Physiotherapy العلاج الطبيعي
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- ItemThe Effect of a Suggested Exercise Program on Balance and Cardiovascular Fitness in Children with DownSyndrome: A Quasi Comparative Study(Al-Quds Univeersity, 2025-12-13) Razan Michael Hilal; رزان ميشيل هلالBackground: Down syndrome (DS), or trisomy 21, is a genetic disorder causedby having an extra copy of chromosome 21, which leads to physical and intellectual disabilities, typicalfacial features, delayed growth, and hypotonia. DS’s people objected tomedicalcomplications:heart defects, obesity, and diabetes. Objective: To evaluate the effectiveness of a structured exercise program that integrates aerobic exercise and balance training, toward improving cardiovascular fitness and balance among DS’s children. Methods: A quasi-comparative (single-blinded) study conducted with 40 DS’s children aged 4 to 12 years from Jemima and Life Gate in Beit Jala. Participants were assigned by convenience sampling to either experimental group, which engaged in a structured exercise program for two sessions per week, with a 60-minute duration, over 12 weeks.Or to control group received standard physiotherapy sessions. Balance and cardiovascular fitness were assessed using the pre- and post-Berg Balance (PBB) Test and the 6-minute walk (6MWT) test. Results:The findings indicate that the structured exercise program hadsignificant improvements in cardiovascular endurance and balance among DS’s children. Participants in the intervention group demonstrated a statistically significant increase in 6MW Test (p=0.001) with a very large effect size (Cohen’s d=3.433), alongside marked improvements in overall balance as measured by the PBB Scale (p=0.001, Cohen’s d=1.447) compared to the control group. Notably, the intervention group showed substantial gains in specific balance tasks, including more challengingactivities such as turning 360 degrees and standing on one foot (p=0.001). Furthermore, a strong positive correlation was found between cardiovascular endurance and balance at post-test (r=0.663, p=0.001). Conclusion:This study demonstrates that a structured exercise program combining aerobic and balance training can effectively enhance cardiovascular endurance and balance amongDS’s children.Suggesting that targeted physical activity interventions may playa crucial role in promoting overall motor function and physical fitness among DS.
- ItemFactors affecting balance and fall risk among elderly people over 60 years in Hebron, Palestine: A Cross–Sectional Study(Al-Quds Univeersity, 2025-12-15) Safa Arafat Essa Al-Batsh; صفاء عرفات عيسى البطشBackground: Falls among older people pose a serious health issue and have been associated with injuries, disability, and loss of quality of life. It is necessary to have a comprehensive outlook on factors influencing physical, cognitive, psychological, and social domains associated with balance and risk of falls. Objective: To explore factors that affect balance and risk of falls among older adults, above 60 years, living within the community of Hebron, Palestine. Methods: A total of 323 participants were given demographic questionnaires and physically and cognitively assessed with balance measures (Berg Balance Scale [BBS], Timed Up and Go Test [TUG], Single Leg Stance [SLS]) and cognitive function measurement tools (Mini-Mental State Examination), as well as psychosocial tools (Fear of Falling Scale, community participation, and domains of quality of life). Correlation and regression analyses were conducted. Results: The average age was 67.8 ± 6.54 years, and females accounted for 56% of the sample. Balance risk testing showed 64.4%, 20.7%, and 14.9% were at low, medium, and high risk for falls, respectively. A significant association with low balance performance existed for cognitive impairment, assistive device use, physical inactivity, difficulty walking on uneven ground, and loss of functional independence (p < 0.001). The Berg Balance Scale (BBS) predicted fall risk better than any other measure and influenced social participation and falls concern but not overall life satisfaction and fear of falls on the Falls Efficacy Scale-International (FES-I). Regression analysis pointed to physical and cognitive variables, such as problems with memory and assistive device use, as vital determinants of balance. Functional change as measured by Fisher Score significantly predicted balance. Conclusion: Balance among older people requires consideration of physical, cognitive, and functional variables. Strategies that focus on enhancing physical activity levels, cognitive functions, usage of assistive devices, addressing sensory impairments, and encouraging independence with activities of daily living should be promoted among elderly populations within the city of Hebron.
- ItemImpact of Early Versus Delayed Physiotherapy Intervention on Humerus Fracture Functional Recovery in Resource-Limited Settings(Al-Quds Univeersity, 2025-12-28) Asem Husien Rushdi Abdelghani; عاصم حسين رشدي عبد الغنيBackground: Humerus fractures represent a significant orthopedic challenge and may result in pain, restricted shoulder mobility, and functional disability if rehabilitation is not initiated appropriately. Although early physiotherapy is believed to enhance recovery, the optimal timing for rehabilitation initiation remains controversial, particularly in resource-limited healthcare settings such as Palestine. Aim: This study aimed to compare the effects of early versus delayed physiotherapy initiation on pain, edema, shoulder range of motion, and functional recovery among adults’post humerus fractures. Methods: A quasi-experimental study was conducted amongst 40 adults aged 18–60 years diagnosed with humerus fractures. Participants were allocated into two groups: an early intervention group (n = 20), in which physiotherapy was initiated within two weeks following orthopedic referral, and a delayed intervention group (n = 20), in which physiotherapy commenced at least after six weeks due to several delayed reasons. Both groups received standardized physiotherapy protocols adapted to fracture stage and patient tolerance. Outcome measures included pain intensity assessed using the Visual Analog Scale (VAS) and the McGill Pain Questionnaireto help patients describe and quantify their pain's quality. While for functional recovery the Upper Extremity Functional Index (UEFI) we used, shoulder range of motion measured using a goniometer, and edema evaluated through standardized circumferential limb measurements and lastly the upper limb function and disability assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and. Assessments were performed at baseline and after an 8-week intervention period. Results: Improvements were observed across all outcome measures in both groups following physiotherapy. However, participants who received early physiotherapy demonstrated greater gains in shoulder range of motion and functional performance compared with those who received delayed intervention. Pain reduction occurred in both groups, with earlier initiation resulting in faster and more clinically meaningful improvement. Early intervention was also associated with lower disability levels and enhanced functional independence at follow-up. Conclusion: Early initiation of physiotherapy following humerus fracture is associated with superior functional recovery, improved shoulder mobility, reduced pain and edema, and decreased disability without compromising safety. These findings support the implementation of timely rehabilitation strategies and highlight the need to improve access to early physiotherapy services in resource-limited settings.
- ItemEfficacy of Quadriceps and Gluteal Strengthening, Self-Management Education, Low-Intensity Laser Therapy Versus Education and Laser Therapy Alone on Knee Osteoarthritis Progression(Al-Quds Univeersity, 2025-12-20) Wafa Salah Natsheh; وفاء صلاح النتشةBackground: Knee osteoarthritis (KOA) is a progressive degenerative disorder that reduces joint mobility and function. Although various therapeutic approaches exist, the combined effect of strengthening the quadriceps, gluteus maximus, and medius muscles in women with KOA has not been well established. Objectives: to investigate the impact of strengthening these muscle groups on pain, strength, endurance, range of motion, and overall function in women with grade I–III KOA. A secondary aim was to determine whether low-intensity laser therapy (LILT) enhanced these outcomes. Methods: A total of 37 women aged 45–65 with KOA were divided into an experimental Group (EG) (n = 18) and a Control Group (CG) (n = 19) for a three-month study. The EG received a structured strengthening program along with LILT and a self-management booklet (SMB), while the CG received LILT and SMB. Outcomes were measured using the Visual Analog Scale (VAS), WOMAC, hand-held dynamometry, 6-Minute Walk Test (6MWT), 30-Second Sit-to-Stand Test (30SCT), and goniometry. Results: Participants ‘mean age of 52 ± 10 years. The EG showed statistically significant improvements compared with the CG in pain (VAS, p = .004), (6MWT, p = .004), and (30SCT, p = .002). Significant or moderate effect sizes were also observed in muscle strength, including right quadriceps strength (p = 0.017), right gluteus maximus (Cohen’s d = 0.564), and left gluteus maximus (p = 0.025). Age stratification (≤55 vs. >55 years) revealed significant differences specifically in the 6MWT (p = .012) and 30SCT (p = 0.010). However, stratification by KOA severity (grades I–III) showed no significant differences (p > 0.05) in post-intervention pain, functional mobility, or muscle strength. Conclusion: targeted strengthening of the quadriceps and hip extensors/abductors produces superior improvements in pain, strength, and endurance compared to LILT alone, although LILT still contributes to pain reduction and functional capacity.
- 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.