Objective: Two point discrimination (2PD) test is a sensory functional test that is both available and valid. This test is used in hand injuries and neurological examination, whose perception takes place in the sensory cortical region.

Materials & Methods: In this study 2PD test was evaluated in 240 normal and blind boys and girls in the range of 10-20 years in Tehran (Cross-sectional descriptive analysis). This test was evaluated on right and left hands by on instrument results.

Results: The 2PD value of the normal subjects were greater than that of the blind subjects (specially at age 10-Th). The boys’ 2PD values were greater than girls. At age 20 years, the value of 2PD was greater than that of l0-th years. The 2PD value in dominant hands was greater than that of the undominant hands.

Conclusion: The hierarchy of the accuracy of the results in the different regions of the hand is as follows: Thumb / Index / Little / Ring / Middle.

Objective: Despite numerous advances in our understanding of the anatomy, Biomechanics, nutrition and Healing, the result Following Fiewor Tendon repair Shiow relatively high rate of failure the purpost of this study was to compare the result of 50 digits treated by either ‘‘Early active mobilization’’ or ‘‘controlled passive mobilization’’ re gimen in Ivan hand rehabilitation center.

Materials & Mathods: Pationt being matched for gende, age, injuries hand, technique of srgery (all with eqitenon first, four strand) in two groups. They were assessed 8 week postoperatibg in respect of total active motion, flexion gap and extension lags. Outcome were defined using ‘‘Strickland’’ and ‘’ Buck – Gramko’’ criteria.

Results: The result were 80% excellent and good, 20% fair and no poor in early active motion group and in second group 40% excellent and good, 44% fair and 16% poor due to Strickland criteria. In buck-grancko criteria 52% extension and good, 32% fair and 16% were poor. Mean of total active motion was significantly greater in early active motion group (in E.A.M.150/2, in passive group: 116/41).

Conclusion: Actively mobilized tendon underwent intrinsic healing without large gap formation. Active motion generated bith tension and motion and offer several advantage over passive motion: improved tendon nutrition, less adhission, higher rate of healing, increased ultimate rang of motion. So early active motion is the best protocle for treating tendons in zons 2 our result is comparable with theory.

Objective: In patients with lateral epicondylitis present of pain and decrease of grip strength are essential problems. Use of splint have major rule in treatment these patients that causes relief of pain and increase of grip strength. Both taping technique and counterforce brace are two methods of treatments of lateral epicondylitis patients but we were not sure which method could be more useful and Answer of this question is magor aim of this study.

Materials & Methods: This study is a Quasi experimental. We selected 30 patients between 30-55 years conveniently and divided them in two groups simple randomized. 

Results: In grip strength test, the average difference between two methods was t = 1/92 which showed there is not significant. So, there isn't any difference between two methods on grip strength. In assessment of pain, we tested patients in two positions: first patient's hand was in comfort position, second in which when wrist of hand was in extension position. In both of position, that average difference between two methods (first t = 3/78 and secondary t = 3/2) found to be significant. Choose of method in such treatment is considered to be important.

Conclusion: taping technique is more effective than counterforce brace to relief of pain of patients with lateral epicondylitis, but in grip strength no difference between two methods.

Objective: Giving birth and training to a child with Mental Retardation (MR) can be stressful for mothers. Therefore mothers need role models and adequate preparation to effectively teach the child to function at optimum level within the environment. Nurses are in a strategic position to assume a vital role in a assisting these mothers. With observation, problem solving, and decision making. There is a lack of studies about mothers' experiences of having a child with MR. This study was preformed to investigate mother's experiences of having a child with MR and how explore and describe the experienced mothers with mental retarded child.

Materials & Methods: A phenomenographic approach was used. The study was preformed at an exceptional school in Tehran. Twelve mothers were interviewed using guided interviews.

Results: From 336 thematic sentences, Six categories emerged, the first having three subcategories and the second having twenty subcategories., the third having three, the fourth category having six, the fifth having two, and the sixth having two subcategories. Mother's experiences of having a child with MR, describes informants a variety of feelings, often ambivalent (acceptance and UN acceptance). In such a situation, attention to God and prayer are the most important coping strategies for positive adaptation in mothers' experiences of having a child with MR, but this perception can not effect to accept him alone. They emphasis on educational and psychological needs for better life.

Conclusions: The findings of this study could be used in mothers education to promote understanding of mothers’ experiences and how best to help them. They could also be used in the general media to improve public understanding.

Objective: This study aimed at determing psychopathology and personal and relationship problems in violent husband.

Materials & Methods: In this cross – sectional study 230 male were selected through a multi clustral sampling from four different regions of Tehran. Then they completed Conflict Tactics Scales-2, personal and relationship Profile and Symptoms Check list-90-Revised. Based on their response to Conflict Tactics Scales-2, they were devided in to two groups. Then the psychopathological profile and personal and Relationship problems were compaired.

Results: Psychopathology, personal and relationshoip Profile were drawn. It showed that violence is associated with Psychopathology and excessive personal and relationship problems in violent husband (P&le0/05).

Conclusion: Violent husband in compare with nonviolent husband have more severe psychological symptomathology and more personal and relationship problems.

Objective: The results of sensory improvement from nerve repair in adult are often poor. To confirm with previous results and this hypothesis that forearm deafferentation would enhance the sensory outcome by increasing the cortical hand representation, this study is aimed to investigate the effect of repeated sessions of cutaneous forearm anaesthesia of the injured limb, in combination with sensory re-education on the sensory outcome in the hand after median or ulnar nerve repair.

Materials & Methods: This experimental study was designed as a double-blind randomized clinical trial. 13 patients that they had been undergoing surgery of hand nerves repaire were selected probability and assigned to examination (n=6) and control (n=7) group. During a 2 week period, a topical anaesthetic cream (Lidocaine) for examination group and a placebo for control group was applied repeatedly (twice a week) for 1 hour onto the flexor aspect of the forearm of injured hand and combined with sensory re-education. Assessments of sensory function were performed prior to the experiment and after the fourth application of Lidocaine/placebo. For analysis of data, Wilcoxon singed rank and Mann - Whitney U-tests were used.

Results: Perception of touch that was measured with SWMs, had been improved significantly in the Lidocaine group in comparison with placebo group (P=0/03).

Conclusion: This finding suggests that forearm deafferentation of injured limb, in combination with sensory re-education, can enhance sensory reover after nerve repair.

Objective: Gross motor activities ability or disability influence on children cognitive performance and their social behavior. This study is aimed to investigation the effect of gross motor activities on attention process (sustained attention, attention shift) of boy students with Down syndrome who are 8 – 12 years old.
Materials & Methods: In this interventional and experimental study, 26 boy students with Down syndrome from 4 schools (Shahid Beheshti, Ahya, Peydayesh and Piroozi) were selected and administered by attention tests(sustained attention , attention shift) and Lincoln Oseretsky development scale. Then they were assigned into two groups randomly. Intervention group received gross motor activities programs for 8 weeks (2 times in a week). Then two groups were administered by attention tests and Lincoln Oseretsky development scale again. Data were analyzed by using paired T-test and Independent T- test.
Results: There was no significant difference in control group in attention tests between before and after intervention (sustained attention P=0.654, attention shift P=0.163) and Oseretsky development scale (P=0.337), but significant differences were observed in intervention group (P<0.001). Score of decreasing interruption of task revealed that there were significant differences in intervention (P<0.001) and control group (P<0.001).
Conclusion: Gross motor activities interventions significantly affect on the process of attention (sustained attention , shift attention) in students with Down syndrome.

Objective: Active straight leg raising (SLR) test is advocated as a valid diagnostic method in diagnosis of sacroiliac joint (SIJ) dysfunction that can assess the quality of load transfer between trunk and lower limb. The aim of this study is Comparison of changes in tonicity and activity of pelvic stabilizer muscles during active SLR, between healthy individuals and patients with sacroiliac joint pain.

Materials & Methods: A case – control study was designed in 26 women (19-50 years old). With use of simple sampling, surface electromyography from rectus abdominis, external oblique, internal oblique, adductor longus, erector spine, gluteus maximus and biceps femoris was recorded in 26 subjects (15 healthy females and 11 females with sacroiliac pain) in resting position and during active SLR test. Resting muscle tonicity and rms during ramp time and hold time in active SLR test were assessed by non parametric-two independent sample test.

Results: Biceps femoris activity in resting position was significantly larger in patients group (P<0.05). During the active SLR, the women with sacroiliac joint pain used much less activity in some pelvic stabilizer muscles compared to the healthy subjects (P<0.05).

Conclusion: The increased resting tonicity of biceps femoris and decreased activity of pelvic stabilizer muscles in subjects with sacroiliac joint pain, suggests an alteration in the strategy for lumbopelvic stabilization that may disrupt load transference through the pelvis.

Objective: To determine the reliability of the Persian translation of the Manual Ability Classification System (MACS) between parents and therapists in children with cerebral palsy (CP).

Materials & Methods: After the forward and backward translation procedures and investigation of face and content validity, inter-rater reliability was assessed between parents and occupational therapists using the intra-class correlation coefficient (ICC) and the weighted kappa coefficient. 100 Children (4 to 18 years, mean age 85.15 months 63 boys, 37 girls) with various types of CP were classified according to MACS by both parents and therapists. Additional data on the Gross Motor Function Classification System (GMFCS), intellectual delay, visual acuity, auditory acuity and epilepsy were collected.

Results. The inter-rater reliability was high the ICC was 0.96 (ranged from 0.94 to 0.97) among occupational therapists and parents .Total agreement there was between the GMFCS and the MACS.

Conclusion. The Persian version of the MACS is found to be reliable between parents and therapists, and is suggested to be appropriate for the assessment of manual ability within the Iranian population.

Objective: Stuttering is a disorder that can cause serious personal, emotional and social problems. Based on its pathophysiology, different treatment approaches to stuttering are controversial. Behavioral treatment has been shown to be effective for stuttering.

  In this study were mentioned to effectiveness of Simplified Habit-reversal as a behavioral approach for treatment of stuttering in Iranian children.

Materials & Methods: Twelve students participated in this study was selected from 350 stuttered children in schools. After baseline assessment in three setting, simplified Habit -reversal was done for the children. Assessment (baseline) , treatment and booster sessions were done in the subject’s home, school and clinic Assessment sessions were done at first -2^nd-3^th-4^th-6^th-12^th-13^th months after treatment. Post hoc tests were done by using paired t-test. Level of significance were considered equal on lest their 0.03

Results: Stuttering frequency was decreased in multiple assessment at home (P<0.03).these changes was observed in two other setting (P<0.02 in school, P<0.03 in clinic). there is no significant relation between decreasing of stuttering frequency and setting (P=0.73). decreasing of stuttering frequency had no relation with demographic variables (P>0.05).

Conclusion: Future researches about effectiveness of this method, especially in older cases and cases with co-morbidity in both sexes, are recommended.

Objective: To determine the cross-cultural validation and test-retest and inter-rater reliability of the Persian translation of Parent version of the Gross Motor Function Classification System (GMFCS) for children with cerebral palsy (CP).

Materials & Methods: 90 Children (2 to 12 years, mean age 6.6 years 57boys, 33girls) with various types of CP were classified according to GMFCS by parents.After the forward and backward translation procedures, face and content validity and test–retest reliability between parents and inter-rater reliability between parents and therapists was assessed using the intra-class correlation coefficient (ICC) and the weighted kappa coefficient.

Results: The ICC was 0.92 and showedexcellent agreement and the weighted kappa coefficient was 0.61 andshowed good agreement. The inter-rater reliability was also high the ICC was 0.88 with excellent agreement and the weighted kappa coefficient was 0.68 and with good agreement.

Conclusion: The Persian translation of Parent version of GMFCS is found to be valid and reliable, and is suggested to be appropriate for the assessment of gross motor function within the Iranian population.

Objective: The aim at this study was the comparison of balance indices between professional athletes with patellofemoral pain syndrome (PFPS) and healthy athletes.

Materials & Methods: In this comparative and Case-Control study, 16 national teams’ male athletes who were selected purposefullyand 16 healthy national teams’ male athletes who were matched based on variables such as weight, height, age, sport, predominance of the lower limbs, have participated. The Biodex balance system was utilized to assess postural balance as overall stability, anterior-posterior and mediolateral stability indices in open and blind conditions on dominant limb. The K-S test has been used to examine the normality of distribution, while the independent T for comparing the target groups.

Results: There was a significant difference between two groups in the open situation only for the overall stability index (P<0.05). In addition, there was a significant differences between the blind condition of both overall stability index (P<0.004) and the anterior-posterior stability index (P<0.01). There was no significant relationship between the other variables.

Conclusion: May be the dynamic stability indices in the athletes with PFPS have been distorted due to ineffectual activity of muscles.

Objective: The aim of study was to design a valid and reliable tool for assessing the occupational therapists’ clinical competency.

Materials & Methods: It was a tool-making study. Many clinical competency statements were extracted from evidences and with two expert-panels helped to emerge a questionnaire with sixty-six statements in seven categories. Face and content validity were confirmed by Lawshe method. Reliability was confirmed by pilot study, test-retest and internal consistency.

Results: Occupational therapists’ clinical competency assessment tool was made with 54 questions in seven categories (critical thinking, practice process, effective communication, professional responsibilities, management of practice environment, practice knowledge, engage in professional development). Face and content validity confirmed by 15 experts CVR=0.84. Reliability (stability) was approved by pilot study, test-retest and Pierson correlation coefficient 0.995 and Cronbach’s alpha 0.973 confirmed internal consistency.

Conclusion: Appropriate tool to assess the occupational therapists’ clinical competency was made with 54 statements in seven categories. Its validity was approved by Lawshe method and reliability was approved by pilot study in 30 people.

Objective: Sensory systems including proprioceptive, vestibular and visual network play an important role in motor control. Loss of information from each sensory channel can cause body sway on static positions.

Materials & Methods: Seventeen blind children (9 girls, 8 boys) and 30 deaf children (14 girls, 16 boys) participated as the sample groups in Ardabil city. Sixteen normal children (30 girls and 30 boys) also selected as the control group. One leg standing and tandem stance tests (reliability=0.87-0.99) in two condition (eyes open and closed) was used for static balance evaluation. One-Way ANOVA and LSD post hoc test was used to compare groups, and independent t-test was used for comparing sexes in each group by using SPSS (16 version) software.

Results: results showed there is no significant difference between blind, deaf and normal girls in any of the balance tasks (p>0.05). While the balance function of deaf and normal boys was better than blind boys in all balance tasks except for tandem stance with eyes closed (p=0.507). Blind girls were better than blind boys in all balance tasks (p=0.05, p=0.02, p=0.02). Deaf boys were better than girls with deafness in one leg stance and tandem stance (eyes open) tasks (p=0.04, p=0.02, p=0.04) but there was no significant different between deaf boys and girls in any other tasks (p=0.63, p=0.29, p=0.89). Normal boys have better performance than girls and only in tandem stance (eyes closed) (p=0.21) and one leg stance (left foot eyes open) (p=0.99) there was no significant difference between normal boys and girls.

Conclusion: findings showed that static balance in deaf and normal children were better than the blinds. Since persons with blindness are not able to compensate the visual loss for postural stability, they show decreased postural stability in static conditions. Inclusive identifying effective factors on balance and its weakness and problems in appropriate time, attention to this factors in training programs for improving balance in sensory impaired children especially the blinds, through specialists, and attending to their physical activity in school is suggested.

Objective: The purpose of the present study was to assess the reliability of PASS in evaluating the self-care skills of patient suffering from multiple sclerosis.

Materials & Methods: The present study is an analytic-descriptive study in which 30 adults suffering from multiple sclerosis (MS) underwent reliability evaluation of PASS in Tehran city with an interval of two weeks. Participants were selected using stratified sample selection method. ICC (Intraclass Correlation Coefficient) was utilized to investigate the repeatability of PASS.

Results: ICC for reliability of the test in ADL was 96%, 96%, and 94% for independence, safety, and outcome respectively (P<0.001). The values for IADL were 96% for independence, 98% for safety, and 95% for outcome (P<0.001). Correlation coefficient for mobility was 99% for all 3 aspects of independence, safety, and outcome (P<0.001). The coefficient for self-care was 97%, 98% and 95% for the 3 aspects of independence, safety, and outcome respectively (P<0.001).

Conclusion: These results were indicative of very high reliability of PASS in all 3 aspects of independence, safety, and outcome for adult patients with MS. It can be used as an appropriate tool for research as well as clinical purposes.

Objective: The purpose of the present study is to identify factors influencing students' participation in the process of teaching -learning from the perspective of faculty members of Social Welfare and Rehabilitation Sciences University, Tehran.

Materials & Methods: This study was a descriptive study survey which was carried out on 116 faculty members using a researcher-made questionnaire. The data were analyzed by one way ANOVA with Bonferroni test for repeated measures on SPSS 16.

Results: The findings indicated that the mean scores of teachers in each of the areas of student participation (mean 23.2 SD=2.8), the quality of interpersonal communication students (mean 25.1 SD=4.1), thinking styles of teachers (mean 24.2 SD=3.4), the quality of working life of teachers (mean 23.3 SD=4.1) and faculty attitudes towards vocational factors of students' participation in the teaching - learning process (mean 26.1 SD=3.1) are significantly different (P>0.05).

Conclusion: According to the results of study, it can be stated that areas of faculty attitudes towards professionalism and quality of interpersonal communication of students have the greatest impact on students' participation in the teaching–learning process.

Objective Caregivers of children with cerebral palsy (CP) are faced with many challenges in self-care, treatment follow-up, educational care, and personal leisure time. Therefore, they should be trained for resolving their needs during caregiving. This study aimed to determine the priority of needs of mothering handling training for family caregiving of children and youth with CP at home based on the family-centered approach.
Materials & Methods This cross-sectional study was performed on 186 children with CP (aged 4-12 years) from the rehabilitation clinics in the city of Arak. The participants were chosen by a convenience sampling strategy. Clinical tests such as the Manual Ability Classification System (MACS) and the Canadian Occupational performance measure were used to assess the level of fine motor function and determine the priority of needs of children with CP, respectively. The data were analyzed using statistical tests including two-way ANOVA.
Results In this study, there were 89 girls and 97 boys with CP with a mean age 7.52+2.38 years. The CP types were as follows: spastic (67.7%), dyskinetic (13.9%), ataxic (5.9%), and hypotonic (4.8%). The most important priority of needs of mothering handling training was self-care and care related to children with CP in the level of V of MACS. The results showed that the priority of needs of the mothering handling training based on occupational performance (self-care, productivity and play/leisure) were toileting in the level of IV of MACS. There were no significant differences in the priority of needs of the training in the areas of sex and level of fine motor function (P>0.05); however, there were significant differences in age and self-care (P<0.05).
Conclusion The results showed that the highest priority of needs of mothering handling training was self-care, feeding, toileting, and functional mobility. However, the needs of mothering handling training enhanced with increasing severity of fine motor function lesions and age. The simultaneous relationships between age and MACS levels in children with CP have no effect on the priorities of mothering handling training. Organized training of families and caregivers about needs of mothering handling training and proper care of their children are facilitating steps in promoting the education of mothers of children with CP. It seems that the understanding and education of mothering handling for therapists responsible for managing children with CP and the education of their parents can open the way to effective caring and treatment.

Objective Stroke is one of the most important causes of disability worldwide. Fear of falling is one of the consequences of stroke that could decrease the quality of life. It presents in the patients who have fallen as well as in patients had not experienced a fall. Fear of falling is essential because of its impact on physical and mental health and even the quality of life. In addition to adverse effects of fear of falling on the patient, it may have a significant impact on the family quality of life. There are few published studies about the fear of falling after stroke, but given its significant implications for quality of life in patients, more studies are needed to improve the knowledge about the correlation of fear of falling and quality of life. The findings could help identify people at risk and also develop the prevention strategy in the management of fear of falling and quality of life. Previous studies assessed the acute and subacute patients with stroke and the authors could not find any research conducted with chronic subjects. Also, they measured the correlation between fear of falling and personal characteristics of participants and there is lack of evidence about the correlation between fear of falling with the rate of falling, postural control and SF-36. The objective of the current study was to examine the relationships between the fear of falling and rate of falling, balance, and quality of life in patients with chronic stroke. 
Materials & Methods The subjects (n=44, 20 males and 24 females) were selected based on the convenience sampling method from the patients who referred rehabilitation clinics. The inclusion criteria were individuals within at least six months after the stroke, unilateral signs, ability to walk independently and the exclusion criteria were metabolic or rheumatologic disease, lower extremity deformities, cognitive impairments and visual impairments. The participants completed a demographic form consisting of age, gender, height, weight, comorbidities, education, and the duration of the stroke, affected side, dominant side and rate of falls in last year. The fear of the falling and quality of life was measured using Fall Efficacy Scale- International and SF-36, respectively. Functional reach test and timed up and go were conducted for balance assessing. The Spearman's correlation was used to find whether there are significant relationships between fear of falling and other variables. 
Results The Pearson analysis showed correlation between Fall Efficacy Scale- International and timed up and go (P<0.001) and Functional reach test (P=0.03) scores and some subscales of SF-36 including physical functioning (P<0.001), role limitations due to physical health (P<0.001) and physical component (P<0.001).However, this association was not observed with the rate of falling (P=0.015), pain (P=0.42), general health (P=0.12), energy (P=0.09), social function (P=0.30) and role limitations due to emotional problems (P=0.24) and metal component (P=0.41).
Conclusion The findings of the present study demonstrated the correlation between balance, physical dimensions of quality of life and fear of falling in patients with stroke; however, the rate of falling has no association with fear of falling.

Objective Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disorder of the Central Nervous System (CNS) and it is also the most common cause of non-traumatic neurological disability in young adults. MS in women, especially young women, is about 1.5 to 3 times more common than men all over the world. About 2.5 million people worldwide are suffering from MS. The destruction of myelin in certain areas exhibits certain signs and symptoms. Balance disorders are particularly problematic because they are associated with difficulty in moving from one position to another, sustaining an upright posture, and performing functional activities such as walking and turning, all of which predisposes people with MS to the loss of equilibrium and falls. Isfahan City in Iran suffers from a high prevalence of MS that put it amongst the regions with the highest prevalence of MS in Asia and Oceania. This study aimed to use the holistic approaches of occupational therapy to investigate the physical and cognitive factors (attention, cognition and muscle strength of lower extremities) that affect the gait of MS patients in the city of Isfahan, Iran.
Materials & Methods The present study was a descriptive-correlational one and convenience sampling method was used to recruit the samples. The study population consisted of all patients with MS in Isfahan City in August 2017. A group of 70 patients (24 males and 46 females with the Mean±SD age of 32.20±7.55 y) met the inclusion-exclusion criteria and were enrolled in the study. To be eligible for the study, the patients had to meet the following inclusion criteria: having a neurologist-confirmed diagnosis of MS with MRI scan, being able to read and write, and walk at least 100 m independently. We excluded patients with cognitive impairments that might hinder understanding of the tasks to be accomplished, those with any comorbid neurologic condition other than MS, and those who are unwilling to collaborate with the research process. After providing sufficient information about the research process and getting informed consent of the patients, the questionnaires and tests were provided to the participants to be completed. The study tools were the Mini-Mental Status Examination (MMSE), 10 m Walking Test (10 MWT), Timed Up and Go test (TUG), Sit to Stand test, and Stroop test. For data analysis, the Pearson correlation coefficient and multiple regression analysis were performed in SPSS version 16.
Results In this study, 70 patients suffering from MS participated. The results showed a significant negative correlation between the scores of walking speed test (10 m walking) and the scores of the functional strength of the lower extremities muscles (P<0.001) and attention (P=0.01). There is also a significant correlation between muscle strength of lower extremity and balance (P=0.01). Regression analysis shows that the muscle strength of lower extremities has the highest contributions in predicting the speed of walking in patients with MS. 
Conclusion According to the study findings, among the physical and cognitive factors affecting gait and balance such as muscle strength of lower extremity or cognition and attention, the muscle strength of lower extremity is the most important factor affecting the balance and speed of walking in patients with MS that still can walk. In the process of rehabilitation, especially in occupational therapy, special attention must be paid to a muscle strengthening program for the lower extremities of patients suffering from MS.