Psychometric Evaluation of the Persian Version of the Functional Mobility Scale: Assessing Validity and Reliability.

AIM: This study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the Functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP). METHODS: Following international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman's coefficient to correlate with the Gross Motor Function Classification System (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen's weighted kappa coefficient. RESULTS: Concurrent validity ranged from -0.912 to -0.941 for children and -0.912 to -0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to 0.987. CONCLUSION: The Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.

Validity and reliability of the Persian version of greenspan social-emotional growth chart.

Background: The estimated prevalence of mental health disorders in children and adolescents is between 10% and 20%. Furthermore, a quarter of very premature infants exhibit socioemotional delays in infancy and childhood. The objective of this study was to determine the validity and reliability of Greenspan social-emotional growth chart (GSEGC) in Persian children aged 1-42 months. Materials and Methods: After translation procedures, the face validity, content validity, construct validity, test-retest reliability, and internal consistency of the GSEGC questionnaire were evaluated. The quality of translating items was obtained using the suggestions of the research group. The face validity of the GSEGC was performed by interviewing with 10 mothers in the target group. To evaluate content validity quantitatively, content validity ratio (CVR) and content validity index (CVI) were used after reviewing the face and content validity and pilot study, 264 parents of children aged 1-42 months completed the GSEGC questionnaire to assess the construct validity and internal consistency. In order to determine the test-retest reliability, after 2 weeks, 18 parents completed the questionnaire again. Results: Eleven questions were changed according to the interviews (questions 1-6, 9-11, and 15-16). The lowest CVR was related to items 30 and 20 (0.636), and other items had an acceptable CVR. The lowest CVI value was related to item 1 of clarity and simplicity (0.818), and other items had an acceptable CVI. Intra-class correlation coefficient was 0.988 for all items of questionnaire. Furthermore, Cronbach's alpha coefficient was 0.952 for all items. In factor analysis, two factors were extracted from the items in questionnaire. Conclusion: The Persian version of GSEGC questionnaire has acceptable face, content and, constructs validity, test-retest reliability and high internal consistency in the target population. Therefore, the Persian version of the GSEGC can be used as a tool to assess 1-42 months sensory processing and socio-emotional development.

Factor structure of Participation Behavioural Questionnaire (PBQ) in patients with hand injuries.

BACKGROUND: Participation is considered a critical outcome of successful rehabilitation and should be evaluated. OBJECTIVE: We aimed to evaluate the structural validity of the Participation Behaviour Questionnaire (PBQ) in people with hand injuries. METHODOLOGY: The PBQ contains 30 items that measure participation as conceptualized in the ICF. PBQ was developed with Rasch analysis to measure participation in hand injured. A sample of 404 patients with hand injuries and a mean age of 37 (16.0) participated and was randomly split for exploratory and confirmatory factor analysis (EFA/CFA). RESULTS: Both EFA and CFA confirmed a four factor-solution. These factors were named: Social Participation and Interpersonal Relationships, Autonomy and Role, Subjective Satisfaction with Participation, Recreational, Sport, and Leisure Time. The value of Cronbach's alpha was 0.96 for the total scale and >0.85 for each subscale. CONCLUSIONS: The structural validity of the PBQ was confirmed using both EFA and CFA. The PBQ measures four dimensions of participation.

Does covid-19 pandemic tell us something about time and space to meet our being, belonging and becoming needs?

BACKGROUND: People's perceptions of events like a pandemic are shaped by individual experiences within their socio-cultural context. Attributing negative or positive meanings to an experience may influence the sense of Being, Belonging and Becoming. AIM AND OBJECTIVES: To investigate the impact of the isolation/social distancing measures on people's sense of Being, Belonging, Becoming and overall sense of Occupational Wholeness compared to the time before the Covid-19 Pandemic as it is perceived by an Iranian population. METHODS: The Model of Occupational Wholeness used to inform the theoretical basis of this study and development of the survey questions. An internet-based survey using a convenient and snowball sampling method was conducted. A self-administered questionnaire was published using a software named Porsline. A sample of 1624 members of the general population in Iran (67% response rate) completed the questionnaire within the first four weeks of the isolation/social distancing period starting on 18 March 2020. The Data was analysed by the SPSS 22. RESULTS: The participants showed a more positive perceived level of Being and Belonging as well as an overall sense of Occupational Wholeness, and no difference in the perceived sense of Becoming during the isolation/social distancing period compared to the time before the Covid 19 pandemic. CONCLUSIONS: The findings show that the isolation/social distancing measures were perceived by participants as an opportunity to meet some of their Being, and Belonging needs that contribute to an overall sense of OccupationalWholeness.This highlights the role that Occupational science and Occupational therapy may have in helping people in situations when they need to rethink and replan for what they Do and the way they attribute meaning to their experiences.

Spirituality as a Neglected Core in Occupational Therapy Practice: An Iranian Exploratory Survey.

Spirituality has received more attention in recent decades from different health disciplines. Occupational Therapy (OT), as a health discipline, believes that all aspects of human experience, including physical, psychological, social, and spiritual, are considered essential aspects of health. OT supports the fact that incorporating spirituality can promote health, well-being, and quality of life. Various researchers have attempted to investigate and explain occupational therapists' views on spirituality. In Iran's OT curriculum, spirituality has not been incorporated directly. The purpose of this study is to acquire information about the knowledge and opinions of Iranian occupational therapists about spirituality. This is a cross-sectional exploratory descriptive survey study in which 125 occupational therapists participated through convenience sampling. Inclusion criteria were, namely (a) at least one-year clinical experience of OT, (b) being educated in Iran, and (c) working in Iran. The Occupational Therapy Assessment of Spirituality (OTAS) questionnaire was used for data collection. The answers to the quantitative questions were analyzed through descriptive statistics. Most of the participants believed that spirituality should be incorporated by occupational therapists, but more than half of the participants disagreed that formal education prepared them to pay any attention to spirituality in their practice. Analyzing qualitative data by frequencies of their repetitions, led to four categories and sixteen subcategories, accordingly. The four categories are (1) the barriers to applying spirituality in OT, (2) the need to acquire knowledge and apply spirituality in OT, (3) the benefits of incorporating spirituality for a client, and (4) the benefits of incorporating spirituality for the occupational therapist. The findings indicate that academic education has failed to prepare Iranian occupational therapists to meet spiritual needs of their clients. However, OTs tend to get information about spirituality from other sources and find it helpful for themselves and their clients. There are also barriers to applying spirituality; therefore, an educational package is needed to address these problems.

Efficacy of Occupational Performance Coaching with and without Four Quadrant Model of Facilitated Learning for mothers of children with specific learning disorder: Study protocol for a randomized controlled trial.

Background: In addition to academic problems, children with a specific learning disability (SLD) encounter problems with participation in activities outside school. Purpose: To investigate the efficacy of Occupational Performance Coaching (OPC) with and without Four Quadrant Model of Facilitated Learning (4QM) in the mothers of children with SLD. Method: A single-blinded, parallel-group randomized clinical trial will be carried out. Mothers of children with SLD will constitute the participants and be allocated to experimental (OPC+4QM) and control (OPC alone) groups. Key issues: Children's occupational performance and satisfaction, participation in activities outside school, goals attainment, executive function, and academic achievement along with self-efficacy of mothers will be measured in baseline, post-intervention, and one-month follow-up stages. Implications: An OPC intervention protocol may improve children's participation in activities outside school and may help clarify whether 4QM promotes maternal empowerment and better results for children with SLD. Trial registration: Clinical Trials, IRCT20140416017301N9. (https://en.irct.ir/trial/55842).

Effect of Occupation Performance Coaching with Four-Quadrant Model of Facilitated Learning on Children with Specific Learning Disorder.

Background: Children with a specific learning disability (SLD) have deficits in everyday occupations along with executive function in addition to academic issues. Objective: The present study is aimed at investigating the effectiveness of Occupational Performance Coaching (OPC) and the Four-Quadrant Model of Facilitated Learning (4QM) interventions on the participation in occupational performance and executive function skills in children with SLD. Method: This study was a single-case experimental design (multiple baselines) in which six children with SLD were randomly assigned to three groups. In the baseline phase, three groups of children underwent repeated executive function assessments using the Stroop Color and Word Test (SCWT) and the Wisconsin Card Sorting Test (WCST) in the multiple baselines. In the intervention phase, all six mothers of children with SLD individually received OPC and 4QM interventions once a week for 14 sessions of 60 minutes and during this period, children were evaluated six more times for executive function skills according to SCWT and WCST. In addition, The Canadian Occupational Performance Measure (COPM) and Behavior Rating Inventory of Executive Function (BRIEF) at the beginning and the end of the baseline phase and the end of the intervention phase were completed by mothers of children with SLD. Results: More than 50% PND of the SCWT and WCST in the visual analysis graph's information along with significant changes in COPM scores and large effect size of BRIEF subscales (Cohen's d ≥ 0.8) in pre- and postintervention showed the effectiveness of OPC and 4QM on the participation in occupational performance and executive function skills in children with SLD. Conclusion: The results of the study support the effectiveness of OPC and 4QM interventions on children with SLD. However, research with more participants and experimental methods can provide further evidence.

The effect of "Elder Care by Elderly People Program" on life satisfaction and quality of life among institutionalized senior citizens.

INTRODUCTION: Improving participation in life meaningful roles is one of the most important predictors of quality of life (QOL) and life satisfaction (LS) in later life. The purpose of this study was to investigate the effect of Elder Care by Elderly People (ECP) on LS and QOL among institutionalized senior citizens. MATERIAL AND METHOD: This was an interventional study involving a targeted sample of 36 older adults in Ghods nursing home in Tehran in 2018. WHOQOL-OLD 24-item and LS 40-item questionnaires were used to measure LS and Olathe repeated-measures ANOVA and descriptive was employed to obtain the objectives. RESULTS: The participants were 36 older adults in Ghods nursing home. The mean age of older adults was 67.27 (standard deviation [SD] = 7.6), of whom about 77.8% were male. The mean score of QOL increased from 74.38 (SD = 13.09) pre intervention to 83.72 (SD = 11.43) 2 months post intervention, with most significant change of 9.3 QOL points between pre intervention and 2 months post intervention alone (P < 0.01). Similarly, LS increased from 114.19 (SD = 26.93) pre intervention to 133.94 (SD = 20.49) 2 months post intervention, with most significant change of 19.7 LS points between pre intervention and 2 months post intervention alone (P < 0.001). CONCLUSIONS: The results of this study showing the evidence of the positive impact of the ECP Programmed for the elderly, therefore, it is suggested that the programmer is evaluated in future studies.

Cognitive Orientation to Daily Occupational Performance (CO-OP) in Children with Cerebral Palsy: A Systematic Review with Meta-analysis.

Background: Cognitive orientation to daily occupational performance (CO-OP) is a client-centered treatment approach that was developed in the 1990s by occupational therapists. Purpose: Exploring current evidence about the effectiveness of CO-OP on children with cerebral palsy (CP). Method: Major electronic databases were searched. A narrative synthesis of current literature and meta-analyses on randomized control trials (RCTs) were conducted on changes in occupational performance. Findings: Seven studies with 103 participants were included. Four studies were RCTs with moderate levels of evidence, and three studies had single-subject designs. Although beneficial effects of CO-OP on goal achievement and transferring learned skills were reported, meta-analyses showed that CO-OP had no significant effect on the performance (WMD = 1.52, 95% CI = -1.58 to 4.63, P = .33) and satisfaction domains (WMD = 1.71, 95% CI = -1.14 to 4.57, P = .24) of Canadian Occupational Performance Measure scores compared to alternative interventions. Implications: CO-OP improves occupational performance but not more than alternative interventions. Results are inconclusive due to small sample sizes and heterogeneity of alternative interventions and participants. Therefore, research with a larger number of participants with sound RCT methods is needed.

Relationship between Work-Related Quality of Life and Job Satisfaction in Iranian Occupational Therapists.

OBJECTIVE: This study is aimed at exploring the relationship between the work-related quality of life and job satisfaction among Iranian occupational therapists. METHODS: In an analytical-descriptive, cross-sectional study, 322 occupational therapists were recruited through a convenient sampling. Inclusion criteria consisted of age between 22 and 50 years, at least one-year work experience, 24 hours of working per week as an occupational therapist, and membership of Iranian Occupation Therapy Association. After signing the informed consent and completing demographic information, each participant completed the Minnesota Satisfaction Questionnaire- Short Form (MSQ-SF) and work-related quality of life scale. RESULTS: The highest quality of working life belonged to occupational therapists who were female, married, with an annual salary of more than 40000$ (compared to below 20000 $), and those with work experience between 5 and 12 years. There was a positive and significant relationship between work-related quality of life and job satisfaction. Work-related quality of life scores could significantly predict MSQ-SF scores (ß1 = 0.54, p < .001). CONCLUSIONS: The significantly positive relationship between work-related quality of life and job satisfaction suggests the importance of organizational programs for enhancing factors of work-related quality of life in order to improve job satisfaction and quality of life among Iranian occupational therapists.

The Effect of the combination of active vestibular interventions and occupational therapy on Balance in Children with Bilateral Spastic Cerebral Palsy: A pilot randomized Controlled trial.

OBJECTIVE: The current study aimed to examine the effect of the combined administration of active vestibular interventions and occupational therapy on balance and the relationship between balance changes and Activity of Daily Living in school-aged children with cerebral palsy (CP). MATERIALS & METHODS: Twenty-four children with Spastic CP, at the level I and II (according to the "Gross Motor Function Classification System) aged 7-12 years were enrolled and randomly assigned into control and intervention groups. Pediatric Balance Scales and Bruininks-Oseretsky Test of Motor Proficiency II were employed to assess the functional balance changes as well as Force Plate (eyes closed and open) to assess changes in the parameters of balance (e.g. center of pressure excursion). The activity of Daily Living was assessed by "Activity Scales for Kids (performance version)". Participants in the intervention group received active vestibular intervention for 20 min and a regular occupational therapy program for 25 min. The control group received a regular occupational therapy program for 45 min. Interventions were provided 3 d/week for 6 weeks in each group. The participants were assessed in three stages: baseline, immediately after, and eight weeks after the intervention. Data were analyzed by ANOVA and linear regression. RESULTS: The results demonstrated that only functional balance, according to Pediatric Balance Scales scores, was significantly increased in the active vestibular interventions group (p=0.02). There was no significant association between functional balance and Activity of Daily Living (P>0.05). CONCLUSION: The combined administration of active vestibular interventions and occupational therapy could improve the functional balance in children with spastic CP. It may be related to the reorganization of the vestibular system with a controlled and precise application of stimuli.

The effects of anxiety and dual-task on upper limb motor control of chronic stroke survivors.

This study was designed to investigate the effects of anxiety and dual-task on reach and grasp motor control in chronic stroke survivors compared with age- and sex-matched healthy subjects (HC). Reach and grasp kinematic data of 68 participants (high-anxiety stroke (HA-stroke), n = 17; low-anxiety stroke (LA-stroke), n = 17; low-anxiety HC, n = 17; and high-anxiety HC, n = 17) were recorded under single- and dual-task conditions. Inefficient reach and grasp of stroke participants, especially HA-stroke were found compared with the control groups under single- and dual-task conditions as evidenced by longer movement time (MT), lower and earlier peak velocity (PV) as well as delayed and smaller hand opening. The effects of dual-task on reach and grasp kinematic measures were similar between HCs and stroke participants (i.e., increased MT, decreased PV that occurred earlier, and delayed and decreased hand opening), with greater effect in stroke groups than HCs, and in HA-stroke group than LA-stroke group. The results indicate that performing a well-learned upper limb movement with concurrent cognitive task leads to decreased efficiency of motor control in chronic stroke survivors compared with HCs. HA-stroke participants were more adversely affected by challenging dual-task conditions, underlying importance of assessing anxiety and designing effective interventions for it in chronic stroke survivors.

Cognitive Assessments Used in Occupational Therapy Practice: A Global Perspective.

This exploratory study was aimed at evaluating the current status of global occupational therapy practice on the use of assessments for clients with cognitive impairments and providing recommendations for ongoing evidence. We targeted international occupational therapy clinicians working with clients experiencing neurocognitive impairments. 323 occupational therapists from a wide range of clinical practice areas participated in the study. A large number of therapists used noncognitive specific assessments with a focus on functional approaches. The most commonly used standardized assessments were the COPM (56.7%), followed by MMSE (54.2%) and MoCA (45.5%), while the nonstandardized assessments were clinical observation (38.4%) and generic ADL assessment (34.1%). The use of main assessments was significantly different across world regions (p < 0.05), as were the reasons for choosing them (p < 0.05). The occupational therapists' use of assessment tools with clients suffering from neurocognitive impairments is inconsistent across the globe. The identification of international best practices for selecting and implementing proper outcome measures is warranted. It is essential to promote the development of an occupational therapy initiative to support the use of appropriate assessments at the international levels to facilitate consistent best practice.

Sensory retraining improves light touch threshold of the paretic hand in chronic stroke survivors: a single-subject A-B design.

Background: Light touch, one of the primary and basic sensations, is often neglected in sensory retraining programmes for stroke survivors.Objective: This study aimed to investigate the effects of sensory retraining on the light touch threshold of the hand, dexterity and upper limb motor function of chronic stroke survivors.Methods: Five chronic stroke survivors with sensory impairment participated in this single-subject A-B design study. In baseline (A) phase, they only received standard rehabilitation. In the treatment (B) phase, they received a 6-week sensory retraining intervention in addition to standard rehabilitation. In both phases, they were evaluated every 3 days. Light touch threshold, manual dexterity and upper limb motor function were assessed using Semmes-Weinstein Monofilaments, Box-Block Test and Fugl-Meyer Assessment, respectively. Visual analysis, nonparametric Mann-Whitney U test and, c-statistic were used for assessing the changes between phases.Results: All participants indicated changes in trend or slope of the total score of light touch or both between the two phases. The results of the c-statistic also showed the statistical difference in the total score of light touch between baseline and treatment in all participants (p < 0.001). Also, the results of the c-statistic and Mann-Whitney U test supported the difference of manual dexterity and motor function of the upper limb between baseline and treatment in all participants (p < 0.001).Conclusion: Current findings showed that sensory retraining may be an effective adjunctive intervention for improving the light touch threshold of the hand, dexterity and upper limb motor function in chronic stroke survivors.

Contextual Intervention Adapted for Autism Spectrum Disorder: An RCT of a Parenting Program with Parents of Children Diagnosed with Autism Spectrum Disorder (ASD).

OBJECTIVES: We investigated the effects of a manualized Contextual Intervention adapted for Autism Spectrum Disorders (CI-ASD), and essential elements of the intervention in promoting children's participation and mothers' parenting self-efficacy. MATERIALS & METHODS: In this randomized controlled trial, conducted in Tehran, Iran in 2017, participants (36 parents of children with ASD) were randomly assigned to wait-list control or intervention groups. The intervention comprised contextually reflective occupational therapy combines 3 elements: sensory processing patterns, coaching, and social support. We provided the program to promote child's participation and parent's efficiency. During phase 1, the participants in the intervention group received CI-ASD as long as Treatment As Usual (TAU) and during phase 2 they received TAU only. We completed the outcome measures at three-time points (pre-intervention, post-intervention, and follow-up). We conducted semi-structured interviews post-intervention to explore acceptability of intervention and participants' experiences of CI-ASD. RESULTS: CI-ASD can produce meaningful effects in eliminating sensory issues, promoting child participation and parenting efficiency in ASD families, compared to TAU. Parents reported high levels of acceptance and also confirmed the family's achievements. CONCLUSION: These gains suggest CI-ASD as an effective intervention for children who have ASD and their families, but further studies are needed to declare and generalize the findings over time. Estimated effect sizes were in the large and medium ranges and favored the intervention group.

Cultural Adaptation and Psychometric Properties of the Persian Version of the Affordance in the Home Environment for Motor Development.

OBJECTIVES: This study aimed to translate the Affordance in the Home Environment for Motor Development (AHEMD) scales (3-18 months (IS) and 18-42 month (SR) versions) into Persian and examine its cultural adaptation and psychometric properties. MATERIALS & METHODS: Four stages process was conducted as translation of the questionnaires (use of International Quality of Life Assessment protocol), cultural adaptation, and determination of its psychometric properties. Qualitative judgments were provided by 11 experts and 30 mothers for interview sessions. Quantitative data were gathered using 212 mothers. RESULTS: For the IS version, validity values ranged from 0.63 to 0.95. Intraclass correlation coefficient for reliability of total score was 0.87 (0.83-0.97) and was Cronbach's alpha (0.75). Validity for the AHEMD-SR ranged from 0.63 to 0.90, with reliability for total score of 0.98 (0.98-0.99, ICC). Cronbach's alpha for this version was 0.84. Correlations with SES were significant for both scales: IS (r = 0.40) and AHEMD-SR (r = 0.42). CONCLUSION: Both translated versions of the AHEMD were valid and reliable assessments of the home environment of Iranian young children.

Construct validity of the Persian version of the Child Occupational Self-Assessment in children with attention-deficit/hyperactivity disorder in Iran.

OBJECTIVE: This study aimed to assess the construct validity of the Child Occupational Self-Assessment, translated to Persian that could provide occupational therapists with a tool to evaluate occupational competence and values of children in Iran. METHODS: A total of 250 children (87 girls and 163 boys) with attention deficit hyperactivity disorder aged 7.5-11 years referred from two specialised children's hospitals were included. The researchers read the questions to the children and they identified their own answers. The data were analysed based on the Rasch Rating Scale Model. RESULTS: Four of the items showed misfit and as a result of deleting these items the Persian version of the questionnaire has 21 items with an appropriate validity. CONCLUSION: The Persian version of Child Occupational Self-Assessment can be used with new items format. It could be also useful to replace the missing question to develop the tool further.

Knowledge about and Attitudes of Interdisciplinary Team Members toward Occupational Therapy Practice: Implications and Future Directions.

OBJECTIVES: In Kuwait, knowledge and attitudes of the health care teams toward occupational therapy practice (OTP) have not been investigated. This current study sought to explore the knowledge about and attitudes of interdisciplinary team members toward OTP. SUBJECTS AND METHODS: This cross-sectional study involved developing and validating a tool to serve the purpose of the study. We used a modified Delphi method to develop a tool that assessed occupational therapy (OT) knowledge (OT areas of practice, domains, and philosophy) as well as attitudes toward OTP. Descriptive statistics were utilized, and nonparametric tests were used to compare knowledge and attitudes along with the demographic data. RESULTS: A convenience sample of 98 participants from various disciplines participated in this study. The tool was found to have an adequate content validity for a total of 27 items and satisfactory reliability (internal consistency); Cronbach's α-values for the knowledge and attitudes subscales were 0.88 and 0.74, respectively. The overall knowledge level of OTP among the participants was limited, whereas their attitudes were favorable. Characteristics of being a female (p = 0.01), a nurse (p = 0.02), and working experiences ≥10 years (p = 0.01) contributed significantly to the knowledge of OTP. The results further indicated that participants working in general hospitals (p = 0.02) and working with occupational therapists (p < 0.001) showed significantly better attitudes toward OTP. CONCLUSION: For effective collaborative practice and better patients' outcomes, the study findings recommend the development of interprofessional initiative committees targeting educational settings as well as clinical environments.

Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius: A Prospective Study.

BACKGROUND: To investigate the role of psychological factors (anxiety and depression) and pain measured on a visual analogue scale (VAS) in the development of complex regional pain syndrome type I (CRPS I) following the distal radius fracture (DRF). METHODS: A consecutive sample of patients (N=60) with a distal radius fracture was measured for signs of CRPS by Budapest criteria weekly till 8 weeks and then another follow-up one year after injury to determine the incidence and predictors of developing CRPS I in a prospective cohort study and also to discover whether there is difference between pain, depression, and anxiety level in the patients with and without CRPS I. The most of the patients were treated by Pin stabilization. The Beck depression inventoryshort form (BDI), State-Trait Anxiety Inventory, and Numerical pain rating scale were used to determine the patients' psychological features and pain intensity at the base line and 8 weeks after the fracture. RESULTS: CRPS I developed in 15 (25%) patients after eight weeks and just last in 10 (16.67%) patients after one year. No difference was found between the two groups (CRPS and non-CRPS group) in terms of state (STAI-I) and trait (STAI-II) anxiety, and BDI score. Pain at the base line was the most important risk factor in developing CRPS (odds ratio [OR] =1.52; 95% CI). CONCLUSIONS: After fracturing the distal radius, patients who have high pain intensity have a higher risk of developing CRPS I. To following these patients closely for the development of CRPS I may be advantageous for early preventative and therapeutic interventions.

A Web-Based Caring Training for Caregivers of Children with Cerebral Palsy: Development and Evaluation.

OBJECTIVES: Caregivers of children with cerebral palsy (CP) have to spend a long time to take care of their children. We aimed to develop a user-friendly web-based intervention for training parents of children with CP and evaluate the process of development using modified CeHRes roadmap. MATERIALS & METHODS: The study was conducted from September 2016 to September 2017 in Tehran, Iran. We did it in four main steps including determining the needs of users, content development, design, operational development and evaluation. RESULTS: The website for caregiver training provided nine general topics and had the possibility that the caregivers could determine their educational priorities. Moreover, the users could share their experiences with other users and could ask questions from an expert. Ten caregivers completed a usability questionnaire after four weeks of use. The average score of 70.5 out of 100 was shown among caregivers. The average score of all statements was above three on a Likert scale between 1 and 5. CONCLUSION: The website has the possibilities including registering caregivers of children with CP, the possibility to confirm registration with an SMS and the possibility to determine the caregiver educational priorities. It has the usability for training caregivers of children with CP.