RESUMO
Aim: To compare between the effects of rebounding exercises and whole body vibration on functional capacity, genu recurvatum angles and bone mineral density in children with Down syndrome. Study Design: Prospective, randomized controlled study. Place and Duration of Study: National Institute for Neuro-Motor System, Egypt, between June 2014 and September 2014. Methodology: Thirty children with Down syndrome (16 boys and 14 girls) whose age ranged from 6 to 8 years. They were assigned randomly into two equal study groups (n=15). Study group I received rebounding exercise and study group II received whole body vibration. In addition, both groups received the same designed exercise program. Functional capacity via 6-minute walk test, genu recurvatum angles and bone mineral density were evaluated before and after 3 successive months of treatment. Results: Significant differences were observed in both groups when comparing their pre and posttreatment mean values of all measuring variables (p<0.05). Six minute walk test was changed from (300±9.258, 294.667±9.904) meters to (350±8.451, 357.333±13.741) meters for study group I and II respectively. Right genu recurvatum angles were changed from (20.330±1.543, 19.730±1.534) degrees to (17.800±1.699, 16.130±1.885) degrees for study groups I and II, respectively while left genu recurvatum angles were changed from (19.930±1.486, 19.870±1.407) degrees to (17.600±1.549, 15.067±1.223) degrees for study groups I and II, respectively. Bone mineral density of femoral neck was changed from (0.576±0.015, 0.580±0.016) g/cm2 to (0.805±0.042, 0.831±0.066) g/cm2; distal tibia changed from (0.335±0.085, 0.339±0.089) g/cm2 to (0.485±0.095, 0.549±0.083) g/cm2; proximal tibia from (0.557±0.017, 0.565±0.017) g/cm2 to (0.781±0.053, 0.827±0.076) g/cm2 for study groups I and II, respectively. No significant differences were recorded between both groups when comparing their post-treatment mean values of six minute walk test and bone mineral density while significant differences were recorded in genu recurvatum angles in favor of the study group II (p < 0.05). Conclusion: Both rebounding exercises and whole body vibration are effective in correcting genu recurvatum, increasing low bone mineral density and functional capacity for the children with Down syndrome. The whole body vibration in correction of genu recurvatum angle is more effective in comparison to rebounding exercises.
RESUMO
Aim: To compare between the effects of routine suctioning and positioning to that of chest physiotherapy on mechanically ventilated newborns. Study Design: Prospective, randomized controlled study. Place and Duration of Study: AL-jahra Hospital, Ministry of Health, Kuwait between January 2012 and April 2013. Methodology: Sixty extremely preterm neonates with respiratory distress syndrome were enrolled in the study. They were mechanically ventilated. Their ages ranged from 4-6 days. They were divided into two equal groups (control and study). The control group received medical treatment, routine suctioning and positioning while the study group received the same medical treatment given to the control group in addition to the selected chest physical therapy program. Arterial blood gases (PaO2, PaCO2, pH) and vital signs (HR, RR, SAP, DAP) were measured. Cranial ultrasound and chest x-ray were done to diagnose any cerebral injuries or rib fractures. All measurements were recorded at baseline measurement, 2 days and 7 days post inclusion in the study. Results: Significant improvement was recorded in arterial blood gases (PaO2, PaCO2, pH) and vital signs (HR, RR, SAP, DAP) for the study group after 2 and 7 days (P< 0.05). In addition to significant differences were observed between both groups in (PaO2, PaCO2, pH, HR, RR, SAP, DAP) in favor of the study one (P< 0.05). No adverse effects regarding to the incidence of rib fractures or cerebral injury were recorded in the study group. Conclusion: Chest physiotherapy is an excellent supplement to the line of treatment of extremely preterm neonates who are mechanically ventilated with respiratory distress syndrome.