The 20th International Scientific Conference Faculty of Physical Therapy Cairo, 6-7 April, 2019

Conference studies

Prepared by

Nerveen Abd El Salam Abd El Kader Ahmed

 

Author Title Abstract
Abeer A. Mansour, Khadiga S. Abd El Aziz, Ghada E. El-Refaye,  Hisham A. Taleb. Effect Of Foot Reflexology On Premenstrual Syndrome.

Background: Premenstrual Syndrome (PMS) is a set of physical, emotional and behavioral symptom that start during the week preceding menstruation and are alleviated when the menstrual flow begins. Reflexology is one of the most popular complementary therapies. As it stimulates the release of endorphins, the body's painkilling chemicals and diet rich in vitamins and calcium, decrease in oil and restrict caffeine also used in treatment. Purpose: This study was aimed to determine the effect of foot reflexology in the treatment of premenstrual syndrome. Subjects and methods: Fifty volunteer, single females with premenstrual syndrome (PMS) were selected randomly from outpatient clinic of obstetrics and gynecology in Abnub Hospital in Assuit to share in this study, their age ranged from 18 to 25 years old and their body mass index (BMI) did not exceed 30kg/m2, the participants were assigned into two groups of equal numbers. The group (A) received therapeutic foot reflexology with dietary modification 3 times/week for8 weeks, while the group (B) received dietary modifications only for 8 weeks. All subjects in both groups were assessed through the visual analogue scale (VAS) for pain. Premenstrual Daily Symptoms Questionnaire for (PMS) related symptoms. Results: The results of the present study revealed that there was statistically significant improvement in both pain and premenstrual related symptoms in group (A) than in group (B).Conclusion: Foot reflexology with dietary modification is an effective method for reducing symptoms associated with premenstrual syndrome.

Key words: Premenstrual syndrome- Dietary modification- Foot reflexology- Girls.

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Ahmed A Hassan1, Gehan M. Ahmed2, Aliaa Mohammed Rehan Mohammed Youssef. The Effectiveness Of Vestibular Rehabilitation In Central Vertigo: A Systematic Review.

Background: Patients with vestibular dysfunction complain of vertigo or dizziness, which may affect balance and quality of life and activities of daily living. Vestibular Rehabilitation Therapy (VRT) aims at teaching the brain to use other senses such as vision and somatosensory to compensate for vestibular damage or hypofunction to alleviate vertigo or dizziness. This therapy includes various exercises such as adaptation, habituation, sensory substitution, balance and gait training. Methods: The following five electronic databases were searched from inception to November 2018:  PEDro, PubMed, Scopus, Web of Science and Cochrane for relevant Randomized Controlled Trials (RCT). Further, manual search of bibliography and snowballing were done on eligible studies from the electronic search. Quality assessment of all eligible studies was done using the PEDro scale. The Primary outcomes were dizziness, vertigo and balance. Secondary outcomes were quality of life or any other functional outcomes. Results: Three articles with 125 patients met our inclusion criteria. Dizziness Handicapped Inventory (DHI) was the main scale that measure dizziness in all included studies. Balance was measured by Posturography, Berg Balance Scale and other scales and tests. According to PEDro scale, two studies were of high quality and one of a moderate quality. All included studies showed significant differences between VRT group and control group in favor of VRT group in dizziness, vertigo and balance. Conclusion: there is a limited evidence to support the effectiveness of VRT in treating patients suffering from central vertigo or dizziness. More high-quality clinical trials are needed to confirm this finding.

Keywords: Dizziness; Vestibular rehabilitation therapy; Vertigo.

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Ahmed M. Elshinnawy, Amir N Wadee, Ahmed M. Tawfick. Influence of Sensory Integration Training on Postural Instability in Elderly with Parkinsonian Disease Following Stereotactic Surgery

Background: Impaired posture is strongly associated with function particularly in parkinsonian patients. Objective: to detect the effect of sensory integration training on postural instability in elderly parkinsonian patients following stereotactic surgery. Methods: The study was conducted in out-patients clinic of the Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt during the period from January 2018 to august 2018. Twenty seven patient's (16 males and11 females) idiopathic Parkinson’s disease were included in the study, age 63.07 ± 2.46 years old. The duration of illness ranges from 5 years till 16 years. The patients were assessed before and after twelve weeks by the postural stability test, times up and go test and the unified Parkinson’s disease rating scale. Participants were randomly assigned into three groups each group included nine patients, Group I received sensory integration training, Group II underwent stereotactic surgery and Group III received sensory integration training after ten days postoperative to stereotactic surgery. Results: There was significant improvement in group III more than in group I and II concerning the Overall stability Index, Ant./Post. and Med./Lat. Index. Conclusion: combining sensory integration training following stereotactic surgery is effective on postural instability in elderly with parkinsonian disease.

Keywords: Parkinsonian patients, Sensory integration and Stereotactic surgery.

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Aisha Mohamed Khaled Saleh, Abdul Aleem Atia, Ann Abdul Kader,
Abeer Abo Bakr Elwishy
 
Bilateral Repetitive Transcranial Magnetic Stimulation Combined With Task Oriented Training in Stroke: Randomized Controlled Trial.  Repetitive transcranial magnetic stimulation (rTMS) changes the excitability of the motor cortex and thereby has the potential to enhance motor recovery after stroke. Task oriented training is an interventional method that has proved effective inrestoration of abnormalpatterns in both the damaged hemisphere and the contralateral hemisphere.The purpose of this study is to evaluate the efficacy of bilateralrTMS as an adjunct to task-oriented training in facilitating restoration of upper limb function after stroke.
Methods
A total of 20 first time stroke patients with upper limb motor deficits were randomly allocated into two equal groups; study group, which received five daily sessions of 5-Hz ipsilesionalr TMS (facilitatory) and 1-Hz contralesionalr TMS (inhibitory), followed bytask oriented training sessions, and control group, which received sham rTMS followed by task oriented training sessions.Task oriented training sessions then continued for one month at 3 sessions per week. Outcome measures included theFugl-Meyer Upper Extremity assessment, and the Wolf Motor Function Test, which were assessed at baseline (pretest) andafterone month of treatment (posttest).
Results
The results of this study showed that;there was no statistically significant difference observed in between groups on both outcome measures of upper limb function at pre and post tests
Conclusion
The present study revealed that combining rTMS with task-oriented training in improving upper limb function post stroke is not superior to task oriented training alone.
Keywords: Upper Limb Function, Repetitive Transcranial Magnetic Stimulation, Stroke, Task Oriented Training.

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Aliaa El-Abd , Ali Farrag , Haytham Elhafez , Omar El-Abd.

The application of total quality management standards in Egyptian physiotherapy colleges.

Background: Higher education is the cornerstone of the progress of societies. it has become very important for the educational institutions to implement the concepts of total quality management (TQM) and their specific standards to improve the quality of educational outputs. So, this study was conducted to identify the extent to which TQM standards applied to Egyptian physiotherapy colleges from the point of view of their administrative leadership, to determine whether there is difference depending on the type of faculty (government or private) and to determine the correlation between the number of experience years and the extent of TQM application. Methods: The study sample consisted of 12 administrative leaders (deans and vice deans) from 7 faculties. The study tool was a questionnaire consisted of 55 items with established validity and reliability; the questionnaire was divided into 7 fields, reflecting the total quality standards in education. Statistical analysis was performed using the means and standard deviations of the areas of the questionnaire, independent sample t tests and using Pearson's correlation coefficient. Results: although the overall average of the means of the scores was high, there is statistically significant difference between the means of the degree of application of TQM in the faculties of physiotherapy in favour of government colleges. Additionally, the results showed no correlation between the number of experience years of the study sample and the grades of their answers on the question axes. Conclusion: implementing comprehensive quality programs in education is highly recommended, paying special attention to private colleges.
Key words: Administrative Leadership; Physical Therapy; Standards; Total Quality Management.

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Amal A. Abdelbaky ,Hisham M.Hussein ,Neveen A Abdel Raoof. Efficacy of SNAGs on dynamic balance level and pain intensity on chronic non-specific low back pain. Background: Low Back Pain (LBP) is a common medical problem in both developing and developed countries.LBP has a major impact on life style, socioeconomic status, and functional abilities. Due to its effects on proprioceptors and muscle performance, LBP can disturb balance. This research aimed to investigate the effect of the Mulligan’s lumbar sustained natural apophyseal glides “SNAGs” on dynamic balance and pain in patients with chronic nonspecific low back pain (CNSLBP). Methods: randomized clinical trial was conducted on 30 participants with CNSLBP. They were randomly allocated into two groups; the study group (n= 15) received lumbar “SNAG” on the symptomatic lumbar level(s), and the control group (n=15) received the sham “SNAG”. Balance measures as well as pain level were assessed before and immediately after interventions. Biodex balance system (BBS) and visual analogue scale (VAS) were used to assess balance and pain respectively. Results:paired t-test revealed that there was a significant improvement in pain and balance after treatment regarding study group (p= 0.0001, p= 0.0014 respectively), while, the control group has showed no statistical significant difference (p= 0.1223, p= 0.1426 respectively). Unpaired t-test showed that lumbar SNAG resulted in significant improvement in pain when compared to sham treatment (p=0.0046). There was no statistical significant difference between lumbar SNAGs and sham treatment regarding dynamic balance (p= 0.1953). Conclusion: This study showed that lumbar SNAGs can immediately improve pain but its immediate effect on dynamic balance is limited.
Key words: SNAGs; Sham; Dynamic; Balance; Low Back Pain

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Amany S Afify, Amira MAl-Tohamy , Amira E Elbagalaty, Nehal H El Saeed

Keywords: Parkinsonian patients, Sensory integration and Stereotactic Aerobic Versus Resisted Exercises on Glycemic Level in Juvenile.

Background: Juvenile diabetes mellitus is an autoimmune disease caused by the immune-mediated destruction of pancreatic beta cells. This destruction is modulated by the body’s immune system and leads to a limitation in, or complete cessation of, the production and secretion of insulin, which results in the need for external insulin delivery for survival. Aim: The current study intended to compare the effect of aerobic exercise and resisted exercise on glycemic level in children with type 1 diabetes mellitus. Subjects and methods: Thirty children of both sexes with type 1 Diabetes Mellitus. Their ages ranged between 11 and 15 years, they participated for twelve weeks, three sessions per week. They were allocated randomly into two groups of equal numbers, group (A) and group (B). Children in group (A) received regular aerobic exercise three days/week for three successive months. Those in the group (B) received a resisted exercise three days/week for three successive months. Results: Pre and post treatment comparisons showed a statistically significant improvement of the measured variables in group (A). Moreover, significant difference was recorded in the group (A). Conclusion: Designed aerobic and resisted exercises contributed to the improvement of blood glucose level in children with type 1diabetes mellitus in favor to group (A) Aerobic exercise is more effective in improving blood glucose level than resisted exercise.
Keywords: Aerobic exercise, resisted exercise, glycemic level, Juvenile diabetes mellitus.

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Amgad Abou-Taleb, Nawal Abou-Shady, Ibrahim Hamoda Robotic-Assisted Locomotor Training For Walking In Spinal Cord Injury Patients :Systematic Review. Objectives: To provide an overview and evaluate the current evidence on robotic-assisted locomotor training approach for gait rehabilitation in patients with spinal cord injury. . Methods: By using electronic database: Pubmed, Cochrane library, google scholar, reference lists, and Physiotherapy Evidence Database (PEDro). Randomized Control Trials (RCTs) were only included in this review and the others were excluded according to eligibility criteria. Results: Nine RCTs were only included in this review, six studies were analyzed by meta-analysis statistics, and the three other studieswere analyzed by descriptive or qualitative analyses. Significant effect in walking function (speed, distance, duration), minimal significant effect in balance and spasticity. Conclusion: robotic-assisted has a minimal significant effect in spinal cord injury patients butmore studies must be included in this area to cover the needs of this study.
Key Words: robotic-assisted, spinal cord injury, locomotor training, gait, rehabilitation, RCTs, PEDro.

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Amina Fadl Hosny Abozethar**, Mariam El-Sayed Mohamed*,Hany Farid Eid Morsy Elsisi*, Walaa ArafaKeshak. Response of Parathyroid Hormone and Blood Calcium Level to Moderate Intensity Aerobic Exercise In Elderly.

Background: One of the main aging biological changes is bone deterioration which affected more by estrogen deficiency in elderly women, Parathyroid hormone is one of the osteoporotic indicesand a major regulator of bone metabolism and calcium homeostasis, the objective is to determine the response of parathyroid hormone and total calcium level to moderate aerobic training in elderly. Methods: Thirty five female subjects were selected from out-patient clinic in Um El-Masryeen General Hospital /Giza/Egypt, Their age ranged between 60 to 70 years with mean age is 64.45, and study was conducted between October 2017 and April 2018. All subjects had participated in moderate intensity aerobic training calculated as 60% to 70% of their predetermined maximum heart rate. The program was applied for three times per week for 12 weeks. Parathyroid hormone and calcium level were measured before and after the training program in laboratory analysis. Results: Statistical analysis showed a significant decrease in parathyroid hormone by 5.98% and a significant increase in total calcium level in the blood by 0.44%. Conclusion: It was concluded that moderate aerobic training decrease parathyroid hormone and increase total calcium serum level in elderly.

Key words: Calcium, Elderly, Osteoporosis, Parathyroid hormone

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Aml M. ABD El Kareem; Khadiga S. Abd El Aziz, Ghada E. El-Refaye, Hassan Omar Effect Of Myofascial Release In Treatment Of Primary Vaginismus. Background: Vaginismus is a condition that affects a woman's ability to engage in vaginal penetration. Purpose of the study: This study was aimed to determine the effect of myofascial release in the treatment of primary vaginisum. Subjects and methods: Fifty volunteer, married females having primary vaginismus were selected randomly from outpatient clinic of obstetrics and gynecology in Kasr Al Ainy Hospitals to participate in this study, their age ranged from 25 to 35 years old and their body mass index(BMI) did not exceed 30kg/m2. The patients were divided randomly into two equal groups (A&B).Group Areceived a home exercise program by kegle exercise. The exercise can be repeated for 20 times at a time. Patient can do them as many times a day for 8 weeks.Group Breceivedmyofacial release therapy for half an hour three times per week for 8 weeks in addition to home exercise program by kegle exercise for 8 weeks. Evaluations of all patients in both groups (A&B) weredone before and after the treatment program (8 weeks).All subjects in both groups were assessed through the visual analogue scale (VAS) for pain and Pelvic floor tone assessmentby perniometer.Results:The results of the present study revealed that there was statistically significant improvement in b pain and sexual function in both groups but there was more improvement in group (B) than in group (A).Conclusion:It is concluded that stretching exercise and Myofacial release is effective and safe interventions for the treatment of primary vaginismus.
Key words: vaginismus- myofascial release- perineometer.

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Amr K. AbdElaal ; Soheir M. EL-Kosery; Ghada E. El-Refaye ;
Amr H. Abbassy
 
Effect Of Aerobic Exercise On Preventing Hyperuricemic Complications After Menopause. Background: It is generally believed that elevated serum uric acid is more common in women after menopause. There are many serious complications are associated with increased serum uric acid such as gout, metabolic syndrome, renal calculi and cardiovascular problems. Purpose: The aim of this study is to determine the effect of aerobic exercise on preventing post menopausalhyperuricemic complications. Subjects and Methods: Forty female patients, have elevated serum uric acid levels were selected randomly from Outpatient clinic of Department of Rheumatology and Rehabilitation in El Kasr El-Einy , Cairo University, their ages ranged from 50 to 65 years old and their body mass index (BMI) didn`t exceed 30kg/m2. The participants were assigned into two groups of equal number. Group (A) (20 patients) treated by aerobic exercise 3 sessions per week and diet modification for 8 weeks and group (B) (20 patients) treated by diet modification only, for 8 weeks. All subjects in both groups were assessed through serum uric acid level testand visual analogue scale (VAS) to measure pain intensity before and after treatment. Results: It was revealedintensily that there was a statistically significant improvement in serum uric acid level and pain in group (A) than group (B) post treatment. Conclusion: The effect of aerobic exercise along with diet modification was more effective in reducing serum uric acid level and pain intensity than diet modification only in postmenopausal hyperuricemicwomen.
Keywords: Aerobic exercise - Hyperuricemic complications - Menopause.

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Amr M. Ahmed, Nasr A. Abdelkader, Salwa F. Abdelmajeed, Ahmad H. Azzam. Prevalence of Flat Foot among Patients with Mechanical Low Back Pain. Background: Persons with mechanical LBP were more likely to have a decrease in dorsiflexion and an increase in navicular drop. However, particularly excessive pronation, has not been examined adequately from a biomechanical perspective. So the Purpose of this study wasto determine the prevalence of flat foot among patients with mechanical low back pain.Methods:Two hundred and twenty five patients suffered from mechanical LBP were selected from Luxor and Aswan, their age ranged from 18 to 40 years and their body mass index (BMI) was ranged from 18 to 25 kg/m2 .Mechanical Inflammatory Low Back Pain Index (MILBPI) was conducted on the recruited participant. Then the patients with the score of very high mechanical component was included in the study. The navicular drop test was applied to these selected patients. Results: The percentage of right flat foot among patients with mechanical LBP was 11.66% and with left flat foot was 10.22% where 26 (11.66%) patients have navicular drop greater than 10 mm and 199 (88.34%) subjects have navicular drop less than 10mm of the right foot. For the left foot, 23 (10.22%) patients have navicular drop greater than 10 mm and 202 (89.78%) patients have navicular drop less than 10mm.Conclusion: The prevalence of flat foot among patients with mechanical low back pain was 11.66%, 10.22% in the Right and Left foot respectively.
Key Words: Flat Foot; Mechanical low back pain; Navicular drop.

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Asmaa A. Alsayed, Amira M. El-Tohamy,
Nanees E. Mohamed.
 
Assessment Of Foot Pressure Distribution In Juvenile Diabetes Mellitus. Background: As the incidence of type 1 diabetes continues to rise, the burden of microvascular complications will also increase and negatively influence the prognosis of young people with the disease. Diabetic vascular complications are often asymptomatic during their early stages, and once symptoms develop, there is little to be done to cure them. Therefore, it is essential that screening for foot complications in young children. The purpose of this study was to investigate foot pressure distribution in diabetic children compared to normal children. Methods: Fifty five children contributed in this study: thirty normal children as control group (A) and twenty five diabetic children as study group (B) their ages ranged between ten and fifteen years with normal body mass index and they were able to follow instructions and understand commands given to them during the testing procedures. None of them had flat foot nor suffer from musculoskeletal deformities and/or neuromuscular disorders; they had neither visual, auditory defects nor autistic features. The planter pressure distribution of the diabetic and normal children was measured by footscan pressure plate during static and walking in each subject during normal walking speed. Maximum pressure values in right and left sides were compared in both groups in static and dynamic situations. Results: data analyzed by “Unpaired t test" to compare Maximum pressure at static and dynamic situations between both groups. The results of current study revealed that there was a statistically significant difference in maximum pressure in both right and left sides between the two groups in both static and dynamic assessment and this significant increase in group (B) in compared to group (A). Conclusion: foot pressure distribution is affected in children with type 1 diabetes mellitus.
Keywords: diabetes mellitus, planter pressure, pressure plate.

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Asmaa G. Abass, Shorouk A ELshennawy, Asmaa O. Sayed. Role of physical therapy modalities in management of pain in children with hemophilia: systematic review. Objective:To investigate the role of physical therapy modalities in management of pain in children with hemophilia: Data sources: This research was identified by searching the following databases pub Med, PEDro, web of science, Cochrane and Google scholar to identify RCT that investigated the Role of physical therapy modalities in management of pain in children with hemophilia. Study selection: Searching identified 917eligible articles evaluate studies published from inception to 2018. Studies were included if they were applied on hemophilic children, written in English, RCT. four studies met the inclusion criteria . Data extraction: Methodological quality of trials was assessed independently by 2 reviewers. who extracted data (study name , design, subjects, intervention, key outcomes results), applied the (PEDro) scale to assess the method quality of selected studies, and determined the strength of the evidence using modified sackett score potential studies. Data synthesis:four studies met the inclusion criteria. PEDro scale values ranged from 4 to 7. The primary outcome was pain while the secondary outcomes were balance, function capacity, gait ,ROM, swelling, muscle strength ,and mobility.The included articles are RCT which investigated a total of 130 subjects, the age of the participants ranged from 9-16 years. The duration of the intervention ranged from 6 to 12 weeks. Conclusions: There is evidence to suggest that physical therapy modalities are effective in control pain in children with hemophilia.
Key words: arthropathy; bleeding; hemophilia; physical therapy modalities; pain; hemoarthrosis. 

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Asmaa K Mohamed, Marwa A Mohamed, Amir A Gaber, Karima A Hassan. Relationship Between Severity Of Stress Urinary Incontinence And Sagittal Lumbopelvic Alignment In Females. Background: Stress urinary incontinence (SUI) is one of the pelvic floor dysfunctions that affecting the females in the middle age. The lumbo-pelvic position may affect the activity of the pelvic floor muscles, which play a primary role in the maintenance of continence and support of the abdominal contents.
Aim: The objective of this study was to investigate the association between the severity of stress incontinence and the lumbo-pelvic alignment in females with SUI.
Design: cross-sectional study
Material and methods: Twenty-eight married females aged from 20-50 years old with stress urinary incontinence were included in this study. The severity of the SUI was determined by using the incontinence severity index (ISI). The lumbopelvic alignment was measured by using lateral standing radiograph of the lumbopelvic spine then the measurement was carried out by using surgimap spine software. The parameters measured include lumbar lordosis, sacral slope, and pelvic tilt. A Spearman's rank-order correlation was run to assess the relationship between incontinence severity index and lumbar lordosis, sacral slop and pelvic tilt. The alpha level was set at 0.05.
Results: it was seen that the increase in the incontinence severity index is consistent with an increase in lumbar lordosis sacral slop while the pelvic tilt showed no change (P < 0.05).There was a positive correlation between severity of stress incontinence lumbar lordosis (p=0.008) and sacral slope (p=0.013).
Conclusion: Females who report SUI have an association between severity of SUI with lumbar lordosis, sacral slope and the sagittal spinal alignment. These finding should be taken into consideration in females have SUI.
Keywords: Sagittallumbopelvic alignment, Stress urinary incontinence.

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Asmaa M. Ahmed Zahran; Khadyga S. Abdel-Aziz; Ghada E. El-Refaye; Mahmoud H. Ebrahem Effect Of Myofascial Release Technique On Postnatal Sacroiliac Joint Pain. Background: A substantial proportion of pregnancy related back pain originates in the sacroiliac joint (SIJ), which may persist postnatal. Myofascial release is the application of a low load, long duration stretch to the myofasciato decrease pain and improve function through normalizing the sliding properties of myofascial restricted tissues. Purpose: This study was aimed to determine the effect of myofascial release technique on postnatal SIJ. Subject & Methods: Fifty multigravidae postpartum women participated in this study who were complaining from sacroiliac joint pain. Women were selected randomly from outpatient clinic of Deraya University in El Minya, their ages ranged from 26 to 35 years old and their body mass index (BMI) didn`t exceed 30kg/m2. The participants were assigned into two groups of equal number. Group (A) (25 patients) treated by lumbo-pelvic stabilizing exercises, 3 sessions per week for 8 weeks and group (B) (25 patients) treated by lumbo-pelvic stabilizing exercises and myofascial release technique, 3 sessions per week for 8 weeks. All subjects in both groups were assessed through visual analogue scale (VAS) to measure pain intensityand modified Oswestry disability questionnaire was used to assess functional disability before and after treatment. Results:it was revealed that there was a statistically significant improvement in pain and functional disability in group (B) than group (A). Conclusion: The performance of myofascial release technique along with lumbo-pelvic stabilizing exercise was more effective in reducing SIJ pain intensity, functional disability and pain sensitivity in postnatal women.

Keywords: Myofascial release technique- Postnatal pain- Sacroiliac joint.

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Asmaa M Saad, Khaled A Olma, Heba H Hazzaa,Sherif N Girgis. Relation Between Body Mass Index And Motor Coordination In School Aged Children. Objective. The purpose of this study was to detect the correlation between body mass index and motor coordination in school aged children. Methods. One hundred children ranged in age from 10-14 years participated in this study. They were selected according to body mass index to be normal weight and obese children. They were divided to two groups, group A 50 normal weight children and group B 50 obese children. Gross motor coordination was assessed by means of the Körperkoordinations test für Kinder. Results. Childhood obesity was found to result in poor KTK performances. Conclusion. It can be concluded that high body mass index has a negative effect on motor coordination in school-aged children.
Key words: Body mass index; Children; Motor coordination.

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Asmaa Mahmoud, Aliaa Rehan Youssef, Mohammed S. Abdelsalam. Effects of Smartphone Usage Duration on Neck Dysfunction in Young Versus Middle-Aged Patients with Chronic Mechanical Neck Pain. Background: Neck pain is a common musculoskeletal disorder. It has many risk factors such as the prolonged use of smartphones. However, it is unclear whether the deleterious effect of prolonged smartphone use is age dependent or not. Therefore, the purpose of this study was to compare the effects of smartphone usage duration on pain, deep cervical flexor (DCF) muscles endurance and neck proprioception in young and middle-age adults with mechanical neck pain. Methods: Eighty females with mechanical neck pain were recruited for this study. Patients were divided into two equal groups based on age (young and middle-aged adult groups). Patients browsed the internet continuously for 10- and 30-minutes, at two different sessions. All variables were assessed before (baseline) and immediately after net browsing (post-task). Results: Patients in the two groups showed significant pain accentuation after smartphone usage, regardless to the duration. However, changes in pain severity with device use were not different between the two groups (P>0.05). For DCF endurance, there were no significant differences within and between the two groups (P>0.05). For proprioception acuity, the middle-aged group showed increased neck extension error after the 10 min task and neck flexion error after the 30 min task (P<0.05). Comparing changes in proprioception acuity between the two groups showed significant defect only in neck flexion after 10 min of smartphone use in young adults (p<0.05). Conclusion: Continuous use of smartphone for net browsing up to 30 minutes increase pain and proprioception deficit in selected directions with no evidence of change in DCF endurance within the same session. Age did not affect the pain severity, DCF endurance and proprioception acuity after smartphone usage.
Keywords: Neck pain, Smartphone, Neck endurance, Age.

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Aya Ahmed A.Ali, Faten H. Abdel Azim, Mostafa S. Mostafa. Comparison of Muscle Thickness between Normal and Hemiplegic Cerebral Palsy Children.

 

Background:children with spastic hemiplegia had disabilities of the upper extremities such as reaching, grasping, and object manipulation result in dependency in daily activities and a lack of successful social integration. Spasticity and decreased activity contribute to muscle weakness and imbalance, muscle atrophy resulting from disuse, muscle contracture, and a reduced range of motion in joints. Purpose: to compare muscle thickness in normal children and spastic hemiplegic cerebral palsy children. Subjects and methods:35 children from both sexes with age range from 2 to 5 years included in this study and divided into two groups. Group (A) included 15 normal children and Group (B) included 20 children with hemiplegic cerebral palsy with spasticity grade 1 and 1+ according to Modified Ashworth scale. Subjects excluded from this study whom had any problems of the following: Recent skin injury, bony joint limitation, and children who take antiepileptic drugs or peak action is at the time of assessment of spasticity. Ultrasonography used to assess muscle thickness. Results: there was statistical significant difference between normal group and spastic group regarding muscle thickness of biceps brachii. Conclusion: According to the results we can conclude that muscle thickness of biceps brachii was lower than in age-matched normal children. Furthermore, it is noted with confidence that a significant positive correlation existed between muscle thickness and functional level.

Keywords:  Cerebral palsy, Hemiplegia, Muscle thickness, Ultrasonography, Normal children.

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Aya Mohamed Abd El-Sadek , Fatma Sedek Amin , Mary Kamal Nassif Takla.
 
Effect of smart phone addiction on scapular symmetry and functional level of neck and upper back.
 
Background: The continuous use of a smartphone for a long time can cause various musculoskeletal problems affecting scapula, neck & upper back. The purpose was to investigate the effect of smart phone addiction on scapular symmetry and functional level of neck and upper back.
Methods: Forty-five subjects' from both genders with age ranging from 15 to 25 years were assigned to three equal groups; 15 subjects for each group. Group I: subjects with smart phone addiction level equal (15 to 30) points. Group II: subjects with smart phone addiction level equal (31to 45) points. Group III: subjects with smart phone addiction level equal (46 to 60) points according to smartphone addiction scale short version (SAS-SV). They were assessed using the functional level of neck and upper back questionnaire & scapular asymmetry was assessed by the lateral scapular slide test (LSST) using palpation meter. Results: There was no significant difference in scapular distance from shoulder adduction between the three groups (p > 0.05).At 45° and 90°shoulder abduction there was a significant decrease in scapular distance of group A compared with that of group B and C (p < 0.05), while there was no significant difference between group B and C (p > 0.05).There was a significant decrease in Neck and upper back functional index of group A compared with that of group C (p < 0.05), while there was no significant difference between group A and B and between group B and C (p > 0.05).Conclusion: Smartphone addiction had a significant effect on functional level of neck and upper back and leads to scapular asymmetry in highly addicted ones.
Key Words: Functional level of neck, Scapular symmetry, Smart phone addiction, Lateral scapular slide test.

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Basma Osama ALSaadawy, Nadia Abdo, Eman Embaby,Aliaa Rehan Youssef. Validity of smartphone use in measuring joint position sense in patients with knee osteoarthritis: A cross-section study.
 
Background: Proprioception deficit is a risk factor for knee osteoarthritis(OA) progression. Thus, proper assessment and treatment of this deficit are important in the management of patients with OA. Recently, smartphone has been used in the assessment of musculoskeletal system. There are a few valid applications to measure proprioception of various joints, suggesting the promising use of smartphone as an alternative economic method to assess proprioception acuity in clinical settings. However, validation of proprioception assessment still needs further confirmation. Therefore, this study aimed atinvestigatingthe concurrent validity of using smartphone in assessing proprioception acuityin patients with knee OA. Methods: Thirty-two knees from 16 participants were assessed; 8 asymptomatic volunteers and 8 patients with bilateral OA. Proprioception acuity was measured in terms of passive joint position (JPS) simultaneously bythe smartphone Goniometer pro application andthe Biodex System 3 Pro Isokinetic Dynamometer. Each participant had the angle of repositioning error measured during passive motion three times and the average was calculated and used for further statistical analyses. Results: There was a strong positive correlation between smartphone and isokinetic dynamometer measurements of repositioning error angle for participantsin the two study groups.For the non-dominant knee, the correlation was perfect in the OA and asymptomatic groups(r =1) (p< 0.05). For the dominant knee, the correlation was significant, positive and high for the asymptomatic (r=0.70) and OA (r=0.90)groups (p<0.05). Conclusion: Smartphone application is a validalternative for the Isokinetic dynamometer in assessing passive JPS in patients with knee OA and asymptomatic controls.
Key words: joint position sense, knee osteoarthritis, smartphone.

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Dina H. Hamed, Sohier M. Elkosery, Hanaa Abd el moneam younis. Effect of aerobic exercise versus resistive exercise accompany with aerobic on early post menopause abdominal obesity. Background: postmenopausal abdominal obesity is a common problem, which affects the majority of women after menopause. Purpose: The aim of this study is to investigate whether 12 weeks of moderate-intensity aerobic, or combined exercise training would induce and sustain improvements in lipid profile which reduce cardiovascular risk, weight and fat loss in overweight in postmenopausal abdominal obese women .Subjects and Methods: Thirty postmenopausal women, suffering from abdominal obesity , participated in this study; their age ranged from 47 to 53 years, and body mass index was was>30 kg/m2.Patients were randomly divided into 2 groups; group (A) walk on treadmill for 30 min in moderate intensity; group (B) walk on treadmill for 30 min in moderate intensity in addition to resistive exercise. Both groups exercising for 3 days/week for 12 weeks. Examining the effects of different exercise regimes on fasting measures of lipids, changes in body weight, BMI and WHR . Results:It showed Group (A) significant decrease and group( B) highly significant decrease (P=0.0001) in BMI. However, group A showed significant decrease in waist hip ratio (WHR) (P=0.0001) and significant increase in HDL (P=0.0001) , significant decrease in LDL (P=0.0001) , significant decrease in FTG(P=0.000) and significant decrease in TC (P=0.0001) . In comparing between GroupA and Group B there is significant difference in improvement Compared to group A, group B showed highly significant decrease in BMI (P=0.0001) highly significant decrease in WHR (P=0.0001), and highly significant increase (P=0.0001) in HDL , and highly significant improvement difference in LDL (P=0.0001) and highly significant decrease in FTG in Group B in compare to Group A with ( P=0.0001) and highly significant decrease in TC in Group B in compare to Group A with ( P=0.001) .Conclusion: Therefore, combination exercise training should be recommended for overweight and abdominal obese postmenopausal women in National Physical Activity Guidelines.
Keywords: Menopause , abdominal obesity , aerobic exercise , resistive exercise.

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Doaa I El Beltagy, Manal S El Dien, Doaa A Sanad. Cognitive Abilities In Children With Different Muscle Tone Disorders.
 
Background: Cognition is the ability of the central nervous system to acquire, process, and act on information from the environment. Children with neuromotor disorders have multidisplinary disabilities, so it is important to investigatehow can the muscle tone disorders affect the cognitive abilities including attention / concentration level, maximum reaction time and figural memory level and its deviation from normal. Methods: Thirty one child ranged in age between five and eight years with muscle tone disorder (15 hypotonic), (16 hypertonic) and 17 age matched normal child participated in this study. They were selected from outpatient clinic of Faculty of Physical Therapy, Cairo University, and National Research Center. Cognitive abilities including attention /concentration, maximum reaction time and figural memory were evaluated by using Rehacom system for each child participated in this study and the results were compared to those of normal age matched individuals. Results: the results revealed a statistically significance difference in attention / concentration and figural memory levels between groups while no significance difference in maximum reaction time. Conclusion: ultimately the study revealed that children with hypertonia and hypotonia have impairment and delayed development of their cognitive abilities and theywere highly deviated from normal.
Key Words: Muscle Tone disorders; Children; Cognition; Rehacom system.

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Esraa E. AbdelazizElderini , Amira M. Eltohamy ,
HodaA. M. El-Talawy.
 
Quality Of Life In Normal And Obese School Aged Children.
 

Background:Obesity in childhood could affect quality of life in different patterns. There is little existing information about the health related quality of life (HRQOL) of obese children in Egypt. The aim of this study was to evaluate the effect of obesity onHRQOL.Methods: This cross sectional study was carried out on 182 children aged from eleven to fourteen years selected from public governmental schools at EL-Mansoura City from September 2018 to January 2019 . They were assigned into two groups : study group (n= 102) ; boys (n=48) girls (n=54) and control group (n=80); boys (n=42) girls (n=38).Only obese children of nutritional cause of obesity were included. The body mass index of obese children ≥ 95th percentile and that of  the normal weight children equal to 5th percentile to less than 85th percentileaccording to Centers for Disease Control and Prevention growth charts. Their weight and height were assessed by StandardWeight and height measuring scale and BMI was calculated by dividing weight (Kg) by height squared (m²) (kg/m²). HRQOL was assessed by Pediatric quality of life inventory Generic core scale version 4(PedsQL ™). Results: The results showed that Mean ± standard deviation of weight and BMI of study and control groups were significantly different. The scores of all domains of HRQOL between both groups were significantly different. There was a negative correlation between all the scores of HRQOL and BMI. Conclusion: The obesity in children had a negative impact on their quality of life.

Keywords: Children; Health related quality of life; Obesity.

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Esraa El Abbas, Faten H Abdelazeim, Samia A. Abdel Rahman Effect of Core Stability Training On Postural Control In Children With Cerebral Palsy: A Systematic Review.

Background :Core stability training is used to improve limitations with postural control in children with cerebral palsy. It likes a corset that works to stabilize the center of the body against external perturbations. The purpose of the current systematic review was to evaluate the effectiveness of core stability training on postural control. Methods: A systematic review was conducted through Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology and American Academy of Cerebral Palsy and Developmental Medicine. Four databases (Pub Med ,Cochrane Library, Pedro and Google Scholar) were searched using the following keywords (“core stability “) AND (cerebral palsy OR hemiplegia OR diplegia) AND (Postural control OR balance OR equilibrium). Articles were assessed according to their level of evidence and conduct rating. Results: Seven articles were included in this review. The whole number of participants was 162 participants with age ranged from 1 to 18 years. Level of evidence ranged from I to V, and the conduct rating ranged from strong to weak. All studies underwent descriptive analysis due to the heterogeneity of the primary and secondary outcomes. Core stability training resulted in improvement in primary outcomes (postural control, static balance, dynamic balance), And secondary outcomes (shoulder stability, diaphragmatic motion, trunk endurance and gait. Conclusion : Core stability training could be considered for included  in rehabilitation programs for children with spastic CP as all reviewed studies showed significant improvements of all variables although of improvements we still needed more trials due to heterogeneity of  studies

Key words: Cerebral palsy; Core stability; Postural control; Systematic Review.

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Esraa M. Ibrahim, Zakria E. Mowafy, Nancy H. Aboelnour
And Ashraf E.
Efficacy Of Combined Isokinetic Training And Aerobic Exercises On Functional Outcomes Postlower Limb Burn.
 
Background: Burn wounds are one of the most complex and dramatic of all injuries. They initially produce a direct local tissue destruction and damage. In addition, severe burn wounds (second- and third-degree) continue to destroy tissue and muscles, exercise therapy stimulates the early expression of angiogenesis- related growth factors so it results in new vessel in-growth that improves blood supply, increases cell proliferation, accelerates tissue regeneration and healing and regain muscle strength. Purpose: The aim of this study was to evaluate the effectiveness of exercise training program (aerobic exercises and resistive exercises) on Muscle power in lower limb burned patients. Material & methods: sixty patients with age ranged from 25 to 40 years old with 2nd degree burn (30% to 40% TBSA) who suffered fromlower limb burn participated in this study. The patients were randomly divided into 3 equal groups. Group A: This group included 20 patients who received isokinetic exercises for 12 weeks in form of (isokinetic device) in addition to the physical therapy program (splinting, stretching exercise, and range of motion exercise). Group B: This group included 20 patients who received aerobic exercises for 12 weeks in form of (stationary bicycle) in addition to the physical therapy program. Group C:This group included 20 patients who received both isokinetic exercise and aerobic exercises post healing in form of (stationary bicycle and isokinetic device) in addition to the physical therapy program. Results:showed significant increase in muscle strength and endurance in combined isokinetic and aerobic exercises more than groupA (isokinetic) and B (aerobic exercises). Conclusion: From the finding of the current study we concluded that that combined isokinetic training and aerobic exercises is an effective, safe, relatively inexpensive, simple and available modality in enhancing muscle power , strength and endurance in lower limb burn.
Key words: Burn, Isokinetic Training ,Aerobic Exercises, dynometery.

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Fatma El Zahraa A El Bayomi , Mohamed A Sarhan , Ahmed H Khater , Nadiaa A Fayyaz. Relation between Chronic Low Back Pain and Navicular drop: Cross- Sectional Study.
 
Background: Epidemiologic data showed that prevalence of chronic low back pain (CLBP) is increasing. Foot pronation and calcaneal eversion are said to cause LBP. Objectives: The purpose of this study was to investigate the relation between CLBP, and navicular drop. Methods: Seventy-Five patients with chronic low back pain (LBP more than 3 months) with their mean ± SD age, weight, height and BMI were 36.32 ± 10.61 years, 76.4 ± 14.63 kg, 164.94 ± 8.92 cm and 28.11 ± 5.23 kg/m². No previous surgery at spine or lower limb. Every patient reported his pain intensity number from 0 to 10 using NPRS while 0 means no pain and 10 means intolerable pain. The navicular drop difference was measured while the patient was sitting (unloaded) with his feet on the floor in mid position. The navicular tuberosity was marked and the distance from it to the floor was measured using a ruler, then the same distance was measured from standing position (loaded). Then the difference between the two positions was measured to determine the navicular drop. Results: The relation between NPRS and right navicular drop of the study group was weak negative non-significant (r = -0.11, p = 0.31). The relation between NPRS and left navicular drop of the study group was very weak positive non-significant (r = 0.02, p = 0.85). Conclusion: There was no relation between chronic low back pain and navicular drop.
Key Words: Chronic Low Back Pain; Flat Foot; LBP; Navicular Drop.

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Hadil Mohamed Onsy Mohamed, Hamed El Khozamy, Mohamed Badr Mohamed, Nadia Abdel AzemFayyaz, Walid Abd Elbaki Correlation between lumbosacral radiculopathy and knee pain in patients with unilateral knee pain. Background: Knee pain is a major disorder of all ages. There are different causes of such pain; one of them may have a neural origin. Lumbosacral radiculopathy occursdue to compression of a nerve root by surrounding structures. H-reflex is a good tool for assessing nerve root function .We aimed to know the relation between lumbosacral radiculopathy and pain in patients with unilateral knee painand the relationship between knee pain and changes of H- reflex.Methods:Twenty patients (male and female) suffered from unilateral non-traumatic knee pain; age ranged from 25 to 45years with body mass index less than 30kg\m2 and knee pain persisted for 3 months or more with or without low back pain. Knee pain evaluated by the numerical pain rating scale and nerve root function assessed by electromyography (H-reflex).Results: the relation between lumbosacral radiculopathy and pain in patients with unilateral knee painwas 50% with decreasedamplitude of H-reflex at affected side relative to H-reflex amplitude at the non-affected side (H\H ratio)and 20% of them with an increased latency difference. There was a significant positive correlation between knee pain and H/H ratio (ρ = 0.37, p= 0.05), a non-significant negative correlation between knee pain and latency difference when p-value <.05. Conclusion: There was high relation between lumbosacral radiculopathy and pain in patients with unilateral knee pain .There was a significant correlation between knee pain and H/H ratio, a non-significant correlation between knee pain and latency difference.

Keywords: H-reflex,knee pain, lumbosacral radiculopathy.

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Hagar M. Ali., Faten H. Abdelazeim , Osama A. Zaki. Effect of Lung Squeezing Technique on Vital Signs and X-Ray Findings in Neonates with Respiratory Distress Syndrome. Background : Respiratory problems like Respiratory Distress Syndrome (RDS) in neonates is one of the leading causes of neonatal morbidity and mortality in developing countries. These respiratory problems are seen in premature neonates, which mainly include RDS. Objective: To investigate the efficacy of lung squeezing technique on vital signs and X-ray findings in neonates with respiratory distress syndrome. Study Design: Prospective, randomized controlled study. Subjects, Materials and Methods: This randomized controlled trial included 30 neonates with RDS under mechanical ventilation. Their ages ranged from 3-15 days. The participants were randomly allocated into 2 equal groups. The control group received conventional physiotherapy (CPT), while the study group received CPT in addition to Lung Squeezing Technique (LST) for 20 minutes duration per session, two sessions per day, for a period of 7 days. Vital signs [heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), Temperature and oxygen saturation (SaO2)] were measured and chest X-ray was done. All measurements were recorded at baseline, 2 days and 7 days of intervention in this study. Results: Significant improvement was recorded invital signs (HR, RR, SAP, DAP, Temperature, SaO2) in favor to study group, while there was no significant difference regarding X-ray findings between both groups. Conclusion: Lung squeezing technique is an excellent supplement to conventional chest physiotherapy in managing RDS in neonates.

Key Words: Lung squeezing technique, Neonates, Respiratory distress syndrome , Vital signs ,X-ray findings.

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Hany R Hana1, Nisreen Ahmed Abdelglil, Raafat Ezz Eldeen. Effect of Magnetic Therapy on Pressure Ulcer in complete spinal Cord injury (SCI) patient.

Background: Pressure sores are an important source of complications in patients who are immobilized and bedridden. The prevalence of Pressure ulcers stage two or greater is between 8.1% and 12.9%. We aimed to investigate the efficiency of magnetic field treatment in pressure sores. Methods: This was a case control study, Female of 40 years complains from ischial pressure ulcer with history of spinal cord injury, in the study magneto-therapy, once a day for 30 minutes and with 90G, magneto-therapy device’s program. The surface areas of the pressure sores were evaluated at the onset of the treatment (1st day), and on the 4th and 30th days. Results: a significant difference was observed between the 1st and 4th day. In addition, there was a significant difference in the scar area. Conclusion: The healing process of the tissue can be accelerated. With the use of magneto therapy in the treatment of pressure sores of stage IV.

Key Words: Magnetic field treatment, pressure sore, spinal cord injury.

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Hasnaa Ahmed Abdel-Aziz, Abeer Ahmad Farghaly, Ahmad Mahdi Ahmad , Hesham Mostafa, Ahmed Abdelkarim Fayed. Effect of Laser Acupuncture on the Ankle-Brachial Index and Walking Ability in Patients with Peripheral Arterial Disease.

Background.Laser acupuncture has produced promising results in the management of many medical conditions; it has been used as a non-invasive therapy with no puncture pain which represents a major advantage over traditional acupuncture or electroacupuncture. Methods.This study aims to investigate the effect of Aluminum Gallium Arsenide (AlGaAs) LASER acupuncture on the lower limb blood supply and functional walking ability in patients with peripheral arterial disease (PAD). Thirty male patients with PAD were recruited from Kasr El-ainy Hospital, and were randomly divided into two groups: study group (n=15) and control group (n=15). Both groups received the routine medical treatment whereas study group received laser acupuncture therapy twice weekly for five weeks. Ankle brachial pressure index (ABPI), six-minute walk test (6MWT) and rating of perceived exertion using modified Borg scale were measured. Results. The results showed that laser acupuncture has induced highly statistically significant improvements in all the measured outcomes (p < 0.01). However, results revealed no significant difference between the two groups except for modified Borg scale. Conclusion. Accordingly, AlGa As Laser acupuncture could be an effective non-pharmacological intervention for improving circulation and functional walking performance in PAD patients and may be recommended as a complementary therapy in the management protocols of PAD.

Keywords: Laser acupuncture; peripheral arterial disease; ABPI; 6-MWT.

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Heba A. Abd El-Azeem MarwaS. Mustafa Saleh, Ibrahim M.Zohairy,
Neveen A. latif Abdel Raoof.
 
Influence Of Different Ankle Positions On Tibial Nerve Conduction Velocity Study.

Background: Changes in joint positions have been reported to affect nerve mobility and adaptability. Purpose: To investigate the influence of different ankle positions on tibial nerve conduction velocity. Methods: This study   was conducted on sixty healthy participants from both sexes (age30.35±6.1years, weight58.28±9.93kg, height1.67±0.11m and BMI 20.82±1.46 kg/m2). Tibial nerve motor distal latencies were recorded  using Neuropack S1MEB-9004 Nihon Koden Japan from different ankle positions (neutral,  20º ankle dorsiflexion and 40º ankle plantarflexion) Results: showed a  significant  effect for ankle positions in motor distal latency of both lateral and medial branches of tibial nerve in favor  of neutral ankle position compared with other positions  Plantarflexionand dorsiflexion, the mean values of motor   distal latency of both lateral and medial branhes for  neutral ankle position were(4.62±0.87,4.57±0.89)respectively,plantarflexion were(5.06±0.81,5.24±0.83) respectively, and dorsiflexion were(5.64±0.92,6.03±0.93) Conclusion: Ankle neutral position is the most convenient position for assessing tibial nerve conduction velocity and it is the most appropriate position for reduce tibial nerve entrapment ,while prolonged ankle dorsiflexion positionshoud be avoided to redue risk of tibial nerve entrapment . 

Keywords: Ankle positions, Nerve conduction velocity,Tibial nerve

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Heba Allah Elnashar, Abeer Abo BakrElwishy, HananHelmy Mohamed, Rasha Mohamed ElRewainy. Effect of Core Muscle Training on Upper Limb Function in Hemiparetic Patients: A Randomized Controlled Study.

Background: Upper limb paresisis a common problem in patients with stroke. Although it is known that trunk control is an integral part of shoulder stability, the effect of core muscle training program on upper limb function is not well established till now so our Purpose to determine the effect of core muscle training on upper limb function in hemiparetic patients.Methods:30 patients with hemiparesis, with mean age 56.9±7.24years with mean duration of illness2.66±1.34years.They assigned into two equal groups method of allocation was concealed in sequentially numbered, sealed envelopes, the control group GA: 15patients received only conventional physical therapy program (stretching for shoulder muscles, active resisted exercises for shoulder and trunk control exercises), the study group GB: 15patients received conventional physical therapy program and additional core muscle training. Patients received 18 sessions for 6 weeks, three sessions/week. The upper limb function was assessed using Wolf motor function test with subscales (function ability scale, time and grip strength), the range of motion of shoulder flexion and abduction was measured by using goniometer. Results: There was no statistical significant difference between two groups in pretreatment assessment using wolf motor function test and shoulder range of motion. In post treatment assessment there was no statistical significant difference between group GA and GB in all the outcome measures. Conclusion: Core muscle training is similar to conventional physical therapy program in improving upper limb function in hemiparetic patients.

Key words: Hemiparesis - Upper Limb Function- Core Muscle Training

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Heba M. Gaber Abd el fadil1, Waleed T. Mansour, Youssef M. Mohamed, Ahmed G. Azab. Relation Between Spasticity And Carpal Tunnel Syndrome In Patients With Stroke. Background: Stroke is the most common cause of mortality and is one of the most common causes of morbidity in the world. Polyneuropathies and entrapment neuropathies are known as the complications of stroke. The purpose of this study was to Investigate the relation between carpal tunnel syndrome in the affected and non-affected hands in patients with stroke. Methodology: sixty stroke patients of both sexes, their ages were ranged from (40-65) years were assigned into three equal groups (group a, b and c): group (A) with mild spasticity (grade 1 and 1+) while group (B) with moderate spasticity (grade 2 and 3) and group (c) with severe spasticity (grade 4) according to modified ashowrth scale. Subjects were assessed using Electrodiagnostic testing (nerve conduction velocity) and clinical tests (Phalen’s test, Tinel's sign, Durkan's test and the hand elevation test). Results: This study revealed that patients with stroke had carpal tunnel syndrome in the affected hand as a result of spasticity and in the non-affected hand due to overuse but the results were more significant in group (c). Conclusion: It was suggested that simultaneous different mechanisms may act in inducing carpal tunnel syndrome in both hands of hemiparetic patient. Our results confirm that, in severe hemiparetic patients, the entrapment neuropathies may be commonly seen, especially in the paretic extremities. The early rehabilitation programs against the development of entrapment neuropathies may be beneficial in stroke patients.
(Key Words: Stroke, Spasticity, Carpal tunnel syndrome, Paretic hand).

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Hebat-Allah H. Abdel-Hamid; Mohamed A. Awad; Ghada E. El-refaye; Hossam H. Kamel. Effect Of Aerobic Exercise On Premature Menopausal Symptoms After Hysterectomy.
 
Background: Women who have a hysterectomy usually go through menopause in earlier age. Estrogen levels fall sharply after hysterectomy and this condition is referred to as premature menopause. It can lead to higher levels of follicle stimulating hormone and luteinizing hormone in blood. Purpose: This study was conducted to detect the effect of aerobic exercise on premature menopausal symptoms after hysterectomy. Subjects &Methods: Forty women with recent total hysterectomy selected randomly. Their ages ranged from 30 to 40 years old and their body mass index was not exceeding 30 kg/m2. They were divided into two groups equal in number, group (A) were treated by hormone replacement therapy (Conjugated Estrogens 2.5 mg and Medroxyprogestrone0.625 mg once daily) only for twelve weeks and group (B) were engaged in aerobic exercise program in the form of treadmill and stationary bicycle for 45 minutes, 3times per week, for twelve weeks and also was treated by the same hormone replacement therapy. Modified Greene scale was used to evaluate the premature menopausal symptoms; Blood sample analysis was used to show the levels of follicle stimulating hormone (FSH) and luteinizing hormone LH) for both groups (A&B) before and after treatment. Results: The obtained results showed a statistically highly significant delay and overcome in the appearance of premature menopausal symptoms was found in group (B) than group (A).Conclusions: It could be concluded that the engagement of aerobic exercise program was very effective in overcoming or delaying the premature menopausal symptoms on post hysterectomy women.
Key words: Aerobic Exercise; Hysterectomy; Premature menopause.

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Hend H. El Haroni,Nawal A. Abo Shady, Hamada A. Hamada. Prevalence of cervicogenic headache and forward head posture among clinical pathologists: An observational cross sectional study.
 
Background: Clinical pathologists are highly trained medical professionals who play an essential part in the diagnosis and treatment plan of malignancies and inflammatory diseases. Their work is associated with potential health hazards including injuries involving infectious human tissue, chemicals which are assumed to be carcinogenic in addition to long periods of microscope and computer work and assuming forward posture most of work time. These factors make them at risk of musculoskeletal disorders like forward head posture and cervicogenic headache.The purpose: of this study was to investigate the prevalence of forward head posture and cervicogenic headache among clinical pathologists. This study was the first study which investigate the prevalence of forward head posture and cervicogenic headache among clinical pathologists. Methods: There were 100 subjects in the study. Their age between 25 to 45 years. The Diagnostic criteria developed by Cervicogenic Headache International Study Groupfor diagnosis of cervicogenic headache, the photography was used to measure the craniovertebral angle (C.V.A.), the AutoCAD 2014 software program was used to analyze the photos and the CROM was used to measure range of motion. Results: The statistical analysis of this study revealed about(48%) among clinical pathologists had cervicogenic headache. While the remaining (52%) of clinical pathologists had no cervicogenic headache. The percent of The Forward head posture were (95%) of clinical pathologists had Forward head posture. While the remaining (5%) of clinical pathologists had normalangle. Conclusion:In this studymost clinical pathologists had forward head posture 95% which is one of the most common musculoskeletal disordersand about half of them 48% had cervicogenic headache such high percent direct us to pay attention on ergonomic considerations during work .

Keywords: Cervicogenic headache, Clinical pathologists, Forward head posture.

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Hend M Mahmoud,Nasr A Abd elKader , Nadia A Fayaz, Mohamed M Bahi El Den. Correlation Between Tibiofemoral Angle And Sacral Angle In Female With Bilateral Genu Valgum.
 
Background: Genu Valgum is adeformity in which the axial alignment of the lower limb is disturbed with exaggeration of the tibio-femoral angle. Such deformities resolve by themselves during infancy and childhood, but if they persist in adolescent age, there is no chance of resolution and might pose serious problems for the individual in the future. The aim of this study was to determine correlation between tibio femoral angle and sacral angle in female with bilateral genu valgum. Methods: Sixty-four female students with bilateral genu valgum participated in the study. They recruited from Deraya University. Their age ranged from 18 to 25 years old,Q angle >20 and BMI≥ 30 (kg/m2).X-ray of the lower limbs used for measurement of tibio-femoral angle; in addition, X-ray of lumbosacral spine used for measurement of sacral angle. Results: However, there was a statistical significant correlation between left tibio-femoral angle and sacral angle (r= -0.3098; p= 0.0126),there was no statistical significant correlation between right tibiofemoral angle and sacral angle (r= -0.1945; p= 0.124).Conclusion: According to results of the study, there was association between left tibio-femoral angle and sacral angle but there was not association between right tibio- femoral angleand sacral angle
Keywords: Genu valgum, tibio femoral angle, sacral angle

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Hend Wageh,Tasneem Mohammad , Mirna M. Elias ,Nagwa Abu Elwafa1 , Mahmoud Nabhan1,Nabila S. Hassan,Aliaa Rehan Youssef . tandardizingsciatic function index rating protocol improves inter-rater reliability and precisionof novice assessors
 
Background: Sciatic function index (SFI) is a simple kinematic analysis used to quantify animals’ functional recovery following sciatic nerve and related musclesinjuries. However, the reliability of this assessment method may vary based on experience level and practice. Therefore, this study investigated whether standardization of rating would improve interrater reliability and precision among novice assessors with no previous experience. Methods: Standardization of SFI measurement was based on the delphi technique. A pilot measurement session was done by four raters (one expert and three novices) on 24 traces, not included in the actual analysis. Then a standardized protocol was developed and agreed upon by consensus through discussion and voting. The four raters then independently assessed 20 other traces obtained from 20 rats; 10normal and 10 animals with a unilateral tibialis anterior induced strain injury. Results: There was no significant differences between the SFI scores of the expert and each of the novice examiners (P-value > 0.05).Furthermore, there was a strong significant positive correlation between expert and novice assessors (r >0.80, P value< 0.001). Yet, the limit of precision was wide and ranged between26.7 to 29.4%. Conclusion: Standardized SFI rating protocol increased the inter-reliability of novice compared to expert raters; however, precision is still low and need further improvement.
Keywords: Sciatic function index; Inter-rater reliability, Standardization.

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Hoda Z. Abd-ElRaheem, Abeer A. Elwishy, Amina M. Awad, Hatem Samir M. Shehata. Effect of Aerobic Exercise on Depression in Patients with Multiple Sclerosis


 
Background: Multiple sclerosis is considered the major cause of neurological disability in young adults worldwide (1). Depression is the commonest psychiatric manifestation in MS patients but still remains unclear (2). The purpose of this study was to investigate the effect of aerobic exercise on depression in patients with Multiple Sclerosis. Methodology: twenty patients of both sexes, their ages were ranged from (20-40) years were assigned into two equal groups (group a, b): group (A) patients were treated by eight hours of aerobic exercise using stationery bicycle while group (B) patients did not receive the previous modality (control group). Subjects were assessed using Beck depression inventory. Results: "Paired t test" revealed that there was a significant reduction of BDI score (p<0.05) at post treatment in compared to pre treatment for group A aerobic exercise while there was no significant difference (p>0.05) at group B control group..
Conclusion: It was suggested that aerobic exercise can decrease depressive symptoms in patient with multiple sclerosis.

(Key Words: Multiple Sclerosis, Depression , Aerobic exercise).

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Mahmoud A. Hassan1, Emam Hassan El-Negamy , Mohamed I. Elassal , Abdelrahim A. Sadek Effect Of Bilateral Arm Exercises On Motor Control Of Hemiparetic Cerebral Palsy Children.
 
Background: Hemiparetic Cerebral Palsy represents the muscle tone and movement disorders on one side of the body in which the upper extremity is more affected than the lower extremity. Children with hemiparetic cerebral palsy often have difficulty in performing activities which rely on the coordinated use of both hands because of movement difficulties of the affected hand. This study aims to determine the effect of bilateral arm exercises on motor control of hemiparetic cerebral palsy children. Methods: Twenty-six hemiparetic cerebral palsy children of both genders (14 boys and12 girls) participated in this study. Their age ranged between 3and 7 years with spasticity ranged from 1 to 2 according to Modified Ashworth Scale and they could follow the order during testing and training. None of them had visual or auditory defect or previous orthopedic surgery of the affected upper extremity and they shouldn't have any structural deformities in any joint or bone. They were randomly assigned into two groups (A&B) of equal number 13 patients each, group (A) received a selected physical therapy program for one and half hours and group (B) received the selected physical therapy program for one hour in addition to bilateral arm exercises for half an hour. Both groups received the selected treatment program 3 times per week for 3 successive months from November 2018 to January 2019. All the patients were evaluated with Modified Ashworth Scale, Functional Independence Measure for children and Pneumatic Squeeze Bulb Dynamometer at pre- and post- treatment. Results: The results of this study revealed statistically significant difference between the two groups after the treatment in favor of group B in Wee Functional Independence Measure motor subtotal score and grip /pinch strength score (p < 0.05) .Conclusion: Bilateral arm exercises are effective in improvement of motor control of the affected side for the children with hemiparetic cerebral palsy.
Keywords: Cerebral palsy, bilateral arm exercises and Motor control.

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Mahmoud M. Elhanafy, Gehan H. Elmeniawy , Asmaa O. Sayed Femoral Neck Shaft Angle In Relation To Spasticity In Children With Spastic Hemiplegic Cerebral Palsy.
 
Background: Femoral neck-shaft angle (NSA) is the measurement of the angle formed between the oblique oriented neck with the vertical shaft and is an important anatomic measurement for the evaluation of biomechanics of hip. Spasticity is a muscular hypertonicity characterized by a velocity- dependent increased resistance to stretch, which interfere with voluntary movement. Subjects: Fifty children with hemiplegic cerebral palsy of both genders with age ranged from 3to 10 years participated in this study. They were selected from El-Bagour general hospital, Ashmoun general Hospital and care scan private center in El-Menoufia Governorate. Purpose: This study was conducted to corelate femoral neck shaft angle measurement with spasticity in children with hemiplegic cerebral palsy. Materials: Anteroposterior x-ray beams of pelvis, Modified ashowrth scale, Sante dicom software and AutoCAD 2014 software. Results: There was a significant increase in the neck shaft angle of the affected side compared with that of the non-affected side in both genders. There was a moderate positive significant correlation between femoral neck shaft angle and spasticity. Conclusion: The femoral neck shaft angle significantly decreases with aging particularly in non- affected side. As the degree of spasticity increases, and neck shaft angle reaches to higher degrees affecting hip geometry. The gender doesn’t directly affect (NSA).
Keywords: Hemiplegic cerebral palsy, Neck shaft angle, spasticity.

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Mahmoud S Aboraya ,Doaa I Amin , Neveen A Abdel Raoof. Correlation between waist circumference and dynamic balance in young male adults. Background: A steadily increasing trend of obesity among young adults, especially college and university students, is becoming more evident. There is a relationship between the weight of individuals and their ability to balance. The fat tissue localization plays a major role in locating the center of mass (COM) hence has a great effect on postural balance. Studying the relation between waist circumference and balance would help to establish risk factors leading to decreased balance and increased risk of falling, helping physiotherapists to define the high risk population. Methods: 21 physical therapy students aged 18-25 years and their body mass index ranged from 30-34.99 kg/m2 were recruited for this study. The dynamic postural balance was measured using Biodex balnce system with at stability level 4 and waist circumference was measured using stretch resistant tape. Results: Pearson`s correlation coefficient was calculated (at α= .05) between waist circumference (WC) and the three stability indices. The correlation between (WC) and overall stability index (OSI) was .54 (p=.017) (significant with moderate strength), the correlation between between (WC) and anterioposterior stability index (APSI) was .52 (p=.02) (significant with moderate strength) and the correlation between between (WC) and mediolateral stability index (MLSI) was .5 (p=.03) (significant with moderate strength). Conclusion: It was concluded that there is a significant correlation of moderate strength between waist circumference and dynamic postural balance in young obese male adults.
Keywords: Dynamic postural balance, Waist circumference, Obesity

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Mahmoud S. Elfakharany, Mariem T. Ali and Dalia I. Tayel. Nutritional State and Gross Motor Function of Children with Cerebral Palsy.
 
Background: Nutritional abnormalities are common across the spectrum of severity of CP. Children with all levels of motor impairment are at risk for malnutrition. Impaired growth of children with CP is commonly reported. CP children are tend to be smaller and to grow more slowly than typically developing children. Growth disorders and nutritional deficits are present in approximately one third of paediatric patients with CP. The aim of this study is to assess the nutritional status of children with cerebral palsy according to their functional abilities.Methods: 105 children with hemiplegic and diaplegic CP of both sexes were selected, their age ranged from 6 months to 12 years, they were classified according to GMFCS in to level II, III, IV, their degree of spasticity are 1, 1+ and 2 and parents accepting to participate in the study referred from Nour- EL Hayah rehabilitation center and EL- Rahma rehabilitation center in Alexandria to assess their dietary intake and to investigate the relation between GMFCS and their nutritional status. Dietary intake was assessed by a 3- day food diary filled by the caregivers report all food and beverages that will be consumed. Finding of dietary intake was analyzed using the Egyptian Food Composition Tables by National Nutrition Institute to determine energy and macronutrient intake. Results: MANOVA revealed that there was a significant difference between GMFM levels in nutritional status (p = 0.001). There was a significant increase in energy, iron, water, fat, protein and carbohydrate of level II compared with that of level III (p > 0.01). However, there was no significant difference in calcium between level II and level III (p > 0.05). There was a significant increase in calcium of level IV compared with that of level II (p > 0.05). There was a significant increase in iron and water of level II compared with that of level IV (p > 0.001).However, there was no significant difference in energy, fat, protein and carbohydrate between level II and level IV (p > 0.05). There was no significant difference between level III and level IV in all parameters (p > 0.05).Discussion: Our finding showed that there was an increase in energy, iron, water, fat, protein and carbohydrate of level II compared with that of level III and also, there was no significant difference in calcium between level II and level III. Conclusion: It could be concluded that, the nutritional state for level II is better than level III and IV.
Key words: cerebral palsy, nutritional status, functional abilities, Dietary intake and gross motor function.

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Mai Gaber Mohamed, Hussein Ahmed Shaker ,
Ebtisam Mohamed Fahmy , Walaa Mohammed Ragab.
 
A Comparative Study Between Muscle Energy Technique And Spinal Extension Exercise Program In Treatment Of Chronic Mechanical low Back Pain patients

 
Background: People with chronic low back pain often experience anger, fear, anxiety decline in physical ability, and inadequacy of role fulfillment. These stressors, along with negative affective states, increase the allostatic load. Objective: This study aimed to compare the efficacy of extension exercise program versus muscle energy technique in treating patients with chronic mechanical low back pain.Subjects: Forty patients participated in this study complaining of chronic mechanical low back pain. Patients were allocated into two equal groups. Group (A): received spinal extension exercise program and Group (B): received muscle energy technique. Treatment sessions were given three times per week for four successive weeks. Patients in both groups were assessed bythe researcher before and after treatment for the outcome measures of pain, functional disability and lumbar range of motion. Results: There was significant increase in lumbar range of motion in both groups, also a significant decrease in the pain and functional disability in both groups. Conclusion: McKenzie and muscle energy technique had significant effect on range of motion on chronic mechanical low back pain patients .while muscle energy technique had better effect in decreasing pain intensity.
Key Words: Chronic mechanical low back pain – muscle energy technique – spinal extension program.

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Eman Samer Fayez , Islam Mahmoud Abd-allah Al-Azab, Michel Alber Fawzy Bouls ,Taha Kamel Taha.

Influence Of Transcranial Direct Current Stimulation On Depression In Stroke Patient

Background: The aim of this work was to investigate the influence of transcranial direct current stimulation (TDCS) on improving depression in stroke patients. Subjects and Methods: forty hemiparetic stroke patients from both sexes represent the sample of this study. The patients' ages ranged from 45 to 60 years with a mean value of 55.475 ± 4.01 years. Patients were assigned randomly into two groups equal in number; the study group A and the control group B. The study group A treated by the prescribed medications for depression as the control group B in addition to transcranial direct current stimulation for 30 minutes, three times per week for one month in addition to physical therapy program. The control group B treated by the prescribed medication only and sham transcranial direct current stimulation in addition to physical therapy program. Depression was evaluated by Hamilton Depression scale pre and post treatment in both groups and quality of life was evaluated by The Stroke Specific Quality Of Life scale. Results: results of this study revealed a significant improvement in all different parameters in study group A P ≤ 0.05; over the control group B. Comparison of post treatment results of both groups showed that transcranial direct current stimulation used in study group A showed significant improvement in post stroke depression and Stroke Specific Quality Of Life than group B. Conclusion: transcranial direct current stimulation has significant effect on treatment of depression and Stroke Specific Quality Of Life in stroke patients.

Key words: Depression, Quality Of Life, Stroke, Transcranial direct current stimulation.

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Mina M. Wahba1, Aliaa Rehan Youssef2, Dina OShokri. The Relationship between Lumbar Proprioception Deficit And The Addiction Of Smartphone Use In Patients With Chronicmechanical
Low Back Pain: A Cross-Section Study.
Background: Excessive Smartphone use has been associated with proprioception deficit in cervical spine, however, it is not clear whether this relationship exists in other spinal regions such as the lower back. The objective of the study was to investigate whether Smartphone addictive use and duration until first use in the morning are associated with lumbar spine proprioception deficit in patients with mechanical chronic low back pain (CLBP).Methods: Fifty patients with mechanical CLBP were included in this study. Smartphone addiction score, usage duration and time to first use in the morning were collected from patients using a self-reported questionnaire and a face-to-face interview. Lower back proprioception deficit was assessed using the Biodex System 3 Pro Isokinetic Dynamometer. Results: Ten males and 40 females with a mean age (± SD)of 22.4 (± 2.48) years and BMI mean (± SD)of23.7 (± 1.98) kg/m2completed all measurements. Proprioception deficit was positively, weakly and non-significantly correlated with smartphone addiction,use duration and time to first use in the morning. Conclusion: Lower back proprioception deficit is independent of Smartphone usage duration and addiction in patients with mechanical CLBP.


Keywords: Chronic low back pain; Proprioception; Reposition error; Smartphone.

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Mohamed A. Awad1; Abdel Hamid A. Atta Allah. Effect Of Myofascial Release Technique Versus Mulligan Mobilization Technique On Post Natal Low Back Pain Background: Low back pain (L.B.P) and pelvic girdle pain are common during pregnancy in many countries. The prevalence rates are variable depending on the criteria used for diagnosing the pain. Purpose: This study was conducted to compare the effect of myofascial release technique and mulligan mobilization technique on post-natal low back pain. Subjects: Fifty primegravidae or multigravidae postnatal women complained of low back pain selected randomly from physical therapy department in Al Zahraa University Hospital. Their ages ranged from 25 to 35 years old. Their body mass index was not exceeding 30 kg/m2. They were medically stable and consented to participate in the study. They did not receive any medical treatment during the research period. They were divided into two equal groups (A&B). Group A: 25 women received Myofascial release technique three times a week for sex weeks. Group B: 25 women received Mulligan mobilization technique three times a week for sex weeks. Methods: Visual analogue scale (VAS) was used to measure pain intensity and Oswestry Disability Questionnaire was used to assess functional disability for both groups (A&B) before and after treatment. Results: The results of this study found that, within groups there was a statistically highly significant decrease (P = 0.001) in low back pain intensity and functional disability in both groups (A&B). Between groups the obtained results showed there was no statistically significant difference in low back pain intensity and functional disability pre treatment. But post treatment there was a statistically highly significant difference in low back pain intensity and functional disability between both groups (more decrease in group A). Conclusion: Myofascial release technique is more effective in reducing pain and improving functional status by decreasing disability of patients with post natal low back pain than mulligan mobilization technique.

Key words: Myofascial Release Technique, Mulligan Mobilization Technique, Post-natal low back pain.

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Mohamed A. Awad1; Abdel Hamid A. Atta Allah Effect Of Electroacupuncture Versus Low Level Laser Therapy On Post Natal Low Back Pain

 

Background: Postpartum lumbopelvic pain is a serious problem for women, as it has an effect on their performance of the daily living activities so that it has an effect on her family and society. Purpose: This study was conducted to compare the effect of Electroacupuncture and Low Level Laser Therapyon post-natal low back pain. Subjects: Fifty primegravidae or multigravidae postnatal women complained of low back pain selected randomly from physical therapy department in Al Zahraa University Hospital. Their ages ranged from 25 to 35 years old. Their body mass index was not exceeding 30 kg/m2. They were medically stable and consented to participate in the study. They did not receive any medical treatment during the research period. They were divided into two equal groups (A&B).Group A: 25 women treated by Electroacupuncture three times a week for sex weeks. Group B: 25 women treated by Low Level Laser Therapy three times a week for sex weeks. Methods: Visual analogue scale (VAS) was used to measure pain intensity and Oswestry Disability Questionnaire was used to assess functional disability for both groups (A&B) before and after treatment. Results: The results of this study found that, within groups there was a statistically highly significant decrease (P = 0.001) in low back pain intensity and functional disability in both groups (A&B). Between groups the obtained results showed there was no statistically significant difference in low back pain intensity and functional disability pre treatment. But post treatment there was a statistically highly significant difference in low back pain intensity and functional disability between both groups (more decrease in group A). Conclusion: Electroacupunctureis more effective in reducing pain and improving functional status by decreasing disability of patients with post natal low back pain than Low Level Laser Therapy.

Key words: Electroacupuncture- Low level laser therapy- Post natal low back pain.

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Mohammed Fouad1*,Azza Abdelazzez Abdelhady 2,Hany Elsisi3ahmed Kamal. The Effect Of Polarized Light Therapy In Treatment Of Chronic Diabetic Foot Ulcers

 
Background/aim:Impaired healing is a problematic and common complication of chronic wounds. Although laser has been used in the treatment of chronic wounds with promising efficacy, its mechanism is still poorly characterized. The cost of wound care is significant. The most important components are the costs of wound-related hospitalisation and the opportunity cost of nurse time. The 32% of patients treated in hospital accounted for 63% of total costs. The use of polarized light in the treatment of wounds has provided conflicting data, with some studies reporting accelerated wound closure and increased tensile strength of scars while others have found no such improvement.The aim of this study was to determine the effect of polarized light therapy on wound surface area and wound volume of chronic diabetic foot ulcers. Material and methods:Sixty men patients with partial or full thickness diabetic foot ulcer complaining from delay healing of ulcer for more than three months participated in this study. Subjects were randomized into 2 groups equal in number, each group consisted of 20 patients. Group A was the Polarized light therapy group, included 30 men patients with foot ulcer and they received polarized light therapy with energy density of an average of 2.4 J/cm2 per minute for 8min, 3 sessions per week in addition to traditional medical treatment and Group B was the traditional medical treatment group, included 30 men patients with foot ulcer and they received traditional medical treatment only. All evaluations were applied by the same physiotherapist12 weeks. Results: Wound Surface Area and Ulcer volume showed significant difference between the two groups in favor of group A, as p was ≤ 0.05 which was considered statistically significant.
Conclusion: We suggest that light therapy should be added to the treatment of chronic diabetic foot ulcers.
 

Key words: Diabetic foot, light therapy, ulcers.

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Mohanad A. Ahmed,  Emam H Elnegmy, Hamada S. Ayoub Effect Of Sustained Weight In Correction
Of Drop Shoulder In Hemiplegic
Cerebral Palsy Children.
Purpose: This study was done to investigate the effect of sustained weight on correction of drop shoulder in hemiplegic cerebral palsy children. Participant and Methods: Thirty children with spastic hemiplegia enrolled in this study, their age ranged from 3 to 8 years and being assessed by posture zone software. They were randomly assigned into two groups of equal numbers 15 children each. The control group (A) received a designed physical therapy program and the study group (B) received the same therapy program in addition to sustained weight (2% out of the total body weight) placed on top of the dropped affected shoulder.Results: Comparison of post treatment results between the control and study groups revealeda significant difference between post treatment mean values of shoulders level angle in favour of the study group.Conclusion: From the obtained results it could be concluded that sustained weight of about 2% of the total body weight has a beneficial effect on drop shoulder in children with spastic hemiplegia.


Key Words: Hemiplegia, Spastic children, Drop shoulder, Sustained weight.
 

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