Journal of Rehabilitation Sciences & Research

Abstract Background: Stroke survivors often experience functional limitations, particularly impairments affecting the upper extremities. This study aimed to evaluate the psychometric properties of the Persian version of the Chedoke Arm and Hand Activity Inventory (CAHAI-13) in individuals with stroke.
Methods: In this cross-sectional study, 105 patients with stroke and 10 experts participated. The CAHAI-13 was translated into Persian following the IQOLA protocol. Participants completed the CAHAI-13 along with the Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), and Fugl-Meyer Assessment for Upper Extremity (FMA-UE). The study evaluated content validity, construct validity, convergent and divergent validity, known-groups validity, internal consistency, test–retest reliability, and inter-rater reliability.
Results: Expert evaluations indicated that the Persian version of the CAHAI-13 demonstrated satisfactory content validity. Significant positive correlations were observed between the CAHAI-13 and the ARAT (r = 0.84), WMFT (r = 0.91), and FMA-UE (r = 0.74) (P < 0.001), supporting its convergent validity. Both exploratory and confirmatory factor analyses supported a one-factor structure with an acceptable model fit in the stroke population. The instrument also demonstrated strong known-groups validity (F = 123.36, P < 0.001). Furthermore, the CAHAI-13 showed excellent internal consistency (α = 0.96), good test–retest reliability (ICC = 0.85), and excellent inter-rater reliability (ICC = 0.93).
Conclusion: The findings suggest that the Persian version of the CAHAI-13 is a valid and reliable instrument for assessing upper-extremity function in stroke survivors and can be used effectively in both clinical practice and research settings.

Abstract Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in both developed and developing countries and imposes a substantial socioeconomic burden on individuals and society. To date, few studies have investigated the clinically meaningful effects of chiropractic care on chronic LBP. Given the high prevalence of LBP and the limited effectiveness of current treatment approaches for chronic LBP, further studies are needed to evaluate the effectiveness of chiropractic interventions.
Methods: This quasi-experimental study was conducted among patients with chronic LBP who were referred to private chiropractic clinics in Shiraz, Iran. Eligible participants had experienced LBP for more than three months and had no pathological abnormalities other than those involving the lumbosacral spine. Data were collected at two time points: baseline (the first visit) and eight weeks after treatment. Treatment outcomes were assessed using three instruments: the Roland–Morris Disability Questionnaire (RMDQ), the Numerical Rating Scale (NRS), and the Global Rating of Change (GRC) self-assessment questionnaire.
Results: A total of 141 patients with a mean age of 40.18 ± 10.42 years were included in the analysis. Of these, 40 (28.4%) were male. The mean differences in disability and pain intensity before and after the intervention were statistically significant (P < 0.001). The mean ± SD GRC score was 56.13 ± 33.03%. No significant differences in GRC scores were observed among patients with mild, moderate, or severe findings on magnetic resonance imaging (MRI).
Conclusion: Overall, chiropractic care may serve as an appropriate adjunct to conventional treatments for improving disability and reducing pain intensity in patients with chronic LBP.

Abstract Background: Mobile phone–based self-care programs are increasingly recognized as effective tools for addressing patients' educational and self-management needs. Given the complex and unique challenges faced by individuals with lower limb amputations who use prostheses, there is a need to provide accessible educational resources to enhance self-care and improve quality of life. This study aimed to evaluate the feasibility of a mobile phone–based self-care training program for individuals with lower limb amputations.
Methods: This descriptive cross-sectional study was conducted in two stages. In the first stage, 10 rehabilitation specialists participated in the expert evaluation. In the second stage, 30 individuals with lower limb amputations participated in the usability assessment. Data collection instruments included the Persian version of a smartphone application usability questionnaire for experts, the System Usability Scale (SUS) for amputees, and the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire for amputees.
Results: The mean age of the participants was 45.37 ± 13.80 years. From the experts' perspective, the mean usability score of the smartphone application was 7.07 ± 1.15, indicating an acceptable level of usability. From the amputees' perspective, the mean System Usability Scale (SUS) score was 88.75 ± 8.27, indicating excellent usability. The overall mean score on the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire was 4.50 ± 0.24, reflecting high levels of perceived usefulness, satisfaction, and ease of use.
Conclusion: The findings suggest that the developed mobile phone–based self-care application is a feasible and highly usable tool for individuals with lower limb amputations. It has the potential to enhance self-care knowledge, support rehabilitation management after amputation, and contribute to improved quality of life and reduced amputation-related complications.

Abstract Background: Dysarthria is a neurological motor speech disorder resulting from impairments in the neuromuscular control of speech. The underlying pathophysiological disturbances affecting speech control and execution arise from one or more sensorimotor abnormalities. Few studies have simultaneously compared the effects of different practice schedules on speech motor learning in both healthy individuals and patients with dysarthria. Therefore, this study investigated the effects of blocked and random practice on speech motor learning in individuals with multiple sclerosis (MS) and dysarthria compared with healthy controls.
Methods: The participants included 34 individuals with multiple sclerosis and dysarthria and 34 healthy controls. Participants were randomly assigned to one of two practice conditions: blocked practice or random practice. They were instructed to produce the target phrase three times at their normal speaking rate.
Results: No significant differences were observed between blocked and random practice in the patient group during the pre-practice, practice, or retention sessions. In contrast, among the healthy controls, significant differences were observed between the blocked and random practice groups during the pre-practice and retention sessions (p ≤ 0.001). In contrast, no significant difference was found during the practice session. Specifically, healthy participants who received blocked practice performed better than those who received random practice during the pre-practice and retention sessions.
Conclusion: The findings suggest that the appropriate selection and application of blocked and random practice schedules at different stages of motor learning may enhance the acquisition and retention of speech motor skills.

Abstract Background: This systematic review aimed to identify and synthesize factors influencing bonding and attachment in infants admitted to the Neonatal Intensive Care Unit (NICU).
Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed between February 21 and March 17, 2024, using the Cochrane Library, PsycNet, PubMed, and Scopus databases. A total of 19 studies met the eligibility criteria and were included in the final analysis.
Results: The findings indicated that several factors either directly predicted or were significantly associated with the development of bonding and attachment in infants following NICU hospitalization. Specifically, the included studies identified the influence of demographic (4 studies), psychological (7 studies), cognitive (2 studies), and physiological (2 studies) factors. In addition, skin-to-skin contact (2 studies) and maternal–infant attachment styles (6 studies) were identified as important contributors to the bonding process in this population.
Conclusion: The findings of this review suggest that infant and parental demographic characteristics, as well as psychological, cognitive, and physiological factors, play important roles in the development of bonding and attachment. Furthermore, skin-to-skin contact and maternal–infant attachment styles appear to be key factors influencing attachment outcomes among infants with a history of NICU hospitalization.

Abstract Background: Aging is commonly associated with a progressive decline in neuromuscular function, which adversely affects balance control, gait stability, and overall mobility. Consequently, fall prevention has become a major concern in the elderly population. This study aimed to investigate the effects of a six-week total resistance exercise (TRX) training program on dynamic balance and gait kinematic parameters in healthy older women.
Methods: This quasi-experimental study included 36 healthy older women aged 55–75 years, recruited through purposive sampling and randomly assigned to either an experimental group or a control group (18 participants per group). The experimental group participated in a TRX training program three times per week for six weeks, with each session lasting 30–40 minutes, whereas the control group received no structured exercise intervention. Both groups underwent pre- and post-tests assessing stride length, stride width, walking speed, and dynamic balance. Dynamic balance was evaluated using the Timed Up and Go (TUG) test. At the same time, gait kinematic parameters were assessed using the Plug-in Gait marker placement protocol and a three-dimensional (3D) motion analysis system. Data were analyzed using one-way analysis of covariance (ANCOVA) in SPSS.
Results: Compared with the control group, the experimental group demonstrated significantly greater improvements in dynamic balance (F_(1,33) = 25.31, p = 0.001, η2 = 0.43), stride length (F_(1,33) = 9.71, p = 0.004, η2 = 0.22), stride width (F_(1,33) = 29.87, p = 0.002, η2 = 0.47) and walking speed (F_(1,33) = 10.83, p = 0.003, η2 = 0.24).
Conclusion: A six-week TRX training program effectively improved dynamic balance and gait kinematic parameters in healthy older women. These findings highlight the value of functional suspension training in enhancing mobility and reducing fall risk among older adults. Accordingly, TRX training may be considered an effective component of rehabilitation and fall-prevention programs for older people.

Abstract Background: Myopathies are a heterogeneous group of muscle disorders that affect more than 1.7 billion people worldwide and present significant therapeutic challenges because of their diverse etiologies, clinical manifestations, and varying degrees of disease severity.
Methods: This narrative review examines current therapeutic approaches for myopathies, including herbal remedies, complementary therapies such as acupuncture and massage, physiotherapy, nutritional interventions, and emerging gene therapies. Herbal remedies and complementary therapies may provide symptomatic relief for some patients, whereas physiotherapy helps preserve muscle function and improve physical performance. Nutritional interventions support overall health and may contribute to disease management, while gene therapies offer promising strategies to target the underlying genetic defects in inherited myopathies. However, the effectiveness of these interventions varies, and robust clinical evidence supporting many of these approaches remains limited.
Results: Herbal remedies and complementary therapies may provide symptomatic relief for some patients, whereas physiotherapy helps preserve muscle function and improve physical performance. Nutritional interventions support overall health and may contribute to disease management, while gene therapies offer promising strategies to target the underlying genetic defects in inherited myopathies. However, the effectiveness of these interventions varies, and robust clinical evidence supporting many of these approaches remains limited.
Conclusion: This review highlights the need for future research to prioritize large-scale, high-quality clinical trials to establish the safety and efficacy of existing and emerging therapies, develop personalized treatment strategies tailored to individual patient characteristics, and improve access to innovative therapeutic options. Addressing these challenges may enhance the clinical management of myopathies and ultimately improve patient outcomes and quality of life across diverse populations.

Abstract Background: In addition to motor speech disorders, patients with Parkinson's disease (PD) experience language impairments. Given the importance of language in human communication and quality of life, this study aimed to examine high-level language skills in Persian-speaking patients with PD.
Methods: Fourteen patients with PD and normal cognitive status and fourteen healthy controls matched for age, sex, and education level were administered a high-level language test. The test included the following subtests: repetition of long sentences, recreating sentences, making inferences, comprehension of logico-grammatical sentences, comprehension of lexical and syntactic ambiguities, comprehension of metaphors, and word definitions.
Results: The results indicated that the mean scores of the patients with PD were consistently lower than those of the healthy control group. Significant differences were observed between the two groups in the repetition of long sentences, recreating sentences, and making inferences subtests, as well as in the total test score (P ≤ 0.005).
Conclusion: The findings of this study indicate that high-level language skills are impaired in patients with PD. These findings may help speech-language pathologists identify the linguistic difficulties these patients experience and develop targeted intervention plans to address the adverse effects of these language impairments.

Abstract Background: Sign language is a complex and rich language that enables people with hearing impairments to communicate through a shared language of interaction. This study aimed to explore occupational experiences in Iranian Sign Language interpreting (SLI).
Methods: Fifty-four participants, including sign language interpreters and individuals with hearing impairments, were interviewed. The data were analyzed using reflexive thematic analysis. Four main themes emerged from the data: SLI as a blessing, necessities, challenges, and needs.
Results: The findings highlighted the vital role of sign language interpreters in facilitating communication between deaf and hearing individuals. However, because sign language interpreting is not officially recognized as a profession in Iran, only a small number of interpreters receive a regular salary. The majority work either voluntarily or for minimal charitable compensation. In addition, most interpreters lack access to employment benefits such as health insurance and retirement plans.
Conclusion: The findings demonstrate the need for policies that formally recognize sign language interpreting as a profession, provide interpreters with the necessary training on occupational risks and risk management, and improve their employment conditions and professional status.

Abstract Background: Healthy child development is strongly influenced by the quality of parent–child attachment. Atypical sensory processing, which is common during early childhood, may affect parent–child interactions and attachment, thereby influencing children's developmental outcomes. Early identification of sensory processing patterns may facilitate timely intervention and help prevent subsequent difficulties in relationships and development. This study aimed to examine the predictive value of children's sensory processing patterns for parent–child attachment in children aged 7–36 months.
Methods: This cross-sectional descriptive-analytical study was conducted in Tehran, Iran, in 2024. A total of 175 parents of children aged 7–36 months completed a demographic questionnaire, the Sensory Profile 2, and the Parent-to-Infant Attachment Questionnaire. All questionnaires were completed during a single assessment session. The questionnaires were self-administered under the supervision of an occupational therapist familiar with sensory processing concepts, who was available to answer participants' questions. The collected data were analyzed using SPSS version 24.
Results: The findings indicated that all four sensory processing patterns—sensory seeking, sensory avoiding, sensory sensitivity, and sensory registration—were significantly associated with parent–child attachment and could predict its quality. However, the direction of these associations differed across the four sensory processing patterns.
Conclusion: This study highlights the importance of recognizing and understanding sensory processing patterns during early childhood to improve the quality of parent–child attachment and promote healthy child development. It also suggests incorporating the assessment of sensory processing patterns into therapeutic protocols to support optimal developmental outcomes during early childhood.

Abstract Background: Providing services and support to individuals with disabilities requires a high level of adaptability and resilience. Spiritual intelligence is considered an important dimension of human health that may contribute to greater adaptation and improved quality of life. Therefore, this study aimed to investigate the relationship between spiritual intelligence and resilience among students at the School of Rehabilitation of Hamadan University of Medical Sciences.
Methods: This cross-sectional study was conducted among students of Hamadan University of Medical Sciences (including physiotherapy, audiology, speech therapy, occupational therapy, and orthotics and prosthetics) during the 2024–2025 academic year. The participants had a mean age of 21.35 ± 1.90 years. A convenience sampling method was used, and 200 students completed the spiritual intelligence and resilience questionnaires. Data were analyzed using SPSS software version 24.
Results: No statistically significant differences in spiritual intelligence or resilience were found among students by gender, age, field of study, marital status, parents’ occupation, or parents’ educational level. However, a significant positive relationship was found between spiritual intelligence and resilience among rehabilitation students (P < 0.05).
Conclusion: Higher levels of spiritual intelligence are associated with greater resilience among rehabilitation students. Therefore, incorporating spiritual intelligence-related concepts into rehabilitation students’ educational curricula may help enhance their resilience.