Journal of Rehabilitation Sciences & Research

Abstract Reasons for dysphagia in patients with at-risk respiratory systems during
the COVID-19 pandemic include muscle weakness. During this time, the
rehabilitation program becomes a critical problem. The current narrative
review purposed to answer the question, “What is the modified management of dysphagia in patients with COVID-19 by speech-language pathologists (SLPs)?” Medline, PubMed, Google Scholar, and Scopus databases were searched for information about COVID-19 and dysphagia using search terms such as “COVID-19 and dysphagia,” “speech therapy and COVID-19,” “COVID-19 and dysphagia speech and language pathologist.” As this narrative review concentrated on the intervention of dysphagia throughout the Covid-19 pandemic, the reference lists of articles identified in the search were also examined, and those we considered relevant in keeping with the selected keywords were accepted. Among the 83 articles selected in the first round, 27 were considered for this review. The number of clinical or original articles fitting our criteria was very limited. The main topics in most of the published papers were dysphagia intervention, COVID-19 transmission risk, swallowing assessment and therapy in patients with COVID-19 by SLPs, dysphagia screening tools, swallowing treatments and sensory stimulation in patients with COVID-19, and swallowing exercises and maneuvers conducted by SLPs in COVID-19 cases. An instrumental evaluation of swallowing should be narrowed during the COVID-19 pandemic. SLPs should find different ways to appropriately manage patients with suspected dysphagia. Generally, dysphagia intervention should be reserved for tele-health.

Abstract Alzheimer’s disease (AD) is the most common cause of dementia which, in addition to affecting memory, cognition, language, and other functions, also appears to be associated with hearing loss and vestibular function. In this paper, the neural pathology of AD, relation to neuroplasticity, and associations between AD and auditory and vestibular dysfunction have been reviewed. In this narrative study, articles published between 2000 and 2021 were reviewed. Fifty articles, related mostly to hearing and vestibular disorders in AD, were selected from a review of 200 English articles. The keywords Alzheimer’s disease, neuroplasticity, auditory and vestibular rehabilitation, auditory and vestibular disorders were searched in PubMed, ScienceDirect, Scopus, ProQuest and Google Scholar databases. Recent studies have shown an association between AD and auditory and vestibular function. Hearing loss can cause dementia and reduced communication skills in patients with AD. It has also been observed that some patients with AD lose their vestibular function, leading to an imbalance in the body and an increased risk of falling. It seems neuroplasticity of the brain is a good treatment for degenerative diseases such as AD, which is possible through auditory and vestibular rehabilitation. Hearing and vestibular evaluation in people with AD can be effective in identifying related problems, so that in cases where the disorder is observed, through the phenomenon of neuroplasticity and the use of auditory and vestibular rehabilitation,therapists can take effective steps in improving the performance and quality of life of these patients.

Abstract Background: Obesity is known to be an important risk factor in the development of UI (urinary incontinence). Physiotherapy (exercise therapy and biofeedback) has been presented as a common treatment for the improvement of UI. Pelvic floor physiotherapy (PFPT) with weight loss (WL) may significantly improve UI in obese women. This study aimed to compare the effects of PFPT with and without WL on UI symptoms in obese women. Methods: This non-randomized clinical trial was performed with 51 middle-aged obese women with UI. Twenty-nine women in the PFPT group received 12 sessions of PFPT, and 22 women in the PFPT+WL group received 12 sessions of PFPT and nutritionist recommendations for WL. The outcome measures included anthropometric measurements, strength and endurance of pelvic floor muscles, intravaginal pressure (IVP), international consultation on incontinence questionnaire (ICIQ-SF), visual analog scale (VAS), and quality of life (QOL). All measurements were taken at baseline and after the 12-session treatment. Results: The PFPT+WL group had a 4.95 kg weight loss (p <0.001). Strength and endurance of PFM, IVP, ICIQ UI-SF, VAS, and QOL showed significant improvement in both groups (p <0.001). The ICIQ UI-SF and total I-QOL in the PFPT+WL group were significantly different from those in the PFPT group (p=0.015, p=0.033, respectively), (95% CI: 2.23 - 5.10 vs. 2.85- 5.35 and 180.48 - 214.67 vs. 164.13 - 203.39, respectively). Conclusion: The proposed protocol of applying PFPT with WL compared to PFPT alone led to more significant improvement in UI severity and QOL in middle-aged obese women with UI.  

Abstract Background: The sudden outbreak of the novel coronavirus has caused a wave
of concern throughout society and among medical staff members. Consecutive
peaks, persistent stress, along with disorders caused by work shifts lead to physical
weakness and psychological complications over time. the aim of the present
study was to investigate the effect of work shifts under Covid-19 conditions on
the emotional exhaustion of medical staff members with the mediating role of
stress of Covid-19 infection.
Methods: This applied and descriptive field research was conducted crosssectionally
in 2020. The statistical population included 250 nurses from
Imam Khomeini Hospital in Amol city, Iran. A total of 150 individuals were
selected using Morgan Table and simple random sampling methods. A
standard questionnaire with confirmed validity and reliability was used as the
data collection instrument. To perform data analysis, the structural equation
modeling method was used to measure the fit of the research model and test the
hypotheses in SPSS ver. 22 and Amos ver. 22 software.
Results: The results showed that disorders caused by work shifts had a significant
effect on the emotional exhaustion and stress of Covid-19 infection in nurses on
a medical staff. Stress of Covid-19 infection had a significant effect on nurses’
emotional fatigue. The mediating role of stress of Covid-19 infection in the
relationship between work shifts and emotional exhaustion was also confirmed.
Conclusion: The transmission rates of different types of Covid-19 mutations
with consecutive peaks have caused constant stress in nurses. Related disorders
caused by work shifts and the large number of patients and hospitalizations will
lead to a lack of energy and of concentration in nurses, which in turn will lead
to poor performance, reduced quality of life, and ultimately emotional fatigue.

Abstract Background: Pain in patients with stroke is one of the essential factors that can
influence upper-limb performance, and it is better to divide these people into
separate groups. The Adult-Assisting Hand Assessment (Ad-AHA) is a tool that
recently is being used in upper-limb performance evaluation among patients
with stroke. The present study aimed to evaluate the diagnostic accuracy of the
Ad-AHA among patients with chronic stroke who had pain to discriminate
between the high upper-limb performance group and the low upper-limb
performance group.
Methods: In this cross-sectional study, 51 patients (mean age±SD = 69.33±8.73)
with chronic stroke who had pain participated and were divided into two groups
of high (group 1) and low (group 2) upper-limb performance measured by
the Action Reach Arm Test. The best cutoff point between groups, sensitivity,
and specificity by receiver operating characteristic (ROC) for Ad-AHA was
calculated.
Results: A significant difference in the total score of Ad-AHA between the
high and low upper-limb performance groups was seen (P˂0.001). The best
cutoff point for the total score of Ad-AHA between stroke patients with high
and low performance in the upper-limb who had pain was 47 (sensitivity=95.45,
specificity=89.21).
Conclusion: The results of this study show that the Ad-AHA has high sensitivity
and specificity to discriminate between stroke patients with high and low
performance in upper-limb performance who had pain.

Abstract Background: Delayed activation of medial hamstrings (MH) relative to lateral hamstrings (LH) could lead to external tibial rotation. It is a long-held belief that altered force sharing between the vastus medialis obliquus (VMO) and the vastus lateralis (VL) plays a main role in the pathophysiology of PFP. It was presumed that patients with patellofemoral pain (PFP) exhibit altered muscular activation pattern of MH and LH during functional tasks. The aim of this study was to compare the electromyography (EMG) activity of hamstrings and quadriceps in patients with PFP and healthy subjects during stair descent.
Methods: Twenty-four women with PFP and 24 non-symptomatic individuals, aged 18-40 years, were recruited through convenience sampling and participated in this observational cross-sectional study. The EMG activity of MH and LH, VMO and VL was recorded during stair descent. The main outcome measures were onset latency and amplitude of muscle activity relative to the moment of foot contact measured by foot switch. Groups were compared by Mann-Whitney test. Repeatability of task was evaluated using intra-class correlation coefficient (ICC).
Results: A statistically significant difference was seen in the onset of hamstring heads between groups (p=0.014). The LH activated before the MH in the PFP group. Normalized muscular activity was significantly reduced for VMO (p=0.002), VL (p=0.045), and LH (p=0.019) in patients with PFP compared to the control group.
Conclusions: Differences in temporal activation patterns of LH and MH may result in a lack of rotational knee stabilization and lead to increased patellofemoral joint pressure. Earlier activation of LH rotates the tibia externally and likely produces lateral patellar tracking.

Abstract Background
Developmental language disorder (DLD) is a common disorder in childhood. The aim of this study was to investigate the performance of Persian-speaking children on sentence repetition task (SRT) as a measure to detect DLD.
Methods
As a cross-sectional and observational study, seven 5-to-7-year-old Persian-speaking children with DLD and thirty normal peers were studied using the Persian version of test of language development (TOLD-P: 3) as a diagnostic test and SRT. Finally, the performance of two groups on the SRT was compared by statistical tests at the significance level of 0.05.
Results
The score of SRT between the children suspected to have DLD and their normal peers were significantly different (P<0.05). Indeed, there was a significant difference between the groups in terms of the mean scores of prepositions (P<0.01), conjunctions (P<0.01), plural case (P<0.01), subject-verb agreement (P<0.05), and word order (P<0.05).
Conclusion
The SRT can be used as a promising measure for early detection and intervention of Persian-speaking children with DLD.

Abstract The first three years of life are a critical period for development. Environmental
stimuli have positive effects on the development of speech and language.
Language skills involve the development of expressive and receptive skills
among children. Speech and language disorders during childhood have
important negative outcomes in the life of the child. Therefore, early detection
of children at risk in the preliminary phases of development and implementing
early intervention for them are very important. In this case study, the effects
of early language intervention in children with a developmental language
disorder (DLD) was investigated. A twenty-seven-month-old child diagnosed
with an autism spectrum disorder )ASD) was evaluated in this case study.
Occupation and speech therapy was performed for him. Results showed that the
early intervention was essential for improving the child’s communication, and
proper environmental stimuli could prevent possible problems in the future. In
addition, the results revealed that child professionals should not adopt a “wait
and see” attitude for improving development.