Author: Ahmed Aboulfotouh Elsayed Abdallah, Wadida Hassan Abdelkader, Rania Nagy Karkousha, Hatem M. El Azizi

Prone Versus Supine Traction in Treatment of Cervical Disc Bulge: A Randomized Controlled Trial

Ahmed Aboulfotouh Elsayed Abdallah, Wadida Hassan Abdelkader, Rania Nagy Karkousha, Hatem M. El Azizi

Ahmed Aboulfotouh Elsayed Abdallah, Wadida Hassan Abdelkader, Rania Nagy Karkousha, Hatem M. El Azizi – Prone Versus Supine Traction in Treatment of Cervical Disc Bulge: A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(3); 158-163

Abstract
Background. Disc bulge could lead to compression on adjacent nerve root causing neurological deficits. The purpose of this study is to compare between the effect of prone traction versus supine traction on the neck function and on the size of disc bulge in patients with cervical disc bulge.
Methods. Randomized controlled clinical trial design, 45 patients diagnosed with cervical disc bulge at C5-C6 and /or C6-C7 levels, their ages ranged from 40 to 50 years and were randomly distributed into three equal groups (A, B and C), the three groups received conventional physical therapy for cervical disc bulge, for (group B) traction from prone position was added and for (group C) traction from supine position was added. All participants received 3 sessions per week for one month. The assessment done before and after one month of treatment using neck disability index for neck function disability while size of disc bulge was assessed by using magnetic resonance image.
Results. A statistical significant decrease in the neck disability index scores of the three groups post treatment in comparison with that of pretreatment with high statistical significant decrease in the scores of group B and C post treatment in comparison with that of group A, while there was no statistical significant difference between group B and C in post treatment scores. There were no statistical significant differences between the post treatment measures in comparison with that of the pretreatment for the three groups regarding disc bulge size.
Conclusions. Adding cervical traction to the conventional physical therapy program for cervical disc bulge at C5-6 and /or C6-7 levels can yield more increase in the neck function compared with conventional physical therapy only, while the position of the patient during traction has no effect on the outcome measures.
Key words:
Traction, Cervical disc, Neck disability index
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The effect of hippotherapy on children with autism – physical and psychological factors

Włodzisław Kuliński, Łukasz Bomba

W. Kuliński, Ł. Bomba – The effect of hippotherapy on children with autism – physical and psychological factors. Fizjoterapia Polska 2020; 20(3); 142-156

Abstract
Introduction. Autism is considered to be a developmental disorder, probably determined by biological causes, and manifesting itself in various aspects of a child’s functioning.
Aim. The aim of the study was to assess the effect of 1-year hippotherapy on the physical and mental functioning in autistic children in selected aspects.
Material and methods. The study involved parents and their autistic children aged 5 to 7 years who had undergone hippotherapy in the previous 2 years. A modified version of the PEP-R, accompanied by a questionnaire prepared by the authors to analyse the demographic and social aspects as well as the course of the disorder, was used to assess the influence of 1-year pedagogical and educational efforts on various areas of development in the autistic children. A statistical analysis was conducted with Student’s t-test and Pearson’s correlation coefficient. The statistical significance level was set at p < 0.05.
Results. The 1-year therapeutic process using hippotherapy resulted in an improvement in motor skills and emotional responses in the autistic children. A high level of motor skills in children with autism has beneficial effects on their emotional state. Children with a milder form of autism show a higher level of physical and mental functioning than children with moderate and severe autism.
Conclusions. Hippotherapy constitutes a part of therapy used in patients with autism.
Key words:
autism, treatment, hippotherapy
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Effect of Electromyogram-Triggered Stimulation versus Alternating Electromyogram Stimulation on Hand Functions in Chronic Stroke Patients: A randomized controlled trial

Dany Alphonse Anwar Habib, Abeer AboBakr El-Wishy, Ebtessam Mohamed Fahmy, Heba A. Bahey El Deen, Shaimaa Shaheen Mohammed, Abd El-HamiedIbrahim El-Sayed Mohammad

Dany Alphonse Anwar Habib, Abeer AboBakr El-Wishy, Ebtessam Mohamed Fahmy, Heba A. Bahey El Deen, Shaimaa Shaheen Mohammed, Abd El-HamiedIbrahim El-Sayed Mohammad – Effect of Electromyogram-Triggered Stimulation versus Alternating Electromyogram Stimulation on Hand Functions in Chronic Stroke Patients: A randomized controlled trial. Fizjoterapia Polska 2020; 20(3); 172-179

Abstract
Aim. The purpose of this study is to compare between electromyogram-triggered stimulation versus alternating electromyogram stimulation on hand function in chronic stroke patients. Material and Methods. Forty five chronic stroke patients of both sexes were divided into 3 equal groups (A, B and C). Each group received the same designed physical therapy program for hand function training in addition to electromyogram-triggered stimulation for group A and alternating electromyogram stimulation for group B. Each patient was assessed before and after the two months of intervention protocol by box and block test to evaluate manual dexterity and by electromyography (EMG) threshold to evaluate peak muscle torque. Results. There was significant post-treatment increase in manual dexterity and peak muscle torque mean scores in all groups. The percentage of improvement was higher in group B compared to other groups. Conclusion. Adding alternating electromyogram stimulation or electromyogram-triggered stimulation to a designed physical therapy program for hand function training improves hand function and peak muscle torque in chronic stroke patients. Alternating electromyogram stimulation was more effective than electromyogram-triggered stimulation.
Key words:
Electromyogram-triggered stimulation, alternating electromyogram stimulation, rehabilitation; stroke, hand function
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Effect of Forward Head Posture Correction Added to Lumber Stabilization Exercises on Lumbopelvic Organization in Mechanical Low Back Pain Patients: A Randomized Clinical Trial

Aliaa M Elabd, Ahmed I Elerian, Salah-Eldin B Ahmed, Haytham M Elhafez, Ahmed F Geneidy, Ahmed Atteya Ashour, Omar M Elabd

Aliaa M Elabd, Ahmed I Elerian, Salah-Eldin B Ahmed, Haytham M Elhafez, Ahmed F Geneidy, Ahmed Atteya Ashour, Omar M Elabd – Effect of Forward Head Posture Correction Added to Lumber Stabilization Exercises on Lumbopelvic Organization in Mechanical Low Back Pain Patients: A Randomized Clinical Trial. Fizjoterapia Polska 2020; 20(3); 132-140

Abstract
Background. Although current Lumbar Stabilization Exercises (LSEs) is beneficial for chronic mechanical low back pain (CMLBP), further research is recommended focusing on normalizing sagittal lumbopelvic alignment. Subjects with forward head posture (FHP) possibly have a problem with the regulation of static upright posture.
Purpose. This study was conducted to determine the effects of adding FHP correction to LSEs on pain, functions and lumbopelvic sagittal alignment in CMLBP patients.
Materials and Methods. Forty adult patients with CMLBP and FHP were assigned into one of two groups. Group A received FHP correction exercises in addition to LSEs for 12 weeks, while group B received only lumber stabilization for 12 weeks. The primary outcome was lumber lordosis (LL). Secondary outcomes included pain intensity, back specific physical functioning, cranio-vertebral angle (CVA), pelvic tilt (PT), pelvic incidence (PI), and sacral slope (SS). Patients were assessed pre and post treatment by an assessor blinded to the patients’ allocation. Reported data was analyzed by Mixed-model-MANOVA.
Results. MANOVA indicated a significant group-by-time interaction (P= 0.00, Partial η2= 0.65). LL, Pain, and SS were reduced in group A more than B. Physical function, CVA, and PT were increased in A when compared to B. There was no significant group-by-time interaction for PI. Within-group comparisons revealed significant differences for all measured variables in both groups except for CVA and PI in the control one.
Conclusion. The addition of FHP correction to LSEs for management of CMLBP seemed to positively affect pain, functioning, and lumbopelvic organization.
Key words:
Exercises, Low Back Pain, Posture, Stabilization
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Physiotherapeutic practice in context of evidence-based medicine

Piotr Bednarski

P. Bednarski – Physiotherapeutic practice in context of evidence-based medicine. Fizjoterapia Polska 2020; 20(3); 122-130

Abstract
The growing awareness of evidence-based practice among physiotherapists is still not reflected by the routine clinical practice as a binding standard. This article discusses some of the barriers to recognisable evidence and presents possible solutions for data presented in the light of medicine and evidence-based practice.
This paper is for reference only. The objective of the study is to systematise existing knowledge about the principles of practice and evidence-based medicine in the context of physiotherapeutic practice.
This article discusses some of the barriers to recognisable evidence and presents possible solutions for data presented in the light of medicine and evidence-based practice. However, it is necessary to establish appropriate rules that should be followed when evaluating interventions undertaken by a physiotherapist.
Key words:
phystiotherapy practice, evidence based medicine, evidence based practice
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Impact of pulsed electromagnetic on chronic pelvic inflammatory disease: A randomized controlled trial

Eman Abdelfatah Mohamed Elhosary, Hamada Ahmed Hamada, Mahmoud Ewidea, Zizi M. Ibrahim

Eman Abdelfatah Mohamed Elhosary, Hamada Ahmed Hamada, Mahmoud Ewidea, Zizi M. Ibrahim – Impact of pulsed electromagnetic field on pain level in Females with chronic pelvic inflammatory disease: A randomized controlled trial. Fizjoterapia Polska 2020; 20(3); 116-120

Abstract
Purpose. Pelvic inflammatory disease (PID) is an infection-induced inflammation of the female upper reproductive tract some cases not respond to medical treatment, the aim of the study to detect the effect of pulsed electromagnetic (PEMF)in treatment of chronic pelvic inflammatory disease. Materials and Methods. this study was designed as single blind randomized controlled trial. Forty females complain from PID, their age ranged from (20-40) years and their body mass index (BMI) not exceeds 30 kg/m², they and were randomly assigned into 2 equal groups: Study group (A) received oral antibiotic (doxycycline100 mg) twice daily for 7 days in addition to PEMF for1 hour, 3 times per week for 12 sessions with 50 Hz in frequency and 60 G in intensity. Control group (B) received routine medical treatment by oral antibiotic (doxycycline100 mg) twice daily for 7 days. Both groups were assessed by present pain intensity scale, estimation of C-reactive protein and ESR level in blood before the treatment and after 12 sessions of PEMF. Results. There were significant differences in pain scores presented by Mean Difference (MD) and 95% Confidence Interval(CI) (MD 2; 95%CI 1.8 to 2.21), ESR (MD 16.75; 95%CI 13.973 to 19.52) and CRP (MD 35.8; 95%CI 31.97 to 39.63) between the both groups. The significant improvement from pretreatment to post treatment, was seen in all dependent variables at study group (p < 0.05) and in pain severity and CRP in control group. Conclusion. Pulsed electromagnetic yields improvement in pain and decrease in inflammation measured by decrease inflammatory markers in the treatment of pelvic inflammatory disease.
Key words:
Pelvic inflammatory disease, Pulsed electromagnetic field, ESR, C-reactive protein
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Methods of manual rehabilitation and assessment of their effectiveness on the example of a patient after temporomandibular joint dislocation

Przemysław Pasiak, Tomasz Tomaszewski

P. Pasiak, T. Tomaszewski – Methods of manual rehabilitation and assessment of their effectiveness on the example of a patient after temporomandibular joint dislocation. Fizjoterapia Polska 2020; 20(3); 108-114

Abstract
Introduction. The paper presents rehabilitation methods used for facial cranial diseases, and also discussed the most common causes predisposing to dislocation of the temporomandibular joint. These disorders are a multifaceted problem. In their healing process, at various stages, it is necessary to involve both specialists in maxillofacial surgery, orthodontists, speech therapists, psychologists and physiotherapists.
Objective of the work. The aim of the study was to discuss physiotherapy methods used in the treatment of temporomandibular joint disorders and to assess their effectiveness on the example of a patient after a right temporomandibular joint dislocation.
Materials and methods. In the work based on the description of the patient who came to the physiotherapy office in whom the right temporomandibular joint was dislocated, the therapeutic procedure used by specialists in the field of maxillofacial surgery and physiotherapists was presented.
Results. The implementation of rehabilitation brought the following effects: increasing the range of mobility of the jaw, reducing pain, reducing edema, and muscle relaxation.
Conclusions. Physiotherapy should be one of the elements of comprehensive treatment of patients with temporomandibular joint disorders.
Key words:
temporomandibular joint, rehabilitation, maxillofacial surgery
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Effect of interferential Electrical Stimulation on pain perception and disability level on Interstitial Cystitis: a randomized controlled trial

Ghada Ebrahim El Refaye, Hamada A. Hamada, Ibtissam M. Saab, Najlaa Fathi Ewais

Ghada Ebrahim El Refaye, Hamada A. Hamada, Ibtissam M. Saab, Najlaa Fathi Ewais – Effect of interferential Electrical Stimulation on pain perception and disability level on Interstitial Cystitis: a randomized controlled trial. Fizjoterapia Polska 2020; 20(3); 102-106

DOI: https://doi.org/10.56984/8ZG140EA9

Abstract
Background. Interstitial cystitis is a range of urological manifestations that are characterized by bladder, pelvic and urethral pain, just as irritative voiding side effects. It is characterized by the International Continence Society as the protest of suprapubic pain, identified with bladder filling combined by different manifestations, for example, expanded day time and evening time recurrence, without demonstrated urinary contamination or different evident pathology of the lower urinary tract. Objective. To investigate the effect of interferential electrical stimulation on pain perception and disability level on interstitial cystitis. Participants and methods. A total of 40 volunteering women diagnosed with interstitial cystitis. Their ages were ranged between 25 to 40 years old and their body mass index was > 30 kg/m2. Participants were randomly assigned to two equally numbered groups; group (A) receiving interferential current at the lower abdomen, in addition to a routine medical intervention, or group (B) receiving solely routine medical intervention for 8 successive weeks. Participants were assessed for pain using visual analog scale (VAS), related disability index using levels using O’Leary–Sant Symptom Index or Interstitial Cystitis Index (ICSI), and blood cortisol concentration. Measurements were taken before and after eight weeks of intervention. Results. The analysis of the results revealed a significant reduction in VAS score (P < 0.0001), ICSI scores (P < 0.0001), and the plasma cortisol concentration (P < 0.0001) in the participants of group (A) at the end of the treatment, compared to group (B). Conclusion. These results concluded that adding IC therapy to routine medical intervention had an excellent effect on the management of interstitial cystitis associated signs and symptoms particularly pain, plasma cortisol levels, related disabilities.
Key words:
Interferential current, pain perception, disability level, interstitial Cystitis
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Place of physical therapy with particular emphasis on exercises and massage in the treatment of patients with Ankylosing Spondylitis

Mateusz Wojciech Romanowski

M. W. Romanowski – Place of physical therapy with particular emphasis on exercises and massage in the treatment of patients with Ankylosing Spondylitis. Fizjoterapia Polska 2020; 20(3); 90-101

Abstract
Place of physical therapy with particular emphasis on exercises and massage in the treatment of patients with Ankylosing SpondylitisThe process includes the sacroiliac joints, spinal joints and ligaments, fibrous rings and peripheral joints. From 0.1% to 0.5% of the population in Central Europe suffer from AS. Treatment of patients with AS requires, first of all, combining pharmacotherapy with non-pharmacological treatment including mainly: physical exercise, massage, participation in self-help groups, education, manual therapy, hydrotherapy, electrotherapy, acupuncture, balneotherapy, spa therapy, systemic cryotherapy, lifestyle modification. So far, no single, proper algorithm for non-pharmacological treatment of patients with AS has been developed.
Key words:
Ankylosing spondylitis, physiotherapy, rheumatology, exercise, massage
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Influence of Vestibular Rehabilitation on Balance and Dual-Task Cost of Walking in Patients with Multiple Sclerosis: A Randomized Controlled Trial

Bassam A. El-Nassag, Amina Awad

Bassam A. El-Nassag, Amina Awad – Influence of Vestibular Rehabilitation on Balance and Dual-Task Cost of Walking in Patients with Multiple Sclerosis: A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(3); 84-89

DOI: https://doi.org/10.56984/8ZG1406E7

Abstract
Background. Balance dysfunction and high dual-task costs are eminent features in multiple sclerosis (MS). Vestibular rehabilitation therapy (VRT) proved to promote functional outcomes; yet, its influence on dynamic balance and dual-task cost of walking (DTCW) in MS needs further research.
Objective. To investigate the effect of adding VRT to aerobic training on dynamic balance and DTCW in people with MS.
Design. Single blinded, parallel randomized controlled trial.
Settings. Out-Patient Clinic at Faculty of Physical Therapy and Kasr Al-Ainy Multiple Sclerosis Unit, Cairo University, Egypt.
Participants. 40 patients with remitting-relapsing multiple sclerosis.
Intervention. Patients were randomized to a control (n = 20) and intervention (n = 20) groups. Over four successive weeks, all patients received stationary bicycle aerobic training. Intervention group received an additional VRT program.
Outcomes measures. Berg Balance Scale (BBS), walking speed tested by the 10 meters timed walk test (10 m-TWT), (DTCW), and overall stability index (SI).
Results. Intervention group showed a remarkable improvement in BBS (p = 0.02), SI at levels four (p = 0.002) and seven (p = 0.03), and DTCW (p = 0.03) compared with control group. Walking speed did not show significant changes post-treatment within or between groups comparison (P > 0.05).
Conclusion. Adding VRT to aerobic training has a positive effect on dynamic balance and dual-task cost of walking in MS.
Key words:
Multiple sclerosis, vestibular rehabilitation, dynamic balance, dual task cost of walking
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