The 18^th International Scientific Conference

Faculty of Physical Therapy

Cairo, 16-17 March, 2017

ABSTRACT

Introduction: Pain at the base of the thumb is common problem especially in physical therapistperforming mobilization techniques .certain maitland techniques apply pressure through the tip of the thumb to produce passive intervertebral mobilization so these techniques apply compressive force longitudinally through the thumb which cause thumb arthritis and subluxation at first carpo-mtacarpaljoint.so I designed a new orthosis that decrease the compressive forces through the thumb and sharing the forces between the tip of the thumb and the orthosis .the purpose of this study to investigate the effectiveness of a novel thumb orthosis for physiotherapists in terms of pain and quality of technique application.Methods: the novel unloader thumb orthosis includes: padded ulnar and radial metal support ,spring system ,open tip circle .during mobilization techniques the applying force transmits from the arm of the physiotherapist to the supporting metals to the spring system which de-load the force on the thumb. Conclusion: the most common strategy used to control thumb pain are changing the choice for treatment, altering thumb joints and using supporting splints so the novel thumb unloader orthosis is needed to manage the cause of the thumb pain for physiotherapist.

Key words: Thumb ,Un-Loader orthosis, Occupational injuries

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Aboubakr Khalil Alshazly

ABSTRACT

Background: influence of a localized injury in a distal joint on the function of proximal muscles is an important consideration in assessment and treatment of musculoskeletal injuries. Many studies approved significant proximal deficits in chronic ankle instability (CAI) subjects regarding EMG activity, motoneurn pool excitability, strength, kinematics and kinetics. Up to our knowledge, there is no study assess flexibility changes in CAI. Objectives: The objective of this study is to investigate Hamstring flexibility in CAI. Material and methods: The study conducted on 42 subjects with unilateral CAI and controls had measure of hamstring flexibility using digital inclinometer during passive knee extension test Results: Revealed statistical and clinical significant difference between non-injured control group and CAI groupwith decreased hamstring flexibility in the later. Conclusion: CAI subjects have proximal muscular affection include hamstring tightness which may alter sacroiliac joint stability and subsequently back pain. Key words: chronic ankle instability, Hamstring, flexibility.

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ABSTRACT

Background: Cerebral palsy (CP) is a disorder of movement and posture caused by damage to the motor cortex, Hemiplegic cerebral palsy is a type of cerebral palsy that results from damage to the part (hemisphere) of the brain that controls muscle movements. The consequences of chronic muscle imbalance and the resultant deformities may be leading to increasing disability with age, that also characterized by abnormalities of motor activity, posture and balance. In CP children, voluntary movement that should be complex, coordinated, and varied is instead uncoordinated, stereotypic, and limited. Simple actions that are performed unconsciously by unaffected individuals require marked effort and concentration and often fail in patients with CP.Aim of the study:  This study designed to study the effect of progression from hydrotherapy to land based exercises program on balance in hemiparetic cerebral palsy children. Subjects and Methods: Thirty children with hemiparetic cerebral palsy from both sexes (16 boys and 14 girls). Their ages ranged between 5-10 years, were assigned into two equal groups: progression from under water to land based intervention group and land based exercises group. Balance was assessed by Biodex Balance System while Gross Motor Function Scale used to assess patient motor functional improvement. Treatment program was conducted for 3 successive months/3 sessions /week. Evaluation for each child in both groups was done before, intermediate and after the conduction of treatment program. Results: Significant difference was recorded between post treatment mean values of the two groups after treatment in favor of underwater intervention group. Conclusion: The obtained results suggested that progression from underwater exercises therapy to land based exercise therapy is effective to improve balance in children with hemiparetic cerebral palsy.

Key words: Cerebral palsy –Hydrotherapy– Balance.

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Effect of progression from hydrotherapy to land-based exercise on balance in children with  hemiparetic cerebral palsy

ABSTRACT

Background: Children with Cerebral Palsy (CP) have different types of motor impairments which divided into primary and secondary impairments. Purpose: to evaluate the effects of primary and secondary impairments on gross functional outcome in children with spastic CP. Subjects and Methods: One hundred and thirty six children with spastic CP (54 hemiplegic and 82 diplegic), aged from 2 to 5 years, all children underwent the evaluation procedures for the gross motor functions, primary and secondary impairments. The gross motor function was evaluated by gross motor function classification system (GMFCS). Primary impairment was evaluated by using Early Clinical Assessment of Balance scale (ECAB) and modified athwarth scale. Secondary impairment was evaluated by using Spinal Alignment and Range of Motion Measure scale (SAROMM), functional strength assessment scale, and early activity scale of endurance. Results: Diplegic CP showed higher GMFCS than hemiplegic CP level (p=0.001), lower ECAB total score than hemiplegic CP (p<0.001), and higher score of secondary impairment than hemiplegic CP (p=0.03). GMFCS showed negative correlation to ECAB total score (r=-0.7, p<0.001) and positive correlation to score of score of secondary impairment(r=0.3, p<0.006). Conclusion: The functional outcome of CP children largely affected by postural stability and the extent of secondary impairment.

Key-words: Cerebral palsy, primary impairment, Secondary impairment.

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Secondary motor impairment in cerebral palsy: relationship to gross motor function and primary motor impairment.

ABSTRACT

Background: Primary dysmenorrhea is a common menstrual cramps that are recurrent and are not due to other diseases that is common cause of stay at home and school or work. Purpose: The purpose of this study was to investigate the effect of pulsed electromagnetic field (PEMF) on menstrual distress in primary dysmenorrhic women. Materials and  Methods: Forty women suffering from primary dysmenorrhea  were selected from Physical Therapy Department in Al Matria Teaching Hospital in Cairo. Their ages  ranged from 20 to 30 years old. They were divided randomly into two groups equal in number, group (A)(Study Group), treated with pulsed electromagnetic field, 3 times /week for three months. Each session lasted for 30 minutes, in addition to medical treatment and, group (B) (Control Group) received medical treatment only [Non Steroidal Anti-Inflammatory Drugs ]. Menstrual distress questionnaire and Visual analoge scale  were used for assessment of menstrual distress and Pain  pre and post treatment for both groups (A & B). Results: The results showed that there is a significant improvement in menstrual distress and pain scores in  both groups (A & B) post treatment ,in favor of group (A). Conclusion, It was concluded that pulsed electromagnetic field is effective in improving dysmenorrhic pain  and menstrual distress score.

Key words:  Primary Dysmenorrhea – Pulsed electromagnetic – Menstrual distress questionnaire.

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ABSTRACT

Background: Mechanical Low back dysfunction is considered a common problem affecting many population and can result in functional disability. Purpose: to investigate the effect of H technique versus X technique kinesio taping on mechanical low back dysfunction. Material and Methods: Forty-five patients from both gender with chronic mechanical low back dysfunction (CMLBD) participated in the study. The age of the participants ranged from 40 to 50 years. The participants were assigned randomly into three groups; group A received H technique and group B cross X technique kinesio taping(KT) respectively in addition to stretching exercises for hamstring, calf and back muscles and strengthening exercises for back and abdominal muscles, the control group C received traditional program (infrared and ultrasound) with the same exercises as A & B. The sessions applied three times per week for total four weeks. Outcome measures, visual analogue scale for pain severity, disability questionnaire and inclinometer for trunk range of respectively. Results: There were significant differences in the measures of pain severity, functional disability, trunk flexion, extension and side bending. Conclusion: A physical therapy program involving stretching exercises for hamstring, calf and back muscles and strengthening exercises for abdominal and back muscles accompanied with kinesio taping was beneficial in the treatment of mechanical chronic low back dysfunction.

Keywords: Mechanical Low Back dysfunction, Kinesio Taping

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Effect of H Technique versus X Technique kinesio taping        on Mechanical Low Back Dysfunction

ABSTRACT

Introduction: Spasticity is one of the main characteristics that define children with spastic cerebral palsy which is specified by hyper-tonia and hyper-reflexia of the muscle. Spastic cerebral palsy children, which clearly accompanied by an increase in soleus muscle activity , shows a limited joints range of motions especially to their ankles dorsiflexion range, affecting functional abilities and standing abilities. Objective: To determine a correlation between soleus muscle activity and ankle range of motion in spastic cerebral palsy children. Participants and methods: the study was carried out onforty eight ankles and soleus muscles of spastic cerebral palsy children selected from the outpatient clinic of the Faculty of physical therapy Cairo University , the children was level II according to Gross Motor Function Classification Systemand their developmental age ranged from 9 to 12 month according to Peabody developmental motor scale , Hoffman reflex to Muscle response (H/M)ratio was used to asses spasticity of soleus muscle ;Ankle dorsiflexion range of motion (ROM)was measured using digital goniometer. Results: the study indicates that H/M Ratio concerning soleus muscle spasticity has a negative moderate correlation (r =-0.5306; p <0.05) to ankle dorsiflexionROM. Conclusion and recommendation: Soleus muscle spasticity in spastic cerebral palsy children is correlated to the ankle dorsiflexion ROM in those children, where the higher the spasticity is the more decrease in the dorsiflexion range, so its highly recommended in physical therapy treatment program to link the goal of increasing the ankle range of action to controlling and inhibiting the soleus muscle spasticity.
Keywords: Spasticity, Cerebral Palsy, Soleus, Ankle,, children.

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ABSTRACT

Background: Breast cancer is the most frequently occurring cancer in women. With this transformation of the disease into a chronic condition that focus of attention is being directed towards late post treatment sequelae like lymphedema which is a swelling of a part of the body secondary to accumulation of interstitial fluid (ISF) due to malformation or malfunction of the lymphatic system.

Purpose: This study was designed to compare the therapeutic effect of the PNF technique and Kinesiotaping on lymphedema after mastectomy. Materials and Methods: Thirty patients who had lymphedema post mastectomy were participated in this study. Their ages ranged from 40-55 years. The participants were selected from National Cancer Instituteand randomly distributed into two equal groups: Group (A): Proprioceptive Neuromuscular Facilitation (PNF) Technique group, they received PNF plus the traditional physical therapy protocol for 3 months (3 sessions of 30 minutes/week) and Group (B)Kinesio taping (KT) technique group They received kinesio tape plus the traditional physical therapy protocol for 3months once weekly. Tape measurement was used to assess the edema volume according to edema equation: V= hx (C²  +Cc +c)/ (π x 12) and Universal goniometer to assess shoulder flexion range of motion (ROM). Evaluations were done before starting the treatment then after the end of the treatment course. Results: Both PNF technique and kinesiotape have a significant improvement on arm lymphedema post mastectomy and shoulder flexion ROM. Conclusion: Both PNF and KT havean effect on decreasing upper limb lymphedema and increasing shoulder flexion ROM.

Key words: Lymphedema, Proprioceptive Neuromuscular Facilitation Technique, Kinesiotaping.

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ABSTRACT

Background: Screening tests are necessary tools in detecting post-stroke cognitive dysfunction. Montreal Cognitive Assessment is a sensitive scale for cognitive impairment. However, assessing its capability for detecting patient improvement after cognitive training is still unknown.  Purpose: The study was conducted to examine Montreal Cognitive Assessment capability for detecting patient improvement after cognitive rehabilitation in stroke patients. Methods: Forty right sided Egyptian male stroke patients participated in the study. They were evaluated through using Montreal Cognitive Assessment (MoCA) and Computer-based Cognitive Assessment device (RehaCom) before and after cognitive training. Cognitive training was performed by RehaCom system for six weeks. Data were collected using the RehaCom system and MoCA scale.Results: It was revealed that RehaCom training significantly improved patient executive functions and working memory. The result revealed also that the mean values of RehaCom percentage of improvements aresignificantly higher than mean values of MoCA percentage of improvements. Conclusion: Montreal Cognitive Assessment has a lower capability than RehaCom device for evaluating patient progression after Cognitive Rehabilitation in stroke patients. Keywords: Montreal Cognitive Assessment, Computer-Based Cognitive Rehabilitation,  Stroke.

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Montreal Cognitive Assessment Capability after Cognitive Rehabilitationin Stroke Patients

ABSTRACT

Background: Postoperative nausea & vomiting (PONV) complicates the lives of both patients and health care providers. Transcutaneous electrical acu point stimulation(TEAS) isnon-invasive and effective stimulation intreatin gnausea (morningsickness).

Purpose: To compare between the effectiveness of transcutaneous electrical acu point stimulation versus Acupressure on post-operative nausea and vomitingin women scheduled for abdominal hysterectomy.

Subjects and Methods: 150 patients (ageranged45-65years)withpost-operative nausea and vomiting after abdominal hysterectomy. They were selected from Department of Gynecology, Kasr El-Aini University Hospital, Cairo University. Their body massin dex was less than30kg/m2without medical history of gastrointestinal diseases Patients were equally divided into three groups. Group (A), received trancutaneous electrical acu point stimulation (TEAS10HzwasappliedontheP6pointofthedominanthand30 min before inductionofanesthesiaandcontinuedfor8hpostoperatively) inadditionto post- operativeanti-emeticdrug.In group (B),acupressure (elasticwristbands with a sphere toapplypressureon P6point)was performedexactlyinthe same wayas in group(A)in addition to post operativeanti-emeticdrug. Patients of group(C)receivedpostoperativeanti-emeticdrugonly.Post-operativemetoclopramid10mg/ivwasadministratedforall patients in groups(A,B&C)as antiemetic .Assessment of all patients in all groups (A, B&C)was carriedout after 4hand8hofthetreatmentthroughMcGillassessment for postoperativenausea and vomiting.

Results: Showed a statistically moresignific antd ecrease (P<.0001)innauseaand vomitingscales for group A thanboth groups B&Cafter4and8hours.

Conclusion: Trancutaneous electrical acu point stimulation of P6pointappearstobe moreeffectivethan acu press ureinalleviating post-operative nausea and vomiting after abdominal hysterectomy.

Keywords: TEAS; acupressure ;nausea; vomiting; hysterectomy

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Transcutaneous Electrical Acu point Stimulation versus Acupressure on Postoperative Nausea and Vomiting after Abdominal Hysterectomy

ABSTRACT

Background: Physical therapy plays an important role in prevention and treatment of stress urinary incontinence but there is a lack of communication between physiotherapists and gynecologists. This study is a trial to investigate the awareness of Egyptian gynecologists by the role of physical therapy modalities used in treatment of stress urinary incontinence. Purpose :to measure the extend of knowledge by the role of physiotherapy in treatment of  stress urinary incontinence and to study what are the limitations that lack of teamwork relationship between gynecologists and physical therapists. Method: 500 gynecologists participated in the study, there were 128 gynecologists from Upper Egypt, 125 gynecologists from Lower Egypt, 97 gynecologists from Delta, and 150 from Greater Cairo. A questionnaire form had been designed from 20 questions based on the reviewed literature. Data was collected and analyzed using descriptive and quantitative statistics. Result: The results of this study assured the less awareness of most gynecologists by the role of physical therapy in treatment of stress urinary incontinence Conclusion: more awareness is needed for gynecologists about the role of physical therapy modalities used for treatment of stress urinary incontinence and more connection is needed between physical therapists and gynecologists to explain physical therapy role. Key words: Physical therapy- Gynecologists -Stress urinary incontinence

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Awareness of Gynecologists About The Role of Physical Therapy in Treatment of Stress Urinary Incontinence

Dalia M. Ayman,  Mohammed A.  Awad  Marwa A. Mohamed Amir A. Gaber

ABSTRACT

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Background: Scoliosis is a lateral curvature of the spine. It is the most common deformity in adolescent females .Kinesio Taping is a method used for treatment ofvarious musculo-skeletal conditions. Purpose : to detect the effect of therapeutic exercises augmented by kinesio tap in treatment of scoliosis in adolescent females Subjects and Methods:Forty adolescent females complain from scoliosis, their ages ranged from 11 to 17 years old, and their BMI was from 15 to 25 kg/m². They were divided randomly into two groups. Group A received therapeutic exercises for scoliosis, while group B received therapeutic exercise in addition to kinesio taping.X ray plain used for measuring of Cobb’s angle and   present pain intensity (Ppi) for pain assessment before and after treatment.Results: There was a significant reduction of Cobb's angle and pain intensity at post treatment at both groups (p<0.05). There were  significant  reduction p<0.0001  in Ppi and this significant reduction in favor of group B. There was no significant differences between both groups in Cobb’s angle. Conclusion: Exercises for scoliosis augmented by kinesio taping had a significant effects on reduction of  both Cobb’s angle and pain intensity.  

Keywords: Adolescent females, Kinesio taping, Scoliosis, Therapeutic exercises

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Effect of therapeutic exercises augmented by kinesio tap in treatment of scoliosis in   adolescent females

ABSTRACT

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Background: Spinal deformities have been considered to affect balance. This study's purpose is to further investigate the relationship of spinal curves alignment as a whole and its effects on balance on young adult Saudi female. Such study can provide vital information for therapeutic approach in treatment of these patients. We hypothesize that there is a relationship between balance and spinal deformities in young adult Saudi female population.  Methodology: A cross sectional randomized control trial of 60 young adult females aged from 18 to 25 years old who will subjected to spinal assessment by (DIERS Formetric III 4D) and balance assessment by (BIODEX Balance System). Data will be analyzed by using descriptive statistics and inferential statistics including t.test with a significant level of 0.05. Results :The results of this study showed that there was a statistically significant reduction in postural stability  normal group compared to lordosis group in open eye stability test which was significant. Conclusion: there is an effect of spinal deformities on balance in young adult female Specially lordotic deformities . Key words: spinal deformities ,balance ,posture

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The Relationship between Balance and Spinal Deformities in Young Adult Female

ABSTRACT

Background: Decrease in endurance is one of the challenging complications in children with type I diabetes mellitus. Purpose: to evaluate the effect of aerobic exercise on the endurance in children with type I diabetes mellitus. Patients and methods: Thirty patients with type I diabetes mellitus from both sexes ranged from 8 to 11 years old. They were selected from Police Hospital at Nasr City. They were divided randomly into control& study groups. Both groups were evaluated pre and post treatment by lab analysis for blood glucose level and treadmill to evaluate endurance (distance& time). Treatment time was 40 minutes \ 3 sessions per week \ 3 successive months. Control group received program as muscle strengthening exercise and same regimen for study group and treadmill as a form of aerobic exercise. Results; Children in both groups were showed significant improvement in all measured variable post treatment (p<0, 05). The significant improvement was in the favor of study group as compared to control group. Conclusion:  aerobic exercise may be added as a part of treatment program in improving the endurance of children with type I diabetes mellitus.

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Faten Hassan Abdel Azim, Mohsen Moustafa Moussa Khaled,

ABSTRACT

Background:Anticipation (feed-forward) is crucial in movement and postural control, whichis learned through trialand error. The purpose of this study: was to investigate the effect of dynamic standing frame on gross motor function in spastic diplegic cerebral palsy children. Methods: Thirty spastic diplegic children ranging in the age from two to four years participated in this study. They were divided randomly into two groups of equal numbers (control and study). The control group was treated by especially designed exercise program, while the study group received the same treatment programgiven to the control group in addition to training on dynamic standing frame. Treatment was conducted for three successive months, at three days/week. Basis evaluation was carried out for each child individually before and after application of the treatment program. Gross Motor Function Measure was used to measure gross motor functional changes in kneeling and standing parameters. The results: No significant difference was recorded between the two groups before treatment, while significant difference was recorded between them in favor of the study group. Conclusion: According to the results of the study, it can be concluded that dynamic standing frame is a beneficial therapeutic toolthat can be used to improve gross motor function in spastic diplegic cerebral palsy children. KEYWORDS: gross motor, dynamic standing frame, spastic diplegia

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Effect of dynamic standing frame on gross motor function in non ambulant spasticdiplegia

Fatma AL-zahraa Hamed, Emam Hassen El-negamy,

ABSTRACT

Background: Hypertension is by far the most paramount risk factor that affects the ladies in the early postmenopausal years. Reflexology is a noninvasive therapy that performed on the hands, feet, or ears at perceivers at categorical reflex points.Purpose: To detect the response of blood pressure to foot reflexology and transcendental meditation training on hypertensive postmenopausal women. Subjects and Methods: Fifty volunteers, postmenopausal women were diagnosed clinically as hypertensive, their age was ranged between (50 – 65) years, their body mass index (BMI) was <30 kg/m² and their blood pressure were ranged between (140/90) mmHg and (180/110) mmHg. They were randomly assigned into two equal groups in number (A& B). Participants in group (A) received the foot reflexology in addition to the transcendental meditation training techniques, while Participants in group (B) received the transcendental meditation training technique only.  The treatment program were done three times per week for 8 weeks. Assessment of all subjects in both groups (A& B) was carried out before and after the treatment program throughout using the mercury column sphygmomanometer. Results: Both groups (A&B) showed a significant reduction (P<0.001) in their blood pressure values after the end of two consecutive months of training program. However, foot reflexology plus transcendental meditation training group (A) showed a greater reduction in the blood pressure values. Conclusion: So, it could be concluded that using the foot reflexology in addition to the transcendental meditation training had a positive effect on hypertensive postmenopausal women than using the transcendental meditation training only. Keywords: Reflexology, Transcendental Meditation, Menopause, Hypertension.

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Blood pressure response to foot reflexology adjunct to transcendental meditation training on postmenopausal hypertension

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Background: Althoughfatigue is one of the most common complaints that impacts quality of life, no study have been investigated the relation between Body Mass Index (BMI) and level of fatigue.Purpose: To investigate the effect of body mass index on the level of fatigue in young adolescent.Subjects: Two hundred and twenty normal healthy subjects from both genders, their age ranged from 12 to 18 years old and their body mass index varied between 13 to 39.9kg/m2. Subjects were divided into five equal groups according to their body mass index; each group consists of forty four subjects, Group 1(underweight) BMI <18.5 kg/m2 ,Group 2(ideal weight) with BMI between 18.5-24.9 kg/m2. Group 3 (over weight) with BMI between 25-29.9 kg/m2. Group 4 (obesity class1) with BMI between 30-34.9 kg/m2. Group5 (obesity class 2) with BMI between 35-39.9 kg/m2. Methods: An Arabic version of the fatigue severity scale (FSS) was used to measure the level of fatigue in the five groups. Results: There was A negative significant correlation between BMI and FSS score in underweight and ideal weight groups (r = −0.571, p = 0.000) and (r = −0.708, p = 0.000) respectively, while there was A positive significant correlation between BMI and FSS score in overweight , obesity class1 and obesity class2groups(r = 0.671, p = 0.000), (r = 0.390, p = 0.000) and (r = 0.946, p = 0.000) respectively, which indicate that group 1 with the lowest BMI value and group 5 with the highest BMI value show the highest level of fatigue than other groups. Conclusion: there was a significant relationship between the body mass index and the level of fatigue in young adolescent.

Key Words: Body mass index, Fatigue severity scale, Under weight, Obesity

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The effect of body mass index on the level of fatigue in young adolescent

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Background: Glucose level is increased in diabetic patient and exercise is an important method in decreasing fasting  and postprandial glucose level. Purpose: the main objective of this study was to determine the effect of mild exercises  versus moderate exercise on glucose level in patients with type 2 diabetes. Methods: 40 patients (men and women) diagnosed with type 2 diabetes (non-insulin dependant diabetes mellitus) with age  ranged from 50 to 60 years old. they were selected from medical Health insurance clinic in Misr el Gedida. They were  divided into two groups. Group A included  20 patients  participated in mild exercise in form of 10 minute walking program 3 times weekly for two months and Group B included 20 patients  participated  in a moderate exercise in form of 10 minute walking program 3 times weekly for two months. Blood sample for measuring fasting and postprandial glucose level before and after exercise program. Results: it showed that in most measures the rate of decrease of fasting and postprandial glucose level in group B who participated moderate exercise is greater than Group A who participated mild exercise. Conclusion: participating exercise decreases fasting and postprandial glucose level in patients with type 2 diabetes. Moderate exercise had a greater effect on decreasing glucose level  than mild exercise. Key words: fasting blood glucose level, type 2 diabetes mellitus, mild and moderate exercise, postprandial glucose level

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Mild  versus moderate  exercises  on glucose level  in  type 2 diabetes mellitus  patients.

Hany Mohamed Ghanemabd el aziz, Zahra Mohamed Hassan Serry, DinaMohamedAbaza, NagwaAbd El Ghaffar Mohammed, Gihan Samir

ABSTRACT

Back ground: Labor is a process that permits a series of extensive physiologic changes in the mother to allow for the delivery through the birth canal. Purpose: This study was conducted to determine the effect of foot reflexology on pain and outcomes of labor. Subjects: Fortyprimigravida women diagnosedin labor clinically by Gynecologist as primigravida. They were selected from obstetrics department in El Sahel Teaching Hospital, their age ranged from 20 to 35 years and their gestational age ranged from 37 to 41 weeks. They were divided into 2 equal groups (A&B).Methods: Group (A): received foot reflexology during labor for 20 minutes for each foot when cervix is at 3to5 cm dilatation in addition to the routine health care as well as verbalandemotional support. Group (B) received routine healthcareas well as verbalandemotional support when cervix was at 3 to 5 cm dilatation.Main measures: Pain was evaluated by Visual Analogue Scale while outcomes of labor were evaluated by Apgar score to evaluate new born physical condition. Results: There was statistical significant increase in the mean value of Apgar score measured after 1 minute and after 5 minutes of labor in group (A) when compared with its corresponding value in group (B) .There was a statistically highly significant decrease in pain, after receiving reflexologyin addition to the routine health care in group (A) compared with the degree of pain in group (B) who receivedroutine healthcare only.Conclusion: It could be concluded that the reflexology was very effective method in reliving labor pain and improving outcomes of labor. Key words: Reflexology-Labor pain – Outcomes of labor -Apgar score.

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Khadyga S Abdulaziz, Ghada E El-Refaye, HanyM Abd El Hameed,

BSTRACT

Background: Brain and spinal cord tumors are the second most common cancers in children after leukemia. They account for about 1 out of 4 childhood cancers. More than 4,000 central nervous system tumors are diagnosed each year in children and teens. It has been reported that those children have easy fatigability. Objective: This study was conducted to investigate the effectiveness of pool therapy on muscle strength in Children with brain tumor. Methods: Twenty-six children of both gender participated in this study. They were selected from Children’s Cancer Hospital Foundation 57357, Cairo. Their ages between 5-12 years old, they have affection of motor function and muscle weakness of upper and lower limbs, Time elapsed since the start of treatment more than 1 month. They were classified into two groups, group Received land-based exercise program for such cases, and group B received hydrotherapy besides the land-based exercise program, Lafayette manual muscle tester used to assess muscle strength of upper and lower limb muscles pre and post 6 weeks. Results: There was a significant improvement in muscle strength of both upper and lower limbs in both groups in favor of the study group. Conclusion: From the obtained study it can be concluded that 6 weeks hydrotherapy is effective, so hydrotherapy can be added to the regular physical therapy program to improve muscle strength in children with brain tumor. Keywords: hydrotherapy, muscle strength, brain tumor.

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Effect of hydrotherapy on muscle strength in children with brain tumor

Mahmoud Usama, FatenAbdelaziem, Wael Zekri

ABSTRACT

Background: A myofascial trigger point (MTrP) has been described as a hyperirritable spot located in a taut band of muscle; which is painful to palpation or compression and refers pain, tenderness, or an autonomic response to a remote area. Some investigators stated that when pressure is applied to aMTrP, a “jump sign” or “jump response” is elicited whereby the patient reacts with facial grimacing or by jumping away from the examiner. Purpose: the aim of this study was to compare between low frequency, high intensity burst-transcutaneous electrical nerve stimulation (TENS) CT and medium frequency, low intensity amplitude modulated frequency (AMF) interferential therapy (IFT) CT on upper trapezius active myofascial trigger points (MTrPs). Design: Single-blinded randomized controlled trial design was used. Methodology: Seventy participants with acute mechanical neck pain and more than two active MTrPs in upper trapezius were allocated randomly into three groups: The Burst-TENS-CT group (A), the AMF-CT group (B) or the sham CT control group (C). Group (A) consisted of 23 patients with mean age and height values of 34.39±5.92 years, and 163.73±11.69 cm respectively. Group (B) consisted of 25 patients with mean age, and height values of 34.88±5.67 years, and 167.92±10.22 cm respectively. Group (C) consisted of 22 patients with mean age and height values of 35.18±5.56 years and 167.5±13.83 cm respectively. All groups received progressive pressure release (PPR) and passive stretch for the upper trapezius muscle, 3 sessions per week for 4 consecutive weeks. Results: Demonstrated that CT significantly increased both PPT values as well as cervical lateral flexion ROM with a P<0.0001. However, among groups comparisonlow frequencyburst TENS-CT (4.73 ±0.59) yield a greater increase in PPT values and cervical lateral flexion ROM with a 547% increase than medium frequency AMF-CT (2.74 ±0.32) with a 290% increase. Primary measurement outcome included pressure pain threshold (PPT) using an electronic digital algometer. Secondary outcome included active cervical lateral flexion using a smart phone Clinometer application. Data was collected prior to the first treatment and at the end of the 4-week trial.   Conclusion: Within the scope of our study, we conclude that both CT modalities were effective in increasing PPT and cervical lateral flexion, however, low frequency, high intensity burst-TENS CT produced significant improvements than medium frequency, low-intensity AMF-CT in the management of upper trapezius active MTrPs. Keywords: combined therapy, interferential therapy, transcutaneous electrical nerve stimulation, myofascial trigger points and pressure pain threshold.

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Marian Amir Fouad,

Ragia Mohamed Kamel, Mary Kamal  Nassif, Ashraf Nihad Moharram

ABSTRACT

Background: Primary dysmenorrhea is one of the most common complaints of women and is also the most common gynecological problem worldwide. These cramps are recurrent and 90% adolescent girls and about 50% women suffer from it. Purpose of the study: to determine which is more effective in treatment of primary dysmenorrhea;pulsed electromagnetic field ordiclofenac drugs. Methodology: Fifty adult female sparticipated in this study, their age ranged from 17 to 24 years and their body mass index was ranged from 20 to 25 kg/m².They were divided randomly into two groups equal in numbers: group (A) received pulsed electromagnetic field applied on pelvic region,3 times per week for 3 months, 20 minutes per day and group (B) received diclofena ctablets, 50 mgonly with onset of menstrual pain. All participants in both groups (A and B) were assessed pre- and post-treatment through measuring progesterone level in the blood, assessment of pain using visual analogue scale and physical as well as psychological symptoms by using menstrual symptom questionnaire. Results: revealed that pre-treatment, there was a non-statistical significant difference between both groups (A&B) in median value of pain, menstrual symptoms questionnaire&progesterone where the p-value was (>0.05). comparison between pre and post treatment showed a statistically highly significant improvement in pain, physical andpsychological symptoms associated with dysmenorrhea  and progesterone blood level in group (A) than in group (B). Conclusion:pulsed electromagnetic field was effectivethan diclofenac drugsin relieving pain and associated symptoms with dysmenorrhea. Key Words: Primary Dysmenorrhea- Pulsed electromagnetic field-Diclofenac drugs

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ABSTRACT

Background: Coagulation is a complex process by which blood forms clots.Disorders of coagulation can lead to an increased risk of bleeding (hemorrhage) or clotting (thrombosis).Purpose:The aim of this study is to determine the effect of aerobic exercises on blood coagulation in obese pre and post menopausal women. Materials and Methods: Forty (pre and post menopausal) women were selected randomly from physical therapy department in El Mahala El Kobara General Hospital.They were divided into: groups (A) and group (B).Their ages ranged from (group A 30-40years) (group B 50-60years). Their body mass indices (BMI) were ranged from 30-40 kg/m². Both groups (A&B) performed aerobic exercises program on treadmill 3 times /week for 12 weeks. Each session took 30 minutes as follow: 5 min warming up exercise by walking on treadmill at low speed, 20 min walking at sub maximal intensity (60-70 % of maximal heart rate) and 5 min cooling down by walking on treadmill at low speed as in warming up.Blood coagulation that included (Platelet aggregation and fibrinogen) were evaluated in the two groups (A&B) before and after the end of the twelve week.Result: The results showed that aerobic exercises have a great effect in reducing blood coagulation in obese pre and post menopausal women. Conclusion: It seems that aerobic exercises can be used as a method of reducing risk factors for cardiovascular diseases of inactive obese women. Key words: Aerobic exercises, Blood coagulation, Menopausal women.

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BSTRACT

Background:Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both, affecting mostly the face but also the back and chest.The Purpose: of this study was to investigate the effect of bipolar radiofrequency on treatment of acne vulgaris. Material and Methods: Thirty patients  suffer from inflammatory acne vulgaris with grade II to gradeIV on acne global severity scale selected randomly from Outpatient Clinic ,Shobra El Khema, Qalubia, Egypt.Their ages ranged from 18- 25 years. They assigned into two groups equal in number: Group (I)(Study group):15 patients received bipolar radiofrequency twice/week for one month plus medications (Salicylic acid soap) twice/day, Group (II)(Control group):15 patients received medications (Salicylic acid soap) twice/day only for one month.Acne global severity scale and digital camera were used to evaluate acne degree before and after the study. Results: There was significant improving in inflammatory acne in study group(I) compared to the control group(II). Conclusion: Bipolar radiofrequency is useful and safe approach in treatment of inflammatory acne vulgaris and improving cosmetic appearance. Key words: Bipolar radiofrequency, Acne vulgaris.

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Mohamed M. Khalaf Shaimaa A. Abase, Hamed A. Hamed, Eriny Raouf Mahros

BSTRACT

Background: Obesity in childhood has significant impact on both physical and psychological health, overweight and obesity are associated with hyperlipidemia, Hypertension, abnormal glucose tolerance, and infertility. In Addition, psychological disorders such as depression occur with an increased frequency in obese children. Purpose: To determine   prevalence   of obesity   in primary school children in Al Minea Governorate. Material and methods: a cross-sectional study was carried out on 1000 Egyptian children to calculate prevalence of overweight and obesity among primary school children at age of 6–12 years  in the second semester of academic year 2015/2016. Nine schools from nine districts in Al Minea Governorate including both sexes were selected randomly in this study. Data were collected in form of anthropometric measurements including weight, height, waist circumference, and body mass index, to calculate  percentile body mass index. Results: the prevalence of overweight and obesity is relatively high 429 (42.9%) distributed as 227(22.7%) overweight, 202(20.2%) obese underweight 15(105%), healthy 556(55.6%).the population divided into 3 age group according to their age (6-8),(8-10),(10-12)y. Conclusion: This study provides further evidence of the increasingly high burden of overweight and obesity among primary school children living Al Minea governorate in Egypt. Different strategies can be implanted through many approaches to outline some important targets for anticipatory guidance to prevent obesity. Keywords: obesity, ALMinea, prevalence.

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Prevalence of obesity among primary school childern in el minea  governorate

ABSTRACT

Back ground: Cerebral palsy (CP) is one of the most common causes of physical disabilities.The prevalence of CP in developing countries isn't clearly documented. Purpose : To determine the prevalence of cerebral palsy in Damanhur at Elbuhera Governorate. Subjects and Methods: One hundred sixty one children with CP receiving physical therapy services of both genders participated in this study. Their ages ranged from one month up to 14 years. They were recruited from two public hospitals and six private centers in Damanhur. They were subjected to modified Australian Registry Form. Results: within study population the results revealed that the prevalence of CP children who received physical therapy services were 0.8/ 1000 live birth in Damanhur. Boys and girls represented 39.1% and 60.9% respectively from total cases. The percentage of CP types was spastic 88.2%, hypotonic 5%, dyskintic 4.9% and ataxic 1.9%.The results   of Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) revealed that level IV and level  V respectively had the highest percentages. Conclusion: Spastic type is the highest percentage while ataxic type is the least percentage of total cases . Based on GMFCS and MACS, most of patients were severe cases. Keywords: Cerebral Palsy, Damanhur, prevalence, GMFCS, MACS.

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Prevalence of Cerebral Palsy in Damanhur at Elbuhera Governorate

ABSTRACT

Background: Adhesive capsulitis is a condition of the shoulder of unknown etiology. It is characterized by pain, loss of function and restriction of both passive and active range of motion (ROM). Both positional release and muscle energy techniques considered effective manual therapy techniques in treatment of many musculoskeletal conditions. Till now the difference in efficacy between both techniques is not known. Objectives: The purpose of this study was to compare between the efficacy of positional release and muscle energy techniques on functional ability of the shoulder in adhesive capsulitis. Methods: Thirty patients from outpatient clinic of Bolak Eldakror hospital had participated in this study; they were randomly assigned in two groups (group A& B). Group A consisted of 15 patient (5males and 10 females) with mean age 50.80±6.48 years, received positional release technique and conventional physical therapy program. Group B consisted of 15 patients (6males, 9 females) with mean age 51.13±5.77 years, received muscle energy technique and conventional physical therapy program. Results: The results revealed that there was a significant difference in the post treatment values (P<0.05) where the t-value was (7.22) and p-value was (0.0001) between Group A and Group B in favor of group B. Conclusion: Both positional release and muscle energy techniques were shown to be effective in improving functional ability of shoulder in Adhesive Capsulitis, but muscle energy technique was better than positional release technique. Key Wards: Positional release, muscle energy, adhesive capsulitis

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Positional Release Versus Muscle Energy Techniques on Functional Ability of Shoulder in Chronic Adhesive Capsulitis

ABSTRACT

Background: wrist hyper tonicity is one of the most common complications associated with hemiplegia. Purpose: To investigate the efficacy of therapeutic taping on wrist flexors hyper tonicity in hemiplegia. Design: A pre-test post-test experimental-control design. Subjects: Thirty hemiplegic patients from both genders (male\female:22\8).Their age ranged between (42 -63) years. Materials and methods: They were assigned randomly in two groups: group (A): Experimental group (n=15) received selected physical therapy program and therapeutic tapping treatment and group (B): Control group (n=15) received selected physical therapy program. All patients were tested for Hoffmann reflex/myogenic response ratio (H/M ratio) before and after twelve sessions using electromyography (EMG). Results: Paired t-Test revealed that there was high statistical significant  decrease in hyper tonicity (t= 4.36 and p=0.001) concerning experimental group (pre-test mean 47.27% ±11.9, post-test mean 32% ±7.2) but there was insignificant statistical increase in hyper tonicity ( t= 0.44 and p=0.07) concerning control group (pre-test mean 46.9% ±8.01,post-test mean 48.15% ±7.3). Unpaired t-Test revealed that there was insignificant results concerning the pre-mean H/M ratio (p= 0.07and t= 0.8) while there was significant results concerning the post-mean H/M ratio (p= 0.001 and t= 4.06). Conclusion: adding therapeutic taping to physical therapy sessions decreased wrist hyper tonicity.

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Efficacy of Therapeutic Taping on Wrist Flexors hyper tonicity in Hemiplegia

Saleh A, Wadee AN and  El Nassag BA

ABSTRACT

Background: The presence of trigger points in the quadriceps muscle is considered one of the most important causes of patellofemoral pain syndrome (PFPS). Manual ischemic compression has been reported to be effective in treating trigger points. Objective: This study was done to investigate the effect of manual ischemic compression on quadriceps trigger points in patients with PFPS. Methodology: Thirty males and females patients aging between 25-40 years old participated in this study. They were assigned randomly into two equal groups; experimental group (group A) consisted of 15 patients who received manual ischemic compression on quadriceps trigger points and the conventional physical therapy program (hot packs, patellar mobilization, and quadriceps strengthening exercises). The control group (group B) consisted of 15 patients who received the conventional physical therapy program only. They got three visits a week for five weeks.All participants were assessed at the baseline and after 15 sessions. Pressure algometer and the Arabic version of Kujala patellofemoral score were used tomeasure pressure pain threshold and functional disability, respectively. Results: The results showed that the experimental group showed statistical significant reduction of pain and functional disability. Conclusion: Manual ischemic compression was effective in reducing the signs and symptoms of PFPS by treating the quadriceps trigger points and could be used as a rehabilitation intervention for patient with PFPS. Keywords: Patellofemoral pain syndrome- Ischemic compression- Triggers points - Pain.

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Manual ischemic compression in patients with

ABSTRACT

Background: Children with Down syndrome have tendency to become overweight and obese. They have problems with collagen, which is the major protein that makes up ligaments, tendons and bones. This creates significant laxity from the feet up. The combination of this ligamentous laxity and low muscle tone contribute to orthopedic problems in them.Purpose:To identify the correlation between increasing the body mass index and the static foot posture in children with Down Syndrome. Subjectsand Methods: the study was carried out on 37 girls with Down Syndrome selected from the public schools of special needs and their ages ranged from 10 to 18 years old. They were classified according to their body mass index into (5 of healthy weight, 12 of overweight and 20 obese). Assessment of the foot posture was conducted by the foot posture index-6. Results: the study indicates that increased body mass index has a negative weak correlation (r =-0.0615; p <0.05) to the value of the foot posture index-6 of right foot and also negative weak correlation (r=-0.0118; p <0.05) to the value of the foot posture index-6 of left foot. Conclusion:Based on the findings of this study, it could be concluded that there was weak negative correlation between increased body mass index and static foot posture in children with Down Syndrome .Keywords: Down Syndrome, Children, Body Mass Index, Foot Posture..

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Pilot Study: Correlation Between Increased Body Mass Index And Static Foot Posture In Children With Down Syndrome

Shaymaa Rushdy Mahmoud, Amira Mohamed El-Tohamy, Maha Saad Ali Zaki