Exercise is established as an important adjunct in the treatment of Parkinson’s disease (PD). Yet the field has spent decades searching for a single “best” program – a quest that is fundamentally misguided. Instead, rehabilitation should be matched to each patient’s main impairments, goals, safety profile, cognitive status, and access to services. Four well-studied approaches – LSVT BIG, HiBalance, supervised therapeutic climbing, and community non-contact boxing – offer different mechanisms, expected outcomes, and practical demands. The core argument of this editorial is that optimal outcomes come from sequencing short, intensive blocks of targeted therapy followed by community‑based maintenance programs, guided by a small set of routinely collected clinical variables. Progress in PD rehabilitation will depend on patient‑centered pathways that integrate physiology‑driven treatment with sustainable community options, not on identifying a universal superior exercise.
LSVT BIG is an intensive, high‑repetition program focused on increasing movement amplitude and recalibrating sensorimotor perception. Randomized trials and meta‑analyses show improved motor scores and gait when the standard protocol is followed [1,2], with physiological studies supporting a proprioceptive recalibration mechanism [3]. These effects are most clearly reported in people with mild‑moderate PD who can tolerate an intensive, therapist‑led schedule [1,2]. The resource intensity and need for trained clinicians should be noted when LSVT BIG is recommended.
HiBalance targets balance subsystem deficits by training sensory integration, anticipatory postural adjustments, and dynamic stability. Short‑term gains in balance and gait have been reported in trials, and imaging studies suggest task‑related neuroplastic changes [4]. The magnitude of benefit has varied across studies, and non‑specific factors such as attention and group support influence outcomes in some trials [5,6]. HiBalance is therefore best used when postural instability or falls are the dominant clinical problems and when supervised, cognitively demanding training is feasible.
Supervised therapeutic climbing combines large‑amplitude limb and trunk movements, vertical loading, and complex visuomotor problem solving. Randomized trials report improvements in motor signs [7], with other controlled studies showing gains in posture and gait [8,9]. High adherence and strong patient engagement are documented in feasibility reports [10]. Notably, most climbing data originate from a single research group; independent confirmatory trials would strengthen generalizability. Proposed mechanisms include axial strengthening, transfer of vertical motor control to horizontal locomotion, and enhanced cognitive‑motor dual‑tasking. Climbing is most suitable where axial extension, posture correction, and sustained engagement are prioritized, and where safe infrastructure and trained supervision are available [7,8]. Attention to safety protocols and implementation costs is required [10].
Community non‑contact boxing programs have been widely adopted because they are engaging, socially reinforcing, and scalable. Trials and reviews report improvements in mood, motivation, and adherence, with modest gains in fitness and some motor outcomes [11,15] – though randomized trials show inconsistent effects on core PD motor signs [12,13]. The principal practical value of boxing is therefore often found in long‑term adherence and psychosocial benefit, which can support maintenance of gains achieved in targeted therapy blocks [14].
From this evidence, several practical principles emerge. Interventions should be matched to mechanism and goal: amplitude‑focused deficits → LSVT BIG; balance subsystem failure → HiBalance; axial/postural problems → supervised climbing where available; long‑term adherence and mood → community boxing when appropriate. Short, intensive blocks (typically 8–12 weeks) of targeted therapy are likely to produce focused gains that require ongoing maintenance. Community‑based or group activities are reasonable maintenance options when safety and access permit.
A critical gap in the original literature has been the absence of a simple, clinically usable decision tool. Table 1 summarizes a simple, hypothesis-generating decision framework based on five routinely collected variables: motor phenotype, fall history, cognitive status, patient goals, and access constraints. This framework is intended to support clinical reasoning and prospective validation, not to serve as a validated treatment algorithm.

Introduction: Mild Cognitive Impairment (MCI) is considered a transitional stage between normal cognitive aging and Alzheimer’s disease. Given the challenges in accurately distinguishing MCI from the healthy elderly (HE), researchers have increasingly turned to event-related potentials (ERPs) to identify early neural changes, particularly in verbal and episodic memory processing.
Methods: This review synthesizes ERP studies from 2000 to 2025 that utilized verbal episodic memory paradigms to differentiate between MCI and HE. The databases PsycINFO and PubMed were searched for peer-reviewed articles. The reporting of this review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results: In these studies, core aspects of verbal processing—including semantic congruity and recognition—combined with episodic memory manipulation have consistently reported alterations in ERP components such as the N400, FN400, and Late Positive Component (LPC) in MCI. Reduced or delayed N400 and LPC responses, as well as altered scalp distributions, have been shown to be sensitive to verbal memory deficits in MCI, often preceding behavioral impairments. Moreover, ERP paradigms integrating semantic and episodic memory have shown that the interaction between memory systems further enhances diagnostic precision.
Conclusion: The reviewed literature highlights that verbal ERP paradigms are not only effective in differentiating MCI from HE but also capture subtle neurophysiological changes that might be overlooked by behavioral measures alone. These results underscore the potential of ERPs as non-invasive, cost-effective biomarkers for early cognitive impairment.

Introduction: The type of feeding has different effects, and the effects of breastfeeding on the auditory system, speech and language has also been confirmed. The aim of this study is to provide a comprehensive review of various studies conducted on the effects of different feeding types on the auditory system, speech and language.
Materials and Methods:  A narrative review was conducted using PubMed, Scopus, Medline, Web of Science, Google Scholar, ScienceDirect, and the Cochrane Library to identify English-language studies on the effects of feeding type on auditory, speech, and language development. A total of 57 studies published between 1981 and 2025 were identified and selected based on predefined inclusion criteria, and the findings were synthesized to evaluate developmental outcomes.
Results: Breastfeeding has different effects on various aspects of hearing, speech, language, and cognition in children compared to formula feeding. Breastfeeding, as a protective factor against middle ear. Breastfeeding is associated with better speech and language development, including verbal intelligence, better receptive and expressive language, improved language skills, and the natural development of oral-motor skills necessary for speech production.
Conclusion: As the optimal source of nutrition for infants, breast milk not only meets physical and motor needs but also contributes to optimal functioning of the peripheral and central auditory systems. It plays a significant role in enhancing communication skills, speech and language development, and related abilities.This review is limited by its narrative design and the heterogeneity of existing studies; future research should employ standardized, longitudinal methodologies to clarify causal mechanisms.

Introduction: Vestibular neuritis (VN) causes acute vertigo from sudden unilateral vestibular dysfunction, mainly in adults aged 30–60. Previous reviews have focused on clinical and therapeutic aspects, but the inflammatory and immune mechanisms are less well understood. This review summarizes recent evidence on viral, immune, and vascular pathways in VN.
Method: A narrative review was conducted using PubMed, Scopus, and Web of Science databases. Forty articles published between 2001 and 2025 were included, focusing on pathophysiology, immune pathways, and therapeutic approaches implications.
Results: VN is primarily caused by HSV-1 reactivation, leading to vestibular nerve inflammation. Other viruses, such as SARS-CoV-2 and Epstein–Barr, are also involved. Immune dysregulation, characterized by alterations in leukocytes and cytokines, drives neuroinflammation. Vascular issues, especially blood-labyrinth barrier disruption, worsen swelling. Corticosteroids reduce inflammation; vestibular rehab aids recovery. Combining treatments improves early outcomes.
Conclusion: VN is a complex disorder caused by viral reactivation, immune inflammation, and vascular issues. Recovery primarily depends on central compensation, rather than peripheral nerve regeneration. Combining anti-inflammatory treatment with early rehab yields the best results. Future research should investigate the molecular connections between viral infection, immune response, and vestibular damage to develop targeted therapies.

Background: Squatting is a fundamental movement in which ankle position is frequently modified with external tools such as shoes, insoles, or wedges. However, the effects of these modifications on shank muscle electromyographic (EMG) activity remain unclear. This systematic review and meta-analysis aimed to examine how changes in sagittal ankle position influence shank muscle EMG activity during squatting.
Material and Methods: A systematic search of six databases was conducted from inception until August 2026. Included studies reported EMG activity of the tibialis anterior (TA), gastrocnemius (GA), or soleus (SOL) during squats performed in plantar flexion or dorsiflexion, compared with a neutral ankle position.
Results: Analysis of eleven studies (141 participants) revealed that the plantar flexion position significantly decreased dorsiflexor (TA) activity (Hedges' g = -1.048; P < 0.001) but had no significant effect on plantar flexor (GA, SOL) activity (Hedges' g = 0.069; P = 0.672). High heterogeneity (I² > 75%) was observed for both meta-analyses. Limited evidence also suggested that dorsiflexed positions may reduce plantar flexor activity.
Conclusions: Ankle plantar flexion during squatting significantly reduces dorsiflexor activity without systematically altering plantar flexor activation. These findings provide preliminary support for the clinical use of heel lifts to offload the TA but question their efficacy for modifying calf muscle recruitment. Future research should prioritize standardizing EMG methodologies and investigating these effects in clinical populations.

This study introduces a human-machine model utilizing OpenSim. It examines the impact of a passive (unactuated) lower-limb rehabilitation exoskeleton on biomechanics during ambulation. The model assesses how well the joints are aligned, how the muscles are used, and how well the design performs. The exoskeleton is made of T6061 aluminum alloy, which makes it light and easy to move. Each leg has three active joints and two passive joints that work in the sagittal plane. Musculoskeletal and exoskeleton models are simulated together in MATLAB and OpenSim. MATLAB scripts set their dynamic properties. A six-degree-of-freedom bushing models the interaction between the human and the exoskeleton at contact points. Joint angles come from experimental gait measurements. A residual-reduction algorithm reduces dynamic errors while keeping the resulting residual forces and moments within acceptable limits. Muscle activations and forces are estimated using computed muscle control, which follows joint paths. Simulations show that even in passive mode, the exoskeleton increases overall lower-limb muscle activation by more than 50% compared to walking without assistance. Significant increases occur in the rectus femoris, gluteus maximus, semimembranosus, and vastus lateralis. Joint torques also change: swing-leg hip and knee torques decrease by about 50%, support-leg torques increase because of the load, and ankle torque adjusts for compensation. These non-invasive simulations show reduced torque variability and support better design updates. This leads to improved exoskeleton alignment and evaluation before physical prototyping.

Introduction: This study aimed to investigate the effects of four ankle taping conditions (high dye and low dye using both elastic and non-elastic tape) on plantar pressure distribution during the stance phase of running in novice runners with chronic ankle instability.
Materials and Methods: This within-subject repeated-measures study design involved thirty-six (n = 36) novice runnerswith chronic ankle instability. Ankle range of motion were recorded using an electrogoniometer device and plantar pressure data were collected using a Footscan pressure platform during running under five taping conditions: no tape, elastic low-dye, elastic high-dye, non-elastic low-dye, and non-elastic high dye. Repeated measures ANOVA with Bonferroni’s correction (P < .005) were conducted to compare outcomes across taping conditions.
Results: Elastic high dye taping resulted in the greatest reduction in plantar pressure and peak force in the lateral foot regions. Compared to non-elastic tapes, elastic tapes significantly reduced pressures and forces in these areas (P < 0.005). Elastic high dye was found to be the most effective taping condition overall for reducing lateral foot loading during running (P < .005). Non-elastic tapings reduced the range of motion of the ankle joint (P <.005).
Conclusion: Elastic high dye taping may influence plantar pressure distribution and reduce lateral foot loading in young male runners with chronic ankle instability. However, as the findings were obtained under barefoot conditions, external validity is limited, and results should be interpreted as short-term biomechanical responses rather than indicators of clinical effectiveness.

Purpose: To determine the prevalence of computer vision syndrome (CVS) and its association with smartphone usage patterns among optometry students at Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Methods: In this cross‑sectional study, 107 optometry students participated between 2023 and 2025. Data were collected using a structured smartphone usage questionnaire and the validated Persian version of the CVS-Questionnaire (CVS‑Q). A CVS‑Q score ≥ 6 indicated CVS. Demographic characteristics, daily smartphone screen time, working distance, body posture during smartphone use, screen illumination, blue light filter use, sleep duration, and optical correction status was recorded. Refractive error was measured using an open-field autorefractometer and confirmed by retinoscopy. Statistical analyses were performed using SPSS v26 )p < 0.05).
Results: Participants’ mean age was 21.93 ± 3.88 years, with 64.5% female. CVS prevalence was 73.8%, with a mean score of 9.54 ± 5.82. The average daily smartphone screen time was 5.6 ± 1.4 hours, and the mean working distance was 35.37 ± 7.49 cm. The most prevalent symptoms were dryness (74.8%), burning sensation (72.9%), increased sensitivity to light (60.7%), and headache (57%). No significant associations were found between CVS severity and screen time, working distance, body posture, screen illumination, blue light filter use, sleep duration, refractive error, or optical correction (p > 0.05). Multiple linear regression analysis did not identify significant predictors of CVS severity (R² = 0.049, p = 0.075).
Conclusion: CVS is highly prevalent among optometry students and demonstrates a multifactorial etiology, extending beyond screen time and blue light exposure alone.

Background: Reading difficulties in school-aged children are frequently associated with oculomotor deficits, including prolonged fixation durations, increased saccade frequency, and frequent refixations. Given the critical role of eye movements in fluent reading, early diagnosis and targeted intervention are essential to mitigate adverse academic, social, and economic outcomes. This study aimed to evaluate pre‑post changes in Developmental Eye Movement test (DEM) test performance following a structured oculomotor training program, delivered via the Sanet Vision Integrator(SVI) system, in Iranian primary school children with reading difficulties.
Material and Methods:This single-group, pre- and post-intervention study included children recruited from primary schools in Shiraz, Iran.Training sessions of 30 minutes, incorporating saccadic and tracking exercises, were conducted three times weekly. Outcomes were assessed before and after the intervention using the DEM test.
Results: Thirty-two children aged 7–12 years with abnormal DEM scores and teacher-reported reading weaknesses participated in a 12-week intervention program. Paired t-tests revealed statistically significant improvements in vertical time, adjusted horizontal time, ratio and total errors following the intervention ( all p < 0.001), with post-treatmentt means closley approximating age-mached normative value across all age groups.
Conclusion: Oculomotor training using the SVI system was associated with improved DEM test performance in children with reading difficulties. However, the absence of a control group limits causal interpretation, as improvements may reflect practice effects, maturation, or non-specific factors. Randomized controlled trials with standardized reading assessments are needed to determine whether such training produces functional reading improvements.

Background: Valid and culturally adapted patient-reported tools are essential for accurate clinical assessment of knee injury outcomes. This study aimed to translate the English Lysholm Knee Scoring Scale (LKSS) into Persian and comprehensively validate it.
Methods: This methodological study (test development) employed a cross-sectional design. The LKSS was translated using Guillemin's standard method. Validity and reliability were assessed in a sample of 182 patients with knee injuries. We evaluated content validity (Content Validity Ratio (CVR) and Content Validity Index (CVI)), face validity (impact score), convergent validity (correlation with the International Knee Documentation Committee (IKDC) form), construct validity (Exploratory Factor Analysis (EFA)), and reliability, including internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient (ICC)), and Standard Error of Measurement (SEM).
Results: All items demonstrated acceptable content validity (CVR >0.79 and CVI >0.62). All face validity impact scores were above the 1.5 threshold. Convergent validity was excellent, with a very high correlation between the LKSS and IKDC (r=0.804, p<0.001). The EFA supported a one-factor structure (KMO=0.829; Bartlett's test p<0.001), explaining 42.39% of the variance. Reliability was outstanding, with an ICC of 0.95, a Cronbach's alpha of 0.894, and an SEM of 5.14.
Conclusion: The Persian LKSS demonstrated high validity and reliability across all measured metrics. These results confirm it is a psychometrically sound and suitable instrument for assessing knee-related function and outcomes in the Iranian population, suitable for both clinical and research applications.

Background: Chronic ankle instability (CAI) induces a disorder of the central nervous system, in which brain waves play an important role in regulating these factors. The aim of this study was to investigate the immediate effect of dual-task training (neuromuscular and cognitive) on brain electrical activity, pain severity, and foot and ankle disability index (FADI) in athletes with CAI.
Methods: This study a single-blind randomized control trial (RCT). Participants were 44 young male and women athletes (N=27 male: N=17 women) with CAI who were randomly divided into two groups; dual-task training group and control group. The immediate effect of dual-task training was performed for 30 minutes. Outcome measures were brain electrical activity (electroencephalography Medina Teb Company, Iran was employed), pain severity (10-centimeter visual analog scale) and disability.
Results: The results indicated that dual-task training significantly improved brain electrical activity and reduced pain severity. Significant reductions in pain were observed (P < 0.001, η² = 0.493), along with decreased theta wave activity at O1 and O2 (P < 0.001, η² = 0.837; P < 0.001, η² = 0.898). In contrast, alpha and beta wave activities significantly increased at both O1 and O2 electrodes (beta: P ≤ 0.001, η²ₚ = 0.702 and 0.898).
Conclusion: The findings of this study indicate that dual-task training has an immediate effect on enhancing brain electrical activity in the O1 and O2 regions and reducing pain severity. Based on these acute findings, physiotherapists and sports rehabilitation practitioners may consider incorporating dual-task training as a complementary approach aimed at improving central nervous system function.