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Background: Patients with cervical spondylosis are commonly suffering from neck pain and dizziness due to disturbance in cervical propriocetion. So, inhibiting the causes and improving proprioception might be a key for a positive treatment effect. Purpose: This study aimed to evaluate the effect of deep cervical flexors (DCFs) training on neck proprioception, pain, muscle strength and dizziness in patients with cervical spondylosis. Methods: Forty patients with cervical spondylosis suffering from neck pain and dizziness were chosen from OutPatient Clinic, Faculty of Physical Therapy, Cairo University to participate in this study. They were randomly divided into two equal groups. The study group (A): received DCFs training plus traditional physical therapy (hot backs, TENS and cervical proprioceptive training). The control group (B): received traditional physical therapy only. Outcome measures included head repositioning accuracy (HRA), severity of pain, DCFs strength, severity of dizziness and dizziness handicap inventory (DHI). Measures were assessed for all patients in both groups before and after 6 weeks of treatment program (3 sessions ∕ week). Results: There was a significant improvement for all of the measured variables after treatment in each group, and there was a significant difference between the two groups in favor of the study group (A) for all of the measured variables including HRA for right rotation (p=0.001), HRA for left rotation (p=0.001), severity of pain (p=0.003), DCFs strength (p=0.001), severity of dizziness (p=0.01) and DHI (p=0.001). Conclusions: The study findings indicate that DCFs training was more effective than traditional physical therapy for improving neck proprioception, pain, muscle strength and dizziness in patients with cervical spondylosis. Hence, it is recommended in the rehabilitation of patients with cervical spondylosis.

Objective: To assess the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) combined with selected physical therapy exercise program on male patients with pudendal neuralgia. Design: A double-blinded randomized controlled study. Setting: Out-patient setting. Participants: Fifty-two male participants with pudendal neuralgia (30–50 years) were allocated randomly into two groups; study and control. The same physical therapy exercises were applied to all participants, plus the same prescribed analgesic medication (Etodolac). Participants in the study group received additional TENS and sham TENS were given to those in control group. Intervention: Intervention lasted for 12 weeks, three sessions per week (60 minutes/session). Outcome measures: Numerical pain rating scale and daily Etodolac intake dose were measured before and after intervention. Results: Statistically significant differences were detected in numerical pain rating scale and daily Etodolac intake in favor of the study group ( P < 0.05). After 12 weeks of intervention, the mean ± SD for numerical pain rating scale and daily Etodolac intake were 4.25 ± 1.9 and 259.25 ± 84.4 mg, in the study group, and 6.22 ± 2.22 and 355.55 ± 93.36 mg in the control group, respectively. The mean difference (95% CI) for numerical pain rating scale and daily Etodolac intake was −1.97 (−3.09: −0.83) and −96.3 (−144.9: −47.69), between groups post treatment, respectively. Conclusion: Adding TENS to physical therapy exercise program is more effective than physical therapy program alone in improving pain in male patients with pudendal neuralgia as measured by numerical pain rating scale and daily analgesic intake dose.

Objective: To investigate whether adding neural mobilization to a standard postoperative physical therapy program could improve the outcomes of patients after lumbar laminectomy. Design: A single blinded randomized controlled trial. Setting: Outpatient setting. Participants: Sixty participants of both sexes who had undergone lumbar laminectomy. Interventions: Participants were allocated randomly to two groups; study and control groups. All patients received a standard postoperative physical therapy program. Those in the study group received additional neural mobilization in the form of straight leg raising and dorsiflexion with two-ended slider. Treatment was administered three times/week for six successive weeks. Outcome measures: Visual analog scale (VAS), Oswestry disability index (ODI), and H-reflex latency were measured pre and post-treatment. Results: The mean age of participants was 44.23 ± 4.64 and 45.3 ± 5.3 in study and control groups respectively ( P > 0.05). There were statistically significant differences in VAS, ODI, and H-reflex latency in favor of the study group ( P < 0.05). The mean ± SD for VAS, ODI, and H-reflex latency pre vs post treatment was 6.13 ± 1.22 vs 1.40 ± 0.77, 64.46 ± 4.05 vs 16.86 ± 2.55, and 32.07 ± 2.76 vs 27.46 ±1.79 in study group and 5.86 ± 1.07 vs 2.46 ± 0.73, 63.93 ± 3.91 vs 23.40 ± 2.93, and 31.76 ± 2.69 vs 29.4 ± 1.94 in control group, respectively. Conclusions: Neural mobilization combined with traditional physical therapy program achieved better improvement in pain, functional disability and H-reflex in patients who underwent decompressive laminectomy than traditional physical therapy program only.

Background: Cervical radiculopathy is a condition caused by the compression of the nerve root in cervical spine that commonly manifests as neck pain and it may also radiate from the neck into the distribution of the affected nerve root. There is a significant amount of evidence available to support the benefit of physical therapy and manual techniques in general for patients with neck pain with or without radicular symptoms.Objective: This study was conducted to assess the efficacy of Mulligan mobilization and low level laser therapy (LLLT) on pain intensity level, EMG dermatomal somatosensory evoked potential and functional level in patients with unilateral cervical radiculopathy. Materials and Methods:Fifty patients of both genders with diagnosis of unilateral cervical radiculopathy, their ages ranged from 40 to 55. They were randomly assigned into two groups; Group A: Patients received SNAGs Mulligan technique, in addition to conventional program. Group B: Patients received LLLT, in addition to conventional program. The treatment was conducted at a frequency of three sessions per week for four weeks.Results: Patients in both groups showed significant improvement post treatment in all the measured variables ; there was non-significant difference between two groups post-study in pain level where P-value was (0.128). There were no significant differences between two groups in amplitude, distal latency post-study, where P-values were (0.132) and (0.328) respectively. There were no significant differences between two groups in functional ability, where P-value was (0.156).Conclusion: Study concludes that both LLLT and SNAGs Mulligan techniques have shown positive results and are effective in improvements in pain intensity, EMG dermatomal somatosensory evoked potential and functional level among Patients with unilateral cervical radiculopathy.

Low rate rTMS assumed to help gait rehabilitation as well as EEG synchronization after stroke. Are these two variables correlated? Materials and MethodsThis is a pre-post intervention study carried on forty-five adult stroke patients of both sexes (16 males and 14 females) ranging in age from 40 to 60 years. Selection of the patients was based on careful

Background: Polyneuropathy is one of the most common chronic complications associated with diabetes mellitus, it is a damage of the peripheral nerves and manifested by signs and symptoms as numbness, irritation, and pain in the upper and lower limbs. This study aimed to evaluate muscular performance and proprioception at the ankle in diabetic neuropathic patients with quantitative and standardized tools and correlate these findings with those of sural nerve conduction velocity (sural NCV) and amplitude.Methods: Fifteen male patients with diabetic neuropathy participated in this study, with age ranged from 40 to 55 years, and fifteen age-matched healthy subjects participated as a control group. Biodex Isokinetic System was used to assess the strength of ankle dorsiflexors and planter flexors and ankle reposition accuracy. Berg balance test was used to assess balance. Sural nerve conduction velocity (NCV) and amplitude were examined by diabetic polyneuropathy check (DPN-check) device. Results:The results showed a significant decrease in the mean peak torque values of the plantar flexors and dorsiflexors and a significant increase in the reposition error in the diabetic neuropathic group (p=0.0001). The results also revealed a significant decrease in the mean values of the Berg balance scores in diabetic neuropathy group (p=0.0001). Sural NCV and amplitude tests revealed abnormal values (p<0.05). Conclusion:It was concluded that the isokinetic system is an objective and sensitive tool to detect the motor and sensory changes of the diabetic neuropathic patients, also an examination by DPN-check device help in the determination of the severity of the disease. Moreover, it can be concluded that there are strong correlations between duration of diabetes and sural nerve NCV and amplitude and the peak torque of the muscles around the ankle.