From injury to rehabilitation: How kinesiology taping helps patients with first metatarsophalangeal joint sprain (turf toe) in pain reduction, gait parameters and functional ability improvement. A randomized clinical trial.

Objective: Turf toe is a common sports injury that may affect mobility and functional ability. For complete recovery, rehabilitation modalities are required to overcome these issues. This study investigated whether kinesio taping (KT) would reduce pain, improve gait performance, and enhance the functional capacity of turf toe patients undergoing physical therapy. Methods: sixty patients with grade II turf toe (age; 25-30 years) assigned randomly into three treatment groups; KT applied alongside an exercise program conducted three times/week for 12 successive weeks. (KT group; n = 20), placebo taping plus exercise (Placebo group; n = 20), or exercise only (Control group; n = 20). Pain, gait parameters, and functional ability assessed using VAS, 3D gait analysis, and 6MWT respectively pre- and post-treatment. Results: There was a significant post-treatment decrease in VAS score in the KT group lower than the control or placebo group and a significant increase in 6MWT distance in the KT group higher than the control or placebo group (p < 0.001). Additionally, there was a significant post-treatment increase in step length, stride length, cadence and velocity of KT group higher than control and placebo group (p < 0.05). There was no significant difference in gait parameters between control and placebo groups post treatment (p > 0.05). Conclusions: The findings of the study demonstrated that KT is a useful complementary modality to exercise in patients with turf toe, as it may result in more favorable improvements to pain, gait characteristics, and functional abilities. Further studies should be conducted to assess the long-term effects, different KT application methods, and tailored treatment protocols on turf toe.

Loaded Functional Strength Training versus Traditional Physical Therapy on Hip and Knee Extensors Strength and Function Walking Capacity in Children with Hemiplegic Cerebral Palsy: Randomized Comparative Study.

Objective: This study's objective was to see how loaded functional strengthening exercises using a plantigrade foot position and a shoe supporter affected muscle strength and walking ability in spastic hemiplegic children. Methods: Seventy-two children with spastic hemiplegic cerebral palsy, both sexes, aged ten to twelve years, were randomly assigned into two groups equal in number (control and intervention groups). The control group received a specially designed physical therapy program, whereas the intervention group received a loaded functional strengthening exercises program using a shoe supporter to maintain a plantigrade foot position. The training program was carried out for 60 min, three times per week for three consecutive months. All participants were evaluated both before and after the therapy program by using a Medical Commander Echo Manual Muscle Tester dynamometer to assess isometric muscle power of hip and knee extensors on the affected side. To assess functional walking capacity, a 6 min walking (6MWT) test was used. Results: Study groups were comparable with respect to all outcome measures at entry (p > 0.05). Within-group comparison showed significant improvements in all measured variables. Furthermore, between-group comparison revealed significantly greater improvements (p < 0.05) in hip and knee extensors strength as well as the functional walking capacity in favor of the intervention group. Conclusions: In all the analyzed variables, loaded functional strength exercises from the plantigrade foot position were found to be considerably more effective in the intervention group than in the control group.

Effect of Pilates Exercises on Standing, Walking, and Balance in Children With Diplegic Cerebral Palsy.

OBJECTIVE: To analyze how Pilates exercises affect standing, walking, and balance in children with diplegic cerebral palsy throughout a 10-week program. METHODS: We included 40 children aged 7-9 years with diplegic cerebral palsy, and randomly allocated them into two groups of the same size: conventional therapy group (group A) and conventional therapy+Pilates group (group B). We administered the same conventional physical therapy program to both groups for 45 minutes, with group B receiving additional Pilates exercises for 45 minutes. Both groups attended the intervention program three times/week for 10 weeks. We used the Growth Motor Function Measure Scale (GMFM-88) to evaluate standing and walking (Dimensions D and E), and the Pediatric Balance Scale to evaluate balance function before and after treatment. RESULTS: Comparison of the average values of all measured variables before and after therapy showed a statistically significant difference (p<0.05) between the two groups. All measured variables showed a significant difference between groups A and B, in favor of group B (p<0.05). CONCLUSION: Pilates exercise in addition to conventional therapy is more effective in improving balance and gross motor function in children with diplegic cerebral palsy than the conventional therapy alone.

Impact of Kinect-based virtual reality training on physical fitness and quality of life in severely burned children: A monocentric randomized controlled trial.

Pediatric burns lead to persistent and detrimental muscle breakdown, weakness and poor quality of life, so rehabilitation is integral for improving physical and psychological outcomes. However, children with burns are a major challenge to a rehabilitation team. To overcome these challenges, enjoyable and interesting interventions are suggested. OBJECTIVE: we aimed to determine the impact of the Xbox Kinect on cardiopulmonary fitness, muscle strength, lean mass, quality of life and enjoyment in severely burned children after hospital discharge. METHODS: this was a randomized controlled trial in a single centre. Participants (n=40 children) with burn injuries were randomized to the Xbox training group (n=20) or control group (n=20) during 12 weeks. All children received a home programme rehabilitation and Xbox training children received Xbox training. Outcomes included cardiopulmonary fitness (VO2peak), muscle strength (peak torque), lean mass (whole-body and regional), quality of life and physical activity enjoyment at baseline, immediately after hospital discharge, and 12 weeks after the intervention. RESULTS: the mean (SD) age of the 40 children was 12.97 (1.42) years and total body surface area of burn was 51% (5). The groups did not differ in characteristics at baseline (P>0.05). After 12 weeks of the intervention, the groups significantly differed in VO2peak, peak torque, quality of life (P<0.001), lean mass and leg lean mass (P<0.05) in favour of Xbox training. The mean difference in VO2peak, peak torque, lean mass and leg lean mass was 3.25 (2.1; 4.5) ml/kg/min, 7.5 (5.8; 9.2) Nm, 1.81 (0.5; 3.1) kg, and 1.1 (0.1; 2.1) kg, respectively. Lean trunk mass did not significantly differ between groups (P=0.07). The Xbox training group reported significantly more enjoyment than did the control group (P<0.001). CONCLUSION: Xbox Kinect training can increase cardiopulmonary fitness, muscle strength, lean mass and quality of life in burned children. It is one of the most enjoyable, motivated and efficient treatment modalities that should be widely introduced into the pediatric burn rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04350034).

Impact of two different pulmonary rehabilitation methods in children with down syndrome.

PURPOSE: To investigate and compare the effect of proprioceptive neuromuscular facilitation of respiratory muscles with that of inspiratory muscle training as a preventive measure on respiratory muscle strength, chest expansion, spirometry, and functional capacity in children with Down syndrome. METHODS: Forty-five Down syndrome participants with an age ranged from 10 to 13 years were enrolled. There were distributed into three groups. The study group A (n = 15) underwent proprioceptive neuromuscular facilitation of respiratory muscles while study group B (n = 15) underwent inspiratory muscle training. Third group C (n = 15) was a control group. The three groups received aerobic exercises using the bicycle ergometer for 20 min, 5 times/week for 12 successive weeks. The treatment program for both study groups was conducted for 20-30 min, 5 times/week for 12 successive weeks. Measurements of respiratory muscle strength (MIP, MEP), chest expansion, spirometry test (VC, FEV1, PEFR, MVV) and 6 min walk test were measured pre and post treatment. RESULTS: The post treatment mean values of all investigated variables were significantly increased in both study groups with higher effect to group underwent proprioceptive neuromuscular facilitation of respiratory muscles. CONCLUSION: Both proprioceptive neuromuscular facilitation of respiratory muscles and inspiratory muscle training are effective in children with Down syndrome on improving respiratory muscle strength, chest expansion, spirometry and functional capacity with superior effect of proprioceptive neuromuscular facilitation.

Effect of Smartphone Usage on Neck Muscle Endurance, Hand Grip and Pinch Strength among Healthy College Students: A Cross-Sectional Study.

In recent years, there has been a significant increase in global smartphone usage driven by different purposes. This study aimed to explore the effect of smartphone usage on neck muscle (flexors and extensors) endurance, hand grip, and pinch strength among young, healthy college students. In total, 40 male students were recruited for this study; 20 of them belonged to the smartphone-addicted group, while the other 20 were in the non-addicted group based on their smartphone addiction scale-short version (SAS-SV) scores (the threshold for determining smartphone addiction: 31/60). Neck flexor endurance time, the ability to perform a neck extensor muscle endurance test, and hand and pinch grip strength were assessed. Multivariate analysis of variance (MANOVA) was used to assess between-group differences in the mean values of neck flexor endurance time, hand grip, and pinch grip. A significant group effect (Wilks' lambda = 0.51, F (5,34) = 6.34, p = 0.001, partial eta squared = 0.48) was found. A decrease in neck flexor endurance time was observed in the smartphone-addicted group compared with that of the non-addicted group (p < 0.001). However, there was no notable difference in the neck extensor muscle endurance test or in hand grip and pinch grip strength of both hands between groups (p > 0.05). Using a smartphone for a prolonged time might affect neck flexor muscle endurance; however, more research is needed to explore the long-term effects of using smartphones on neck muscle endurance and hand/pinch grip strength and the risk of developing upper limb neuromusculoskeletal dysfunction.

Effect of whole body vibration training on bone mineral density and functional capacity in children with thalassemia.

Purpose: To investigate the effectiveness of whole body vibration (WBV) on bone mineral density (BMD) and functional capacity in children with ß-thalassemia major. Methods: Thirty-nine children (23 boys and 16 girls) with ß-thalassemia major, with ages ranging from 6 to 10 years, participated in a randomized controlled trial. They were selected and randomly divided, using computer-generated random numbers into two groups. The control group (n = 20) received the medical treatment and the physical therapy program whereas the study group (n = 19) received the same program as the control group in addition to WBV training (25-30 Hz, 2 mm amplitude, 10 repetitions (30-60 s) with 1 min rest, 15-20 min/day, 3 days/week/24 weeks). Bone mineral density and functional capacity were assessed before and after 24 weeks. Results: Both groups showed a significant increase in BMD and functional capacity after treatment compared with that before treatment (P ˂ 0.05). However, children in the study group demonstrated a significant increase in the functional capacity and the BMD of the lumbar spine, femoral neck and total body compared with that of the control group (P > .01). Conclusions: Whole body vibration may be an effective modality in improving BMD and functional capacity in children with ß-thalassemia major.

Effect of twister wrap orthosis on foot pressure distribution and balance in diplegic cerebral palsy.

OBJECTIVES: To evaluate the effectiveness of twister wrap orthosis (TWO) on foot pressure distribution and postural balance in children with spastic diplegic cerebral palsy (CP). METHODS: Thirty children with spastic diplegic CP, with ages ranging from 6 to 8 years, were assigned randomly into two groups. The control group received the conventional physical therapy and ankle foot orthosis (AFO), whereas the study group received the same program as the control group in addition to TWO. Measurement of foot pressure distribution using a pressure platform as well as stability indices using the Biodex Stability System was performed before and after 12 weeks of the treatment program. RESULTS: Both groups showed a significant increase in mean and peak planter pressure on forefoot and rear foot with a significant decrease on mid foot after treatment (P⟨0.05). The study group showed a significant improvement in balance after treatment (P⟨0.05) while there was no significant difference in the control group. After treatment, the study group showed significant improvement in planter pressure and balance compared with the control group (P⟨0.05). CONCLUSIONS: TWO could provide correction of foot pressure distribution and improve postural balance in children with spastic diplegic CP.

Effect of isokinetic training on muscle strength and postural balance in children with Down's syndrome.

Children with Down's syndrome (DS) often have greater postural sway and delay in motor development. Muscle weakness and hypotonia, particularly of the lower extremities, are theorized to impair their overall physical health and ability to perform daily activities. Therefore, the aim of this study was to investigate the effects of isokinetic training on muscle strength and postural balance in children with DS. Thirty-one children with DS ranging in age from 9 to 12 years were assigned randomly into two groups. The control group received the conventional physical therapy, whereas the study group received the same therapy as the control group in addition to the isokinetic training 3 days a week for 12 weeks. Measurement of stability indices using the Biodex Stability System as well as peak torque of knee flexors and extensors of both sides using the isokinetic dynamometer was performed before and after 12 weeks of the treatment program. Each group showed significant improvements in postural balance and peak torque of knee flexors and extensors (P<0.05), with significantly greater improvements observed in the study group compared with the control group (P<0.05). These outcomes indicated that participation in the isokinetic training program induced greater improvements in muscle strength and postural balance in children with DS.

Effect of Electromyographic Biofeedback Training on Pain, Quadriceps Muscle Strength, and Functional Ability in Juvenile Rheumatoid Arthritis.

OBJECTIVE: To investigate the effects of electromyographic (EMG) biofeedback training on pain, quadriceps strength, and functional ability in juvenile rheumatoid arthritis (JRA). DESIGN: This is a randomized controlled study; 36 children (11 boys and 25 girls) with polyarticular JRA, with ages ranging from 8 to 13 years, were selected and assigned randomly, using computer-generated random numbers, into 2 groups. The control group (n = 18) received the conventional physical therapy program, whereas the study group (n = 18) received the same program as the control group in addition to EMG biofeedback-guided isometric exercises for 3 days a week for 12 weeks. Pain, peak torque of quadriceps strength, and functional ability were evaluated before, after 6 weeks, and at the end of 12 weeks of the treatment program. RESULTS: By 6 weeks, significant differences were observed in the study group (P < 0.05) in all measured variables except pain levels, whereas nonsignificant differences were observed in all measured variables in the control group. By 12 weeks, each group demonstrated significant improvements in pain, quadriceps strength, and functional ability (P < 0.05), with significantly greater improvements seen in the study group compared to the control group (P < 0.05). Both groups showed significant improvement at 12 weeks compared to that at 6 weeks. CONCLUSIONS: Electromyographic biofeedback may be a useful intervention modality to reduce pain, improve quadriceps strength, and functional performance in JRA.

LASER versus electromagnetic field in treatment of hemarthrosis in children with hemophilia.

Children with hemophilia usually have recurrent joint bleeding that leads to joint damage, loss of range of motion, and restriction of mobility, therefore affecting the quality of life in these children. The purpose of this study was to compare the effects of low-level laser therapy (LLLT) to that of pulsed electromagnetic field (PEMF) in treatment of hemarthrosis in children with hemophilia. Thirty boys with hemophilia A with ages ranging from 9 to 13 years were selected and assigned randomly, using sealed envelopes, into two equal intervention groups. The study group I received the traditional physical therapy program in addition to LLLT, whereas the study group II received the same physical therapy program given to the study group I in addition to PEMF. Both groups received the treatment sessions three times per week for three successive months. Pain, laboratory investigations, swelling, and range of motion (ROM) of the affected knee joint, in addition to physical fitness were evaluated before, at the end of the sixth week and at 12 weeks of the treatment program. Laser group showed significant improvement in all measured variables after the sixth week of treatment when compared with PEMF. By 12 weeks of treatment, there was a significant improvement in pain, ROM, ESR and leucocytes levels in laser group compared with PEMF, while there was no significant difference in knee circumferences and the 6-min walk test (6MWT) between both groups. Both groups showed significant improvement at 12 weeks of treatment compared with that at 6 weeks. Both LLLT and PEMF are effective modalities in reducing pain, swelling, increasing ROM and improving physical fitness. Twelve weeks of treatment of both modalities demonstrated significant improvement than 6 weeks of treatment. Laser therapy induced significant improvement than electromagnetic therapy in treatment of hemarthrosis-related problems in children with hemophilia.