Assessment tools for evaluating Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) are very important. These instruments are developed in especial context and especial community. Given the increase in the number of the ageing population, it is important to identify the barriers and performance problems of this community by these tools.

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Background: Katz Index is a well-known index for assessing basic activities of daily living. The aim was to determine validity and reliability of the Katz Index in Iranian patients with acute stroke. Methods: Eighty-seven patients (56 male, 31 female) with acute stroke (1-30 days post-stroke) participated in this psychometric properties study. Interval time for retest was 14 days. All participants were Iranian with Persian as native language, had no other major diseases (e.g. cancer, Alzheimer) and no psychiatric disorder. Cognitive mental score of all participants was above 18 (according to Mini-Mental State Examination). If they had another stroke during the following-up period, they were excluded from the study. Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) were calculated to investigate the reliability of the KI. Criterion validity of the KI was assessed by Spearman’s Correlation Coefficient (ρ). Moreover, Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) were performed to investigate the construct validity of the KI. Results: Inter-rater and intra-rater reliability of Persian Katz Index were reasonable (ICC2,1=0.93, ICC2,1=0.83; respectively). Internal consistency of this index was high (cronbach’s alpha=0.79). The high to excellent correlation was found between Katz Index and the motion (ρ=0.88), self-care (ρ=0.98), and total scores (ρ=0.92) of Barthel Index. Factor analysis of the Persian Katz Index indicated two factors including motion (bathing, toileting, and transferring) and self-care (dressing, bowel & bladder control, and feeding). Conclusion: The results of this study suggest that Persian version of Katz Index in patients with acute stroke can be considered as an acceptable clinical instrument in practice and research.

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BackgroundAlthough anxiety is a common non-motor outcome of Parkinson's disease (PD) affecting 40% of patients, little attention has been paid so far to its effects on balance impairment and postural control. Improvement of postural control through focusing on the environment (i.e. external focus) has been reported, but the role of anxiety, as a confounding variable, remains unclear.ObjectivesThis study aimed to investigate the influence of anxiety and attentional focus instruction on the standing postural control of PD patients.MethodsThirty-four patients with PD (17 with high anxiety (HA-PD) and 17 with low anxiety (LA-PD)), as well as 17 gender- and age-matched healthy control subjects (HC) participated in the study. Postural control was evaluated using a combination of two levels of postural difficulty (standing on a rigid force plate surface with open eyes (RO) and standing on a foam surface with open eyes (FO)), as well as three attentional focus instructions (internal, external and no focus).ResultsOnly the HA-PD group demonstrated significant postural control impairment as compared to the control, as indicated by significantly greater postural sway measures. Moreover, external focus significantly reduced postural sway in all participants especially during the FO condition.ConclusionThe results of the current study provide evidence that anxiety influences balance control and postural stability in patients with PD, particularly those with high levels of anxiety. The results also confirmed that external focus is a potential strategy that significantly improves the postural control of these patients. Further investigation of clinical applicability is warranted towards developing effective therapeutic and rehabilitative treatment plans.

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Background:Handwriting difficulties are one of the most common reasons for referral to school-based occupational therapy. Assessing handwriting performance using standardized tools is necessary for scientific research and clinical assessment. Objectives:The objective of this study was to develop and validate the Persian handwriting assessment tool to evaluate legibility and speed in near-point copying and dictation domains in primary school-aged children.Methods: This methodological study was conducted in Tehran, Iran during 2015 -2016. Measurement items were selected by reviewing the past literature and considering the opinions of an expert panel. The scale development, the analysis of content validity, and item analysis were performed in phase one using the data from 131 students in grades two and three. Exploratory factor analysis and discriminant validity were analyzed in phase two using the data from 208 subjects. Sampling was conducted using the random cluster method. Confirmatory factor analysis was conducted on a randomly split sample of half of the data. Results:The content validity ratio of most of the criteria was greater than 0.57. Item analysis confirmed the writing assignments in the copying and dictation domains. Principal component analysis revealed that measurements in the copying and dictation domains loaded into three components separately, which accounted for 71.96% of the variance in the copying domain and 70.46% of the variance in the dictation domain. Confirmatory factor analysis also confirmed the accuracy of the three-dimensional structure designated through exploratory factor analysis. Discriminant validity showed that handwriting speed and legibility increased with maturation. Conclusions:The Persian handwriting assessment tool as a comprehensive and quickly scored tool that can help therapists identify primary school students with handwriting problems so that appropriate interventions for these students can be implemented.

The following study was carried out in order to translate, cultural adaptation, and determine the content and face validity of the "Patient-Rated Wrist Evaluation" questionnaire with the aim of evaluating the two components of pain and disability in patients with wrist injuries. Materials and Methods: The methodology of this survey was non-experimental study. After translation and cultural adaptation according to the Beaton method (approved by the American Surgeon Association), the pilot test was performed on patients with wrist injuries (fractures of the distal radius, scaphoid fractures and carpal tunnel syndrome). To assess content and face validity, the questionnaire was given to 10 specialists (6 of whom were occupational therapists, 2 were physiotherapists, and 2 were orthopaedic surgeons), and 20 patients with wrist injuries. Results: The qualitative content and face validity of the questionnaire for wrist injuries was appropriately reported good. Each item of the content validity ratio was slightly higher than 0.75 and this justified the necessity to include all items. Each item of the content validity index was slightly higher than 0.79. Therefore, all the items were approved in terms of their simplicity, clarity, and relevance. The impact score in order to evaluate the importance of each item was calculated and all were higher than 1.5. Therefore, in terms of face validity all the items were approved. Conclusion: The results showed that the Persian version of the "Patient-Rated Wrist Evaluation" questionnaire for evaluating the pain and disability of wrist injuries was indeed satisfactory, in terms of it's content and face validity, thus it can be used in patients by specialists and therapists.