Effects of pre-transplant chest physical therapy on spirometric values and respiratory muscle strength in patients waiting for allogeneic hematopoietic stem cell transplantation: a randomized controlled trial.

Introduction: Many noninfectious pulmonary complications occur immediately within the first few weeks after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study aimed to evaluate the efficacy of chest physical therapy (CPT) performed during the pre-transplant period in terms of spirometric values and respiratory muscle strength (RMS) in patients waiting for allo-HSCT. Material and methods: Fifty patients aged 40 to 55 years who were scheduled for allo-HSCT were randomly allocated into two equal-sized groups, a CPT group and a control group. The CPT group (n = 25) received CPT in addition to routine medical treatment, while the control group (n = 25) received routine medical treatment only. Patients in both groups received standard physical therapy during the inpatient waiting period. Interventions were conducted daily for 3 weeks before allo-HSCT. Pulmonary function (FEV1, FVC, and FEV1/FVC) was measured by spirometry, and RMS was measured by a respiratory pressure meter. A baseline assessment was done 3 weeks before allo-HSCT (T0), then at the end of treatment immediately before allo-HSCT (T1) and the last assessment at 3 weeks after allo-HSCT (T2) for all measured variables. Results: In comparing the two groups at T1 and T2, the mean spirometric values and RMS, maximal inspiratory pressure, and maximal expiratory pressure were all improved significantly in the CPT group in comparison with the control group (p < 0.05). Conclusions: Adding a 3-week CPT intervention to the pre-transplant rehabilitation program seems to be effective and safe for allo-HSCT recipients, as it improves pre-transplant pulmonary function and respiratory muscle strength and prevents their post-transplant decrease.

Beneficial Effects of Paraffin Bath Therapy as Additional Treatment of Chronic Hand Eczema: A Randomized, Single-Blind, Active-Controlled, Parallel-Group Study.

Objective: Chronic hand eczema (CHE) is a common inflammatory skin disease with a major psychological and socioeconomic impacts on patients' quality of life (QoL) and work ability. To the best of knowledge, this study is the first randomized-controlled trial conducted to evaluate the effect of paraffin bath therapy in management of hand eczema and its related symptoms. Design: This study was a parallel-group, active-control, randomized clinical trial with measures at pretreatment, 6th week, and 12th week of treatment. Settings: The study took place at the Outpatient Clinic of Faculty of Physical Therapy, Cairo University, and some licensed rehabilitation centers in Cairo for a 1-year period. Subjects: Sixty patients with moderate to severe CHE were randomly assigned into two groups of equal number; the paraffin bath therapy group and the control group. Interventions: The paraffin group received paraffin bath therapy for 5 days a week for 12 weeks, in addition to the routine skin care program, while the control group only received the routine skin care program. Outcome measures: SCORing Atopic Dermatitis (SCORAD) was used to assess the severity of atopic dermatitis and dermatology life quality index (DLQI) to assess the effect of CHE on quality of patients' life. All measurements were obtained before, at the 6th week, and at the 12th week of treatment. Results: Marked improvement in the severity of the disease symptoms was observed, reflected by a highly decrease in objective SCORAD score in the paraffin group over time more than the control group. The percentage of reduction was 28.6% in paraffin group versus 0.41% in control group. Subjective item score (itching and sleepiness) was reduced in the paraffin group more than the control group with a percentage of improvement (47% and 5.5%), respectively. Regarding QoL measure, there were highly positive changes in DLQI in paraffin group more than the control group. The percentage of improvement was 60% in paraffin group and 3.8% in control group. Conclusions: Paraffin bath therapy applied for a 12-week duration seems to be effective, both in reducing severity of eczema symptoms and improving QoL in patients with CHE.

Effectiveness of an early mobility protocol for stroke patients in Intensive Care Unit.

OBJECTIVE: To evaluate the effectiveness of an early mobility protocol for stroke patients in the intensive care unit. METHODS: Participants were patients with first or recurrent stroke (n=60, age=49.02+/- 6.36 years, body mass index=32.95+/-5.67 kg/m2) admitted to the intensive care stroke unit in general hospitals, Riyadh during October and December 2016. Single group pretest-posttest design involving an early mobility protocol was started within first 24 hours admission. Pre and post measurements of muscle strength, pulmonary function and quality of life were carried out. RESULTS: There were significant improvements in muscle strength of upper and lower extremities` muscles after treatment (p less than 0.05), pulmonary functions including Forced Vital Capacity, Forced Expiratory Volume 1 (p less than 0.05) and quality of life, namely, Barthel Index and modified Rankin Scale (p less than 0.01). CONCLUSION: This study demonstrates that initiating an early mobility protocol is safe and effective for intensive care unit stroke patients and supports introducing the current protocol as a standard protocol in neurogenic Intensive Care Units.