https://medrehab.sbmu.ac.ir/ The Scientific Journal of Rehabilitation Medicine en daily 1 Sun, 01 Dec 2024 00:00:00 +0330 Sun, 01 Dec 2024 00:00:00 +0330 https://medrehab.sbmu.ac.ir/article_1101741.html Introduction: Evidence is emerging on the importance of psychological readiness to return to sport after anterior cruciate ligament (ACL) reconstruction. The ACL-Return to Sport after Injury scale (ACL-RSI) is developed to assess this. The purpose of this study was to translate, localize and validate the Persian version of the return to sports questionnaire after anterior cruciate ligament injury (ACL-RSI).Martials and Methods: The ACL-RSI questionnaire was first translated into Farsi by two teams of bilingual experts. The validity of the content of the Farsi version was quantitatively evaluated by calculating the content validity index (CVI) and the content validity ratio (CVR) using a group of 10 experts. Then, 120 football players who underwent ACL reconstruction answered demographic and injury information questionnaires, ACL-RSI translated questionnaire, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tempa Fear of Movement Scale (TSK-11SV) and quality of life (SF12). Statistical analysis included reliability tests (Cronbach's alpha and retest), construct validity and exploratory factor analysis.Results: The ACLRSI-Pr showed excellent internal consistency (Cronbach’s alpha 0.82) and was significantlycorrelated with the KOOS ‘quality of life’ (r = 0.70, p < 0.001), ‘symptoms’ (r = 0.53, p < 0.001), ‘pain’ (r = 0.58, p < 0.001), and ‘sports’ (r = 080, p < 0.001) subscales. The ACLRSI-Pr also correlated significantlyith the IKDC (r = 0.72, p< 0.001), TSK (r = − 0.55, p < 0.001) and SF-12 (r = − 0.49, p < 0.001) scores.Conclusion: The Persian version of the ACL-RSI scale was valid, discriminant, consistent and reliable in football player who had undergone ACL reconstruction. This score could be useful to evaluate the effect of psychological factors on return to sport following ACL surgery. https://medrehab.sbmu.ac.ir/article_1101760.html Background and Aims: Volunteering refers to any activity to which free time is allocated in the interest of another person, group, or organization. Since volunteering is culture-based and no study has been conducted so far in Iran related to comparison of cognitive function and physical fitness based on participation in volunteering in the community dwelling older adults, for this reason, the present study was conducted to comparison of cognitive function and physical fitness in the community dwelling older adults with and without participation in volunteering.Materials and Methods: In this study, 296 retired community-dwelling older adults over age 60 filled out the questionnaires voluntarily; among them, 147 people participated in volunteering. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive functioning, and the Short-Form 36 (SF36) Health Survey and the General Health Questionnaire (GHQ) were completed by the participants to assess their physical fitness; their participation in volunteering and their demographic information were also assessed using the Demographic Information Questionnaire.Results: The study results indicated that the cognitive functioning (r=0.367, P<0.001, U=0.6316) and physical fitness (r=0.189, P=0.001, 2.8582) of the older adults participating in volunteering were significantly higher than those not participating in volunteering; this relationship was stronger for females than for males (p<0.05) and also for those with a higher education level (p<0.05).Conclusion: According to the findings of this study, the older adults who actively participate in volunteering will probably have better physical fitness, quality of life and cognitive function. Therefore, it is recommended to develop interventions based on volunteering to improve the cognitive function, physical fitness and quality of life of the community dwelling older adults. https://medrehab.sbmu.ac.ir/article_1101800.html This study was conducted to investigate auditory stimuli' effect on learning motor scheduling of follow-up tasks in children and adolescents with developmental coordination disorder (DCD). Simultaneously, with the visual scheduling signs, the audio stimulus was presented in four specific directions. Participants included 42 male students aged 9 to 12 years ) With an average age = 10/84 (with DCD in Neishabour city who enrolled based on the results of Teacher Movement Inventory, Parental Developmental Disorder Questionnaire, MABC2 motor test, spatial-visual memory assessment, intelligence assessment, Reaction time test and physical and mental health test and randomly replaced in three groups of auditory stimuli, control 1 (visual) and control 2. For this purpose, the motion tracking software was designed, and the specified pattern displayed on the tablet monitor screen (12 inches). Research stages included the pre-test, practice (10 blocks of five attempts), acquisition test, delayed retention test and transfer test. The results showed a significant difference between the acquisition stage and retention in the relative timing variable (p https://medrehab.sbmu.ac.ir/article_1101895.html In an era when the world relies more than ever on knowledge, innovation, and scientific collaboration to address complex global challenges, wars and military conflicts remain among the greatest obstacles to sustainable development and scientific advancement. Recent conflicts in various regions of the world, particularly in the Middle East, have once again drawn international attention to the far-reaching consequences of warfare. While public discourse often focuses on human casualties, infrastructural destruction, and economic losses, a less visible yet equally significant consequence is the profound disruption of scientific, academic, and research ecosystems. https://medrehab.sbmu.ac.ir/article_1101869.html Background and Aims Non-contact anterior cruciate ligament (ACL) injuries are severe and common in sports. Hip rotation range of motion (ROM) is crucial for limb control and may affect ACL injury risk, but existing evidence remains contradictory. This systematic review and meta-analysis aimed to investigate whether hip internal rotation and external rotation ROM differ between individuals with non-contact ACL injury and healthy subjects.Methods This study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Comprehensive search was conducted in PubMed, Scopus, Web of Science, ProQuest, ScienceDirect, Scientific Information Database (SID) and, Magiran. Data extraction and quality assessment were performed independently by two reviewers using the modified Downs and Black checklist. Standardized mean differences (SMD) were pooled using a random-effects model. Heterogeneity was assessed using I² and Cochran’s Q. Publication bias was evaluated through funnel plots and Egger’s regression tests. Sensitivity analysis was performed using the leave-one-out method.Results A total of 14 studies (1437 participants) were eligible for the internal rotation analysis and 13 studies (1113 participants) for the external rotation analysis. Meta-analysis showed no significant differences between the ACL-injured and control groups for hip internal rotation (SMD=–0.60; 95% CI, –1.40 to 0.20; P=0.14; I²=0%) or hip external rotation (SMD=–0.45; 95% CI, –1.23 to 0.33; P=0.26; I²=0%). Sensitivity analyses confirmed the stability of the findings. Egger’s test detected no publication bias for either variable (internal rotation: P=0.69; external rotation: P=0.95).Conclusion It seems that hip internal rotation and external rotation ROM alone are not independent predictors of non-contact ACL injury. However, combined rotational imbalance, particularly increased internal rotation with limited external rotation, may contribute to altered knee loading patterns in high-risk individuals. Multidimensional biomechanical assessment, rather than reliance on isolated hip ROM measures, is recommended for ACL injury screening and prevention. https://medrehab.sbmu.ac.ir/article_1101872.html Background and Aims Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impairments in social communication and restricted, repetitive behaviors. The DIR/Floortime intervention, a play-based approach, aims to enhance emotional and social functioning in autistic children. This systematic review aimed to synthesize evidence on the effectiveness of DIR/Floortime in children with high-functioning ASD.Methods A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines was conducted. Electronic databases (Science Direct, PsycINFO, PubMed, Scopus, and Medline) were searched for studies published between 2007 and 2025 using relevant keywords. Eligible studies included randomized controlled trials (RCTs), quasi-experimental, and prospective observational designs that applied DIR/Floortime interventions to children with ASD and measured developmental, social, or cognitive outcomes.Results Out of 40 initially identified studies, 9 met the inclusion criteria. The interventions, ranging from 3 to 18 months, included play-based Floortime therapy, parent training, and home-based programs. The evidence demonstrated significant improvements in social skills, reduced autism severity, enhanced parent-child interactions, and improved self-regulation in children. Methodological quality assessed by the PEDro scale varied, with 33% of studies rated as high quality.Conclusion DIR/Floortime interventions show promising effectiveness in improving social-emotional functioning in children with high-functioning ASD. Further high-quality RCTs with larger samples and long-term follow-up are warranted to strengthen existing evidence. https://medrehab.sbmu.ac.ir/article_1101846.html Background and Aims This study aims to assess the kinetic parameters and muscle activation involved in the anticipatory postural adjustment (APA) phase of gait initiation in individuals with and without chronic ankle instability (CAI).Methods Twenty participants, evenly divided into 2 groups of 10, voluntarily took part in this study. They were asked to initiate gait after the auditory cue while standing on the force plate. The muscle activity of the tibialis anterior (TA), soleus (SL), biceps femoris (BF), rectus femoris (RF), peroneus longus (PL), gluteus medius (Gmed), and gluteus maximus (Gmax) in both (left and right) legs, along with force parameters (in 3 directions) and center of pressure (in 2 directions) were measured for the 2 groups. The dependent variables were analyzed by using the independent t tests.Results The findings revealed significant differences in the kinetic parameters and the activations of the TA_r (P=0.04), BF_L (P=0.04), and SL_L (P=0.03) muscles between the 2 groups. No statistically significant differences were observed in the other muscles (P>0.05). The outcomes suggest that during the APA phase, individuals with CAI exhibit decreased muscle activities in TA_r and SL_r, and increased muscle activities in BF_L muscle compared to the control group. These changes, which aim to maintain body stability, may reflect alterations in neural transmission patterns originating from the central nervous system (CNS).Conclusion Since the APA phase is regulated by the secondary motor area, alterations in motor control observed in those with CAI could be attributed to changes in supraspinal. Neuromuscular training for muscles which influence motor control strategies affected by CAI may be a beneficial way of the rehabilitation program for these individuals. https://medrehab.sbmu.ac.ir/article_1101848.html Background and Aims One of the most common language disorders in people with Down syndrome is the deletion of language sounds. This research deals with the study of the deletion phonological process in Persian language sounds, specifically consonants deletion, in the speech production of educable students with Down syndrome who study in the third to sixth grades in elementary schools, in Tehran City, Iran. This study considers the students’ ability of recognition and dominancy on the most common deleted consonants in the speech production of students within the framework of Generative Phonology School. Methods The statistical population of this research comprised 19 boys and 11 girls, educable students with Down syndrome, speaking only Persian language, without any vision, hearing, stuttering, reading, and writing problems at the chronological age of 11-18 years old, studying in the exceptional elementary schools in Tehran. The method of research was based on spontaneous speech of students through the naming single words of 300 simple pictures. All deleted consonants in the production of words by students were considered, and the most common deleted consonants were registered.  Then, we analyzed their ability to recognize and dominate these deleted consonants used in their writing skills. Besides, the Wepman auditory discrimination test was used to assess the students’ ability to distinguish between similar language sounds. In this descriptive-analytic study, the method of data collection was based on field research and data were statistically analyzed via the Kolmogorov-Smirnov and Wilcoxon tests, using SPSS software version 26.Results The most common deleted consonants in the speech production of students were alveolar-liquid [r], alveolar-nasal [n], alveolar-stop [t], alveolar-liquid [l], and alveolar-stop [d]. There was no significant difference between two variables, the most deleted consonants in speech and writing (P<0.05). Conclusion findings showed that the educable students with Down syndrome, studying in the third to sixth grades in exceptional elementary schools in Tehran have adequate ability of realizing and dominancy on the most deleted consonants in their speech which indicates the development of phonological perception of students. Thus, the main cause of using frequently this phonological process (consonants deletion) was not phonological errors, but for the structural and functional defects in the speech production organs. https://medrehab.sbmu.ac.ir/article_1101876.html Background and Aims Obesity is associated with chronic inflammation and an increased risk of cardiovascular diseases. On the other hand, physical activity is recognized as an effective strategy for improving inflammatory and metabolic factors. The present study aimed to investigate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on serum CTRP1 levels and cardiovascular inflammatory markers in obese men.Methods In a quasi-experimental study, 30 obese men (BMI≥30 kg/m²) were randomly assigned to three groups of 10 participants each: high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and control. HIIT (90%-100% of maximal heart rate) and MICT (60%-75% of heart rate reserve) were performed for 6 weeks, 3 sessions per week. Serum levels of C1q/TNF-related protein-1 (CTRP1), interleukin (IL)-6, and C-reactive protein (CRP) were measured before the intervention and 48 hours after the last training session. Data were analyzed using analysis of covariance (ANCOVA), paired t tests, and LSD post-hoc tests at a significance level of P≤0.05.Results Between-group analysis using ANCOVA showed significant differences among the study groups in CTRP1 (F=8.64, P=0.002), IL-6 (F=6.47, P=0.004), and CRP (F=14.00, P=0.004). LSD post-hoc tests indicated that both HIIT and MICT groups, compared to the control group, had significant changes in CTRP1, IL-6, and CRP (P≤0.05). No significant differences were observed between the HIIT and MICT groups for any of the variables.Conclusion The results of this study indicate that both HIIT and MICT can serve as effective strategies for improving pro- and anti-inflammatory markers related to cardiovascular risk in obese individuals, although the effects of higher-intensity training appear to be more pronounced. https://medrehab.sbmu.ac.ir/article_1101873.html Background and Aims Anterior cruciate ligament (ACL) injury risk in soccer players is associated with abnormal landing and cutting mechanics; however, most screening tools assess single tasks or isolated devices. This study quantified the inter-rater and test-retest reliability of a synchronized multimodal test battery integrating 3-dimensional motion capture, force plates, surface electromyography (sEMG), and isokinetic dynamometry across 6 functional assessments (drop vertical jump, change of direction, landing error scoring system, tuck jump, single-leg squat, star excursion balance test) in male soccer players.Methods A total of 35 male soccer players completed two identical testing sessions separated by 72 h under standardized conditions. Inter-rater reliability was calculated using the  intraclass correlation (ICC)(2,1), and test-retest reliability using ICC(3,1). Absolute measurement error was quantified using the standard error of measurement (SEM) and the minimum detectable change at 95% confidence (MDC95).Results Inter-rater reproducibility was highest for motion capture (median ICC=0.94) and isokinetic dynamometry (0.91), but acceptable for force plates (0.87) and sEMG (0.82). Test-retest reliability was strongest for isokinetic measures (ICC=0.88), moderate for motion capture (0.77) and sEMG (0.78); however, force plates demonstrated the lowest reproducibility (0.48). Landing-based tasks exhibited lower MDC95 values (13%-15%) than multidirectional and plyometric tasks (exceeding 20%-30%). Conclusion These results established device- and task-specific thresholds for interpreting significant neuromechanical change and supported the application of synchronized multimodal screening as a measurement foundation for preseason assessment, longitudinal monitoring, and return-to-play decision-making in soccer players. https://medrehab.sbmu.ac.ir/article_1101874.html Background and Aims Dyslexia is one of the most common learning disorders and is associated with deficits in fundamental reading-related skills, particularly phonological processing and auditory working memory. The present study examined the effect of the McCarney intervention program on improving phonological processing and auditory working memory in students with dyslexia.Methods This study employed a quasi-experimental design with pretest, posttest, a control group, and a 45-day follow-up. The sample consisted of 40 students with dyslexia from the city of Isfahan, Iran, who were randomly assigned to the experimental and control groups. The experimental group participated in ten 45-min sessions of the McCarney intervention program. Data were collected using the Kormi-Nouri et al. reading and dyslexia Test and the Daneman and Carpenter auditory working memory test. Data analysis was conducted using repeated measures analysis of variance.Results The results indicated that the McCarney intervention program led to a significant improvement in phonological processing and auditory working memory in the experimental group compared to the control group (P<0.001). These improvements were maintained at the follow-up stage, and the significant interaction between group and time indicated the sustained effect of the intervention over time.Conclusion The McCarney intervention program, with its emphasis on a structured and multisensory approach, can effectively enhance reading-related cognitive functions in students with dyslexia, with effects that remain stable over time. https://medrehab.sbmu.ac.ir/article_1101875.html Background and Aims Forward head posture (FHP) is a prevalent postural disorder characterized by a straightened cervical arch, resulting in the head being positioned forward of the body’s vertical line. This condition has become increasingly common with the rise of computer and mobile device usage. Exercise therapy is recognized as the most effective treatment for FHP, and incorporating innovative methods like virtual reality (VR) could enhance its effectiveness by increasing motivation, repetitions, and exercise duration. This study aims to investigate the impact of virtual reality-based exercise therapy on individuals with forward head posture.Methods In this interventional clinical trial, 50 young adults aged 18 to 29 with FHP were randomly assigned to two groups. The virtual reality group performed the chin tuck exercise in a game format using VR glasses, while the control group carried out the same exercise at home without VR assistance. Key variables, including craniovertebral angle, pain levels, neck disability index, range of motion, and balance, were assessed before and after the intervention for both groups.Results The results indicated that both the chin tuck exercise with VR and the exercise without VR significantly improved the measured variables (P<0.05). However, there was no significant difference in the outcomes between the two groups.Conclusion This study concluded that both conventional exercise therapy and exercise therapy enhanced by virtual reality effectively improved the craniovertebral angle, pain levels, neck disability, range of motion, and balance in young individuals with forward head posture. https://medrehab.sbmu.ac.ir/article_1101878.html Background and Aims Pregnancy induces significant structural, postural, and biomechanical adaptations that can affect gait and balance. Pregnancy-related low back pain (LBP), one of the most common musculoskeletal complaints during gestation, may intensify these changes, leading to compensatory movement strategies and impaired postural stability. This study aimed to compare changes in spatiotemporal gait parameters and static balance between early first trimester and late third trimester among pregnant women with varying LBP severity.Methods In this prospective study, participants were assessed in the third and ninth months of pregnancy. LBP severity was measured in the ninth month using the visual analogue scale (VAS), categorizing participants into mild and moderate-to-severe LBP groups. Static balance was evaluated using a Wii balance board, with center of pressure (COP) path length as the main outcome. Gait was recorded in the sagittal plane at 100 Hz. Participants performed 6 walking trials; the first three were excluded to ensure habitual gait. Three consecutive right steps from trials 4 to 6 were analyzed. Videos were calibrated and analyzed using Kinovea software (version 0.9.5), with virtual markers on the heel, lateral malleolus, and fifth metatarsal head. Changes in variables were calculated as differences between third- and ninth-month measurements and analyzed using independent t tests or the Mann-Whitney U tests.Results Stride time changes differed significantly between groups (P<0.01). Women with moderate-to-severe LBP showed greater reductions in stride length and step length and greater increases in step time compared to the mild LBP group (P<0.05), indicating adoption of a more cautious gait strategy. COP path length also increased significantly more in the moderate-to-severe group (P<0.05), reflecting reduced postural stability.Conclusion Higher LBP severity in late pregnancy is associated with unfavorable gait adaptations and increased postural sway. These findings highlight the importance of monitoring motor function and implementing targeted rehabilitation strategies to maintain mobility and balance during pregnancy. https://medrehab.sbmu.ac.ir/article_1101871.html Background and Aims Finite element analysis has become one of the common approaches for predicting load distribution between the foot and different supporting structures, providing valuable insights into the internal stresses of bone structures. The construction of accurate models using this method relies on medical imaging data to reconstruct the geometry of bones and tissues. CT scanning is the most widely used imaging modality for bone visualization and serves as the main basis for biomechanical joint modeling. However, radiation-related concerns, particularly in repeated imaging of individuals, children, or sensitive populations, highlight the need for safer and radiation-free alternatives, such as magnetic resonance imaging (MRI). Despite the advantages of MRI, including superior soft tissue quality and radiation safety, direct extraction of bone geometry from MRI remains challenging due to the low contrast of bone boundaries, especially in complex joints, such as the ankle. Recently, another imaging approach known as AI generated CT has emerged, in which CT-like images are generated from MRI data using artificial intelligence techniques. This study aimed to evaluate the accuracy and substitution capability of bone models obtained from a specific MRI sequence and AI generated CT, in comparison with reference CT scans for ankle joint stress analysis.Methods For this purpose, CT scans, MRI data, and AI generated CT images were acquired from three healthy ankle joint samples. A total of 6 three-dimensional models were constructed based on these imaging modalities. Bone segmentation was performed using Mimics software, and the resulting 3-D models were further processed in 3-matic for standardized positioning, cartilage generation, minor surface smoothing, and mesh generation. Finite element modeling and mechanical simulations were then conducted in the Abaqus software environment. Contact stress distribution and von Mises stresses in the talus bone and cartilage were analyzed and compared across the different imaging-based models.Results The findings demonstrated that AI generated CT models exhibited good agreement with reference CT scans in terms of maximum stress values and stress distribution patterns, with a maximum difference of 5% in contact stress. In contrast, bone MRI-based models showed noticeable deviations in stress distribution patterns, as well as differences of 12% in maximum contact stress and 45% in von Mises stress.Conclusion These results indicate that, under current conditions, direct modeling from bone MRI lacks sufficient accuracy for mechanical stress analysis. Nevertheless, generating AI generated CT images from bone MRI using artificial intelligence methods provides a promising pathway for replacing CT scans in future biomechanical modeling of the ankle joint. https://medrehab.sbmu.ac.ir/article_1101863.html Introduction and Aim: Ankle dysfunction is a common consequence of hemiplegia and other neurological disorders such as stroke, often leading to reduced foot stability and impaired gait. The ankle-foot orthosis (AFO) is a key rehabilitation device designed to improve gait performance and ankle-foot function. Among the available designs, the posterior and anterior AFOs are the most commonly prescribed. This systematic review aimed to evaluate the effects of anterior AFOs on gait parameters, balance, and functional performance in hemiplegic patients with foot drop, and to compare these effects with those of posterior AFOs and walking without an AFO. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, ProQuest, and Google Scholar databases from their inception to September 2025. Studies that investigated the effects of anterior AFOs on gait variables, balance, and functional outcomes in individuals with hemiplegia were included. The methodological quality of the selected studies was assessed using the modified Downs and Black checklist. Results: Eleven studies involving 218 individuals with hemiplegia met the inclusion criteria. Most studies were quasi-experimental with moderate methodological quality, while two were rated as good quality. Overall, the use of an anterior AFO significantly improved stride length, walking speed, lateral weight shifting, and weight bearing on the affected limb compared with no AFO (P < 0.05). When compared with posterior AFOs, most parameters showed no significant differences (P > 0.05); however, several studies reported lower energy expenditure and greater user comfort with anterior AFOs. Conclusion: Wearing an anterior AFO may enhance gait and balance performance in individuals with hemiplegia, although the current evidence is of moderate quality. Further randomized controlled trials with larger sample sizes and standardized protocols are recommended to better elucidate the long-term effects of anterior AFOs and to examine the role of therapist-supervised gait training during orthosis use. https://medrehab.sbmu.ac.ir/article_1101870.html Background and Aim: The purpose of the present study was to determine the immediate influence of balance training with balance board and its durability sense of ankle position in basketball players. Materials and Methods: participants of the study were 40 male subjects was randomly divided into two control and experimental groups (n=20). Then, after 5 minute warm up, ankle joint reconstruction errors were randomly assigned to all subjects at 30 degrees anterolateral plantar flexion by photogrammetry, respectively. Afterwards, experimental group participated in the short-term training protocol while the control group rested during this period. Finally, immediately after exercise and one hour after exercise, in both groups, pre-tests in post-tests, their ankle joint posture was measured and recorded. Data were analyzed by descriptive and inferential statistics using SPSS 21 software. Results: Results of t-test showed that ankle (df=19, t=11.001, p=0.001) of subjects after attending training session along with a balance board, significantly improved. Also, statistically difference in absolute error ankle reconstruction angle between post-test and subsequent following an hour ( ankle df=19, t=0.112, p=0.538), but in the control group ,the absolute error ankle reconstruction position in the pre-test and post-test and subsequent one hour detraining, no significant difference was found ( ankle df=19, t=0.018, p=0.027). Conclusion: According to the results It seems that a balance training session stimulates the ankle joint sensory receptors of male basketball players, which increases the accuracy of posture and remains in effect for one hour after exercise. Therefore, it is recommended to use this method of warming up players before training and competition, as it seems that with increasing accuracy of ankle joint position, the probability of injury in these joints is reduced https://medrehab.sbmu.ac.ir/article_1101877.html Background and Objectives:: Musculoskeletal disorders related to work are injuries or disorders of muscles, nerves, tendons, joints, cartilage and spinal disc, which are the result of the work environment and the performance of people at work. This study was conducted with the aim of determining the prevalence of musculoskeletal discomfort, pain and its relationship with the demographic and occupational information of the administrative staff of Arak Farhangian University. Maerial and methods: In this cross-sectional descriptive study, 100 office workers (64% men and 36% women) of Arak Farhangian University with an average age of 42.81 years and an average weight of 75.95 kg were included in the research. Nordic Questionnaire (NMQ) was used to collect data and visual analog scale was used to measure pain. Subsequently, a conceptual model was introduced illustrating the interaction of demographic and occupational variables that leads to the prevalence of musculoskeletal disorders in specific body regions. To analyze the data, frequency, mean, standard deviation and covariance index were used. Results: The most musculoskeletal disorders were related to the back (42%), shoulder (40%), back and neck (36% each). Back discomfort had a significant relationship with age, gender, organizational position and computer use. Shoulder discomfort had a significant relationship with age, weight, work experience and computer use. Back discomfort with age and organizational position factors and neck discomfort also had a significant relationship with age, height and computer use. Conclusion: Appropriate employment of employees in work positions and also training to maintain correct physical posture while working are among the measures that can be effective in preventing and improving musculoskeletal pain and It is recommended to have a sports and physiotherapy program at work to reduce sitting time and increase daily physical activity of employees and reduce clinical pain. https://medrehab.sbmu.ac.ir/article_1101879.html Background and Aims: Mirror therapy using visual feedback has emerged as a promising treatment for children with cerebral palsy, and its therapeutic effects on the upper limbs of children with hemiplegic cerebral palsy are still under investigation. This study aimed to investigate the effect of mirror therapy on wrist extension range of motion and upper limb function in children with hemiplegic cerebral palsy. Materials and Methods: In this single-blind clinical trial study, 30 children with hemiplegic cerebral palsy in the age range of 9-14 years were selected based on the inclusion criteria and randomly divided into two intervention and control groups. The usual occupational therapy program was performed for both groups. In addition, the intervention group underwent mirror therapy for 6 weeks, three days a week. Before and after the intervention, wrist extension range of motion was measured with a goniometer and upper limb motor function was measured with the Fugl- Meyer. The data were analyzed by t-test. Results: analysis of the data showed that the difference between the mean scores obtained from the evaluation of upper limb function and active range of motion of wrist extension in the mirror therapy group was significantly higher than the mean difference in the control group (P<0.05). Conclusion: It seems that, mirror therapy in the children with hemiplegic is useful in improving of upper limb function and in order to prove this, more studies are required with a larger sample size. Keywords: Hemiplegic cerebral palsy, Mirror therapy, Upper limb function https://medrehab.sbmu.ac.ir/article_1101880.html Background and Aims: Successful performance in wheelchair basketball is highly dependent on upper limb muscle strength and balance. The repetitive nature of activities such as wheelchair propulsion, passing, and shooting places considerable stress on the shoulder and elbow joints and may lead to functional changes and muscular imbalances. The aim of the present study was to compare the isokinetic strength of the shoulder and elbow joints between elite and beginner wheelchair basketball players. Materials and Methods: This study was conducted on 18 wheelchair basketball players in two groups: elite (n = 10) and beginner (n = 8). The isokinetic strength of the elbow flexors and extensors, as well as the shoulder internal and external rotators, was measured at angular velocities of 60 and 180 degrees per second using an isokinetic dynamometer. An independent t-test was used to compare the groups at a significance level of α ≤ 0.05. Results: The results showed that elite players had significantly higher values than beginner players in peak torque of the elbow flexors at angular velocities of 60 and 180 degrees per second, peak torque of the elbow extensors at 180 degrees per second, and the agonist-to-antagonist ratio of the shoulder rotators at 60 degrees per second (P < 0.05). However, no significant differences were observed between the two groups in the other variables (P > 0.05). Conclusion: The results of this study showed that the difference between the elite and beginner players with wheelchairs is not limited to the general increase in muscle strength, but this difference is observed in some of the upper limb functional indicators. Elite players in the power of elbow flexors had better performance in both test speeds and elbow expenses at high speed, while there was no significant difference in the absolute strength indices of the shoulder. On the other hand, there was a significant difference in the ratio of an agonist to the shoulder antagonist that the higher skill level can be associated with a more favorable muscle balance pattern. These findings indicate that the progress of performance in basketball with wheelchair is not only dependent on increasing the volume of exercise, but also related to neurological adaptations, strength development in key muscle and improve muscle coordination. Applied, it is recommended that in beginner players, in addition to public power exercises, targeted programs for flexor and elbow, shoulder muscle and muscle correction, to improve both exercise and reduce the risk of shoulder and elbow damage. Keywords: Wheelchair basketball, isokinetic strength, shoulder joint, elbow joint https://medrehab.sbmu.ac.ir/article_1101881.html Introduction and Objectives: Dyslexia is characterized by an intricate neuro-etiological architecture. Contemporary models posit that foundational sensory processing deficits—by precipitating perceptual instability and saturating cognitive resources—fundamentally impede the learning trajectory. The present study was conducted to synthesize scientific evidence regarding the multidimensional explanations of dyslexia and to evaluate the clinical efficacy of interventions predicated on sensory processing paradigms and cognitive rehabilitation in ameliorating reading proficiency. Materials and Methods This a scoping review study was Guided by PRISMA 2020 standards (2010–2025), this systematic search utilized domestic (NoorMags, IranDoc, Civilica) and international (ScienceDirect, ERIC, Scopus, PubMed, SAGE) databases. Of 480 records identified via keywords “dyslexia,” “cognitive Remediation,” and “sensory processing,” 41 eligible studies were ultimately included following deduplication and rigorous screening. Extracted data were descriptively categorized based on their thematic orientations and research paradigms. Results The findings were articulated across three dimensions. First, neurobiological evidence indicated that children with reading disorders exhibit sensory dysregulation, which contributes to unstable eye movements and deficits in visual attention. Second, sensory processing impairments impose an additional cognitive load that diminishes working memory capacity. Finally, integrative therapeutic approaches incorporating controlled sensory stimulation and sensory–cognitive activities provide a foundation for improving reading skills. Conclusion Dyslexia is a disorder with subcortical origins and cortical manifestations. Exclusive reliance on educational interventions, without addressing underlying sensory infrastructures, often results in therapeutic resistance. The findings of the present review propose the implementation of a hierarchical clinical protocol: first, the regulation of foundational sensory processing mechanisms; second, the rehabilitation of executive cognitive functions; and finally, the direct instruction of reading skills. Such an integrative approach disrupts the maladaptive cycle of reading disability. https://medrehab.sbmu.ac.ir/article_1101882.html Background and Aim: Chronic ankle instability (CAI) is the most common sequelae of recurrent ankle sprains in soccer players. Given the methodological limitations of previous studies, such as comparing the involved limb with the healthy contralateral limb, the present study aimed to compare the eversion-to-inversion strength ratio (E/I ratio) and center of pressure (COP) path length during single-leg landing between soccer players with CAI and healthy controls using a matched-side design. Methods: This was a cross-sectional comparative study involving two independent groups. 28 soccer players with CAI (CAIT score: 17.50 ± 2.13) and 28 healthy soccer players (CAIT score: 28.32 ± 1.09) participated. The concentric isokinetic E/I ratio was measured at an angular velocity of 60°/s using a Biodex System 3 dynamometer. Dynamic postural control was assessed using the COP path length parameter during a single-leg landing task from a 30-cm height onto a Footscan pressure plate. Results: The results showed that E/I ratio was significantly lower in soccer players with CAI compared to the control group (t(54) = -2.19, P = 0.03, ES = 0.63). Furthermore, the COP path length was significantly greater in the injured players compared to the control group (t(54) = 3.31, P < 0.001, ES = 0.89). Conclusion: Soccer players with CAI demonstrated a significant reduction in E/I ratio and a marked increase in COP oscillations during single-leg landing. Future studies should examine whether evertor strengthening exercises improve the eversion-to-inversion ratio and dynamic postural control. Additionally, a matched-side design is recommended for accurate assessment of deficits in this population. https://medrehab.sbmu.ac.ir/article_1101883.html Background: Age-related auditory decline is increasingly recognized as a multidimensional process that extends beyond pure-tone threshold elevation. Subtle changes in auditory processing, particularly under challenging listening conditions such as speech-in-noise, may emerge as early as midlife. These changes often increase listening effort and cognitive load, potentially compromising memory performance even when conventional audiometric measures remain within normal limits. Objective: This narrative review aims to synthesize current evidence on the relationship between auditory aging, listening effort, cognitive load, and memory performance, with a specific focus on middle-aged adults. Emphasis is placed on short-term and episodic memory as sensitive cognitive domains reflecting the downstream consequences of effortful listening. Methods: A narrative review approach was employed to integrate behavioral, cognitive, and neurophysiological findings published primarily after 2000. Studies addressing auditory processing beyond pure-tone sensitivity, effortful listening, memory function, and associated neural markers were selectively reviewed, with middle adulthood considered a critical yet underexplored period. Results: The reviewed evidence suggests that even mild auditory processing changes in midlife can substantially increase cognitive load during speech perception. To maintain adequate speech understanding, individuals increasingly rely on compensatory cognitive mechanisms, reallocating attentional and working memory resources. While such mechanisms support immediate comprehension, they incur a hidden cognitive cost, manifested as reduced efficiency in memory encoding and subsequent recall, particularly for episodic information. Conclusion: Middle adulthood represents a critical window for observing the mechanisms linking auditory decline to cognitive vulnerability, rather than merely their clinical consequences. Integrating auditory, cognitive, and neural perspectives highlights the limitations of threshold-based hearing assessment and underscores the importance of evaluating listening effort and memory function. This framework supports earlier identification of cognitive vulnerability and informs more comprehensive, prevention-oriented approaches in audiological practice. https://medrehab.sbmu.ac.ir/article_1101884.html Background and Aims: Impairments in gait pattern and neuromuscular control are common consequences following anterior cruciate ligament reconstruction (ACL‑R) and may be exacerbated under fatigue conditions. Kinesio taping has been proposed as an adjunctive strategy to enhance proprioceptive feedback and joint stability. Therefore, the present study aimed to investigate the short‑term effects of Kinesio taping on gait parameters in athletes with ACL‑R before and after fatigue, and to compare the findings with those of healthy individuals. Materials and Methods: This semi-experimental study was conducted on thirty semi-professional athletes (15 healthy controls and 15 with a history of anterior cruciate ligament reconstruction). Spatiotemporal gait variables were assessed before and after induced muscular fatigue using a Vicon motion analysis system. Fatigue was induced through a protocol consisting of squats, eccentric calf contractions, and vertical jumps. In the ACL‑R group, Kinesio taping was applied using a facilitation pattern for the hamstrings and inhibition for the quadriceps. Data were analyzed using the Shapiro–Wilk test, repeated measures ANOVA, paired t-test, and MANOVA in SPSS, with statistical significance set at p<0.05. Results: In the ACL‑R group without Kinesio taping, fatigue significantly reduced step time (p=0.01), stride time (p=0.01), single‑limb support (p=0.02), and double‑limb support (p=0.02), while other variables were unchanged (p>0.05). With Kinesio taping, no significant post‑fatigue changes occurred. Only walking speed differed among walking post fatigue with kinesiotape in contrast to walking post fatigue without tapes (p=0.04), with no differences among ACL‑R and healthy groups (p>0.05). Conclusion: Findings indicated that the gait pattern of athletes with ACL reconstruction was generallycomparable to that of healthy individuals. Although Kinesio taping did not lead to statistically significant changes in spatiotemporal parameters under the studied conditions, the absence of fatigue-related alterations following taping may suggest a potential protective effect on gait stability. However, no substantial between-group differences were observed. These findings may reflect relatively adequate neuromuscular control during walking in athletes with ACL-R, while also indicating that the short-term rehabilitative effects of Kinesio taping on gait performance are limited. https://medrehab.sbmu.ac.ir/article_1101885.html English Abstract Background and Aims: In individuals with scapular movement disorders, decreased activation of the serratus anterior muscle and compensatory overactivation of the upper trapezius during arm elevation have been reported. These alterations may lead to changes in the scapulothoracic motion pattern and eventually result in shoulder dysfunction. Therefore, the present study aimed to investigate the effect of reactive neuromuscular training (RNT) on scapulohumeral rhythm and shoulder joint repositioning error in volleyball players with Type II scapular dyskinesis. Materials and Methods: In this quasi-experimental study, 30 male volleyball players with Type II scapular dyskinesis were randomly assigned to experimental and control groups (n=15 each). Before and after eight weeks of reactive neuromuscular training, scapulohumeral rhythm and shoulder joint repositioning error were assessed using an inclinometer and an isokinetic dynamometer, respectively. For inferential analysis, ANCOVA was utilized at a significance level of p<0.05. Results: The ANCOVA results revealed that after eight weeks of reactive neuromuscular training, scapulohumeral rhythm significantly improved in the experimental group at all abduction angles (0°, 45°, 90°, and 135°) (p<0.05), indicating better coordination between humeral and scapular motion. Furthermore, the shoulder joint repositioning error significantly decreased at both 45° of internal rotation and 75° of external rotation (p<0.05). Conclusion: Reactive neuromuscular training led to a significant improvement in scapulohumeral rhythm and a reduction in shoulder joint repositioning error among volleyball players with Type II scapular dyskinesis. These findings suggest that enhancing neuromuscular control and proprioceptive accuracy through reactive training can help correct inefficient movement patterns and prevent functional shoulder injuries in overhead sports. https://medrehab.sbmu.ac.ir/article_1101886.html Abstract Anterior cruciate ligament (ACL) injury is a common sports-related condition that often leads to persistent biomechanical deficits, even following reconstruction (ACLR). Proprioceptive training is proposed as a potential intervention to address these deficits. This systematic review aimed to evaluate the effect of proprioceptive training on kinematic, kinetic, and neuromuscular parameters in patients post-ACLR. A systematic search was conducted across PubMed, ScienceDirect, Scopus, and Web of Science. Inclusion criteria comprised studies investigating the effects of proprioceptive training on biomechanical outcomes (kinematics, kinetics, and EMG) in ACLR patients. Case reports, conference papers, and studies with additional pathologies were excluded. Six studies involving 244 participants (aged 18–50 years) met the inclusion criteria. The findings suggest that proprioceptive training may be associated with improvements in knee kinematics (e.g., joint angles), kinetics (e.g., center of pressure, joint moments), and neuromuscular symmetry as measured by EMG. Current evidence suggests that proprioceptive training may have a positive impact on biomechanical parameters post-ACLR. However, given the limited number of studies and methodological heterogeneity, these findings should be interpreted with caution. Future research with more standardized clinical trials is warranted to confirm these effects and provide robust evidence for rehabilitation protoco Anterior cruciate ligament, proprioceptive training, kinematics, kinetic, muscle activity Keywords Anterior Cruciate Ligament Reconstruction (ACLR); Proprioceptive Training; Kinematics; Kinetics; Neuromuscular Control. https://medrehab.sbmu.ac.ir/article_1101887.html Background and Aims: Individuals with non-specific chronic low back pain appear to present with core stability muscle weakness, disability, motor function deficits, and decreased quality of life. Accordingly, the present study aims to investigate the relationship between sagittal lumbar spine curvature and postural control as well as functional status in individuals with non-specific chronic low back pain. Materials and Methods: This research was conducted as a correlational study on individuals aged 30 to 50 years with non-specific chronic low back pain. Participants were selected using purposive and convenience sampling methods. In this study, to assess lumbar lordosis angle, postural control, core endurance, functional disability, functional capacity, and range of motion, the following tools were used respectively: a flexible ruler, the Balance Error Scoring System (BESS), the McGill protocol, the Oswestry Disability Index, the floor-to-waist lifting test, and functional range of motion tests. For data analysis, the non-parametric Spearman correlation coefficient was used to examine the relationships between the research variables at a significance level of p < 0.05. Statistical calculations and graphing were performed using SPSS software version 27 and Excel 2019. Results: The results of the Spearman correlation test showed that there was no significant relationship between sagittal curvature of the lumbar spine and disability and functional capacity in individuals with non-specific chronic low back pain (p > 0.05). However, the results revealed significant relationships between sagittal curvature of the lumbar spine and the following variables: postural control on a stable surface (p = 0.02, R = 0.69) and on an unstable surface (p = 0.03, R = 0.49); endurance of the trunk flexor muscles (p = 0.001, R = -0.62); trunk extensor endurance (p = 0.02, R = -0.49); right lateral flexor endurance (p = 0.03, R = -0.51); left lateral flexor endurance (p = 0.03, R = -0.47); overall core stability score (p = 0.02, R = -0.53); range of motion of lumbar flexion (p = 0.01, R = -0.67); and lumbar extension range of motion (p = 0.001, R = -0.69). Conclusion: The results of this study indicate that the degree of sagittal curvature of the lumbar spine is not significantly associated with disability or functional capacity indicators. However, this curvature shows significant relationships with factors such as postural control, core muscle strength and stability, and joint range of motion. Therefore, although changes in lumbar curvature do not necessarily lead to functional decline or disability, they can negatively affect an individual's balance, core stability, and flexibility. Clinically, this finding suggests that interventions aimed at improving postural control and core muscle strength may be beneficial for individuals with abnormal lumbar curvature, even in the absence of overt disability. Keywords: Chronic non-specific low back pain, lumbar curvature, core muscle endurance, functional status, postural control. https://medrehab.sbmu.ac.ir/article_1101888.html Background and Aims: Low back pain is a prevalent issue within the rowing community, often reported as a common complaint. Therefore, the objective of the present study was to examine the impact of a specific training program on pain levels and the relative lumbosacral angle in professional rowers who are prone to low back pain. Materials and Methods: The present study is a quasi-experimental research design utilizing a pretest-posttest framework. It consists of an experimental group undergoing a selected set of designed exercises (n = 15) and a control group (n = 15). Pain levels were assessed using a Visual Analog Scale (VAS), while joint angles were measured with three wearable IMU sensors developed by BSNlab.com. For data analysis, repeated measures analysis of variance (ANOVA) and Bonferroni post hoc tests were conducted, with a significance level set at p < 0.05. Statistical calculations and graphical representations were performed using SPSS version 27 and Excel 2019 software. Results: The results of the study indicated that there were no significant differences in pain levels and lumbosacral angles between the experimental and control groups at the pre-test stage (P ≥ 0.05). However, the findings revealed that the selected exercise program implemented in the experimental group led to a significant reduction in pain and an increase in the lumbosacral angle (P = 0.001). In contrast, these changes were not observed to be significant in the control group (P ≥ 0.05). Conclusion: The results of the present study demonstrated that the designed exercises not only contributed to a reduction in pain among the rowers but also led to an increase in the lumbosacral angle. These findings highlight the significance of targeted training interventions in the management and enhancement of low back pain in athletes. Furthermore, they suggest that by improving motor control and biomechanical alignment, the risk of future injuries can be mitigated, ultimately enhancing athletic performance. Keywords: Rowers, prone to back pain, lumbosacral angle, selected exercises. https://medrehab.sbmu.ac.ir/article_1101889.html Introduction Anterior Cruciate Ligament (ACL) injuries are highly prevalent in sports, with approximately 91% of these injuries occurring during athletic activities [1]. Dynamic knee valgus (DKV) is considered as a significant risk factor for ACL injuries. DKV is a multiplanar lower extremity movement pattern characterized by hip adduction and internal rotation, knee abduction, anterior tibial translation, tibial external rotation, and foot inversion [2]. This movement pattern may increase mechanical stress on the knee joint and surrounding structures, thereby increasing the risk of both acute and chronic musculoskeletal injuries, particularly non-contact ACL tears. Injury prevention strategies should focus on increasing knee flexion angle and decreasing knee valgus angle during landing. One common strategy for preventing ACL injuries and for improving lower extremity alignment, especially knee valgus, is the use of motor control strategies and feedback-based training instructions. Visual feedback has been employed to target neuromuscular changes in real-time or post-task. Real-time feedback allows individuals to observe their movements and make immediate biomechanical adjustments. Another effective strategy to prevent DKV is Differential Learning (DL) method. This method emphasizes movement variability and motor adaptation rather than repetitive movement execution. Methods that incorporate practice variability facilitate motor adaptability, as such variability increases the number of degrees of freedom involved in motor control, ultimately leading to improved performance and reduced injury risk. Neuromuscular training programs have been shown to reduce ACL injury risk by up to 50% in men and 67% in women [22]. However, there is still no consensus on the optimal approach. Given that these programs typically last 6 to 8 weeks, the development of quicker intervention methods for ACL injury prevention is a crucial step. Since both valgus-control feedback (VCF) and DL methods have been proposed as rapid and effective methods for preventing ACL injuries, a direct comparison of these two approaches may help identify a more effective intervention strategy for injury prevention and optimize injury prevention programs. Based on the above, the aim of this study was to investigate the immediate effects of VCF and DL on feedforward muscle activity of the lower limbs in female athletes with DKV. Material and methods This study employed a quasi-experimental, pre-test post-test design to evaluate the effects of the intervention. The study population consisted of female recreational athletes (aged 20-25 years) participating in jumping sports (handball, basketball, and volleyball) in Tehran. Sample size calculation was performed using G*Power (version 3.1.9.2) based on a two-way repeated measures ANOVA with an effect size of 0.25, alpha level of 0.05, power of 0.80, and two measurement points, resulting in a required sample size of 28 participants. Considering a 20% dropout rate, 34 participants were recruited and randomly assigned to two groups: VCF strategy group (n=17) and DL strategy group (n=17). Kinovea software was used to screen for DKV during a 32 cm drop landing. Individuals with a DKV angle greater than 10 degrees were considered at risk for ACL injury. Muscle activity was recorded using a 32-channel electromyography system (TeleMyo DTS, Noraxon Inc., Scottsdale, USA) with a sampling frequency of 2000 Hz. The raw electromyographic signals were filtered using a fourth-order zero-lag Butterworth filter with a band-pass range of 20–450 Hz. All participants in both groups performed a pre-test of the Single leg drop vertical jump (SL-DVJ) task while wearing the electrodes sensors. After three successful and acceptable trials of the SL-DVJ task, the pre-test data for both groups were recorded. Subsequently, participants in both groups immediately performed four exercise tasks: double-leg squats, single-leg squats, single-leg step-downs, and lateral step-downs. Participants repeated each exercise ten times. Participants in the VCF group performed all four exercises in front of a full-length mirror and were instructed by a corrective exercise specialist to prevent their knees from moving towards the midline of the body by visually monitoring their knee valgus alignment [1]. Participants in the DL group were engaged in a structured training process characterized by non-repetitive practice attempts, consistent with DL principles. No augmented feedback was given to the participants in the DL group. Prior to each training session, the trainer designed a diverse set of task variations for each of the four designated exercises [3]. After completing the exercise sets, both groups performed a post-test under the same conditions as the pre-test, completing three successful trials of the SL-DVJ task. In the data processing procedure, we used Excel 2019 and MATLAB (version 8.4, 2014b). statistical indicators were examined at a significant level 0.05, using SPSS software, version 22. Results: A significant group × time interaction effect was observed for the feedforward activity of the gluteus medius (F 2،33 = 6.308, p = 0.017) and medial hamstring (F2, 33 = 6.095, p = 0.019) muscles (p < 0.05). The main effect of time was significant for all study variables. A significant main effect of group was also found for the gluteus medius (F2, 33 = 5.032, p = 0.032) and medial hamstring (F2, 33 = 9.680, p = 0.004) muscles. Furthermore, significant between-group differences were identified between the VCF and DL groups in the feedforward activity of the gluteus medius (p = 0.012) and medial hamstring (p = 0.002) muscles. Post hoc Bonferroni analysis demonstrated that both the VCF and DL groups showed significant increases in the feedforward activity of the gluteus maximus (p = 0.014, p = 0.002, respectively), gluteus medius (p = 0.005, p = 0.001, respectively), vastus medialis (p = 0.011, p = 0.001, respectively), and medial hamstring (p = 0.025, p = 0.001, respectively). Moreover, both groups exhibited significant reductions in the feedforward activity of the vastus lateralis (p = 0.002, p = 0.001, respectively) and lateral hamstring (p = 0.003, p = 0.001, respectively). Conclusion: Both the VCF and DL approaches were effective in modifying neuromuscular variables associated with ACL injury risk. However, the DL group demonstrated greater improvements in feedforward muscle activity of the gluteus medius and medial hamstring compared with the VCF group. These findings suggest that incorporating movement variability and task-specific modifications may enhance neuromuscular control in female athletes with DKV. https://medrehab.sbmu.ac.ir/article_1101890.html English Abstract Background and Aims: Special attention to vulnerable populations, including individuals with intellectual disabilities, is essential due to their increased risk of cardiovascular and respiratory disorders. In addition to cognitive limitations, these individuals often experience multiple physical impairments that require targeted and structured interventions. Therefore, the present study aimed to investigate the effects of dynamic neuromuscular stabilization (DNS) exercises performed on a trampoline on respiratory function in individuals with intellectual disabilities, and to propose an effective approach for improving physical capacity and enhancing their quality of life. Materials and Methods: This quasi-experimental study was conducted on 30 individuals with intellectual disabilities (age: 29.96±4.30years; height: 156.84±6.26cm; weight: 60.87±6.72kg; IQ: 64.09±5.47). Participants were selected through convenience sampling and were randomly assigned to either a trampoline exercise group or a ground-based exercise group. The intervention lasted eight weeks and consisted of three 45-minute sessions per week. Respiratory function was assessed using spirometry. Data were analyzed using repeated-measures analysis of variance, with statistical significance set at p ≤ 0.05. Results: After eight weeks, both groups showed significant improvements in Forced Expiratory Volume in One second (FEV1), Forced Vital Capacity (FVC), and the FEV1/FVC ratio (p ≤ 0.05); however, the improvements were significantly greater in the trampoline group compared to the ground group. Conclusion: Dynamic neuromuscular stabilization exercises, whether performed on a trampoline or on the ground, led to significant improvements in respiratory function, although the magnitude of the effects differed between groups. Trampoline based DNS training appears to be a promising method for improving respiratory function in individuals with intellectual disability; however, confirmation requires further studies with larger sample sizes and follow up periods. Keywords: Intellectual disability, respiratory function, dynamic neuromuscular stabilization (DNS), trampoline. https://medrehab.sbmu.ac.ir/article_1101891.html Background and Aims: Shoulder impingement syndrome is a common cause of shoulder pain and upper extremity dysfunction. Although exercise therapy is widely used in the management of this condition, evidence regarding the comparative effectiveness of different exercise approaches remains limited. This study aimed to compare the effects of six weeks of stretching and resistance exercises with scapular stabilization exercises on pain and upper extremity function in patients with shoulder impingement syndrome. Materials and Methods: This study was a quasi-experimental investigation with a pretest–posttest design and a control group. A total of 45 patients with shoulder impingement syndrome were selected purposively following confirmation of diagnosis by an orthopedic specialist and positive results on the Neer, Hawkins–Kennedy, and Empty Can tests. Participants were randomly assigned into three groups of 15 subjects each: stretching and resistance exercises, scapular stabilization exercises, and control. The intervention programs were performed for six weeks, three sessions per week, with each session lasting 45–60 minutes. Pain intensity was assessed using the Visual Analog Scale (VAS), and upper extremity function was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Data were analyzed using one-way analysis of variance and post hoc tests (p≤0.05). Results: Results showed that the reduction in pain and improvement in upper extremity function in the scapular stabilization exercise group were significantly greater compared to the stretching–resistance group (P=0.002) and the control group (P=0.001). In addition, the stretching–resistance group showed greater reductions in pain and improvements in upper extremity function compared to the control group (P=0.001). Conclusion: It appears that both exercise approaches are effective in improving symptoms in patients with shoulder impingement syndrome; however, scapular stabilization exercises may provide greater benefits, possibly due to their enhanced effects on neuromuscular control and functional shoulder stability. https://medrehab.sbmu.ac.ir/article_1101892.html Background and Objectives: Genu varum (GV) is a serious musculoskeletal impairment that has become increasingly prevalent among young populations as well as individuals with knee osteoarthritis (KOA). This deformity alters the kinetic chain, thereby increasing the mechanical loading on the medial compartment of the knee. The objective of this narrative review was to critically analyze the biomechanical evidence regarding the effects of medial and lateral wedge insoles on the knee adduction moment (KAM) and frontal alignment of the lower limb in individuals with GV deformity. Methodology: A comprehensive search was conducted across PubMed, ScienceDirect, Scopus, and Web of Science databases without any timeframe restrictions, utilizing a combination of keywords: Orthopedic insole (“Foot Orthoses” OR “Orthoses, Foot” OR “Foot Orthosis” OR “Orthosis, Foot”); Genu Varum (“Bow Leg” OR “Bow Legs” OR “Genu Varum” OR “Knee Varus”); and Biomechanics (“Kinematics” OR “Kinetics” OR “Knee Adduction Moment” OR “KAM”). Studies evaluating the effects of insoles on the kinematic and kinetic parameters of individuals with GV were included, while case reports, conference proceedings, and book chapters were excluded. A total of 10 studies meeting the inclusion criteria were analyzed. Results: Evidence indicated that lateral wedge insoles may reduce the knee adduction moment by shifting the center of pressure laterally; however, the efficacy of these insoles decreases in cases of severe GV deformity and in patients with concomitant KOA. Conversely, combining insoles with corrective braces appears to yield greater positive effects on restoring mechanical loading. Conclusion: In conclusion, wedge insoles may be effective in managing mild-to-moderate structural genu varum; however, in severe conditions or when accompanied by KOA, the closed kinetic chain appears to require a larger corrective moment, which can be achieved through the simultaneous application of both insoles and braces. https://medrehab.sbmu.ac.ir/article_1101893.html Background and Aims: Exercise and antioxidant supplementation may effectively mitigate the inflammatory complications associated with obesity. This study aimed to investigate the effects of eight weeks of high-intensity interval training (HIIT) and resveratrol supplementation on serum levels of adiponectin, lipocalin-2, interleukin-10 (IL-10), and C-reactive protein (CRP) in inactive, obese, middle-aged women. Materials and Methods: Forty inactive, obese, middle-aged women (BMI 30–40 kg/m²; no regular exercise in the previous six months) were recruited and randomly assigned to four equal groups (n=10 each): exercise (HIIT), supplement + exercise (HIIT+RES), supplement (RES), and control. The HIIT groups followed an interval training protocol three times weekly for eight weeks. The supplement groups consumed 250 mg of resveratrol daily on an empty stomach. Data were analyzed using repeated measures ANOVA and Bonferroni post-hoc tests, with significance set at P≤0.05. Results: Post-test results showed that serum levels of adiponectin and IL-10 significantly increased in the HIIT (p<0.001), HIIT+RES (p<0.001), and RES (p=0.041 and p<0.001, respectively) groups compared to pre-test values. Serum lipocalin-2 and CRP significantly decreased in the HIIT (p<0.001) and HIIT+RES (p<0.001) groups; however, in the RES group, only CRP showed a significant decrease (p=0.029). Post-test adiponectin and IL-10 levels were significantly higher in the HIIT and HIIT+RES groups compared to the control (p<0.001), and in the HIIT+RES group compared to the RES group (p<0.001). No significant differences were observed between the HIIT+RES and HIIT-only groups (p=0.167 and p=0.245, respectively). Furthermore, post-test lipocalin-2 and CRP levels were significantly lower in the HIIT+RES and RES groups compared to the control (p<0.001 and p=0.041, respectively), and lower in the HIIT+RES group compared to both the HIIT (p<0.001, p=0.017) and RES (p<0.001, p=0.020) groups. Conclusion: HIIT significantly improved the anti-inflammatory profile by increasing adiponectin and IL-10 and decreasing CRP. While 250 mg of resveratrol significantly reduced CRP, it had no significant effect on other markers, likely due to the relatively low dosage administered. https://medrehab.sbmu.ac.ir/article_1101894.html Background and Aims: Age-related hearing loss, by impairing communication skills, can accelerate the onset of cognitive problems in the elderly. This study aimed to investigate the link between hearing loss and cognitive decline and to evaluate the role of rehabilitation interventions in this area. Materials and Methods: In this review, articles published in PubMed, Web of Science, and Scopus databases between 2000 and 2026 were searched and reviewed using relevant keywords. Results: The findings show that the consequences of hearing loss in the elderly go beyond reduced sound perception and also affect various aspects of life, including social relationships, self-esteem, and motor skills, and are an independent risk factor for developing cognitive disorders. Also, timely rehabilitation of hearing loss and the use of hearing aids can significantly reduce the risk of cognitive problems. Conclusion: The study of neural mechanisms shows that hearing loss plays a direct role in the occurrence and progression of cognitive impairments in old age by causing structural changes in the brain and increasing processing load. Therefore, early diagnosis, intervention, and rehabilitation are essential to maintain brain function and reduce the socio-economic burden of dementia in the elderly.