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 ek, 30 min each session) of locomotor training. We compared these findings between two groups of 10 patients, each with an expanded disability status scale (EDSS) of 3-6, who performed the gait training with or without rhythmic visual stimulus. Results: Time×group interaction effect indicated greater significant improvements in the group with rhythmic visual stimulus in self-selected walking speed (SSWS) (P=0.041), stride frequency (P=0.009), stance time (P=0.021), and locomotor rehabilitation index (P=0.036). Stride length, double stance, and swing time were improved in the group with rhythmic visual stimulus, but this change was not significant. Also, bilateral symmetry did not change significantly in the experimental group. Therefore, rhythmic visual stimulation can help improve functional mobility and locomotor rehabilitation index in patients with MS, especially due to the improvements in the temporal parameters of gait. Conclusion: Therefore, synchronizing gait with a rhythmic visual stimulus can be an effective therapeutic strategy to improve gait and main temporal parameters in patients with MS. 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

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 19 1 2025 03 31 30 40 EN Simin Dehghani Student Research Committee, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Marzieh Pashmdarfard Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Pashazadeh Azari Department of Occupational Therapy, School of Rehabilitation, 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. Sima Dehghani Student Research Committee, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Navid Mirzakhani Araghi Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 01 28 2024 07 21 Introduction: Autism spectrum disorder (ASD) is a sensory processing, social communication, and occupational performance disorder. Sensory diets can have positive effects on these fields. Current research compared the effectiveness of the sensory diet program with and without teleoccupational therapy on sensory processing patterns, social competency and occupational performance in children with ASD. Materials and Methods: The study sample comprised 32 children with ASD 4-10 years old. They were placed in the control and intervention groups. The number of sessions for both groups was 20 30-minute sessions administered over 8 weeks. Through photos, videos, and explanations, sensory problems were described in both groups, the mother presented and implemented activities and environmental adaptations, and the therapist supervised the implemen