Journal of Rehabilitation Sciences & Research

Abstract Background:
Studies on telerehabilitation in India have primarily addressed the clinicians’ perspective. Therefore, this study aimed to understand the perspectives of clients—specifically adults who stutter—regarding telerehabilitation during the COVID-19 pandemic.
Method
A mixed-methods survey, combining interviews and self-report questionnaires, explored client perspectives on telerehabilitation for adults who stutter during the pandemic. Twelve adults who stutter aged 18 to 40 attending telerehabilitation sessions at a tertiary rehabilitation center participated in the study.
Results
All participants expressed comfort in discussing their problems and anxieties with the clinician during teletherapy sessions. Additionally, 91.7% (n = 11) reported feeling confident in managing the online platform. Of the participants, 66.7% (n = 8) rated the sessions as excellent, while 33.3% (n = 4) rated them as good. Preferences regarding session modes were evenly split, with 50% favoring teletherapy and the other 50% preferring a hybrid approach. The majority of participants considered avoiding travel during the pandemic to be a significant advantage of telerehabilitation. However, internet connectivity issues were identified as a major disadvantage.
Conclusion
The findings of this study highlight both the advantages and challenges of telerehabilitation for adults who stutter. Participants reported that telerehabilitation helped improve their speech fluency and proved a viable and effective approach for addressing stuttering during the COVID-19 pandemic.
 

Abstract Background: Attention and concentration disorders, alongside tone disorders and imbalance, are among the significant challenges faced by children with cerebral palsy (CP). This study investigated the relationship between attention and balance in children with CP.
Methods: This cross-sectional study included 15 children with hemiplegia (mean age: 8.8 ± 2 years) and 10 children with diplegia (mean age: 8.5 ± 1.43 years) recruited from occupational therapy clinics in Tehran, Iran. All participants were classified as level II on both the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). Attention and balance were assessed using the Continuous Performance Test (CPT) and the Pediatric Balance Scale (PBS). Spearman's correlation coefficient was calculated to determine the relationship between attention and balance, with a significance threshold of α=0.05.
Results: The results showed no significant correlation between dynamic and static balance with attention (P > 0.05) in children with hemiplegia. However, in children with diplegia, there were significant correlations between dynamic balance and attention (P = 0.04), static balance and attention (P = 0.01), and total balance and attention (P = 0.02).
Conclusion: This study found a significant correlation between attention and balance in children with diplegic CP but not those with hemiplegic CP. Given that children with diplegia exhibited weaker dynamic and static balance compared to those with hemiplegia, their balance deficits appear to demand more significant attentional resources. Due to the small sample size, further research is necessary to validate these findings.
 

Abstract Background: This study aims to explore the psychometric properties of a tool designed to assess and improve the identification of talents in children with special needs in Indonesia.
Method: This study used a cross-sectional and descriptive quantitative design. The qualitative part involved teachers from special schools in Indonesia who were purposefully selected. The quantitative part's sample size consisted of 354 participants chosen through random sampling. The qualitative data were analyzed by transcribing interviews and coding the main themes through several steps. Content validity, item analysis, internal consistency, and test-retest reliability were examined for the quantitative analysis.
Results: The qualitative analysis revealed that the talents of children with special needs in Indonesia can be categorized into six areas: cognitive, language, movement, social and emotional skills, learning and education, and daily life skills. The items' Content Validity Ratio (CVR) ranged from 0.8 to 1. The correlation between each item and the scale's total score indicated that all items were significantly correlated with the total score. Exploratory factor analysis supported the existence of six factors, all of which demonstrated acceptable factor loadings.
Conclusion: This study's findings suggest that the children's behavioral questionnaire possesses acceptable psychometric properties and is suitable for research and rehabilitation activities.
 

Abstract Background: Back pain is one of the most common disorders, caused by various factors and leading to diverse consequences. This study aimed to compare specific postural and functional indicators in adolescent boys with and without non-specific chronic low back pain.
Methods: The present study employed a causal-comparative design. A total of 30 adolescent male students with non-specific chronic low back pain and 30 healthy adolescent male students were purposefully selected. Individuals with non-specific chronic low back pain were identified using a visual pain scale and confirmed by a physical medicine specialist. Kyphosis and lordosis were assessed using a flexible ruler, proprioception was evaluated through the lumbar angle active reconstruction test at a 30-degree angle using a goniometer, core stability was measured using McGill functional tests, upper limb function was assessed with the Upper Limb Y Test, and static and dynamic balance were evaluated using the Stork Test and the Lower Limb Y Test, respectively. An independent t-test was used to compare the average variables between the two groups.
Results: The findings revealed significant differences in proprioception, core stability, and static and dynamic balance between the groups with and without non-specific chronic low back pain. However, the two groups observed no significant differences between other variables.
Conclusions: These results highlight the importance of proprioception, core stability, and static and dynamic balance in adolescent boys with non-specific chronic low back pain. Rehabilitation protocols for this population should prioritize developing and strengthening these components.
 

 

Abstract Background: Learning social skills presents a significant challenge for Hearing Impaired Children (HIC). Play therapy is a recommended intervention to facilitate and accelerate social-emotional development. This study aimed to evaluate the effectiveness of Puppet Play Therapy (PPT) on the social skills of male children aged 6 to 9 years with Cochlear Implants (CI).
Methods: This quasi-experimental study utilized a pretest-posttest design with a control group. A total of 24 male students aged 6 to 9 years with CI were randomly assigned to the experimental (n=12) and control (n=12) groups. The
experimental group received cognitive-behavioral play therapy using puppets in ten 45–60-minute sessions. Social skills were assessed using the Gersham and Eliot Social Skills Rating System during the pretest and posttest.
Results: The findings indicated that the mean scores of three social skills subscales, including cooperation (P<0.001), assertion (P<0.001), and selfcontrol (P<0.001), were significantly higher in the experimental group after receiving PPT.
Conclusion: The results suggest that Puppet Play Therapy is an effective intervention for enhancing social skills in children with CI, and it can serve as a valuable supplementary rehabilitation approach.

Abstract Background: Anterior cruciate ligament (ACL) rupture is one of the most severe and complex knee injuries commonly occurring in soccer. The Sportsmetrics Soccer Training (SMST) protocol is a well-established program for preventing knee injuries and enhancing soccer players' performance. This study aimed to compare the effect of the SMST injury prevention protocol on the performance of soccer players with and without anterior cruciate ligament reconstruction (ACLR).
Methods: This research employed a semi-experimental design, including 42 soccer players aged 18–30, each with at least three years of regular soccer experience. Participants were divided into two groups of 21 subjects: players with ACLR and those without ACLR. Physical performance was evaluated using the Illinois Agility Test, 40-Yard Sprint Test, and Sargent Vertical Jump Test in both groups before and after six weeks of intervention. The SMST protocol was conducted in three 90-minute weekly sessions for six weeks. Statistical analyses were performed to assess intra-group differences using the dependent t-test and inter-group differences using the covariance analysis test (P ≤ 0.05).
Results: The dependent t-test results demonstrated significant improvements in speed (P = 0.01), agility (P = 0.01), and explosive power (P = 0.01) in both groups following six weeks of SMST training. However, the results of the covariance analysis revealed no significant differences between the two groups in terms of speed (P = 0.57), agility (P = 0.07), and explosive power (P = 0.71) after six weeks of training.
Conclusion: The improvements in performance indicators among the participants were primarily attributed to the alignment between the components of the SMST protocol and the performance evaluation tests. SMST training is highly recommended for healthy and ACLR soccer players, as it effectively enhances physical and athletic performance while reducing the risk of ACL injury and re-injury.
 

Abstract Background: This study investigated the effectiveness of a 4-week TRX suspension training program on knee and hip alignment as well as hip muscle strength in male basketball players with dynamic knee valgus.
Methods: The present study was Quasi-experimental, and its statistical population consisted of basketball players (18-25 years old) from Mashhad, Iran. Thirty-two athletes diagnosed with dynamic knee valgus were randomly selected as samples and randomly assigned to experimental (n=16) and control (n=16) groups. Data measurement tools included Kinovea software (Kinovea Robotics, Canada, 2006) and an isokinetic dynamometer (JTECH MedicalTM Commander instruments). To measure kinematic angles, athletes performed standardized tasks such as squats and lunges, which were selected to elicit dynamic knee valgus and accurately assess knee and hip alignment.  A 4-week TRX suspension training program (3 sessions/week, 30-45 minutes/session) was implemented for the exercise group. Statistical analyses (paired t-tests, ANCOVA) were conducted using SPSS software (p < 0.05).
Results: Paired-sample t-tests revealed significant improvements in knee and hip alignment (reduced knee valgus (p=0.003) and hip drop angles (p=0.013)) in the exercise group post-training compared to pre-training. The exercise group's dominant leg also observed significant increases in hip abductor, extensor, and external rotator strength (p=0.0001). Analysis of covariance (ANCOVA) controlling for pre-test scores demonstrated significant between-group differences in all outcome measures, indicating the TRX program's effectiveness in the dynamic knee valgus group compared to the control.
Conclusion: This study suggests that a 4-week TRX suspension training program can effectively improve knee and hip alignment and strengthen hip musculature in male basketball players with dynamic knee valgus.
 

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