Background: Auditory neuropathy spectrum disorder (ANSD) disrupts neural coordination despite normal outer hair cell function, impairing speech comprehension, especially in noisy environments.
Objectives: This review explores the genetic mechanisms underlying ANSD.
Methods: PubMed, Scopus, and Web of Science were searched from 2010 to 2023 for studies on ANSD genetics, excluding those focused on non-genetic causes or lacking relevant data.
Results: ANSD is associated with conditions such as Brown-Vialetto-Van Laere Syndrome and Charcot-Marie-Tooth disease, often resulting from mutations in the auditory nerve. Non-syndromic ANSD is associated with genes such as OTOF and PJVK, which are essential for neural function.
Conclusions: ANSD is a multifactorial condition resulting from genetic mutations in key genes, which disrupt auditory pathways and impair sound signal transmission. Further research is needed to identify additional genes and understand molecular mechanisms contributing to ANSD. This knowledge will improve diagnosis, prognosis, and therapeutic strategies, and could lead to innovative treatment approaches in the future.

Background: In recent years, exergames have emerged as a potential rehabilitation tool to address balance dysfunction in patients with multiple sclerosis (PwMS). Although preliminary findings have shown promise, their overall effectiveness remains inconclusive, primarily due to their reliance on commercial games. This underscores the critical need for user-centered games tailored to the specific needs of patients. Despite this necessity, existing literature lacks established frameworks that guide the development of such games, highlighting a gap in literature.  Therefore, the objective of this research was to propose the first evidence-based framework to guide the development of user-centered games for balance rehabilitation in PwMS.
Materials and Methods: A two-step method was used to achieve this objective. The first step involved the examination of commercial games used in clinical studies, identifying their mechanics and limitations. The second step involved reviewing the literature to identify relevant findings that could inform the development of user-centered games.
Results: A set of targeted recommendations was proposed, emphasizing the necessity of developing adaptable games with focused therapeutic designs to effectively address the distinct balance impairments observed in PwMS. A game prototype was also presented to illustrate the practical applications of these recommendations.
Conclusion: This research establishes the first structured framework to guide the design of user-centered exergames for balance rehabilitation in PwMS. Beyond its theoretical insights, this framework provides actionable guidelines for developing clinically effective exergames aligned with patient impairments and therapeutic needs. Ultimately, this will contribute to improved therapeutic outcomes, enhanced patient care, and advancements in both rehabilitation and game design fields.

Background: Tinnitus, defined as the perception of sound without an external source, affects 10% to 24% of adults and can significantly impair quality of life. Mind-body approaches—including mindfulness-based interventions, yoga, and hypnosis—have been increasingly explored as complementary strategies for tinnitus management, though their efficacy remains under investigation.
Methods: A narrative review was conducted utilizing PubMed, Scopus, Medline, Web of Science, and Google Scholar to identify English-language studies (1995-2024) on mindfulness, yoga, and hypnosis for tinnitus management. Studies were selected based on predefined inclusion criteria, and the findings were summarized to assess efficacy, mechanisms, and limitations.       
Results: Mindfulness-based interventions (e.g., Mindfulness-Based Cognitive Therapy [MBCT], Mindfulness-Based Stress Reduction [MBSR]) demonstrate moderate evidence of reducing tinnitus distress and improving anxiety and depression, with some studies reporting sustained benefits for up to six months. Although rigorous trials are lacking, yoga has preliminary evidence, with small studies suggesting benefits for stress and tinnitus-related symptoms. Hypnosis studies, often outdated, indicate preliminary benefits for tinnitus severity and psychological symptoms; however, effects are inconsistent and poorly sustained. Negative findings, such as limited impact on tinnitus intensity or anxiety, tend to be underreported.
Conclusion: Mindfulness-based interventions show promising clinical efficacy for managing tinnitus, especially the psychological symptoms, whereas yoga and hypnosis necessitate further rigorous trials. Future studies should emphasize head-to-head comparisons, long-term outcomes, integration with existing therapies like cognitive behavioral therapy, and include diverse populations to enhance clinical applicability.

Background: Learning disabilities (LDs) are among the most common developmental and educational challenges faced by school-age children worldwide. This systematic review and meta-analysis aimed to provide a pooled estimate of the prevalence of all types of learning disabilities in elementary school students in Iran.
Material and Methods: A comprehensive systematic search was performed in the international and national databases, including PubMed, Scopus, Web of Science, Google Scholar, Magiran, and SID, from 1990 to March 18, 2025. The quality of articles was evaluated by the Joanna Briggs Institute (JBI). All analyses in this study were performed using Comprehensive Meta-Analysis (CMA) software, version 3.0.
Results: A total of 32 studies, comprising 81363 students, were included. The pooled prevalence of LDs among elementary school children in Iran was 5.6% (boys 6.4% and girls 5%). The prevalence of LDs in first-, second-, third-, fourth-, fifth-, and sixth-grade students was 9.5%, 6.9%, 6.2%, 5.2%, 4.5%, and 3.1%, respectively. The pooled prevalence of dyslexia, dyscalculia, and dysgraphia was 5.4%, 4.3%, and 3.4%, respectively.
Conclusions: This systematic review and meta-analysis reveal that at least one in 20 Iranian students has a learning disability, and this rate rises to one in ten in early grades.

Introduction: Hearing and balance are vital body functions that allow us to communicate with our surroundings and effectively participate in everyday activities. These two functions are influenced by a variety of factors, including vitamins. In this article, we will examine the role of vitamins on hearing and balance, and the effects of deficiencies in these nutrients on ear and balance health.
Materials and Methods: This review examined the effects of vitamins on hearing. We identified 71 studies published since 2000 through searches of Medline (PubMed), Google Scholar, ScienceDirect, PubMed, EBSCO, ASHA, Thieme and the ProQuest.
Results: Evidence suggests that vitamins A, B, C, D, and E are associated with auditory and vestibular health. Deficiencies in these vitamins have been linked to hearing loss, tinnitus, dizziness, and impaired inner ear function. In particular, vitamins A and E support hair cell integrity and protect against oxidative stress, while B and C vitamins contribute to neural function. Vitamin D is also important for vestibular health through its role in calcium regulation.
Conclusion: Ensuring adequate intake of these vitamins through diet or supplementation may help prevent hearing and balance disorders and improve quality of life

Background: Numerous studies have demonstrated that physical environments play a critical role in regulating behavior, and information processing in children with Attention-Deficit/Hyperactivity Disorder (ADHD). This study aims to identify architectural features of rehabilitation environments and examine their relationship with the information processing abilities of children with ADHD.
Material and Methods: Thirty five children (mean age: 7.6m range: 5-10) diagnosed with ADHD from 10 rehabilitation centers in Tehran were recruited for this descriptive-analytical study. Data was collected via a researcher-designed questionnaire for evaluating important architectural elements in the rehabilitation centers and was validated for content and construct (Cronbach’s alpha = 0.81). The total score and the score for each item of the questionnaire were evaluated by a Professional architects. The sensory improvement of the children was also evaluated by short sensory profile questionnaire 2 times; at the base line and after 1 month of their treatment. Correlation between each architectural items and the improvement in the children’s sensory profiles were assessed by Pearson’s correlation tests.
Results: A significant positive and moderate correlation between elements such as natural light (r=0.58), calming color schemes (r=0.55), noise reduction (r=0.49), with improved information processing speed ability in children with ADHD (p < 0.01).
Conclusions: The results indicate that careful and intentional architectural design of rehabilitation environments can play an effective role in enhancing cognitive performance in children with ADHD. It is recommended that architects and rehabilitation professionals collaborate more closely to meet the perceptual and cognitive needs of these children in space design.

Background and aim: Repetition rate of stimulus as an audiological assessment criterion plays important role in differential diagnosis in some special populations. Therefore, the goal of this study was to evaluate normal variation of the auditory brainstem response (ABR) parameters including latency, amplitude, morphology and component’s duration (width) by using two different rates with tonal stimuli at different frequencies in Wistar rats.
Methods: In this experimental study, forty-five young adult male Wistar rats were subjected to ABR measurements with tone burst stimuli in octave frequencies from 2 to 16 kHz with two rates of 11.1 and 57.1/sec, following the relevant protocols. The stimuli were delivered at an intensity of 80 dB SPL and through a speaker.
Results: At high rate, latency changes in later waves were greater than earlier components whereas amplitude changes in later waves were smaller than earlier ones. Rate-dependent changes as a function of frequency were uniform for latency versus amplitude. Morphologically, ABR components were broadened in a frequency-dependent way. Duration of wave I was shorter than wave IV as well as wave duration changes influenced by frequency. These findings were statistically significant (p<0.05).
Conclusion: The results can be likely due to differences in adaptation mechanisms in auditory system, additive synapse theory and, desynchronization by increasing stimulation rate. Knowledge of the various effects of rate as a function of frequency on ABR parameters in normal rats is basic to understanding how different changes of these parameters at each wave could lead to more precise diagnosis in neuro-pathologic conditions.

Introduction: Soccer is the most popular sport globally for both men and women. The Functional Movement Screen (FMS) is a seven-part standardized tool created by experts to evaluate movement quality. This research compared FMS scores and performance between male and female soccer players.
Materials and Methods: A total of sixty semi-professional soccer players (30 males and 30 females) participated in this study. All participants completed the FMS test, Y-Balance Test, Davies Test, Single hop for distance, and Crossover Hop Test. Between-group comparisons were performed using independent t-tests for normally distributed variables and Mann-Whitney U tests for non-normally distributed variables.
Results: There were no significant differences between male and female players in Deep Squat, Hurdle Step, In-Line Lunge, or Overall FMS Score (P>0.05). However, significant differences were found in Shoulder Mobility, Active Straight Leg Raise, Trunk Stability Push-Up, and rotary stability (P<0.05). Males performed better in Trunk Stability, while females excelled in Shoulder Mobility and Active Straight Leg Raise. Males outperformed females in Single hop for distance and Cross-over hop. In upper extremity performance, males performed better in the Davies test and dynamic balance in the superolateral direction, with no significant differences in other upper extremity dynamic balance directions.
Conclusion: This study demonstrates the necessity of gender-specific training programs, as they are crucial in enhancing performance and reducing the risk of injury. According to the findings, it is recommended that flexibility and mobility exercises be implemented for male soccer players and core stability and strength training for female soccer players.

Objectives: Between ages 2-7, children develop the ability to narrate stories with improved detail and organization, including main characters, events, responses, efforts, and settings. Narrative assessment, a tool for evaluating language development, allows speech pathologists to examine syntax, vocabulary, and complexity. This study aimed to develop a tool for evaluating storytelling skills in children aged 4-5.
Results: The speech therapists evaluated and confirmed the face validity of the story and images, implementing necessary adjustments.. Construct validity was significant (P = 0.000), indicating alignment with typical development. Inter-evaluator reliability (k=0.712) and test-retest reliability (r=0.591) were moderate to good. Internal consistency varied, with α > 0.5 in one story and α < 0.5 in others.
Discussion: The findings indicate that the test demonstrates validity and moderate reliability, suggesting its suitability for practical applications

Purpose: To compare objective clinical signs and subjective symptoms of dry eye disease in patients with and without primary Sjögren's syndrome (SS).
Methods: This study included patients diagnosed with dry eye disease (DED) due to primary Sjögren’s syndrome and patients with DED without SS (non-SS DED), all meeting the inclusion criteria at Helal Hospital (Tehran, Iran). Objective clinical assessments—including tear film breakup time (TBUT), Oxford corneal staining, tear osmolarity, and Schirmer's test I—were conducted in both groups. Subjective symptoms were assessed with the Ocular Surface Disease Index (OSDI) questionnaire. Correlation coefficients were calculated using linear regression analysis.
Results: This study was conducted from January 2023 to February 2024. Forty patients were included: 20 with SS DED and 20 with non-SS DED. The non-SS DED group had a significantly higher OSDI score (41.66 ± 7.50) than the SS DED group (37.29 ± 6.04; p = 0.05). Tear secretion measured by Schirmer I was significantly higher in the non-SS DED group (p = 0.00), while corneal staining scores were higher in the SS DED group (p = 0.00). The association between OSDI scores and objective clinical test results was weak in both groups. Among SS DED patients, OSDI scores showed a significant moderate correlation with disease duration (r = −0.529, p = 0.017). Additionally, within this group, higher tear osmolarity showed a very weak correlation with lower OSDI scores (r = −0.383, p = 0.096).
Conclusion: There is a weak and inconsistent association between subjective symptoms (OSDI scores) and objective clinical signs of DED in both patients with and without primary SS. Patients with SS may underreport their discomfort despite having more severe clinical signs of DED. 

Background: Heart failure (HF) is one of the most common cardiovascular diseases that considered as a progressive and debilitating disorder. One of the main problems in these patients is frequent hospitalizations due to the exacerbation of symptoms. Therefore, the aim of this study is to investigate the simultaneous effect of muscle electrical stimulation and exercise therapy on quality of life and functional capacity in hospitalized patients with chronic heart failure.
Material and Methods: The present study included 40 hospitalized patients with chronic heart failure among the volunteers and randomly divided into two groups of 20 patients. The first group underwent cardiac rehabilitation based on resistance training along with muscle electrical stimulation (RT+ES). The second group received only resistance training program (RT). Resistance training consisted of performing three leg presses, cuff presses, and triceps movements with Traband. Functional capacity and quality of life evaluated before and after intervention.
Results: Quality of Life Index in the RT+ES increased more than RT (P≤0.05). Although the functional capacity in both groups had increased relative to the pre-test (P≤0.05). However, there were no meaningful differences between the two groups (P≥0.05).
Conclusion: Resistance training with electrical stimulation during hospitalization improves the quality of life and functional capacity of patients with chronic heart failure.

Background: Altered foot kinematics during walking, including reduced tibial inclination (the angle between the tibia and a vertical line during gait), as well as medial longitudinal arch (MLA) flattening and first metatarsophalangeal (MTP1) extension angle have been linked to various musculoskeletal disorders. Such abnormalities can have considerable clinical ramifications; hence, it is essential to identify them accurately.
Aim: We aimed to assess the diagnostic accuracy of KineFeet, a web-based application that employs a depth camera technique to detect foot kinematic changes for human gait analysis.
Methods: KineFeet and Kinovea^® gait analysis software were used to diagnose altered foot kinematics in 89 healthy participants in this cross-sectional study. The main kinematic parameters investigated were Ankle Inclination angle at Terminal Stance (AI_TSt), Medial Longitudinal Arch angle at Terminal Stance (MLA_TSt), and Metatarsophalangeal angle 1 at maximal hallux extension (MTP_HE). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the receiver-operating characteristic area under the curve (AUC) were computed.
Results: KineFeet showed excellent diagnostic performance. AI_TSt had a sensitivity of 88.23% and a specificity of 95.83%, with PPV and NPV values of 83.33% and 97.18%, respectively (AUC = 0.97). MLA_TSt and MTP_HE also had high discriminative abilities, with sensitivities of 79.54% and 79.00%, specificities of 95.55% and 91.30%, and attributed AUCs of 0.94 and 0.91, respectively.
Conclusion: KineFeet was able to accurately detect foot kinematics deformity during human gait. Its high diagnostic accuracy makes it a promising screening and evaluation tool. Further studies on human gait pathologies are warranted.

Introduction: Multiple Sclerosis (MS) is a degenerative disease affecting the central nervous system. Patients with MS experience difficulties in speech, language, and cognitive abilities. This research aimed to explore the relationship between cognitive functions, syntax, and the severity of dysarthria in Persian patients with Relapsing-Remitting Multiple Sclerosis (RRMS), compared to healthy individuals.
Mterials and Methods: In this cross-sectional study, 31 patients diagnosed with RRMS were compared to 31 healthy adults matched by age, gender, and education. Participants were assessed using the Montreal Cognitive Assessment, the syntax comprehension sub-test from the Bilingual Aphasia Test, and the sentence production test. Dysarthria was evaluated through the Frenchay Dysarthria Assessment (FDA-2a), and severity was determined using the visual analog scale by three speech and language pathologists based on recorded speech samples.
Results: Findings showed significant differences between MS patients and the control group (P≤0.05). Dysarthria severity correlated significantly with syntax comprehension (P=0.002, Cohen’s d=0.803), syntax production (P=0.005, Cohen’s d=0.820), and MoCA (P=0.001, Cohen’s d=0.579). Significant correlations were also found between MoCA and syntax comprehension and production within the patient group (P≤0.05). Data were analyzed using SPSS version 26. Differences between groups were calculated by an independent t-test, and correlations were analyzed with the Spearman test at a significance level of P≤0.05.
Conclusion: Syntactic challenges in MS patients may be linked to cognitive impairments, and as dysarthria severity increases, syntactic problems escalate. These results can assist speech and language pathologists in clinical evaluations and comprehensive interventions.

Introduction: Positive psychology can be the antidote to fatigue and burnout in environments where workers face disability, adversity, and suffering. The present study aimed to determine the effectiveness of positive psychotherapy based on the PERMA flourishing model in reducing occupational burnout and compassion fatigue among staff working in rehabilitation centers affiliated with the Welfare Organization — an understudied population whose wellbeing may affect service quality and client outcomes.
Materials and Methods: A single-case experimental design was used with five rehabilitation staff members in Yazd, Iran. Participants received eight weekly sessions of the PERMA flourishing program. Burnout and compassion fatigue were assessed before, during, and after the intervention, with clinical improvement evaluated using the Reliable Change Index (RCI).  
Results: The results demonstrated a significant reduction in burnout and compassion fatigue, with an acceptable percentage of improvement and RCI values exceeding 1.96 (p < 0.05). For emotional exhaustion, depersonalization, and secondary traumatic stress, RCI values exceeded 2.58 (p < 0.01), with improvement percentages ranging from 23–100%, 52–64%, and 24–80%, respectively. For compassion satisfaction, compassion fatigue, and secondary traumatic stress, RCI values ranged from 1.96 to 2.58 (p < 0.05–0.01), with improvement percentages of 14–48%, 25–52%, and 23–33%, respectively. These results indicate statistically and clinically meaningful improvements following the PERMA flourishing intervention.
Conclusion: Based on these findings, it can be concluded that the PERMA flourishing program may serve as an effective intervention for reducing occupational burnout and compassion fatigue among rehabilitation personnel.

Background - Duchenne Muscular Dystrophy (DMD) is an inherited neuromuscular disorder caused by mutations in the dystrophin gene, leading to progressive muscle weakness. This study aimed to evaluate the efficacy of telerehabilitation in the improvement of pulmonary function in DMD patients.
Materials and Methods - An interventional study was conducted among boys aged 5 to 12 years with DMD enrolled in the Pediatric Neurology clinic between September 2023 to February 2024. Telemedicine-based respiratory exercises were explained to the patients and their parents every 15 days for a 3 month-period, and patients were encouraged to do exercise for at least 5 days a week. Pulmonary function tests, including Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1), were recorded before and after intervention.
Results –67 children participated in this study. There was significant improvement in forced vital capacity (FVC) [p value <0.001, Cohen’s d value=1.93] and forced expiratory volume in one second (FEV1) [p value <0.001, Cohen’s d value=1.06]. The FEV1/FVC ratio, a parameter that can be elevated in restrictive diseases, was also significantly decreased [p value <0.001, Cohen’s d value = -0.63]. For a one-unit increase in age, the FVC change after intervention was predicted to decrease significantly by 0.24 units, holding other variables constant.
Conclusions: Telemedicine-based pulmonary rehabilitation for 3 months markedly improved the pulmonary function, thus concluding that this intervention is effective in improving the pulmonary function of DMD patients, and effectiveness is more if telerehabilitation is started at an early age.