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Background: This study is an extended follow up of the original trial study (NCT00600197) that has been published in the clinical journal of pain. This trial aimed to explore if the proposed multidisciplinary program could improve quality of life and disability of the patients suffering from chronic low back up to 36 months. Methods and Material: In this Clinical Randomized trial seventy percent (139 of 197) of the participants who had taken part in the original study including 66 patients in intervention group and 73 patients in control group were followed up to 36 months after intervention. The intervention group continued receiving monthly motivational consultation and booster classes plus oral medication but the other group received just medication. Data on measures of Short Form 36 (SF-36) Quebec Disability Scale (QDS) and Ronald Morris Disability (RDQ) were collected at 3-6-12-18-24-30- and 36-month follow ups and analyzed through RMANOVA. Results: The 2 groups were comparable regarding all baseline characteristics (P > 0.05) except for education level that was better in intervention group (P = 0.01). Two groups were improved regarding all studied variables over time up to 36 month (P < 0.001) Moreover the intervention group in comparison with the control group had consistently better outcomes regarding all variables. There were no significant differences within each group by time in terms of all variables (P < 0.05). Conclusions: The proposed multidisciplinary program could reduce low back pain and improve quality of life and disability up to 36 months in chronic low back pain patients.

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To determine the occurrence of Work related Musculoskeletal Disorder (WMSD), its prevalence and risk factors among school teachers in India. 100 questionnaires was passed out and sent to teachers of different schools ranging from primary school to higher secondary schools across Kolkata and Aizawl. 72 percent of the teachers responded. A standardized Dutch Musculoskeletal Questionnaire (DMQ) was used. Neck pain was the most prevalent musculoskeletal complaint, reported by 53.52% of the respondents while chronic neck pain was not reported by the teachers. Shoulder and back pain were less prevalent than neck pain but the prevalence of chronic pain in these body sites were higher. Furthermore wrist/hand and knee pain were less prevalent than the other complaints. Working with hands above the shoulder was the highest reported risk factor (62.27%). School teachers are susceptible to WMSD with a significant prevalence for neck, shoulder, back, wrist/hand and knee pain. Prolonged working nature like bending the neck forward/backward or holding the neck in a Forward/backward posture, same movements with arms, hands or fingers many times, hands above the shoulder level, reaching with arms or hands and standing are important factors which affect the occurrence of musculoskeletal disorders.

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Background: This study aimed to assess the influence of video games on voice learning in students of speech therapy.
Methods & Materials: This study was a clinical trial study in which 102 fifth semester students of speech therapy group of Ahvaz Jundishapur University of Medical Sciences took part and were divided into two groups. The first group included 27students who were admitted in the university from 2008and2009 trained in traditional training and the second group (N = 75) who were admitted in 2010, 2011, 2012, and 2013 spent their traditional training plus using the software of Avaz-e-Ma. at the end of each semester. Students' satisfaction of the learning of each group was obtained through using the qualitative scale and the final exam of each group. The relationship between the learning type and the student scores was analyzed using Pearson correlation coefficient and the difference between of both groups were analyzed by independent T-test.
Results: The mean age of the first and the second group were 20.11 ± 3.02 and 20.25 ± 2.12 years old respectively. The mean score of the students who learned by software were 18 ± 0.2 and the students by traditional way was 12 ± 0.2 that was significant difference (P < 0.001). The majority of the students (90%) believed that the use of software has been useful.
Conclusion: The use of educational games in the classroom leads to an increase in the students' grades and the satisfaction of the students with the quality of instruction. Accordingly, using technology in educational system is recommended.

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Aim: Since physical performance is one of the important parts of health, proper evaluation of people's performance is so much important, as it helps rehabilitation team to choose the best methods to improve performance. Involving all the muscles and joints, jumping is an activity used to evaluate performance. The accelerometer is an instrument that has recently been considered in the field of performance evaluation for some reasons like being economical, accessible, and the ability to replace expensive tools in the health system. This article reviews some studies that use accelerometer to evaluate performance of the neuromuscular system.
Method and Materials: Keywords were searched in PubMed, Scopus, and Google Scholar databases to find studies on the reliability and validity of accelerometers in jump performance from 2010 to January 2024.
Findings: In calculating most variables including jump height, flight time, contact time, stiffness, force, power, and reactive strength index of countermovement, squat, and drop jumps, studies have revealed high validity and reliability for this device. In calculating peak power and peak velocity, accelerometer has low validity and reliability, though.
Conclusion: Under the ground of the fact that accelerometer is a valid and reliable instrument in evaluating most jump performance variables, it may be counted as a useful instrument. Rehabilitation team, physical medicine, and sports medicine specialists would use this device to evaluate musculoskeletal system performance; Therefore, they will be able to adjust, modify, and finally improve the rehabilitation program for patients or athletes and thus promote health in society.
 

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Abstract: The experience of last earthquakes has shown the vulnerability of most of structures. This has been caused the speeding up of the seismic evaluation and retrofitting of projects in Iran. In this regard, the instructions for seismic rehabilitation of the existing buildings have been published and are currently beiong used in the evaluation and retrofitting projects. The experience of retrofitting the structures in the past has shown that one of the most important problems in Iran is seismic evaluation and retrofitting of the foundations. The evaluation procedures are usually done such that they results in huge retrofitting plans for foundations and this opinion has been raised that seismic evaluation and retrofitting of the structures is not economical. This paper presents some suggestions for accurate seismic evaluation of structural and geotechnical components of foundations. The results showed that by using the correct relations and understanding the behavior of structure exactly, the retrofitting procedure do not result in massive strengthening.

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Aim Urmia Lake Restoration Headquarters has carried out actions since its establishment until now, and there are disagreements between supporters and opponents about its outputs. For this purpose, in the year 2021, this research was conducted to evaluate the environmental effectiveness of the actions of rehabilitation headquarters from the point of view of local communities. Materials & Methods an applied and fundamental research was done to reach the study golds. . In terms of method, regarding to the nature of the subject and research objectives, the descriptive-analytical and survey method (survey of local communities) has been used. The tool for collecting information and data was a researcher-made questionnaire that was randomly filled through interviews with residents. Findings The results showed that different actions have significant differences in terms of respondents' satisfaction, so the highest level of satisfaction, with a value of 2.89, is related to the non-living windbreak, and the lowest level is related to the Poly -Shrub Planting with the value of 1.67. Conclusion In general, despite the relative success of the actions of the rehabilitation headquarters, these actions have not been full effective in the proper management of surface and subsurface water resources, the modification of the cultivation pattern, and the prevention of the spread of soil salinity in agricultural lands. Therefore, to prevent the environmental disaster and its destructive consequences, it is suggested to take urgent action to save Urmia Lake by using all local and international capacities.

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Aims: New developments in artificial intelligence offer promising prospects for transforming therapeutic approaches and enhancing outcomes for individuals with a range of abilities. Therefore, the aim of this systematic review was to investigate the applications of artificial intelligence in occupational therapy.
Information & Methods: In this systematic review, adhering to the PRISMA guidelines, we searched English-language studies regarding the use of artificial intelligence in occupational therapy, on February 18, 2024, using the databases PubMed, Embase, Scopus, and Web of Science.
Findings: Six eligible studies were included in this review. The artificial intelligence approaches used in these studies included artificial neural networks, multi-core learning models, deep learning models, machine learning models, and classification and regression trees. All the studies reported promising results regarding the use of artificial intelligence in evaluating and predicting return to work, alleviating symptoms, recovering social function, reducing disease recurrence, improving re-employment rates, and enhancing the overall health level of patients.
Conclusion: One of the most common issues with artificial intelligence models is their low accuracy and the potential for errors.

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Aims: Telerehabilitation is a branch of telemedicine and an emerging method of providing rehabilitation services through information and communication technology between patients and healthcare providers. This systematic review aimed to examine healthcare professionals' attitudes, knowledge, and awareness of telerehabilitation.
Information & Methods: A systematic search was conducted without a time limit in PubMed, Embase, Scopus, and Web of Science databases on May 27, 2024. We followed the PRISMA guidelines for reporting evidence from the studies included in this systematic review. Titles and abstracts were independently screened based on eligibility criteria. A checklist was used for data extraction. The Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies was used to assess the quality of the studies included in this review.
Findings: A total of 33 eligible articles were identified through this review. Out of these, 25 studies investigated healthcare professionals' attitudes toward telerehabilitation. Additionally, 15 studies evaluated the knowledge of healthcare professionals regarding telerehabilitation, while 10 studies explored their awareness of telerehabilitation.
Conclusion: All health professionals have a positive and promising attitude toward the use of telerehabilitation, but half of the specialists have insufficient knowledge and limited experience in telerehabilitation.

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In recent years using steel plate shear wall system, because of its advantages in comparison with other earthquake resistant systems, has been a matter of attention. Some of its advantages relative to other systems include abundance advantage, high ductility, good hysteretic behavior and energy absorption capacity, high stiffness and economic advantages. Regarding that in Iran there is high seismicity risk and the need to strengthen old and unsafe urban textures and buildings, using this system as a lateral load resistant system seems appropriate and economical. In the present research strengthening of x-braced steel frames with steel plate shear walls is evaluated. Addition of bracing to unbraced frame spans, substituting braces with thin steel shear wall panels and adding thin steel shear wall panels to unbraced spans which do not have architectural requirements are considered as retrofitting strategies. The focus is on the methods in which retrofitting is only done by adding steel plate shear wall elements to braced frames. Some of these methods have many economic and practical advantages. Others are only proper for some special cases. In this study a number of x-braced steel frames designed by the first edition of Iranian code of practice for seismic resistant design of buildings (Iranian Standard No. 2800) are taken as basic frames which need to be retrofitted. These basic frames are retrofitted by adding steel panels with different methods. Then nonlinear static analysis (pushover analysis) with displacement control pattern has been done on both basic and retrofitted finite element frame models and the capacity curves (diagram of story displacements against base shear) of basic frames and retrofitted frames are compared. Considering the results of the pushover analysis of models in which seismic retrofitting is done by replacing x-bracing earthquake resistant system with steel plate shear walls and the results of other methods of strengthening, it is seen that seismic behavior of retrofitted frames is more desirable in terms of overstrength factor (Ω) and overall ductility of structure ( ). The failure and fracture mode in most of the medium-rise frames was ductile but in the short-rise frames the fracture was brittle. Thus, replacing the braces in short-rise structure with thin steel shear walls seems irrational and unjustified economically. But it is to be mentioned that strengthening and increasing the moment of inertia of the adjacent columns of steel shear wall panels in structures with brittle fracture mode could result the change from brittle to ductile fracture. The results of this research show that in the case of steel braced frames with regard to some scientific, technical and practical points; replacing concentric steel bracing earthquake resistant system by steel plate shear walls can be used as a suitable method for retrofitting a wide range of existing steel structures in Iran.

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It is required to rehabilitate the existing structures due to many reasons including the retrofitting of damaged structures under earthquakes or the need to strengthen or retrofit an undamaged structure designed based on old building codes. So, the rehabilitation and retrofit of structures against seismic loads is unavoidable. This paper presents the results of a nonlinear finite element analysis of an ordinary reinforced concrete frame and also strengthened frame by steel prop and curb under monotonic lateral load. The effect of steel prop on linear and nonlinear behavior of reinforced concrete frame and also increasing the rigidity, ultimate strength, rate of energy absorption and ductility parameter of frame are investigated. The experimental results of a one-bay and one-story reinforced concrete frame are considered and after calibrating the numerical results against it, the mentioned parameters have been investigated. Numerical results show that using steel curb and prop box in compression and tension state with 5,7.5,10 cm2 area in frame will considerably increase the rigidity, ultimate strength and decrease the ultimate displacement of frame. Furthermore, the yielding of steel prop as a preliminary defensive system against lateral loads will increase the energy absorption and ductility and also will decrease the stresses in panel zone.

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Evaluation of Vehicle Operating Costs (VOC) are necessary in pavement management. Vehicle Operating Costs including Fuel consumption costs, accident costs, oil consumption costs, maintenance costs and vehicle depreciation that often paid by road users. Vehicle Fuel consumption costs, is one of the important components of the life cycle costs analysis that it is typically between 20 to 40 percent of the total vehicle operating costs. There are many factors that effect on vehicles fuel consumption. Vehicle type, pavement surface condition, road geometry, vehicle speed and,…effect on vehicle fuel consumption and pavement life cycle costs. Pavement surface condition is one of the factors that effected on vehicle fuel consumption. Pavement roughness, skid resistance and the pavement deterioration are the components of the pavement surface condition. Using of pavement maintenance alternatives at the appropriate time, in addition to improve the pavement surface condition, reduce the vehicle operating costs and vehicle fuel consumptions. The goal of this research is to evaluate the effect of pavement maintenance in a 10 years analysis period on vehicle fuel consumption costs using HDM-4 software. HDM-4 is an application software for pavement management and evaluation of pavement surface condition that has been developed by the world bank. This software needed a serious of input data to analysis. This input data are divided in to four parts, including road networks, vehicle fleets, road works (repair and rehabilitation standards), and HDM-4 Configuring (define standards criteria for each of the variables in the program). For this purpose, effect of pavement maintanence and rehabilitation evaluated in 1170 km of Khozestan province road networks. This rehabilitation alternatives including routine maintenance, single surface dressing, 50 mm overlay, 100 mm overlay and, pavement reconstruction. In this research each rehabilitation approaches was used Separately as a pavement maintenance alternative. In rehabilitation approaches it was supposed that after performed pavement rehabilitation IRI reached to 1.5 m/km. According to HDM-4 ranking this IRI is good. Results of this research showed that, pavement surface conditions effect on vehicle fuel consumption. In other words, improving pavement surface condition cause to reduced vehicle fuel consumption. With applying routine maintenance (crack sealing and patching) there was no change on reducing the vehicle fuel consumption. But, with applying single surface dressing vehicle fuel consumption was reduced during the pavement analysis period. The reduction in vehicle fuel consumption after applying pavement rehabilitation is varies for different type of vehicles. Although the costs of rehabilitation alternatives are more than the cost of routine maintenance, but the economic savings in reduction of vehicle fuel consumption costs are more than the costs of the pavement rehabilitation alternatives in the long terms analysis. According to the result, economic saving from the single surface dressing alternative is more than the other pavement maintenance and rehabilitations alternatives. It was concluded that using rehabilitation in the appropriate time could cause reduction in fuel consumption and resulted in cost saving.

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The aim of this paper is to investigate a new control algorithm of gait rehabilitation robots that simultaneously provides more freedom for the patients and corrects their walking trajectory. The controller utilizes a gait-phase dependent reference trajectory and a gait-phase detection algorithm to determine the desired position and velocity of joints based on of their actual positions and velocities. Moreover, the controller uses two separate control blocks for the correction of the path and the cadence of walking of the patient. Since the reference trajectory is time independent, the patient can change the cadence of his/her walking. Furthermore, the separate control structure enables the controller to provide different levels of freedom and assistive force to be delivered to the patients. The control method has been implemented through ARMan , a gait rehabilitation robot and its effectiveness is evaluated on the walking trajectory of three healthy subjects and one stroke patient. The results of the experiments demonstrate that the proposed control method corrects the gait pattern of the subjects as good as impedance control method. In addition, this method provides more freedom for the patients to walk based on their desired cadence.

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In this paper, a cable actuated robot is introduced as a new rehabilitation approach. The quality improvement of human and machine interface has led to create a new device in this area. The interface between the robots with the physical characteristics of body can improve the interaction forces and the patient safety. Considering the joint compliance during the motion range can make the patient feel better and thus, bring success for the rehabilitation program. The key element "cable" makes the possibility of force transmission in this mechanism. Cable actuator is used in this project in order to achieve to maximum adaptation with elbow operation Moreover in the design of rehabilitation device, some advantages are regarded like the low-cost and light weight, smooth joint motion with adjustable stiffness, motor size reduction. The dynamic parameters related to the elbow behavior are described with amplitude and frequency investigating. The performance of the elbow rehabilitation device is examined. Stiffness variation of robot joint is effectively compatible with the elbow joint stiffness according to rehabilitation protocols. As the presented mechanism able to simulate elbow rehabilitation, it can be used more widely in the field of medical robotics.

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Abstract This paper presents the mathematical modeling and simulation of a cable-driven robotic device that can be used in gait rehabilitation of patients with lower extremity disabilities. A parallel cable robot is considered to assist a model of human body during walking. First, a proper pattern of walking is considered and kinematic and dynamic equations are solved to obtain tensions in cables for entire cycle of walking. By exploiting a numerical procedure, the workspace of the robot are explored to find suspension points of the cables in which the model remain in controllable workspace of the robot. Remaining of the model in controllable workspace means that cables always remain in tension and robot can effectively engaged in rehabilitation. The optimum locations are determined based on minimum cable tensions (energy consumption) and a Neural Network is trained to quickly determine suspension points based on anthropometric parameters of patient. The simulation results show the effectiveness of the method in tracking of the desired trajectory of walking. The results of this study can be used for development and fabrication of an efficient cable driven rehabilitation system.

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The purpose of this study, control and monitoring of a rehabilitation robot with two degrees of freedom (2-DOF) for rehabilitation of the lower limbs of patients with loss of ability for movement due to injury, disease, stroke or surgical operations. After determining the movements, that is included flexion-extension movements of the knee and hip joints, the performance of the mechanism was investigated using dynamic analysis and simulation. Then, a programmable logic controller (PLC) was employed to control the robot performance. Finally, the accuracy of PLC program was guaranteed by monitoring the robot. Passive, assistive and resistive exercises were considered in programming the controller. In assistive exercises, the forces needed by the patient to perform the movements were actually set automatically by using the feedback data provided by the patient's forces. In addition, to perform the resistive exercises rather than using actual weights, negative loads were employed. The results obtained represent considerable accuracy to perform the movements and create safe conditions for the patient. Also, high flexibility in programming has provided the possibility to perform a wide range of rehabilitation exercises.

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One of the common bracing systems in our country is Y-shaped bracing system. Because of architectural advantages, it attracts more attention in comparison to x shape concentric braced frame (CBF). But, its stiffness is less and it has more potential for out of plane buckling. One of the extensively used methods for improving the seismic behavior of the structural systems is using the passive control systems. By reducing seismic demand and increasing ductility, this control way can reduce the rate of seismic damage. Yielding dampers are one of the elements to achieve this kind of control in the structures. Because of good ability of yielding dampers in earthquake energy dissipation, the use of these dampers is increased through recent decade in passive control of structures. Due to development of passive control methods for earthquake energy dissipation and for preventing the structures from earthquake losses, this paper proposes a new improved dissipating element for Y shape bracing systems which could be used for structural rehabilitation of steel structures. The basis of the proposed element operation is its operation as a fuse element to improve the bracing elements behavior. The operation of the proposed element is in such a way that before formation of a hinge in bracing element, the presented element is yielded and by absorbing appropriate energy, prevents the bracing elements from inappropriate performance. Before inserting the proposed element in the bracing frames, using the ANSYS software, the element performance is studied for different dimensions and appropriate dimensions are determined. The energy absorbing element is inserted into two different positions in the bracing systems of interest. 2D steel frames with three different number of stories (4, 6 and 8 story frames) are modeled in SAP 2000 software, using conventional braced frames and their behavior is compared to braced frames with the proposed energy absorbing element. The frames are analyzed through nonlinear time history analysis, using appropriate time history records from near source and far source locations. The results show the appropriate ductility of the proposed element, the improvement of bracing elements behavior and also, the higher energy dissipation of the new bracing system, which can be shown through comparison of the hysteresis loops of the bracing frames, solely and those with proposed elements. It could be shown that the ductility of the system is affected by the position of the proposed element. Reducing the base shear due to earthquake records and also decreasing the permanent displacement of the structural stories after earthquake occurrence are some of other advantageous of the presented element. Inserting the new proposed elements in bracing system can also reduce the input energy of the system, during the earthquake. In general view, it can be concluded that by appropriate design of the proposed element, the other structural elements behave elastically and the inelastic behavior is happened in the presented elements, which is resulted in improving the seismic structural performance of the new system.The results of this study can be used in seismic design of earthquake resistant structures

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In this study, a vertically placed double-acting pneumatic cylinder controlled by two On/Off solenoid valves is applied for the purpose of the lower limb rehabilitation. Because of the different physical conditions and degrees of disability of patients and changes of the system dynamic parameters, admittance control strategy is used to compliantly interact between users and actuator. To analyze the stability, a linear model of the servo-pneumatic system is developed and its continuous transfer function is derived. Due to the exponential functions in the continuous transfer function of the system, the necessary transformations are used to achieve the discrete closed-loop transfer function of the system. In this way, the determination of the stable performance boundaries of the admittance control parameters related to changes in other dynamic parameters of the system is possible by root locus analysis of the discrete closed-loop system. These dynamics parameters include equivalent mass, damping and stiffness of the actuator and leg impedance and the proportional and differential gains of the inner loop position controller. Good correspondence is observed between the analytical and experimental stability limits of the system. Analytical results for appropriate choice of the admittance control and other dynamic parameters of the servo-pneumatic system are applicable to get smoothly and stable performance during the rehabilitation process.

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In this study, a novel robust impedance control for a lower-limb rehabilitation robotic system using voltage control strategy is used. Most existing control approaches are based on control torque strategy, which require the knowledge of robot dynamics as well as dynamics of patients. This requires the controller to overcome complex problems such as uncertainty and nonlinearity involved in the dynamics of the system, robot and patients. Conversely, the voltage-based control approaches is free from the system dynamics. In addition, it considers the actuator dynamics. The performance of voltage-based approaches is demonstrated by experimental result in robotic applications. Compared with a torque control scheme, it is simpler, less computational and more efficient. Nevertheless, uncertainty of actuator dynamics results in challenges for the voltage control strategy applications. The present paper, presents a novel robust impedance control based on the voltage control strategy. To overcome uncertainties, the adaptive fuzzy estimator is designed based on the voltage-based strategy. The proposed control is verified by a stability analysis. To illustrate the effectiveness of the control approach, a 1-DOF lower-limb rehabilitation robot is designed. Both torque-based impedance control and the voltage-based impedance control are compared through a therapeutic exercise. It is shown that the voltage-based impedance control perform better than the traditional torque-based impedance control. Simulation and experimental results both shows that the proposed voltage-based robust impedance control is superior to voltage-based impedance control in presence of uncertainties.