BACKGROUND: Individuals with hemiparetic cerebral palsy (h-CP) encounter postural control issues that largely interfere with activity and participation. So, there might be a need for improved, clearly effective rehabilitation protocols that target postural control dysfunction, which may, then, reduce activity limitations and participation restrictions. OBJECTIVE: This trial was undertaken to examine the effect of a structured, 12-week aqua-plyometric (Aqua-PLYO) exercise program on postural control and functional ability in children with h-CP. METHODS: Fifty-six children with h-CP took part in a two-arm, randomized single-blind controlled trial. They were randomly assigned to either receive the standard physical therapy (Control group; n = 28) or the Aqua-PLYO training program (Aqua-PLYO group; n = 28), three times/week over 12 consecutive weeks. The dynamic limit of stability [i.e., movement directional control (M-DC), reaction time (ReT), movement velocity (M-Vel), endpoint excursion (EP-Exc), and maximum excursion (M-Exc)] and functional ability [i.e., 30-second sit-to-stand test (30sec-STS), timed up and down stairs test (TUDS), and the dynamic gait index (DGI)] were assessed pre- and post-treatment. RESULTS: From the pre- to post-treatment occasion, the Aqua-PLYO group achieved greater improvement for the M-DC (P = 0.013), ReT (P = 0.004), M-Vel (P = 0.03), EP-Exc (P = 0.002), and M-Exc (P = 0.006), compared to controls. Besides, the Aqua-PLYO group showed more conducive changes in functional ability [as evidenced by the 30sec-STS (P = 0.005), TUDS (P = 0.002), and DGI (P = 0.004) scores]. CONCLUSION: Aqua-PLYO training is likely an effective training paradigm for enhancing postural control and functional ability in children with h-CP. Further studies are, however, recommended to substantiate the current evidence.

Purpose: Individuals are utilizing smartphones for different tasks on a daily basis. Prolonged smartphone usage might lead to deficient postures such as forward head posture and rounded shoulders. The purpose of this study was to look at the impact of the heavy use of smartphones versus light use on Joint Position Error (JPE), Craniovertebral Angle (CVA), and balance measures. Method: Thirty healthy participants were recruited in this study, and they were divided into two groups: light use (phone use<4 h/d) and heavy use (phone use>4 h/d). Subjects were assessed for cervical repositioning errors using the JPE test. Forward head posture was measured by CVA. Dynamic balance was assessed using the Biodex stability system. Results: There was a significant increase in JPE of both right and left rotation in the heavy-use group compared with that of light-use group. Also, there was a significant increase in balance indices in the heavy-use group. However, there was no significant difference in CVA between groups. Conclusion: Our study showed that prolonged duration of smartphone use could negatively affect cervical proprioception and dynamic balance ability. Further considerations are required to outline the negative impacts of heavy usage of smartphones and to implement preventive measures.

In recent years, there has been a significant increase in global smartphone usage driven by different purposes. This study aimed to explore the effect of smartphone usage on neck muscle (flexors and extensors) endurance, hand grip, and pinch strength among young, healthy college students. In total, 40 male students were recruited for this study; 20 of them belonged to the smartphone-addicted group, while the other 20 were in the non-addicted group based on their smartphone addiction scale—short version (SAS-SV) scores (the threshold for determining smartphone addiction: 31/60). Neck flexor endurance time, the ability to perform a neck extensor muscle endurance test, and hand and pinch grip strength were assessed. Multivariate analysis of variance (MANOVA) was used to assess between-group differences in the mean values of neck flexor endurance time, hand grip, and pinch grip. A significant group effect (Wilks’ lambda = 0.51, F (5,34) = 6.34, p = 0.001, partial eta squared = 0.48) was found. A decrease in neck flexor endurance time was observed in the smartphone-addicted group compared with that of the non-addicted group (p < 0.001). However, there was no notable difference in the neck extensor muscle endurance test or in hand grip and pinch grip strength of both hands between groups (p > 0.05). Using a smartphone for a prolonged time might affect neck flexor muscle endurance; however, more research is needed to explore the long-term effects of using smartphones on neck muscle endurance and hand/pinch grip strength and the risk of developing upper limb neuromusculoskeletal dysfunction.

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Background The rate of complications after revision of reverse shoulder arthroplasty (RSA) is higher than it is in primary RSA, depending on the type of surgical intervention, the follow-up time, the preoperative condition of the patient, and the experience of the surgeon. Objective The current article represents an evaluation of the authors’ experiences with revisions of RSA and a review of literature, in order to define prognostic parameters and surgical options for the most common modes of failure. Materials and methods Between 2010 and 2019, 136 revisions of RSA were performed. Mean age of the patients at surgery was 68.3 years (29–88 years). The main indication was instability in 24 patients and chronic infection in 34. Aseptic loosening of the stem was the main indication in 15 and aseptic loosening of the baseplate in 23 patients. Periprosthetic fractures were present in 21 patients. Fractures of the scapular spine were operated on in 6 and surgery was performed for progressive notching due to malposition of the glenosphere in 4 patients. Results Staged procedures, use of allografts, and custom-made implants are common, especially for chronic infections and severe bone loss. Most of the patients (88.2%) were treated successfully. Two salvage procedures and two retentions of spacers occurred. We identified risk groups for re-revision: chronic dislocations, chronic infections, advanced bone loss, and scapular spine fractures. We observed a shift of indications and techniques, often related to the design of the implants. Conclusion These results confirm that careful preoperative planning, special implants, and a high level of experience are mandatory. With time, the authors developed an algorithm for certain indications because it was recognized that failures are often of multifactorial origin. Today, numerous implant designs which differ considerably in biomechanical features and failure modes are available. This makes revisions of RSA more complex than it was in the past.

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Background. Surgical repair for anorectal malformation in children had post-operative unsatisfactory results as children still suffering from faecal incontinence. Objective. The effect of Biofeedback in treating children fecal incontinence after anorectal malformations repair was investigated. Methodology. A randomized controlled trial design was conducted in the Pediatric hospital, Mansoura University. Forty-eight children with postsurgical anorectal malformations repair were assessed for eligibility. Forty children (twenty-two boys and eighteen girls) underwent simple randomization into two matched groups, control and study group. The anal function was assessed by Anorectal manometry and faecal incontinence was evaluated by Baylor social continence scale. Measurements were done before and after two months of intervention, and after four months of follow-up. Result. There was statistically significant improvement in maximal resting anal pressure, maximal voluntary contraction pressure, voluntary contraction time, the threshold of rectal sensation, maximal tolerable rectal volume and Baylor social continence scale (P < 0.05) for biofeedback group after two months of intervention and four months of follow-up in comparison with conservative treatment. Conclusion. Biofeedback improved faecal incontinence after ARM repair and had an intermediate follow up effect in conjunction with conservative interventions.

IntroductionThe aim of this study was to evaluate whether physical exercise (PE) in addition to shockwaves therapy (ESWT) is more effective in improving erectile function as compared to PE and ESWT alone in diabetic patients with erectile dysfunction (ED).Material and methodsForty-five patients with type 2 diabetes mellitus (DM) and ED were divided into three equal groups: group1 (ESWT group) received treatment with ESWT twice weekly for 6 weeks, comprising 3000 shockwaves at an energy density of 0.25 mJ/mm2 and an emission frequency of 6 Hz; group2 (PE group) received treatment with physical exercise three times per week for 12 weeks; and group3 (combined group) was treated using physical exercise in the form of the program followed by the PE group, plus ESWT in the form of the same parameter and protocol as that of the ESWT group. Treatment outcomes were measured by International Index of Erectile Function-5 (IIEF-5) score variations recorded at 4 and 12 weeks after the end of treatment with respect to the baseline.ResultsThe mean IIEF-5 scores significantly improved in all groups at the 4-week follow-up without intergroup differences. At the 12-week follow-up, the mean IIEF-5 improvement and durability were significantly higher among patients in combined groups.ConclusionsThe conclusion of this study combined approach of ESWT and PE provides significant advantages in erectile dysfunction improvement and durability as compared to ESWT or PE alone in diabetic patients with ED.