Binocular diplopia is a challenging oculomotor disorder that significantly impacts patients’ quality of life. This review provides a comprehensive overview of the etiology, diagnostic methods, and treatment strategies for binocular diplopia. Proper diagnosis begins with differentiating between monocular and binocular diplopia, followed by determining whether the cause is motor or sensory. Diagnostic methods include detailed medical history, qualitative and quantitative assessment of diplopia, analysis using tools like the Haab Grid, evaluation of ocular motility, and assessment of head postures. The level of oculomotor defect should be investigated to differentiate between nuclear and supranuclear lesions. Treatment approaches are diverse and depend on the underlying cause. Functional strategies may include prismatic correction, which can provide immediate relief from diplopia. Surgical interventions are considered for cases of paralytic strabismus or when conservative measures are insufficient. The choice of treatment is guided by factors, such as the etiology, duration, and severity of diplopia. Prismatic correction is often used as both a diagnostic tool and a treatment option, allowing for precise adjustment of eye alignment. In cases of acute diplopia, a systematic approach to diagnosis and appropriate identification of possible causes enables better patient management. This comprehensive approach to binocular diplopia, encompassing thorough diagnostic methods and a range of treatment strategies, improves functional outcomes and enhances the quality of life for affected patients. This study emphasizes the complexity of diplopia, distinguishing between monocular and binocular types, and motor and sensory forms. Management involves functional therapies, prismatic correction, and if needed, botulinum toxin or surgery. Prompt evaluation and multidisciplinary collaboration are essential, particularly for neurological causes.

The third cranial nerve (oculomotor nerve) plays an essential role in the function of ocular movement and mainly innervates the inferior oblique, medial rectus, inferior rectus, superior rectus, levator palpebrae, pupillary sphincter, and ciliary muscle. The most frequent clinical manifestations of oculomotor nerve palsy are ophthalmoplegia, ptosis, pupillary dysfunction, and diplopia. The etiology of oculomotor nerve palsy is complex, including congenital tumors, craniocerebral trauma, intracranial inflammation, diabetes, intracranial aneurysm, cerebrovascular infarction or hemorrhagic disease, myasthenia gravis, multiple myeloma demyelinating diseases, and other uncommon causes. Each etiology of oculomotor nerve palsy has its corresponding clinical features. The present study comprehensively reviews the common etiologies of oculomotor nerve palsy and the corresponding clinical manifestations and treatment methods to help practitioners with the prompt and accurate clinical diagnosis of the causes and effective management plan.

Introduction: Lower extremity surgeries, such as total knee arthroplasty, total hip arthroplasty (THA), and anterior cruciate ligament reconstruction require extensive rehabilitation to restore mobility and function. Traditional rehabilitation faces various challenges, such as patient adherence and access to care. Virtual reality (VR) has emerged as a promising tool to enhance rehabilitation outcomes by offering interactive, engaging environments that improve patient motivation.
Materials and Methods: A narrative review was conducted to evaluate the current literature on VR-based rehabilitation for post-operative lower extremity conditions. Relevant studies from 2019 to 2024 were selected from online databases, such as PubMed, Scopus, and Cochrane, focusing on VR’s application in patients recovering from total knee arthroplasty, THA, ACL reconstruction, and traumatic lower limb amputations.
Results: VR interventions significantly improved proprioception, balance, and patient engagement compared to traditional rehabilitation methods. VR’s interactive nature provided real-time feedback and enhanced patient motivation. However, mixed results were reported regarding VR’s superiority in pain management and overall functional outcomes. VR was shown to complement traditional therapy rather than replace it.
Conclusion: VR-based rehabilitation offers a promising adjunct to traditional methods, improving patient engagement and specific functional outcomes. While VR enhances recovery, further research is needed to establish standardized protocols and determine its long-term efficacy in post-operative rehabilitation.

Introduction: Liver transplantation can change the quality of life, physical activity, mood, and psychological symptoms in patients. Considering that exercise capacity is correlated to the level of depression and quality of life among patients, this study investigates the effect of exercise therapy on the quality of life and depression in orthotopic liver transplantation recipients (LTRs).
Materials and Methods: This was a single-blinded study with randomized controlled trial parallel groups, and 30 LTRs were randomly assigned in a 1:1 ratio. The experimental group underwent a three-month home-based exercise therapy, while the control group received no exercise therapy. Assessments included short-form-36 and the Beck depression questionnaires, along with the 6-min walk test.
Results: There was no significant difference between groups in demographic characteristics. Before the intervention, the mean scores of depression in the intervention and control groups were 27.87±8.68 and 25.77±6.77, respectively. After the intervention, t-test revealed a significant difference between the two groups (P=0.001). The results of the t-test indicated that the average quality of life dimensions improved post-intervention compared to the control group, with significant differences in the scores of these dimensions. After the intervention, the t-test showed a significant difference between the two groups in terms of the 6-min walk test (P=0.001).
Conclusion: Rehabilitation through prescribed exercise can improve quality of life and physical activity, and alleviate depression symptoms in LTRs. As a result, incorporating physiotherapy into the post-transplantation care of transplant recipients holds potential benefits.

Introduction: Recently, machine learning adoption has significantly increased across various applications, including the prediction of diseases based on a person’s clinical profile. Accordingly, this study develops and evaluates a supervised machine learning method to predict trunk muscle activity in people with chronic low back pain.
Materials and Methods: This was a secondary data analysis from a subgroup of people with nonspecific chronic low back pain. The correlation between labeled data and the output data of muscle activity level was measured through surface electromyography. The result showed a good correlation, suggesting the potential utility of this approach in distinguishing individuals with low back pain from pain-free controls.
Results: To validate the performance of the developed machine learning, the results were compared with the SPSS software, version 17. The model’s predictive performance was further assessed using various evaluation methods, including the area under the receiver operating characteristics curve. The study’s findings indicate that the model achieved area under the curve values ranging from 0.5 to 0.9 across all muscles and different tasks for people with back pain. In contrast, the pain-free group exhibited area under the curve values between 0.4 and 0.8.
Conclusion: The supervised machine learning approach using logistic regression may offer clinically meaningful predictions in defining the differences in trunk muscle activity between individuals with non-specific chronic low back pain and pain-free controls. While the obtained results demonstrate promise, further studies need to enhance the model’s performance and achieve a more accurate estimation of muscle activity levels.

Introduction: Women’s soccer and preventive training strategies have gained popularity in the last decade; accordingly, this study determines the effectiveness of a dynamic balance exercise protocol in amateur soccer players.
Materials and Methods: A total of 24 females participated in this study and were randomly assigned to a control (n=12) and an experimental group (n=12). The experimental group received a dynamic balance exercise intervention with three weekly sessions for six weeks, while the control group maintained regular training. Balance was assessed before and after by the Y balance test in its anterior, posterior medial, and posterior lateral directions. The data were analyzed through the t-test for independent and related samples.
Results: The analysis of this study shows significant improvements in dynamic balance (P=0.000) in the experimental group after the intervention of the dynamic balance exercise program for six weeks, while in the control group, there were no significant improvements.
Conclusion: Dynamic balance exercise programs can be used to increase the balance of amateur female soccer players.

Introduction: Studies on subclinical neck pain (SCNP), known as mild pain lack proper literature. This study examines the differences in anxiety, neck movement, disability, and proprioception in people with chronic SCNP (12 females and 4 males, age = 28.1±4.0 years) and people without neck pain (17 females and 6 males, age = 25.8±3.1 years).
Materials and Methods: A cross-sectional study with 39 participants was conducted. The participants were instructed to score their pain using the visual analog scale (pain group: < 4/10 and normal group: 0/10), anxiety level with the state-trait anxiety inventory, and neck disability with the neck disability index. In addition, active range of motion and joint position errors were assessed in participants of both groups.
Results: There was no significant difference in mean baseline characteristics between the two groups. The participants in the pain group reported significantly higher median neck disability index (P≤0.001) and higher mean current state-trait anxiety inventory state (P=0.032) scores compared to participants with no pain. No significant differences in mean flexion, extension, lateral flexion right, lateral flexion left, rotation right, or rotation left were found between groups (P=0.95, P=0.68, P=0.29, P=0.59, P=0.70, and P=0.17, respectively). In addition, there were no significant differences in mean cervical spine joint position error flexion, extension, rotation right, and rotation left by the study group (P=0.65, P=0.33, P=0.26, and P=0.23, respectively).
Conclusion: SCNP can substantially influence functional ability and anxiety levels, especially among students in higher education institutions dealing with additional stressors. The interaction between pain intensity, disability, and anxiety underscores the potential for a detrimental feedback loop, underscoring the significance of early intervention.

Introduction: This study investigates the occupational performance and life habits of elderly adults with early stages of Alzheimer disease.
Materials and Methods: This was a cross-sectional study. The participants were elderly adults, aged 65-85 years with Alzheimer disease who were referred to Roozbeh and Ziaeian Hospital, in addition to Kahrizak Charity in Tehran City, Iran in 2022. A total of 70 Seventy patients (36 male, 34 female) were recruited based on the convenience sampling method. The Canadian occupational performance measure and life habits questionnaire were used to determine occupational performance and life habits. Meanwhile, the data were analyzed using the independent t-test and the Mann-Whitney test using the SPSS software, version 21.
Results: The mean age of elderly males and females was 72.02±3.74 and 71.14±4.09 years, respectively. Meanwhile, 68.3% of the priorities of occupational performance were related to self-care. In the male participants, the priorities of self-care were 76.7% and in female subjects, it was 59.4%. No significant gender difference was found in satisfaction with occupational performance (P>0.05; P>0.05). In the life habit questionnaire, fitness had the highest participation level, while communication had the lowest. A significant gender difference was observed in participation levels in daily activities (P<0.05).
Conclusion: The most important occupational performance priority of elderly adults with Alzheimer disease was self-care. The highest level of participation in daily activities was related to fitness and the lowest was communication. This study helps occupational therapists identify the priorities, habits, and participation levels of men and women with early Alzheimer in daily activities.

Introduction: Athletes involved in sports requiring frequent cutting and pivoting movements are at increased risk of anterior cruciate ligament (ACL) injuries. This study investigates the effectiveness of neuromuscular warm-up exercises, including strength, balance, plyometric, and core stability training, in reducing ACL injury risk.
Materials and Methods: A total of 30 adolescent male basketball players (age = 13-18 years) were randomly assigned to either the control group (n=15; age = 15.66±1.7 years, height = 172.7±9.6 cm, weight = 66.74±11.2 kg) or the neuromuscular training (NMT) group (n=15; age = 14.73±0.70 years, height = 174.0±6.7 cm, weight = 64.79±10.8 kg). The NMT group performed a structured injury prevention warm-up program three times a week for eight weeks before regular basketball training (20 min), while the control group followed their usual basketball practice. Measurements of knee proprioception (including specific motion directions), knee valgus and flexion torque, trunk endurance via the Biering-Sorenson test, and isometric strength of various muscle groups were taken pre- and post-intervention.
Results: Significant improvements in isometric strength were observed in all assessed muscle groups in the NMT group (P<0.05); however, no significant changes were found in knee valgus, flexion torque, trunk endurance, or knee proprioception (P>0.05).
Conclusion: While the NMT protocol significantly improves isometric muscle strength in adolescent male basketball players, it does not show a direct effect on other ACL injury risk factors. Therefore, incorporating NMT into training routines may support strength development but should be combined with other targeted interventions to reduce ACL injury risk more effectively.

Introduction: As the global population ages, the need for sensitive language assessments for dementia increases. While the Barnes language assessment (BLA) is a valuable tool in English, it has not been translated and validated for Persian-speaking populations.
Materials and Methods: This cross-sectional translated and culturally adapted the BLA into Persian (BLA-Per) and evaluated its psychometric properties. The translation process followed the international quality of life assessment protocol. The BLA-Per was administered to 30 healthy older adults and 30 individuals with Alzheimer disease (AD). Test-retest reliability was assessed in the AD group. Statistical data analysis was performed using the SPSS software (version 24) at a significance level of 0.05.
Results: Due to significant differences between the patients and cognitively healthy groups regarding age and education years, we used the analysis of covariance to control for these variables’ effects on between-group comparisons. Significant differences in BLA-Per scores were observed between healthy controls and AD patients in 8 out of 14 test components, demonstrating good discriminative validity. Intra-class correlation coefficients for test-retest reliability were above 0.75 for most subtests.
Conclusion: The BLA-Per demonstrated good validity and reliability in assessing language impairments in Persian-speaking individuals with AD. Future research should investigate the BLA-Per in larger samples across different age groups and stages of AD.