Relationship between quality of life and hypertonia in young adults with spastic cerebral palsy

Background: The complications associated with spastic cerebral palsy can affect the physical ability and quality of life of individuals suffering from this motor disorder. The aim of this study was to assess the relationship between quality of life and hypertonia in adults with spastic cerebral palsy

Methods: In an analytical cross sectional study, 70 subjects with the diagnosis of spastic cerebral palsy from three Ra'ad Rehabilitation Goodwill complexes in Tehran and Karaj cities took part in this study through convenient sampling. The severity of spasticity and contracture of the knee flexors were measured by Modified Tardieu Scale. Also the quality of life was assessed through World Health Organization quality of life-BREF questionnaire. To analyze data, Pearson and spearman correlation coefficient were used

Results: Participants of this study were 42.9% male, 57.1% female with mean age 26.24 +/- 5 years. No correlation existed between quality of life with knee flexor muscles spasticity. However, psychological and environmental domains showed low correlations with knee extension range [respectively r=0.26 and r=0.28; p< 0.05]

Conclusion: The influences of the mechanical component of hypertonia [contracture] on the quality of life are more prominent than neural factors such as spasticity

Impaired ipsilateral upper extremity dexterity and its relationship with disability in post-stroke right hemiparesis

Background: The objectives of this study were to compare manual dexterity [gross and fine] and coordination performance of the ipsilateral upper extremity of the right hemisphere stroke patients with the same side of a healthy group, and to determine the relationship of ipsilateral upper extremity dexterity and disability

Methods: In a non-randomized analytical study, 30 individuals with a unilateral first-ever stroke from outpatient rehabilitation clinics and 30 age and sex-matched adults without history of neurological disorders were enrolled. Purdue Pegboard, Box and Block, and Finger to Nose tests were used to measure dexterity [fine and gross] and coordination performance of the stroke group compared with the same hand of the healthy group. The Barthel index was also used to assess disability or dependency of stroke patients in basic activities of daily living

Results: Results showed that stroke individuals with involvement of ipsilateral hand had less coordination and dexterity when compared to the same hand of normal subjects [P=0.001]. In addition, the relationship of gross and fine manual dexterity performance of the ipsilateral upper extremity with disability, including dependence in basic activities of daily living, were significant respectively [r=0.376, r=0.391]

Conclusion: People with right stroke had significant ipsilateral upper extremity impairments [manual dexterity and coordination tasks], and this hand dexterity deterioration had an impact on their dependence in basic activities of daily living

Experience of physiotherapists of teamwork results: a qualitative study

Purpose: In modern societies, in order to save medical costs and provide improved and comprehensive healthcare services, cooperation of various specialties in the form of teamwork has gained significant popularity. Physiotherapists, as members of the treatment team, try to improve the health of their fellow human beings. This study aimed to describe physiotherapists' experience and perception of teamwork in hospital environment

Methods: This study was conducted using the conventional qualitative method of content4analysis. Participants were 11 physiotherapists with 7-25 years of work experience, who were4purposefully selected from 6 hospitals in Tehran. For data collection, in-depth semi-structured4interviews over one year [2012-2013] were conducted and the obtained data were analyzed using content analysis method

Results: The findings obtained from the interviews were categorized into two main areas: 1] changes in the beliefs and feelings of the physiotherapists, including increased satisfaction, motivation, increased relaxation, decreased stress and work pressure, accepting criticism, increased trust in and respect for physiotherapy services, giving specialists a holistic view, and 2] increased job productivity, higher quality of services, more references; avoiding parallel procedures; reduction of secondary complications of diseases, increased awareness and knowledge

Conclusion: Teamwork has positive effects on the beliefs, feelings, and job productivity of the physiotherapists working in Tehran hospitals. Because of the growing trend of chronic diseases and increasing elderly population in Iran, provision of comprehensive and holistic healthcare services seems to be necessary in Iran and the need for further research on teamwork is pressing

Test-retest reliability of Motricity index strength assessments for lower extremity in post stroke hemiparesis

The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval. In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured. The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index [ICC=0.93]. The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke

Association between spasticity and the level of motor function with quality of life in community dwelling Iranian young adults with spastic cerebral palsy

Consequences of cerebral palsy in adulthood can affect physical, psychological capabilities and quality of life. The purpose of this study was to investigate the relationship between quality of life with spasticity and level of motor function in Iranian young adults with spastic cerebral palsy who were community dweller. In an analytical cross sectional study, 77 participants with spastic cerebral palsy [44 women¡ 33 men] with age range of 20 to 40 years; [mean age 26.19 +/- 5 yr] took part in this study. They were enrolled from three Raad Rehabilitation Goodwill complexes in Tehran and Karaj cities. All subjects were recruited through convenient sampling. Severity of Spasticity for knee flexors was measured with Modified Tardieu Scale. In addition, the level of motor function, and quality of life were assessed respectively through Gross Motor Function Classification System and World Health Organization Quality of life questionnaire [WHOQOL- BREF]. To analyze data, Pearson and spearman correlation coefficient was used. No correlation found between quality of life with knee flexor muscles spasticity and level of motor function [p> 0.05]. Quality of life as a multi dimensional concept has been impacted by many factors such as physical status, environmental issues and culture. Possibly, severity of spasticity and level of function have a less pronounced effect on quality of life in community dwelling adults with cerebral palsy

Pain-related disability measurement: the cultural adaptation and validation of "pain disability index [PDI]" and "pain disability questionnaire [PDQ]" among Iranian low back pain patients

Low Back Pain [LBP] is still a medical problem in 21[st] century. Having back pain and being disabled by it are not the same thing. It is common to come across with patients who have simple back pain but surprisingly totally disabled and vice versa. In clinical practice, it is important to have a proper evaluation of disability and making a clear distinction between pain and disability. During the past two decades several self-report measures and questionnaires have been developed to evaluate disability in LBP patients, however most of these questionnaire were designed in English language and based on European or American studies. The aim of these questionnaires were designed in English language and based on European or American Studies. The aim of this study was to develop and validate a translated and culturally adapt "Pain Disability Index [PDI]" and "Pain Disability Questionnaire [PDQ]" among Iranian patients with loc back pain. The Persian versions of the PDI, PDQ were created through systematic translation and cross-cultural adaptation of the original questionnaires. The Oswestry Disability Index and visual Analogue Scale were used for validation studies. Patients were asked to complete these questionnaires initially and also at 7 days later as retest. A total of 304 patients with acute and chronic LBP completed the Persian versions of PDI, PDQ, "Oswestry Disability Index" [ODI] and "Visual Analogue Scale" [VAS]. Among patients 111 patients participated for retest after seven days. The Cronbach's alpha [coefficient of reliability] for the PDI and PDQ was satisfactory. The PDI and PDQ showed high and very high test-retest reliability [ICC=0.8 and 0.92 respectively]. The Pearson correlation coefficient among PDI, PDQ with ODI was 0.64 and 0.72, and for PDI, PDQ, ODI with VAS was 0.36, 0.47 and 0.57, respectively [P<0.001]. The Persian version of the PDI and PDQ questionnaire are reliable and valid instruments to evaluate generic perceived disability in Persian-speaking patients with LBP. It is shown that PDI and PDQ are capable of measuring the disability in LBP patients. They could be used in clinical and research encounters with acceptable confidence