[Purpose] Cervicogenic headache is a major problem in patients with upper cervical
dysfunction. However, its physical therapy management is a topic of debate. This study
aims to determine the effect of C1-C2 Mulligan sustained natural apophyseal glide
mobilizations on cervicogenic headache and associated dizziness. [Participants and
Methods] This study included 48 patients with cervicogenic headache, who were randomly
assigned to three equal groups: Group A (Headache SNAG), group B (C1-C2 SNAG rotation),
and group C (combined). Neck Disability Index was used to examine neck pain intensity and
cervicogenic headache symptoms. The 6-item Headache Impact Test scale was used to examine
headache severity and its adverse effects on social life and functions. Flexion-Rotation
Test was used to assess rotation range of motion at the level of C1-C2 and confirmed by a
cervical range of motion device. Dizziness Handicap Inventory scale was used to evaluate
dizziness. The evaluation was done pre- and post-treatment and compared between the
groups. [Results] Group C showed significant improvement in all variables compared with
groups A and B. [Conclusion] Sustained natural apophyseal glide mobilizations used in the
study were effective in reducing cervicogenic headache and dizziness in all groups with a
greater improvement in the combined group. The use of cervical SNAG mobilizations is
encouraged as a noninvasive intervention depending on the therapist’s assessment,
findings, and clinical reasoning.
This study aimed to assess the effectiveness of low‐intensity extracorporeal shockwave therapy (Li‐ESWT) in the management of erectile dysfunction in diabetic patients with mixed vasculogenic and neurogenic causes as confirmed by nerve conduction and Doppler studies. This randomised controlled trial included 42 patients 41–55 years of age with a confirmed diagnosis of erectile dysfunction and diabetic polyneuropathy. They were randomly allocated to one of two groups: shock wave group (n = 21) treated with Li‐ESWT plus pelvic floor muscle training and control Group (n = 21) treated with pelvic floor muscle exercise and sham therapy by a shock wave. The erectile function was scored according to the five‐item version of the International Index of Erectile Function (IIEF‐5). Colour‐coded duplex sonography was used for the evaluation of penile perfusion of the two cavernous arteries. The assessment was done before and three months after treatment. IIEF‐EF increased significantly in the study group (p < .001), but not in the control group (p = .194). Peak systolic velocity increased significantly in the two groups; however, the post‐treatment peak systolic velocity was significantly higher in the study group compared to the control group (p < .001, for both arteries).
[Purpose] This study investigated the effect of shoulder girdle strengthening,
particularly the scapular muscles, on poststroke trunk alignment. [Subjects and Methods]
The study involved 30 patients with residual hemiparesis following cerebrovascular stroke.
Patient assessment included measuring shoulder muscle peak torque, scapular muscles peak
force, spinal lateral deviation angle, and motor functional performance. Patients were
randomly allocated either to the control group or the study group and received an
18-session strengthening program including active resisted exercises for shoulder
abductors and external rotators in addition to trunk control exercises. The study group
received additional strengthening exercises for the scapular muscles. [Results] The two
groups showed significant improvement in strength of all shoulder and scapular muscles,
with higher improvement in the study group. Similarly, the lateral spinal deviation angles
significantly improved in both groups, with significantly higher improvement in the study
group. Transfer activity, sitting balance, upper limb functions, and hand movements
significantly improved in the two groups, with higher improvement in the latter two
functions in the study group. [Conclusion] Strengthening of shoulder girdle muscles,
particularly scapular muscles, can significantly contribute to improving the postural
alignment of the trunk in patients with poststroke hemiparesis.
[Purpose] This study was performed to investigate the effect of the length of backpack
shoulder straps on upper trapezius muscle pain threshold and craniovertebral angle.
[Subjects and Methods] There were 25 participants, with ages from 15 to 23 years old.
Upper trapezius pain threshold and craniovertebral angle were measured for all subjects
without the backpack then re-measured after walking on a treadmill for 15 min under 2
conditions: 1) wearing a backpack with short straps; and 2) wearing a backpack with long
straps. [Results] there was a significant reduction in upper trapezius pain threshold and
craniovertebral angle while carrying a backpack with long shoulder straps, compared to use
of a backpack with short shoulder straps or no backpack. [Conclusion] A backpack with
short straps is less harmful than a backpack with long straps. This result should be
considered in ergonomic design of backpacks to reduce the incidence of various
physiological and biomechanical disorders.
Objective: To investigate the effect of kinetic control retraining versus the hands-on Mulligan SMWLM on functional outcomes in patients with lumbar radiculopathy. Methods: Design: Randomized Comparative Study. Setting: Outpatient, faculty of physical therapy clinic of Cairo university. Participants: Sixty subjects, suffered from chronic LBP with radiculopathy randomized equally into two groups. Intervention: The Kinetic control group, thirty subjects received kinetic control retraining plus convectional physical therapy. Mulligan group, thirty subjects received Mulligan`s mobilization plus convectional physical therapy, (for 3setions/week, for 8weeks). Outcome measures: All patients were examined by inclinometer (for trunk range of motion), Oswestry disability index (for functional ability), pain detect questionnaire (neuropathic pain) and visual analogue scale(for pain intensity). All outcomes were measured initially at baseline and after intervention. Results: After the intervention, both groups showed significant improvement on the outcome measures with superior improvement of the kinetic control group for Oswestry Disability Index (
Background: Overactive Bladder Syndrome (OAB) refers to individuals with the following symptoms: urinary urgency, excessive urinary frequency, or urge incontinence. These symptoms usually occur after partial spinal cord injury. Objective: to investigate the urodynamic effect of transcutaneous posterior tibial nerve stimulation in overactive bladder after partial spinal cord injury. Subjects: thirty subjects were divided into 2 groups: -Group (A): fifteen patients with overactive bladder after partial spinal cord injury above T12 (treated by transcutaneous posterior nerve stimulation and pelvic floor muscle exercises). Group (B): fifteen patients with overactive bladder after partial spinal cord injury above T12 (treated by pelvic floor muscle exercises) Methods: All subjects were submitted to complete clinical evaluation and assessed using urodynamic test and revised urinary incontinence scale (RUIS). Results: By comparison between both groups, the group which was treated by electrical stimulation and pelvic floor muscle exercise (group A) show increase in urodynamics parameters as bladder maximum cytometric capacity, bladder stability, maximum flow rate more than ( group B) which was treated by pelvic floor muscle exercises only. Conclusion: Transcutaneous posterior tibial nerve stimulation has good urodynamic effect on overactive bladder in patients after partial spinal cord injury.
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