Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 10 13 1 8 Majid Karimi Department of Audiology, Rehabilitation Research Centre, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohsen Ahadi Department of Audiology, Rehabilitation Research Centre, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohammad Ajalloueyan Department of Otorhinolaryngology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran. Nader Saki Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. & Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Saeid Morovvati Faculty of Advanced Sciences and Technology, TeMS.c., Islamic Azad University, Tehran, Iran. Golshan Mirmomeni Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2025 02 17 2025 06 01 Introduction: Despite normal outer hair cell function, auditory neuropathy spectrum disorder (ANSD) disrupts neural coordination and impairs speech comprehension, especially in noisy environments.This review study explores the genetic mechanisms underlying ANSD. Materials and 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 (BVVL) and Charcot-Marie-Tooth (CMT) disease, often resulting from mutations in the auditory nerve. Nonsyndromic ANSD is associated with genes such as OTOF and PJVK, which are essential for neural function. Conclusion: 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. https://jmr.tums.ac.ir/index.php/jmr/article/view/1265

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 10 13 9 22 Hiyam Ibrahim Department of Physical Therapy, Doctoral School of Sciences and Technology, Lebanese University, Hadath, Lebanon. & Cologne Game Lab, Faculty of Cultural Studies, Cologne University of Applied Sciences, Köln, Germany. Emmanuel Guardiola Cologne Game Lab, Faculty of Cultural Studies, Cologne University of Applied Sciences, Köln, Germany. Ahmad Diab Department of Biomedical Engineering, Signal Processing Research Group, Faculty of Engineering, Lebanese International University, Tripoli, Lebanon. & Department of Biomedical Engineering, Signal Processing Research Group, Faculty of Engineering, The International University of Beirut, Beirut, Lebanon. 2025 02 11 2025 06 08 Introduction: 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 held promises, their overall effectiveness remains inconclusive, primarily because they rely on commercial games. This issue underscores the critical need for user-centered games tailored to patients’ specific needs. Despite this necessity, the existing literature lacks established frameworks to develop such games, highlighting a gap.  Therefore, the objective of this research was to propose the first evidence-based framework to create 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 examining commercial games used in clinical studies, identifying their mechanics and limitations. The second step involved reviewing the literature to identify relevant findings that could help the development of user-centered games. Results: A set of targeted recommendations was proposed, emphasizing the need to develop adaptable games with focused therapeutic designs and to address the distinct balance impairments observed in PwMS effectively. A game prototype was also presented to illustrate the practical applications of these recommendations. Conclusion: This research establishes the first structured framework to design user-centered exergames for balance rehabilitation in PwMS. In addition to its theoretical insights, this framework provides actionable guidelines for developing clinically effective exergames that align with patient impairments and therapeutic needs. Ultimately, this work will contribute to improved therapeutic outcomes, enhanced patient care, and advancements in both rehabilitation and game design fields. https://jmr.tums.ac.ir/index.php/jmr/article/view/1261

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 10 13 23 35 EN Alireza Zare Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran. Hashem Piri Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran. Razieh Hajizadeh Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran. Amir Reza Saeidizadeh Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran. Amir Reza Ghareh Gharakhanloo Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran. 2025 05 13 2025 06 07 Introduction: Soccer is the most popular sport globally for both men and women. The functional movement screen (FMS) is a 7-part standardized tool created by experts to evaluate movement quality. This research compares FMS scores and performance between male and female soccer players. Materials and Methods: A total of 60 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 cross-over hop test. Between-group comparisons were performed using an independent t test for normally distributed variables and the Mann-Whitney U test 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). Men performed better in trunk stability, while women excelled in shoulder mobility and active straight leg raise. Men outperformed women in the single-hop distance and the 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: The study’s findings demonstrate the necessity of gender-specific training programs to enhance performance and reduce injury risk. According to the findings, it is recommended that flexibility and mobility exercises be implemented for male soccer players and that core stability and strength training be implemented for female soccer players. https://jmr.tums.ac.ir/index.php/jmr/article/view/1358

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 09 29 36 46 EN Akram Pourbakht Department of Audiology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Heidari Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2025 07 08 2025 09 29 Introduction: The repetition rate of a stimulus serves as a crucial criterion in audiological assessments for differential diagnosis in certain special populations. Therefore, this study aimed to evaluate the normal variation of auditory brainstem response (ABR) parameters, including latency, amplitude, morphology, and component duration (width), using two different rates of tonal stimuli with varying frequencies in Wistar rats. Materials and Methods: In this experimental study, 45 young adult male Wistar rats were subjected to ABR measurements using tone burst stimuli at octave frequencies ranging from 2 to 16 kHz, with two rates of 11.1 and 57.1/s, following the relevant protocols. The stimuli were delivered at an intensity of 80 dB SPL and through a speaker. Results: At a high rate, latency changes in later waves were greater than those in earlier components, whereas amplitude changes in later waves were smaller than those in earlier ones. Rate-dependent changes, as a function of frequency, were uniform for both latency and amplitude. Morphologically, ABR components were broadened in a frequency-dependent way. The duration of wave I was shorter than that of wave IV, and the wave duration changes were influenced by frequency. These findings were statistically significant (P<0.05). Conclusion: The results can be attributed to differences in adaptation mechanisms within the auditory system, the additive synapse theory, and desynchronization resulting from increased stimulation rates. Knowledge of the various effects of rate as a function of frequency on ABR parameters in normal rats is essential to understanding how different changes in these parameters at each wave could lead to a more precise diagnosis in neuro-pathological conditions. https://jmr.tums.ac.ir/index.php/jmr/article/view/1374

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 11 11 47 55 Fitri Anestherita Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. & Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Angela Tulaar Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Maria Rachmawati Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Em Yunir Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Dante Harbuwono Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Retno Asti Werdhani Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Ahmad Safri Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Muhammad Rachmadi Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. & Faculty of Computer Science, Universitas Indonesia, Depok, Indonesia. Muhammad Nadhif Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. & Department of Medical Physiology and Biophysics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Azwien Hawalie Marzuki Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Luh Wahyuni Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Nelfidayani . Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia. Boya Nugraha Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hannover Medical School, Hannover, Germany. 2025 06 13 2025 10 21 Introduction: 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 significant clinical implications; therefore, it is crucial to accurately identify them. Materials and Methods: 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. KineFeet software, version 1.3 and Kinovea gait analysis software, version 2023.1.2 were used to diagnose altered foot kinematics in 89 healthy participants in this cross-sectional study. The main kinematic parameters investigated were the ankle inclination angle at terminal stance (AI_TSt), the MLA angle at terminal stance (MLA_TSt), and the MTP1 angle 1 at maximal hallux extension (MTP_HE). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the receiver operating characteristic (ROC) 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 can accurately detect foot kinematic deformities during human gait. Its high diagnostic accuracy makes it a promising screening and evaluation tool. Further studies on human gait pathologies are warranted. https://jmr.tums.ac.ir/index.php/jmr/article/view/1367

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 20 1 2025 11 11 56 63 Mohsen Miarkiani Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Azar Mehri Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Shohre Jalaei Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. 2025 07 14 y> Introduction: This study evaluates the effectiveness of music therapy on anxiety caused by stuttering in children aged 4 to 12 years in Yazd City, Iran. Materials and Methods: This is an experimental study with a pre-test/post-test design and a control group. The statistical population of the study consisted of 4-12-year-old children with stuttering referred to speech therapy centers in Yazd City, Iran, who were selected based on available sampling and divided into two equal groups, experimental and control, using a simple random method. The instrument of this research included the Spence children’s anxiety scale, parent version (SCAS-P). Children with anxiety in the experimental group underwent music therapy for ten 1-h sessions. To analyze the data, the SPSS software, version 24, was used and the significance level of the tests was considered 0.05. The statistical method of covariance analysis was used to analyze the research data. Results: Based on the results of the analysis of covariance between the two control groups and the music therapy experiment, there was a significant reduction in the average level of anxiety (P<0.001, F=157.045) of children in the post-test stage. Conclusion: Music therapy is effective in reducing the anxiety level of children with stuttering; therefore, it can be considered a complementary method to reduce children’s anxiety. https://jmr.tums.ac.ir/index.php/jmr/article/view/972

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 4 2024 10 01 461 470 Maryam Sohrabi Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Giti Torkaman Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Fariba Bahrami Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran. 2023 11 18 2024 01 17 Introduction: Flat feet are prevalent among individuals with medial compartment knee osteoarthritis (KOA), showing a correlation with elevated knee pain and cartilage degeneration. This study investigates the relationship between calcaneal eversion angle (CEA) and medial longitudinal arch angle (MLAA) with knee kinetics and pain. Materials and Methods: This analytical observational study included 30 volunteers with moderate KOA. The Vicon motion analysis system and two synchronized force plates were employed to capture level walking and the static standing position to measure CEA and MLAA. The study assessed the first and second peaks of the knee adduction moment, knee adduction moment impulse, peak knee flexion moment, and the peak knee flexion angle at heel strike (PKFA-HS). The Western Ontario and McMaster Universities arthritis index (WOMAC) pain and physical function were evaluated. Results: A significant positive correlation was found between CEA and the knee pain sub-score (Pearson correlation [PC]=0.446, P=0.011) and WOMAC total score (PC=0.363, P=0.049). Additionally, a significant negative correlation was observed between CEA and peak knee flexion moment/PKFA-HS (PC=-0.418, P=0.022, and PC=-0.479, P=0.001, respectively). The results also indicated a negative significant correlation between MLAA and WOMAC pain sub-score (PC=-0.389, P=0.034). Conclusion: Increased CEA and decreased MLAA are associated with elevated WOMAC pain sub-score and decreased PKFA-HS in individuals with moderate KOA. Addressing flat feet should be considered in KOA management to enhance pain relief and functional outcomes. https://jmr.tums.ac.ir/index.php/jmr/article/view/984

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 4 2024 10 01 471 479 Marzieh Amiri Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Neda Orakifar Department of Physical Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Fatemeh Taheri Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Nasrin Khajeali Educational Development Center (EDC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Nahid Pirayeh Department of Physical Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mojtaba Tavakoli Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Masoume Hosseini Bidokhti Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Maryam Saadat Department of Physical Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Amin Behdarvandan Department of Physical Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Majid Soltani Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Arash Bayat Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Parisa Heidari Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2023 11 22 2024 03 10 Introduction: Team-observed structured clinical examination (TOSCE) is a powerful approach to formative assessment resources, regarded as an essential element of students’ performance in a team format. Considering the importance of teamwork in rehabilitation, this study implements an intervention focused on enhancing teamwork skills within diverse groups of rehabilitation students, employing TOSCE as a tool for assessment and improvement. Materials and Methods: A total of 49 fourth-year undergraduate students specializing in audiology, physical therapy, and speech therapy constituted three groups in our study. Students in each major were randomly divided into four groups. The students were asked to complete the teamwork (19-item scale of Lencioni) and satisfaction (researcher-made scale) questionnaires after TOSCE. A knowledge assessment questionnaire was also conducted at pre- and post-TOSCE time points. Results: There was no significant difference between the average score of the teamwork (F=1.508, P>0.05) and satisfaction (F=3.508, P>0.05) levels across different majors. All participants had high scores on both teamwork and satisfaction scales. By comparing the pre-test and post-test knowledge assessment, in all groups, there was a statistically significant difference between the pre-and post-test results (P<0.05). The students obtained a higher score after the implementation of the TOSCE. Conclusion: The TOSCE method provides a valuable and viable educational opportunity for rehabilitation students to receive feedback on their clinical performance, enhance their knowledge, and, most importantly, lead to a positive feeling of teamwork among students. https://jmr.tums.ac.ir/index.php/jmr/article/view/985

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 4 2024 10 01 480 488 Saeideh Farahmand Department of Physiotherapy, School of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran Majid Ghasemi Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Keivan Basiri Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Ehsan Ghasemi Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 2024 02 04 2024 07 07 Introduction: Stroke is one of the most common causes of disability. Spasticity is a common clinical impairment that occurs after a stroke. This study investigates the effect of Nintendo Wii games on the outcomes of spasticity, functional mobility, and quality of life in patients with stroke. Materials and Methods: In this single-blind clinical trial study, 30 patients with stroke were randomly assigned to one of the experimental and control groups. Subjects of both groups received conventional physiotherapy. In addition, the experimental group also received Nintendo Wii games for 30 min, three times a week for a total of 12 sessions. The primary outcomes spasticity and functional mobility that respectively evaluated using the modified modified Ashworth scale (MMAS) and the timed up-and-go test before and after the treatment. The assessor was blind about group assignment. Meanwhile, the secondary outcome included quality of life. All statistical analyses were performed using the SPSS software, version 20. Results: The intragroup results showed that in the experimental group, spasticity was significantly reduced (P=0.001), functional mobility improved (P=0.001), and the quality of life increased significantly (P<0.001); however, in the control group, only a significant improvement in functional mobility (P=0.04) was observed. The comparison between the two groups showed that there is no statistically significant difference in the results between the experimental and control groups (P>0.05). Conclusion: Considering these results, the use of Nintendo Wii can be suggested as a treatment modality alongside the usual treatments to achieve more and faster effectiveness in patients with stroke. https://jmr.tums.ac.ir/index.php/jmr/article/view/1028

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 4 2024 10 01 489 498 EN Hassan Tamartash Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran. Afsaneh Dadarkhah Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran. Sharif Najafi Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran. Jalal Kargar Shouraki Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran. Seyed Morteza Tabatabaee Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran. Sirous Azizi Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran. 2024 05 13