Influences of methotrexate iontophoresis on functional lifestyle disabilities, functional capacity, and pain in patients with plantar psoriasis.

Objectives: This study was aimed to evaluating the influences of methotrexate iontophoresis on functional lifestyle disabilities, functional capacity, and pain after a 6-min walking distance (6MWD) test in patients with plantar psoriasis (PP). Patients and methods: Forty­five patients (29 females, 16 males; mean age 33.9±6.6 years; range, 20 to 45 years) with hyperkeratotic PP were enrolled in the randomized, placebo-controlled, parallel-groups, double-blinded study. They were assigned randomly into the active methotrexate iontophoresis (MI) group (n=23) and the placebo iontophoresis group (n=22). The patients in both groups were assessed before starting the treatment intervention and after completing eight sessions of the treatment intervention through functional lifestyle disabilities measured on the Arabic version of psoriasis disability index, functional capacity using the 6MWD test, and pain after the 6MWD test. Results: The pre-treatment measurements of the three variables among the two groups did not reveal statistically significant differences (p>0.05). However, there were statistically significant differences in the post-treatment results between the two groups (p<0.05). Additionally, the pre-and post-treatment values of the three outcome measures revealed statistically significant differences within the MI group (p<0.05). In contrast, there were no significant differences within the placebo group (p>0.05). Conclusion: Methotrexate iontophoresis is effective in improving functional lifestyle disabilities, enhancing functional capacity, and decreasing pain in patients with PP.

The efficacy of isokinetic strength training versus core stability training on the trunk muscle strength and quality of life after surgical repair of incisional hernia in adolescents.

Objectives: The study aimed to compare the impact of isokinetic strength training (IST) with core stability training (CST) in terms of trunk muscle strength and quality of life (QoL) after surgical repair of incisional hernia in adolescents. Patients and methods: The prospective, randomized, comparative study was conducted at the College of Applied Medical Sciences, Department of Health and Rehabilitation Sciences between August 2019 and June 2020. Thirty patients (16 males, 14 females; mean age: 17.1±0.6 years; range, 12 to 18 years) who had undergone primary incisional hernia repair surgery were included in the study. The patients were randomly divided into two groups: the IST group of 15 patients who underwent the isokinetic exercise program for trunk muscles and the CST group of 15 patients who practiced the core exercise program. Each group exercised three times per week for six weeks. All patients were assessed pre-and post-treatment by an isokinetic dynamometer for trunk flexors and extensors at 60 and 90°/s angular velocities and the European Registry for Abdominal Wall Hernias (EuraHS)-QoL questionnaire. Results: The trunk flexor and extensor Peak torque/body weight ratio at 60 and 90o/s angular velocities and QoL were significantly improved in both IST and CST groups (p<0.05). The post-treatment values of both groups revealed marked but not statistically significant differences in all measured variables (p>0.05). Conclusion: Both IST and CST are effective training programs that can improve the strength of trunk flexors and extensors as well as QoL after surgical repair of incisional hernia in adolescents.

Influences of Intermittent Pneumatic Compression Therapy on Edema and Postoperative Patient's Satisfaction After Lipoabdominoplasty.

BACKGROUND: Lipoabdominoplasty (LABP) is a frequently performed surgical procedure in the field of plastic surgery that often requires physical therapy in order to minimize postoperative complications, augment the postoperative outcomes, and enhance recovery. Intermittent pneumatic compression therapy (IPCT) is a physical therapy modality that may be used in the management of LABP population. This study aimed to assess the influences of intermittent pneumatic compression therapy on the resolution of edema and improvement in postoperative patient satisfaction following LABP. METHODS: Forty-three females, aged 35-55 years, who underwent LABP, were involved in this prospective randomized study. They were divided into two groups: group A wherein 22 patients wore a compression garment (CG) for 24 h, through 4 weeks; group B wherein 21 patients wore CG besides the application of IPCT for 45 min, 3 times a week, for 4 weeks. The abdominal circumferences were measured at three positions: 3 cm above the umbilicus, at the umbilicus, and 3 cm below the umbilicus. Additionally, patient satisfaction rate was assessed by visual analog scale (VAS; in mm). All patients were assessed three times (Initial Assessment, During Assessment, and Final Assessment). RESULTS: With reference to the abdominal circumferences at three levels and VAS satisfactory scores, there were statistically significant differences between both groups in Final Assessment (p < .04) in favor of group B. CONCLUSION: Application of IPCT while wearing CG was superior as compared to CG alone in reducing the abdominal edema and improving postoperative patient satisfaction following LABP. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessing the effects of 6 weeks of intermittent aerobic exercise on aerobic capacity, muscle fatigability, and quality of life in diabetic burned patients: Randomized control study.

BACKGROUND: Both burn and diabetes mellitus (DM) cause functional and psychosocial disabilities. A low-cost and safe approach is greatly required to reduce these disabilities and the effects of aerobic exercise have generated varied evidence to date. The aim of the study was to explore the effects of 6 weeks of intermittent aerobic exercise (IAE) on aerobic capacity, muscle fatigability, and quality of life (QoL) in diabetic burned patients (DBPs). METHODS: The study design was a prospective, single-blind, randomized controlled trial. Between March 2018 and July 2019 thirty-six (22 males and 16 females) diabetic burned patients were included in the study, their age ranged 35-55 years. They were clinically diagnosed with type 2 DM and total body surface area (TBSA) was 15-30%. The participants were randomly assigned to the IAE group (n = 18) and controls (n = 18). Aerobic capacity, muscle fatigability, and QoL were assessed initially and repeated after 6 weeks of intervention. RESULTS: Initial data demonstrated non-significant differences between the IAE and control groups (p > 0.05). Comparing pre- and post-intervention outcomes showed significant improvement of VO2max, muscle fatigability, QoL domains in the IAE group after 6 weeks intervention (p < 0.05) and non-significant changes in the control group (p > 0.05). The IAE group showed statistically significant improvement more than the control group in all outcome measures (p < 0.05). CONCLUSIONS: 6 weeks of intermittent aerobic exercise is an effective alternative modality to improve aerobic capacity, muscle fatigability, and QoL in DBPs. Adherence to intermittent aerobic exercise should be practicable into mainstream clinical intervention for those patients.

Low-Level Laser Therapy for Diabetic Dermopathy in Patients With Type 2 Diabetes: A Placebo-Controlled Pilot Study.

Introduction: Diabetic dermopathy (DD) is the most common cutaneous diabetes marker. Few studies have targeted DD using low-level laser therapy (LLLT). This pilot study aimed to evaluate the effect of LLLT on DD in patients with type 2 diabetes (T2D). Methods: 12 patients with T2D (9 men, 3 women) and bilateral DD were enrolled in this placebo controlled pilot study, and their ages ranged 50-65 years. One side was subjected to LLLT, three sessions weekly for one month (LLLT side), while the other side received the same treatment protocol with a laser device switched off as a placebo (placebo side). All patients were instructed to receive skincare for both sides, such as debridement, antibiotic creams, and dressings with betadine solution. The diameter of DD lesion and the cutaneous blood flow of the knees and ankles sites were assessed before and after one month at the end of the intervention. Results: At the baseline, no significant differences existed between LLLT and placebo sides in the DD and skin blood flow at the knee and ankle sites (P >0.05). Post-intervention, a significant improvement occurred in DD diameter and the skin blood flow of the knee and ankle sites in the LLLT side (P <0.05), while the placebo side showed a significant improvement only in DD diameter (P <0.05) and non-significant changes in skin blood flow (P >0.05). Comparing both sides, all measures significantly favored LLLT. Conclusion: The findings of this study indicate that LLLT has beneficial effects on decreasing DD in T2D patients. Also, it was approved that the short term of LLLT is a safe modality to control DD in T2D patients.

A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial.

INTRODUCTION: Nocturnal enuresis is an infrequent uncontrolled voiding during sleep in a child aged 5 years or more without any congenital or acquired disorders of the central nervous system. OBJECTIVE: To compare immediate and short-term effects of interferential currents (IFC) and transcutaneous electrical nerve stimulation (TENS) in the treatment of children with primary nocturnal enuresis (PNE) in numbers of wet nights and quality of life (QoL). STUDY DESIGN: 52 children aged 7-14 (10.6 ± 1.9) having PNE, were assigned randomly into two groups (26 children for each group). Both IFC and TENS groups continued treatment session for 20 min, 3 sessions per week for 6 weeks. The outcome measures were the number of wet nights, and QoL through pediatric incontinence questionnaire (PinQ).The measurements were evaluated before treatment (Pre-), after the last session (Post-1), and 6 months later (Post-2). RESULTS: By comparing the Pre- and Post-1 mean values, the number of wet nights, reduced significantly (P < 0.05) in both groups, in favor of IFC group. Post-1 showed many children with full and good responses and few numbers with partial or no responses to IFC than TENS. Post-1 revealed that PinQ was significantly reduced in both groups in favor of the IFC group (P < 0.05). The values were slightly improved in both groups in Post-2, they were significantly different between Pre- and post-measurements in each group (P < 0.05). Comparison between both groups showed significant differences in the mean values between Post-1 and Post-2 in favor of IFC group (P < 0.05). CONCLUSIONS: IFC and TENS had immediate and short-term improvements in children with PNE by reducing numbers of wet nights and enhancing QoL in favor of the IFC group.

Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university's employees with non-specific low back pain: A pilot study.

OBJECTIVE: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health-Related Quality of Life (HRQOL). METHODS: Forty-two University's employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment. RESULTS: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05). CONCLUSIONS: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university's employees with nonspecific LBP.

Impacts of low-energy extracorporeal shockwave therapy on pain, pruritus, and health-related quality of life in patients with burn: A randomized placebo-controlled study.

BACKGROUND: The management of post-burn pain and pruritus remain a potent challenge because of their bad effects on health-related quality of life (HRQOL). The main purpose of this study was to evaluate the impacts of low-energy extracorporeal shockwave therapy (low-energy ESWT) in the management of pain, pruritus, and HRQOL in patients with burn. METHODS: Forty-five adult patients with burn, their age ranged from 18 to 55 years, were included in the study, they randomly assigned into 22 patients in the study group (low-energy ESWT) and 23 patients in the placebo group. The study group received low-energy ESWT (0.05-0.20mJ/mm2, a frequency of 4Hz with total shocks from 1000 to 2000 shocks) once per week for 4 successive weeks, while the placebo group received ESWT without energy. Both groups received traditional physical therapy program of selective different exercises (respiratory, range of motion, endurance, strengthening, balance, mobilization, stretching, and gait training) 3days per week for 4 weeks. Numerical Rating Scale (NRS) for pain and for pruritus, Pressure Pain Threshold (PPT), 12-Item Pruritus Severity Scale (12-PSS), and Burn Specific Health Scale-Brief (BSHS-B) were measured before and after treatment procedures in both groups. RESULTS: NRS were decreased significantly in the study group than in the placebo group (P<0.05). PPT, 12-PSS, and BSHS-B scores were improved more significantly in the study group than in the placebo group (P<0.05) while body image and burn associated issues were improved at the same level in both groups (P>0.05). CONCLUSION: The findings suggest that low-energy ESWT with traditional regular physical therapy may relive post-burn pain and pruritus, and improve HRQOL, particularly in adult patients with burn.