 30 randomly selected patients were asked to complete the ASES questionnaire 48 hours later for the second time. After data collection the Statistical analysis was performed by using SPSS software.

Results: The Cronbach's alpha was used to indicate internal consistency. Cronbach's alpha was 0.91 for ASES. Test-retest reliability was quantified by use of the intraclass correlation coefficient. It was 0.91 for ASES questionnaire. The Pearson Correlation Coefficient was used for the questionnaire validation study. The DASH questionnaire showed high correlation of ICC=0.78 with ASES. The ASES showed moderate correlation of 0.48 to 0.62 with those of the various scales of the SF-36.

Conclusion: The Iranian ASES showed good reliability and validity and can be used for shoulder-specific patient self-assessment.

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Background and Aim: In studies of the spinal circuits, change of Renshaw cell activity is measured by H´ response. For recording H' response, new electrical stimulation device was designed and built and the first recorded H' response in Iran was done. The purpose of this study was to investigate the intersession and intra-session reliability of peak amplitude of H´ response and its related intensity detected of new device.
Materials and Methods: Soleus muscles of dominant extremity in 6 subjects were tested in 3 sessions and 2 times in each session that intra-session interval was 20 minutes and intersession interval was 1 week.
Results: Peak amplitude and its related intensity exhibited intra-session and intersession reliability 0.92, 0.98, 0.86 and 0.9 respectively. Standard Error of Measurement was 0.37 and 0.47 for intrasession and 0.44 and 1.06 for inter session respectively.
Conclusion: Peak amplitude and its related intensity exhibited very high intra-session and intersession reliability.

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Background and Aim: The current research was performed to investigate validity measurement of Persian version of stuttering prediction instrument (SPI) in children among 3-8 years old who stutter and determination of its reliability.
Materials and Methods: Translation of the SPI Test was examined by using IQOLA's translation protocol and equalization. Then for determination of it's logical validity, expertise views were collected by means of the method of Lawasche content validity. 52 children who stutter were examined by SPI test and also SSI3 test and the cooper stuttering chronicity prediction checklist for determination of construct and concurrent validity. Internal stability was examined by using alpha ration and finally at the end, Persian version of SPI was completed by twice examination of 15 stutterer children with duration of 7-10 days concerning examination of reliability of test-retest. */1-+
Conclusion: Existing strong and meaningful correlation between SSI3 and SPI test and also between cooper chronicity prediction checklist and SPI test are indicative of good convergence of each part in SPI test. Finally, these analyses verify that all parts of the test are benefiting from proper reliability and validity.

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Background and Aim: Semantic test "Pyramid and Palm Trees"(PPT) Test was used for assessing cognition and semantic system in brain disorders, semantic dementia, Alzheimer disease and aphasia. This test was designed in 1992 by Howard and Patterson and includes both versions picture and word. It has validity and reliability. The aim of this study is to determine of validity and reliability of Persian picture version "Pyramids and Palm Trees" Test and compare with aphasia and normal adults.

Materials and Methods: In this cross - sectional study, 45 subjects included 15 Aphasia and 30 normal adults respectively the mean age and standard deviation of 53 (7.77), 53 (7.91) years participated. All of participants were matched in the age and sex, and education and bilingualism. In the first stage, the picture version PPT had given to 14 expert(11 Speech and language pathologists, 3 Linguists) in order to determine content and face validity. According to their comments, pictures that were very far from Persian culture were replaced with proportional pictures with Persian culture. Then the reliability was calculated by performance of PPT during an interval of 5-7 days in two stages for all of aphasia patients. In order to compare of results, PPT was performed on normal adults. Then, the results were analyzed by SPSS18 software. The statistic tests were included of lavashh correlation for validity, Intra-class correlation coefficients (ICC) for reliability and independent T-Test for comparison of scores mean of picture version PPT between aphasia and normal adults.

Results: ICC ranges for reliability were 0.88 – 0.93. Also difference of scores mean of picture version PPT between aphasia and normal adults were significant (p<0.05).

Conclusion: The Persian version PPT have validity and reliability. This study showed semantic disorder in aphasia patients in compared with normal adults.