Original Articles

The Prevalence of Challenging Behaviors in 6-11 Years Old Children with Cerebral Palsy

Shila Shabdini, Maryam Mehdizadeh, Fatemeh Mahdizadeh, Mehdi Bigham Sostani

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 1-4

Introduction: Addressing behavioral problems helps facilitate social interactions and community acceptance of children with cerebral palsy. This study examines the prevalence of behavioral challenges in children with cerebral palsy. Materials and Methods: A hundred children with cerebral palsy {mean age (±SD)=8.47 (±1.86) years} took part in this study. To measure behavioral disorders, Rutter’s children’s behavior questionnaire was used. Raven test was employed to measure IQ of the children. Spearman correlation coefficient was used to investigate the relationship between behavioral disorder whit IQ and age. One-way ANOVA test was applied to evaluate the types of behavioral disorders in 4 groups of cerebral palsy. Results: The results have not shown any significant relationship between the total score of the Rutter form with intelligence and age (r = 0.08 and 0.09 Pv> 0.05). Aggression, hyperactivity, and attention deficit disorders between the athetoid group and different groups of cerebral palsy were shown to be significant. There was no marked difference in depression, social incompatibility, and antisocial behaviors among different groups of cerebral palsy. Conclusion: The results of this study show that there is a disparity in challenging behaviors in different groups of cerebral palsy. To improve the quality of life of these groups of children, further studies are recommended to figure out intervention processes to address their challenging behaviors as much as possible.

Keywords: Cerebral Palsy, Behavioral Disorders, Children

The Persian version of Penn Parkinson's Daily Activities Questionnaire-15: Face and Content Validity

Neger Nikbakht, Mehdi Rezaee, Minoo Kalantari, Seyed Mehdi Tabatabaee

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 5-8

Introduction: Cognitive deficits impact the ability to perform instrumental activities of daily living (IADL) in patients diagnosed with Parkinson's disease (PD). Improved IADL measurement plays an important role in the assessment of functional independence and new cognition-enhancing treatments in PD. The purpose of this study was to translate and investigate the face and content validity of Penn Parkinson's Daily Activities Questionnaire-15 in Persian. Materials and Methods: This was a methodological study where the forward-backward method was used for the translation process. Face validity by 15 knowledgeable informants (KI) of PD participants and content validity by 15 occupational therapists were evaluated. Face validity was measured using quantitative and qualitative approaches, and quantitative content validity was determined by calculating Content Validity Ratio (CVR) and Content Validity Index (CVI). Results: Face validity was high (2/92-5), and all items were reported to be acceptable and understandable by KI, except for one question that needed to be explained to them with an example. Final corrections were done. Also, CVR (0.73-1) and CVI (0.86-1) were found to be within the acceptable range. Discussion: The Persian version of PDAQ-15 shows strong psychometric properties and also appears suitable for use as a clinical and research tool to evaluate daily cognitive functioning in PD patients.

Key words: Parkinson's disease, instrumental activities of daily living, cognition, face validity, content validity

Effect of Wrapping Technique on Range of Motion and Muscle Tone of Upper Extremity in Children with Spastic Cerebral Palsy: A Pilot Study

Mehdi Bigham Sarvestani, Maryam Mehdizadeh, Fatemeh Mehdizadeh, Shila Shabdini

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 9-12

Introduction: In children with severe spastic cerebral palsy, the presence of primary reflexes prevents normal movement patterns and delayed treatment. Wrapping technique is one of the methods used to reduce muscle tone. Wrapping technique is one of the methods used to increasing upper extremity function. The aim of this study was to evaluate the effect of this technique on the reduction of spasticity and increase the range of upper extremity in children with cerebral palsy. Materials and Methods: In this experimental and pilot study, 20 children {mean (±SD) age = 4.35 (±1.18) year} were randomly assigned to intervention and control groups. In both groups, the passive ranges of motion and muscle tone (external shoulder rotation, shoulder abduction, shoulder flexion, and wrist extension) were measured by goniometer and modified Ashworth scale before and after the intervention. Both groups received regular rehabilitation services, and the intervention group took wrapping along with those services. Independent t-test was used to examine the pretest and posttest to differentiate between the two groups. Results: The results of this test showed an increase in the passive range of motion in the intervention group compared with the control group. Our study also suggested tone reduction in all intended muscles, except in wrist extensor, during 12 treatment sessions in the intervention group. Discussion: In summary, the use of the wrapping technique is an effective method for reducing muscle tone and increasing the passive range of motion.

Key words: Muscle Tone, Range of Motion, Spastic Cerebral Palsy, Upper Extremity, Wrapping Technique

Relationship between Physical Fitness and Functional Movement Screening Scores in Active Males: Providing Preventing Model

Ramin Arghadeh, Amir Letafatkar, Seyyed Sadreddin Shojaeddin

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 13-20

Introduction An increasing number of sports injuries and consequences of the injuries suggest that prevention of sports injuries is essential. The first step in the prevention of sports injury is screening, and one of the most critical tools in the field is functional movement screening tests. This study aimed to evaluate the relationship between physical fitness and functional movement screening scores in active males. Materials and Methods: This was a correlation study. For execution, 50 active males from Iran, East azerbaijan state, Bonab city (age 22.60±3.09 yr, height 177.70±6.38 cm, weight 74.06±10.12 kg, sports history 11.12±3.73 yr and physical activity per week 8.50±4.52 h) were selected purposefully. The functional movement screening tests include: deep squat, hurdle step, in-line lunge, shoulder mobility, active straight-leg raise, trunk stability push-up, and rotary stability. Flexibility, speed, power, and agility were assessed using sit-and-reach, 20-m sprint, vertical and standing broad jumps, and modified T-test, respectively. Results: The results demonstrated that there was a significant correlation between functional movement screening tests, flexibility, and power. However, no significant correlations were found between functional movement screening tests, speed, and agility. Also left leg flexibility and vertical power were significant predictors for functional movement screening tests. Discussion: Scores of functional movement screening tests provides the primary injury prevention model for coaches to predict future injury in athletes. Therefore, it is recommended for coaches to pay more attention to the factor of flexibility and vertical and horizontal power to prevent the injuries by considering the specificity principles of training.

Key words: Agility, Flexibility, Functional Movement Screening, Power, Speed

Introduction: Previous studies indicated that anterior cruciate ligament demage prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of complex motor skills required for sports. The purpose of the current study was to investigate the effect of feedback training on kinetic, kinematic, and functional factors of active subjects. Materials and Methods: A total of 24 men (age 24.83±2.77 years, height 176.79±4.05 cm, and mass 72.20±9.30 kg) were randomly assigned to feedback and control groups. Participants completed feedback training for 8 weeks. Peak knee valgus angle was measured using 3D motion analysis during landing and peak hip abduction moment measured using isokinetic set as well as functional movement was measured by triple hop cross test. For data analysis repeated measure analysis of variance, independent-sample, and paired t tests were used. Results: Our findings revealed that feedback training caused significant differences in peak hip abduction moment (P=0.004) and triple hop cross test (p=0.005). However, there was no effect on peak knee valgus (P=0.117). Discussion: Our study confirms large effect size of feedback training on peak hip abduction moment and functional movement of participants. Therefore, it is recommended to use the feedback training by coaches and athletes to prevent the anterior cruciate ligament demage and increase athletic functional performance.

Key words: Anterior Cruciate Ligament, Demage Prevention, Feedback, Focus of Attention, Kinematic

Evaluation of the Relationship between Functional Independence and Quality of Life in Patients with Chronic Stroke

Elahe Fathi Azar, Mahnaz Hejazi Shirmard, Ehsan Jamshidian

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 29-33

Stroke is a primary cause of long-term disabilities. Impact of stroke on individuals can be devastating which include an increased dependency on others for activities of daily living, change in mood and cognition, and disruption of social interactions. Such changes have negative influences on the quality of life (QoL); however, it is commonly neglected. This study aimed to determine the functional independence and QoL in chronic stroke patients and the relationship between these factors. Materials and Methods: In this cross-sectional study, QoL and functional independence of chronic stroke patients (n=63, aged 24-65 years) were assessed by World Health Organization Quality Of Life questionnaire (WHOQOL-Bref) and Barthel index. These participants had experienced only one stroke and had no other orthopedic, neurologic or psychological disorders. Results: The mean age of participants was 46.11±11.93. The mean score of total QoL was relatively low (58.91±12.21) and mean score of Barthel Index was 87.46±13.04. Psychological and environmental domains had lowest and highest scores respectively, and males had a higher QoL in comparison to females in all domains. There was a correlation between functional independence and overall QoL (r=0.001), functional independence was highly correlated with physical (r=0.000) and environmental (r=0.016) domains (P<0.001). Discussion: The results demonstrated that in the majority of participants the QoL was not favorable and is correlated with functional independence level, although further studies are necessary to confirm these findings. The results emphasize more attention to psychosocial aspects of stroke survivors.

Key words: Functional independence, Quality of Life, Stroke

Introduction: Flat foot is a condition with decreased neutral foot arch due to different factors such as muscle weakness. It can cause excessive pronation of subtalar joint in the stance phase of the gait cycle, increasing of external rotation of the femur, apparent changes in lower limbs kinematics and also gait dysfunctions. Various studies showed the effects of the whole-body vibration on the strengthening of knee musculature, especially in a patient with anterior cruciate ligament deficiency. None of the study reported the positive impact of whole-body vibration in foot dysfunctions. The current study aimed to evaluate the navicular drop changes in children aged 6-12 years with flexible flat feet. Materials and Methods: The current Quasi-Experimental study enrolled 44 children (girls and boys, aged 6-12 years) with a flexible flat foot and divided into two groups of 22 participants. One group received whole-body vibration, and the other group received routine exercise therapy for six weeks. The navicular drop was measured before and immediately after six weeks. Results: The results showed a significant change in both the groups in the direction of treatment of flat foot (p<0.001). However, the changes were more prominent in whole-body vibration group (47%) than the exercise group (15%) (p<0.001). Discussion: These findings show that both the presiders of the whole-body vibration and routine exercise therapy could make significant changes in treatments groups. However, whole-body vibration could be more efficient than the exercise therapy. Further studies in this field are recommended using higher number of samples and different age groups.

Key words: Whole Body Vibration, Flexible Flat Foot, Exercise Therapy, child, Medial Longitudinal Arch

Case Report

Physiotherapy Approach in Treatment of Trigeminal Neuralgia: A Case Report

Sahar Zamani, Farshad Okhovatian

Journal of Clinical Physiotherapy Research, Vol. 3 No. 1 (2018), , Page 42-47

This study deals with the assessment and treatment of a 45-year-old female suffering from trigeminal neuralgia (TN). The neuralgic pain was recurrent lancinating right-sided facial, which run along mandibular branch of trigeminal nerve, shooting from the corner of the mouth to the angle of the jaw. The patient’s main complaint was sudden neural pain along with persistent fatigue in the face that developed following talking and remained after the attacks. Patient’s neurologist prescribed carbamazepine and referred the patient to the physiotherapy center. Physiotherapy approach included electrotherapy [transcutaneous electrical nerve stimulation (TENS), ultrasound (US), low-level laser therapy, and superficial moist heat], manual therapy, exercise therapy, and self-massage education. The patient was treated in 15 sessions, and final examinations indicated a significant decrease in frequency of neural attacks, reduction in the durability of facial fatigue following the neural attacks, and improvement in initiation time of facial fatigue while talking. We suggest that physiotherapy approach along with medication can be effective in relieving symptoms in patient suffering from TN. Sharing the experiences of physiotherapist and neurologist can make this belief that physiotherapy can be effective in such complicated cases where medication alone is not effective.