Author: Afaf Mohamed Mahmoud Botla, Marwa Shafiek Mustafa Saleh

Effect of Russian Current Stimulation on Abdominal Strength and Endurance in Postnatal Diastasis Recti: A Randomized Controlled Trial

Afaf Mohamed Mahmoud Botla, Marwa Shafiek Mustafa Saleh

Afaf Mohamed Mahmoud Botla, Marwa Shafiek Mustafa Saleh – Effect of Russian Current Stimulation on Abdominal Strength and Endurance in Postnatal Diastasis Recti: A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(1); 16-22

Abstract
Background. Postnatal diastasis recti (DR) can result in cosmetic defects, psychological discomfort, and other related problems such as low back pain (LBP) and pelvic instability. Although, Russian current stimulation is one of the most widely used modalities for improving muscle strength, there is still inconclusive evidence to support its effectiveness in patients with postnatal DR. Objective. This study was conducted to investigate the effect of Russian current stimulation on abdominal strength and endurance in postnatal DR. Methods. Thirty six women suffering from postnatal DR randomly assigned to study or a control group. The control group (n = 18) participated in an abdominal exercise program for 30 minutes per session, whereas the study group (n = 18) received Russian stimulation to rectus abdominis muscles in addition to the same abdominal exercise program. Outcome measures included inter recti distance (IRD), waist/hip ratio (WHR), abdominal muscle strength (peak torque, maximum repetition total work, and average power), abdominal endurance and body appreciation. Measures were assessed for all participants in both groups before and after 6 weeks of treatment program. Results. Analysis showed that both groups had improved in all outcomes measures. Further, there was a significant difference between the two groups in favor of the study group for all of the measured variables. Conclusions. The study showed that adding Russian current stimulation to abdominal exercises program is more effective than abdominal exercises program only in treatment of postnatal DR.

Key words:
Diastasis recti, Abdominal exercises, Russian stimulation, Abdominal strength, Abdominal endurance

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Training with virtual reality and its impact on the heart and the ability to use in physiotherapy

Paula Migała, Mariusz Migała, Beata Skolik

P. Migała, M. Migała, B. Skolik – Training with virtual reality and its impact on the heart and the ability to use in physiotherapy. Fizjoterapia Polska 2020; 20(1); 6-14

Abstract
Admission. The term “virtual reality” means an environment created by an electronic device that consumes the user. The relationship between the virtual object and the person is triggered. The most important phenomenon that affects the human psyche is immersion, or the ability to create a sense of presence in a place generated by a computer.
Goal. Evaluation of the impact of training using non-emulsion and immersion projection with training on a stationary cyclometer on heart action, i.e. heart rate, systolic and diastolic blood pressure and saturation. Comparison of the impact of training with occurring phenomenon of absorption and without on the previously mentioned factors, evaluation of the effects of training with the use of virtual reality and the possibility of using the training with VR in physiotherapy.
Material and methodology of testes. The study group of 20 people (20-35 years). Three trainings were conducted each time. The first training (A) was carried out on a stationary cycloergometer (constant load 50 WAT). Second training (B) under the same conditions, but additionally with the use of virtual reality goggles and immersion projection. The third training (C) also under the same conditions, but a non-oven projection was used on the laptop screen. RR measurements were taken every 3 minutes and HR and SpO2 every 1 minute.
Results. The mean value of the training pulse in training A was 94,7 BPM, in training B 96,5 BPM, and in training C 97,2 BPM (p < 0.99). Average values of saturation in training A 96,46%, training B 96,22%, training C 96,61% (p < 0.19). In the pressure changes, mean values during training A RR 123,21/79,6 mmHg, training B RR 127,64/79,1 mmHg, training C RR 123,54/75,1 mmHg. RR p < 3.04, p < 2.4. Despite the lack of relevance, a trend was noticed.
Conclusions. Studies have shown no significant differences in the comparison of the effects of training using different stimuli on direct stimulation of heart rate and saturation. A greater impact on the initial heart rate ceiling in training using virtual reality goggles compared to controlled training on a stationary cycloergometer and with non-immersive projection has been proven. No major impact of one-time training with the use of virtual reality goggles on the persistence of effects immediately after training has been proven. It was found possible to use this type of training in physiotherapy to increase patient involvement in performing a physical task, make training more attractive, and improve patients’ well-being.

Key words:
virtual reality, immersion, stationary cycloergometr, virtual training, heart rate, arterial pressure, saturation

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Effect of Functional Trunk Training Program on Gait Harmony in Children with Spastic Diplegia: A Randomized Controlled Trial

Rasha Atef Saad El Metwally, Kamal El Sayed Shoukry, Amira El Sayed El Bagalaty

Rasha Atef Saad El Metwally, Kamal El Sayed Shoukry, Amira El Sayed El Bagalaty – Effect of Functional Trunk Training Program on Gait Harmony in Children with Spastic Diplegia: A Randomized Controlled Trial. Fizjoterapia Polska 2019; 19(4); 162-170

DOI: https://doi.org/10.56984/8ZG1A35D2

Abstract
Purpose. To determine the effect of functional trunk training on gait harmony in children with spastic diplegic CP by using the core stability and gait training program through strengthen the core area and the modified walker tool. Design. Single blind randomized controlled trial. Methods. Thirty children with CP spastic diplegia participated in this study with ages between four to seven years. They were randomly and equally divided into two groups (A and B), the control and study group respectively. Group A received selected physical therapy program for two hours aiming to improve functional gait ability while group B received the same as group A for only one hour plus the intervention program. The intervention program which is aiming to improve gait harmony consists of two fundamental parts. Firstly, core training and mobility exercises for half an hour. Secondly, gait training on different surfaces by using Modified walker for half an hour. Treatment was conducted for 3 times per week for a successive 3 months for both groups (control A & study B). Modified Ashworth scale (MAS) was used for sample selection. Gait harmony was measured by golden ratio equations which determine the spatiotemporal data from tracker motion analysis program version 5.0.6. Results. By using descriptive analysis to show mean ± standard deviation (SD) for all comparative variables, non-parametric test (chi square) to express the MAS values pretreatment for selection, paired t-test for measuring the pre and post treatment results within group and independent t-test between both groups (control and study) for measuring the results of Gross Motor Function Measure score (GMFM) for walking domain that showed a significant difference between both groups (A & B) post treatment. Usage of multivariate analysis (MANOVA) multivariate to determine the effect of independent variables (side, time and the intervention in both groups A&B) on the dependent variables equation (a, b, and the difference between both equations). There was a significant difference in the following: the proportion of stance/ swing phase time (equation a), the proportion of gait cycle/ stance phase time (equation b) and the difference between the values of both proportions (equation a and b) between both groups. Conclusion. It can be concluded that functional trunk training program in conjunction with a selected physical therapy program improved the gait harmony significantly in children with spastic diplegic CP. Which is obvious in gait harmony equations.

Key words:
cerebral palsy, spastic diplegia, gait harmony, golden ratio, GMFM, MAS

 

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Impact of computer-assisted speech therapy on naming skills in patients with post-stroke aphasia

Anna Obszyńska-Litwiniec, Monika Lewandowska, Dariusz Boguszewski, Izabela Korabiewska, Maria Kłoda, Dariusz Białoszewski

Anna Obszyńska-Litwiniec, Monika Lewandowska, Dariusz Boguszewski, Izabela Korabiewska, Maria Kłoda, Dariusz Białoszewski – Impact of computer-assisted speech therapy on naming skills in patients with post-stroke aphasia . Fizjoterapia Polska 2019; 19(4); 156-161

Abstract
Objective. The objective of the study was to determine the impact of intensive, computer-assisted rehabilitation of speech disorders on improving naming skills among post-stroke aphasia patients.
Material and method. A total of 73 patients with aphasia were included in the study. After hospitalization, patients were assigned to the study group
(n = 36) or to the control group (n = 37). A diagnostic test was performed in both groups using the Boston Naming Test (BTN). Patients in SG participated in the intensive rehabilitation AfaSystem program for 2 months. Patients in CG received standard speech therapy care. After completion of the therapy, all patients were again subjected to the BNT test. Then, the results obtained before and after the intervention were compared. Statistical analysis was used to evaluate the results.
Results. After completing 2-month computer-assisted therapy, patients in SG achieved a much greater improvement in BNT naming skills than patients in CG. This difference was statistically significant and amounted to p = 0.0044
Conclusions
1. Intensive rehabilitation using the AfaSystem computer tool significantly contributes to the improvement of naming skills in patients with post-stroke aphasia.
2. The use of computer tools to support aphasia therapy can ensure high intensity of rehabilitation, which is considered to be a necessary condition for effective treatment of speech disorders.’

Key words:
aphasia, speech therapy, computer program, anomy

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Focused versus radial extracorporeal shock wave therapy in post burn hypertrophic scar: A single blinded randomized controlled trial

Nancy Hassan Aboelnour, Najlaa Fathi Ewais, Hamada Ahmed Hamada

Nancy Hassan Aboelnour, Najlaa Fathi Ewais, Hamada Ahmed Hamada – Focused versus radial extracorporeal shock wave therapy in post burn hypertrophic scar: A single blinded randomized controlled trial. Fizjoterapia Polska 2019; 19(4); 150-155

DOI: https://doi.org/10.56984/8ZG1A3652

Abstract
Purpose. Hypertrophic scar (HTS) is one of the common post-burn complications that lead to functional and cosmetic impairments, so we pursued to examine efficacy of extracorporeal shock wave therapy (ESWT) on HTS in expression of improving scar thickness and appearance. Materials and Methods. 60 patients with post burn HTS were recruited in this trial and divided randomly into 3 equal groups. Group A: received focus ESWT (100 shock waves per cm2, 0.037 mJ/mm2, 4 Hz, 2 times/week for six weeks) plus traditional topical medication (MEBO Scaro cream). Group B: received radial ESWT (500 shock waves per cm2, 0.13 mJ/mm2, 6 Hz, 2 times/week for six weeks) plus MEBO Scaro cream. Group: received only MEBO Scaro cream. Ultrasonography was utilized for scar thickness measurement and scar characteristics assessment was done by Modified Vancouver Scar Scale (MVSS). All measures were gathered before the start of the study, and after termination of the trial (after 6 weeks). Results. Both focus and radial ESWT showed significant advance in scar thickness and MVSS post treatment (p > 0.001), without statistical differences between them (p > 0.05), while group C showed only a significant diminution in MVSS post treatment (p > 0.001), without any change in scar thickness. Conclusion. Higher statistical results were achieved with both focus and radial ESWT without any side effects, confirming the safety and efficiency of ESWT in HTS management.

Key words:
hypertrophic scar, Extracorporeal Shock Wave Therapy (ESWT), Modified Vancouver Scar Scale (MVSS), ultrasonography

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Functional symptoms of core stability improvement in rehabilitation of patients with low back pain syndrom

Tomasz Łosień, Krzysztof Banasiak, Katarzyna Kniaziew-Gomoluch, Marek Woszczak, Beata Kita

T. Łosień, K. Banasiak, K. Kniaziew-Gomoluch, M. Woszczak, B. Kita – Functional symptoms of core stability improvement in rehabilitation of patients with low back pain syndrome. Fizjoterapia Polska 2019; 19(4); 142-148

Abstract
Aim. The goal of the below work was to estimate the effectiveness of deep torso muscles exercises and its influence on the low back pain syndrome.
Material and methods: Research group consisted of 46 individuals, including 30 women and 16 men, who suffered from the low back pain syndrome. Age range of patients was between 32 and 62 years old, with the average age of 47 years old. Two research tools were used in the above work, the international questionnaire Revised Oswestry Low Back Pain Disability which contains 10 questions about the pain sensations during performing daily activities, and self-created questionnaire containing 6 questions including one about the level of pain felt by the patient. After filling both questionnaires patients took part in the 30 day long rehabilitation program where exercises strengthening the deep torso muscles were performed. After they finished the program, the individuals were asked to fill questionnaires again.
Results. Total level of health complaints after training cycle was 7.91 and decreased in a statistically significant way in relation to the value before the training cycle when it was 23.59, the difference being 15.67. The results arousing from the study clearly indicate a decrease in pain sensations among patients submitted to this analysis. After a full monthly therapy, average perceptible pain measured by the VAS scale decreased by 2.2 points and amounted to 3.67 points.
Conclusions. Performed tests clearly indicate that deep muscle exercise therapy repeated in cycles significantly reduced the subjective pain sensations among examined patients. General physical fitness improvement was also observed. Final results of research prove that strengthening of the torso muscles is an effective way of low back pain treatment.

Key words:
low back pain syndrome, functional training, deep torso muscles, VAS, Revised Oswestry Low Back Pain Disability Questionary

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Effect of Pilates Exercises on Shoulder Dysfunction Post Thyroidectomy: A Prospective Randomized Controlled Trial

Ereny S. Wahba, Noran A. Elbehary, Reda Kotb Abd Elrazik, Hamada Ahmed Hamada

Ereny S. Wahba, Noran A. Elbehary, Reda Kotb Abd Elrazik, Hamada Ahmed Hamada – Effect of Pilates Exercises on Shoulder Dysfunction Post Thyroidectomy: A Prospective Randomized Controlled Trial. Fizjoterapia Polska 2019; 19(4); 136-141

Abstract
Introduction. Thyroid cancer is the most common type of cancer in the endocrine system. Thyroidectomy has potential complications. Shoulder dysfunction is the most reported physical complication following neck dissection surgery post thyroidectomy. Various treatment is utilized to diminish or counteract shoulder distortion. The purpose of this study was conducted to determine the effect of Pilates Exercises on Shoulder Dysfunction after Thyroidectomy. Methods. A prospective, randomized, controlled study with the pretest-posttest design was performed; 50 patients who were 6 months to 1-year post unilateral neck dissection and aged 30-50 years (at the time of surgery). They were randomly assigned to 2 groups: Experimental Group (Group- A): (25 Patients, 14 males and 11 females) were treated with Pilate’s exercises in the clinic under the supervision of a physiotherapist, for 12 weeks, 3 sessions /week. Control Group (Group-B): (25 patients, 12 males and 13 females) were treated with conventional therapy. All treatment interventions were applied at the frequency of 3 sessions/week for 12 weeks. The participants were recruited from the National Cancer Institute in Cairo to be treated in the outpatient clinic, Faculty of Physical Therapy, Cairo University at the period from September 2018 and May 2019. Results. Outcome measures were taken with Shoulder Pain and disability index (SPADI) was developed to evaluate the shoulder pain and disability and Shoulder range of motion: Active ROM of shoulder flexion, abduction, and external and internal rotation; was measured by a digital goniometer, before the treatment, and 12 weeks after the intervention. The comparison among the 2 groups revealed that there was a significant decrease in pain, disability and total percentage of SPADI of group A compared with that of group B (p < 0.05); Also there was a significant increase in flexion, abduction, external and internal shoulder ROM of group A compared with that of group B (p < 0.05). Conclusions. It was concluded that Pilate’s exercises have greater efficacy than conventional therapy in the rehabilitation of patients with shoulder dysfunction post thyroidectomy.

Key words:
thyroidectomy, shoulder dysfunction, Pilate’s exercises

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Comparison of the effectiveness of two health resort therapy programs in office workers with the pain in the cervical spine occurring in the course of degenerative changes

Ewa Puszczałowska-Lizis, Kamila Dobrucka, Izabela Zbrońska

E. Puszczałowska-Lizis, K. Dobrucka, I. Zbrońska – Comparison of the effectiveness of two health resort therapy programs in office workers with the pain in the cervical spine occurring in the course of degenerative changes. Fizjoterapia Polska 2019; 19(4); 126-135

Abstract
Background. Back problems become a medical and social problem in the era of modern civilization. Wide variety of pain syndromes, their recurrent character and persisting pain in chronic cases prompts the search for effective diagnostic and therapeutic methods. The aim of the study was to compare the effectiveness of two spa therapy programs in alleviating pain and eliminating functional limitations in office workers with degenerative disease of the cervical spine.
Material and methods. The study involved 144 office workers aged 45-55, staying on a rehabilitation stay due to pain in the cervical spine caused by degenerative changes. Patients were divided into two groups depending on the rehabilitation programme administered. Research tools was functional tests of the cervical spine (Valsalva, Kernig, compression test and traction test), linear measurements of ranges of cervical spine, NRS scale and NDI questionnaire. The data were analyzed based on the Chi-square test, Student t test, Mann Whitney U test, Wilcoxon test.
Results. In both groups, after improvement, a statistically significant improvement was noted in terms of functional test results, cervical spine movement ranges, NRS scale values and NDI index. The differences in the results obtained in Test II in relation to I were significantly greater for patients from group I. The application of both therapeutic programs had an effect on alleviating pain and improving functional capacity.
Conclusions. Application of both programs contributed to the relief intensity of pain and improved functional capacity, however, the extent of improvement was significantly greater in the case of patients subjected to a program containing mud therapy.

Key words:
cervical spine, pain, functional capacity, balneotherapy

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Exercise on Maternal and Neonatal Outcomes in Obese Elderly Primigravida: A Randomized Clinical Trial

Eman Awad, Amir N Wadee, Heba Ali Abd EL-Ghaffaar, Hamada Ahmed Hamada

Eman Awad, Amir N Wadee, Heba Ali Abd EL-Ghaffaar, Hamada Ahmed Hamada – Exercise on Maternal and Neonatal Outcomes in Obese Elderly Primigravida: A Randomized Clinical Trial. Fizjoterapia Polska 2019; 19(4); 120-125

Abstract
Background. In obstetric practice, advanced maternal age such as in case of elderly primigravida is known to be associated with adverse maternal and fetal outcomes. Obesity is a commonly occurring risk factor with advancing maternal age. Exercise in pregnancy could prevent and limit adverse maternal and fetal morbidities. Further research was warranted to study the effect of exercise in this high risk group due to lack of research in this area. Objective. To investigate the effect of a specialized exercise program combined with diet conducted early in pregnancy on maternal and neonatal outcomes in obese elderly primigravida. Methods. Design: A randomized, clinical, controlled trial. Setting: The study was conducted at physical therapy Department of Bab El-Sharia University Hospital, Egypt, between May 2016 and May 2017. Participants: 80 obese elderly primigravida participants enrolled into experimental and control groups. Interventions: The experimental group participants were closely supervised to perform the exercise program starting from 14 weeks’ gestation till 37 weeks’ gestation with a moderate restricted diet and received advice specific to each trimester of pregnancy, while the control group participants were provided with specific instructions to perform the exercise program with the same diet and advice. Outcome measures: Primary outcome measure was the last BMI of each participant measured at 37 weeks of gestation while the secondary outcome measures were mode of delivery, neonatal weight and neonatal APGAR score. Results. Eighty obese elderly primigravida (control group n = 40; experimental group n = 40) were randomized. There were statistical significant differences between groups in last BMI, mode of delivery and neonates APGAR scores at 1st minute of life and 5th minute of life (p < 0.05). While, there was no statistical significant difference between groups in neonatal weight (p > 0.05). Conclusion: A specialized antenatal exercise program is very effective in decreasing maternal and neonatal complications in obese elderly primigravidae and their off springs.

Key words:
elderly primigravida, obesity, neonatal outcomes, maternal outcomes, exercise

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