The Role Of Fine Motor Abilities In Reading Components: A Cross-Sectional Study In Children With And Without Dyslexia.

Objectives: This study aimed to investigate the relationship between fine motor skills and reading components and compare the fine motor skills of normal children and children with dyslexia. Materials & Methods: In this study, 47 children with dyslexia children and 47 normal children in the first to the third grade of elementary school in the age range of seven to nine years were examined with the Bruininks-Oseretsky Test of Motor Proficiency and NEMA reading test. Data were analyzed using Kolmogorov-Smirnov, Shapiro-Wilk, U Mann-Whitney methods, multiple linear regression, and Spearman correlation coefficient. Results: The results showed children with dyslexia were significantly weaker in fine motor skills than normal children (p <0.001). In addition, a relationship existed between the subtest of response speed and reading accuracy in normal children, but it was in normal children. A significant relationship was found between visual-motor control subtests and Upper-limb speed and dexterity with reading accuracy and speed. None of the motor subtests were related to reading comprehension. In children with dyslexia, no association was found between motor subtests and reading components. Conclusion: Seemingly, fine motor skills can be used as an essential factor along with other effective factors in improving the reading skills of children with reading disabilities.

The relationship between executive function and activities of daily living in children with specific learning disorders.

This study explores the relationship between executive functions (EF) and activities of daily living in children with specific learning disorder (SLD). Thirty SLD children (14 females and 16 males) and thirty typically developing (TD) children (13 females and 17 males) aged 8 to 11 years were selected from learning disabilities schools and centers as well as public schools in Tehran, Iran. The mean age for the TD group was 9.67 ± 0.82 and for the SLD group was 9.5 ± 0.5. Basic Activities of Daily Living (B-ADL) and Instrumental Activities of Daily Living (IADLs) were assessed using the Modified Barthel questionnaire and the Lawton scale, respectively. Executive function was evaluated using the Parent Form of Behavior Rating Inventory of Executive Function (BRIEF) questionnaire. Pearson correlations were utilized to determine the correlation between the average score of "executive function" and "daily life activities". Results indicated that children with SLD scored significantly lower in EFs compared to TD children. Although there was no significant difference in B-ADL between the two groups, children with SLD scored lower in IADL. This study sheds light on the impact of EF on the ability of children with SLD to complete daily living activities. Further research is needed to better understand and address these challenges.

Evaluating Oculomotor Tests before and after Vestibular Rehabilitation in Patients with Parkinson's Disease: A Pilot Pre-Post Study.

Introduction: The elderly population is commonly affected by balance and gait disorders that increase the risk of falls. Pivotal systems for efficient postural control are sensory, motor, visual, vestibular, and cognitive. Disruption in any of these systems could lead to postural instability. Vestibular rehabilitation is a set of exercises that positively affect the primary components of the central sensory-motor integration, including somatosensory, visual, and vestibular systems. Accordingly, we hypothesized that vestibular rehabilitation exercises might improve both oculomotor functions and upright postural control in patients with Parkinson's disease. Materials and Methods: 11 idiopathic Parkinson's patients voluntarily participated in this study based on inclusion criteria: central vestibular dysfunction and the Hoehn and Yahr scale scores less than or equal to 3. Videonystagmography (VNG) and the Berg Balance Scale (BBS) scores were measured at the baseline. Then, the patients underwent vestibular rehabilitation training for 24 sessions (3 sessions per week). The VNG and BBS were measured again after 48 hours of the completion of the last session of the training. Result: After completing vestibular rehabilitation sessions, there were significant improvements in balance (P ≤ 0.001). Eye-tracking and gaze function statistically improved in 7 patients and 6 patients, respectively. Conclusion: Vestibular rehabilitation produced positive effects on oculomotor function and balance in a small cohort of people with PD. Consequently, it could be considered as a possible effective intervention for Parkinson's patients. This trial is registered with IRCT201709123551N6.

Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy.

PURPOSE: To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. MATERIALS AND METHODS: Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I-II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water). RESULTS: The UE condition had significant effects on Overall Stability Index (OSI) (F(2,44) = 24.899, p < .001), Medial-Lateral Stability Index (MLSI) (F(2,44) = 4.380, p = .018), Anterior-Posterior Stability Index (F(2,44) = 6.187, p = .004), and TUG scores (F(2,44) = 113.372, p < .001). Group was significant for OSI (F(1,22) = 7.906, p = .010), MLSI (F(1,22) = 13.113, p = .002), and TUG (F(1,22) = 36.282, p < .001). CONCLUSIONS: The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs.

The effect of dual-task conditions on gait and balance performance in children with cerebral palsy: A systematic review and meta-analysis of observational studies.

Dual-task conditions are commonly experienced in daily routines. The aim of the present systematic review is to investigate the effect of dual-task conditions on gait and balance performance in children with cerebral palsy (CP) and to perform meta-analyses where applicable. Five databases, "ProQuest", "PubMed", "OTSeeker", "Scopus", and "PEDro" from the incipient date of databases up to Aug 24, 2020 were searched for studies focusing on the effects of dual-task conditions on gait and balance performance in children with CP. After removing irrelevant articles and applying inclusion and exclusion criteria, nine articles were included in the present systematic review and meta-analysis. The results of the meta-analysis showed that walking speed was slower during dual-task conditions compared to single-task conditions in children with CP (WMD = -0.29 m/s, 95% CI = -0.34, -0.24, P ≤ 0.001) and walking speed decreased in children with CP during dual-task conditions in comparison with the typical development (TD) control group (WMD = -0.19 m/s, 95% CI = -0.23 to -0.15, P ≤ 0.001). The results of subgroup analysis based on the type of task indicated that adding concurrent tasks to walking degrades walking speed under varied dual-task conditions. Additionally, theoretical synthesis of the literature demonstrated that other gait and balance variables are changed by performing cognitive and motor secondary tasks differently. Although these changes may be compensatory strategies to retain their stability, there was not sufficient evidence to reach a firm conclusion. Research gaps and recommendations for future studies are discussed.

Sensory interventions on motor function, activities of daily living, and spasticity of the upper limb in people with stroke: A randomized clinical trial.

STUDY DESIGN: This is a single-blinded clinical trial study. Clinical Trial Number registry: IRCT201610223551N4. INTRODUCTION: Stroke is the second cause of death around the world. Motor and sensory problems are common complications of the stroke. These defects in the upper limb cause reduced use of the affected limb and consequently a decrease in the quality of life. PURPOSE OF THE STUDY: The purpose of this study was to examine the effect of exteroceptive and proprioceptive stimulations on motor function, spasticity of the upper limb, and activities of daily living in people who have had stroke. METHODS: Sixty people with chronic stroke selected by convenience sampling. Before the intervention, Modified Ashworth Scale, Fugl-Meyer assessment of Motor Recovery after Stroke, and Barthel Index were measured and then the intervention phase was started. Exteroceptive and proprioceptive sensory stimulations were performed for 6 weeks. Independent t-test was used to compare groups. RESULTS: The intervention group made improvement in motor function (P = .0001, Cohen's d = 2.14), activities of daily living of upper limb (P = .0001, Cohen's d = 1.32), and spasticity (P = .002, Cohen's d = -0.94). DISCUSSION: Motor function and activities of daily living and spasticity of the upper limb can be improved through exteroceptive and proprioceptive stimulations. In this study, this type of intervention had the most impact on motor function compared with the rest. CONCLUSION: Exteroceptive and proprioceptive stimulations in upper limb can be used in chronic phase of stroke. Improvement in motor function and activities of daily living and reducing spasticity are the results of these stimulations.

Effects of Vestibular Rehabilitation on Fatigue and Activities of Daily Living in People with Parkinson's Disease: A Pilot Randomized Controlled Trial Study.

One of the most disabling nonmotor symptoms in persons with Parkinson's disease is fatigue, which can decrease the quality of life by restricting the function and activities of daily living (ADL). Nonetheless, sufficient evidence for treating fatigue, including drug or nondrug treatment, is not available. In this study, we evaluated the probable effects of vestibular rehabilitation on fatigue and ADL in patients with Parkinson's disease. Methods. This was a single-blind clinical trial study in which patients with Parkinson's disease voluntarily participated based on the inclusion and exclusion criteria. The patients were randomly assigned to the case and control groups. The case group received 24 sessions of vestibular rehabilitation protocol, and conventional rehabilitation was performed in the control group (i.e., 3 sessions each week, each lasted about 60 minutes). Both groups were also given fatigue management advice. Fatigue was measured by the Parkinson Fatigue Scale (PFS) and the Modified Fatigue Impact Scale (MFIS). ADL was measured by the Functional Independence Measure (FIM). All changes were measured from the baseline at the completion of the intervention. Results. Both fatigue (P ≤ 0.001) and ADL (P ≤ 0.001) improved significantly more in the vestibular intervention group than in the control one. Conclusion. Vestibular rehabilitation may improve fatigue and ADL and therefore can be used as an effective intervention for patients with Parkinson's disease, which was also found to be well tolerated.

Validity and reliability of the Persian ABILHAND-Kids in a sample of Iranian children with cerebral palsy.

Aim: To develop a Persian version of ABILHAND-Kids and to determine its reliability and validity in Persian-speaking children with cerebral palsy (CP).Method: The ABILHAND-Kids questionnaire was translated into Persian language and cross-culturally adapted following guidelines. The Persian ABILHAND-Kids was administered to 50 parents of CP children. Among the 50 parents of CP children, 30 of them participated in a test-retest reliability phase. Fifty parents of healthy children participated for discriminative validity.Results: The Rasch analysis indicated the unidimensionality, reliability, and global invariance of the Persian ABILHAND-Kids. The internal consistency reliability was high (Cronbach's alpha = 0.96). Floor and ceiling effects were insignificant (4%). The Intraclass Correlation Coefficients of test-retest reliability were 0.96 and 0.70 for item difficulties and children's measures, respectively. The standard error of measurement and smallest detectable change for CP measure were 11.21 and 31.07%, respectively. The discriminative validity of the Persian ABILHAND-Kids was demonstrated by statistically significant lower ABILHAND-Kids measures in CP children than in healthy children (p < 0.001). Cross-cultural validity between the Persian and original version was established for 19 out of the 21 ABILHAND-Kids items.Interpretation: The Persian ABILHAND-Kids questionnaire is reliable and valid for assessing manual ability in Persian speaking children with CP.Implications for rehabilitationThe Persian version of ABILHAND-Kids is developed and presented as a valid and reliable instrument for use by Persian-speaking clinicians and researchers.It is now possible for the Persian-speaking researchers to participate in international investigations and to compare Persian data with those from other countries.

Assessment priorities in cerebral palsy using ICF core set by Iranian occupational therapists.

BACKGROUND.: International Classification of Functioning, Disability and Health (ICF) core set for cerebral palsy allows for the description of the levels of functioning in cerebral palsy. It is not exactly clear which of these levels is more important for evaluation from the perspective of occupational therapists in Iran. By identifying these priorities, we can establish a better plan for intervention. PURPOSE.: This study defines assessment priorities in children with cerebral palsy (<6 years). METHOD.: Sixty-two Iranian occupational therapists studied the priorities of assessment based on the Iranian ICF core set. The therapists were asked to rate the code categories from 1 to 3. The results are presented as mean values. FINDINGS.: Occupational therapists first focus on body functions assessment, then activities/participation, and ultimately, environmental factors. IMPLICATIONS.: Occupational therapists in Iran have a bottom-up approach toward clients with cerebral palsy. It may be necessary to revise the educational curriculum, prepare a training course, and provide more supervision for practising occupational therapists.

Content Validity of the Comprehensive ICF Core Set for Children with Cerebral Palsy Aged 0-6 Years: Iranian Occupational Therapists Perspective.

OBJECTIVES: Comprehensive ICF Core Set of cerebral palsy (CP) includes a set of functions of children with CP has been created recently. This study determined the content validity of this version based on Iranian Occupational Therapists' perspectives to explore whether the ICF Core Sets for CP include the areas of function of CP in Occupational Therapy practice. MATERIALS & METHODS: This qualitative study conducted from Feb 2015 to Apr 2016 in Tehran, Iran. Experts were the academic staffs selected through convenience sampling. Content validity of comprehensive ICF-Core Set of CP with 135 ICF categories was done by them. Delphi survey was used for generating consensus on the final version. Participants were 50 clinical Occupational Therapists invited via email from across Iran. An agreement of 75% was considered as the cut-off for inclusion of each code-category. RESULTS: About 60% of the code-categories of comprehensive version of ICF Core Set of CP were approved by Occupational Therapists. In the final version, 82 code-categories were listed that included 21 code-categories for Body Functions, 40 for Activity/Participation, and 21 for Environmental Factors. CONCLUSION: The validity of the Iranian ICF Core Set for children with CP aged 0-6 yr was supported by Iranian Occupational Therapists. It could be the basis for evaluation of this population in Occupational Therapy.

Cross-cultural validation of the Persian version of the Functional Independence Measure for patients with stroke.

PURPOSE: To translate and cross-culturally adapt the Functional Independence Measure (FIM) into the Persian language and to test the reliability and validity of the Persian FIM (PFIM) in patients with stroke. METHOD: In this cross-sectional study carried out in an outpatient stroke rehabilitation center, 40 patients with stroke (mean age 60 years) were participated. A standard forward-backward translation method and expert panel validation was followed to develop the PFIM. Two experienced occupational therapists (OTs) assessed the patients independently in all items of the PFIM in a single session for inter-rater reliability. One of the OTs reassessed the patients after 1 week for intra-rater reliability. RESULTS: There were no floor or ceiling effects for the PFIM. Excellent inter-rater and intra-rater reliability was noted for the PFIM total score, motor and cognitive subscales (ICC(agreement)0.88-0.98). According to the Bland-Altman agreement analysis, there was no systematic bias between raters and within raters. The internal consistency of the PFIM was with Cronbach's alpha from 0.70 to 0.96. The principal component analysis with varimax rotation indicated a three-factor structure: (1) self-care and mobility; (2) sphincter control and (3) cognitive that jointly accounted for 74.8% of the total variance. Construct validity was supported by a significant Pearson correlation between the PFIM and the Persian Barthel Index (r = 0.95; p < 0.001). CONCLUSIONS: The PFIM is a highly reliable and valid instrument for measuring functional status of Persian patients with stroke. IMPLICATIONS FOR REHABILITATION: The Functional Independence Measure (FIM) is an outcome measure for disability based on the International Classification of Functioning, Disability and Health (ICF). The FIM was cross-culturally adapted and validated into Persian language. The Persian version of the FIM (PFIM) is reliable and valid for assessing functional status of patients with stroke. The PFIM can be used in Persian speaking countries to assess the limitations in activities of daily living of patients with stroke.

Relationship between Semmes-Weinstein Monofilaments perception Test and sensory nerve conduction studies in Carpal Tunnel Syndrome.

BACKGROUND: The Semmes-Weinstein Monofilament Test (SWMT) is a clinical widely used test to quantify the sensibility in patients with Carpal Tunnel Syndrome (CTS). No study has investigated the relationship between the SWMT and sensory nerve conduction studies (SNCS) in patients with CTS. OBJECTIVE: To assess the relationship between the SWMT and SNCS findings in patients with CTS. METHODS: This cross-sectional clinical measurement study included 35 patients with CTS (55 hands) with a mean age of 45 ± 12 years. The outcome measures were the SWMT and SNCS measures of distal latency (DLs), amplitude (AMPs), and nerve conduction velocity (NCV). The median innervated fingers were tested using SWMT and electrodiagnostic tests. The primary outcome was the correlations between the SWMTs and NCS measures. RESULTS: All of the patients/hands had abnormal NCS findings. When looking at the three digits of interest (thumb, index and middle), the thumb SWMTs had the highest number of abnormal findings (58.2%), with the middle digit having the lowest (45.5%). All NCS findings were statistically different between abnormal and normal thumb SWMTs and abnormal and normal total summed SWMTs. There were significant moderate correlations between thumb SWMT scores and all NCS outcomes. CONCLUSIONS: Although only approximately 50% of the CTS diagnosed through NCS are corroborated through SWMT; the significant associations between SWMT and NCS measures suggest that SWMT is a valid test for assessing sensations in patients with CTS.