Diabetic patients are particularly burdened by foot ulcer as about 2.5% of patients with diabetes will develop a foot ulcer each year leads to lower extremity amputation by 15-40 times in diabetics greater than the rate in patients without diabetes mellitus. The aim of this study was to determine which therapeutic method out from hyperbaric oxygen therapy (HBO); laser and ultrasound, in addition to medical treatment obtain the best improvement in healing rate of foot ulcers in diabetic patients. Forty-five non-insulin dependent diabetic patients of both sexes complicated with foot ulcer grade II. Their age ranged from 35 to 50 years. were included into 3 equal groups ; Group (A) received laser therapy, group (B) received HBO and group (C) received the pulsed ultrasound therapy in addition to medical treatment. Measurements of ulcer surface area and volume for all patients in the three groups were done before treatment and after two months at the treatment program. There was a statistically significant difference between mean levels of the investigated parameters in laser therapy group and HBO group and HBO group & pulsed ultrasound therapy group after treatment. Where there was no significant difference between laser therapy group & pulsed ultrasound therapy group (p>0.05). It is recommended to use HBO in addition to medical treatment to accelerate healing rate of foot ulcers in diabetic patients.

Background: Pulmonary difficulties is the most common cause of morbidity and mortality following spinal cord injury, which is the main cause of chronic respiratory failure in young adults. Objective: This study aimed to investigate the effect of resistive respiratory muscle training on blood gases and pulmonary function of patients with cervical spinal cord injury. Methods: Thirty six patients with complete spinal cord injury at level from C5 to C8 of both sexes (23 males and 9 females), their age ranged from 23-41 years (30.51±6.82 year) were selected from ICU of Cairo University Hospital participated in this study. Their height ranged between 149-185cm. Participants equally enrolled to either training group (group A) or control group (group B). The respiratory muscle resisted training program was started for group (A) after the clinical stability of patient condition with a threshold positive expiratory pressure device using a three-way valve system via flanged mouthpiece. The patient performed six work sets, five minutes in duration, with a rest period in between for three minutes. All patients received a 45 minutes training/day, five days/ week for six weeks. The arterial blood gases and pulmonary function test are measured before and after exercise program. Results: The mean value of heart rate (HR), respiratory rate (RR), partial pressure of arterial carbon dioxide (PaCO2) and PH revealed significant reduction, where forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and partial pressure of arterial oxygen (PaO2) revealed significant increase in group (A) at the end of the study. However, changes in group (B) were not significant. Moreover, there were significant differences between both groups at the end of the study (P<0.05). Conclusion: Resistive respiratory muscle training improves blood gases and pulmonary function suggesting this intervention as an efficacious therapy for patients with cervical spinal cord injury.

Background: Pulmonary difficulties is the most common cause of morbidity and mortality following spinal cord injury, which is the main cause of chronic respiratory failure in young adults. Objective: This study aimed to investigate the effect of resistive respiratory muscle training on blood gases and pulmonary function of patients with cervical spinal cord injury. Methods: Thirty six patients with complete spinal cord injury at level from C5 to C8 of both sexes (23 males and 9 females), their age ranged from 23-41 years (30.51±6.82 year) were selected from ICU of Cairo University Hospital participated in this study. Their height ranged between 149-185cm. Participants equally enrolled to either training group (group A) or control group (group B). The respiratory muscle resisted training program was started for group (A) after the clinical stability of patient condition with a threshold positive expiratory pressure device using a three-way valve system via flanged mouthpiece. The patient performed six work sets, five minutes in duration, with a rest period in between for three minutes. All patients received a 45 minutes training/day, five days/ week for six weeks. The arterial blood gases and pulmonary function test are measured before and after exercise program. Results: the mean value of heart rate (HR), respiratory rate (RR), partial pressure of arterial carbon dioxide (PaCO 2) and PH revealed significant reduction, where forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1) and partial pressure of arterial oxygen (PaO 2) revealed significant increase in group (A) at the end of the study. However, changes in group (B) were not significant. Moreover, there were significant differences between both groups at the end of the study (P<0.05). Conclusion: Resistive respiratory muscle training improves blood gases and pulmonary function suggesting this intervention as an efficacious therapy for patients with cervical spinal cord injury.

Background: Reduced range of motion at the ankle joint may be a risk factor for tripping and falling.Objective: This study was conducted to evaluate the impact of ankle joint mobility program on the balance performance in elderly diabetic patients.Material and methods: Forty elderly type 2 diabetic patients, age ranged 60-67 years participated in this study. Twenty subjects (training group) received ankle joint mobility training program for 6 weeks. The control group, included twenty subjects, received no training intervention and practiced their ordinary life style over the 6 weeks of the study. The ankle joint mobility was measured by the universal goniometer and the balance performance was measured by the Biodex Balance System. Results:The mean values of overall stability, anteroposterior and mediolateral indexes during standing on both feet with head forward were significantly decreased which means improved postural stability, where dorsiflexion range of motion and planterflexion range of motion were significantly increased in group (A) which means improved ankle joint mobility, while changes in group (B) were not significant. In addition, there were significant differences between both groups at the end of the study. Moreover, Pearson's correlation coefficients test for the relationship between Biodex Balance System measured values (overall stability, anteroposterior and mediolateral indexes) and ankle range of motion (ROM) (dorsiflexion ROM and planterflexion ROM) at the end of the study in both groups showed a strong inverse relationship. Conclusion:Improved ankle joint mobility enhances balance performance in elderly type 2 diabetic subjects. Keywords Material and methods SubjectsForty elderly type 2 diabetic patients, age ranged 60-67 years (65.13±4.62), participated in this study as they had been selected from patients follow up lists in diabetic outpatient clinics in Cairo University Hospital. Twenty subjects (training group) received ankle joint mobility training program for 6 weeks. Inclusion criteria included: history of diabetes mellitus, ability to lie supine, ability to walk independently without an assistive device and equal leg length. However, exclusion criteria included current or previous severe orthopedic injury to the lower extremity (e.g. ankle fracture, joint fusion, joint replacement) or a current or previous neurological insult (e.g. cerebrovascular accident). While, the control group included twenty subjects, that received no training intervention and practiced their ordinary life style over the 6 weeks of the study. The ankle joint mobility was measured by the universal goniometer and the Biodex Balance System measured the balance performance. These measurements were applied for both groups before and after 6 weeks. InstrumentationBiodex balance instrument: Biodex Balance System (Biodex medical systems Inc., Shirley, New York, USA) is a simple, efficient, commercially available balance screening and training tool. The system consists of a movable balance platform, which pro...

Aim: Alzheimer's disease is one of the leading cause of all deaths worldwide , it contributes to a reduction in overall function