Physical Therapy

Effect of intradialytic aerobic exercise on patients with diabetic nephropathy Abdel Raoof A Neveen, El Nahas G Nesreen, Marae K Nadia, Galal M Al Shaimaa Bulletin of Faculty of Physical Therapy 2019 24(1):1-7 Background Diabetes is a major health problem in nowadays’ society, as the number of patients with diabetes is growing continuously with their diabetic complications, especially kidney diseases, which is the most feared complication because of its substantial comorbidity, cost, and mortality. Purpose The aim of this study was to determine the effect of intradialytic aerobic exercise on kidney functions tests [serum calcium, serum creatinine, urine creatinine, urine albumin, and estimated glomerular filtration rate (GFR)] in patients with diabetic nephropathy. Materials and methods Thirty patients of both sexes (19 male and 11 female) under hemodialysis with a mean age of 54.13±4.32 years were selected from the renal rehabilitation unit of Edfou General Hospital. They were assigned randomly to two groups of equal number. Group A received a moderate-intensity intradialytic aerobic exercise program (12–13 on rate of perceived exertion scale), and group B received their regular dialysis program only. The treatment program continued for 8 weeks (three exercise sessions per week). Laboratory investigations for serum calcium, serum creatinine, urine creatinine, urine albumin, and estimated GFR were carried out at the beginning and after the end of the treatment program in both groups. Results The results of this study revealed a significant increase in serum calcium in group A compared with group B, and a significant decrease in serum creatinine and urine creatinine in group A compared with group B (P=0.03 and 0.04, respectively). There was no significant change in urine albumin and estimated GFR between the two groups. Conclusion Moderate-intensity intradialytic aerobic exercise (12–13 rate of perceived exertion scale) is beneficial in modulating serum calcium, serum creatinine, and urine creatinine in diabetic nephropathy patients.

Balance training: its influence on pulmonary rehabilitation Khaled M Mounir, Noha S Elserty, Hany E Obaya Bulletin of Faculty of Physical Therapy 2019 24(1):8-13 Background Balance disorders are one of the most important complications for patients with chronic obstructive pulmonary disease (COPD). Objective To investigate the effect of adding balance training to pulmonary rehabilitation program in improving balance in patients with COPD. Patients and methods A total of 48 male patients diagnosed as having COPD were selected from the outpatient clinic of Wadi El-Neel Hospital, Cairo, and their ages ranged from 60 to 65 years. Patients were assigned randomly into two equal groups. The study group received balance training with pulmonary rehabilitation program, and the control group received pulmonary rehabilitation program only. Exercise training was performed for both groups three times a week for 8 weeks. Balance assessment was performed by Berg Balance Scale, Balance Evaluation Systems Test, and 6-min walking test before and after training. Results The 2×2 mixed-model analysis of variance analysis demonstrated significant increase in the Berg Balance Scale and Balance Evaluation Systems Test after treatment in both groups, with a percentage of improvement in control group was 5.01 and 9.15%, respectively, whereas in the study group was 16.04 and 25.46%, respectively. However, the study group showed significant improvement than the control group after treatment in both tests. Regarding 6-min walking test, both groups showed significant increase after treatment, with a similar percentage of improvement in the control group (23.95%) and the study group (24.93%). There was no significant difference between the control and the study group after treatment. Conclusion Addition of balance training to pulmonary rehabilitation program was more effective in improving balance in elderly patients with COPD.

The interaction of sex and body mass index on ventilatory functions in school children Eman Wagdy, Samy A Nasef Bulletin of Faculty of Physical Therapy 2019 24(1):14-19 Purpose This study was designed to study the interaction of sex and BMI on ventilatory functions in Egyptian school children. Design A cross-sectional study among the school children aged 8–12 years. Patients and methods Two hundred and nineteen normal children of both sexes (118 boys and 101 girls), their ages ranged between 8 and 12 years, were selected from one of the Egyptian governmental primary schools, Educational Administration, East Cairo, participated in this study. They were divided into two groups based on their BMI (low BMI 115 and normal BMI 104 consequently). Then each group was subdivided according to the sex (67 boys and 48 girls for low BMI subgroup while in normal BMI subgroup 51 boys and 53 girls were included). Anthropometric measurements were used to calculate the BMI. Ventilatory functions were measured using a spirometer. Results The results revealed statistically significant interaction between the effect of sex and BMI on forced vital capacity (P≤0.0001), forced expiratory volume in the first second (P≤0.0001) and no statistically significant interaction on forced expiratory volume in the first second/forced vital capacity % (P=0.44). Furthermore, there was no difference between boys and girls among the measured ventilatory functions. Conclusion There was an interaction between the effect of sex and BMI on ventilatory functions among Egyptian school children. Therefore, healthy nutrition and exercises are highly recommended in children with low BMI.

Acute response of serum cortisol to different intensities of resisted exercise in the elderly Mona M Taha, Khaled M Mounir Bulletin of Faculty of Physical Therapy 2019 24(1):20-25 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.

Impact of chronic kidney disease on anthropometric profile, health-related quality of life and cognitive function in children Amira M. Abd El-Monem Bulletin of Faculty of Physical Therapy 2019 24(1):26-31 Background Chronic kidney disease (CKD) is commonly labelled as a silent killer associated with multiple comorbid conditions. Purpose To explore the impact of CKD on anthropometric profile, health-related quality of life (QoL) and cognitive function in children. Patients and methods A total of 150 children with CKD, age ranged from 8 to 12 years were assigned according to glomerular filtration rate into three groups of equal numbers; group I (stage 2 and 3), group II (stage 4) and group III (stage 5). Anthropometric measurements, QoL and cognitive function were measured and compared to 100 healthy age-matched groups. Results Compared with normal children, children with CKD showed a statistically significant short stature, low body weight, anaemia and poor QoL and cognitive impairments. Moreover, those at stage 5 yielded the worse scores. Conclusion CKD is associated with comorbid conditions as growth failure, anaemia, poor QoL performance and cognitive impairments.

Lidocaine iontophoresis for postmastectomy intercostobrachial neuralgia: single-blinded randomized controlled trial Nancy H Aboelnour, Walid A Abouelnaga Bulletin of Faculty of Physical Therapy 2019 24(1):32-39 Aim The aim was to investigate the efficacy of lidocaine iontophoresis for neuropathic pain management in intercostobrachial neuralgia after mastectomy. Design A single-blinded randomized controlled trial was conducted. Patients and methods A total of 40 patients with partial or radical mastectomy were randomly divided into two equal groups: group A (lidocaine iontophoresis) and group B (lidocaine patch). The methods of assessment included visual analog scale (VAS) and pain DETECT questionnaire. Group A received lidocaine iontophoresis day after day for 4 weeks. Group B received lidocaine 5% patch (LIDODERM) onto the painful area for 12 h daily. Treatment program extended for 1 month, whereas evaluation was done before and after treatment. Results There was no significant difference between both groups in VAS (0.14) and pain DETECT questionnaire (0.32), before treatment. Comparison between groups after treatment revealed a significant reduction in VAS and pain DETECT questionnaire of group A compared with that of group B (P=0.0001). The percent of reduction in VAS of groups A and B was 86.47 and 61.11%, respectively, whereas the percent of reduction in pain DETECT questionnaire was 76 and 49.57%, respectively. Conclusion It was concluded that lidocaine iontophoresis was safe and effective method for intercostobrachial neuralgia management after mastectomy in expression of decreasing pain intensity and quality.

The effect of 12 weeks of resistive exercises versus aerobic exercises in overweight hypertensive postmenopausal women Ghada E El-Refaye, Hanaa A Younis Bulletin of Faculty of Physical Therapy 2019 24(1):40-48 Background Hypertension is the most important risk factor that affects women in the early years of postmenopausal period. Approximately 30–50% of the women develop hypertension before starting the age of 60 years, and beginning of hypertension can cause a variety of manifestations that are frequently associated with menopause. Objective The aim of this study was to determine and compare the effect of 12 weeks of resistive exercises versus aerobic exercises for the treatment of postmenopausal hypertension. Participants and methods A total of 60 postmenopausal women with hypertension were included. Their ages ranged from 50 to 60 years old; their BMI ranged from 30 to 34.9 kg/m2; and their blood pressure ranged between 140/90 and 170/105 mmHg. They were randomly assigned to group A, which received resistive exercises; group B, which received aerobic exercises; or group C (control group), which received antihypertensive medication (bisoprolol fumarate 5 mg). The three groups followed the treatment program for 12 weeks. Assessment of the systolic blood pressure (SBP) and diastolic blood pressure (DBP) for all participants in the three groups (A, B, and C) was carried out before, after 6 weeks, and after the end of the treatment program through the use of mercury column sphygmomanometer. Results All groups (A, B, and C) recorded a significant decrease in both SBP and DBP values (P=0.001, 0.001, and 0.003, respectively, and P=0.001, 0.001, and 0.009, respectively) after the end of the 12 weeks of the treatment program when compared with their corresponding values measured before treatment. However, the participants in group A exhibited a greater reduction in DBP more than groups B and C. Conclusion These results suggest that the resistance exercises may be more effective than aerobic exercises in reducing SBP and DBP in postmenopausal women.

Alterations of static and dynamic balance in patients with lumbar radiculopathy Mary K.N Takla Bulletin of Faculty of Physical Therapy 2019 24(1):49-55 Background Lumbosacral radiculopathy (LR) is strongly associated with delayed recovery and persistent disability. Chronic LR may lead to somatosensory system impairment, resulting in decline of postural balance. Purpose The aim of the study was to investigate static and dynamic postural balance alterations in individuals with LR owing to lumbar disc herniation. Participants and methods In this case–control study design, 12 patients presenting with unilateral LR were included, whereas 12 normal individuals were randomly selected for control. Static balance was assessed functionally using Functional Reach Test. Dynamic balance was assessed via Biodex Balance System, where postural stability indices and the dynamic limits of stability were evaluated. Dynamic limits of stability parameters were expressed as direction control and time required to complete the test. Results There was significant reduction of mean values of Functional Reach Test in LR group (P<0.0001) when compared with the control. In addition, there was a significant increase of the mean values of overall stability index (P<0.0001) and postural stability indices (P<0.0002) and a significant decrease of the mean values of direction control (P<0.0001) in the LR group. Conclusion Patients with chronic LR have shown to have limited functional abilities and decreased postural balance both statically and dynamically when compared with normal individuals.