Physical Therapy and Health Rehabilitation

Background: Medications are limited for patients with nonalcoholic fatty liver disease (NAFLD). It has been reported that aerobic exercise is effective in reducing the characteristics of NAFLD, although unclear data have ascertained the effects of high-intensity interval aerobic exercise on health-related quality of life (HRQoL) in diabetic obese patients with NAFLD. Objectives: This a randomized controlled trial aimed to ascertain the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides (IHTG), visceral lipids and HRQoL in diabetic obese patients with NAFLD. Study design: Between August and December 2017, 32 diabetic obese patients with NAFLD aged 45 to 60 years (21 men and 11 women) were enrolled in this study. They were randomly assigned to 2 groups, 16 patients in each group, high-intensity interval (HII) exercise and control groups. The HII group received a program of HII aerobic exercise for 8 weeks with medications of NAFLD and the control group received only medications without any type of exercise intervention. The test of IHTG, visceral lipids, and HRQoL were recorded at the initial assessment and at the end of the program after 8 weeks. Results: There were significant differences between the 2 groups at the end of the study. These study findings exhibited significant improvements in IHTG, VO 2peak, visceral lipids, glycohemoglobin, plasma glucose, and all dimensions of HRQoL in the HII group (P <.05), But there was non-significant improvement in any measure in the control group (P >.05) after the 8-week intervention. Conclusion: Eight-week high-intensity interval aerobic exercise has a beneficial effect on IHTG, visceral lipids, and HRQoL in diabetic obese patients with NAFLD. Effort and awareness should be dedicated to encouraging the active lifestyle among different population, especially diabetic obese patients with NAFLD. Abbreviations: ALT = alanine-transaminase, BMI = body mass index, CLDQ = Chronic Liver Disease Questionnaire, HbA1c = glycohemoglobin, HDLs = high-density lipoproteins, HII = high-intensity interval, HOMA-IR = insulin resistance, HRQoL = health-related quality of life, IHTG = intrahepatic triglyceride, LDLs = low-density lipoproteins, MRI = magnetic resonance imaging, NAFLD = nonalcoholic fatty liver disease, TGs = triglycerides, VLDLs = very low-density lipoproteins, VO 2peak = peak oxygen uptake.

Background: Impairment of peripheral skeletal muscle function is a common phenomenon in patients with cystic fibrosis (CF) in addition to great clinical connotations, such as lack of exercise tolerance and decrease of health-related quality of life. There is very limited data on the effects of maximal exercise on muscle fatiguability and exercise capacity in children with cystic fibrosis. Objectives: The aim of this study was to evaluate the effect of progressive maximal exercise training of the lower extremities on exercise capacity and muscle fatiguability in children with cystic fibrosis. Study design: Between June and September 2017, eighteen children aged 8-12 years were recruited in this study. This study had two groups of children; the CF group consisted of nine children (6 males and 3 females) with cystic fibrosis and the control group consisted of nine healthy age matched children (6 males and 3 females). The children underwent a progressive maximal cardiopulmonary exercise cycling test (CPET), muscle fatigue test, and magnetic resonance imaging (MRI) to measure a muscle cross-section area (CSA). Also, pulmonary functions were assessed. Results: The findings of this study showed that the CF children had less pulmonary functions, had a less exercise capacity, and had a higher breathing reserve index and oxygen desaturation when compared with healthy children (p<0.05). On the other hand, there was a non-significant difference in muscle fatiguability, muscle cross-section area, and maximal voluntary contraction between the CF and healthy children (p>0.05). Conclusion: This study indicates that progressive maximal exercise doesn't affect muscle fatiguability, muscle cross-section area, and maximal voluntary contraction in CF children with moderate respiratory diseases but includes lower exercise capacity. CF children and healthy age matched children have similar responses to maximal exercise in muscle fatiguability, muscle cross-section area, and maximal voluntary contractions but lower exercise capacity in the CF group.

Background: Isokinetic training (IKT) and core stabilization training (CST) are commonly used for balance training in musculoskeletal conditions. The knowledge about the effective implementation of these training protocols on radiological and biochemical effects in university football players with chronic low back pain (LBP) is lacking.

Background: Obesity is very common worldwide and is related to critical morbidity and mortality. It has a large number of impacts on the human body. Constipation has a prevalence from 4% to 29% in various parts of the world and is considered to be a major health problem, with an estimated incidence of 5% in males and 15% in females. There is a strong association between obesity and constipation. This study aimed to investigate the effect of physical activity and a low-calorie diet on constipation in middle-aged obese women. Methods: This study included 125 obese women (age 20-40 years) who had chronic constipation. Participants were randomly assigned to two groups. Group A included 62 women who received a suggested protocol of physical activity, a low-calorie diet, and the routine standard care for constipation, whereas Group B included 63 women who received only the standard medical care for constipation and a low-calorie diet. Both groups followed the program for 12 weeks. Changes in the Patient Assessment of Constipation Symptoms (PAC-SYM) and Patient Assessment Quality of Life (PAC-QOL) scores, and in the body mass index (BMI) were recorded in study subjects, both at baseline and at the end of the study program. Results: There were no statistically significant differences in the baseline characteristics of patients in the two groups. After 12 weeks of intervention, both groups showed significant intragroup differences (p < 0.05) in all of the measured variables, except the BMI which showed a nonsignificant difference (p > 0.05) in Group B. Between-groups comparison showed significant differences (p < 0.05) in all of the measured parameters in favor of Group A. Conclusion: Physical activity and weight reduction improve PAC-SYM and PAC-QOL scores in middle-aged, premenopausal women with constipation in the short term (up to 12 weeks).

Objective. To estimate the relationship between physical activity and health-related utility for people with knee osteoarthritis (OA) and implications for designing cost-effective interventions. Methods. We used generalized estimating equation regression analysis to estimate partial association of accelerometermeasured physical activity levels with health-related utility after controlling for demographics, health status, knee OA severity level, pain, and functioning. Results. Moving from the lowest to the middle tertile of physical activity level was associated with a 0.071 (P < 0.01) increase in health-related utility after controlling for demographics and a 0.036 (P < 0.05) increase in utility after controlling for demographics, health status, knee OA severity level, weight, pain, and functional impairments. Conclusion. Intervention programs that move individuals out of the lowest tertile of physical activity have the potential to be cost effective. ClinicalTrials.gov identifier: NCT00248105. Supported by the Arthritis Foundation and NIH grants R01-AR055287 and P60-AR48098.

Back ground and Purpose: Bronchiectasis is associated with impairment of the mucociliary escalator and retention of secretions within the bronchial tree, making airway clearance a primary concern in the management of bronchiectasis. Patients and methodology: Objective: The objective of this study was to determine the effect of active cycle of breathing as an airway clearance technique on functional capacity in adults with productive bronchiectasis by using six minute walk test and dyspnea index. Design: The study was cohort design carried out on 45 patients (mean age 54. 93± 3.82 years) of both genders with stable productive bronchiectasis receiving multiple sessions (3 times/week for two months) of active cycle of breathing. Measurements: Pre and post treatment measures were recorded for functional capacity in form of six minute walk test and dyspnea index. Results: All 45 patients were stable during the study period. The functional capacity and level of dyspnea were significantly improved post treatment sessions with mean difference 48.06 for six minute walk test and 29.2 for dyspnea index. Conclusion: The active cycle of breathing technique is an effective method for airway clearance and improving functional capacity in patients with bronchiectasis.

Background and Purpose: Frozen shoulder is a common condition commonly affecting 2-5% of the industrial population typically between 40 and 60 years of age. Most of the studies were analysed the individual interventions and did not investigate the combination of interventions. The purpose of this study is to find two different forms of massage techniques Trigger Point therapy and Myofascial release in second stage of Frozen Shoulder to reduce pain and improve the Range of motion. Subjects: 30 subjects working in industry with unilateral second stage frozen shoulder lasting 3 months or more and 25% decrease in passive joint mobility relative to the non affected side were enrolled in this study. Methods: Subjects who were willing to participate in the study and to fulfil the inclusion and exclusion criteria were included in the study and they were divided into two Groups (A and B) randomly. Group A was treated with Trigger Point therapy, Myofascial release, Scapula Stabilization Exercises, and Interferential Therapy (IFT) and Group B were treated only with Scapula Stabilization Exercises and IFT. The duration of treatment was 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by Visual Analog Scale (VAS) and Range of Motion (ROM) by goniometer. Results: Subjects in both Groups improved over 4 weeks after intervention. Significant (p £ 0.05) difference were found between both Groups after 4 weeks in VAS and ROM. But statistically (p £ 0.05) greater change scores were found in the Group A for VAS and ROM than Group B. Discussion and Conclusion: Group A and B was effective in reducing pain and improving the ROM in patients with second stage of Frozen Shoulder. However, subjects in Group A, who received Trigger Point therapy and Myofascial release showed better improvement in reduce pain and improve the ROM than Group B. In conclusion the treatment program consisting of Trigger Point therapy and Myofascial release may be more effective in reducing pain and improving the ROM in second stage Frozen Shoulder among industrial workers.

Objectives: This study aim was to compare the impacts of high intensity interval (HII) to moderate intensity continuous exercise (MIC) on ventilatory markers in patients with coronary heart disease (CHD). Design: Twenty eight patients with mild to moderate CHD aged 50-60 years were selected for this study. They randomized to two groups, each group comprised of 14 patients, group I received a program of high intensity interval exercise (HII 3 times/week for 12 weeks) and group II received a program of moderate intensity continuous aerobic exercise (MIC 3 times/week for 12 weeks). The ventilatory marker changes (O 2 P, slope of VE/VCO 2 and OUES) have been measured at the beginning and the end of the study. Result: After 12 weeks of enrollment, HII group showed statistically significant improvement in O 2 P but no significant changes in MIC group (21% with p<0.05 versus 1% with p>0.05). No significant differences appeared in VE/VCO 2 and OUES (pre-and post-program) in the two groups p>0.05. Conclusions: It was concluded that HII had greater improvements than MIC on ventilatory markers in patients with CHD in a short term (up to twelve weeks).

Obesity is very common worldwide and is related to critical morbidity and mortality. It has a large number of impacts on the human body. Constipation has a prevalence from 4% to 29% in various parts of the world and is considered to be a major health problem, with an estimated incidence of 5% in males and 15% in females. There is a strong association between obesity and constipation. This study aimed to investigate the effect of physical activity and a low-calorie diet on constipation in middle-aged obese women. This study included 125 obese women (age 20-40 years) who had chronic constipation. Participants were randomly assigned to two groups. Group A included 62 women who received a suggested protocol of physical activity, a low-calorie diet, and the routine standard care for constipation, whereas Group B included 63 women who received only the standard medical care for constipation and a low-calorie diet. Both groups followed the program for 12 weeks. Changes in the Patient Asses...

To compare the effects of a single high-intensity interval exercise session (HIIE) with a moderate-intensity continuous exercise session (MICE) on the inflammatory profile, IgA levels, and lipid peroxidation in sedentary obese males. Ten sedentary obese men (age 28.5 ± 2.7 years; BMI 35.9 ± 4.9 kg/m; body fat 40.6 ± 2.0%) performed three experimental sessions, on separate days with 1 week wash-out period between interventions, according to a randomized order: (1) HIIE: 10 × 60 s at 90% of the HR alternated by 60 s of active recovery; (2) MICE: 20 min at 70% of the HR (3) Rest-control. Blood and saliva samples were collected before, immediately after and 60 min after the end of each session in order to analyse serum levels of cytokines, IgA, and lipoperoxidation markers. Leptin levels decreased immediately after HIIE ( = 0.033) and was different from the MICE ( = 0.025). IFN-γ levels were reduced immediately after ( = 0.032) and 60 min after HIIE ( = 0.003) compared to baseline, and ...

Background: Breast cancer stands out among the most widely recognized forms of cancer among women. It has been observed that upper extremity lymphedema is one of the most risky and prevalent complication following breast cancer surgery that prompts functional impairment, psychological, and social problems. Purpose: To compare the effects of Kinesio taping and the application of the pressure garment on secondary lymphedema of the upper extremity. Methods: 66 women were randomly allocated to the Kinesio taping (KT) group (n=33) and pressure garment (PG) group (n=33). The KT group received Kinesio taping application (2 times per week for 3 weeks), while the PG group received pressure garment (20- 60 mmHg) for at least 15-18 hours per day for 3 weeks. The outcome measures were limb circumference, Shoulder Pain and Disability Index questionnaire (SPADI), hand grip strength, and quality of life at the baseline and end of intervention. Results: The sum of limb circumferences, SPADI, hand g...