Traditional Physical Therapy Program Research Articles

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

Effect of photobiomodulation therapy on trunk flexor performance after incisional hernia repair: a randomized controlled trial.

To investigate the effect of two photobiomodulation approaches on trunk flexor performance after incisional hernia repairand to compare the effects of both wavelengths. Forty-five patients were randomly distributed after isokinetic trunk flexor assessments into infrared laser, red laser, and placebo groups. Each patient received laser treatment followed by a traditional physical therapy program. In laser treatment, 24 points in both recti were irradiated by infrared or red laser light with the following parameters; 0.6J per point, 214.28J/cm2 as energy density, and 17.85W/cm2 as intensity, while the control group received a placebo approach. All groups received clinical treatments at a rate of 3 sessions per week for 4weeks; in addition, the physical therapy program was continued on other days for all groups. Isokinetic trunk flexor strength was measured before treatment and 4weeks after treatment as in each measurement, fatigue protocol was designed, and the trunk flexor strength was measured before fatigue test while the trunk flexor resistance to fatigue was measured after fatigue test. After 4weeks, pre-and post-fatigue trunk flexor strengths in both laser groups were significantly increased compared to pre-and post-fatigue trunk flexor strength in the placebo group, respectively, and there was no significant difference between the two laser groups.Photobiomodulation approaches enhance trunk flexor response to exercise after incisional hernia repair. This enhancement leads to greater strength and more fatigue resistance for the trunk flexors in photobiomodulation groups compared to the placebo groupand no difference between the two photobiomodulation effects.

Effectiveness of Shock Wave Therapy versus Intra-Articular Corticosteroid Injection in Diabetic Frozen Shoulder Patients’ Management: Randomized Controlled Trial

Frozen shoulder is a major musculoskeletal illness in diabetic patients. This study aimed to compare the effectiveness of shock wave and corticosteroid injection in the management of diabetic frozen shoulder patients. Fifty subjects with diabetic frozen shoulder were divided randomly into group A (the intra-articular corticosteroid injection group) and group B that received 12 sessions of shock wave therapy, while each patient in both groups received the traditional physiotherapy program. The level of pain and disability, the range of motion, as well as the glucose triad were evaluated before patient assignment to each group, during the study and at the end of the study. Compared to the pretreatment evaluations there were significant improvements of shoulder pain and disability and in shoulder flexion and abduction range of motion in both groups (p &lt; 0.05). The shock wave group revealed a more significant improvement the intra-articular corticosteroid injection group, where p was 0.001 for shoulder pain and disability and shoulder flexion and abduction. Regarding the effect of both interventions on the glucose triad, there were significant improvements in glucose control with group B, where p was 0.001. Shock waves provide a more effective and safer treatment modality for diabetic frozen shoulder treatment than corticosteroid intra-articular injection.

Effect of Graft Rupture Prevention Training on Young Athletes After Anterior Cruciate Ligament Reconstruction: An 8-Year Prospective Intervention Study.

Background:There is a lack of research on the effects of a postoperative rehabilitation program on anterior cruciate ligament (ACL) graft rupture.Hypothesis:We hypothesized that a hip-focused rehabilitation protocol with graft rupture education and avoidance training (HIP-GREAT program) would demonstrate lower ACL graft rupture rates compared with a traditional physical therapy (PT) program.Study Design:Cohort study; Level of evidence, 3.Methods:This study consisted of young athletes who had undergone ACL reconstruction at a single institution. Postoperatively, 136 participants (mean age, 16.9 ± 2.4 years) were enrolled in a traditional PT protocol between 2006 and 2010, and 153 participants (mean age, 17.0 ± 2.3 years) were enrolled in the HIP-GREAT protocol between 2011 and 2015. Follow-up rates were 31% (42/136) and 27% (41/153) in the traditional PT and HIP-GREAT groups, respectively, at 3 years postoperatively. The hazard ratio was calculated, and absolute risk reduction (ARR) and number-needed-to-treat (NNT) analyses were performed to compare the 2 protocols.Results:ACL graft rupture occurred in 10 patients (7.4%) in the traditional PT group and 5 patients (3.3%) in the HIP-GREAT group. This difference was not statistically significant (hazard ratio, 0.39; 95% CI, 0.14 to 1.16; P = .09). The ARR was 0.041 (95% CI, –0.011 to 0.093), and the NNT was 24.5.Conclusion:This study did not demonstrate a statistically significant reduction of ACL graft rupture in patients in the HIP-GREAT group. However, high ARR values and low NNT values were found, which suggests the possible effectiveness of the HIP-GREAT protocol to reduce ACL graft ruptures in young athletes.

Can Functional Electrical Stimulation affect Equilibrium and motor functions in Spastic hemiparetic Cerebral Palsy A Randomized Controlled Study

Background and aim: Using of F.E.S in rehabilitation program results is auspicious, although there’re doubts about FES efficiency in balance and main motor functions amelioration in hemiplegic infants. The research studied the impact of FES in balance and main motor skills improvement in infants diagnosed with hemiparetic cerebral palsy if we placed it on ventral muscle group of leg. Design and Place: Randomized controlled study in National Institute for Neuro-Motor System in Egypt. Methodology: 30 infants who are diagnosed with hemiplegic CP aging from 6 to 8 years is chosen from both genders. In two egalitarian sets randomly (control and study). Prior and after 3 months of treatment Assessment was carried out, utilizing Biodex balance system to gauge static balance plus Peabody progressive motor scale to evaluate gross motor functions. Control set is put in an elected Physiotherapy program. The other set (study one) received FES as well as the elected Physiotherapy program. Results: Study group patients showed a considerable amelioration in main motor skills test. Furthermore, in same group it’s showed that balance control was better according to the other set (control group) after training. Conclusion: Electrical stimulation addition to traditional Physiotherapy program over leg ventral group muscles can ameliorate balance and the gross motor functions in hemiparetic cerebral palsy infants.

Effect of Aerobic Training on Selected Cardiopulmonary Parameters in Myocardial Infarction Patients with Stroke

Background: Patients in cardiac rehabilitation are typically advised to complete a period of maintenance phase. The purpose of this study was to determine if there was any difference in effect of aerobic training on selected cardiopulmonary parameters in myocardial infarction patients with stroke. Methodology: Forty patients of both sexes with age 40-50 years with chronic myocardial infarction patients with stroke after 6 months participated in the study. Patient’s were assigned for 4 weeks into two groups: group (A) received aerobic training and traditional physical therapy program and group (B) which received traditional physical therapy program. Patients were assessed pre and post treatment using through Stress exercise test unit (Modified Bruce protocol) and modified ashwarth scale. Results: This study revealed that there is significantly improved in resting heart rate (10.10%), maximum heart rate (4.67%), METs (64.95%), maximum systolic blood pressure (4.45%), maximum diastolic blood pressure (9.45%) and VO2 max (35.36%) variables in group (A) treated by aerobic training than those of traditional physical therapy program only. Conclusion: Aerobic training was a valuable method for management myocardial infarction patients with stroke.

Dynamic Stability and Trunk Control Improvements Following Robotic Balance and Core Stability Training in Chronic Stroke Survivors: A Pilot Study.

Stroke survivors show greater postural oscillations and altered muscular activation compared to healthy controls. This results in difficulties in walking and standing, and in an increased risk of falls. A proper control of the trunk is related to a stable walk and to a lower falling risk; to this extent, rehabilitative protocols are currently working on core stability. The main objective of this work was to evaluate the effectiveness of trunk and balance training performed with a new robotic device designed for evaluation and training of balance and core stability, in improving the recovery of chronic stroke patients compared with a traditional physical therapy program. Thirty chronic stroke patients, randomly divided in two groups, either underwent a traditional rehabilitative protocol, or a robot-based program. Each patient was assessed before and after the rehabilitation and at 3-months follow-up with clinical and robot-based evaluation exercises focused on static and dynamic balance and trunk control. Results from clinical scores showed an improvement in both groups in balance and trunk control. Robot-based indices analysis indicated that the experimental group showed greater improvements in proprioceptive control, reactive balance and postural control in unstable conditions, compared to the control group, showing an improved trunk control with reduced compensatory strategies at the end of the training. Moreover, the experimental group had an increased retention of the benefits obtained with training at 3 months follow up. These results support the idea that such robotic device is a promising tool for stroke rehabilitation.

Influence of rhythmic auditory feedback on gait in hemiparetic children

Background: The spastic hemiparetic gait pattern is characterized by temporal and spatial asymmetries, which are resistant features to correction. More information about the effect of new therapeutic modalities on the hemiparetic gait pattern should be investigated and obtained. Aim: The purpose of this study was to investigate the effect of rhythmic auditory-cued gait training on spatiotemporal asymmetries of gait in hemiparetic children. Methods: A randomized controlled study was conducted on 30 spastic hemiparetic children (15 boys and 15 girls) in the age range of 6–10 years. They were randomly allocated in two equal groups. The investigator performed two-dimensional gait analysis for every child before and after the treatment program to assess the gait symmetry. Gait Symmetry Index (SI) was applied to investigate the spatiotemporal gait symmetry. The study group received rhythmic auditory-cued gait training in addition to traditional physical therapy program training, whereas the control group received the traditional physical therapy program training, three times/week for 4 months. Results: There was a statistically significant decrease in SI of step length, stride length, stance time, and swing time posttreatment in the study and control groups compared with that pretreatment (P > 0.01). Furthermore, comparison between the study and control groups posttreatment revealed a significant decrease in SI of step length, stride length, stance time, and swing time of the study group compared with that of the control group (P > 0.01) which indicate improvement of symmetry. Conclusions: Gait training using rhythmic auditory feedback is superior to conventional physical therapy training for improving the gait symmetry of children with spastic hemiparesis.

Comparison of Radial Extracorporeal Shock Wave Therapy and Traditional Physiotherapy in Rotator Cuff Calcific Tendinitis Treatment.

This study aims to investigate the efficacy of radial extracorporeal shock wave therapy (rESWT) in relieving pain and improving range of motion (ROM) and functionality besides conventional physiotherapy methods in the treatment of chronic rotator cuff calcific tendinitis (RCCT). We studied 80 patients (35 males, 45 females; mean age 53.3±9.6 years; range, 40 to 70 years) with chronic RCCT. Patients were randomly divided into two groups: rESWT group (n=40) treated with conventional physiotherapy and rESWT, and control group (n=40) treated only with a conventional physiotherapy program. The traditional physiotherapy program included ultrasound, transcutaneous electrical nerve stimulation, shoulder joint ROM and stretching exercises, and ice applications. All patients received a total of 20 treatments, five days a week for four weeks. rESWT was applied once a week for four weeks in total. Before and after treatment, all patients were evaluated for age, height, weight, Body Mass Index (BMI), pain intensity with a Visual Analog Scale, shoulder ROM, and functional disability status with the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Mean BMI value of the participants was 26.1±3.0 kg/m2. Although all parameters of the patients in both groups improved significantly, patients in the rESWT group had a statistically significant improvement in pain, ROM and QuickDash scores (p<0.001, p<0.001, and p<0.001, respectively). We assume that rESWT is an effective and noninvasive method of reducing pain and increasing ROM and functional status without the need for surgery.

Effect of Upper Thoracic Mobilization on Chronic Mechanical Neck Pain

AbstractBackground: Recently, attention has been given to use the manual therapy for thoracic spine to treat Mechanical Neck Pain (MNP).The Aim of Study: To investigate the effect of upper thoracic mobilization on Cervical Range of Motion (CROM), resting pain level and functional abilities of the neck in patients with chronic mechanical neck pain.Subjects and Method: Thirty patients with chronic me-chanical neck pain participated in this study. Subjects were divided into two groups, fifteen in each group. The first group was the treatment group (Group A) who received upper thoracic mobilization and traditional physical therapy program; and the second group was the control group (Group B) who received the traditional physical therapy program only. Before and after the treatment, the CROM was measured by baseline cervical inclinometer, the rest pain level was measured by a Visual Analog Scale (VAS) and neck disability was measured by Neck Disability Index (NDI). Patients in treatment group were treated with upper thoracic mobilization, infra-red, transcutaneous electrical nerve stimulation and cervical muscle stretching exercises. On the other hand, patients in control group were treated the same like treatment group without upper thoracic mobilization.Results: There is a statistical significant difference between both groups. There is a positive effect of upper thoracic mobilization on CROM and neck function when comparing with routine physical therapy, there was no a statistical significant effect of upper thoracic mobilization on resting pain level when compared with routine physical therapy.Conclusion: There is a positive effect of upper thoracic mobilization on all CROM and neck function, although there was no a significant effect on resting pain level.

Efficacy of Biofeedback Exercise of Deep Neck Flexors on Cervicogenic Headache

AbstractBackground: Cervicogenic Headache (CGH) is a common condition causing significant disability. Patients with CGH had less strength and endurance of Deep Neck Flexors (DNF).Aim of Study: The purpose of this study was to investigate the efficacy of (DNF) strength exercise using Pressure Bio-feedback Unit (PBU) for CGH patients.Material and Methods: Thirty patients (15 females and 15 males) with CGH, their age ranged from twenty to forty years, were randomly allocated into DNF group received DNF strength exercise using PBU in addition to traditional program and traditional treatment group received traditional physical therapy program only. Treatment applied three times per week for 4 weeks, each patient has been assessed for pain, functional disability, and cervical range of motion using Visual Analog Scale (VAS), Neck Disability Index (NDI) and OB Myrin goniometry respectively in addition to headache frequency per week pre and post-treatment.Results: The results showed that: There was no significant difference in the mean values of the headache pain (p=0.13), neck pain (p=0.78), NDI (p=0.77) and ROM (p>0.5) between DNF group and traditional group post-treatment but there was a significant decrease in the mean values of headache frequency of the DNF group post-treatment compared with that of traditional treatment group (p=0.003).Conclusion: These results suggest that deep neck flexors exercises using pressure biofeedback unit is effective in the reducing headache frequency in individuals with the cervico-genic headache than traditional exercise only.

Impacts of low-energy extracorporeal shockwave therapy on pain, pruritus, and health-related quality of life in patients with burn: A randomized placebo-controlled study

BackgroundThe management of post-burn pain and pruritus remain a potent challenge because of their bad effects on health-related quality of life (HRQOL). The main purpose of this study was to evaluate the impacts of low-energy extracorporeal shockwave therapy (low-energy ESWT) in the management of pain, pruritus, and HRQOL in patients with burn. MethodsForty-five adult patients with burn, their age ranged from 18 to 55 years, were included in the study, they randomly assigned into 22 patients in the study group (low-energy ESWT) and 23 patients in the placebo group. The study group received low-energy ESWT (0.05–0.20mJ/mm2, a frequency of 4Hz with total shocks from 1000 to 2000 shocks) once per week for 4 successive weeks, while the placebo group received ESWT without energy. Both groups received traditional physical therapy program of selective different exercises (respiratory, range of motion, endurance, strengthening, balance, mobilization, stretching, and gait training) 3days per week for 4 weeks. Numerical Rating Scale (NRS) for pain and for pruritus, Pressure Pain Threshold (PPT), 12-Item Pruritus Severity Scale (12-PSS), and Burn Specific Health Scale-Brief (BSHS-B) were measured before and after treatment procedures in both groups. ResultsNRS were decreased significantly in the study group than in the placebo group (P<0.05). PPT, 12-PSS, and BSHS-B scores were improved more significantly in the study group than in the placebo group (P<0.05) while body image and burn associated issues were improved at the same level in both groups (P>0.05). ConclusionThe findings suggest that low-energy ESWT with traditional regular physical therapy may relive post-burn pain and pruritus, and improve HRQOL, particularly in adult patients with burn.

Effect of push-up exercises on hand grip strength in diplegic children.

Background: Diplegia is a spastic form of cerebral palsy with lower limbs more affected than upper limbs. The hand is effector organ of upper extremity for support, manipulation and prehension. Purpose: The purpose of this study is to determinethe effect of push-up exercises on hand grip strength in spastic diplegic cerebral palsied children. Subjects and methods: Sixty spastic diplegic children with age ranged from 4 to 7 years from both sexes participated in this study. They were chosen from physical therapy department, Mubarak Central Hospital, Giza Governorate, Egypt. Subjects were divided randomly into three groups A, B and C, of equal number [twenty patients each]. Each patient was evaluated pre and post-treatment individually by using Peabody Developmental Motor Scale (PDMS-2) to determine standard scores of grasping subtest and age equivalent for fine motor activities and Baseline pneumatic squeeze handheld dynamometer to detect maximum hand grip strength. Control group (A) received traditional physiotherapy program for spastic diplegia and the two study groups (B and C) received the same traditional physiotherapy program in addition to push-up exercises on stable surface for group B in form of wide base push-up exercises, while group C in form of narrow base push-up exercises. The treatment protocol was conducted for three successive months and six times per week. Results: The results of this study revealed significant improvement in hand grip strength, standard scores of grasping and age equivalent in the three groups equally. Conclusion: Conventional physiotherapy program is effective as push-up exercises in improving hand function in spastic diplegic children. Push-up exercises only do not add benefits on hand grip strength.

The Impact of Myofascial Release on Vital Capacity and Diaphragmatic Excursion in Postsurgical Pleural Effusion

AbstractBackground: Accumulation of fluid in pleural space may affect on function of respiratory muscles primarily because of increase of chest wall volume. Force-length relationship of respiratory muscles indicate that for a given neural acti-vation, the pressure developed by muscles decrease with decreasing length. An increase of chest wall volume decrease length of respiratory muscles mainly diaphragm and increase of expiratory muscles length. It follows that with pleural effusion, all else being the same for a given, neural activation, pressure developed by the inspiratory and expiratory muscles should decrease and increase, respectively. So, the aim of the study to maintain flexibility of the diaphragm and intercostal muscles in order to get the optimum action of theses muscles, increase chest expansion, improve the respiratory function of these patients.Aim of Study: To evaluate the effect of of myofascial release for diaphragm and intercostal muscles on vital capacity and diaphragmatic excursion in post surgical pleural effusion.Subject and Methods: Forty subjects (male only) were randomly assigned into two groups equal in number. (Study group A): Consisted of 20 patients was enrolled in the myo-fascial release protocol in addition to traditional physical therapy program for pleural effusion. (Study group B): Con-sisted of 20 patients was enrolled in the traditional physical therapy program for pleural effusion only. Their vital capacity and diaphragmatic excursion were measured before and after 8 weeks of training program for both groups. The myofascial release protocol performed a 1-hour session 3 times a week for 8 weeks.Results: Group (A) myofascial release group, showed a statistical significant improvement in vital capacity and diaphragmatic excursion, that was 13.49%, more than the improvement in group (B) traditional physical therapy group, that was 8.68%.Conclusions: The myofascial release for diaphragm and intercostal muscles is effective on vital capacity and diaphrag-matic excursion in post surgical pleural effusion.

Evaluation of Physical Therapy Effectiveness after Anterior Cruciate Ligament Reconstruction

Research background and hypothesis. The aim of physical therapy after sports trauma is to help patients to restore physical activity as it was before injury. The participants who applied for intensive physical therapy after anterior cruciate ligament reconstructive surgery will achieve better leg muscle strength results.Research aim was to compare the effectiveness of intensive and traditional rehabilitation of the knee extensor and flexor muscle strength after the surgery for patients after anterior cruciate ligament reconstruction.Research methods. The method that we used was “Biodex Medical System 3 PRO” for the knee muscle strength. A total of 30 patients were enrolled in this study. The subjects were divided into two groups. The muscle strength was measured while leg was flexed and extended at the knee joint.Research results. The research results showed that participants who received intensive physical therapy program developed better muscle strength than in standard physical therapy group. Participant’s leg muscles recovered faster in intensive physical therapy group than in standard physical therapy group.Discussion and conclusions. The participants who received physical therapy before surgery, electrostimulation and intensive physical therapy program after surgery, achieved higher levels of knee extensor and flexor muscle strength after anterior cruciate ligament reconstructive surgery than those patients undergoing a traditional physical therapy program only after surgery.Keywords: anterior cruciate ligament, intensive physical therapy, muscle strength.

Efficacy of Whole Body Vibration on Strength of Calf and Quadriceps Muscles Post Burn

AbstractBackground: This study was conducted to evaluate the efficacy of whole-body vibration on strength of calf and quadriceps muscles post burn.Patients and Methods: Thirty patients (male and female) had second degree burn of lower limb with surface area about (20-35%) suffering from weakness of quadriceps and calf muscles. Their ages ranged between (20-35) years were participated in this study. The study conducted during the period between March and July (2017) at Makka Hospital and Al-Nada Hospital.They were assigned randomly into two Groups (A and B) equal in number: Group (A) Fifteen patients had received vibration training on vibration platform plus traditional physical therapy program (eight weeks, three times a week). Group (B) fifteen patients had received the same traditional physical therapy program only.Evaluation: Evaluations of both Groups (A and B) were done before starting the treatment and at the end of study after eight weeks using hand held dynamometer and manual muscle test.Treatment: Started immediately post wound closure. This study showed a statistically significant increase in calf and quadriceps muscle strength after eight weeks of receiving whole body vibration in addition to home based physical therapy program, compared with Group B who received traditional physical therapy program only.Results: Comparison between both Groups (A and B) before starting the study revealed that there was a statistically nonsignificant difference in calf and quadriceps muscle force between them. At the end of the study, there was a significant increase in the muscle force in the study group (Group A) compared with control groups (Group B).Conclusion: Participation in Whole Body Vibration (WBV) program resulted in a greater improvement in quadriceps and calf muscle strength in adults with healed thermal burn compared to base line values; a WBV program is an effective for strength gain in rehabilitation of burned patients.

Effect of Electrical Stimulation of Abdominal and Back Muscles on Balance in Children with Spastic Diplegia

AbstractBackground: Spastic diplegia is one of the most common clinical subtypes of cerebral palsy regardless of birth weight and gestation. It is used when there is motor impairment in the upper extremities as well as the lower extremities, although it is milder in the upper extremities than the lower one. Children with spastic diplegia may exhibit clumsiness and frequent falls during regular motor activities or may not be able to maintain standing position independently.Aim of the Study: The purpose of this study was to inves-tigate the effect of neuromuscular electrical stimulation of abdominal and back muscles on balance in spastic diplegic children.Material and Methods: Thirty children with spastic diple-gic CP of both sexes were selected, ranging in age from 4 to 8 years. They were classified randomly into two groups of equal number (A & B). Evaluation of children balance was performed before and after 6 weeks of treatment using Biodex stability system. Group (A) received traditional physical therapy program based on neurodevelopmental approach used for rehabilitation of such patients and Group (B) received the same traditional physical therapy program applied on Group (A) in addition to 30min neuromuscular electrical stimulation of abdominal and back muscles.Results: No significant difference in Overall Dynamic Stability Index, Antero/Posterior Stability Index and, Medio/ Lateral Stability Index (ODSI, APSI, and MLSI) was recorded between the two groups before treatment, significant improve-ment was recorded in ODSI, APSI, and MLSI in each group after treatment. Significant differences in ODSI, APSI, and MLSI were recorded between the two groups after treatment in favor of Group (B).Conclusion: From the obtained results of this study, supported by the relevant literature it can be concluded that neuromuscular electrical stimulation of abdominal and back muscles can be added to the physical therapy program to improve the balance in spastic diplegic children.

Effect of strengthening lower trapezius muscle on scapular tipping in patients with diabetic frozen shoulder: A randomized controlled study

Background: The muscle imbalances between upper and lower trapezius muscle activity are related to abnormal scapular motion in patients with frozen shoulder. This explains the importance of rehabilitation of the lower trapezius muscle in addition to common stretching and mobilizing treatment protocols for patients with frozen shoulder. Purpose: This study aims to investigate the effect of additional strengthening exercises of lower fibers of trapezius muscle on the scapular tipping in patients with Diabetic Frozen Shoulder (DFS). Subjects and Methods: Thirty patients with DFS were randomly assigned into two equal groups A and B. Both groups received a traditional physical therapy program, however group B additionally received strengthening exercises for lower fibers of trapezius. Baseline and post-treatment assessment for the scapular tipping were evaluated by using (A-T) distance test. Results: After treatment; mixed design MANOVA revealed significant improvement in scapular tipping (A-T) distance from supine position, supine position with scapula retraction, standing position, and standing position with scapula retraction, for group B more than group A (P<0.05). There were significant improvements in scapular tipping when comparing the post-treatment mean value with pretreatment in group B only (P<0.05). Conclusion: Strengthening of the lower trapezius fibers plus traditional physical therapy program yields improvement in scapular tipping in patients with DFS more than traditional physical therapy alone.

The effect of Siwan therapy in management of patients with rheumatoid arthritis: A single blind randomized controlled trial

Background: There is a growing interest in treatments involving natural means and procedures, alternative to those of conventional medicine. Some special sands are being used worldwide in therapeutic applications, especially in musculoskeletal problems. Objectives: To compare the effect of Siwan traditional therapy versus conventional therapy for functional disability and pain in rheumatoid arthritis. Design: A prospective, randomized, single-blind, pre-post-test, controlled trial. Setting: Four physical therapy departments in four multidiscipline, outpatient medical centers, located in Marsa Matrouh. The study was conducted between June 2015 and August 2016. Participants: Thirty patient’s rheumatoid arthritis (aged between 20 and 50 y) according to the American Rheumatism Association criteria 2010, participated in the study. Interventions: The patients were randomly assigned into 2 equal groups. Group (A) received Siwan traditional therapy in the form of sand bathing, followed by massage with olive oil for 7 d and group (B) received conventional physical therapy for two months’ day after day in the form of heat application, electrical stimulation (TENS), and exercise. Main outcome measure: The primary outcome was pain severity measured by visual analogue scale while the secondary outcome was functional disability measured by Health Assessment Questionnaire (HAQ). Results: Thirty patient with rheumatoid arthritis (group (A) n=15; group (B) n=15) were randomized and analysed. Comparing both groups post-program revealed that there were significant differences (P<0.05) in pain level and HAQ between both groups with a significant reduction in favor of the group (A). Conclusion: The Siwan therapy program was more effective than traditional physical therapy program in the treatment of rheumatic patients.