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 stgraduate general and sport physiotherapy students participated in this study from 2016 to 2019. Two theoretical courses were designed and delivered based on the FC approach. The data were collected using a questionnaire that contained 12 items based on the 5-point Likert scale. The data were analyzed using descriptive statistics, Mann-Whitney, and Fisher exact tests. Results: The students’ familiarity with FC was 2.52±1.51 (median=3). The total agreement with FC was 3.42±0.92 (median=3). Only 22.7% of the students reported no increase in motivation. Meanwhile, 71% of the students agreed with a blended classroom, while only 52% preferred to teach only with FC. Conclusion: Most students preferred a blended classroom combining in-class and home activities. Also, the FC could augment the interaction and motivation of the students. Accordingly, FC is a valuable teaching strategy for postgraduate physiotherapy students. https://jmr.tums.ac.ir/index.php/jmr/article/view/662

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 1 2024 01 01 70 75 Siddharth Satish Mishra MGM College of Physiotherapy, Maharashtra University of Health Sciences (MUHS), Navi Mumbai, India. Tushar Palekar College of Physiotherapy, Dr. D Y Patil Vidyapeeth University, Pune, India. Vrushali Panhale MGM College of Physiotherapy, Maharashtra University of Health Sciences (MUHS), Navi Mumbai, India. 2022 07 19 2022 11 06 Introduction: Simulation-based teaching is a technique for imitating a situation’s behavior or process via a suitable analog situation for training or teaching purposes. Simulation-based teaching is widely used in various domains; however, there is limited literature on evaluating the role of simulated-based teaching in physiotherapy. This study investigates the effect of simulation-based teaching on learning domains for traumatic brain injury topics framed for final-year physiotherapy students. Materials and Methods: A total of 51 final-year physiotherapy students were randomly selected and allocated into two groups. Group A (n=25) includes didactic with PowerPoint presentation teaching session. Group B (n=26) includes simulated-based teaching sessions. There were eight simulators selected and trained for the Ranchos Los Amigos stages. The students were assessed using a self-designed pre-post multiple-choice questions (MCQ) test for knowledge and a clinical evaluation exercise for affective and psychomotor skills. Results: This study showed that group B significantly improved in the pre-post self-made MCQ test (t=17.34, P=0.00), and in the clinical evaluation exercise, group B performed 43.66% better than group A. Conclusion: The study concludes that simulation-based teaching significantly improves cognitive, affective, and psychomotor skills compared to traditional methods for traumatic brain injury topics framed for final-year physiotherapy students. https://jmr.tums.ac.ir/index.php/jmr/article/view/708

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 1 2024 01 01 76 83 Leyla Bastami Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Seifolah Jahantabi-Nejad Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. & Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Roya Ghasemzadeh Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Maimanat Akbari Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Maryam Dastoorpour Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, School of Heath, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2022 08 23 2022 11 14 Introduction: Having a child with cerebral palsy (CP) is a stressful experience for the family, particularly mothers. Caring for these children occupies great time and energy from the family. The balance of life may be decreased by the influence of factors related to the child or mother. Accordingly, this study investigates the predictive factors affecting the life balance of mothers with CP. Materials and Methods: This cross-sectional descriptive-analytical research was conducted in Ahvaz City, Iran, in 2021. A total of 135 mothers (mean age=33.37 [7.93]) with at least one child under the age of ten suffering from CP participated in this research. The data were collected using the life-balance index, general health questionnaire, time management quality, and demographic information checklists. The gross motor function classification system was expanded and revised, and the manual ability classification system was used to determine the gross motor and manual ability function levels. Generalized univariate linear models were used to investigate the effects of predictor variables on the quantity of life balance. Results: The life balance of mothers of children with CP was heavily unbalanced (45.2%) or unbalanced (35.6%). Based on the regression coefficient of each variable, it was determined that manual ability classification system (β=0.192), comorbidity in the children with CP (β=0.187), gross motor function (β=0.137), general health (β=0.024), and maternal age (β=0.01), respectively, contributed the most in the prediction of life balance variances. Conclusion: Life balance is a seriously affected domain in mothers caring for CP children. Child-related factors had a more effective role in predicting the life balance of mothers of CP children than mother-related factors. https://jmr.tums.ac.ir/index.php/jmr/article/view/731

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 1 2024 01 01 84 92 Zahra Najafi Department of Rehabilitation Management, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Kianoush Abdi Department of Rehabilitation Management, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Mohammad Saeed Khanjani Department of Counseling, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Hamid Dalvand Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Amiri Department of Rehabilitation Management, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 2022 07 14 2022 11 21 Introduction: In 2008, Iran acceded to the convention on the rights of persons with disabilities (CRPD), including the right to health and rehabilitation. However, the goals of this convention have not yet been achieved in Iran. This study provides solutions for implementing articles 25 (health) and 26 (rehabilitation) CRPD in Iran. Materials and Methods: This was a qualitative study conducted through content analysis. A total of 21 individuals were selected via the purposive sampling method. The data were collected through semi-structured interviews. The interviews continued until we reached information saturation. Data analysis was performed manually using the MAXQDA software version 10. Results: After the interviews, 860 initial codes were obtained. After removing the unrelated codes and merging the codes by overlap, 725 codes remained. The concepts were classified into four main categories and 15 subcategories: Development of a comprehensive rehabilitation program, culture and education, capacity building, and compliance with legal requirements. Conclusion: According to the results, because of severe problems in the field of health and rehabilitation of disabled people in Iran, taking necessary measures to solve these problems is essential. Hence, a comprehensive plan should be developed. Meanwhile, proper education, culture building, talents, and opportunities should be considered more carefully. Also, by facilitating services for people with disabilities and paying attention to the importance of being demanding, we can build capacity in the country. The findings of this research will provide a bright way for policymakers, administrators, and planners of the country. https://jmr.tums.ac.ir/index.php/jmr/article/view/706

Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 18 1 2024 01 01 93 105 Masaki Takeyoshi Division of Rehabilitation Technology, Department of Medical Technology, Kumamoto University Hospital, Kumamoto, Japan. Wakana Togami Department of Physical Medicine and Rehabilitation, Kumamoto University Hospital, Kumamoto, Japan. Kei Hiyama Department of Physical Medicine and Rehabilitation, Kumamoto University Hospital, Kumamoto, Japan. Seiji Takashio Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan. Yuichiro Arima Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan. Kenichi Tsujita Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan. Takeshi Miyamoto Department of Physical Medicine and Rehabilitation, Kumamoto University Hospital, Kumamoto, Japan. & Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. 2022 08 28 2022 11 21 Introduction: As an essential factor affecting life prognosis and rehospitalization in patients with chronic heart failure, exercise tolerance is a significant outcome of cardiac rehabilitation. Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has recently increased among patients with chronic heart failure. This study evaluates the factors indicating exercise tolerance in patients with HFpEF from various perspectives, including cardiac and skeletal muscle functions. Materials and Methods: The subjects were 31 patients with HFpEF who underwent cardiac rehabilitation. The exercise tolerance was assessed using a 6-min walking test. Physical function, physical activity, body composition test, baseline characteristics, blood data, and echocardiography results were extracted from medical records to identify the indicators of exercise tolerance. Results: Gait speed significantly differed in exercise tolerance for HFpEF patients (β=0.75, P<0.01). Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF was not significantly different in brain natriuretic peptide levels and cardiac function. Conclusion: Gait speed indicates exercise tolerance in HFpEF patients; however, its pathological course differs from heart failure with reduced ejection fraction, suggesting that it is poorly related to brain natriuretic peptide, a biomarker for heart failure and cardiac function. https://jmr.tums.ac.ir/index.php/jmr/article/view/738