Physiotherapy

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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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    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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    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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    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