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Volume 10, Issue 2 (7-2009)
Objective: The proprioception is important and determinant in dynamic stability of glenohumeral joint of overhead thrower in the presence of significant capsular laxity and excessive range of motion. The purpose of this study was to compare the joint position sense and kinesthesia between female volleyball players and non-athlete females in order to evaluation of their proprioception.
Materials & Methods: By simple and convenient sampling 15 female volleyball players were selected from Tehran first grade teams. Also, 15 non athlete females were selected and matched by athletes and participated in this comparative and case-control study. Joint position sense and kinesthesia was measured by continuous passive movement (CPM) Fisiotek HP2 equipment. Data were analyzed by Independent T test.
Results: Volleyball players demonstrated a significantly greater external rotation (P=0.035) and lower errors on joint repositioning test (P=0.017), but there was not significant difference in shoulder kinesthesia between two groups (P=0.392).
Conclusion: Female volleyball players exhibited improved joint reposition abilities at external rotation mid range of motion in comparison with non-athletes females. The throwing shoulder requires the pitchers to repeatedly subject their shoulder to repetitive , forceful, circumduction motions , resulting in neuromuscular adaptation and improved proprioception.
Volume 16, Issue 1 (4-2015)
Objective: The purpose of the present study was to investigate of the efficacy of group play therapy on the social skills of pre-school hearing-impaired children.
Materials & Methods: The present research was a semi-experimental study with pre-test, post-test design and control group. The participants were 30 male hearing-impaired children from pre-schools centers in Varamin and Gharchak provinces using an available method. Subjects were randomly divided into experimental and control groups, each group consisting of 15 children. The experimental group received 12 sessions of group play therapy and the control group did not. The instruments were done using the Raven coloure progressive matrices test and social skills rating scale. The data were recorded and statistically analyzed using MANCOVA.
Results: The results of MANCOVA showed that group play therapy had a significant effect on the social skills of hearing-impaired children (P<0.001). The results also revealed that group play therapy had a positive and significant effect on all subscales of social skills in these children: cooperation, self-assertiveness and self-control (P<0.001).
Conclusion: Group play therapy can improve the social skills of hearing-impaired children. It is recommended that planning play therapy for hearing-impaired children receives serious attention .
Volume 17, Issue 3 (11-2016)
Objective Communication deficiency is one of the diagnostic criteria for autism, which leads to difficulty in learning speech and linguistic skills. Nowadays, it is common to use play therapy for supporting children with autism. Play therapy is an active approach that helps a child to reveal his conscious and unconscious feelings through playing. The present study aimed to determine the effectiveness of group play therapy on the communication skills of children with high functioning autism.
Materials & Methods The present research was an experimental study, including a pretest and posttest design with a control group. Twelve 5-8 years old boys with high functioning autism were selected purposively from the Autism Charity Foundation in Tehran in 2013. All subjects were included according to get a diagnose of high functioning autism, literacy of parents to complete the questionnaire, lack of sensory disorders such as visual or auditory disorders, lack of physical or motor disorders such as cerebral palsy, not attending to the same play therapy intervention program simultaneously. All subjects were assigned randomly to the experimental and control groups (6 children in each group). The experimental group participated in 20 sessions (three times a week; 45 to 60 minutes for each session) and received group play therapy along with the routine program (mental and physical occupational therapy, and speech therapy). However, the control group received only the routine program. The communication skills of all the children were evaluated using the Gilliam Autism Rating Scale (GARS) before, at 20th session, and 2 months after the intervention. The collected data from two situations (pre-test, post-test) were analyzed by analysis of covariance. Repeated measure test was used to determine the lasting effect of group play therapy on the communication of boys after two months follow-up.
Results The findings of the analysis of covariance showed that the group play therapy significantly influenced the communication of male children with high functioning autism. In addition, it was found that the effects of the group play therapy lasted significantly on the communication skills of the children even at two months follow-up (P<0.001).
Conclusion It is concluded that the group play therapy can help the children to understand and communicate well. This therapy can be used as a complementary training and therapeutic method for children with high functioning autism to help improve their communication deficiencies.
Volume 19, Issue 2 (7-2018)
Materials & Methods A semi-experimental study with pre-test and post-test design was conducted with 30 male participants, aged 5–6 years. These participants with ADHD were selected using an available method from the pre-school centers of Aran and Bidgol cities. The participants were divided into experimental and control groups, each group consisting of 15 children. The experimental group received 12 sessions of play therapy based on the cognitive-behavioral model while the control group did not have any sessions. The experiments were conducted using the Rutter child behavior questionnaire for parents (1975) and social skills rating scale of Gresham and Elliott (1990). Problem behavior questionnaires were completed by parents, and social skills rating scale was completed by teachers for all subjects during pre-test and post-test. Data collected before and after the training sessions were analyzed by multivariate analysis of covariance (MANCOVA) using the SPSS software V. 23.
Results Normality of variables and contingency of variance and covariance assumptions were tested. The Kolmogorov-Smirnov test showed that all variables were normal (P>0.05). The Box test confirmed the contingency of variance-covariance assumption. The results of MANCOVA showed that play therapy based on the cognitive-behavioral model had a significant effect on the behavioral problems and social skills of children with attention deficit hyperactivity disorder (P<0.0001). It also had a significant effect on all the subscales of behavioral problems (aggression and hyperactivity, anxiety and depression, social maladjustment, antisocial behaviors, and attention shortage) and social skills (cooperation, self-assertiveness, and self-control) (P<0.0001) in these children. It can be stated that according to Eta square, 70%, 51%, 62%, 66%, 68%, and 67% of variations in components such as aggression and hyperactivity, anxiety and depression, social maladjustment, antisocial behaviors, antisocial behaviors, attention shortage, and behavioral problems, respectively, can be explained by the subjects’ participation in the play therapy program. Also, according to Eta square, 69%, 58%, 52%, and 61% of variations in components such as cooperation, self-assertiveness, self-control, and social skills respectively, can be explained by the subjects’ participation in the play therapy.
Conclusion Play therapy based on the cognitive-behavioral model can reduce behavioral problems and improve the social skills of children with attention deficit hyperactivity disorder. It is recommended that serious attention be paid while planning play therapy for children.
Volume 19, Issue 3 (10-2018)
Materials & Methods This research was a quasi-experimental study. The study population included all elementary deaf students in the city of Sari in 2011-2012. According to statistics, they comprised 40 students and the entire selected community were included in the study. Out of 40, twenty were randomly assigned in the experimental group and 20 in the control group. The experimental group were treated by game therapy during 12 weekly sessions. The study instruments were Social Skills Rating Scale and Skills Test-Revised communication were used to collect data.
Results Descriptive statistics and scores of each communication skills and social adaptation of deaf children participating in this study indicated that the participants in the experimental group had a better improvement than the control group participants (P<0.05). Also, the results of covariance analysis showed that play therapy significantly improved the mean scores of communication skills and social adaptation in the experimental group compared to the control group. In other words, in deaf children, the effectiveness of play therapy in increasing social adjustment and communication skills is significantly more than non-treated control group.
Conclusion Play therapy is an effective way to improve the social and communication skills of deaf children. Therefore, in the area of working with deaf and hearing impaired children, experts and health professionals can use play therapy as an effective way to improve their social adaptation and communication skills, given the physical problems of these individuals and their limitations.
Volume 19, Issue 3 (10-2018)
Materials & Methods The present research was a quasi-experimental study with pretest, post-test design and control group. The participants were 22 students with intellectual disability aged 7-11 years in 2017-2018 academic year. They belonged to middle socio-economical class. Subjects were selected by convenience sampling method from school of Shahidan Nouri in Isfahan. They were divided into experimental and control groups, each group consisting of 14 students. The experimental group received group play therapy training program in 7 sessions (each session 40 minutes), while control group did not participate in this program but participated in common group play therapy program in the school. The study instrument was the social skills scale of Matson. Social skills scale was completed by parents for all subjects in pretest and post-test. The relevant data were collected through the questionnaire before and after the training sessions. Multivariate Analysis of Covariance (MANCOVA) was performed in SPSS V. 23.
Results first, normality of variables and contingency of variance and covariance assumptions were tested. The Kolmogorov-Smirnov test showed that all variables were normally distributed (P>0.05). Also, Box test confirmed contingency of variance-covariance assumption. So, assumptions of MANCOVA test were confirmed and could be used for data analysis. The results of MANCOVA showed that group play therapy training with cognitive-behavioral approach program had a significant effect on the social skills of students with intellectual disability (P<0.001). The results also revealed that group play therapy training program had a significant effect on all subscales of social skills (appropriate social behavior, asocial behavior, aggressive and impulsive behavior, superiority and self-confidence, communication with peers) in these students (P<0.001). It can be stated that according to Eta square, 67%, 55%, 61%, 56%, 62%, and 55% of variations in components of appropriate social behavior, asocial behavior, aggressive and impulsive behavior, superiority and self-confidence, communication with peers, and social skills, respectively, can be explained by the subjects’ participation in group play therapy training program.
Conclusion Group play therapy training program with cognitive-behavioral approach improved the social skills of students with intellectual disability. In other words, applying this training program has been associated with effective and positive outcomes, because social skills of the control group did not shown significant improvement. Therefore, paying attention to the group play therapy training program with cognitive-behavioral approach is essential and planning for providing training of this type of group play therapy program for children and students with intellectual disability is of particular importance.
Volume 21, Issue 2 (7-2020)
Objective: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects the person’ life. The prevalence of ASD in Iran is increasing. The complicated nature of this disorder disrupts the balance and work routines in the family, which puts a lot of stress on the entire family, especially mothers. Mental health of the mother affects all family members, including a child with ASD. On the other hand, mothers’ confusion and failure in relation to their ASD child causes more stress and discomfort for them. In this study, we aimed to investigate the effect of filial therapy, as a play therapy, on the parenting stress of mothers with ASD children.
Materials & Methods: In this experimental study, participants were the mothers of 32 children with ASD (9 girls and 23 boys) aged 4-12 years referred to autism centers and occupational therapy clinics in Isfahan, Iran who were selected using a convenience sampling method. After obtaining an ethical approval from the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (code: IR.USWR.REC.1396.97), and necessary permissions, researchers referred to the clinics and after explaining the purpose of the study to the mothers, an informed consent was obtained from them. Then, they completed a demographic form, Gilliam Autism Rating Scale-2 (GARS-2), and Abidin’s Parenting Stress Index-Short Form (PSI-SF). Participants were randomly divided into two intervention and control groups after matching for the child’s age, GARS score, and the education of children and mothers. The intervention group received 10 sessions of filial therapy, once a week, each for two hours, while the control group continued routine treatment. After intervention, PSI-SF was completed by all mothers again. The collected data were analyzed by using ANCOVA, paired t-test and independent t-test. Shapiro-Wilk test was used to determine the normality of PSI-SF data distribution at Pre-test and Post-test phases.
Results: Paired t-test results showed that there was no statistically significant difference in the mean total parenting stress score between the two groups in the Pre-test phase (P= 0.679) but it was significant in the Post-test phase (P=0.010). The results of independent t-test showed that the difference between the mean Pre-test and Post-test scores of total parenting stress in the control group was not significant (P= 0.268) but it was significant in the intervention group (P=0.001). ANCOVA results showed that the Pre-test score of parenting stress had an effect on the total parenting stress score after intervention such that it could explain 82% of variations in this variable. After controlling the Pre-test score, the total parenting stress was significantly different in two groups (P=0.001). Eta squared value indicated that the intervention could explain 54% of changes in total parenting stress of mothers.
Conclusion: Filial therapy can help better acceptance of the ASD children by their parents and reduce parenting stress by improving child-parent relationships. This method can be taught as a complementary intervention to the mothers of ASD children.
Volume 21, Issue 3 (9-2020)
Objective: One of the most significant issues in children with attention deficit hyperactivity disorder (ADHD) is emotional/behavioral problems, which disrupt their social communication at home and school. Some of these problems include social problems, rule-breaking behavior, and aggressive behavior. These problems, if left untreated in childhood, can cause problems in adulthood such as substance abuse, insubordination in the workplace, shorter stay at a job, and more anti-social acts. Nowadays, the use of play therapy for children with ADHD has become common. It is an active approach that allows the children to express their feelings through play. In group play therapy, children are asked to evaluate their personality according to their peers’ reactions. The study investigates the effect of group play therapy on emotional/behavioral problems in children with ADHD aged 6-12 years.
Materials & Methods: This is a randomized controlled trial. The study population consists of all children with ADHD referred to the Dostdaran Koodak Occupational Therapy Clinic in Isfahan City, Iran. Of these, 28 children aged 6-12 years (average age: 8 years), including 8 girls and 20 boys, were selected using a convenience sampling technique. First, the study objective was explained to the parents, and children were then randomly assigned into the intervention and control groups. Considering error (d)=3, with 95% confidence level and 80% test power, the sample size was determined 14 for each group. The intervention group received 12 sessions of group play therapy (2 sessions per week, each for 45-60 minutes), besides two sessions of individual occupational therapy per week. However, the control group received two sessions of occupational therapy per week only. The emotional/behavior problems of subjects in both groups were assessed before and after the intervention using the CBCL. Data analysis was performed in SPSS V. 21 software using the Shapiro-Wilk test and ANCOVA.
Results: After the group play therapy, there was a significant decrease in the scores of emotional/behavioral problems, including social issues, aggressive behavior, and rule-breaking behavior, as well as in the overall score (P˂0.001).
Conclusion: Group play therapy can be used as a complementary method with other common occupational therapies for reducing the emotional/behavioral problems in children with ADHD.
Volume 23, Issue 2 (7-2022)
Objective Intellectual disability is a common neurodevelopmental disorder. Working memory deficit can affect children. One of the effective methods in the field of learning is playing games and the application of play therapy techniques. In this method, children are allowed to practice useful social behaviors and experience new thoughts and feelings in a safe environment with supportive relationships. This study aimed to examine the effectiveness of Adlerian play therapy on the working memory of female students aged 7 to 12 years with mild intellectual disability.
Materials & Methods Out of 60 female students aged 7 to 12 years with a diagnosis of mild intellectual disability in Fatemeh Zahra Special School in Qom, 28 students met the inclusion criteria. They were divided into the experimental and control groups by 1: 1 random allocation. The experimental group received the Adlerian therapy protocol for ten weeks in three 45-minute sessions (30 sessions) every week. The working memory of both groups was examined in three stages, including pre-test, post-test, and one month later, without receiving any intervention for follow-up, by the fourth version of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Data analysis was done by Shapiro-Wilk, Friedman, Mann-Whitney, and Bonferroni tests and generalized estimation equation by SPSS software v. 22 at the significance level of 5%.
Results Most of the subjects in each group were aged 7 years (first grade) with six people (43%), whereas the lowest frequency was related to the age of 9 years (third grade) with two people (14%) per group. The mean and standard deviation of the working memory subtest in the experimental group increased from 6.28 3.66 in the pre-test to 10.4 86 in the post-test and increased to 12.64 5.25 in the follow-up stage. However, in the control group, the mean and standard deviation changed from 5.92 3.19 in the pre-test to 5.64 3.17 and 5.85 3.41 in the post-test and follow-up, respectively. In the experimental group, there was a significant difference in the mean score of working memory in all stages of measurement (p< 0.05). In the pre-test stage, there was no significant difference in the mean score of working memory in the experimental and control groups (p>0.05). In the post-test stage, because the P was very close to 0.05, we can ignore it and consider it significant. In the follow-up stage, there was a significant difference in the mean score of working memory in the experimental and control groups (P<0.05).
Conclusion It seems that child-centered Adlerian play therapy has a persistent effect on the working memory of students with mild intellectual disabilities. Therefore, Adlerian play therapy can be used in educational planning to enhance the working memory of these students
Volume 23, Issue 2 (7-2022)
Objective: The present study aimed to investigate the effect of brain neuroplasticity on the incidence of anterior cruciate ligament (ACL) injury and on brain function and structure before and after ligament reconstruction and after a period of rehabilitation exercises.
Materials & Methods: In this review study, a search was conducted in PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, MedLine, Pedro, CINAHL, SPORTDiscus, and Cochrane Databases as well as national databases on related studies published from 1970 to 2021 using keywords in Persian and English related to the research topic.
Results: The initial search yielded 65 articles. Based on the inclusion and exclusion criteria, 24 articles were selected for review of which 5 articles prospectively examined the effect of brain neuroplasticity on the incidence of ACL injury. Their results showed that the brains of people with ACL injury was different from the uninjured people, especially in the motor-sensory part of the cerebral cortex and cerebellum, which caused errors during movement planning of these persons. Ten articles examined the effect of ACL injury before reconstruction on brain function and structure and reported that changes occur in the level of motor-sensory cortex of the brain at least two weeks after the injury; after one year, these structural and functional changes were widely increased in injured people compared to healthy people. These studies also showed that the ligament dysfunction and the damage to mechanical receptors cause the reorganization of the central nervous system. In injured people, the control activity of motor-visual areas and their need for visual feedback have increased. Seven articles examined these changes after ligament reconstruction and showed that the brain neuroplasticity or functional and structural changes resulting from the injury not only did not return to normal conditions, but also increased after a while despite the reconstruction. Two articles examined these changes after a period of rehabilitation exercises and showed that functional and
Conclusion: The changes in the brain after ACL injury not only persist after ligament reconstruction, but also increase after reconstruction. The common rehabilitation exercises whose main focus is not on eliminating these functional and structural changes in the brain cannot overdrive this negative neuroplasticity after injury which is one of the important causes of secondary injury and subsequent complications. In developing exercises to prevent ACL injury and for rehabilitation, it is better to use the new principles of motor learning and exercises related to visual feedback along with conventional exercises to overdrive negative neuroplasticity created in the brain and create positive neuroplasticity to support ACL.
Volume 24, Issue 2 (7-2023)
Materials & Methods This is a non-blinded randomized controlled clinical trial. The participants were recruited from among the mothers of premature babies (<37 weeks) admitted to the NICU of Hazrat-e Ali Asghar Hospital and divided into two groups of intervention (n=20) and control (n=20) using the block randomization method. They were 20-35 years old with at least a high school diploma. Their babies had stable physiological conditions with no physical disorders or specific diseases. The anxiety of mothers was measured by Spielberger’s State-Trait anxiety inventory (STAI) before study and two days after discharge. The intervention group received the play-based program for their babies at least once a day, for at least 5 days until discharge. The control group received routine hospital care.
Results Independent t-test results showed no significant difference in the scores of STAI and its domains between the two groups before and after the intervention. However, mean difference of pre- and post-scores of total STAI and state anxiety domain was significant in two groups (P<0.05), but it was not significant in terms of trait anxiety (P>0.05). The ANCOVA results showed that the effect size of intervention on state anxiety (P=0.001) and total anxiety score (P=0.004) was 27% and 20%, respectively.
Conclusion The play-based intervention, can reduce the anxiety of mothers of premature babies admitted to the NICU and consequently affect the growth of children and mental health of family and society.
Corresonding author: Hoshang Mirzaei, E-mail:hooshang_mirzaie@yahoo.com
You can also search for this author in: PubMed, Google Scholar
Volume 25, Issue 1 (4-2024)
Materials & Methods This is a scoping review study. Research studies and indexed in scientific databases including were available in PubMed/Web of Science/Scopus or retrieved by Google Scholar search engine were searched and reviewed. Inclusion criteria included the report of studies in English and Persian papers published from 2000 to 2023 that were mainly focused and the main subject of early rehabilitation intervention studies (occupational therapy and physiotherapy) on the development of neuromotor skills of preterm infants in the neonatal intensive care unit. After selecting the keywords and organized search, the found articles were matched with the entry criteria and finally considered studies were selected.
Results Among the reviewed studies, 15 studies met the inclusion criteria. Among the available studies, 7 studies related to multi-modal interventions and 2 studies related to multi-sensory intervention .2 studies related to neuro-developmental interventions. 2 studies related to interventions implemented by parents –administered. 2 studies related to interventions supporting play exploration and early developmental intervention.
Conclusion Based on the findings of this research and the meetings held with experts in this field, we were able to organize early rehabilitation interventions for motor skills of preterm infants in 4 groups: 1) multimodal and multisensory interventions 2) neurodevelopmental interventions 3) parents-administered interventions 4) supporting play exploration and early developmental intervention to categorize. In this way, all types of therapeutic interventions in improving motor skills of infants were identified. Most of the studies included interventions that were performed in a short period of time and reported short-term effects on motor improvement. Only the supportive play exploration intervention continued after discharge and bridged the gap of early NICU-to-home interventions and reported improved motor development in the short- and long-term (6, 12 months).
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