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Reliability of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy Aged 2 to 12 Years

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Reliability of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy Aged 2 to 12 Years
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  35 4 ﺴﻤﺷ   ﺴ      ﻤﺷ   1    3   9  0 ﺘﺴ     ﺎﺘﺴ       ﻬﭼ    ﻬﭼﻤﺷ       ﻤﺷ   ﻢ   ﻢ                            ﺎﻛﺮﺣ   ﺖﻴﻔﻴﻛ   ﻮﻣ   ﺮﻳﺬﭘ   ﺮﻜﺗ   ﻲﺳ  ﺮﺑ  ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻲ ﺎﻗﻮﻓ 6     ﻴﺣ  ، 5 ﻲﻧﺎﻀﻣ    ﻬﻣ   ، 4 ﻲﺤﻟﺎﺻ   ﻮﻌﺴﻣ   ، 3 ﻲﻨﻴﺴﺣ   ﻲﻠﻋ ﻴﺳ   ، 2 ﺐﻳﺮﻏ   ﻮﻌﺴﻣ *   ، 1 ﻲﻤﻴﻬﻓ   ﺮﺒﻛ  ﻼﻳ  ﺎﻧ    ﮔ   ﻲ ﻧﺎﻣ  ﺎﻛ    ﺘﻛ   ﻮﺠ ﺸﻧ  1  ﻮ ﻠﻋ   ﺎﮕ ﺸﻧ  ،ﻲ ﻧﺎﻣ  ﺎﻛ   ﻲ ﺷ  ﻮﻣ    ﻲﺸﺨﺒﻧ  ﻮﺗ   ﻲﺘﺴﻳﺰﻬﺑ   ﺎﻘﻴﻘﺤﺗ   ﺰﻛ ﻣ   ،ﻲﻧﺎﻣ  ﺎﻛ   ﺪﺷ   ﺎﻨﺷ  ﺎﻛ  2  ﻮﻠﻋ   ﺎﮕ ﺸﻧ   ﺎﻔﻃ   ﺎﺼﻋ  ﻲ ﺸﺨﺒﻧ  ﻮﺗﻲﺸﺨﺒﻧ  ﻮﺗ   ﻲﺘﺴﻳﺰﻬﺑ   ﻲ ﺸﺨﺒﻧ  ﻮﺗ   ﺎﻘﻴﻘﺤﺗ   ﺰﻛ ﻣ   ﺎ ﻳ   ﺎﺘ ﺳ  3  ﻲ ﺷ  ﻮﻣ    ﮔ   ،  ﺎ ﻔﻃ   ﺎ ﺼﻋ   ﻲﺘﺴﻳﺰﻬﺑ   ﻮﻠﻋ   ﺎﮕ ﺸﻧ  ﻲﻧﺎﻣ  ﺎﻛﻲﺸﺨﺒﻧ  ﻮﺗ    ﮔ   ﺎﻳ  ﺎﺘﺳ  ،ﻲﺘ ﺴﻳ   ﺎﻣ    ﺘﻛ  4  ﺖﻳ ﻳﺪﻣ   ﺪﻜ ﺸﻧ  ﻲﺘ ﺴﻳ   ﺎ ﻣ    ﻮﻠﻋ   ﺎﮕﺸﻧ  ﻲﻜﺷﺰﭘ   ﻲﻧﺎ ﺳ    ﻼﻃ   ﻬﺗ   ﻲﻜﺷﺰﭘﻲﻣﻮﺗﺎﻧ  ﺪﺷ   ﺎﻨﺷ  ﺎﻛ  5  ،ﻲﺸﺨﺒﻧ  ﻮﺗ   ﺖﻳ ﻳﺪﻣ   ﺪﺷ   ﺎﻨﺷ  ﺎﻛ  6 ﺪﻤﻫ   ﻲﻜﺷﺰﭘ   ﻮﻠﻋ   ﺎﮕﺸﻧ 89/6/6 : ﻪﻟﺎﻘﻣ   ﺖﻓﺎﻳ 90/12/8 : ﻪﻟﺎﻘﻣ    ﻳﺬﭘ  : ﻮﺌﺴﻣ    ﻨﺴﻳﻮﻧ      *   ،ﻮﺠ ﺸﻧ   ﻮ ﻠﺑ   ،ﻦ ﻳ  ،   ﻬﺗ   ﻲﺘﺴﻳﺰﻬﺑ   ﻮﻠﻋ   ﺎﮕ ﺸﻧ  ،  ﺎﻴﻛ  ﻮﻛ   ﻲﺸﺨﺒﻧ  ﻮﺗ   ﺎﻘﻴﻘﺤﺗ   ﺰﻛ ﻣ   ،ﻲﺸﺨﺒﻧ  ﻮﺗ  ﺎﻔﻃ   ﺎﺼﻋ 22180099 : ﻦﻔﻠﺗ   * : ﻪﻣﺎﻧﺎﻳ  *gharib_masoud@yahoo.com    ﻴﻜﭼ    ﻤﻠﻴﻓ   ﺪﺑ   ﺎﺑ   ﺘﻳ    ﺘﻨﻳ  ، ﺘﻳ  ﺘﻨﻳ    ﻳﺬﭘ    ﻜﺗ   ﻲﺳ   ﺑ   ،ﺶﻫ  ﮋﭘ   ﻦﻳ   ﺪﻫ  :   . ﻮﺑ   ﻚﻴﺘﺳﺎﭙﺳ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻲﻧﺎﻗﻮﻓ   ﺪﻧ   ﺎﻛ ﺣ   ﺖﻴﻔﻴﻛ   ﻮﻣ    ﺪﻧ   ﺎﻫ  ﺎﻬﻣ   ﺖﻴﻔﻴﻛ   ﻪﻣﺎﻨﺸﺳ ﭘ   ﻲﺠﻨــﺳ   ﺎ ﺘﻋ  ﻪﺑ   ﻲﻌﻄﻘﻣ   ﻪﻌﻟﺎﻄﻣ   ﻚﻳ    : ﻲــﺳ  ﺮﺑ     ﺎﺑ   ﻪﻫﺎﻣ  19-95  ﺪﺑ   ﻪﻤﻴﻧ   ﺰﻐﻣ   ﺞﻠﻓ   ﻮــﻛ  50 . ﺪــﺷ   ﻪﺘﺧ   ﭘ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻲﻧﺎﻗﻮﻓ  . ﺪﻧ   ﻛ   ﺖﻛ ﺷ   ﻪﻌﻟﺎﻄﻣ     ﺘﺳ   ﻲﻓ  ﺎﺼﺗ ﻴﻏ   ﺎﺨﺘﻧ  ﺎﺑ   ﺎﻣ  61/31  ± 25/7 ﻲﻨــﺳ   ﻦﻴﮕﻧﺎﻴﻣ   ﺘﻳ  ﺘﻨﻳ  ﻲﺑﺎﻳ    ﺎﺠﻧ  ﻪــﺴﻠﺟ   ﻚﻳ   ﺘﻳ    ﺘﻨﻳ  ﻲﺑﺎﻳ  ﻦﻳﺪﻟ   ﺖﻳﺎﺿ  ﺐــﺴﻛ   ﺲﭘ    ﻮﻛ  46 ﻢﻠﻴﻓ   ﺪﻫﺎﺸﻣ   ﺎﺑ   ﻮﺳ   ﮕﻧﻮﻣ  ﺲﭙــﺳ  . ﺪــﺷ   ﺎﺠﻧ    ﻤﻠﻴﻓ   ﺎﺑ    ﻤﻫ   ﺪﻌﺑ   10   ﻳﺬﭘ   ﻜﺗ    ﺑ  ( ICC ) ﻦﻣ ﻴﭙﺳ  ﻲﮕﺘــﺴ ﻤﻫ   ﺐﻳ ﺿ   ﻮﻣ   . ﻮﻤﻧ   ﺪﺠﻣ   ﻲﺑﺎﻳ  ،  ﻮﻛ  50 66 ﺖﺷ   ﺎﻛ ﺣ    ﻜﻠﻤﻋ   ﺪﻨﺑ   ﻪﻘ ﻃ   ﻢﺘــﺴﻴﺳ     ﻤﻠﻴﻓ   ﺪﺑ   ﺎﺑ   ﺘﻳ    ﺘﻨﻳ  ، ﺘﻳ  ﺘﻨﻳ  . ﺪﻳ   ﮔ   ﺎﻔﺘﺳ   ﻮﻛ    ﻜﻠﻤﻋ   ﻦﻴﻴﻌﺗ   ﺖﻬﺟ    ﻤﻠﻴﻓ   ﺪــﺑ   ﺘﻳ   ﺘﻨﻳ  ﻲﮕﺘــﺴ ﻤﻫ   (0/996 - 0/774) ــﺘﻳ   ﺘﻨﻳ  ﻲﮕﺘــﺴ ﻤﻫ  : ﺎــ ﻪﺘﻓﺎﻳ   ﻮﺳ     (0/974 - 0/710)  ﻮﺳ      ﮕﻧﻮﻣ  ﻦﻴﺑ    ﻤﻠﻴﻓ   ﺎﺑ   (998/0 - 663/0). ﻮﺑ  ( P< 0/01)  ﺎﻤﺘﺣ   ﺪﻘﻣ   ﺎﺑ   ﻪﻣﺎﻨﺸﺳ ﭘ   ﻲﻠﻛ    ﻤﻧ   ﺎﻫ  ﺎﻴﻘﻣ    ﺧ   (0/938 - 0/652)  ﺎﻫ  ﺎﻬﻣ   ﺖﻴﻔﻴﻛ   ﻮﻣ    ﻤﻠﻴﻓ   ﺪﺑ   ﺎﺑ   ﺘﻳ   ﺘﻨﻳ   ﺘﻳ   ﺘﻨﻳ    ﻳﺬﭘ   ﻜﺗ   : ﺮﻴﮔﻪﺠﻴﺘﻧ   ﻲﺑﺎﻳ    ﺑ   ﺘﻌﻣ   ﻮﻣ  ﻚﻳ   ﻮﻨﻋ   ﻪﺑ   ﻦﻳ   ﺑﺎﻨﺑ   ﺖﺳ  ﻻﺎﺑ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻲﻧﺎﻗﻮﻓ   ﺪﻧ  . ﻮﺷﻲﻣ   ﺎﻬﻨﺸﻴﭘ   ﺎﻛ  ﻮﻛ   ﻦﻳ  ﻲﻧﺎﻗﻮﻓ   ﺪﻧ   ﺎﻛ ﺣ   ﺖﻴﻔﻴﻛ   ﻳﺬﭘ    ﻜﺗ   ،ﻲﻧﺎﻗﻮﻓ   ﺪﻧ   ﺎﻫ  ﺎﻬﻣ   ﺖﻴﻔﻴﻛ   ﻮﻣ  ،  ﺰﻐﻣ   ﺞﻠﻓ  : ﺎ   ژ   ﻴﻠﻛ  36 ... ﺎﻗﻮﻓ   ﺪ    ﺎﻛﺮﺣ   ﺖﻴﻔﻴﻛ   ﻮﻣ   ﺮﻳﺬﭘ   ﺮﻜﺗ   ﺳ   ﺮﺑ 4 ﺴﻤﺷ   ﺴ      ﻤﺷ   1    3   9  0 ﺘﺴ     ﺎﺘﺴ       ﻬﭼ    ﻬﭼﻤﺷ       ﻤﺷ   ﻢ   ﻢ                       ﺪﻘ ﻛﺮﺣ   ﺐﻴــﺳ   ﺪﻧ  ﺮــﺸﻴﭘ   ﺮﻴﻏ   ﺎﻫ  ﺪﻨــﺳ   ﻔﻴﻃ   ﺰﻐﻣ   ﺞﻠﻓ    ﻛﺮﺣ   ﻧ  ﻮﺗﺎﻧ   ﻞﻠﻋ   ﻦﻳﺮﺗﻊﻳﺎــﺷ   ﻪﻛ   ﺖــﺳ  ﻴﻌﺿ    ﻢ ﺴﻴﺳ   ﻪﺑ   ﺐﻴﺳ   ــﺷﺎﻧ   ﻼ ﺧ  ﻦﻳ  .  ﻣ   ﺎﻤــﺷ   ﻪﺑ   ﻛ  ﻮﻛ .(1) ﺖﺳ  ﺪﺷ   ﺎﺣ    ﺰﻛﺮﻣ   ﺎﺼﻋ   ﻪﺟﻮﺗ   ﺎﺑ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﺮﺑ   ﻧﺎﻣ  ﻪﻣﺎﻧﺮﺑ    ﺎﻣ    ﻮﻧ   ﻦﻴﻴﻌﺗ   ﺮﻴﺛﺄﺗ   ﺑﺎﻴﺷ    ﺎﺒﻧ  ﻪﺑ   ،  ﻮﮔﺎﻧﻮﮔ   ﺎﻫ  ﺮﻜﻳ   ﺎﻫﻪﻨﻳﺰﻫ   ﻪﺑ   ﻢﻬﻣ   ﺎﻴــﺴﺑ   ﺎﻛ  ﻮﻛ   ﻦﻳ  ﻛﺮﺣ   ﺮﻛ  ﺎﻛ   ﺮﻴﮔ  ﺪﻧ   ﮋﻳﻮﺑ   ﺎﻣ   ﻪﺑ   ﻧﺎﻣ   ﻼﺧ  ﺪﻣ   ﺮﻴﺛﺄﺗ   ﺑﺎﻴﺷ  ﻦﻴﻴﻌﺗ   ﺮﺑ   ﻚﺷ   ﺑ   ﺖــﺳ . ﺖﺳ   ﺎﻴﻧ   ﺎﻳﺎﭘ   ﻪﻠﻴﺳ  ﻚﻳ   ﺮﻛ  ﺎﻛ   ﺑﺎﻴــﺷ   ﺮﺑ   ﺮ ــﺳ    ﺎــﻫ  ﺰﺑ   ﺖــﻳ  ﺪﺤﻣ   ﺎﻛ  ﻮﻛ   ﻦﻳ   ﻮﺒﻬﺑ   ﺖﺒﺛ   ﻓﺎﻛ   ﺪﻫ  ﻮﺷ   ﺪﻘﻓ   ﻪﺑ   ﺮﺠﻨﻣ   ﻛﺮﺣ   ﻪﻌﺳﻮﺗ   ﻌﻴﺒﻃ   ﺎﻛ  ﻮﻛ   ﺮﺑ   ًﻓﺮﺻ   ﺎﻫ  ﺰﺑ  ﺮ ﺸﻴﺑ   ﺮﻳ  ،ﺖﺳ   ﺪــﺷ   ﻮﺑ   ﺐﺳﺎﻨﻣ   ﻪﻜﻨﻳ   ﺎﺟ   ﻪﺑ   ،ﺪﻧ  ﺪﺷ   ﺶﻳﺎﻣ  ﺎﻬﻧ  ﺮ ﺸﻴﺑ   ﺪﻧ  ﻪ ﻓﺎﻳ   ﺮﻜﻠﻤﻋ  .(3-6)  ﻮﺷ   ﺪﻴﻳﺄﺗ   ﺎﺷ  ﺮﻳﺬﭘﺮﻴﺛﺎﺗ    ﺮﻳﺬﭘ   ﺮﻜﺗ   ، ﻳ   ﻼﺧ  ﺪﻣ    ﻮﻧ   ﺎﺤﻟ   ﻪﭼ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮــﻛ   ﻧﺎﻗﻮﻓ   ﺪﻧ   ﻦﻴﻘﻘﺤﻣ   ﻪﻗﻼﻋ   ﻮﻣ   ﻮﻤﻫ   ﺑﺎﻴﺷ    ﻮﻧ   ﺎﺤﻟ   ﻪﭼ   ﻧﺎﻣ . ﺖﺴﻫ    ﻮﺑ   ﺎﻛ  ﻮﻛ   ﻧﺎﻗﻮﻓ   ﺪﻧ   ﺮﻜﻠﻤﻋ   ﺖﻬﺟ   ﻮﺟﻮﻣ   ﺑﺎﻳ   ﺎﻫ  ﺰﺑ  .(7-8) ﺪﻨ ﺴﻫ   ﺲﺣ   ﺎﻳ     ﺮﺤﺗ   ،  ﺪﻗ   ﻞﻣﺎﺷ   ﺮ ــﺸﻴﺑ   ﺰﻐﻣ   ﺞﻠﻓ   ﺑﺎﻳ   ــﺳ  ﻧﻼﻀﻋ   ﻮﻣ  ﻖﻳﺮﻃ    ﺪﻗ   ﺑﺎﻳ  ًﻼــﺜﻣ   ﺮﻳﺎﺳ   (9) 1   ﻮﺷ  ﻪ ﻓﺎﻳ   ﻞﻳﺪﻌﺗ   ﻢ ﺴﻴﺳ   ﻖﻳﺮﻃ   ﻴــﺴﻴ ﺳﺎﭙﺳ   ﺖﺳ   3 ﻪﻄﻘﻧ   ﻦﻴﺑ   ﺰﻳﺎﻤﺗ   2 ﺲﻳ  ﻮﻨﮔ  ﺮ ــﺳ  ﻞﻣﺎﺷ   ﻪﻛ   ﺎﻫ ﺑﺎﻳ   ،ﻪﻠﻀﻋ   ﺪﻗ   ﺳ  ﺮﺑ   ﺖﻬﺟ   ﺮﻛ  ﺎﻛ   ﺎﻫ ﺑﺎﻳ  ﺮ ــﺸﻴﺑ  .(10)  ﺎﻫﺖﺳ  ﻳ  ﺮﺟ   ﺮﻛ  ﺎﻛ   ــﺴﺣ   ﺖﻴﻌﺿ  ،ﻞﺼﻔﻣ   ﻛﺮﺣ   ﻪﻨﻣ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﺮﺑ   ﺲﭙﺳ   ﺪﻧ  ﺪﺷ   ﺎﺠﻳ   ﻻﺎــﺴﮔ  ﺰﺑ   ﺮﺑ  . ﺖﻓﺮﮔ   ﺮﻗ   ﺎﻔ ﺳ   ﻮﻣ   ﺰﻴﻧ   ﺮﻠﻴﺗ   ﻂﺳﻮﺗ   ﺪﺷ    ﻼﺻ   ﻮﻣ  ﺶﻧ  ﺎﻜﻤﻫ   ﺪﻨﺳ   ﺎﺜﻣ   ﻮﻨﻋ   ﻪﺑ   ﺎﻫﺖﻴﻌﻤﺟ     ﻮﺑ   ﺪﺷ   ﺣ  ﺮﻃ   ﻻﺎﺴﮔ  ﺰﺑ   ﺮﺑ   ﻪﻛ   ﻮﺴﺒﺟ   ﺎﻜﺑ   ﻛﺮﺣ   ﺎﻫ ﻳﺎﻧ  ﻮﺗﺎﻧ   ﻞﺳﻮﮕﻨﻨﻣﻮﻠﻴﻣ   ﺎﻛ  ﻮﻛ   ﻞﻣﺎﺷ   ﻒﻠ ﺨﻣ   ،ﺖﺳ  4 ﻖﻴﻗ  ﻦ ﻓﺮﮔ   ــﺳ  ﺮﺑ   ﺮﺑ   ﻧﻮﻣ   ﺎﻫ  ،ﺪﻧ  ﺮﺑ    ﺮﻳﺬﭘ  ﺮﻜﺗ   ﻪــﻛ   ﺮﻛ   ﺣ  ﺮﻃ   ﻮﺗﺎﻧ   ﻪﻟﺎــﺳ  6 ﺎﺗ  0  ﺎﻛ  ﻮــﻛ   ﺎﻔ ﺳ   ﺎﻫ  ﺎﻴﻌﻣ   ،ﺖــﺳ  ﺖــﺳ   ﻤﻛ   ﺎﻋﻼﻃ   ﻳ .(11) ﺖﺳ  ﺳ  ﺮﺑ   ﺖﺤﺗ   ﻮﻨﻫ   ﻫ  ﺮﻤﻧ   ﺮﺑ   ﺪﺷ   ﺪﺷ  ﺰﻳ   ﺎﻛﺮﺣ    ﻮــﺴﺒﺟ   ﺮﻠﻴﺗ   ﺮﻴﻈﻧ   ﺮﮕﻳ   ﺎﻫ  ﻮﻣ  ﺧﺮﺑ   ﻮﻣ  ﻟ  ﺪﻨﻨﻛ ﻣ   ﺑﺎﻳ   ﺖــﺳ   ﺮﻜﻠﻤﻋ   5  ﺎﺑ   ﭘ   ﻛﺮﺣ   ﺎﻬﻨﺗ     ﺎﺒ ﻋ    ﺮﺗﻻﺎﺑ   ﺎﻳ    ﺎﺳ  6  ﺎﻛ  ﻮﻛ   ﺮﺑ   ﺮ ﺸﻴﺑ    ﻦﻳ   ﺮﻳﺬﭘ  ﺮﻜﺗ   ﻮﻃ    ﻮﺗﺎﻧ   ﻮﻛ  20  ﻂﻠ ﺨﻣ   ﺮــﮔ   ﻚﻳ   ﻮﻣ   (12) ﺪﻧﺪﺷ   ﻮﻣ   ﺎــﺳ 10 ﺎﺗ  8  ﻨــﺳ   ﻦﻴﮕﻧﺎﻴﻣ   ﺎﺑ   ﻮﻣ    ﻻﻼ ﺧ  ﺎﺑ   ﺎﻛ  ﻮــﻛ   ﺮﺑ   ﺎﺑ   ﭘ   ﻛﺮﺣ   ﺪــﺷ  ﺰﻳ   ﺎﻛﺮﺣ  .(13) ﺖﺳ  ﺮﻳﺬﭘ   ﺮﻜﺗ   ﺎــﺳ  6 ﺎﺗ  2 ﻦﻴﻨــﺳ   ﻦﻴﺑ   ﻒﻠ ﺨﻣ   ﺪــﺷ   ﺮﺑ   ﺎﻫ  ﻮﻣ  ﻦﻳ  ﻪﻛ   ﺖﺴﻴﻧ   ﺺﺨﺸﻣ   ًﻘﻴﻗ  ﻪﻛ   ﺖﺳﺎﻨﻌﻣ   ﺪﺑ   ﻦﻳ . ﺪﺷﺎﺑ   ﺐﺳﺎﻨﻣ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻪــﺑ   ﺎــﺴﺣ   ﻪﻛ   ﻳﺎﻫ  ﺮﻴﮔ  ﺪﻧ  ﻪﺟﻮ ﻣ   ،ﺶﻧ  ﺎﻜﻤﻫ    ﺎــﺒﻧ   ،  ﻮﺑ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﻧﺎﻗﻮﻓ   ﺪﻧ   ﺮﻜﻠﻤﻋ   ﻨﻴﻟﺎﺑ   ﺮــﻴﻴﻐﺗ   ﺮﺑ   ﻮﻣ    ﺎﺠﻳ  ﻪﺑ   ﺎﻘﻘﺤﻣ   ﺐﻴﻏﺮﺗ   ﺐﺟﻮﻣ   ﻦﻳ  .(14) ﺪﻧﺪﺷ   ﺖﻴﻔﻴﻛ   ﺑﺎﻳ   ﻮﻣ  ،ﻞﻣﺎﺷ   ﻪﻛ   ﺪﺷ   ﻧﺎﻗﻮﻓ   ﺪﻧ   ﺮﻜﻠﻤﻋ   ﺑﺎﻳ   ﻪﻓﺮﻄﻜﻳ   ﺑﺎﻳ   ( QUEST ) 6 (15) ــﻧﺎﻗﻮﻓ   ﺪﻧ   ﺎــﻫ  ﺎﻬﻣ   ﺮﺒ ﻌﻣ    ﮋﻳ   ﻮﻣ   ﺮﻫ  .(16) 7  ﻮﺒﻠﻣ   ﻧﺎﻗﻮﻓ   ﺪــﻧ   ﺮﻜﻠﻤﻋ    ﺮﻜﻠﻤﻋ   ﺐﻴﺳ   ﺒﻴﻛﺮﺗ   ﺖــﺳ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﺮﺑ   ﺎــﺳ  15 ﺎﺗ  5  ﺎﻛ  ﻮﻛ   ﺮﺑ   ﺪﻧ  ﻮﺗ ﻣ   ﻮﺒﻠﻣ   ﺑﺎﻳ  . ﺪﺠﻨــﺳ ﻣ  18 ﻦﺳ    ﺎﻛ  ﻮﻛ   ﺑﺎﻳ  ﻳﺎﻧ  ﻮﺗ   QUEST   ﻟ  . ﻮﺷ   ﺎﻔ ــﺳ .  ﮕﻟﺎﺳ  8 ﺎﺗ   ﮕﻫﺎﻣ   ــﺸﺨﺑ   ﺮﻳ  ﻢﻳﺪــﺷ   ﺰﻛﺮﻤ ﻣ   QUEST   ﻪﻌﻟﺎﻄﻣ   ﻦﻳ   ﺎﻣ   ﻮﻣ  ﻦﻳ  . ﺖﺳ  ﻂﺒﺗﺮﻣ   ﺎﮕﻨﻫ    ﻼﺧ  ﺪﻣ   ﺎﺠﻧ  ﻪﺑ   ﺎﻘﻴﻘﺤﺗ . ﺪﺷ   ﻪ ﺧﺎﺳ   ﺎﻧﺎﻛ   ﺶﻧ  ﺎﻜﻤﻫ   ﻮ ﻣ  ﻂﺳﻮﺗ  1991  ﺎﺳ    ﻞﻤﺤﺗ، ( ﺎﻴﻘﻣ   ﺮﺧ  24) ﻦ ﻓﺮﮔ، ( ﺎﻴﻘﻣ   ﺮﺧ  64) ﺰﺠﻣ   ﺎﻛﺮﺣ  4 ( ﺎﻴﻘﻣ   ﺮﺧ  36)  ﻇﺎﻔﺣ   ﺮﻛ   ﺎﺑ   ( ﺎﻴﻘﻣ   ﺮﺧ  50)  ﺎﻛﺮﺣ   ﺎﺠﻧ   ﺮﺑ   ﺎﻴﻌﻣ   ﺶﺨﺑ   ﺮﻫ    ﺪﻨــﺷﺎﺑ ﻣ   ﻮﻣ  ﺶﺨﺑ   ﺎﻫ  ﺎﻴﻘﻣ   ﺮﺧ   ﺎﻤﺗ    ﺮﻤﻧ  . ﺖﺳ   ﺪﺷ   ﺢﻴﺿﻮﺗ   ﺑﻮﺧ   ﻪﺑ   ﺶﺨﺑ   ﺮﻫ   ﺮﺑ   ﺮﻤﻧ  . ﺖﺳ  ( ﺪﺸﻧ   ﺖﺴﺗ ) ، ( ﺮﻴﺧ ) ، ( ﻪﻠﺑ )  ﻮﺻ   ﻪﺑ   ﺮﺒﺟ    ﺪﺸﻧ   ﺖﺴﺗ   ﺎﻫ  ﻮﻣ   ﻪﻛ   ﻮﺷ ﻣ   ﻪﺒﺳﺎﺤﻣ   ﻮﻣﺮﻓ   ﻚﻳ   ﺎﺑ   ﻪﺒﺳﺎﺤﻣ   ﺎــﺸﻋ  ﻢﻗ  2 ﺎﺗ   100 ﺎﺗ  0  ﺶﺨﺑ   ﺮﻫ   ﺮﻤﻧ  . ﺪﻨﻛ ﻣ   ﺮﺑ   ﻢﻴﺴﻘﺗ   ﺎﻫ  ﻮﺣ   ﻪﻤﻫ   ﺮﻤﻧ    ﻮﻤﺠﻣ    ﻮﻣ  ﻠﻛ   ﺮﻤﻧ  . ﻮﺷ ﻣ   ﺎ ﻓ  ،ﺮﮔ  ﺪﻫﺎﺸﻣ   ﻨﻫ   ﺎﺳﺎﺴﺣ  . ﺪﻳ    ﻣ   ﺖﺳ  ﻪﺑ   ﺎﻫ  ﻮﺣ   ﺪﻌﺗ   ﻮﻃ   ﻪﺑ   ﻴــﺴﻴ ﺳﺎﭙﺳ   ﺰــﻴﻣ   ﺑﺎﻳ   ﺎــﻣ   ﻮﻃ    ﻮــﻛ   ﻮﻣ   ﺬﮔ  ﺮﻤﻧ    ﺎــﺳﺎﺴﺣ  ﻦﻳ  . ﻮﺷ ﻣ   ﺖﺒﺛ   ﻪﻧﺎﮔ  ﺪﺟ  . ﺬﮔ ﻤﻧ   ﺮﻴﺛﺄﺗ   ﺰﻴﻧ   ﻮﻣ  ﻳﺎﻳﺎﭘ   ،ﻦﻳ  ﺮﺑﺎﻨﺑ    ﺪﻧ   ﺮﺛ   ﺐﻴﺳ   ﺎﺒﻧ  ﻪﺑ   ﺖﺳ   ﺮﻜﻠﻤﻋ   ﻤﻛ   ﺑﺎﻳ  ﻚﻳ   ﻮﻣ  ﻦﻳ     ﺎــﺴﺣ   ،ﺮﻳﺬﭘ   ﺮﻜﺗ   ﻮﻣ  . ﺪﻳ    ﻣ   ﻢﻫ  ﺮﻓ   ﻪﻴﻟ  ﻚــﻳژﻮﻟ  ﻮﻧ   ﺮﺑ   ﻮﻣ  . ﺖــﺳ  ﻚﻴ ــﺳﺎﭙﺳ   ﺰﻐﻣ   ﺞﻠﻓ   ﺎﻛ  ﻮﻛ   ﺮــﺑ   ﺪﻴﻔﻣ  .(6 ، 11 ، 14 ، 17 ، 20) ﺖــﺳ  ﺐــﺳﺎﻨﻣ   ﻪﻟﺎــﺳ  8 ﺎﺗ   ﻪﻫﺎﻣ  18  ﺎﻛ  ﻮﻛ   ﻪ ﻓﺮﻳﺬﭘ   ﻮــﺻ   ﻮﻣ  ﻦﻳ   ﻮــﻣ   ﻪﻛ   ﻳﺎﻫ ﻳﺎﻳﺎﭘ   ﻮــﻨﻛ   ﺎﺗ   ﻮﺑ   ﺎﻬﻧ  ﻦــﻴﺑ   ﮕ ــﺴﺒﻤﻫ   ﺶﺨﺑ   ﺮﻫ   ﻠﻛ   ﺮــﻤﻧ   ﺎــﺳ  ﺮﺑ   ﺐﻳﺮﻏ   ﻂــﺳﻮﺗ   ﻮﻣ  ﻦﻳ  ﺰﻴﻧ   ﺎﻣ   ﻮــﺸﻛ   (10 ، 13-14) ﺖــﺳ   ﻦﻴﺑ   ﺮﻳﺬﭘ  ﺮﻜﺗ   ــﺳ  ﺮﺑ   ﻦﻴﻳﺎﭘ   ﻪﻧﻮﻤﻧ   ﻢﺠﺣ   ﺎﺑ   ﺎﻜــﻤﻫ   1- Modified Ashworth 2- Stregnosis 3- Two Point of Discrimination 4- Prehention5- Fine Motor Developmental Motor Pea Body 6- Quality of Upper Extremity Skills Test7- Melbourne Assessment of Unilateral Upper-Limb Function  37    ﻤﻫ   ﻲﻤﻴﻬﻓ   ﺮﺒﻛ   ﻼﻳ    ﻧ 4 ﺴﻤﺷ   ﺴ      ﻤﺷ   1    3   9  0 ﺘﺴ     ﺎﺘﺴ       ﻬﭼ    ﻬﭼﻤﺷ       ﻤﺷ   ﻢ   ﻢ                      1- Gross Motor Function Classification System-66 (GMFCS-66)    ﻧ    ﻘﻴﻘﺤﺗ   ﺮــﺑ   ﺮﻣ   ﺑ   ﻪﻛ  (18)  ﻮﺑ   ﺪــﺷ   ﻳ ﭘ     ﺮــﻓ   ﺪﻳ   ﻮﺗﻲﻣ   QUEST   ﻮــﻣ   ﺮﻳﺬﭘ  ﺮﻜﺗ   ﻮﺼﺧ    ﺪــﺷ   ﻮﻣ   ﺮﻳ   ﺪــﺷ    ﻔﺘــﺳ  ﻲﻫ   ﺮﻤﻧ   ﺖﻬﺟ    ﻳ  ﺪﻨﭼ   ﻪــﻛ   ﻬﻨﺗ   ﻦﻴﻨﭽﻤﻫ   ﺰﻳ   ﺖﺷ    ﻛﺮﺣ   ﻲﻧﻮﮔ ﻧﻮﮔ    ﻫﺖﻴﻌﺿ    ﺨﺘﻧ  ﻪﻛ  (20) ﺪ ﻨﺳﻲﻣ   ( ﺪﺸﻧ   ﺖــﺴﺗ ) ، ( ﺮﻴﺧ ) ، ( ﻪﻠﺑ ) ﺖﻟ ﺣ  3   ﺨﺘﻧ    ﻤﺘﺣ  ﻦﻳ  ﺮﺑ ﻨﺑ      ﻳ  ﺮﻈﻧ   ﻪﺑ   ﻲﮕﺘــﺴﺑ   ﻪﻨﻳﺰﮔ   ﺮﻫ   ﻦﻳ   ﻢﻳﺪﺷ   ﺮﺑ  .  ــﺳﻲﻣ   ﻪﺟ  ﻮﻣ   ﻞﻜﺸﻣ   ﺑ   ﺐــﺳ ﻨﻣ   ﻪﻨﻳﺰﮔ   ﻲﺑ ﻳ  ﺖﻗ  ﺶﻳ  ﺰﻓ   ﻮﻈﻨﻣ   ﻪﺑ   ﺮﺗﻻ ﺑ   ﻪﻧﻮﻤﻧ   ﻢ ﺣ   ﺑ   ﻖــﻴﻘﺤﺗ   ﻦﻴﺑ   ﻲﮕﺘﺴﺒﻤﻫ   ﻲﺳ  ﺮﺑ   ﺮﺑ   ﻼﻋ   ﺗ   ﻢﻴﻳ ﻤﻧ    ﻔﺘــﺳ  ﺰﻴﻧ   ﺮﺒﻤﻠﻴﻓ   ﺰﻴﻧ   ﻫ   ﻴﻘﻣ   ﺮﺧ   ﻚﺗ   ﻚﺗ   ﻲﮕﺘــﺴﺒﻤﻫ   ،ﺶﺨﺑ   ﺮﻫ   ﻲﻠﻛ   ﺮﻤﻧ   ﺮﮕﻧﻮﻣ  ﻪﻛ   ﻮﻤﻧ   ﺺﺨﺸﻣ   ﻖﻴﻗ   ﻮﻃ   ﻪﺑ   ﻮﺘﺑ   ﺗ   ﻢﻴﻳ ﻤﻧ   ﻲــﺳ  ﺮﺑ   ﻳ   ﺮﺘﻤﻛ   ﺮــﻈﻧ    ﻔﺗ  ﻫﺶﺨﺑ   ﻳ   ﺶــﺨﺑ   ﺪﻛ    ﺮﮕﻧﻮﻣ  ــﻳ  . ﺪﻧ   ﺮﺘﺸﻴﺑ    ﺮﺑ      ﻫ   ﻬﻣ   ﺖﻴﻔﻴﻛ   ﻪﻣ ﻨﺸﺳﺮﭘ   ﻲ ﻨﺳ   ﺒﺘﻋ  ﻪﺑ   ﻲﻌﻄﻘﻣ   ﻪﻌﻟ ﻄﻣ   ﻚﻳ    ﻦﻳ    ﻣ  ﻪﻌﻣ ﺟ . ﺪﺷ   ﻪﺘﺧ  ﺮﭘ   ﺰﻐﻣ   ﺞﻠﻓ    ﻛ  ﻮﻛ   ﻲﻧ ﻗﻮﻓ   ﺪﻧ  19-95 ﻦﻴﻨــﺳ   ﻦﻴﺑ   ﻚﻴﺘــﺳ ﭙﺳ   ﺰﻐﻣ   ﺞﻠﻓ    ﻛ  ﻮﻛ   ﻪﻴﻠﻛ   ﺶﻫ  ﮋﭘ   ،ﺮﺼﻋ   ﺪﻴﻣ     ــﻬﺑ   ﻲــﺸﺨﺒﻧ  ﻮﺗ   ﺰﻛﺮﻣ    ﻬﭼ   ﻪﺑ   ﺪﻨﻨﻛ   ﻪﻌﺟ  ﺮﻣ    ــﻣ   ﺪﻌﺗ  . ﻮﺑ  1389 ﺰﻴﻳ ﭘ   ﺗ  1387   ــﺳ    ﺘــﺴﺑ ﺗ   ﺮﻔﻇ   ،ﺪﻴﻣ   ﻮﻧ   ﻞﻴﻟ  ﻪﺑ   ﻮﻛ  5 ،  ﺪــﻌﺗ   ﻦﻳ  ﻦﻴﺑ   ﺪﻧ  ﻮﺑ   ﺮﻔﻧ  55   ﻛ  ﻮــﻛ   ﻦــﻳ   . ﺪﻧﺪﺷ    ﺧ   ﻪﻌﻟ ﻄﻣ   ﺪﻳﺪــﺷ   ﻲﻨﻫ   ﻲﺘﺧ ﻨــﺷ   ﻼﻜــﺸﻣ   ﺞﻠﻓ    ﻮﻧ   ﺺﻴﺨــﺸﺗ   ،ﺪﻧ  ﺮﻛ   ﺖﻛﺮــﺷ   ﻪﻌﻟ ﻄﻣ    ﻮﻛ  50 ﺖﻳ ﻬﻧ   ﺢﻄﺳ     ﺼﻋ   ﺰﻐﻣ   ﺺﺼﺨﺘﻣ   ﻚﺷﺰﭘ   ﻂﺳﻮﺗ    ﻛ  ﻮﻛ   ﻦﻳ   ﺰﻐﻣ    ﻛﺮﺣ   ﺪﻨﺑ   ﻪﻘﺒﻃ   ﻢﺘﺴﻴﺳ   ﻪﻣ ﻨﺸﺳﺮﭘ    ﺳ  ﺮﺑ    ﻛ  ﻮﻛ   ﺮﻛ   ﻛ   ﻮﺤﻧ   ﻲﻫ ﮔ   ﺲﭘ   ﻦﻳﺪﻟ  . ﺪﻳ  ﺮﮔ   ﻦﻴﻴﻌﺗ   ﺰﻴﻧ  (19) 1 66 ﺖﺷ   ﺮﺑ   ﻲﻟ ﻤﺘﺣ  ﺮﻄﺧ   ﻪﻧﻮﮔﺮﻫ     ﻨﻴﻤﻃ   ﻮــﺼﺣ   ﻲﺑ ﻳ    ﻧ    ﻫ   ﻴﻌﻣ . ﺪﻧ  ﻮﻤﻧ   ﺖﻛﺮﺷ   ﻪﻌﻟ ﻄﻣ   ﻞﻣ ﻛ   ﺖﻳ ﺿ  ﺑ    ــﺸﻧ ﻛ  ﻮﻛ    ﻮﻧ   ﺰﻐﻣ   ﺞﻠﻓ   ﻪﺑ   ﻼﺘﺑ  ،   ﻣ  95-19 ﻦــﺳ  : ﻞﻣ ــﺷ   ﻪﻌﻟ ﻄﻣ   ﻪﺑ    ﺮﺧ    ﻫ   ﻴﻌﻣ   ﺖﻳ ﻤﺣ   ﺪﺑ   ﻦﺘــﺴﺸﻧ   ﻲﻳ ﻧ  ﻮﺗ   ،ﻚﻴﺘــﺳ ﭙﺳ   ﺐﻘﻋ     ﺘﻓ  ،ﻲﺘﺧ ﻨﺷ   ﻼﺘﺧ  ،   ﺘﻓ   ﻼﻜﺸﻣ   ﻦﺘﺷ  : ﻞﻣ ﺷ   ﻨﻴﺑ ﻧ ) ﻲﻳ  ﻮﻨﺷ   ﻲﻳ ﻨﻴﺑ   ﻼﻜــﺸﻣ   ،ﻪﺟﻮﺗ   ﻼﺘﺧ  ،ﻲﻨﻫ  ﻲﮔﺪﻧ ﻣ  . ﻮﺑ   ﻪﺘﺷﺬﮔ    ﺳ   ﻚﻳ    ﺪﭘﻮﺗ  ﻲﺣ  ﺮﺟ    ﻧ   ( ﻮﻨﺷ ﻧ    ﻳ  ﻚﻳ   ﻂﺳﻮﺗ    ﺒﻜﻳ   ،ﻪﻌﻟ ﻄﻣ   ﺮﺑ   ﺪﺷ    ﺨﺘﻧ    ﻛ  ﻮﻛ   ﺪﺘﺑ   ﺮﮕﻧ ﻣ  ﻂــﺳﻮﺗ    ﻪﻠﺻ ﻓ   ﻪﺑ   ﺮﮕﻳ    ﺑ  ( ﺮــﺘﻳ  ﺮﺘﻨﻳ ) ()  ﺑ   ﺮﻤﻫ  ( ﺮﺘﻳ  ﺮﺘﻨﻳ )  ﻣﺰﻤﻫ   ﻮــﻃ   ﻪﺑ  () ﺮﮕﻳ  ﺮــﮕﻧ ﻣ      ﻮﻛ   ﺖــﺸﭘ   ﻮﻠﺟ   ( SX  220 ﻦﻧ ﻛ   ﻦﻴﺑ )  ﺮــﺒﻤﻠﻴﻓ  45 ﺗ  30  ﺪﺣ   ﻮﻣ   ﺮﺟ  . ﺪﻧﺪــﺷ   ﻪﻌﻟ ﻄﻣ   ﻮﻣ    ﻧ  ﻦﻴﺣ   ﺪﺘﻣ    ﻫ   ﻣ    ﻛ  ﻮﻛ    ﻦﻳ   ﻮﻃ   . ﺪﻴﺸﻛ   ﻮﻃ   ﻪﻘﻴﻗ   ﻦﻳ  ﻪﻛ   ﺪــﺷ   ﺮﻓ  . ﺪﻧ  ﺮﻛﻲﻣ   ﺖﻓ ﻳ   ﻲﭘ  ﺮﺗﻮﻳﺰﻴﻓ   ﻲﻧ ﻣ   ﻛ   ﺮﻴﮕﻤــﺸﭼ   ﺮﻴﻴﻐﺗ    ﺮﻴﮔﻮﻠﺟ   ﺮــﺑ  ( ) ﻲﻧ ﻣ  ﻪــﻠﺻ ﻓ   ﺑ  ( ﻮﺳ ) ﺮﮕﻳ  ﺮﮕﻧ ﻣ  ﺲﭙــﺳ  . ﻮﺑ    ﺗﻮﻛ   ﻲﻓ ﻛ   ﺪﻧ  ﻪﺑ   ﺪــﺷ   ﻫ   ﻴﻘﻣ   ﺮﺧ   ،ﻪﻌﻟ ﻄﻣ   ﻮﻣ   ﻮﻛ  50   ﻮﻛ  46 ﻢﻠﻴﻓ   ﺪﻫ ﺸﻣ   ﺖﺳﺪﺑ    ﻫ  .( ﺮﺒﻤﻠﻴﻓ   ﺑ   ﺮﻳﺬﭘ   ﺮﻜﺗ ) ﻮﻤﻧ   ﻲﻫ   ﺮﻤﻧ    ،  ،ﻲﭘ،    ﻣ   ﺰــﻓ   ﺮﻧ     ﻔﺘــﺳ  ﺑ   ﺶﻫ  ﮋﭘ    ﺪﻣ     ﻣ   ﻪﻛ   ﻮــﺻ   ﻦﻳ  ﻪﺑ  . ﺖﻓﺮﮔ   ﺮﻗ   ﻞﻴﻠﺤﺗ   ﻮــﻣ  16 ﻪﺨــﺴﻧ   ﺮﺑ   ﺪﺻ     ــﻴﻌﻣ   ﺮﺤﻧ   ﻦﻴﮕﻧ ﻴﻣ   ﻪــﻠﻤﺟ   ،ﻲــﻔﻴﺻﻮﺗ   ﺐﻳﺮﺿ   ﻮﻣ    ﺪــﺷ    ﻔﺘــﺳ  ﻪﻧﻮﻤﻧ    ﻫﻲﮔﮋﻳ     ــﺸﻧ   ﺮﺘﻨﻳ   ﺮﺘﻳ  ﺮﺘﻨﻳ   ﺮﻳﺬﭘ  ﺮﻜﺗ   ﻲــﺳ  ﺮﺑ   ﺮﺑ   ﻦﻣﺮﻴﭙﺳ  ﻲﮕﺘــﺴﺒﻤﻫ . ﺪﺷ    ﻔﺘﺳ   ﺮﺒﻤﻠﻴﻓ   ﺪﺑ   ﺑ   ﺮﺘﻳ  ﺎﻫﻪﺘﻓﺎﻳ  ( ﺪﺻ  44) ﺮﻔﻧ  22 ﺪــﻧ  ﺮﻛ   ﺖﻛﺮــﺷ   ﻪﻌﻟ ﻄﻣ   ﻪﻛ   ﻲﻛ  ﻮﻛ  50   ﺰﻐﻣ   ﺞﻠﻓ    ﭼ   ﻮــﻛ  25 ﻪﻛ   ،ﺪﻧ  ﻮﺑ   ﺮﺘﺧ  ﻲﻘﺑ ﻣ   ﺮــﺴﭘ   ﻬﻧ   10  ﻲﻧ ﺘﺤﺗ   ﺪــﻧ  ﺞﻠﻓ    ــﭼ   ﻮﻛ  15   ﺪــﺑ   ﻪﻤﻴﻧ    ﻮــﻧ   61/31  ±  25/7 ﻬﻧ  ﻲﻨﺳ   ﻦﻴﮕﻧ ﻴﻣ   ﺪﻧ  ﻮﺑ   ﺪﻧ    ﻬﭼ   ﺞﻠﻓ   ﻮﻛ     ﻛ  ﻮﻛ،  ﺮﻳﺬﭘ  ﺮﻜﺗ   ﻲــﺳ  ﺮﺑ    ﻧ   ﻞﺒﻗ   ﻦﻴﻨﭽﻤﻫ   ،  ﻮــﺑ    ﻣ   ﺮﻗ   ﻲﺳ  ﺮﺑ   ﻮﻣ  66 ﺖــﺷ    ﻛﺮﺣ   ﺪﻨﺑ   ﻪﻘﺒﻃ   ﻢﺘــﺴﻴﺳ    ﺤﻟ   ﺢﻄﺳ   ﺪﺻ  20 ﻪﺳ   ﺢﻄــﺳ   ﺪﺻ  50 ﻚﻳ   ﺢﻄــﺳ   ﻪﻛ   ﺪﻨﺘﻓﺮﮔ     ﮔﺪﻨﻨﻛ   ﺖﻛﺮــﺷ   ﻞﻛ   ﺪﺻ  10  ﺪﻛ   ﺮﻫ   ﺰﻴﻧ   ،   ﻬﭼ   ،ﺞﻨﭘ .(1  ﺪﺟ ) ﺪﻧ  ﻲﻣ   ﻞﻴﻜﺸﺗ   ﺮﻛ    ﺑ   ﻮﺣ    ﻮﻛ   ﻚﻳ   ، ( ﺮﺘﻳ  ﺮﺘﻨﻳ ) ﻲﺑ ﻳ   ﻪﻠﺣﺮﻣ       ﻮﻠﻄﻣ    ﻜﻤﻫ   ﻞﻤﺤﺗ   ﻮﺣ   ﺮﮕﻳ  ﻲﻛ  ﻮﻛ   ﻲﺘﻇ ﻔﺣ   ﺮﺘﻳ  ﺮﺘﻨﻳ    ﻫ   ﻴﻘﻣ   ﺮﺧ   ﻻ ﺑ   ﻲﮕﺘﺴﺒﻤﻫ   ﻲﻛ ﺣ   ﺞﻳ ﺘ . ﺪﻨﺘﺷ  ﺪ  (0/981 - 0/812) ﺮــﺘﻳ  ﺮﺘﻨﻳ  ﻲﻠﻛ   ﺮــﻤﻧ   (0/996-0/774)  (0/988 - 0/663)  ﺮﺒﻤﻠﻴﻓ   ﺪﺑﺮﺘﻳ  ﺮﺘﻨﻳ    ﻫ   ﻴﻘﻣ  ﺮﺧ   ﺪﻘﻣ   ﺑ  (0/981 - 0/771)  ﺮﺒﻤﻠﻴﻓ   ﺪﺑ   ﺮﺘﻳ  ﺮﺘﻨﻳ  ﻲﻠﻛ   ﺮﻤﻧ  .(2  ﺪﺟ ) ﻮﺑ  P< 0/01   ﻤﺘﺣ   ﺮﺧ    ﺮــﺒﻤﻠﻴﻓ   ﺑ   ﺮﺘﻳ  ﺮــﺘﻨﻳ  ﻲﮕﺘــﺴﺒﻤﻫ   ﺞﻳ ﺘﻧ   ﻦــﻴﻨﭽﻤﻫ   ﺮﻤﻧ   (0/964 - 0/710)  ﻮــﺳ      ﻳ  ﻦﻴﺑ   ، ﻫ    ــﻴﻘﻣ    ﻴﻘﻣ   ﺮﺧ   (0/948 - 0/802)  ﻮﺳ      ﻳ  ﻦﻴﺑ   ،ﻲﻠﻛ   ﻦﻴﺑ   ،ﻲﻠﻛ   ﺮﻤﻧ   (0/954 - 0/652)  ﻮــﺳ      ﻳ  ﻦﻴﺑ   ، ﻫ  P< 0/01   ﻤﺘﺣ   ﺪﻘﻣ   ﺑ  (0/936 - 0/741)  ﻮﺳ      ﻳ .(3  ﺪﺟ ) ﻮﺑ  38 ... ﺎﻗﻮﻓ   ﺪ    ﺎﻛﺮﺣ   ﺖﻴﻔﻴﻛ   ﻮﻣ   ﺮﻳﺬﭘ   ﺮﻜﺗ   ﺳ   ﺮﺑ 4 ﺴﻤﺷ   ﺴ      ﻤﺷ   1    3   9  0 ﺘﺴ     ﺎﺘﺴ       ﻬﭼ    ﻬﭼﻤﺷ       ﻤﺷ   ﻢ   ﻢ                       ﻟﺎﻄﻣ    ﺪﻨﻨﻛ   ﺖﻛﺮﺷ   ﺎﻛ  ﻮﻛ   ﻲﻨﻴﻟﺎﺑ   ﺎﺼّﺨﺸﻣ   ـ 1 ﺪﺟﻲﻧﺎﻗﻮﻓ   ﺪﻧ   ﺎﻬﺗ  ﺎﻬﻣ   ﺖﻴﻔﻴﻛ   ﻮﻣ   ،  ﺮﺒﻤﻠﻴﻓ   ﺪﺑ   ﺮﺘﻳ  ﺮﺘﻨﻳ   ﺮﺘﻳ  ﺮﺘﻨﻳ  ﻲﮕﺘﺴﺒﻤﻫ   ﺐﻳ  ﺮﺿ   ـ 2  ﺪﺟ  39    ﻤﻫ   ﻲﻤﻴﻬﻓ   ﺮﺒﻛ   ﻼﻳ    ﻧ 4 ﺴﻤﺷ   ﺴ      ﻤﺷ   1    3   9  0 ﺘﺴ     ﺎﺘﺴ       ﻬﭼ    ﻬﭼﻤﺷ       ﻤﺷ   ﻢ   ﻢ                       ﺑ   QUEST      ﻪــﻛ   ﺖــﺳ    ﻲﻛﺎﺣ   ﺮﺿﺎﺣ   ﺶﻫ  ﮋﭘ   ﺞﻳﺎﺘﻧ   ﻲﻳﻻﺎﺑ   ﺮــﺒﻤﻠﻴﻓ   ﺪﺑ   ﺎﺑ   ﺮــﺘﻳ  ﺮﺘﻨﻳ   ﺮــﺘﻳ  ﺮﺘﻨﻳ  ﻲــﻳﺎﻳﺎﭘ  . ﺖﺳ    ﺧﺮﺑ   ﻲﻳﺎﻳﺎﭘ   ﻲﺳ  ﺮﺑ   ﻪﻛ   ﺖﺳ  ﻲﺗﺎﻌﻟﺎﻄ ﺎﺑ   ــﺴﻤﻫ   ﺎ ﺶﻫ  ﮋﭘ   ﺞﻳﺎﺘﻧ   ﺎ ﺰﻤﻫ    ﻃ   ﻪﺑ   ﺮﮕﻧ   ﻦﻴﺑ   ﻪﻛ   ﺶﻧ  ﺎﻜﻤﻫ   ﻟ   ﻂﺳ ﺗ   ﻪﻴﻟ    95   ﻲﮕﺘــﺴﺒﻤﻫ   ﻪﻛ   ﺖﻓﺮﻳﺬﭘ    ﺻ    ــﻛ  16  ﺮــﺑ  95   ﺎﺗ  75   ﻦــﻴﺑ   ﺎﻫ   ﺣ   ﺮﻳﺎــﺳ    ﻲﻳﺎﻳﺎﭘ   ﺮﮕﻳ   ﻪــﻌﻟﺎﻄ ﻪﻛ   ﻪﻌﻟﺎﻄ  ﻦﻴﻨﭽﻤﻫ   (11 ، 17) ﺖــﺳ    ﺑ   ﺪ  ﺖــﺳ  ﻪﺑ  2-4/5   ﻛ   ﻚــﻳ   ﺖــﺴﻴﺑ   ﺶﻧ  ﺎﻜﻤﻫ   ﻪﻜﻨﻴﻧ   ﻂــﺳ ﺗ   ﺮﮔ       (0/85 - 0/94)   ــ   ﺎﺑ      ﺞﻳﺎﺘﻧ   ﻪﻟﺎــﺳ    ﺻ   ﻪﺑ   ﻪﻛ  (0/72 - 0/92)  ﺮﮔ     ﻦﻴﺑ   (0/63 - 0/95)   ﺑ      ﻦﻳ   ﻻﺎــﺑ   ﻲﻳﺎﻳﺎﭘ   ﻲﻛﺎﺣ   ،ﺪــﺷ   ﺎﺠﻧ   ﺮــﺒﻤﻠﻴﻓ   ﻲﻳﻻﺎﺑ   ﻲﻳﺎﻳﺎﭘ   ﺶﻧ  ﺎﻜﻤﻫ   1 ﻲﻜــﺳﺰﻛﺎﺳ   ﻦﻴﻨﭽﻤﻫ   (21) ﺖــﺳ  .(22) ﺪﻧ   ﺰﮔ   ﺎﻫ   ﺣ   ﺎﻤﺗ   (0/85 - 0/98)  ﻲﻳﻻﺎﺑ   ﺎﻴﺴﺑ   ﻲﮕﺘﺴﺒﻤﻫ   ﺖﺳ  ﺖﻴﻤﻫ  ﺰﺋﺎﺣ   ﻪﻌﻟﺎﻄ ﻦﻳ   ﻪﻛ   ﻪﭽﻧ    ﺮﻛ   ﺎﺑ    ﻞــﻤﺤﺗ   ،ﻦﺘﻓﺮﮔ   ﺎﻫ  ﺎﻴﻘ  ﺮﺧ   ﻪﻛ   ﺖــﺳ   ﺪﻌﺗ    ﺑ   ﻻﺎــﺑ      ﺿ ﻦﻳ  ﻞــﻴﻟ  ﺎ .   ﺟ  ﻲــﺘﻇﺎﻔﺣ   ﻖﻴﻗ  ﺢﻴﺿ ﺗ    ﺪــﺷ   ﺮﺒ ﺎﻧ    ﺣ   ﻪــﺳ   ﺎﻫ  ﺎﻴﻘ  ﺮــﺧ   ﻢﻴﻬﻔﺗ   ﻪﺑ   ﺮﺠﻨ ﺖﻳﺎﻬﻧ   ﻪــﻛ   ﻢﻴﻧ  ﻲ  ﺎﻴﻘ  ﺮﺧ   ﺎﺠﻧ    ــﺤﻧ   ﺎﺜ   ﻨﻋ   ﻪﺑ  .  ــﺷﻲ ﻪﻨﻳﺰﮔ   ﻦﻳﺮﺘﻬﺑ   ﺎﺨﺘﻧ   ،  ﺎﻳ  ﺮــﺘﻬﺑ  6   ﺟ   ﺎﺑ ﺒﺣ   ﺎﻴﻘ  ﺮﺧ   QUEST   ﻦــﺘﻓﺮﮔ    ﺣ    ﺪﻨﻛﻲ ﻚﻤﻛ   ﺎﻳ  ﻪﺑ   ﺎﺑ ﺒﺣ   ﻦﺘﻓﺮﮔ    ﺤﻧ   ﻒﻠﺘﺨ ﺖــﻟﺎﺣ   ﺎﻛﺮﺣ    ﺣ   ﺲــﻜﻋ   ﺮﺑ   ﺪﻨﻛ   ﺎﺨﺘﻧ   ﻪﻨﻳﺰﮔ   ﻦــﻳﺮﺘﻬﺑ   ﺎــﺗ   ﺮﺧ   ﺮﻫ   ﺎﺠﻧ    ــﺤﻧ        ﺪــﻧ  ﺢﻴﺿ ﺗ   QUEST   ﺰــﺠ ﺪﻫ   ﺧ   ﻞﻜــﺸ  ﺎﭼ  ﻪﻨﻳﺰﮔ   ﻦﻳﺮﺘﻬﺑ   ﻦﻴﻴﻌﺗ     ﺎﻳ   ﺎــﻴﻘ ﻻﺎﺑ   ﺰﻴﻧ   ﺮﺒﻤﻠﻴﻓ   ﺎﺑ   ﻲﮕﺘــﺴﺒﻤﻫ   ﺞﻳﺎﺘﻧ   ﺪﻨﭼ   ﺮﻫ   ﻦﻴﻨﭽﻤﻫ  . ﺮﻛ   ﺎﺘــﺸﮕﻧ  ﺖﻴﻌﺿ  ﻪﻜﻧ  ﻞﻴﻟﺪﺑ   ﻦﺘﻓﺮﮔ   ﺎﻴﻘ  ﺮﺧ   ﻲﻟ    ﺑ   ﺮﺘﻳ  ﺮﺘﻨﻳ  ﻪﺑ   ﺖﺒــﺴﻧ   ﻲﮕﺘــﺴﺒﻤﻫ   ﺰﻴ   ﺒﻧ   ﺺﺨــﺸ  ﺪﺣ   ﺎﺗ   ﺖﻔﮔ    ﺗﻲ ﻪﻛ   ﺖﺳ  ﻪﺘﻓﺎﻳ   ﺶﻫﺎﻛ   ﺮﺘﻳ  ﺮﺘﻨﻳ    ﺮﺒﻤﻠﻴﻓ   ﺪﺑ 1- Sakzewski ﻲﻧﺎﻗ ﻓ   ﺪﻧ   ﺎﻫ  ﺎﻬ ﺖﻴﻔﻴﻛ       ، ( ﺮﺒﻤﻠﻴﻓ )  ﺳ   ﺎﺑ   ﺮﮕﻧ     ﺳ   ﺎﺑ   ﺮﮕﻧ  ﻲﮕﺘﺴﺒﻤﻫ   ﺐﻳ  ﺮﺿ  -3  ﺪﺟ
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