Balance reactions in middle-aged chronic low back pain patients

To measure the balance reactions with force-plate stabilometry in a group of subjects with back pain and those with healthy back to determine if there is difference between them and correlate balance stability indices with pain assessment parameters [pain duration and back pain disability score] in a group of patients with back pain Forty middle-age subjects complaining of chronic back pain of variable causes [lumber spondyolosis, old discotomy, chronic back strain and sacroiliac dysfunction] were included in this study [25 males and 15 females] with age between 20 and 42 years [mean32 +/- 7.16]. Also thirty subjects with healthy back were included in this study with age between 20-45 [mean 32.1 +/- 6.7]. All patients with back pain [not less than 6 months] were assessed through careful history and examination using Oswestery back pain disability questionnaire [ODS]. Balance responses [body sway] of each subject was evaluated by using computerized force-plate stabilometry [Biodex stability system] that provides dynamic multiaxial platform with variable degrees of eight instability levels ranging from least stability level to most stability level. The mean of anteroposterior [A-P] and mediolateral [M-L] stability indices for all dynamic positions in subjects with chronic LBP were greater than A-P and M-L stability indices in subjects with healthy back in the same positions with a statistic significant difference [p<0.05]. There was a significant positive correlation between both pain duration and ODS and A-P stability index and a non-significant negative correlation between them and M-L stability index. Dynamic balance is disturbed in patients with chronic back pain as compared to normal subjects in different dynamic balance positions especially in the A-P direction. The least stable position e.g. standing on one foot and with turning head and closed eye significantly increased the A-P stability index in patients with LBP than in normal subjects

Relationship between severity of airflow obstruction and isokinetic skeletal muscle strength in chronic obstructive pulmonary disease patients

Evaluate the relationship between skeletal muscle strength and severity of the airflow obstruction in patients with COPD This study included sixty patients with chronic obstructive pulmonary disease [COPD] classified into two groups [25 patients don't received steroid and 35 patient received steroid] and thirty sedentary, non smoker, healthy male as a control group. All patients and control group are subjected to Plain X ray chest, pulmonary function tests, [cross sectional area] CSA-CT scan and isokinetic measurement of [Quadriceps, Hamstring] muscles for lower limb and [shoulder abductor and adductor] muscles for upper limb. the results of this study showed that Force Expiratory Volume in one sec. FEV-1], Forced Vital Capacity FVC and PaO2 mmHg in the patients with COPD were significantly lower than control group [p<0.05]. Also, isokinetic measurement of muscles [peak torque] PT of the patients with COPD was significantly lower than control group [p<0.05]. Muscle cross section area CSA was significantly decrease in patients with COPD than control group p<0.05. Pulmonary function tests showed no significant differences in steroid and non steroid treated COPD groups. While, isokinetic measurement of muscles [peak torque] PT significantly decrease in patients received steroid than patients don't received steroid COPD group where [p<0.05]. There was relationship between COPD and muscle strength deficit which can be evaluated using isokinetic dynamometry measurement

Evaluation of bone resorption in male patients with bilharzial periportal hepatic fibrosis

To evaluate bone resorption and bone mineral metabolism in male patients suffering from bilharzial periportal hepatic fibrosis by assessment of liver function tests and factors that regulate bone resorption and formation and correlate these factors to bone mineral density assessing bone mineral metabolism. This study was carried out on 50 male patients suffering from bilharzial periportal hepatic fibrosis; their mean age was 38.6 +/- 8.14. Also 40 age matched healthy males were included in this study as a control group. Both patients and control groups were subjected to the following investigations [parathyroid hormone [PTH], testosterone, vitamin D3 [1-25 hydroxycholecalciferol], serum calcium and phosphorus, total alkaline phosphatase and liver function tests including [SGOT, SGPT, total protein, albumin, total and direct bilirubin] in addition to dual energy X-ray absorbtiometry [DEXA] and abdominal ultrasonography. patients suffering from bilharzial periportal hepatic fibrosis showed highly significant reduction of serum testosterone and bone mineral density [BMD] in comparison to control group [p<0.001] and the testosterone is highly correlated with BMD [p<0.001] parathyroid hormone, vitamin D3, serum calcium and phosphorus showed non significant difference between both studied groups [p>0.05] and not correlated with BMD [p>0.05]. However, liver function tests were significantly higher in patients than control group [p<0.01]. Our results demonstrate that the liver is an important organ responsible for bone integrity and any chronic liver disease like bilharzial periportal liver fibrosis can directly affect the bone and causing osteoporosis which indicated by diminished BMD and this osteoporosis was accompanied with gonadal dysfunction indicated by reduced testosterone so it is called [Andropausal osteoporosis]

Efficacy of thermal massage therapy in chronic low back pain

The effect of thermal massage therapy for 3 months duration of treatment on pain intensity, self-experienced disability and lumber fatigability was evaluated in 104 patients who suffered from chronic low back pain. The patients constituted 54 men and 50 women. They were divided according to the cause of back pain into discogenic group and mechanical group. The mean age was 52.9 +/- 10.8 and the disease duration ranged from 3 months to 30 years [7.8 +/- 7.1]. Before starting therapeutic intervention and after 3 months of treatment, the back pain intensity and functional disability were measured subjectively using the visual analog scale [VAS] and Oswestry low back pain disability score [ODS]. However, the lumber endurance was measured objectively by spectral electromyography, mean power frequency slope [MPF slope]. Analysis of the current study results with multivariate analysis of variance [MANOVA] showed that the back pain intensity, functional disability and lumber muscle fatigability in both discogenic and mechanical groups were similar at the baseline [before therapeutic intervention] [p>0.05]. After treatment with the thermal massage bed and strengthening exercises for 3 months, the analysis showed a significant decrease in back pain intensity and disability and improvement of lumber muscle endurance in both groups [p<0.05]. Also, this improvement was more in the mechanical group than in the discogenic group [p< 0.05]. Our results demonstrate that the thermal massage rehabilitation program was more successful in reducing back pain and self-experienced disability and in improving lumber muscle endurance

Bone mineral content and risk of vertebral fractures in ankylosing spondylitis

Osteoporosis and vertebral fractures are encountered in ankylosing spondylitis. This study was undertaken to visualize whether such is due to the disease itself or due to mechanical factors and limited mobility. The study was performed on 26 ankylosing spondylitis patients recruited from the Out-patient Clinic of the Rheumatology and Rehabilitation Departments of Al-Azhar and Al-Menya Universities Hospitals. Sixteen of them had the disease for less than 10 years [G1] and ten had it for more than 10 years [G2]. Twenty-five apparently normal staff members matched in age and sex were taken as a control group. Patients underwent medical history taking, clinical examination, metreological assessment, radiological evaluation according to New York criteria, determination of vertebral fractures according to Black et al. [1991] as well as DEXA examination of the lumbar spine, femoral neck and wrist. There was a reduction of BMC in all of the studied areas lumbar spine, femoral neck and distal forearm in AS patients. Two out of sixteen [12.50%] patients with mild AS [<10 years] had vertebral fractures as compared with three out of twelve [25%] patients with AS [>10 Years] and one out of 25 controls [4%]. No significant correlation was observed between vertebral fractures and BMC in any of the examined areas