Evaluation of the effect of balance training in hemiplegic patients

Aim of the work: To assess the postural instability in hemiplegic patient and evaluate the effect of balance training by the biodex balance system [BBS-SD]

Patients and methods: Forty patients with hemiplegia [hemiplegic group] and 30 healthy volunteers [control group]. The hemiplegic group was subdivided randomly into two subgroupsnI and IInaccording to the rehabilitation program .Group I received balance training by BSS-SD in addition to traditional rehabilitation program for hemiplegia .Group II received traditional rehabilitation program for hemiplegia. All patients were functionally assessed by Stroke Specific Quality of life scale [Ss-QOL] scale and balance assessment by berg balance scale and by using BSS-SD

Results: There was significant affection of overall stability index of postural stability test, fall risk test and parameters of limits of stability [LOS]test in hemiplegic group in comparison to the apparently control group [p

Conclusions: Stroke patients have postural instability and increased risk of falling. Balance training by using BSS-SD in addition to the traditional rehabilitation program decreases the postural instability, also improves the quality of life more than the traditional rehabilitation program only

Association of interstitial pulmonary fibrosis and rheumatic disorders in chronic hepatitis c virus infection patients

To investigate the association of idiopathic pulmonary fibrosis [IFF] and rheumatological disorders in patients with chronic hepatitis C virus [HCV] infection via clinical laboratory and radiological studies. Fifty one patients, 36 males and 15 females, with documented HCV and 25 healthy subjects, 18 males and 7 females, were enrolled in the study. Clinical examination, laboratory investigations [biochemical, virological and immunological] and plain chest X-ray [CXR], high resolution computed tomography [HRCT] and pulmonary function tests [PFT] were performed in all subjects. The presence of arthralgia, myalgia, fibromyalgia, polymyositis [PM], type II mixed cryoglobulinaemia [MC], purpura, and Raynaud's phenomenon and pulmonary fibrosis, were observed in 8/51, 10/51, 4/51, 5/51, 9/51, 2/51, 1/51 and 9/51 of HCV-positive patients, respectively. The presence of high serum creatinine kinase [CK], RF, ANA, complement-4 [C4] reduction and Anti-Jo-1 antibodies were observed in 5/51,5/51, 2/51, 3/51 and 3/51 of HCV-positive patients, respectively. There was a significant difference between controls and patients with HCV for the presence of arthralgia, myalgia, polymyositis, type II MC and IFF on HRCT [p<0.01, <0.01, <0.05, <0.01 and <0.01 respectively]. Pulmonary fibrosis was found in 3/5 and 5/9 patients with polymyositis and type II MC respectively. HRCT findings of IFF consisted of nodular areas of high attenuation, ground-glass attenuation, consolidation, septal lines, non-septal lines, and honeycombing in 6/51, 2/51, 1/51, 2/51, 4/51, and 1/51 patients with HCV, respectively. Our nine patients with interstitial pulmonary involvement had HRCT scores consistent with mild parenchymal abnormalities in 3, moderate in 5 and severe in one patient. Only one case in the controls [1/25] had ground-glass attenuation on HRCT. PFT abnormalities were present in only 13 patients [-26%]. PFT measurements revealed that VC, FVC, FEV1, and FEF25-75 were below 80% of the predicted value in 10/51, 11/51, 8/51 and 16/51 patients with HCV, respectively. DLCO was decreased in 21/51 patients. However, there was no significant difference between controls and patients with HCV infection in mean PFT parameters. No correlation was found among HRCT features and PFT abnormalities. The results of this study suggest that chronic HCV infection appears to be involved in the pathogenesis of rheumatic diseases and pulmonary fibrosis. An association between interstitial lung disease [ILD] and polymyositis and/or type II mixed cryoglobulinemia seems to occur frequently in patients with chronic HCV infection. HRCT provides a sensitive and noninvasive technique than PFTs for detecting pulmonary involvement in HCV despite absence of symptoms, normal chest radiograph, and normal pulmonary function testing

Some therapeutic options in treating chronic sciatic pain

Chronic back pain has become one of the most expensive causes of disability among people under the age of 45 years. A wide variety of non operative treatment options are advocated in the management of chronic sciatic pain [CSP] due to lumbar disc prolapse [LDP]. The most prevalent therapy for this pain is physical therapy. Recently electro-acupuncture [EA] is an established adjuvant analgesic modality in the management of chronic pain. In our study we tried to evaluate the efficacy of exercise therapy, low power laser therapy [LPL] and electro-acupuncture [EA] in the treatment of chronic sciatic pain due to lumbar disc prolapse. 45 patients with chronic sciatic pain due to [LDP] were included in this study. Their age ranged from 20 to 45 years. They were divided into 3 groups: Group I [Exercise only], Group II [LPL+ Exercise] and Group III [EA + Exercise]. The treatment program continued 3 months. All patients were evaluated by taking full history, full clinical examination and investigated by plain X-ray and MRI. They were assessed by VAS, Roland Disability Questionnaire [RDQ], Schober's test, Finger Floor Test, Straight Leg Raising [SLR] test and Japanese Orthopedic Association [JOA] score. Our results demonstrated significant improvement in all parameters in the 3 studied groups with best improvement was in group III. Electro-acupuncture is an effective modality in controlling chronic sciatic pain and complications and may thus be used as a good alternative in indicated cases