Computer-aided Measurement System Using Image Processing for Measuring Cobb Angle in Scoliosis

Background: One of the spine deformities is scoliosis, and Cobb angle is generally used to assess it. Objectives: In this study, a computer-aided measurement system (CAMS) was presented as a new repeatable and reproducible approach to assess the Cobb angle in idiopathic scoliosis patients. Methods: Python libraries, including OpenCV and Numpy were used for image processing and design of the software. To assess the repeatability and reproducibility of the CAMS, a series of 98 anterior-posterior radiographs from patients with idiopathic scoliosis were used. Assessments were done by five independent observers. Each radiograph was assessed by each observer three times with a minimum break of two weeks among assessment. The single measure intraclass correlation coefficient (ICC), the mean absolute difference (MAD), and the standard error measurement (SEM) values were used for intra- and inter-observer reliability. Results: The inter-observer analysis indicated that the ICCs ranged from 0.94 - 0.99, and the MAD between manual and CAMS were less than 3°. For intra-observer measurements, the combined SEM between all observers for the manual and CAMS was 1.79° and 1.27°, respectively. An ICC value of 0.97 with 95% confidence interval (CI) was excellent in CAMS for inter-observer reliability. The MAD of CAMS was 2.18 ± 2.01 degrees. Conclusions: The CAMS is an effective and reliable approach for assessing scoliotic curvature in the standing radiographs of thoraco-lumbar. Moreover, CAMS can accelerate clinical visits, and its calculation results are reliable.

What Will the Post-Pandemic World Be Like? A Qualitative Study on the Perceptions of Brazilians with Spinal Cord Injury

Background: Given the worldwide pandemic caused by SARS-CoV-2, this study sought to understand how people with spinal cord injury (SCI) perceive the post-pandemic context. Objectives: We aimed to understand the perceptions of people with SCI in Brazil regarding the world in the post-pandemic context. Methods: This qualitative study was conducted on SCI Brazilians using a form published on SurveyMonkey® with questions regarding their perspectives on the post-pandemic world. The responses were analyzed considering Bardin, Axel Honneth, and Ernst Bloch. Results: The results demonstrated that the lives of SCI people in Brazil did not change during the pandemic, as they were already isolated due to the lack of accessibility. Conclusions: Imagining future scenarios following the pandemic is highly complex; however, the present can be understood as a moment to reflect on how humanity has developed thus far, especially concerning impaired accessibility and the pervasive lack of empathy and solidarity.

Barriers of Implementing Evidence-Based Practice Perceived by Iranian Speech and Language Pathologists: A Qualitative Study

Background: Identifying and removing the barriers faced by speech and language pathologists (SLPs) for implementing evidence-based practice (EBP) can facilitate its administration among Iranian SLPs. Objectives: The present study was conducted to explore the barriers to implementing EBP among Iranian SLPs. Methods: A total of 14 SLPs were recruited using a purposive sampling technique. Semi-structured interviews were conducted for data collection. The interviews continued until data saturation was reached. Data were recorded and transcribed verbatim, and qualitative content analysis was used for data analysis. Results: Data analysis yielded three themes, including individual factors, organizational (workplace) factors, and extra organizational factors, and 13 subthemes. Conclusions: This study demonstrated that Iranian SLPs are faced with several barriers to using EBP in clinical practice, which may be related to both the SLPs themselves and their surroundings. These barriers should be considered by policymakers, administrators, teachers, and rehabilitation team members to facilitate the implementation of EBP by SLPs.

Reliability and Validity of the Tampa Scale of Kinesiophobia Questionnaire in Individuals with Non-specific Low Back Pain

Background: The Tampa Scale of Kinesiophobia (TSK) is considered a valid and reliable tool to assess the fear-avoidance behavior in patients. There is a valid and reliable Persian version of the TSK-17. Objectives: The present study aimed to assess the internal consistency as a measurement for the test reliability and factor (domain) validity of the Persian version of the TSK-17 to determine whether a modified form can be proposed. Methods: This study analyzed the data of 295 individuals with non-specific low back pain (NSLBP). Cronbach’s alpha was used to assess internal consistency (reliability). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to evaluate factor validity which is an aspect of the construct validity. The Chi-square divided by the degrees of freedom, the goodness of fit index (GFI), the confirmatory fit index (CFI), and the root mean square error of approximation (RMSEA) indices were utilized as the goodness-of-fit criteria. Data analysis was performed using SPSS software (version 18), AMOS software (version 20), and EQS software (version 6.2). Results: Two factors were extracted for the TSK-17 questionnaire using EFA, and then the structure was confirmed with CFA. Cronbach’s alpha as an internal consistency index was 0.949 for the entire questionnaire, 0.931 for the 11-item fear-of-movement factor, and 0.971 for the 6-item belief factor. The evaluation of the inappropriate items demonstrated that no items were selected for the deletion; therefore, a modified version of the TSK was not presented. The goodness-of-fit indices were reported as GFI = 0.882, RMSEA=0.066 (90% CI: 0.055-0.076), CFI = 0.983, and minimum discrepancy per degree of freedom = 2.27. Conclusions: The Persian version of the TSK-17 can be considered a valid and reliable tool to assess the fear of movement and avoidance behavior in individuals with NSLBP.

Generalized Anxiety Disorder 7-Item Scale and Templer’s Death Anxiety Scale in Iranian Inpatients with COVID-19: Evaluation of Psychometric Properties and Diagnostic Accuracy

Background: During the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, anxiety has always been with patients. Objectives: It is necessary to obtain a valid instrument for the evaluation and screening of patients with anxiety. The current study attempted to evaluate the sensitivity and specificity and provide the clinical cut-off scores for the Death Anxiety Scale (DAS) and Generalized Anxiety Disorder 7-Item (GAD-7) Scale in hospitalized patients diagnosed with COVID-19 in Iran. Methods: This diagnostic accuracy study was carried out for 4 months on 150 hospitalized patients diagnosed with COVID-19 to evaluate generalized anxiety disorder and death anxiety. Cronbach’s alpha was used to evaluate reliability. For the determination of the presence of anxiety disorders, the Structured Clinical Interview with hospitalized subjects was conducted by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria. Results: The Cronbach’s alpha coefficients for the GAD-7 Scale and DAS questionnaires were observed to be 0.88 and 0.74, respectively, confirming their reliability. Based on cut-off scores with the best balance, the sensitivity and specificity of the GAD-7 Scale questionnaire were 61.9% and 86.9%, respectively. Moreover, the sensitivity and specificity values related to the DAS questionnaire were 47.8% and 73.8%, respectively. The values for the area under the curve were 0.75 and 0.63 for the GAD-7 Scale and DAS, respectively. With this scoring method, those who scored higher than 8 and 7 in the GAD-7 Scale and DAS questionnaires were considered patients, respectively. Moreover, in these two tests, higher levels of generalized anxiety and death anxiety were reported in female patients. Conclusions: The GAD-7 Scale and DAS both showed adequate psychometric properties and diagnostic accuracy; therefore, they are applicable for anxiety screening in patients with COVID-19. It will likely take a few years to bring the virus under control worldwide. Iran’s Ministry of Health should implement exact psychological interventions during hospitalization and after discharge to prevent the adverse mental health consequences of COVID-19.

Evaluation of the Relationship Between Daily Physical Activity Level and Laboratory Factors and the Length of Hospitalization in Patients with COVID-19

Background: Different degrees of disorders are reported in the respiratory, physical, and psychological functions of patients with corona virus disease 2019 (COVID-19). With the experience of improved and discharged COVID-19 patients, physical activity and sports are considered as one of the factors in controlling chronic mental and physical illnesses. Objectives: This study was aimed at investigating the impact of the level of physical activity on some important clinical parameters and convalescence. Methods: Overall, 71 patients with COVID-19 under the age of 65 years admitted to the hospital with positive PCR were included in the study. Based on Beck’s questionnaire, patients were divided into two groups of (1) low and (2) moderate to high physical activity. The duration of hospitalization and some important clinical tests were examined at the time of hospitalization and discharge. The patients were then monitored until discharge. Results: Statistical analyses showed that people with moderate to high physical activity were discharged earlier than the group with low physical activity (P < 0.01). Moreover, patients with moderate to high physical activity had lower erythrocyte sedimentation rate than the group with low physical activity at discharge (P = 0.01). Conclusions: Moderate to high physical activity can significantly reduce the length of hospitalization by improving the immune system to fight COVID-19. However, the factors that can be examined in expressing the reason for this finding need further studies.

Effect of Low-Level Laser Therapy Combined with Therapeutic Ultrasound on Hand Pain and Function Following Carpal Tunnel Syndrome: A Randomized Controlled Trial

Background: Carpal tunnel syndrome (CTS) is the most prevalent compression neuropathy in the upper extremity. Objectives: The present study aimed to compare ultrasound and laser therapies separately and together in relieving hand pain and improving performance in mild and moderate CTS patients. Methods: In this single-blind trial, 45 patients (84 wrists) suffering from CTS were randomly divided into three treatment groups: the ultrasound and laser combination group (15 patients), the ultrasound therapy group (15 patients), and the laser therapy group (15 patients). Low-level laser therapy (total intensity of 9 J on 5 points) and ultrasound therapy (intensity of 1.25 W/cm and duty cycle of 20% for 5 minutes per session) were applied on the carpal tunnel for 10 sessions. For the ultrasound and laser combination group, the laser was first conducted in the same way for the laser therapy group, and ultrasound was performed immediately after, with the same parameters as those of the ultrasound therapy group. A visual analog scale (VAS), grip strength, pinch strength, and the Boston Questionnaire results were evaluated before and after the treatment. Results: All three treatment groups (the ultrasound and laser combination group, the ultrasound therapy group, and the laser therapy group) demonstrated significantly improved VAS (P=0.000, P = 0.000, and P = 0.000, respectively), grip strength (P = 0.003, P = 0.001, and P = 0.01, respectively), pinch strength (P = 0.000, P = 0.004, and P = 0.002, respectively), and Boston questionnaire results (P = 0.000, P = 0.000, and P = 0.000, respectively). However, a comparison of treatment groups' mean changes indicated no significant difference among them (P > 0.05). Conclusions: Both ultrasound and laser modalities effectively relieve pain and improve functional hand performance in patients with mild and moderate CTS in the short term. The compound use of these two modalities may have a greater impact in treating these patients.

Language Processing in Individuals with Non-fluent Aphasia: Evidence from Root and Synthetic Compound Nouns

Background: Neurolinguists are increasingly inclined to study the language behavior of patients with aphasia (PWAs) to discover more about the relationship between the brain and language. Objectives: This study investigated the production of synthetic and root compound nouns in the PWAs to discover how these lexemes were processed. Methods: Using a confrontation naming task, four PWAs (two patients with Broca aphasia and two patients with transcortical motor aphasia) named 80 random black and white drawings of simple and compound nouns. They also repeated the nouns through an auditory repetition task. Compound nouns were of two root and synthetic types. Root nouns belonged to the noun-noun, and synthetic compounds belonged to the noun-verb category. Results: There was a significant difference between the affected components in naming and repetition of compound nouns. Moreover, there was a significant difference between naming and repetition of simple and compound nouns. There was no significant difference between naming and repetition of root and synthetic nouns. Conclusions: PWAs process compound nouns through the dual-route model. They cannot retrieve the phonological forms of compound nouns, but they retain their knowledge of word-formation, indicating the modularity of linguistic ability. Morphological structure plays a role in word processing.

An Iranian Model for Elderly Care in Residential Long-Term Care Institutions: A Delphi-Based Study

Background: It is necessary to develop a functional and evidence-based model to meet the various care needs of elderly individuals. Objectives: The present study was conducted to propose a national residential care model for Iranian elderly individuals. Methods: A systematic review was designed to identify common models of residential care centers in developed countries. A two-round Delphi survey consisting of 48 potential and eligible experts was also conducted to make a consensus on the standards of residential care applicable to the Iranian model. The study experts were the professors and officers with at least 5 years of academic and executive experiences in geriatric health. Results: The primary questionnaire was prepared with 305 care standards which were obtained from well-developed elderly care models. In the first round, 40 questionnaires were given back and analyzed, and 232 care standards were approved by the experts. In the second round, 38 questionnaires were returned from 40 distributed questionnaires, and 40 consensus standards were approved (from 73 standards). Moreover, others failed to enter the ultimate model. In the final model, out of the 275 accepted standards, 102 (37.09%), 75 (27.27%), 42 (15.27%), 42 (15.27%), 9 (3.27%), and 5 (1.81%) standards were related to health-related services, service providers, public services, facilities of care centers, eligibility criteria, and financing, respectively. Conclusions: Given the high consensus of experts on developed standards and the unique comprehensiveness of criteria, the obtained model can be implemented after conducting a pilot study in the Iranian elderly care centers. It seems that the implementation of the model will improve the provided care leading to higher levels of life expectancy and quality of life among elderly individuals.

Immediate and Short-Term Effect of Quadriceps Kinesio-Taping on Postural Sway in Children with Spastic Cerebral Palsy: A Before-After Trial

Background: Kinesio-Tape (KT) is a common method used in rehabilitation, but the KT short-term therapeutic effects on children with cerebral palsy (CP) are unclear yet. Objectives: This study aims to investigate the short-term and immediate effects of KT on postural sway in children with CP. Methods: In this before- and after-study, 27 children aged between 4 and 11 years old with spastic CP were included. Immediate and short-term effects of KT on Quadriceps muscle (QcM) were then assessed using time-up and go test (TUG) and COP (center of pressure) displacement in five assessments. Results: The results of Repeated Measure Analysis show that the short-term use of KT on QcM could reduce COP displacement in both the mediolateral and anteroposterior directions and improve the balance among children with CP (P < 0.05). Conclusions: The immediate effects of KT on the QcM did not change the COP’s displacement and balance. It was demonstrated that the short-term use of KT in QcM could improve the balance of COP and reduce its displacement.