The 21^th International Scientific Conference Faculty of Physical Therapy Cairo, 28-29 July , 2022

Conference studies 2022

on library website Prepared by

Nerveen Abd El Salam Abd El Kader Ahmed

Abstract

Abdallah Megahead Ibrahim Badr, Wael S. Shendy, Eman S. Fayez.

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Abdelrahaman M. Hewidy, Karim Ghuiba, Waleed M. Ewais, Mohammed S. Abdelsalam.

Background: Osteoarthritis is a major public health problem. Both neuromuscular training, and strengthening has been increasingly applied for patients with osteoarthritis. Purpose of the study: was to compare effects of neuromuscular training and strengthening exercises on pain, disability level, and physical activity in knee osteoarthritis. Subjects and Methods: Fifty one patients with knee osteoarthritis, aged 45–65 years, and BMI 18-30 kg/m², participated in this study. Patients were divided randomly into 3 equal groups of 17 patients each. Group [A] [Control group], received TENS and warm up exercises. Group [B] [Strengthening exercises group] received same as group [A] plus strengthening exercise program. Group [C] [Neuromuscular control group] received same as group [A] plus neuromuscular control training program. All participants were evaluated before and after 12 sessions (3 sessions a week for 4 weeks) through measuring visual analog scale, Western Ontario and McMaster Universities Arthritis Index, timed up and go test and 6-minutes walking test, to evaluate pain, disability level, and physical activity respectively. Results: The results revealed a significant effect of treatment in improving all parameters within all groups. Further, groups B and C were significantly better than group A in pain (VAS), and level of disability (WOMAC), but with non-significant differences in functional tests, post- treatment. Albeit, there was no significant difference between groups BandC. Conclusion: both neuromuscular and strengthening program showed significant improvement with no differences between both groups on decreasing pain, improving disability level, and improving physical activity in KOA patients.

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Ahmed M. Abdou, Neveen Abdel Latif Abdel Raoof, Shimaa T. Abu El-Kasem.

Background: Proprioceptive information plays an important role in joint stabilization, body coordination and proper function. Flatfoot affect the mechanics of lower limb as foot pronation causes tibial internal rotation, which causes knee valgus. Flat foot deformity may alter the proprioception of knee joint and that may predispose to joint injury. Objective: Is to investigate the effect of bilateral flexible second degree flatfoot on weight bearing and non-weight bearing knee proprioception. Methods: Thirty-two males and females subjects with age ranged from 18-25 years old were assigned into two equal groups, Group A (the normal group) and group B (the flat foot group). Lateral weight bearing radiographs were performed bilaterally for each subject in both groups to determine the degree of flat foot by measuring the talus first metatarsal angle. Active repositioning test of knee flexion was measured in weight bearing and non-weight bearing state by digital goniometer to assess proprioception joint reposition error of knee joint. Results: MANOVA revealed that there was no significant difference in reposition error of knee joint in the flatfoot group compared with control group in weight bearing state as p ≥ 0.05. And there was significant difference in reposition error of knee joint in the flatfoot group compared with control group in non-weight bearing state as p ≤ 0.05. Conclusion: The findings indicate that flatfoot affect knee proprioception in non-weight bearing state only.

Keywords: knee Proprioception; weight-bearing; non-weight-bearing; flexible flatfoot.

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Ahmed Mohammad Abd El Monem, Soheir Shehata RezkAllah Samaan, Ghada Abd El Monem.

Background: Among people with shoulder pain, supraspinatus tendinitis has the highest prevalence and accounts for 36% of shoulder disorders and its recurrence is common after treatment. Myofascial trigger points (MTrPs) in the supraspinatus muscle were found in 65% of patients diagnosed with shoulder impingement. Purpose: To investigate the effect of low level laser therapy (LLLT) versus dry needling (DN) on shoulder pain, function, and range of motion in patients with supraspinatus tendinitis. Materials and Methods: Seventy-five subjects of both genders with MTrPs associated with grade 2 (according to Neer’s classification) supraspinatus tendinitis participated in this study. Subjects were randomly assigned into three groups (each group consisted of twenty five subjects). Group (A) with a mean age of 40.4 (±7.76) years was LLLT group (Gallium arsenide laser at a wavelength of 810 nm and 583 Hz with maximum power output of 150 mW for 160 seconds so that the total energy density was 8 J/cm2) was applied on MTrPs, group (B) with a mean age of 42.2(±9.25) years was DN group (with depth of insertion range from 30-35mm), group (C) with a mean age of 40.84 (±7.58) years was the control group. Subjects in all groups received conventional physical therapy for 5 consecutive days. Subject data was called at baseline and after treatment regarding shoulder flexion, abduction, internal and external rotation ROM and shoulder pain and disability index (SPADI). Results: Subjects of the three groups showed statistical significant improvement in all the measured variables. Between groups comparison revealed a significant difference in flexion, abduction ROM, and SPADI score of groups A and B compared with that of group C (p < 0.01). There was no significant difference in the shoulder flexion, abduction ROM, and SPADI score between group A and B post treatment (p > 0.05). Also there was no significant difference in internal and external rotation between the three groups post treatment (p > 0.05). Conclusion: both low level laser therapy and dry needling are effective in treatment of patients with myofascial trigger points associated with chronic stage 2 supraspinatus tendinitis with no statistically significant differences between them. However, low level laser therapy may be considered as a treatment of choice because it is non-invasive, easy to apply in contrary of dry needling which needs learning and practice, there is no agitation of hyperirritated areas, and it may be the method of choice for patients with a fear of needles and health professionals inexperienced with the dry needling technique.

 KEY WORDS: Low level laser, Supraspinatus tendinitis, Myofascial trigger points, and Dry needling.

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Alaa T. Habashy,  Khaddija S. Abdel-Aziz, Asmaa M. Ali , Manar S. Mohamed.

Back ground: Hypertension after menopause sets women up for an increased risk of negative cardiovascular outcomes. Reflexology is a systematic practice of applying some pressure to specific points on the feet and hands give impacts on the health of related parts of the body. A variety of relaxation techniques exist, which aim to relive stress and reduce blood pressure. Purpose: The present study was conducted to compare between the effects of relaxation exercises versus foot reflexology on decreasing hypertension in postmenopausal women. Subjects and Methods: Thirty women diagnosed with postmenopausal hypertension. Their age ranged from 50 - 65 years. they were assigned randomly into two groups of equal number (A and B). Group (A) consisted of 15 patients who received foot reflexology combined with antihypertensive drugs while group (B) consisted of 15 patients who received relaxation exercises combined with antihypertensive drugs. The treatment program was conducted for 30 min (each foot 15 min) 3 times per week for 6 weeks. Results: The results revealed significant decrease in systolic and diastolic blood pressure as well as blood cortisol level for both groups (A and B) in favor of group (B). Conclusion: It could be concluded that relaxation exercises are more effective than foot reflexology in decreasing hypertension in postmenopausal women.

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Alaaullah A Said , Awny F Rahmy , Heba K. Sedrak , Asmaa M Mohamed.

Background: There is lack of awareness of the efficacy of whole body vibration and aerobic training on liver function in obese adult women in Egypt. Purpose: The aim of the study was to show the difference of the whole body vibration and aerobic training on liver function in obese adult women. Subjects and Methods: Forty obese adult women were enrolled in this study, they were recruited from the relatives of the patients from the out-patient clinic of faculty of physical therapy, Cairo University and from the out-patient clinics of Bolaq El-Dakrour hospital, Cairo, Egypt. Their age ranged from 35 - 45 years with body mass index (BMI) between 30 – 34.9 kg/m² (Class I obesity), the waist/hip ratio) less than one and they were assigned randomly into two groups of equal number (A and B). Group (A) includes 20 obese adult women who received diet advices (to prevent increasing weight) and aerobic training in form of treadmill training while group (B) received includes 20 obese adult women who received the same diet advices of group (A) and whole body vibration exercises (vibration frequency was set to 30 Hz then increased gradually to 35 Hz, then the subject took about 20 minutes to fulfill a training session). The participated subjects in this study were assessed by liver enzyme test (alanine transaminase (ALT) (SGPT)) and anthropometric measurement (waist/hip ratio). They were evaluated before and after the treatment program about three sessions per week for eight weeks. Results: The obtained results revealed significant differences of all measured variables before and after treatment in the two groups. Statistical significant difference was also found in post-treatment values of all measured variables when compared between the two groups in favor of group (A) and the percentage of improvement of ALT was 11.86 % and waist/hip ratio was 3.66 %. Conclusion: Aerobic training in form of treadmill training and whole body vibration exercise can be added to the physical therapy program.

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Amany M. Abd-Allah, KHADIGA S. ABD EL AZIZ, Ghada E. EL- Refaye, HOSSAM A. HUSSIEN.

Background: Premenstrual symptoms are common, a smaller proportion of women meet clinical criteria for premenstrual syndrome (PMS), which affects their daily activities and quality of life. Purpose: This study was conducted to compare between Kinesio taping versus spiral taping as methods for alleviating premenstrual syndrome. Materials and Methods: Sixty virgin women were selected from Faculty of Pharmacy Zagazig University to share in the study. Their ages ranged from 20-25 years and their body mass index was ≤ 30 kg/m². The subjects were randomly divided into three equal number groups; a Kinesio taping group (A), a spiral taping group (B) and a control group (C). Subjects with a regular menstrual cycle underwent taping three times per week for about six weeks starting from 14 days before menstruation until its end.  Degrees of menstrual pain was measured by using Visual analogue scale (VAS) and premenstrual syndrome were assessed using Menstrual Distress Questionnaire (MDQ). Results: The results of this study revealed that there was statistically significant decrease in mean value of VAS of Kinesio group (A) when compared with its corresponding value in group (B) and (C) with  p-value = 0.003.There was a highly statistically significant decrease in symptoms of premenstrual syndrome in the group (A) (kinesio group) compared with those in other groups. Conclusion: Both taping methods before menstruation brought significant relief to menstrual pain, which suggests that kinesio taping is more effective than spiral taping method in alleviating premenstrual symptoms.

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Amira M Nabil Hussien, Dina MA Mohamed

Hossam El Din H Kamel, Dalia M Kamel Awad.

Background a lot of changes occur in women’s post-menopausal period, one of these symptoms is fatigue or a lack of energy which is a potential symptom of menopause, it can be one of the most difficult symptoms to manage. Few studies are concerned with postmenopausal fatigue treatment. Pilates is a mind body exercise focusing on muscle strength, core stability, endurance, muscle control, posture, and respiration which seems to improve both the physical and psychological components in postmenopausal women. The purpose was to determine the effect of Pilates exercises on fatigue in postmenopausal women. Methods Fifty-two postmenopausal women suffering fatigue, their ages ranged from 50 to 55 years, their body mass index (BMI) below 30 kg/m2 and they all became menopause at least for one year ago. The patients were selected randomly from out clinic of El Kasr EL-Aini hospital and randomly divided into two equal groups. Group A composed of twenty-six patients received Pilates exercises and medical standard care for fatigue and group B, twenty-six patients received medical standard care for fatigue only. It was a randomized controlled trial for 8 weeks, the outcome measures were FAS and IL-6. Results there was a significant decrease in fatigue assessment scale (FAS) (P<0.00001), and interluken-6 test (IL-6) (P<0.00001) after treatment for group A while there was no significant reduction for group B. Conclusions Pilates exercises is considered an effective modality to reduce fatigue in postmenopausal women.

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Amr Hamada, Alaa Al-Nemr, Walaa ElNaggar, Faten Abd El Azeim.

Background: Deficient manual ability and dissociated arm movements are common problems in unilateral spastic cerebral palsy. These children have disturbance of manual ability which is the capacity to manage daily upper limb activities and interfering with doing the fundamental functions. Another problem in USCP is the dissociated arm movements which is the performance of intrasegmental and intersegmental isolated movements. It is the ability to isolate the activation of muscles in a selected pattern in response to demands of a voluntary posture or movements. Purpose of the study: to investigate the correlation between dissociated arm movements and manual ability in unilateral spastic cerebral palsy during middle childhood stage. Methods: 24 unilateral spastic cerebral palsy children with ages between 6-8 years old, the grade of spasticity are 1 and 1+ according to the Modified Ashworth Scale, and the Manual ability classification system of hand level II-III. ABILHAND-Kids questionnaire was used to assess the manual ability and Quality of Upper Extremity Skills Test was used to assess dissociated arm movements. All patients were assessed for one shot. The Study design was cross sectional observational study. Children were randomly selected. Results: a significant Correlation was detected between dissociated arm movements and manual ability in unilateral spastic cerebral palsy during middle childhood stage. Conclusion: There is a strong significant relationship between isolated arm movements and manual ability needed for active participation in daily life.

 Keywords: Dissociated movements, manual ability, unilateral spastic cerebral palsy.

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Andrew G. Mourice, Gehan M. Abd El-Maksoud and Walaa A. Abd El-Nabie.

Background: Motor imagery is widely recognized as an effective method to enhance motor performance. Purpose:  The aim of this study was to investigate the effect of motor imagery training on range of motion of shoulder joint in children with hemiplegic cerebral palsy. Subjects and Methods: Thirty children with hemiplegic cerebral palsy, aged from 8 to 12 years of both sexes were participated in this study. They were selected from the Outpatient Clinic of Faculty of Physical Therapy, Cairo University. They were randomly divided into two equal groups, A (study group) and B (control group). Both groups received designed physical therapy program while, group A received motor imagery training program in addition to the designed physical therapy program. The treatment program was conducted for one hour, three times per week for three successive months for each group. Pre- and post-treatment assessments of range of motion of shoulder joint (flexion and abduction) were performed by an electronic goniometer. Results: Both groups showed; significant increase in shoulder flexion and abduction (p<0.001) after treatment protocols. However, there were no statistically significant differences in the mean values of the measured outcomes between both groups (p>0.001). Conclusions: Motor imagery training may be used within the rehabilitation program of children with hemiplegic cerebral palsy to improve their range of motion of shoulder joint.

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Asmaa Mostafa AbdElkader & , Awny Fouad Rahmy , Islam Reda Mohamed , Heba Ali Abed Elgaffar.

Background: expiratory rib cage compression technique is one of the most practiced chest physiotherapy technique in mechanically ventilated patients in intensive care unit. Purpose: this study was conducted to detect the effect of manual rib cage compression on blood gases in mechanically ventilated patients. Subjects &methods: forty adult mechanically ventilated patients participated in this study , their ages ranged from 40 to 50 years old and randomly distributed into two equal groups (A and B). Group (A): twenty mechanically ventilated patients received traditional physiotherapy (positioning, percussion, vibration and suctioning). Group (B): twenty mechanically ventilated patients received manual expiratory rib cage compression technique in addition to the same traditional treatment. Each patient in both groups assessed before treatment and reassessed after three successive days of treatment with a rate of two sessions per day regarding ABG parameters (PaO2, and PaCo2). Results: there were significant increase after treatment in PaO2 compared to before-treatment within control group and study group. Study group improved higher PaO2 than control group .But, no significant differences (P>0.05) between before and after treatment in PCO2 within control group and study group. And Between both groups indicated no significant differences (P>0.05) at before and after treatment in PCO2, PO2, between control group and study group. Conclusion: Addition of manual rib cage compression technique to traditional chest physiotherapy show positive clinical effects on PaO2 but has no effect on PaCO2.

Key words: intensive care; mechanical ventilation; chest physiotherapy; manual rib cage compression; expiratory rib cage compression.

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Eman S. Mohamed; Soheir M. El-Kosery; Engy M. El Nahas; 
Ahmed M. Darwish.
 

Background: This study was conducted to determine the effect of electro acupuncture versus paced respiration on post-menopausal hot flashes. Subject Materials And Methods: Thirty post-menopausal women suffering from hot flashes participated in this study. The participants were divided randomly  into two groups equal in numbers (A and B); group A (n=15) received electro acupuncture on the acupuncture point for hot flashes for 15 minutes, 3 times/week for one month, group B (n=15) received relaxation technique in form of (paced respiration) for 15 minutes /sessions, 3 times/ week for one month Assessment of hot flashes in both groups was performed by using serum FSH level and hot flash questionnaire before and after the study. The results showed that: there was a statistically significant reduction in the post testing mean values of F.S.H in both experimental groups (A and B) compared with their pre testing one (p < 0.05) and this mean there was improvement of F.S.H in both groups. Moreover, there was significant difference in the mean values of F.S.H in favor of group (A) than group (B) (p =0.002). It can be concluded that four weeks of acupuncture and paced respiration were capable of improving serum FSH and can be used as intervention programs for menopausal hot flashes. In addition, patients with menopausal hot flashes may get additional benefit in improving their FSH level through acupuncture more than paced respiration.

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Enas Wagdy Elsaid Ahmed,  Akram Abd el-Aziz Sayed, Marwa Mahmoud el-Sayed Mahmoud, Mohammed Hassan Aly Abou Mansour.

Effect of Low Level Laser Therapy on Hypercoagulability in Patients with COVID-19.

Background : COVID-19  is one of the sever acute respiratory syndrome,  it can have an impact on a person’s physical, psychological,  and  social  well-being Along with respiratory illness , profound pro thrombotic milieu leading to both arterial and venous thrombosis .These patients are primarily managed with anti-coagulant drugs combined with circulatory exercises. Purpose: Finding out if there is effect of low level laser therapy on hypercoagulability in patients with COVID-19. Subjects & Methods: Sixty patients with COVID-19 both gender, their ages ranged from 35 to 45 years. The participants selected from ELMenshawy general hospital, Tanta governorate, Egypt randomly assigned into two groups equal in number. The experimental group received a program of low intensity laser therapy three times per week for two months, circulatory exercises, and medical treatment, and the control group received circulatory exercises and medical treatment. Demographic data will be collected as marital status, level of income, level of education, and occupation. Subject and Conclusion It  was  concouled  from  the  study  that  LLLT  combined  with circulatory  exercises  is  beneficial  for  protection  from hypercoagulability  in  patients  with  COVID-19.

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Eslam M. Mahmoud, Awny F. Rahmy . Heba R. Kamal . Rana H.M. Elbanna.

Background: pressure ulcers are a leading cause of serious complications among bed-ridden population with an incidence rate of 10.0 to 25.9%. Thus, it was crucial to examine the relation between the prevalence and risk factors of pressure ulcers among hospitalized patients in Beni Suef Governorate of Egypt. Purpose: To examine the relation between the prevalence and risk factors of pressure ulcers among Hospitalized patients in Beni-Suef governorate of Egypt. Subjects and Methods: A cross sectional study was conducted on 400 patients of both genders, aged between 25 and 65 years and selected from the intensive care unit of Beni Suef’s governmental hospitals that covered all municipal divisions of the governorate. Risk of pressure ulcers were assessed by sociodemographic variables, Braden risk assessment scale, clinical characteristics of patient illness and physical examination to assess the grade of pressure ulcer. Results: there was a statistically significant negative relation between prevalence and risk factors of pressure ulcers among hospitalized patients in Beni Suef governorate of Egypt. Conclusion: There is no single risk factor for developing pressure ulcers; it is a consequence of multiple risk factors including age, body mass index, the presence of chronic conditions, and the length of hospital stay. The Barden scale is a useful tool for assessing and predicting pressure ulcers.

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Eslam M. Gomaa, Emam.H.EL-Negmy, Mohamed.I.El-Assal, Mohamed. I. Ahmed Mabrouk.

Keywords: Hemiplegia; Cerebral Palsy; Muscle Strength; Muscle Pennation Angle.

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Esraa Hany Sayed, Mohmed Hussein El-gendy,  Mohamed Ibrahim Abdelhay.

Background: Shoulder stability is very important for distal mobility and this concept may affect the performance of tennis players. Shoulder rotators have important role in shoulder joint stability. Purpose of the study was to investigate the correlation between shoulder torque and hand grip strength in Egyptian tennis players. Subjects: Eighty-four players from both genders with age ranging from 17 to 25 years, weight ranging from 57 to 82 kg, height ranging from 162 to180 cm, BMI ranging from 21 to 27 kg/m2, were assigned to one equal group. Methods: Hand grip dynamometer was used for measuring grip strength and isokinetic system was used for measuring shoulder torque for internal and external rotators. Results: There was significant correlation between hand grip strength and shoulder internal rotators’ peak torque (r = 0.81, p = 0.0001) and significant correlations between hand grip strength and shoulder external rotators’ peak torque (r = 0.89, p = 0.0001). Conclusion: There was a significant correlation between hand grip strength and shoulder torque in tennis players.

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Fatma Y. M. A. El-Salam, Zahra M.H. Serry ,Moustafa S.M. Ahmed  ,Heba A. A. El-ghafar.

Background: The most common gastrointestinal (GI) condition is irritable bowel syndrome (IBS), affecting millions of people throughout the world. IBS is a type of functional bowel condition marked by chronic or recurrent abdominal pain that is relieved or worsened by defecation or a change in bowel behavior. Purpose: To determine the effect of reflexology on quality of life in medical students with Irritable bowel syndrome. Subjects and Methods: Sixty female medical student with irritable bowel syndrome aged from 18-30 years old and recruited from out patients clinic in Cairo university student Hospital. They were assigned into two groups: Group A: included 30 patients who received medications for consecutive 6 weeks. Group B: included 30 patients who received reflexology 60 minute/session, twice/week for consecutive 6 weeks. Results: The study's findings revealed that before the treatment, the severity of constipation and quality of life (QOL) score were not significantly different between the two groups (p>0.05), but that after the treatment, the severity of constipation was significantly reduced in the reflexology group (p0.05), and that the reflexology group's quality of life (QOL) score was increased (p>0.05) compared with control group. Conclusion: The results demonstrated that reflexology has equal effect on quality of life in medical students with irritable bowel syndrome.

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Hagar A. A.  Othman ,   Zahra  M. H.  Serry , Maha  H.A. Ibrahim . Heba  A. A. El Gaffar

Background: Diabetes is spreading at an alarming rate around the world.  According   to studies, including exercise into one's regular routine might significantly delay and prevent diabetes. Purpose  :  was  to  compare  between  the  effect  of  passive  stretching  exercises versus  electrical  stimulation  on  blood  glucose  levels  in Diabetic  patients  in  their  older years. Subject and Methods: sixty elderly type 2 diabetic patients of both genders participated in this study. The patient's age ranged from 60 to 75 years. The patients were assigned randomly into to 2 groups. The first  group (A):  passive  stretching   group  ,  included  30  patients(29 female and one male )  were  treated  with  passive stretching  exercises.   The second group (B):  electrical stimulation group,   included 30 patients (29 female and one male) were treated with electrical stimulation. The protocol of treatment was conducted three times per week, for twelve weeks. Venous blood sample was analyzed to determine level of Hemoglobin A1c (HbA1c) before and after twelve weeks. Glucometer was used to measure  fasting  blood  glucose  level  (FBGL)  and  post-prandial  blood  glucose  level( PPBGL) after the first session and after twelve weeks of protocol. The functional ability was assessed using the time up and go test (TUG). Fatigue severity scale (FSS) is a nine item questionnaire that is used to determine the degree of tiredness. Results: There was a significant decrease in HbA1c, FBGL, PPBGL, TUG and FSS post treatment in the group A   and  B  compared with  the  pre - treatment.  There was non - significant difference between groups post treatment.  Conclusion:  The  obtained  results  suggest  that  both  passive  stretching  exercises  and electrical stimulation have positive effects on blood glucose level , time up and go test and fatigue severity scale in elderly diabetic patients.

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Hasnaa Tourky Ebrahim, Azaa Abd-Elaziz Abd-Elhady, Elham Ahmed Mohamed And Gehad Ali Abd-Elhaseeb.

Falls is a major concern for elderly adults with diabetes mellitus. In this randomized, controlled study, sixty elderly diabetic women patients were included. Balance disturbance and falling risk were assessed by berg balance scale and timed up and go test. All of parameters were evaluated before and after 12 weeks from the beginning of the training. Thirty patients underwent Otago exercise program plus conventional balance exercise ,while conventional balance exercise was applied in the remaining thirty patients , there were significant change in berg balance scale  and Timed up and go tests in both groups post treatment compared with that pretreatment and There was a significant increase in the berg balance scale  and a significant decrease Timed up and go of the group A post treatment compared with that of the group B. It was concluded that  Otago exercise program plus conventional balance exercise improve balance more than conventional exercise only

 Keywords: Conventional balance exercise / Diabetes /Otago exercise

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Heba K. Abd El_Mageed, Gehan M. Abd El-Maksoud, Emad Abd El- Maksoud Mabrouk.

Background: A lot of attention deficit hyperactive disorder children suffer from associated tactile defensiveness which affects their daily living activities and school development. Purpose: To examine relation between tactile defensiveness and fine motor skills in children with attention deficit hyperactivity disorder. Methods: Twenty five children with attention deficit hyperactivity disorder and tactile defensiveness, aged from 6 to 10 years of both sexes were participated in this study. They were selected from Abo-El-Reesh Children Hospital. Tactile defensiveness was assessed by Touch Inventory for Elementary-School-Aged Children and sensory profile and fine motor skills were assessed by Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Results: There was statistically non-significant correlation between tactile defensiveness and fine motor skills in children with attention deficit hyperactivity (P >0.05). Conclusion:  There was a weak negative relationship between tactile defensiveness and fine motor skills in children with attention deficit hyperactivity disorder.

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Hoda Abbas, Mohmed H. El-Gendy, Mayada A. Mahmoud.

Background: Cervicogenic Headache is typically chronic , presented as unilateral cephalgia, and is believed to be acquired by musculoskeletal dysfunction of the neck. Cervical proprioception has a significant job in keeping up ordinary spinal development , stability and maintaining the balance of the body as a whole. Objective :The point of this examination was to research the impact of  cervicogenic headache on cervical active repositioning accuracy and cervical range of motion. Materials and Methods: Fourty subjects of both genders (28 females and 12 males) were selected and allocated into 2 groups ,Cervicogenic Headache (CGH) group comprising of 15 females and 5 males and control group (13 females and 7 males). Their age range was (20-40).Cervical proprioception and range of motion were evaluated by CROM device. Cervical proprioception was surveyed utilizing a head repositioning task: subjects were asked to relocate their heads as accurately as possible to a previously remembered head position following an active movement (flexion, extension and left and right rotations). Results: There was a significant effect of Cervicogenic Headache on cervical reposition error in all tested cervical movements and there was statistical significant decrease in ROM values of all tested cervical movements( flexion, extention  and right &left rotation ).Conclusion: There was a connection between CGH and the increase in cervical reposition error and limited ROM contrasted with healthy subjects. These effects ought to be considered in the rehabilitation program of patients with CGH.

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Kareem Ezz Eldeen Ali Ghaly, Hany Ezzat Obeya, Ramy Salama Draz.

Background: Smartphones have become an integral part of our everyday lives, and the number of individuals who use smartphones is growing every day with plenty of those individuals suffered from mechanical neck pain especially after long-term smartphone use which in turn can affect the ventilatory functions. Objectives: This study aimed to evaluate two parameters from the ventilatory functions, including (FVC) forced vital capacity and (FEV1) Forced expiratory volume in first second. Methods: A total of 100 of smartphone addicts of both genders with mechanical neck pain were enrolled in this study; they were recruited from students of Delta university. Age ranges from (18 to 25). Results: The study results revealed statistical significant difference between mean value of FVC and FEV1 within study group compared to the predicted normal value Conclusions:  It was concluded that mechanical neck pain has a significant negative effect on the ventilatory functions in smartphone addicted population.

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Khadega H Hussen ,  Emam H Elnegmy ,  Amina S Hendawy and  Mona M Nabil.

Back ground: Obstetric brachial plexus palsy (OBPP) is a disturbing form of
cervical nerve injury that frequently leads to significant physical disability.  It occurs or delivery as a consequence of pressure or a traction injury on any of the brachial plexus parts. Purpose:  This  study  was conducted  to  determine  the  efficacy  of using  Kinesio  tape  over  wrist extensors  in children with unilateral Erb’s palsy. Participant and Methods:  Thirty children of both sexes (16 girl and 14 boy) having unilateral Erb's palsy, their ages ranged from one month to one year. They were selected from  the  out-patient  clinic,  Faculty  of  Physical  Therapy,  Cairo  University.  The children's percentage of degeneration of radial nerve was evaluated by using Electroneurography technique before and after 3 months of treatment program. The children were classified  randomly  into  two  groups  of  equal  number.  Group  A  (control)  received  a  selected physical  therapy  program,  where  group  B (study)  received  the  same  exercise  program  given  to group A, in addition to Kinesio taping to activate wrist and fingers extensors. Results:. The results of this study revealed significant improvement in the  percentage of degeneration of the radial nerve of  the  two  groups  (A  and  B),  when  comparing  their  pre  and  post-treatment  mean  values.  Significant  difference  was  also  recorded  when  comparing  the  post-treatment  results  of  the  two  groups  in  the  favor  of  the study group.Conclusion:  It could  be  concluded  that  using  kinesio  taping  in  conjunction  with  designed physical therapy program positively ifluence recovery of wrist extesnors activation in infants with OBPP.

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Maali Mohamed Hassan, Ahmad Mahdi Ahmad  Nagwan Adel Ismail, Shymaa Mohamed Ali.

 Inspiratory muscle weakness occurs as a consequence of aging, neuromuscular disease, after cardiothoracic or abdominal surgery, and prolonged mechanical ventilation. In such a case, patients’ respiratory status could be too fragile to withstand inspiratory muscle training. Transcutaneous electrical diaphragmatic stimulation (TEDS) is a passive modality that requires no effort from patients and aims at recruiting the highest number of intact muscle fibers to generate muscle contraction and strengthen the muscle. TEDS involves the usage of two pairs of electrodes: one pair in the parasternal region beside the xiphoid process, and the other pair are located between the sixth and seventh intercostal spaces at the mid-axillary line. TEDS has recently increased respiratory muscle strength and enhanced weaning rate in ICU patients on prolonged mechanical ventilation. TEDS also led to positive changes in selected cardiovascular parameters such as systolic blood pressure and heart rate in healthy subjects. Further, TEDS through Russian currents increased minute ventilatory volume and induced a clinically meaningful increase in the six-minute walk distance in COPD patients. Russian currents are alternating currents at a frequency of 2.5 kHz and burst modulated at a frequency of 50 Hz. The stimulus lasts for 10 seconds, followed by 50 seconds of rest, with an optimal duration of 10 minutes per session, applied once daily or every other day over a period of weeks. The theoretical basis for the use of Russian currents is that maximum stimulation of almost all muscle motor units may produce more muscle contraction than can’t be achieved by voluntary contraction. TEDS through Russian current is a good therapeutic modality for promoting diaphragmatic contraction in different patient populations suffering from diaphragmatic weakness.  

Keywords: Transcutaneous electrical diaphragmatic stimulation, Russian Current, muscle strength 

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Maha M Mohammed , Zahra M Hassan , Samia Ali Abdulla , Asmaa M Mohamed.

Background: In Egypt, there is a dearth of understanding of the benefits of reflexology and aerobic exercise on hypertension patients' quality of life. The study's goal is to examine the impact of reflexology and aerobic exercise on hypertension patients' quality of life. Subjects and Methods: Forty hypertensive female patients between 35 and 45 were assigned two equal groups equal in number (A and B). Twenty female patients in group (A) got medications and aerobic training, while twenty female patients in group (B) had the exact treatment as group (A) as well as foot reflexology. A short form 36 quality of life questionnaire was used to assess the patients who took part in the study (SF-36). They were assessed before and after the eight-week treatment program, which consisted of three sessions each week; following four weeks of treatment (post-1) and additional four weeks of treatment (post-2). Results: The results demonstrated substantial variations in the measured variable between the two groups before and after treatment (post-1) and (post-2). When the measured variable's post-treatment values (post-1) and (post-2) were compared between the two foot reflexology and aerobic training can be added to the physical therapy program.

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Mahinour M Osama, Neveen A. Abdel Raoof , Amira Hussin Draz.

Background: Fighter pilots are known to be prone to have work related musculoskeletal disorders (WMSDs) where they are exposing to high gravitational forces and high accelerations during the flight with their aircrafts but its prevalence among Egyptians fighter pilots has not been reported. Objective of the study was to investigate the prevalence of work related musculoskeletal disorders in different body parts among Egyptian fighter pilots. Methods: Ninety fighter pilots were involved in this research; they were recruited from different Egyptian airbases to assess musculoskeletal disorders. An ethical approval and informed consent were collected from them. The participants were asked to answer Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Results: The prevalence of WMSDs of the study group for different body regions was reported that the lower back (77.77%) was the most affected part, neck (61%), hip/Buttocks (51.1%) and upper back (43.33%). Lowest prevalence of WMSDs was reported for left upper arm (8.9%) and left wrist and knees (10%). No WMSDs were reported for forearm, legs and foot. Conclusion: There was a high prevalence of work related musculoskeletal disorders among Egyptian fighter pilots, Mostly in lower back, neck, hip/buttocks disorders and upper back disorders, consequently. The prevalence of WMSDs among fighter pilots in Egypt is near to values reported for the counterparts around the world.

Keywords:  Cornell questionnaire, Fighter pilots; G-forces; prevalence; work related musculoskeletal disorders

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Mahmoud El-Sayed A. Ragab; M., Heba A. Abd El-Ghaffar;  Youssef Mohamed A. Soliman and El-Sayed Essam El-Sayed Felaya.

Background:  Controlled mechanical ventilation results in an ineffective cough that causes weaning and extubation failure and may be a threatening life cause. Also, the role of cough augmentation is unclear for critically ill patients requiring intubation and for post-extubation respiratory failure. Purpose:  This study investigated the effect of the lung volume recruitment technique “LVR” in combination with traditional chest physiotherapy “TCP” on cough effectiveness assessed by measuring Cough peak flow “CPF” and Peak expiratory flow “PEF”, Oxygen saturation, and the extubation success rate compared to TCP alone. Subjects and methods:  Fifty post-extubated patients, after mechanical ventilation for ≥ 48 hours, with suboptimal productive cough (CPF< 270L/min), ages 40 to 60 years old, were recruited and were randomly assigned into two groups. Study Group (A): Twenty-five patients who received TCP in addition to the LVR; and Control Group (B): Twenty-five patients who received the TCP only that involved percussion, vibration, and positioning methods. The treatment session for both groups was for 30 to 45 minutes, twice a day for four days or till the need for reintubation. Data obtained from both groups regarding CPF, PEF, and Oxygen saturation, were statistically analyzed and compared. Results: Group (A) showed significant improvements in CPF rate, PEF rate, and O2 saturation compared with baseline and group (B). Also, Group (A) showed a significant enhancement in extubation success rate compared to group (B). The improvement percentage of CPF rate, PEF rate, and O2 saturation was about 51.73%, 57.30%, and 4.11% respectively for group (A), and was about 14.74%, 15.74%, and 1.72% respectively for group (B) (with P value=0.0001; P<0.05). Also, the overall percentage of successful extubation was 92 % in group (A), and 72% in group (B). The net results gave the privilege of the intervention of the study group. Conclusion: It could be concluded that combining the LVR technique with TCP in post extubated patients with a suboptimal cough could be more beneficial for managing the cough ineffectiveness, by improving the CPF and PEF as measures of cough effectiveness, increasing the oxygen saturation, and for enhancing the success of extubation than TCP alone.

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Manar A. Abdelgfar, Samir A. Algazzar, Shawky A. Fouad and Saifeldeen A. Ragab.

Background and Objective: The purpose of the study was to compare the acute effect of whole body vibration (WBV) to acute effect of resistance exercise on blood pressure in patients with hypertension. Methods: fifty patients (24 males and 26 females) were selected of both sexes and their age were ranged from 40 to 50 years old selected from Beni-seuf Health Insurance Hospital and they were assigned into two equal groups: Group (A) Twenty-five patients had performed WBV exercise &Group (B) Twenty-five patients performed resistance exercise. The duration of each method was 25 minutes performed for one session. Systolic blood pressure and Diastolic blood pressure were measured before and after the program. Results: In Group (A) when post treatment results compared with pre-treatment results there was a significant decrease in SBP and DBP by 3.32%and 7.41%, respectively. In Group (B) when post treatment results compared with pre-treatment results there was a significant decrease in SBP and DBP by 2.50%and 6.24%, respectively. In addition, Group A results versus Group B results there was significant difference in mean values of SBP&DBP. Conclusion: in this study acute effect of WBV is more effective than did the resistive exercise in reducing blood pressure in hypertensive patients.

 Keywords: Diastolic blood pressure, Resistance exercise, Systolic blood pressure and Whole Body Vibration. 

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Mohamed Gamil Omar, Amel Mohamed Yousef, Hossam El-din Hussein Kamel, Mahitab Mohamed Yosri.

Background: Pelvic floor dysfunction (PFD) involves a 333large array of conditions that negatively impact many women around the world. Polycystic ovarian syndrome (PCOS) is another disorder with long-term serious consequences. Being a disease of hormonal imbalances, PCOS may possibly affect the function of the pelvic floor muscles leading to PFD. Purpose: To explore the incidence of PFD among women with PCOS. Methods: This is an observational, case–control study. A total of 368 women, aged from 20 to 35 years, with a body mass index (BMI) range of 20 to 30 kg/m² recruited from Kasr El-Ainy university hospital. They were classified into case- group (PCOS patients; n=184) and control group (healthy participants, with matched age and BMI for comparison; n=184). All case- group women were diagnosed with PCOS, based on Rotterdam diagnostic criteria, while the control group women had regular menstrual cycles. Pelvic Floor Distress Inventory-20 (PFDI-20) was used to identify PFD in the tested groups. Results: 368 women were involved in the study with Age and BMI of 28.48±4.87 years and 25.9±5.8 kg/m2, respectively for the control group, and 28.76±5.33 years and 27±6.1 kg/m2, respectively PCOS group, with non-significant difference between groups (P > 0.05). The PFDI-20 score, the control group scored 17.11±26.50, while the PCOS group was 26.25±22.23. There was a statistically significant difference in the mean PFDI-20 total values between both groups (P=0.002). Conclusion: PFD was prevalent among women with PCOS, compared to the control group, suggesting a possible link between both conditions.

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Mohamed Ramadan, Enas F. Youssef, Mohamed Ezzat Mohamed, Mohammed Shawki Abdelsalam.

Background: Custom-made arch support insoles (ASI) are commonly described for flexible flatfoot (FFF) patients. Whether using of ASI has similar effects compared to standard foot insoles needs to be explored. Purpose: to compare custom-made ASI added to strengthening exercise of foot muscles versus standard insole added to strengthening exercise of foot muscles on dynamic balance, and ankle muscles strength in patients with bilateral FFF. Materials and Methods: Thirty-four patients with FFF recruited to participate in this study; age 18 to 30 years old. All patients’ evaluation included balance by means of star excursion balance test (SEBT), and hand-held dynamometer (HHD) for ankle muscles strength. They were randomized into two groups, A and B. Group A used custom-made arch support insole (ASI) combined with strengthening of foot muscles, while group B used standard insole combined with the same strengthening exercises of foot muscles applied in group A. Results: A significant improvement in means of SEBT values has been detected in comparing groups in favor of Group A in both limbs. On the other hand, no significant difference was noticed in reported means of muscle strength among groups in dorsiflexion, plantar flexion, and inversion in both limbs. Evertors were the only muscles group showing marginal significant difference in muscle strength between groups in both limbs in favor of group A (P=0.048). Conclusion: in the current study it could be concluded that custom-made ASI was more effective than standard insole in terms of dynamic balance, and foot evertors’ strength.

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Mona El Naggar, Karim Ghuiba, Ashraf El Tabie, Mohammed Shawki Abdelsalam.

Background: Knee osteoarthritis is a joint degenerative disease characterized by joint pain, decreased mobility, and functional disability, resulting in difficulty with daily activities and a lower quality of life. Purpose: The study aim is to compare outcomes of applying extracorporeal shock wave therapy (ESWT) versus low-level laser therapy (LLL) on pain, and function in patients suffering osteoarthritis of the knee. Subjects and methods: Thirty patients with unilateral knee OA, age ranged from 50-60 years, were assigned randomly into two groups. The first group (n=15) received ESWT two sessions a week for four weeks. The second group (n=15) received low level laser three sessions a week for four weeks. Both groups received an exercise program in the form of strengthening for quadriceps, hip adductors, hip abductors, and stretching for the hamstrings, and calf muscles 3 sessions a week for four weeks. Visual Analogue Scale (VAS) was used to assess pain intensity, Western Ontario and McMaster Universities Osteoarthritis questionnaire (WOMAC) and Time up and go test were used to assess functional performance pre and post treatment.  Results: There were statistically significant improvements in the dependent variables of both groups when comparing their pre and post treatment mean values (P<0.05). However, there were no statistically significant differences in the measured variables between the ESWT and the LLLT groups. Conclusion: Both ESWT and LLLT were effective in relieving knee pain, improving functional disability in knee osteoarthritis patients. However, outcomes showed that both interventions have comparable effects, where neither of ESWT or LLLT showed to be superior to the other.

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Mona Ibrahim Hassan, Haytham M. Elhafez , Mary Nassif Takla.

This systematic review aimed at evaluating the risk factors for cervical muscles and neck complaints associated with touch screen devices use. PubMed central, Science direct , Google scholar and Springer link were searched. The methodological quality of included studies was assessed. Strength of evidence for risk factors was determined based on study designs, methodological quality and consistency of results. This review demonstrates that the prevalence of musculoskeletal complaints among mobile device users ranges from 1.0% to 67.8% and neck complaints have the highest prevalence rates ranging from 17.3% to 67.8%. This review also finds some evidence for neck flexion, frequency of phone calls, texting and gaming in relation to musculoskeletal complaints among mobile device users. People using mobile touch screen devices have been exposed to the musculoskeletal disorder because of physical risk factors. Inconclusive evidence is shown for other risk factors such as duration of use and human-device interaction techniques due to inconsistent results or a limited number of studies.

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Mostafa Fahmy, Wael Shendy, Yasser Salem, Hatem Samir, Amr El-Feky, Ali Ramadan

Background: Stroke is a frequent cause of problems in body function resulting in limitations of functional activity. Stroke generally leads to greater postural instability, and muscle weakening compared with healthy individuals. Strength of non-paretic limbs can be less than predicted and it tends to be more impaired proximally than distally. The strength of multiple muscle groups of both the paretic and non-paretic lower limbs have been shown to correlate with independence in sit to stand transfer and gait. Purpose of the study: to investigate if resistance exercises of non-paretic lower limb may improve the functional activities in chronic stroke patients. Methods: 12 patients with ischemic or hemorrhagic stroke with ages between 45-65 years old, the duration of stroke ranged from 1 to 5 years, and Brunstrom Stage of Recovery ranged from 4 to 6. Resistance Exercises program for adductors and abductors muscles of non-paretic extremity in addition to traditional physical therapy program were used. Portable dynamometer was used to assess any increase in muscle forces of non-paretic lower limb muscles. Also, Functional Independence Measure (FIM) scale was used to assess any improvement in function of these patients. All patients were assessed pre and post intervention without follow-up. Results: The study group showed a significant improvement in muscle forces of both adductors and abductors of non-paretic lower extremity and FIM scores. Conclusion: Resistance exercises for non-paretic lower limb muscles may show short term improvement on the locomotor function of chronic stroke patients.

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Mostafa M. Barghash, Hebatallah M. Kamal, Mohamed B. Ibrahem.

Back ground: Cerebral palsy (CP) registers appear to be appropriate tools for answering questions regarding the prevalence and characteristics of the disease. Purposes: physical therapy registry for establishment of cerebral palsy in Itay El -Baroud, Rasheed and Shubrakheet at Al_Buhera governorate. Subject and methods: Three hundreds forty seven children with CP receiving physical therapy services of both genders participated in this study. Their ages ranged from four months up to 12 years. They were recruited from three public hospitals, one private hospital, one Ministry of Health, Insurance hospitals and eight private centers in previous three cities. They were subjected to modified Australian Registry Form. Results: within study population the results revealed that the incidence of CP children who received physical therapy services was   1.02/ 1000 live birth in previous cities. Boys and girls represented 57.9% and 42.1% respectively from total cases. Governmental hospitals and private hospital represented 74.4 and 25.6 respectively.   The percentage of CP types was spastic 80.1%, dyskintic 11.2%, ataxic 4.9% and hypotonic 3.7%.The results of Gross Motor Function Classification System (GMFCS) level V had the highest percentages and the results of Gross Motor Function Measure (GMFM) represented that less than one hundred was 70% from all percentages.  Conclusion: registry of CP previous cities is high. Spastic type is the highest percentage while hypotonic type is the least percentage of total cases. Based on GMFCS and GMFM, most of patients were severe cases.

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Nada H. Mohamed,  Mohammed M. Hegazy; Leonardo Longo,  Mohammed S. Abdelsalam.

Background: lumbar disc herniation (LDH) is a common cause of low back pain (LBP). Low and high power laser are among the modalities having significant effects in pain reduction and disability in LDH. Purpose: To study the effects of high power laser (HPL) and low power laser (LPL) combined with core stability exercises on pain, back disability, lumbar range of motion and angle of straight leg raising, in patients with acute and subacute LDH. Patients and Methods: This study was conducted at the outpatient clinic, Faculty of physical therapy, Badr University between October 2021 and April 2022. Sixty male and female patients with acute or subacute LDH were included in the study. Patients were randomly assigned into three groups (A, B and C) receiving either HPL, LPL or placebo combined with core stability exercise. Visual analogue scale (VAS), Oswestry disability index (ODI), Angle of straight leg raising (SLR) and back range of motion instrument (BROM) were used to assess patients. Patients received 3 sessions per week for 4 weeks.  Results: There was a significant decrease in VAS and ODI scores in HPL and LPL groups compared with that of placebo group. Albeit, were reported a significant decrease in HPL group compared with LPL group. Moreover, there was a significant increase in SLR and back ROM in HPL group compared with that of LPL group and placebo group and a significant increase in SLR and back ROM of LPL group compared with that of placebo group. Conclusion: HPL is more effective than LPL and placebo in treating patients with LDH.

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Naglaa Ezzat Abd Allah, Hebatallah Mohamed Kamal² and Walaa Abd El-Hakiem Abd El-Nabie.

Background: Children with cerebral palsy suffer from deficits in balance and abnormal body alignment. Pelvic movements are essential in daily living activities. Purpose: This study aimed to investigate the relation between pelvic inclination (anterior and posterior pelvic tilt) and dynamic standing balance in children with diplegia. Subjects and Methods: Thirty children with spastic diplegic cerebral palsy of both sexes, aged from 5 to 14 years participated in this study. Their degree of spasticity ranged from 1 to 1+ according to the Modified Ashworth' Scale and they were level I or II on the Gross Motor Function Classification System. Pelvic inclination angle was measured by using the Formetric instrumentation system during standing position, while dynamic standing balance was assessed by the Biodex balance system. Results: The results showed a moderate positive significant correlation between pelvic inclination and the overall, anteroposterior, and mediolateral stability indices of dynamic standing balance (P < 0.05). Conclusion: Abnormal pelvic alignment affects dynamic balance abilities in children with spastic diplegia.

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^{Nahla M. ElAmrawy, Fatmaa Sedeek, Ehab E.Kamel,  Maha M. Mohammed.}

Background: Osteoarthritis is a disabling disease that leads to severe morbidity and deterioration of physical activity. The intra-articular injections of ozone have been documented as a treatment of osteoarthritis. Purpose: To examine the effect of intra-articular ozone injection on osteoarthritic knee treated with traditional physical therapy program in terms of knee joint pain and range of motion. Methods: Thirty participants with grade II knee osteoarthritis (Kellgren and Lawrence classification) with age ranged from 40-55 years, were randomly assigned into 2 equal groups: the control group (group A), and the experimental group (group B).  All patients received assessment for knee pain intensity using visual analogue scale and knee joint range of motion using the digital water level (inclinometer) pre and post treatment. Both groups received traditional physical therapy program three sessions a week, for 6 weeks and group B received intra-articular ozone injections two sessions a week, for 6 weeks. Results: There was a significant improvement in both groups as regard to knee joint pain and range of motion with a statistically significant difference between both groups in favor of group B (P< 0.05). Conclusion: Adding intra-articular ozone injection to physical therapy program can soothe pain and increase range of motion in patients with osteoarthritic knee more than using the traditional physical therapy alone.

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Nahla Tharwat Mousa.

Back ground: Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders .Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Aim of the study : to investigate the effect of combined Respiratory muscle training and Ketogenic diet on patients risky to obesity hypoventilation syndrome. Methods: Forty five obese patients from both sexes )15 males &30 females)at risk to develop obesity hypoventilation syndrome aged from 30-40 years old  andrecruited from Oman rehabilitation center , Sultanate Oman. They were assigned into threegroups: Group A :  included15 patients  who  practiced respiratory muscle training  by using threshold inspiratory muscle training( IMT) combined with ketogenic diet for 12 weeks. Group B: included15 patients who followed ketogenic diet only for 12 weeks. Group C: included 15 patients whofollowed  low caloric diet for 12 weeks. Results: Group (A) , showed a statistical significant improvement in ABG parameters (PH, , Paco2 and Pao2) that were (0.82%, 14.52%, 36.6.%) respectively and showed improvement in (WHR and BMI)(17.2%,14.12%)respectively , more than the improvement in group (B)and group (C),for group B that were(0.41%, 5.22%, 21.2%) respectively, and(14.8%,11.52%)respectively, and for group Cthat were (0.54%,3.37%15.7%)respectively,and (8.13%,5.8%) respectively. Conclusions :it is concluded that,combination of  Respiratory muscle training and Ketogenic diet  have an effect on patients at risk to develop obesity hypoventilation syndrome.

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Nesma H. Hafez, Azza B. Kassab, Asmaa M. El bandrawy.

Background: Premenopause is known with profound reproductive and hormonal changes. These changes have been well chronicled and matched with concomitant symptoms. Estrogen affects almost every tissue or organ system, including the heart and blood vessels. Abdominal exercises may have significant effect on cardiovascular system, therefore, the purpose of this study was to find the effect of abdominal exercises on the cardiovascular system. Methods: Forty five premenopausal females were recruited for this study. Participants were assigned equally in three groups. Group (A) performed straight partial sit up, group (B) performed oblique partial sit up and group (C) performed lying hip flexion. Assessment of all groups was carried out through measurement of blood pressure, respiratory rate and heart rate before and after the exercise session. Results: The results revealed a significant increase in heart rate, systolic and diastolic blood pressure as well as respiratory rate in all groups (A, B, &C) after the exercise session compared with pre exercise (p < 0.01). Between group comparisons pre exercise revealed a non-significant difference in all parameters (p > 0.05). Comparison between groups post exercise revealed a significant increase in heart rate of group C compared with that of group A and B (p < 0.01) and a significant decrease in systolic and diastolic blood pressure of group C compared with that of group A and B (p < 0.01). There was no significant difference between group A and B in all parameters post exercises (p > 0.05). Also, there was no significant difference between the three groups in respiratory rate post exercise (p > 0.05).  Conclusion: In healthy premenopausal women, abdominal exercises from different positions influenced the cardiovascular parameters after the end of the training session with more effect of lying hip flexion exercise.

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Nisreen A Helmy, Dalia M Kamel, Amir A Gabr, and Mai Ali Shehata.

Background: Premenstrual syndrome (PMS) considers a common recurring emotional as well as physical disorder which has an effect on the women’s quality of life. Results of previous studies about the association between PMS and food intake are contradicted. Purpose: To investigate the relation between the PMS and dietary habits in menstrual females. Design: A descriptive observational study. Setting: The study was carried out in the Outpatient Physiotherapy department clinic in Cairo University, Giza, Egypt. The study was carried out from October 2021 to March 2022. Subjects: One hundred participants that were having PMS enrolled into this study. Methods: The PMS scale was used to assess the degree of PMS and a food frequency questionnaire (FFQ) was applied to evaluate the dietary habits. Results: There was a significant association between PMS severity and specific food consumption as consumption of tubers as well as fish and seafood (p = 0.03 & p = 0.008 respectively). However, there was no significant association between PMS and grains, dairy products, caffeine intake, fat intake, sweets, vegetables, fruits, seasonings and pickles. Conclusion: The present study suggested that severity of PMS might be affected by specific dietary habits. Therefore, further studies are needed to investigate the relationship between PMS and amount of food consumption.

 Keywords: Dietary habits; Egyptian females; Food intake; Premenstrual syndrome. 

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Noura Abou EL Fotouh,Hebattallah Mohamed Kamal, Zeinab Ahmed Hussein.

Background: The development of gross motor functions is an interactions between both genetic and environmental factors which include family and her socioeconomic status (SES).

Aim of study: To determine the correlation between SES and   the development of gross motor functions in children with spastic cerebral palsy. Subjects and procedures: Cross sectional study was conducted on fifty three children aged from two to four years.  They  were diagnosed with spastic cerebral palsy from both sexes. They were classified according to diagnosis by Modified Ashworth Scale into hemiplegia, diplegia and quadriplegia groups. The Egyptian socioeconomic scale was used to detect the level of family socioeconomic status (SES) .Gross motor function measure (GMFM 88) were used to evaluate the development of gross motor functions. Results:  There were strong and moderate positive correlation between family SES and GMFM in children with hemiplegic(p value ˂0.005), moderate positive correlation in diplagic children (p value ˂0.005), and   weak nonsignificant correlation (p value ≥0.05) in children with quadriplegic. Conclusion: family SES is related to the gross motor development in children with spastic cerebral palsy according to distribution of spasticity so SES must be considered as a factor affects physical therapy rehabilitation program.

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Nourhan M. Abd Elaleem, Emam H. Elnegmy,  Doaa A. Sanad.

Purpose: This study was done to investigate the effect of using spiral strapping in correction of hip rotation abnormalities in hemiparetic cerebral palsy children to prevent deformity and improving hip rotation range of motion. Participant and Methods: Thirty children with spastic hemiparesis enrolled in his study. Their age ranges between 3 and 6 years and being assessed by digital goniometer. They were randomly assigned into two groups of equal number 15 patients each of them. The control group (A) received a designed physical therapy program and the study group (B) received the same therapy program in addition to the spiral strapping technique on the affected lower limb for 3 successive months their hip range of motion was assessed by digital goniometer. Results: All participated children were evaluated before and after the treatment. Comparison of post treatment results between the two groups revealed a significant difference between the mean values of external hip rotation angle in faver of the study group. Conclusion: From the obtained results it concluded that spinal strapping has a beneficial effect on correction of abnormal hip rotation in hemiparetic children.

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Osama Fouad Sayed Ahmed, Zakaria Mowafy Emam Mowafy, Hamed Abd Allah Hamed Aya Gamal Fawzy El-Sayed.

Purpose: to evaluate and compare the efficacy of two different pulsed electromagnetic field therapy programmes on post-herpetic neuralgia of the sciatic nerve. Methods:- Thirty patients who had post-herpetic neuralgia of the sciatic nerve and their ages ranged from 25 to 40 years were  divided  into  two  groups.  Group  (A)    composed  of  15  patients  who  received  the traditional physical therapy treatment plus the PEMFT programme (1) of strong impulses, stimulating South polarity of the magnetic pulses with frequency fluently changing from 12.5- 50 Hz, with buttons 1,3 and 6 up while buttons 2,4 and 5 down. Group (B) composed of 15 patients who received the traditional physical therapy treatment plus the PEMFT programme (2) of mild impulses, soothing North polarity of the magnetic pulses with frequency of 12.5Hz with buttons 1,2,4 and 5 down while buttons 3 and 6 up, duration of the  application was 20 minutes applied day after day 2months. Results: Results showed Highly significant decreases of the VAS and the CMI in both groups. Estimation gear instruments: 1-Visual Analog Scale (VAS): beginning treatment (first record), aggravation level was estimated utilizing visual simple scale (VAS), afterward again following two months treatment (as second last record). 2-Estimation Carbamazepin Intake: (CMI): It was used to evaluate improvement in sciatic nerve post-herpetic. Conclusion:- Both PEMFT programs had a valuable effects on post- herpetic neuralgia of the sciatic  nerve  and  the mild impulses, soothing North polarity of the magnetic pulses was more beneficial than the strong impulses, stimulating South polarity of the magnetic pulses.

Key words (Strong impulses, stimulating South polarity PEMFT, Mild impulses, soothing North polarity PEMFT, Post-herpetic neuralgia, Sciatica, Visual analogue scale and Carbamazepin Intake).

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Radwa Mahmoud Hassan, Akram Abd El-Aziz Sayed, Al-Sayed Mohamed Rashed and Marwa Mahmoud El-Sayed.

Background: Most patients with renal failure depend on hemodialysis with deterioration in physical performance and biochemical markers; although intradialytic exercises have rarely been used it can be very effective. Purpose: This study aimed to examine the effect of intradialytic aerobic exercises on physical performance and biochemical markers and correlation between outcomes after the intervention. Subjects &Methods: Fifty seven patients  with chronic renal failure were randomly allocated into two groups, 29 patients in the experimental group received  intradialytic aerobic exercises with the dialysis treatment and 28 patients in the control group received just stretching exercises with the dialysis. Both the groups were receiving therapy three times per week for 12 weeks. Following assessments (6-minutes walking test, sit to stand test as well as serum analysis of urea, creatinine and albumin; and calculating the dialysis efficacy Kt/v) were done before and after treatment. Results: The experimental group showed a statistically significant improvement in median values of all the measured variables post-treatment (P<0.001); except of albumin (P =0.487); and showed positive correlation between 6 minutes walking test and dialysis efficacy (P=0.040) and negative correlation between sit to stand test and dialysis efficacy (P=0.022).Conclusions: Based on these results, this study proved that intradialytic aerobic exercises were effective in improving physical performance and biochemical markers and dialysis efficiency in patients with chronic renal failure.

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RamyT.Soliman, Manal S. Abd El-Wahab; AbeerAbd El-Rahman,Wafaa M. Hassan.

Background: Electro-magnetic radiations have an effect on brain structure and motor development of infant rabbits. The aim: This study aimed to compare between different duration exposure to cell phone rays and Wi-Fi waves on brainstructureand motor behavior development of infant rabbits. Methods: From a Rabbitry of 300 mothers’ capacity, 120 rabbits were selected to participate in the current study. They were divided into six homogeneous comparable experimental groups (20 in each) (Study groups 1, 2 and 3 were exposed to mobile phoneradiation, 900 MHZ for 2, 4 and 6 hours daily respectively, Study groups 4, 5 and 6 were exposed to Wi-Fi radiation, 2500 MHZ for 2, 4 and 6 hours daily respectively). The Experiments were lasted 6 weeks, a week for preparation the field work and to make all mothers nurse only five infant rabbits. Rabbit mothers with litter size at birth more than five bunnies (newborns) were still adopting another mother, whereas the mothers with litter size at birth less than five bunnies (newborns) were adopting other bunnies. The actual duration of experimental work represented in exposing animals to different electro-magnetic radiations and collecting data were five weeks.In this study motor development was measured by hindlimb motor function; locomotion and circular motion, and brain histology regarding neural apoptosis was assessed, respectively in both groups after each time exposure. The results: Before the study, there was no significant difference in the mean values of all variables among the six groups. After study there weresignificantly (P≤0.5 or 0.1) harmful in each parameters studied represented in values of each of (hindlimb motor functions; locomotion and circular motion).WiFi groups recorded the worst value in both parameters studied (motor development and neural stress revealed by apoptosis in histological examination), compared by mobile phone.The harmful effects of electro-magnetic radiation were increased by increasing exposure time in all studied groups (mobile phone and WlFl groups). Conclusion: Electro-magnetic radiations result in marked disturbances of motor development and brain structure in infant rabbits that result from exposure to cell phone and Wi-Firadiation at different duration interval.WiFi radiation recorded bad effects more than those of mobile phone radiation, in motor function and brain structure.

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Rana Essam EL Din,Nesreen Gharib El- Nahas,  and Youssef Mohamed A. soliman.

Background: Interstitial lung disease (ILD) is a heterogeneous group of disorders characterized by a common presentation of cough (mostly dry), breathlessness, and related symptoms with a systemic disorder when present. Interstitial lung disease and pulmonary fibrosis are two types of lung diseases that involve inflammation and fibrosis of the lung parenchyma. Objective: This study aimed to investigate the effect of paranyama exercises on functional capacity in patient with interstitial lung disease, to determine its benefit as a simple, safe exercises , and to determine how much  paranyama exercises useful in enhancing the functional capacity and quality of life in patient with interstitial lung disease. Methods: Sixty patients of both sex(26 men & 34 women) ,their age  ranged from 40 to 50years, their body mass index (BMI) ranged from 25 to 30 Kg/m2, referred and they were selected from the Outpatient clinic and the chest department of El-Kasr El aini Teaching Hospital, Cairo,Egypt . Patients were randomly assigned into two equal groups .; Group A: This  group included 30 patients received paranyama exercises ( Nadi Sodhana , Kapalbhati paranyama , Bhramarii paranyama, shitali paranyama, Bhastrika paranyama, Ujjai paranyama, shitali paranyama , sheetkari paranyama ,annuloma and viloma paranyama,  in addition to medical treatment. Group B: This group included 30 patients received   medical control only.. The treatment session for both groups was  conducted for 30 to 45 minutes, three days per week,  for eight weeks. Data obtained from both groups regarding  anthropometric measurement (weight and BMI), measurement of complete blood count (CBC), oxygen cost, modified medical research council( MMRC) and quality of life (QOL) assessment using the  SF-12 Health Survey Questionnaire,   statistically analyzed and  compared. Results: Comparing both groups post treatment revealed  significant increase of physical score with  percentage of 419.48% and mental score quality of life with percentage of 237.28 for group (A) with percentage 5.16 % (with P<0.05), There was also a significant decrease in RBCs with percentage  11.68% ,  oxygen cost with percentage 56%  , TLC  with percentage 37.47%  and MMRC   for group (A) (with P  value=0.0001; P<0.05).there was no significance in Hb with percentage 5.16% ( p = 0.63). Conclusion: Pranayama exercises  are important in improving blood gases, dypsnea and quality of life in patient with interstitial lung disease (ILD),and also, strengthens respiratory muscles, increases surfactant levels, stimulates stretch receptors, and relieves tension, all of which increase lung  volumes and capacities. It aids in the treatment of respiratory diseases. Pranayama aids in the maintenance of vital energy in the body, the maintenance of body rhythms,  detoxification of internal organs. Pranayama improves the  efficiency  of the respiratory system and regulates the overall  circulatory process of the body. So paranyama  adjunct to  conventional therapy for pulmonary rehabilitation programs  for ILD patients.

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Reham Ali Elhady, Sahar Nour Eldeen, Manal Salah Eldeen , Walaa Abd El-Hakiem Abd El-Nabie.

Thera suit Versus Universal Exercise Unit on Muscle Strength and Functional Mobility in Children with Spastic Cerebral Palsy.

Background: Impaired muscle strength and functional mobility are common problems facing children with cerebral palsy. Purpose: The purpose of this comparative study was to compare between the effect of universal exercise unit and Thera suit on improving muscle strength and functional mobility in children with diplegic cerebral palsy.Methods: Fifty-three children with spastic diplegic cerebral palsy of both sexes aged from five to eight years participated in this study. They were randomly classified into two study groups; A and B. Group A included 27 children received therapeutic exercise program with Thera suit while, group B involved 26 children received the same exercise program in universal exercise unit to improve muscle strength and functional mobility. treatment protocols were conducted Muscle strength of quadriceps and hamstring and functional mobility were assessed before and after treatment by hand-held dynamometer and mobility questionnaire. Results: a statistically insignificant differences in quadriceps and hamstring force and mobility questionnaire score between both groups (p > 0.05). Conclusion: Both Thera suit and universal exercise unit has the same effect on muscle strength and functional mobility in children with diplegic cerebral palsy.

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Sara Mohamed elabasiry Mohamed, Manal Salah EL Din, Sahar Nour.

Background and Purpose: Mirror mediated therapy and constraining induced movement therapy (CIMT ) are two rehabilitation techniques that  used for treatment of upper extremity for hemiplegic children. The purpose of this study was to detect the degree of deviation of hand grip strength from normal child before and after application of two different techniques of hand rehabilitation therapy in hemiplegic cerebral palsy children.Subjects and Procedures: Thirty children with hemiplegic cerebral palsy (CP) of both sexes ranged in age from 4 to 9 years participated in this study. Hand grip strength was measured in both groups before and after intervention  and compared to its corresponding value of age matching normal children .Children in group(A) who were treated by mirror mediated therapy while children in group (B) received intervention with constraint induced movement therapy. Both groups received conventional physical therapy. Result:  In children who received mirror therapy ,the percent deviation of hand grip strength in girls measured pre-treatment was 65.09% and decreased after treatment to 39.33%, While in boys it was 70.30% and decreased to 47.46%, respectively but In group B, the percent deviation in hand grip strength in girls measured at pre- treatment was 62.60% and decreased after treatment to 48.47%, While in boys it was 71.82% and decreased to 58.88%,  respectively. Conclusion: Both techniques (mirror therapy and constraining therapy) decreased deviation from normal children in hand grip strength but the mirror therapy has more significant effect than CIMT in hand grip strength in hemiplegic children.

 Keywords: Hemiplegic cerebral palsy, Mirror therapy, Constraining induced therapy, Hand grip strength.

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Shahira Sami Abdelrazeq; Amal Mohamed Abdelbaky; Samy Ramzy Shahata And Hussein Gamal  Mogahed.

Background and Objective: Postoperative lymphedema post mastectomy is a secondary lymphedema that alters lymph drainage of the breast. Its signs and symptoms include increased weight and size of the limb. Materials and Methods: Thirty female patients suffering from unilateral upper limb lymphedema post mastectomy. Their ages were ranged from 40 to 60 years. The patients were randomly divided into two equal groups: Group (A)composed of 15 female patients who received negative pressure therapy for 30min in addition to their physical therapy program (elevation and active range of motion exercises), hygiene and skin care. Group (B)composed of 15 female patients who received intermittent pneumatic compression for 30min in addition to their physical therapy program (elevation and active range of motionexercises), hygiene and skin care. Methods of evaluation werecircumference measurement and volumetric measurement.The study conducted six months from July 2019 to December 2019. Results: There was a decrease in limb volume and limb circumference post treatment in both groups compared with that pretreatment. There was a significant decrease in limb volume of the group B compared with that of the group A. Conclusion: There was a difference between before and after treatment between both groups, but treatment with intermittent pneumatic compression device is effective in reducing limb volume and limb circumference compared with negative pressure therapy so that intermittent pneumatic compression can be considered more effective in reducing lymphedema post mastectomy.

Significant statement:This study confirmed that intermittent pneumatic compression is more effective in treatment upper limb lymphedema postmastectomy. The study providing physiotherapist with the effective techniques used for treatment of lymphedema inpost mastectomy breast cancer patients.

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Shaimaa R. El Deab , Bassem El Nahass , Mohammed S. Abdelsalam , Nevien El Liethy.

Background: The rising prevalence of chronic low back pain (CLBP) could be due to complex existence of undefined mechanisms including biomechanical and neurophysiological peripheral and central influences. There were inconsistent results regarding motor control changes of hip muscles in patients with CLBP. The present study was designed to examine activation pattern of the gluteus maximus (GM) muscle in subjects with unilateral chronic low back pain (CLBP) and healthy subjects during prone hip extension (PHE) test. Methods: Fifteen patients with unilateral CLBP and 15 healthy subjects without CLBP participated in this study. Surface electromyography (EMG) was used to record from the gluteus maximus during PHE. Independent t-tests was used to compare demographic information and (EMG) signal amplitude of the GM muscle between groups. Results: There was no significant difference between groups regarding normalized electromyographic signal amplitudes in gluteus maximus (P = 0.876). Conclusions:      Although results were statistically non-significant, results of this study showed a general trend of higher GM muscle activity in patients with CLBP than did controls during PHE. Findings suggested that motor pattern of hip muscles could be affected in CLBP patients. Further, researches are required to support this suggestion.

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Yomna F. Ahmed, Marian M. Shafeek, Shimaa T. Abu El-Kasem.

Introduction (purpose): Thermotherapy is commonly modalities used in therapeutic intervention of adolescence before and after treatment in physical therapy program, but its effect of on dynamic balance are not discussed yet. The outcomes of this study would provide significant contributions to fill the gap in researches about the effect of thermotherapy modalities on dynamic balance in adolescent subjects. Methods: Forty healthy normal adolescent subjects of both genders participated in this study their age ranged from (13-18 years). The dynamic balance was assessed by biodex balance system under two situations (1) control situations: at room temperature, (2) experimental situations after hot pack application on ankle joint. The order of control and experimental was randomized using a coin flip. Results: Paired T test revealed that there was significant decrease  in dynamic balance  values (OAS, AP and ML)   after application hot  as (p ≤0.05). Conclusion: The result suggested that hot pack application of dominant ankle joint improve dynamic balance in healthy adolescent subjects.

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Zaky MH, Rezk-allah , Shalaby AS, Hanna MZ.

Breast cancer is to be considered one of the most prevalent types of cancer in Egypt. Post Mastectomy Pain Syndrome (PMPS) is a common complication after surgical intervention for breast cancer. PMPS very badly affects patient’s quality of life in aspects of losing shoulder full range of motion, pain, and depression. Transcranial Direct Current Stimulation (tDCS) was used as it is one of the non-invasive brain stimulation techniques and has been proven to have a positive feedback on reducing pain in cancer patients.Aim:  To investigate the effect of bilateral anodal tDCS of motor cortex (M1) on pain, depression, and shoulder range of motion (ROM) in Post-mastectomy pain syndrome.Study design:  Randomized controlled trial.Methods: A total of 30 female patients with post mastectomy neuropathic pain were randomized into two groups; intervention group which received bilateral tDCS on motor cortex (M1) and control group that received sham bilateral tDCS on M1. As pain affects shoulder range of motion (ROM) so shoulder ROM was measured by electronic goniometer pre and post tDCS application. In addition the levels of pain and depression have been measured pre and post treatment. Results: A significant difference was noted in group A regarding pain, depression and shoulder ROM (p= 0.001, p= 0.003, and p= 0.003 respectively). Between group comparison revealed a significant difference of VAS scores and shoulder flexion ROM between groups, the study group and the control group (p=0.041 and 0.048 respectively). Conclusions:  The Application of tDCS decreases the severity of complications suffered by breast cancer patients after mastectomy and improves their quality of life.

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