Feeding difficulties are common in children with diplegic cerebral palsy (CP). Swallowing difficulties, extended feeding times, poor postural control, frequent chocking/coughing, trouble drinking, and frequent vomiting are the most common feeding challenges. The dysfunctional daily eating activities among these population result in reduced quality of life, limited functional performance, and they become dependent in most of oral health care and mealtimes.The specific nature and severity of the feeding problems may differ to some degree, in relation to sensorimotor impairment, gross and fine motor limitations. This study was conducted to investigate the effect of electrical stimulation on oro-motor skills and gross motor abilities in children with diplegic cerebral palsy and to find out if there was a relationship between them. Eighteen children with diplegic cerebral palsy aged from 3 to 5 years from both sexes participated in this study. They received a designed physical therapy, oromotor exercises for 60 minutes followed by electrical stimulation for 40 minutes. The treatment was conducted two sessions per week for three successive months. Data obtained from both groups pre treatment and post treatment regarding Gross Motor Function Measure (GMFM-88), Oral Motor Assessment Scale (OMAS).
Chronic low back pain (CLBP) is a very common disorder with various management strategies. There is still debate regarding treatment alternatives for axial CLBP. This study aimed to compare the effect of epidural steroid injection (ESI), interferential current (IFC) therapy and core strengthening exercises in a prospective randomized controlled manner. Hence, sixty patients complaining of axial CLBP were included and randomly assigned into either a group of ESI and exercises (group A) or IFC and exercises (group B) or exercises only (group C); each group was of 20 patients. Outcomes were visual analogue scale (VAS) for pain, Oswestry disability index (ODI) for function and Beck's depression inventory (BDI) for depression, assessed at baseline and 3-, 6- and 12-week follow-ups. At the start of the study, there were no significant differences between the three groups in age, gender, cause and duration of CLBP, body mass index, abdominal muscle power, muscle spasm or tenderness (p > 0.05). Significant improvement in VAS and ODI at 3-, 6- and 12-weeks was observed compared to baseline assessment in the three studied groups. The improvement was higher for group A compared to B and C. BDI was significantly improved in group A and C at 3 weeks, and in all groups at 6- and 12-weeks compared to baseline. However, at the end of the study, there was no significant difference in the BDI between the three groups. From this study and over a period of 3 months, all studied groups showed improvement in pain, function, and depression but the group who received epidural steroid injection with core strengthening exercises was statistically better than the other two groups, with significant improvement in pain and function, but not in depression. Early effective assessment and dealing with depression, even prophylactic treatment and cognitive behavioral therapy should be addressed. Trial registration: The Pan African Clinical Trial Registry (www.pactr.org) identification number is PACTR201901523042787 on 16 January 2019.
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