Amr Almaz Abdel-aziem

Plantar-flexor Static Stretch Training Effect on Eccentric and Concentric Peak Torque - A comparative Study of Trained versus Untrained Subjects

Abstract The aim of this study was to examine the long-term effects of static stretching of the plantar-flexor muscles on eccentric and concentric torque and ankle dorsiflexion range of motion in healthy subjects. Seventy five healthy male volunteers, with no previous history of trauma to the calf that required surgery, absence of knee flexion contracture and no history of neurologic dysfunction or disease, systemic disease affecting the lower extremities were selected for this study. The participants were divided into three equal groups. The control group did not stretch the plantar-flexor muscles. Two Experimental groups (trained and untrained) were instructed to perform static stretching exercise of 30 second duration and 5 repetitions twice daily. The stretching sessions were carried out 5 days a week for 6 weeks. The dorsiflexion range of motion was measured in all subjects. Also measured was the eccentric and concentric torque of plantar-flexors at angular velocities of 30 and 120o/s pre and post stretching. Analysis of variance showed a significant increase in plantar-flexor eccentric and concentric torque (p < 0.05) of trained and untrained groups, and an increase in dorsiflexion range of motion (p < 0.05) at both angular velocities for the untrained group only. The static stretching program of plantar-flexors was effective in increasing the concentric and eccentric plantarflexion torque at angular velocities of 30 and 120o/s. Increases in plantar-flexors flexibility were observed in untrained subjects.

Effect of backward walking training on postural balance in children with hemiparetic cerebral palsy: a randomized controlled study

Objective: To study the effect of additional backward walking training on postural control in children with hemiparetic cerebral palsy. Design: Randomized controlled study. Setting: Physical therapy clinics. Subjects: Thirty spastic hemiparetic cerebral palsied children of both sexes (10-14 years, 14 girls and 16 boys). Intervention: Children were randomly assigned into two equal groups: experimental and control groups. Both groups received a traditional physical therapy program for 12 weeks. Experimental group additionally received backward walking training which was provided 25 min/day, 3 days/week for 3 successive months. Outcome measures: Baseline and post-treatment assessment for overall, anteroposterior, and mediolateral stability indices were evaluated by using Biodex balance system. Results: After treatment; two way ANOVA revealed significant improvement in overall, anteroposterior and mediolateral stability indices of experimental group at the most stable level (level 12) and moderately unstable level (level 7) (1.40 ± 0.44 and 1.73 ± 0.51; 1.11 ± 0.34 and 2.13 ± 0.52; 1.93 ± 0.51 and 2.68 ± 0.52) respectively, than control group (1.77 ± 0.44 and 2.17 ± 0.56; 1.44 ± 0.44 and 2.54 ± 0.49; 2.39 ± 0.65 and 3.11 ± 0.49) respectively, (P < 0.05). There were significant improvement in all measured variables for both groups at both levels (P < 0.05). Conclusion: Additional backward walking training to traditional physical therapy program yields improvement in postural stability indices in children with spastic hemiparetic cerebral palsy than traditional physical therapy alone.

Effectiveness of backward walking training on walking ability in children with hemiparetic cerebral palsy: a randomized controlled trial:

Objective: To compare the effects of backward walking training and forward walking training on spatiotemporal gait parameters, and gross motor function measures in children with cerebral palsy. Design: Randomized controlled clinical trial. Setting: Physical therapy clinics. Subjects: A total of 30 children with hemiparetic cerebral palsy of both sexes (10 to 14 years of age, classified as I or II by gross motor function classification system) participated in this study. They were randomly assigned into two equal groups. Interventions: Both groups received a conventional physical therapy program for 12 successive weeks (three sessions per week). The experimental group additionally received (25 min) backward walking training. The control group additionally received (25 min) forward walking training. Outcome measures: Baseline, posttreatment, and follow-up assessment for spatiotemporal gait parameters and gross motor functions were evaluated by using three dimensional gait analysis system and gross motor function measures. Results: There was a significant improvement in step length, walking velocity, cadence, stance phase, and swing phase percentage and gross motor function measures (Dimensions D and E) of the experimental group (0.55 ±0.16, 0.53 ±0.19, 121.73 ±2.89, 54.73 ±1.67, 44.40 ±1.40, 90.20 ±6.44, 82.47 ±12.82), respectively, than the control group (0.39 ±0.13, 0.46 ±0.20, 125.80 ±2.96, 50.27 ±1.62, 49.47 ±1.55, 82.47 ±7.05, 80.47 ±12.61), respectively, (p < 0.05). The significant improvement of all measured outcomes of the experimental group was maintained at 1 month follow-up assessment (p < 0.05). Conclusion: In addition to a conventional physical therapy program, backward walking training is more effective than forward walking training on spatiotemporal gait parameters, and gross motor function measures in children with hemiparetic cerebral palsy.

Isokinetic imbalance of hip muscles in soccer players with osteitis pubis

Abstract In this study, we compared the isokinetic torques of hip flexors/extensors and abductors/adductors in soccer players suffering from osteitis pubis (OP), with normal soccer players. Twenty soccer male athletes with OP and 20 normal soccer athletes were included in this study. Peak torque/body weight (PT/BW) was recorded from hip flexor/extensor and abductor/adductor muscles during isokinetic concentric contraction modes at angular velocity of 2.1 rad · s−1, for both groups. The results showed a significant difference between the normal and OP groups for hip flexors (P < 0.05). The normal group had significant, lower PT/BW value than the OP group for their hip flexors (P < 0.05). The hip flexor/extensor PT ratio of OP affected and non-affected limbs was significantly different from that of normal dominant and non-dominant limbs. There were no significant differences between the normal and OP groups for hip extensor, adductor and abductor muscles (P > 0.05). Regarding the hip adductor/abductor PT ratio, there was no significant difference between the normal and OP groups of athletes (P > 0.05). The OP group displayed increase in hip flexor strength that disturbed the hip flexor/extensor torque ratio of OP. Therefore, increasing the hip extensor strength should be part of rehabilitation programmes of patients with OP.

Concentric and eccentric strength of trunk muscles in osteitis pubis soccer players

BACKGROUND AND OBJECTIVES Osteitis pubis refers to a painful, inflammatory condition involving the pubic bones, pubic symphysis, and adjacent structures. So, the aims of the study were to evaluate the strength of trunk muscles of soccer players suffering from osteitis pubis, and to compare the agonist/antagonist ratio of trunk muscles in osteitis pubis athletes with that of healthy athletes. MATERIALS AND METHODS Twenty-five soccer male athletes with osteitis pubis, and 25 healthy soccer athletes. Peak torque/body weight (PT/BW) was recorded from trunk muscles during isokinetic concentric and eccentric contraction modes at a speed of 120°/s for healthy and osteitis pubis soccer players. RESULTS There was a significant decrease in concentric contraction of back muscles in osteitis pubis group (p=0.01). A significant decrease in eccentric contraction of abdominal muscles was also recorded in osteitis pubis group (p=0.008). Concentric abdominal/back muscles ratio was significantly higher in osteitis pubis group (p=0.016), with no significant difference in eccentric abdominal/back muscles ratio between both groups (p>0.05). CONCLUSION Osteitis pubis group displayed concentric weakness of back muscle and eccentric weakness of abdominal muscles that lead to disturbance of the normal concentric abdominal/back ratio.

Chronic ankle instability alters eccentric eversion/inversion and dorsiflexion/ plantarflexion ratio

OBJECTIVE To determine if the eccentric evertor/invertor and dorsiflexor/plantar-flexor ratio are altered in subjects with chronic ankle instability. METHODS Twenty chronic ankle instability (CAI) subjects as an experimental group, and twenty healthy subjects as a control group, were matched in age, gender, and activity level. CAI subjects have a history of at least one ankle sprain and repeated episodes of giving way were included in CAI group. Subjects with no prior history of ankle injury were included in the control group. Ankle evertor/invertor and dorsiflexor/plantar-flexor muscles eccentric torque ratios were measured using the eccentric muscle contraction at angular velocities 60 and 120°/s. RESULTS Analysis of variance revealed that the eccentric contraction eversion/inversion ratio of CAI group was significantly lower than normal group ratio at angular velocities 60 and 120°/s (p=0.041 and 0.012) respectively. The eccentric contraction dorsiflexion/plantarflexion ratio of CAI group was significantly higher than normal group ratio at both angular velocities (p=0.036 and 0.013) respectively. Moreover, at angular velocities of 60°/s and 120°/s a deficit in inversion and eversion eccentric torques were identified in CAI group (p=0.000), plantarflexion torque deficit of CAI group (p=0.034 and 0.028), respectively, and no deficit was identified for dorsiflexion torque of CAI group (p=0.595 and 0.696) respectively. CONCLUSION Chronic ankle instability increases the dorsiflexion/plantarflexion muscles torque ratio and decreases the eversion/inversion ratio at angular velocities 60 and 120°/s. Therefore, the restoration of a normal eccentric inversion, eversion, and plantarflexion strength may prevent recurrent lateral ankle ligament sprain.

Backpack carriage effect on head posture and ground reaction forces in school children

BACKGROUND Carrying the school bag may lead to forward leaning of the head and trunk which may result in spinal deformities. OBJECTIVE The purpose of this study was to evaluate the effect of carrying a backpack on neck angles and ground reaction forces (GRFs) in children. METHODS 3-D motion analysis system, with a force plate, was used to examine the effect of carrying backpack on neck angles and GRFs of thirty children with mean age (10.06 ± 1.31 years), mean weight (34.56 ± 6.9 kg), and mean height (138.63 ± 9.82 cm). The unloaded posture was compared with posture when carrying a backpack. The static test was used to assess the three angles of the neck, and the dynamic test was used to assess the GRFs. RESULTS There were no significant differences in the craniohorizontal angle and shoulder sagittal posture between carrying backpack and without backpack (p = 0.153 and 0.272) respectively. There was a significant decrease in the craniovertebral angle in carrying backpack than without backpack (p = 0.032). There was a significant increase in GRFs values in carrying backpack than without backpack (p < 0.032). CONCLUSION Carrying backpack with a load 7.5% of the childs body weight alters the head posture and GRFs values.

The effect of knee osteoarthritis on ankle proprioception and concentric torque of dorsiflexor and plantar-flexor muscles

BACKGROUND: Muscle function and functional performance are affected in patients with osteoarthritis (OA). PURPOSE: To assess the relationship between knee OA and ankle proprioception and concentric peak torque of the dorsiflexor and plantar-flexor muscles in older patients. METHODS: Forty participants took part in the study; 20 participants with chronic unilateral knee OA and a control group of 20 healthy participants. Ankle proprioception and concentric peak torque were measured by an isokinetic dynamometer (Biodex). MAIN RESULTS: There was a significantly greater absolute error at the ankle among the knee OA group (p= 0.0001). The concentric peak torque value of dorsiflexor and plantar-flexor muscles of the control group was significantly higher than the knee OA group (p= 0.003, p= 0.008) respectively. CONCLUSION: Those with OA of the knee displayed deficits in ankle proprioception and concentric peak torque of the dorsiflexor and plantar-flexor muscles.

Partial versus full range of back extension endurance testing using the swiss ball in discogenic low back pain patients : a comparative study

Abstract Background and aim: Decreased back extensor muscles endurance is the most common significant finding in patients with discogenic low back pain (DLBP). The aim of this study was to determine whether the holding time at partial range of motion (ROM) is different from full ROM during back extension endurance testing. Methods: Fifty consecutive chronic DLBP patients (35 males, 15 females) aged between 25 and 65 years were recruited using a purposive sample. First, pain, back disability and sagittal mobility were measured to establish eligibility. Second, back extension endurance holding time was tested by measuring back extension on the Swiss ball at partial and full ROM. Results: The mean holding time, in seconds, for first partial and first full back extension was 20.9 (SD = 12.7) and13.2 (SD = 9.8) (p < 0.001), respectively. The mean holding time for second partial and second full back extension was 22.1 (SD = 16.1) and 14.6 (SD = 10.2) (p < 0.001), respectively. The holding time was analysed using paired-sample t-test. The intraclass correlation coefficient (ICCs) for partial and full back extension endurance testing was 0.93 and 0.96, respectively. Conclusion: The patients had increased holding time when back extension endurance testing was performed at partial as opposed to full range of motion.

Effect of Ultrasound Combined with Conventional Therapy on Neck Pain, Function, and Disability in Patients with Cervical Spondylosis: A Randomized Placebo-Controlled Trial

Abstract Objective: The purpose of this study was to evaluate the effect of continuous ultrasound [US] compared with placebo US combined with conventional physiotherapy program for patients with cervical spondylosis. Methods: This was a randomized placebo-controlled trial. Patients, diagnosed with cervical spondylosis, were randomly assigned to one of two groups in an orthopedic physical therapy clinic: a group that received electrotherapy, exercise, hot packs, and therapeutic US [True US group] and a group that received electrotherapy, exercise, hot packs, and sham US [Sham US group]. Patients were treated, on average, three times per week for 4 weeks. Outcome measurements were collected at baseline and after 4 weeks using the Numeric Pain Rating Scale, Patient-Specific Functional Scale, and Neck Disability Index. Results: Analysis of variance showed that both groups had improved regarding Numeric Pain Rating Scale, Patient-Specific Functional Scale, and Neck Disability Index [p < 0.05]. There was no significant difference between both groups for pretest and post-test values [p > 0.05] for all measures. Conclusions: The addition of US to conventional physiotherapy program of electrotherapy, exercise, and hot packs yields no additional benefit to neck pain, function, or disability in patients with cervical spondylosis.