Middle East Journal of Rehabilitation and Health Middle East Journal of Rehabilitation and Health Middle East J Rehabil Health http://www.jrehabilhealth.com 2423-4451 10.5812/mejrh. en jalali 2017 6 28 gregorian 2017 6 28 2 4
en 10.17795/mejrh-32907 Vitamin B12 in Vegetarian Diets Vitamin B12 in Vegetarian Diets letter letter Vitamin B 12;Diet;Vegetarian;Cobalamin Vitamin B 12;Diet;Vegetarian;Cobalamin http://www.jrehabilhealth.com/index.php?page=article&article_id=32907 Roman Pawlak Roman Pawlak Department of Nutrition Science, East Carolina University, Greenville, NC, USA; Department of Nutrition Science, East Carolina University, Greenville, North Carolina, USA. Department of Nutrition Science, East Carolina University, Greenville, NC, USA; Department of Nutrition Science, East Carolina University, Greenville, North Carolina, USA.
en 10.17795/mejrh-32216 Effect of Quadriceps Exercise Training on Muscle Fiber Angle in Patients With Patellofemoral Pain Syndrome Effect of Quadriceps Exercise Training on Muscle Fiber Angle in Patients With Patellofemoral Pain Syndrome research-article research-article Conclusions

The study findings indicate that short-term exercises had no significant effect on the ratio of VMO to VL muscle fiber angles in patients with PFPS.

Results

There were no significant differences in the muscle strength and fiber angle of the VMO, VL oblique and longus muscles after training between the control and experimental groups (P > 0.05).

Patients and Methods

Thirty-five subjects (23 females and 12 males, mean age 26.6 years ± 1.1 SD) with PFPS were randomized into an exercise group or a control group. The exercise group performed knee extension exercises for four weeks based on the Kaya exercise program (three times per week), while the control group received no treatment. Measurements included knee extensor concentric and eccentric muscle torque using a Biodex isokinetic machine and the fiber angle of the VMO, VL oblique and longus muscles using ultrasonography, all of which were evaluated at the time of the initial examination and at the end of the four-week period.

Objectives

The purpose of this study was to investigate the effect of quadriceps muscle strengthening exercises on the ratio of VMO to VL oblique and longus muscle fiber angles.

Background

Imbalance between the vastus medialis oblique (VMO) muscle and the vastus lateralis oblique (VTO) Vastus lateralis has been thought to be a primary cause of abnormal patellar tracking, possibly leading to patellofemoral pain syndrome (PFPS).

Conclusions

The study findings indicate that short-term exercises had no significant effect on the ratio of VMO to VL muscle fiber angles in patients with PFPS.

Results

There were no significant differences in the muscle strength and fiber angle of the VMO, VL oblique and longus muscles after training between the control and experimental groups (P > 0.05).

Patients and Methods

Thirty-five subjects (23 females and 12 males, mean age 26.6 years ± 1.1 SD) with PFPS were randomized into an exercise group or a control group. The exercise group performed knee extension exercises for four weeks based on the Kaya exercise program (three times per week), while the control group received no treatment. Measurements included knee extensor concentric and eccentric muscle torque using a Biodex isokinetic machine and the fiber angle of the VMO, VL oblique and longus muscles using ultrasonography, all of which were evaluated at the time of the initial examination and at the end of the four-week period.

Objectives

The purpose of this study was to investigate the effect of quadriceps muscle strengthening exercises on the ratio of VMO to VL oblique and longus muscle fiber angles.

Background

Imbalance between the vastus medialis oblique (VMO) muscle and the vastus lateralis oblique (VTO) Vastus lateralis has been thought to be a primary cause of abnormal patellar tracking, possibly leading to patellofemoral pain syndrome (PFPS).

Patellofemoral Pain Syndrome;Torque;Ultrasonography;Muscle Fiber Angle Patellofemoral Pain Syndrome;Torque;Ultrasonography;Muscle Fiber Angle http://www.jrehabilhealth.com/index.php?page=article&article_id=32216 Roshanak Honarpishe Roshanak Honarpishe Neuromuscular Rehabilitation Research Center, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, IR Iran Amir Hoshang Bakhtiary Amir Hoshang Bakhtiary Neuromuscular Rehabilitation Research Center, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-9123311892, Fax: +98-233332850 Neuromuscular Rehabilitation Research Center, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-9123311892, Fax: +98-233332850 Gholamreza Olyaei Gholamreza Olyaei Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.17795/mejrh-31310 Assessment the Interests of Elderly People Residing in Nursing Homes in Individual Activities Assessment the Interests of Elderly People Residing in Nursing Homes in Individual Activities research-article research-article Conclusions

The results showed that in the domain of individual activities in both sexes, the rates of interest in daily activities, cultural-educational pursuits, and physical exercise were very similar. However, in some cases, there were differences between the two sexes in terms of their interest in specific activities.

Patients and Methods

In this descriptive–analytical study, 80 elderly people in the age group 65 to 85 years residing in eight nursing homes in Tehran, Iran and affiliated with the Welfare Organization were studied. Their interest in three domains of individual activities daily activities, cultural educational affairs, and physical exercises were measured using a questionnaire and Interest Check List taken from Matsutessiu’s and Klyczek et al.’s studies. To analyze the data, the frequency percentage, the Chi-square test, and the Fisher test were used with a significance level of 5% as determined via SPSS-18. Moreover, to evaluate the statistical validity of data, cluster analysis was used.

Results

Investigation of the elderly people’s interests in three domains of individual activities showed the greatest interest in the activities of daily living; elderly of both sexes were interested in putting on makeup up appearance dressing up , going shopping, and dust , while the women were interested in cooking (over 80%). Meanwhile significant difference was seen in the women’s and men’s interest in driving, cooking,and washing (P = 0.05). In terms of cultural–educational pursuits, both sexes were interested in scientific and religious studies, praying, and listening to lectures. However, men were more interested in historical studies and concert (over 80%). Moreover, a significant difference between the two genders was evident in terms of writing and math calculations (P < 0.05). Both sexes were interested in physical exercise, such as hiking and fitness. A significant difference between the two genders was observed in relation to activities like playing football, swimming, traditional sports, cycling, volleyball, tennis, and basketball (P > 0.001).

Background

Aging is a process that happens over the course of human development in the last stage of life, the elderly have individual needs and interests which have been unknown due to differences between generations and lack of knowledge to them.

Objectives

The aim of this study was to identify the interests of the elderly in the domain of individual activities to be used by institutions and organizations for planning.

Conclusions

The results showed that in the domain of individual activities in both sexes, the rates of interest in daily activities, cultural-educational pursuits, and physical exercise were very similar. However, in some cases, there were differences between the two sexes in terms of their interest in specific activities.

Patients and Methods

In this descriptive–analytical study, 80 elderly people in the age group 65 to 85 years residing in eight nursing homes in Tehran, Iran and affiliated with the Welfare Organization were studied. Their interest in three domains of individual activities daily activities, cultural educational affairs, and physical exercises were measured using a questionnaire and Interest Check List taken from Matsutessiu’s and Klyczek et al.’s studies. To analyze the data, the frequency percentage, the Chi-square test, and the Fisher test were used with a significance level of 5% as determined via SPSS-18. Moreover, to evaluate the statistical validity of data, cluster analysis was used.

Results

Investigation of the elderly people’s interests in three domains of individual activities showed the greatest interest in the activities of daily living; elderly of both sexes were interested in putting on makeup up appearance dressing up , going shopping, and dust , while the women were interested in cooking (over 80%). Meanwhile significant difference was seen in the women’s and men’s interest in driving, cooking,and washing (P = 0.05). In terms of cultural–educational pursuits, both sexes were interested in scientific and religious studies, praying, and listening to lectures. However, men were more interested in historical studies and concert (over 80%). Moreover, a significant difference between the two genders was evident in terms of writing and math calculations (P < 0.05). Both sexes were interested in physical exercise, such as hiking and fitness. A significant difference between the two genders was observed in relation to activities like playing football, swimming, traditional sports, cycling, volleyball, tennis, and basketball (P > 0.001).

Background

Aging is a process that happens over the course of human development in the last stage of life, the elderly have individual needs and interests which have been unknown due to differences between generations and lack of knowledge to them.

Objectives

The aim of this study was to identify the interests of the elderly in the domain of individual activities to be used by institutions and organizations for planning.

Aging;Individual Interests;Physical Exercise;Cultural and Educational Affairs;Daily Activities Aging;Individual Interests;Physical Exercise;Cultural and Educational Affairs;Daily Activities http://www.jrehabilhealth.com/index.php?page=article&article_id=31310 Massomeh Rasoulzadeh Massomeh Rasoulzadeh Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Mina Sadat Mirshoja Mina Sadat Mirshoja Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-2333654180, Fax: +98-23333654180 Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-2333654180, Fax: +98-23333654180 Mohammad Amouzadeh Khalili Mohammad Amouzadeh Khalili Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Mona Simin Qhualam Mona Simin Qhualam Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Alliakbar Pahlavanian Alliakbar Pahlavanian Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, IR Iran Mehdi Rezaee Mehdi Rezaee Occupational Therapy Department, Shahid Beheshti Medical University, Theran, IR Iran Occupational Therapy Department, Shahid Beheshti Medical University, Theran, IR Iran
en 10.17795/mejrh-33274 Comparison of Fine Motor Skills in Patients With Chronic Stroke in Final Stages of Bronestrum and Healthy Adults Comparison of Fine Motor Skills in Patients With Chronic Stroke in Final Stages of Bronestrum and Healthy Adults research-article research-article Conclusions

The results showed that the dexterity fingers of patients suffering from stroke at the final stages of Bronestrum is much closer to the dexterity of healthy controls.

Background

One of the main problems of chronic stroke patients is the inability to move the fingers separately despite the passing of an extended period of time since the onset of the disease. Dexterity is a fine motor skill that allows one to manipulate objects through voluntary movement.

Results

The results showed that the mean variation of speed in the BBT test (standard deviation [SD]) in the left hands of the patients (recessive limb) was 57.8 (12.75), greater than in their right hand (dominant limb) (54.76 [8.67]). The rate of speed in healthy people’s right hands was 68.58 (8.31), greater than in their left hands (63.5 [8.54]). In addition, the results of the NHPT showed that the stroke patients needed more time to manipulate the objects than the healthy ones. For the NHPT, the mean (SD) of the right hand (dominant limb) patients (4.89) and healthy controls 36.7 (14.5) 21.98, mean (SD) of the left hand (dominant limb) patients (4.45) and 30.4 in healthy subjects (4.09) 24.18 respectively. Independent T-test showed P < 0.05 in all the results obtained, respectively.

Objectives

The aim of this study was to compare the fine motor skills of patients with chronic stroke to those of healthy controls.

Patients and Methods

This analytic and descriptive cross-sectional study was carried out randomly on 50 patients with chronic stroke with a mean age of 57.8 years suffering for 46 - 72 months and on 50 healthy people with a mean age of 51.16 years. Patients did not receive any intervention before or after one week of assessment. The function of both hands of each patient was measured with the nine-holepegtest (NHPT) and the box and block test (BBT).

Conclusions

The results showed that the dexterity fingers of patients suffering from stroke at the final stages of Bronestrum is much closer to the dexterity of healthy controls.

Background

One of the main problems of chronic stroke patients is the inability to move the fingers separately despite the passing of an extended period of time since the onset of the disease. Dexterity is a fine motor skill that allows one to manipulate objects through voluntary movement.

Results

The results showed that the mean variation of speed in the BBT test (standard deviation [SD]) in the left hands of the patients (recessive limb) was 57.8 (12.75), greater than in their right hand (dominant limb) (54.76 [8.67]). The rate of speed in healthy people’s right hands was 68.58 (8.31), greater than in their left hands (63.5 [8.54]). In addition, the results of the NHPT showed that the stroke patients needed more time to manipulate the objects than the healthy ones. For the NHPT, the mean (SD) of the right hand (dominant limb) patients (4.89) and healthy controls 36.7 (14.5) 21.98, mean (SD) of the left hand (dominant limb) patients (4.45) and 30.4 in healthy subjects (4.09) 24.18 respectively. Independent T-test showed P < 0.05 in all the results obtained, respectively.

Objectives

The aim of this study was to compare the fine motor skills of patients with chronic stroke to those of healthy controls.

Patients and Methods

This analytic and descriptive cross-sectional study was carried out randomly on 50 patients with chronic stroke with a mean age of 57.8 years suffering for 46 - 72 months and on 50 healthy people with a mean age of 51.16 years. Patients did not receive any intervention before or after one week of assessment. The function of both hands of each patient was measured with the nine-holepegtest (NHPT) and the box and block test (BBT).

Fine Motor Skills;Chronic Stroke;Healthy Adults Fine Motor Skills;Chronic Stroke;Healthy Adults http://www.jrehabilhealth.com/index.php?page=article&article_id=33274 Mina Sadat Mirshoja Mina Sadat Mirshoja Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran Ali Akbar Pahlevanian Ali Akbar Pahlevanian Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-2333654180 Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran; Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran. Tel: +98-2333654180 Mohammad Amoozadeh Khalili Mohammad Amoozadeh Khalili Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran Neuromuscular Rehabilitation Research Center, Department of Occupational Therapy, Semnan University of Medical Sciences, Semnan, IR Iran
en 10.17795/mejrh-32200 Investigating Phonological Awareness in Persian-Speaking Children With Phonological Disorders Investigating Phonological Awareness in Persian-Speaking Children With Phonological Disorders research-article research-article Conclusions

The results suggested that PA skills in children with phonological disorders are affected by error type. We also found the type of errors that can play a more effective role in PA investigations as compared to PCC. The results also showed that children with CAP require special attention.

Results

The CAP group showed significant difference with the ND group in alliteration (P = 0.001), rhyme (P = 0.001), identification of words with the same initial phoneme (P = 0.002), and identification of words with the same final phoneme (P = 0.001) [except blending phonemes (P = 0.504)]. Though performing more poorly, the delayed group did not show significant difference with ND group (P > 0.05). The ICP and ND groups did not show significant difference in PA except in identifying words with the same final phoneme (P = 0.008). The relation between PCC and PA was observed only in the CAP group (P = 0.021).

Background

In terms of error patterns, children with phonological disorders (PD) are a heterogeneous population. These children are at risk for phonological awareness (PA) deficits.

Objectives

This study aimed to investigate phonological awareness in Persian-speaking children with phonological disorders.

Patients and Methods

Thirty-six children with PD aged 5 - 6 years were selected by a convenience sampling method during 12 months. Children with PD were divided into three groups according to their error patterns. Fourteen normally developing (ND) children were selected as the control group. In order to equalize socioeconomic status, ND children were similar to the PD groups based on age, residential area, and mothers’ educational attainments. Language, speech sound production, oro-motor, and PA skills were investigated. Intra-syllabic and phonological awareness (PA) were compared to investigate PA skills in the four groups. Relation between percent consonant correct (PCC) and PA was also investigated in the four groups. Fourteen children with phonological delay, 12 children with consistent atypical phonological disorders (CAP), and 10 children with inconsistent phonological disorders (ICP) formed the PD groups.

Conclusions

The results suggested that PA skills in children with phonological disorders are affected by error type. We also found the type of errors that can play a more effective role in PA investigations as compared to PCC. The results also showed that children with CAP require special attention.

Results

The CAP group showed significant difference with the ND group in alliteration (P = 0.001), rhyme (P = 0.001), identification of words with the same initial phoneme (P = 0.002), and identification of words with the same final phoneme (P = 0.001) [except blending phonemes (P = 0.504)]. Though performing more poorly, the delayed group did not show significant difference with ND group (P > 0.05). The ICP and ND groups did not show significant difference in PA except in identifying words with the same final phoneme (P = 0.008). The relation between PCC and PA was observed only in the CAP group (P = 0.021).

Background

In terms of error patterns, children with phonological disorders (PD) are a heterogeneous population. These children are at risk for phonological awareness (PA) deficits.

Objectives

This study aimed to investigate phonological awareness in Persian-speaking children with phonological disorders.

Patients and Methods

Thirty-six children with PD aged 5 - 6 years were selected by a convenience sampling method during 12 months. Children with PD were divided into three groups according to their error patterns. Fourteen normally developing (ND) children were selected as the control group. In order to equalize socioeconomic status, ND children were similar to the PD groups based on age, residential area, and mothers’ educational attainments. Language, speech sound production, oro-motor, and PA skills were investigated. Intra-syllabic and phonological awareness (PA) were compared to investigate PA skills in the four groups. Relation between percent consonant correct (PCC) and PA was also investigated in the four groups. Fourteen children with phonological delay, 12 children with consistent atypical phonological disorders (CAP), and 10 children with inconsistent phonological disorders (ICP) formed the PD groups.

Speech-Sound Disorder;Child;Classification;Iran Speech-Sound Disorder;Child;Classification;Iran http://www.jrehabilhealth.com/index.php?page=article&article_id=32200 Navideh Shakeri Navideh Shakeri Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran Zahra Soleymani Zahra Soleymani Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122036683, Fax: +98-2177534133 Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122036683, Fax: +98-2177534133 Talieh Zarifian Talieh Zarifian Department of Speech Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Department of Speech Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Mohammad Kamali Mohammad Kamali Department of Rehabilitation Management, School of Rehabilitation, Iran University of Medical Sciences, Tehran, IR Iran Department of Rehabilitation Management, School of Rehabilitation, Iran University of Medical Sciences, Tehran, IR Iran
en 10.17795/mejrh-32392 Does Deafness Affect Resilience? Does Deafness Affect Resilience? research-article research-article Discussion

Similar resilience scores in deaf and hearing participants may be due to appropriate interaction of deaf signers with family members and society. Male deaf subjects were more resilient than female ones; studies should be done to examine the effects of cultural characteristics that may provide females with less communication opportunities than males.

Materials and Methods

This comparative study was performed to assess self-evaluated resilience in 45 deaf signers and in 76 matched hearing subjects from Hamadan, Iran. Resilience scores were measured using a modified connor-davidson resilience scale.

Results

The average resilience score was 61.20 in deaf signers and 62.8 in hearing subjects; however, this difference was not statistically significant. The resilience score was different in female and male deaf participants. It was 65.22 for male deaf participants (SD = 10.4) and 55.17 for female deaf participants (SD = 16.1), and this difference was statistically significant (P = 0.014). The gender difference between the resilience scores of hearing participants (male, 66.24 [SD = 16.7] and female, 59.36 [SD = 13.9]) was not significant (P = 0.057).

Background

Resilience is a positive psychological characteristic that contributes to mental health and adjustment under challenging conditions, such as deafness. Deafness is a traumatic experience and causes communication disorders; it may also affect resilience.

Objectives

We compared the resilience of deaf signers to that of a matched group of hearing individuals.

Discussion

Similar resilience scores in deaf and hearing participants may be due to appropriate interaction of deaf signers with family members and society. Male deaf subjects were more resilient than female ones; studies should be done to examine the effects of cultural characteristics that may provide females with less communication opportunities than males.

Materials and Methods

This comparative study was performed to assess self-evaluated resilience in 45 deaf signers and in 76 matched hearing subjects from Hamadan, Iran. Resilience scores were measured using a modified connor-davidson resilience scale.

Results

The average resilience score was 61.20 in deaf signers and 62.8 in hearing subjects; however, this difference was not statistically significant. The resilience score was different in female and male deaf participants. It was 65.22 for male deaf participants (SD = 10.4) and 55.17 for female deaf participants (SD = 16.1), and this difference was statistically significant (P = 0.014). The gender difference between the resilience scores of hearing participants (male, 66.24 [SD = 16.7] and female, 59.36 [SD = 13.9]) was not significant (P = 0.057).

Background

Resilience is a positive psychological characteristic that contributes to mental health and adjustment under challenging conditions, such as deafness. Deafness is a traumatic experience and causes communication disorders; it may also affect resilience.

Objectives

We compared the resilience of deaf signers to that of a matched group of hearing individuals.

Resilience;Deafness;Mental Health Resilience;Deafness;Mental Health http://www.jrehabilhealth.com/index.php?page=article&article_id=32392 Nassim Ahmadi Nassim Ahmadi Department of Speech and Language Pathology, Faculty of Rehabilitation Science, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Speech and Language Pathology, Faculty of Rehabilitation Science, Hamadan University of Medical Sciences, Hamadan, IR Iran Tahereh Afshari Tahereh Afshari Shahid Beheshti University, Tehran, IR Iran Shahid Beheshti University, Tehran, IR Iran Mohammad Reza Nikoo Mohammad Reza Nikoo Department of Occupational Therapy, Faculty of Rehabilitation Science, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Occupational Therapy, Faculty of Rehabilitation Science, Hamadan University of Medical Sciences, Hamadan, IR Iran Fatemeh Rajati Fatemeh Rajati Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Bahram Tahmacbi Bahram Tahmacbi Department of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Mohammad Kamali Mohammad Kamali Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, IR Iran Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, IR Iran Farhad Farahani Farhad Farahani Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran; Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Fax: +98-8138381572 Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran; Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Fax: +98-8138381572