Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 04 28 327 333 Bashar Ali Naji Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Teheran, Iran. Asad Hameed Alnajar Department of Biology, College of Sciences, Mustansiriyah University, Baghdad, Iraq. 2025 02 06 2025 04 28 Introduction: Tinnitus—the perception of sound in the absence of an external stimulus—affects approximately 14.4% of adults worldwide and significantly impacts mental health. It is frequently associated with anxiety, depression, and cognitive dysfunction, leading to a reduced quality of life (QoL). Tinnitus may be classified as subjective or objective, with severity and related psychological distress varying considerably among individuals. Materials and Methods: A comprehensive review of literature published between 2010 and 2024 was conducted using databases including PubMed, Scopus, Web of Science, and Google Scholar. Keywords related to tinnitus and mental health (e.g. anxiety, depression, mood disorders) were used to identify human studies examining the psychological impact of tinnitus. Results: Research consistently indicates that individuals with tinnitus experience varying prevalence rates of anxiety and depression, ranging from 18.5% to 48.33% for anxiety and from 6% to 84% for depression. Shared neural circuits—including the anterior cingulate cortex, insula, and amygdala—are implicated in both tinnitus and mental health conditions. Psychological interventions such as cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBIs) have demonstrated effectiveness in alleviating tinnitus-related distress and enhancing mental well-being. Conclusion: Tinnitus significantly affects mental health, contributing to anxiety, depression, and sleep disturbances. A multidisciplinary treatment approach that addresses both auditory and psychological dimensions of tinnitus is essential for effective management. Further research is warranted to refine therapeutic strategies and better understand the complex relationship between tinnitus and mental health. https://jmr.tums.ac.ir/index.php/jmr/article/view/1258

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 06 11 334 345 Ebrahim Jafarzadehpur Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohammad Reza Pishnamaz Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohamad Saeid Hoseinzade Firozabadi Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Leila Mirzaee Saba Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Faezeh Fayaz Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Rasoul Amini Vishteh Department of Optometry, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 2025 02 04 2025 06 11 Introduction: Active vision therapy, integrating perceptual learning with dichoptic or binocular environments, has shown potential effectiveness in treating amblyopia. However, uncertainties remain regarding the optimal types of stimuli and the best approaches and sequences for their delivery. This systematic review aimed to evaluate the effectiveness of psychophysical visual-stimuli-based interventions, particularly perceptual learning and dichoptic training, in treating amblyopia. Materials and Methods: A comprehensive literature search across major databases, such as PubMed and Google Scholar, yielded 26 studies involving 993 patients with amblyopia. These studies investigated various visual training methods, including perceptual learning, dichoptic stimulation, and combinations of both, using stimuli, such as Gabor patches, letter optotypes, Vernier stimuli, and random-dot stereograms. Results: The findings indicate that perceptual learning enhances visual acuity, contrast sensitivity, and stereopsis by leveraging neural plasticity, even in adult patients. Dichoptic training, which engages both eyes simultaneously, shows promise in reducing suppression and improving binocular integration, offering potential advantages over traditional patching therapy. Gabor patches emerged as particularly effective, stimulating the visual cortex to drive neural efficiency. Conclusion: Vision therapy is an effective strategy for treating amblyopia and may reduce overall treatment time when used in conjunction with patching. In addition, it is crucial to tailor stimuli to match the individual characteristics of each patient during monocular and binocular training. https://jmr.tums.ac.ir/index.php/jmr/article/view/1252

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 05 04 346 357 Farnoush Jarollahi Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Tayyebe Fallahnezhad Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Farideh Aslibeigi Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 2025 02 17 2025 05 04 Introduction: To systematically review and evaluate the evidence regarding the effect of sign language on language development in deaf and hard-of-hearing children. Materials and Methods: A comprehensive search of electronic databases, including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, Google Scholar, and ProQuest, from 1995 to April 2024, with no language restrictions, was conducted. Two authors independently assessed the risk of bias using the Newcastle-Ottawa scale (NOS). Results: Six studies involving 259 participants found that exposure to sign language benefits language development in deaf children using hearing aids or cochlear implants (CIs). Children exposed to sign language showed similar or even better spoken language skills than those with limited exposure to sign language. Encouraging parents to learn sign language can significantly support deaf children’s communication and language development. Conclusion: Deaf children with CIs benefit most from communication approaches tailored to their needs. Early intervention, parental involvement, and a rich language environment (signed or spoken) are crucial. While sign language exposure shows promise, further research is needed, especially on its long-term effects and use by hearing parents. https://jmr.tums.ac.ir/index.php/jmr/article/view/1264

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 05 31 358 364 Divyashree Magendran Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. Buvanesh Annadurai Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. Vinodhkumar Ramalingam Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. Kajamohideen Rahman Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. 2025 03 08 2025 05 31 Introduction: Patellar tendinopathy (PT) is a prevalent overuse injury among volleyball players, primarily due to repetitive jumping, landing, and sudden directional changes required in the sport. Plyometric training enhances tendon strength and neuromuscular coordination; however, it involves high-impact movements that may exacerbate symptoms. Aquatic training offers a low-impact alternative, using water’s buoyancy to reduce stress while enhancing strength and flexibility. This study aimed to evaluate the effectiveness of these interventions in reducing pain and improving the function of volleyball players with PT. Materials and Methods: Volleyball players aged 18–24 years who had been diagnosed with PT were recruited. Thirty university-level volleyball players were randomly assigned to two groups: Group A (plyometric training; n=15) and group B (aquatic training; n=15). All players underwent pre-test measurements using the numeric pain rating scale (NPRS) and the Victorian Institute of Sport Assessment-Patellar (VISA-P) score. Post-test measurements were taken at the end of the sixth week. Results: Comparing pre-test and post-test values of the NPRS and VISA-P between the groups revealed significant differences. Group B showed better outcomes, with a mean NPRS value of 1.73±0.703 compared to group A’s 3.13±0.743 (P≤0.05, effect size d=1.93). Similarly, group B’s mean VISA-P score (65.80±5.37) was higher than group A’s (58.73±5.29) (P≤0.05, effect size d=1.32). These results indicate that aquatic training was more effective than plyometric training. Conclusion: This study demonstrates that aquatic training is more effective than plyometric training in managing PT in university-level volleyball players, showing significant improvements in symptoms. https://jmr.tums.ac.ir/index.php/jmr/article/view/1295

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 06 07 365 371 Keerthana Ravi Department of Obstetrics and Urology, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. Senthilkumar Selvakumar Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India. Mohammed Basha Clinical Physiotherapist, Chennai, Tamil Nadu, India. 2025 03 22 2025 06 07 Introduction: Pelvic organ prolapse (POP), defined as the descent of pelvic organs from their anatomical position, significantly affects women’s quality of life. Although traditional pelvic floor muscle training (PFMT) offers benefits, adherence to and proper execution of the technique remain challenging. The Franklin method is designed to enhance body awareness and neuromuscular control. This study aimed to evaluate the effects of combining Franklin method with PFMT in women with POP. Materials and Methods: The participants included women aged 45–55 years with POP stages 1–2, no neurological impairments, and no active urogynecological disorders. The exclusion criteria included uncontrolled systemic illness, a history of malignancy, active infections (e.g. pelvic inflammatory disease), ongoing hormonal therapy, cognitive barriers to questionnaire completion, or recent pelvic surgery (within the past 4 weeks). All 120 participants underwent 6 weeks of the Franklin method and PFMT. Outcomes were assessed using the prolapse quality of life (P-QoL) questionnaire and the international consultation on incontinence questionnaire female lower urinary tract symptoms (ICIQ-FLUTS) Tamil, measured pre- and post-intervention. Results: P-QoL scores improved from 56.74 (pre-test) to 47.06 (post-test). International consultation on ICIQ-FLUTS Tamil scores decreased from 36.09 to 20.22. Both quality of life and incontinence symptoms showed statistically significant improvement (P≤0.001) post-intervention. Conclusion: Franklin method, combined with PFMT, significantly alleviated POP symptoms. https://jmr.tums.ac.ir/index.php/jmr/article/view/1310

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 06 10 372 380 Amir Seyed Ahmadi Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Laleh Lajevardi Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Ghorban Taghizadeh Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Akram Azad Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 2025 04 13 2025 06 10 Introduction: Ankle sprains are among the most common injuries that affect functional mobility, lower extremity function, and health status. Access to a reliable measurement tool to assess diverse real-world lower extremity use in patients with ankle sprains is essential. Researchers have developed several measures to determine rehabilitation goals and assess the effects of therapeutic interventions. This study aimed to translate the original English lower extremity motor activity log (LE-MAL) into Persian and investigate the psychometric properties of the Persian version. Materials and Methods: The LE-MAL was translated into Persian and adapted to Persian culture. A total of 140 patients with ankle sprains completed the Persian LE-MAL, lower extremity functional scale (LEFS), and life space questionnaire (LSQ). The Persian LE-MAL was re-completed by participants with an interval of two weeks, and internal consistency, test re-test reliability, and construct validity were assessed. Results: The Persian LE-MAL exhibited good internal consistency (Cronbach’s α=0.95) and test re-test reliability (intraclass correlation coefficient [ICC]=0.76). The construct validity of the Persian LE-MAL was demonstrated to be acceptable, as a result of its significantly strong correlations with the LEFS and LSQ (0.74< r <0.77). The standard error of measurement was less than 10% of the total instrument score (standard error of measurement [SEM]=0.43), and the minimal detectable change was 1.2. No ceiling or floor effects were observed. Conclusion: The Persian version of the LE-MAL is a valid and reliable measure to assess lower extremity function in individuals with ankle sprains. https://jmr.tums.ac.ir/index.php/jmr/article/view/1326

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 4 2025 07 22 381 393 EN Husnul Mubarak Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Andi Islam Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Andi Bintang Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Muhammad Massi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Hening Putra Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Jumraini https://jmr.tums.ac.ir/index.php/jmr/article/view/1127

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 1 2025 03 31 62 70 Hamidreza Nemati Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hoda Niknam Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Khosro Kalantari Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Baghban Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Negin Jalili Department of Physiotherapy, Faculty of Rehabilitation, University of Social Welfare and Rehabilitation, Tehran, Iran. 2024 05 25 2024 09 23 Introduction: Low back pain is a leading cause of disability worldwide. Various treatments have been recommended to address this prevalent issue, with core stability and McKenzie exercises being among the most evidence-based options. However, recent comparative studies lack mechanical assessment and functional tests. This study compares the effects of core stability and McKenzie exercises on the range of motion, pain, disability, and function in patients with mechanical low back pain. Materials and Methods: In this clinical trial, 22 patients received core stability exercises, and 22 received McKenzie exercises based on individual mechanical assessments. Before treatment, each patient underwent mechanical assessment via the McKenzie mechanical assessment form, pain assessment using the visual analog scale, disability evaluation with the Oswestry disability index questionnaire, muscle control, as well as function assessment with unilateral single limb stance, and range of motion evaluation using fingertip-to-floor distance measurements. All variables were measured again after 8 sessions over two weeks of intervention. Results: Both groups showed significant improvements in trunk flexion range of motion, disability, functional status, and pain (P>0.05). However, the two groups had no significant differences (P<0.05). Conclusion: Both core stabilization and McKenzie exercises are effective in reducing pain disability, increasing range of motion, and enhancing functional status in patients with mechanical low back pain. https://jmr.tums.ac.ir/index.php/jmr/article/view/1117

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 1 2025 03 31 53 61 Mohamed El-Gendy Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt. Mahmoud Salah Abd El-Fattah Department of Basic Sciences, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt. Mohamed Magdy El Meligie Department of Basic Sciences, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt. Efrem Kentiba Department of Sports Science, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia. Yasser Lasheen Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt. 2024 05 04 2024 09 07 Introduction: Joint positioning can impact nerve function. Few studies have explored the effects of ankle positions on deep peroneal nerve conduction. This cross-sectional study investigated the influence of different ankle joint positions on the deep peroneal nerve’s distal motor and sensory onset latencies. Materials and Methods: A total of 31 healthy adults (23.4±3.9 years old) underwent a deep peroneal nerve conduction study. Distal motor and sensory onset latencies were measured at neutral (0°), dorsiflexion (20°) and plantar flexion (40°) ankle positions. Results: Changing ankle position significantly affected distal motor (P=0.001) and sensory onset latencies (P=0.001). Latencies were shortest in dorsiflexion (motor: 3.8±0.46; sensory: 2.4±0.2 ms), followed by neutral (motor: 4.2±0.5; sensory: 2.6±0.3 ms) and most prolonged in plantar flexion (motor: 5±0.6; sensory: 3.3±0.2 ms). Conclusion: Ankle position impacts deep peroneal nerve conduction. Dorsiflexion and neutral positions reduced distal motor and sensory latencies compared to plantar flexion. These findings provide preliminary evidence that may help optimize ankle positioning in electrodiagnostic testing. Further blinded research with larger, more diverse samples is warranted. https://jmr.tums.ac.ir/index.php/jmr/article/view/1105

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 1 2025 03 31 41 52 Maryam Zolghadr Department of Physical Therapy, Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Shohreh Dehkordi Department of Physical Therapy, Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Javad Sarrafzadeh Department of Physical Therapy, Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Saeed Talebian Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Hassan Haddadzade Niri Department of Audiology, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Marzieh Yassin Department of Physical Therapy, Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran. 2024 04 18 2024 07 21 Introduction: Upper limb motor disability, with a prevalence of approximately 77%, is the most common complication after stroke. Despite advancements in rehabilitation, many patients face persistent upper limb discrepancies. Adopting top-down and bottom-up interventions may enhance neuroplasticity and improve upper limb function. This study aims to determine the effect of motor cortical transcranial direct-current stimulation (tDCS) as a top-down approach combined with task-oriented training (TOT) as a bottom-up intervention on changes in electroencephalography (EEG) spectral power in chronic stroke patients. Materials and Methods: Thirty chronic hemiparetic stroke survivors were randomly assigned to receive real or sham stimulation targeting the primary motor cortex (C3/C4) at 2 mA for 20 minutes and TOT daily over 15 sessions. EEG was conducted before and after the intervention, with a 3-month follow-up and the relative powers of delta to gamma frequency bands were recorded during the movement task with each hand (healthy and involved). Results: Significant differences in the theta (P=0.000), alpha (P=0.004), beta (P=0.000) and gamma (P=0.003) relative powers were observed between groups at follow-up. Additionally, the Friedman test revealed a significant decrease in alpha and beta bands’ relative powers in the healthy hand of the control group at follow-up (P=0.001). The experimental group displayed increased alpha and beta powers and decreased theta without statistical significance. Conclusion: The increase in the relative power of low frequencies and the decrease in high frequencies in the sham group, which were more prominent than the increases in alpha and beta bands’ relative power and the decrease in theta in the experimental group, can indicate that the real-tDCS can prevent the recovery drop of relative powers. Due to the inconsistent effects of tDCS on the EEG power spectrum in stroke patients, conventional tDCS administration may require adjustments for optimal application to brain target points. https://jmr.tums.ac.ir/index.php/jmr/article/view/1095

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