Traditional Physical Therapy Program Research Articles

Comparison of the effects of mechanical hippotherapy and Cawthorne-Cooksey exercises in patients with multiple sclerosis: Randomized trial

BackgroundPatients diagnosed with multiple sclerosis (MS) commonly encounter heightened postural instability and challenges in aligning their eyes, head, and bodily motions while engaging in specific tasks. This study aims to compare the effects of Cawthorne-Cooksey and mechanical hippotherapy exercises on fatigue, balance, gait, dizziness, and life quality in patients with MS. MethodsThe MS patients were randomly divided into Cawthorne-Cooksey (n:25) and mechanical hippotherapy exercise (n:25) groups. In addition to the traditional physical therapy program, Cawthorne-Cooksey and hippotherapy exercises were applied to the groups 3 days a week, for 8 weeks. The trial's clinical number is NCT06005909. The Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Dizziness Handicap Inventory, Tinetti Balance and Gait Assessment Scale, and Ferrans&Powers Quality-of-Life Index were used for pre-and post-treatment assessment. ResultsBoth groups exhibited a significant decrease in FSS, FIS, and Dizziness Handicap Inventory scores, as well as an increase in Tinetti Balance and Gait Assessment Scale and Ferrans&Powers Quality-of-Life Index scores following treatment. In the inter-group comparison, the Tinetti balance and gait assessment and the Ferrans&Powers quality of life index scores were higher in the hippotherapy group compared to the Cooksey group. ConclusionsAlthough both forms of physical activity have demonstrated effectiveness in reducing fatigue among individuals with MS, hippotherapy shows superior efficacy in enhancing balance, gait, and overall quality of life.

Effect of dry needling on quality of life in patients with trigger finger: a randomized controlled trial

BackgroundAn inflammatory disorder known as trigger finger (TF) results in pain inthe proximal and distal palm and digit, as well as restricted movement and diminished function. Physiotherapists use a specific treatment called dry needling (DN) to reduce musculoskeletal pain and assist patients with mobility restriction.ObjectivesThis study aimed to examine the effectiveness of DN on quality of life in patients suffering from trigger finger.MethodsForty patients, ranging in age from 45 to 75, were randomized into one of two groups in this Prospective pre and post-test, single-blind parallel group randomized controlled trial. Twenty patients were assigned to the intervention group, which included traditional physiotherapy splinting and ultrasound (ultrasonic dosage was 3MHz, the intensity of 0.5 W/cm2, and the duty cycle 50%. Duration: 5 minutes) as well as to DN upon a nodule at the proximal end of the 1st annular (A1) pulley as well as the discrepancy that existed between the flexor tendon's diameter along with its sheath at the metacarpal head. Twenty patients were assigned to the control group, which consisted of traditional treatment alone, twice weekly, for a total of ten sessions over five weeks. The trial evaluated the quality of life, severity of pain, and hand grip strength using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), visual analogue scale, and Camry dynamometer respectively two times, beforetreatment and after 10 treatment sessions.ResultsWithin-group analysis using MANOVA demonstrated a significant decline in VAS (p = 0.001) and a significant improvement in quality of life (p = 0.001) and hand grip strength (p = 0.001). Regarding between group comparison using MANOVA there was significant improvement in favor of the DN intervention (p = 0.001) for all measured variables.ConclusionsA 5-week dry needling approach with a traditional physiotherapy program was effective in improving in quality of life, pain intensity, and hand grip strength in patients with trigger finger, emphasizing it as the better option.Trial registration:Clinical Trial. Gov, NCT05671523. Registered 14 December 2022.

Kinesiotaping versus counterforce brace in the management of lateral elbow tendinopathy

Purpose: The main purpose of the current study was to assess whether counter force brace (CFB) offers any additional value over Kinesiotaping (KT) in the management of tennis elbow. Materials and Methods: Forty-five females with clinically diagnosed tennis elbow participated in the current study. They were equally assigned into three groups of equal numbers. 12 sessions over 4 weeks of treatment interventions; experimental group A received the traditional physiotherapy program in addition to KT. Group B received the physiotherapy program in addition to the CFB. Group C (Control Group) received the physiotherapy program only. The degree of tennis elbow pain and myoelectrical activities of forearm muscles were measured. Results: There was a statistically significant reduction of pain in the experimental group A (KT) in comparison with the control group (p = 0.000), while a statistically significant reduction of pain (p = 0.000) and improvement of the myoelectrical activities of the forearm muscles (p = 0.000) were detected in the experimental group B (CFB) in comparison with the control group. In addition, the statistically significant reduction of pain (p = 0.000) and improvements in wrist flexors and extensors (p = 0.001 and p = 0.000, respectively) were detected in CFB compared with KT. Conclusion: Compared to KT or a physical therapy program alone, the use of CFB in the treatment of lateral elbow tendinopathy may be beneficial, especially in reducing pain and enhancing the muscle activities of the elbow flexors and extensors.

Post-Mastectomy Shoulder Pain and Lymphedema Responses to Ga-As Laser Versus Microcurrent Electrical Stimulation

Objective: to evaluate the efficacy of GA-AS laser against microcurrent electrical stimulation on postmastectomy shoulder pain as well as lymphedema. Method: a double blinded randomized controlled study. sixty breast cancer patients with lymph-edema stage I and II ,40-55 years old were assigned randomly into study -group A, n = 20 or study -group B, (n = 20) in addition to control group C, (n = 20). The study group was given 20 minutes GA-AS laser, 90 minutes complete decongestive therapy (CDT). study -group B received 20 minutes of microcurrent electrical stimulation (MENS) and 90minutes CDT, control group C was given 90 minutes CDT. All treatment interventions were applied at a frequency of three sessions per week for 12 weeks. Arm volume calculated by circumference measurement, Shoulder and Hand (DASH) questionnaire as well as pain intensity utilizing a visual analogue scale (VAS) were measured at before and following 12 weeks of treatment. Results: a statistically significant difference has been detected in limb volume, DASH questionnaire as well as VAS favoring the study group A ((p = 0.001).) and the study group B ((p = 0.001). following 12 weeks of intervention. The mean (SD) for limb-volume, DASH questionnaire as well as pain score were 1236.74 ± 43.34, 27.21 ± 7.16, and 3.20 ± 0.62in the study group A, and 1331.76 ± 46.92, 34.52 ± 4.38 and 3.90 ± 0.78in the study group B and 1390.18 ± 58.77 ml, 40.68 ± 6.93and 5.30 ± 0.86in the control group C respectively. Conclusion: adding GA-AS laser and microcurrent electrical stimulation to the conventional physical therapy program had a valuable effect than traditional physical therapy program alone in improving postmastectomy shoulder pain as well as lymphedema.

Dry needling versus muscle energy technique on shoulder adhesive capsulitis post mastectomy

Objectives. To compare the effect of dry needling and muscle energy technique on adhesive capsulitis post mastectomy. Design. A single-blinded randomized clinical study. Setting. Outpatient setting. Subjects. Fifty female patients diagnosed with shoulder adhesive capsulitis post mastectomy, ranging in age from 30 to 60 years, were randomly assigned to two groups. Participants in Group A were administered dry needling treatment, plus a traditional physical therapy program in the form of shoulder joint mobilization, shoulder muscle stretching, and ROM exercise; Group B received muscle energy technique, plus a traditional physical therapy program in the form of shoulder joint mobilization, shoulder muscle stretching, and ROM exercise. Intervention. Two sessions per week over five weeks. Outcome measures. Shoulder range of motion, pressure pain threshold, and shoulder dysfunction were measured pre-treatment and post-treatment. Results. There was no statistically significant difference observed in the age distribution between the groups (p > 0.05). Following the treatment, there was a notable rise in the pressure pain threshold and a considerable decline in shoulder dysfunction when compared to the pre-treatment condition (p < 0.001). There was a notable rise in the ranges of shoulder flexion, abduction, and external rotation after the treatment when compared to before the treatment in both group A and B (p > 0.001). The percentage of change in flexion, abduction, and external rotation in group A was 125.03%, 76.43%, and 58.72%, respectively. In contrast, group B exhibited percentage changes of 137.48%, 97.51%, and 68.78% in flexion, abduction, and external rotation, respectively. There was no statistically significant difference seen between the groups prior to treatment, as shown by a p-value greater than 0.05. The analysis of the data after treatment demonstrated a statistically significant rise in the pressure pain threshold for group A in comparison to group B (p < 0.001). However, there was no significant disparity observed in shoulder dysfunction between the two groups (p > 0.05). Following the treatment, there was a notable rise in the range of motion (ROM) for flexion, extension, and abduction in group B when compared to group A (p < 0.001). Conclusion. Application of either dry needling or muscle energy technique results in a notable enhancement in the severity of symptoms in adhesive capsulitis post mastectomy, with superiority for dry needling.

EFFICACY OF MUSCLE ENERGY TECHNIQUE ON SHOULDER ADHESIVE CAPSULITIS POST MASTECTOMY

Background: Shoulder pain, disability and impaired movements are frequently reported complication in post- mastectomy patients. Most individuals who have had a mastectomy suffer from adhesive capsulitis, which causes shoulder pain and impairment. Aim: The current study was conducted to investigate the effectiveness of Muscle energy technique (MET) on shoulder adhesive capsulitis post mastectomy. Patients and methods: The present work was carried-out on sixty patients with adhesive capsulitis after mastectomy who participated in this study, they were aged from 40 to 60 years. The individuals were recruited from National Cancer Institute, Cairo University. They were randomized into 2 groups; every group included 30 patients. Group (A) (study group): were givenMET5 days per week for eight weeks as well as their traditional physiotherapy program (Mobilization exercises, stretching of the Posterior capsule, as well as Range of motion (ROM) exercises). Group (B) (control group):received only the conventional physical therapy program, 5 days per week for eight weeks. Visual analogue scale (VAS) was utilized to measure the shoulder pain. Goniometer was utilized to evaluate shoulder ROM. Shoulder pain and disability index (SPADI) was utilized to evaluate shoulder function. All assessments were conducted pretreatment as well as post treatment. Results: In both Groups A and B, post-treatment VAS as well as SPADI scores were significantly lower than pre-treatment scores (p < 0.001). the percentage of change of VAS as well as SPADI in Group A was 68.28% and 71.88% respectively, while it was, 45.76% and 54.4% in group B respectively. In both groups, post-treatment shoulder flexion, abduction, as well as lateral rotation were all significantly higher than pre-treatment values. Shoulder flexion, abduction, as well as external rotation all increased by 128.25, 75.76, and 99.95% in group A, whereas they increased by 97.58, 59.9, and 89.38% in group B, respectively. Pretreatment comparisons showed no statistically significant differences among the groups. Post-treatment comparisons between the two groups showed that VAS and SPADI scores were significantly lower in Group A compared to Group B (p < 0.001). Shoulder flexion, abduction, as well as external rotation were significantly improved in group A than in group B after treatment (p < 0.001). Conclusion: adding MET in rehabilitation program can improve the shoulder pain, ROM as well as function in adhesive capsulitis management Postmastectomy.

Effect of anti-gravity treadmill (Alter G) training on gait characteristics and postural stability in adult with healed burns: A single blinded randomized controlled trial

BackgroundBurns constitute one of the foremost contributors to premature mortality and morbidity, and the recovery process from burn injuries is characterized by its intricate and protracted nature. ObjectiveThe principal aim of this study was to assess the influence of an anti-gravity treadmill (Alter G) training program on both gait characteristics and postural stability indices (PSI) in adult individuals who have recovered from burns. DesignThis study followed a single-blind, randomized, controlled design. MethodsA total of 45 adults, aged 18–35 years, with healed lower extremity burns that were circumferential and encompassed 35–50% of their total body surface area (TBSA) were randomly allocated to either the anti-gravity treadmill (Alter G) Training group (n = 22) or the traditional physical therapy program (TPTP) group (n=23). The TPTP group received conventional physical therapy, while the anti-gravity treadmill (Alter G) training group engaged in anti-gravity treadmill exercises alongside the traditional physical therapy program. The primary outcome measures, evaluated at both baseline and the conclusion of the 12-week intervention, included gait characteristics assessed using the GAITRite system and PSI measured by the Biodex Balance System (BBS). ResultsThe anti-gravity treadmill (Alter G) training group exhibited significantly greater enhancements than the TPTP group in terms of mean values and percentage changes in gait characteristics and PSI. Specifically, the percentage changes for the Alter G group were as follows: stride length (20.57%), step time (22.58%), step length (20.47%), velocity (15.67%), cadence (23.28%), and double support time (29.03%). In contrast, the TPTP group’s percentage changes were: 6.73%, 8.19%, 7.65%, 7.75%, 8.89%, and 9.37%, respectively. Concerning PSI, the Alter G group exhibited percentage changes of 55.17% for the medio-lateral stability index (MLI), 48.21% for antero-posterior stability index (API), and 48.48% for the overall stability index (OSI). The TPTP group’s corresponding percentage changes were 20%, 14.03%, and 16.41%. ConclusionsThe amalgamation of anti-gravity treadmill training with the traditional physical therapy program yields greater efficacy than TPTP in isolation. Consequently, the findings underscore the efficiency of anti-gravity treadmill (Alter G) Training as a valuable tool for rehabilitating patients with burn injuries.

The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: A single-blinded, randomized controlled study

Study designSingle-blinded, randomized controlled study. IntroductionCarpal Tunnel Syndrome (CTS) causes pain and loss of function in the affected hand. The mobilization with movement (MWM) technique is a manual therapy method applied to correct joint movement limitation and to relieve pain and functional disorders. Purpose of the studyThis study aimed to examine the effectiveness of MWM technique on pain, grip strength, range of motion, edema, hand reaction, nerve conduction, and functional status in patients with CTS. MethodsA total of 45 patients enrolled in the study. The MWM group (n = 18) completed a 4-week combined conservative physiotherapy and MWM program, whereas the control group (n = 18) received only the 4 weeks of conservative physiotherapy. Pain severity according to the numerical rating scale was used as primary outcome. ResultsWe found an improvement within the subjects in resting pain (MWMG:5.1 ± 3.6 vs 1.1 ± 2.4, Effect Size (ES)=1.3; CG:4.5 ± 3.3 vs 1.0 ± 2.2, ES=1.1), in activity pain (MWMG:6.5 ± 3.7 vs 1.1 ± 2.4, ES=1.5; CG:4.8 ± 3.4 vs 2.2 ± 2.3, ES=1) and in night pain (MWMG:5.9 ± 3.2 vs 1.8 ± 2.5, ES=1.2; CG:5.3 ± 4.2 vs ± 2.3 ± 3.5, ES=0.9). For between the groups, a statistical difference was found for the activity pain, Disabilities of the Arm Shoulder and Hand Questionnaire score (MWMG:52.2 ± 23.8 vs 27 ± 24.7, ES=1.3; CG:47.0 ± 24.8 vs 41.5 ± 22.1, ES=0.2), Michigan Hand Outcomes Questionnaire (MHQ-1), (MWMG:44.4 ± 23.7 vs 74.7 ± 24.5, ES=1.3; CG:44.8 ± 17.4 vs 57.4 ± 21.7, ES=0.9) and MHQ-5 (MWMG:68.8 ± 13.1 vs 82.5 ± 11.5, ES=0.9; CG:63.4 ± 26.7 vs 59.3 ± 25.8, ES=0.1) parameters in favour of MWM group. DiscussionThis study showed that MWM compared to conservative physiotherapy might be more effective in reducing perceived symptoms in mild and moderate CTS patients. ConclusionsMWM produced a small benefit to recovery of activity pain and upper extremity functionality level outcomes of patients with mild to moderate CTS when added to a traditional CTS physical therapy program.

Combined effect of graded Thera-Band and scapular stabilization exercises on shoulder adhesive capsulitis post-mastectomy

PurposeThe main aim of the trial was to assess the combined impact of graded Thera-Band strengthening exercises and scapular stabilization exercises on shoulder pain, physical function, and quality of life (QoL) in post-mastectomy adhesive capsulitis (AC).MethodsSeventy females with unilateral post-mastectomy AC partook in the trial. Participants were subdivided equally into two groups at random. Both groups obtained the traditional physical therapy program; in addition, the intervention group received graded Thera-Band exercises for shoulder muscles and scapular stabilization exercises 5 days a week for 8 weeks. Range of motion (ROM) and muscle power of shoulder were assessed by digital goniometer and handheld dynamometer, respectively. Disability of the Arm, Shoulder, and Hand questionnaire (DASH) was utilized for assessment of shoulder function and visual analogue scale (VAS) for pain measurement while short-form (SF-36) for QoL assessment. All evaluation data was recorded prior to the trial and at the eighth week of interventions for both groups.ResultsAll participants achieved improvements in shoulder ROM, muscle power, pain, and all aspects of QoL; however, higher statistical improvements were reported in all measurements with respect to strengthening exercises group (p < 0.001).ConclusionThe addition of graded Thera-Band strengthening exercises and scapular stabilization exercises in post-mastectomy AC rehabilitation program has significant benefits in shoulder function and patients’ QoL.Trial registration: This study is retrospectively registered at ClinicalTrials.gov NCT05311839.

Adjunctive effect of pulsed electromagnetic field therapy on quadriceps muscle strength after burn injury

Purpose. This study was conducted to examine the effect of pulsed electromagnetic field therapy on quadriceps muscle strength after burn injury. Methods. From April 2021 to June 2022, sixty male patients who suffered from second degree lower limb thermal burn injury and Total body surface area (TBSA) from 25% to 35% participated in this study. Their ages ranged from (20-40) years. They were randomly assigned in two groups, a study group composed of 30 patients who received (PEMF) over thigh area before strengthening exercise for quadriceps muscle and a control group composed of 30 patients who received strengthening exercise for quadriceps muscle. Patients of both groups received traditional physical therapy program.. Evaluation tool was isokinetic dynamometer to measure the quadriceps muscle peak torque before the treatment and after 8 weeks of treatment for both groups. Results. There was no significant difference between both group (study and control) in mean values of quadriceps peak torque pre-treatment (P &gt; 0.05). There was a significant increase in the mean values of quadriceps peak torque after 8 weeks of treatment in both groups (p &lt; 0.05) while there was a significant difference in post treatment mean values of quadriceps peak torque in the study group when compared with control group (p &lt; 0.05). Conclusion. Pulsed electromagnetic field therapy is an effective modality that can be used for improving muscle strength and performance in patients with lower limb burn when applied prior to strengthening exercise.

Effect of simultaneous application of positional release technique and Maitland mobilization technique on sciatica: a randomized controlled trial

BackgroundLow back pain (LBP) associated with sciatica is considered the primary cause of seeking medical and physical therapy advice. Treating sciatica symptoms is the main goal in the physical therapy practice, and the literature supports the use of manual therapy techniques in management of patients with sciatica.ObjectivesThis study aimed to assess the effect of simultaneous application of positional release technique and grade-4 Maitland mobilization technique on sciatic nerve sensory nerve conduction velocity (NCV) in patients with LBP associated with sciatica.MethodsA randomized controlled trial was performed among 50 patients (mean age 41.86 ± 7.90) diagnosed with LBP with sciatica. Patients were randomly assigned to two groups: experimental “group A, n = 25” and control “group B, n = 25.” Patients were tested twice, before and after a 6-week period, during which group A received a traditional physical therapy program along with piriformis muscle positional release technique and grade-4 Maitland mobilization technique, while group B received a traditional physical therapy program along with a sham mobilization technique.ResultsStatistical analysis revealed a significant increase (p < 0.05) in the sciatic nerve sensory NCV in the post-test condition compared with the pre-test in group A with no significant difference (p > 0.05) in group B.ConclusionSimultaneous application of the piriformis muscle positional release technique and grade-4 Maitland mobilization technique on lower lumbar spine may improve sciatic nerve function in patients with LBP associated with sciatica.

Effect of functional electrical stimulation on postural control in children with hemiplegic cerebral palsy: a randomized controlled trial

BackgroundChildren with cerebral palsy have impairments of postural control during static and dynamic activities. Improving postural control is one of the primary objectives of rehabilitation for children with cerebral palsy. Therefore, the objective of this study was to study the effect of functional electric stimulation on postural control in children with hemiplegic cerebral palsy. A randomized controlled study was conducted on 30 children with hemiplegic cerebral palsy (18 boys and 12 girls) between the ages of 8 and 12 years. The children were distributed in two equal groups. The experimental group received functional electrical stimulation (pulse width 300 μs, frequency 33 Hz, 2 h/day, 3 days/week, / 3 consecutive months) in addition to the traditional physical therapy program. While the control group received the traditional physiotherapy program only for the same duration. The outcomes included postural stability indices that were measured at baseline and following 3 months of intervention using the Biodex balance system.ResultsA significant improvement was found in the postural stability indices of children in both groups, comparing their mean values before and after treatment. Furthermore, the results revealed a greater improvement in the postural stability of the experimental group (P < 0.001).ConclusionFunctional electrical stimulation may be a useful tool to enhance the postural stability of children with hemiplegic cerebral palsy.Clinical trial registrationThis study was registered in the ClinicalTrial.gov PRS (NCT04269798). https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009LHP&selectaction=Edit&uid=U0003GAI&ts=4&cx=74k74l

Effect of Aerobic Versus Anaerobic Exercise on Quality of Life in Stroke Patients

Background: Stroke is one of the world's leading causes of death and long-term lack of ability. Objectives: This study aimed to test the effect of aerobic versus anaerobic exercise on stroke patients' quality of life. Methods: Thirty male patients with stroke enrolled in this study. The patients were divided into three groups at random: two research groups (GA) and (GB) and one control group (GC). A traditional physical-therapy program was provided for the control group (GC) including: Passive Range of motion exercises for tightens muscles, Facilitation for weak muscles through: PNF technique, quick stretching. Besides traditional physical therapy, an aerobic exercise was performed by the patients in a study group (GA). Other than traditional physical treatment, patients received anaerobic training in the study group (GB). The session time for each group was 50-60 min; it is conducted three times a week for eight weeks. The Outcome Measures: The Arabic version of a short form dimension test (SF-36) used to assess the QOL items of the SF-36 were divided into eight different domains. All groups were evaluated before and after intervention with a QOL questionnaire (SF36). Results: There was a statistical meaningful increase in physical functioning, (vitality) energy/fatigue, emotional well-being, social functioning, pain and general-health in study groups (GA), (GB) compared with that of control group (GC) after therapy. However, there was no significant difference between groups in role limitations due to physical health and role limitations due to emotional problems. There was no meaningful difference in the quality of life items within groups (GA), (GB) after therapy. Conclusion: Eight weeks of training revealed non-significant difference between aerobic and anaerobic groups. However, either aerobic or anaerobic training has a beneficial effect on quality of life in stroke patients.

Efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy

BackgroundThe use of TheraTogs orthotic undergarments has been suggested to improve the ability to stabilize the posture, to correct or prevent deformities, to improve functionality, and to enable the user a more appropriate functional pattern. The aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy. Forty children with diplegic cerebral palsy, with ages ranging from 6 to 9 years, were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Spinal geometry was measured at baseline and after 3 months of intervention using the Formetric system.ResultsChildren in both groups showed significant improvements in the spinal geometry (P < 0.05), with significantly greater improvements in the experimental group than the control group. The post-treatment mean values of lateral deviation (mm), pelvic tilt (mm), trunk imbalance (mm), and surface rotation (mm) were 5.45, 6.35, 8.8, and 3.65 and 8, 8.9, 11.2, and 5.9 for the experimental and control group, respectively.ConclusionsTheraTogs orthotic undergarment may be a useful tool for improving spinal geometry in children with diplegic cerebral palsy.Trial registrationThis study was registered in the ClinicalTrial.gov PRS (NCT04271618).

Effect of Mulligan Bent Leg Raise Technique on Hamestring Shortening Following Lower Limb Burn

Abstract Background: Globally, burns are a serious public health problem and Knee post burn scar flexion contractures, makes up 22% of large joint contractures. Stretching is effective method to improve muscle length and mulligan bent leg raise is a modification of straight leg raise which increase hamstring flexibility and length. Aim of Study: This study has been conducted to evaluate the effect of the mulligan bent leg raise technique on elongation of hamstring muscle and the reflection of that on some quan-titative gait parameters and the range of motion (ROM) of knee extension. Patients and Methods: Thirty male patients between 30- 50 years were participated in this study, with a second-degree posterior leg burn and a total body surface area of 15-20%. They were divided randomly into two equal groups, study group (A), 15 patients received mulligan bent leg raise technique plus the traditional physical therapy program and control group (B), 15 patients received only the same traditional physical therapy program. Measurements were recorded before treatment and after third, sixth and eighth week of treatment (session for 30 minutes, 5 days/week for a total period of 2 months). A 16-meter walkway and tape measure were used to measure the quantitative gait parameters, while manual goniometer was used for measuring ROM of knee flexion. patients were exam-ined at the outpatient clinic of Cairo University during the period from December 2020 to February 2021. Results: There was a significant decrease in knee flexion ROM and step width and a significant increase in step length and stride length of the study group (group A) at post I, post II and post III compared with that of the control group (group B) (p < 0.001). Conclusion: It is concluded that the mulligan bent leg raise technique is effective in elongating the hamstring muscle as reflected by the improved gait parameters as well as the ROM of knee extension.

AN INTERVENTION TO ENHANCE OCCUPATIONAL PERFORMANCE OF CHILDREN WITH OBSTETRICAL BRACHIAL PLEXUS PALSY

Purpose: Children with obstetric brachial plexus palsy (OBPP) have problems with activity and participation, even if they are operated. The study aimed to investigate the intervention's effects to increase the occupational performance (OP) of children with OBPP. Methods: Twenty-nine children with OBPP, aged 4-7 years, participated in this study. The intervention group consisted of six girls and 12 boys, and a control group was composed of eight girls and three boys. The Canadian Occupational Performance Measure (COPM) determined children's OP. The Pediatric Evaluation of Disability Inventory (PEDI) was used to evaluate functional capability. All subjects continued their traditional physiotherapy program of 45 minutes every two days. The intervention group participated in an intervention program, consisting of the children and their families' needs, expectations, and therapists' assessment, about OP 40 minutes per day three days per week for three months. Results: The PEDI self-care, mobility, social function, and total scores and COPM-performance and COPM-satisfaction scores significantly increased in the intervention group (p&amp;lt;0.05). PEDI mobility, social function, and total scores significantly improved in the control group (p&amp;lt;0.05, Table 1). There was a significant difference in PEDI self-care (p=0.020) and total scores (p=0.009) between the two groups. There was no significant difference in COPM-performance and COPM-satisfaction scores in the control group (p&amp;gt;0.05). Conclusions: The present study is the first study on OP intervention in children with OBPP. The present study suggests intervening to enhance OP and via assessing using COPM in the children with OBPP.

Effects of adding neural mobilization to traditional physical therapy on pain, functional disability, and H-reflex in patients after lumbar laminectomy: A randomized controlled trial

Objective: To investigate whether adding neural mobilization to a standard postoperative physical therapy program could improve the outcomes of patients after lumbar laminectomy. Design: A single blinded randomized controlled trial. Setting: Outpatient setting. Participants: Sixty participants of both sexes who had undergone lumbar laminectomy. Interventions: Participants were allocated randomly to two groups; study and control groups. All patients received a standard postoperative physical therapy program. Those in the study group received additional neural mobilization in the form of straight leg raising and dorsiflexion with two-ended slider. Treatment was administered three times/week for six successive weeks. Outcome measures: Visual analog scale (VAS), Oswestry disability index (ODI), and H-reflex latency were measured pre and post-treatment. Results: The mean age of participants was 44.23 ± 4.64 and 45.3 ± 5.3 in study and control groups respectively (P > 0.05). There were statistically significant differences in VAS, ODI, and H-reflex latency in favor of the study group (P < 0.05). The mean ± SD for VAS, ODI, and H-reflex latency pre vs post treatment was 6.13 ± 1.22 vs 1.40 ± 0.77, 64.46 ± 4.05 vs 16.86 ± 2.55, and 32.07 ± 2.76 vs 27.46 ±1.79 in study group and 5.86 ± 1.07 vs 2.46 ± 0.73, 63.93 ± 3.91 vs 23.40 ± 2.93, and 31.76 ± 2.69 vs 29.4 ± 1.94 in control group, respectively. Conclusions: Neural mobilization combined with traditional physical therapy program achieved better improvement in pain, functional disability and H-reflex in patients who underwent decompressive laminectomy than traditional physical therapy program only.

Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

BackgroundTheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis.ResultsChildren in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group.ConclusionsThe use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy.Trial registrationThis trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

Efficacy of whole-body vibration on balance control, postural stability, and mobility after thermal burn injuries: A prospective randomized controlled trial

Objective: To investigate the additive effects of whole-body vibration (WBV) training to the traditional physical therapy program (TPTP) on balance control, postural stability, and mobility after thermal burn injuries. Design: A single-blinded, randomized controlled study. Setting: Outpatient physical therapy setting. Participants: Forty participants, 20–45 years old, with deep second-degree thermal burn involving the lower limbs and trunk, with 35%–40% total body service area, were randomly allocated either into the study group or the control group. Intervention: The study group received WBV plus TPTP while the control group received the TPTP only. Interventions were applied three sessions a week for eight weeks. Outcome measures: Anteroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI), timed-up and go (TUG), and Berg balance scale (BBS) were measured at baseline and after eight weeks of interventions. Results: There were statistically significant differences in APSI, MLSI, OSI, BBS, and TUG in favor of the WBV group after eight weeks of intervention (P < 0.001). After eight weeks of intervention, the mean (SD) for APSI, MLSI, OSI, BBS, and TUG scores were 1.87 ± 0.51, 41.36 ± 0.18, 1.95 ± 0.56, 47.2 ± 6.12, and 8.15 ± 1.05 seconds in the WBV group, and 2.41 ± 0.71, 2.21 ± 0.54, 2.68 ± 0.73, 40.65 ± 4.7, and 10.95 ± 2.44 seconds in the control group, respectively. Conclusions: The whole-body vibration training combined with the TPTP was more beneficial in improving APS, MLS, OSI, TUG, and BBS than TPTP alone. It might be considered a useful adjunctive therapy in treating patients with healed wounds with a deep second-degree burn of the trunk and lower limbs.

Effect of vestibular rehabilitation therapy on visual and motor functions in children with dyspraxia

Purpose: To investigate the effect of vestibular rehabilitation therapy program on the visual and motor functions in children with dyspraxia. Method: Twelve children with dyspraxia from both genders, aged from 4 to 12 years, are included in this study. All of them had movement dyspraxia affecting their ability to stand and walk alone according to chick list of developmental dyspraxia. Also, they had level 2 or 3 of visual function level. They received vestibular rehabilitation therapy program in addition to traditional physical therapy program, for three times/ week, for three months. Visual and gross motor functions were assessed before and after three months of treatment using Hoyt's levels of visual function and Peabody Developmental Motor Scale (PDMS- 2) respectively. Results: Results showed highly significant improvement in visual function level and gross motor functions for the study group when comparing it's results before and after three months of treatment (P ≤ 0.05) Conclusion: Vestibular rehabilitation therapy program is an effective modality for improving visual and motor functions in children with dyspraxia. Key words: Dyspraxia, motor functions, Vestibular Rehabilitation Therapy program, visual functions