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[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

[Purpose] To explore the relationship between functional outcome measurements of spinal mobility, static balance and functional performance. [Participants and Methods] Fifty two healthy participants aged between 18-36 years participated. Spinal mobility included forward bending and side bending. Balance was tested via maintaining single-leg stance position with eyes open and with eyes closed. Functional testing included five times squat to stand, walking on heels and walking on tiptoes. [Results] Two-way mixed intraclass correlation coefficients (ICCs) consistency model average measure (ICC3,K) for single-leg standing with the eyes are open and closed was excellent (0.85) and very good (0.79) respectively. Mean forward spinal mobility score of the recreationally active group (M= 3.3 ± 5.7) was significantly lower (M= 9.5 ± 10.5) than inactive group. Regarding five times squat to stand, the mean score of the recreationally active group (10.4 ± 4.3) was not significantly different from the mean of the recreationally inactive group (9.5 ± 2.6). [Conclusion] Walking on heels significantly took more time and perceived with more exertion than tiptoes walking. Also, standing on one leg was harder when eyes are closed. Recreationally active had shown significant forward mobility but no difference between sidebending mobility. The relationships between different outcome measures need to be furtherly explored.

[Purpose] To identify the risk factors and the stroke types in recurrent stroke patients of Madinah Al-Munawarah city. [Participants and Methods] A prospective research hospital based study was conducted through the year of 2014. The patients were entered in the study when they had recurrent cerebrovascular accident led to hospital admission. All details of patients were obtained include history, demographic data, risk factors and stroke types. [Results] Ninety-four (83.9%) ischaemic strokes, 12 (10.7%) intercerebral hemorrhage strokes and 6 (5.4%) undefined out of 112 patients had recurrent stroke found in this study. Hypertension was the most prevalent risk factors (90.2%) followed by diabetes mellitus (62.5%) and ischaemic heart disease (51.8%). [Conclusion] Hypertension, diabetes, and ischaemic heart disease in particular were exhibited to be crucial risk factors for stroke recurrence in this study. Future studies are needed for secondary prevention planning.

الملخص: تعرض هذه الحالة بالتفصيل لموظف ذكر عمره ٣١ عاما يعاني من آلام على نطاق واسع ومعاناة حدت بشكل كبير من عمله اليومي. تلقى المريض بعض جلسات العلاج الطبيعي ولكن لسوء الحظ كانت النتائج سيئة وغير مرضية. تم استدعاء خبير في هذا المجال ذي خبرة متميزة للتقييم باستخدام أسلوب منهجي جديد. أجري تقييم شامل للجسم باستخدام التقييم الشامل-إعادة التقييم والتقييم باستخدام أسلوب علم الحركة الحيوي. هذا الأسلوب مخصص لتوجيه المتخصصين في العلاج الطبيعي وإعادة التأهيل لإجراء التقييم الشامل خصوصا للحالات العصبية العضلية الهيكلية المعقدة. استخدم الخبير أسلوب الوقوف على مدى انتشار الأعراض المستعصية. الأسلوب المنهجي يوفر بالإضافة إلى التقييم الشامل إرشادا للمعالجين حديثي الخبرة في تنفيذ تداخلات العلاج الطبيعي. تؤكد الدراسة أن الحالات المستعصية تحتاج إلى تقييم بدقة باستخدام الأسلوب المنهجي من قبل المعالجين المدربين تدريبا عاليا. Abstract: This case report details the case of a 31-year-old male clerk who complained of widespread pain that significantly limited his daily work. The patient underwent some physical therapy sessions, but unfortunately, the results were unsatisfactory. An expert in the field with distinguished experience was called to evaluate the patient using a new systematic approach. Comprehensive whole body evaluation was conducted using a total assessment-reassessment & evaluation using biokinesiologic (TAREK) approach. This approach is aimed at guiding physical therapists and rehabilitation professionals in conducting comprehensive evaluations, particularly for complex neuromusculoskeletal cases. The expert used the TAREK approach to address the patient; persistent symptoms. The systematic approach not only enables comprehensive evaluation but also guides junior therapists in implementing physical therapy interventions. The study suggests that complex neuromusculoskeletal cases need to be thoroughly evaluated by highly trained therapists using the systematic approach. الكلمات المفتاحية: التقييم, الرأي الإكلينيكي, البرهان الإكلينيكي, رأي الخبير, Keywords: Assessment, Clinical judgment, Clinical reasoning, Expert opinion

Background Spinal muscles endurance is fundamental for providing adequate trunk stability. Objective The purpose of this study was to compare the side bridge static endurance ability of the right versus left side. Methods Forty right hand dominant students, aged between 18 and 25 years, were recruited from Taibah University. Every participant had to lie down on his side and bear trunk weight on the arm with shoulder abducted to 90∘ and elbow flexed to 90∘. Every participant had to lift off his trunk of the supporting surface, keeping the trunk straight in neutral position, breathing normally and holding on that position as long as tolerated. Results A paired sample t test was calculated. The mean score, in seconds, for right side bridge was 41.6 (SD = 30.08), and for left side bridge was 38.00 (SD = 26.93). No significant difference was found between right and left side bridge endurance ability [t (39) = 1.67, p> 0.05]. Pearson correlation showed high positive correlation [r (38) = 0.89, p Conclusions Among healthy participants, clinicians should expect very close endurance profile for the musculature of the two sides of trunk. Clinicians should equally train both sides of trunk muscles stabilizers in order to enhance tolerance.

[Purpose] To introduce a new systematic physical therapy evaluation aiming to facilitate the process of examining complicated musculoskeletal cases. [Subject and Methods] The patient was a 20 years old male college student who had major motor vehicle accident one year ago. The patient was poorly responding to physical therapy and he felt that his case was worsening. The complexity of the case dictated a new evaluation with a different approach to resolve the barriers hindering the patient from showing functional improvements. [Results] The new evaluation approach explained many undetermined and stubborn symptoms experienced by the patient. The expert confirmed that the traditional evaluations methods utilized were insufficient to address patient’s complaints. [Conclusion] Total Assessment-Reassessment & Evaluation using bioKinesiologic (TAREK) approach is comprehensive evaluation strategy using systematic pathway that guides clinicians to pinpoint the contribution of pathoanatomical structures in producing pathomechanical mobility and poor functional outcomes.

The purpose of this study was to compare the effectiveness of balance training using the Biodex balance system and a conventional balance training programme on balance score and on gross motor skills of children with spastic diplegia.A randomized controlled study was conducted on 48 spastic diplegic children with cerebral palsy (26 boys and 22 girls) in the age range of 5-8 years. The children were randomly allocated to two equal groups. The investigators performed balance and gross motor function assessments for every child using the paediatric Berg balance scale and the gross motor function measure -88 scale (dimensions D and E) before and after the treatment programme. Passive repositioning sense was measured by a Biodex III isokinetic dynamometer. The study group received Biodex balance training and traditional physical therapy programme training, whereas the control group received conventional balance training in addition to the traditional physical therapy programme training, 3 times per week for 12 weeks.Significant improvement was observed in all outcome measures of the two groups, comparing their pre- and post-treatment mean values. Furthermore, the results revealed a significant (Balance training using the Biodex balance system is superior to conventional balance training for improving the balance abilities and gross motor functions of children with cerebral palsy and spastic diplegia.تهدف هذه الدراسة لمقارنة فاعلية تدريبات التوازن باستخدام جهاز التوازن ”بيودكس“ ببرنامج التوازن التقليدي على نتيجة التوازن والمهارات الحركية الإجمالية للأطفال المصابين بالشلل المزدوج التشنجي.أجريت هذه الدراسة العشوائية على ٤٨ طفلا مصابا بالشلل الدماغي التشنجي المزدوج (٢٦ طفلا و٢٢ طفلة) في عمر يتراوح من ٥ إلى ٨ سنوات. تم توزيع الأطفال عشوائيا إلى مجموعتين متساويتين. أجرى الباحثون تقييم التوازن والوظائف الحركية الإجمالية لكل طفل باستخدام مقياس ”بيرغ“ لتوازن الأطفال وإجمالي مقياس الوظيفة الحركية -٨٨ (الأبعاد ”د“ و ”إي“) قبل وبعد برنامج العلاج. تم قياس إعادة الوضع السلبي بواسطة بيودكس ٣ المقوي الحركي. تلقت مجموعة الدراسة التدريب بجهاز التوازن بيودكس وبرنامج العلاج الطبيعي التقليدي في حين تلقت المجموعة الضابطة التدريب بالتوازن التقليدي بالإضافة إلى برنامج العلاج الطبيعي التقليدي ٣ مرات أسبوعيا لمدة ١٢ أسبوعا.تم ملاحظة تحسنا كبيرا في جميع نتائج القياسات للمجموعتين بمقارنة القيم الرئيسة قبل وبعد العلاج. بالإضافة إلى ذلك، أظهرت النتائج تحسنا كبيرا في القيم الرئيسة بعد العلاج لصالح مجموعة التدريب بجهاز بيودكس.تفوقت تدريبات التوازن باستخدام جهاز التوازن بيودكس على التدريب بالتوازن التقليدي لتحسين القدرة على التوازن والوظائف الحركية الإجمالية عند الأطفال المصابين بالشلل الدماغي والشلل التشنجي المزدوج.

ObjectivesEarly-onset physical morbidity is likely to affect the emotional balance and behavioral adaptation of children and adolescents. Few published studies have investigated psychological morbidity in children with rheumatic heart diseases (RHD). Our work aims to explore the psychiatric symptoms

The main objective of the study was to compare the biomedical and bio -psychosocial models of delivery of health care in the physical therapy and rehabilitation fields. An expert in the field with over 25 years of experience in multiple academic institutions and clinical practices was invited to have a through professional discussion using real life didactic educational model. The expert has engaged in full discussion with students, clinicians, staff members and other professionals to understand their perspectives regarding the practical application of the benefits obtained from adopting either the biomedical or the bio-psychosocial model of care delivery. A real complex case scenario was fully described to communicate the benefits and drawbacks derived from adopting certain model of care delivery. About 84% of participants indicated that they are lacking adequate understanding of the philosophy behind either model of health care delivery especially with complex rehabilitation conditions. In conclusion, the bio-psychosocial model of delivery of health care is more comprehensive and viable for addressing the multidimensional aspects of the needs of complex physical therapy and rehabilitation conditions.

Background Elevated admission plasma glucose is associated with increased mortality in patients who are admitted with acute coronary syndromes. Aim To validate the hypothesis that tight glycemic control could reduce major adverse cardiac events in hyperglycemic patients with acute coronary syndromes. Methods Fifty adult patients admitted with acute coronary syndromes within 6 h of presentation with “RBS > 140 mg/dl” were enrolled in this study to evaluate the effect of tight glycemic control using insulin actrapid infusion (aiming at RBS of 80–130 mg/dl during the 1st 24 h post admission) on decreasing infarct size, and major adverse cardiac events during ICU admission and 30 days follow up. Results Of 50 patients enrolled in the study, 25 patients received insulin by infusion (group A), while the rest received insulin via S.C. route (group B). The glycemic control was significantly lower in group A. Heart failure at 7 and 30 days was 4% and 12%, respectively, in group A vs. 20% and 24%, respectively, in group B. Hemodynamic instability was seen in 8% in group A vs. 28% in group B during the ICU stay. Mortality at 7 and 30 days was 0% and 0%, respectively, for group A vs. 4% and 12%, respectively, for group B. Conclusion Tight glycemic control in patients with acute coronary syndromes presenting with hyperglycemia on admission is beneficial.

Background: Maintaining good strength at trunk muscles extensors plays a vital role in enjoying good physical health. Purpose: The main aim of this study was to examine the effect of assuming different scapular positions on the isokinetic output of the trunk extensors. Method and Materials: Twenty six healthy college students were recruited to participate. The researcher collected demographic data in addition to recording full spinal mobility. Every participant was instructed to extend his trunk against the Biodex machine that was set at a velocity of 60° per second. Every participant has to assume the position of scapular protraction, retraction and depression via changing the elbows positions while having the fingers interlaced. The researcher measured the average peak torque and the average power in addition to all other available outputs. Results: A one-way MANOVA was calculated examining the effect of changing scapular positions on average power and average peak torque. No significant effect was found [Lambda (2,24) = 1.09, p > 0.05] for average power. No significant effect was also found [Lambda (2,24) = 0.60, p > 0.05] for average peak torque. Conclusion: No significant difference was detected while assuming different scapular positions and having participants doing back extension at 60° per second. However, from clinical perspective, clinicians should consider the level of difficulties experienced by subjects in designing a viable gradual resistive exercise program.

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.

Background: Daily living activities such as walking, dressing and feeding require adequate proficiency in gross and fine motor skills; however inadequate proficiency leads to multiple difficulties that range from increased anxiety and poor self-esteem to significant difficulties with academic achievements. Recent research findings claimed that children’s skill proficiency tends to lag behind the established developmental norms. Purpose: The aim of this study was to examine the interrelationship among different subtests of gross and fine motor skill in school aged children in Al-Madinah Al-Munawara. Methods: Children (N= 99) from 2nd, 3rd and 4th grades completed the gross and fine motor composite of the Bruininks- Oseretsky Test of motor proficiency 2nd Edition (BOT-2). Results: Analysis revealed a weak correlation between gross motor composite and fine motor composite. A weak correlation was found for gross motor subtests except a significant correlation was found for the relationship between balance and bilateral coordination. Conclusion: Therapists should closely look at upper limb speed dexterity and upper limb coordination since they are significantly correlated.

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

Background : Spastic diplegic cerebral palsy (SDCP) is the most common form of cerebral palsy.It is characterized by multiple postural disorders.Objective: The aim of this study was to evaluate the effect of postural control training using Biodex balance system on back geometry. Method: Forty SDCP children (22 boys and 18 girls) in the age ranged from 5 to 7 years old were randomly allocated into two groups of 20 children each. All children were assessed before and after the treatment program by the formetric system. The study group received postural control training using Biodex balance system and therapeutic exercise program. The control group received only the therapeutic exercise program. Results: The results revealed significant improvement in all post treatment mean values which was higher for the study group. Conclusion: Postural control training using Biodex balance system can be used to improve postural alignments in children with spastic diplegia.

Spinal extensors endurance is a vital and fundamental pillar for the general endurance. Good endurance helps in injury prevention, and improves efficiency in all physical activities across different ages. Endurance testing of back extensors has been extensively examined in literature but there are many criticisms to the suitability and the practicality of the commonly used tests. The purpose of this study was to compare the endurance ability of the trunk extensors on the Swiss ball and on the peanut ball. Thirty five physical therapy students, aged between 18 and 22 years, were recruited from college of medical rehabilitation to participate in the study. The physical therapist demonstrated the activity to the participants. Every participant had to lie down over the gym ball and the peanut ball and arch the trunk backwards as long as tolerated. The order of measurement was counterbalanced. The mean score, in minutes, on the gym ball was 2.00 (SD=0.93), and the mean on the peanut ball was 2.48(SD=0.87). A significant increase in endurance holding time from gym ball to peanut ball was found [ t (34)= -3.43, p