eng Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 2 7 article Shahrzad Pakjouei sh_pakjouei@yahoo.com 1 Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ore than a billion people suffer from different disabilities and require special healthcare due to their special condition compared to others; however, they usually receive less healthcare and face difficulties accessing health and medical services which, in return, can result in adverse health consequences for them. http://rehabilitationj.uswr.ac.ir/article-1-2901-en.pdf COVID-19 Pandemic People with disabilities Experiences Iran per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 8 31 article Farin Soleimani Soleimani_farin@Yahoo.com 1 Nadia Azari Farinir@Yahoo.com 2 Roshanak Vameghi r_vameghi@yahoo.com 3 Seyyed Hamed Barekati barekati-h@health.gov.ir 4 Hamidreza Lornejad lornejad@health.gov.ir 5 Adis Kraskian adiskraskian@yahoo.com 6 Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Clinical Education, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Ministry of Health and Medical Education, Tehran, Iran. Ministry of Health and Medical Education, Tehran, Iran. Department of psychology, Islamic Azad University, Branch of Karaj, Karaj, Iran. Objective: The first years of life are particularly important because vital developments occur in all development domains including motor, cognition, communication, and social-emotional. Early detection of developmental delays is essential in planning for early intervention. This study aims to standardize the score of bayley scales of infants and toddlers development-third edition (Bayley-III) for Iranian samples aged 1-42 months. Materials & Methods: Participants included 1700 children divided into 17 age groups of 100 children. The normative information was based on a national sample representative of Iran’s population for infants aged 1-42 months based on the 2011 national population and housing census. For each age group, the total raw scores of each Bayley-III subscale (cognition, receptive communication, expressive communication, fine motor, and gross motor) were converted to scaled scores with a Mean±SD of 10±3. The composite scores (cognition, language and motor domains) were obtained by summing up the scaled scores. The composite scores were scaled to a metric with Mean±SD of 100±15 ranged 40-160. Growth scores (ranged 200-800, with a Mean±SD 500±100), percentile ranks (ranged from 1-99, with 50 as the mean and median), and developmental age equivalent were also determined. Confidence intervals for all five subscales were also determined. To compare the development level of the US children (norm samples) and Iranian children, their mean raw scores in five subscales were compared for finding the difference in scores. Results: The Bayley-III was performed on 1744 children aged 0-42 months, including 908 (52.1%) girls and 836 (47.9%) boys. In comparing the development level of Iranian and US children, it was found that the mean scores were significantly different in 28 age groups (P<0.05). In seven age groups, the US children’s scores were higher (age groups <6 months), and in 21 age groups, the scores of Iranian children were higher ( age groups >6 months). Conclusion: For early detection and intervention of children with developmental delays, a test with a normalized score should be used in Iran. Using the US norm-based scores in Iranian children leads to inaccuracy in the early detection of children with developmental delays.   http://rehabilitationj.uswr.ac.ir/article-1-2890-en.pdf Child Developmental delay Standardization Bayley Scales of Infants and Toddlers Development per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 32 49 article Mohammad Ashori m.ashori@edu.ui.ac.ir 1 Department of Psychology and Education of People With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. Objective The current study was conducted with the aim of phenomenology of the lived experience of hearing teenagers with hearing impaired parents in Isfahan City. Materials & Methods The investigation of this research was qualitative and based on the descriptive phenomenology approach that was conducted in 2018. The participants were selected by purposive sampling among hearing teenagers with parents with severe and profound hearing loss in the schools of Isfahan, and there were ten of them. To collect data, semi-structured interviews were used and the life experiences of hearing teenagers with hearing impaired parents were investigated through interviews with them. The duration of the interviews was between 56 and 80 minutes. Results: The results of the interviews were classified into seven main categories and 38 subcategories after extracting themes. The first main category was parental acceptance, which included subcategories such as deaf parents' acceptance, willingness to communicate with parents, and parents' social acceptance. The second main category was cultural values and its subcategories included cultural differences, respect for cultures, and awareness of cultural values and beliefs. The third main category was the cycle of emotions, which included subcategories such as feelings of incompetence and weak self-efficacy in parents, emotional instability, feelings of shame and doubt, anxiety and stress, feelings of loneliness and the need for empathy. The fourth main category was social conditions, which included sub-categories such as inappropriate attitude towards deaf people, inappropriate reactions of others, social distance, poor information, inappropriate social interaction and lack of attention to social justice. The fifth main category was knowledge and thinking, whose sub-categories were parents' ignorance, hearing and deaf people's misunderstanding of each other, duality in the way hearing and deaf people think, deaf parents' lack of attention towards their children's future. The sixth main category was support networks with subcategories such as insufficient support from parents, weak support from formal and informal institutions, and lack of coordination between support sources. The last main category was life challenges, which included subcategories such as behavior management, expectations, inadequate services, financial problems, and worry about the future. Conclusion: Based on the findings, the analysis of the lived experience of hearing teenagers with hearing-impaired parents showed that they are affected by the hearing status of their parents in different ways; therefore, these categories can be used to design educational and psychological programs for hearing teenagers with hearing-impaired parents.   http://rehabilitationj.uswr.ac.ir/article-1-2920-en.pdf Hearing Adolescent Deaf Parent per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 50 67 article Masoomeh Amirkhani mahshid_a179@yahoo.com 1 Bijan Shafiei shafiei_al@yahoo.com 2 Asieh Maghamimehr asimaghami@yahoo.com 3 Department of Speech Therapy, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Speech Therapy, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Department of Statistics, Shiraz Payam Noor University, Shiraz, Iran. Objective: Stuttering is not just a speech disorder. It can cause negative feelings and emotions in a person especially in children. Therefore, we need a standard tool to identify, study and measure these negative effects and then try to eliminate or reduce them. Considering the increased clinical and research needs for a valid and reliable tool to assess the negative effect of stuttering in Iran, this study aims to design and validate a questionnaire (parents form) for assessment of social/emotional /behavioral disorders in preschool children with stuttering  Materials & Methods: This is a methodological study that was conducted in three steps in spring and summer of 2018 in Isfahan, Iran. Participants included 60 parents of preschool children with stuttering aged 3 to 5 years and 11 months (36 boys and 24 girls), who had referred to speech therapy clinics in Isfahan.  In the first stage, 10 parents received in-depth and open-ended interviews to collect information about social, emotional and behavioral disorders in children with stuttering. Afterwards, based on these information and the opinions of experts in psychology and speech therapy, the main constructs of the questionnaire were identified: "uncompromising/ hyperactive behavior", "social skills", "communication skills", "aggression", "fear", and "separation anxiety". In the second stage, in order to determine the face validity, 10 experts were interviewed face to face. In order to determine the content validity, 15 other experts were asked to examine each item according. Content validity was determined by calculating the content validity ratio (CVR), content validity index (CVI), and total content validity (Lawshe method). Confirmatory factor analysis was used to examine the construct validity.  In the last step, the internal consistency was determined by calculating Cronbach's alpha coefficient, and the relaibility was determined by test-retest method and intraclass correlation coefficient (ICC) Results: The initial version consisted of 61 items and 6 subscales. According to the experts, by merging items with overlapping concepts, the number of items were reduced to 40. In the face validity assessment stage, items were examined based on difficulty, relevance, and ambiguity. The phrases were read several times, and the opinions of experts were applied. Then, it was reviewed by two experts in Persian literature and finally was approved. The CVR and CVI  vaues were obtained 0.76 and 0.90, respectively. For its internal consistency, the Cronbach's alpha coefficient was obtained 0.89 and ICC was more than 0.7 and significant (P<0.001). For the construct validity assessed in AMOS software, the calculated X2 was 631.25. The low number of X2 indicated a good fit of the model (P<0.000). Conclusion: The designed questionnaire has acceptable validity and reliability and can be used as a reliable and valid tool for assessing social/emotional/behavioral disorders in Iranian preschool children with stuttering.    http://rehabilitationj.uswr.ac.ir/article-1-2852-en.pdf Stuttering Preschool Children Parents Questionnaire Social-Emotional Disorders eng Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 68 87 article Bita Sadeghi bitasadeghi95@gmail.com 1 Fatemeh Estebsari fa_estebsari@yahoo.com 2 Abbas Ebadi Ebadi1347@yahoo.com 3 Maryam Rasouli rassouli.m@gmail.com 4 Elahe Sadeghi elahesadegh321@gmail.comi 5 Department of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of medical surgical nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran. Objective: Multiple sclerosis (MS) is one of the most common chronic progressive neurological diseases. It is the non-traumatic cause of neurological disability in adults. This disease increases the patient’s need for care due to the progressive course of disease that intensifies the symptoms over time. Family caregivers of these patients have different challenges and needs for caregiving. The present study aims to investigate the supportive needs of family caregivers of patients with MS in Iran. Materials & Methods: This is a qualitative study conducted in MS Association of Isfahan, Iran in 2018-2019 for 8 months. Participants were selected by a purposive sampling method who included 8 patients, 13 family caregivers, and 4 treatment staff. Semi-structured interviews were used to survey the supportive needs of caregivers. Interviews took about 30-60 minutes. Sampling and data collection were saturated after 25 interviews. We used Guba and Lincoln’s criteria (credibility, dependability, transferability, and conformability) to evaluate and validate the data. The contract content analysis technique was used to analyze the data. Results: The results of analysis yielded 795 initial codes. After merging these codes based on common features, 562 codes were remained. The supportive needs of family caregivers of MS patients were presented in three main categories (creating interaction opportunities to reduce isolation, empathetic interaction with peers and treatment staff, and financial support) and nine sub-categories. Conclusion: Most of the family caregivers of MS patients in Iran do not receive adequate social and systemic supports from health care providers and do not have access to support resources. Policymakers and health caregivers should provide the required supporting programs for these caregivers so that they can optimally play their role in caregiving MS patients, especially at home, while receiving appropriate social and systemic supports.   http://rehabilitationj.uswr.ac.ir/article-1-2886-en.pdf Multiple sclerosis Family caregivers Social support needs Iran per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 88 111 article Niloufar Mahmoudi niloufarmahmoudi1228@gmail.com 1 Yadollah Abolfathi Momtaz yabolfathi@gmail.com 2 Mahshid Foroughan Foroughanm@gmail.com 3 Nasibe Zanjari zanjari.nz@gmail.com 4 Seyyed H Mohaqeqi Kamal hosseinmohaqeq@gmail.com 5 Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Objective: Social isolation is one of the important concerns in the elderly population which can negatively affect their quality of life and health. The present study aims to determine the prevalence of social isolation among older adults aged 60 years and older in Tehran, Iran and find its associated factors. Materials & Methods: This is a secondary analysis study on data obtained from a large cross-sectional study conducted on older adults in Tehran in 2020. The Persian version of lubben social network scale (LSNS-6) was used to measure social isolation. The demographic characteristics (age, gender, marital status, living arrangements, and number of children), socio-economic status (educational level, employment status, and household income) and health-related information (history of chronic diseases and use of assistive devices) were collected using a checklist. Data were analyzed in SPSS v. 23 software using multivariate logistic regression analysis. The significance level was set at Results: The data were related to 1280 older adults aged 60 years and older (Mean±SD age=70.97±8.07 years). The prevalence of social isolation was 30.8%. The results of chi-square test revealed that living arrangement (P<0.001, X2=46.93), marital status (P<0.001, X2=26.91), household income (P<0.001, X2=67.44), level of education (P<0.05, X2=20.26), employment status (P <0.001, X2=29.21), musculoskeletal problems (P<0.001, X2=15.47), respiratory problems (P<0.05, X2=10.43), vision problems (P<0.05, X2=4.4), hyperlipidemia (P<0.001, X2=13.53), and wearing glasses (P<0.05, X2=3.92) had significant association with social isolation. The regression analysis model could significantly predict social isolation (X2=188.35, P<0.001). The model revealed that being male (P<0.05, OR=1.7), living with spouse (P<0.05, OR=0.4), musculoskeletal disease (P<0.05, OR=1.42), diabetes (P<0.05, OR=1.41), household income (P<0.001, OR=5.82), being unemployed (P<0.001, OR=2.13), having hyperlipidemia (P<0.001, OR=0.58), and living in developed areas (P<0.001, OR=2.02) significantly predicted the social isolation. Conclusion: There is a strong association between social isolation and some socio-economic, demographic-health related factors in older adults. Health policymakers and healthcare experts can develop the screening and prevention programs related to the mental and social health of older adults in Tehran, Iran in order to moderate and control these factors.    http://rehabilitationj.uswr.ac.ir/article-1-2947-en.pdf Social isolation Iran Prevalence Aged Risk factors per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 112 125 article Hadi Khoshrou khoshrou_pt@yahoo.com 1 Neda Mostafaee neda_mostafaee@yahoo.com 2 Hossein Negahban honegahban@yahoo.com 3 Seyyed Javad Raeesi raeesij@yahoo.com 4 Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. Objective: This study aims to translate and cross-culturally adapt the University of California at Los Angles Activity Scale (UCLA) to Iranian samples and evaluate the reliability and validity of the Persian UCLA in candidates for knee replacement surgery.  Materials & Methods: In this cross-sectional study, cross-cultural adaptation was performed according to the international quality of life assessment protocol in three stages: standard forward translation, translation synthesis, and backward translation. The Persian UCLA, tegner activity scale (TAS), short-form health survey (SF-36) and international physical activity questionnaire (IPAQ) were completed by 103 participants (candidates for knee replacement surgery). The Persian UCLA questionnaire was re-completed by 66 participants in the retest session with an interval of 3-7 days. An intra-class correlation coefficient (ICC) was used to evaluate test-retest reliability. The standard error of measurement (SEM) was used to determine smallest detectable change (SDC) in scores. To evaluate convergent validity of the Persian UCLA, its correlation with TAS, SF-36, and IPAQ was assessed using Spearman’s correlation test. The ceiling and floor effects were also calculated. Results: In the Persian version, no special changes were made and no problem or ambiguity was reported by the respondents based on a pilot study. The type of activities mentioned in the original version was not changed either and none of the participants had difficulty understanding the items. The Mean±SD of UCLA scores were 2.98±1.37 in the test phase and 2.89±1.32 in the retest phase. Psychometric tests results showed acceptable test-retest reliability of the Persian UCLA (ICC=0.96, 95% CI=0.93-0.97). Given an SDC score of 0.50 at 95% confidence interval, it can be said that if the UCLA score be above or less than 0.50, there is an improvement or decline in the activity level of patients. Based on the results of Spearman correlation test, the Persian UCLA showed a strong correlation with TAS (rs=0.71, P<0.001), a moderate correlation with IPAQ (rs=0.58, P<0.001) and physical health summary component of SF-36 (rs=0.59, P<0.001), and a weak correlation with the mental health summary component of SF-36 (rs=0.39, P<0.001). The Persian UCLA questionnaire had no ceiling or floor effects. Conclusion: The Persian version of the UCLA questionnaire has acceptable reliability and validity for Iranian candidates for knee replacement surgery.    http://rehabilitationj.uswr.ac.ir/article-1-2979-en.pdf UCLA activity scale Knee replacement Psychometric properties Outcome per Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 126 139 article Mohammad-Hasan Modares Sabzevari Modares68@gmail.com 1 Mehrdad Anbarian mehrdadanbarian36@gmail.com 2 Mohammad-Reza Safari m.r.safari.k@gmail.com 3 Seyyed-Farhad Tabatabai tabatabai@aut.ac.ir 4 Mohammad-Javad Razi Mohamadjavadrazi@gmail.co 5 Department of Sports Biomechanics, Faculty of Sport Sciences, Bu-Ali Sina University, Hamadan, Iran. Department of Sports Biomechanics, Faculty of Sport Sciences, Bu-Ali Sina University, Hamadan, Iran. Department of Sports Biomechanics, Faculty of Sport Sciences, Bu-Ali Sina University, Hamadan, Iran. Department of Ergonomics, Faculty of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran. Objective Amputation of the lower limb due to the loss of a part of musculoskeletal structure reduces performance and increases injury during locomotion. The effect of various types of prosthetic feet during running has been analyzed in several studies. This study aims to conduct a biomechanical analysis of the effects of Although the Solid Ankle Cushion Heel (SACH) and dynamic-response feet on several kinetic variables during running in individuals with unilateral transtibial amputation. Materials & Methods In this quasi-experimental study, participants were 8 left-leg transtibial amputees who were selected using a convenience sampling method who were able to run and referred to Kosar Rehabilitation Center in Tehran, Iran from 2008 to 2012. To adapt to the feet, each foot was worn by the subjects for at least one week before the experiment. All subjects participated in three running sessions for evaluation; one session included the use of own foot (familiarization session), one session included the use of SACH foot, and one session included the use of dynamic-response foot. Only data from the two last sessions were used to compare the feet. Each subject ran in a 12-meter walkway three times at a speed of 2.5 m/s. The same running speed was used for the comparability of kinetic variables. Sport shoes were used to create an actual running condition. In each session, three successful trials were performed so that the foot was in full and perfect contact with the force plate. Kistler force plate and a three-dimensional motion capture system (Vicon) were used to collect kinetic and kinematic data, respectively. The camera and force plate data were sampled simultaneously at 200 and 1000 Hz, respectively. The trajectories of markers and analog data were filtered using the predicted mean square error filter in Vicon v. 1.7 software. The Kinetic variables were generated using the dynamic model of Vicon’s gait Plugin. The vertical ground reaction force was normalized for body weight. Five variables were selected for biomechanical analysis of feet. The maximum vertical ground reaction force, power, spring efficiency, plantar flexion in the amputated leg, and the symmetry ratio (percentage) of the maximum vertical ground reaction force between the amputated and intact legs were calculated. All values in each trial were averaged for each subject with each foot. Paired t-test and Wilcoxon test were used to analyze the data based on normality od distribution, considering a significance level of  P≤0.05. Results The results of paired t-test and Wilcoxon test showed that spring efficiency and maximum plantar flexion were significantly different between the SACH and dynamic-response feet (P≤0.05). The spring efficiency was greater with dynamic-response foot (P=0.05), while the maximum plantar flexion was greater with the SACH foot (P=0.05). There was no significant difference between the maximum vertical ground reaction force, maximum power absorption and generation in ankle, knee, and hip, maximum dorsiflexion moment, and the symmetry ratio of the maximum vertical ground reaction force between the amputated and intact legs. Conclusion During running, the spring efficiency with dynamic-response foot is greater than with SACH foot and is closer to the spring efficiency of a normal foot. Therefore, the dynamic-response foot has more natural performance than the SACH foot.   http://rehabilitationj.uswr.ac.ir/article-1-2878-en.pdf Biomechanics SACH Foot Dynamic-Response Foot Running Transtibial Amputee eng Archives of Rehabilitation 2538-6247 2538-6247 2022-05 23 1 140 161 article Fatemeh Ghasemi Fard fg.star1373@gmail.com 1 Hooshang Mirzaie fg.star1373@yahoo.com 2 Seyyed Ali Hoseini alihosse@gmail.com 3 Abbas Riazi abbas.riazi@gmail.com 4 Abbas Ebadi ebadi1347@yahoo.com 5 Narges Houshmandzadeh nrg.houshmandzadeh@uswr.ac.ir 6 Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Optometry, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Department of Nursing, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran. Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Objective: The use of standard tools can show the exact effects of interventions in children and adolescents with visual impairment (CYP-VI). However, to date, no comprehensive review study has evaluated the general characteristics and psychometrics of the instruments used in CYP-VI. Therefore, the present study investigated the psychometric properties of the tools used for CYP-VI. Materials & Methods: Databases of Cochrane, Scopus, PubMed, Web of Science, Iran Medex, Magiran, National Library of Iran (INL) and Google Scholar were searched using Persian and English keywords until 2021. The studies and tools used in CYP-VI were reviewed by two people in terms of inclusion criteria. Relevant information and quality assessment of the tools were checked with the adapted Casmin checklist (COSMIN) and Critical Review Form – Quantitative Studies. Psychometric properties of the studied instruments in the narrative categories were analyzed with face, content, criterion-dependent and reliability with internal and external reliability subgroups.  Results: Out of 1738 articles found, 39 studies were analyzed. Out of 39 articles, 26 were of high quality and others were of medium level. Study design included tool development/cultural adaptation, experimental, longitudinal or cross-sectional studies. Assessments were categorized into developmental (general skills, cognitive and social skills), Activities of Daily Living (ADL), Quality of Life (QoL) and Functional Vision (FV). Among the developmental tools; Only Decker intelligence test, vision related quality of life, Cardiff visual acuity questionnaire for children, first and second versions of LV Prasad functional vision questionnaire and functional vision questionnaire for children and young people with desirable psychometric properties have been reported. In relation to adaptive instruments, the changes made included the use of auditory, tactile, olfactory and motor aids, vocabulary changes, instrumental methods and the use of assistive devices, only a few of which reported psychometric properties. Conclusion: This review study shows that limited tools have been designed for CYP-VI whose validity and reliability have not been fully evaluated and reported. However, to improve the quality of studies and control systematic errors, we need standard tools. http://rehabilitationj.uswr.ac.ir/article-1-2893-en.pdf Questionnaire Visual Impairment Child Instrument Clinimetric