Effect of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury.

OBJECTIVES: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. METHODS: Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks). Mallet system scores for shoulder function and shoulder abduction, and external rotation range of motion (ROM) were obtained; shoulder abductor, and external rotators isometric strength were evaluated pre-and post-treatment using Mallet scoring system, standard universal goniometer, and handheld dynamometer. RESULTS: The results of this study indicate that the children in both groups showed improvement in shoulder functions post-treatment with greater improvements in group B. The abduction muscle strength after treatment was 8.53 and 11.3 Nm for group A and group B, respectively. The external rotation muscle strength after treatment was 5.88 and 7.45 Nm for group A and group B, respectively. CONCLUSIONS: The virtual reality program is a significantly more effective than conventional physiotherapy program in improving the upper extremity functions in children with obstetric brachial plexus injury.

Effect of whole body vibration training on quadriceps strength, bone mineral density, and functional capacity in children with hemophilia: a randomized clinical trial.

OBJECTIVES: The objective was to evaluate the effects of whole body vibration training on quadriceps strength, bone mineral density, and functional capacity in children with hemophilia. METHODS: Thirty children with hemophilia with age ranging from 9 to 13 years were selected and randomly assigned to either the study group that received whole body vibration training (30-40 Hz, 2-4 mm of peak-to-peak vertical plate displacement for 15 minutes/day, 3 days/week/ 12 weeks) plus the conventional physical therapy program or the control group that performed a conventional physical therapy program only. Outcomes included quadriceps strength, bone mineral density, and the functional capacity. RESULTS: Children in the study group showed a significant improvement in all outcomes compared with the control group. The quadriceps peak torque after treatment was 70.26 and 56.46 Nm for the study and control group, respectively (p⟨0.001). The lumbar spine bone mineral density after treatment was 0.85 and 0.72 g/cm2 for the study and control group, respectively (p⟨0.001). The functional capacity after treatment was 325 and 290 m for the study and control group, respectively (p=0.006). CONCLUSIONS: Whole body vibration training is an effective modality in increasing quadriceps strength, bone mineral density, and functional capacity in children with hemophilia.

Dialysis therapy of severe psoriasis: a random study of forty cases.

Forty patients with severe psoriasis (greater than 50% body surface area affected) were randomly distributed into three groups. Group I treated by haemodialysis, group II treated by peritoneal dialysis, and group III treated by modified Goeckerman treatment. Skin biopsies and blood samples were obtained before and after treatment. Skin biopsies were examined by direct immunofluorescence for IgG, IgA, IgE, IgM, C3 and C4 deposits. Trace metals (zinc and copper) concentrations were determined in plasma and skin tissue. Statistical analysis of the data obtained following ten dialysis sessions showed better response in peritoneal than haemodialysis, and both were better than Goeckerman treatment. This was insignificant as to the degree of improvement, but definitely significant as to the duration of remission induced. There were no important changes in plasma and tissue zinc and copper, yet there was significant decrease in IgG deposits after treatment in the three groups examined. We have concluded that dialysis treatment is a good therapeutic modality, especially for those with severe lesions in whom mortality and morbidity are high, especially if there is a contraindication to the other potent therapeutic modalities such as methotrexate.

Genetic susceptibility in pityriasis versicolor.

300 patients with pityriasis versicolor, 168 males and 132 females, of different ages were included in this study. Each was subjected to a detailed structured questionnaire. All the available relatives had been examined. Pedigrees were constructed and segregation analysis was done using the mathematics of population genetics. The collected data showed genetic susceptibility which is inconsistent with any of the single gene defects but fulfill the criteria of multifactorial (genetic-environmental) inheritance. The heritability was estimated to be 22.2% in the first-degree relatives.