Low-energy laser therapy application on knee joints as an auxiliary treatment in patients with polyarticular juvenile idiopathic arthritis: a dual-arm randomized clinical trial.

Patients with juvenile idiopathic arthritis (JIA) always experience persistent pain and stiffness which induces muscle weakness, fatigue, and functional limitations. This study evaluated whether applying low-energy laser therapy (LLT) on the knee joint could be an effective adjuvant intervention for patients with JIA. Sixty children with polyarticular JIA participated and were randomly allocated to receive either LLT (wavelength λ = 903 nm; power output of 50 mW; and energy of 1.5 J) plus exercises (LLT group) or exercises alone (control group). Pain, peak concentric torque of quadriceps muscles, fatigue, and functional status were measured by the visual analogue scale, isokinetic testing system, Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, and Childhood Health Assessment Questionnaire, respectively pre- and post-intervention, and at 6-month follow-up. Per the mixed-model analysis of variance, the LLT group showed a statistically more favorable improvement in pain (P = .003, ηp2 = .014), fatigue perception (P = .004, ηp2 = .015), and functional status (P = .022, ηp2 = .09) across the three assessment occasions, as compared to the control group. However, no significant difference was demonstrated between both groups concerning peak concentric torque (all P > .05). Incorporation of LLT into the standard physical rehabilitation program for patients with JIA has the potential to induce more conducive improvements in pain, fatigue, and functional performance, but is not effective for improving muscle performance.

Laser photobiomodulation is more effective than ultrasound therapy in patients with chronic nonspecific low back pain: a comparative study.

The purpose of this study was to compare the effects of laser photobiomodulation therapy (lPBMt) and ultrasound therapy (UST) in patients with chronic non-specific low back pain (CNLBP). Forty-five patients with CNLBP aged 30-40 years were divided randomly into three groups of 15 subjects each. The lPBMt group received 8 weeks of lPBMt with an exercise program, while the UST group received 8 weeks of UST with the same exercise program; the control group received only the exercise program for 8 weeks. Pain, disability, functional performance, and lumbar range of motion were assessed at the beginning of the study and after 8 weeks. There were no significant differences in demographic and clinical characteristics among the three groups at baseline (p > 0.05). At the end of the study, there were significant improvements in pain, disability, and functional performance in the two experimental groups (p < 0.05), but changes in the control group were non-significant. However, lumbar range of motion was significantly improved only in the lPBMt group (p < 0.05). When the three groups were compared in terms of a change in clinical variables, there was a significant difference among the three groups in all measures in favor of lPBMt group. Based on our results, both lPBMt or UST combined with an 8-week exercise program seemed to be effective methods for decreasing pain, reducing disability, and increasing functional performance in patients with CNLBP, although lPBMt is more effective than UST.

A randomized controlled trial comparing helium-neon laser therapy and infrared laser therapy in patients with diabetic foot ulcer.

This study aimed to compare the effects of (HNLT) and (ILT) on diabetic foot ulcer. Sixty-five patients with diabetic foot ulcer (51 males and 14 females) aged 50-60 years. The participants were classified randomly to two groups, groups I and II. Group I received helium-neon laser therapy (HNLT) and conventional therapy with and group II received infrared laser therapy (ILT) and conventional therapy with for 8 weeks. Ulcer surface area was assessed using a sheet of cellophane paper at the beginning of the study, after 4 weeks, and after 8 weeks at the end of the study. At the beginning of the study, baseline clinical characteristics showed non-significant differences between the two groups (p > 0.05). After 4 weeks intervention, there were significant improvements in ulcer surface area in the two groups (p < 0.05). At the end of the study, after 8 weeks intervention, there were higher reduction in ulcer area in HNLT group more than ILT group, but this difference was statistically non- significant between the two groups (p > 0.05). The present study demonstrates that HNLT and ILT have similar effects to control diabetic foot ulcer in a short-term (up to 8 weeks). Eight weeks of laser therapy have beneficial impacts in diabetic foot ulcer.

Effects of second-hand smoking on lung functions in athlete and non-athlete school-aged children - observational study.

BACKGROUND: Second-hand smoking or environmental tobacco smoke is a critical health risk. Children are the most vulnerable to second-hand smoking because of their small bronchial ducts, less developed immunity, and low-physical activity. OBJECTIVES: The purpose of this study was to ascertain the effects of second-hand smoking on lung functions in athlete and non-athlete school-aged children. METHODS: This observational study included forty-six school-aged children, their age was 8-15 years, assigned to three groups; 2 study groups and 1 control group (n=15). The study groups comprised of 16 football players, and of 15 cyclists. Lung functions were evaluated recording forced vital capacity, forced expiratory volume in 1 sec and peak expiratory flow using digital spirometer. RESULTS: All measures were recorded in definite values and the children were also classified into second-hand smoking (SH), or non-exposed to tobacco smoking (NE). The findings presented a significant increase (p<0.05) of the study groups in forced vital capacity, forced expiratory volume in 1 sec and peak expiratory flow solely for the non-exposed children. However, there were non-significant differences between the cyclists and football players or between the passive smoking children and non-exposed children in any of the two study groups (p>0.05). CONCLUSION: The outcomes of this study suggest beneficial influences of the sports activity on the lung functions, without different influences of the cyclists and football players on the lung functions.

Effects of isokinetic knee muscle training on bone morphogenetic proteins and inflammatory biomarkers in post-traumatic osteoarthritis after anterior cruciate ligament injury: A randomized trial.

OBJECTIVE: To determine the effects of isokinetic training of the knee muscles on bone morphogenetic proteins and inflammatory biomarkers in post-traumatic osteoarthritis after anterior cruciate ligament injury in university football players. METHODS: A total of 60 participants with post-traumatic osteoarthritis after anterior cruciate ligament injury were randomly allocated into 3 groups: isokinetic training (n = 20), sensory motor training (n = 20) and control (n = 20) groups. The groups underwent different training programmes for 4 weeks. Clinical and biochemical values were measured at baseline, 4-week, 8-week and 6-month follow-ups. RESULTS: Four weeks after training the isokinetic group showed more significant changes in pain intensity and functional disability than the sensory motor training or control groups (p < 0.001). There was no significant improvement in bone morphogenic protein measures, (e.g. bone morphogenic proteins 2, 4, 6, and 7) in any of the groups. There was an improvement in inflammatory markers (CRP, TNF-α, IL-2, IL-4, IL-6) in the isokinetic training group compared with the other 2 groups (p < 0.001). CONCLUSION: Isokinetic training results in greater improvements in pain and functional disability than sensory motor training in post-traumatic osteoarthritis after anterior cruciate ligament injury in university football players. The isokinetic training programme had a beneficial effect on levels of inflammatory biomarkers and negligible effect on bone morphogenic proteins.

Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial.

BACKGROUND: Stress urinary incontinence is common in men after prostate cancer surgery. Rehabilitative interventions incorporate pelvic floor muscle training, biofeedback, electrical stimulation, lifestyle changes, or a combination of these strategies. However, little is known about the physiological impact of whole-body vibration for stress urinary incontinence after radical prostatectomy. OBJECTIVE: To investigate the effect of whole-body vibration training on stress urinary incontinence after prostate cancer surgery. DESIGN: Randomised controlled trial. SETTING: Tertiary university hospitals. PARTICIPANTS: Sixty-one patients with mild stress urinary incontinence after radical prostatectomy. INTERVENTION: Group 1 included 30 patients who performed pelvic floor muscle training and whole-body vibration training with a frequency and amplitude of 20Hz/2mm for the first two sessions and 40Hz/4mm for the rest of the intervention. Group 2 included 31 patients who performed pelvic floor muscle training alone. The intervention in both groups was conducted three times per week for 4 weeks. MAIN OUTCOMES: Incontinence Visual Analogue Scale (I-VAS) score, International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) score and 24-hour pad test result. RESULTS: I-VAS score, ICIQ-UI-SF score and 24-hour pad test result showed significant within-group differences at each assessment with the exception of the baseline and post-intervention I-VAS score in Group 2. For example, Group 1 I-VAS score had a median difference of 3.9cm [95% confidence interval (CI) -4.0 to -3.8] from baseline to first follow-up, and a median difference of -2.0cm (95% CI -2.2 to -1.8) at 4-week follow-up. Comparisons between the groups demonstrated significant differences in favour of Group 1 after 4 weeks of intervention and at follow-up for all measured parameters. CONCLUSION: Whole-body vibration training is an effective modality for treating patients with stress urinary incontinence after prostatectomy. TRIAL REGISTRATION: Clinicaltrial.gov (NCT03325660).

Comparative Study Between the Effects of Kinesio Taping and Pressure Garment on Secondary Upper Extremity Lymphedema and Quality of Life Following Mastectomy: A Randomized Controlled Trial.

BACKGROUND: Breast cancer stands out among the most widely recognized forms of cancer among women. It has been observed that upper extremity lymphedema is one of the most risky and prevalent complication following breast cancer surgery that prompts functional impairment, psychological, and social problems. PURPOSE: To compare the effects of Kinesio taping and the application of the pressure garment on secondary lymphedema of the upper extremity. METHODS: 66 women were randomly allocated to the Kinesio taping (KT) group (n=33) and pressure garment (PG) group (n=33). The KT group received Kinesio taping application (2 times per week for 3 weeks), while the PG group received pressure garment (20- 60 mmHg) for at least 15-18 hours per day for 3 weeks. The outcome measures were limb circumference, Shoulder Pain and Disability Index questionnaire (SPADI), hand grip strength, and quality of life at the baseline and end of intervention. RESULTS: The sum of limb circumferences, SPADI, hand grip strength, and quality of life significantly improved after treatment in the KT group (P<0.05). While the PG group showed no significant improvement in SPADI, hand grip strength, physical, role, pain, and fatigue score p>0.05, while the sum of limb circumferences significantly decreased (P<0.05). Significant differences were observed between the KT and PG groups at the end of the intervention (P<0.05). CONCLUSION: KT had significant changes in limb circumference, SPADI, hand grip strength and overall quality of life than PG in the treatment of subjects diagnosed with lymphedema after mastectomy.

Cardiovascular risk profile, oxygen uptake, and perceived exertion rate in children with obesity: the interactive effect of exercise intensity and duration.

BACKGROUND: Although physical exercise is a crucial element in the management of childhood obesity, the most effective training intensity and duration remain controversial. The primary purpose of this study was to analyze the interaction effects of exercise intensity and duration on cardiovascular risk profile, maximum oxygen uptake ( VO 2 max ), and rating of perceived exertion (RPE) in obese children. METHODS: Eighty obese children were allocated evenly to four groups (20 in each group): groups I and II performed 20 -minute and 40-minute constant-load treadmill training, respectively, with the intensity set at running speed, corresponding to 100% of first ventilatory threshold (VT1), and groups III and IV performed 20 -minute and 40-minute training, respectively, with the intensity set at running speed, corresponding to 80% of VT1. Training was conducted every other day for eight consecutive weeks. Blood lipids, VO 2 max , and RPE were assessed pre- and postintervention. RESULTS: Postintervention, significant between-group differences regarding all outcome measures (P<0.05) were indicated. Total cholesterol level had dropped significantly in group II compared to the other groups (adjusted P<0.05), and low-density lipoprotein and triglycerides had decreased significantly in group II compared to group III (adjusted P=0.003 and 0.007, respectively). VO 2 max had increased significantly in group II compared to group I (adjusted P=0.008). RPE had decreased significantly in group II in comparison to other groups (adjusted P<0.05). CONCLUSION: Intensity and duration are essential factors in aerobic-exercise prescription to reduce cardiovascular risk factors, increase oxygen uptake, and improve perceived exertion in obese children.

Exercise capacity and muscle fatiguability alterations following a progressive maximal exercise of lower extremities in children with cystic fibrosis.

BACKGROUND: Impairment of peripheral skeletal muscle function is a common phenomenon in patients with cystic fibrosis (CF) in addition to great clinical connotations, such as lack of exercise tolerance and decrease of health-related quality of life. There is very limited data on the effects of maximal exercise on muscle fatiguability and exercise capacity in children with cystic fibrosis. OBJECTIVES: The aim of this study was to evaluate the effect of progressive maximal exercise training of the lower extremities on exercise capacity and muscle fatiguability in children with cystic fibrosis. STUDY DESIGN: Between June and September 2017, eighteen children aged 8-12 years were recruited in this study. This study had two groups of children; the CF group consisted of nine children (6 males and 3 females) with cystic fibrosis and the control group consisted of nine healthy age matched children (6 males and 3 females). The children underwent a progressive maximal cardiopulmonary exercise cycling test (CPET), muscle fatigue test, and magnetic resonance imaging (MRI) to measure a muscle cross-section area (CSA). Also, pulmonary functions were assessed. RESULTS: The findings of this study showed that the CF children had less pulmonary functions, had a less exercise capacity, and had a higher breathing reserve index and oxygen desaturation when compared with healthy children (p<0.05). On the other hand, there was a non-significant difference in muscle fatiguability, muscle cross-section area, and maximal voluntary contraction between the CF and healthy children (p>0.05). CONCLUSION: This study indicates that progressive maximal exercise doesn't affect muscle fatiguability, muscle cross-section area, and maximal voluntary contraction in CF children with moderate respiratory diseases but includes lower exercise capacity. CF children and healthy age matched children have similar responses to maximal exercise in muscle fatiguability, muscle cross-section area, and maximal voluntary contractions but lower exercise capacity in the CF group.

Evaluating pulmonary function, aerobic capacity, and pediatric quality of life following a 10-week aerobic exercise training in school-aged asthmatics: a randomized controlled trial.

BACKGROUND: It has been documented that aerobic exercise may increase pulmonary functions and aerobic capacity, but limited data has evaluated a child's satisfaction and pediatric quality of life (PQoL) with exercise training. OBJECTIVES: This study aimed to investigate the effects of moderate-intensity exercise training on asthmatic school-aged children. SUBJECTS AND METHODS: This study included 38 school-aged children with asthma (23 males and 15 females) aged between 8-12 years. They were randomly assigned to two groups, aerobic exercise (AE) and conventional treatment (Con ttt) groups. The AE group received a program of moderate-intensity aerobic exercise for 10 weeks with asthma medications and the Con ttt group received only asthma medications without exercise intervention. A home respiratory exercise was recommended for the two groups. Aerobic capacity was investigated using maximal oxygen uptake (VO2max), 6-minute walk test (6MWT), and fatigue index. PQoL was evaluated using Pediatric Quality of Life Questionnaire (PQoLQ). Also, pulmonary function tests were performed, and the results recorded. RESULTS: The findings of this study showed significant improvements in pulmonary functions and VO2max in the two groups; however, this improvement was significantly higher in the AE group than in the Con ttt group (p<0.05). The 6MWT and fatigue index improved in the AE group (p<0.05) but not in the Con ttt group (p>0.05). All dimensions of PQoL significantly improved in the AE group (p<0.05), but there was no significant improvement in the Con ttt group after the 10-week intervention period (p>0.05). CONCLUSION: Ten weeks of physical exercise had beneficial effects on pulmonary functions, aerobic capacity, and PQoL in school-aged children with asthma. Effort and awareness should be dedicated to encouraging the active lifestyle among different populations, especially asthmatic children.