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IntroductionChronic venous and diabetic ulcers are hard to treat that cause patients long time of suffering as well as significant healthcare and financial costs.PurposeThe conducted study was to evaluate the efficacy of bee venom (BV) phonophoresis on the healing of chronic unhealed venous and/or diabetic foot ulcers Also, to compare the healing rate of diabetic and venous ulcers.MethodologyThe study included 100 patients (71 males and 29 females) with an age range of 40-60 years' old who had chronic unhealed venous leg ulcers of grade I, grade II, or diabetic foot ulcers with type II diabetes mellitus. They randomly assigned into four equal groups of 25: Group A (diabetic foot ulcer study group) and group C (venous ulcer study group) who both received conservative treatment of medical ulcer care and phonophoresis with BV gel, in addition to group B (diabetic foot ulcer control group) and group D (venous ulcer control group) who both received conservative treatment of medical ulcer care and received ultrasound sessions only without BV gel. Wound surface area (WSA) and ulcer volume measurement (UVM) were used to assess the ulcer healing pre-application (P0), post-6 weeks of treatment (P1), and after 12 weeks of treatment (P2). In addition to Ki-67 immunohistochemistry was used to evaluate the cell proliferative in the granulation tissue of ulcers pre-application (P0) and after 12 weeks of treatment (P2) for all groups.ResultsThis research revealed a statistical significance improvement (p ≤ 0.0) in the WSA, and UVM with no significant difference between study groups after treatment. Regarding Ki-67 immunohistochemistry showed higher post treatment values in the venous ulcer group in comparison to the diabetic foot ulcer group.ConclusionBee venom (BV) provided by phonophoresis is effective adjuvant treatment in accelerating venous and diabetic foot ulcer healing with higher proliferative effect on venous ulcer.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT05285930.

This study examines the effect of behavioural therapy (biofeedback) and interferential current on bladder dysfunction in multiple sclerosis patients.Fifty patients with secondary progressive type multiple sclerosis (SPMS) suffering from bladder dysfunction were divided equally into two groups randomly. Group A (GA) received behavioural therapy (biofeedback training), while Group B (GB) received interferential current training. Both groups were assessed by urodynamics for detrusor pressure and maximum flow rate before and after eight weeks of behavioural therapy and interferential training.Both groups, GA and GB, showed significant increase in the detrusor pressure and maximum flow rate after eight weeks of training. There was no significant difference between both methods. However, GA showed more improvement by close observation.Both behavioural therapy and interferential current training effectively managed bladder dysfunction in patients with SPMS, with more evident effects in behavioural therapy patients by close observation.لمقارنة تأثير العلاج السلوكي (التغذية الراجعة) والتيار التداخلي على اختلال وظائف المثانة لدى مرضى التصلب المتعدد.تم تقسيم خمسين مريضا يعانون من مرض التصلب المتعدد التدريجي الثانوي (الذين يعانون من اختلال وظائف المثانة) بالتساوي إلى مجموعتين بشكل عشوائي. تلقت المجموعة "أ" العلاج السلوكي (تدريب التغذية الراجعة)، بينما تلقت المجموعة "ب" تدريب تيار تداخلي. تم تقييم كلا المجموعتين من خلال ديناميكا البول لضغط عضلة المثانة ومعدل التدفق الأقصى قبل وبعد ثمانية أسابيع من العلاج السلوكي والتدريب التداخلي.كلا المجموعتين أظهرت زيادة ذات دلالة احصائية في ضغط عضلة المثانة ومعدل التدفق الأقصى بعد ثمانية أسابيع من التدريب. بينما أظهرت المجموعة أ فقط زيادة أكبر بالملاحظة.أظهر كل من العلاج السلوكي والتدريب بالتيار التداخلي فاعلية في علاج ضعف المثانة لدى المرضى الذين يعانون من مرض التصلب المتعدد التدريجي الثانوي، مع تأثيرات إيجابية أكثر وضوحا في مرضى مجموعة العلاج السلوكي.

الملخص: أهداف البحث: تقييم ذروة عزم الدوران ومتوسط قوة العضلات القابضة والباسطة للعمود الفقري لدى المراهقين الذين تتراوح أعمارهم بين ١٢ ١٨ عاما ومعرفة ما إذا كان هناك اختلاف في أداء عضلات الجذع باختلاف نوع مؤشر كتلة الجسم. طرق البحث: تم قياس ذروة عزم الدوران ومتوسط قوة العضلات القابضة والباسطة للعمود الفقري لدى ١٨٠ شخصا (تتراوح أعمارهم من ١٢ إلى ١٨ عاما) تم تصنيفهم الى أربع مجموعات وفقا لمؤشر كتلة الجسم. كما تم إجراء التقييم باستخدام جهاز الايزوكينيتك حيث تم تقييم ذروة عزم الدوران ومتوسط قوة العضلات القابضة والباسطة للعمود الفقري بسرعات ٦٠ درجة و١٢٠ درجة / ثانية. وتم تحليل البيانات باستخدام تحليل التباين متعدد الاتجاهات لتحديد ما إذا كانت هناك أي فروق ذات دلالة إحصائية بين المجموعات الأربع. النتائج: أشارت نتائج تحليل التباين متعدد الاتجاهات إلى انخفاض في قوة عضلات الجذع مع زيادة مؤشر كتلة الجسم. وكذلك أوضحت النتائج ارتفاعا ملحوظا في عزم الدوران ومتوسط قوة عضلات الجذع في مجموعة الأشخاص ذوي الوزن الطبيعي مقارنة بالأشخاص الذين يعانون من نقص الوزن وزيادة الوزن والسمنة. وأيضا أظهرت نتائج معامل ارتباط بيرسون وجود ارتباطا معنويا سلبيا بين الوزن وعزم دوران الذروة للعضلات القابضة والباسطة للعمود الفقري. وكان هناك ارتباط سلبي ملحوظ بين الوزن ومتوسط قوة هذه العضلات. الاستنتاجات: خلصت هذه الدراسة إلى وجود علاقة سلبية بين مؤشر كتلة الجسم وعزم الدوران الأقصى ومتوسط قوة عضلات الجذع والعضلات القابضة والباسطة للظهر. وبالتالي يجب أن تتضمن برامج إعادة التأهيل للمراهقين الذين يعانون من زيادة الوزن والسمنة برنامج لتقوية عضلات الظهر بهدف تحسين فاعلية تلك التدخلات العلاجية وبالتالي تحسين نوعية حياة هؤلاء الأشخاص. Abstract: Objective: This study aims to evaluate the isokinetic performance for the peak torque and average power of the spinal flexor and extensor muscles in adolescents aged 12 to 18 years. The study also analyses the differences between the trunk muscle peak torque and average power with body mass index (BMI). Method: The peak torque and average power of the trunk flexor and extensor muscles were measured in 180 adolescents (aged 12–18 years). The participants were classified into four groups according to BMI. The Biodex isokinetic dynamometer in concentric mode at speeds of 60° and 120°/sec was used for assessment. Results: One-way multivariate analysis of variance MANOVA results demonstrated a significant difference in trunk muscle peak torque and average power with different BMI (F = 14.692, p = 0.0005). A Pearson's correlation analysis demonstrated a significantly negative correlation between weight and peak torque of trunk flexors and extensors (r = - 0.43, p = 0.0001; r = −0.31, p = 0.007, respectively). Finally, the results showed a negative correlation between weight and average power of trunk flexors and extensors (r = −0.54, p = 0.0001; r = −0.31, p = 0.007). Conclusion: In this study, overweight and obese adolescents are found to be correlated with decreased trunk muscle torque and power. Thus, therapeutic interventions for overweight and obese adolescents, along with exercise training programmes, may help improve muscle performance including peak torque and power. Finally, these measures may enhance the quality of life of such adolescents.

IntroductionPurpose: The study was conducted to investigate the influence of pulsed magnetic field therapy on hand function, grip and pinch grip strength in post flexor tendon repair patients.Material and methodsMethods: Fifty male patients with flexor tendon repair took part in this research, with ages ranging from 25 to 50 years. They were assigned randomly into two groups: Group A (experimental) received pulsed magnetic therapy together with exercise, whereas Group B (control) received only exercise. Evaluation of hand grip strength with Jamar hydraulic hand dynamometer, pinch strength with Baseline pinch gauge and hand function with Michigan Hand Outcomes Questionnaire, all measurements were made before and after the treatment. They were received 16 sessions for 8 weeks (2 sessions/week).ResultsResults: 2 x2 mixed design MANOVA revealed that no significant difference between both groups pre- treatment and post treatment in MHOQ total, function, aesthetic (p>0.05) and in hand grip strength while there was a significant difference across groups after treatment in the strength of pinch grip, MHOQ ADL, pain and satisfaction p ConclusionsConclusion: PMF increases the efficiency of physical therapy treatment and it also increases the strength of both hand grip and pinches grip in patients after flexor tendon repair in zone II.

[Purpose] To compare flexion and extension peak torque of patients with nonspecific-chronic low back pain who were classified as directional preference subgroups, and their matched healthy controls. [Participants and Methods] Fifty male volunteers (25 with non-specific chronic low back pain and 25 healthy-matched controls) consented to participate. The investigator collected all demographic data, hips, knees and spinal mobility in addition to the peak torque using the Biodex isokinetic dynamometer. The measurement protocol consisted of 2 sets of 10 consecutive flexion-extension efforts performed at 120°/sec and 60°/sec angular velocity. A two minutes rest period was given between sets. The preset 50° range of motion included 20°(+20°) of trunk extension and 30°(-30°) of trunk flexion. [Results] A 2 × 2 mixed-design ANOVA showed a significant group X isokinetic velocity interaction. The main effect of isokinetic velocity was also significant. In reference to the peak torque of the flexors of the trunk, the main effect of group was significant. [Conclusion] The extension peak torque significantly depends on the velocity of the isokinetic dynamometer; however the flexion peak torque significantly depends on the participants' group attribution.

الملخص: أهداف البحث: إن قوة القبضة مهمة للاستقلال بالرعاية الذاتية ومؤشر على الانخفاض الوظيفي. هدفت هذه الدراسة إلى تحديد ما إذا كان الأفراد الأصحاء سيظهرون قبضة لليد وقوة قرصة مختلفة: أولا، عند اختبارهما في ثلاثة أوضاع مختلفة للذراع؛ وثانيا، عند المقارنة بين اليد المهيمنة واليد غير المهيمنة. طرق البحث: تم استقطاب، وبصورة متتابعة، ما مجموعه ٦١ من طلاب الجامعة الذكور من ذوي اليد اليمنى المهيمنة، الذين تتراوح أعمارهم بين ١٩ و٢٣ سنة من كلية علوم التأهيل الطبي. أُخذت القياسات عن طريق ثلاثة من الباحثين. ضُبِط مقبض ''جامار'' لقياس القبضة اليدوية على الموضع الثاني لجميع الفحوصات. وتم توجيه المشاركين للضغط على المقبض اليدوي في حالة انثناء الكوع ٩٠ درجة، وحالة انحناء الكتف ٩٠ درجة، وحالة الذراع المتدلية. فيما يتعلق بقوة القرصة، كان على كل مشارك أن يضغط على لوحة الإبهام مقابل الجانب الوحشي للعظمة الوسطى للسبابة. وتم قياس قوة القرصة من نفس المواضع المستخدمة لقياس قوة قبضة اليد. أُخفيت النتائج عن المشاركين. النتائج: لم تُظهر قبضة اليد وقوة القرصة تأثيرا كبيرا. كما أنه لم تكن هناك فوارق ذات قيمة عند مقارنة قوة قبضة اليد اليمنى واليسرى. إلا أن قوة القرصة أظهرت زيادة كبيرة لصالح اليد المهيمنة. الاستنتاجات: يمكن للأطباء اختيار أي موضع للطرف العلوي لقياس قبضة اليد وقوة القرصة. أظهرت هذه الدراسة أنه يجب على الأطباء الحفاظ على، واستعادة درجة قريبة جدا من قبضة اليد وقوة قرصة الأيدي المهيمنة وغير المهيمنة لتحسين وظيفة الأيدي. Abstract: Objective: Grip strength is important for independent self-care and is a predictor of functional decline. This study aimed to determine if healthy individuals would demonstrate different hand-grip and key-pinch strengths at three different arm positions and in comparisons between dominant and non-dominant hands. Methods: A total of 61 right-hand–dominant male college students aged 19–23 years were consecutively recruited from the College of Medical Rehabilitation Sciences. Three researchers performed the measurements. All tests were performed with the JAMAR® hand-grip dynamometer handle set in its second position. Participants were instructed to squeeze the handle of the hand-grip dynamometer in the 90° elbow flexion, 90° shoulder flexion, and arm dangled positions. For assessment of key-pinch strength, every participant had to squeeze the thumb pad against the lateral aspect of the middle phalanx of the index finger. Key-pinch strength was measured in the same positions used for assessment of hand-grip strength. Participants were blinded for the outcome measurements. The significance level was set at p

This study aims to investigate the effects of radial extracorporeal shock wave therapy on selective motor control, spasticity, gross motor function, and balance in children with unilateral cerebral palsy.This randomised controlled study recruited 34 children aged 7-9 with spastic unilateral cerebral palsy. They were randomly allocated to either the control or study group. Both groups undertook traditional exercises for 12 weeks. The study group received shock waves (one session/week) on the calf muscle (1500 shocks, frequency of 4 Hz, energy of 0.030 mJ/mmMixed analysis of variance and Mann-Whitney results showed significant improvement in eccentric peak torque, torque threshold angles, gross motor function, selective motor control, and balance in the study group compared with the control group (Shock wave therapy may be a valuable instrument for reducing spasticity, improving the ability to isolate and control movement, and consequently, improving balance and gross motor function in children with unilateral cerebral palsy.تهدف الدراسة لمعرفة تأثير العلاج بالموجات التصادمية الشعاعية خارج الجسم على التحكم الحركي الانتقائي، التشنج، الوظيفة الحركية الإجمالية والتوازن لدى الأطفال المصابين بالشلل الدماغي احادي الجانب.تم إجراء هذه الدراسة العشوائية الضابطة على ۳٤ طفلا أعمارهم ٧ الى ٩ أعوام، مصابين بالشلل الدماغي احادي الجانب. الذين تم تقسيمهم عشوائيا للمجموعة الضابطة أو مجموعة الدراسة. تلقت المجموعتان تمارين تقليدية لمدة ۱٢ أسبوعا. تلقت مجموعة الدراسة موجات تصادمية (جلسة واحدة / أسبوع) على عضلات الساق (۱٥٠٠صدمة، تردد ٤ هرتز، طاقة ٠٫٠۳٠مللي جول / ممأظهرت النتائج تحسنا ملحوظا في عزم الدوران المنحرف، وزوايا عتبة عزم الدوران، والوظيفة الحركية الإجمالية، والتحكم الحركي الانتقائي والتوازن في مجموعة الدراسة بالمقارنة بالمجموعة الضابطة.قد يكون العلاج بالموجات التصادمية أداة قيمة إلى حد كبير للحد من التشنج، تحسين القدرة على عزل الحركة والتحكم فيها، وبالتالي، تحسين التوازن والوظيفة الحركية الإجمالية لدى الأطفال المصابين بالشلل الدماغي أحادي الجانب.

El objetivo de este estudio fue examinar el resultado de la terapia de ondas de choque extracorpóreas (TOCH) en mujeres con dolor en la articulación sacroilíaca posparto. Cuarenta mujeres primigrávidas (seis semanas después del parto) con dolor sacroilíaco participaron en este estudio. Fueron asignadas al azar a los grupos A y B. El grupo A fue tratado mediante TOCH, además de ejercicios de corrección postural y ejercicios de inclinación pélvica posterior. El grupo B fue tratado únicamente con el mismo programa de ejercicios. Ambos grupos recibieron dos sesiones por semana durante cuatro semanas. Las variables estudiadas fueron el dolor sacroilíaco y el nivel de función, las cuales se midieron mediante la escala visual analógica (EVA) y la escala funcional de dolor de espalda (EFDE), respectivamente. Todas las mediciones se evaluaron antes y después de las cuatro semanas de intervención. El análisis dentro de los grupos mostró una mejora significativa en la EVA y un aumento significativo en la EFDE en ambos grupos después del tratamiento en comparación con el valor inicial. Con respecto a los análisis entre grupos, hubo una mejora significativa en la EVA y un aumento significativo en la EFDE en el grupo A en comparación al grupo B. En conclusión, tanto la TOCH como el programa de ejercicios son efectivos para disminuir el dolor y mejorar la función en mujeres con dolor sacroilíaco posparto. Sin embargo, al agregar TOCH a los ejercicios en el programa de tratamiento, los resultados son mejores, por lo que esta combinación se recomienda en el tratamiento de mujeres con dolor sacroilíaco posparto. Examining the outcome of the extracorporeal shock wave therapy (ESWT) on females with postpartum sacroiliac joint pain was the aim of this study. Forty primigravida (six weeks postpartum) females with sacroiliac pain was the sample in this study. The subjects equally randomly allocated in group A and B. Group A was treated by ESWT in addition to postural correction and posterior pelvic tilting exercises. Group B was treated by the same exercise program only. Two sessions every week for four weeks were received by both groups. The measurement variables were sacroiliac pain and function level that were measured by visual analogue scale (VAS) and the back pain functional scale (BPFS), respectively. All measurements were evaluated pre and post four weeks of intervention. The within groups analysis showed a significant improvement in VAS and a significant increase in BPFS in both groups after treatment compared with baseline. Regarding between groups analyses there was a significant improvement in VAS and a significant increase in BPFS in group A compared with group B. In conclusion, both ESWT and exercise program are effective in decreasing the pain and improving the function in females with postpartum sacroiliac pain. However, by adding ESWT to exercises in the treatment program the results are better, so this combination is recommended in treatment of females with postpartum sacroiliac pain.

Supermarket cashiers face a significant amount of stress, including time constraints, mental pressure, and physical demands that require repetitive movements. The job description of a supermarket cashier involves work-related risk factors that may lead to musculoskeletal disorder (MSD) symptoms. This study aimed to investigate supermarket cashiers to determine the prevalence of MSD symptoms and their quality of life. Data were collected from a convenience sample of supermarket cashiers working in Saudi Arabia. Information included direct questions on pain in the previous 12 months, demographic data, and health- or occupation-related factors. Moreover, data was collected based on the 36-item short form survey (SF-36), and descriptive statistics were computed. A total of 193 supermarket cashiers participated in this study. The sample included 140 men (72.5%) and 53 women (27.5%), with a mean age of 27.2 &plusmn, 6.4 years. The majority of the participants (90%) had MSD symptoms in at least one body region, with the neck (66.84%) and lower back (65.80%) constituting the most prominent regions. The mean SF-36 scores were higher in participants without pain compared to participants with pain in all domains, except for the physical functioning domain. The high prevalence of MSD symptoms among young cashiers suggest the need for additional investigations to determine the risk factors of these disorders. Additionally, this study recommends preventive procedures to reduce the prevalence of MSD symptoms among cashiers.

Background: Osteoarthritis (OA) is one of the most prevalent causes of musculoskeletal pain and disability among the middle age and elderly population. It significantly affects the overall quality of life of the affected individuals. Objectives: To find out the impact of high intensity laser therapy (HILT) on myofascial trigger points (MTrPs) in symptomatic knee OA. Methods: This is a single-blinded pre–post randomized experimental trial. A total of 40 patients, both male and female, falling within the age group of 35-55 years, BMI 25–29.9 Kg/Cm2, diagnosed with bilateral knee osteoarthritis (grade 2), were recruited as participants of the study. All the participants were clinically evaluated for the signs and symptoms of myofascial pain, tenderness over the vastus medialis muscle and the medial head of the gastrocnemius muscle. The participants were randomly allocated into two groups with n=20 in each group. The participants of the experimental group received high-power laser therapy and underwent exercises on the MTrPS of the vastus medialis and the medial head of the gastrocnemius muscle. The participants of the control group received placebo laser "sham laser" and underwent exercises for the vastus medialis and the medial head of the gastrocnemius muscle. A blood cortisol level test, pressure algometer, digital electronic goniometer, and the KOOS-PS questionnaire were used to measure the pain level, pain threshold, knee ROM, and knee function. Outcome assessment was done at Day 0 and post intervention at the end of 4 weeks. Results: The MANOVA test revealed that both groups improved significantly in all parameters at week 4, with the HILT group improving more than the sham group in blood cortisol levels, pressure algometer measures, knee passive ROM, and KOOS scores (P < .05). Conclusion: HILT is an efficient approach in the treatment of MTrPs in knee OA.

Although, nosocomial infections (NIs) are considered to be an important cause of mortality and prolonged stay in hospitals, there are only a few studies that are concerned with their prevention and reduction in rehabilitation units. This could be because most NI surveys have been carried out mainly in acute and long-stay in hospitals. As a result, limited information is available on prevention and reduction of NIs in rehabilitation units. The present study is a systematic review that draws attention to the significance of setting up specific means for infection control in hospital units concerned with critical cases, and stresses on the need to adapt to new infection control policies, training of healthcare professionals, educating patients regarding safety measures and fighting nosocomial infections. Furthermore, this study aims to show the obligations of following certain considerations while prescribing antimicrobial therapy so as to maximize the efficacy and reduce the adverse effects of conventional antibiotics. Systematic review survey methods were adopted throughout the study. Results of the study were debatable concerning the question of predominance of Gram positive or negative microorganisms as nosocomial etiological agents. Infection control measures such as continuous surveillance protocols, suitable prevention methods and appropriate therapeutic treatment strategies such as de-escalation and rotational antibiotic therapies might help reduce nosocomial infections. Much attention should be given in hospitals to the environmental conditions including quality of water and air. Patients with a suppressed immune system during their stay in hospitals are susceptible to levels of microorganisms that are considered safe for a healthy community. Hence, this study suggests that special safety levels should be set up regarding the levels of microorganisms in hospitals and these should be much lower than those used for a healthy community. Key words: Nosocomial infections, rehabilitation units, antibiotics, immunocompromised patients.

Background: Stroke is one of the major causes of morbidity and mortality throughout the world. A number of studies were conducted in Saudi Arabia. However, there were no studies conducted in Al-Madinah Al-Munawarah city. Objective: The aim of this study was to ascertain the incidence rate of first time stroke and the age-specific incidence in both genders in Al-Madinah Al-Munawarah city. Methods: A prospective hospital based study was conducted over a 1-year period (2014). The cases were included in the study when they were admitted with a diagnosis of cerebrovascular accident. Results: A total 164 patients (91 men and 73 women) who had first time stroke were found in this study with no significant difference between them (p = 0.565). The crude incidence rate of stroke was 13.89 per 100,000 persons. The age-specific incidence rate increased with age in the current study, where the peak was in the age group of more than 75 years old for men and women. Conclusions: Total crude and the age-specific rates for first time stroke patients revealed in this study were markedly lower than the range reported from the developed countries. However, they were within the range that showed previously in Saudi Arabia and Arabian Peninsula countries.

الملخص: أهداف البحث: سبق وأن تم الإبلاغ عن مضاعفات رئوية مثل الانخماص، والوذمة الرئوية، والانصباب الجنبي، والتشنج القصبي والالتهاب الرئوي خلال الفترة التي تتلو عمليات جراحة القلب. يُعتبر التنفس الضحل المؤدي إلى ضعف وظائف الرئة السبب الرئيس لمضاعفات الجهاز التنفسي. ويمكن قياس انخفاض قوة العضلات التنفسية عن طريق الضغط الشهيقي الأقصى والضغط الزفيري الأقصى الناتج في تجويف الفم. هدفت هذه الدراسة إلى تحديد انخفاض قوة العضلات التنفسية بعد ثمانية أسابيع من جراحة القلب. علاوة على ذلك، تمت دراسة العلاقة بين وظيفة الرئة وقوة العضلات التنفسية. طرق البحث: في هذه الدراسة المبنية على الملاحظة، تمت دراسة ٤٢ مريضا من مرضى جراحة القلب البالغين (أعمارهم ٦٥ ± ٧ سنوات). كان هناك ١٠ نساء و٣٢ رجلا. تم قياس وظيفة الرئة وقوة العضلات التنفسية قبل العملية وشهرين بعد العملية. النتائج: كانت قوة عضلات الجهاز التنفسي قبل وبعد العملية الجراحية وفقا للقيم المتوقعة؛ حيث كان الضغط الشهيقي الأقصى قبل العملية ٨١.٧٥+/- ٢٢.٠٤سم ماء، وبعد العملية بشهرين ٧٤.٥٦+/- ١٨.٨٦سم ماء. وكان الضغط الزفيري الأقصى قبل العملية ٩٨.٥٥+/- ٢٢.٢٤ سم ماء، وبعد العملية بشهرين ٨٨.٨٦+/- ١٨.١٤سم ماء. وكانت وظيفة الرئة قبل العملية وفقا للقيم المتوقعة، إلا أنه انخفضت بشكل ملحوظ بعد العملية. في زيارة المتابعة بعد العملية بشهرين، وكانت هناك علاقة معتدلة بين الضغط الشهيقي الأقصى وحجم الزفير القسري. الاستنتاجات: أظهرت هذه الدراسة أن قوة عضلات الجهاز التنفسي لم تعرقل، لا سابقا ولا شهرين بعد جراحة القلب. ولكن الآلية المحددة لهذا التعديل في وظائف الرئة ليست مفهومة بشكل واضح. يجب أن تركز التدابير الرامية إلى إعادة تحديد القدرة المثالية للرئة بعد العملية الجراحية على تمارين رئوية مختلفة قبل وبعد العملية. Abstract: Objectives: Pulmonary complications, such as atelectasis, pulmonary oedema, pleural effusion, bronchospasm, and pneumonia, have been reported following cardiac surgery. Shallow breathing leading to impaired lung function is the major cause of respiratory complications. Decreases in respiratory muscle strength can be measured using the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) produced in the oral cavity. This study aimed to determine the decrease in respiratory muscle strength 8 weeks following cardiac surgery. Moreover, the relationship between lung function and respiratory muscle strength was studied. Methods: In this observational study, 42 adult cardiac surgery patients (10 women, 32 men; mean age 65 ± 7 years) were investigated. Lung function and respiratory muscle strength were measured preoperatively and at 2 months postoperatively. Results: The pre- and postoperative respiratory muscle strengths were in accordance with the predicted values. The MIP was 81.75 ± 22.04 cmH2O preoperatively and 74.56 ± 18.86 cmH2O at the 2-month follow-up (p = 0.146). The MEP was 98.55 ± 22.24 cmH2O preoperatively and 88.86 ± 18.14 cmH2O at the 2-month follow-up (p = 0.19). The preoperative lung function was in accordance with the predicted values; however, lung function significantly decreased postoperatively. At the 2-month follow-up, there was a moderate correlation between the MIP and forced expiratory volume (r = 0.59, p = 0 .0078). Conclusions: The respiratory muscle strength was not impeded either before or 2 months after cardiac surgery. However, the exact mechanism for the alteration in lung function remains unclear. Measures to re-establish the ideal postoperative lung capacity should concentrate on different perioperative pulmonary exercises. الكلمات المفتاحية: جراحة القلب, وظيفة الرئة, قوة العضلات التنفسية, الضغط الشهيقي الأقصى, الضغط الزفيري الأقصى, Keywords: Cardiac surgery, Lung function, Maximal expiratory pressure (MEP), Maximal inspiratory pressure (MIP), Respiratory muscle strength

Patients with chronic obstructive pulmonary disease (COPD) have been shown to benefit from pulmonary rehabilitation programmes. The purpose of this study was to ascertain the effects of a short-term pulmonary rehabilitation programme (PRP) on exercise capacity, pulmonary function and quality of life in patients with COPD.A pre-test and post-test experimental design was conducted on patients from the outpatient physical therapy department. Thirty stable COPD patients with mild to severe airflow obstruction, (mean age 54.1 ± 5.22, FEVSix-minute walk distance (6MWD), pulmonary function (FEVA 6-week outpatient-based PRP significantly improves exercise capacity and quality of life, irrespective of the degree of airflow obstruction.لقد تبين أن المرضى الذين يعانون من مرض الانسداد الرئوي المزمن يستفيدون من برامج إعادة التأهيل الرئوي. هدف هذه الدراسة هو التأكد من تأثير برنامج إعادة التأهيل الرئوي على المدى القصير على القدرة على ممارسة الرياضة، والوظيفة الرئوية ونوعية الحياة في المرضى الذين يعانون من مرض الانسداد الرئوي المزمن.أُجري اختبار تجريبي قبلي وآخر بعدي على المرضى في العيادات الخارجية بقسم العلاج الطبيعي. ضمت الدراسة ثلاثين مريضا في حالة مستقرة لمرض الانسداد الرئوي المزمن يعانون من انسداد تدفق الهواء من خفيف إلى شديد (بمتوسط عمر٥٤.١+٥.٢٢) لبرنامج شامل لإعادة التأهيل الرئوي لمدة ٦ أسابيع، شملت التعليم والتمرينات. وتضمنت معايير الاستبعاد الحالات القلبية الوعائية التي يمكن أن تتفاقم بسبب ممارسة الرياضة، والعجز الحركي، ونفث الدم، والضعف الإدراكي، وارتفاع ضغط الدم الرئوي الحاد والسرطان النقيلي. كما تم تقسيم المرضى عشوائيا إلى مجموعتين تجريبية وضابطة.تم قياس السير على الأقدام لمدة ٦ دقائق، وقياس الوظيفة الرئوية، ومجموع نقاط استبانة سانت جورج للجهاز التنفسي الحد الأدنى، عند البدء ونهاية الأسبوع الثالث والسادس. وأظهرت النتائج تحسنا كبيرا في السير على الأقدام لمدة ٦ دقائق ومجموع نقاط استبانة سانت جورج للجهاز التنفسي.أظهر البرنامج الشامل لإعادة التأهيل الرئوي لمدة ٦ أسابيع تحسنا ملحوظا في القدرة على ممارسة الرياضة وجودة الحياة بغض النظر عن درجة انسداد تدفق الهواء.

Introduction Previous studies in Nigeria have documented significant association between maternal education and child immunization. However, little is known about the pathway through which maternal education improves immunization uptake. This study aims to examine whether maternal literacy and socioeconomic status mediates the relationship between maternal education and complete immunization coverage in children. Methods Nationally representative data from the first wave of the Nigeria General Household Survey-Panel were used, which includes 661 children aged one year and below. Regression analyses were used to model the association between maternal education and child's immunization uptake; we then examined whether maternal literacy and household economic status mediates this association. Results Of the 661 children, 40% had complete immunization. The prevalence ratio (PR) of complete immunization in children whose mothers were educated versus those whose mothers were not educated was 1.44 (95% CI: 1.16-1.77). Maternal literacy substantially reduced the estimated association between maternal education and complete immunization by 90%, whereas household economic status reduced the estimates by 27%. Conclusion These findings suggest that complete immunization was higher in children whose mothers were educated, partly because maternal education leads to acquisition of literacy skills and better health-seeking behavior which then improves immunization uptake for their children. Socioeconomic status is an alternative pathway but with less substantial indirect effect.

Objectives: This review describes the possible factors that may have contributed to the variability of the results between studies that have assessed the efficacy of low intensity laser therapy (LILT) in treating myofascial trigger points (MTrPs). Furthermore, it aims to make recommendations to overcome the methodological shortcomings identified. Methods: A search of the literature was conducted by a single reviewer. Only randomised controlled and clinical trials were included. Results: Sixteen studies were critically reviewed and showed considerable variability in treatment parameters, techniques, symptoms duration and diagnoses. Discussion: Studies that have investigated the use of LILT in treating MTrPs produce conflicting results regarding the efficacy of this treatment modality. However, these are probably due to varying symptoms duration, treatment parameters and techniques, non-homogenous populations, and inaccessible and/or poor laser machine specifications.

Background: The purpose of this study was to apply the scientific, educational, linguistic& formative (SELF) evaluation strategy on a sample of multiple choice questions (MCQs) administered at introduction to research course Purpose: The aim of this study was to apply the SELF evaluation strategy on a sample of multiple choice questions (MCQs) administered at introduction to research course Method and Materials: A number of MCQs were carefully chosen from a pool of administered MCQs. All questions were discussed along with the justification of choosing one answer and excluding the other options. The justification was built of running the SELF evaluation strategy on all questions. Results: Discrimination and difficulty indices were calculated for all questions included. The indices were settled in a template for convenience. Conclusion: It is concluded that SELF evaluation strategy is feasible and practical, even among inexperienced academics, to assess the validity of MCQs within the field of research. It is recommended to use SELF evaluation strategy to have quality MCQs that lead to developing competency in research methodology.

This review describes the possible factors that may have contributed to the variability of the results between studies that have assessed the effects of phototherapy on peripheral nerve regeneration. Furthermore, it aims to make recommendations to overcome the methodological shortcomings identified. A search of the literature was conducted. In vitro and in vivo experimental studies and clinical trials were included. Twenty five studies were critically reviewed and showed considerable variability in irradiation parameters, techniques, approaches, length of irradiation courses, experimental injury tools and procedures. Many studies that have investigated the use of phototherapy in nerve regeneration produce positive results. However, the majority of these studies suffered from a number of shortcomings: no evidence of blinding and/or randomizing procedures, lack of specification of irradiation parameters, unspecified and/or inadequate tests in their experimental injury procedures, inappropriate irradiation parameters and/or poor experimental conditions.

Background: Balance is an essential component for the overall physical performance among individuals. Objectives: The purpose of this study was to investigate and to compare the static balance ability, in terms of endurance time, during trunk stability push-up and during deep squat. Method and Materials: Twenty three healthy physical therapy students, aged between 20 and 23 years, were recruited from college of medical rehabilitation to participate in the study. The physical therapy testers demonstrated the activity to the participants. Every participant had to maintain his balance as long as tolerated during deep squat and during doing push-up while maintaining the trunk stable. The order of measurement was counterbalanced. Results: The mean score, in seconds, for trunk stability push-up was 49.57 (SD=22.07), and the mean score for deep squat was 52.83 (SD=24.60). No significant difference between trunk stability push-up and deep squat mean value, was found [ t (22)= -0.639, p >0.05]. Also, a moderate positive correlation was found [r (21) = 0.454, p

Background: Balance skills play an axial and vital role in enjoying good physical health. Static balance skills like standing on one leg are necessary for activity of daily living. Standing on one leg is a readily simple test used for assessment of static balance across different ages Objectives - The aims of this study was to 1) compare the static balance ability when changing the hands position and 2) compare static balance ability when having eyes open versus closed Methods and Materials Thirty three college students instructed to maintain balance as long as tolerated while standing on one leg. The order of measurement; for hands on chest, hands on pelvis, and hands dangled, was randomized. Open versus closed eyes tested from hands on pelvis position. Results: The mean score, in seconds, for standing on right leg with hands dangled was 74.00 (SD=41.43), with hands on pelvis was 75.75 (SD=44.20), and with hands on chest was 82.09 (SD=37.95). One-way repeated-measure ANOVA showed significant effect [ F(2,64)=3.06, P

Objectives: To investigate the test-retest reliability of the following clinical diagnostic characteristics of myofascial trigger points: taut band, spot tenderness, jump sign, pain recognition, referred pain and local twitch responses (LTRs). Design: Test-retest reliability study. Setting: This study was undertaken in an outpatient physiotherapy department. Subjects: Fifty-eight patients (31 males and 27 females) with rotator cuff tendonitis were recruited into this study. Intervention: Rotator cuff muscles were assessed by an expert for the presence or absence of the main clinical diagnostic characteristics of trigger point assessment. The process was then repeated three days later by the same expert. Main measures: Outcomes included the presence or absence of: a taut band, spot tenderness, jump sign, pain recognition, referred pain and LTRs. Results: Kappa values between testing situations for the taut band, spot tenderness, jump sign and pain recognition were 1. Kappa scores for referred pain ranged between 0.79 and 0.88 and for the local twitch response between 0.75 and 1 depending on the muscles under investigation. Conclusions: The presence or absence of the taut band, spot tenderness, jump sign and pain recognition was highly reliable between sessions. Referred pain and local twitch response reliability varied depending on the muscle being studied.

The purpose of this study was to investigate the efficacy of LLLT in the treatment of trigger points (TrPs) that are associated with rotator cuff tendonitis. A double-blind randomized controlled trail was conducted. Sixty patients were randomly allocated to one of two groups: sham or laser therapy. The laser (Excel, Omega Universal Technologies Ltd, London, UK) parameters used were a wavelength of 820 nm, a power output of 100 mW, a frequency of 5000 Hz (modulated) and energy density of 32 J/cm2. The two groups received a course of 12 treatment sessions for four weeks (3 sessions per week). Pain, functional activities (as measured using the Shoulder Pain and Disability Index, SPADI), pressure pain threshold (PPT) and range of motion (ROM) were assessed pre and post treatment, with a three month follow-up assessment. Significant improvements in pain (p < 0.001) were observed for the laser group (6 cm median improvement on a 10 cm VAS) compared to the sham group (2 cm median improvement) immediately post treatment. The improvements in the laser group continued post treatment with a 7 cm median improvement observed at three month follow-up. Similar between group differences were observed for ROM (p < 0.01), functional activities (p ≤ 0.001) and PPT (p ≤ 0.05). The findings of the current study suggested that LLLT is effective in treating patients with TrPs associated with rotator cuff tendonitis, when using the parameters described. However, the mechanism of its action is not yet clear, and will require further investigation.© (2003) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.