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ORIGINAL ARTICLES
Inter-rater and intra-rater reliability of Kinovea software for measurement of shoulder range of motion
Reham M Abd Elrahim, Eman A Embaby, Mohamed F Ali, Ragia M Kamel
July-December 2016, 21(2):80-87
DOI:10.4103/1110-6611.196778  
Background Goniometry is a tool used frequently for measuring and documenting range of motion (ROM) during a physical therapy examination. With modern innovations in technology, new methods other than the universal goniometer have been applied. Kinovea software is a recent video-based method that uses a virtual goniometer to obtain values for the ROM of joints. However, the software’s reliability in measuring shoulder joint ROM has not been studied. Purpose This study was conducted to investigate the inter-rater and intrarater reliability of Kinovea software for measuring shoulder joint ROM in healthy individuals. Materials and methods Shoulder joint ROM was measured in 52 healthy individuals (mean±SD age was 26.7±4.2 years) using Kinovea photographic measurements by three trained raters. Intrarater reliability was examined by a single rater within the same day. Shoulder flexion, abduction, and external and internal rotation ROM were measured with the patient in supine position. Results The inter-rater reliability ranged from an intraclass correlation coefficient value of 0.95 to 0.98, whereas the intrarater reliability ranged from an intraclass correlation coefficient value of 0.98 to 0.99. Conclusion This study showed highly reliable shoulder joint ROM measurements in healthy adults using the Kinovea software.
  5 4,366 745
Efficacy of noninvasive respiratory techniques in the treatment of children with bronchial asthma: a randomized controlled trial
Ragab K Elnaggar, Mohammed A Shendy
January-June 2016, 21(1):1-10
DOI:10.4103/1110-6611.188025  
Background and purpose Although the effects of the respiratory techniques are appreciated, it is yet in need to be defined for the treatment of children with bronchial asthma. Thus, this study aimed to compare the effects of the active cycle of breathing technique (ACBT), Buteyko breathing technique (BBT), and thoracic lymphatic pump technique (TLPT) on the total serum immunoglobulin (Ig) E, ventilatory function, and asthma perception in children with bronchial asthma. Materials and methods In a randomized controlled trial, 54 children with bronchial asthma randomly allocated to three equal groups. The groups were then randomly assigned to the following interventions: the ACBT group, the BBT group, or the TLPT group. Total serum IgE, ventilatory function, and perception of asthma were evaluated before treatment and after 3 consecutive months of treatment. Results No significant differences were found between groups at entry (P>0.05). There were nonsignificant differences as regards all outcome measures within the ACBT group (P>0.05) and significant differences within the BBT group and the TLPT group (P<0.05). Significant difference in total serum IgE in favor of the BBT group was recorded when compared with ACBT group (P=0.046) and the TLPT group (P=0.036). Moreover, significant differences in ventilatory function measures favoring the BBT group in comparison with the ACBT group and the BBT group (P<0.05) were recorded. Finally, asthma control was significantly higher in the BBT group than ACBT group (P=0.017) but not BBT group (P=0.081). Conclusion The BBT and TLPT are more advantageous compared with the ACBT in the treatment of children with bronchial asthma, and Buteyko breathing is potentially more valuable.
  2 3,696 485
Effect of kinesio taping therapy combined with breathing exercises on childbirth duration and labor pain: a randomized controlled trial
Ghada E El-Refaye, Engy M El Nahas, Hassan O Ghareeb
January-June 2016, 21(1):23-31
DOI:10.4103/1110-6611.188026  
Background Labor pain is a common complaint. The method used to reduce maternal discomfort should be efficacious and safe for the mother and the child. Several alternative methods have been reported to reduce childbirth pain. Objective This study was conducted to evaluate the effect of kinesio taping combined with breathing exercises on childbirth duration and labor pain. Participants and methods This study was conducted on 40 normal full-term primigravida women during the first stage of labor with regular painful, palpable uterine contraction, and cervical dilatation between 3 and 5 cm. They were randomly assigned into two equal groups, group A and group B. Group A (the study group) consisted of 20 women, and group B (the control group) consisted of 20 women. All participants in both groups A and B performed breathing exercises in addition to conventional medical treatment. However, group A patients received kinesio taping at the lumbar region and anterior lower abdomen during the first stage of normal labor. Assessment of all participants in both groups A and B was carried out before and after the treatment program using visual analogue scale (VAS), cardiotocography, and by measuring the duration of the first stage of labor using a stopwatch. Results There was a nonsignificant difference between group A and group B in pain intensity using VAS in the first stage of labor at the first reading (cervical dilatation: 3–4 cm). However, there was a highly significant difference between group A and group B in the pain intensity using VAS in the first stage of labor at the second reading (cervical dilatation: 7–8 cm), favoring group A. Furthermore, there was a highly significant difference between group A and group B in the duration of the first stage of labor, favoring group A. Conclusion These results suggest that kinesio taping combined with breathing exercise is an effective method in reducing labor pain and shortening the duration of the first stage of labor.
  2 4,434 437
Sex differences of knee joint repositioning accuracy in healthy adolescents
Rania N Karkousha
January-June 2016, 21(1):56-60
DOI:10.4103/1110-6611.188029  
Introduction Sex differences in the knee joint have long been known and impaired proprioceptive accuracy is an important risk factor that could be associated with knee joint injury. This study was conducted to compare the accuracy of knee repositioning between healthy male and female adolescents. Participants and methods A total of 64 healthy adolescents (32 males, 32 females) aging from 15 to 18 years participated in this study. Active angle repositioning test was used to assess the proprioceptive accuracy of the right knee joint at 45° knee flexion by using a Biodex system 3 pro-isokinetic dynamometer. Results The statistical analysis revealed that the repositioning accuracy of the knee joint was significantly lower in female participants than in males, as the mean values of repositioning errors were 3.54 ± 1.20 for males and 4.76 ± 1.29 for females (P < 0.05). Conclusion Sex-based difference in the accuracy of knee joint proprioception may imply that knee proprioceptive sensitivity might potentially contribute to the high incidence of knee injury in females compared with males, particularly during adolescence.
  2 1,542 181
Effect of trunk belt on function in children with diplegia
Hend A Wahsh, Kamal E Shoukry, Nanees E Mohamed
July-December 2016, 21(2):68-73
DOI:10.4103/1110-6611.196777  
Background and purpose Trunk control can offer many solutions for posture and movement. The purpose of this study was to determine the effect of using modified trunk belt on sitting and standing in diplegic children. Patients and methods Thirty diplegic cerebral palsy children from both sexes participated. Their ages ranged from 3 to 6 years. They were divided randomly into two groups: control and study. The control group received a designed physical therapy program, and the study group received a designed physical therapy program in addition to proprioceptive training using a modified trunk belt. The sitting and standing domains were evaluated using the Gross Motor Function Measure for both groups before and after 3 successive months of treatment. Results The Wilcoxon test revealed that the gross motor function of children from both groups improved significantly after 3 months of treatment in both the sitting and standing domains. The Mann–Whitney test revealed that children in the study group showed a significantly greater improvement in both domains compared with the control group. Conclusion Proprioceptive training using trunk belt with physical therapy program could be used as an effective method for improving gross motor function of both sitting and standing in children with diplegia.
  1 1,955 1,563
Assessment of lumbar proprioception in participants with functional ankle instability: a cross-sectional study
Olfat Ibrahim Ali, Sahar Abdallah Alasar
July-December 2016, 21(2):74-79
DOI:10.4103/1110-6611.196780  
Background Functional ankle instability (FAI) represents 40–75% of residual disability after acute lateral ankle sprain. FAI has been associated with impaired muscle strength and postural and neuromuscular control. Purpose The aim of this study was to investigate the association between FAI and lumbar proprioception. Patients and methods Thirty individuals of both sexes (17 female and 13 male) were selected. The FAI group included 15 participants (nine female and six male) and the control group included 15 normal individuals (eight female and seven male). Lumbar proprioception was assessed using the Biodex system 3 pro isokinetic dynamometer. Results There was a significant increase in repositioning error in the FAI group compared with the control group (P<0.001). Conclusion There was an association between FAI and an increase in lumbar reposition error compared with healthy individuals. This effect should be considered in the rehabilitation protocol of patients with FAI.
  1 2,446 471
Acute response of serum cortisol to different intensities of resisted exercise in the elderly
Mona M Taha, Khaled M Mounir
January-June 2019, 24(1):20-25
DOI:10.4103/bfpt.bfpt_13_18  
Background Cortisol has a main role in stress response and high stress can affect the psychological and physical performance in the elderly. Aim To determine the acute response of serum cortisol to different intensities of resisted exercise in the elderly. Patients and methods A total of 60 elderly patients from both sexes (60–70 years) were equally and randomly assigned to three resistive training bouts: low-intensity (group A, 30% of 1RM), moderate-intensity (group B, 50% of 1RM), and high-intensity (group C, 80% of 1RM) with a 90–120 s rest period between sets. Blood samples that were analyzed included serum cortisol hormone before and 15 min postintervention. Results There was a statistically significant decrease in serum cortisol level in groups A and B at postintervention when compared with the preintervention value, while group C showed an insignificant difference. Conclusion In a sample of elderly patients undergoing three bouts of different intensities of resisted exercise, a low to moderate resisted exercise was superior to high intensity in decreasing the serum cortisol and consequently less stress post-exercise.
  1 1,734 182
Balance training versus reciprocal electrical stimulation on knee joint alignment in spastic diplegic cerebral palsy children
Wanees M Badawy, Mohamed B Ibrahim
July-December 2015, 20(2):146-153
DOI:10.4103/1110-6611.174694  
Background and purpose Spastic diplegia is the most common pattern of motor impairment in patients with cerebral palsy (CP) because of a number of deficits, including poor muscle control, weakness, impaired balance, and spasticity, which cause malalignment of the knee joint during standing and walking. This study aimed to evaluate the effect of balance training (BT) versus reciprocal electrical stimulation (RES) of knee extensors and flexors on knee joint alignment in spastic diplegic CP children. Materials and methods Thirty children with spastic diplegic CP of both sexes were selected, ranging in age from 6 to 8 years. Children were divided randomly into two equal groups (I and II). Evaluation was performed before and after 12 weeks of treatment using a digital goniometer to measure range of motion of the knee joint, tape measurement to measure the distance between the buttock and the heel, and gross motor functional measure to provide functional evaluation of standing and walking abilities. Group I received a BT program on the Biodex balance system in addition to a selected physical therapy program. Group II received RES of knee extensors and flexors in addition to the same selected physical therapy program. Results Both BT and RES for 12 weeks in spastic diplegic CP seem to yield a beneficial and statistically significant increase in adjusting knee alignment and improving the functional abilities in standing and walking (P < 0.05). However, BT seems to exert a more beneficially and statistically significant effect than RES. Conclusion BT and RES have a significant effect on improving knee alignment in spastic diplegic CP children.
  1 2,757 282
Impact of high-intensity interval training on HbA1c in patients with type 2 diabetes mellitus
Hany F Elsisi, Yasser M Aneis, Khaled M Mounir
July-December 2015, 20(2):168-175
DOI:10.4103/1110-6611.174710  
Background Exercises are often recommended for patients with type 2 diabetes mellitus (T2DM) to improve physical conditioning and glycemic control. Objective The aim of this study was to determine the impact of high-intensity interval training (HIIT) on glycated hemoglobin (HbA1c) in T2DM on a short-term basis (after 12 weeks of training). Patients and methods Forty patients women diagnosed with T2DM were selected from the outpatient clinic of Faculty of Physical Therapy, Cairo University; their ages ranged from 55 to 65 years. Patients were assigned randomly to two equal groups (n = 20). Group A, the study group, received HIIT and training by treadmill and group B, the control group, received training by treadmill. Exercise training was performed for 20-38 min for group A and for 20-30 min for group B three times a week for 12 weeks. HbA1c was evaluated before training and after 3 months of training (after training). Results There was a statistically significant difference in the two groups in HbA1c, where the mean values for group A before and after treatment were 6.290 ± 0.130 and 5.460 ± 0.092, respectively, and those for group B before and after treatment were 6.405 ± 107 and 6.025 ± 0.156, respectively. Also, there was a statistically significant difference between the two groups in HbA1c (P = 0.04), where group A showed greater improvement in HbA1c than group B on a short-term basis. Conclusion Regular participation in HIIT was more effective and an alternative to aerobic training in improving HbA1c in T2DM.
  1 3,022 387
Intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photographs
Nesma A Helmy, Mohsen M El-Sayyad, Omaima M Kattabei
July-December 2015, 20(2):193-199
DOI:10.4103/1110-6611.174719  
Background and purpose An accurate noninvasive measurement of spinal angles is crucial for detecting postural problems and for assessing therapeutic intervention for students in school. This study was conducted to evaluate the intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photos of adolescents in schools. Participants and methods Twenty-two adolescent students of both sexes (10 boys and 12 girls) participated in this reliability study. The researcher took four photographs of each adolescent from different standing views; at intra-rater analysis, one rater analyzed the four photos at three different time, whereas at inter-rater analysis three raters analyzed them once. Reliability was quantified with intraclass correlation coefficient (ICC), repeated measurement analysis (RMA), and standard of measurement error (SEM). Results Intra-rater reliability of all spinal postural angles [head tilt, shoulder tilt, pelvic tilt from anterior view, scapular tilt, gaze angle, craniovertebral angle, trunk angle, lumbar angle, pelvic tilt from lateral view, and sway angle for right and left sides] showed excellent results, with ICC above 0.9, whereas ICC for pelvic tilt from the posterior view (0.813) was very good. SEM ranged from 0.28 to 1.5° and RMA showed no statistical difference between measurements of the same rater. ICC values for inter-rater reliability of all spinal postural angles ranged from 0.836 to 0.992. SEM ranged from 0.3 to 1.63° and RMA showed no statistical difference in measurements between different raters. Conclusion Surgimap Spine software is a reliable method for measuring spinal postural angles of adolescents from different views in standing position from digital photographs.
  1 2,567 655