Efficacy of telehealth core exercises during COVID-19 after bariatric surgery: a randomized controlled trial.

BACKGROUND: Bariatric surgery (BS) is presently the most durable and effective intervention to address severe obesity. BS results in significant weight loss and body composition changes, with reductions in both fat mass and lean mass. Conequently, muscle tissue wasting and a reduction in muscle strength and endurance seem to take place. Some studies have evaluated the impact of resistance training on changes in lean body mass and muscle strength either alone or along with protein supplementation in the first year after BS. However, the effects of core stabilization training on core endurance, postural control, and aerobic capacity in patients after BS have not been evaluated. AIM: This study assessed the effect of a home telehealth core stabilization exercise program on core stability, postural control, and aerobic capacity in patients after BS. DESIGN: A single-blinded randomized controlled trial. SETTING: Home-based exercise program. POPULATION: Patients after BS. METHODS: Fifty-four patients who underwent BS randomly assigned into study and control groups. The study group followed a telehealth supervised home core stabilization program for 8 weeks, while the control group did not receive any form of exercises. Core endurance tests, postural stability, and aerobic capacity were assessed at baseline and after 8 weeks in both groups. RESULTS: No significant difference was noted between groups at baseline (P>0.05). The outcome of the group comparisons showed significant improvement in core endurance tests, postural stability, and aerobic capacity in the study group. Between groups comparision showed that the study group scores significantly higher than the control group (P<0.05). However, the control group showed non-significant changes in any measured variables after eight weeks (P>0.05). CONCLUSIONS: Eight weeks of a home-based telehealth core exercise program improves core endurance, postural stability, and aerobic capacity in patients after BS. CLINICAL REHABILITATION IMPACT: The core stabilization exercise is an important rehabilitation program that should be implemented after BS. Telehealth is an alternative rehabilitation tool during the COVID -19 pandemic.

Biofeedback versus bilateral transcutaneous posterior tibial nerve stimulation in the treatment of functional non-retentive fecal incontinence in children: A randomized controlled trial.

BACKGROUND: Biofeedback and transcutaneous posterior tibial nerve stimulation (TPTNS) can be used in treatment of Functional non-retentive fecal incontinence (FNRFI). Aim of this study was to evaluate the early effect of Biofeedback versus (TPTNS) and treatment by Kegal exercises and dietetic regulations in management of (FNRFI) in children. METHODOLOGY: The current prospective randomized controlled study included 93 children with FNRFI who were randomly allocated into the 3 groups. Group A (n = 28) were treated by dietetic regulation and Kegal exercises. Group B (n = 34) received biofeedback while group C (n = 31) received (TPTNS) for 3 months. Follow up using St' Mark's incontinence score and high resolution manometry was done at 3 and 6 months and compared to the initial records. RESULTS: There was statistically significant decrease in the incontinence score in Group B and C compared to Group A at 3 and 6 months (p ˂ 0.001). Resting and squeeze pressures showed significant increase group B and C (p ˂ 0.001). Patients in Group B and C showed significant decrease volume of balloon required for 1st sensation (p ˂ 0.001 and 0.034) respectively. CONCLUSION: Biofeedback is more effective than TPTNS, Kegal exercises and dietetic regulations in treatment of FNRFI in children for short term follow-up. LEVEL OF EVIDENCE: Level I. TYPE OF STUDY: Treatment Study.