Journal of Rehabilitation Sciences & Research

Original Articles

Assessment of Knee Angular Deformities: Correlation between Photogrammetric, Clinical and Radiographic Methods

Nasim Rashedi; Bina Eftekharsadat; Neda Dolatkhah; Jafar Soleymanpour; Yaghoub Salekzamani; Soraya Babaie

Articles in Press, Accepted Manuscript, Available Online from 20 May 2024

Abstract

  Background: Photogrammetry is a safe and non-invasive technique for evaluating posture in clinical settings.  Body vision is a novel system that employs photogrammetric principles ...  Read More Background: Photogrammetry is a safe and non-invasive technique for evaluating posture in clinical settings.  Body vision is a novel system that employs photogrammetric principles to assess postural parameters. This study aimed to determine the relationship between clinical, photogrammetric, and radiologic techniques in knee angular deformity detection.Methods: This cross-sectional study was performed on 53 volunteers of both genders, with a total of 106 lower limbs with complaints of knee pain or knee deformity. Sampling was conducted in a non-random and accessible manner considering the inclusion and exclusion criteria. Moreover, all of the participants had previously full-length lower limb radiographs. The clinical evaluation was conducted through the measurement of the anatomical axis, Q angle, and intermalleolar and intercondylar distances. The aforementioned parameters were evaluated using the Body Vision photogrammetric system while the patient was in a standing position. Finally, the analysis was performed using angles and distances obtained from these methods.Results: The evaluations indicated a strong correlation between the photogrammetric and radiological methods regarding the anatomical axis of the lower limb (r=0.939, p<0.001). Moreover, a high correlation was obtained between the clinical and photogrammetric methods to the intermalleolar distance (r=0.948, p<0.001) and intercondylar distance (r=0.927, p<0.001). Regarding the Q angle, a high but relatively lower correlation was detected between the clinical and photogrammetric methods compared to the previous cases (r=0.834, p<0.001). However, a moderate correlation has been detected from the clinical measurement of the anatomical axis with photogrammetric and radiological methods (r= 0.70, r= 0.62 respectively).Conclusions: As a result of this study, a strong correlation was demonstrated between the photogrammetric technique and the gold standard method, indicating that photogrammetry can be used as an alternative method for evaluating knee angular deviations.  

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Original Articles

Comparing the effectiveness of modified Iranian and rigid Minerva braces in cervical and thoracic spine movements

Alireza Khalili; hossein asiyaeimehr; Mohammad taghi Karimi; Amirhossein Zare

Articles in Press, Corrected Proof, Available Online from 11 June 2024

Abstract

  Background: To facilitate the fusion of the injury site For nonoperative treatment or after surgery, various braces are available to immobilize an unstable cervical spine. The most ...  Read More Background: To facilitate the fusion of the injury site For nonoperative treatment or after surgery, various braces are available to immobilize an unstable cervical spine. The most effective and successful braces for immobilizing unstable cervical spine injuries are Minerva and Halo. The performance of cervical braces was measured by the degree of motion restriction. This study aims to obtain information on the function of modified Iranian and rigid Minerva braces compared with each other by relying on three-dimensional motion analysis as a standard method. Methods: Twenty-nine healthy male subjects without a history of spinal pain, malformation, and surgery were included in the study. This is a cross-sectional study. A 3D Motion capture system was used to record cervical and thoracic spine flexion, extension, lateral bending, and rotation. Range of motion was tested without a brace, with modified Iranian and rigid Minerva braces. Results: Immobilization in flexion (89.03%>87.8%) and rotation (84.85%>83.19%) were higher in the modified Iranian Minerva than in rigid Minerva, but extension (89.37%>85.95%) and lateral bending (81.26%>71.71%) were higher in rigid Minerva at cervical region (p value>0.05). In flexion (76.35% <75.96%), lateral bending (46.92% >44.5%) and extension (79.44%>62.58%) immobilization were higher in the rigid Minerva than modified Iranian Minerva, but rotation (53.04%>41.21%) was more restricted in the modified Iranian Minerva than in the rigid Minerva at the thoracic region (p-value>0.05).  Conclusion: Both Minerva braces significantly reduced the neck’s range of motion (p-value<0.05). The Rigid Minerva was more effective in controlling extension and lateral bending, but the modified Iranian Minerva provided greater flexion and rotation limitations (p-value<0.05).    

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Original Articles

Effect of 8 Weeks of Modified Dynamic Neuromuscular Stabilization Exercises on Core Region Function and Shoulder Pain in Patients with Incomplete Paraplegic Spinal Cord Injury

Eskandar moghanloo; Gholamali Ghasemi; Morteza Sadeghi; Navidreza Ghasemi Kahrizsangi

Articles in Press, Accepted Manuscript, Available Online from 27 August 2024

Abstract

  Background and purpose: Spinal cord injury (SCI) causes a decline in core region function and shoulder pain in wheelchair users. This study aimed to determine the effectiveness of modified ...  Read More Background and purpose: Spinal cord injury (SCI) causes a decline in core region function and shoulder pain in wheelchair users. This study aimed to determine the effectiveness of modified dynamic neuromuscular stabilization (DNS) exercises on core region function and shoulder pain in patients with incomplete paraplegic SCI.  Materials and Methods: Ten male SCI patients were purposefully selected based on inclusion criteria and participated in this experimental study. Before the exercise period, variables of core region function and shoulder pain were measured by modified plank test, an abdominal pressure cuff device, and the Wheelchair Users' Shoulder Pain Index (WUSPI) questionnaire, respectively. Participants underwent an eight-week non-exercise period, followed by an intermediate test, and after that, they performed eight weeks of modified DNS exercises. Measurements were repeated at the end of the second eight-week period. Data were analyzed by SPSS version 26 and inferential statistics analysis of variance for repeated measures (P≤0.05).  Results and Conclusion: The results showed significant improvement in the core function, transverse abdominal muscle strength, and shoulder pain (WUSPI) after the exercise period compared to the non-exercise period (P≤0.05). Based on this study, this exercise method can be recommended as a complementary and low-cost method in the physical rehabilitation process of these patients.      

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Systematic Reviews

Caregiver burden in primary caregivers of community-dwelling older adults: Systematic review

Kiana Ramezani; marzieh Pashmdarfard; Mehdi Rezaee; Zeinab Bagheri; mino kalantari

Articles in Press, Accepted Manuscript, Available Online from 28 August 2024

Abstract

  Background: Caregivers are those who are responsible for helping old, sick, or disabled people. Most care services are provided by family members as primary caregivers. Taking care ...  Read More Background: Caregivers are those who are responsible for helping old, sick, or disabled people. Most care services are provided by family members as primary caregivers. Taking care of the elderly requires a lot of expenses and physical and psychosocial pressure, which ultimately leads to a decrease in caregivers’ quality of life and care service quality. With the increasing proportion of people aged 60 and over and advances in medicine and technology to extend life, concerns about care for the elderly are increasing. Methods: The current systematic review study reviewed systematically the effects of intervention on burden on primary caregivers of community-dwelling older adults and identify influential factors in caregiving problems and challenges. In this study, 354 articles, published in peer-reviewed journals from 2000 to 2023, were extracted from different databases, including Embase, PubMed, and Scopus. The agreement rate in relation to the search of the articles that was done by the first and third author was 93%. In addition, the quality of these articles was assessed through PEDro scale, their abstract and full texts were thoroughly analyzed by the second and fourth author, and the agreement rate in this regard was 89% too. Results: In total, 13 articles included in the review based on inclusion and exclusion criteria. All the thirteen eligible articles reviewed in this study were of medium to high quality with a score of 5 or above on the PEDro scale. These articles centered on direct interventions for older adults (four articles), interventions for caregivers (five articles), and interventions for both (four articles which direct caregiver interventions are the most efficient approach on reducing caregiver burden among them. The results of these studies were analyzed with respect to variations in the burden, stress, and depression of caregivers. Conclusion: Based on the results, it is concluded that direct caregiver intervention is the most efficient approach on reducing caregiver burden. Furthermore, the design and evaluation of individualized programs can be highly effective in enhancing the impact of intervention and devising better subsequent programs.  

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Case Report

Early mobilization and functional training for early recovery after Stevens-Johnson Syndrome- A case report.

Naveen Kumar I

Articles in Press, Accepted Manuscript, Available Online from 22 September 2024

Abstract

  Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe dermatological disorders with limited prevalence, leading to insufficient awareness among physical therapists. ...  Read More Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe dermatological disorders with limited prevalence, leading to insufficient awareness among physical therapists. This knowledge gap can result in suboptimal care and heightened complications due to immobility. This case report documents the physical therapy intervention for a 20-year-old female with SJS, admitted to an Indian rural tertiary hospital. Assessments at baseline, 7th, 20th days, and 1-month post-admission showcased substantial improvements, particularly after the 7th day. Progress was evident in critical parameters: ICU mobility scale, FSS ICU tool, Barthel Index, and joint range of motion. The report highlights the intricate relationship between disease severity, impairments, and functional limitations. It underscores the pivotal role of early mobilization rooted in functional tasks, expediting recovery, and curtailing musculoskeletal and pulmonary complications, thus reducing hospital stays. This study enhances the understanding of SJS management via physical therapy, emphasizing tailored protocols, early mobilization, and interdisciplinary collaboration to optimize outcomes and alleviate SJS-related morbidity.

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Original Articles

The Prevalence of Academic Procrastination among Students of School of Rehabilitation Sciences in Shiraz University of Medical Sciences

Sara Abolahrari-Shirazi; Farzaneh Moslemi Haghighi; Farahnaz Emami

Articles in Press, Accepted Manuscript, Available Online from 22 September 2024

Abstract

  Background:Academic procrastination is as an irrational tendency to defer at the beginning or completing an academic task and is reportedly associated with negative emotions, psychological ...  Read More Background:Academic procrastination is as an irrational tendency to defer at the beginning or completing an academic task and is reportedly associated with negative emotions, psychological distress, sense of failure, guilt, lower levels of self-regulated learning and self-efficacy and unsatisfactory academic performance. Academic procrastination is a common phenomenon among university students.  Therefore, this study was designed to investigate the prevalence of academic procrastination among students of School of Rehabilitation Sciences in Shiraz University of Medical Sciences.  Methods:  All of university students (a total of 368), 230 (62.5%) female and 138 (37.5%) males participated voluntarily in the present cross-sectional descriptive study. The participants were undergraduate and postgraduate students from different grade levels enrolled in 5 departments. The mean age of students was 21.66 ± 2.27. To ascertain the prevalence of procrastination, we followed Solomon and Rothblum academic procrastination questionnaire. This questionnaire consists of 27 items which designate to measure three areas: Preparing for exams, preparing assignments and preparation of final paper. We used descriptive, Pearson correlation coefficient, one way ANOVA and independent t-test. P value less than 0.05 was regarded statistically significant. Results: Two hundred and ninety-seven students answered all questions about procrastination. Of the participants, 44.2% of students claimed to be moderate procrastinators and 54.5% stated they were severing procrastinators. It was shown that 40.9% of males had moderate and 57.3% of them had severe problems with academic procrastination. Moreover, 46% of females had moderate and 52.9% of them exhibited sever procrastinator behaviors. Furthermore, 42.5% of undergraduate students reported a tendency to moderate procrastination and 56% tendency to sever procrastinator behaviors. Moreover, %58.1 of postgraduate had moderate level and 41.9% faced with sever procrastination behaviors. In addition, the results revealed that academic procrastination prevail at all of components among students and was more prevalent in undergraduate students in preparing assignments (P<0.05).  Conclusion: Academic procrastination behaviors was equally prevalent among all educational levels, disciplines and sexes. Students experienced procrastination tendency in all components of academic procrastination. These data may aid institutions in order to developing better intervention techniques to decrease the impact of academic procrastination and increase academic attainments.  

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Original Articles

Impact of group reality therapy Glaser on self-esteem and depression of betrayed women: An experimental study with control group

Shiva Moradi; Hossein Komeili Sani; Bahman Dashtbozorgi; Saeed Ghanbari

Articles in Press, Accepted Manuscript, Available Online from 22 September 2024

Abstract

  Background: Marital infidelity is one of the most challenging issues in married life, resulting in consequences such as depression and low self-esteem. This study aimed to investigate ...  Read More Background: Marital infidelity is one of the most challenging issues in married life, resulting in consequences such as depression and low self-esteem. This study aimed to investigate the impact of Glaser group reality therapy on self-esteem and depression in betrayed women. Methods: The present study was an experimental study with control group using a pre-test and post-test design. Thirty-six women referred to social welfare-supervised counseling centers were randomly assigned to control and intervention groups. The experimental group received ten 90-minute sessions of a reality therapy intervention. The data collection instruments were the Marital Adjustment Scale, Rosenberg Self-Esteem, and Beck Depression Questionnaires. The data analysis was performed using SPSS software version 22 with a significance level of 0.05. Results: There was no significant difference between the demographic variables in the two groups. The mean scores of self-esteem (p=0.756) and depression  (P=0.875) also did not differ significantly in the two groups before the intervention. The mean scores for depression and self-esteem after group reality therapy training using the Glaser method in the intervention group showed a significant difference from the control group (p < 0.001). Conclusion: Group reality therapy improves self-esteem and reduces depression in women affected by marital infidelity. Therefore, it is recommended that relevant authorities consider a program for couples during their married life.  

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Original Articles

Designing and studying the effectiveness of Nava game multimedia software in teaching the diagnosis of dysarthria symptoms in speech therapy students.

Parvaneh Rahimifar; Negin Moradi; Majid Soltani; Mohammad jafar Shaterzadeh Yazdi

Articles in Press, Accepted Manuscript, Available Online from 12 October 2024

Abstract

  Background: Different studies found the use of educational games effective in improving the quality of students' learning and benefiting from the materials in clinical environments ...  Read More Background: Different studies found the use of educational games effective in improving the quality of students' learning and benefiting from the materials in clinical environments So,in this study, we designed the Nava game multimedia software in teaching dysarthria diagnostic skills in speech therapy students and investigating the effectiveness of the software in speech therapy students. Methods: This is a descriptive-analytical study. After we designed and produced the content of Nava's educational game. This study was evaluated for 42 speech therapy students who were divided into two groups (the first group learned the topic of dysarthria by theoretical teaching and the second group learned it by theoretical teaching along with the use of Nava software).At the end, the level of students' knowledge was evaluated by the final exam score and the attitude level was checked using a researcher-made questionnaire. Results: Examining the mean and standard deviation scores of the students of the first group was 15.01±1.32 and the second group was 17.86±1.04 and the difference between the two groups was significant (p<0.001). The attitude level of the first group was29.61±14.72 and the second group was 43.14±16.50,which showed the significance difference between the two groups (p<0.001). Discussion: Nava is game software that can be installed on an Android phone, which led to an increase in learning, students' attitude towards learning, and the level of satisfaction of instructors and students in the diagnosis of dysarthria.    

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Original Articles

Validation of the Persian Version of the Life Balance Inventory in Iranian Population

naser havaei; Babak kashefimehr; ahmad mohammadi; Mina Ahmadi Kahjoogh

Articles in Press, Accepted Manuscript, Available Online from 12 October 2024

Abstract

  Background: Life balance is defined as having a satisfying pattern of activities or occupations that is sustainable and meaningful to a person within his/her current context and life ...  Read More Background: Life balance is defined as having a satisfying pattern of activities or occupations that is sustainable and meaningful to a person within his/her current context and life conditions, and could be considered as an important outcome in medical-rehabilitation services. The Life Balance Inventory (LBI) is a self-reported and comprehensive measure developed to evaluate life balance. The aim of this study was to translate and validate the LBI with the Iranian population.Methods: A methodological and cross-sectional study with a sample population consisted of 150 healthy and 93 mentally ill people were studied. The validation processes, including content validity, discriminant validity (construct validity), test-retest reliability, and internal consistency of the LBI, were conducted.Results: Persian translation of LBI has an acceptable content validity. Discriminant validity showed difference between the life balance of healthy people and people with mental disorders. The test-retest reliability was 0.7 to 0.93 over a 2-week period. The internal consistency was good (Cronbach’s alpha = 0.88).Conclusion: The LBI has acceptable statistical values for use in Iranians. This questionnaire can also discriminate between people with and without mental disorders. The Persian version of the LBI can be used in different specialties and settings. 

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Meta-Analyses

The effects of combined training on functionality, balance and gait speed of the elderly: A systematic review and meta-analysis

mahboobeh dehnavi; Amirali Jafarnejadgero; Farhad Tabatabai Ghomsheh; Ali Fatahi

Articles in Press, Accepted Manuscript, Available Online from 23 October 2024

Abstract

  Background: Ensuring the safety of the elderly is an increasingly important concern today. Fall prevention guidelines recommend highly challenging training modes to decrease falls. ...  Read More Background: Ensuring the safety of the elderly is an increasingly important concern today. Fall prevention guidelines recommend highly challenging training modes to decrease falls. Therefore, the purpose of this systematic review is to examine the effects of combined training (CT) on functionality, balance and gait speed of the elderly.Methods: Primary sources were obtained from 4 databases including PubMed, SCOPUS, Cochrane Central, and Web of Science. The search period covered years from inception to June 2th, 2024. Standardized mean differences (SMDs), weighted mean differences, and 95% CIs were calculated using random or fixed-effect models for outcomes.Results: Following the screening process, 12 studies involving a total of 570 participants were included in the systematic review. The results of the meta-analysis showed that CT increased functionality (0.64 [95% CI: 0.34-0.93], p=0.003), balance (0.65 [95% CI: 0.39-0.90], p=0.001), and gait speed (1.18 [95% CI: 0.76-1.59], p=0.001). Additionally, the results of the meta-analysis demonstrated that there was significant difference between CT and traditional training (TT) on functionality (0.50 [95% CI: 0.28-0.73), p=0.001), in favors of CT.Conclusion: The results meta-analysis demonstrated that CT has a positive effect on the functionality, balance, and gait speed of the elderly. Also, comparing CT with TT, significant difference was observed between these two types of training. CT had more effect on functionality of the elderly than TT. Therefore, CT is a viable method to increase the functionality, balance, and gait speed of the elderly. 

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Original Articles

Evaluating dynamic stability, spatiotemporal and kinematic parameters of gait during walking in day and night shift nurses

Mohammad Taghi Karimi; Farzaneh Yazdani; Mahbobeh Razavi

Articles in Press, Accepted Manuscript, Available Online from 23 October 2024

Abstract

  Background: Despite the importance of investigating the effect of night shift on gait kinematics of nurses, literature lacks evidences to evaluate this relationship. Therefore, the ...  Read More Background: Despite the importance of investigating the effect of night shift on gait kinematics of nurses, literature lacks evidences to evaluate this relationship. Therefore, the purpose of the present study was to compare gait kinematics among day and night shift nurses.Methods: Participants (N = 31) of this cross-sectional study were female nurses aged 27-47 years old working at night (N=16) and day shifts (N=15). A Qualisys motion analysis system with 8 high-speed cameras was utilized to record the motion of the body segments during walking. The spatiotemporal characteristics of gait (stride length, walking velocity, and cadence), kinematics of the ankle, knee, hip, pelvic, and trunk, were the parameters selected for statistical analysis. Dynamic stability while walking was assessed by simple measurement of center of mass movements (COM).Results: The difference between the mean values of spatiotemporal gait parameters of the nurses worked in day and night shifts was not meaningful. Moreover, the difference between mean values of range of motions of the lower extremity joints and pelvic and trunk segments during the stance phase of the gait were not significant between both groups. As a measure of dynamic stability, COM movement in mediolateral direction was significantly different between both groups.Conclusion: No difference was found between spatiotemporal gait parameters, dynamic stability in vertical direction, and joints range of motion (ROM) of the nurses working during day and night. Therefore, the results of the present study suggested that working in the night shift does not change the biomechanical gait patterns of nurses.  

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Systematic Reviews

Prevalence of Soft Tissue Injuries in Upper and Lower Limb among Professional Racquet Sports Players: A Systematic Review

Gunjan Chaudhary; Sumit Raghav; Anshika Singh; Shagun Agarwal; Latika Gulyani

Articles in Press, Accepted Manuscript, Available Online from 10 November 2024

Abstract

  Background: - The purpose of this systematic review was to determine the prevalence of soft tissue injuries in upper limb and lower limb among professional racquet players. Methods: ...  Read More Background: - The purpose of this systematic review was to determine the prevalence of soft tissue injuries in upper limb and lower limb among professional racquet players. Methods: - This systematic review has been conducted using electronic search for publications in various electronic database: Google Scholar, PubMed and Science Direct. After implementing the selection criteria, articles published between the years 2000 to 2023 have been selected .Total 84 published full text articles were selected from different database. Out of 84, only 09 articles were included in this systematic review study on the basis of selection criteria. Results:- On reviewing and analyzing the previous selected articles, the result of this study shows that there is high prevalence of soft tissue injuries at elbow joint and ankle joint in upper limb and lower limb respectively. Furthermore, on the basis of grading of injury, there was high incidence of mild injury and low incidence of severe injury of soft tissue at the elbow joint and ankle joint respectively. Conclusion:- On the basis of findings, there is high prevalence of mild injuries and low prevalence of severe injuries found related to soft tissues at different joints in upper as well as lower limb statistically.  Furthermore, on the basis of grading of injury, there was high incidence of mild injury 70% and low incidence of severe injury 10% of soft tissue at the elbow joint and ankle joint respectively.  

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Original Articles

A Combined Exercise Program in Sedentary Older Adults: A Randomized Control Trial

Behnoosh Aminikhah; hamed babagoltabar-samakoush; Behnam Gholami-Borujeni

Articles in Press, Accepted Manuscript, Available Online from 10 November 2024

Abstract

  Background: The present study investigated the effectiveness and durability of a combined exercise program on strength, endurance, speed, agility, flexibility, and quality of life in ...  Read More Background: The present study investigated the effectiveness and durability of a combined exercise program on strength, endurance, speed, agility, flexibility, and quality of life in sedentary older adults. Methods: In this randomized control trial, 27 older adults participated, including 13 people in the training group (TG; six women and seven men) and 14 individuals in the control group (CG; six women and eight men). Quality of life, agility, flexibility, speed, and lower limb muscle endurance and strength were evaluated at the pretest and post-test stages and two months after the completion of the measurements at the post-test stage. The TG performed the combined exercises (strength + functional training) for eight weeks, three sessions per week. Results: The study results revealed a significant difference between both groups at the post-test stage in speed (p < 0.001), flexibility (p = 0.04), lower limb muscle strength (p = 0.002), and endurance (p < 0.001), agility (p=0.001), quality of life in the physical (p < 0.001) and mental (p < 0.001) components. Also, the study results showed a significant difference between groups at the follow-up stage in the variables of speed (p < 0.001), flexibility (p = 0.03), strength (p = 0.001), and endurance (p < 0.001), agility (p < 0.001), quality of life in the physical (p = 0.03) and mental (p = 0.04) components. Conclusion: According to the findings, the combined exercise program can durably improve the functional capacity and quality of life of older adults.    

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Systematic Reviews

The association between obesity and lung functions: A systematic review

Fatemeh Rahimi; Nahid Rahmani; Nahid Pirayeh; Khadijeh Kazemi

Articles in Press, Accepted Manuscript, Available Online from 26 January 2025

Abstract

  Background: The purpose of this study was to systematically evaluate the studies that assessed the association between obesity and lung functions in obese adult individuals.Method: ...  Read More Background: The purpose of this study was to systematically evaluate the studies that assessed the association between obesity and lung functions in obese adult individuals.Method: This study is a systematic review. Different databases including PubMed, Scopus, Science Direct, EMBASE, ProQuest, and Google Scholar were searched up to 30 June 2021. The keywords used were: “obesity”, “overweight”, “breathing function”, “respiratory function”, “breathing physiology”, and “breathing disorders”. Study selection, data extraction, and quality assessment were conducted by two independent reviewers.Result: sixteen articles were eligible to be included in this review.  8 articles were cohort, 4 articles were case-control and 4 articles were cross-sectional studies.Conclusion: Based on Critical Appraisal Skills Program (CASP) quality assessment tools, all of the included studies were assessed as high quality except one of the cohort studies (approximately 6% of all included studies) was assessed as a moderate quality level.  According to the results of these 16 reviewed articles, there is a strong inverse correlation between the amount of obesity and some lung volumes and capacities in adult individuals.Prospero Registration Number:   CRD42021238652

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Original Articles

The Prevalence of Language Impairment in 5-year old Persian-Speaking Children after COVID-19

Masoomeh Salmani; Masume Zareei; Marziyeh Maddah; Mozhgan Asadi; Fatemeh Esmaili Moqadam; Sepideh Seyed; Mana Aminian; Reyhaneh Farajianpour

Articles in Press, Accepted Manuscript, Available Online from 26 January 2025

Abstract

  Objectives: Children’s language skills develop based on the physical development and experience. During pandemics such as COVID-19, a lot of restrictions have been imposed on ...  Read More Objectives: Children’s language skills develop based on the physical development and experience. During pandemics such as COVID-19, a lot of restrictions have been imposed on people’s life. Such restrictions may have compromised children’s life experience. This study investigated the rate of language impairment or LI among 5-year-old children after  COVID-19 pandemic. Materials & Methods: language skills of 340 5-year-old Persian-speaking children without any defects in the pre-school screening, no advice to receive speech therapy or rehabilitation services, and from all socioeconomic levels according to the maternal education and fathers’ jobs were examined in this cross-sectional study using the Farsi Language Development Test-3. The 1.25 standard deviation below the mean in spoken language composite score was considered the cutoff point for LI. The data were compared with appropriate statistical tests. Results: More than 20% of children obtained standard scores below 6.25 in relational vocabulary, sentence imitation, and word differentiation subtests. Children language age in these sub-tests was three, equivalent to two years less than their chronological age. The spoken language scores in boys, in children whose mothers had lower education, and those whose fathers were private employee were significantly lower than their counterparts (p < 0.05). Conclusion: This study showed rate of LI in Persian monolingual population increased significantly at the end of the COVID-19 pandemic, such increase could be a consequesnce of COVID-19 circumestamces or the side-effects of this pandemic over families lives.  

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Original Articles

The Psychometric Evaluation of the Coping with MS Caregiving Inventory (CMSCI) for Iranian Caregivers

Mohammad Mohebbirad; laleh lajevardi; Seyed Hassan Saneii; Fatemeh Motaharinezhad; Afsoon Hassani Mehraban

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: coping means cognitive and behavioral attempts made to manage a stressful situation. Caring for multiple sclerosis (MS) patients is associated with increased stress in the ...  Read More Background: coping means cognitive and behavioral attempts made to manage a stressful situation. Caring for multiple sclerosis (MS) patients is associated with increased stress in the caregiver. Recognizing and managing caregivers' coping strategies can speed up the rehabilitation of MS patients and improve the quality of treatment. Therefore, this study was conducted to translate and evaluate the validity and reliability of the Persian version of Coping with MS Caregiving Inventory (CMSCI). Method(s): In this methodological research, as many as 170 caregivers of MS patients have been investigated. This scale's Persian translation was conducted using the International Quality of Life Assessment (IQOLA) method. The face validity of CMSCI was achieved by researching 10 caregivers and the content validity was conducted by qualitative and quantitative methods using the content validity index and content validity ratio methods. To evaluate the reliability of CMSCI, a test-retest was conducted on 54 caregivers who completed the questionnaire with an interval of 10 days. Internal consistency was assessed using Cronbach’s alpha method. Results: The mean (SD) for the participant caregiver's age in this study was 42.3 (11.1). The mean (SD) for people with MS who were under care by caregivers was 38.6 (9.2). The reliability of the test-retest of CMSCI was calculated to be 0.82 to determine the stability. The internal consistency of CMSCI was determined to be 0.75 by Cronbach’s alpha method. Conclusion: The Persian version of CMSCI demonstrated good validity and reliability in assessing coping skills for caregivers of people with MS. Considering the vital role of caregivers in the treatment team and the impact of effective coping strategies on the quality of care for people with MS, utilizing the CMSCI can be beneficial in evaluating and enhancing the rehabilitation process for people with MS and their caregivers.  

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Original Articles

Evaluating the Predictive Power of Cognitive Assessment Tools for Cortical Hypometabolism in Alzheimer’s Disease

Mohammad Sadeghi; Salimeh Jafari; Hadi Aligholi; Zahra Shayan; Alireza Keshavarz Bahaqiqat

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: Alzheimer's disease (AD) is a serious progressive neurodegenerative disorder that is characterized by memory loss and cognitive performance decline. one of the theories ...  Read More Background: Alzheimer's disease (AD) is a serious progressive neurodegenerative disorder that is characterized by memory loss and cognitive performance decline. one of the theories to explain AD pathology is the emergence of abnormal hypometabolism. The current study aimed to investigate the association of cortical hypometabolism, and cognitive assessment tools in dementia spectrum. Methods: Our cross sectional/longitudinal study used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), including 1048 subjects with 291 cognitively normal (CN), 579 mild cognitive impairment (MCI), and 178 AD. The FDG-PET data (as an indicator for hypometabolism) and cognitive assessment scores including Alzheimer's Disease Assessment Scale (ADAS11 and ADAS13 subtests), Montreal Cognitive Assessment (MoCA), Everyday Cognition Scale (ECog), and Mini-Mental State Exam (MMSE) were gathered. ANOVA, multiple regression, ROC and AUC analyses were used to analyze data. Results: According to linear regression analysis, ADAS11, ADAS13, and MMSE predicted PET scores in the MCI group (p-values:0.002,0.002, 0.017), but MoCA predicted PET scores in the CN group (β=0.016, p=0.045). ADAS13 exhibited the greatest discriminative capacity (AUC=0.786), followed by ADAS11 (AUC=0.767), according to ROC analysis. Over time, PET scores declined significantly in all groups, with the AD group exhibiting the biggest fall. The PET scores of the CN and MCI groups were notably higher than those of the AD group at 24 months (p<0.001).   Conclusion: The ADAS11 and ADAS13 tests could distinguish between normal and abnormal hypometabolism. Additionally, ADAS13 has the best discriminative ability, which is useful for clinicians and researchers for early detection and monitoring of the AD spectrum.          

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Original Articles

Effects of Transcranial Direct Current Stimulation (tDCS) on balance, functional performance, and neurocognitive function in males with Chronic Ankle Instability: study protocol for a randomized controlled trial

Sara Asadi Abadi; Azadeh Shadmehr; Zeinab Shiravi; Sara Fereydounnia; Michael A Nitsche; Azita Yazdani

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: Approximately 40% of subjects who experience an ankle sprain, develop chronic ankle instability (CAI). Changes in CNS and deficits in neurocognitive function have been reported ...  Read More Background: Approximately 40% of subjects who experience an ankle sprain, develop chronic ankle instability (CAI). Changes in CNS and deficits in neurocognitive function have been reported in CAI. This is a protocol study for a randomized controlled trial that aims to assess the effectiveness of transcranial direct current stimulation (tDCS) on self-reported questionnaires, balance, functional performance, and neurocognitive function in CAI. Methods: A randomized, sham-controlled, single-blind clinical trial will be conducted, with the subjects divided into two groups: 1) anodal tDCS (a-tDCS) in combination with exercises, and 2) sham tDCS in combination with exercises (n= 10 per group). Subjects will receive interventions for 12 sessions (3 sessions per week). Assessment of outcome measures will be done at first, sixth, and twelfth sessions. Self-reported questionnaires will be assessed at first and twelfth sessions. Discussion: Based on previous studies, tDCS is a beneficial tool for improving balance and cognitive function. Due to correlations between neurocognitive conditions and musculoskeletal disorders, the findings of this study may provide more evidence of the effects of tDCS in CAI population and may introduce a complementary intervention to exercise therapy. Trial registration: Iranian Registry of Clinical Trials, IRCT20230208057352N1. Registered on 20 February 2023.                  

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Original Articles

Life Satisfaction and Socioeconomic Situation among Individuals with Spinal Cord Injury at Community Settings in Bangladesh

Faruq Ahmed; Md Nazmul Hassan; Saiba Muhammad Sabrin; Mohammad Nazmul Hasan; Shajida Akter; Golam Moula; Moeidu Bhuian Priti; Maruful Hasan Faruki

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: Individuals with spinal cord injury (SCI) have to face many challenges in community settings after completing rehabilitation. The study aimed to explore the level of life ...  Read More Background: Individuals with spinal cord injury (SCI) have to face many challenges in community settings after completing rehabilitation. The study aimed to explore the level of life satisfaction and socioeconomic situation among people with SCI in the community setting. Methods: A cross-sectional survey through phone calls was conducted with the community-dwelling SCI population who had completed their rehabilitation from a specialized rehabilitation center in Bangladesh. The survey covered all eight divisional areas of Bangladesh with 150 SCI participants. LISAT-11 and WHODAS 2.0 were used to explore life satisfaction and socioeconomic situation respectively. Multivariate linear regression and Spearman’s correlation were used to find association and relationship between the variables. Results: Among the participants, the traumatic SCI was highest at 84% and males were 90%, where, 64.7% were found as paraplegic and 74% were from rural areas. While considering the socio-economic status, the majority of the participants (46.7%) had a considerable amount of monthly income. While participating in society, the highest proportion of SCI participants faced a moderate type of disability (43.68%) and a significant proportion of SCI participants were found to be satisfied with their life as a whole (30.67%). Individuals with higher disability scores tend to have lower life satisfaction (rp= -0.852, p=.001). Monthly income and injury severity were found to be associated with life satisfaction. Conclusion: Participants with SCI who returned to the community faced economic challenges, difficulties in community participation, and a significant decline in life satisfaction.  

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Original Articles

Translation and psychometric evaluation of the Persian version of the Chedoke Arm and Hand Activity Inventory-13

Seyed Hossein Hosseini; Moslem Cheraghifard; Akram Azad; Ghorban Taghizadeh; Laleh Lajevardi

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: Stroke survivors suffer from functional limitations, including upper extremity impairments. The present paper aimed to investigate psychometric properties of Chedoke Arm ...  Read More Background: Stroke survivors suffer from functional limitations, including upper extremity impairments. The present paper aimed to investigate psychometric properties of Chedoke Arm and Hand Activity Inventory (CAHAI-13) in patients with stroke. Methods: This cross-sectional study included 105 stroke patients and 10 experts. Translation was performed according to IQOLA protocol. The CAHAI-13 alongside Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), and Fugl-Meyer Assessment-Upper Extremity (FMA-UE) were administered. Content, construct, convergent, divergent and known-group validity, internal consistency, test-retest, and inter-rater reliability were examined. Results: Experts expressed that the Persian CAHAI-13 had acceptable content validity. A significant (P<0.001) positive correlation was found between CAHAI-13 and ARAT (r=0.84), WMFT (r=0.91), and FMA-UE (r=0.74) indicating sufficient convergent validity. Exploratory and confirmatory factor analysis revealed that one-factor model had proper fit indices in stroke population. The CAHAI-13 had good discriminative ability (F=123.36, P<0.001). The results showed acceptable internal consistency (α=0.96), test-retest reliability (ICC=0.85), and excellent inter-rater reliability (ICC=0.93). Conclusion: The results of the current study showed that CAHAI-13 has acceptable psychometric features for evaluating upper extremity in stroke survivors in research and clinical settings.      

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Original Articles

A Novel Approach to Analyzing Wrestling Skills: Multidimensional Recurrence Quantification Analysis of Muscle Activity

Kazem Esfandiarian-Nasab; Mansour Eslami; Fateme Salari-Esker; Rohollah Yousefpour

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: As athletes develop their skills, their motor patterns shift from variable to adaptive neuromuscular control strategies, enabling the precise execution of complex movements. ...  Read More Background: As athletes develop their skills, their motor patterns shift from variable to adaptive neuromuscular control strategies, enabling the precise execution of complex movements. Traditional linear biomechanical analyses of wrestling techniques focus on average data points and often overlook the importance of motor pattern variability and nonlinear dynamic elements. Understanding these nonlinear dynamics in wrestling can enhance skill acquisition, injury prevention, and training optimization. This study is the first to apply multidimensional recurrence quantification analysis (MDRQA) of electromyography (EMG) signals to compare motor patterns in elite and sub-elite wrestlers during a shadow freestyle tie-up drill (SFTUD). This is an Original Research study. Methods: EMG signals from the triceps, biceps, anterior deltoid, and latissimus dorsi muscles in the dominant upper limb were recorded during a 15-second SFTUD. Determinism (%DET) and laminarity (%LAM) assessed repeatability and stability, while diagonal (EntL) and vertical (EntV) entropy measured complexity and adaptability. Results: Elite wrestlers exhibited significantly higher %DET and %LAM, indicating greater consistency in their motor patterns. Their elevated EntL and EntV values further suggest enhanced complexity and adaptability in neuromuscular control, reflecting the chaotic dynamics that contribute to superior performance. Conclusion: These findings highlight the importance of nonlinear motor pattern dynamics in understanding wrestlers’ skill development. By identifying expertise-related movement patterns through MDRQA, coaches, and practitioners can design targeted training programs that optimize performance and minimize injury risk.      

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Original Articles

The effect of Partial sleep deprivation on the ground reaction force components before and after fatigue

yasin hoseini; leila ghazaleh; paria mahmoodi; Fateme Badie

Articles in Press, Accepted Manuscript, Available Online from 17 March 2025

Abstract

  Background: The interaction of lack of sleep and fatigue increases the possibility of injury in different people. Examining the components of ground reaction forces during activities ...  Read More Background: The interaction of lack of sleep and fatigue increases the possibility of injury in different people. Examining the components of ground reaction forces during activities such as cutting maneuver, provides valuable information about the correct functioning of the musculoskeletal system. The aim of the present study was to investigate the effect of Partial sleep deprivation on the components of the ground reaction force before and after fatigue. Method: The present research method was semi-experimental. 14 young women participated in this study. Each subject was evaluated twice with an interval of 5 days. The night before the pre-test, the subjects had full sleep, and the night before the post-test, the subjects experienced 4 hours of sleep deprivation at the beginning of the night. In the pre-test and post-test, participants repeated 5 attempts without fatigue and 3 attempts with fatigue. In all conditions, ground reaction force (GRF) components were measured using the Kistler force plate. Results: The results showed that at the heel contact phase (FZ1), fatigue (P=0.012) and fatigue with partial sleep deprivation (P=0.025) decreased the time to reach the peak of vertical ground reaction force. Also, the interaction of fatigue and partial sleep deprivation caused a significant decrease in vertical loading rate (p=0.019). However, no significant difference was observed in the peak of ground reaction forces and the impulse between different conditions. Conclusion: It seems that the interaction of fatigue and partial sleep deprivation significantly increases the risk factors for injury, include loading rates, by reducing the time to reach peak ground reaction forces.      

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Original Articles

Investigating the effects of adding Kinesio taping to diaphragm strengthening exercise on pain, function, core muscle endurance, agility, and balance in women athletes with chronic non-specific low back pain: A Randomized clinical trial Study Protocol

Sara Jafarpour; Leila Abbasi; Marzieh Mohamadi; Hadi Sarafraz; aida karami

Articles in Press, Accepted Manuscript, Available Online from 12 April 2025

Abstract

  Background: Chronic non-specific low back pain (NS-LBP) is a common musculoskeletal condition affecting athletes. While core muscle strengthening is effective, the diaphragm's role ...  Read More Background: Chronic non-specific low back pain (NS-LBP) is a common musculoskeletal condition affecting athletes. While core muscle strengthening is effective, the diaphragm's role in spinal stability is often overlooked. Kinesio taping may enhance muscle function, but its effectiveness when combined with diaphragm strengthening exercises remains unexplored in female athletes with NS-LBP.This study aims to investigate the effects of adding Kinesio taping to diaphragm strengthening exercises on pain, function, core muscle endurance, agility, and balance in female athletes with chronic NS-LBP.Methods: This single-blind randomized controlled trial will recruit 32 female recreational athletes (aged 30-50 years) with chronic NS-LBP. Participants will be randomly allocated to two groups: diaphragmatic exercises with Kinesio taping (experimental group) or diaphragmatic exercises alone (control group). The intervention will last 4 weeks. Outcome measures will include pain (Numerical Rating Scale), function (Oswestry Disability Index and Athlete Disability Index), core muscle endurance (Prone Bridge Test, Side Bridge Test, Unilateral Hip Bridge Endurance test, Feet Elevated Side Support test), balance (Single Leg Stance test, Y Balance Test), and agility (Illinois Agility Test). Assessments will be conducted at baseline, post-intervention, and 2-week follow-up. Results: This study will provide evidence regarding the efficacy of combining Kinesio taping with diaphragm strengthening exercises in female athletes with NS-LBP.Conclusion: Findings may inform clinical practice by establishing whether this combined approach offers superior outcomes compared to exercise alone. 

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Systematic Reviews

Factors affecting attachment and bonding in infants with a history of hospitalization in the intensive care unit (NICU): systematic review

Hanieh Esmail Darjani; Narges Talebi; Marzieh Pashmdarfard; Leila Asgarzadeh

Articles in Press, Accepted Manuscript, Available Online from 14 April 2025

Abstract

  Background: The present study was conducted to investigate the effective factors related to attachment and bonding in infants with a history of hospitalization in the intensive care ...  Read More Background: The present study was conducted to investigate the effective factors related to attachment and bonding in infants with a history of hospitalization in the intensive care unit (NICU).   Methods:  this systematic review study  using PRISMA guidelines to review the factors affecting bonding and attachment in infants with a history of hospitalization in the NICU. The search for articles was conducted between February 21 and March 17, 2024 in the databases including Scopus, PubMed, PsycNet, and Cochrane library. Nineteen eligible articles were finally reviewed in this study. Results: Based on the results, findings showed that some factors are affecting and some are Associative with bonding and attachment in infants with a history of hospitalization in the NICU. The results showed that in 4 articles demographic characteristics, in 7 articles psychological, in 2 articles cognitive, in 2 articles physiological, in 2 articles skin to skin contact, and in 6 articles attachment style are as factors affecting or associative with bonding and attachment in infants with a history of hospitalization in the NICU. Conclusion:  demographic characteristics of infants and parents, psychological, cognitive, and physiological characteristics of infants, features of skin-to-skin contact and attachment style are among the effective and associative factors with Attachment and Bonding in infants with a history of hospitalization in NICU.  

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Original Articles

Immediate Effects of Mulligan’s Mobilization with and without Kinesio Taping on Pain, Range of Motion, and Cervical Proprioception in Patients with Chronic Neck Pain: A Pilot Randomized Controlled Trial

Fatemeh Dokhaei; Azadeh Shadmehr; Kazem Malmir; Sara Fereydounnia

Articles in Press, Accepted Manuscript, Available Online from 28 April 2025

Abstract

  Background:  Neck pain is a common musculoskeletal issue associated with proprioceptive abnormalities and limited neck movement. This study assessed the immediate effects of Mulligan's ...  Read More Background:  Neck pain is a common musculoskeletal issue associated with proprioceptive abnormalities and limited neck movement. This study assessed the immediate effects of Mulligan's mobilization, with and without Kinesio taping, and conventional physiotherapy on pain intensity, range of motion (RoM), and proprioception in patients with non-specific chronic neck pain. Methods: This pilot randomized controlled trial involved 24 patients (9 men, 15 women, and aged 20-55 years) with non-specific chronic neck pain. They were randomly allocated to two groups: the experimental group received conventional physiotherapy, Mulligan's mobilization, and Kinesio taping, while the control group received conventional physiotherapy and Mulligan's mobilization. Pain intensity, active RoM, and cervical proprioception were measured before and immediately after intervention. Paired t-tests and Wilcoxon tests were used for within-group comparisons; independent t-tests and Mann-Whitney tests for between-group comparisons. Results: Both groups showed significant post-treatment pain reduction (control: p=0.10; experimental: p<0.001). The experimental group exhibited significant RoM increases in flexion and left lateral flexion, while the control group improved in extension and right lateral flexion (p<0.05). In proprioception, the experimental group showed significant improvement in repositioning from left rotation to neutral (p=0.02) and to target (p=0.03); no other significant proprioceptive changes were observed (p>0.05). Conclusion: Pain reduction and enhancement in RoM were observed when Mulligan's mobilization was added to conventional physiotherapy and specially combined with Kinesio taping. Furthermore, the concurrent application of Mulligan's mobilization and kinesio taping demonstrated greater improvements in neck proprioception compared to the isolated use of Mulligan's mobilization.  

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Original Articles

The Impact of Online Group Wheelchair Mobility and Transfer Training on the performance of people with spinal cord injuries: A superiority randomized controlled trial

Shahriar Parvaneh; Fatemeh Motaharinezhad; Fatemeh Hoseinpour; Mona Mohajer; Yahya Salimi

Articles in Press, Accepted Manuscript, Available Online from 28 April 2025

Abstract

  Objectives: Online training for rehabilitating People with Spinal Cord injuries people with SCI is necessary. Various environmental barriers create challenges in transferring and transporting ...  Read More Objectives: Online training for rehabilitating People with Spinal Cord injuries people with SCI is necessary. Various environmental barriers create challenges in transferring and transporting these individuals out of the home to participate in face-to-face interventions. This research aims to investigate the effectiveness of online group wheelchair mobility and transfer training, on the level of performance and satisfaction in people with SCI. Methods: In a single-blind randomized controlled trial, individuals with spinal cord injury (SCI) were selected from SCI association hospitals and clinics, and then randomly assigned to an online training group (OTG) or a control group (CG) using blocked randomization. The OTG participated in five online training sessions over five weeks, while the CG received routine guidance through an individual online booklet. Results were analyzed to assess changes in occupational performance and satisfaction immediately after the intervention and one month later. To determine the efficacy of treatment and compare the results in each group, the repeated measures analysis of variance (ANOVA) was used. Results: 37 (CG=18 and OTG=19) out of 49 participants completed the 5-week intervention and follow-up assessments. The average age of participants in the CG was 35.0 years, and the OTG was 33.7 years. We found a significant increase in performance (p <0.001) and satisfaction (p <0.001) within the OTG during the pre-post assessment. There were also significant differences in performance (p <0.026) and satisfaction (p <0.015) between groups. Discussion: The results showed that online wheelchair mobility and transfer training could be a suitable method for telerehabilitation and training People with SCI.  

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Original Articles

The Impact of Body Types and Digital Device Usage on Spinal Posture in Female Middle School Students during the COVID-19 Pandemic

Mohammad seyedahmadi; Karim Khalaghi; Fatemeh Jeddi

Articles in Press, Accepted Manuscript, Available Online from 28 April 2025

Abstract

  Objective: This study investigated the relationship between ectomorph, mesomorph, and endomorph body types and the duration of digital device use on spinal angle changes among female ...  Read More Objective: This study investigated the relationship between ectomorph, mesomorph, and endomorph body types and the duration of digital device use on spinal angle changes among female middle school students during the COVID-19 Pandemic. Methodology: A descriptive-correlational study was conducted. The study population consisted of female students aged 13 to 15 from the first secondary-level schools in Chenaran City during the academic year from October 7, 2021, to December 1, 2021. From a pool of 10 first-grade girls' high schools (totaling 1000 students), four schools were randomly selected. Out of these, 150 students were randomly chosen and assessed according to inclusion and exclusion criteria. The research tools included an informed consent form, anthropometric body measurement tools, the Smartphone Addiction Scale-Short Version (SAS-SV), a goniometer, a flexible ruler (IDIO brand), and a craniovertebral angle measurement tool. Data were analyzed using Spearman's correlation coefficient test with SPSS version 22 software. Results: The findings revealed no significant relationship between body type and kyphosis angle (p = 0.651, r = 0.038), lordosis angle (p = 0.083, r = 0.147), or forward head angle (p = 0.785, r = 0.023). However, a significant correlation was observed between the duration of digital device use and both kyphosis angle and forward head angle, though not with the lordosis angle. Conclusion: Prolonged digital device use significantly influences spinal angles, particularly increasing kyphosis and forward head angles. Although body type was not found to have a significant impact, factors such as physical activity and age should be considered when addressing posture-related issues. This study underscores the importance of educating students on proper posture and limiting screen time to mitigate potential spinal health issues.    

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Original Articles

The effect of Prevent injury and enhance performance training program on time to stability and center of pressure Changes in soccer players with and without anterior cruciate ligament reconstruction

moosareza ghorbani; hasan daneshmandi; Ali Shamsi Majelan; Mehdi Majlesi

Articles in Press, Accepted Manuscript, Available Online from 28 April 2025

Abstract

  Background: Background: Anterior cruciate ligament (ACL) injuries are prevalent in soccer and can significantly affect an athlete's stability and performance. The Prevent Injury and ...  Read More Background: Background: Anterior cruciate ligament (ACL) injuries are prevalent in soccer and can significantly affect an athlete's stability and performance. The Prevent Injury and Enhance Performance (PEP) training program is designed to reduce the risk of ACL injuries. This study aimed to investigate the effect of the PEP training program on time to stability (TTS) and center of pressure (COP) changes in soccer players with and without ACL reconstruction (ACLR). Method: Twenty-one male soccer players (mean age: 25.43 years), 15.12 months post-ACLR, and 21 healthy male soccer players (mean age: 22.79 years) underwent a jump-landing test. Data related to COP and TTS changes were collected before and after an 8-week PEP training program. intra-group comparisons was conducted using a paired t-test, while a one-way ANOVA was used for inter-group analyses, with a significance level set at p ≤ 0.05.   Results: intra-group comparisons showed significant reductions in COP fluctuations (M-L, p = 0.018) and TTS (M-L, p = 0.001) in the healthy group, and COP fluctuations (M-L, p = 0.001), COP variability (M-L, p = 0.034), total TTS (p = 0.015), and TTS (M-L, p = 0.001) in the ACLR group between the pre-test and post-test. Pre-test inter-group comparisons showed significantly higher COP fluctuations (M-L, p = 0.001), COP variability (M-L, p = 0.044), and total TTS (p = 0.021) in the ACLR group. Post-test comparisons showed no significant differences between groups (p > 0.05), indicating that the PEP training program effectively reduced deficits in the ACLR group, bringing their performance closer to that of healthy players. Conclusion: The implementation of the 8-week PEP training program can lead to positive changes in postural control among both healthy and ACLR soccer players, which may further clarify the effectiveness of such programs in reducing the risk of ACL injury or re-injury.  

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Original Articles

Effects of DIR/Floortime™ on social skills and social adjustment of children with mild autism spectrum disorder

Solmaz Mohammadi; Benyamin Hamid; Leila Ganji; Malek Amini; Marzieh Pashmdarfard

Articles in Press, Accepted Manuscript, Available Online from 07 May 2025

Abstract

  Background: This study investigates the effects of DIR/Floortime™ on the social skills and social adaptation of children with mild autism spectrum disorder (ASD). The purpose ...  Read More Background: This study investigates the effects of DIR/Floortime™ on the social skills and social adaptation of children with mild autism spectrum disorder (ASD). The purpose of this study is to evaluate whether training in Floortime™ significantly enhances the social capabilities and adjustment of affected children. Methods: A quasi experimental design was employed, and data was gathered using the social Gresham and Elliott Social Skills Scale and Bell’s Social Adjustment Inventory. Participants included 30 children diagnosed with mild ASD, along with their families, who underwent Floortime™ interventions over 8 sessions. Results: Results indicated significant improvements in social communication and emotional regulation among children. Parents reported enhanced parent-child interactions and increased engagement in daily activities, highlighting the intervention's positive impact on family dynamics. Additionally, the statistical analysis demonstrated meaningful advancements in the children's ability to initiate joint attention and respond to social cues, which are vital for effective communication. Conclusion: In conclusion, family-oriented DIR/Floortime™ proves to be an effective intervention for enhancing the social skills and adaptation of children with mild ASD. The study underlines the importance of parental involvement and tailored interventions in supporting children’s development. Future research is encouraged to explore the long-term effects of Floortime™ on social functioning in diverse settings.  

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Review Article

Instruments to Screen Specific Learning Disorder in Children and Adolescents: protocol for a systematic review

Farin Soleimani; Zahra nobakht; Fatemeh Hassanati; Mohammad Saatchi; Fatemeh ghasemifard; Zahra ghorbanpour; Mersede Imani-Shakibayi

Articles in Press, Accepted Manuscript, Available Online from 14 May 2025

Abstract

  Background: Specific learning disorder is an expanding problem in the world. It is directly related to the decrease in self-confidence and dropout of these children. So the purpose ...  Read More Background: Specific learning disorder is an expanding problem in the world. It is directly related to the decrease in self-confidence and dropout of these children. So the purpose of this study is to write a protocol for a systematic review of specific learning disorder screening instruments in children and adolescentsMethods: In order to do a task accurately, a precise protocol is needed first. this is a systematic review protocol will be done based on the preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) method.It intends to review articles that have validated different screening instruments for specific learning disorders in children and adolescents. The PubMed, Web of Science, Scopus, Cochrane Library, PsycINFO will be searched for peer reviewed publications. Gray literature will also be reviewed. The eligible studies will be assessed by Modified COSMIN Risk of Bias checklist to report their methodological quality.Results: Many researchers and clinicians use instruments for screening specific learning disorders. But there isn’t any study for choosing best of them or reporting the benefits, gaps and psychometric properties of them together.Conclusion: This study will review them to evaluate both the benefits and limitations of reported instruments, and share information about psychometric indexes of them and methodological quality based on Modified COSMIN checklist. This protocol, which is a requirement for a robust review, provides a clear path for the systematic review of specific learning disorder screening tools.Systematic review registration: CRD42023398531 

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Original Articles

A Comparison of Executive Function in Children with Developmental Coordination Disorder with Typically Developing Peers: A comparative study

Fatemeh Sharafian; Gholam Hossain Nazemzadegan

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

Abstract

  Background: Developmental coordination disorder (DCD) is a neurodevelopmental impairment that affects motor skills and causes attentional and executive impairments. Moreover, the Presence ...  Read More Background: Developmental coordination disorder (DCD) is a neurodevelopmental impairment that affects motor skills and causes attentional and executive impairments. Moreover, the Presence of neurodevelopmental disorders and comorbidities in these individuals  influences the cognitive factors of DCD children. Aim: The objective of this study was to compare differences in two components of executive functions in children with DCD to those of typically developing peers (TD).  Methods: In this study, 250  primary school students in Sepidan (age 8.86 ± 0.44) were examined using the MABC-2 test to identify DCD children from TD children. 20 DCD children were compared to their TD peers in two components of executive function (working memory assessed with the N-Back test and cognitive flexibility assessed with the Simple Stroop test). Multivariate and univariate analyses of variance were used to examine executive functions. Results: The results show that the number of correct answers in DCD children (Result1)) (56.60±21.43), was significantly lower than that of TD children (97.90±13.42) (P= 0.001). Additionally, the response time (Time1) in working memory for DCD children (910.35±174.92) was significantly longer than for TD children (745.4±164.35) (P= 0.004). In cognitive flexibility (Interference score) DCD children (11.2±6.32) was significantly higher than TD children (5.4±2.99) (P= 0.001).   Conclusions: The results showed that the performance of TD children in both components of executive function (working memory and cognitive flexibility) was significantly better than DCD children. Weak performance in multiple components of executive functions in DCD children highlights the need for motor/cognitive interventions in affected individuals.   

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Review Article

Examining the Return to Sport Time and Influential Factors After ACL Surgery in Professional Football Players

Javad Habibi; Ali Shamsi Majelan; Parisa Sedaghti

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

Abstract

  Purpose: Anterior cruciate ligament (ACL) injury is one of the most common injuries among football players and requires a prolonged recovery period after surgery. Return to play is ...  Read More Purpose: Anterior cruciate ligament (ACL) injury is one of the most common injuries among football players and requires a prolonged recovery period after surgery. Return to play is one of the major concerns for professional football players and healthcare professionals after an ACL injury. According to the findings, the average time for return to play in football players after ACL injury is 7 to 10 months, the precise timing of return varies for each individual based on pre-injury physical condition, age, gender, genetics and psychological factors (fear of re-injury , motivation). Increased risk of re-injury to the affected or contralateral limb due to premature return, or increased risk of early-onset osteoarthritis with delayed return, emphasize the importance of evaluating and determining the appropriate time for return to play. To review the literature on ACL injury and return to play time, as well as the factors influencing it, in professional football players. Methods: In the present review research Using 4 databases (PEDro/Web of Science/PubMed/Google Scholar) on November 25, 2023, with keywords such as RTP (Return to Play)/Return to Game/Return to Sport/ACL Reconstruction/ACL surgery/After ACL surgery/Elite soccer Player/Professional soccer player), 8 relevant studies were identified after excluding duplicates, irrelevant studies, different populations, and those without a precise return to play time. Results: According to the studies, the average time for return to play in football players after ACL injury is 7 to 10 months. One of the critical factors influencing the return to play time is the risk of re-injury to the affected or contralateral limb. Conclusion: Several factors have been identified for determining the precise timing for an athlete's return to play or initiation of rehabilitation stages, with individual differences (genetics), pre-surgery fitness level, psychological factors, H/Q ratio (quadriceps to hamstring), and injury severity being the most important evaluation criteria.  

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Original Articles

The effectiveness of the chiropractic modality in patients with chronic low back pain: a quasi-experimental study

Behdokht Aleali; Mohammad Hossein Sharifi; yasaman vazani; Hossein Molavi Vardanjani; Saeed Keshavarz; Malihe Sousani; Alireza Salehi

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

Abstract

  Background  Low back pain (LBP) is one of the most prevalent diseases in developed and developing countries and imposes a high socioeconomic burden on both individuals and communities. ...  Read More Background  Low back pain (LBP) is one of the most prevalent diseases in developed and developing countries and imposes a high socioeconomic burden on both individuals and communities. To date, few studies have explored the clinically significant impact of the chiropractic modality on chronic LBP. Given the high prevalence of LBP in communities and limited effects of current therapeutic methods on chronic LBP, studies are needed to evaluate the effectiveness of chiropractic approaches.   Methods The present quasi-experimental study was conducted on patients who were referred to private chiropractic clinics in Shiraz, Iran with more than three months of chronic LBP and had no pathological abnormalities, except for the lumbosacral spine. The data were collected in two stages: the first visit and eight weeks after treatment. The effect of the intervention was measured via three questionnaires: the Roland Morris Disability Questionnaire (RMDQ), the Numerical Rating Scale (NRS), and the self-assessment Global Rating of Change (GRC). Results In total, 141 patients with a mean age of 40.18 ± 10.42 years were analyzed. Among the patients, 40 (28.4%) were male. The mean differences in the pain disability and pain intensity before and after the intervention were statistically significant (p<0.001). The mean ± SD of the GRC was 56.13 ± 33.03%. It was not different in patients with mild, moderate, and even severe Magnetic Resonance Imaging (MRI) findings. Conclusion Overall, complementary chiropractic treatment may be an appropriate adjuvant to conventional treatments to improve disability and reduce pain intensity among patients with chronic LBP.    

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Original Articles

Investigating the applicability of a mobile phone-based self-care training program in lower limb amputees

vahid velayati; Alireza Taheri; saeed forghany; davood farahmandi

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

Abstract

  Background: The self-care program based on mobile phones is considered one of the effective ways to solve patients' problems. Considering the complex and unique situation of lower limb ...  Read More Background: The self-care program based on mobile phones is considered one of the effective ways to solve patients' problems. Considering the complex and unique situation of lower limb amputees with prostheses, there is a need to educate and raise awareness among these patients in order to improve their quality of life. The present study was conducted to evaluate the feasibility of a mobile -based self-care training program for lower limb amputation. methods: This study was a descriptive cross-sectional study that in the first stage, 10 specialists rehabilitation were selected. In the second stage, 30 people with lower limb amputations were chosen as participants. The data collection tools, smartphone-based app usability questionnaires Persian for the experts' and usability questionnaires for the amputees and satisfaction questionnaire from the amputees. Results: The average age of participants were 45.37±13.80 years. The results of the smartphone-based application usability questionnaire from the experts' point of view showed that the average score of the questionnaire is 7.07±1.15 and the questionnaire is in an acceptable state and approved by the experts. The results of the system usability questionnaire from the participants' point of view showed that the average final score of this questionnaire is 88.75±8.27 and the mobile phone-based self-care training program has the necessary efficiency, satisfaction, and effectiveness from the point of view of the lower limb amputation subjects. The overall average of the questionnaire of usefulness, satisfaction, ease of use, and ease of learning (4.50±0.24) demonstrates that the mobile phone-based self-care program is approved from the point of view of amputees. Conclusion: The designed self-care application can be used to increase awareness, help manage rehabilitation problems after amputation, increase the level of quality of life and reduce the complications of the disease for people with lower limb amputation with high efficiency and comfort.    

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Original Articles

Comparison of Strength, muscle length and Shoulder Position Sense Between Dominant and Non-Dominant Sides in Individuals With and Without Uneven Shoulders

Bayan Feizi; Ali Asghar Norasteh; Seyed Hosein Hoseini

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

Abstract

  Purpose: This study aimed to compare the differences in shoulder strength, muscle length, and proprioception between dominant and non-dominant sides in individuals with and without ...  Read More Purpose: This study aimed to compare the differences in shoulder strength, muscle length, and proprioception between dominant and non-dominant sides in individuals with and without uneven shoulders. Methods: This cross-sectional comparative study examined 20 females with uneven shoulders and 20 matched controls aged 20–30, selected purposefully to compare shoulder strength, muscle length, and proprioception. Shoulder asymmetry was assessed using digital photography and analyzed via AutoCAD 2020. Muscle strength was measured with a manual dynamometer. Proprioception was evaluated by assessing joint angle reconstruction errors using a goniometer, and muscle length was determined using standardized tests. Data analysis was performed using SPSS version 22. Results: The findings indicated significant differences between the two groups in the mean error of shoulder flexion angle reconstruction (p = 0.049, d = 0.56) and internal rotation (p = 0.037, d = 0.61), as well as in the length of the pectoralis minor (p = 0.036, d = 0.58) and levator scapulae muscles (p = 0.021, d = 0.64). Individuals with uneven shoulders showed greater side-to-side differences compared to the control group. However, no significant differences were observed in shoulder strength or the length of the upper trapezius between groups. Conclusion: In summary, individuals with uneven shoulders demonstrated greater error in joint position sense and asymmetry in specific muscle lengths. These findings suggest uneven shoulders may be associated with impaired proprioception and altered muscle length, especially in the pectoralis minor and levator scapulae.  

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Review Article

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. 

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