Physiotherapy

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    Associations between motor coordination and cardiorespiratory fitness with academic achievement in school students (11-13 years) in the West Bank/Palestine
    (Al-Quds University, 2023-07-08) Wafa Abed Almote Tanineh; وفاء عبدالمعطي طنينه
    Children make up about half of the population in Palestine. Children in schools face numerous academic difficulties regarding academic achievement, and vital factors that may help children attain better academic achievement are good motor coordination and cardiorespiratory fitness. Objectives: This study aimed to investigate the association between motor coordination and cardiorespiratory capacity with academic achievement among school students (11—13 years) in the West Bank/Palestine. Methods: a cross-sectional study was conducted with a total of 252 students (11–13 years old) from various private schools in villages northwest of Jerusalem and the city of Ramallah. The sample was divided into two equal groups (males and females) using a stratified random sample. Motor coordination and physical fitness measures were evaluated by the flamingo balance test, plate tapping test, alternative wall toss test, and modified bass dynamic balance test. Cardiorespiratory fitness was evaluated by the 3-minute step test. Academic performance was obtained through students' grade point average (GPA) scores at the end of the school previous year and the current year, additionally, the rate of subjects: mathematics, language (Arabic), and foreign language (English) was recorded and computed. The Mann-Whitney Test, Kruskal Wallis Test, and Spearman's rank correlation coefficient were used to examine the association between motor coordination and cardiorespiratory capacity and academic achievement variables. The statistical significance level was set at p<.05. Results: There was a significant correlation between academic achievement and motor coordination (p=.00), and cardiorespiratory capacity (p=.00) among school students (11-13 years). A linear regression result indicated that a significant correlation was recorded between Modified balance, Alternate Hand Wall Toss (AHWT), three minutes, The number of study hours per day for the student, and grade point average current year (p<.05). In addition, there is a statistically significant correlation (p=.00) between fine and gross coordination. Also, students who practice physical activity and sports had better coordination, cardiorespiratory capacity, and academic achievement compared to students who don’t (p=.00). Conclusion: This study showed that motor coordination and cardiorespiratory capacity among school students positively correlated academic achievement. Therefore, promoting physiotherapy and physical activity interventions to enhance cardiorespiratory capacity and motor coordination in school students is recommended and encouraged.
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    Clinical, Physical, Psychological, and Functional Impacts of A suggested Quantified-Modeling for Progressive Core Stability Exercise in Tele-Physiotherapeutic Management of Discopathy- Low Back Pain
    (Al-Quds University, 2024-07-11) Hiba Mohammad saadi Nimer ALFakhori; هبة محمد سعدي نمر الفاخوري
    Low back pain (LBP) caused by Discopathy is a frequent problem that harms how people live and function. Core stability exercises in physical therapy help to enhance muscular strength, proprioception, and function. Tele-physiotherapy with mobile apps provides remote, full rehabilitation programs. These technologies offer effective LBP care through easily available, supervised activities, possibly enhancing results and adherence without requiring in-person visits. Purpose: The study aimed to enhance functional performance and overall patient care in the region by investigating the efficaciousness of core stability exercises as Tele-physiotherapeutic intervention delivered through WhatsApp technology to manage Discopathy- low back pain in Palestine. Method: In a quasi-experimental study, 30 women with disc herniation-related lower back pain (DP-LBP) were non-randomly chosen from Hebron's Tariq Bin Ziyad Community Center to participate in one group therapy intervention using a suggested Tele-physiotherapy protocol of progressive core stability exercise PCSE. The suggested protocol was remotely delivered and monitored through WhatsApp, and continued along four weeks, with three sessions per week. Demographic, anthropometric, medical history, pain intensity, lumbar spine range of motion, level of functional activity, and psychological aspects of Discopathic low back pain in female patients were repeatedly assessed during the pre-, mid, and posttests. Result: The study found significant reductions in pain intensity, improvement in physical function, and psychological factors using remote physical therapy through WhatsApp for patients with disc herniationrelated lower back pain, proving its effectiveness across all evaluated outcomes. Conclusion: Using WhatsApp technology to remotely deliver PCSE in the management of DP-LBP, Telephysiotherapy was proven to be advantageous in reducing pain, improving physical aspects of muscle performance, range of motion, enhancing functional abilities among patients with DP-LBP, leading to considerable improvements in the clinical, physical, psychological, and functional domains in treating low back pain
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    Comparisons Study of Supervised Physiotherapy Intervention and Home Program on Pain, Fatigue & Functional Abilities among Women Post Breast Cancer
    (Al-Quds University, 2023-12-28) Enas Kamel Ali Safadi; إيناس كامل علي صفدي
    Background: Appreciation to early diagnosis and enhanced treatment, the survival rate in patients with breast cancer has improved. However, breast cancer survivor women often suffer from long-term complications such as pain fatigue, reduced ROM, and functional abilities. Physiotherapy has been identified as a viable and successful intervention strategy that can help reduce some of the side effects of cancer treatments. Supervised physiotherapy intervention that includes exercises to improve ROM, as well as manual therapy techniques such as mobilization and stretching, help with improving function and reducing pain. A home exercise program can also be beneficial to help maintain and improve ROM. Aim of the study: to investigate and compare the effects of supervised physiotherapy intervention and unsupervised home programs on pain, fatigue, functional abilities, and shoulder range of motion in breast cancer survivor women. Materials and methods: A prospective quasi-experimental, 2-arm parallel research on 84 breast cancer patients was done. The intervention program included 3 sessions a week for 8 weeks. 40 women (Group A) received supervised physiotherapy intervention, while 44 women (Group B) followed an unsupervised home program. The outcome measures were pain intensity by visual analog scale, shoulder range of motion by goniometer and the quick dash questionnaire, Fatigue by the brief Fatigue Inventory, and assessment of aerobic capacity and endurance by the 6-minute walk test. Statistical analysis was carried out utilizing paired and independent t-tests. Results: Both intervention groups improved significantly after the intervention. When compared to Group B, Group A showed a higher reduction in pain (p 0.001), exhaustion (p 0.001), and improved functional abilities (p 0.001). Furthermore, Group A improved significantly on the Six Minute Walk Test scale (p 0.001) and shoulder range of motion (p 0.001). Conclusion: The study found that exercise programs significantly reduced fatigue in breast cancer patients, improved functional abilities, and reduced pain, while physiotherapy had a greater impact on fatigue and functional abilities
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    Determinants of Ankle Sprain Among Soccer Players in Hebron Governorate- Case Control Study
    (Al-Quds University, 2023-12-30) Muath Deab Imran AbuShkeidem; معاذ دياب عمران أبو شخيدم
    Chronic ankle sprain is a persistent condition resulting from repeated or improperly healed ankle ligament injuries. It can lead to ongoing pain, instability, and functional limitations, This study's primary objective is to examine the epidemiological aspects of ankle sprains (AS) in Palestinian athletes in Hebron, focusing on incidence, risk factors, and injury patterns. Methods: The research employed a case-control study design to explore the factors influencing Ankle Sprain (AS) by comparing athletes in the AS case group (n=30) with athletes having no history of AS in the control group (n=30). Data collected included age, weight, height, true limb length, the disparity in muscle bulks (gastrocnemius and quadriceps muscles), proprioception, balance (one-leg stance with eyes open and closed), dominant foot, and history of knee and ankle sprain injuries, were collected from participants. The Y balance test was conducted to assess the impact of determinant factors on both case and control groups. Outcome measures, such as the Cumberland Ankle Instability Tool (CAIT) and Foot and Ankle Ability Measure (FAAM) were calculated. Results: The control and case groups differ in age and athletic age with p-values 0.00 and 0.00, but not in training hours weekly or BMI. There are statistically significant variations in quadriceps measurements between the case and control groups (P = 0.00). The gastrocnemius and patella epicondylar circumferences were not significantly different (p-values of 0.721 and 0.152). The case and control groups had no statistically significant differences in dorsiflexion, plantarflexion, inversion, or eversion ROM. Athletic age, play to return number of days, and age were predictive factors that contributed 56.8% of the variation in the case group. Also, risk factor analysis found substantial relationships between right and left knee injuries. Positive Single leg stance (OR = 1.522) and Ankle angle reproduction (proprioception) test (OR = 1.385). These factors affected case-control group differences in balancing right and left close eyes and proprioception with p-values of 0.01, 0.00, and 0.005. The Y balancing test influenced right and left posteromedial and posterolateral aspects, with p-values of 0.021 and 0.03 for left and 0.03 and 0.01 for right. CAIT (right and left) and FAAM indicated significant group differences with p-values of 0.00 for outcome evaluations. Conclusion: The study provides valuable insights into the determinants of ankle sprains among Palestinian athletes, highlighting the importance athletic age, age, Days to play return, and history of previous left and right knee injury. These risk factors may be used in and rehabilitating these injuries, that can be detected by single leg stance with eyes closed and Y balance test, in addition to CAIT and FAAM measurements.
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    Diagnostic Accuracy of Physical Tests for Subacromial Impingement Syndrome among Adults
    (Al-Quds University, 2022-05-18) Fares Edmon Ishak Janineh; فارس إدمون إسحق جعنينة
    المقدمة:تعد متلازمة الاصطدام تحت الأخرمي أحد الأسباب الأكثر شيوعًا لآلام الكتف وتترافق مع ضعف كبير في الكتف. ان متلازمة الاصطدام تحت الأخرمي تعد مشكلة صحية عامة و تؤثر على ما يقارب حوالي 7٪ من السكان سنويا. الهدف من هذه الدراسة: هو التحقق من نتائج اختبارات الفحص الإكلينيكي مقارنة بالرنين المغناطيسي لاكتشاف و تشخيص متلازمة الاصطدام تحت الأخرمي. المنهج المتبع للدراسة:: دراسة استطلاعية باستخدام عينة ملائمة تشمل 30 مشاركًا ، تتراوح أعمارهم بين 20- 60 عامًا يعانون من آلام في الكتف. تم إجراء 5 اختبارات إكلينيكيةلجميع المشاركين من قبل أخصائي العلاج الطبيعي. في خلال أسبوع ،و بعد ذلك تم اخذ صورة الرنين المغناطيسي (MRI) باعتبارها "المعيار الذهبي" من قبل أخصائيي أشعة ذوي الخبرة باستخدام نموذج تقرير موحد. ويتم التشخيص بالطريقتين على التوالي. التحليل الإحصائي: البيانات التي تم تحليلها بواسطة SPSS 26 ، التحليل الذي تم إجراؤه لتقييم القيمة التشخيصية للاختبارات مقارنة بنتائج التصوير بالرنين المغناطيسي. تم تحليل المعلومات من خلال الاختبار عينة واحدة T-TEST و ANOVA. تم تقييم الحساسية والنوعية والقيم التنبؤية الإيجابية والسلبية لتشخيص الالام الكتف بين اختبارات الفحص البدني والتصوير بالرنين المغناطيسي ، ويتم حسابها بواسطة جدول 2*2 نتائجالدراسة:تضمنت الدراسة 30 مشاركًا ، وكانت جميع اختبارات الفحص الإكلينيكيةإيجابية في أكثر من نصف المرضى ، وكان اختبار هوكينز وكينيدي يتمتع بحساسية عالية (94.1٪) ودقة (73.3٪). أشارت نتائج التصوير بالرنين المغناطيسي إلى أن عددًا من 17 مريضًا (56.7٪) لديهم علامات إيجابية لـ SIS. الاستنتاج: أظهرت اختبارات الفحص الإكلينيكيدقة تشخيصية جيدة لتحديد SIS ، وفقًا لنتائجنا. يعد اختبار هوكينز وكينيدي ، بالإضافة إلى اختبار علامة نير ، طريقتين تشخيصيتين فعالتين لتاكيدSIS ، بأعلى حساسية ودقة. قد يساعد الاكتشاف الدقيق والمبكر لتشخيص SIS في الممارسة السريرية في تعزيز علاج أولئك الذين يعانون من آلام الكتف.
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    The effect of Bridge technique mobilization with movement versus trapezius Dry Needling in the management of cervical dysfunction
    (Al-Quds University, 2021-05-16) Ruqaia mohammad Hassan Malash; رقية محمد حسن ملش
    Background: Hypomobility of the Cervicothoracic junction has been proposed as a contributing factor for cervical dysfunction. Objectives: This study investigates the effect of Bridge technique mobilization with movement compared to the Trapezius Dry Needling technique on physiotherapy outcome in patients with cervical dysfunction. Methods: A randomized clinical trial was conducted where participants with cervical dysfunction complaints were randomly assigned to either the Bridge MWM intervention group or the Trapezius Dry needling. Forty participants with a mean age of 32-year-old in the Bridge (experimental) group: and 29 years old in the Dry needling group The primary outcome measures used were visual analogue scale, Northwick Park Questionnaire, Neck Disability Index, Quality of life scale, and Goniometer for cervical extension ROM. Results: There was a statistically significant difference (improvement ) on an active cervical extension after application Bridge technique represented in the increase of the mean of extension ROM (from 23 ± to 52 ±), while in Dry needling group( from 20 ± to 37±). Statistically significant reduction of pain mean was achieved after application of the Bridge technique (from 7.9 ± to 0.3 ±), while in Dry needling group( from 7.65 ± to 4.48.±) as well as decreasing in the degree of disability in (NPQ & NDI) compared with the baseline and control group measurements (P<.005). However, an improvement was found in both groups in improving the Quality of life score. Conclusion: The study identified that both techniques are effective in improving CROM, pain, and functional abilities outcomes, but the Bridge technique was more effective than Dry Needling in the management of cervical dysfunction
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    The Effect of Kinetic Control Program Versus Rotator Cuff Muscle Imbalance-Based Program in Physiotherapy Management of Rotator Cuff Dysfunction -Experimental Comparative Study
    (Al-Quds University, 2023-12-30) Ayat Ameen Ata Amro; آيات أمين عطا عمرو
    Background: Rotator cuff dysfunction frequently occurs as a result of improper shoulder mechanics, fatigue, overload exercise, and excessive work in daily life, therefore it may limit functional movement of the upper extremities as a result of extreme pain, weakness, and deterioration of the shoulder stability. Objectives. The main objective of this study is to investigate the effect of a muscle imbalance-based exercise program compared to a kinetic control exercise program on pain severity, shoulder mobility, and functional outcomes among patients with shoulder tendinopathy. Methods: Experimental Comparative Study, the study was carried out at the Alia Governmental Hospital the study included 40 patients (males and females) with Rotator cuff Tendinopathy, aged 40 - 60 years. Patients were randomly assigned into two groups (by Excel software coding), all groups received 12 sessions at Hebron Governmental Hospital 3 days/week, the first group received a kinetic exercise control program, while the other group received a muscle imbalance-based exercise program. Patients were evaluated at the baseline and follow-up using the Western Ontario Rotator Cuff Index (WORC), Arabic Quick DASH questionnaire, Range of Motion (ROM), and pain level by a Numeric Rating Scale (NRS), Oxford Scale (MMT). Results: patients in both groups improved significantly in all directions of range of motion, with statically significant improvement of abduction, lateral rotation, and cognitive movement-testing flexion (CMT) in the kinetic control program (p<0.05). this improvement in lateral rotation and MCP flexion was predicted by being in the kinetic group and less BMI, while the abduction was predicted by being in the kinetic control group only. Muscle power improved in abduction, medial and lateral rotation, in the muscle imbalance group more than in the motor control group (p<0.05). No statistically significant difference was found between any of the outcome measures mean improvement between the two groups. Conclusion: Both techniques are effective in the management of rotator dysfunction, with more ROM outcomes associated with the kinetic control program
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    The Effect of Mulligan’s Mobilization with Movement versus Dry Needling on Pain, Function, and Range of Motion among Athletes with Hip Adductor Related Groin Pain and Dysfunction
    (Al-Quds University, 2021-08-17) Ayman Khader Saleem Salem; أيمن خضر سليم سالم
    III Abstract Background Injuries are considered a common challenge in the sports field, 31% of the injuries are muscular, especially in the lower extremities. Injuries in the groin area are a major and serious problem because they are common, lead to prolonged symptoms, and had a high recurrence rate. Study objective This study aims to highlight and investigate the effectiveness of two common management practices in physiotherapy, dry needling DN intervention as a soft tissue technique and Mulligan mobilization with movements MWM as a joint technique. Methods A convenience sampling of thirty football players who were diagnosed with hip adductorrelated groin pain and dysfunction were recruited from different cities in the west bank who participated in this randomized clinical trial, the participants were randomly divided into two groups, the dry needling group (15), and dry needling combined with Mulligan mobilization MWM (15). Numiric Pain Rating Scale (NPRS), Five-Second Copenhagen Squeeze test, Hip Abduction Range of Motion, Adductor Squeeze Test, Flexion Abduction External Rotation Test (FABER), Y Balance Test, and The Copenhagen Hip and Groin Outcome Score (HAGOS) were used as outcome measures (NPRS and 5-second squeeze test performed each session for the two groups). Results There was a significant improvement in NPRS, ROM, adductor squeeze test, 5 seconds squeeze test, Y balance test, FABER test, and HAGOS score on both groups between the pre, mid, and post-treatment (p < 0.05), at the same time, both DN and DN&MWM were equally effective and there was no significant differences in the effect between both interventions. Conclusion Both DN and DN&MWM were equally effective in improving the above-mentioned clinical variables and can be considered as an effective method in the treatment and management of hip adductor-related groin pain and dysfunction. IV For further similar research comparing mulligan mobilization only versus dry needling or conventional treatment and considering the effect of using a parallel technique like a physical agent in augmentation the aimed results are recommended. also testing the effect of both interventions on add muscle like the EMG. Also, the researcher recommended the call for a unified protocol and guidelines for adductors-related groin pain assessment and management protocol.
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    The effect of Myofascial Release Technique combined with core stability exercises versus core stability exercises among adult males with non-specific chronic low back pain.
    (Al-Quds University, 2023-12-17) Al-Tayeb Mohammad Saber Shehada; الطيّب محمد صابر شحادة
    Low back pain (LBP) is a frequent ailment that may interfere with daily activities. It can manifest as either non-specific or specific reason of condition. Myofascial release (MR) is a manual therapeutic technique with a stretch for the fascia in particular. Core Stability Exercises (CSE) is a kind of strengthening exercises for the lower trunk area from the lower rib to the buttocks area. Objective: To investigate the effectiveness of MR and CSE in contrast with CSE alone on pain, back mobility, lumbar Range of Motion (ROM), and the Quality Of Life (QOL) among males with Non-Specific Chronic Low Back Pain (NSCLBP). Methods: A single-blinded randomized control trial (RCT) with a SHAM group, with sixty-four adult male participants, randomly divided into an MR with a CSE Experimental group and a Control group consisting of SHAM (Superficial Massage (SM)) combined with CSE, by three sessions per week for eight weeks. The participants of both groups were assessed with Short-Form McGill Pain Questionnaire (SF-MPQ) to measure pain severity, Oswestry Disability Index (ODI) for back disability, TiltMeter advance app for flexion and extension ROM, and EQ-5D-5L for the QOL pre and post-intervention. All participants were blinded and knew nothing about whether they got into experimental or control groups. Results: There was a significant improvement among both experimental and control groups at post-test (p=.00) for all the following measures: - pain intensity, back disability, ROM, and QOL, moreover, statistical analysis revealed based on the effect size between groups at post-test, that the experimental group had a larger effect than the control group also at all four measures (Cohen’s d > .97). Conclusion: The MR combined with CSE is considered effective with pain intensity, ROM, back disability, and QOL. Even when the Control group (CSE & SHAM) had also a significant improvement in the post-test, the experimental group (CSE & MR) had quite better-improved results with a large effect size for all four outcome measures. Finally, CSE combined with MR can be considered an effective therapy for CLBP.
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    The Effect of passive manual kinesiotherapy in ‎short and midterm management of patients ‎with chronic neck pain ‎
    (Al-Quds University, 2023-07-18) MOHAMMED AMJAD MOHAMMED SAADI SALAYMA; محمد امجد محمد سعدي سلايمه
    Background Chronic neck pain (CNP) is one of the most common musculoskeletal disorders in this time that affects individuals’ daily life. Thus, different manual therapy techniques were used to manage CNP without consideration of all underlying structures. However a little literature is known about this subject. Objective This study aims to investigate the short and midterm effectiveness of suggested holistic approaches on patients with CNP. Methods Fifteen patients with CNP enrolled in one group. A ‎randomized controlled trial was adopted, and the experimental group underwent to Passive oriented manual kinesiotherapy techniques for two weeks. ‎The cervical spine range of motion, muscle strength, and muscle endurance were all ‎assessed. Neck Disability Index (NDI) as a primary functional outcome ‎measure. Visual analog scale, CAROM, and Modified Sphygmomanometer were used to study and ‎investigate the effect of the suggested program.‎ Result The suggested therapeutic intervention for the management of CNP leads to ‎significant improvement in the clinical, physical, and functional. Initially, the utilized ‎treatment methods led to fast improvements in clinical and physical aspects of neck ‎mobility at the end of each therapeutic session. the ‎rate of improvement gradually slowed down. The progressive passive to active ‎manual kinesiotherapy techniques found effective in reducing pain ‎intensity, increasing pain-free range of motion, and in improving muscle strength in neck mobility.‎ Conclusion: The hot packs, classical massage, Maitland mobilization, and active exercises, results in significant improvements of clinical, physical, and functional aspects among patients with chronic neck mobility.
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    The Effect of Self vs Therapist Mulligan Mobilization on Cervicogenic Headache
    (Al-Quds University, 2022-05-28) Wael Omar Yousif Nazzal; وائل عمر يوسف نزال
    الخلفية: الم الراس الناتج عن مشاكل الرقبة هو ألم مزمن في الجمجمة يرجع إلى الرأس إما من البنية العظمية أو الأنسجة الرخوة للرقبة، ويؤدي إلى الكثير من الاضطرابات والاختلالات الوظيفية. أظهرت الدراسات الحديثة أن الأفراد الذين يعانون من الم الراس الناتج عن مشاكل الرقبة يعانون من خلل وظيفي في الفقرة الرقبة الأولى والثانية والذي تم تقييمه من خلال اختبار دوران الانثناء. لعلاج هذا الخلل الوظيفي، وصف مولجان بعض تقنيات العلاج، على الرغم من قلة وجود دراسات تتحقق من فعالية هذه التدخلات. الأهداف: مقارنة تأثير التحريك بطريقة مولجان من قبل المريض مقابل أثر التحريك بطريقة مولجان عن طريق المعالج في علاج وجع الرأس الناتج عن مشاكل الرقبة. تصميم الدراسة: تجربة سريرية عشوائية الطريقة: العينة تكونت من 37 مريض يعانون من صداع مرتبط بالرقية واختبار انثناء إيجابي للدوران، تم تقسيم المشاركين عشوائيا إلى مجموعتين، المجموعة التجريبية (تقنية مولجان الذاتية مع العلاج التقليدي (تقوية عضلات الرقبة العميقة، استطالة العضلات الخلفية للرقبة، والتدليك) والمجموعة الضابطة (تقنية مولجان من المعالج مع العلاج التقليدي المتعلق بمرونة العنق، إطالة العضلات الخلفية للرقبة، والتدليك). تم قياس أعراض الصداع واختبار انثناء الدوران وقراءتها قبل بدء العلاج وبعد أسبوعين من انتهاء العلاج. النتيجة: تم العثور على فرق معتد به إحصائيًا بين الاختبارين القبلي والبعدي الذي لوحظ في المجموعة التجريبية (التحريك الذاتي) مع التحسن في مستويات الحركة للرقبة (p <0.05)، والتحسن في مقاييس نتائج الصداع (p <0.05)، وتحسين مظاهر الصداع (p <0.05). بالإضافة إلى ذلك، كان هناك فرق معتد به إحصائيًا لوحظ في المجموعة الضابطة (تحريك المعالج) بين الاختبارات السابقة واللاحقة، والتحسن في مستويات الحركة (p <0.05)، والتحسن في مقاييس نتائج الصداع (p <0.05)، وتحسن في مظاهر الصداع (p <0.05). هذا يعني أن تطبيق كل من التحريك الذاتي والتحريك من المعالج فعال ويساهم في إدارة ومعالجة الصداع.
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    The Effectiveness of Tubi Grip vs. Pressure Garments in the Rehabilitation Program of Post-Burn Hypertrophic Scar
    (Al-Quds University, 2022-05-18) Mohanad Mohammad Saleh Mansoor; مهند محمد صالح منصور
    يقوم به اخصائي العلاج الطبيعي بهدف تحسين مستوى الندب الجلديه للمرضى وذلك من خلال تطبيق ضاغط توبي واللباس الضاغط ،و يعد كلا النوعين جزء اساسيا من برنامج تأهيل الندب الجلدية بعد الحروق. ويشتمل البرنامج على إعطاء تعليمات لذوي المرضى موضحا كيفيه تطبيق ضاغط توبي واللباس الضاغط على الندب الجلديه بعد الحروق مع ايضاح البرنامج الزمني وذلك تفاديا لاي مضاعفات ممكن ان تحدث . وسيكون المؤشر على مدى التحسن الذي حدث للندب الجلديه هو قياس الموجات فوق الصوتي ومقياس ندبة فانكوفر المعدل. المقدمة: تعد الندب الجلديه والتي قد تكون نتيجه الإصابات الكدميه والإجراءات الجراحية وغالبا الحروق ، الخطر الأكبر بالنسبة للمرضى وقد تؤدي الى قيود اجتماعيه ونفسيه و وظيفية للمرضى بعد اصابتهم بالحروق. ومن جهة أخرى تشكل الندب الجلديه و بشكل كبير تحديا رئيسيا للمعالج الطبيعي و كذلك لجراحي التجميل. وقد تؤدي بعض الاجراءات العلاجية مثل تدليك الندب واستخدام شريحة السيليكون إلى تحقيق نتائج مفيدة وتساعد على تجنب ومنع التدخلات الجراحية. لذلك يعتيرضاغط توبي واللباس الضاغط إجراءات علاجية أساسيه للحد من الندب الجلديه بعد الحروق. هدف الدراسة: تهدف هذه الدراسة إلى تقييم الفعالية العلاجية لضاغط توبي واللباس الضاغط والمقارنة بينهما من ناحية سمات الندب الجلديه التي تصيب المرضى بعد الحروق. المنهج المتبع في الدراسة: سيتم استخدام تصميم تجريبي عشوائي متحكم في هذه الدراسة ،حيث سيكون قياس الموجات فوق الصوتي المقياس الرئيسي للنتائج، بالإضافة إلى مقياس ندبة فانكوفر المعدل. سيتم اختيار 30 مريضا بشكل عشوائي اعتمادا على منهجية اخذ عينات منتظمة، حيث سيتم فصل المرضى وتقسيمهم إلى مجموعتين تجريبية و مجموعه مراقبة. حيث تشمل معايير الإدراج أن يكون المشاركون في كلتا المجموعتين بين 6 و 18 سنة، ويعانون من ندب جلديه في الأطراف العلويه اوالسفلية نتيجة تعرضهم للحروق،و سيتم الحرص على تلقي علاجهم في قسم العلاج الطبيعي في مستشفى رفيديا الحكومي كجزء من هذه الدراسة. سوف تحصل المجموعة التجريبية على العلاج من خلال استخدام ضاغط توبي بالإضافة إلى الإجراءات العلاجية الاعتيادية التي تتضمن التدليك اليدوي والجبائر وهلام السيليكون والتمارين اضافه الى استخدام كريم ترطيبي. أما بالنسبة لمجموعة المراقبة سوف تحصل على العلاج باستخدام اللباس الضاغط ، اضافة إلى الإجراءات العلاجية الاعتيادية كما في المجوعة التجريبيه. اجريت الدراسة في الفترة ما بين أذار– تشرين أول / 2021. نتائج الدراسة: اظهرت النتائج تحسن معنوي في كلا المجموعتين بين نتائج الاختبار القبلي والبعدي (P≤0.05). وهذا يعني بأن تطبيق ضاغط توبي والمشدات الضاغطه ذات فاعليه في انخفاض مستوى الندب الجلديه بعد الحروق باستخدام مقياس الموجات فوق الصوتيه ومقياس فانكوفر المعدل. اضافه لذلك انه لا يوجد فرق معنوي بين كلا المجموعتين من حيث الفاعليه، اي ان استخدام ضاغط توبي واللباس الضاغط لهما نفس التاثير في انخفاض الندب الجلديه بعد الحرق (p ≥ 0.05). الاستنتاج: سلطت هذه الدراسه الضوء على التجربه المرتبطه بتطبيق نوعين من المشدات الضاغطه ( ضاغط توبي و المشدات الضاغطه) على الندب الجلديه بعد الحروق. وقد اثبتت انه لا يوجد فرق معنوي بين ضاغط نوبي و اللباس الضاغط من ناحيه التاثير على الندب الجلديه بعد الحروق. ولكن تم استنتاج بأن ضاغط توبي ذات فاعليه عاليه من حيث التكلفة الماديه لإعادة تأهيل الندب الجلديه بعد الحرق. كلمات مفتاحية: حروق، الندب الجلدية، تدليك الندب، مقياس فانكوفر المعدل للندب الجلديه،مقياس الامواج فوق الصوتيه.
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    The Efficacy of Continuous Passive Motion Device After Traumatic Knee Joint Fracture Versus Physiotherapy : A Randomized Comparative Trial Study for ImprovingKnee Joint Outcome
    (Al-Quds University, 2023-12-20) Qais Ibrahim Mohammad Saleh; قيس ابراهيم محمد صالح
    Background: In physiotherapy, continuous passive motion (CPM) devices are often used to improve joint range of motion (ROM) following severe knee fractures. However, the effectiveness of CPM is still debatable, especially with other knee joint outcomes. Many other physiotherapy techniques could be used during the early recovery time to improve knee joint outcomes such as pain, ROM and ADL. Objective: The main objective of this study was to evaluate the effectiveness of (CPM) on early post-traumatic knee fracture as defined by pain and (ROM) as compared with non-CPM device users and that of regular physiotherapy (PT) treatment. Methods: A randomized comparative design single-blinded with two groups was used. The study was conducted at Rafedia Hospital's Physiotherapy Department in Nablus, Palestine. A total of 70 post-traumatic knee fracture patients were assigned randomly to either the CPM (n=35) or traditional physiotherapy (n=35) groups. Results: Both groups have shown an improvement. However, the CPM group had enhanced significantly compared to the control group in many knee outcomes such as in Oxford knee score (OKS), questionnaire, as there remained a significant difference in functional activity of daily living scores mean between pre- and post-test of the experimental group (P< 0.05). Also, the mean of the experimental group at the post-test (M = 23.0±SD 6.4) was lower than the pre-test (M = 40.6±SD 7.7). Furthermore, there were significant improvements in pain, ROM, in the CPM group compare to the control group. Conclusion: CPM appears to be an effective method for decreasing pain, and restoring function, and knee (ROM) in individuals with knee fracture, according to the findings of this study. CPM has been shown to be more effective than traditional physiotherapy in terms of pain relief plus functional abilities. More study is required to validate these findings and identify the best length and intensity of CPM treatment.
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    A Randomized Comparative Study between High-Intensity Laser Therapy and Ultrasound Therapy on Chronic Neck Pain among Adult Patients
    (Al-Quds University, 2022-05-09) Adel Zeen Aldeen Yousef Ashour; عادل زين الدين يوسف عاشور
    هو بحث يهدف لفحص تأثير العلاج الطبيعي بإستخدام جهاز الليزر عالي الكثافة على أوجاع الرقبة المزمنة لدي البالغين ومقارنته بالعلاج بإستخدام جهاز الموجات الفوق صوتية على المرضى البالغين الذين يعانون من أوجاع مزمنة في الرقبة التدخل العلاجي يقوم به أخصائي العلاج الطبيعي بهدف تحسين شدة الوجع والمدى الحركي والأداء الوظيفي للمرضى. من خلال برنامج علاجي يتضمن 10 جلسات من العلاج بإستخدام الليزر على مدار 4 أسابيع بالإضافةإلى مجموعة من التمارين العلاجية الخاصة بأوجاع الرقبة. وفي المجموعة الضابطة سيتم عمل برنامج علاجي يتضمن 10 جلسات من العلاج بإستخدام الموجات الفوق صوتية بالإضافةإلى نفس التمارين العلاجية للمجموعة الأولى. وسيتم عمل مقارنة بين النتائج في كلا المجموعتين. المقدمة:أوجاع الرقبة المزمنة تعتبر من الإضطرابات الشائعة التي تصيب الجهاز الهيكلي والعضلي. يعاني الناس من هذه الأوجاع في مختلف الفئات العمرية وخاصة البالغين، وتؤثر هذه الأوجاع بشكل كبير على الشخص وعلى أداءه الوظيفي وحياته اليومية، وقد تستمر هذه الأوجاع لعدة أشهر او لسنوات. العديد من الأساليب تستخدم في علاج هذه الأوجاع مثل الأدوية والعلاج النفسي والعلاج الطبيعي وغيرها من الأساليب. العلاج الطبيعي هو مهنة صحية تشارك في علاج العديد من أمراض الجهاز الهيكلي والعضلي ؛ حيث يلعب العلاج الطبيعي دورًا رئيسيا في علاج هذه الأوجاع، ومساعدة المرضى في تخفيف الوجع وتحسين الأداء الوظيفي والنشاط اليومي ، و المحافظة عل صحة العضلات والمفاصل من خلال الحركة والتمارين. هـدف الدراسة: المقارنة بين تأثير العلاج الطبيعي بإستخدام تقنية الليزر عالي الكثافة والعلاج بالموجات فوق الصوتيةعلى آلام الرقبة المزمنة لدى البالغين. المنهج المتبع للدراسة: هذه الدراسة هي دراسة تجريبية، حيث تم دراسة 43 مريض ومريضة يعانون من أوجاع الرقبة المزمنة. مجموعة الليزر ( ذكور=9، اناث=14) ، متوسط العمر لمجموعة الليزر هو 34.35 عام ، بينما كان فيمجموعة الموجات فوق الصوتية حوالي 32.30 عام. تم تقسيمهم لمجموعتين بشكل عشوائي وموزعين على كتل مبنية على العمر والجنس: المجموعة الأولى هي مجموعة الليزرتلقت العلاج بإستخدام الليزر عالي الكثافة ( 23 مريض)، والمجموعة الثانية هي مجموعة الموجات فوق الصوتية حيث تلقت العلاج بالموجات الفوق صوتية (20 مريض). جميع المرضى في المجموعة الأولى تلقوا 10 جلسات من العلاج بإستخدام الليزر عالي الكثافة بالإضافةإلى التمارين العلاجية خلال 4 أسابيع. بينما المجموعة الثانية تلقت 10 جلسات من العلاج بإستخدام الموجات الفوق صوتية بالإضافةإلى نفس التمارين العلاجية خلال 4 اسابيع . خضعت جميع العينة للإختبارات القبلية والبعدية لشدة الوجع، الأداء الوظيفي ،والمدى الحركي للرقبة.تم إستخدام برنامج SPSS نسخة ٢٣ في التحليل الإحصائي، قام الباحث بإستخدام paired sample t-test لتحليل كلا المجموعتين قبل وبعد التدخل العلاجي لفحصأثر العلاج ومن ثم إستخدام independent sample-test لمقارنة الفرق بين المجموعتين بعد العلاج ومن ثم قام الباحث بفحص العلاقة بين جميع الفحوصات المستخدمة مع العمر والجنس عن طريق Pearson’s correlation test نتائج الدراسة:أظهرت النتائج تحسنمعنوي في كلا المجموعتين بين نتائج الإختبار القبلي والبعدي (P<0.05). وكما أظهرت النتائج بأنه لا يوجدفرق معنوي لصالح أي من المجموعتين في نتائج الإختبار البعدي في جميع المقاييس (شدة الألم ، الأداء الوظيفي ، ومدى حركة الرقبة) ، إضافة إلى ذلك أظهرت النتائج أن عاملي الجنس والعمر غير مرتبطين بنتائج التحسن في العينة. الإستنتاج: العلاج بالليزر عالي الكثافة بالإضافة إلى التمارين والعلاج بالموجات فوق الصوتية بالإضافة إلى التمارين يقلل
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    A randomized comparative study of active cycle of breathing technique versus oscillating positive expiratory pressure therapy on lung function and quality of life in children with primary ciliary dyskinesia
    (Al-Quds University, 2023-12-27) Bishara Hanna Fashho; بشارة حنا فشحو
    Background: Primary Ciliary Dyskinesia (PCD) is a rare inherited disease that causes recurrent respiratory tract infections and sputum retention due to inadequate mucociliary clearance. Airway clearance techniques are commonly recommended for patients with PCD to facilitate mucus clearance as a part of the treatment protocol. Study objectives: Our primary goal of this study was to compare the efficiency of the active cycle of breathing technique (ACBT) and oscillating positive expiratory pressure therapy (OPEP) on lung function and functional capacity in children with PCD. Our secondary goal was to evaluate the quality of life and activities of daily living. There is a limitation in the use of standardized chest physiotherapy guidelines with PCD patients. In Palestine, there is a lack of awareness of using positive expiratory pressure devices, which could be beneficial to PCD patients. Methods: An experimental randomized comparative study design was conducted. A total of 32 PCD children, ages ranging from 6 to 18 years were enrolled in the two groups. The first group was assigned to the ACBT, while the second group was assigned to the OPEP. Study tools and outcome measures included a data collection sheet, spirometry measurements, a six-minute walk test (6MWT), and the PCD quality of life questionnaire (PCD QOL). The study took a period of three months, a pretest was conducted at baseline, a mid-test after six weeks, and a post-test after 12 weeks. Descriptive statistical analysis, T-tests, ANOVA, and correlation tests were performed as needed. The effect size was computed as Cohen’s d. The statistical significance level was set at p-value < 0.05. iv Results: The FEV1 and MEF25-75%, as well as the 6MWT, showed statistical significance between the two groups (p=0.02, p=0.04, and p=0.05) in favor of the OPEP group with the effect size of Cohen’s d equals (0.86, 0.76, and 0.71) respectively. However, the FVC and FEV1/ FVC showed no statistical significance p > 0.05. In addition, positive correlations were found between the FEV1, FVC, and 6MWT, and also between 6MWT and the PCD QOL. Conclusion: For PCD patients, daily airway clearance techniques are crucial. The ACBT and OPEP are two efficient home-based physiotherapy techniques. In the FEV1, MEF25-75%, and 6MWT, the OPEP device seems to be more efficient. OPEP might be an efficient alternative method for airway clearance in PCD patients. Additional research is needed to further examine the effectiveness of the two techniques.
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    Reactive and Proactive Balance Training effects on Balance and Functional Performance among chronic stroke Survivors
    (Al-Quds University, 2024-05-28) Amani Mohammed Shaker Abuassba; أماني محمد شاكر أبو عصبه
    Background: Falling is a serious problem after a stroke that leads to loss of function and independence. Balance training is one of the most important elements that we need to focus on with our treatment plan for chronic stroke Patients. Most physical therapy interventions utilize proactive balance training, which is an anticipatory and self-initiated approach of strength and balance exercises to improve balance for the prevention of falls. Reactive balance training, on the other hand, is the practice of responses to unexpected perturbations that cause losses of balance, such as a slip, trip, or nudge. This study will highlight the effects of proactive and reactive training among chronic stroke patients. Methods: This Randomized control trial (RCT) study consisted of 40 chronic stroke patients and was allocated randomly into 2 groups, the intervention group n=20 had reactive-balance training, and the control group n=20 had proactive balance training, the two groups were blinded. This study used the following outcome measures: Fall Efficacy Scale (FES), Time Up & Go (TUG), 10 Meters Walking Test (10MWT), Tinetti Balance Assessment, Mini-BEST, and 2 Minute Walking Test /(2MWT). The outcome measures were measured on all participants at pre- and post. Results: There was a statistically significant difference at baseline between groups in FES, 10MWT, Tinetti Balance Assessment, and 2MWT. which means that the proactive balance training group was more severe than the reactive balance training group. Both interventions statistically and significantly improved between pre and post-treatment in all of the outcome measures (p<0.05). and at post-treatment, there was a statistically significant difference between groups in favor of the reactive balance training group. The main predictors of FES were FES Pre, Type of intervention, Age, 10 MWT, and duration between D.O.S and D.O.A. The TUG predictors were TUG Pre, 10MWT Pre, and Age. The primary predictors for 10MWT were 10MWT Pre, Age, and Gender, while the Tinetti predictors were Tinetti pre, and Gender, and the primary predictors of Mini BEST were Mi-BEST Pre, Type of intervention, Tinetti pre, and Affected Side. While the 2MWT predictors were recurrent stroke. There was a positive correlation between FES and TUG, and Tinetti, and there was a positive correlation between TUG and 10MWT and Mini-BEST (p<0.05). Conclusion: Reactive balance and proactive balance training significantly improve balance and functional performance among stroke survivors. Reactive balance training was superior than proactive balance training in improving Balance and functional outcome.
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    The Use of Rehabilitation Outcome Measures in Palestine; A Descriptive Study
    (Al-Quds University, 2023-07-16) Raia Mahmoud Hadban Morjan; ريا محمود هدبان مرجان
    Standardized Outcome Measures (SOMs) have been differently defined in literature, including the use of a tool to assess the patient’s current situation, as well as the assessment of the impact of specific interventions. The use of SOMs is valid worldwide, as it is associated with several positive consequences on the health and quality of care. Objectives: This study aimed to to investigate the use, benefits and problems related to the implication of SOMs among Palestinian physiotherapists. Methods: The current study adopted a cross-sectional descriptive design and recruited a convenient sample of 30 physiotherapists from different cities in West Bank – Palestine, who received a self-administered valid questionnaire to assess the perceived benefits and problems related to the use of SOMs. Data were analyzed using SPSS software, with the commitment to the ethical principles of anonymity and confidentiality. Results: The sample contained 63.3% females, with 36.7% of 11-20 years of experience, and 83.3% of baccalaureate professional degree, mainly working in outpatient facilities (83.3%) and treating all ages of patients (86.7%). More than three fourths of the participants (76.7%) stated that they use SOMs with their patients. The proportional scores showed an overall positive attitude toward the benefits (91.11 ± 8.85), problems (65.71 ± 10.45) and use (80.77 ± 10.30) of SOM< as well as the overall score (77.61 ± 6.77). None of the demographic factors were considered significant predictor for the use of SOM (p-value > 0.05).Conclusion: The use of SOMs is important in the field of physiotherapy, yet it is underestimated in the Palestinian settings, as it is scarce in the literature. There is a need to focus on such topics, with more studies, larger sample sizes and more rigorous.