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. JumrainiDepartment of Physiotherapy, Student Research Committee, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sedigheh Sadat Naimi Department of Physiotherapy, Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Ahmad Raeissadat Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohsen Abedi Department of Physiotherapy, Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahmood Beheshti Monfared Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Akbarzadeh Baghban Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2025 02 11 2025 03 17 Introduction: Inspiratory muscle strength (IMS) is a crucial predictor of the development of pulmonary complications after cardiac surgery. The strength index (S-index), a novel non-invasive tool, dynamically assesses inspiratory muscles and is associated with lower risks for heart patients than static tests. This study aims to investigate the reliability of the S-index in patients scheduled for cardiac surgery. Materials and Methods: This study included 20 preoperative cardiac surgery candidates (11 men and 9 women; mean age, 56±13 years). The S-index, peak inspiratory flow (PIF) and vital capacity (VC) were evaluated using a power breath K5 Electronic respiratory device. An examiner conducted these measurements at two distinct intervals, one hour apart. Each index’s average and best values were evaluated for reliability using the intra-class correlation coefficient (ICC). Results: The study revealed excellent (ICC>0.9) and good (ICC>0.8) intra-examiner reliability for the best and average values of the S-index and PIF, respectively. Also, the results of the present study showed excellent intra-examiner reliability for the best and average values of the VC (ICC>0.9) Conclusion: The ICC results of the present study showed that the S-index can be used to determine the dynamic strength of the inspiratory muscles with acceptable repeatability in cardiac surgery candidates. One of its advantages is the ability to determine the appropriate load for inspiratory muscle training (IMT) exercises during the hospitalization phase of these patients dynamically without breath-holding. https://jmr.tums.ac.ir/index.php/jmr/article/view/1260

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 3 2025 03 17 300 310 Milad Karimi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Amin Modarres Zadeh Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Payam Kabiri Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hasan Ashayeri Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Ahmad Rreza Khatoonabadi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. ; Department of Geriatric Health, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. ; Endocrinology and Metabolism Research Institute, Tehran, Iran. ;Elderly Health Research Center, Endocrine Population Sciences Institute, Tehran, Iran. Elke Kalbe Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany. 2025 02 16 2025 03 17 Introduction: The older adult population is growing worldwide, particularly in Iran, leading to a decline in cognitive function. Cognitive training effectively enhances these skills. NEUROvitalis is a structured cognitive training program incorporating psychoeducation with individual and group cognitive tasks. It accommodates up to eight participants aged 50 and above, spanning 12 sessions over six weeks. This study aims to prepare translation, cultural adaptation, and content validity of the structured cognitive training program “NEUROvitalis Materials and Methods: We conducted this methodological study using a standard forward-backward process. Subsequently, German translators checked the accuracy of the translation. We assessed the fluency and comprehensibility of translated material. Twelve Tehran University of Medical Sciences assessors scored each psychoeducational component, pamphlet, group game and individual exercise on a 5-point visual scale. The content validity index (CVI) was then calculated. Results: A total of 12 participants (eight females, four males, aged 23–41, mean age 28.83±6.23) were included in the evaluation of comprehensibility and fluency. The CVI ranged from 0.8 to 1, which successfully validated the program’s comprehensibility and fluency. Conclusion: The current study’s results indicate that the Persian version of the structured cognitive training program “NEUROvitalis” can be a proper, valid and comprehensive tool for cognitive training in Persian-speaking individuals aged 50 years and above. https://jmr.tums.ac.ir/index.php/jmr/article/view/1263

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 3 2025 04 21 311 317 Saeed Sheykh chalandari Department of Speech Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Morteza Farazi Department of Speech Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Zahra Sadeghi Department of Speech Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Mehdi Norouzi Department of Speech Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ; Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 2025 01 01 2025 04 21 Introduction: To determine the frequency, comorbidities, and relationship between dysarthria and dysphagia in patients with traumatic spinal cord injury (tSCI). Materials and Methods: A descriptive-analytical cross-sectional study was conducted enrolling 61 patients with tSCI from rehabilitation centers in Tehran Province, Iran between January and September 2024. Dysarthria and dysphagia were assessed using the Persian-adapted versions of the frenchay dysarthria assessment (FDA) and northwestern dysphagia patient check sheet (NDPCS), respectively. Logistic regression analysis was employed to evaluate the relationship between these conditions, with odds ratios (ORs) calculated to quantify the strength of the relationship. Results: Dysarthria was observed in 87% of participants, with mixed dysarthria being the most prevalent subtype (34%). Dysphagia was identified in 49% of participants, of whom 49% exhibited both disorders concurrently. Logistic regression analysis indicated that patients with dysarthria were approximately nine times more likely to experience dysphagia (odds ratio [OR]=9.69, P<0.05), even after adjusting for weight and sex. Conclusion: This study underscores the high prevalence and significant comorbidity of dysarthria and dysphagia in patients with tSCI, with dysarthria identified as a robust predictor of dysphagia. These results highlight the necessity of concurrent assessment and integrated rehabilitation approaches targeting both disorders to improve patient outcomes and quality of life. https://jmr.tums.ac.ir/index.php/jmr/article/view/1224

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 3 2025 04 12 318 325 Aliasghar Jamebozorgi Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahrokh Ghahari Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Jameh Bozorgi Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Mahnaz Hejazi-Shirmard Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.