Zaheen A. Iqbal

Effect of Deep Cervical Flexor Muscles Training Using Pressure Biofeedback on Pain and Disability of School Teachers with Neck Pain

[Purpose] The job of secondary school teachers involves a lot of head down posture as frequent reading, assignment correction, computer use and writing on a board put them at risk of developing occupational related neck pain. Available studies of neck pain experienced by teachers are limited. The purpose of this study was to determine whether training of deep cervical flexor muscles with pressure biofeedback has any significant advantage over conventional training for pain and disability experienced by school teachers with neck pain. [Subjects] Thirty teachers aged 25–45 years with neck pain and poor craniocervical flexion test participated in this study. [Methods] A pretest posttest experimental group design was used in which experimental group has received training with pressure biofeedback and conventional exercises while control group received conventional exercises only. Measurements of dependent variables were taken at baseline, and after 2 and 4 weeks of training. Pain intensity was assessed using a numeric pain rating scale and functional disability was assessed using the neck disability index. [Results] The data analysis revealed that there was significant improvement in pain and disability in both the groups and the results were better in the experimental group. [Conclusion] Addition of pressure biofeedback for deep cervical flexor muscles training gave a better result than conventional exercises alone. Feedback helps motor learning which is the set of processes associated with practice or experience leading to permanent changes in ability to respond.

Work-related musculoskeletal disorders among dental professionals in Saudi Arabia.

[Purpose] Musculoskeletal disorders are common causes of work-related disability in different professions involving the frequent practice of lifting, stooping, twisting, prolonged sitting, or standing. The dental profession is one such profession. Our aim was to determine the prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia, the factors associated with them, and their consequences and to propose preventive measures for them. [Subjects and Methods] A self-administered online questionnaire was sent to 225 members of the Saudi Dental Association. It included questions on demographic and professional characteristics, general medical history, and history of work-related musculoskeletal disorders before and after joining the dental profession. [Results] The questionnaire was completed by 65% of the respondents. Among them 85% reported that they had developed some pain due to work after joining the dental profession, and 42% reported that they were suffering pain at the time of the survey. Besides lower back, shoulder, and neck regions, the hands, upper back, and other regions like the elbows, buttocks, thighs, leg, and feet were areas in which they pain. [Conclusion] The prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia is high, affecting their daily activities, sometimes even forcing them to change their work setting. Age, gender, specialty of work, work setting, number of contact hours with patients, etc., were all found to be related to their work-related pain. We need to emphasize the role of ergonomics, counseling, proper techniques of patient handling, etc., during the training of dental professionals so that they can work efficiently.

An update on vestibular physical therapy.

&NA; Vestibular physical therapy is a specialized exercise based intervention for management of symptoms associated with vestibular dysfunction that manifests itself as dizziness and imbalance related to position or movement of the body. The aim of this review is to evaluate and summarize the efficacy of vestibular physical therapy for the treatment of vestibular disorders. A literature review was conducted to identify references related to vestibular disorders plus rehabilitation. Articles ranged from descriptions of vestibular dysfunction, its diagnosis, treatment, and rehabilitation in various populations. Case studies, case series with no controls, and controlled studies support the use of vestibular rehabilitation physical therapy for persons with peripheral vestibular disorders. There are emerging data that support vestibular rehabilitation physical therapy for persons with central vestibular disorders.

Physical therapy education in Saudi Arabia.

[Purpose] To review the physical therapy educational program model, professional curriculum, and gender representation at major universities, as well as the quality and scope of physical therapy practice in Saudi Arabia. [Methods] Information regarding course curriculum, gender representation, and the quality and scope of physical therapy practice was collected from six universities in Saudi Arabia, the Saudi Physical Therapy Association, and the Saudi Health Commission. [Results] The first bachelor’s degree course of physical therapy was started in Saudi Arabia more than 30 years ago. In the last 10 years, the number of universities offering a bachelor’s degree in physical therapy has risen from 6 to 16, of which 14 are governmental and two are private. The 5- to 6 year bachelor’s degree program in physiotherapy includes an internship and preparatory prerequisite courses. Postgraduate study in physical therapy was introduced in 2000. Most universities offer segregated physical therapy courses for male and female students. [Conclusion] The enrollment of students in physical therapy programs in Saudi Arabia is gradually increasing. There are many opportunities to extend the scope of practice and contribute to the health needs of the Arab population and international communities.

Effects of sitting time associated with media consumption on physical activity patterns and daily energy expenditure of Saudi school students

[Purpose] This study was performed to assess the effect of daily sitting time during media consumption on physical fitness, total energy expenditure (TEE), and body composition indices of Saudi school children. [Subjects and Methods] A total of 180 healthy Saudi school students (8–18 years) were included in this study. Sitting time, total energy expenditure, and levels of physical activity were evaluated with pre-validated internet based questionnaires. Body composition indices were evaluated using anthropometric analysis. [Results] Out of the studied participants, only 22.2% of students were physically inactive. Children with moderate and active physical scores demonstrated less sedentary behavior (TV viewing and computer usage), lower body composition values (BMI, WC, WHtR), and higher TEE than sedentary or mild activity level participants. Boys showed higher fitness scores and less sedentary behavior than girls. Media sitting time among the studied subjects correlated negatively with physical scores and positively with body composition. [Conclusion] The data presented here suggests that poor physical fitness, lower TEE, and longer sitting times differentially influence normal body composition indices among school children which may lead to overweight or obese individuals. Thus, decreasing sitting time during media consumption and enhancing physical activity may play a pivotal role in preventing obesity in young children.

Television watching, diet and body mass index of school children in Saudi Arabia

Watching television has been widely associated with various health and psychological outcomes in children. Excessive intake of carbonated, sweetened beverages and fast foods, inadequate intake of fruit and dairy products; and reduced levels of physical activity also pose a risk to healthy lifestyle among youth. Limited literature is available, however, on the cross‐cultural aspects of duration of television viewing, diet preferences and their effect on weight in school children in the Middle East, especially in Saudi Arabia. We conducted an online survey in school children in Saudi Arabia (age 12–16 years) to determine whether there is any association between duration of daily television watching, body mass index (BMI), eating habits and diet preferences.

Effect of chewing on postural stability during quiet standing in healthy young males

Abstract Background and aims: There is an important role of the neck sensory motor system in control of body posture and balance, and it is reasonable to believe that the jaw sensory motor system can directly and indirectly influence the modulation of the postural control system. The purpose of this study was to evaluate possible effects of dynamic jaw position while chewing on the postural control system. Materials and methods: We compared the mean center of gravity (COG) velocity during quite standing on a foam surface with eyes closed during three test conditions: (i) with resting jaw position, (ii) with open jaw position, and (iii) while chewing standard bolus of chewing gum. One hundred and sixteen normal healthy male subjects (average age 31.56 ± 8.51 years; height 170.86 ± 7.26 cm) were recruited for the study. Their COG velocity (deg/s) was measured using the NeuroCom® Balance Master Version 8.5.0 (Clackamas, OR, USA). Statistical analysis: Data was tested by the Friedman test. Results and conclusions. The results show that COG velocity decreased significantly while chewing in comparison to both open and resting jaw position (p < 0.0001). Our finding corroborates previous studies and suggests that the jaw sensory motor system can modulate postural control mechanisms. Gum chewing activity can enhance the postural stability during upright standing on an unstable surface and in the absence of visual input in healthy young adults. Our results should be taken into consideration in treatment and rehabilitation planning for patients with postural instability.

Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia

[Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy.

Effect of sitting postures and shoulder position on the cervicocephalic kinesthesia in healthy young males

Abstract Information about head orientation, position, and movement with respect to the trunk relies on the visual, vestibular, extensive muscular, and articular proprioceptive system of the neck. Various factors can affect proprioception since it is the function of afferent integration, and tuning of muscular and articular receptors. Pain, muscle fatigue, and joint position have been shown to affect proprioceptive capacity. Thus, it can be speculated that changes in body posture can alter the neck proprioception. This study was undertaken to investigate the effect of body posture on cervicocephalic kinesthetic sense in healthy subjects. Cervicocephalic kinesthetic sensibility was measured by the kinesthetic sensibility test in healthy young adults while in (a) habitual slouched sitting position with arms hanging by the side (SS), (b) habitual slouched sitting position with arms unloaded (supported) (SS-AS), and (c) upright sitting position with arms hanging by the side (US) during maximum and 30 degree right, left rotations, flexion, and extension. Thirty healthy male adults (mean age 27.83; SD 3.41) volunteered for this study. The least mean error was found for the SS-AS position (0.48; SD 0.24), followed by SS (0.60; SD 0.43) and US (0.96; SD 0.71), respectively. For all test conditions, there was significant difference in mean absolute error while head repositioning from maximum and 30 degree rotation during SS and SS-AS positions (p < 0.05). In conclusion, body posture can affect the proprioception function of the neck. Supporting the upper extremities in such a way that their weight is unloaded, which leads to reduction in the tension between the neck and shoulder girdle, can improve cervicocephalic kinesthetic sense in both the horizontal and vertical planes. The findings of this study can be implemented in people who have to do repeated arm and neck movements, by using ergonomically effective chairs with proper arm supports. This might help in prevention and treatment of neck pain.

Effect of absence of vision on posture

[Purpose] The visual system is one of the sensory systems that enables the body to assess and process information about the external environment. In the absence of vision, a blind person loses contact with the outside world and develops faulty motor patterns, which results in postural deficiencies. However, literature regarding the development of such deficiencies is limited. The aim of this study was to discuss the effect of absence of vision on posture, the possible biomechanics behind the resulting postural deficiencies, and strategies to correct and prevent them. [Subjects and Methods] Various electronic databases including PubMed, Medline, and Google scholar were examined using the words “body”, “posture”, “blind” and “absence of vision”. References in the retrieved articles were also examined for cross-references. The search was limited to articles in the English language. [Results] A total of 74 papers were shortlisted for this review, most of which dated back to the 1950s and 60s. [Conclusion] Blind people exhibit consistent musculoskeletal deformities. Absence of vision leads to numerous abnormal sensory and motor interactions that often limit blind people in isolation. Rehabilitation of the blind is a multidisciplinary task. Specialists from different fields need to diagnose and treat the deficiencies of the blind together as a team. Before restoring the normal mechanics of posture and gait, the missing link with the external world should be reestablished.