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Objective: This research has been carried out with the aim of adaptation, standardization and finding the validity and reliability of Visual-Motor Skills-revised Test for children.

Materials & Methods: A multi-stage sampling from the children of the city of Tehran resulted in a sample of 1281 subjects, ages 2,11 through 13,11.the test consisted of 23 geometric designs and each of the designs was assessed through a definite criteria and was scored as errors(weakness) and accuracies(strength).For adaptation and standardization of this test, at first step the examiner`s manual and the test items were translated into Farsi. The final form of the test was obtained after performing the pre-tryout and tryout stages, and doing the data analysis by classic model of reliability. Internal consistency coefficients of the subtests were obtained by Cronbach`s Alpha time consistency of the subtests and compound scores were obtained by test-retest. Alpha coefficients for the compound scores were obtained by Guilford formula, which is designed for estimating the compound scores. To obtain the content validity, criterion-related validity and construct validity of the subtests and compound scores, appropriate methods were used.

Results: The results obtained ensure the applicability of this test for the evaluation of visual-motor skills of children of Tehran.

Conclusion: According to the findings, this test can be used for the disorders in eye-hand coordination, the identification of children with disorders in visual – motor skills. It can also be used for the documentation of the development of fine – motor skills specially in visual – motor skills in 3-14 years – old children.

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Objective: To determine the causes of sever visual impairment and blindness in students in school for the blind in Mashad to aid in planning for the prevention and management of avoidable causes is the aim of this study.

Materials & Methods: In this analytical study in 2006, two hundred sixty (260) students attending in four schools for blinds in Mashad, were examined by using the modified WHO/PBL Eye Examination Record, for children with blindness and low vision protocol. The anatomical abnormality and underlying etiology for each eye were recorded. 

Results: The mean age was 14/2±4/2 years. Hundred fifty seven (54/9%) were males and 129 (45/1%) were females. The major anatomical site of visual loss was retina (28/6%), followed by optic nerve atrophy, congenital cataract, corneal opacity, congenital glaucoma, albinism and whole globe problems. The most common type of eye surgery was cataract. The difference between men and women and the distribution of no light Perception (NLP), was statistically significant (P<0.01).

Conclusion: Genetically determined disorders play an important role in the causation of childhood blindness. Genetic consultation, early eye screening of children and public education may help in prevention of blindness.

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Objective: Visual-motor skill is a part of visual perception which can integrate visual processing skills to fine movements. Visual-motor dysfunction is often to cause problems in copying and writing. The purpose of this study is investigation of occupational therapy interventions effect on the visual-motor skill in children with learning disorders.

Materials & Methods: In this interventional and experimental study, 23 students with learning disorders (2nd, 3rd, 4th grade) were selected and they were divided (through Randomized Block Method) into two groups, 11 persons as intervention group and the others as the control group (12 people). Both groups were administered the “Test of Visual-Motor Skills- Revised” (TVMS-R). Then case group received occupational therapy interventions for 16 sessions and two groups were administered by TVMS-R again. Data was analyzed by using paired T-test and independent T-test.

Results: Total mark of TVMS-R demonstrated statistically significant difference in visual-motor skills between case and control groups (P<0/001). This test has 8 categories. Total mark of 1, 3,4,6,8 categories demonstrated that occupational therapy had significant effect on visual analysis skills (P<0/005). Total mark of 2, 5, 7 categories demonstrated that occupational therapy had significant effect on visual-spatial skills (P<0/001).

Conclusion: Occupational therapy interventions had significant effect on the visual-motor skills and its items (visual-spatial, visual analysis, visual-motor integration and eye fixation skills).

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Objective: The purpose of the present study was to assess the effect of local muscle fatigue induced at proximal and distal segments of lower extremity on sagittal plane mover on visual dependency in quiet standing postural stability.

Materials & Methods: In this Quasi–experimental study (before – after comparison) sagittal plane prime movers of the ankle and hip musculature were fatigued using isokinetic contractions at two test sessions with a randomized order and one week interval. Twenty five healthy young female students were َselected by using non probability selection and sample of convenience and asked to maintain single leg upright posture as immobile as possible. RMS and SD of Center of Pressure displacements were assessed in 30 seconds and consequently, the eyes were closed after 15 seconds. A analysis of variance (ANOVA) for repeated measures was used to analyze the effect of the following factors over two periods of 5 seconds immediately before and after eye closure: (1) fatigue, (2) vision, (3) segment of fatigue.

Results: The main effects of each within-subject factors (fatigue, vision and segment of fatigue) were significant (P<0.05). The analysis of RMS and SD of Center of Pressure demonstrated a significant interaction between fatigue and vision, and fatigue and segment of fatigue so that the effects of Fatigue on Proximal segment and eye closed conditions were increased.

Conclusion: The visual dependency for control of postural stability incremented following muscle fatigue. Proximal muscle fatigue lead to exaggeration of visual dependency for control of postural stability. Based on the present results, emphasis on the proprioception of proximal segment of lower extremity may be recommended for postural stability training.

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Objective: Idiopathic Parkinson is a chronic degenerative nervous system disease that body imbalance is its main characteristic. The aim of this study is evaluation of visual feedback effects on balance in Parkinson disease patients.

Materials & Methods: In this cross sectional and comparative study that was applied as before and after comparison, 16 Parkinson’s patients were selected by random sampling from convenient cases. Balance examinations were done by Biodex balance system in both open and closed eyes conditions. Data were analyzed by use of Paired T test.

Results: There was significant difference between open and closed eyes conditions of Parkinson patients in overall stability index (P=0/004), anterior-posterior balance index (P=0/009), medial-lateral balance index (P=0/002) and time of place on A zone (P<0/001), B zone (P=0/003) and C zone (P=0/001), but there was no significant difference in time of place on D zone (P=0/286) and Parts I (P=0/664), II (P=0/075), III (P=0/135) and IV (P=0/282).

Conclusion: Visual feedback improves balance of Parkinson’s patients in open eyes condition than closed eye condition and this improvement in the indices of overall stability, anterior-posterior balance and medial-lateral balance is obvious absolutly.

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Objective: The purpose of this research was to study the effect of mild and moderate visual and auditory impairment on activities of daily living (ADL) and Balance in the elderly people.
Materials & Methods: In this analytical and comparative research, thirty six elderly persons were selected simply and conveniently among 370 men and women whom were residing in 6 sanitariums in the north of Tehran. At the end, Snellen visual chart & Audiometer were used to measure visual acuity & auditory intensity. Samples were taken in 4 groups: 1- with visual impairment 2- with auditory impairment 3- with combined visual & auditory impairment 4- without any sensory impairment. Finally Berg balance scale and physical self maintenance scale as an ADL scale were used in 4 groups.
Results: Relative risk in ADL for visual impairment was 2.46, for auditory impairment was 1.5 and for combined visual and auditory impairment was 2.85. Auditory impairment didn't have any effect on balance and falling. However even mild visual impairment was an effective factor on balance (P<0.001). Contemporary auditory and visual impairment was an effective factor on balance (P<0.001).
Conclusion: Even mild and moderate auditory impairment can cause disability in the basic ADL. If mild and moderate auditory impairment exist simultaneously with visual impairment, the person had balance disability. Auditory impairment didn't have any effect on balance.

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Objective: The purpose of this study was to examine the effect of visual Arts education on improvement of visual perceptual skills in dyscalculic students.

Materials & Methods: utilizing an experimental pretest – posttest with control group design and using screening and via DSM-IV dyscalculia diagnosis questionnaire 30 dyscalculic male students were selected who were studying in the primary school and the research instruments used were Frostig Visual Perception and Key- mat Tests.

Results: the data of the research were analyzed through descriptive statistic method and covariance analysis model which showed that there is meaningful difference between clay, painting and control groups. .

Conclusion: the Visual Arts education can be effective on all of the visual perceptual skills in dyscalculic students except the Form Constancy skill.

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Objective: This study was aimed to determine visual perceptual skills of normal children aged 7 to 13 years in Tehran, comparing visual perceptual skills between boys and girls, age groups and student of different educational areas and finding the correlation among subtests with each other and subtests with total test.

Materials & Methods: In this cross sectional study 788 children aged 7 to 13 years old from 40 elementary and high schools of 5 educational areas of Tehran were selected by simple randomized and proportional to size method of sampling. Subjects were categorized in 3 age groups and then they were assessed by TVPS-R. The data were analyzed by statistical tests including Kolmogorov Smirnov, Bartllet, Analyze of variances, Independent T test, Kruskal-Wallis, U mann-whitney and Spearman correlation coefficient in SPSS software.

Results: According to results, standard scores for all visual perceptual skills were about average (Visual Perceptual Quotient=94.68). Analysis of data revealed significant differences among age groups in visual perceptual skills except Visual Memory and Visual Sequential Memory (from P=0.045 for Visual Closure to P<0.001 for Visual Form Constancy). Students of different educational areas in Tehran had significant differences in visual perceptual skills (P<0.001 for all visual skills). No significant differences were found between girls and boys in five of visual perceptual skills but there was significant difference between them in Visual Form Constancy (P=0.009), Visual Figure Ground (P<0.001) and Visual Perceptual Quotient (P=0.011). Correlation between subtests and total test was higher (Rho>0.617) but it was lower among subtests to each other (Rho<0.508).

Conclusion: The results of this study determined the visual perceptual skills scores in normal children. These scores will play as criteria for next studies especially the ones related to abnormal children.

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Objective: Assessment of cognitive functions in schizophrenia patients is very important. Because the cognitive deficiencies in memory and intelligence are the fundamental and underlying aspects. Both indicate from a structural and neurological similar deficits. The present study sought to examine the impact of severity and prognosis of schizophrenia on cognitive function, such as memory and intelligence and the relationship between intelligence and memory.

Material & Methods: In this study, 60 schizophrenia patients participate, who had at least 2 years of their diagnosis. Based on interviews by the PANSS scale in the two groups of 30 persons including the first group with mild symptoms (stable group) and the second group with severe symptoms (deteriorate group), were studied. Two groups by age, literacy, lack of mental retardation before diagnosis of disease, the use of ECT, the lack of anti-psychotic drug treatment more than three months during the past year were cloning. the Wechsler memory test and the raven IQ test for adults were used, the results were analyzed with using independent t-test, correlation and regression.

Results: Average of memory quotient in stable group with 77.4 and in deteriorated group with 65.93 had significant difference (P=0.002). Average of IQ in stable group with 84.26 and in deteriorated group with 76.9 had significant difference (P=0.015). Regression test showed that the memory can be predicted from IQ (P=0.001).

Conclusion: with severity of disease and deteriorated of schizophrenia and negative symptoms, deficiency in memory, has increased. In these patients, there was a positive relationship between intelligence and memory. The level of intelligence was in deteriorated group significantly lower than from stable group

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Objective: If we consider reading, writing and accounting as three substantial skills in primary school, reading will be most important skill of them and therefore, understanding reading processes and its methods is required. The aim of this study was to assay improvement of reading in fourth grade primary school students with visual impairment and comparison with the normal peer students.

Materials & Methods: The current research was a Causal-Comparative study and performed by the use of PIRLS (2006) international standardized booklet as instrument. Twenty seven students with fourth grade primary exceptional school in Tehran, Rey and Qom cities were selected by means of non-convenience sampling and compared with the equal students in adjacent schools selected by simple random method. The independent samples t-test method was used in statistical analysis.

Results: In the levels of reading literacy (P=0.017) and understanding of literal contents, there was significant difference between students with visual impairment and normal students (P=0.07) whereas in understanding of information contents there was not significant difference (P=0.053).

Conclusion: The visual impairment was effective on reading literacy therefore there is necessity to special attention to students with acute visual impairment and reviewing their reading programs. It is recommended that teachers and authorities provide more text in brail for blind children and utilize modern assistive methods to improve their reading literacy.

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Objective: Inadequate processing of sensory information especially vestibular leads to typical behaviors in attention deficit hyperactivity (ADHD) children which manifested as inattentive behaviors. In this research we aimed to study the effects of vestibular stimulation on visual attention in 7-12 year old ADHD children, using IVA-PLUS-CPT (Integrated Visual and Auditory Continuous Performance Test).

Materials & Methods: Thirty Children diagnosed as ADHD (7-12 year old), which were right handed and have had normal IQ based on Wechsler test participated in this research following their consent and divided randomly in the intervention and control groups. All participants were assessed using IVA-PLUS-CPT, then the intervention group participated in normal occupational therapy activities plus vestibular stimulation while the control group were recruited only in normal occupational therapy activities. Intervention continued for 10 sessions, twice a week for 5 weeks. At the end, all participants were evaluated again using IVA-PLUS-CPT. The collected date was analyzed using SPSS software version 16 and differences in pre and post test were comprised between the two groups using independent T-Test.

Results: Vestibular stimulation leaded to significantly differences in, visual attention, impulse (P<0.05) but visual impulse control did not show significant differences amongst the two groups.

Conclusion: Vestibular stimulation can affect meaningfully visual attention in ADHD children. So it can be used as a therapeutic technique in treating these children.

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Objective: Cerebral palsy is one of the most common causes of physical disability in childhood that lead to various difficulties for children. These children may have abnormalities in visual perception. Visual perception plays an important role in learning of basic childhood’s skills. This research was designed to study the relation between each of subtests of visual perception with accuracy and speed components of reading skills in school-aged cerebral palsy children.

Materials & Methods: In this cross-sectional study, 24 spastic cerebral palsy students in second grade (10 girls and 14 boy) were selected be available as from Tehran’s rehabilitation clinics. Visual perception and Reading skills were evaluated with the Test of Visual Perceptual Skill-revised (TVPS-R) and Diagnostic Reading Test.

Results: The results showed that between standard score of visual perception with accuracy and speed components of reading skills of cerebral palsy student were significantly correlated. Visual Discrimination with accuracy (P<0.001) and with speed (P<0.001), Visual Memory with accuracy  (P=0.002) and with speed (P=0.004), Visual-Spatial with accuracy (P<0.001) and with speed (P<0.001), Form Constancy with accuracy (P=0.003) and with speed (p<0.001), Visual Sequential Memory with accuracy (P=0.023) and with speed (P<0.028), Figure Ground Discrimination with accuracy (P=0.010) and with speed (P<0.011), Visual Closure with accuracy (p=0.009) and with speed (P<0.009)

Conclusion: In general we can say that the relationship between visual perception skills with reading skills in first and second grade students with cerebral palsy is evident.

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Objective Bender-Gestalt is one of the well-known neurocognitive tests designed by Lorta Bender to evaluate perceptual-motor development level in children. Besides its principle application in evaluation of cerebral damage, Bender test has other important applications, such as evaluating children for entering school, anticipating educational progress, diagnosing children with reading and learning disorders, studying growth retardation, as well as a nonverbal intelligence test to evaluate children’s reading readiness to enroll in elementary school. Because of the importance of this test in many diagnostics aspects, it is necessary to prepare a normalized form of this test. In this study, we tried to provide this form in a more comprehensive and updated form compared to previous studies.
Materials & Methods This is a descriptive-analytic research. The study population comprised all preschool children in Tehran. In this research, we surveyed 523 (271 boys and 252 girls) preschool children in 3 groups of 4-5 years old (200 children, 95 boys and 105 girls), 5-6 years old (199 children, 112 boys and 87 girls), and 6-7 years old (124 children, 64 boys and 60 girls) who were selected by cluster sampling method from some preschools centers in south, north, and center of Tehran during the spring of 2012. The inclusion criteria were having normal intelligence quotient and being in the range of preschool age. Obtained protocols were numbered on the basis of expanded Koppitz scoring system, and finally were analyzed using the Chi-squared test.
Results Data analysis for 4-5 years old group revealed the result of M(SD) as 14.75(1.82). The most frequent errors belonged to distortion in plans A, 7, and then 8. Also, the least frequent errors belonged to linear drawing of plans 3 and 6. With regard to misproportion error in plan A and repetition error in plan 2, girls made significantly less errors than boys, while with regard to spin errors of plan 7 and misproportion in plan 7, boys got the higher scores. In 5-6 years old group of children, M(SD) was 9.67(4.38). Also, the most frequent errors belonged to distortion in plans 8 and A. Furthermore, the least frequent errors belonged to linear drawing in plan 3, distortion in plan 7, and isproportion of components in plan 5. With regard to inappropriate composition and linear drawing of plan 5, boys made significant higher errors than girls. For children of 6-7 years old, M(SD) was 8.14(4.17). The most common errors in drawing belonged to first distortion errors in plans A and 8, and then spins in plans 7 and 3, and lastly to misproportion in plan 7. The least frequent errors belonged to linear drawing of plans 5 and 3, spin in plans 8 and 1, and finally distortion in plan 1. Male gender was effective in committing errors of wrong composition of plans A and 3, spin in plan 1, figure distortion in plans 6 and 7, also female gender in errors of wrong composition of plan 2, spin in plans 2 and 8.
Conclusion Consistent with Koppit’z maturational hypothesis and previous studies (Iranian and foreign), our results showed visual-motor improvement of perceptual performance with increasing age. In conclusion, koppitz scoring system is applicable to Iranian children protocols.

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Objective: This study was conducted to investigate the strategies used by visually impaired and blind people in Iran to cope with difficulty performing daily living activities.
Materials & Methods: This research is a qualitative study using a content analysis method. The participants were 18 visually impaired and blind people who were purposefully selected from those referred to the Visual Aid Research Center of Iran University of Medical Sciences in Tehran City, Iran. A semi-structured interview was first used using general questions about some daily living activities to discover the participants’ experiences. Attempts were made to allow participants to express their experiences independently without the help of the interviewer. The interviews were recorded as an audio file. After the interview, the audio files were transcribed and analyzed using thematic content analysis. The key sentences were extracted from the main texts, and the strategies or concepts extracted from those sentences were identified. Common strategies were put under one category. After the data saturation, when no new concept was found in the sentences, the interviews ended. By examining similar strategies in a category, subcategories were defined, and finally, similar subcategories were placed in a more general category, and the main themes or strategies were identified.
Results: The Mean±SD age of the participants was 39.5±11 years, ranging from 22 to 66 years. Of 18 participants, 7 were blind, 7 had severe visual impairment, and 4 had moderate visual impairment. Their duration of blindness or visual impairment was more than five years. In terms of education, 7 had no high school diploma, and 11 had a high school diploma or higher degree. Vision loss was congenital in some subjects and acquired in others. We extracted 8 main themes or strategies used by the subjects to cope with difficulty performing daily living activities. These themes are trust in others, use of alternative senses, efficient vision care, use of technology, optimization of the living environment, avoiding a specific activity, increasing emotional intelligence, and use of intelligence and memory.
Conclusion: The strategies used by the visually impaired and blind people in Iran are entirely personal and innovative and play an influential role in increasing their quality of life. According to their own statements, these strategies can solve their many problems in performing daily living activities.

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Objective Students with visual impairments have built negative attitudes towards their abilities due to difficulties in achieving social skills, orientation, and independent mobility. Their negative attitude towards blindness puts them at high-risk developing loneliness, social isolation, depression, anxiety, decreased life expentancy, no participation in group activities, and low levels of social support. Lack or no social skill reduces social acceptance and real feeling about themselves, which in turn reduces self-esteem in students with visual impaiments. Using appropriate therapeutic intervention with the aim of ensuring mental health as well as promoting self-esteem can prevent many psychological problems in these people. The acceptance and commitment therapy (ACT) is one of the third wave approaches to behavioral therapy that aims to control effectively the pain, suffering and stress that a person faces in the life. The acceptance and commitment therapy helps the person increases her psychological relations with herself and her feelings, trying to adapt to the environment and community instead of changing her cognition. The present study aimed to determine the effectiveness of the acceptance and commitment group therapy on self-esteem of students with visual impairment in Tehran City. 
Materials & Methods The present study was a quasi-experimental study in which a pretest-posttest design with a control group used along with a two-month follow-up. The sample was consisted of twenty-eight 14-20 year old female students who was selected from the population of students with visual impairment studying in the schooling year of 2019-2020 in Narjes day-and-night school for the blind individuals. In Tehran, there is only one school for female blind students and the sample purposefully selected according to the probability of sample’s dropout. At first, 50 students completed the Cooper Smith Self-Esteem Questionnaire (CSSEQ) and after scoring the CSSEQ, twenty-eigth students selected according to receiving a score of 23 or lower in the CSSEQ. All subjects matched based on their age and grade, then randomly assigned to the experimental and the control group. The experimental group (two subgroups consisted of seven people in each) participated in eight therapeutic sessions (twice a week and 75 minutes for per session) and received the acceptance and commitment group therapy while the control group participated only in the mainstream programs at the school. At the end of the therapeutic sessions all subjects completed the CSSEQ again and the experimental group completed CSSEQ after two months follow-up.The multiple analysis of covariance (MANCOVA) used for analyzing the obtained data. Furthermore, for comparing the posttest and follow-up situations in the experimental group the related t-test used. 
Results The results of multiple analysis of covariance for the data obtained from the self-esteem questionnaire showed that the participation of female students with visual impairment in the acceptance and commitment group therapy sessions led to significant increase (P<0.001) in self-esteem (general, family, social, and educational) of them. In fact, according to Eta quotient, 71%, 78%, 78%, and 72% of variation in self-esteem (general, family, social, and educational respectively) of the experimental group can be explained by participating in the acceptance and commitment group therapy sessions. The results of the related t-test for comparing the self-esteem of the experimental group in post test and follow-up situations showed that the effectiveness of group therapy based on acceptance and commitment has been lasted on the self-esteem (general, family, social, and educational) of the experimental group after two months follow-up later (P>0.05). 
Conclusion We conclude according to the findings of the present study that the acceptance and commitment group therapy can use for planning and policy making instructional courses suitable for students with visual impairments. Furthermore, the specialists who are working with these children can use the ACT as a practical technique for improving self-esteem and the adaptation in many areas such as family, social and educational areas in students with visual impaiments. Additionally, the ACT recommend improving self-esteem and positive performance of students with visual impairment in social, educational and family areas along side the routin instructional couses. However, the acceptance and commitment group therapy helps the students with visual impairment know how to control their thoughts and feelings in order to prevent problems from getting worse. This therapeutic method helpls them to accept their behavioral changes through accepting the unpleasant thoughts and feelings. 

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Objective Progressive visual impairment is one of the problems that threatening the health of patients and has the negative effects on their abilities. This study aimed to explore the health concerns of patients with Retinitis Pigmentosa (RP).
Materials & Methods A qualitative inductive approach was used. Eleven patients with RP, participated in this study in Iran. Patients were selected through purposeful sampling. Data collection was done through two methods of in-depth semi-structured individual interviews and field notes. Data analysis was performed using approach of conventional content analysis.
Results The categories of "perceived health threat" and "perceived support needs", were extracted. The category of perceived health threat included sub-subcategories of "gradual decline in physical function", "sustained fluctuations in mental health", and "weakening of social capability". "need for socio-economic support", "need for educational support", "need for psychological support", and "need for a personal assistant" were extracted as sub-subcategories of perceived support needs.
Conclusion RP Patients faced with the problem of abilities impairment in various physical, mental, and social dimensions and need for support in society. So, to improve the health of these patients, members of the health group are suggested to develop a context-based wholistic care program through multidisciplinary cooperation.

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Objective: The use of standard tools can show the exact effects of interventions in children and adolescents with visual impairment (CYP-VI). However, to date, no comprehensive review study has evaluated the general characteristics and psychometrics of the instruments used in CYP-VI. Therefore, the present study investigated the psychometric properties of the tools used for CYP-VI.
Materials & Methods: Databases of Cochrane, Scopus, PubMed, Web of Science, Iran Medex, Magiran, National Library of Iran (INL) and Google Scholar were searched using Persian and English keywords until 2021. The studies and tools used in CYP-VI were reviewed by two people in terms of inclusion criteria. Relevant information and quality assessment of the tools were checked with the adapted Casmin checklist (COSMIN) and Critical Review Form – Quantitative Studies. Psychometric properties of the studied instruments in the narrative categories were analyzed with face, content, criterion-dependent and reliability with internal and external reliability subgroups. 
Results: Out of 1738 articles found, 39 studies were analyzed. Out of 39 articles, 26 were of high quality and others were of medium level. Study design included tool development/cultural adaptation, experimental, longitudinal or cross-sectional studies. Assessments were categorized into developmental (general skills, cognitive and social skills), Activities of Daily Living (ADL), Quality of Life (QoL) and Functional Vision (FV). Among the developmental tools; Only Decker intelligence test, vision related quality of life, Cardiff visual acuity questionnaire for children, first and second versions of LV Prasad functional vision questionnaire and functional vision questionnaire for children and young people with desirable psychometric properties have been reported. In relation to adaptive instruments, the changes made included the use of auditory, tactile, olfactory and motor aids, vocabulary changes, instrumental methods and the use of assistive devices, only a few of which reported psychometric properties.
Conclusion: This review study shows that limited tools have been designed for CYP-VI whose validity and reliability have not been fully evaluated and reported. However, to improve the quality of studies and control systematic errors, we need standard tools.

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Objective: The present study aimed to investigate the effect of brain neuroplasticity on the incidence of anterior cruciate ligament (ACL) injury and on brain function and structure before and after ligament reconstruction and after a period of rehabilitation exercises.
Materials & Methods: In this review study, a search was conducted in PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, MedLine, Pedro, CINAHL, SPORTDiscus, and Cochrane Databases as well as national databases on related studies published from 1970 to 2021 using keywords in Persian and English related to the research topic.
Results: The initial search yielded 65 articles. Based on the inclusion and exclusion criteria, 24 articles were selected for review of which 5 articles prospectively examined the effect of brain neuroplasticity on the incidence of ACL injury. Their results showed that the brains of people with ACL injury was different from the uninjured people, especially in the motor-sensory part of the cerebral cortex and cerebellum, which caused errors during movement planning of these persons. Ten articles examined the effect of ACL injury before reconstruction on brain function and structure and reported that changes occur in the level of motor-sensory cortex of the brain at least two weeks after the injury; after one year, these structural and functional changes were widely increased in injured people compared to healthy people. These studies also showed that the ligament dysfunction and the damage to mechanical receptors cause the reorganization of the central nervous system. In injured people, the control activity of motor-visual areas and their need for visual feedback have increased. Seven articles examined these changes after ligament reconstruction and showed that the brain neuroplasticity or functional and structural changes resulting from the injury not only did not return to normal conditions, but also increased after a while despite the reconstruction. Two articles examined these changes after a period of rehabilitation exercises and showed that functional and 
Conclusion: The changes in the brain after ACL injury not only persist after ligament reconstruction, but also increase after reconstruction. The common rehabilitation exercises whose main focus is not on eliminating these functional and structural changes in the brain cannot overdrive this negative neuroplasticity after injury which is one of the important causes of secondary injury and subsequent complications. In developing exercises to prevent ACL injury and for rehabilitation, it is better to use the new principles of motor learning and exercises related to visual feedback along with conventional exercises to overdrive negative neuroplasticity created in the brain and create positive neuroplasticity to support ACL.
 

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