Influence of aerobic exercise on inhibitory control of executive functions in children with hemiplegic cerebral palsy: A randomized controlled trial.

OBJECTIVE: This study investigates the influence of aerobic exercise training on inhibitory control of executive functions in children with hemiplegic cerebral palsy. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient Physical Therapy Clinic. PARTICIPANTS: Children aged 7-11 with left-sided hemiplegic cerebral palsy with emotional and behavioral dysregulation evidenced by scores >28 on Paediatric Symptom Checklist and GMFCS I or II (n = 60). INTERVENTION: Participants were randomly allocated into two equal groups. The control group received standard-of-care physical therapy for 1 h, and the aerobic exercise group received standard-of-care physical therapy for 30 min and moderate-intensity continuous exercise on a bicycle ergometer for 30 min. All groups received treatment three times a week for 12 weeks. MAIN MEASURES: The Eriksen Flanker test and Stroop Color-Word test were used to assess inhibitory control of executive function at the baseline and after 12 weeks. RESULTS: Differences between pre- and post-treatment values in the exercise group showed significant improvement in Flanker response accuracy and Stroop response accuracy (p = 0.001) and significant decreases in Flanker congruent reaction time and Stroop congruent reaction time (p < 0.05). However, there were no significant differences between both groups in Flanker incongruent reaction time and Stroop incongruent reaction time (p > 0.05). CONCLUSIONS: Aerobic exercise has a promising effect on inhibitory control of executive function in children with left-sided hemiplegic cerebral palsy.

The influence of radial extracorporeal shock wave therapy on shoulder pain and structural abnormalities in stroke patients.

Introduction: Structural abnormalities in the shoulder joint are a common complication post stroke, and the consequent pain and functional limitations become devastating quality of life problems for such patients. Shock wave therapy is a non-invasive method that can enhance the level of perfusion in ischaemic tissues, relieve inflammation, and promote healing. The aim of the study was to examine the efficacy of radial extracorporeal shock wave therapy (rESWT) on pain and disability levels in stroke patients with shoulder structural abnormalities. Material and methods: Thirty subacute stroke patients aged between 40 and 60 years were randomly allocated into 2 equal groups after signing an institutional consent form. The real rESWT group (GA) underwent rESWT in addition to a designed program of physical therapy to the shoulder joint. The control group (GB) received sham rESWT in addition to the same physical therapy program as for GA. The treatment protocol for both groups was 2 times per week for a month. Baseline and post-intervention findings in both groups were assessed and compared for primary outcomes including shoulder structural changes, pressure pain threshold (PPT), and shoulder disability, measured by ultrasonography (USS), a handheld algometer, and the shoulder pain disability index (SPADI), respectively. Results: Significant reduction of all post-treatment SPADI scores (pain, disability, and total scores) in both groups with a remarkable decrease in the rESWT group (GA) (p < 0.05). In addition, USS scores and PPT findings showed notable preference in favour of the GA group, which was demonstrated as significant decrease in USS score with an increase in PPT findings only in the rESWT group (GA) (p < 0.05). Conclusions: The addition of radial extracorporeal shock wave therapy (rESWT) to a designed physical therapy program is more efficient in reducing shoulder structural abnormalities, pain, and disability in subacute stroke patients.

Virtual reality versus Biodex training in adolescents with chronic ankle instability: a randomized controlled trial.

Introduction: Ankle instability is a common injury in athletes, affecting the quality of life, functional limitation, as well as static and dynamic balance. The aim of the study was to compare the efficacy of virtual reality and Biodex balance training in the treatment of ankle instability in adolescent athletes. Material and methods: Ninety football players were enrolled in this study after the assessment of their eligibility. Their age ranged from 12 to 16 years. They were randomly allocated to three groups of equal numbers. Group 1 received a guideline protocol, group 2 received the same guideline protocol in addition to Wii Sport Training, and group 3 received the same guideline protocol in addition to Biodex balance training. All groups received treatment protocols three times a week for 3 months. Outcome measures included the stability indices (overall stability, anteroposterior stability, and mediolateral) measured by the Biodex Balance System as well as ankle instability measured by the Cumberland Ankle Instability Tool. Measurements were collected at the baseline and after 3 months of treatment. Results: Post-treatment findings revealed a statistically significant decrease in the overall, anteroposterior, and mediolateral stability indices, as well as significant increase in Cumberland Ankle Instability outcomes of all groups (p < 0.05). On the other hand, there were no statistically significant differences between the virtual reality and Biodex balance training groups. Conclusions: Virtual reality training has a significant effect which appears to be similar to the Biodex balance training in adolescent athletes with chronic ankle instability.