KNEE JOINT PROPRIOCEPTION AND QUADRICEPS MUSCLE STRENGTH AMONG DIABETIC AND NON DIABETIC SUBJECTS

Background: Diabetes mellitus is a group of metabolic disorders characterized by increased blood sugar (glucose) levels (hyperglycemia) with absolute/relative deficiency in carbohydrate, protein and fat metabolism caused by defect in insulin secretion, action of insulin or both. Diabetes mellitus can be combined with problems/impairments which can lead to the decrease in muscles strength and proprioception specially, in the lower limbs. The purpose of the study is to investigate the knee joint repositioning accuracy as a measure of knee joint proprioception and peak torque of the quadriceps muscle as a measure of quadriceps strength between type II diabetic patients (in the first five years of the disease) and healthy subjects. Methods: Thirty male subjects aged between 35–55 years old were included in this study; they were assigned into two equal groups, the study group which included15 type II diabetic patients in early five years of the disease and the control group which included 15 healthy subjects. Active knee joint repositioning accuracy as a measure of knee joint proprioception and the isokinetic peak torque of the quadriceps muscle as a measure of quadriceps strength were measured for both groups by Biodex multipoint system, pro Isokinetic dynamometer. Results: The unpaired t test results between the two groups showed no significant differences in knee joint repositioning errors where P-value was (0.319) and also there was no significant difference in quadriceps muscle strength between the control and study groups where the P-value was (0.157). Conclusion: Knee joint repositioning accuracy and quadriceps muscle strength aren't affected in type II diabetes mellitus patients in early five years of the disease

ISOKINETIC TESTING OF ANKLE MUSCULAR STRENGTH AND PROPRIOCEPTION, BALANCE AND NERVE CONDUCTION IN PATIENTS WITH POLYNEUROPATHY

Background: Polyneuropathy is one of the most common chronic complications associated with diabetes mellitus, it is a damage to the peripheral nerves and manifested by signs and symptoms as numbness, irritation, and pain in the upper and lower limbs. This study aimed to evaluate muscular performance and proprioception at the ankle in diabetic neuropathic patients with quantitative and standardized tools and correlate these findings with those of sural nerve conduction velocity (sural NCV) and amplitude. Methods: Fifteen male patients with diabetic neuropathy participated in this study, with age ranged from 40 to 55 years, and fifteen age-matched healthy subjects participated as a control group. Biodex Isokinetic System was used to assess the strength of ankle dorsiflexors and planter flexors and ankle reposition accuracy. Berg balance test was used to assess balance. Sural nerve conduction velocity (NCV) and amplitude were examined by diabetic polyneuropathy check (DPN-check) device. Results: The results showed a significant decrease in the mean peak torque values of the plantar flexors and dorsiflexors and a significant increase in the reposition error in the diabetic neuropathic group (p=0.0001). The results also revealed a significant decrease in the mean values of the Berg balance scores in diabetic neuropathy group (p=0.0001). Sural NCV and amplitude tests revealed abnormal values (p<0.05). Conclusion: It was concluded that the isokinetic system is an objective and sensitive tool to detect the motor and sensory changes of the diabetic neuropathic patients, also an examination by DPN-check device help in the determination of the severity of the disease. Moreover, it can be concluded that there are strong correlations between duration of diabetes and sural nerve NCV and amplitude and the peak torque of the muscles around the ankle

Effect of adding systematic desensitization to goal-directed paradigm on risk of falling in patients with stroke: a randomized controlled trial

BackgroundImprovement in rehabilitation outcomes for patients suffering from chronic stroke can be attained through systematic desensitization of their fear of falling, which in turn reduces the risk of falling.PurposeThis study aimed to examine the effect of adding systematic desensitization to a goal-directed paradigm on functional performance, balance, risk of falling, and fear of falling among chronic ischemic stroke patients.MethodologyTwo equally sized groups, each comprising 40 stroke patients of both sexes, were randomly divided. For 8 weeks, Group A received three sessions per week of combined treatment consisting of systematic desensitization and a goal-directed paradigm, while Group B received only the goal-directed paradigm. The Timed Up and Go (TUG) test and Dynamic Gait Index (DGI) were used to assess function performance; the Berg Balance Scale (BBS) and the Biodex Fall Risk Index (FRI) were used to evaluate balance; and the 16-item Fall Efficacy Scale-International (FES-I) was used to evaluate fear of falling. At baseline and after the treatment, all measurements were obtained.ResultsBoth groups (A and B) revealed a substantial increase in functional performance through a decrease in TUG scores and an increase in DGI. Additionally, there was a decrease in the risk of falling through an increase in the BBS scores and a decrease in the FRI. Furthermore, there was a decrease in the fear of falling, as measured using the FES-I, after treatment, with superior improvement in Group A with a p-value of &lt;0.001.ConclusionSystematic desensitization combined with a goal-directed paradigm has a superior effect on improving functional performance and reducing the risk of falling and the fear of falling in patients with stroke compared to a goal-directed paradigm alone

Impact of foot reflexology combined with dietary modification on premenstrual syndrome: A randomized controlled trial

Article accepted.The article will be published here soon.Pending final quality checks

Impact of core stability exercises vs. interferential therapy on pelvic floor muscle strength in women with pelvic organ prolapse

OBJECTIVE: Pelvic organ prolapse (POP) is the descent of the pelvic organs into or through the vaginal walls. Females who have prolapse have symptoms that interfere with their daily lives, sexual function, and exercise. POP can have a negative effect on one’s sexuality and body image. This study attempted to assess the significance of core stability exercises vs. interferential therapy on the power of the pelvic floor muscles in females with prolapsed pelvic organs. PATIENTS AND METHODS: A randomized control trial was conducted on forty participants (aged between 40-60 years, diagnosed with mild degree pelvic organ prolapse participated in the research. Participants were randomly divided into two groups: (group A; n = 20) and (group B; n = 20). The participants were tested twice, before and after 12 weeks, during which group (A) performed core stability exercises while group (B) received interferential therapy. A modified Oxford grading scale and the perineometer were used to assess how the vaginal squeeze pressure changed. RESULTS: The study’s findings demonstrated that the modified Oxford grading scale values and vaginal squeeze pressure had a non-statistically significant difference (p-value ≥ 0.05) between both groups pre-treatment while had a statistically significant difference (p-value ≤ 0.05) between both groups post-treatment in favor of group A. CONCLUSIONS: It was concluded that both training programs are efficient at strengthening the pelvic floor muscles, but the core stability exercises were more effective

Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12–18 years) were randomized to PsCS (n = 27), PlyoML (n = 27), or a combined intervention (n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability—LoS), balance, and mobility (Community Balance and Mobility Scale—CB&M; Functional Walking Test—FWT; Timed Up and Down Stair test—TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP