Physiotherapy العلاج الطبيعي
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- ItemPredictors of Stroke Rehabilitation Outcome(Al-Quds University, 2025-08-16) Malak Ayed Abdel-Mughni Abdel-Hafez Wazwaz; ملاك عايد عبد المغني عبد الحافظ وزوزStroke is the second leading cause of mortality and mortality and Disability-Adjusted Life Year (DALY) loss globally, with over 30% struggling with instrumental ADLs. Rehabilitation improves functional outcomes and quality of life for stroke patients. Factors influencing recovery include clinical severity, comorbidities, demographic characteristics, socioeconomic status, and access to care. In Palestine, stroke rehabilitation faces structural limitations, with non-governmental organizations providing primary post-stroke therapy services. Methods: A prospective cohort study was conducted in Hebron, Palestine, involving 36 first-ever stroke patients recruited from hospitals, 32 participants completed both baseline and 3 month follow-up assessments. The mean age was 64.22 years, with equal gender distribution. Rehabilitation outcomes were assessed using standardized ICF-based tools: Fugl-Meyer Assessment and NIHSS (impairment level), ARAT and Barthel Index (Functional activity level), and Adapted Participation Questionnaire (participation level). Data on demographics, comorbidities, socioeconomic status, and rehabilitation service utilization across care settings were also collected. Results: A statistically significant improvement in impairment level was observed between baseline and three-month follow-up, as measured by the Fugl-Meyer Upper Extremity (FMUE) scores (Z = -2.657, p = 0.008). Key predictors of FMUE improvement included age, body mass index (BMI), stroke type and severity (NIHSS), presence of diabetes mellitus (DM), and the total amount of physical therapy received across home, hospital, and inpatient settings. Similarly, significant improvement was noted in the Fugl-Meyer Lower Extremity (FMLE) scores (Z = -2.621, p = 0.009), with improvement predicted by gender, smoking status, osteoarthritis (OA), coronary artery disease (CAD), and inpatient physical therapy. At the functional activity level, the Barthel Index showed a significant increase (Z = 4.787, p < 0.001), with improvement predicted by the number of children, financial status, I stroke type, referral to rehabilitation, and receipt of physical, occupational, and psychological therapy in inpatient settings, as well as physical therapy at home. The Action Research Arm Test (ARAT) also demonstrated significant improvement (Z = -3.521, p < 0.001), with predictive factors including DM, HT, OA, financial status, stroke severity (NIHSS), employment status, physical therapy at home, and outpatient occupational therapy. Finally, at the participation level, no statistically significant improvement was observed, as measured by the Adapted Participation Questionnaire (Z = -1.387, p = 0.07). Conclusion: At three months post-stroke, rehabilitation was associated with statistically significant improvements in impairment and functional activity levels. However, no significant change was observed in the participation level. Keywords: Stroke, Predictors, The International Classification of Functioning, Disability and Health, Impairment level, functional activity level, participation level, use of care settings.
- ItemThe 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 ملشBackground: 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
- ItemClinical, 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 الفاخوريLow 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
- ItemReactive 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 عصبهBackground: 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.
- ItemThe 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 شحادةLow 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.