Journal of Rehabilitation Sciences & Research

Therapeutic Challenges and Opportunities in Myopathy Management: A Narrative Review

Mahsa Rezaei; Katayoon Rezaei

Articles in Press, Accepted Manuscript, Available Online from 01 July 2025

Abstract

  Background: Myopathies, a diverse group of muscle disorders affecting over 1.7 billion people globally, pose significant therapeutic challenges due to their varied causes and symptom ...  Read More Background: Myopathies, a diverse group of muscle disorders affecting over 1.7 billion people globally, pose significant therapeutic challenges due to their varied causes and symptom severity.Method: This narrative review explores current treatment approaches, including herbal remedies, complementary therapies like acupuncture and massage, physiotherapy, nutritional plans, and emerging gene therapies. Herbal remedies and complementary therapies offer symptom relief for some patients, while physiotherapy aids in maintaining muscle function. Nutritional plans support overall health, and gene therapies hold promise for addressing underlying genetic defects. However, treatment efficacy varies, and many approaches lack robust evidence.Conclusion: This review highlights the need for future research to focus on large-scale clinical trials to evaluate safety and effectiveness, personalize treatment strategies based on individual patient profiles, and improve access to innovative therapies. By addressing these gaps, the medical community can better manage this widespread and debilitating set of disorders, ultimately enhancing patient outcomes and quality of life across diverse populations. 

---

• View Article

Assessing the Impact of Closed and Open Kinetic Chain Hydrotherapy on Vertical Ground Reaction Force, Rate of Loading, Lumbo-Pelvic Stability, Pain Intensity, and Kinesiophobia in Men with Non-Specific Chronic Low Back Pain: A Randomized Clinical Trial

Hossien Ashoury; Ali Yalfani; Mahdi Arjipour

Volume 12, Issue 3 , September 2025, , Pages 43-54

Abstract

  Background: Chronic non-specific low back pain (CNSLBP) is a leading cause of work absenteeism and increased dependence on healthcare services and insurance. Despite its prevalence, ...  Read More Background: Chronic non-specific low back pain (CNSLBP) is a leading cause of work absenteeism and increased dependence on healthcare services and insurance. Despite its prevalence, limited research has explored the effects of open and closed kinetic chain (O/CKC) exercises performed in water on improving CNSLBP-related outcomes. This study aimed to assess the impact of hydrotherapy-based closed and open kinetic chain exercises on lumbo-pelvic stability, pain intensity, kinesiophobia, rate of loading (ROL), and vertical ground reaction force (vGRF) in men with CNSLBP. Methods: The double-blind randomized controlled trial was designed with a pre-post test in men aged 40–60 (48.10 ± 5.97) with CNSLBP. Patients were randomly assigned to two hydrotherapy groups—CKCE and OKCE—and a control group. Pain intensity, kinesiophobia, lumbo-pelvic stability (LPS), rate of loading (ROL), and vertical ground reaction force (vGRF) were measured using the visual analog scale, Tampa Kinesiophobia Scale, biofeedback pressure device, and plantar pressure device. The intervention groups performed prescribed exercises for eight weeks, with three sessions per week. Covariance analysis was used to compare group differences. Results: In the comparison within the OKCE and CKCE groups, significant differences were observed between the pre- and post-intervention measurements (p < 0.05). Moreover, statistically significant differences were found in pain (p = 0.001) and kinesiophobia scores (p = 0.001), both with a large effect size. Additionally, noteworthy differences were noted in vGRF (p = 0.003), ROL (p = 0.012), and LPS (p = 0.022). Conclusion: The study results indicate that hydrotherapy exercises involving open and closed kinetic chains benefit individuals with CNSLBP. It is recommended that healthcare professionals, including physicians, physiotherapists, and occupational therapists, incorporate these exercises into comprehensive rehabilitation programs for such patients.

---

• View Article
• PDF 1.84 M

Physical Therapy Interventions for a Patient with Poor Muscle Strength,Knee Function, and Psychological Readiness After Anterior Cruciate Ligament Reconstruction with Meniscus Repair: A Case Report

I Putu Gde Surya Adhitya; I Gusti Ngurah Wien Aryana; Putu Ayu Sita Saraswati; Fajar Purnama; Ida Kurniawati; Noval Adhitya Wardhana; I Putu Prananda Dinata; Putu Devinda Ardaswari; Tabita Febyola Wijaya

Volume 12, Issue 2 , June 2025, , Pages 110-115

Abstract

  Background: This case report aims to evaluate phase III of physical therapy management, focusing on the late rehabilitation phase tailored to a patient’s specific goals and athletic ...  Read More Background: This case report aims to evaluate phase III of physical therapy management, focusing on the late rehabilitation phase tailored to a patient’s specific goals and athletic demands. The objective was to improve muscle strength, knee function, and psychological readiness following anterior cruciate ligament reconstruction (ACLR). Case Presentation: A patient underwent ACLR with a hamstring tendon graft and lateral meniscus repair on November 7, 2022. Thirteen weeks post-surgery, the patient exhibited poor muscle strength (<10 mmHg compared to the uninjured leg), reduced knee function (Lysholm score <80), and low psychological readiness (ACL Return to Sport Index [ACL-RSI] score <70). From February 6 to February 15, 2023, the patient participated in five sessions of standard physical therapy interventions. Baseline and follow-up assessments were conducted, measuring leg circumferences, muscle strengths, and knee functions. Improvements were noted in leg circumferences: increases of 0.2 cm, 1 cm, and 0.5 cm at 20 cm, 10 cm, and 5 cm above the center of the patella (COP), respectively, and a 1 cm increase below COP. Muscle strength improvements were recorded for the quadriceps (+12 mmHg), hamstrings (+15 mmHg), and calf muscles (+25 mmHg). The Lysholm score increased by 27 points, and the ACL-RSI score improved by 32 points. Conclusion: This case study demonstrates that phase III physical therapy interventions effectively enhance leg circumferences, muscle strength, knee function, and psychological readiness in post-ACLR patients. The protocols used in this case provide a valuable reference for treating similar cases.    

---

• View Article
• PDF 2.12 M

Stance Phase Characteristics and Asymmetry in Females with Low Back Pain

Morteza Sadeghi; Hamed Esmaeili

Volume 10, Issue 4 , December 2023, , Pages 188-193

Abstract

  Background:This study aimed to investigate stance phase characteristics and asymmetry in females with non-specific low back pain (LBPP) which they adopt different strategies in walking ...  Read More Background:This study aimed to investigate stance phase characteristics and asymmetry in females with non-specific low back pain (LBPP) which they adopt different strategies in walking to reduce pain and enhance walking quality. The results of this research can provide new insight into gait characteristics for individuals with LBPP by examining temporal characteristics and asymmetry in their stance phase during walking.Method: In this cross-sectional study, 36 females were purposefully recruited and divided into two groups: one consisting of 18 individuals with low back pain (LBPP) and the other without LBPP. Data were collected using the Footscan system and analyzed with the Footscan Gait 7 gait generation software. Independent t-tests were employed to compare the outcomes between the two groups.Results: The results indicated that the right (p=0.001) and left (p=0.001) foot progression angles in the low back pain group were higher than those in the healthy group. Additionally, the low back pain group exhibited higher asymmetry in the timings of the initial contact phase (p=0.02) and forefoot contact phase (p=0.02), as well as in foot progression angle asymmetry (p=0.009) compared to the healthy group.Conclusion:Given the higher foot progression angle and observed asymmetries in individuals with low back pain, rehabilitative exercises need to consider these differences when evaluating and planning rehabilitation procedures. 

---

• View Article
• PDF 772.25 K

Effect of Priority and Delay of Prone Positioning and Chest Physiotherapy on Respiratory Outcomes in Patients with COVID-19: A Randomized Clinical Trial

Ali Rezaee Chamanabad; Mehrnaz Kajbafvala; holakoo Mohsenifar

Volume 10, Issue 4 , December 2023, , Pages 209-215

Abstract

  Background: COVID-19, caused by the SARS-CoV-2 virus, is a novel coronavirus that has led to a global pandemic. Physiotherapy is among the beneficial treatments for this disease. This ...  Read More Background: COVID-19, caused by the SARS-CoV-2 virus, is a novel coronavirus that has led to a global pandemic. Physiotherapy is among the beneficial treatments for this disease. This study investigated the impact of the priority and delay of prone positioning and chest physiotherapy (CPT) on patients with COVID-19. Methods: A randomized clinical trial was conducted involving 26 COVID-19 patients who were randomly assigned to two groups: one group prioritizing prone positioning over chest physiotherapy (comprising seven men and six women, with an average age of 67.46 ± 5.91) and the other group prioritizing CPT over prone positioning (comprising eight men and five women, with an average age of 68.38 ± 5.85). Respiratory outcomes, including SpO2, PaO2, FiO2, FEV1, and FVC, were measured using pulse oximetry, arterial blood gas analysis (ABG), and spirometry). FEV1/FVC and SpO2/FiO2 ratios were evaluated both before and after the intervention Results: The demographic characteristics of the patients and the baseline respiratory outcomes between the two groups did not exhibit significant differences (P > 0.05). A significant difference was observed in respiratory outcomes within each group before and after the intervention (P < 0.05). However, after the intervention, there were no significant differences between the two groups in terms of respiratory outcomes (P > 0.05) Conclusion: Both prioritizing prone positioning over CPT and prioritizing CPT over prone positioning appeared to improve each respiratory outcome. Nevertheless, it was not observed that prioritizing or delaying prone positioning and CPT improved respiratory outcomes in patients with COVID-19.    

---

• View Article
• PDF 661.04 K

Dysphagia as a Main Symptom of Myasthenia Gravis in a Middleaged Adult Male: A Case Report

Payam Sariaslani; Ghazaleh Homagostar; Hiwa Mohammadi

Volume 10, Issue 2 , June 2023, , Pages 106-108

Abstract

  Background: Myasthenia gravis (MG) is a rare neuromuscular disorder resulting from the destruction of acetylcholine receptors at the neuromuscular junction by IgG antibodies. Although ...  Read More Background: Myasthenia gravis (MG) is a rare neuromuscular disorder resulting from the destruction of acetylcholine receptors at the neuromuscular junction by IgG antibodies. Although dysphagia is a common symptom in generalized form of MG, it is rarely reported as a sole manifestation of the disease, specifically in younger patients. Herein, we report a middle-aged adult patient with dysphagia as the sole manifestation of MG.Case presentation: A 49-year-old male complaining of severe dysphagia underwent an extensive clinical and paraclinical examination. Oropharyngeal dysphagia was confirmed by an experienced speech-language pathologist using the water swallowing test. Unilateral right paresis of the soft palate and vocal fold was confirmed using laryngeal video stroboscopy. Chest computerized tomography (CT) scan, brain Magnetic resonance imaging (MRI), and routine blood, urine, and thyroid tests were normal. In electromyography, slow repetitive nerve stimulation (RNS) showed a decremental response in the right nasalis muscle. The diagnostic neostigmine test with 1.5 mg of intramuscular neostigmine led to significant recovery of laryngeal and pharyngeal motor dysfunction and dysphagia within 12 hours, so the MG diagnosis was confirmed. The patient was treated with plasmapheresis, pyridostigmine, and prednisolone, which followed an improving course and led to better swallowing of solid and liquid foods.Conclusion: MG should be considered as a diagnosis in middle-aged adults with complaints of dysphagia.

---

• View Article
• PDF 844.8 K

Rehabilitation Educators′ Perceptions of Clinical Education Challenges in Iran: Is COVID-19 Having Redundant Effects?

Zeinab Rashidi; Neda Orakifar; Meimanat Akbari; Razieh Mofateh; Fereshteh Zamani-Alavijeh; Marzieh Araban

Volume 9, Issue 4 , December 2022, , Pages 173-179

Abstract

  Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many ...  Read More Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many shortcomings that should be addressed.Methods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators with particular focus on the new challenges created bythe COVID-19 outbreak. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were conducted with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences, Iran. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.Results: Through data analysis, 240 initial codes were extracted in three main categories and nine sub-categories, indicating redundant challenges imposed by COVID-19 comprising restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), an inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), and personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).Conclusion: The results of this study provide deeper insight into the perceptions and experiences of rehabilitation educators regarding clinical education challenges. At present, an accidental and unexpected problematic event (COVID-19 pandemic) has inflicted detrimental effects on various aspects of clinical rehabilitation sciences. It is necessary to implement changes in future plans which include adaptations for COVID-19. 

---

• View Article
• PDF 628.76 K

Review on Spatial Hearing Processing Disorder and Its’ Rehabilitation Methods among Elderly in Iran

Maryam Delphi; Afsaneh Doosti

Volume 8, Issue 4 , December 2021, , Pages 164-168

Abstract

  Background: The hearing system can detect the location of the sound source and help us pay attention to it. In the presence of the background noise, it helps detecting the desired signal ...  Read More Background: The hearing system can detect the location of the sound source and help us pay attention to it. In the presence of the background noise, it helps detecting the desired signal (especially speech) and comprehend it. This ability is called spatial hearing processing. Spatial hearing processing disorder can adversely affect signal detection in noise, which is very important in the elderly. The aim of the present paper was reviewing the spatial hearing processing disorder and its ‘rehabilitation methods in Iran for the elderly. Method: In this narrative paper, theoretically, all papers on spatial hearing processing disorder and its’ rehabilitation methods among the elderly in Iran from 2000 to February 2021 were collected. The papers with the following keywords in Medline, Google scholar, Proquest, science direct, Scopus, and Magiran were studied after discarding duplicated papers: spatial stream, binaural advantage, spatial release of masking, spatial hearing segregation, rehabilitation, aging, elderly, speech in noise, localization, training, and Iran . Results: Aging adversely affects the spatial hearing processing and especially in complex environments, so rehabilitation of spatial hearing disorders can potentially improve comprehending speech in noise for the elderly. Conclusion: The results of this study showed that there is absolutely necessary to develop different rehabilitation programs for different elderly groups base on their needs.

---

• View Article
• PDF 576.39 K

Comparison of personal independence between soft dressing and immediate postoperative prosthesis method in older diabetic amputees

seyed mahmoud mousavi ziarati; kia hedayatrad; aliakbar nazari; mohammad reza kalantar motamed; behnoush asadollahi dehkordi

Volume 8, Issue 2 , June 2021, , Pages 57-61

Abstract

  Background: Elderly diabetic patients face a lack of independence in daily and social activities such as going to the toilet and bathing, aside from walking and communication, which ...  Read More Background: Elderly diabetic patients face a lack of independence in daily and social activities such as going to the toilet and bathing, aside from walking and communication, which are affected by the ability to stand and walk bilaterally. This study aims to compare the rehabilitative outcome of post-amputation soft dressing with IPOp Method and materials: In this randomized clinical trial study four parameters were measured, including the time between amputation and the first standing, amputation and taking the first steps, amputation and an independent personal activity and amputation and fitting the first permanent prosthesis. Thirty elderly diabetic patients (aged 65-80) were divided into two groups. The Intervention group received IPOP and the control group received soft dressing. results: Patients who received immediate post-operative prosthesis took significantly lower time in all four variables. Conclusion: The results showed that it takes the control group, on average, 148 days longer to receive their first final prosthesis and achieve the same ADL and social status as the intervention group. 

---

• View Article
• PDF 902.16 K

Design and Control of an Active Wrist Orthosis for Rehabilitation

zahra vahabi; Ali Mokhtarian; mohammad taghi karimi; faezeh jahanshah; reza arefi

Volume 8, Issue 1 , March 2021, , Pages 46-50

Abstract

  Background: In this study, an active orthosis has been designed to rehabilitate patients with weak wrist flexor and extensor muscles. Methods: First, the mechanical design of the actuating ...  Read More Background: In this study, an active orthosis has been designed to rehabilitate patients with weak wrist flexor and extensor muscles. Methods: First, the mechanical design of the actuating mechanism with a linear servo motor to provide the desired wrist rotation, is performed in SolidWorks software. Also, to determine the force created by the actuator during flexion and extension of the wrist, the movement of the mechanism is simulated in Visual Nastran software. After molding the patient's wrist, the main body of the orthosis is made by forming the thermoplastic sheets on the mold, and the components of the mechanical part of the mechanism are installed on it.  Then, the hardware part of the electronic circuits to drive the motor and to communicate between the control modules and the actuator is designed. For the programming of microcontrollers and synchronizing of deriver to the joystick, Bascom AVR software is used. The simulation of electrical circuit is performed in Proteus software and the printed board circuit is made in Altium Designer software. Results: The results of applying this orthosis on the wrist of a healthy subject indicate its proper performance in creating an acceptable angle range for the wrist extension and flexion. Conclusion: The use of the designed active wrist orthosis can improve the rehabilitation process of the patients with weakness in their wrist muscles.

---

• View Article
• PDF 2.1 M

Developing Professional Ethics for Rehabilitation Professionals: A Qualitative Study

Masoud Ghofrani; Alireza Parsapour; behrouz attarbashi moghadam; Amirahmad Shojaei

Volume 7, Issue 4 , December 2020, , Pages 147-154

Abstract

  Codes of ethics are a set of moral standards based on a value system widely accepted by members of a profession. In order to choose the right course of action and resolve potential ...  Read More Codes of ethics are a set of moral standards based on a value system widely accepted by members of a profession. In order to choose the right course of action and resolve potential ethical challenges, these codes will need to be developed so that ethical values can be identified and prioritized. Medical ethics covers all areas of medicine, and surely, rehabilitation is not an exception. This study aims to codify the ethics of the rehabilitation profession while considering the cultural and religious issues in Iran. For this purpose, we used a qualitative research method, including literature review, questionnaire, targeted interviews, content analysis, group discussion, and code extraction. The results were categorized into seven sections: “respect and empathy”, “autonomy”, “offering responsible care and reducing suffering”, “doing the right thing”, “beneficence”, “privacy and confidentiality”, and “social responsibility”. The development of ethical codes for rehabilitation determines moral norms in order to protect the rights of people who need rehabilitation services. These codes can also be used as a guide to the ethical challenges of the profession.  

---

• View Article
• PDF 631.58 K

Effects of Regular Aerobic with Nasal Breathing Exercise Training on Olfactory Rehabilitation in Asthmatic Patients with Chronic Rhino Sinusitis

Azam Zarneshan

Volume 7, Issue 4 , December 2020, , Pages 178-183

Abstract

  Background:Chronic rhinosinusitis (CRS) is the most common cause of smell loss and has a strong association with asthma. Breathing exercise training has been known to be an effective ...  Read More Background:Chronic rhinosinusitis (CRS) is the most common cause of smell loss and has a strong association with asthma. Breathing exercise training has been known to be an effective treatment for decreasing asthma symptoms. However, its effect on the olfactory disorder in asthmatic patients with CRS is unknown. This research aimed to investigate the effects of regular aerobic with nasal breathing exercise trainingon olfactory rehabilitation in asthmatic patients with CRS. Methods: In this quasi-experimental study, thirty-five inactive asthmatic women with CRS and olfaction disorder (mean age = 34.7±7.5 years) were selected and grouped into experimental (n=18) and control (n=17) groups. The experimental group participated in an aerobic and breathing exercise program (60 min/day, three days a week), and the control group refrained from participating in regular exercise for 12 weeks. Self-rated olfactory acuity and function questionnaires were used to assess changes in exercise-induced olfactory acuity and function. Results: After 12 weeks, the exercise group improved smell function (p =0.002) and exhibited significantly increased acuity in smelling the odor of gas (p =0.019) compared with the control group. BMI decreased (p =0.019) and forced expiratory volume in 1 second (FEV1( increased (p =0.002) significantly in the exercise group. There was a negative relationship between mean change in BMI and mean change in acuity in smelling the odor of gas (r=-0.381, p =0.024). Conclusion: According to the self-report olfactory acuity and function questionnaires, the improvement in the smell function of asthmatic patients with chronic sinusitis after 12 weeks of regular aerobic with nasal breathing exercise was promising and should be studied further.  

---

• View Article
• PDF 728.07 K

Using of Rehabilitation Services, The Main Concern of Autism Spectrum Disorder: What Can Be Done?

Mahta alsadat Aarabi; Kianoush Abdi; Mohamad Saeid Khanjani

Volume 7, Issue 4 , December 2020, , Pages 189-190

Abstract

  the following strategies are suggested for using rehabilitation service for children with autism spectrum disorder: Collaborating and forming a conversation between all organization ...  Read More the following strategies are suggested for using rehabilitation service for children with autism spectrum disorder: Collaborating and forming a conversation between all organization in charge of people with autism spectrum disorder, such as welfare organization, the ministry of health, autism associations, etc.  Participation and employment of individuals with autism spectrum disorder and their families.  Strengthen and empower NGOs related to autism spectrum disorder.  Increasing the media participation in order to raise awareness and improve public attitudes.  Holding the training courses for health care providers to become more familiar with the phenomenon of autism spectrum disorder.  Expand the special healthcare and rehabilitation centers for people with autism spectrum disorder.  Changing the insight, attitudes and approach of policy makers and managers in allocating credits and insurance coverage.

---

• View Article
• PDF 480.68 K

Effective Swallowing Rehabilitation Strategies in Patients with Multiple Sclerosis Suffering from Dysphagia; A Review of Literature

Shahryar Zainaee; Shima Rahmani; Hamide Ghaemi

Volume 7, Issue 3 , September 2020, , Pages 106-113

Abstract

  Background: Multiple sclerosis (MS) is a disease of the central nervous system (CNS) which leads to various clinical signs and symptoms such as dysphagia. Given the prevalence and consequences ...  Read More Background: Multiple sclerosis (MS) is a disease of the central nervous system (CNS) which leads to various clinical signs and symptoms such as dysphagia. Given the prevalence and consequences of the disease, it is vital for patients with MS (PWMS) to be under medical supervision and receive specific care and services immediately. The present study aimed to comprehensively and inherently describe various SRSs and clarify the probable effects of each on the swallowing mechanism in PWMS suffering from dysphagia and to eventually answer the question: Which SRS(s) are effective on dysphagia in PWMS? Study design: This study is a literature review. Method: A search of the Web of Science, PubMed, and Science Direct databases was carried out for relevant studies published from 1990 to 2020 and written in English. The search resulted in 772 articles. Ultimately, 103 articles in total were selected for inclusion in the present study. Results: The clinical results show that using different SRSs in dysphagia management can help reducing dysphagia and the risk for aspiration. These approaches are classified in four categories: compensatory methods, stimulation techniques, exercises, and maneuvers. Conclusion: The current review reports the positive impact of SRSs such as electrical and sensory stimulation methods, maneuvers, and compensatory methods on dysphagia in PWMS. They can reduce the risk of aspiration for PWMS and, consequently, provide a better quality of life.  

---

• View Article
• PDF 877.54 K

Lower Limb Amputee patients have comorbidities and risk of complications - Findings from a hospital audit

Shyh Poh Teo

Volume 7, Issue 2 , June 2020, , Pages 60-65

Abstract

  Background: Lower limb amputee patients tend to have multiple co-morbidities and are at risk of developing complications during early rehabilitation for lower limb amputees. These complications ...  Read More Background: Lower limb amputee patients tend to have multiple co-morbidities and are at risk of developing complications during early rehabilitation for lower limb amputees. These complications are associated with worse outcomes and interruption in rehabilitation, requiring a transfer from the rehabilitation ward to acute medical or surgical care. This study aims to describe the circumstances of patients transferred from early lower limb amputee rehabilitation ward to regional hospitals, and identify areas of potential improvement in management. Methods: The present study is a retrospective study of electronic records for patients admitted or transferred to Hutt Hospital from vascular surgery wards for early lower limb amputee rehabilitation between 1st January 2009 and 31st December 2011. The data collected was identified through a multidisciplinary discussion to determine appropriate standards of care for amputee patients. This included patient demographics, comorbidities, cognitive and physical function, as well as complications during rehabilitation. Results: There were 42 lower limb amputations with median age of patients 71.5 years. Dysvascularity was the most common cause (57.1%) for amputation. Patient care was inappropriately stepped-down to a rehabilitation ward, including one in six amputees who were not haemodynamically stable, and one-quarter of patients with hypoglycaemia. Handover between allied health staff and comprehensive assessment, particularly of the contralateral limb should be improved. Complications during rehabilitation involved 71.4% patients, the most common non-wound issues were decubitus ulcers, chest infections and delirium. A quarter of the patients, initially living at home were discharged to residential care. The median length of hospital stay was 44.5 days. Conclusions: Amputee patients have multiple co-morbidities and a high risk of complications. The areas of improvement identified included transfer of care between allied health professionals, appropriateness of step-down transfer to rehabilitation, assessment of the contra-lateral limb and standardisation of care. Education of healthcare professionals and systematic transfer of care should be implemented for patients transferred for early rehabilitation for lower limb amputees.

---

• View Article
• PDF 574.25 K

Design, Analysis and Control of the 4 Fingers Rehabilitation Robot

Amir Hossein Kermanshahani; Farzad Cheraghpour Samavati

Volume 6, Issue 4 , December 2019, , Pages 160-168

Abstract

  Background: People who have lost their ability to walk, shake hands or even talk due to brain stroke may revert their ability back to normal or near normal with the assistance of rehabilitation ...  Read More Background: People who have lost their ability to walk, shake hands or even talk due to brain stroke may revert their ability back to normal or near normal with the assistance of rehabilitation robots. Previous literature reviews of rehabilitation studies have shown that, in most cases, repeated movement of a patient’s member can help restore the function of the injured member in patients, in which, the use of robots can be very effective. Method: The method of this research is the experimental method. The paper aims to investigate the ability of a parallel robot for rehabilitation of injured fingers. The motions of human finger joints for physical therapy purposes has been investigated and been considered as the optimal route of the design process and as the set point of control procedure of robot movements. The proposed robot has been designed with the right choice of kinematic loops, where the robot pursues the optimal path to rehabilitation, and at the same time, does not come into direct contact with the patient, allowing the patient to be more tolerant as they feel more comfortable and at ease. In addition to the above-mentioned advantages, the designed robot reduces the number of operators as well as the number of parameters necessary to change and control the algorithm for different patients. Results: After presenting the robot’s conceptual design, the kinematics analysis of the robot was dealt with. In the next step, the dynamic equations of the robot were extracted. Ultimately, using the control methods, the position, stability and efficiency of the rehabilitation robot was simulated. Finally, the constructed prototype of the robot is presented and control method and program sectors are introduced. Conclusion: The proposed robot for rehabilitation of four fingers with a simplified design and low cost of manufacturing could be used in robotic applications in home based care for disabled people.

---

• View Article
• PDF 3.01 M

Design and Fabrication of an Active Knee Orthosis for Rehabilitation of lower limbs

Mohammad Amin Iravani Rad; Ali Mokhtarian; Mohammad Taghi Karimi

Volume 6, Issue 3 , September 2019, , Pages 109-116

Abstract

  Background: The main objective of this study is to design and produce a two-link active knee orthosis with 2 degrees of freedom to rehabilitate patients’ lower extremities in ...  Read More Background: The main objective of this study is to design and produce a two-link active knee orthosis with 2 degrees of freedom to rehabilitate patients’ lower extremities in moving their feet. This study aimed to provide motor independence in patients with cerebrospinal cord injury, quadriceps and knee joint injuries in athletes, and deviation of the quadriceps angle in the elderly.Methods: The current research is an experimental method. We have tried, while eliminating a physiotherapist, to enable movement modification of organs that suffer from dynamics poverty and ensure an improved movement for injured organs. In order to reduce external fluctuations and turbulences and determine orthosis opening and closing angle, a DC motor with a helical gearbox and a PID controller was used. In addition, an Arduino microcontroller and a potentiometer were used for processing and angle determination, respectively, to provide minimum wiring and maximum accuracy and performance for the proposed orthosis.Results: In order to verify the mechanical parts of the proposed orthosis, three tests were performed with different angles without charging the orthosis.Conclusion: Results showed that the proposed orthosis admissibly tracked intended angles and had a proper weight and volume to provide safety and comfort for the foot and knee joint.

---

• View Article
• PDF 2.51 M

The Association between Spatiotemporal Gait Asymmetry and Walking Balance in People Post Stroke

Mania Sheikh; Hossein asghar Hosseini

Volume 6, Issue 3 , September 2019, , Pages 117-122

Abstract

  Background: Falls are a common complication post-stroke and often induce due to poor balance. Given that falls often occur during walking, it is possible that gait patterns influence ...  Read More Background: Falls are a common complication post-stroke and often induce due to poor balance. Given that falls often occur during walking, it is possible that gait patterns influence balance during walking. Walking post-stroke is frequently spatiotemporally asymmetric, which may reduce walking balance. The aim of this study was to determine the relationship between gait asymmetry and walking balance in persons with chronic stroke. Methods: Fifty-four persons with chronic stroke (34 men and 20 women) with the mean age of 57.28 participated in this cross-sectional study.Participants walked at their self-selected speed to calculate gait asymmetry ratios for stance time, swing time, and step length. The data were collected using a conventional camera with a sampling frequency of 60 Hz. Reflective markers were attached to the heel and toe regions. Participants also performed walking balance tests including Functional Gait Assessment (FGA) and Mini Balance Evaluation System Test (Mini-BESTest). Pearson correlation test was used to determine the relationships between gait asymmetry and walking balance. Results: The mean ± standard deviation values of stance, swing and step asymmetry ratios and FGA and Mini-BESTest were 1.2 ± 0.11, 1.43 ± 0.24, 1.25 ± 0.15, 24.11 ± 2.93 and 22.87 ± 2.29, respectively. Increased FGA and Mini-BESTest scores were related to decreased swing (r = -0.64, P ≤ 0.001 and, r = -0.71, P ≤ 0.0001, respectively) and step asymmetry (r = -0.41, P ≤ 0.002 and, r = -0.51, P ≤ 0.001, respectively). No significant relationship was identified between FGA, and Mini-BESTest and stance asymmetry (r = -0.25, P ≤ 0.06 and r = -0.23, P ≤ 0.08 respectively). Conclusion: According to the current results spatiotemporal gait asymmetry may be related to decreased balance during walking in individuals with chronic stroke suggesting that rehabilitation interventions should focus specifically on ameliorating spatiotemporal gait asymmetry.

---

• View Article
• PDF 850.82 K

Assessing the Satisfaction Level of Rehabilitation Trainers and Students from the Clinical Internship Assessment Checklist

Negin Moradi; Masoume Hosseini Beidokhti

Volume 4, Issue 4 , December 2017, , Pages 114-119

Abstract

  Background: Valid assessment and validation indices are very important to evaluate and teach students, especially in clinical education settings. Considering the fact that rehabilitation ...  Read More Background: Valid assessment and validation indices are very important to evaluate and teach students, especially in clinical education settings. Considering the fact that rehabilitation science fields have about 1200 h of clinical education, planning of clinical skills training and how to evaluate them is important to improve the quality of education. Due to the importance of clinical skills teaching, clinical logbooks are used in various medical sciences in the world and some of the fields of medical sciences in Iran. This study was conducted to design and evaluate a clinical logbook for rehabilitation fields.Methods: Students [153] and trainers [43] surveys were conducted on how to evaluate clinical units. The clinical training logbooks of reputable rehabilitation universities of the world were studied and clinical activity logbooks for different rehabilitation fields were designed and administered in the clinical education and governance council meetings. Then, the level of satisfaction of trainers and students with the evaluation method was investigated using the logbook.Results: The results of this research showed a significant increase in students’ satisfaction with the assessment of internship and improvement of the quality of clinical education (above 80%) (P=0.02). Content validity results for the questionnaire were above 68% and Cronbach’s coefficient alpha was 75%.Conclusion: Given the similarity of internship courses throughout Iran, the logbook can be used in rehabilitation fields in the country by discipline to evaluate the clinical dimension of rehabilitation courses.

---

• View Article
• PDF 495.24 K

Investigating the Auditory Differentiation Skill in Normal 7-8 Year Old Persian Children in Shiraz

Afsaneh Doosti; Fatemeh Nourmohammadi; Maryam Delphi

Volume 4, Issue 3 , September 2017, , Pages 66-69

Abstract

  Background: Development of auditory differentiation skill plays an imperativerole in the development of speech and language skills of children as well as centralauditory processing. ...  Read More Background: Development of auditory differentiation skill plays an imperativerole in the development of speech and language skills of children as well as centralauditory processing. One of the instruments employed in the investigation ofthis skill is auditory differentiation test. The present study was conducted withthe aim of investigating the auditory differentiation skill in normal 7-8 year oldchildren.Methods: The present cross-sectional descriptive study was performed on 200normal girls and boys within the age bracket of 7-8 years with equal numbers ofgenders (100 girls and 100 boys). In order to examine the auditory differentiationskill, the Persian version of Wepman auditory differentiation test was employed.The significance level in this research was considered as P=0.05.Results: The auditory differentiation score according to percentiles of 5 and 95was 38 and 40 among the seven year old group, respectively, while it was 38.05and 40 in the eight year old group, respectively. The mean auditory differentiationscore of the seven year old children was significantly lower than that of the eightyear old children (P=0.04). No significant difference was observed between thetwo genders (P=0.19).Conclusion: According to the results obtained in this research, the auditorydifferentiation score was significantly different between the seven and eight yearold groups, but no significant difference was observed between boys and girls.

---

• View Article
• PDF 448.5 K