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Objectives: The Micro Manual Muscle Tester (MMMT) is a Hand-Held Dynamometer (HHD). The current study aimed to evaluate the intra- and inter-rater reliability of this device. Methods: To determine the reliability of the MMMT, two previously trained assessors to work with HHD performed HHD measurements on 7 muscle groups of the lower extremities (hip flexors, hip extensors, hip abductors, knee extensors, knee flexors, ankle plantar-, and dorsiflexors) using the make-test method. The study participants were evaluated thrice by two occupational therapists in 10 separate days. Results: All the inter- and intra-correlations were reported as excellent (ICC>0.90), except for ICC2,3 in the hip flexor muscles; and ICC2,3 in the dorsiflexor muscles that were similarly good (ICC=0.75-0.89) at a high significance level (P˂0.001). Discussion: The MMMT had an acceptable reliability. Furthermore, this device is useful for investigating changes in strength after rehabilitation interventions.

Background and Objective: This study aimed to examine the relationship between age, gender and body mass index with performance of fundamental motor skills among children aged 7-10 years. Methods: A total of 600 children aged 7-10 years from Tehran participated in this research. Body mass index was directly measured from height (m)2/weight(kg) for each child. Fundamental motor skills were assessed by using the OSU-SIGMA scale. Results: The results showed that age and gender variables had a significant relationship on walking and running skills, but BMI was not significant (P>0.05). Also age, gender and body mass index variables had a significant relationship on jumping, skipping, hopping and ladder climbing (P

Study DesignWhiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars.PurposeThe present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion.Overview of LiteratureMany studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane.MethodsTwenty-nine healthy subjects aged 18–26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm2 were used to record kinematic data. According to the normality of the data, a paired t-test was used for statistical analyses. The level of significance was set at α=0.01.ResultsAll motion significantly decreased when subjects used soft collars (pConclusionsThis study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions.

Objectives: To assess the relationship between visual rehabilitation with the quality of life and visual status in children who had been diagnosed with amblyopia in the national amblyopia screening program. Methods: Information was gathered from optometric centers in the cities of Nowshahr, Chalus, and Kelardasht, or in case it was not available, from parents of participating children. The KINDL Health-Related Quality of Life Questionnaire for Children was also completed by the children. Children were examined regarding visual acuity, stereopsis, strabismus, and refractive errors. Statistical tests such as one way ANOVA and Pearson correlation coefficient were used via SPSS software version 22. Results: Overall, the researchers obtained the records of 90 children with amblyopia, of which 76 were included in the study based on the inclusion criteria. The amblyopic children who did not have an early and timely start of treatment aid and did not complete treatment were the most prevalent group (38.2%). The lowest frequency (13.2%) pertained to those who did not have a timely start of treatment but experienced a completed treatment process. The highest proportion of children with entirely uncorrected amblyopia was those who had a timely start of treatment but did not complete the treatment. The majority of amblyopic children who had a completely corrected amblyopia had strictly acted in accordance with their therapist’s prescription. In contrast, the majority of those children whose amblyopia was left completely untreated had not acted in accordance with the therapist’s prescription. The children who had started treatment early but had not completed it obtained the lowest score on quality of life. The highest mean score was observed in the children who had completed their treatment process, either with or without an early start of the treatment. Discussion: The completion of treatment seemed to be of higher importance in the correction of amblyopia and increased the quality of life than the early start of treatment. Therefore, the authorities and therapists are recommended to pay more attention to follow-ups for completion of the treatment process and its important impact on improving eyesight and children’s quality of life.

Objectives: Autism Spectrum Disorder (ASD) is a group of neurodevelopment syndromes with impairments in social communications and restrictive or repetitive behaviors. Neurofeedback is a new method that may regulate neuro and metabolic function in brain. This study is semi-experimental, with pre and post test. Methods: In 26 children with ASD, 40 sessions of Neurofeedback were done. Brain waves were recorded before and after intervention by EEG/ERP 19 channels. Results: The average of Theta (low frequency) power decreased, but there was no difference in the Gamma of Gamma waves (High frequency). Discussion: Our findings showed that the implementation of Neurofeedback sessions improved Theta, which leads to better social communication.

Background and objective: According to the importance of effective social factors on health, in this study a model of the relation between socioeconomic status, perceived stress, social support and domestic violence with women’ depression in reproductive age in Tehran the year of 2014 was tested. Materials and methods: This sectional descriptive-correlative study was performed on 1053 women referred to the medical centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through multi-stage random sampling. For collecting the data, demographic and socio-economic status, perceived stress, perceived social support, domestic violence and Beck depression questionnaires were used. The data were analyzed using SPSS 19 & Lisrel 8.8 software. Results: Results showed that 49.7% of women had mild to severe degree of depression. The average stress score of perceived stress was 23.22±8.34, and most of them (43.1%) had moderate of social support. 70% had good socioeconomic status. 41.1% were taken domestic violence. The final path model fitted well (GFI=1; RMSEA=0.08) and showed that socioeconomic status had direct (β=- 0.20) and indirect effect (β= - 0.07251), perceived stress had direct effect (β=0.16), social support had direct(β=- 0.22) and indirect effect (β=- 0.0672), domestic violence had direct effect (β=0.20) on depression, and in the overall effect social support had the most effects on depression (β= -0.2872). Conclusion: According to the relation between all variables that investigated with depression of women, screening of these factors for prevention and diagnosis of depression in order to promote mental health and early intervention is recommended. Paper Type: Research Article.

Background: The present study aimed to provide a field-tested model of constituting factors affecting mental health in young Iranian adolescents. Materials and Methods: In this cross-sectional study, a conceptual model was proposed based on an extensive literature review. A total of 254 young adolescents aged 11–14 years were recruited from north, south, east, and west regions of Tehran megacity by a random cluster sampling procedure, of whom 244 adolescents participated. The adolescents and their mothers altogether completed eight questionnaires pertaining to the proposed conceptual model: (1) Strengths and Difficulties Questionnaire (SDQ), (2) Childhood Experience of Care and Abuse Questionnaire, (3) Child Exposure to Domestic Violence Scale, (4) Drug Abuse Screening Test-10, (5) Baumrind Parenting Style Questionnaire, (6) Conflict Behavior Questionnaire, (7) General Health Questionnaire-28, and (8) Garmaroodi Socioeconomic Status Questionnaire. The statistical analysis was performed using structural equation modeling. Results: This study demonstrated that parent mental health (b = −0.111), experience of father's care (b = −1.112), conflict with mother (b = 0.309), conflict with father (b = 0.135), and exposure to domestic violence (b = 0.217), as well as age (b = 0.93) and gender (b = 0.139), had direct effect on adolescent mental health (all P < 0.05). Further, the results showed that exposure to domestic violence and conflict with mother had the greatest direct impact on adolescent mental health among all other family-related factors, followed by conflict with father and parent mental health. Conflict with mother and conflict with father also affected adolescent mental health indirectly through experience of domestic violence and had a mediating effect for the influence of several other factors on adolescent mental health, thus playing an important role in the pathway leading to young adolescent mental health status in the Iranian population. Conclusion: Overall, the final model proved to be fit and the factors constituting the final model were able to predict 88% of the variations in the mental health of Iranian adolescents. This model can guide clinical psychologists, psychiatrists, and other mental health workers in a more realistic and effective prevention or treatment planning for their young clients. Moreover, it may help in arriving at a comprehensive preventive policymaking for mental health policymakers.

Objectives: One of the problems in the process of assessment and evaluation, especially of clinical training in rehabilitation disciplines, is the lack of an instrument with objective criteria for evaluation. Considering the effects of appropriate evaluation on quality assurance of clinical training, the aim of the present study was to design a valid and reliable tool for general evaluation of clinical training in rehabilitation disciplines. Methods: This study was a methodological research. Initially by literature review and also by holding a focus group discussion with professors of clinical training of rehabilitation disciplines who were recruited by convenient purposive sampling, the main indicators for evaluation of clinical education in those fields were determined. Then, after classification of the indicators and first evaluation tool was developed. The face validity and content validity of the tool were determined with the Lawasche's method and its reliability was determined with the test- retest method and Cronbakh's alpha coefficient in SPSS-19. Results: Content analysis of the focus group discussion resulted in 57 indices, classified in 5 categories (including: the educator, the Trainees, Administration of clinical training, field of clinical training and Evaluation of clinical training). Finally, the final tool was adjusted in two separate questionnaires. The correlation coefficient for the questionnaire of the clinical educators was 0.9, its Cronbakh's alpha coefficient was 0.88 and its content validity coefficient was 0.84. The correlation coefficient for the questionnaire of the students, was 0.7, its Cronbakh's alpha was 0.92 and its content validity coefficient was 0.81. Discussion: The tool designed for the evaluation of clinical training in rehabilitation disciplines has appropriate and acceptable validity and reliability.

Development is a dynamic and continuous phenomenon that is under the influence of various factors forming a complicated multidimensional system together. Any impairment in these factors can lead to impaired development in children, which is one of the most common problems in children. Therefore, this study provides a brief overview of these factors and the way they affect early childhood development. A brief review was performed in databases including Google scholar, PUBMED, Proquest, SID, Magiran, Iranmedex, Irandoc with following keywords: child development, income, occupation, education, employment, boy, girl, gender, sex, social class, Race and Ethnicity. All of article was reviewed then categorized based on WHO model. Among the papers reviewed, most of the studies were about employment, education, and income and most of them investigated these risk factors in terms of socioeconomic status. Structural factors of social determinants of health had a close relationship with each other, and they had affected development through each other. Given that, only few studies on structural factors, except for socioeconomic factors, have been conducted and little attention has been paid to the way these factors affect child development, further studies in this area are required to propose a model in order to better understand the interaction between these factors.

Objectives: The aim of this research was to assess the level of awareness of rehabilitation professionals employed in academic rehabilitation centers in Tehran with reference to Tele-rehabilitation technology. Methods: In this study, a descriptive cross-sectional research method was used. The research was implemented by using a researcher-designed questionnaire which was developed by the integration and cultural adaptation of different tools collected in the field of tele-health implementation feasibility. The content and face validity of the questionnaire was determined and approved by Lawsche’s method. The reliability of the questionnaire was assessed by test-retest correlation coefficient determinations. After considering the inclusion and exclusion criteria, informed consent was obtained, and the questionnaires were distributed among the study sample, which comprised of 141 rehabilitation professionals. Results: The findings show that a desirable level of awareness does not exist among rehabilitation professionals with regards to this technology. Based upon the results, only 8% of the participants had basic knowledge of this technology required in case of implementation. Discussion: Since rehabilitation professionals’ awareness and knowledge can be a major key to a better implementation and application of this technology, it seems that there is a need for some developmental and training programs, such as informative educational workshops and seminars, to help them improve their level of knowledge and awareness.

Background: Given the significant health effects of domestic violence against women, the present study was conducted in 2016, in Tehran, Iran in order to compare the socioeconomic status, perceived social support and mental status in women of reproductive age experiencing and not experiencing domestic violence. Methods: This descriptive-analytical cross-sectional study was conducted on 500 women. The data collection tools used included questionnaires: demographic information, Socioeconomic, Beck’s Depression, Spielberger’s Anxiety, Cohen’s Perceived Stress, Sarason’s Perceived Social Support and WHO’s Domestic Violence Inventory. Results: The results showed that 43.2% of women said they had experienced at least one case of domestic violence, among which 16.4%, 15% and 36.6% of women had experienced physical, sexual and emotional-verbal types of violence, respectively. The mean age (p less than 0.001) and educational level (p=0/018) of violated women and their spouses (p less than 0.001) were lower than those of non-violated women. Furthermore, violated women experienced lower socioeconomic status (p less than 0.05), higher perceived stress (p less than 0.008), higher depression (p less than 0.001), and higher overt anxiety (0.002. They also perceived lower levels of social support (p less than 0.001). Conclusions: The issue of domestic violence was rather prevalent in the participants of the present study, particularly the younger, less educated and more socioeconomically deprived communities and families.

Introduction: This study intends to determine the needs assessment of rehabilitation specialists for training in child development (0-8 years old).Material and Methods: This study is a cross -sectional, descriptive- analytic. At the first, a questionnaire was made for the assessment of the knowledge and skills of the specialists that work in the rehabilitation team of the children with developmental disorders (occupational therapy, speech therapy, physiotherapy, technical orthopedics, preschool children education, audiometry, social working and psychology of children with special needs). The content and face validity and reliability of the questionnaire were determined. Then 400 rehabilitation specialists fill in the questionnaires. After data collection and analysis, the needs of these specialists were determined.Results: The Cronbach's Alpha of questionnaire was 0.93, which was good. One hundred and four persons (43.2%) knew the most necessity to skill increasing in normal children development indexes as the first priority. Sixty-four persons (26.1%) knew the most necessity in primary prevention methods from developmental disorders as the second priority and 66 persons (27.2%) knew the methods of early detection and intervention in developmental disorders as the third priority. One hundred and twenty five persons (45.1%) knew the most necessity to knowledge increasing in normal children development indexes as the first priority. Seventy- six persons (27.4%) knew the most necessity to the methods of early detection and intervention in developmental disorders as the second priority and 74 persons (26.2%) knew the primary prevention methods from developmental disorders as the third priority.Conclusion: It is necessary to plan and perform training of the different rehabilitation specialists for increasing the knowledge and skills in children development themes that they have sensed as the most necessities.

Objective (s): The purpose of this study was to compare quality of life among rural and urban elderly outpatients attending the Imam Sajjad Hospital of Shahryar during 2010-2011.Methods: This was a cross-sectional study of a sample of 203 rural and urban elderly outpatients. HRQoL was measured using the Short Form Health Survey (SF-36). Data were analyzed using student t-test, ANOVA, and regression analysis in order to indicate the major quality of life determinants.Results: In a step-wise regression analysis gender, age and employment had significant effect on physical functioning. For role physical, education; for bodily pain, education, gender and living area; for general health, gender and employment; for vitality, employment; for social functioning, employment; for role emotional, living area; and for mental health, gender had a significant effect on quality of life.Conclusion: Overall the findings suggest that the urban and rural environment do not have significant effect on health-related quality of life.

The prevalence of childhood obesity is a serious public health problem. This problem is a multi-component disease and several factors are involved in its development. The childhood obesity led to poor mastery of fundamental motor skills (FMS) and failure to develop in specialized skills that required in organized sports and activities. Thus, the purpose of this study was to examine the relationship between age, sex and body mass index (BMI) with FMS in 3 to 6 years-old children. A total of 600 preschool children (300 boys and 300 girls) between the ages of 3 to 6 years old participated in this research. Subjects were selected through multi-stage cluster random sampling in five regions in Tehran. Using the Ohio State University Scale of Intra Gross Motor Assessment (OSU-SIGMA) FMS were assess. Body mass index (BMI) was directly measured from height (m)2/weight (kg) for each child. The results showed that the negative correlations between jumping, skipping, hopping and throwing skills and BMI in any 3 groups children were significant (P0.05). The boys were performed better than girls in all FMS except hopping and skipping skills. In these skills the girls were better performed in all ages. These results highlight the need to provide organized opportunities which facilitate FMS and decreased high BMI levels in preschool children.

Objective(s): To identify the validity and reliability of Denver Developmental Screening Test II (DDST II) in Iranian children, in order to provide an appropriate developmental screening tool for evaluation of Iranian children development.Methods: A precise translation of the original test to Persian was done and it was revised by three developmental pediatricians. Then, DDST II was performed on 221 children aged 0 to 6 years, in four child health care centers of Tehran city. Available sampling was used. In order to determine agreement coefficient, these children were also evaluated by ASQ test in 4-60 months old children, and by developmental pediatricians in children who were out of this range. Obtained data was analyzed by SPSS software.Results: There were developmental disorders in 34% and 12% of children who were examined by DDST II, and ASQ test respectively. The estimated consistency coefficient between DDST II and ASQ was weak (0.21), and between DDST II and physician’s examination was 0.44. All of the questions in DDST II had content validity, and there was no need to change them. Test-retest and interrater methods were used in order to determine reliability of test, and Cronbach’s α and Kauder-Richardson coefficients. Kauder- Richardson coefficient for different developmental domains was 61- 74%. Kappa measure of agreement for test-retest and interrater were 87% and 76% respectively.Conclusion: DDST II has a good validity and reliability, and can be used as a screening tool for developmental screening of Iranian children, but it is necessary to prepare and standardize of diagnostic developmental tests in Iran due to the low and medium consistency coefficient between DDST II and ASQ and physician’s examination respectively.

Objectives: Massage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of wedish massage on abnormal reflexes in children with spastic cerebral palsy (CP). Methods: This study was a single blind clinical trial conducted on forty children with spastic CP who were recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. The routine occupational therapy (OT) techniques were performed during a 3 month-period in both groups. The intervention group also received Swedish massage for 30 minutes before every OT session. Primary, spinal, brain stem, midbrain, cortical and automatic reflexes were evaluated at the beginning of the study and 3 months later. The data analysis was done by parametric and nonparametric tests. Results: Finally, thirteen subjects in the intervention group and 14 subjects in the control group were remained and studied. The average ages in the intervention and control groups were 49.5 and 42.1 months respectively. There were no statistically significant differences in abnormal reflexes in the intervention group in comparison to the control (P>0.05). Discussion: Adding Swedish massage to traditional OT techniques had no significant effects on abnormal reflexes in children with spastic cerebral palsy. Evidently more research is required in order to completely reject the effects of Swedish massage on abnormal reflexes of children with CP.

Introduction. This study aimed to assess rehabilitation professionals’ attitude toward implementation and application of telerehabilitation technology as a novel study in rehabilitation academic centers and affiliated clinics in Tehran.Methods. It was a descriptive cross-sectional study. To collect data, a researcher-designed questionnaire was developed. 141 rehabilitation experts participated in the study.Results. A majority of faculty members (78%) and clinicians (89.7%) either were in “definite agreement” or “somewhat agreed” with implementation and application of this technology, which demonstrates an overall positive attitude.Discussion. Based on the positive attitudes of the majority of participants toward implementation and application of this technology and their preferences in offering different telerehabilitation services, it seems that there is an appropriate and desirable acceptance and administrative culture to implement this technology among rehabilitation experts in Tehran. It is thus expected that implementation and application of this technology will be a promising experience in rehabilitation academic centers and affiliate clinics in Tehran.

Objectives: Quality of life, when referring to an individual’s health, is called health-related quality of life. The purpose of this study is to assess self-perceived hearing loss related quality of life of adolescents with hearing loss and its relationship with sex, age sub-groups or school settings with domains of quality of life. Methods: A school based survey was conducted in Tehran city. Using stratified sampling, 255 7th to 12th grade students with hearing loss, aged 11-19 years, studying in main streaming and special school sitting, were participated in the study by completing the health-related quality of life adolescent’s questionnaire. Physical, Emotional and Social health-related quality of life domain scores as well as Total health-related quality of life scores was calculated in a 0-100 scoring system. Results: As a whole, health-related quality of life of adolescents calculated to be 64.7±16.5. Students with milder hearing loss reported their quality of life (physical, emotional and social domains, as well as total quality of life) better than those with more severe hearing loss. Girls reported their physical and total health-related quality of life better than boys, and adolescents who were studied in mainstreaming reported better physical, social and total health-related quality of life. No significant differences were seen between reported health-related quality of life in early, mid or late adolescent age sub-groups. Nevertheless the power of tests was not enough to exclude differences between groups. Discussion: Findings of this study could be readily used to focus interventions on domains with more weakness in each group of adolescents. Beyond that the results could be helpful as a base line for detecting effectiveness of interventions in future.

Objectives: Regarding the type of service receivers as well as the technicality of the services provided, these services often bear high complexity and difficulty which can eventually lead to job burnout and shortage of motivation in the staffIn this study, the factors affecting job motivation from the viewpoints of staff and managers of Semnan Welfare Organization have been identified and possible differences have been analyzed. Methods: In the present study, based on Herzberg’s model of job motivation and considering several assessment tools produced according to this model, a draft of a researcher-designed questionnaire was prepared in order to determine the factors affecting job motivation in the staff and managers of the State Welfare Organization in Semnan province. The content and face validity of the questionnaire was determined and approved by 10 experts, 5 managers and 15 staff members of the Semnan Welfare Organization who were selected purposefully, using the Lawsche’s method. The reliability of the questionnaire was assessed and approved by test-retest correlation coefficient determination. After informed consent was obtained, all staff and managers conforming to the inclusion criteria were invited to participate in the study and to complete the questionnaire. Results: In contrast to Herzberg’s theory which considers intrinsic factors as more important than extrinsic factors in causing motivation, our results demonstrated that staff and managers of Semnan Welfare Organization believed extrinsic factors provoked higher motivation. Discussion: The major motivation factors for staff and managers of Semnan Welfare province were somehow related to management practices of managers and staff, both of which are categorized as extrinsic factors.

Objectives: Speech and language development is one of the main aspects of evolution in humans and is one of the most complex brain functions such that it is referred to as one of the highest cortical functions such as thinking, reading and writing. Speech and language disorders are considered as a major public health problem because they cause many secondary complications in the childhood and adulthood period which affect one’s socioeconomic status overall. Methods: This study was conducted in two phases. The first phase was to identify all potential factors influencing delay in referral of children with speech and language disorders for receiving rehabilitation services, based on literature as well as the families’ and experts’ points of view. In the second phase of the study which was designed in a case-control manner, actual factors influencing the time of referral were compared between two groups of participants. Results: Parental knowledge of their children's problems related to speech and language had no significant impact on the on-time referral for treatment for children with speech and language disorders. After the child definite diagnosis of speech and language disorders, parents’ information about the consequences of speech and language disorders, had a significant influence on early referral for speech and language pathology services. Discussion: In this study family structure plays an important role in the early identification of children with developmental disorders. Two-parent families had access to more resources than single-parent families. In addition, single-parent families may be more involved in the work and business of life.