Mohamed M. Ahmed

Background and Objectives: Low-grade systemic inflammation plays an important role in the pathophysiology of knee osteoarthritis (OA), yet the effects of joint mobilization on inflammatory biomarkers remain unclear. This randomized clinical trial investigated the effects of mobilization with movement (MWM) compared with sham MWM on inflammatory biomarkers and clinical outcomes in individuals with knee OA. Materials and Methods: Forty participants with mild-to-moderate knee OA were randomly assigned to either a mobilization group receiving standardized care plus MWM (n = 20) or a sham mobilization group receiving standardized care plus sham MWM (n = 20). Interventions were delivered twice weekly for four weeks. Primary outcomes were inflammatory biomarkers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Secondary outcomes included pain intensity (Visual Analog Scale [VAS]), physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), knee range of motion (ROM), and muscle strength. Outcomes were assessed at baseline and after the 4-week intervention. This study was prospectively registered at ClinicalTrials.gov (NCT07166068) on 28 November 2024. Results: Both groups demonstrated significant improvements in one inflammatory biomarker, namely CRP, and all secondary outcomes following treatment (all p < 0.05). However, no significant between-group differences were observed for CRP, ESR, pain, function, or muscle strength (all p ≥ 0.256). Participants in the MWM group showed greater improvement in knee flexion ROM compared with the sham MWM group (adjusted mean difference = 6.56°, 95% CI: 0.14–13.00, p = 0.046), with a moderate effect size. Conclusions: MWM combined with standardized care did not produce superior improvements in inflammatory biomarkers or most clinical outcomes compared with sham MWM over four weeks.

Background/Objectives: Subacromial impingement syndrome (SIS) may be associated with altered kinetic-chain mechanics above and below the shoulder. The posterior oblique sling integrates the gluteus maximus and latissimus dorsi through established fascial and neuromuscular connections, yet empirical evidence examining its relevance in SIS remains limited. Therefore, this cross-sectional observational study aimed to investigate the surface electromyographic (sEMG) activity of the latissimus dorsi (LD) and contralateral gluteus maximus (GM) and evaluate their associations with pain, disability, and shoulder range of motion (ROM) in young adults with SIS. Methods: Sixty sedentary young adults with SIS and matched controls were assessed using the Numeric Pain Rating Scale, Arabic QuickDASH, twin-axis electrogoniometer, and sEMG of the gluteus maximus and latissimus dorsi. Results: The SIS group had significantly lower GM activity (23.96 ± 3.54% MVIC for SIS and 34.49 ± 4.16% MVIC for controls) and significantly higher LD activity (118.63 ± 24.87% MVIC for SIS and 75.52 ± 25.93% MVIC for controls) (p = 0.001). In addition to these differences, the SIS group exhibited significantly less ROM in all directions (flexion, extension, abduction, and rotation) and greater disability and pain intensity (both p = 0.001) than controls. Correlations between sEMG activity and clinical outcome measures in the SIS group were weak and not statistically significant. Discriminant logistic regression indicated that both GM and LD sEMG were significant discriminative variables of group membership, with GM underactivity showing the greater discriminative value. Conclusions: These results indicate an altered neuromuscular activation pattern observed in participants with SIS, characterized by decreased GM and increased LD sEMG activity. They may justify further investigation of kinetic-chain-informed rehabilitation, with attention to both hip/lumbopelvic function and shoulder-based treatment.

Musculoskeletal disorders (MSDs) are among the most common work-related health problems and are frequently associated with prolonged sitting, poor computer workstation ergonomics, and inadequate sleep. This study aimed to determine the prevalence of MSD complaints and examine their associations with computer workstation ergonomics and sleep quality among employees at Jazan University, Saudi Arabia. A cross-sectional study was conducted between December 2024 and April 2025 among 460 university employees selected using a multistage cluster random sampling technique. Data were collected using the Nordic Musculoskeletal Questionnaire, the National Institutes of Health Computer Workstation Ergonomic Self-Assessment Checklist, and the Pittsburgh Sleep Quality Index. Data were analyzed using IBM SPSS Statistics, version 27. MSDs were highly prevalent, with the low back (65.9%), neck (65.0%), shoulders (57.2%), and upper back (46.3%) being the most commonly affected body regions, whereas the elbows were the least affected (16.7%). Male employees had significantly lower odds of hip pain (odds ratio [OR] = 0.22, 95% confidence interval [CI]: 0.07–0.66) and ankle pain (OR = 0.34, 95% CI: 0.13–0.90) than female employees. Compared with employees from the College of Arts and Humanities, those from the College of Science had significantly higher odds of wrist pain (OR = 2.12, 95% CI: 1.07–4.20), elbow pain (OR = 2.45, 95% CI: 1.09–5.53), and ankle pain (OR = 2.48, 95% CI: 1.15–5.33). Poor sleep quality was independently associated with increased odds of neck pain (OR = 1.13, 95% CI: 1.03–1.24), upper-back pain (OR = 2.47, 95% CI: 1.08–5.67), and knee pain (OR = 4.28, 95% CI: 1.70–10.80). In addition, poor workstation ergonomics were independently associated with several MSDs after adjustment for potential confounders. MSDs were highly prevalent among university employees and were independently associated with poor workstation ergonomics and poor sleep quality. These findings highlight the importance of implementing workplace ergonomic interventions and employee wellness programs to reduce the burden of MSDs. Future longitudinal studies are needed to evaluate the effectiveness of ergonomic and sleep-related interventions and to further investigate the contributions of occupational stress and screen time to MSD risk.

Background/Objectives: Nutrition is essential in healthcare and rehabilitation, although the readiness of physiotherapists in Saudi Arabia to integrate nutritional assessment and counseling remains ambiguous. This study aimed to assess their knowledge of nutrition, lifestyle choices, and attitudes towards incorporating nutrition into practice. Methods: This cross-sectional study included 500 licensed physiotherapists practicing across Saudi Arabia and used a culturally adapted questionnaire derived from previously validated instruments. The survey assessed background characteristics, nutrition knowledge, nutritional lifestyle, and attitudes toward integrating nutrition into physical therapy. Descriptive statistics, analysis of variance, Pearson correlation, and multiple linear regression analyses were performed. Results: Participants demonstrated moderate nutrition knowledge (59.68 ± 17.25) and favorable nutritional lifestyles (20.67 ± 3.79), with positive attitudes toward integrating nutritional assessment and counseling into their practice (13.63 ± 4.64). A significant positive correlation was observed between nutritional lifestyle scores and nutrition integration scores (r = 0.29, p < 0.01). Because lower nutritional lifestyle scores indicate healthier lifestyles and lower integration scores reflect greater integration, participants with healthier nutritional lifestyles tend to show greater nutrition integration. Nutrition knowledge scores were negatively correlated with integration scores (r = −0.37, p < 0.01). Multiple linear regression analysis identified professional seniority, nutritional lifestyle, and nutrition knowledge as significant predictors of nutrition integration score, explaining 22.8% of the variance (F = 29.24, R² = 0.22, p = 0.001). Conclusions: Saudi physiotherapists showed positive attitudes toward integrating nutritional assessment and counseling into the practice, but their nutrition knowledge was moderate, with knowledge gaps. Nutrition integration correlated significantly with nutritional lifestyle scores, nutrition knowledge, and professional seniority. The findings indicate the need to improve nutrition-related competencies and interdisciplinary collaboration in rehabilitation practice.

Purpose: To clarify the clinical, imaging, and laboratory changes after application of honey phonophoresis combined with conventional physiotherapy in a patient with knee osteoarthritis (OA). Patients and Methods: A 55-year-old male with Grade II medial knee osteoarthritis presented with chronic pain, morning stiffness, and functional limitations. Baseline assessment included pain intensity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), musculoskeletal ultrasound (MSK-US) evaluation of medial femoral cartilage thickness, and systemic inflammatory markers. The patient underwent a four-week multimodal physiotherapy program consisting of honey phonophoresis applied to the medial tibiofemoral compartment, transcutaneous electrical nerve stimulation (TENS), and supervised quadriceps strengthening exercises. Results: Following the intervention, pain intensity decreased from 8/10 to 4/10, and the total WOMAC score improved from 58/96 to 43/96. MSK-US demonstrated increased medial femoral cartilage thickness on both longitudinal (0.26 to 0.30 cm) and transverse (0.20 to 0.26 cm) posterior views. Systemic inflammatory markers also improved, with C-reactive protein decreasing from 8.08 to 5.2 mg/L and erythrocyte sedimentation rate from 29 to 18 mm/h. No adverse events were observed. Conclusion: Integration of honey phonophoresis with conventional physiotherapy in this single case may be associated with improvements in the patient’s reported outcomes, cartilage ultrasound assessment, and inflammatory biomarkers in OA. Causal relationships cannot be inferred from a single case due to the uncontrolled, multimodal design; thus, imaging changes should be interpreted cautiously. The findings of this case are exploratory and hypothesis-generating, supporting further investigation through well-designed randomized controlled trials.

Due to their cognitive and physical impairments, children with autism spectrum disorder (ASD) have detrimental effects on their daily activities. The goals of physical therapy (PT) treatment plans are to lessen impairments to body structure and function, support milestones, and encourage developmental sequence. Neurodevelopmental treatment (NDT) is a sensory–motor approach used by physical therapists/occupational therapists to children and adult function and manage movement disorders due to neurological impairment. No studies until now have focused on the role of the NDT approach of PT on children with ASD. So, the purpose of this study was to investigate the effect of NDT PT approach on the gross motor development and cognition of children with ASD. Forty children with ASD were randomly distributed into two groups: group A (intervention group) for PT, and group B (control group). They were evaluated using gross motor functional measure (GMFM)-66 to measure gross motor skills and Stanford-Binet Intelligence Scales fifth edition (SB5) to measure the intelligence quotient and cognitive variables before and after intervention. Intervention continued for 3 months for children with ASD in the Jazan region, Kingdom of Saudi Arabia. Group A had significant improvements for both gross motor function (P = 0.001) and cognition (P = 0.001), and group B showed no significant change for both gross motor (P = 0.69) and cognition (P = 0.21) while between-groups comparison showed significant improvement in group A for cognition (P = 0.003) and gross motor function (P = 0.003). It was concluded that gross motor development on GMFM-66 and cognitive functions of children with ASD on SB5 significantly improved after a structured individualized NDT PT program for 3 months of daily sessions for 1 h at school age for non-obese children with ASD.

Children with autism spectrum disorder (ASD) experience negative effects on their everyday activities due to cognitive and motor disabilities. Physiotherapy treatment plans aim to reduce body structure and function impairments, promote developmental sequence, and facilitate milestones, while gluten-free casein-free (GFCF) diets have been proven effective in improving autism symptoms. So, the purpose of this study was to investigate the effect of a combined GFCF diet and neurodevelopmental (NDT) physical therapy program on the gross motor development and cognition of children with ASDs. Eighty children with ASD were distributed into four groups: A, for diet intervention; B, for physical therapy; C, for combined diet and physical therapy; and D was the control group. The evaluation was performed using gross motor functional measures and Stanford–Binet V5 before and after intervention. Intervention continued for 3 months for the children with ASD in the Jazan region, Kingdom of Saudi Arabia. Group A showed non-significant change for both gross motor (P = 0.89) and cognition (P = 0.53) functions, Groups B and C revealed significant improvement for both gross motor [mean difference (MD) = −12.77, 14.61] and cognition (MD = −14.2, 14.55), respectively, with (P = 0.001), and finally Group D showed no significant change for both gross motor (P = 0.65) and cognition (P = 0.16). Gross motor development and cognitive function of children with ASD significantly improved with the combination of the GFCF diet and NDT physical therapy program, with significant improvement with the NDT physical therapy alone on gross motor development and cognition, while using the GFCF diet alone had no change.

Background: The consumption of energy drinks (EDs) has become a global public health concern due to the increasing numbers of consumers and their adverse effects on health. This study aims to determine the prevalence of energy drink consumption among female students at Jazan University, KSA, and also to study the adverse effects on health. Methodology: A total of 999 female students from applied medical science and medical colleges were subjected to this study during the period from (2017 to 2018). The data was collected from students using a self-administered questionnaire that included 25 questions in three sections. Question 1 assessed demographic information [age and weight]. Question 2 inquiried about the participant's study level. Questions 3 and 4 inquire about anemia and hemoglobin value in the blood. The following questions assess the consistency of the menstrual cycle, bone pain, diabetes, present diabetes parent, abdominal pain, kidney disease, blood pressure, and other health problems. The final question inquiries about the participant's immunity (strong, weak, or normal). SPSS version 22.0 was used to analyze the data, and P 0.05 was considered statistically significant. Results: 612 students out of 999 (61.3 %) were ED consumers. The highest frequency of ED usage was 268 (43.8%) who drank it 1-4 times/week, while the lowest was 26 (4.2%) who drank it more than once a day. The data showed that 159 (26%) of consumers prefer to mix more than one type of ED, while the majority of 453 (74%) drink it alone, but 52 (8.5%) of consumers prefer adding Panadol during usage, while the majority of consumers 560 (91.5%) drink it without Panadol. The relationship between EDs and headache during usage, abstaining from EDs, study pattern, study level, anemia, diabetes, menstrual period disturbance, bone pain, kidney disease, blood pressure, and immunity were investigated. Blood samples were drawn from ED consumers to estimate creatinine, cholesterol, triglycerides, uric acid, urea, total protein, albumin, alkaline phosphatase, and hematocrit. In general, ED users harm their health. Conclusion: There is an increasing rate of usage of EDs among female students and there is an adverse effect on their health. We should try to reduce the habit of drinking these drinks and replace them with fruit juices.

Purpose: This study was conducted to release the debate and examine the short-term impact of KT on the quadriceps muscle following arthroscopic surgery for partial meniscectomy. Patients and Methods: As part of a double-blind, randomized controlled trial, 40 people who had an arthroscopic partial meniscectomy (APM) were randomly put into two groups, A and B. Group A received Kinesio tape (KT) for the superficial heads of the quadriceps muscle, while group B received placebo KTk. After 10 minutes of KT application, the peak torque of both groups was measured using a Biodex isokinetic dynamometer. Results: Peak torque showed a significant increase in group A in comparison with group B during angular velocity 60◦/Sec. (F (1, 130) = 58.9, p < 0.001, ƞ2 =0.31) and during angular velocity 180◦/Sec. (F (1, 38) = 25.0, p < 0.001, ƞ2 =0.40). Conclusion: After APM, individuals experienced an immediate and significant improvement in the quadriceps’ peak torque following KT application to the Rectus femoris, Vastus medialis, and Vastus lateralis muscles from origin to insertion.

(1) Background: Neck pain intensity, psychosocial factors, and physical function have been identified as potential predictors of neck disability. Machine learning algorithms have shown promise in classifying patients based on their neck disability status. So, the current study was conducted to identify predictors of neck disability in patients with neck pain based on clinical findings using machine learning algorithms. (2) Methods: Ninety participants with chronic neck pain took part in the study. Demographic characteristics in addition to neck pain intensity, the neck disability index, cervical spine contour, and surface electromyographic characteristics of the axioscapular muscles were measured. Participants were categorised into high disability and low disability groups based on the median value (22.2) of their neck disability index scores. Several regression and classification machine learning models were trained and assessed using a 10-fold cross-validation method; also, MANCOVA was used to compare between the two groups. (3) Results: The multilayer perceptron (MLP) revealed the highest adjusted R2 of 0.768, while linear discriminate analysis showed the highest receiver characteristic operator (ROC) area under the curve of 0.91. Pain intensity was the most important feature in both models with the highest effect size of 0.568 with p < 0.001. (4) Conclusions: The study findings provide valuable insights into pain as the most important predictor of neck disability in patients with cervical pain. Tailoring interventions based on pain can improve patient outcomes and potentially prevent or reduce neck disability.