Publications by authors named "Mohammad Kamali"

82 Publications

Psychological aspects of climate change risk perception: A content analysis in Iranian context.

J Educ Health Promot 2020 29;9:346. Epub 2020 Dec 29.

Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Risk perception is an important predictor to mitigate climate change effects which can produce mental health consequences such as anxiety and depression. For developing policies of climate risk adaptation, awareness of public attitudes, beliefs, and perception is essential. At this study, researchers tried to focus on the often "unseen" psychological aspects of climate change.

Materials And Methods: A qualitative approach was done with a consistent content analysis method. The study consisted of 33 participants including ordinary people and experts in disasters and climate change. Purposeful sampling was adopted until data saturation. The data collection was performed through in-depth and semi-structured interviews. All interviews were transcribed after listening again and again and reading several times to catch an overall understanding of the interviews.

Results: The main theme of the study was "Complexity nature of climate change risk perception" and related categories including "the Mental health dimension," "the Cognitive dimension" and "Interaction of imposed components." The structure of the research community strongly reflected effects of cultural and religious factors in all aspects of community life. Participants' life experiences of extreme events were associated to their perception of climate change.

Conclusions: Risk perception is multifactorial and complicate and should clearly be understood to improve community participation to manage climate change-related risks. We propose that authorities and related managers should pay attention to it as a priority. This may assist in developing research on public mental health practices.
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http://dx.doi.org/10.4103/jehp.jehp_415_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871946PMC
December 2020

Psychometric Assessment of the Persian Version of the Revised Convergence Insufficiency Symptom Survey in Young Adults with Convergence Insufficiency.

J Curr Ophthalmol 2020 Oct-Dec;32(4):395-401. Epub 2020 Dec 12.

Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Purpose: To translate the Convergence Insufficiency Symptom Survey (CISS) to Persian and to assess its validity and reliability in a group of young adult Iranian patients with convergence insufficiency (CI).

Methods: The questionnaire was translated in backward and forward phases. Face validity was measured using a 6-point scale (very weak, weak, moderate, good, very good, best), and a score of ≥4 for each item indicated an acceptable face validity. The content validity was assessed using three indices of relevancy, clarity, and comprehensiveness. Relevancy and clarity were checked for each item and for the whole scale using a 4-point scale (1-undesirable, 2-relatively desirable, 3-desirable, 4-completely desirable), and Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI) were calculated for the above indices. Comprehensiveness was measured at the scale level using a 4-point scale (1-incomprehensive, 2-relatively comprehensive, 3-comprehensive, 4-totally comprehensive), and S-CVI was calculated. The internal consistency and test-retest reliability were assessed using Cronbach's alpha coefficient and interclass correlation coefficient (ICC), respectively. To evaluate discriminant validity, CI was categorized into mild, moderate, and severe stages, and the mean overall CISS score was compared between these groups.

Results: Thirty CI patients aged 18-34 years participated in this study. On face validity assessment, all items finally had a score of ≥4. As for relevancy and clarity, I-CVI was above 80% for all items, and S-CVI was 98.8% and 96.6%, respectively. The S-CVI was 100% for comprehensiveness. The overall Cronbach's coefficient and ICC were 0.77 and 0.95, respectively. There was a significant difference in the overall score between the three severity groups.

Conclusion: The Persian CISS is a valid and reliable tool for clinical and research applications.
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http://dx.doi.org/10.4103/JOCO.JOCO_194_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861096PMC
December 2020

The effect of articulated AFO with hydra pneumatic damper in biomechanical characteristic of drop foot: A pilot study.

Med J Islam Repub Iran 2020 7;34:115. Epub 2020 Sep 7.

Department of Orthotics & Prosthetics, School of Rehabilitation Sciences, Iran University of Medial Sciences, Tehran, Iran.

Ankle Foot Orthosis (AFOs) are frequently prescribed in the management of drop-foot patients. However, few studies have examined the benefits of different design of Ankle Foot Orthosis with extra elements like dampers or springs. Therefore, the objective of this study was to investigate the efficacy of articulated Ankle Foot Orthosis with Hydra pneumatic damper, in kinetic, kinematic and spatiotemporal parameters of drop foot patients. Ten drop foot patients were recruited for this study, walked at self-selected comfortable speed. A three-dimensional motion analysis, were used for obtaining kinetic, spatio-temporal and kinematic gait parameters. The articulated Ankle Foot Orthosis with Hydra pneumatic damper was significantly improved speed, cadence, step length of walking (p<0.005). Furthermore, the peak and mean of moment, push off velocity and energy storing/returning were significantly improved by articulated Ankle Foot Orthosis with Hydra pneumatic damper (p<0.005). The newly designed articulated Ankle Foot Orthosis with Hydra pneumatic damper improved the ankle moment in at the loading response, power generation and the ankle range in drop foot patient.
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http://dx.doi.org/10.34171/mjiri.34.115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722968PMC
September 2020

Ground reaction force complexity in hallux valgus.

Clin Biomech (Bristol, Avon) 2021 Jan 17;81:105229. Epub 2020 Nov 17.

Foot and Ankle Department, Milad Hospital, Tehran, Iran.

Background: Investigating the complexity of movement systems can be insightful in clinical decision making. The study conducted to evaluate whether complexity of ground reaction force is affected by hallux valgus grades and footwear or foot side conditions.

Methods: A sample of 120 females including 30 participants in each group of healthy and mild, moderate, and severe hallux valgus were recruited in this case-control study. Hallux valgus grades were assessed using Manchester scale. Ground reaction force were measured in bare foot and shod conditions for both feet and weighted permutation entropy was used to calculate the complexity. Nonparametric tests were employed for statistical inference.

Findings: The first important result was that hallux valgus caused loss of complexity of ground reaction force with a medium to large effect size. However, we did not find any difference between three grades of hallux valgus entropy. The second finding was that entropy of healthy group decreased from barefoot to shod condition with a large effect size and the third finding was that ground reaction force entropy were similar in both feet.

Interpretation: The findings are aligned with the theory that loss of complexity appears when the biological systems become functionally impaired. As soon as hallux valgus initiates, all potential risks related to the reduction of complexity appear. So, we suggest to administer conservative treatments in the early stages of hallux valgus. The study outcomes can be used for evaluation of foot function, classification of the foot types, or footwear selection.
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http://dx.doi.org/10.1016/j.clinbiomech.2020.105229DOI Listing
January 2021

Foot structural factors and ground reaction force in hallux valgus grades.

Foot (Edinb) 2020 Dec 16;45:101689. Epub 2020 May 16.

Orthopedic Foot and Ankle Surgeon, Senior Consultant, Milad Hospital, Tehran, Iran.

Background: Little attention has been paid to foot structural factors and ground reaction force in hallux valgus. Investigating the structural factors in detail and determining their biomechanical effects can help to better manage hallux valgus.

Methods: In this case-control study, 120 females, 90 hallux valgus and 30 healthy, were recruited. Hallux valgus grades (mild, moderate, severe), first metatarsal mobility, foot pronation, hallux rotation, and pain were assessed by clinical tests. Ground reaction forces were measured in barefoot and shod conditions for both feet and analyzed using mixed within-between MANOVA. The association between structural factors and pain with force was analyzed using Spearman correlation coefficient.

Results: The frequency of foot structural factors and pain severity were reported in hallux valgus grades. A significant difference was seen in the force values between groups (P<0.001). Bonferroni post hoc test indicated that the mean of the first peak for the severe group was significantly higher than the mild group (P=0.013) and the mean of second peak for the moderate group was higher than that of the healthy group (P=0.009). The force values were affected by wearing shoe (P<0.001) but not by foot side (P=0.086). There was a medium, positive correlation between the hallux rotation and force in the moderate group (r=0.39, P=0.03) and also between the pronation and force in the severe group (r=0.36, P=0.04).

Conclusion: Foot structural factors, pain, and force were different in each hallux valgus grads. Similar force in both feet, and increased force by wearing shoe were seen. The relationship between the pronation and hallux rotation with force revealed the importance of these factors from the biomechanical viewpoint.
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http://dx.doi.org/10.1016/j.foot.2020.101689DOI Listing
December 2020

The functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with Hallux Valgus deformity: A systematic review.

Foot (Edinb) 2020 Dec 15;45:101706. Epub 2020 Jun 15.

Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: The intrinsic foot muscles are vital for maintaining normal foot function. This study was conducted to systematically review the literature on the functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with Hallux Valgus (HV) deformity.

Methods: A search was carried out in all available electronic databases, including Pub Med, Scopus, Embase and Web of Science, for identifying any relevant studies published from 1990 to October 2018.

Results: Three studies had investigated intrinsic foot muscle size using ultrasound imaging; two had reported electromyography parameters and four had measured the muscle force capacity. The results of the present review suggested that the functional capacity and morphological characteristics of intrinsic foot muscles are different in subjects with HV compared to those without this deformity.

Conclusion: This review found scientific evidence on muscle performance impairment in the abductor hallucis and flexor hallucis brevis in subjects with HV deformity.
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http://dx.doi.org/10.1016/j.foot.2020.101706DOI Listing
December 2020

Essential components of rehabilitation services provided to visually impaired people.

Clin Exp Optom 2020 Oct 6. Epub 2020 Oct 6.

Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Clinical Relevance: This study was conducted to determine the essential components in the delivery of vision rehabilitation services. The findings could be useful in the planning of vision rehabilitation services by optometrists or health managers.

Background: Appropriate models of delivering vision rehabilitation services are a challenge for service providers worldwide. Studies have not revealed the key characteristics of a suitable model for delivering vision rehabilitation services. This study investigated the viewpoints of the key informants for identifying the most important components of a suitable model for delivering vision rehabilitation services.

Methods: Semi-structured in-depth interviews were conducted with 19 participants including managers and service providers in Iran. All the interviews were recorded and transcribed verbatim. An inductive framework analysis approach was used to analyse the data. Qualitative analysis was done using the MAXQDA 10 software.

Results: Four main themes emerged from the data, including creating maximum access (three subcategories: screening for visual impairment, creating a stepped-model for service delivery, and public and professional awareness of vision rehabilitation services), early intervention (two sub-categories: timely identification of people at the onset of disability and starting off with counselling services), need for financial support (two subcategories: providing affordable visual aid equipment and insurance coverage), and informed and skilled personnel (two subcategories: training vision rehabilitation specialists and familiarity of the rehabilitation staff with the rehabilitation program).

Conclusion: This study identified the key features of an appropriate model for providing vision rehabilitation services to blind and visually impaired people from the viewpoints of key informants who were experienced in providing vision rehabilitation services. The findings have valuable implications for policy-making and planning for vision rehabilitation services by the health system.
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http://dx.doi.org/10.1111/cxo.13121DOI Listing
October 2020

The impact of carbon monoxide inhalation on developing noise-induced hearing loss in guinea pigs.

Med Gas Res 2020 Jul-Sep;10(3):110-113

Department of Occupational Health Engineering and Safety at Work, School of Health and Nutrition, Lorestan University of Medical Sciences, Khoramabad, Iran.

Carbon monoxide (CO) poisoning is one of the most common types of fatal poisonings worldwide. Acute exposure to high levels of CO as well as chronic exposure to low levels of CO and excessive noise can lead to high frequency hearing loss. In this study, twelve guinea pigs were randomly divided into two groups: (1) exposed to noise and (2) exposed to noise plus CO. Auditory brainstem responses (ABRs) were measured prior to the experiment and immediately, 5, 10 and 15 days post exposures. There was a significant difference between the ABR thresholds before and immediately after exposure to noise at frequencies of 4, 8, and 16 kHz and the most threshold shift was observed at 8 kHz. There was also a significant difference between the ABR thresholds before and immediately after exposure to noise and CO at frequencies of 2, 4, 8, and 16 kHz which demonstrated a temporary hearing loss after exposure to noise and CO and the major impact of CO on developing noise induced hearing loss occurred at 8 kHz. No significant difference was observed between the ABR thresholds recorded before conducting the experiments and the ones obtained 5, 10 and 15 days after simultaneous exposure to noise and CO at none of frequencies. Simultaneous exposure to noise and CO contributes to transient hearing loss in guinea pigs with the most evident temporary shift at 8 kHz. The methods were accepted in the Ethics Committee of Iran University of Medical Science (registration No. CTRI/2016/01/017170) on January 18, 2016.
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http://dx.doi.org/10.4103/2045-9912.296040DOI Listing
October 2020

Effects of rehabilitation training on an elderly population with mild to moderate hearing loss: study protocol for a randomised clinical trial.

F1000Res 2020 9;9:582. Epub 2020 Jun 9.

Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, 15459-13487, Iran.

Age-related hearing loss (presbycusis) is a form of hearing loss in over 60-years-olds and has a negative impact on quality of life. Presbycusis is multifactorial and is predominately characterised with a loss of speech perception in noise. In the cochlea, auditory filters decompose broadband sound into a series of narrowband output signals, which contains two kinds of temporal information: slow changes in overall amplitude envelope (ENV) and faster variations in temporal fine structure (TFS). TFS is important for recognition of target speech in noise. The main aim of the study is to evaluate the effect of TFS rehabilitation training in participants over the age of 60 years with mild to moderate hearing loss. A randomised clinical trial  conducted on 30 participants with mild (loss of 20-39dB HL) to moderate (40-69dB HL) hearing loss, aged between 60 and 75 years old. Participants with conductive hearing loss, abnormal middle ear pathology and central nervous system disease were excluded. Participants were selected randomly  to an intervention and control group with a 1:1 ratio. Rehabilitation for the intervention Group are 30-minute sessions three times a week for a total five weeks of vowel consonant vowel words that are used to eliminate ENV and keep only TFS. Word in noise test, binaural TFS test, and Speech, Spatial and Qualities of Hearing Scale scores are performed at the beginning and end of study to evaluate the effect of rehabilitation training.  Life expectancy in the elderly has improved, leading to an increased prevalence of age-related diseases including presbycusis. A literature review highlighted that TFS damage is permanent; however, in this study we will attempt to prove that TFS training may lead to speech in noise perception improvement. Registry of Clinical Trials, IRCT2019625044006N1 (7 August 2019).
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http://dx.doi.org/10.12688/f1000research.23332.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416574PMC
June 2020

Physical rehabilitation in Iran after international sanctions: explored findings from a qualitative study.

Global Health 2020 09 23;16(1):86. Epub 2020 Sep 23.

Iran-Helal Institute of Applied Science and Technology, Tehran, Iran.

Background: Although the main aims of sanctions are the political and economic pressures on governments, literature has demonstrated the harsh effects of sanctions on the general public, especially on the patients, poor and disabled people. Since the international sanctions regime negatively affected almost all dimensions of Iran's health sector, this qualitative study was conducted to investigate the situation of the physical rehabilitation sector after these sanctions.

Methods: This qualitative study was conducted from January 2019 to June 2019 in Iran using Skype, telephone, and face-to-face in-depth semi-structured interviews. Purposive and snowball sampling approaches were used to identify the participants. Also, framework analysis approach was applied to analyze the collected data.

Results: In total, 38 individuals including health policy-maker, faculty member, rehabilitation expert, Physiotherapist, Occupational therapist, and Orthotist/Prosthetist, were involved in the study. Based on our findings, a number of challenges facing the Iranian physical rehabilitation sector during the international sanctions period included: 1) socioeconomic challenges (inadequate funding, rising inflation rate, high unemployment rate, catastrophic expenditures, and inappropriate employment status of practitioners); 2) education challenges (decreased international collaboration and shortage of training devices and materials); 3) international challenges (rising issues in accessing services for patients from neighborhood countries); and 4) service delivery challenges (shortage of raw materials for producing the orthoses and prostheses, hardening of the importing the needed equipment, inappropriate infrastructures, and impossibility to use external assistance).

Conclusion: After international sanctions, the Iranian physical rehabilitation sector has faced considerable multifaceted challenges. Therefore, the international community must be aware of the situation and be concerned about the irreparable consequences.
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http://dx.doi.org/10.1186/s12992-020-00618-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510125PMC
September 2020

Financing of physical rehabilitation services in Iran: a stakeholder and social network analysis.

BMC Health Serv Res 2020 Jul 1;20(1):599. Epub 2020 Jul 1.

Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Inadequate financing is one of the major barriers in securing equitable access to high-quality physical rehabilitation services, without imposing financial hardship. Despite this, no sufficient attention has been paid to physical rehabilitation services and no specific financial resources have been allocated to such services in many countries including Iran. Owing to the fact that effective decision- and policy-making requires identifying possible stakeholders and actors and their characteristics, in the current study a stakeholder analysis and also a social network analysis (SNA) was conducted to identify the potential stakeholders and also their characteristics involved in physical rehabilitation financing (PRF)-related policies in Iran.

Methods: The present study was performed in two phases. Firstly, semi-structured interviews and relevant document review were conducted to identify the stakeholders. Then, the position, power, interest, and influence of each stakeholder were determined using a web-based questionnaire. Secondly, SNA approach was utilized to map and visualize the interactions among stakeholders.

Results: The findings showed that there are different stakeholders in PRF-related decision- and policy-making processes in Iran. In addition, the position, power, interest, and influence level of the identified stakeholders were varied. Moreover, although some stakeholders, like the Ministry of Health and the parliament have the highest level of power and position, they lack sufficient interest to participate in PRF-policies. Furthermore, SNA demonstrated that social network density was low, which indicates the lack of proper collaboration and interaction among the stakeholders.

Conclusion: As many powerful and influential stakeholders had low interest levels to warrant participate in the FPR-related decision- and policy-making processes in Iran, employing careful and effective strategies, that is ongoing negotiations, receiving advocacy, and making senior managers and policy-makers aware can be helpful.
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http://dx.doi.org/10.1186/s12913-020-05447-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328275PMC
July 2020

The predictors of access to health services for people with disabilities: A cross sectional study in Iranian context.

Med J Islam Repub Iran 2019 23;33:125. Epub 2019 Nov 23.

Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

In developing countries, people with disabilities (PWD) are more likely to have unequitable access to health care services than their counterparts without disabilities. Access to health care is a multidimensional concept and PWD experience various barriers to use health care. This quantitative study explored the predictors and determents of access to health care for PWD in an Iranian context. Data were collected from a cross sectional study conducted in Tehran in 2017. A total of 403 adults with physical and/or intellectual disabilities were selected using census method. The data on PWD were collected from 14 rehabilitation centers affiliated to Welfare Organization and Red Crescent Organization. The self-report World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to collect data on disability status. T test, ANOVA, and multiple linear regressions were used to determine factors influencing access to health care for PWD. Significance level was set at 5%. Also, SPSS software version 20.0 was used for data analysis. The mean of access to health care among people with intellectual disabilities (mean: 61.77, 95% confidence interval (CI):59.20, 64.35) was significantly lower than their counterparts with physical disabilities (Mean: 67.97, 95% CI: 65.26, 70.69). The results of multiple linear regression analysis showed that in the affordability dimension, type of disability, marital status, and supplemental health insurance could predict access to health services for PWD. In availability dimension, only location predicted the outcome variable significantly. Also, location and type of disability were considered to be potential predictors of access to health services in acceptability dimension. The results indicate that various factors can limit access to health services for PWD. To achieve universal health coverage, vulnerable groups and their needs should be identified to increase equitable access to health care services. Also, the health care system should pay more attention to demographic differences when planning and providing affordable and acceptable health care for PWD. Finally, the role of the government as the heath stewardship is vital to promote health care access for PWD in Iran.
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http://dx.doi.org/10.34171/mjiri.33.125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137830PMC
November 2019

Language therapy outcomes in deaf children with cochlear implant using a new developed program: A pilot study.

Int J Pediatr Otorhinolaryngol 2020 Jun 16;133:110009. Epub 2020 Mar 16.

Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Cochlear implanted (CI) children have problems in most aspects of language and in particular with regards to grammar. Considering the lack of studies in the field of grammar treatment in CI children and bearing in the mind that CI children have the potential to develop language, the aim of the present study was to investigate the effect of treating grammar in CI children using a treatment grammar program.

Methodology: first, the literature related to grammar were reviewed so as to extract different grammatical components for developing grammar treatment program and to make sentences for each element as well as to compile a manual for its implementation. Second, the validity of the sentences was examined using the Delphi method. Third, grammar treatment was performed on five CI children. Persian Developmental Sentence Scoring(PDSS) and Mean Length of Utterance(MLU) were used to evaluate them before and after treatment.

Results: Five grammatical classes were extracted, and the grammatical elements were classified in each category according to age. For all of the grammatical items, 2076 sentences were constructed. After applying the Delphi method, a total of 1936 sentences with Kendall's coefficient of concordance (W) of 71%, remained. Using this program, grammar treatment was effective in all five children. The PDSS and MLU increased in all five children during the treatment phase, which was confirmed by Percentage of Non-overlapping Data (PND), Improvement Rate Difference (IRD). During the follow-up period, the children showed that they were able to maintain the trained components.

Conclusion: Cochlear implants have the potential to learn language skills, and the present study confirms their ability to learn grammar, using a comprehensive grammar treatment program.
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http://dx.doi.org/10.1016/j.ijporl.2020.110009DOI Listing
June 2020

Comparison of the quality of life in individuals with spinal cord injury wearing either reciprocating gait orthosis or hip knee ankle foot orthosis: a cross-sectional study.

Disabil Rehabil Assist Technol 2020 Mar 19:1-5. Epub 2020 Mar 19.

Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

The quality of life (QoL) for patients with spinal cord injuries (SCI) is lower than that for healthy individuals. The main purpose of prescribing orthoses for these individuals is to improve their mobility and QoL. The hip knee ankle foot orthosis (HKAFO) has been the conventional choice for such patients, whilst the reciprocating gait orthosis (RGO) is a more contemporary option. Although the impact of these two types of orthoses on the biomechanics of walking has been previously evaluated in patients with SCI, there has been no specific comparison of their relative effects on QoL. This study aimed to evaluate the Sickness Impact Profile (SIP-68) QoL questionnaire's total score and its sub-scores in patients with SCIs wearing either RGOs or HKAFOs. This study was performed on 22 participants (11 participants wearing RGOs and 11 wearing HKAFOs). QoL scores were evaluated in each group of patients using the total and sub-scores from the SIP-68 questionnaire. There were no significant differences in the total SIP-68 scores between the RGO and HKAFO groups ( = .57). However, emotional stability and emotional independence sub-scores were significantly lower for the RGO users than for the HKAFO users ( = .03 and  = .01), respectively. Based upon this preliminary study, participants wearing RGOs or HKAFOs had similar QoL scores. However, those wearing RGOs may experience better emotional stability, communication, and emotional independence. This preliminary study does not provide definite conclusions since a large randomized control trial is required to compare the effects of these orthoses on the QoL scores in patients with SCIs.Implications for rehabilitationOur main aim in the current investigation was to shed light on the question that does the biomechanical superiority of the RGO to the HKAFO leads to better quality of life in SCI subjects who are using RGO. Regarding the fact that the primary goal of rehabilitation of people with SCI is to improve their quality of life, it seems that the more complicated newer orthosis (RGO) has no difference with the older type (HKAFO) in achieving the rehabilitation goals. More studies will in fact be necessary to find a definitive answer for this important question.According to the findings of our study, it seems to be more appropriate to prescribe RGO for male participants with higher body weight.
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http://dx.doi.org/10.1080/17483107.2019.1685014DOI Listing
March 2020

The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials.

Clin Rehabil 2020 Feb 11;34(2):145-159. Epub 2019 Dec 11.

Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Objective: The aim of this study was to evaluate the effects of ankle-foot orthoses on speed walking in patients with stroke.

Data Sources: PubMed, Embase, Web of Science, Scopus, CENTRAL, PEDro, RehabData, RECAL, and ProQuest were searched from inception until 30 September 2019.

Review Methods: This study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. Risk of bias assessment was performed using the Cochrane Risk of Bias Tool. Begg's test and Egger's regression method were used to assess the publication bias. Trim and fill analysis was also used to adjust any potential publication bias. Sensitivity analysis was performed to evaluate the effect of individual studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.

Results: Overall, 14 studies were included with a total of 1186 participants. A small-to-moderate and non-significant improvement in favor of the ankle-foot orthosis versus without ankle-foot orthosis (standardized mean difference (SMD) = 0.41, 95% confidence interval = -0.15 to 0.96), similar effects of ankle-foot orthosis and functional electrical stimulation (SMD = 0.00, 95% confidence interval = -0.16 to 0.16), and a small and non-significant improvement in favor of ankle-foot orthosis versus another type of ankle-foot orthosis (SMD = 0.22, 95% confidence interval = -0.05 to 0.49) in walking speed were found. However, the quality of evidence for all comparisons was low or very low.

Conclusion: Despite reported positive effects in some studies, there is no firm evidence of any benefit of ankle-foot orthoses on walking speed.
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http://dx.doi.org/10.1177/0269215519887784DOI Listing
February 2020

The effect of base-in prism on vision-related symptoms and clinical characteristics of young adults with convergence insufficiency; a placebo-controlled randomised clinical trial.

Ophthalmic Physiol Opt 2020 01 3;40(1):8-16. Epub 2019 Dec 3.

Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: The aim of the present study was to evaluate the effect of base-in prism on symptoms and clinical characteristics of young adults with convergence insufficiency.

Methods: In this randomised clinical trial, 64 CI patients aged 18-38 years who presented to Bina Eye Hospital, Tehran, Iran between November 2018 and April 2019 were selected and randomly assigned to either prism or placebo groups. All participants underwent complete optometric examinations, including the measurement of visual acuity, objective and subjective refraction, and complete accommodative and binocular vision examinations. Clinical examinations were repeated after three months. The overall score of the Convergence Insufficiency Symptom Survey (CISS) was considered as the primary outcome measure. Secondary outcome measures included near exophoria, positive fusional vergence at near, near point of convergence, vergence facility, monocular accommodative facility, accommodative response, negative relative accommodation and accommodative convergence/accommodation (AC/A) ratio.

Results: The mean (S.D.) age of the participants was 25.5 (5.5) years and 44% of them were male. The mean CISS score was significantly lower in the prism group compared to the placebo group in the outcome examination (p < 0.001). Moreover, the values of monocular accommodative facility, accommodative response, and negative relative accommodation were significantly higher in the prism group versus the placebo group (p < 0.001). There was no significant difference in other parameters, including near positive fusional vergence, near point of convergence, vergence facility, and AC/A ratio between the two groups in the outcome examination (p > 0.10).

Conclusion: The base-in prism reduced symptoms in young adults with convergence insufficiency, while it had no significant effect on the near point of convergence, near positive fusional vergence, vergence facility and AC/A ratio. However, the results of this study only supports the symptomatic effectiveness of prism in the short term and further studies are needed to assess the long-term effect of prism.
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http://dx.doi.org/10.1111/opo.12654DOI Listing
January 2020

Developing a Persian test battery of prereading skills for screening Preschool-aged children.

Med J Islam Repub Iran 2019 10;33:81. Epub 2019 Aug 10.

Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran.

The lack of screening test battery has made it difficult for early identification and intervention of Persian-speaking children with risk of reading problems prior to formal education. The purpose of this study was to develop and introduce a Persian prereading test battery based on the multidimensional reading perspective for screening preschool children. First, the predicators of reading skill and dyslexia along with the subscales of each predictor were identified through literature review and holding expert's panel. The batteries of tests were performed on 48 typically-developing children (5.6-6.6 years old) selected using the random (cluster) method. The Pearson correlation coefficient, item analysis and then reliability were measured. The 5-component test battery with 8 subtests was formed. Findings indicated there were moderate and significant correlations between subtests (all r>0.4, p<0.001). Internal consistency reliability for the subscales was 0.51 to 0.89. The Persian test battery of prereading skills including phonological awareness, identification of first and closing phonemes, visual discrimination skill, rapid automatic naming and phonological working memory may identify children who are at risk. A longitudinal study is warranted to evaluate its detailed psychometric properties.
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http://dx.doi.org/10.34171/mjiri.33.81DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825371PMC
August 2019

Physical Rehabilitation Services in Disasters and Emergencies: A Systematic Review.

Iran J Public Health 2019 May;48(5):808-815

Department of Health in Disasters and Emergencies, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services is completely dependent on time of intervention, the importance of good timing in providing services during disasters is not well understood. The objective of this study was to systematically review the physical rehabilitation services provided in disasters and emergencies.

Methods: An electronic search of PubMed, Scopus, Cochrane, and PEDro (Physiotherapy Evidence Database) was undertaken from Jan 2000 to Sep 2017. All English studies reporting physical rehabilitation services in natural and man-made disasters were selected regardless of study design. The included studies were analyzed by descriptive and analytical method.

Results: Thirteen studies were included after reviewing by title, abstract and full text in this study. Most of the physical rehabilitation studies come back to recent years. Most of the disaster physical rehabilitation services were physiotherapy and occupational therapy. The physical rehabilitation experts have been attended in the affected area from the few first hours until several months after disasters in order to provide the required services to the affected population.

Conclusion: There are few studies about physical rehabilitation services provided in the disaster-affected areas and this study showed that the services were limited and at different times. Physical rehabilitation services post disasters should have a comprehensive service model, like other health services. Therefore, it is necessary to conduct further studies to achieve this aim.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717404PMC
May 2019

Comprehension of Complex Sentences in the Persian-Speaking Patients With Aphasia.

Basic Clin Neurosci 2019 May-Jun;10(3):199-208. Epub 2019 May 1.

Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Introduction: To study sentence comprehension in Persian-speaking Patients with Aphasia considering the factors of complexity.

Methods: In this cross-sectional study, the performance of 6 non-fluent aphasic patients were tested and their performance was compared to 15 matched control group. Comprehension of semantically reversible sentences was assessed using a binary sentence-picture matching task. The stimuli were as follows: clefts; subject clefts and object clefts, also relative clauses; subject relatives and object relatives. All of them were types of movement-derived structures and also simple declarative sentences as the control task.

Results: The best performance of aphasic patients were seen in the comprehension of subject clefts, although prior to this result we assumed that simple declarative sentences (in which there is no structural factor of complexity) can be understood easily. They showed the highest difficulty in the comprehension of object relatives. Furthermore, the performance of patients in the comprehension of relative clauses was significantly weaker than understanding the clefts.

Conclusion: The outcomes of this study suggest that the sentence comprehension deficits of aphasic patients, in contrast to the specific deficit models, may not be related to linguistic disabilities. Moreover, the problems in the comprehension of non-canonical sentences may be related to failure in the allocation of attention. Finally, our results support the claims that neural characterization of the cognitive resources (e.g. working memory) is disrupted in sentence comprehension deficits.
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http://dx.doi.org/10.32598/bcn.9.10.185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712637PMC
May 2019

Efficacy of different techniques of AFO construction for hemiplegia patients: A systematic review.

Med J Islam Repub Iran 2019 3;33:50. Epub 2019 Jun 3.

Kermanshah University of Medial Sciences, Kermanshah, Iran.

Ankle foot orthoses (AFOs) are frequently prescribed to improve gait deviation and normalize walking pattern in patients with drop foot hemiplegia disorder. This study was to review the efficacy of different techniques of AFO construction and biomechanics parameters of AFOs. Furthermore, this study aimed to provide a guideline for researchers in detail and help them choose a sufficient measurement instrument. Information sources included MEDLINE, CINAHL, Scopus, PubMed, and the Full Cochrane Library up to December 25, 2015. The inclusion criteria include: (1) type and method of controlled clinical trial studies; (2) age of hemiplegia groups (3); AFOs as an intervention; and (4) kinetic and kinematic parameters, and energy expenditure as an intervention of gait performance. Considering eligibility criteria such as study design, setting, time frame and Language 9 papers with Pedro scores of 5 to 8 for methodological quality were included in the review. The findings of this review can help to develop guidelines for the best AFO reporting as an intervention and to prevent vagueness of results in the different types of AFOs.
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http://dx.doi.org/10.34171/mjiri.33.50DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708092PMC
June 2019

A systematic review on the validity and reliability of tape measurement method in leg length discrepancy.

Med J Islam Repub Iran 2019 26;33:46. Epub 2019 May 26.

Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical sciences, Tehran, Iran.

Leg length discrepancy measurement is an essential part of musculoskeletal clinical assessment, and tape measurement is a common clinical method. This study aimed to systematically review the results of the findings of studies on validity and reliability of the tape measurement method and the quality of reporting the literature on this topic. A search was performed in PubMed, EBSCO, Science Direct, Web of Knowledge, Scopus, Embase, and Google Scholar using selected keywords from inception to December 2017.This systematic review was based on the PRISMA guideline. After a systematic selection process, the quality of the included studies was assessed independently by 2 reviewers using the Brink and Louw Scale for quality assessment. A total of 11 studies were finally considered for this systematic review. Two studies were about the validity of (a measurement tool) studies and 4 were reliability analysis only. Validity and reliability analyses were simultaneously applied to 5 studies. Also, 9 out of 11 studies were deemed to be of high quality based on Brink and Louw Scale. Studies showed high (ICC=0.7) to very high (ICC=0.9) levels of interrater and intrarater reliability. The validity of the methods ranged from low to very high depending on subjects. Tape measurement method has acceptable reliability and validity in healthy people, but it does not have acceptable validity in measuring obese people and patients with musculoskeletal disorders. Thus, using a suitable method for LLD leg length discrepancy measurement seems to be necessary for obese and individuals with leg length discrepancy.
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http://dx.doi.org/10.34171/mjiri.33.46DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708090PMC
May 2019

Assessment of Speech Sound Production by Story-retelling in Persian Speaking Children: Introducing a New Instrument.

Iran J Med Sci 2019 Jul;44(4):299-306

Communication Disorders Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Speech and language pathologists should include connected speech assessment as part of their evaluation for children with speech sound disorders. The purpose of the present study was to design and validate an instrument for assessment of articulation by story-retelling for Persian children.

Methods: 261 typically developing children, aged 4-5 years old in Iran, Tehran, in 2016-2017, were recruited in the current study. First, two stories were designed. Next, the expert panel reviewed those two stories and selected one story for assessment. The strengths of the test for discriminating between the two age groups (48-54 months and 55-60 months) and between boys and girls were investigated for construct validity. Test-retest was performed for 15 children. Also, inter-rater reliability was evaluated via calculating the correlation between the two examiners' scores. Statistical Package for Social Sciences (SPSS), version 24, was used for statistical analysis. The significance level was set at (P<0.05).

Results: There was 80% or more agreement in experts' response to questions regarding content validity. All of the reliability values were higher than 0.85. No significant difference was observed between boys and girls (P=0.77), but there was a significant difference between the two age groups (P<0.001). There was a significant correlation between this test and phonetic test of the Persian version of diagnostic articulation and phonology (r=0.62, P=0.002).

Conclusion: The Persian story for the assessment of speech sound production is a reliable and valid instrument that can be used to evaluate the articulation of Persian children.
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http://dx.doi.org/10.30476/IJMS.2019.44956DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661520PMC
July 2019

Financial Barriers to Access to Health Services for Adult People with Disability in Iran: The Challenges for Universal Health Coverage.

Iran J Public Health 2019 Mar;48(3):508-515

Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Background: Reducing inequities in access to healthcare is one of the most important goals for all health systems. Financial barriers play a fundamental role here. People with disability (PWD) experience further financial barriers in access to their needed healthcare services. This study aimed to explore the causes of barriers in access to health services for PWD in Tehran, Iran.

Methods: In this qualitative study, we used semi-structured in-depth interviews to collect data and selected participants through purposeful sampling with maximum variation. We conducted 56 individual interviews with people with disability, healthcare providers and policymakers from Sep 2015 until May 2016, at different locations in Tehran, Iran.

Results: We identified four categories and eight subcategories of financial barriers affecting access to healthcare services among PWD. Four categories were related to health insurance (i.e. lack of insurance coverage for services like dentistry, occupational therapy and speech therapy), affordability (low income for PWD and their family), financial supports (e.g. low levels of pensions for people with disabilities) and transportation costs (high cost of transportation to reach healthcare facilities for PWD).

Conclusion: Financial problems can lead to poor access to health care services. To achieve universal health coverage, government should reduce health insurance barriers and increase job opportunities and sufficient financial support for PWD.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570792PMC
March 2019

Reliability and Concurrent Validity of a Culturally Adapted Persian Version of the Brace Questionnaire in Adolescents With Idiopathic Scoliosis.

Spine Deform 2019 07;7(4):553-558

Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran Avenue, Shahnazari St., Madar square, Mirdamad Blvd., Tehran, Iran.

Study Design: Cross-sectional.

Objectives: To determine the validity and reliability of culturally adapted Persian version of the Brace Questionnaire (P-BrQ).

Summary Of Background Data: The BrQ has proved to be a reliable and valid instrument for evaluating the quality of life of adolescents with idiopathic scoliosis and has been translated to different languages. But, lack of a Persian translated version makes its use impractical in the Persian speaking scoliotic patients.

Methods: Forward and backward translation of P-BrQ was conducted according to the International Quality of Life Assessment guidelines. The final version of the P-BrQ was administered to 51 adolescents (1 boy and 50 girls) with idiopathic scoliosis. The mean age of the participants was 13.88 ± 2.14 years. The questionnaire's internal consistency was determined using Cronbach's alpha. A subgroup of 38 participants were randomly selected to complete the BrQ for a second time one week later. The test-retest reliability was then analyzed using the intraclass correlation coefficient, while the concurrent validity was assessed by comparing the BrQ with the Scoliosis Research Society-22 questionnaire.

Results: The total Cronbach's alpha coefficient of the P-BrQ was 0.96, and the overall intraclass correlation coefficient of the questionnaire was also 0.96. The intraclass correlation coefficients for the corresponding domains were as follows: general health perception, 0.96; physical functioning, 0.96; emotional functioning, 0.98; self-esteem, 0.80; vitality, 0.97; school activity, 0.98; pain, 0.97; and social functioning, 0.98.

Conclusions: The culturally adapted Persian version of the BrQ can be used to assess the quality of life of adolescents with idiopathic scoliosis who wear a brace.

Level Of Evidence: II.
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http://dx.doi.org/10.1016/j.jspd.2018.10.001DOI Listing
July 2019

Development and validation of a new scale for assessment of speech stimulability in Persian speaking children.

Int J Pediatr Otorhinolaryngol 2019 Jul 16;122:180-184. Epub 2019 Apr 16.

Department of Psychology and Education of Exceptional Children, Allameh Tabataba'i University, Tehran, Iran.

Objectives: Speech and language pathologists need to assess speech stimulability as a crucial component of assessment in clients with speech sound disorders. The purpose of the current survey was to develop and validate an instrument to assess speech stimulability in Persian speaking children.

Methods: The present study was accomplished in two steps. In step I, the test material was developed based on extensive literature review, and five experts were requested to make judgment on the content validity of the test. We evaluated other psychometric properties in step II. A pilot study was performed by the administration of the test on 25 children, and then the correct answer percentages of 100 participants for each item of the Persian test of speech stimulability were calculated. The participants were divided into four groups by six-month intervals. Inter-rater reliability, test-retest, and internal consistency were computed for the reliability measures. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for the statistical analysis of the data. The significance level was (P < 0.05).

Results: The final version of the test includes 132 items (consonant and vowel singleton words and sentences). There was no significant difference among experts' judgment in the content validity of the items (P > 0.05). All of the children could easily repeat the items in the pilot study. The participants were stimulable more than 80% for all of the consonants except/ʒ/and 100% for the vowels in the items of the final version of the Persian test of speech stimulability. All of the reliability values (inter-rater reliability, test-retest, and internal consistency) were higher than 0.8.

Conclusion: Investigation of psychometric properties of the Persian test of speech stimulability showed that this test is a valid and reliable scale to assess the speech stimulability in Persian speaking children.
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http://dx.doi.org/10.1016/j.ijporl.2019.04.018DOI Listing
July 2019

The relationship between comprehension of syntax and reading comprehension in cochlear implanted and hearing children.

Int J Pediatr Otorhinolaryngol 2019 Jun 11;121:114-119. Epub 2019 Mar 11.

Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Objectives: There is a large variation in the function of cochlear implanted children in language assessments. However, they usually have poorer performance in language abilities compared with their normal hearing peers. The purpose of the present study was to determine the relationship between syntax comprehension and reading comprehension in cochlear implanted and hearing children in the third to fifth grades of the elementary school and to identify the relationship between their reading comprehension and the age of receiving a cochlear implant as well as the duration of receiving speech therapy in cochlear implanted children.

Methods: A total of 15 cochlear implanted children and 15 hearing children studying in the third to fifth grades of the elementary school participated in the present descriptive-analytic and cross-sectional study. Two skills of reading comprehension and syntax comprehension were evaluated in these two groups of children.

Results: The results showed that there was a significant relationship between reading comprehension and comprehension of syntax in cochlear implanted children (P < 0.001). According to the linear regression, the score of reading comprehension increases with the increase in the score of syntax comprehension. No significant relationship was observed between reading comprehension and the age of receiving a cochlear implant (p = 0.337) and the duration of receiving speech therapy (p = 0.227).

Conclusion: Based on the findings of the present study, it can be concluded that focusing on comprehension of syntax for intervention can improve reading comprehension. Particularly, it seems that working on structures which are complicated for the children helps to improve their reading comprehension.
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http://dx.doi.org/10.1016/j.ijporl.2019.03.004DOI Listing
June 2019

Continuous post-disaster physical rehabilitation: a qualitative study on barriers and opportunities in Iran.

J Inj Violence Res 2019 Jan 12;11(1):35-44. Epub 2019 Jan 12.

Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. . Email:

Background: Internationally, inclusion of physical rehabilitation services during early disaster response is relatively new. The aim of the study was to gain an understanding of disaster relief physical rehabilitation in Iran.

Methods: A qualitative study design was employed and sixteen semi-structured interviews were conducted for data collection. Content analysis was used for data analysis. The participants in this study were purposively selected among people who experienced the Bam (2003) and Varzaghan (2012) earthquakes.

Results: Three main themes were explored including: indispensable intervention, barriers to continuous intervention and opportunities for intervention. Almost all participants reiterated the importance of effective physical rehabilitation services during disasters. Some participants mentioned significant barriers for delivering such services in the context of Iran. The lack of an effective responsible body, weak disaster-related competencies and under-prioritization by government were among other barriers. On a more positive note, some interviewees talked about national programs that could facilitate service delivery.

Conclusions: Providing disaster relief physical rehabilitation has faced many barriers in Iran. However, there are some facilitators in the country that could help provide these services. Finally, the feasibility of post-disaster physical rehabilitation services delivery completely depends on the current national rehabilitation system.
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http://dx.doi.org/10.5249/jivr.v11i1.1036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420917PMC
January 2019

Persian adaptation of the Bad Sobernheim stress questionnaire for adolescent with idiopathic scoliosis.

Disabil Rehabil 2020 02 16;42(4):562-566. Epub 2018 Oct 16.

Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

To examine the validity and reliability of the Persian versions of the Bad Sobernheim Stress Questionnaire-Deformity/Brace in adolescent idiopathic scoliosis. Persian forward/backward translation of the Bad Sobernheim Stress Questionnaire-Deformity/Brace was produced, and all stages for a cross-cultural adaptation process were carried out based on the International Quality of Life Assessment guidelines. The measurements of internal consistency and test-retest reliability were assessed by Cronbach's α and intraclass correlation coefficient (ICC), respectively. The Spearman correlation coefficient was used to analyse the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire. A total of 53 scoliosis patients (age 13.47 ± 1.78 years, Cobb angle 27.66 ± 11.77°) was included. The Bad Sobernheim Stress Questionnaire-Deformity/Brace presented acceptable internal consistency (Cronbach's α for both: 0.72) and ICCs (0.97 and 0.88, respectively). The Bad Sobernheim Stress Questionnaire-Deformity showed no significant correlation with the Scoliosis Research Society-22r, while the Bad Sobernheim Stress Questionnaire-Brace showed a significant correlation with the Scoliosis Research Society-22r total score, function/activity, self-image, and mental health dimensions ( < 0.01). The Persian Bad Sobernheim Stress Questionnaire-Brace validly and reliably measures brace-related stress in AIS patients undergoing brace treatment.Implications for rehabilitationThe cross-cultural adaptation of the Persian version of the Bad Sobernheim Stress Questionnaire was performed.The Persian-Bad Sobernheim Stress Questionnaire has satisfactory internal consistency, test-retest reliability, and concurrent validity in adolescents with idiopathic scoliosis.The Persian version of the Bad Sobernheim Stress Questionnaire is suitable for clinical investigations.
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http://dx.doi.org/10.1080/09638288.2018.1503728DOI Listing
February 2020

Single word test for the assessment of speech sound production in Persian speaking children: Development, validity and reliability.

Int J Pediatr Otorhinolaryngol 2018 Nov 21;114:61-66. Epub 2018 Aug 21.

Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Objectives: Single word tests are used frequently to determine clients' speech sound errors. These tools are user-friendly and popular for speech and language pathologists. The aim of this study was to design and validate a single word test for the assessment of speech sound production for Persian speaking children.

Methods: The present study included two phases. In phase I, test material was developed. Psychometric properties were evaluated in phase II. In the next phase, 525 typically developing Persian-speaking children with the age range of 3-5 years old were studied. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for statistical analysis of this study. The significance level was set at (p < 0.05). Pilot study was performed by administrating the test on 25 typically developing children, construct validity: by administrating the test on 400 typically developing children and the comparison of performance of the children in 4 age groups (discriminative validity regarding age and by administration of this test and phonetic subtest of Persian version of diagnostic evaluation of articulation and phonology on 100 children (convergent validity)). Inter-rater reliability was performed by transcription and scoring of samples of 25 children and calculation of Intra Correlation Coefficient (ICC) was calculated. Test-retest was completed by administrating the test two times on 30 children with two weeks intervals. Internal consistency was achieved by the calculation of the correlation of the items of test.

Results: The final version of the test includes 70 target words for assessment of the consonants in three positions, vowels in medial position and consonant clusters (CVCC). There was 80% or more than it for the percentage agreement between experts for the content validity. There wasn't any significant difference between experts' responses about items of the test. 4 pictures were revised based on children's responses for the pilot study. All of the reliability values (test-re test, internal consistency and inter-rater reliability) were higher than 0.85. There was a significant difference between the four age groups for the mean value of Persian single word test for speech sound production (p < 0.0001). There was a high correlation between the score of this instrument and the scores of participants in the Phonetic sub-test of the Persian version of Diagnostic evaluation of articulation and phonology(r = 0.934, p < 0.0001).

Conclusion: It seems that the Persian Speech sound Production Test is a reliable and valid tool that can be used to measure speech sound errors for Persian speaking children.
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http://dx.doi.org/10.1016/j.ijporl.2018.08.018DOI Listing
November 2018

Normative data for the Pyramids and Palm Trees Test in literate Persian adults.

Iran J Neurol 2018 Jan;17(1):18-23

Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research, Tehran, Iran.

Semantic test of Pyramids and Palm Trees (PPT) is the most common test for assessing memory. Since this test is related to language and culture, normative data in different populations are needed. This study was conducted on 270 literate men and women Persian adults aged from 20 to 69 years. Subjects must select a picture or word between two pictures or words that was closer to target. The word score was significantly positively correlated with the picture score (r = 0.508, P < 0.001). Word scores (median = 50, Q-Q = 49-51) were higher than the picture scores (median = 50, Q-Q = 48-51), although the difference was small (P < 0.001). Demographic variables such as age, gender, and level of education were not significant predictors for both versions in Persian population.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121202PMC
January 2018