Marzieh Shirazikhah, Arash Mirabzadeh, Homeira Sajjadi, Mohammad Taghi Joghataei, Akbar Biglarian, Farahnaz Mohammadi Shahboulaghi, Hamid Sharif Nia, Zahra Jorjoran Shushtari,
Volume 18, Issue 2 (6-2020)
Abstract
Objectives: The primary focus in the rehabilitation services program is the universal coverage of these services, in other words, to provide better access to these services in any place and situation. The present study aimed to develop and validate a physical rehabilitation accessibility assessment questionnaire as a standardized instrument that can be adaptable to people with physical disabilities.
Methods: An exploratory sequential mixed methods design was used to develop and validate this questionnaire. Appropriate content was prepared through the literature review, related studies analysis, and focus group discussions with a qualitative approach. Then, the face, content, and construct validity and reliability of the questionnaire were evaluated.
Results: The physical rehabilitation accessibility questionnaire with 17 items was formulated, and its psychometric properties were evaluated through testing in a study sample of 200 people with disabilities who filled up the questionnaire. Exploratory factor analysis indicated that 81% of the variance of the accessibility to physical rehabilitation services was determined by four factors of affordability, transport, social support, and information access. Indices of PCFI=0.772, PNFI=0.717, NFI=0.877, CFI=0.952, CMIN/DF=1.867, RMSEA=0.066, and AGFI=0.871 confirmed the fitness of the final model. The convergent and divergent validity and reliability of the questionnaire were also confirmed.
Discussion: The questionnaire has an appropriate psychometric property that makes it useful for assessing the accessibility of physical rehabilitation services for people with physical disabilities. This questionnaire can be used in subsequent studies to measure the accessibility of rehabilitation services.
Daniela Cerón-Perdomo, Carolina Mancipe-García, Daniel G. Fernández-Ávila, Óscar Muñoz-Velandia, Ángel García,
Volume 18, Issue 2 (6-2020)
Abstract
Objectives: Our research seeks to examine the correlation between the presence of physical medicine and rehabilitation journals in social networks and the SJR impact factor.
Methods: We carried out a correlation study. For the research, we took into account all physical medicine and rehabilitation journals included in the SCImago Journal Rank. The number of followers on Twitter, Facebook, YouTube, and the number of tweets were extracted from verified accounts. Journal differences according to the presence in social networks were evaluated using non-parametric tests, and the Spearman correlation coefficient was calculated between the metrics of dissemination in social networks and the SCImago Journal Rank.
Results: Out of 122 physical medicine and rehabilitation journals, 25.4% had the presence in one social network. The H Index medians (32 vs 17, P=0.014) and of the SJR (0.67 vs 0.32, P= 0.001) were better in journals with the presence in social networks. A moderate correlation was found between the SJR and the number of followers on Twitter (r=0.5, P=0.066). The global correlation between the SJR and followers on Facebook was acceptable (r=0.4, P=0.1205).
Discussion: Our data show that scientific journals of physical medicine and rehabilitation with presence in social networks have superior quality metrics. Additionally, SJR and the indicators of dissemination in social networks are moderately correlated. Both metrics offer complementary information. Presence in social networks could improve the visibility of journals and their interaction with readers.
Nasser Mohammad Rahimi, Reza Mahdavinejad, Seyyed Reza Attarzadeh Hosseini, Hossein Negahban,
Volume 18, Issue 3 (9-2020)
Abstract
Objectives: Dynamic Neuromuscular Stabilization (DNS) approach evaluates and activates the spinal stabilizers to optimize the performance of posture and respiratory system. This study investigated the effects of DNS breathing exercises on upper and lower chest wall mobility (UCM and LCM), trunk extensor endurance, and thoracic kyphosis in a group of sedentary students with poor posture.
Methods: In this randomized, controlled 6-week trial, 52 participants were randomly divided into two groups: a DNS breathing exercise group (n=26) and a control group (n=26). First, a pre-test of the UCM, LCM, trunk muscle endurance and thoracic kyphosis was done on each participant in random order. DNS breathing exercise protocol (six times a week for six weeks) was implemented and after its completion, all post-test parameters were taken. Descriptive statistical and the paired-sample t test were used to analyze the obtained data.
Results: Significant improvements were observed in the post-test compared with pre-test in DNS breathing exercise group in UCM (6.2±1.6 vs 4.4±0.9 cm, P<0.001), LCM (7.7±1.7 vs 5.5±1.0 cm, P<0.001), trunk muscle endurance (110.1±33.5 vs 88.7±34.1 s, P<0.001), and thoracic kyphosis (146.9±5.5 vs 142.7±4.0 degree, P<0.001). In contrast, the change in these parameters in the control group was not statistically significant.
Discussion: DNS breathing exercise with a focus on the integrated spinal stabilizing system and breathing techniques is an effective protocol to significantly improve UCM and LCM, trunk muscle endurance, and thoracic kyphosis. It is suggested that DNS breathing exercises be introduced to improve chest mobility and posture and provide physiological stabilization for the overall health and performance of student
Mahsa Fadavi-Ghaffari, Akram Azad, Ghorban Taghizade, Noureddin Nakhostin-Ansari, Hooman Shariatzadeh, Sina Aminizadeh,
Volume 19, Issue 1 (3-2021)
Abstract
Objectives: It is essential to have a suitable instrument for the accurate assessments of pain and disability outcomes during interventions; such tools also help to guide hand surgery and rehabilitation programs in distal radius or scaphoid fracture. This study aimed to evaluate the psychometric features of the Patient-rated Wrist Evaluation (PRWE) questionnaire in Iranians with a history of scaphoid and distal radius fractures.
Methods: One hundred and fifty subjects with a history of scaphoid and distal radius fractures were recruited from hospital-based outpatient hand clinics and completed the PRWE, 2 and 7 days after the occurrence of fracture. Additionally, the Quick-Disabilities of Arm, Shoulder, and Hand (Quick-DASH), the percentage of Wrist Range of Motion (%ROM), Visual Analog Scale Pain/Disability (VAS-P, VAS-D), Short-form Health Survey (SF-36) questionnaires, and pinch and grip strength (%) were conducted in the study participants. Cronbach’s alpha (α) coefficient and Intraclass Correlation Coefficient (ICC) were used to evaluate the internal consistency and test-retest reliability of the scale, respectively. Pearson or Spearman correlation coefficient was calculated for assessing the test’s construct validity.
Results: No floor or ceiling effect was found. A very high test-retest reliability was obtained for the PRWE’s total score and subscores (ICC≥0.92). Cronbach’s α coefficient was obtained as ≥0.78 for the PRWE and its subscales. The PRWE total score presented a weak to strong (0.24-0.74) correlation with the average values of %ROM, %power grip, %pinch strength, VAS-P, VAS-D, SF-36, and Quick-DASH. The standard error of the measurement of PRWE total score equaled 3.93; its smallest real difference was 10.86.
Discussion: The PRWE presented acceptable validity and excellent reliability for measuring disability and pain in individuals with the scaphoid and distal radius fractures in Iran.
Ali Sharifnezhad, Gholam Reza Raissi, Bijan Forogh, Hosnieh Soleymanzadeh, Shadan Mohammadpour, Mina Daliran, Masumeh Bagherzadeh Cham,
Volume 19, Issue 2 (6-2021)
Abstract
Objectives: The present study evaluated the inter-rater and intra-rater validity and reliability of posturography by Kinovea software to measure the thoracic kyphosis and lumbar lordosis.
Methods: Eighteen subjects (10 females & 8 males) referring for radiographic imaging were included in this cross-sectional study. For evaluating the validity, the thoracic kyphosis and lumbar lordosis were measured according to the Cobb method and Kinovea in standing position. The inter-rater and intra-rater reliability of Kinovea were tested by 3 evaluators and one expert evaluator, respectively.
Results: Pearson correlation coefficient data suggested that the validity of measuring the thoracic kyphosis depends on the evaluator’s expertise. Besides, the correlation was not significant in measuring the lumbar lordosis angle (P>0.05). The inter-rater and intra-rater repeatability revealed that the correlation was significant in all angles by the intraclass correlation coefficient (P<0.001).
Discussion: Posturography by Kinovea, as a noninvasive method presents an excellent inter-rater and intra-rater repeatability for measuring thoracic kyphosis and lumbar lordosis. This reliable method is simple, efficient, and inexpensive.
Kseniya Yurku, Sergey Bondarev, Irina Lazareva, Tatiana Krasavina, Mark Ivanov,
Volume 19, Issue 3 (9-2021)
Abstract
Objectives: Symptoms associated with spinal disk herniation may heal without surgery. In some patients, imaging reveals a reduction in hernia size, too. This phenomenon is referred to as spontaneous regression of the herniated disk. It was first reported in 1984 and is widely covered in today’s research papers.
Case Presentation: This paper describes a case of spontaneous regression of lumbar disk herniation at L5-S1, where another disk was herniated at L4-L5 after only 8 months. The patient (F) sought help complaining of pain in the lumbar region. An MRI scan revealed a 6.2-mm hernia at L5-S1. The patient was prescribed conservative treatment comprising non-steroidal anti-inflammatory drugs and kinesitherapy, to which she refused to adhere and decided to treat the condition on her own. Eight months later, the patient sought help again, reporting other symptoms of pronounced constant pain in the rear lateral surface of the left leg and lameness. A further MRI scan revealed spontaneous hernia resorption at L5-S1 with an emergent vacuum phenomenon and a different disk herniated at L4-L5 to 9.4 mm.
Discussion: Since the symptoms were pronounced and non-steroidal anti-inflammatory drugs did not have a therapeutic effect, the patient required surgery.
Surajo Kamilu Sulaiman, Ashiru Hamza Mohammad, Aminu Alhassan Ibrahim, Sham’unu Isa Abdu, Bashir Kaka,
Volume 19, Issue 3 (9-2021)
Abstract
Objectives: To overcome the inherent limitations of the medical and social models of disability, the World Health Organization developed the first international conceptualization of disability: the International Classification of Functioning, Disability, and Health (ICF). Despite the ICF’s robustness, it is still underutilized in research and practice in Low- and Middle-Income Countries (LMICs). This article discusses the applications, strengths, limitations, and unique considerations when using the ICF to explore disabilities in LMICs like Nigeria.
Methods: A literature search was conducted in Medline, CINAHL, Web of Science, AMED, and Google Scholar. Articles were selected if they reported on any of the development, structure, applications, strengths, and limitations of the ICF. The review draws from the selected articles using a narrative discussion.
Results: The literature search yielded 22 articles that met the eligibility criteria. The ICF is a classification of components of health and functioning, which views disability as an outcome of a dynamic interaction between a person’s health condition and contextual factors. The ICF was developed cross-culturally; thus, it is applicable in various socio-environmental contexts. However, despite its comprehensiveness, the ICF is criticized for lack of clear theoretical underpinnings, overlapping and redundant components, and absence of systematized personal factors.
Discussion: The ICF has brought a significant paradigm shift in the measurement of disability by explicitly recognizing the role of contextual factors in the incapacitation process and placing all health conditions on an equal footing. Hence, stakeholders in disability research and practice in LMICs need to prioritize the ICF over other disablement models.
Irma Ruslina Defi, Novitri Novitri, Ilin Nurina,
Volume 19, Issue 4 (12-2021)
Abstract
Objectives: This study aimed to elucidate the outcome of an Inspiratory Muscle Training (IMT) rehabilitation intervention on the lung function, functional mobilization, balance, and peripheral muscle strength of the paretic side in patients with subacute stroke.
Methods: This double-blind, randomized controlled trial study was conducted on patients with stable subacute stroke. For 8 weeks, the intervention group (n=16) received 40% intensity IMT while the control group (n=16) received 10% intensity IMT. We assessed the patients’ lung function (spirometer) before and after the intervention, as well as their pulmonary muscle strength (micro-respiratory pressure meter [RPM]), quadriceps strength (handheld dynamometer), grip strength (Jamar), walking speed (10-m walk test), balance (Berg Balance Scale [BBS]), and functional mobilization (sit-to-stand test).
Results: There were significant differences between the intervention group and the control group after IMT for forced vital capacity (FVC)% (P<0.01; d=3.20), forced expiratory volume in the first second (FEV1)/FVC (P<0.001; d=2.55), FEV1% (P<0.001; d=5.10), walking speed (P<0.05; d=1.62), hand grip (P<0.001; d=2.45), quadriceps strength (P<0.001; d=4.18), functional mobilization (P<0.01; d=2.41), and maximal inspiratory mouth pressure (P<0.001; d=1.62), but no significant changes were seen in balance (P=0.304; d=0.57).
Discussion: IMT improved lung function, functional mobilization, handgrip strength, and quadriceps strength on the paretic side of subacute stroke patients and is expected to improve functional status and allow the patient to participate in social activities. IMT exercise can be included in the rehabilitation program for subacute stroke patients.
Sadra Ashrafi, Maryam Shabaani Mehr, Tahereh Khaleghdoost Mohammadi, Shirin Jafroudi, Ehsan Kazemnezhad Leyli,
Volume 20, Issue 0 (1-2022)
Abstract
Objectives: One of the most important problems seen in patients after stroke is that they cannot develop normal muscle strength. In recent years, the use of Mirror Therapy (MT) in the recovery of this condition has been noticed in different studies. This study investigated the effect of MT on motor recovery in patients after stroke.
Methods: In this clinical trial, 93 patients were divided into three groups, including MT, non-reflective surface, and control groups. The tools used in this study included the patient’s profile questionnaire, Mini-Mental State Examination Test, and Brunnstrom Recovery Stages. After the routine physiotherapy program, the intervention groups underwent MT for 20 sessions. The analysis of data was performed by SPSS software v. 22.
Results: There was a significant difference between the non-reflective surface and MT groups (P=0.043) in pairwise comparison of their motor recovery stages in the 20th session, but the difference between the non-reflective surface and control groups was not significant. There was also a significant statistical difference between the MT and control groups in motor recovery stages in the 20th session, (P=0.0332)
Conclusion: The obtained findings suggest that MT can increase patients’ motor recovery after stroke. This method can be used as a simple, cheap, and usable method at home.
Arash Babaei-Ghazani, Negar Aflakian, Hamid Reza Fadavi, Ali Babashahi, Maziar Azar, Fariba Afshari-Azar, Hosnieh Soleymanzadeh, Mathieu Boudier-Reveret, Bina Eftekharsadat,
Volume 20, Issue 1 (3-2022)
Abstract
Objectives: Neck roots lesions are among the etiologies of cervical and arm pain. A detailed patient evaluation could assist the diagnosis, reduce imaging requests, and promote the treatment of cervical pain. We tried to estimate the value of pronator teres reflex in C6 and C7 roots irritation.
Methods: The present study comprises 118 participants, including 56 patients with C6 and C7 lesions and 62 normal controls. The reliability and usefulness of this reflex in C6 and C7 roots lesions were compared to positive electromyography and imaging with magnetic resonance.
Results: The sensitivity, specificity, positive predictive value, and negative predictive value for pronator teres reflex were 36.4%, 13.6%, 64.8%, and 4.6%, respectively.
Discussion: This reflex can be considered an additional reflex during the physical examination for C6 and C7 nerve roots injury, but its diagnostic value for C6 and C7 radiculopathy is unreliable to be used for screening purposes.
Mohammadjavad Hadianfard, Batoul Safari, Leila Sadat Mohamadi Jahromi,
Volume 21, Issue 1 (3-2023)
Abstract
Objectives: Hallux rigidus is one of the main etiologies of disability in the elderly. It is a degenerative disease of the first metatarsophalangeal joint causing restriction of movement as well as pain and swelling. This study was conducted to evaluate the effectiveness of methylprednisolone and dextrose prolotherapy in pain reduction and functional improvement of patients with hallux rigidus.
Methods: A randomized double-blind control trial was designed with the inclusion of 32 patients assigned to the two groups. Group one received a mixture of 1 cc methylprednisolone 40 mg with 1 cc lidocaine 2% while the second group received a combination of 1 cc dextrose 50% with 1 cc lidocaine 2%. Standard questionnaires, including visual analog scale (VAS) and Manchester-Oxford foot questionnaire (MOXFQ) were completed by all patients at baseline and 1, 4, and 8 weeks after injections.
Results: Both groups revealed significant improvement in VAS and MOXFQ scores 1, 4, and 8 weeks post-injection with no difference between the two groups in the follow-up.
Discussion: Both corticosteroid injections and prolotherapy are effective in pain reduction and functional improvement in patients with hallux rigidus but neither is superior to the other.
Hamna Afzal, Rabiya Noor, Nazia Mumtaz, Muhammad Salman Bashir, Ghulam Saqulain,
Volume 21, Issue 3 (9-2023)
Abstract
Objectives: To determine the impact of Kendall versus Gong’s intervention according to pain sensation, range of movement, function, strength, and posture in cases with text neck syndrome.
Methods: This randomized clinical trial recruited a sample of 24 patients with text neck syndrome from Fatima Hospital, Sargodha, Pakistan from January to April 2021. The samples were randomly divided into 2 groups using the envelope method. Group A received Kendall’s intervention while group B received Gong’s mobilization. The intervention was performed in 18 sessions for each patient during 6 weeks i.e. 3 per week. Neck disability index, numeric pain rating scale, cervical range of motion (ROM), cranio-vertebral angle (CVA), rounded shoulder angle (RSA), and modified sphygmomanometer test were used to collect data. All outcomes were measured at baseline and six weeks after intervention and analyzed using SPSS software, version 23. T-test was used to analyze within and between-group differences, and P<0.05 was considered significant.
Results: A significant difference with P<0.05 was observed for within and between group statistics. Gong’s mobilization showed more effectiveness (P<0.001) for all output measures depending on differences between mean scores.
Discussion: The study concluded that both Kendall’s exercise and Gong’s mobilization were useful in the reduction of pain and functional disability; improvement in cervical range and strength of cervical muscles. However, Gong’s mobilization was superior to Kendall’s exercise in improving text neck syndrome for outcome measures, including neck pain, disability, craniovertebral angle, rounded shoulder angle, cervical range of motion (ROM), and cervical muscle strength.
Coresponding author: Ghulam Saqulain, E-mail: ghulam_saqulain@yahoo.com
You can also search for this author in: PubMed, Google Scholar
Dr. Arnengsih Nazir, Dr. Badai Bhatara Tiksnadi, Mr. Mochammad Farhan Fajrial Aditama Ridzki,
Volume 22, Issue 1 (3-2024)
Abstract
Objectives: This review aimed to determine the form, results, and barriers to exercise-based rehabilitation programs for severe COVID-19 survivors.
Methods: Searching for the article was carried out from August to October 2021. We used the PubMed database as a search media with the keywords ([‘COVID-19’ OR ‘COVID 19’ OR ‘SARS CoV-2’ OR ‘post COVID-19’] AND [‘rehabilitation’]). Original articles and case reports published in the last 2 years (July 2019-2022), written in English, available in full text, and accessible in PDF or HTML format were included. Articles were excluded if they did not fit the research topic after reading the full text.
Results: There were a total of 7461 articles found at the initial screening using keywords. In the next screening using the inclusion and exclusion criteria and after reading the whole article, we found 9 articles that matched the topic. Of these, 7 articles were original articles and 2 case reports. All of the articles explained the forms and outcomes of exercise-based rehabilitation in severe cases of COVID-19 survivors. However, no article explained the barriers to rehabilitation.
Discussion: Exercise was generally given to increase exercise tolerance in severe COVID-19 survivors in both inpatient and outpatient cardiopulmonary rehabilitation programs. The form of exercise was aerobic, strength, or endurance training, and other forms of exercise such as balance training as well as breathing exercises. The type and intensity of exercises given were tailored to the patient’s needs. Research showed that exercise-based rehabilitation programs resulted in a positive impact on increasing the survivor’s quality of life, functional capability, and exercise tolerance. A previous study explained that barriers to rehabilitation in COVID-19 were related to the patient’s health condition, COVID-19 infectivity, and issues related to health services.
Ms. Somayeh Hashemi, Ms. Sahar Farahbakhsh, Dr. Aliasghar Fallahi, Dr. Farhad Daryanoosh, Prof. Mohammad Ali Babaei Beigi, Ms. Narges Jamshidian Tehrani,
Volume 22, Issue 3 (9-2024)
Abstract
Objectives: This study evaluates the effects of combining aerobic running and anaerobic Pilates exercises to reduce fatigue improve cardiovascular and muscular fitness, and enhance the quality of life (QoL) in systemic lupus erythematosus (SLE) patients.
Methods: A total of 19 SLE patients with index SLE disease activity index (SLEDAI) scores ≤4 were randomly assigned into an intervention group (n=10), undertaking the combined exercise program, and a control group (n=9), undertaking normal activities of daily living only. The combined exercise program lasted 8 weeks and consisted of three 1-h weekly sessions. In both groups, functional capacity, cardiovascular fitness, muscle endurance capacity and QoL were assessed before and following the programmed activity or ADL only. The data were analyzed by the SPSS software, version 18 at the significance level of 0.05.
Results: The results confirm that this combined exercise program provides significant benefits over activities of daily living concerning pre-test and post-test difference scores for functional capacity (VO2peak 1.86±1.45 vs -0.95±1.43 mL/min/kg, P<0.01). Significant benefits were also observed for the number of sit-ups achieved (11.30±9.91 vs 0.5±1.06, P<0.01), sit and reach improvements (6.92±5.09 vs 0.5±0.92 cm, P<0.05), subjective fatigue (-3.38±5.59 vs 1.75±1.48, P<0.05), and regarding the overall mean of summed QoL subscales scores (10.80±4.90 vs 0.06±1.56).
Discussion: Combining aerobic and anaerobic exercises can mitigate subjective fatigue and significantly improve functional capacity, myocardial metabolism, muscular endurance, flexibility, and QoL in SLE patients.
