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   Table of Contents - Current issue
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January-June 2017
Volume 22 | Issue 1
Page Nos. 1-65

Online since Thursday, July 6, 2017

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ORIGINAL ARTICLES  

Acu-tens improves lung function in patients with chronic bronchial asthma: a randomized placebo-controlled trial p. 1
Faten M Elnozhe, Nezar Rifaat
DOI:10.4103/1110-6611.209873  
Context Bronchial asthma greatly affects patient’s quality of life. Application of transcutaneous electrical nerve stimulation on acupuncture is a promising noninvasive modality that may assist in controlling dyspnoea and improving lung function in those patients. Aims This study investigated the effect of Acu-TENS on lung function [forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] and the modified medical research council dyspnoea scale. Settings and design This study was conducted as a double-blind randomized controlled trial among 40 male patients diagnosed with moderate chronic bronchial asthma selected from Elmenia University Hospitals. Patients and methods Their ages ranged from 35 to 45 years with a mean value of 41.45±2.74 years. They were assigned randomly to two equal groups: the experimental (Acu-TENS) group, which received 45 min of Acu-TENS on bilateral Dingchuan acupoints three sessions/week for 4 weeks, and the control (placebo-TENS) group, which received 45 min of placebo-TENS 3 sessions/week for 4 weeks. Lung function was measured as FEV1 and FVC using a portable spirometer. Dyspnoea was measured using the modified medical research council dyspnoea scale. Assessment was carried out before and after 1 month of treatment. Results The results revealed that after treatment there was a significant improvement in FEV1, which increased by 15.08%, and FVC, which increased by 13.18%, in favour of the Acu-TENS group when compared with the control group (P=0.037 and 0.016 for FEV1 and FVC, respectively). However, there was no significant difference in the modified medical research council dyspnoea scale between the Acu-TENS group and the placebo-TENS group after treatment (P=0.343). Conclusion It was concluded that Acu-TENS on bilateral Ding Chuan acupoints for 4 weeks is an effective approach for improving lung function (FEV1 and FVC).
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Efficacy of pulsed electromagnetic field on pain and nerve conduction velocity in patients with diabetic neuropathy p. 9
Kadrya Battecha
DOI:10.4103/1110-6611.209877  
Background Diabetic peripheral neuropathy is one of the most common and disabling complication of diabetes mellitus. Aim The aim of this study was to investigate the effect of pulsed electromagnetic field (PEMF) on diabetic peripheral neuropathy. Settings and design A total of 30 patients with diabetic neuropathy from both sexes were selected from the Outpatient Clinic of Diabetes Mellitus, Faculty of Medicine, Cairo University, with age ranging from 40 to 50 years. They were divided into two equal groups: PEMF group (group A) and control group (group B). Materials and methods Group A received PEMF with frequency of 50 Hz and intensity of 20 G in addition to traditional physical therapy program. Group B received traditional physical therapy program only. The treatment program was conducted three times per week for 4 weeks. Measurements of pain intensity by visual analog scale and peroneal nerve conduction velocity by computerized electromyography device were done before and after treatment. Results Results revealed that there was a significant reduction of pain intensity and significant improvement of peroneal nerve conduction velocity (m/s) in both groups (P<0.05), with slightly in favor of group A. Conclusion It could be concluded that PEMF combined with traditional physical therapy program has a positive effect on diabetic neuropathy symptoms.
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Progressive pressure release versus dry needling on cervical latent trigger points p. 15
Mary K.N. Takla, Omnia A Atwa, Neveen A El-Latif
DOI:10.4103/1110-6611.209874  
Background Latent myofascial trigger points (L-MTrPs) may account for the development of muscle cramps, restricted joint range of motion, muscle weakness, and accelerated fatigability. Progressive pressure release (PPR) and dynamic deep dry needling (DDDN) are two recognized techniques used in the management of myofascial trigger points. Aim The aim of this study was to compare the effect of both PPR and DDDN on pain and range of motion in upper trapezius L-MTrPs. Setting and design Single-blinded randomized trial design was used, in which 60 pain-free participants with more than two L-MTrPs in the upper trapezius were allocated randomly to two equal groups. Primary measurement outcome included pressure pain threshold (PPT) using an electronic digital algometer. Secondary outcome included active cervical lateral flexion and rotation using a baseline bubble inclinometer. Data were collected before the first treatment and at the end of the 8-week trial. Participants and materials There were fibve dropouts. The PPR group included 28 participants who received passive stretch and PPR, and the DDDN group included 27 participants who received passive stretch and DDDN. Both groups received 3 sessions/week for eight consecutive weeks. Results The PPR group showed a significant increase in PPT values (P<0.01), cervical lateral flexion (P<0.006), and rotation (P<0.027) compared with the DDDN group. Conclusion Within the scope of our study, we have concluded that both techniques have been effective in increasing PPT, cervical lateral flexion, and rotation. However, the PPR technique has been considered to be superior to DDDN in the management of cervical L-MTrPs.
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Relation between the prevelance of work-related musculoskeletal disorders and years of job experience among workers of Nag Hammadi sugar factory in Egypt p. 23
Rania N Karkousha, Haytham M Elhafeza
DOI:10.4103/1110-6611.209876  
Background Assessment of the level of exposure to work-related musculoskeletal disorders (WMSDs) risk factors can be an appropriate basis for planning and implementing an interventional ergonomics program in the workplace. This study was conducted among workers of Nag Hammadi sugar factory to investigate the relation between prevalence of WRSDs and years of job experience among factory workers. Materials and methods A total of 109 workers were selected from Nag Hammadi sugar factory and included in the study. The Nordic musculoskeletal questionnaire was used to study the prevalence of WMSDs. Results The statistical analysis has shown that there was no statistically significant difference of WMSDs prevalence in participants and years of job experience in all body regions except for upper back. Workers who have worked for 6–10 years showed a significant prevalence of upper back pain than those who worked less than 5 years (P<0.05). Conclusion Ergonomic interventions and education programmes that might improve the working conditions may be necessary to decrease upper back trouble in those worker population.
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Cardiovascular performance in Egyptian obese children and adolescents p. 27
Soheir S RezkAllah, Gehan M Abd-El Maksoud, Bassant H El-Refaey
DOI:10.4103/1110-6611.209878  
Background/purpose Overweight and obesity during childhood and adolescence have been identified as a major health problem. In Egypt, increasing rates of obesity in children and adolescents are an emerging concern and have a great impact on the healthcare system. The aim of the study was to compare between nonobese and obese children and adolescents with respect to maximum oxygen consumption, resting heart rate, systolic blood pressure (BP), diastolic BP, pulse pressure, and mean arterial pressure (MAP). Participants A total of 360 children and adolescents, aged 7–18 years (the children were aged 7–12 years and adolescents were aged >12–18 years), participated in this study. Methods BMI was computed for all participants to categorize them into two groups: the nonobese group, which included normal-weight participants, and the obese group, which included overweight and obese participants. One-mile endurance run test was completed by all participants. Maximal oxygen consumption was predicted using a specific equation. Heart rate, systolic BP, diastolic BP, pulse pressure, and MAP were assessed at rest. Age differences were investigated in both groups. Results Significant differences in all measured variables were found between nonobese and obese groups (P<0.05). There was significant interaction effect between group and age on all measured variables (P<0.05). Conclusion Childhood and adolescence obesity affects cardiovascular performance. It decreases aerobic fitness and increases resting BP, heart rate, pulse pressure, and MAP. Adolescents are affected more than children.
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Effect of pulsed electromagnetic therapy versus low-level laser therapy on bone mineral density in the elderly with primary osteoporosis: a randomized, controlled trial p. 34
Ashraf A.M. Abdelaal, Mona M Taha, Doaa I Amin, Amira H Draz
DOI:10.4103/bfpt.bfpt_58_16  
Background Osteoporosis is a major health problem in the elderly worldwide. Aim The aim of the present study was to evaluate and compare the effect of low-frequency pulsed electromagnetic field therapy (LFPEMFT) versus low-level laser therapy (LLLT) on bone mineral density (BMD) in osteoporotic elderly. Patients and methods A total of 60 participants with primary osteoporosis, aged 55–65 years, were randomly allocated into three groups: the LFPEMFT group (group I; n=20), the LLLT group (group II; n=20), and the control group (group III; n=20). Each treatment regimen was applied for 30 min, three times weekly for 3 months on the lumbar region. BMD was evaluated using dual-energy X-ray absorptiometry. Results There were significant increases in BMD in groups I and II, whereas there was a nonsignificant increase in group III (P<0.001, 0.001, and 0.14 for groups I, II, and III, respectively). Between groups, there were significant differences in BMD but in favor of group I (P<0.001). The mean values and percentages of change in BMD were −1.94±0.76 and 39.48%, −2.63±0.49 and 16.79%, and −3.19±0.54 and 0.79% in groups I, II, and III, respectively. Conclusion LFPEMFT and LLLT are useful therapeutic procedures to increase BMD in osteoporotic elderly. Furthermore, LFPEMFT is more effective than LLLT in increasing BMD in the elderly with primary osteoporosis.
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Efficacy of class IV diode laser on pain and dysfunction in patients with knee osteoarthritis: a randomized placebo-control trial p. 40
Mohamed S Alayat, Mohamed M Ali
DOI:10.4103/1110-6611.209880  
Objectives The aim of this study was to investigate the effect of class IV diode laser on knee pain and functions in patients with knee osteoarthritis. Patients and methods Fifty patients with a mean±SD) age of 55.68±8.88 years, height of 173.84±4.946 cm, weight of 83.86±5.28 kg, and BMI of 27.78±1.89 kg/cm2 were randomly assigned equally into two groups (25 patients in each group). Group I received a multiwave locked system laser plus exercises and group II received placebo laser plus exercises three times weekly for 4 weeks. Exercise program was applied for both groups three times weekly for 4 weeks. The exercises included range of motion, stretching, isometric, and isotonic resisted exercises to the quadriceps and hamstring muscles. Pain was evaluated using a visual analog scale and knee function by using the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). Statistical analyses were performed to compare differences between baseline and post-treatment results for both groups. Results Visual analog scale and WOMAC were significantly decreased in both groups after 4 weeks of treatment, with a more significant decrease gained in group I (P>0.0001). Conclusion Class IV diode laser combined with exercise was more effective than exercise alone in the treatment of patients with knee osteoarthritis. Multiwave locked system laser combined with exercise effectively decreased pain and WOMAC as compared with the placebo laser plus exercises group.
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Efficacy of feedback respiratory training on respiratory muscle strength and quality of life in children with spastic cerebral palsy: Randomized controlled trial p. 46
Basant Hamdy El-Refaey, Gehan Mosaad Abd-El Maksoud, Olfat Ibrahim Ali
DOI:10.4103/bfpt.bfpt_65_16  
Background/aim Respiratory muscle weakness and a low upper to lower chest diameter ratio are common respiratory dysfunction manifestations in children with cerebral palsy (CP), which negatively affect their quality of life. This study was conducted to investigate the effect of incentive spirometry (IS) training on these manifestations in those children. Materials and methods Totally, 30 children with spastic diplegic CP, aged between 6 and 12 years, were randomly assigned into two groups: the study group and the control group. Both groups received a traditional physical therapy program for 60 min. The study group received also IS training twice per session (15 min each). Children in both groups received 20 training sessions (five times/week for 4 weeks). Outcomes Respiratory muscle strength, ratio of upper to lower chest wall, gross motor function, and health-related quality of life were assessed before and after training. Results After training, significant improvements of maximal inspiratory pressure, maximal expiratory pressure, and ratio of upper to lower chest wall were obtained in the study group (P=0.002, 0.002, 0.005, respectively), whereas nonsignificant changes were obtained in the control group (P=0.719, 1, 0.284, respectively). In addition, a significant difference was observed between both groups in maximal inspiratory pressure, maximal expiratory pressure, but in favor of study group (P=0.001, 0.001, respectively), whereas there was a nonsignificant difference in the ratio of upper to lower chest wall, gross motor function, and health-related quality of life (P=0.279, 0.527, 0.876, respectively). Conclusion Feedback respiratory training improves respiratory muscle strength in spastic CP children.
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Efficacy of pulsed electromagnetic wave versus low-level laser therapy in treatment of primary dysmenorrhea: a randomized trial p. 53
Eman Abd El Fatah Mohamed
DOI:10.4103/bfpt.bfpt_69_16  
Background Primary dysmenorrhea is defined as pain during menstruation, and it affects participation in daily activities. Objective This study was conducted to compare and add evidence between the effect of pulsed electromagnetic wave and low-level laser therapy (LLLT) in the treatment of primary dysmenorrhea. Participants and methods A total of 50 female students complained of primary dysmenorrhea, with age ranging from 16 to 22 years and BMI from 18.5 to 25 kg/m2. They were divided randomly into two equal groups − group A comprised 25 female students who received Pulsed electromagnetic field, and group B comprised 25 female students who received LLLT. Samples of blood were taken before and after treatment to detect the level of prostaglandins in blood. Present pain intensity scale (Ppi) is used for the assessment of pain before and after treatment. Results There was a significant reduction (P<0.05), in prostaglandin level in both groups post-treatment; when comparing between groups there was no statistical significant difference (P>0.05), whereas there was a clinical difference in favor of group A. In addition, there was a statistically significant reduction (P=0.0001) post-treatment in Ppi scale in both groups. When comparing between both groups, there was a significant reduction (P=0.0001), in Ppi and this significant reduction was in favor of group A. Conclusion The results of this study suggested that both pulsed electromagnetic waves and LLLT are effective methods in the treatment of primary dysmenorrhea, with better effects of pulsed electromagnetic waves than LLLT.
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Sagittal lumbar motion during sit-to-stand task and its relation to balance in chronic stroke patients p. 59
Nevein M.M. Gharib, Nagwa I Rehab, Soheir S Rezk-Allah
DOI:10.4103/bfpt.bfpt_50_16  
Background and purpose Sit-to-stand (STS) task requires the ability to maintain balance while pivoting the body mass over the feet. Following stroke, the rising ability from the seated position is reduced because of difficulty in generating timing and sufficient force in muscles of the trunk and lower limbs to propel the body mass vertically. The aims of this study were to analyze the sagittal lumbar range of motion (ROM) during STS task, calculate the total time of the task, and investigate their relations to balance in patients with chronic stroke. Patients and methods Thirty male patients with chronic stroke (mean age: 51.2±3.75 years) were included in this study. They were divided into two equal groups (group I and group II). Group I had a mild degree of spasticity, whereas group II had a moderate degree in the affected lower limb. Lumbar ROM before and after buttock lift-off (LO) and the total time of STS were recorded using three-dimensional motion analysis system. Balance was assessed using Berg Balance Scale (BBS). Results The patients in group I showed a significant increase of lumbar ROM before (P=0.02) and after (P=0.03) buttock LO and also in BBS scores (P=0.0001) as compared with the patients in group II. However, there was a significant reduction in STS duration in favor to group I compared with group II (P=0.01). In addition, there was a statistically significant moderate negative correlation between BBS scores and lumbar ROM before buttock LO in both groups (P<0.05) and after LO in group I only (r=−0.69). Conclusion Patients suffering from stroke with moderate degree of spasticity show less lumbar ROM at pre-LO and post-LO phases than those with mild spasticity, and took longer time to execute STS task aiming to improve balance and postural stability.
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