Journal of Modern Rehabilitation

The Impact of Tinnitus on Mental Health

Bashar Ali Naji — 2025-09-28

Introduction: Tinnitus—the perception of sound in the absence of an external stimulus— affects approximately 14.4% of adults worldwide and significantly impacts mental health. It is frequently associated with anxiety, depression, and cognitive dysfunction, leading to a reduced quality of life (QoL). Tinnitus may be classified as subjective or objective, with severity and related psychological distress varying considerably among individuals.

Materials and Methods: A comprehensive review of literature published between 2010 and 2024 was conducted using databases including PubMed, Scopus, Web of Science, and Google Scholar. Keywords related to tinnitus and mental health (e.g. anxiety, depression, mood disorders) were used to identify human studies examining the psychological impact of tinnitus.

Results: Research consistently indicates that individuals with tinnitus experience varying prevalence rates of anxiety and depression, ranging from 18.5% to 48.33% for anxiety and from 6% to 84% for depression. Shared neural circuits—including the anterior cingulate cortex, insula, and amygdala—are implicated in both tinnitus and mental health conditions. Psychological interventions such as cognitive behavioral therapy (CBT) and mindfulness- based interventions (MBIs) have demonstrated effectiveness in alleviating tinnitus-related distress and enhancing mental well-being.

Conclusion: Tinnitus significantly affects mental health, contributing to anxiety, depression, and sleep disturbances. A multidisciplinary treatment approach that addresses both auditory and psychological dimensions of tinnitus is essential for effective management. Further research is warranted to refine therapeutic strategies and better understand the complex relationship between tinnitus and mental health.

Effectiveness of Psychophysical Visual Stimuli-Based Interventions in Amblyopia Treatment: A Systematic Review

Ebrahim Jafarzadehpur — 2025-09-28

Introduction: Active vision therapy, integrating perceptual learning with dichoptic or binocular environments, has shown potential effectiveness in treating amblyopia. However, uncertainties remain regarding the optimal types of stimuli and the best approaches and sequences for their delivery. This systematic review aimed to evaluate the effectiveness of psychophysical visual-stimuli-based interventions, particularly perceptual learning and dichoptic training, in treating amblyopia.

Materials and Methods: A comprehensive literature search across major databases, such as PubMed and Google Scholar, yielded 26 studies involving 993 patients with amblyopia. These studies investigated various visual training methods, including perceptual learning, dichoptic stimulation, and combinations of both, using stimuli, such as Gabor patches, letter optotypes, Vernier stimuli, and random-dot stereograms.

Results: The findings indicate that perceptual learning enhances visual acuity, contrast sensitivity, and stereopsis by leveraging neural plasticity, even in adult patients. Dichoptic training, which engages both eyes simultaneously, shows promise in reducing suppression and improving binocular integration, offering potential advantages over traditional patching therapy. Gabor patches emerged as particularly effective, stimulating the visual cortex to drive neural efficiency.

Conclusion: Vision therapy is an effective strategy for treating amblyopia and may reduce overall treatment time when used in conjunction with patching. In addition, it is crucial to tailor stimuli to match the individual characteristics of each patient during monocular and binocular training.

The Effect of Sign Language on the Language Development of Deaf and Hard-of-Hearing Children: A Systematic Review

Farnoush Jarollahi — 2025-09-28

Introduction: To systematically review and evaluate the evidence regarding the effect of sign language on language development in deaf and hard-of-hearing children.

Materials and Methods: A comprehensive search of electronic databases, including PubMed/ MEDLINE, Web of Science, Scopus, EMBASE, Google Scholar, and ProQuest, from 1995 to April 2024, with no language restrictions, was conducted. Two authors independently assessed the risk of bias using the Newcastle-Ottawa scale (NOS).

Results: Six studies involving 259 participants found that exposure to sign language benefits language development in deaf children using hearing aids or cochlear implants (CIs). Children exposed to sign language showed similar or even better spoken language skills than those with limited exposure to sign language. Encouraging parents to learn sign language can significantly support deaf children’s communication and language development.

Conclusion: Deaf children with CIs benefit most from communication approaches tailored to their needs. Early intervention, parental involvement, and a rich language environment (signed or spoken) are crucial. While sign language exposure shows promise, further research is needed, especially on its long-term effects and use by hearing parents.

The Effectiveness of Plyometric Training and Aquatic Training on Patellar Tendinopathy among University- Level Volleyball Players

Divyashree Magendran — 2025-09-28

Introduction: Patellar tendinopathy (PT) is a prevalent overuse injury among volleyball players, primarily due to repetitive jumping, landing, and sudden directional changes required in the sport. Plyometric training enhances tendon strength and neuromuscular coordination; however, it involves high-impact movements that may exacerbate symptoms. Aquatic training offers a low-impact alternative, using water’s buoyancy to reduce stress while enhancing strength and flexibility. This study aimed to evaluate the effectiveness of these interventions in reducing pain and improving the function of volleyball players with PT.

Materials and Methods: Volleyball players aged 18–24 years who had been diagnosed with PT were recruited. Thirty university-level volleyball players were randomly assigned to two groups: Group A (plyometric training; n=15) and group B (aquatic training; n=15). All players underwent pre-test measurements using the numeric pain rating scale (NPRS) and the Victorian Institute of Sport Assessment-Patellar (VISA-P) score. Post-test measurements were taken at the end of the sixth week.

Results: Comparing pre-test and post-test values of the NPRS and VISA-P between the groups revealed significant differences. Group B showed better outcomes, with a mean NPRS value of 1.73±0.703 compared to group A’s 3.13±0.743 (P≤0.05, effect size d=1.93). Similarly, group B’s mean VISA-P score (65.80±5.37) was higher than group A’s (58.73±5.29) (P≤0.05, effect size d=1.32). These results indicate that aquatic training was more effective than plyometric training.

Conclusion: This study demonstrates that aquatic training is more effective than plyometric training in managing PT in university-level volleyball players, showing significant improvements in symptoms.

Integrating the Effects of the Franklin Method with Pelvic Floor Muscle Training in Women with Pelvic Organ Prolapse

Keerthana Ravi — 2025-09-28

Introduction: Pelvic organ prolapse (POP), defined as the descent of pelvic organs from their anatomical position, significantly affects women’s quality of life. Although traditional pelvic floor muscle training (PFMT) offers benefits, adherence to and proper execution of the technique remain challenging. The Franklin method is designed to enhance body awareness and neuromuscular control. This study aimed to evaluate the effects of combining Franklin method with PFMT in women with POP.

Materials and Methods: The participants included women aged 45–55 years with POP stages 1–2, no neurological impairments, and no active urogynecological disorders. The exclusion criteria included uncontrolled systemic illness, a history of malignancy, active infections (e.g. pelvic inflammatory disease), ongoing hormonal therapy, cognitive barriers to questionnaire completion, or recent pelvic surgery (within the past 4 weeks). All 120 participants underwent 6 weeks of the Franklin method and PFMT. Outcomes were assessed using the prolapse quality of life (P-QoL) questionnaire and the international consultation on incontinence questionnaire female lower urinary tract symptoms (ICIQ-FLUTS) Tamil, measured pre- and post-intervention.

Results: P-QoL scores improved from 56.74 (pre-test) to 47.06 (post-test). International consultation on ICIQ-FLUTS Tamil scores decreased from 36.09 to 20.22. Both quality of life and incontinence symptoms showed statistically significant improvement (P≤0.001) post- intervention.

Reliability and Validity of the Lower Extremity Motor Activity Log in Persian People with Ankle Sprain

Amir Seyed Ahmadi — 2025-09-28

Introduction: Ankle sprains are among the most common injuries that affect functional mobility, lower extremity function, and health status. Access to a reliable measurement tool to assess diverse real-world lower extremity use in patients with ankle sprains is essential. Researchers have developed several measures to determine rehabilitation goals and assess the effects of therapeutic interventions. This study aimed to translate the original English lower extremity motor activity log (LE-MAL) into Persian and investigate the psychometric properties of the Persian version.

Materials and Methods: The LE-MAL was translated into Persian and adapted to Persian culture. A total of 140 patients with ankle sprains completed the Persian LE-MAL, lower extremity functional scale (LEFS), and life space questionnaire (LSQ). The Persian LE-MAL was re-completed by participants with an interval of two weeks, and internal consistency, test re-test reliability, and construct validity were assessed.

Results: The Persian LE-MAL exhibited good internal consistency (Cronbach’s α=0.95) and test re-test reliability (intraclass correlation coefficient [ICC]=0.76). The construct validity of the Persian LE-MAL was demonstrated to be acceptable, as a result of its significantly strong correlations with the LEFS and LSQ (0.74< r <0.77). The standard error of measurement was less than 10% of the total instrument score (standard error of measurement [SEM]=0.43), and the minimal detectable change was 1.2. No ceiling or floor effects were observed.

Conclusion: The Persian version of the LE-MAL is a valid and reliable measure to assess lower extremity function in individuals with ankle sprains.

Correlation of Brain-Derived Neurotrophic Factor and Fugl-Meyer Score Changes after Telerehabilitation in Stroke

Husnul Mubarak — 2025-09-28

Introduction: Early post-stroke rehabilitation reduces disability and improves quality of life. However, limited access to rehabilitation facilities presents a significant challenge. Home-based telerehabilitation has emerged as a viable solution to reach distant stroke populations. Motor recovery relies on penumbral reorganization and restructuring. Brain-derived neurotrophic factor (BDNF) plays a crucial role in regulating synaptic plasticity. However, the impact of additional rehabilitation sessions on BDNF levels and motor function in post-stroke patients remains unexplored.

Materials and Methods: A randomized controlled trial was conducted from June to September 2023, involving 50 patients with stroke. A medical history was assessed using a questionnaire, and motor function was evaluated using the Fugl-Meyer assessment (FMA). Blood samples were collected to measure BDNF levels. The intervention included prescribing home-based exercises using a telerehabilitation application on cell phones for 12 weeks. BDNF levels and FMA scores were reassessed at the end of the study.

Results: Significant increases in BDNF and FMA scores were observed in the mobile-based telerehabilitation group. The increase in BDNF and FMA levels in the intervention group exceeded that of the control group.

Conclusion: Mobile-based telerehabilitation is superior to conventional home exercise programs for delivering home-based therapeutic exercises

Effects of Exercise-Induced Fatigue on Attention Networks in Active and Inactive Individuals: A Pilot Study

Maryam Kayvani1 — 2025-09-28

Introduction: Previous research has shown that neural mechanisms contribute to muscle fatigue by reducing neural drive to the muscles. This pilot study aimed to investigate whether exercise-induced fatigue influences cognitive functions, particularly attentional control (i.e. alerting, orienting, and executive function [(EF)]), and to determine whether these effects differ between physically active and inactive individuals.

Materials and Methods: Twenty-four participants were categorized into two subgroups: Active and inactive. Fatigue was induced by performing submaximal aerobic endurance exercise until exhaustion was reached.

Results: Fatiguing exercise improved alertness in both groups. Orientation performance declined in the inactive group but remained unchanged in the active group. EF improved in the active group but showed increased error rates in the inactive group.

Conclusion: The effects of exercise-induced fatigue on attentional networks appear to depend on the physical activity level and specific attention component assessed.

Effects of Hamstring Flossing on Balance and Foot Function in Female Patients with Plantar Fasciopathy: A Randomized Controlled Study

Eman Ahmed Ahmed — 2025-09-28

Introduction: A relationship between hamstring tightness and plantar fasciopathy (PF) has been reported. Hamstring flossing has been reported to improve hamstring flexibility; however, its effects on balance and foot function in patients with PF have not been investigated. This study aimed to compare the efficacy of a conventional physical therapy treatment protocol combined with hamstring flossing versus a conventional physical therapy treatment protocol alone on balance and foot function in patients with PF.

Materials and Methods: Thirty patients with PF were randomly assigned to two groups: The study group (A) received hamstring flossing in addition to the conventional physical therapy treatment protocol, whereas patients in the control group (B) received only the conventional physical therapy treatment protocol. Foot function was evaluated using the foot function index (FFI), and the Biodex balance system (BBS) was used to assess the overall stability index (OSI). Outcomes were evaluated at baseline and three weeks after the intervention. The groups were compared using a two-way mixed-design multivariate analysis of variance (MANOVA).

Results: The post-test mean values of the FFI score and OSI were significantly higher than the pre-test values in both the flossing and control groups (P=0.001). No significant intergroup differences were observed for either variable post-treatment (P>0.05).

Conclusion: The combination of conventional treatment for PF and hamstring flossing provided no additive benefit compared to conventional treatment alone in patients with PF.

Logistic Regression Analysis of Functional Constipation Factors in the Elderly

Zeinab Shiravi — 2025-09-28

Introduction: Machine learning software programs are of great interest in medical sciences for their diagnostic and therapeutic applications. Elderly individuals can greatly benefit from these technologies due to their physical limitations. This study aimed to develop and evaluate a supervised machine learning model for predicting functional constipation (FC) in older adults.

Materials and Methods: Specific software was developed in Excel as a logistic regression supervised machine learning model (LR-SML 402). This software was developed based on a secondary analysis of existing data, including articles and doctoral dissertations on elderly individuals with FC who underwent colorectal evaluations using advanced laboratory equipment. The correlation between labeled data and colorectal parameter outputs was measured using 480 datasets from published sources and research laboratories. Strong correlations were observed between variables, such as age, body mass index, Wexner’s questionnaire scores, and FC parameters.

Results: To validate the performance of LR-SML 402, the results were compared with those of a neural network model using SPSS software. The Excel-based model demonstrated strong performance in terms of sensitivity, specificity, and area under the curve.

Conclusion: The LR-SML 402 model shows that supervised machine learning using logistic regression may yield meaningful clinical predictions of FC indicators in the elderly. This approach can reduce diagnostic time and cost.