Journal of Rehabilitation Sciences & Research

Abstract Background: Caregivers are individuals responsible for assisting older, sick, or disabled persons. The majority of care services are provided by family members acting as primary caregivers. Providing care for older people entails considerable financial, physical, and psychosocial strain, which can reduce both the quality of life of caregivers and the quality of care provided. With the growing proportion of individuals aged 60 and above, along with advancements in medical and technological fields that extend life expectancy, concerns regarding elder care are increasing.
Methods: This systematic review examined the effects of interventions on caregiver burden among primary caregivers of community-dwelling older adults and identified key factors influencing caregiving challenges. A total of 354 peer-reviewed articles published between 2000 and 2023 were extracted from databases including Embase, PubMed, and Scopus. The agreement rate between the first and third authors during the article selection process was 93%. Article quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Abstracts and full texts were reviewed by the second and fourth authors, with an inter-rater agreement of 89%.
Results: Thirteen articles met the inclusion criteria and were included in the final review. All were of medium to high methodological quality, each scoring five or above on the PEDro scale. The studies focused on interventions targeting older adults (n=4), caregivers (n=5), or both (n=4). Interventions aimed directly at caregivers were identified as the most effective in reducing caregiver burden. Findings were synthesized based on reported outcomes related to caregiver burden, stress, and depression.
Conclusion: The review concludes that direct interventions for caregivers are the most effective strategy for reducing caregiver burden. Designing and evaluating individualized intervention programs may further enhance their effectiveness and inform future caregiving support strategies.

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 to assess postural parameters. This study aimed to determine the relationship between clinical, photogrammetric, and radiological techniques in detecting knee angular deformities.
Methods: This cross-sectional study was performed on 53 volunteers of both genders, encompassing a total of 106 lower limbs with complaints of knee pain or knee deformity. Sampling was conducted in a non-random and accessible manner based on predefined inclusion and exclusion criteria. All participants had previously obtained full-length radiographs of their lower limbs. The clinical evaluation included measurements of the anatomical axis, Q angle, and intermalleolar and intercondylar distances. These parameters were also assessed using the Body Vision photogrammetric system while the patient was in a standing position. Data from all three methods were compared using the measured angles and distances.
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). A high correlation was also observed between the clinical and photogrammetric methods for the intermalleolar distance (r = 0.948, p < 0.001) and intercondylar distance (r = 0.927, p < 0.001). For the Q angle, a high but relatively lower correlation was found between the clinical and photogrammetric methods (r = 0.834, p < 0.001). However, a moderate correlation was detected between the clinical measurement of the anatomical axis and both the photogrammetric (r = 0.70) and radiological (r = 0.62) methods.
Conclusion: This study demonstrated a strong correlation between the photogrammetric technique and the gold standard radiological method, indicating that photogrammetry can serve as a viable alternative for evaluating knee angular deviations.

Abstract Background: Academic procrastination is an irrational tendency to delay starting or completing academic tasks. It is reportedly associated with negative emotions, psychological distress, a 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 at the School of Rehabilitation Sciences, Shiraz University of Medical Sciences.
Methods: All university students (a total of 368), including 230 (62.5%) females and 138 (37.5%) males, voluntarily participated in this cross-sectional descriptive study. The participants were undergraduate and postgraduate students from different academic levels across five departments. The mean age of students was 21.66 ± 2.27 years. To ascertain the prevalence of procrastination, we used the Solomon and Rothblum Academic Procrastination Questionnaire. This questionnaire consists of 27 items designed to measure three areas: preparing for exams, preparing assignments, and preparing the final paper. Descriptive statistics, Pearson correlation coefficient, one-way ANOVA, and independent t-tests were applied. A p-value less than 0.05 was regarded as statistically significant.
Results: A total of 297 students completed all items on the procrastination questionnaire. Among the participants, 44.2% reported being moderate procrastinators, and 54.5% reported severe procrastination behaviors. Specifically, 40.9% of males reported moderate procrastination, while 57.3% reported severe procrastination. Among females, 46% reported moderate procrastination, and 52.9% exhibited severe procrastinator behaviors. Furthermore, 42.5% of undergraduate students reported a tendency toward moderate procrastination, while 56% exhibited severe procrastination behaviors. Among postgraduates, 58.1% reported moderate procrastination, and 41.9% reported severe procrastination behaviors. In addition, academic procrastination was prevalent across all components of the questionnaire, with undergraduate students exhibiting significantly higher procrastination levels in preparing assignments (P < 0.05).
Conclusion: Academic procrastination behaviors were equally prevalent across all educational levels, disciplines, and sexes. Students exhibited tendencies towards procrastination across all components of academic procrastination. These findings may help institutions develop more effective intervention strategies to mitigate the impact of academic procrastination and improve academic achievement.

Abstract Background: Marital infidelity is one of the most challenging issues in married life, often leading to adverse psychological outcomes such as depression and diminished self-esteem. This study aimed to examine the impact of Glaser’s group reality therapy on self-esteem and depression in betrayed women.
Methods: This experimental study employed a pre-test–post-test design with a control group. Thirty-six women referred to counseling centers under the supervision of the Social Welfare Organization were randomly assigned to either the intervention or control group. The intervention group participated in ten 90-minute sessions of reality therapy. Data were collected using the Marital Adjustment Scale, Rosenberg Self-Esteem Scale, and Beck Depression Inventory. Statistical analyses were performed using SPSS software version 22, with a significance level set at p < 0.05.
Results: No significant differences were observed between the two groups regarding demographic variables. Similarly, pre-intervention scores for self-esteem (p = 0.756) and depression (p = 0.875) showed no significant difference between the groups. However, post-intervention analysis revealed a significant improvement in self-esteem and a significant reduction in depression scores in the intervention group compared to the control group (p < 0.001).
Conclusion: Group reality therapy based on Glaser’s model effectively enhances self-esteem and reduces depression among women affected by marital infidelity. It is recommended that relevant authorities incorporate such programs into support services for couples during their married life.

Abstract Background: Life balance is defined as having a satisfying pattern of activities or occupations that is sustainable and meaningful to a person within their current context and life conditions. It can be considered an important outcome in medical and rehabilitation services. The Life Balance Inventory (LBI) is a self-reported, comprehensive measure developed to evaluate life balance. This study aimed to translate and validate the LBI for the Iranian population.
Methods: This methodological and cross-sectional study included a sample of 150 healthy individuals and 93 people with mental illnesses. Validation procedures included content validity, discriminant validity (construct validity), test-retest reliability, and internal consistency assessment of the LBI.
Results: The Persian translation of the LBI demonstrated acceptable content validity. Discriminant validity showed significant differences in life balance between healthy individuals and those with mental disorders. Test-retest reliability ranged from 0.70 to 0.93 over a two-week interval. Internal consistency was strong, with a Cronbach’s alpha of 0.88.
Conclusion: The LBI shows acceptable psychometric properties for use among Iranians. This questionnaire effectively discriminates between individuals with and without mental disorders. The Persian version of the LBI can be applied in various specialties and settings.

Abstract Background: To facilitate the fusion of the injury site for non-operative treatment or postoperative care, various braces are available to immobilize an unstable cervical spine. Among these, Minerva and Halo braces are the most effective and widely used for immobilizing unstable cervical spine injuries. The performance of cervical braces is commonly evaluated by the degree of motion restriction they provide. This study aimed to compare the function of modified Iranian and rigid Minerva braces using three-dimensional motion analysis as the standard assessment method.
Methods: Twenty-nine healthy male subjects without any history of spinal pain, malformation, or surgery were recruited for this 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 (ROM) was assessed under three conditions: without a brace, with the modified Iranian Minerva brace, and with the rigid Minerva brace.
Results: At the cervical region, immobilization in flexion (89.03% > 87.8%) and rotation (84.85% > 83.19%) was greater with the modified Iranian Minerva, whereas extension (89.37% > 85.95%) and lateral bending (81.26% > 71.71%) were more restricted by the rigid Minerva (p > 0.05). At the thoracic region, immobilization in flexion (76.35% < 75.96%), lateral bending (46.92% > 44.5%), and extension (79.44% > 62.58%) were higher with the rigid Minerva, while rotation (53.04% > 41.21%) was more limited by the modified Iranian Minerva (p > 0.05).
Conclusion: Both Minerva braces significantly reduced cervical range of motion (p < 0.05). The rigid Minerva was more effective in controlling extension and lateral bending, while the modified Iranian Minerva provided greater restriction in flexion and rotation (p < 0.05).

Abstract Background: Spinal cord injury (SCI) often results in reduced core region function and shoulder pain among wheelchair users. This study aimed to investigate the effectiveness of modified dynamic neuromuscular stabilization (DNS) exercises on core region function and shoulder pain in patients with incomplete paraplegic SCI.
Methods: In this semi-experimental study, ten male patients with SCI were purposefully selected based on inclusion criteria and participated as an experimental group. Core region function and shoulder pain were measured before intervention using the modified plank test, an abdominal pressure cuff device, and the Wheelchair Users' Shoulder Pain Index (WUSPI) questionnaire. Participants first completed an eight-week non-exercise period, followed by an intermediate assessment. They then engaged in eight weeks of modified DNS exercises, after which measurements were repeated. Data were analyzed using SPSS version 26, with repeated measures ANOVA applied (P≤0.05).
Results: Significant improvements were observed in core function, transverse abdominal muscle strength, and shoulder pain (measured by WUSPI scores) after the exercise period compared to the non-exercise phase. These improvements were statistically significant (P≤0.05).
Conclusion: The findings suggest that modified DNS exercises can be an effective and low-cost addition to the physical rehabilitation of patients with incomplete paraplegic SCI.

Abstract Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by memory loss and cognitive decline. One of the leading theories explaining AD pathology is the emergence of cortical hypometabolism. This study aimed to investigate the association between cortical hypometabolism and various cognitive assessment tools across the dementia spectrum.
Methods: This cross-sectional and longitudinal study utilized data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), including 1,048 participants: 291 cognitively normal (CN), 579 with mild cognitive impairment (MCI), and 178 with AD. Fluorodeoxyglucose positron emission tomography (FDG-PET) data (as an indicator of hypometabolism) and cognitive assessment scores—including the Alzheimer’s Disease Assessment Scale (ADAS11 and ADAS13 subtests), Montreal Cognitive Assessment (MoCA), Everyday Cognition Scale (ECog), and Mini-Mental State Exam (MMSE)—were analyzed. Statistical methods included ANOVA, multiple regression, and ROC/AUC analyses.
Results: Linear regression revealed that ADAS11, ADAS13, and MMSE significantly predicted PET scores in the MCI group (p=0.002, p=0.002, p=0.017, respectively), while MoCA predicted PET scores in the CN group (β=0.016, p=0.045). ROC analysis showed that ADAS13 had the greatest discriminative capacity (AUC=0.786), followed by ADAS11 (AUC=0.767). Over time, PET scores declined significantly across all groups, with the AD group showing the largest decline. At 24 months, PET scores in the CN and MCI groups were notably higher than those in the AD group (p<0.001).
Conclusion: ADAS11 and ADAS13 can effectively differentiate between normal and abnormal cortical hypometabolism. Among all cognitive measures, ADAS13 demonstrated the highest discriminative ability, making it a valuable tool for clinicians and researchers in the early detection and longitudinal monitoring of Alzheimer’s disease.

Abstract Background: Despite the importance of investigating the effect of night shifts on the gait kinematics of nurses, the literature lacks sufficient evidence to evaluate this relationship. Therefore, the present study aimed to compare gait kinematics between day and night shift nurses.
Methods: Participants (N = 31) in this cross-sectional study were female nurses aged 27–47 years, working either night shifts (N = 16) or day shifts (N = 15). A Qualisys motion analysis system with eight high-speed cameras was used to record body segment movements during walking. The spatiotemporal gait characteristics (stride length, walking velocity, and cadence) and kinematics of the ankle, knee, hip, pelvis, and trunk were analyzed. Dynamic stability during walking was assessed by measuring center of mass (COM) movements.
Results: No significant differences were found between the mean values of spatiotemporal gait parameters of nurses working day and night shifts. Similarly, the mean range of motion (ROM) values of lower extremity joints and pelvic and trunk segments during the stance phase of gait did not differ significantly between the two groups. However, as a measure of dynamic stability, COM movement in the mediolateral direction was significantly different between the groups.
Conclusion: There were no differences in spatiotemporal gait parameters, vertical dynamic stability, or joint ROM between nurses working day and night shifts. These findings suggest that working night shifts does not alter the biomechanical gait patterns of nurses.

Abstract Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but severe dermatological disorders. Their limited prevalence contributes to low awareness among physical therapists, which may lead to suboptimal rehabilitation and complications from immobility.
Methods: This report describes the physical therapy management of a 20-year-old female with SJS admitted to a rural tertiary care hospital in India. Physical therapy interventions were initiated early and progressed through functional task-based mobilization. Assessments were conducted at baseline, on the 7th and 20th days of admission, and at 1-month follow-up.
Results: Marked functional gains were observed, especially after the 7th day. Improvements were documented in the Intensive Care Unit Mobility Scale (IMS), Functional Status Score for the ICU (FSS-ICU), Barthel Index, and joint range of motion. Early mobilization contributed to reduced musculoskeletal and pulmonary complications, promoting faster recovery and shorter hospital stay.
Conclusion: This case highlights the importance of early, tailored physical therapy in SJS rehabilitation. Interdisciplinary collaboration and functional-task–oriented mobilization are essential to optimize outcomes, reduce morbidity, and enhance overall management of SJS.