rehabilitation

Background and Aims Children with attention-deficit/hyperactivity disorder (ADHD) are highly vulnerable to visual distractions in therapeutic and home environments, which may reduce the effectiveness of rehabilitation interventions. Eye-tracking technology provides a novel tool to objectively quantify visual attention and identify distracting stimuli. This study aimed to evaluate the feasibility and test–retest reliability of a desktop-based eye-tracking system in detecting distracting visual elements presented in simulated rehabilitation and home environments for children with ADHD.Methods Sixteen children with ADHD aged 8–12 years (10 boys, 6 girls) participated. Each child viewed a high-resolution panoramic image of a therapeutic room and a home setting displayed on a monitor for 8 seconds in two repeated trials separated by a 15-minute interval. Eye-tracking metrics included fixation duration on task-relevant versus distracting stimuli, number of distractor fixations, and heat map distributions. Reliability was assessed using Pearson correlation and intraclass correlation coefficients (ICC).Results Mean fixation duration on task-relevant areas was 4.3±0.5 seconds in Trial 1 and 4.4±0.4 seconds  in Trial 2. The number of distractor fixations averaged 3.0±1.2 in Trial 1 and 3.1±1.1 in Trial 2. Reliability analyses revealed strong consistency: Fixation duration (r= 0.83, ICC=0.81), distractor fixations (r=0.85, ICC=0.84). Heat maps demonstrated nearly identical gaze patterns across trials.Conclusion Eye-tracking technology demonstrated strong feasibility and test–retest reliability for detecting distracting visual stimuli in rehabilitation and home-like environments for children with ADHD. These findings support its application as an objective, repeatable tool for assessing environmental distractors in clinical and home-based rehabilitation contexts.

Chronic schizophrenia is one of the most disabling psychiatric disorders, characterized by positive and negative symptoms, as well as deficits in cognitive insight. Given the limited effectiveness of pharmacological treatments, examining novel psychological interventions is of particular importance. This study aimed to evaluate the effectiveness of recovery-oriented cognitive therapy in reducing positive and negative symptoms and enhancing cognitive insight in patients with chronic schizophrenia.

This semi-experimental study employed a pretest–posttest design with a control group and one-month follow-up. The sample consisted of 30 patients with chronic schizophrenia residing in rehabilitation centers in Ardabil, Iran, who were selected through convenience sampling and randomly assigned to experimental and control groups in equal numbers. The experimental group received eight 60-minute recovery-oriented cognitive therapy sessions over four weeks, while the control group received no intervention. The data were collected using the Positive and Negative Syndrome Scale and the Beck Cognitive Insight Scale.

The results indicated that recovery-oriented cognitive therapy led to a significant reduction in positive symptoms, negative symptoms, and disorganization within the experimental group over time; however, the interaction effect between group and time did not reach statistical significance. Moreover, recovery-oriented cognitive therapy significantly improved cognitive insight, including increased self-reflectiveness and decreased self-certainty. These changes remained stable at the one-month follow-up.

Recovery-oriented cognitive therapy may serve as a complementary approach to partially reducing psychotic symptoms and enhancing cognitive insight in patients with chronic schizophrenia. The relative stability of these effects indicates that the implementation of recovery-oriented cognitive therapy within psychiatric rehabilitation centers may offer meaningful clinical benefits.

 This study investigated how the built environment influences therapeutic outcomes for children with attention-deficit/hyperactivity disorder (ADHD), who often experience sensory processing difficulties, attention deficits, and learning challenges. Environmental distractions and sensory overload can hinder engagement and progress during therapy. To address this, the research proposes using eye-tracking technology as a non-invasive method to measure children’s visual attention and identify design elements, such as lighting, color, clutter, and spatial layout that contribute to distraction, anxiety, or disengagement.

This study employed a mixed-methods design in two phases. In Phase 1, children’s gaze behaviors (fixation duration, saccades, and gaze distribution) will be recorded during therapy to pinpoint distracting environmental features. In phase 2, these environments will be modified to minimize identified distractors, followed by reassessment to measure improvements in focus, engagement, and behavior. Complementary assessments—the short sensory profile 2 (SSP2), conners continuous performance test (CPT-3), and strengths and difficulties questionnaire (SDQ)—will evaluate sensory and behavioral responses before and after environmental redesign.

Expected outcomes include identifying key environmental factors that hinder attention, demonstrating the effectiveness of spatial modifications, and developing a framework for designing therapeutic spaces optimized for children with ADHD. 

The findings aim to bridge clinical rehabilitation and environmental psychology, guiding evidence-based design principles for therapy centers, classrooms, and inclusive learning environments that better support children’s neurological and sensory needs.

Falling and balance disorders are the main causes of injuries in the elderly. Imbalance and the likelihood of falling are important health indicators. This research aimed to perform a systematic review of the effect of a virtual-reality rehabilitation protocol on balance and the risk of falling in the elderly.

Articles were searched in the databases of Jihad Daneshgahi, Magiran, Irandoc, Alamnet, PEDro, Trip PubMed databases, and Google Scholar search engine utilizing different keywords, including elderly, rehabilitation, virtual reality balance exercises, and fall risk in Persian, along with English keywords and fall risk in Persian, virtual-reality rehabilitation exercises in English, and virtual-reality-reality exercises. Additionally, the quality of the selected articles relied on the National Institutes of Health tool.

Based on the inclusion and exclusion criteria, 10 studies were selected from a total of 329 studies to examine the results. The quality of the selected studies, according to the National Institutes of Health tool, indicated that 5 studies were of high quality while 5 studies were of moderate quality. The results showed a statistically significant difference between virtual reality exercises and other rehabilitation protocols regarding balance and fall risk in the elderly.

Virtual reality exercises enhances balance and reduce fall risk in the elderly by strengthening the central nervous system. The elderly appear to show more interested in using virtual reality exercises for enhancing physical activity compared to traditional protocols, prompting physiotherapists and therapists to incorporate these exercises into rehabilitation.

Elderly burn victims face physical limitations that hinder rehabilitation. Technologies like Kinect motion systems have been used to boost patient participation; however little is known about their experiences and perceptions. This study explores elderly burn patients’ experiences with Kinect-based motor rehabilitation.

This qualitative study was conducted in the spring of 2025 using a conventional content analysis approach. Participants were purposively selected from hospitalized older adults with burn injuries admitted to the Burn Unit of Imam Reza Hospital in Mashhad, Iran, all of whom had experience participating in a Kinect‑based technology‑assisted rehabilitation program. Data were collected through semi‑structured interviews. Following transcription, the data were managed in Microsoft Excel (version 2019) and systematically coded and categorized.

Analysis of 18 individual interviews and one focus group discussion yielded 215 initial codes, organized into four main categories and 12 subcategories. The four themes were: "from confusion to adaptation", "enhanced motivation and engagement in the treatment process", "perceived independence and self- efficacy", and "sense of safety and comfort with technology". Findings revealed that while the use of technology in rehabilitation was initially associated with feelings of unfamiliarity and anxiety, adaptation improved over time through increased self- confidence and support from healthcare professionals and family members. Technology enhanced patients’ motivation, active participation, and adherence to rehabilitation exercises, making the process more enjoyable. Additionally, increased independence, improved self- efficacy, and reduced reliance on others emerged as key outcomes. Ultimately, the technology fostered a sense of safety and control, reduced stress and pain during exercises, and improved the overall rehabilitation experience.

Kinect-based rehabilitation can enhance elderly burn victims’ participation, independence, and satisfaction; however, individual and contextual challenges must be addressed for effective use in this population.

COVID-19 is a systemic disease that, in some individuals, leads to post-COVID syndrome (Long COVID)—a chronic condition characterized by symptoms such as fatigue, myalgia, arthralgia, and low back pain. These musculoskeletal manifestations arise from complex pathophysiological mechanisms, including direct infection of muscle and joint cells via ACE2/TMPRSS2 receptors, activation of autoimmune responses (targeting muscle and cartilage), T-lymphocyte dysregulation (reduced Treg and elevated TH17 cells), chronic inflammation driven by cytokines such as IL-6 and TNF-α, mitochondrial dysfunction, microglial activation in the central nervous system, and epigenetic modifications that collectively sustain a state of chronic immune activation.

Studies have consistently demonstrated that musculoskeletal symptoms are highly prevalent among Long COVID patients. In an Iranian study, 99% of patients reported at least one musculoskeletal symptom, and 50% experienced low back pain. Reduced physical activity, obesity, sleep disturbances, and psychological conditions—further exacerbate these symptoms. Conversely, structured rehabilitation programs incorporating guided exercise, respiratory physiotherapy, and strengthening exercises have led to significant improvements in cardiorespiratory function, muscle strength, and overall quality of life.

Musculoskeletal disorders in post-COVID syndrome result from a multifactorial interplay of inflammatory, immunological, and metabolic pathways. Regular exercise, patient education, psychological counseling, and management of comorbid factors (such as obesity and sleep disorders) are integral components of effective patient care.

People with disabilities (PWD) face various barriers to accessing services. Identifying and addressing these obstacles is essential to ensure equitable service use and should be a priority for policymakers. This study synthesizes existing evidence on these challenges in Iran and suggests potential solutions.

The research was conducted in two consecutive phases. In the first phase, a scoping review was conducted using selected keywords to search five English and two Persian databases. One researcher conducted the search, screening, and data extraction according to the inclusion and exlusion criteria. Of 7,985 studies identified, 82 were included in the review, with data analyzed narratively. In the second phase, a stakeholder dialogue session was held with 14 purposively selected informants to complement the review findings. A neutral facilitator managed the two-hour session, during which the findings were presented and discussed. With participants' consent, the session was recorded, notes were taken, and the data were analyzed using qualitative content analysis.

Of the included studies, 71 (86%) were published in English, and 44 (53%) were conducted after 2021. The primary objective of 67 studies was to identify barriers to access and propose solutions. Based on the review findings and stakeholder dialogue, seven main categories of barriers and solutions were identified: individual, cultural, communicational, financial, physical, institutional, and legal barriers.

To improve access to services for PWD, policymakers should prioritize the development of physical and infrastructural facilities, support employment and economic improvement, empower professionals, enhance public awareness, and strengthen legal protections.

Assessment of functional dependency levels in neurological patients plays an important role in nursing care planning and resource allocation in rehabilitation centers. The Barthel Index is a simple tool for measuring daily activities, whereas the Northwick Park Dependency Scale – Hospital Version (NPDS-H), with its multidimensional structure, assesses more complex care needs. The aim of this study was to compare the efficiency, correlation, and agreement between these two instruments in hospitalized neurological patients.

This descriptive–analytical study was conducted in 2025 at Rofaydeh Hospital in Tehran. Forty patients with neurological disorders were selected through convenience sampling. Patient assessments were independently performed by two trained nurses using the Barthel Index and the NPDS-H. The interval between the two assessments was one day. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and the Intraclass Correlation Coefficient (ICC).

A significant inverse correlation was observed between the Barthel Index and NPDS-H scores (r = –0.78, p < 0.001). The mean Barthel score was 29.5 (±15.4), and the mean NPDS-H score was 37.9 (±10.2). The score range for the Barthel Index was 0 to 70, and for the NPDS-H, it was 18 to 58. The inter-rater agreement, based on the ICC, was reported to be above 0.99.

The NPDS-H, with its multidimensional structure and coverage of specialized care needs, provides higher accuracy in assessing functional dependency. The concurrent use of this tool alongside the Barthel Index can enhance nursing decision-making and support person-centered rehabilitation planning.

Tendon rupture is a common musculoskeletal injury characterized by slow and often incomplete healing. This study investigated the effects of daily treadmill exercise initiated after the inflammatory phase on Achilles tendon repair in a rat model.

In this experimental study, twenty-one mature female rats were randomly assigned to three groups: control, tendon injury, and tendon injury + treadmill. The Achilles tendon was surgically transected to induce injury. One week after surgery, the treadmill group performed running exercise at a speed of 10 m/min for 30 minutes per session, five days per week, on a 0 incline for four consecutive weeks. Following the training period, a footprint test was conducted to evaluate functional recovery and gait performance, after which the animals were euthanized for histological and biomechanical analyses.

Treadmill training initiated after the inflammatory phase led to notable improvements in tendon repair. The Achilles Functional Index (AFI) was significantly higher in the treadmill group than in the tendon injury group (P< 0.05). Footprint analysis demonstrated that the tendon injury + treadmill group’s gait profile closely resembled that of the uninjured control group. Histological examination showed disorganized collagen fibers, inflammatory infiltration, and increased cell density in the injury group, whereas the treadmill-trained group displayed more organized collagen alignment, reduced inflammation, and lower cellular density. Biomechanical (tensiometric) testing confirmed superior mechanical strength and recovery in the tendon injury + treadmill group compared with the tendon injury group.

Post-injury treadmill exercise enhances tendon healing and maintains functional integrity, suggesting that controlled aerobic activity initiated after the inflammatory phase may facilitate tissue repair. Further research is warranted to determine the optimal timing, intensity, and duration of exercise for effective clinical translation

Severe pain is a a critical factor in reducing the quality of life of patients suffering from chronic non-specific low back pain. Therefore, the review study aimed to investigate the effect of lumbar-pelvic exercises on pain intensity in the patients with chronic non-specific low back pain.

The present study was a systematic review carried out following the guidelines established by PRISMA. A search for English-language articles limited to the period 2000-2025 was conducted using the scientific databases Web of Science, PubMed, Scopus Since direct, and Google scholar. In addition, a Persian search was performed in the scientific databases of the Scientific Information Database of the Magiran, Irandoc, and Alamnet from April 2011 to March 2024. The extracted articles were screened according to the inclusion and exclusion criteria, and the quality of the selected studies was assessed using the Pedro index.

Following the search and review of the studies, a total of 12 studies were finally selected to examine the results. Out of the 12 selected studies, 8 were rated high quality and 4 moderate quality according to the Pedro index. The selected studies had strengths in the random assignment of participants and the quality of their reporting. Three studies reported that lumbo-pelvic exercises reduced pain intensity more than  strength, stretching, and general physiotherapy exercises. Additionally, combined exercises (lumbopelvic exercises combined with Pilates and lumbopelvic exercises combined with neuromuscular proprioception facilitation exercises) showed a decreased in pain intensity.

In the patients suffering from chronic nonspecific low back pain, pain intensity is a crucial clinical factor in improving rehabilitation. This review study showed that lumbopelvic exercises and combined lumbopelvic exercises effectively reduce pain intensity in the patients with chronic nonspecific low back pain. This protocol is advised for physicians and physiotherapists to rehabilitate patients suffering from chronic nonspecific low back pain.

Despite all the successes of Iran's primary health care (PHC) network over the past decades and despite numerous reform programs, it still faces several challenges. Among these challenges is the lack of effective integration of rehabilitation services, including physiotherapy services, into this network. In response to such conditions, the aim of this study was to find critical policy points to facilitate the integration of physiotherapy services into Iran's PHC network, using a systems thinking approach.

In this study, the findings of the qualitative phase as well as the findings of the review section were used to develop systems thinking maps that represent the actors and their interactions in facilitating the integration of physiotherapy services into PHC. In the qualitative phase, 38 individuals including health policy makers, rehabilitation managers, physiotherapy faculty members, and physiotherapists participated. Also, in the second phase of the study, a review was conducted of all published qualitative studies related to the challenges and facilitators of the integration of physiotherapy services into primary health care around the world.

Various factors play a role in the integration of physiotherapy services into PHC in Iran. The existing relationships between variables as well as the existing dynamics can affect the process of such integration. Based on the output of systems thinking, several macro factors play a role in this process, including the need for policymakers to be aware of physiotherapy services, attracting political support, seeking support from key stakeholders, participation of physiotherapy professionals in policy and decision-making processes, the existence of binding laws, and cross- and inter-sectoral collaborations. However, the existence of such facilitating factors requires the participation of the community, service recipients, and non-governmental organizations in the advocacy processes.

Several strategies can be used to strengthen the integration of these services into primary health care. These strategies include increasing awareness of physiotherapy services among policymakers and decision-makers, involving physiotherapists in policy-making processes, increasing community and non-governmental participation, seeking support from powerful and influential institutions, utilizing tele-rehabilitation, providing comprehensive educational services to physiotherapists, and providing a platform for professional and career development for physiotherapists..

Health is a fundamental human right; however, individuals with spinal cord injuries generally experience poorer health compared to the wider population. The goal of this research was to explain barriers and facilitators of accessing rehabilitation services within the healthcare system for individuals with spinal cord injuries in Iran.

This study was conducted using a qualitative paradigm and conventional content analysis approach. The participants were 14 individuals with spinal cord injuries, their caregivers, and rehabilitation specialists selected through purposive sampling. Sampling was carried out until the point of data saturation being reached. Information was collected and analyzed through individual, in-depth, and semi-structured interviews. Data categorization was performed using MAXQDA 2020 software.

Analyzing the participants' experiences resulted in the discovery of 701 codes. Barriers were classified into 4 main categories: “economic hardships”, “restrictive environment”, “disruption of social and cultural interactions” and “organizational heterogeneity”. Facilitating factors include 2 main categories of “supportive community”, and “reliance on individual abilities”.

According to the research findings, individuals with spinal cord injuries face many barriers in accessing rehabilitation services. Conversely, there are factors at the family, social, and individual levels that facilitate their access. Most participants considered economic hardships and the restrictive environment as the most important barriers to accessing rehabilitation services. All agreed that a supportive society and reliance on individual capabilities have facilitated access to these services. Therefore, it is recommended to carefully formulate and plan to reduce economic bottlenecks, carry out coordinated organizational interventions, and provide the necessary conditions to upgrade the urban environment according to the abilities of individuals with spinal cord injuries.