Self-reported musculoskeletal pain, headache, jaw pain and swallowing dysfunction in a sample of young Saudi adults who stutter.

Objectives: To report the prevalence of musculoskeletal pain, headache, jaw pain and difficulty in swallowing among people who stutter (PWS). METHODS: The cross-sectioal study was conducted from October 3, 2021, to March 21, 2022, after approval from the ethics review committee of King Khalid University, Abha, Saudi Arabia, and comprised adult people who stutter belonging to different regions of Saudi Arabia. They were divided into five groups based on stuttering severity as estimated by Stuttering Severity Instrument-4. Data was collected on musculoskeletal pain in different body areas using a questionnaire.. Data ws analysed using SPSS 22. RESULTS: Of the 101 Arabic-speaking subjects, 63(62.4%) were males and 38(37.6%) were females. The overall mean age was 27±7 years (range: 18-39 years). The largest group was of subjects with moderate severity of stuttering 31(30.6%); 21(68%) males and 10(32%) females. The increase in number of musculoskeletal pain locations was related to the severity of stuttering (p<0.05). The most common musculoskeletal pain sites were the lower back 31(31%), neck 26(26%) and shoulder 26(26%). Frequent headaches and difficulty chewing hard food due to jaw pain were reported by 49(49%) and 22(22%) participants, respectively (p<0.05). Swallowing difficulty was reported by 9(9%) participants (p>0.05). CONCLUSIONS: Widespread chronic musculoskeletal pain of low intensity was found to be common among people who stuttered, and the number of pain locations was positively related to stuttering severity.

Effects of Integrating Jaw Opening and Closing Movements with Active Neck Exercises in the Management of Chronic Non-Specific Neck Pain: A Randomized Controlled Trial.

Background and Objectives: It has been seen that jaw opening is associated with neck extension and jaw closing is associated with neck flexion. This natural association between the jaw and neck can be used as a novel approach to treat chronic non-specific neck pain, although the effects of this concept have never been previously evaluated as a treatment strategy. This article intends to study the effects of integrating jaw opening and closing movements along with active neck exercises versus active neck exercises alone in the management of chronic non-specific neck pain. Materials and Methods: A total of 80 patients, aged 20 to 50, with chronic non-specific neck pain were included in a double-blind randomized controlled trial, conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan from 2018 to 2022. The patients were divided into two groups: Group A patients were assigned jaw movements with active neck exercises, while Group B patients were assigned only active neck exercises. Both groups were assigned isometric strengthening exercises and self-resisted strengthening exercises for cervical spine muscles as a home plan. The study used various outcome measures, including the numerical pain rating scale (NPRS), neck disability index (NDI), neck flexion endurance (NFE), neck extension endurance (NEE), the neck proprioception error (NPE): neck flexion proprioception error (NFPE), neck extension proprioception error (NEPE), neck right rotation proprioception error (NRRPE), and neck left rotation proprioception error (NLRPE), with measurements taken at week 1 and week 6, respectively; the mean differences between the groups were measured using a two-way repeated ANOVA. Results: The experimental group showed better improvements compared to the control group, NPRS (73%), NDI (57%), NFE (152%), NEE (83%), NFPE (58%), NEPE (65%), NRRPE (65%), and NLRPE (62%), with a significant difference (p < 0.05). Conclusions: Active neck extension and flexion movements combined with jaw opening and closing are more effective in reducing pain and disability, improving neck muscles endurance and normalizing neck proprioception in patients with chronic neck pain.

The effects of lumbar stabilization exercises with and without jaw movements in non-specific low back pain (A randomized controlled trial).

Objective: This study aimed to investigate the added effect of jaw clenching on the efficacy of lumbar stabilization exercises to manage chronic non-specific low back pain. Methods: This randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation (SIPM&R) Karachi from April 2021 to April 2023. Eighty patients with chronic non-specific low back pain participated in this study. Forty patients each were randomly allocated to the lumbar stability exercise (LSE) group' and the lumbar stability exercise with teeth clenching (LSETC) group. Patients in both groups performed respective exercises twice weekly for 12 weeks. The Numeric Pain Rating Scale (NPRS), Roland Morris Disability Questionnaire (RMDQ), and Pressure Biofeedback Unit (PBU) were used to assess pain, disability, and muscle endurance respectively. Data were collected at the baseline, after six weeks and 12 weeks of intervention. A p-value of <0.05 was considered statistically significant. Results: Both groups showed statistically significant improvements in pain, disability, and muscle endurance. Upon further stratification, participants aged 20-30 years in the LSETC group showed significantly higher scores than the LSE group for NPRS, RMDQ, and PBU after 12 weeks. Overall, the LSETC group showed relatively higher improvement in mean scores for NPRS, RMDQ, and PBU than the LSE group. Conclusion: Lumbar stabilization exercises with and without jaw movement are effective for the treatment of chronic non-specific low back pain. The addition of teeth clenching enhanced the effectiveness of lumbar stability exercises, especially in young adults. Trial Registration: Clinicaltrials.gov (NCT04801212), Prospectively registered on March 16, 2021.

Intrarater Reliability Of Cervical Range Of Motion Device Among Adults With And Without Chronic Non-Specific Neck Pain.

Objective: To evaluate the intrarater reliability of the cervical range of motion device among adults with and without chronic non-specific neck pain. METHODS: The analytical, cross-sectional study was conducted from January to March 2019 at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, and comprised healthy adults with no neck pain in the preceding 6 months in Group A, and adults of either gender with chronic non-specific neck pain for >3 months in Group B. The two groups were further divided into age groups 21-30 years, 31-40 years and 41-50 years. A cervical range of motion device was used to measure the range of flexion, extension, right and left lateral flexion and right and left rotation of all the subjects. The measurements were taken by a single tester on day-1 and day-3 to assess the intrarater reliability. Data was analysed using SPSS 26. RESULTS: Of the 60 subjects, there were 30(50%) in each of the two groups. Within the groups, there were 10(33.3%) subjects in each of the 3 age subgroups. Overall, there were 27(45%) males and 33(55%) females. In Group A, the intraclass correlation coefficient values for all cervical ranges were between 0.81 and 0.99, whereas in Group B, the values ranged from 0.64 to 0.88. The intraclass correlation coefficient values yielded good to excellent agreement in both groups (>0.75) except for left lateral flexion in Group B (p=0.64), and all the values were statistically significant (p<0.05). Conclusion: There was good to excellent intrarater reliability of cervical range of motion device in adults with and without chronic non-specific neck pain.

Effectiveness Of Neuro Mobilisation On Pain, Range Of Motion, Muscle Endurance And Disability In Cervical Radiculopathy: A Systematic Review.

Objective: To assess the effects of the neural mobilisation technique on mobility, pain and disability in cervical radiculopathy patients, and to assess the functional activity level. METHODS: The systematic review was conducted from January 5 to July 5, 2022, and comprised search on Medline, PEDro, Cochrane Library and Embase databases for randomised controlled trials involving patients diagnosed with cervical radiculopathy that were published in the preceding 10 years in the English language. The search terms were divided into four classes by using the guideline for systematic reviews of trials of interventions in the Cochrane neck and back groups and related spinal disorders. Data wasretrieved afterthe studies were subjected to quality assessment and risk of biasness. RESULTS: Of the 1563 studies initially found, 8 (0.51%)were reviewed.Nomatter the approach ordosage used,manual therapy was successful in treating cervical radiculopathy symptomsin all investigations. Conclusion: A multimodal strategy incorporating neural mobilisation appears to be the most successful short-term technique.

Effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders: a randomized controlled trial.

BACKGROUND: Impaired vision is one of the commonest and most disabling consequence following stroke. Among all visual impairments, eye movement disorders are found in 70% of stroke patients which include nystagmus, strabismus, gaze palsies, disconjugate eye movements and cranial nerve palsies. They have a wide ranging impact on balance and activities of daily livings by creating difficulties in maintaining normal alignment and appropriate movement of eyes. The purpose of this study was to examine the effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders. METHODS: This study is a randomized controlled trial and was conducted in the University of Lahore Teaching Hospital from May 2019 to October 2020. A sample of 64 patients was recruited and randomly allocated into experimental and control group. 32 patients in experimental group were treated with visual scanning exercises along with task specific approach and 32 patients in control group were treated with task specific approach alone. Pre and post assessment of balance and activities of daily livings was assessed on BERG BALANCE SCALE and BARTHEL INDEX SCALE at baseline and at 4th week. RESULTS: Intra-group analysis of BERG BALANCE SCALE in experimental group showed statistically significant result (p < 0.05) in all items except in items 4, 13 and 14 respectively. Intra-group analysis of BERG BALANCE SCALE in control group showed statistically significant result (p < 0.05) in items 3, 5, 8 and 12 respectively, whereas remaining all items showed statistically insignificant result. Intra-group analysis of BARTHEL INDEX SCALE in experimental group showed statistically significant result in all items (p < 0.05) except in items 9 and 10 respectively. Intra-group analysis of BARTHEL INDEX in control group showed statistically significant result (p < 0.05) in items 1, 3, 4 and 8 respectively whereas remaining all items showed statistically insignificant result. Inter-group analysis showed statistically significant result in total scores of BERG BALANCE SCALE (p = 0.000) and BARTHEL INEX SCALE (p = 0.033). CONCLUSION: Visual scanning exercises along with task specific approach were found to be more effective in comparison to task specific approach alone. TRIAL REGISTRATION: Trial registration number: [IRCT20190717044237N1], trial registration date: 10/11/2019.

Effects of breathing re-education on clinical outcomes in patients with nonspecific chronic neck pain.

The present study evaluated the effectiveness of breathing re-education with routine physical therapy. This mixed method study was conducted at the District Headquarter Hospital Faisalabad, Faisalabad from April 2020 to July 2020. Fourteen participants (6men and 8 women) with chronic neck pain were recruited over a 16-week period and were equally divided into breathing re-education and routine physical therapy groups. The mean age of the patients was 38.48±5.92 years. Feasibility outcomes were recruitment, randomisation and retention rates of the participants. Clinical outcomes assessed for full trial were neck pain, cervical ROM, strength and endurance of neck muscles, quality of life and pulmonary functions. Outcomes were measured at baseline, fourth and eighth weeks. All the participants completed all the treatment sessions. No adverse events were reported. The breathing re-education group showed significant improvement in clinical outcomes. The results of this feasibility study provide supporting evidence for a future large-scale trial. Breathing re-education appears to be an effective treatment for chronic neck pain.

Inter-rater reliability of pressure biofeedback unit among individuals with and without chronic low back pain.

Objectives: To determine the inter-rater reliability of pressure biofeedback unit among individuals with and without chronic low back pain. Methods: This cross-sectional survey was conducted from February 2021 to March 2021 at the Physiotherapy Department of the Sindh Institute of Physical Medicine and Rehabilitation. Sixteen subjects which were recruited with and without chronic low back pain.(CLBP). During the test, abdominal drawing in movement was monitored by measuring a change in pressure detected in PBU. Each test was performed once by two trained assessors with period of seven days. Reliability indices of Pressure Biofeedback (PBU) measures including the Intraclass correlation coefficient [ICC] and Band Altman plot were analyzed. Results: This study found an intra-class correlation coefficient (ICC) = 0.94 [95% confidence interval (CI) (0.37, 0.99] for inter-rater reliability in healthy individuals, and an ICC of 0.97 (95% CI 0.97, 0.98) for inter-rater reliability in CLBP. The interrater agreement (Limits of Agreement-LOA=5.92, -3.9 mmHg) in CLBP and the interrater agreement (LOA=5.75, -3.25 mmHg) in healthy individuals were within the limits of agreement on 95% of occasions. Conclusion: Pressure Biofeedback Unit has showed excellent inter-rater reliability in measuring Transverse Abdominis muscle activity for individuals with and without chronic LBP.

Assessment of Knowledge about Dental Ergonomics among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia.

AIM: To assess the knowledge about dental ergonomics and work-related musculoskeletal disorders (WRMSDs) among dental students of King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia, undergoing practical clinical training. MATERIALS AND METHODS: A self-designed questionnaire after pre-testing was distributed to 150 dental students of KSU undergoing clinical training, to collect data related to (a) basic knowledge about dental ergonomics; (b) any course/workshop about dental ergonomics attended; (c) basic knowledge about WRMSDs; (d) familiarity about preventive measures to decrease the risk of WRMSDs; and (e) knowledge about treatment options for WRMSDs. RESULTS: One hundred forty-two students (95%) returned the completed questionnaires, of them 54 (38%) were males and 88 (62%) were females. The main findings of the study are that only 30% of the students knew about dental ergonomics; 93% of students have not attended any course/workshop about dental ergonomics; about half the students knew about WRMSDs; 62% of the students did not know about preventive measures to decrease the risk of WRMSDs, and 80% of students did not have knowledge about treatment options for WRMSDs. In general, female students had a better understanding of dental ergonomics and WRMSDs than male students. CONCLUSION: The basic knowledge of the dental ergonomics among dental students at King Saud University, Riyadh, Kingdom of Saudi Arabia is not adequate. CLINICAL SIGNIFICANCE: There is a need for introducing dedicated theoretical and practical courses covering all aspects of dental ergonomics in the undergraduate curriculum of dental education.

Prevalence of Work-related Musculoskeletal Disorders among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia.

AIM: To evaluate the presence of work-related musculoskeletal disorders (WRMSDs) among undergraduate dental students of the College of Dentistry, King Saud University (KSU), Riyadh, Saudi Arabia. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey was conducted in 2017 and distributed to150 undergraduate female, and male dental students of KSU who had started to work with patients in the clinic or with manikins. Data were collected related to WRMSDs. RESULTS: Nearly, 142 (95%) students returned the completed questionnaire, 88 (62%) were females and 54 (38%) were males. The results of this study indicate that musculoskeletal symptoms among dental students of KSU are high. Females generally reported more WRMSDs. Seventy-two percent of females and 41% of males reported frequent headaches. Fourteen percent of females and 6% of males had some musculoskeletal pain disorders before joining the dental profession, whereas 68% of females and 43% of males reported pain attributed to their clinical dental work. In the majority of females (67%) and males (61%), the onset of pain was gradual. Commonly reported pain sites in both females and males were the neck, shoulder, upper and lower back. The most common pain sites, among females were shoulder and neck, and upper- and lower-back among males. CONCLUSION: The WRMSDs can affect the dental professionals from the early stages of their clinical carrier, even as dental students. Concrete steps are required to prevent the occurrence of WRMSDs among dental students by providing them the detailed knowledge about theoretical and practical aspects of dental ergonomics. Higher prevalence of WRMSDs among female dental students indicate that female dental professionals need to be extra vigilant to adhere to the principles of dental ergonomics from the very beginning of their clinical career. CLINICAL SIGNIFICANCE: The awareness to implement the principles of dental ergonomics among dental students can help to prevent early development of WRMSDs among them. The inclusion of dental ergonomics as a detailed stand-alone subject in the dental curriculum before the start of clinical training can contribute minimize the risk of WRMSDs throughout the professional life of the dentists.

Effect of footwear on standing balance in healthy young adult males.

OBJECTIVE: The present study aimed to evaluate the effect of footwear on standing balance in healthy young adult males. METHODS: Thirty healthy male participants aged 20-30 years were tested for standing balance on the Balance Master on three occasions, including wearing a sandal, standard shoe, or no footwear (barefoot). The tests of postural stability include; "Modified Clinical Test of Sensory Interaction on Balance" (mCTSIB), "Unilateral Stance" (US), and the "Limits of Stability" (LOS). The balance scores (mCTSIB, US, and LOS) was analyzed. RESULTS: There was a significant effect between footwear conditions for mCTIB with eye closed on a firm surface (p=0.002). There was a significant effect between footwear conditions for the US with eye open and closed (p⟨0.05). There was a significant effect between footwear conditions for LOS reaction time during forward movement (p=0.02). Similarly, there was a significant effect between footwear conditions for LOS reaction time during left side movement (p=0.01). CONCLUSIONS: Wearing sandals compared to bare feet significantly increased postural sway and reduced stability in healthy young adult males. However, wearing a standard shoe compared to bare feet did not significantly affect balance scores in standing.

Effect of quadriceps and calf muscles fatigue on standing balance in healthy young adult males.

OBJECTIVE: The present study aimed to compare the effects of quadriceps or calf muscles fatigue on static and dynamic standing balance in young healthy adult males. METHODS: Forty-five healthy, physically active male adults aged 18-30 years were randomly divided into three groups; Quadriceps muscle fatigue group (n=15), Calf muscles fatigue group (n=15), and a control group (n=15). The Modified Clinical Test of Sensory Interaction on Balance, Unilateral Stance, and Limits of Stability (reaction time and movement velocity) were selected as outcome measures for this study. RESULTS: The results showed a non-significant difference between pretest and posttest balance scores (p>0.05) for quadriceps and calf muscles fatigue on balance. Similarly, there were non-significant differences in posttest balance scores when comparing fatigue effects between the groups (p>0.05). CONCLUSIONS: These results suggested that the fatigue of the quadriceps or calf muscles did not influence standing balance in healthy young adult males. Future longitudinal studies are recommended to further understanding the mechanisms behind localized muscle fatigue effects on standing balance in subjects of different age groups of both genders.

Hand grip strength and dexterity function in children aged 6-12 years: A cross-sectional study.

STUDY DESIGN: Cross-sectional and clinical measurement. INTRODUCTION: Assessment of hand function considers an essential part in clinical practice. PURPOSE OF THE STUDY: To develop normative values of hand grip strength and dexterity function for 6-12-year-old children in Saudi Arabia. METHODS: Grip strength and dexterity function was measured in 525 children using Grip Track hand dynamometer (JTECH Medical, Midvale, UT, USA) and 9-hole pegboard test respectively. RESULTS: The grip strength and dexterity function was improved as age progressed regardless of gender. Across all age groups, the hand grip strength of boys was significantly higher than girls for dominant hand (31.75 ± 10.33 vs 28.24 ± 9.35; P < .001) and nondominant hand (31.01 ± 10.27 vs 27.27 ± 9.30; P < .001). The girls performed slightly faster than boys for dominant hand (19.70 vs 20.68; P < .05) and nondominant hand (21.79 vs 23.46; P < .05). In general, girls completed a 9-HPT faster than boys in the 2 of 7 age groups: 11 years (9-HPT scores = 2.10 seconds; P < .01) and 12 years (9-HPT scores = 1.93 seconds; P < .01). DISCUSSION: The overall patterns of hand grip strength and dexterity function observed in the present study are similar to the previous studies that established acceleration of grip strength with advanced age, and faster performance scores in older children than younger children in both genders. CONCLUSIONS: Norms of hand grip strength and dexterity enable therapists to identify some developmental characteristics of hand function among Saudi children, determine the presence of impairment, and compare scores from children in different clinical settings. LEVEL OF EVIDENCE: Not applicable.

Incidence of orthodontic brackets detachment during orthodontic treatment: A systematic review.

OBJECTIVES: To evaluate the incidence of orthodontic brackets detachment during orthodontic treatment. METHODS: Using electronic databases; eligible studies up to January 2018 were retrieved, independently reviewed, and screened. The Coleman Methodology Scoring System (CMS) and Cochrane Collaboration's tool were used to assess quality and risk of bias in the included studies. RESULTS: Of the seventeen studies included in the final synthesis, thirteen were categorized as randomized clinical trials (RCTs), one prospective cohort and retrospective survey each, whereas two studies could not be categorized. The number of patients in the selected studies ranged between 19 and 153; the mean age was between 10.5 to 38.7 years, and male to female ratio was 353:495. Almost all studies had a high risk of bias, and more than half of the studies had CMS score of 70 or above. The numbers of brackets examined in the studies ranged between 361 and 3336. The incidence of brackets detachment ranged from 0.6 to 28.3%. CONCLUSIONS: The incidence of brackets detachment during orthodontic treatment is high.

Effect of sitting postures and shoulder position on the cervicocephalic kinesthesia in healthy young males.

Information about head orientation, position, and movement with respect to the trunk relies on the visual, vestibular, extensive muscular, and articular proprioceptive system of the neck. Various factors can affect proprioception since it is the function of afferent integration, and tuning of muscular and articular receptors. Pain, muscle fatigue, and joint position have been shown to affect proprioceptive capacity. Thus, it can be speculated that changes in body posture can alter the neck proprioception. This study was undertaken to investigate the effect of body posture on cervicocephalic kinesthetic sense in healthy subjects. Cervicocephalic kinesthetic sensibility was measured by the kinesthetic sensibility test in healthy young adults while in (a) habitual slouched sitting position with arms hanging by the side (SS), (b) habitual slouched sitting position with arms unloaded (supported) (SS-AS), and (c) upright sitting position with arms hanging by the side (US) during maximum and 30 degree right, left rotations, flexion, and extension. Thirty healthy male adults (mean age 27.83; SD 3.41) volunteered for this study. The least mean error was found for the SS-AS position (0.48; SD 0.24), followed by SS (0.60; SD 0.43) and US (0.96; SD 0.71), respectively. For all test conditions, there was significant difference in mean absolute error while head repositioning from maximum and 30 degree rotation during SS and SS-AS positions (p < 0.05). In conclusion, body posture can affect the proprioception function of the neck. Supporting the upper extremities in such a way that their weight is unloaded, which leads to reduction in the tension between the neck and shoulder girdle, can improve cervicocephalic kinesthetic sense in both the horizontal and vertical planes. The findings of this study can be implemented in people who have to do repeated arm and neck movements, by using ergonomically effective chairs with proper arm supports. This might help in prevention and treatment of neck pain.

Effect of chewing on postural stability during quiet standing in healthy young males.

BACKGROUND AND AIMS: There is an important role of the neck sensory motor system in control of body posture and balance, and it is reasonable to believe that the jaw sensory motor system can directly and indirectly influence the modulation of the postural control system. The purpose of this study was to evaluate possible effects of dynamic jaw position while chewing on the postural control system. MATERIALS AND METHODS: We compared the mean center of gravity (COG) velocity during quite standing on a foam surface with eyes closed during three test conditions: (i) with resting jaw position, (ii) with open jaw position, and (iii) while chewing standard bolus of chewing gum. One hundred and sixteen normal healthy male subjects (average age 31.56 ± 8.51 years; height 170.86 ± 7.26 cm) were recruited for the study. Their COG velocity (deg/s) was measured using the NeuroCom® Balance Master Version 8.5.0 (Clackamas, OR, USA). STATISTICAL ANALYSIS: Data was tested by the Friedman test. RESULTS AND CONCLUSIONS: The results show that COG velocity decreased significantly while chewing in comparison to both open and resting jaw position (p < 0.0001). Our finding corroborates previous studies and suggests that the jaw sensory motor system can modulate postural control mechanisms. Gum chewing activity can enhance the postural stability during upright standing on an unstable surface and in the absence of visual input in healthy young adults. Our results should be taken into consideration in treatment and rehabilitation planning for patients with postural instability.

Effect of tongue position on postural stability during quiet standing in healthy young males.

BACKGROUND AND AIMS: Role of the neck and jaw sensory motor system in control of body balance has been established. Tongue is an integral part of jaw sensory motor system and helps in execution of purposeful and precise motor tasks like eating, drinking and speaking. The purpose of this study was to evaluate the possible effects of tongue position on the postural control system. MATERIALS AND METHOD: We compared the mean center of gravity (COG) velocity during quiet standing on an unstable surface with eyes closed during two test conditions: (i) with habitual jaw resting position and (ii) with instructed tongue positioned against the upper incisors. One hundred and sixteen normal healthy male subjects (average age 31.56 ± 8.51 years and height 170.86 ± 7.26 cm) participated in the study. Their COG velocity (deg/s) was measured using the NeuroCom® Balance Master version 8.5.0 (Clackamas, OR, USA). RESULTS AND CONCLUSIONS: The results show that COG velocity decreased significantly while tongue was positioned against upper incisors in comparison to the habitual jaw resting position. Our findings suggest that the tongue positioning can modulate postural control mechanisms. Tongue positioning against the upper incisors can enhance the postural stability during upright standing on an unstable surface and in the absence of vision in healthy young adults. Our findings can be of value for evaluation and rehabilitation protocols for postural control dysfunction.

Therapeutic effects of whole-body vibration training in knee osteoarthritis: a systematic review and meta-analysis.

OBJECTIVE: To examine the current evidence regarding the effects of whole-body vibration (WBV) training in individuals with knee osteoarthritis (OA). DATA SOURCES: We searched PubMed, CINAHL, Embase, Scopus, Physiotherapy Evidence Database (PEDro), and Science Citation Index for research articles published prior to January 2015 using the keywords whole body vibration, vibration training, and vibratory exercise in combination with the Medical Subject Heading osteoarthritis knee. STUDY SELECTION: This meta-analysis was restricted to randomized controlled trials published in the English language. The quality of the selected studies was assessed by the PEDro Scale. The risk of bias was assessed using the Cochrane collaboration's tool in the domain-based evaluation. We also evaluated the quality of each study based on the criteria given by the International Society of Musculoskeletal and Neuronal Interactions for reporting WBV intervention studies, consisting of 13 factors. DATA EXTRACTION: Descriptive data regarding subjects, design, intervention, WBV parameters, outcomes, and conclusions were collected from each study by 2 independent evaluators. The mean and SD of the baseline and final endpoint scores for pain, stiffness, and function were extracted from the included studies. DATA SYNTHESIS: A total of 83 studies were found in the search. Of these, 5 studies met the inclusion criteria and were further analyzed. Four of these 5 studies reached high methodologic quality on the PEDro Scale. Overall, studies demonstrated mixed results in favor of additive effects of WBV for reducing pain and improving function in knee OA. There was considerable variation in the parameters of the WBV included in this systematic review. CONCLUSIONS: WBV training reduces pain and improves function in individuals with knee OA.

Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia.

[Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy.

Physical therapy education in Saudi Arabia.

[Purpose] To review the physical therapy educational program model, professional curriculum, and gender representation at major universities, as well as the quality and scope of physical therapy practice in Saudi Arabia. [Methods] Information regarding course curriculum, gender representation, and the quality and scope of physical therapy practice was collected from six universities in Saudi Arabia, the Saudi Physical Therapy Association, and the Saudi Health Commission. [Results] The first bachelor's degree course of physical therapy was started in Saudi Arabia more than 30 years ago. In the last 10 years, the number of universities offering a bachelor's degree in physical therapy has risen from 6 to 16, of which 14 are governmental and two are private. The 5- to 6 year bachelor's degree program in physiotherapy includes an internship and preparatory prerequisite courses. Postgraduate study in physical therapy was introduced in 2000. Most universities offer segregated physical therapy courses for male and female students. [Conclusion] The enrollment of students in physical therapy programs in Saudi Arabia is gradually increasing. There are many opportunities to extend the scope of practice and contribute to the health needs of the Arab population and international communities.