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   2015| July-December  | Volume 20 | Issue 2  
    Online since January 22, 2016

 
 
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ORIGINAL ARTICLES
Accumulative effect of ankle kinesio taping on postural control in children with hemiparetic cerebral palsy
Zeinab A Hussein, Gehan H El-Meniawy
July-December 2015, 20(2):154-160
DOI:10.4103/1110-6611.174696  
Background and purpose Postural control deficit is one of the primary causes of impairments in hemiparetic cerebral palsy, and ankle strategy is one of the muscle synergies to control posture. The purpose of this study was to evaluate the accumulative effect of ankle taping on postural control in children with hemiparetic cerebral palsy. Patients and methods A total of 30 children participated in this study, with a mean age of 6.2 ± 0.79 years, mean weight of 25.06 ± 4.43 kg, mean height of 120.6 ± 12.33 cm, and with a degree of spasticity of 1 and 1+ according to the Modified Ashworth Scale. They were divided randomly into two groups: group A and group B. Kinesio taping was applied to the involved ankle joint for children in group B for successive 5 days/week. Rehabilitation exercises were prescribed for children in both groups three times per week for successive 12 weeks. The Biodex system was used to measure dynamic stability indexes. The measurements were carried out before and after the treatment program. Results The post-treatment results revealed a significant decrease in stability indexes in group B after 6 weeks of treatment and a significant decrease in stability indexes between the two groups before and after 12 weeks of treatment program (P < 0.001). Conclusion Ankle taping has an accumulative effect on postural control and it can improve postural control in conjunction with physical rehabilitation for children with hemiparetic cerebral palsy.
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Efficacy of cryoflow therapy in induced muscle soreness: a randomized trial
Salah Eldin B Elsayed, Neveen A Abdel Raoof, Nagwa S Abdallah
July-December 2015, 20(2):137-145
DOI:10.4103/1110-6611.174692  
Background An individual experiencing delayed-onset muscle soreness notices pain and aching within the affected muscles, decreased range of motion, and loss in muscle strength beginning 12-24 h after exercise, peaking between 48 and 72 h, and subsiding within 5-7 days after exercise. The aim of this study was to investigate the effect of locally applied cryoflow therapy on pain and function in induced muscle soreness of nondominant elbow flexors. Participants and methods Sixty healthy individuals participated in this study. They were divided randomly into two groups, 30 in each group. Pre-exercise measures were recorded for pressure pain threshold using a pressure algometer and level of limitation using Patient-Rated Elbow Evaluation. Participants performed free-weight curl exercises until fatigue using a 10-lb dumbbell at a tempo of 1 s for the concentric phase and 3 s for the eccentric phase to induce muscle soreness. Group A underwent cryoflow therapy administered immediately after exercise using a ShockMaster ICE-CT cryotherapy device at 12°C for 10 min once a day for 4 days. Group B underwent cold treatment using a flexible gel pack for 10 min once a day for 4 days. Dependent variables were assessed at 0, 24, 48, and 72 h after exercise. Results Statistically significant differences were found between both groups for pain using pressure threshold and pain level of the Patient-Rated Elbow Evaluation scale at 48 and 72 h (P = 0.01, 0.002, and 0.0006, 0.0001, respectively); for the functional scale, statistically significant differences were found only at 72 h (P = 0.0001). Conclusion Cryoflow therapy was superior in overcoming delayed-onset muscle soreness than the use of a cryogel pack in case of induced muscle soreness.
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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.
  3,005 387 1
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.
  2,555 655 1
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.
  2,756 282 1
Effect of induced fatigue on dynamic postural balance in healthy young adults
Enas E Abutaleb, Assmaa H Mohamed
July-December 2015, 20(2):161-167
DOI:10.4103/1110-6611.174699  
Background Fatigue may impair the proprioceptive and kinesthetic properties of joints and has been shown to have a negative effect on neuromuscular control, thus increasing the risk for injury. Purpose This study aimed to determine the effect of induced whole-body fatigue on dynamic balance control in healthy young adults. Participants and methods Thirty healthy young participants of both sexes were included in this study; their ages ranged between 18 and 22 years. All of the participants were tested on the Biodex Stability System (BSS) at a stability level 4, subjected to induced fatigue on a treadmill, and then retested directly on the BSS again to evaluate dynamic postural balance. Results There was a significant decrease in the overall stability index, anteroposterior stability index, and mediolateral stability index of dynamic balance at stability level 4 of BSS in healthy young adults as P-values were 0.0001, 0.0001, and 0.0001, respectively. Conclusion and implication It was concluded that induced whole-body fatigue decreased the dynamic postural balance (overall stability index, anteroposterior stability index, and mediolateral stability index) in healthy young adults. This implies that muscles of a fatigued individual are at increased risk for musculoskeletal injury, and steps should be taken during conditioning and rehabilitation programs to prevent muscle fatigue through balance training and endurance exercises to avoid disturbed balance related to fatigue among young healthy adults.
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Effect of using visual cognitive task on gait in children with spastic diplegia
Zeinb A Hussein
July-December 2015, 20(2):176-180
DOI:10.4103/1110-6611.174716  
Background Cognitive processing plays an important role in motor performance; thus, the aim of this study was to evaluate the effect of concurrent use of visual cognitive task and gait training task on gait in children with spastic diplegic cerebral palsy. Participants and methods Fifteen spastic diplgic cerebral palsied children selected from out patient clinic Faculty of Physical Therapy Cairo University (nine boys and six girls) participated in this study. Children with a mean age of 8.15 ± 1.21 years, with a degree of spasticity 2 according to the modified Ashworth scale, with level II according to the Gross Motor Function Classification System, and having a trunk lurching pattern during gait were selected. They received the physical therapy program for an hour and visual cognitive task during gait training for another hour per day. The treatment program was conducted three times per week for 3 successive months. The lateral trunk lurching and gait parameters (spatial and temporal) were assessed, before and after treatments with the proreflex system. Results The results revealed a significant decrease in lateral trunk lurching angle before and after treatment (P < 0.001), a significant decrease in gait speed and cadence, and a significant increase in stride length and time of double limb support before and after treatment (P < 0.001). Conclusion The concurrent use of visual cognitive task during gait training in conjunction with physical program improves the stability of trunk and measured gait parameters for children with diplegic cerebral palsy
  1,635 175 -
High-intensity circuit weight training versus aerobic training in patients with nonalcoholic fatty liver disease
Hany F Elsisi, Yasser M Aneis
July-December 2015, 20(2):181-192
DOI:10.4103/1110-6611.174717  
Background Nonalcoholic fatty liver disease (NAFLD) has become one of the most common causes of liver disease worldwide and has been recognized as a major health burden. To date, no evidence-based therapy has proven to be effective for NAFLD, except for exercise and dietary interventions. The unsuitability of weight-oriented aerobic training for obese people with NAFLD because of the difficulty in maintaining weight loss necessitates the development of alternative strategies such as resistance training. Objective The aim of the study was to evaluate the effect of high-intensity circuit weight training (CWT) compared with aerobic training in NAFLD patients. Materials and methods A randomized controlled trial enrolling 32 NAFLD patients of both sexes (15 men and 17 women) with ages ranging from 30 to 55 years without secondary liver disease (e.g. without hepatitis B virus, hepatitis C virus, or alcohol consumption) was conducted. Patients were randomly allocated either to CWT or to aerobic exercise training, three times weekly, for 3 months. Anthropometrics, lipid profile, liver enzymes, and liver steatosis were assessed. Steatosis was quantified with the hepatorenal-ultrasound index (HRI) representing the ratio between the brightness level of the liver and the right kidney. Results All baseline characteristics were similar for the two treatment groups with respect to demographics, anthropometrics, lipid profile, liver enzymes, and liver steatosis on imaging. HRI score was significantly reduced in the CWT group as compared with the aerobic exercise training group (−0.38 ± 0.37 vs. −0.17 ± 0.28, P = 0.017), representing an 18 versus 8.54% relative reduction from baseline in the two groups, respectively. CWT also improved body composition, most importantly waist circumference, which was positively correlated with the change in HRI (r = 0.645 and P = 0.009). Conclusion This randomized controlled trial demonstrated a significant reduction in steatosis, as assessed by HRI, after 3 months of CWT accompanied by favorable anthropometric, lipid profile, and liver enzyme changes. CWT may serve as a complement to the treatment of NAFLD.
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