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.

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.

Clinical and functional efficacy of gallium-arsenide super pulsed laser therapy on temporo mandibular joint pain with orofacial myalgia following healed unilateral cervicofacial burn - A randomized trial.

BACKGROUND: Cervicofacial burn (CB) is a unique type of burn, involving the lateral part of the face, neck and chest region with significant skin contractures. Temporomandibular joint (TJ) pain and orofacial myalgia (OM) are the major problems in physiotherapy context to treat. Laser is commonly used as an adjunct therapy in painful conditions. However, clinical studies are lacking in investigating the effects of gallium-arsenide (Ga-As) super pulsed laser therapy on temporomandibular joint pain and orofacial myalgia following healed cervicofacial burn patients. OBJECTIVE: To investigate the effects of clinical and functional efficacy of Ga-As super pulsed laser therapy on temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn patients. METHODS: Through two block random sampling method, the eligible participants were randomized and allocated into active laser (Active-L; n = 18) and placebo laser (Placebo-L; n = 18) groups. The Active-L group received laser treatment and the Placebo-L group received placebo laser effect (inactive laser) with regular physiotherapy care for 3 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the end 4th week, 8th week and 6 month follow up. RESULTS: Baseline subjective and clinical attributes show homogenous presentation among the study groups (p > 0.05). After four weeks of treatment, and at the end of 6 months follow up, the pain intensity, 2.9 (CI 95% 2.80-3.00), pain threshold 19.2 (CI 95% -30.4 to -7.9), pain frequency 3.4 (CI 95% 3.14-3.65), mouth opening, -16.0 (CI 95%-16.5 to -15.4), disability level 11.3 (CI 95%11.14-11.45), and quality of life -31.7 (CI 95%-37.1 to -26.2) showed more improvement (p < 0.001) in Active-L group than Placebo-L group. CONCLUSION: The reports of this study proved that, four weeks active laser therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of temporomandibular joint pain rehabilitation.

Optimization of pulmonary function, functional capacity, and quality of life in adolescents with thoracic burns after a 2-month arm cycling exercise programme: A randomized controlled study.

BACKGROUND: Burns to the thorax are at high risk for long-term pulmonary complications due to chest muscle contractures and chronic inflammation in both adolescents and young adults. Few studies have investigated the effects of arm cycling exercise in those individuals. For that reason, this study examined pulmonary function, functional capacity, and quality of life (QOL) in adolescents with thoracic burns subsequent to 2-month arm cycling exercise programme. METHODS: A single-blinded, two-month randomized prospective controlled study was carried out between July 2019 and March 2020 on thirty adolescents with chest burns aged 11-17 years. They were randomized into two equal groups (n = 15), traditional physiotherapy programme (control group), and arm cycling exercise plus traditonal physiotherapy (arm cycling exercise group) for 2 consecutive months. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), six-minute walk test (6MWT), and Pediatric Quality of Life Inventory (PedsQL) were measured in both groups at baseline and after 2-month after intervention. RESULTS: No statistical significance was detected at baseline between control and arm cycling exercise groups (FVC, p = 0.903, FEV1, p = 0.835, 6MWT, p = 0.817, and PedsQL, p = 0.612). 2 months after intervention showed statistical improvements in the arm cycling exercise group in all measures (FVC, p = 0.001, FEV1, p < 0.0001, 6MWT, p = 0.001, and PedsQL, p = 0.001) however, the control group showed statistical improvements in FVC, p = 0.044 and FEV1, p = 0.024 with non-statistically significant changes in 6MWT, p = 0.145 and PedsQL, p = 0.067. The arm cycling exercise group showed greater improvements than control group in the outcome measures (FVC, p = 0.034, FEV1, p < 0.017, 6MWT, p = 0.037, and PedsQL, p = 0.021). CONCLUSIONS: This prospective study clearly demonstrated positive and beneficial influences of two-month arm cycling exercise in the optimization of pulmonary functions, functional performance, and QOL in adolescents suffering from chest burns and thereby eliminating post-burn complications.

Effect of physical therapy rehabilitation program combined with music on children with lower limb burns: A twelve-week randomized controlled study.

BACKGROUND: Burn injuries cause significant physical impairments that need comprehensive rehabilitation and coordination with the acute burn care team. Music had been shown to increase positive mood during exercise, which may result in motivation for participation in exercise programs. The current study aimed to evaluate the effect of physical therapy rehabilitation program combined with music therapy on children with lower limb burns. METHODS: A twelve-week randomized controlled study including thirty pediatrics with lower limb burns. They were randomly assigned into two equal groups, 15 children per each. Group A received a physical therapy rehabilitation program combined with music therapy in addition to routine medical care. However, Group B received a physical therapy rehabilitation program without music therapy. Assessment of pain was by visual analogue scale (VAS), assessment of the range of motion (ROM) by goniometer, and gait assessed by GAIT Rite. The evaluation was carried before and after the interventions. RESULTS: Before starting the study, no significant differences were detected between the two study groups (p < 0.05). The study results reported statistically significant improvement in VAS, ROM, and GAIT Rite in both groups after the intervention (p < 0.05). Group A showed greater improvement than group B in all outcome measures (p < 0.05). CONCLUSION: Physical therapy program combined with music therapy is an effective and safe modality for improving pain, range of motion, and gait parameters in pediatrics with lower limb burn. Also, physical therapy combined with music therapy is more effective than physical therapy alone in the treatment of pediatrics with lower limb burns.

The impact of using chickpea flour and dried carp fish powder on pizza quality.

Pizza being the most popular food worldwide, quality and sensory appeal are important considerations during its modification effort. This study was aimed to evaluate the quality of pizza made using two different sources of proteins, chickpea (Cicer arietinum) flour and dried carp fish powder (Cyprinus carpio). Analysis indicated nutrients richness specificity of chickpea flour (higher fiber, energy, iron, zinc, linoleic acid and total nonessential amino acids) and dried carp fish powder (higher contents of protein, fats, ash, oleic acid and total essential amino acids) complementing wheat flour to enhance nutritional value of pizza. Total plate count and thiobarbituric acid were increased (P<0.05) in dried carp fish powder after 45 days of storage, but no Coliform were detected. Wheat flour was substituted with 5, 7.5 and 10% chickpea flour or dried carp fish powder and chemical, textural, sensory and storage evaluation parameters of in pizza were investigated. Dried carp fish powder increased (P<0.05) contents of protein, ash, fats, zinc and protein digestibility of pizza. Chickpea flour increased iron and zinc contents of the pizza. Water activity (aw) was decreased in fish powder and chickpea pizza. Pizza firmness and gumminess were significantly (p<0.05) increased at every level of protein source, but cohesiveness was decreased with 10% chickpea flour. Pizza chewiness was the same (P>0.05) across the levels of two protein sources. Springiness was decreased (P<0.05) with high level (10%) dried fish powder and low/intermediate level of chickpea flour. Chickpea and dried carp fish incorporation up to 7.50% in pizza at the expense of wheat flour had no effect (P>0.05) on all sensorial parameters except for odor values. The results could be useful in utilization of chickpea flour and carp fish powder in designing nutritious pizza for consumers.