Groups Posttreatment Research Articles

Efficacy of gabapentin phonophoresis on post mastectomy intercostobrachial neuralgia

Aim. To investigate the efficacy of gabapentin phonophoresis for neuropathic pain management in intercostobrachial neuralgia cases. Material and methods. Fifty-seven females with intercostobrachial neuralgia were randomly collected then allocated into two groups, Study group (gabapentin phonophoresis) and Control group (gabapentin gel). Study group: received gabapentin phonophoresis 4 times/week for 4 weeks (a total of 16 sessions) using continuous ultrasound (1 MHz, 1.5 W/cm², for 5 minutes). Control group: received topical 6% w/w gabapentin gel three times per day for 4 weeks on the affected site. The methods of assessment included visual analogue scale (VAS) and Neuropathic pain scale (NPS). All measurements were collected before the beginning of the study and after the end of the treatment (after 4 weeks). Results. There was no significant difference between both groups in VAS (= 0.43) and NPS (= 0.46) pre-treatment. Comparison between groups post treatment revealed a significant decrease in VAS and NPS of study group compared with that of control group (p < 0.001). The percentage of decrease in VAS of study group and control group was 51.32% and 43.03% respectively while the percent of decrease in NPS was 50.79% and 45.05% respectively. Conclusion. It was concluded that conduction of gabapentin gel topically or by using phonophoresis is safe and effective method for neuropathic pain management and can alleviate pain intensity; however, phonophoresis achieved better results and was superior to traditional gel application.

From injury to rehabilitation: How kinesiology taping helps patients with first metatarsophalangeal joint sprain (turf toe) in pain reduction, gait parameters and functional ability improvement. A randomized clinical trial

ObjectiveTurf toe is a common sports injury that may affect mobility and functional ability. For complete recovery, rehabilitation modalities are required to overcome these issues. This study investigated whether kinesio taping (KT) would reduce pain, improve gait performance, and enhance the functional capacity of turf toe patients undergoing physical therapy. Methodssixty patients with grade II turf toe (age; 25–30 years) assigned randomly into three treatment groups; KT applied alongside an exercise program conducted three times/week for 12 successive weeks. (KT group; n = 20), placebo taping plus exercise (Placebo group; n = 20), or exercise only (Control group; n = 20). Pain, gait parameters, and functional ability assessed using VAS, 3D gait analysis, and 6MWT respectively pre- and post-treatment. ResultsThere was a significant post-treatment decrease in VAS score in the KT group lower than the control or placebo group and a significant increase in 6MWT distance in the KT group higher than the control or placebo group (p < 0.001). Additionally, there was a significant post-treatment increase in step length, stride length, cadence and velocity of KT group higher than control and placebo group (p < 0.05). There was no significant difference in gait parameters between control and placebo groups post treatment (p > 0.05). ConclusionsThe findings of the study demonstrated that KT is a useful complementary modality to exercise in patients with turf toe, as it may result in more favorable improvements to pain, gait characteristics, and functional abilities. Further studies should be conducted to assess the long-term effects, different KT application methods, and tailored treatment protocols on turf toe.

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Background. Virtual reality and balancing beam are widely acknowledged as a highly successful approach for improving balance as well as walking performance among children suffering from hemiplegic cerebral palsy (CP). Purpose. The aim of this study was to compare between the impact of virtual reality and balance beam on walking performance (balance and functional walking capacity) in children with hemiplegic CP. Subjects and methods. A total of seventy-five children with hemiplegic CP, comprising 31 boys and 44 girls, aged between 7 and 11 years of both genders, were included in this study. The participants were allocated randomly into three groups (n = 25), A (control group) and B, C (study groups). All children received designed physical therapy programs based on neurodevelopmental technique, in addition to balance and gait training exercises for control group A, virtual reality training for group B and balance beam training for group C. The treatment program was administered to each group three times weekly for three consecutive months, lasting one hour each session. All children were examined clinically pre- and post-treatment using HUMAC balance and tilt system, and 6- minutes walking test (6mWT) to assess balance, walking functional capacity respectively. Results. There was a significant improvement in balance and 6MWT of three groups post treatment when contrasted with that pretreatment (p &lt; 0.001). Furthermore, group B and C's measured variables showed a substantial improvement over group A's when compared (p &lt; 0.01), while group B and C did not differ significantly (p &gt; 0.05). Conclusions. Virtual reality and balance beam training have an effective influence on the improvement of balance and walking performance.

Impact of foot reflexology combined with dietary modification on premenstrual syndrome: A randomized controlled trial

Purpose: This investigation was intended to know the impact of reflexology of the foot on premenstrual syndrome management. Methods: Fifty single female subjects diagnosed with premenstrual syndrome (PMS), aged 18 to 25 years old and BMI ≤ 30kg/m2, participated in this study. They were divided into two groups of equal numbers, A and B. Group (A) got the therapeutic reflexology of the foot in addition to the dietary modification, 3 sessions weekly for eight weeks. The group (B) got only the diet modification for eight weeks. All subjects in the two groups were assessed for pain by the visual analogue scale (VAS), and the PMS related symptoms were assessed by the Premenstrual Daily Symptoms Questionnaire, in addition to the beta-endorphin level in the blood. Results: The results showed significant improvement of pain level, beta-endorphin level in blood and premenstrual related symptoms in both groups when comparing pre and post treatment values (p &lt; 0.05). There was significant difference between both groups post treatment in favor of the study group (A) (p &lt; 0.05). Conclusion: Reflexology of the foot in addition to dietary modification is an efficacious technique for decreasing the premenstrual symptoms.

Effectiveness of a preoperative orlistat-based weight management plan and its impact on the results of one-anastomosis gastric bypass: A retrospective study.

The aim was to first investigate the efficacy of a preoperative weight management program centered on orlistat, which is mechanistically similar to gastrointestinal bypass procedures in that it restricts dietary fat absorption, and then assess its impact on the results of one-anastomosis gastric bypass (OAGB). We retrospectively reviewed the clinical data of consecutive patients aged 20-65 years with a body mass index (BMI) ≥ 42.5 kg/m2 who underwent primary OAGB from 2014 to 2020. Eligible patients who adhered to a 10-14 day orlistat regimen as part of a 4-6-week diet/lifestyle modification plan preceding surgery were stratified into weight reduction (Group 1) and weight gain (Group 2) groups post treatment. The correlation between pre- and postoperative weight loss and perioperative outcomes was assessed. Of 62 eligible patients, 55 met the inclusion criteria and complied with treatment; 35 (64%) patients in Group 1 lost a median of 2.0 kg, and Group 2 had a median weight gain of 2.9 kg. Group 1 had a significantly higher initial BMI (48.9 kg/m2 vs. 44.6 kg/m2; p = 0.003), more females (54% vs. 25%) and a shorter operation time than Group 2 (107 min vs. 140 min; p = 0.109). There was no difference in the incidence of 30-day complications. Weight loss did not differ between the groups at 24 months. Effective weight control through an orlistat-containing regimen benefitted two-thirds of patients who underwent OAGB; however, further weight loss was not observed at 2 years post-surgery.

Modulation of the angle of rigid ankle-foot orthosis to control knee hyperextension in children with unilateral cerebral palsy

The aim of this study was to compare the effects of a modified 5° dorsiflexion ankle-foot orthosis (AFO) to the traditional right angle rigid AFO on controlling knee hyperextension and improving spatiotemporal gait parameters in children with unilateral cerebral palsy (CP). We used a pretest-posttest experimental design in which forty children (2-6 years) of both genders with unilateral CP were randomly assigned into two equal groups (A and B). Group A used a traditional right angle rigid AFO and received a selective exercise program to enhance walking pattern while group B used a modified 5° dorsiflexion rigid AFO and received the same exercise program as group A. Assessments for the knee angle during mid-stance and spatiotemporal gait parameters were done pre and post-intervention programs for both groups. All statistical analyses were conducted using the Statistical Package for Social Studies (SPSS) version 25 for windows (IBM SPSS, Chicago, IL, USA). There was a significant decrease in the knee angle in mid-stance post-treatment in groups A and B compared to pre-treatment (p &lt; 0.001) but a significant increase in spatiotemporal gait parameters post-treatment in groups A and B compared to pre-treatment (p &lt; 0.001). There was a significant decrease in the knee angle in mid-stance of group B compared to group A in post-treatment (p &gt; 0.001). However, there was no significant difference in spatiotemporal gait parameters between groups post treatment (p &gt; 0.05). In conclusion, using a rigid AFO improves the spatiotemporal gait parameters and decreases knee hyperextension for children with unilateral CP. Furthermore, a modified 5° dorsiflexion rigid AFO is recommended for better control of knee hyperextension than a traditional right angle rigid AFO for such cases.

Efficacy of high-cervical spinal cord stimulation in vegetative patients and its effect on blood flow

To investigate the efficacy of high-cervical spinal cord stimulation in vegetative patients and its effect on blood flow. Sixty patients with persistent vegetative state were assigned in a control group (n=30) for routine coma arousal program and a treatment group (n=30) for high-cervical spinal cord stimulation besides routine coma arousal program using a random number table method. The number of patients out from vegetative state, consciousness (Coma Recovery Scale-revised), electroencephalogram, brainstem auditory evoked potential, somatosensory evoked potential and cerebral blood flow were observed before and post treatment. One patient in the control group while seven patients in the treatment group were out from vegetative state 6 months after treatment (P&lt;0.05). Post-treatment Coma Recovery Scale-Revised scores increased in both groups of patients (9.23±2.78 vs 4.43±1.06 and 7.12±2.91 vs 4.51±1.16, P&lt;0.001), with a more evident increase in the treatment group than in the control group (9.23±2.78 vs 7.12±2.91, P&lt;0.01). Electroencephalogram, brainstem auditory evoked potential and somatosensory evoked potential enhanced post treatment (all P&lt;0.01), with greater improvements in the treatment group (all P&lt;0.01). Cerebral blood flow rose in both groups post treatment (56.32±5.88 vs 44.22±5.21 and 51.12±5.56 vs 44.99±5.32, P&lt;0.001), with a more distinct increase in the treatment group than in the control group (56.32±5.88 vs 51.12±5.56, P&lt;0.001). High-cervical spinal cord stimulation for patients with persistent vegetative state can promote the recovery of consciousness, enhance neuroelectrophysiological activity and improve cerebral blood flow. However, more clinical studies are needed to confirm its efficacy.

Impact of integrated neuromuscular inhibition technique versus electro-acupuncture stimulation of posterior tibial nerve in males with chronic pelvic pain of myofascial origin

The aim of the study was to examine the impact of the integrated neuromuscular inhibition technique and electro-acupuncture stimulation of posterior tibial nerve in males diagnosed with chronic pelvic pain of myofascial origin. Sixty male patients with chronic pelvic pain participated in this randomized, single-blind, active-controlled trial and they were randomly divided into 3 groups of equal size. The group A (20 patients) received integrated neuromuscular inhibition technique (INIT) and pelvic floor exercise, the group B (20 patients) received posterior tibial nerve electroacupuncture using TENS acupuncture as a noninvasive pelvic floor muscle neuromodulation technique and pelvic floor exercise, and the control group C (20 patients) received pelvic floor exercise only. Serum cortisol level (SCL) measurement was done, and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score was used to assess the severity of symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The measurements were done at baseline and after the next two months. Comparing the three groups post treatment, our results show that there are statistically significant differences in serum cortisol level and in the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire score in both group A and B (p&lt;0.05). There are no statistically significant differences in the control group C (p&gt;0.05). The findings of this research showed a significant reduction of blood cortisol level and improvement of NIH CPSI questionnaire total value in men with chronic pelvic pain who used an integrated neuromuscular inhibition technique and percutaneous posterior tibial nerve stimulation, and a non-significant difference in the control group C. The INIT has superiority over electro-acupuncture stimulation of the posterior tibial nerve in reducing pain and improving quality of life.

Effect of training on health outcome including fatigue, depression and quality of life in patients with systemic lupus erythromatosus

BackgroundSystemic lupus erythematosus is an inflammatory condition that causes significant tissue damage and inflammation, and is more common in women. Despite the fact that medical treatment seeks to prevent flare-ups and organ damage, up to 50% of patients believe their wellbeing is suboptimal due to unmet needs like exhaustion and pain. The aim of the new systemic lupus erythematosus treatment guidelines is to improve people's quality of life. In people with systemic lupus erythematosus, fatigue is associated with reduced health, exercise capacity, muscle strength, and impairment. The aim of the study is to compare the effects of strengthening exercise on fatigue, depression, and quality of life in patients with systemic lupus erythematosus compared to the control sedentary group. This study included 20 patients with systemic lupus erythematosus from the department of internal medicine, compared to 25 control patients. Both groups had been treated with strengthening exercises for three months. Self-rating depression scale, quality of life questioner, fatigue severity scale, 6 min’ walk test, 2 min step test and body mass index (BMI). All parameters were measured before and after 3 months of treatment.ResultsAnalysis of data showed that systemic lupus erythematosus has more depression and fatigue than sedentary control. After exercises, both groups have a significant difference between pre and post treatment, but still have a difference between both groups. Both groups have a significant difference between pre and post treatment in 6-min walk test, 2-min step test, and quality of life measured by SF-36. No significant difference was found between both groups pre and post treatment in BMI, although each group has a significant difference between pre and post treatment BMI.ConclusionsExercises are very important in the management of systemic lupus erythematosus. They help to decrease fatigue, depression, and improve quality of life.

Effect of cough assist device on blood gasses and period of mechanical ventilator for pneumonic children with general hypotonia

BackgroundCough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device.ResultsThis study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03).ConclusionThe cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.

Manual Hyperinflation, A Novel Technique in Physiotherapy of Pediatric Post Cardiac Surgery Patients

Background: Physiotherapy plays an important role in Pediatric Intensive Care Unit (PICU) after cardiac surgery, and addition of manual hyperinflation (MHI) to physiotherapy program may help early weaning from mechanical ventilation and decrease length of stay in PICU. Objective: To measure the effect of MHI on ventilation period and ICU stay days in pediatric post cardiac surgery patients. Patients and methods: Thirty patients from both sexes were selected from PICU at Academic Institute for Heart Surgery, Ain Shams University. Their ages ranged from 6 to 36 months. Results: There was a significant decrease in PaCO2 post treatment compared with that pre-treatment in the study and control groups (p>0.05). There was a significant increase in PaO2 post treatment compared with that pre-treatment in the study and control groups (p>0.001). Comparison between groups post treatment revealed a significant increase in PaO2 and a significant decrease in PaCO2 of the study group compared with that of the control group (p>0.01). There was a significant decrease in ventilation days and ICU stay days of the study group. Conclusion: Based on this study, it could be concluded that manual hyperinflation improves arterial oxygenation and reduces length of stay in PICU.

Effectiveness of transcutaneous electrical nerve stimulation as an adjunct to selected physical therapy exercise program on male patients with pudendal neuralgia: A randomized controlled trial

Objective: To assess the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) combined with selected physical therapy exercise program on male patients with pudendal neuralgia. Design: A double-blinded randomized controlled study. Setting: Out-patient setting. Participants: Fifty-two male participants with pudendal neuralgia (30–50 years) were allocated randomly into two groups; study and control. The same physical therapy exercises were applied to all participants, plus the same prescribed analgesic medication (Etodolac). Participants in the study group received additional TENS and sham TENS were given to those in control group. Intervention: Intervention lasted for 12 weeks, three sessions per week (60 minutes/session). Outcome measures: Numerical pain rating scale and daily Etodolac intake dose were measured before and after intervention. Results: Statistically significant differences were detected in numerical pain rating scale and daily Etodolac intake in favor of the study group (P < 0.05). After 12 weeks of intervention, the mean ± SD for numerical pain rating scale and daily Etodolac intake were 4.25 ± 1.9 and 259.25 ± 84.4 mg, in the study group, and 6.22 ± 2.22 and 355.55 ± 93.36 mg in the control group, respectively. The mean difference (95% CI) for numerical pain rating scale and daily Etodolac intake was −1.97 (−3.09: −0.83) and −96.3 (−144.9: −47.69), between groups post treatment, respectively. Conclusion: Adding TENS to physical therapy exercise program is more effective than physical therapy program alone in improving pain in male patients with pudendal neuralgia as measured by numerical pain rating scale and daily analgesic intake dose.

Effect of Aerobic Exercises in Prevention of Bone Mass Loss Post Bariatric Surgeries

Background: Patients who have been submitted to bariatric surgery are prone to bone mass abnormalities caused by restriction of calcium intake associated with malabsorption of both calcium and vitamin D. Reduced calcium absorption is secondary to the exclusion of duodenum and proximal jejunum where calcium is maximally absorbed. Aerobic weight bearing exercise is more adapted to improve bone mass over whatever viable physical activity, they assume a double part over stressing the bones as they set both gravitational and muscular stress on bones. Objective: To determine the effect of aerobic exercises in prevention of bone mass loss post bariatric surgeries. Patients and Methods: Thirty female patients with post bariatric surgeries participated in this, their ages were between 25 to 45 years selected from Shebin El-Kom Hospital, Menoufia and randomly distributed into two equal groups: Group A (Study group): included 15 patients who received 30 minutes of aerobic exercise through walking on treadmill, in addition to conventional medical care 3 days per week and group B (Control group): included 15 patients who were on their conventional medical care. Results: There was no significant difference in T score of spine (L2-L4), femoral neck and total femur between both groups pre-treatment (p > 0.05). Comparison between both groups post treatment revealed a significant increase in T score of spine (L2-L4), femoral neck and total femur of the study group compared with that of the control group (p > 0.001). Conclusion: It can be concluded that aerobic exercises had fruitful effects in cases of osteoporosis patients after bariatric surgery as evidenced by the significant increase in BMD and T-score mean, so decrease risk of fractures and enhance physical performance.

Effect of Aerobic Exercises in Prevention of Bone Mass Loss Post Bariatric Surgeries

Background: Patients who have been submitted to bariatric surgery are prone to bone mass abnormalities caused by restriction of calcium intake associated with malabsorption of both calcium and vitamin D. Reduced calcium absorption is secondary to the exclusion of duodenum and proximal jejunum where calcium is maximally absorbed. Aerobic weight bearing exercise is more adapted to improve bone mass over whatever viable physical activity, they assume a double part over stressing the bones as they set both gravitational and muscular stress on bones. Objective: To determine the effect of aerobic exercises in prevention of bone mass loss post bariatric surgeries. Patients and Methods: Thirty female patients with post bariatric surgeries participated in this, their ages were between 25 to 45 years selected from Shebin El-Kom Hospital, Menoufia and randomly distributed into two equal groups: Group A (Study group): included 15 patients who received 30 minutes of aerobic exercise through walking on treadmill, in addition to conventional medical care 3 days per week and group B (Control group): included 15 patients who were on their conventional medical care. Results: There was no significant difference in T score of spine (L2-L4), femoral neck and total femur between both groups pre-treatment (p > 0.05). Comparison between both groups post treatment revealed a significant increase in T score of spine (L2-L4), femoral neck and total femur of the study group compared with that of the control group (p > 0.001). Conclusion: It can be concluded that aerobic exercises had fruitful effects in cases of osteoporosis patients after bariatric surgery as evidenced by the significant increase in BMD and T-score mean, so decrease risk of fractures and enhance physical performance.

Kinesio Taping and Strength Recovery of Postnatal Abdominal Muscles after Cesarean Section

Background: Physiotherapists in primary healthcare often encounter Post-cesarean health problems as, it affects abdominal muscles strength. But there are few studies on the contribution of decrease of abdominal muscle strength after cesarean section and very little guidance in the literature for health professionals on the management of abdominal muscle strength recovery after cesarean section. Objective: To assess the effect of Kinesio Taping on the recovery of abdominal muscle strength in postnatal women after cesarean section. Methods: Forty cesarean section women participated in this study after two months of delivery. They were divided into two equal groups; Group(A) performed abdominal exercises and group(B) received Kinesio Taping (KT) in addition to performing abdominal exercises as group (A). The intervention sessions in both groups were twice per week for 8 weeks. The outcome measures were evaluating pre and post treatment via assessing the inter recti distance and abdominal muscle thickness for the right and left rectus abdominal muscles and external oblique muscles by using ultrasonography. Results: The inter recti distance showed highly significant decrease (p < 0.0001) and highly significant increase (p < 0.0001) in rectus abdominis as well as external oblique muscles in both groups (A&B) post treatment. Comparison between both groups post treatment showed a highly significant difference (p < 0.0001) in favor of group(B) in muscle thickness and inter recti distance. Conclusion: Kinesio Taping (KT) helps in recovery of abdominal muscle after cesarean delivery.

EFFECT OF PILATES EXERCISE ON LIPID PROFILE IN POST MENOPAUSAL OBESE WOMEN

Background.menopause is the permanent cessation of menstruation due to loss of ovarian folicular function this hormonal change would have an effect on women`s lipid profile that leading to atherosclerosis. Aim.to investigate the effect of Pilates ex on lipid profile in postmenopausal women subjects&methods.30 postmenopausal obese women aged 45-55 y.They were randomly assigned into 2 equal groups: Group A consist of 15 postmenopausal obese women instructed to follow low caloric diet.Group B consist of 15 women instructed to follow low caloric diet and perform Pilates ex for 30 min/5 times per week for 12 weeks.evaluation was done by measuring lipid profile (CH,TG,LDL AND HDL), BMI and W/H ratio before and after 12 weeks for both groups results. there is good improvement (p˂0.05)in the lipid profile and significant difference between both groups post treatment in favor of group B conclusion. Pilates exercise combined with diet control had better effects on lipid profile in postmenopausal obese women.

Effect of Lumbar Hyperlordosis Correction on Craniovertebral Angle in Low Back Pain Patients

Abstract Background: Several studies have indicated the clinical and functional importance of lumbar lordosis. It is a key component in maintaining the sagittal balance. Aim of Study: To investigate the effect of lumbar hyper-lordosis correction on crainovertebral angle in chronic low back pain patients. Subjects and Methods: 30 patients of both genders diag-nosed as chronic low back pain with lumbar hyperlordosis (cobb anlge >40 degrees) selected from outpatient clinic of the faculty of physical therapy, Beni Suef University through the period between October 2019 to January 2020. Their ages ranged from 20 to 35 years. Patients were assigned randomly by sealed envelope into two groups after signing institutionally approved consent. Group A (Experimental group): 15 patients received muscle energy technique (MET) for 3 sessions/week for 4 weeks. Group B (Control group): 15 patients received William program for 3 sessions/week for 4 week. Lumbar lordosis angle was measured by plain X-ray imaging, cranio-vertebral angle by photographic analysis method, pain intensity level by visual analogue scale, trunk range of motion by tape (flexion, extension, side bending and rotation) before and after four weeks of treatment. Results: The study findings revealed that there was a significant improvement in the craniovertebral angle of both groups post treatment compared with that pre treatment (p= 0.0001), There was significant increase in trunk range of motion in both groups post treatment compared with that pre treatment (p=0.0001), There was a significant decrease in pain intensity on VAS in the both groups post treatment compared with that pre treatment (p=0.0001). Conclusion: The correction of lumbar hyperlordosis had a positive effect on improving craniovertebral angle, improving trunk range of motion, and decrease pain level in chronic low back pain patients.

Photodynamic therapry with curcumin in the reduction of enterococcus faecalis biofilm in bone cavity: rMicrobiological and spectral fluorescense analysis.

Antimicrobial photodynamic therapy (PDT) has emerged as a therapeutic strategy to conventional procedures using antibiotics. To evaluate the antimicrobial effectiveness of PDT using blue light emitting diode (LED) associated with curcumin on biofilms of Enterococcus faecalis in bovine bone cavities and also to analyze the presence of these biofilms through spectral fluorescence. Standardized suspensions of E. faecalis (ATCC 29212) were incubated in artificial bone cavities for 14 days at 36 °C ± 1 °C for biofilm formation. The test specimens were distributed among the four experimental groups (n = 10): L-C- (control), L + C- (LED for 5 min), L-C+ (curcumin for 5 min) and L + C+ (PDT). Aliquots were collected from the bone cavities after treatments and seeded on BHI agar for 24 h at 36 °C ± 1 °C for CFU count. Before and after each treatment the specimens were submitted to spectral fluorescence, whose images were compared in the Image J program. The log10 CFU/mL results were submitted to the Kruskal-Wallis test (5%) and the biofilm fluorescence spectroscopy results were submitted to the Wilcoxon test (5%). All treatments presented statistical difference when compared to the control, and PDT was responsible for the largest reduction (1.92 log10 CFU/mL). There was a reduction in the fluorescence emitted after the treatments, with greater statistical difference in the PDT group. PDT was efficient in the reduction of E. faecalis biofilms. In all groups post treatment there was a significant reduction of biofilms in the fluorescence spectroscopy images with greater reduction in the PDT group.

Effect of Integrated Neuromuscular Inhibition Technique on Frozen Shoulder

Background: Frozen shoulder is a painful condition of the joint capsule leading to loss of range of motion of the joint. Due to pain and inability to move the involved shoulder, patients tend to avoid any movement of the involved arm. This leads to formation of Myofascial Trigger points and tender points in the muscles. This overall makes the prognosis more challenging as the focus is mostly on the joint. Integrated Neuromuscular Inhibition Technique is a soft tissue manipulation technique that has been proven to relieve trigger and tender points. Although proven to be efficiently effective in many disorders, this technique is not as such practiced as a common and regular approach by professionals. Thus, this technique was undertaken and experimented on Frozen Shoulder. Objectives: Objectives of the study were to determine the effect of Integrated Neuromuscular Inhibition Technique in Frozen Shoulder and compare the effect of Integrated Neuromuscular Inhibition Technique with conventional treatment in frozen shoulder. Material and Method: In this experimental study, 40 Frozen Shoulder subjects were assessed using Visual Analogue Scale (VAS), Goniometer for Range of Motion (ROM) and Shoulder Pain and Disability Index (SPADI). The subjects were divided into 2 groups, Group A Included 20 subjects treated with Hot moist pack, Therapeutic Ultrasound, Exercises and Capsular Stretching and Sleeper stretch. Group B included 20 subjects treated with Hot moist pack, Therapeutic Ultrasound, Exercises and Capsular Stretching and Sleeper stretch and Integrated Neuromuscular Inhibition Technique. Results: Within group statistical analysis of VAS, ROM and SPADI for both the groups were found to be extremely significant with a p value of <0.0001. On comparing between the two groups post treatment, there was extremely significant difference in Group B as compared to Group A regarding VAS (p=0.002), very significant difference for SPADI (p=0.0047), FLEXION ROM (p=0.0076) and ABDUCTION ROM (p=0.0026). But, there was no significant difference between the two groups regarding MEDIAL ROTATION ROM (p=0.1772) and LATERAL ROTATION ROM (p=0.7602). Conclusion: The study concluded that Integrated Neuromuscular Inhibition Technique and Conventional Physiotherapy are both effective in the management of Frozen Shoulder. Also, Integrated Neuromuscular Inhibition Technique given with Conventional Treatment is significantly more effective as compared to conventional treatment alone on pain, range of motion and functional status of Shoulder and thus Alternate Hypothesis accepted

Cognitive behavioural therapy and core stabilization exercise on pain-related disability and psychological status in patients with non-specific chronic low back pain

Introduction. Exercises have been shown to relieve symptoms in non-specific chronic low back pain (NSCLBP) patients. Aim. This study compared the effects of cognitive behavioural therapy (CBT) and core stabilization exercises (CSE) on pain-related disability, psychological status and sleep disturbance in patients with NSCLBP. Material and methods. This randomized controlled trial involved a total of thirty-seven (37) participants. They were randomly allotted into three groups [CBT (11), CSE (14) and control (12)]. The intervention was done once per week for duration of 60 minutes for the CBT group, 30 minutes for CSE group and 10 minutes for the control group twice per week for 8 consecutive weeks. Assessment of outcome was done at baseline, 4 weeks and 8 weeks. Data were analyzed using statistical package for social science version 25 at alpha level of less than 0.05. Results. The results of this study showed that there was significant improvement in the level of pain-related disability (p= 0.001), level of anxiety (p =0.001), depression (p = 0.01, p = 0.001, p =0.001) and sleep disturbance (p = 0.001) in all the groups (CBT, CSE, control) post treatment. Conclusion. CBT and CSE are both effective in the treatment of pain-related disability, sleep disturbance, and psychological status of NSCLBP patients.