Introduction: Lateral elbow tendinopathy is not merely a localized elbow condition and is often associated with proximal movement impairments, such as scapular dyskinesis, which may contribute to persistent pain and functional limitations in racket-sport athletes. This study aimed to compare the effects of scapular stabilization and elbow strengthening exercises on pain, disability, and functional performance in racket-sport athletes with lateral elbow tendinopathy accompanied by scapular dyskinesis. Materials and Methods: In this single-blind randomized controlled trial with a pret-est–post- test control group design, 49 racket sport athletes aged 18–25 years and diagnosed with lateral elbow tendinopathy and scapular dyskinesis were randomly assigned to elbow strengthening exercises, combined training (elbow strengthening plus scapular stabilization), or a control group. Interventions were conducted over eight weeks, three sessions per week. Outcome measures included pain intensity, upper-limb disability, muscle strength, dynamic balance (YBT), upper-limb power, and functional movement performance. Results: Both intervention groups showed reductions in pain and disability and improvements in functional performance, with greater and clinically meaningful improvements observed in the combined training group. Conclusion: Incorporating scapular stabilization exercises into elbow strengthening programs leads to superior clinical and functional outcomes and supports a kinetic chain–based rehabilitation approach for racket sport athletes with lateral elbow tendinopathy.
Introduction: Islamic prayer has several components that enhance physical and mental health. This study aimed to evaluate the impact of prayer on balance control. Materials and Methods: Thirty healthy elderly men were divided into two groups in the study: One group (n=15) consisted of people who regularly prayed (WP). Another group (n=15) who did not pray (WOP) was matched on various factors with the praying group, such as demographics, lifestyle, physical and psychological abilities, cognitive abilities, and heart rate variability (HRV) indices. Biodex recorded the balance indexes under simple and dual- task conditions. Mann-Whitney and Pearson chi-square tests were used for non-parametric analyses, while t-test and analysis of covariance (ANCOVA) were used for parametric analyses and to balance variables. The tests were conducted from 9:00 to 13:00. Results: ANCOVA showed that the overall, Ant-Post, and Med-Lat balance index values in simple and dual-task conditions were significantly lower in the WP group than in the WOP group (P<0.05). Age was considered a covariate. Other variables that influence balance control, such as demographics, lifestyle, psychological and physical health, cognitive abilities, and changes in HRV during tests, did not differ significantly between the groups. Conclusion: Islamic prayer is associated with improved balance control in elderly men, independent of other effective factors. It can be used as a physiotherapy intervention for the elderly.
Introduction: Hearing and balance are vital body functions that allow communication with our surroundings and effective participation in everyday activities. Various factors, including vitamins, influence these two functions. This study aimed to examine the role of vitamins in hearing and balance and the effects of deficiencies in these nutrients on ear and balance health. Materials and Methods: This review examined the effects of vitamins on hearing. We identified 71 studies published since 2000 through searches of Medline (PubMed), Google Scholar, ScienceDirect, EBSCO, ASHA, Thieme, and ProQuest. Results: Evidence suggests that Vitamins A, B, C, D, and E are associated with auditory and vestibular health. Vitamin deficiencies have been linked to hearing loss, tinnitus, dizziness, and impaired inner ear function. In particular, vitamins A and E support hair cell integrity and protect against oxidative stress, while vitamins B and C contribute to neural function. Vitamin D is also important for vestibular health through its role in calcium regulation. Conclusion: Ensuring adequate intake of these vitamins through diet or supplementation may help prevent hearing and balance disorders and improve quality of life
Introduction: Cardiac rehabilitation (CR) is a cornerstone of secondary prevention following coronary revascularization; however, its utilization remains suboptimal in underserved regions. This study aimed to evaluate referral, participation, and completion rates of CR and their associated factors in Birjand, Iran. Materials and Methods: This retrospective cohort study included 758 consecutive patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) between April 2022 and May 2023. Data on demographics, insurance status, education level, and physician CR familiarity were collected using a structured checklist and phone follow-up. The CR program was defined as 36 supervised sessions. Multivariate logistic regression models were used to identify factors associated with referral, participation, and completion. All reported odds ratios were derived from fully adjusted models. Results: Among 749 eligible patients, 19(26.3%) were referred to CR, 103(52.3% of referred) participated, and 69(67.0% of participants) completed the program. Multivariate analysis showed that higher education was the strongest predictor of referral (odds ratio [OR]=9.50, 95% confidence interval [CI], 4.9%, 18.27%, P<0.001), followed by male gender (OR=2.12, 95% CI, 1%, 4.49%, P=0.005). Furthermore, physicians familiar with CR had approximately a 3-fold higher referral rate compared to less-familiar colleagues. Insurance coverage was significantly associated with program completion (78% of insured vs 59% of uninsured completers; P=0.018). Conclusion: Referral is the main systemic barrier to CR utilization in this underprivileged region. Participation and completion among referred patients reflect a selected group with adequate access, highlighting the need for system level interventions focused on physician referral practices—particularly for women and less educated patients—and improved insurance coverage to enhance equitable access to CR.
Understanding how spectacle lens coating-types are distributed across retail channels is essential for anticipating demand and guiding inventory and service planning. In Iran, optical retail operates through distinct socioeconomic and purchasing channels, including high-income area stores, low-income area stores, and online shops, each associated with different levels of affordability and product assortment. This editorial summarizes coating- type selection patterns across these segments and interprets observed time trends and 10year logarithmic forecasts to outline plausible market evolution. Data from 4,615 ophthalmic lenses were analyzed, comprising 2,521 lenses from high-income area stores, 1,674 from low-income area stores, and 420 from online shops. Antireflex coatings constituted the dominant baseline option in physical retail settings, whereas Blue Cut lenses occupied a broadly accessible mid- tier position across income groups. In contrast, Blue Control lenses, representing a premium blue light filtering option, were minimally represented in low-income retail but accounted for nearly half of online sales, reflecting a strong afford ability and channel-specific gradient. Photochromic lenses formed a smaller but persistent share across all segments. Hard coating (CR-39) was observed exclusively in low-income stores, consistent with budget-constrained purchasing. Timetrend analysis and 10year forecasts suggest that premium feature growth will remain concentrated in affluent retail environments and the online channel, while low-income stores are likely to continue transitioning away from the lowest quality lens options. The pace of this transition is expected to depend on supply chain stability, inventory capability, and the availability of affordable mid-tier alternatives. Overall, coating-type selection in Iranian optical retail reflects durable socioeconomic segmentation, with implications for demand forecasting, inventory management, and service planning over the coming decade.
Introduction: Learning disabilities (LDs) are among the most common developmental and educational challenges faced by school-age children worldwide. This systematic review and meta-analysis aimed to provide a pooled estimate of the prevalence of all types of LDs in elementary school students in Iran. Materials and Methods: A comprehensive systematic search was performed in international and national databases, including PubMed, Scopus, Web of Science, Google Scholar, Magiran, and SID, from January 1990 to March 2025. The quality of the articles was evaluated using the Joanna briggs institute (JBI). All analyses in this study were performed using the comprehensive meta-analysis (CMA) software, version 3.0. Results: A total of 32 studies, comprising 81363 students, were included. The pooled prevalence of LDs among elementary school children in Iran was 5.6% (boys, 6.4%; girls, 5%). The prevalence of LDs in first-, second-, third-, fourth-, fifth-, and sixth-grade students was 9.5%, 6.9%, 6.2%, 5.2%, 4.5%, and 3.1%, respectively. The pooled prevalence of dyslexia, dyscalculia, and dysgraphia was 5.4%, 4.3%, and 3.4%, respectively. Conclusion: This systematic review and meta-analysis reveal that at least one in 20 Iranian students has a learning disability, and this rate rises to one in ten in early grades.
Introduction: Ankle sprains are common in competitive sports, especially football, accounting for approximately 15–17% of collegiate athletic injuries. Lateral ankle sprains (LAS) occur frequently due to rapid directional changes, jumping, and intense landings. Plyometric training, involving explosive and dynamic movements, is gaining attention for its role in rehabilitation and injury prevention. This study aimed to evaluate the effectiveness of plyometric training on balance and foot function among collegiate football players with LAS. Materials and Methods: Collegiate football players with LAS completed a four-week plyometric training program consisting of three 30-minute sessions per week that included Pogo hops, lateral jumps, forward jumps, and single-leg split squats. The values of the star excursion balance test (SEBT) and foot function index (FFI) scores pre- and post-intervention were compared using a paired-samples t-test with significance set at P<0.05. Results: The study showed significant improvements in SEBT scores in the right (anterior: 83.5±6.2% to 87.6±5.9%, P<0.001) and left limbs (anterior: 82.9±6.4% to 87±6.1%, P<0.001), with similar gains in the posteromedial and posterolateral directions. FFI total scores also improved significantly (23.4±6.8 to 15.9±5.7, t=8.62, P<0.001), indicating better balance and foot function. Conclusion: Plyometric training is typically effective at enhancing balance and foot function in collegiate football players recovering from LAS.
Introduction: Stroke is a leading cause of adult disability. Spasticity is a neurological condition that occurs secondary to stroke and affects the patient’s quality of life. This study aimed to compare the effects of reactive and proactive exercises on spasticity in people with stroke. Materials and Methods: In this single-blind clinical trial, 30 individuals with stroke were randomly divided into three groups: Control, reactive, and proactive, of which 27 patients completed the study. These individuals were treated for 12 sessions for 4 weeks (three times a week). The control group received conventional exercises, the reactive group received conventional exercises plus reactive exercises, and the proactive group received conventional exercises plus proactive exercises. The outcomes were clinical measures of spasticity at baseline and neural properties, evaluated using the Modified Modified Ashworth Scale and H-reflex latency and Hmax/Mmax ratio. All statistical analyses were performed using SPSS software, version 20. Results: No significant differences were observed between the groups in H-reflex latency (F=0.404, P=0.672, ηp²=0.033) and Hmax/Mmax ratio (F=0.878, P=0.429, ηp²=0.071). Conclusion: Intergroup comparisons did not show a significant advantage of proactive and reactive exercises over conventional exercises alone in improving neural properties of spasticity.
Duane retraction syndrome (DRS) is a congenital ocular motility disorder characterized by dysinnervation of the lateral rectus muscle, limited horizontal movement, and globe retraction with palpebral fissure narrowing on adduction. Many affected children adopt Naseri M. Non-surgical management of AHP. JMR. 2026; 20(3):234-238. (AHP) to maintain binocular single vision and avoid diplopia. When such postures appear early in life and persist through the years of rapid craniofacial growth, they may predispose the patient to facial asymmetry and musculoskeletal imbalance. Surgical correction can improve alignment and reduce AHP in selected cases but is often deferred in very young children or when primary position deviation is small. This short communication summarizes the patterns of AHP in the main clinical types of DRS, reviews key elements of non-surgical management (including amblyopia therapy, refractive correction, simple positioning strategies, and use of the patch test), and highlights the importance of early recognition and intervention to reduce the risk of permanent craniofacial changes.
Introduction: Post-prostatectomy stress urinary incontinence (PPSUI) is a common complication of radical prostatectomy. This study aimed to compare the efficacy of integrative physical therapy (IPT) and supervised pelvic floor muscle training (PFMT) in managing PPSUI. Materials and Methods: Sixty-six men aged 50–80 years with PPSUI were randomly assigned to IPT, PFMT, or control groups. The IPT program included electrotherapy, manual therapy, diaphragmatic breathing, and PFMT. The PFMT group received supervised PFMT. The control group received a sham form of electrotherapy. All interventions were delivered in 12 sessions over four weeks. Outcome measures included voided volume, fluid intake, micturition frequency, incontinence frequency, and health-related quality of life (QoL), assessed using the 12-item short-form (SF-12) questionnaire. Results: Both IPT and PFMT significantly reduced micturition and incontinence frequency and improved SF-12 scores compared with the control group (P<0.001). The control group showed no significant improvements across any outcome measures. IPT demonstrated superior improvements relative to PFMT in micturition frequency, incontinence frequency, and SF-12 scores (P<0.05). Conclusion: IPT and PFMT are effective for PPSUI, with IPT showing greater overall efficacy.
Introduction: Parkinson’s disease (PD) affects not only motor function but also cognition and language, including narrative discourse, which relies on linguistic processes and higher- order cognitive functions, such as working memory and executive functions. Therefore, this study aimed to investigate the relationship between narrative discourse features and cognitive functions in Persian-speaking patients with PD. Materials and Methods: In this cross-sectional study, 26 patients with PD and 26 age-, sex- , and education-matched healthy controls participated. Cognitive performance was assessed using the Persian Montreal cognitive assessment (MoCA-P), digit span, Stroop, verbal fluency, and the Persian cognitive reserve index (CRIq). Narrative discourse was evaluated using the Persian narrative discourse test. Data were analyzed using the Mann-Whitney test and Spearman correlation. Results: In patients with PD, syntactic complexity correlated positively with MoCA-P (P=0.001, rs=0.627), CRIq (P=0.012, rs=0.487), phonological verbal fluency (P=0.032, rs=0.420), and forward digit span (P=0.015, rs=0.472). Lexical cohesion correlated with MoCA-P (P=0.012, rs=0.484) and CRIq (P=0.002, rs=0.573), while conjunctive cohesion was associated with MoCA-P (P=0.022, rs=0.448) and semantic verbal fluency (fruits) (P=0.041, rs=0.404). Conclusion: The results of this study demonstrate that higher levels of global cognition, working memory, verbal fluency, and cognitive reserve are associated with increased syntactic complexity and enhanced lexical and conjunctive cohesion in the narrative discourse of patients with PD. These findings indicate that cognitive decline adversely affects narrative organization and structural integrity.
Introduction: Positive psychology may serve as a protective approach against fatigue and burnout in environments where workers face disability, adversity, and suffering. The present study aimed to determine the effectiveness of positive psychotherapy based on the positive emotion, engagement, relationships, meaning, and accomplishment (PERMA) flourishing model in reducing occupational burnout and compassion fatigue among staff working in rehabilitation centers affiliated with the Welfare Organization—an understudied population whose wellbeing may affect service quality and client outcomes. Materials and Methods: A single-case experimental design was used with five rehabilitation staff members from Yazd Province, Iran. Participants received eight weekly sessions of the PERMA flourishing program. Burnout and compassion fatigue were assessed before, during, and after the intervention, with clinical improvement evaluated using the reliable change index (RCI). Results: The results demonstrated a significant reduction in burnout and compassion fatigue, with an acceptable percentage of improvement and RCI values exceeding 1.96 (P<0.05). For emotional exhaustion, depersonalization, and secondary traumatic stress, RCI values exceeded 2.58 (P<0.01), with improvement percentages ranging from 23–100%, 52–64%, and 24–80%, respectively. For compassion satisfaction, compassion fatigue, and secondary traumatic stress, RCI values ranged from 1.96 to 2.58 (P<0.05), with improvement percentages of 14–48%, 25– 52%, and 23–33%, respectively. These results indicated statistically and clinically meaningful improvements following the PERMA flourishing intervention. Conclusion: Based on these findings, the PERMA flourishing program may be an effective intervention for reducing occupational burnout and compassion fatigue among rehabilitation personnel.
Introduction: Low back pain (LBP) is a musculoskeletal disorder commonly associated with altered gait patterns; however, little information exists on comparative specific spatiotemporal gait parameters in individuals with LBP. This gap is addressed in the present study by comparing the mean values of stride length, step length, and stride time, as well as corresponding measures of hip extension and peak knee flexion angle, using Kinovea software (version 0.9.5). Materials and Methods: This observational study included 200 participants, 100 healthy individuals (group I) and 100 individuals with LBP (group II). The inclusion and exclusion criteria were used to select the study participants. All participants underwent a gait analysis using Kinovea software (version 0.9.5), and gait parameters, including stride length, step time, and hip extension, were also measured. Statistical associations between gait parameters and LBP presence were analyzed. Results: Subjects with LBP showed significant gait alteration with decreased stride length (mean difference [MD] 32.93 cm, P=0.001), decreased step length (18.52 cm, P=0.001), and reduced hip extension (1.88°, P=0.001) with weak to moderate correlation (r=0.214-0.282). These gait impairments were independent of the body composition. Conclusion: This study identifies significant changes in gait patterns between patients with and without LBP, as revealed by Kinovea software (version 0.9.5), characterized by shorter step length, longer temporal duration, and lower hip extension magnitude. These results provide quantifiable differences in gait dynamics due to inter-individual differences observed clinically.
Introduction: Cardiac rehabilitation (CR) is a vital measure aimed at improving the quality of life (QoL) and preventing secondary complications and recurrence in individuals with a high cardiac risk profile. As an alternative to traditional CR, e-rehabilitation (e-rehab) using smartphones or web-based platforms is a modern solution for effective CR. This study aimed to identify its implementation and evaluate its effectiveness on functional capacity, adherence, and QoL. Materials and Methods: A systematic search of randomized controlled trials (RCTs) was conducted in electronic databases, such as Medline, Embase, and Cochrane Central Register of Controlled Trials, between January 2015 and January 2025. The selected studies included e-rehab as an intervention, implemented through a hybrid model, among a heart disease population. A total of 210 studies were identified, of which 13 with higher-quality evidence were selected as appropriate to our scope. Results: CR using the e-rehab protocol improved functional capacity and QoL. Participants’ follow-up rates and interest were noticeably lower in traditional CR compared to e-rehab. Conclusion: Overall, e-rehab-based CR was effective, but when implemented alongside telemonitoring devices, it may reduce the risk of physical activity-induced adverse reactions. Such a model enhances patients’ willingness to enroll in exercise-based CR
Introduction: Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder caused by mutations in the dystrophin gene, leading to progressive muscle weakness. This study aimed to evaluate the efficacy of telerehabilitation in improving pulmonary function in patients with DMD. Materials and Methods: An interventional study was conducted among boys aged 5-12 years with DMD enrolled in the Pediatric Neurology Clinic from September 2023 to February 2024. Telemedicine-based respiratory exercises were explained to patients and their parents every 15 days for a 3-month period, and the patients were encouraged to exercise for at least 5 days a week. Pulmonary function tests (PFTs), including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), were recorded before and after the intervention. Results: A total of 67 children participated in the study. There was significant improvement in FVC (P<0.001, Cohen’s d=1.93) and FEV1 (P<0.001, Cohen’s d=1.06). The FEV1/FVC ratio, a parameter that can be elevated in restrictive diseases, was also significantly decreased (P<0.001, Cohen’s d=-0.63). For a one-unit increase in age, the FVC change after intervention was predicted to decrease significantly by 0.24 units, holding other variables constant. Conclusion: Telemedicine-based pulmonary rehabilitation for 3 months markedly improved pulmonary function, indicating that this intervention is effective in improving pulmonary function in patients with DMD, with greater effectiveness when initiated at an early age.
Introduction: Dynamic temporal and tactile cueing (DTTC) is a treatment method for childhood apraxia of speech (AOS), and its characteristics make it a suitable option for treating patients with AOS. Additionally, no documented treatment protocol has been published in Iran for the treatment of patients with AOS. This study protocol aims to investigate the efficacy of DTTC in the treatment of Persian-speaking patients with acquired AOS, who will be recruited using non-probability, convenience sampling. Materials and Methods: A single-subject study with multiple baseline designs across participants was designed to obtain detailed information about the intervention procedure on at least three participants’ performance, and a perceptual scoring system was introduced to measure the accuracy of treated and untreated words and phrases as a dependent variable. Results: The results of a visual analysis will be provided based for the assessment of participants at three phases of baseline, treatment, and follow-up, and the effect sizes will be reported. Conclusion: This study describes the first research investigating the efficacy of DTTC on the speech of AOS patients and the first treatment protocol for Persian-speaking patients with AOS.
Introduction: Blue-light-blocking filters are crucial for reducing the harmful effects of light emitted by digital screens. Materials and Methods: This narrative review, based on a comprehensive search across databases, including PubMed, Web of Science, Cochrane, Medline, Scopus, Google Scholar, and ScienceDirect, aimed to examine studies published between 2010 and 2024 and evaluate the effects of these filters on eye health, sleep quality, and related functions. Results: The findings indicated that the use of these filters can help reduce visual discomfort and improve physiological parameters, such as circadian rhythm and sleep quality. Moreover, the relationship between blue-light-blocking filters and the reduction of sleep disorders, such as insomnia, anxiety, migraine, photophobia, mania, computer vision syndrome (CVS), and accommodative problems, has been investigated. Their effects on retinal structure and function, potential role in reducing the risk of age-related macular degeneration, and influence on contrast sensitivity, color perception, and motion detection have also been discussed. Some studies suggest that these filters may affect contrast sensitivity; however, further research is required to clarify these effects. These filters may be beneficial for individuals continuously exposed to digital devices. Although these lenses do not significantly impact overall color perception, they may make it difficult to distinguish colors, particularly in the blue spectrum. Conclusion: This study’s narrative review provides a comprehensive overview of the effects of blue-light-blocking filters and emphasizes the need for further research in this area.
Introduction: Back pain remains a prevalent musculoskeletal condition with significant implications for quality of life and long-term spinal health. Conventional rehabilitation approaches often suffer from low patient adherence and limited engagement, highlighting the need for innovative, technology-driven solutions that motivate sustained therapeutic participation. Materials and Methods: A real-time pose detection system was integrated with a Unity- based gaming platform to deliver personalized exercise regimens targeting flexibility, strength, and postural correction. The system incorporated computer vision algorithms for real-time biomechanical analysis and immediate performance feedback. Three therapeutic exercises were evaluated: the knee-to-chest stretch (cross crunches), side bend, and forward and backward bends. Exercise performance was gamified within the Unity engine to enhance user motivation and adherence. Results: The system successfully detected and analysed user performance across all three target exercises in real time. A measurable improvement in user scoring patterns was observed over successive sessions, indicating enhanced engagement and more effective exercise execution. The gamified framework demonstrated reliable performance analysis and responsiveness to individual rehabilitation needs. Conclusion: Integrating real-time pose detection with interactive game-based environments represents a viable and scalable approach to back pain rehabilitation. By transforming therapeutic exercises into engaging gameplay, the proposed system promotes greater adherence to treatment protocols and supports superior long-term spinal health outcomes. The framework's adaptability positions it as a promising tool for individuals with diverse rehabilitation requirements.
Introduction: Tinnitus, defined as the perception of sound without an external source, affects 10% to 24% of adults and can significantly impair quality of life (QoL). Mind-body approaches—including mindfulness-based interventions, yoga, and hypnosis—have been increasingly explored as complementary strategies for tinnitus management, though their efficacy remains under investigation. Materials and Methods: A narrative review was conducted using PubMed, Scopus, Medline, Web of Science, and Google Scholar to identify English-language studies (1995- 2024) on mindfulness, yoga, and hypnosis for tinnitus management. Studies were selected based on predefined inclusion criteria, and the findings were summarized to assess efficacy, mechanisms, and limitations. Results: Mindfulness-based interventions (e.g. mindfulness-based cognitive therapy, mindfulness-based stress reduction) provide moderate evidence for reducing tinnitus distress and improving anxiety and depression, with some studies reporting sustained benefits for up to six months. Although rigorous trials are lacking, yoga has preliminary evidence, with small studies suggesting benefits for stress and tinnitus-related symptoms. Hypnosis studies, often outdated, indicate preliminary benefits for tinnitus severity and psychological symptoms; however, effects are inconsistent and poorly sustained. Negative findings, such as limited impact on tinnitus intensity or anxiety, tend to be underreported. Conclusion: Mindfulness-based interventions show promising clinical efficacy for managing tinnitus, especially the psychological symptoms, whereas yoga and hypnosis necessitate further rigorous trials. Future studies should emphasize head-to-head comparisons, long- term outcomes, integration with existing therapies, such as cognitive behavioral therapy, and inclusion of diverse populations to enhance clinical applicability
