Effectiveness of videogames on balance and fear of falling in chronic stroke patient

Objectives: Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are newly used in people with motor problems. It is very important to use different interventions for balance issues. The aim of this study is to determine the effectiveness of videogame on balance and fear of falling in one participant. Methods: This experimental study was done in a single subject system, A-B design for one patient with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess fear of falling. Analysis of results was done by C-statistic, Bayesian factor, Mann Whitney U, and visual analysis graphs. Results: The results showed significant improvement for balance skills, the maximum force produced by lower extremities and reducing fear of falling parameters. But the deviation from center graphs did not showed distinct pattern. Discussion: All analysis confirmed the efficacy of videogames on balance skills and fear of falling improvement. However, the deviation from center did not show improvement and it seems to need more studies

Short communication: Play-based occupational therapy for hospitalized children with cancer: A short communication

The benefits of play-based occupational therapy for hospitalized children with cancer warrant further exploration. Pediatric cancer disease symptoms, complications from treatment, and multiple and prolonged hospitalizations restrict participation in the daily activities of a child's life. However, occupational therapy services in pediatric oncology are limited because of the disease nature, treatment complications, hospital environment, and unclear playbased occupational therapy frame. For this purpose, we decided to introduce the process of occupational therapy in such children, using the play-based approach by reviewing the current literature. Considering limitations and problems in hospitalized children with cancer, it seems that controlling symptoms, facilitating independent doing of daily activities, improving the Quality of Life (QoL), and making hospital environment more acceptable are more accessible, using the play-based approach compared with other traditional interventions. © 2020 University of Social Welfare and Rehabilitation Sciences

The impact of chronic low back pain on daily occupations: A qualitative study in Iranian context

Objectives: Low back pain is one of the main health problems which affect many people worldwide. The daily course of life is highly disrupted due to the chronic back pain problem. This study aims to explore the occupational performance of individuals with chronic low back pain. Methods: Fifteen people with chronic low back pain were included in this study using purposeful sampling. The participants were interviewed, and a qualitative content analysis was employed to analyze the data. Results: The three main resulted themes were: 1) Occupational disturbance because of low back pain; 2) Difficulty in moving around and remaining in any given position; and 3) Permanent mind struggle owing to back pain. People with chronic low back pain experience difficulty in all areas of daily occupation including self-care, work, and leisure, plus having trouble with being physically active and being persistent in certain positions. Furthermore, mind struggle with back pain which implies preoccupation with back pain in addition to fear of movement are other findings of present study. Discussion: Chronic low back pain greatly influences the daily occupations of individuals. Mind struggle with back pain, which implies preoccupation with back pain, in addition to the fear of movement are significant findings of the present study. Occupational therapists can play an important role in re-engagement of people with chronic low back pain in their daily occupations

A computer-based selective visual attention test for first-grade school children: Design, development and psychometric properties

Background: Visual attention is known as a critical base for learning. The purpose of the present study was to design, develop and evaluate the test-retest and internal consistency reliability as well as face, content and convergent validity of the computer- based selective visual attention test (SeVAT) for healthy first-grade school children. Methods: In the first phase of this study, the computer-based SeVAT was developed in two versions of original and parallel. Ten experts in occupational therapy helped to measure the content validity using the CVR and CVI methods. Face validity was measured through opinions collected from 10 first-grade children. The convergent validity of the test was examined using the Spearman correlation between the SeVAT and Stroop test. In addition, test-retest reliability was determined by measuring the intra-class correlation (ICC) between the original and parallel versions of the SeVAT in a single session. The internal consistency was calculated by Cronbach's alpha coefficients. Sixty first grade children (30 girls/30boys) participated in this study. Results: The developed test was found to have good content and face validity. The SeVAT showed an excellent test-retest reliability (ICC= 0.778, p<0.001) and internal consistency (Cronbach's Alpha of original and parallel tests were 0.857 and 0.831, respectively). SeVAT and Stroop test demonstrated a positive correlation upon the convergent validity testing. Conclusion: Our results suggested an acceptable reliability and validity for the computer-based SeVAT in the assessment of selective attention in children. Further research may warrant the differential validity of such a test in other age groups and neuro-cognitively disordered populations

The comparison of participation in school-aged cerebral palsy children and normal peers: A preliminary study

Background: Participation in daily activities during childhood is an important aspect for health and social development. Objectives: This study was designed to investigate the participation of children with cerebral palsy aged 8 to 14 years, and their normal peers. Patients and Methods: In this cross-sectional study, 30 children with cerebral palsy, and 30 normal children were selected via the non-probability convenience sampling. Their participation was evaluated with children�s assessment of participation and enjoyment (CAPE) through interviews. Results: Significant differences were found between the means of the two groups regarding the diversity, intensity, overall participation (P = 0.000) and all types of the activities except the recreational activities. The children with cerebral palsy took part in the skill-based activities and overall activities individually compared to the normal peers. The children with cerebral palsy, in comparison with their normal peers, often performed most of the activities inside the house. The main effect of gender and the interaction between gender and groups were not statistically significant in any of the variables of the CAPE test. Conclusions: Physical disability can influence the children�s daily activities and socialization. Understanding the participation of physically disabled children can help health care professionals in designing and introducing appropriate treatment according to their needs. © 2016, Growth & Development Research Center

Recourse allocation in young and elderly adults

Objectives: The role of cognitive processes in postural control was shown in dual task studies. However, there was no definite evidence on how verbal instructions influence the allocation of attention to postural control. This study determined whether young and elderly adults are able to deliberately control the resource allocation when performing a sensorimotor and cognitive task simultaneously and if there are any differences between young and older adults in this regard. Method: A Cross-sectional study was performed in 16 young adults aged (23.95±3.31) and 20 elderly adults (61±2.21). Participants were selected by non-probable sampling method. Parallel standing and tandem standing on a hard surface were used as postural tasks. Force plate was used for postural performance. Postural sway was measured and the choice reaction time task was conducted as the cognitive task. Dual-task performance was measured under three different instructions including paying attention to the cognitive task, postural task, and equal attention to both tasks. Results: For postural performance the main effect of instructions and interactions by difficulty and groups were not significant (P�0.05) for cognitive performance. However, the main effect of group was significant (F=5.672, P=0.023), showing that elderly adults have longer reaction times. The interaction of instruction by group effect and also interaction of instruction by postural difficulty on mean reaction time was also significant, (F=3.710, P=0.030), (F=5.242, P=0.008) respectively . Discussion: Because of age related changes in the brain, flexibility in elderly adults are less than young adults

The effects of Virtual Reality on upper limb function in chronic stroke patients: A clinical trial

Objectives: Stroke is one of the main causes of disability and mortality worldwide. Most survivors experience impairments in their upper limb motor function. Methods: This experimental study was performed as a clinical trial on 30 chronic stroke patients who experienced stroke from 6 to 96 months ago. Patients were non-randomly divided into the intervention (Virtual Reality besides conventional occupational therapy) and control (conventional occupational therapy) groups. Each treatment session lasted for one hour which was divided into conducting conventional occupational therapy techniques and Virtual Reality (VR) for the intervention group, and routine techniques for the control group. The intervention effectiveness was evaluated by the Fugl-Meyer Upper Extremity Scale, Stroke Impact Scale, Chedoke Arm and Hand Activity Inventory, Motricity Index, Modified Ashworth Scale and goniometer. Results were analyzed by SPSS and one-sample Kolmogorov-Smirnov, Shapiro- Wilk test, Independent Samples t-test and Mann Whitney U test were applied to assess the normality of data and to detect significant differences between study variables. Results: The results suggested that investigated parameters such as upper limb motor function, muscle tone and the range of motion were significantly different in the intervention group, compared to control group; however, there was no significant changes in none of the group's daily living activities. Discussion: VR-based computer games in combination with routine occupational therapy interventions could improve upper extremities functional impairments in chronic stroke patients. However, it seems the mechanisms behind the effectiveness of video games and their impact on brain cortex as well as upper limbs function need to be further investigated. © 2019, Iranian Rehabilitation Journal

Occupational challenges in the caregivers of people with multiple sclerosis: A qualitative study

Background: Multiple Sclerosis (MS) is a neurodegenerative disorder. The progressive and unpredictable nature of MS indicates the patients� need for long-term care as well as the increased burden of their primary caregivers� care and occupational challenges that emerge in their daily life activities. Objectives: The current study aimed to explore the occupational challenges caused by engaging in the care process for the caregivers of people with MS Methods: This qualitative study was conducted on 21 caregivers of MS patients using a content analysis approach. Data were collected through semi-structured face-to-face interviews. Results: Three main themes emerged: Time limitations in occupation implementation, care needs in occupation implementation, and emotional reactions affecting occupations. Conclusions: According to the results, the caregivers of people with MS were faced with a variety of occupational challenges. The time limitations for performing routine occupations and desired activities, unmet patient care-facilitating needs, and the occurrence of psychosocial reactions and behaviors were contributed to these challenges and their exacerbation. Identifying these challenges is both useful for designing interventional programs and to help caregivers to successfully perform their desired occupations in spite of challenges in the care process. © 2020, Semnan University of Medical Sciences. All rights reserved

A survey on alzheimer�s disease detection using gait analysis

Introduction: Early detection of Alzheimer's disease (AD), as a neurodegenerative disease and the most common cause of dementia in the elderly people, using gait analysis have been particularly noted by researcher in recent years. Because this novel method is non-invasive, less cost, and feasible in non-clinical and laboratory environments. Therefore, in this Meta-Analysis review article, detection of AD using gait analysis based on information technology tools surveyed in previous studies. Materials and Methods: The search for previous articles was done in databases such as Google Scholar, Pubmed, IEEE, Springer, and Elsevier. After finding articles in these databases, appropriate articles were selected to survey based on criteria such as focusing of the study on elderly patients with AD or mild cognitive impairment, the detection and assessment of AD, and the use of sensor technology to record gait. Results: AD can be detected, even in the early stages and also at a stage of mild cognitive impairment based on gait analysis using new technologies with sensors and information technologies. Also, it is possible to quantitatively evaluate and more accurately detect the disease based on the combination of different sensor technologies and the use of artificial intelligence techniques. Conclusion: Although gait analysis can be a novel tool for early detection of AD, but it is essential to be developed and improved based on sensors and artificial intelligence in order to be used as a reliable clinical tools. © 2020, Semnan University of Medical Sciences. All rights reserved

Development and validation of iranian children's participation assessment scale

Background: Participation is mostly cultural and familial based, and there is not any assessment scales for evaluating kids' participation in Iranian context, therefore the purpose of this study was developing children's participation assessment scale for Iranian children. Methods: Development of this scale occurred in two phases; phase I: planning: following reviewing the literature and adopting and compiling some items of available evaluation tools in the area (such as CAPE, CPQ, CLASS, Life-H) and receiving advice from two expert panels, the preliminary94- item questionnaire was prepared. Phase II: construct: the survey study was carried out on40 children and 21 of their parents to assess the popularity of the activity in Iran; thus, the items of the questionnaire reduced to 92 and after face and content validity, the final version prepared with 71 items. Results: The final 71-item questionnaire was developed in two parent-report and child-report versions. The 71 items based on the literature and expert panels' advice were categorized in 8 areas of occupation according to Occupational Therapy Practice Framework (ADL, IADL, Play, leisure, social participation, education, work, and sleep/rest). Conclusion: Iranian children's participation assessment is a useful and culturally relevant tool to measure participation of Iranian children. It can be used in rigorous clinical and population-based research