Effect of adding a supervised physical therapy exercise program to photobiomodulation therapy in the treatment of cervicogenic somatosensory tinnitus: A randomized controlled study.

OBJECTIVES: To evaluate the effectiveness of adding a supervised physical therapy exercise program to photobiomodulation therapy (PBMT) in the treatment of cervicogenic somatosensory tinnitus (CST). METHODS: Forty patients suffering from CST with age 45-55 years were included in the study. They were assigned randomly into 2 groups, 20 per each. (Study group) Group (A) received a supervised physical therapy exercise program in addition to 20 minutes PBMT with a 650-nanometer wavelength and a 5 milliWatt power output, spot size of 1 cm2, and energy density of 6 Joules, 3 sessions per week for 8 consecutive weeks, plus traditional medical treatment. While (control group), group (B) received the same PBMT protocol, 3 sessions per week for 8 consecutive weeks in addition to the traditional medical treatment. Tinnitus visual analog scaling (VAS), tinnitus handicap inventory (THI), and cervical range of motion (ROM) were measured at baseline and after 8 weeks. RESULTS: Mixed MANOVA showed a statistically significant reduction in tinnitus VAS, THI, and a significant improvement in cervical ROM (flexion, extension, right bending, left bending, right rotation, and left rotation) in favor of Group A (P < .05). There was a significant decrease in posttreatment VAS treatment (P > .001) MD [-2.05(-2.68:-1.41)], and THI relative to pretreatment mean difference [-5.35(-8.51: -2.19)] and a significant increase in posttreatment neck ROM in Groups A and B relative to pretreatment neck ROM (P > .001). Flexion range posttreatment MD[3.65(1.64:5.65)], Extension MD [6.55(1.35:11.75)], right bending MD[3.8(2.51:5.08)], left bending MD[1.75(0.19:3.3)], right rotation MD [3.5(1.28:5.71)] and left rotation [2.75(0.67:4.82)]. CONCLUSIONS: Adding a supervised physical therapy exercise program to PBMT showed positive and beneficial effects in the treatment of CST using VAS, THI, and Cervical ROM assessment tools.

Polarized Light Therapy in the Treatment of Wounds: A Review.

The most prevalent type of photo therapies are low-level laser therapy (LLLT) and ultraviolet (UV) treatments, which are distinguished by the physical properties of the light employed. However, in latest years, it has been suggested that polarization and an extensive light band including all light spectra are essential aspects in light treatment. Light waves are filtered to align and vibrate in a single plane, resulting in polarized light (PL). Light that has been polarized can penetrate tissues more deeply than light that has not been polarized. The visible light spectrum is very broad. PL varies from other types of light therapy in that it uses a considerably wider spectrum of wavelengths than LLLT or UV. As a result, PLT devices are often less expensive and simple to operate. Since the late 1960s, light therapy has been used to treat anything from neonatal jaundice to psoriasis and vitiligo. Fenyö created a PL source and found that it can stimulate wound healing in a similar way to the low-energy laser. In comparison to the laser, this source of light had numerous gains: lesser prices, fewer hazards, a greater area to be treated, and no sophisticated user expertise. Despite several findings from fundamental research (in vitro, in vivo, and animal trials), practitioners continue to have reservations regarding PL's potency and utility in treating musculoskeletal problems. It is even largely believed that the commercial use of these therapies is validated by a sufficient amount of scientific evidence based on reliable clinical papers. The major goal of this study is to gather information on the use of PL for treatment of various wound types in animal and human investigations.

Inhalation injury in adult males: Evaluation of the short-term efficacy of transcutaneous electrical acupoint stimulation on pulmonary functions and diaphragmatic mobility after burn: A double-blind randomized controlled study.

BACKGROUND: Inhalation injuries can cause problems with diaphragmatic mobility and pulmonary function, which are accompanied by significant morbidity and mortality. No previous studies have determined the outcomes of acupoint transcutaneous electrical stimulation (Acu-TENS) in the treatment of inhalation burn injuries. The current study is therefore aimed at evaluating the influences of Acu-TENS on pulmonary functions and diaphragmatic mobility in adult-male patients experiencing after burn inhalation injury. METHODS: This randomized controlled study was double blinded in an inpatient setting and was conducted between June 2018 and July 2019. Forty-male participants with inhalation-injury (20-40 yrs.) were randomly allocated into two study and control groups equal in numbers; the same pulmonary rehabilitation program plus early mobility exercise was conducted in both groups. The study group (group A) received additional Acu-TENS while shame Acu-TENS was carried out on the control group (group B). The intervention program continued for four weeks, three sessions a week for 45 min bilaterally on the bilateral Ding-Chuan points (Ex-B1). Spirometry was used to assess pulmonary functions, the 5-points-Likert scale was used to assess dyspnea, and ultrasonography was used to assess diaphragmatic mobility (DM), and evaluations were performed before and after interventions. RESULTS: At baseline assessment, no significant differences were detected between the two study groups (p˃0.05). In the post-interventional program, a noteworthy difference was detected in all outcome measures in the two study groups (p˂0.05), supporting group A. After 4 weeks of intervention, the mean (SD) for FVC, FEV1, and DM was 83.7 ± 4.34, 86.75 ± 4.59, and 5.93 ± 1.13 in group A, 79.65 ± 5.14, 83.1 ± 4.44, and 5.08 ± 1.15, in-group B. The mean difference for FVC, FEV1, and DM was 4.05 (1: 7.09), 3.65 (0.75: 6.54), and 0.85 (0.11: 1.57) between groups after treatment, respectively. CONCLUSION: Depending on the study findings, Acu-TENS on bilateral Ding-Chuan points could be considered an effective approach for improving pulmonary functions and diaphragmatic mobility in patients with inhalation injuries after thermal burn. Future studies with a larger sample size and longer duration on different types of burn injuries are recommended.

Comparison of Extracorporeal Shock Wave Therapy versus Manual Lymphatic Drainage on Cellulite after Liposuction: A Randomized Clinical Trial.

INTRODUCTION: Cellulite is associated with variations in the skin appearance with cottage cheese, mattress-like, or orange peel. The most common areas for these lesions are the posterior or upper thighs and buttocks and mainly affect females after puberty. The objective of the study was to determine whether extracorporeal shock wave therapy (ESWT) or manual lymphatic drainage (MLD) is more effective for the reduction of the grade of cellulite after liposuction. METHODS: This study is a single-blinded randomized controlled clinical trial. Thirty females with grade 3 cellulite were randomly distributed into two groups equal in number (n = 15), group A was equipped to ESWT and group B was equipped to MLD. The cellulite grading scale was used to assess cellulite grade, and the skinfold caliper was used to assess the thickness of subcutaneous fat. The assessment was carried out before and four weeks after starting the treatment. Both groups received topical retinol twice daily for four weeks; in addition, group A received ESWT, while group B received MLD, two times/week for 4 weeks. RESULTS: The mean values of the skinfold caliper in group A decreased by 24.4% and in group B by 15.38% with a significant difference between the two groups (p < 0.001). Also, the mean values of the cellulite grading scale decreased significantly after treatment in group A compared with the mean values of group B (p < 0.001). CONCLUSIONS: There was more reduction in the grade of cellulite and thickness of subcutaneous fat in the ESWT group than the MLD group after liposuction.

Efficacy of whole-body vibration on balance control, postural stability, and mobility after thermal burn injuries: A prospective randomized controlled trial.

OBJECTIVE: To investigate the additive effects of whole-body vibration (WBV) training to the traditional physical therapy program (TPTP) on balance control, postural stability, and mobility after thermal burn injuries. DESIGN: A single-blinded, randomized controlled study. SETTING: Outpatient physical therapy setting. PARTICIPANTS: Forty participants, 20-45 years old, with deep second-degree thermal burn involving the lower limbs and trunk, with 35%-40% total body service area, were randomly allocated either into the study group or the control group. INTERVENTION: The study group received WBV plus TPTP while the control group received the TPTP only. Interventions were applied three sessions a week for eight weeks. OUTCOME MEASURES: Anteroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI), timed-up and go (TUG), and Berg balance scale (BBS) were measured at baseline and after eight weeks of interventions. RESULTS: There were statistically significant differences in APSI, MLSI, OSI, BBS, and TUG in favor of the WBV group after eight weeks of intervention (P < 0.001). After eight weeks of intervention, the mean (SD) for APSI, MLSI, OSI, BBS, and TUG scores were 1.87 ± 0.51, 41.36 ± 0.18, 1.95 ± 0.56, 47.2 ± 6.12, and 8.15 ± 1.05 seconds in the WBV group, and 2.41 ± 0.71, 2.21 ± 0.54, 2.68 ± 0.73, 40.65 ± 4.7, and 10.95 ± 2.44 seconds in the control group, respectively. CONCLUSIONS: The whole-body vibration training combined with the TPTP was more beneficial in improving APS, MLS, OSI, TUG, and BBS than TPTP alone. It might be considered a useful adjunctive therapy in treating patients with healed wounds with a deep second-degree burn of the trunk and lower limbs.

Narrow Band Ultraviolet B Versus Red Light-Emitting Diodes in the Treatment of Facial Acne Vulgaris: A Randomized Controlled Trial.

Background: One of the most common dermatological conditions affecting most teenagers is acne. Phototherapy was described as a therapeutic modality with low-side effects of acne vulgaris (AV). Hence, we examined the effects of narrow band ultraviolet B (NBUVB) versus red light-emitting diodes (LEDs) on facial AV. Methods: Forty-five subjects suffering from facial AV mild to a moderate degree were randomly assigned into three groups, 15 subjects within every group. Group A was equipped to NBUVB with 311-313 nm and an initial dose of 250 mJ/cm2, thrice a week for 8 weeks, Group B was equipped red LED with wavelengths 633 ± 6 nm and power density of 80 mW/cm2, thrice a week for 8 weeks, whereas group C had received the only erythromycin as a control group. Outcome measures included measurement of acne lesion count and degree of severity. Measures at three-time intervals were assessed: baseline, 4 weeks (post I), and 8 weeks (post II). Results: Acne numeral findings revealed a significant variance among groups A, B, and C in favor of group A (p < 0.001). Notable improvements were observed across all three groups (p < 0.001). The degree of adjustment effects indicated a greater increase in group A in comparison with group B (p < 0.01), whereas no statistical variance was detected between group B and group C (p > 0.05). Conclusions: Both NBUVB and red LED were effective in acne treatment; NBUVB, however, revealed a highly efficient treatment than red LED in decreasing the acne lesions count and the improved degree of AV severity as measured by the global investigator's assessment scale. Clinical Trial Registration No. NCT04254601.

Effect of Aqua Therapy Exercises on Postmastectomy Lymphedema: A Prospective Randomized Controlled Trial.

OBJECTIVE: To investigate the effect of aqua therapy resistance exercise on arm volume, pain, and shoulder range of movements in post-mastectomy lymphedema. METHODS: This was a single-blind randomized controlled trial. Fifty eligible breast cancer survivors (median, 10 years after surgery) with lymphedema (median, 21% inter-limb difference) were assigned randomly to group A (n=25) or control group B (n=25). The study group underwent 60 minutes of aqua therapy exercise comprising of warm-up for 10 minutes, 40 minutes of strengthening exercises, and 10 minutes of cooling down, three times a week for 8 weeks. The control group underwent 60 minutes of land-based exercise three times a week for 8 weeks. Arm volume calculated by measuring the arm circumference, shoulder flexion, and abduction range of motion (ROM), and pain using a visual analog scale (VAS) were assessed at baseline and after 8 weeks of treatment. RESULTS: There was a statistically significant difference in limb volume, shoulder flexion and abduction ROM, and VAS scores in favor of the study group (p<0.001) after 8 weeks of intervention. The mean±standard deviation for limb volume, shoulder flexion, abduction, and pain score were 2,108.71±200.97 mL, 169.68°±4.54°, 150.44°±3.92°, and 3.16±1.1 in the study group and 2,256.41±186.94 mL, 147.36°±5.32°, 131.32°±4.38°, and 5.68±0.94 in the control group, respectively. CONCLUSION: Adding aqua therapy resistance exercise to routine physical therapy might be more effective in decreasing the limb volume and pain intensity and improving ROM of the shoulder in postmastectomy lymphedema.

Effectiveness of transcutaneous electrical nerve stimulation as an adjunct to selected physical therapy exercise program on male patients with pudendal neuralgia: A randomized controlled trial.

OBJECTIVE: To assess the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) combined with selected physical therapy exercise program on male patients with pudendal neuralgia. DESIGN: A double-blinded randomized controlled study. SETTING: Out-patient setting. PARTICIPANTS: Fifty-two male participants with pudendal neuralgia (30-50 years) were allocated randomly into two groups; study and control. The same physical therapy exercises were applied to all participants, plus the same prescribed analgesic medication (Etodolac). Participants in the study group received additional TENS and sham TENS were given to those in control group. INTERVENTION: Intervention lasted for 12 weeks, three sessions per week (60 minutes/session). OUTCOME MEASURES: Numerical pain rating scale and daily Etodolac intake dose were measured before and after intervention. RESULTS: Statistically significant differences were detected in numerical pain rating scale and daily Etodolac intake in favor of the study group (P < 0.05). After 12 weeks of intervention, the mean ± SD for numerical pain rating scale and daily Etodolac intake were 4.25 ± 1.9 and 259.25 ± 84.4 mg, in the study group, and 6.22 ± 2.22 and 355.55 ± 93.36 mg in the control group, respectively. The mean difference (95% CI) for numerical pain rating scale and daily Etodolac intake was -1.97 (-3.09: -0.83) and -96.3 (-144.9: -47.69), between groups post treatment, respectively. CONCLUSION: Adding TENS to physical therapy exercise program is more effective than physical therapy program alone in improving pain in male patients with pudendal neuralgia as measured by numerical pain rating scale and daily analgesic intake dose.

Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded, randomized controlled trial.

OBJECTIVE: To determine the efficacy of high-intensity laser therapy (HILT) on arthropathy of the hands in patients with systemic lupus erythematosus. DESIGN: A double-blinded randomized, controlled study. SETTING: Outpatient setting. PARTICIPANTS: Fifty patients, 30-50-years-old, suffering from arthropathy of the hands were randomly assigned either into the experimental group, received HILT plus the routine physical therapy program or the control group, received sham HILT plus the same routine physical therapy program. INTERVENTION: All treatment interventions were applied at a frequency of three sessions per week for eight weeks. OUTCOME MEASURES: Handgrip strength, joints swelling counts, joints tenderness counts, visual analog scale (VAS) were measured before and after eight-weeks of interventions. RESULTS: There were statistically significant differences in handgrip strength, joint swelling count, joint tenderness count and VAS in favor of the study group (P < 0.05). After eight-weeks of intervention, the mean (SD) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 28.34 ± 8.3 kg, 4.4 ± 2.18, 5 ± 2.1, and 35.6 ± 13.87 mm in the study group, and 22.96 ± 8.76 kg, 7.36 ± 2.14, 9.08 ± 1.63, and 58.8 ± 10.54 mm in the control group, respectively. The MD (95%CI) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 5.38(0.53,10.23) kg, -2.96(-4.19, -1.73), -4.08(-5.15, -3.01), and -23.2(-30.2, -16.2) mm between groups, respectively. CONCLUSIONS: Adding HILT to the routine physical therapy program might be more effective than routine physical therapy program alone in improving handgrip strength, decreasing joint swelling counts, joint tenderness counts, and pain in patients with arthropathy of the hands.

Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer.

OBJECTIVE: To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC). METHODS: Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks. RESULTS: ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05). CONCLUSION: The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.