Amira Mahmoud Abd-Elmonem

Background: Autism Spectrum disorder (ASD) is a neurodevelopmental condition characterized by intensely repetitive and limited behaviors as well as deficiencies in perceptuo‐motor processing and interpersonal interaction capabilities. Objectives: The objective of this paper is to evaluate the effectiveness of aquatic training (AT) versus land‐based exercises (LBE) on the quality of life (QoL), motor function, and autistic traits in children with ASD. Methods: Fifty children with ASD diagnoses of both sexes, aged from three to five years, were assigned to two groups at random ( n = 25 each). AT was given to the AT group, whereas LBE was given to the LE group for 45 min three times a week for three successive months. Before and after the recommended intervention period, the Childhood Autism Rating Scale (CARS‐2), Peabody Developmental Motor Scale (PDMS‐2), and Arabic version of the Pediatric QoL generic core scale (PedsQL) were used to measure autistic features, motor skills, and QoL, respectively. Results: Within‐group comparison showed significant improvement in PedsQL, PDMS‐2 and CARS‐2 scores ( p < 0.001). Additionally, between‐group comparison reveled significant improvement in CARS‐2 and PedsQL and PDMS‐2 (stationery and locomotion age equivalent and gross motor quotient) of the AT group compared with that of the LE group posttreatment ( p < 0.001). Conclusion: AT demonstrated higher efficacy than LBE, yielding greater improvements in motor development and QoL, as well as more pronounced enhancements in sensory integration among young children with ASD. Thereupon, it is worthwhile for physical rehabilitation practitioners to include the AT in the intervention plans for children with ASD. Trial Registration: The clinical trial registration number of the current study is as follows: Registry submission date 11/5/2021 URL: https://www.clinicaltrials.gov/study/NCT05123066?tab=table ; ID number: NCT05123066

Background and Purpose: Children with hemiparesis show a characteristic walking pattern resulting from weakness and spasticity on one side of the body. Nordic walking (NW) engages both the upper and lower bodies, which can help improve coordination and balance. This study aimed to assess the efficacy of NW on gait asymmetry patterns in children with hemiparesis. Study Design: Assessor‐blinded randomized controlled trial. Method: Forty children with hemiparesis, ranging in age from 6 to 10 years, were randomly allocated to two groups equal in numbers. Control group received a designed physical therapy program for 60 min per session, three times a week, for three consecutive months and NW‐group received the same designed physical therapy program while the NW training for 20 min replaced the functional gait training. Results: There was no significant difference between groups pre‐treatment ( p > 0.05). Within group comparison showed improvement in all measured variables. Post‐treatment comparison showed greater improvements in the NW group, including reduced symmetry index (11.34 ± 4.12 vs. 16.19 ± 4.87) and increased affected‐side step length (26.54 ± 2.92 vs. 22.03 ± 3.89) and cadence (95.30 ± 15.81 vs. 80.10 ± 17.81), compared with the control group (all p < 0.01). Conclusion: NW training has a positive influence on selected spatiotemporal and kinematic parameters and improves gait symmetry in children with hemiparesis and may serve as a feasible adjunct to conventional pediatric gait training. Trail Registration: The clinical trial registration number of the current study is (NCT05644652)

Background and purposeTight hamstring muscles are a common musculoskeletal condition that can negatively impact function and increase injury risk. Physiotherapists use various techniques like the ‘muscle energy technique (MET) and Mulligan straight leg raise (SLR)’ to improve flexibility. Evidence comparing these methods is limited. The objective was to compare the effectiveness of ;muscle energy technique and Mulligan straight leg raise’ for improving hamstrings flexibility. Materials and MethodsA parallel group randomized controlled trial was conducted at the outpatient physiotherapy clinic of a university hospital. Forty-six healthy subjects aged 18-25 years, with an active knee extension loss of 20-50 degrees with the hip and knee at a 90-degree popliteal angle were randomly allocated into three groups: Muscle energy technique, Mulligan straight leg raise, and control. Subjects received their respective interventions thrice weekly for four weeks. The “active knee extension test (AKET)”, “passive compliance and passive peak torque were assessed pre- and post-intervention. ResultsBoth the Muscle energy technique and Mulligan straight leg raise groups showed significant improvements in ‘active knee extension test, passive compliance, and passive peak torque’ (p<0.005). However, ‘muscle energy technique’ demonstrated greater improvements compared to Mulligan SLR and control groups. Conclusion‘Muscle energy technique’ appears to be more effective than Mulligan straight leg raise in improving hamstring flexibility, suggesting its potential as a preferred method in physiotherapy for treating hamstring tightness. Further research is needed to explore the long-term effects of Muscle energy technique and the potential benefits of a maintenance program.

Objectives: To compare between the effects of plyometric exercises versus Wii on upper extremity functions in children with unilateral cerebral palsy (UCP). Method: Forty-two children with UCP, ranging in age from 8 to 12 years were allocated to receive plyometric exercises (PLYO -group) or Wii training (Wii-group) for 45 min. both groups received selected occupational therapy programs for 30 min twice a week over 3-month. The intervention was delivered on non-consecutive days. The quality of upper extremity skills test (QUEST), Test of arm selective control (TASC) and pneumatic squeeze bulb dynamometer were used to assess upper extremity function, SMC and HGS, respectively. Results: Overall, 42 children (21 in the PLYO-group, 21 in the Wii-group) completed data collection and treatment. With-in group comparison showed significant improvement in both groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.05 (1.47: 2.63) and HGS is 2.86 (2.20: 3.53) ( p  < 0.05; 95% Confidence interval) in favor of the PLYO-group. Conclusions: Plyometric exercises are significantly more effective than Wii training in improving upper extremity function and strength in children with UCP.

Background: Diabetes mellitus type 1 (T1D) is frequently associated with concurrent medical conditions that cause physical limitations. Purpose: Investigate the relation between anthropometric measurements and balance in children with T1D using Human Assessment Computer (HUMAC) balance system. Material and Methods: The assessment procedures were collected from Outpatient Diabetes Clinic of Abu El-rish Hospital. Participants: Sixty children with type 1 diabetes, age ranged from 7 to 14 years, they had a disease from less than 5 years ago, didn't have other problems. Outcome measures: The (HUMAC balance system) HUMAC balancing system was used to evaluate the limitations of stability, pressure center, sensory organization, and balance.Results: Children with higher body mass index (BMI) decreased sensory integration and balance were all statistically significant, when standing on soft surface and eye closed. There was significant when related the height to center of pressure (COP) score and sensory integration especially when standing on soft surface and eye closed.Conclusion: Children with T1D who have higher BMI and height exhibit poor postural stability especially when standing on soft surface and eye closed. Early detection of these deficits is suggested to reduce the risk of complications in maturity.

Background/Aim A key aspect of hand function is dexterity, which is described as fine voluntary movements used to manipulate small objects during a specific task. The contralateral hand in children with unilateral cerebral palsy (U-CP); is commonly referred to as a “good” and “unimpaired” hand, while others have noted that it has subtle limitations. Therefore, this study aimed to assess and compare between the strength and dexterity of less-affected hand of children with U-CP and the dominant hand of normal peers. Methods A sample of 120 volunteer children from both sexes and age ranged from 6 to 10 years participated in this study. Out of the 120 children, sixty were normal typically developing (TD) and sixty children with U-CP. Assessment of fine motor dexterity and grip and pinch strength were carried out by the Functional dexterity test (FDT) and Pneumatic squeeze Blub Dynamometer respectively. Results The results showed that there was a significant lower in pinch and grip strength (p < 0.01) and significant higher FDT scores of children with U-CP compared with that of TD children (p = 0.001). Moreover, there was a significant higher functional levels in TD children compared with that of children with U-CP (p < 0.001) with no significant difference between groups in penalty distribution (p > 0.05). Conclusion Children with U-CP underperformed with their less-affected hand than the dominant hand of TD age matched peers. Future researches on bilateral hand function may be used to determine the best rehabilitation interventions.

BACKGROUND: Cerebral palsy is the most frequent condition affecting the central nervous system and causing large disability. OBJECTIVE: To determine the impact of touch screen tablet upon fine motor functions in children with hemiparesis. METHOD: This was a randomized controlled trial involving 60 children, ranging in age from 5 to 7 years old, randomized into two groups: intervention or control group (30 children per group). Both groups were given 12 consecutive weeks of designed fine motor tasks. Additionally, for thirty minutes, the intervention group was given a fine motor exercise program on a touch screen tablet. Upper limb function, finger dexterity and pinch strength were measured pre and post the recommended treatment program using the quality of upper extremity skill test (QUEST), Nine-Hole Peg Test and Jamar hydraulic pinch gauge, respectively. RESULTS: All outcome measures were equivalent between intervention groups at admission (P > 0.05). Significant improvements were found in all assessed variables within the two groups. Meanwhile, the intervention group had significantly higher improvements (P < 0.05) in finger dexterity, pinch strength, and upper limb function when compared with the control groups. CONCLUSION: Including a touch screen smart tablet application with a specially designed fine motor program is an effective method that helps children with U-CP perform more effectively with their fine motor skills.

BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity. OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia. METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II). RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group. CONCLUSION: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.

Background: Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities.Aim: To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP.Design: This was a double‐masked, randomized, controlled clinical trial.Setting: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al‐Agouza Hospital, Giza, Egypt.Population: Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers.Method: Children were allocated to receive conventional therapy (CONV‐group; n = 20) or plyometric exercises (PLYO‐group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3‐month. The intervention was delivered on non‐consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively.Results: Overall, 35 children (18 in the CONV‐group, 17 in the PLYO‐group) completed data collection and treatment. With‐in group comparison showed significant improvement in the study groups while post‐treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO‐group.Conclusions: Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP.