Journal of Modern Rehabilitation

Effects of Physical Therapy Management on Gross Motor Function and Spasticity among Diplegic Cerebral Palsy

Sun, 13 Jul 2025 05:33:56 +0000

Introduction: Cerebral palsy (CP) is a leading cause of disability among the pediatric population, especially in Asia. Permanent disability is mostly due to spasticity and poor gross motor function, which adds a significant socioeconomic burden to the healthcare system. This study aims to evaluate the effectiveness of physical therapy-based interventions in improving gross motor function and reducing spasticity.

Materials and Methods: From February to July 2024, a thorough search was conducted on CINAHL, PubMed, PEDro, Web of Science and Scopus for studies assessing spasticity using the modified Ashworth scale (MAS) and gross motor function using the gross motor function measure (GMFM)-88 standing/walking dimensions in children with diplegic CP. Seventeen eligible trials were analyzed using fixed/random-effects models in MedCalc.

Results: The analysis showed significant improvements in walking ability P<0.0001 (confidence interval [CI] 95%, 0.20%, 0.50%], standardized mean differences [SMD]=0.563, Q=43.9325) and standing ability P=0.0004 (CI 95%, 0.20%, 0.50%,SMD=0.187, Q=22.5239) in the experimental group (EG), as measured using the GMFM-88. However, no significant impact was observed on any dimension of the GMFM-88 P=0.5821 (CI 95%, -0.0508%, 0.301%, SMD=0.125, Q=6.5843). According to the MAS, interventions targeting spasticity reduction showed no significant effects P=0.1018 (CI 95%, 0.20%, 0.50%, SMD=0.306, Q=10.5922).

Conclusion: This meta-analysis reveals that modified suit therapy, vibration therapy, and hippotherapy enhance standing and walking in GMFM-88 but did not reveal significant effects of physical therapy interventions in improving overall gross motor function or reducing spasticity in children with diplegic CP.

Mechanisms of Listening Effort in Individuals with Hearing Loss

Zahra Iran Pour Mobarakeh, Marzieh Amiri, Elham Tavanai, Vida Rahimi — Sun, 13 Jul 2025 05:43:50 +0000

Introduction: Listening effort refers to the cognitive resources required to understand speech, particularly in challenging environments. Individuals with hearing loss experience increased listening effort due to auditory deficits, affecting their communication and cognitive load. Understanding the mechanisms underlying listening efforts is essential for developing effective hearing interventions. This study aims to explore the mechanisms underlying listening efforts in individuals with hearing impairments.

Materials and Methods: A narrative review was conducted using specific keywords in Google Scholar (as a search engine) and the research databases Web of Science, Scopus and PubMed. Relevant articles were selected based on their alignment with the focus on the mechanisms of listening effort in individuals with hearing loss.

Results: Hearing loss triggers compensatory cognitive strategies, engaging the prefrontal regions and working memory to process degraded auditory signals. Neural adaptations, including cross-modal plasticity and reliance on top-down processing, further elevate mental workload. Degraded temporal processing and attentional demands in noisy environments exacerbate effort, often leading to fatigue.

Conclusion: Understanding these mechanisms informs interventions, such as adaptive hearing technologies, cognitive training to optimize resource allocation and personalized communication strategies. Integrating neurophysiological insights into clinical practice can reduce cognitive fatigue and enhance communication outcomes.

Neck Exercises Versus Myofascial Release for Chronic Tension-Type Headache and Posture: A Randomized Controlled Trial Protocol

Mobina Ahmadi, Mohammadreza Pourahmadi, Mansoureh Togha, Reza Salehi — Sun, 13 Jul 2025 05:51:14 +0000

Introduction: Tension-type headache (TTH) is the most common type of headache worldwide, causing significant psychological, physical, financial, and societal consequences. One of the activating factors of chronic TTH (CTTH) is cervical dysfunction, such as forward head posture (FHP), leading to suboccipital muscle tenderness and deep neck flexor (DNF) muscle weakness. Physiotherapy affects these patients through two mechanisms: Top-down (e.g. DNF exercises) and bottom-up (e.g. suboccipital myofascial release [MFR]), but their relative effectiveness in reducing headache-related parameters remains unclear.

Materials and Methods: This randomized, parallel-group, assessor-blind, double-dummy clinical trial included 44 participants divided into two groups: One receiving MFR with sham exercise and the other receiving DNF exercises with sham MFR. Interventions were performed over four weeks, followed by a six-week follow-up. The primary outcomes were headache intensity and craniovertebral angle (CVA), while the secondary outcomes were headache frequency, duration, pressure pain threshold (PPT), disability and quality of life.

Results: After the trial's completion, all collected data will undergo statistical analysis and subsequently be published in international, high-impact factor, related journals. In addition, the findings will be presented at neurology or physiotherapy conferences.

Conclusion: This study compares the effectiveness of a top-down versus a bottom-up physiotherapy approach in CTTH patients with FHP. If a significant difference is found, the study will identify the superior approach for short- and medium-term outcomes, providing valuable insights for clinicians and healthcare managers.

Cultural Adaptation of the “Language-Based Reading Disabilities Checklist” for Persian-Speaking Students: A Psychometric Study

Mina Armin, Masoomeh Salmani, Mozhgan Asadi, Fatemeh Paknazar — Sun, 13 Jul 2025 05:53:49 +0000

Introduction: Regarding the prevalence of learning disabilities (LD) and its consequences, the availability of a valid and reliable screening tool will help provide early diagnosis and intervention for at-risk students. A significant number of students with a LD have a history of language problems; therefore, it is rational to recognize them through a checklist entitled “language-based reading disabilities checklist.” This study aims to examine the translation, cross-cultural adaptation, and assessment of the psychometric features of the checklist for Persian-speaking students.

Materials and Methods: The research team administered forward and backward translations, cognitive briefing and validity and reliability evaluations. Content validity and face validity were calculated based on the content validity ratio (CVR) (critical value ≥0.42), critical validity index (CVI) (critical value ≥0.79) and item impact score (IIS) (critical value ≥1.5). The Kuder- Richardson-21 was administered to calculate the internal consistency.

Results: In translation, two words (‘wanders’ and ‘rhymes’) must be equated. Teachers assessed the checklist as easy to understand and clear. They required approximately five minutes to complete the checklist for each student. The panelists removed two items with a CVR≤0.42 and one item based on the CVI and IIS. The internal consistency of the checklist was 0.94, and the item’s intraclass correlation coefficient (ICC) ranged from 0.543 to 0.885.

Conclusion: The Persian version of the language-based reading disabilities checklist is a valid and reliable tool for Persian-speaking students in Iran. It should be checked whether this tool also applies to bilingual Iranian students (Turkish, Kurdish, Lor, Arabic and Baloochi).

Impact of 6 Week Neuromuscular Training on Muscle Strength, Balance, and Proprioception in Males with Lateral Ankle Sprain

Mohammadreza Karami, Aliasghar Jamehbozorgi, Parsa Salemi, Mehdi Rezaei — Sun, 13 Jul 2025 05:56:10 +0000

Introduction: Ankle sprains are the most common sports injuries. This study aims to assess the effects of six weeks of neuromuscular training on muscle strength, balance, range of motion (ROM), and proprioception in participants with ankle sprains.

Materials and Methods: Seventeen semi-professional athletes with ankle sprains were randomly allocated to the intervention group (n=9) and the control group (n=8). The intervention group followed a prescribed neuromuscular training program, while the control group followed their normal training routine.

Results: A significant difference was observed in the muscle strength of the invertor muscles before and after the training at an angular velocity of 60 ^°/s and before and after the training program at an angular velocity of 120 ^°/s in the intervention group (P<0.05). Also, a significant difference was observed between muscle strength of evertor muscles before and after a training program with an angular velocity of 60 ^°/s and before and after training, an angular velocity of 120 ^°/s in the intervention group (P<0.05). A significant difference was observed between the overall balance scores before and after training in the intervention group (P<0.05). A significant difference was observed in proprioception before and after training in the intervention group (P<0.05). No significant difference was observed in the ROM before and after training in the intervention group (P>0.05).
Conclusion: Six weeks of neuromuscular training improved muscle strength, balance and proprioception in athletes with lateral ankle sprains (LASs).

Effectiveness of Cardiac Rehabilitation for Patients after Coronary Artery Bypass Graft: Randomized Controlled Trial

Ali Suleiman Harbi, Kim Lam Soh, Putri Yubbu, Kim Geok Soh — Sun, 13 Jul 2025 06:00:23 +0000

Introduction: Cardiac rehabilitation is a program designed to help patients adopt healthy lifestyle changes. This study aims to investigate the effectiveness of a comprehensive cardiac rehabilitation program (CCRP) on anxiety, depression, perceived health status (PHS) and 90- day readmission rate in patients who underwent coronary artery bypass grafting (CABG).

Materials and Methods: A total of 122 patients were randomized into two groups: The intervention group received CCRP. The program lasted for 12 weeks. Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS) and PHS was assessed using the short form-36 health survey. The CCRP’s effectiveness was measured using analysis of variance (ANOVA).

Results: The sample comprised 122 participants, of whom 85(69.7%) were male, with a mean age of 53.01±7.26 years. At baseline, the groups showed no significant differences. At 12 weeks and one month later, significant differences were observed between the groups for anxiety (F =937.69, P<0.001, partial η2=0.90), depression (F =1036.00, P<0.001, partial1 11η2=0.91), physical component summary (PCS) (F =14.73, P<0.001, partial η2=0.13) and mental component summary (MCS) (F =13.87, P<0.001, partial η2=0.121) of PHS, respectively.

Conclusion: CCRP is an effective intervention that can significantly improve anxiety, depression, and PHS. Although the readmission rate difference was insignificant, it may have resulted in substantial rewards. The protocol of the present study was registered and approved in ClinicalTrials.gov PRS.

Assessing the Reliability of the Dynamic-Index of Inspiratory Muscle Strength in Cardiac Surgery Candidates

Sun, 13 Jul 2025 06:05:05 +0000

Introduction: Inspiratory muscle strength (IMS) is a crucial predictor of the development of pulmonary complications after cardiac surgery. The strength index (S-index), a novel non- invasive tool, dynamically assesses inspiratory muscles and is associated with lower risks for heart patients than static tests. This study aims to investigate the reliability of the S-index in patients scheduled for cardiac surgery.

Materials and Methods: This study included 20 preoperative cardiac surgery candidates (11 men and 9 women; mean age, 56±13 years). The S-index, peak inspiratory flow (PIF) and vital capacity (VC) were evaluated using a power breath K5 Electronic respiratory device. An examiner conducted these measurements at two distinct intervals, one hour apart. Each index’s average and best values were evaluated for reliability using the intra-class correlation coefficient (ICC).

Results: The study revealed excellent (ICC>0.9) and good (ICC>0.8) intra-examiner reliability for the best and average values of the S-index and PIF, respectively. Also, the results of the present study showed excellent intra-examiner reliability for the best and average values of the VC (ICC>0.9)

Conclusion: The ICC results of the present study showed that the S-index can be used to determine the dynamic strength of the inspiratory muscles with acceptable repeatability in cardiac surgery candidates. One of its advantages is the ability to determine the appropriate load for inspiratory muscle training (IMT) exercises during the hospitalization phase of these patients dynamically without breath-holding.

Translation, Cultural Adaptation and Content Validity of the Persian Version of the Structured Cognitive Training Program “NEUROvitalis”

Sun, 13 Jul 2025 06:08:22 +0000

Introduction: The older adult population is growing worldwide, particularly in Iran, leading to a decline in cognitive function. Cognitive training effectively enhances these skills. NEUROvitalis is a structured cognitive training program incorporating psychoeducation with individual and group cognitive tasks. It accommodates up to eight participants aged 50 and above, spanning 12 sessions over six weeks. This study aims to prepare translation, cultural adaptation, and content validity of the structured cognitive training program “NEUROvitalis

Materials and Methods: We conducted this methodological study using a standard forward- backward process. Subsequently, German translators checked the accuracy of the translation. We assessed the fluency and comprehensibility of translated material. Twelve Tehran University of Medical Sciences assessors scored each psychoeducational component, pamphlet, group game and individual exercise on a 5-point visual scale. The content validity index (CVI) was then calculated.

Results: Atotal of 12 participants (eight females, four males, aged 23–41, mean age 28.83±6.23) were included in the evaluation of comprehensibility and fluency. The CVI ranged from 0.8 to 1, which successfully validated the program’s comprehensibility and fluency.

Conclusion: The current study’s results indicate that the Persian version of the structured cognitive training program “NEUROvitalis” can be a proper, valid and comprehensive tool for cognitive training in Persian-speaking individuals aged 50 years and above

Dysarthria and Dysphagia in Traumatic Spinal Cord Injury: Frequency and Comorbidity in a Cross- Sectional Study

Saeed Sheykh Chalandari, Morteza Farazi, Zahra Sadeghi, Mehdi Norouzi — Sun, 13 Jul 2025 06:10:53 +0000

Introduction: To determine the frequency, comorbidities, and relationship between dysarthria and dysphagia in patients with traumatic spinal cord injury (tSCI).

Materials and Methods: A descriptive-analytical cross-sectional study was conducted enrolling 61 patients with tSCI from rehabilitation centers in Tehran Province, Iran between January and September 2024. Dysarthria and dysphagia were assessed using the Persian- adapted versions of the frenchay dysarthria assessment (FDA) and northwestern dysphagia patient check sheet (NDPCS), respectively. Logistic regression analysis was employed to evaluate the relationship between these conditions, with odds ratios (ORs) calculated to quantify the strength of the relationship.

Results: Dysarthria was observed in 87% of participants, with mixed dysarthria being the most prevalent subtype (34%). Dysphagia was identified in 49% of participants, of whom 49% exhibited both disorders concurrently. Logistic regression analysis indicated that patients with dysarthria were approximately nine times more likely to experience dysphagia (odds ratio [OR]=9.69, P<0.05), even after adjusting for weight and sex.

Conclusion: This study underscores the high prevalence and significant comorbidity of dysarthria and dysphagia in patients with tSCI, with dysarthria identified as a robust predictor of dysphagia. These results highlight the necessity of concurrent assessment and integrated rehabilitation approaches targeting both disorders to improve patient outcomes and quality of life

Effectiveness of an Early Occupational Therapy Intervention in Post-Surgery Carpal Tunnel Syndrome Patients

Sun, 13 Jul 2025 06:13:32 +0000

Introduction: Carpal tunnel syndrome (CTS) is the most prevalent peripheral neuropathy affecting the upper limb and carpal tunnel release (CTR) is the preferred treatment for moderate-to-severe cases. This quasi-experimental study aimed to investigate the effectiveness of early occupational therapy intervention in post-surgery patients with CTS.

Materials and Methods: Twenty women with idiopathic CTS who were candidates for surgery were recruited and assessed before surgery. After surgery, they were assigned to the intervention (n=10) or control group (n=10). The control group received standard care, while the intervention group underwent early occupational therapy intervention (10 sessions over 3 weeks). Range of motion, hand and pinch strength, and pain level were measured using a goniometer, hand dynamometer, pinch gauge and visual analog scale (VAS). The Boston carpal tunnel questionnaire (BCTQ) was used to evaluate symptom severity and hand function. We used paired sample t-tests, independent t-tests and Fisher’s exact tests to compare variables between groups.

Results: The intervention significantly improved wrist active flexion and two-point and three- point pinch strengths in the intervention group. Both groups had reduced pain intensity, with a significantly greater decrease in the intervention group. The intervention group also showed better symptom severity and functional status results, with a significantly greater improvement in symptom severity (P≤0.05).

Conclusion: Early occupational therapy following CTR is more effective than routine interventions in enhancing pinch strength and alleviating pain and symptoms. Nevertheless, randomized controlled trials are necessary to determine the duration of these benefits.