Ashraf Ramadan Hafez

Treatment of knee osteoarthritis in relation to hamstring and quadriceps strength.

[Purpose] To assess the effect of hamstring and quadriceps strengthening exercises on pain intensity, gait velocity, maximum isometric strength, and activities of daily living of patients with knee osteoarthritis (OA). [Subjects and Methods] A total of 20 patients with knee OA, 50 to 65 years of age (57.65 ± 4.78 years), received hot packs, strengthening exercises for the quadriceps and the hamstring muscles and stretching exercises for hamstring muscles. Outcome measures included: the Western Ontario and McMaster Universities OA index questionnaire (WOMAC) scores for assessing health status and health outcomes of knee OA; self-reported pain intensity scores, measured using a visual analogue scale; the 50 ft walk test (a measure of gait velocity and function); and handheld dynamometry (a tool used to measure maximum isometric strength of knee extension and flexion). [Results] There was a significant difference between pre- and post-intervention measures of pain intensity, 50 ft walk times, hamstring strength, and quadriceps strength. Significant differences in WOMAC measures were also observed in the subscales of pain, stiffness and physical function, as well as WOMAC total scores. [Conclusion] Strengthening the hamstring muscles in addition to strengthening the quadriceps muscles proved to be beneficial for perceived knee pain, range of motion, and decreasing the limitation of functional performance of patients with knee OA.

Impact of knee osteoarthritis on the quality of life among Saudi elders: A comparative study

Background: The population sector of elders is progressively increasing, and it is estimated that it will reach almost one third of the total population in 2025. Large number of elders is suffering from knee osteoarthritis (OA) as the most prevalent rheumatic diseases worldwide. Recently there is a growing concern among researchers and health professionals regarding the impact of knee OA on elders and their quality of life (QOL). Objectives: To explore the impact of knee OA on QOL among Saudi elders aged between 60-70 years and to define which of the Short from survey (SF-36) domain (s) and which component, physical or mental, are mostly affected by this knee OA. In addition to study the presence of correlation between scores of SF-36 domains and components and the following factors; patient′s age, gender, weight, height, body mass index (BMI), disease duration and severity, educational level, stability of the income source, income, housing type, housing ownership, and care giver. Subjects and Methods: This study was carried out during (December/ 2010 - March/ 2011). One hundred and twenty Saudi elders, (58, 48.3% male), aged between 60-70 years with mean± SD (64.5 ± 3.03) participated in this comparative study. Half of them had severe knee OA, as defined by knee society score (KSS), they were recruited from King Saud Medical City. The other half were without knee OA, were recruited from Prince Salman Social Center and the Saudi association for the Cooperative Retirees. Arabic version of Short Form -36 questionnaire was used to measure participants QOL domains scores as well as the overall scores of the physical and mental components of the questionnaire. Data collected were statistically treated and presented in tables. Results: Current study showed a better significant scores for Saudi elders without knee OA on all SF-36 domains (p = 0.0001). Calculating the patients′ domain′s scores as percentage from the maximum domain′s scores which showed that, the mental health component of elders patients was more affected than physical health component and that role limitation due to emotional problems domain (RLEP) was the most affected domain (22.7%). Physical component showed positive correlation with income (r= 0.320, P= 0.013). While mental component showed negative correlation with disease duration (r = -0.341, P=0.008). Conclusion: Knee OA has negative impact on Saudi elders′ QOL. Mental health component was more affected than physical health component. Consequently RLEP domain was the most affected domain. Patients′ QOL was positively correlated to income and negatively correlated to disease duration.

Effect of Early Elbow Crutch Mobility on Patients with Post-Anterior Cruciate Ligament Repair

OBJECTIVE Rehabilitation after anterior cruciate ligament (ACL) reconstruction has focused over the past decade on early mobility and exercises in the recent years, due to advancements in the surgical techniques, presumably less strain on the graft. Thus it was necessary to investigate the effect of early mobilization with the single elbow crutch with conventional methods and its outcome responses. MATERIALS AND METHODS Totally, 40 subjects of day 1 post-ACL oblique repair with mean age of 25 ± 5.3 years participated in the study. Subjects were divided into experimental and control groups for rehabilitation with single elbow crutch and walker, respectively, along with conventional exercises for 6 weeks. After 4th week elbow crutch and walker were discarded for both groups. Interventional outcomes were assessed by static, dynamic stability, and knee functional score at 4th and 6th weeks post-operatively for both groups. RESULTS Both groups showed statistically significant difference in static and dynamic stability at 4th and 6th weeks. Whereas compared with experimental group, in control group Lysholm functional score was low in at 4th and 6th weeks. It was found that outcomes were improved within each group from 4th to 6th week. CONCLUSION Study concluded that knee stability and Lysholm functional Knee Score were significantly improved by early mobilization although functional score was more significant in single elbow crutch group than walker and also recommended early weaning off walking aids for faster outcomes during rehabilitation of post-ACL repair.