Elnaggar, R. K., A. R. Azab, A. S. Alhowimel, M. A. Alotaibi, M. S. Abdrabo, and M. S. Elfakharany, "Effects of Plyometric-Based Hydro-Kinesiotherapy on Pain, Muscle Strength, Postural Stability, and Functional Performance in Children with Hemophilic Knee Arthropathy: A Randomized Trial.", Physical & occupational therapy in pediatrics, vol. 44, issue 5, pp. 704-720, 2024. Abstract

AIM: To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA).

METHODS: Forty-eight children with HKA (age: 8-16 years) were randomly allocated to the Plyo-HKT group ( = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group ( = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 /sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention.

RESULTS: In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain ( = .028, = 0.10), peak torque of quadriceps [120°/sec ( = .007, = 0.15); 180°/sec ( = .011, = 0.13)] and hamstring [120°/sec ( = .024, = 0.11); 180°/sec ( = .036, = 0.09)], DLPS [forward ( = .007, = 0.15); backward ( = .013, = 0.12); affected side ( = .008, = 0.14); non-affected side ( = .002, = 0.20)], DLPS ( < .001, = 0.32), and functional performance [FISH ( < .001, = 0.26); 6-MWT ( = .002, = 0.19)].

CONCLUSION: Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.

Elnaggar, R. K., A. M. Osailan, M. Alghadier, T. E. ELNEGAMY, W. E. Morsy, M. S. Abdrabo, F. A. Qissi, M. A. Shendy, R. A. N. I. A. R. MOHAMED, and M. S. Elfakharany, "Exercise strategies for reversing cardiopulmonary deconditioning in obese children with bronchial asthma: A randomized comparative effectiveness study of constant-load and graded aerobic training.", Medicine, vol. 103, issue 48, pp. e40667, 2024. Abstractexercise_strategies_for_reversing_cardiopulmonary.60.pdf

BACKGROUND: This study evaluates the differential effects of constant-load (CL-AE) and graded (G-AE) aerobic exercise training approaches on cardiopulmonary fitness and functional capacity in obese children with bronchial asthma (BA).

METHODS: Seventy-eight obese children with moderate BA (age: 14.14 ± 2.31 years; body mass index: 31.93 ± 1.26 kg/m2) were randomly assigned to 3 intervention-based groups: control, CL-AE, or G-AE group (n = 26 in a group). The cardiorespiratory fitness (peak oxygen uptake, minute ventilation [VE], ventilation-oxygen uptake ratio, stroke volume of oxygen, oxygen/carbon-dioxide exchange ratio, heart rate maximum, and heart rate recovery at one minute) and functional capacity (6-minute walk test and perceived dyspnea and fatigue) were assessed at the baseline and posttreatment.

RESULTS: The G-AE group exhibited more favorable changes in cardiorespiratory fitness [VO2peak (P = .03), VE (P = .021), VE/VO2 (P = .032), SVO2 (P = .025), O2/CO2 ratio (P = .004), HRmax (P = .016), HRR1 (P = .046)] and functional capacity [6-minute walk test (P = .021), dyspnea (P = .041), fatigue (P = .04)] as compared to the CL-AE group.

CONCLUSION: The G-AE, compared to CL-AE, appears to be a more potent stimulus for enhancing cardiorespiratory fitness and functional capacity in obese children with BA. Further investigations are, however, required to corroborate the observed effects.

Mohamed, M. A., M. S. El-Dein, S. N. M. El-Deen, and M. S. Elfakharany, "Sensory integration versus Masgutova neuro-sensorimotor reflex integration program on controlling primitive reflexes and gross motor abilities in children with diplegic cerebral palsy.", Physiotherapy research international : the journal for researchers and clinicians in physical therapy, vol. 28, issue 4, pp. e2030, 2023. Abstract

BACKGROUND AND OBJECTIVE: An abnormality in muscular tone, lack of postural control, and a lack of coordination are all linked to the retention of primitive and immature postural reflexes. The Purpose of this study aimed of detecting which therapeutic approach is more effective in integrating retained primitive reflexes, either Masgutova neuro-sensorimotor reflex integration or Sensory integration (SI) program.

METHODS: Forty children with spastic diplegic cerebral palsy (CP) (11 girls and 29 boys), involved in the current study and their ages ranged from 3 to 6 years old. They were divided at random into two groups (A and B), patients in the study group (A) (n = 20) were treated by Masgutova neuro-sensorimotor reflex integration program (MNRI) while those of study group (B) (n = 20), were subjected to Sensory integration program (SIP), A standardized physical treatment regimen was provided to both groups (Stretching exercise, Strengthening exercise, and facilitation of developing motor milestones) All children were evaluated by using GMFM-88 and (PDMS-2) reflexes subtest before and after treatment that lasted for three successive months at a frequency of three sessions per week.

RESULTS: There was a statistically substantial increase in GMFM scores and control of primitive reflexes post treatment in each group compared to those of the pretreatment mean values (p > 0.05). There was also a statistically non-significance difference between group A and group B regarding post treatment results (p > 0.05).

IMPLICATIONS ON PHYSIOTHERAPY PRACTICE: SI and MNRI programs can equally be used in the treatment of children with spastic CP who suffer from retained primitive reflexes and delayed gross motor function.

Elnaggar, R. K., A. Alhowimel, M. Alotaibi, M. S. Abdrabo, and M. S. Elfakharany, "Exploring Temporospatial Gait Asymmetry, Dynamic Balance, and Locomotor Capacity After a 12-Week Split-Belt Treadmill Training in Adolescents with Unilateral Cerebral Palsy: A Randomized Clinical Study.", Physical & occupational therapy in pediatrics, vol. 43, issue 6, pp. 660-677, 2023. Abstract

AIM: To investigate the effects of a 12-week split-belt treadmill walking (Sb-TW) practice using an error augmentation strategy on temporospatial gait asymmetries, dynamic balance, and locomotor capacity in adolescents with unilateral cerebral palsy (ULCP).

METHODS: Fifty-two adolescents with ULCP (age: 10-16 years) were randomized into either the Sb-TW group ( = 26; underwent repeated Sb-TW practice, with exaggeration of the initial step-length asymmetry, three times/week, for 12 sequential weeks) or control group ( = 26; received equivalent dosages of traditional single-belt treadmill training). Step-length and swing-time asymmetries, directional (LoS) and overall (LoS) limits of stability, and locomotor capacity [6-minute walk test (6-MWT), Timed Up and Down Stair test (TUDS), and 10-m Shuttle Run Test (10mSRT)] were assessed pre- and post-intervention.

RESULTS: The Sb-TW group demonstrated more favorable changes in step-length asymmetry ( < .001,  = 0.27), LoS [affected side direction ( = .033,  = 0.09), forward direction ( = .004,  = 0.16), and backward direction ( = .01,  = 0.12)], and LoS ( < .001,  = 0.31) than the control group. Also, the Sb-TW group showed significantly higher locomotor capacity [6-MWT ( < .001,  = 0.38), TUDS ( = .032,  = 0.09), 10mSRT ( = .021,  = 0.10)] as compared to the control group.

CONCLUSION: The Sb-TW-induced adaptations can be capitalized on for remediating spatial gait asymmetry, dynamic balance deficits, and impaired locomotor performance in adolescents with ULCP.

Elnaggar, R. K., and M. S. Elfakharany, "Aqua-Plyometric Exercises-Induced Changes in Muscle Strength, Bone Mineral Properties, and Physical Fitness in Patients With Juvenile Idiopathic Arthritis: A 12-Week, Randomized Controlled Trial.", Pediatric exercise science, vol. 35, issue 4, pp. 198-205, 2023. Abstract

PURPOSE: To determine whether a 12-week, lower body-targeted aqua-plyometric (AquaPlyo) exercise program could improve muscle strength, bone mineral properties, and physical fitness in patients with juvenile idiopathic arthritis.

METHODS: A randomized controlled trial was adopted and included 48 patients with polyarticular juvenile idiopathic arthritis (age: 12-18 y). Patients were assigned to undergo either AquaPlyo exercises (AquaPlyo group, n = 24) or standard exercises (control group, n = 24). The outcome measures were assessed pretreatment and posttreatment and included concentric quadriceps peak torque, bone mineral properties (areal bone mineral density [BMD], volumetric BMD, bone mineral content, and BMD Z score), and physical fitness.

RESULTS: A significant posttreatment increase in the concentric quadriceps peak torque was detected in the AquaPlyo group compared with the control group (either at an angular velocity of 90°/s [right side: P = .016, left side: P = .025] or 180°/s [right side: P = .007, left side: P = .029]). Besides, a considerably greater improvement in the areal BMD (P = .0006), volumetric BMD (P = .027), bone mineral content (P = .002), and BMD Z score (P = .0004) was observed in the AquaPlyo group. Moreover, a remarkably greater rise in the physical fitness (P < .001) was revealed in the AquaPlyo group.

CONCLUSION: AquaPlyo training can efficiently enhance muscle strength, improve bone mineral properties, and boost physical fitness in patients with juvenile idiopathic arthritis.

Alrefaie, W. A., N. A. Salem, M. E. S. Fakharany, and M. E. Y. Zanaty, "Role of Assistive Devices on Gait in Patients with Incomplete Spinal Cord Injury: Systematic Review", The Egyptian Journal of Hospital Medicine, vol. 85, issue 2, pp. 4075-4084, 2021.
Elfakharany, M. S., R. K. Elnaggar, B. A. Alqahtani, and W. S. Mahmoud, "Prospective analysis of physical activity levels and associated fitness factors amid COVID-19 pandemic and social-distancing rules. A special focus on adolescents", Science & Sports , vol. 37, issue 3, pp. 131—138, 2022.
Sherief, A. E. A. A., A. S. Abdelfattah, and M. S. Elfakharany, Electrodiagnostic effect of Armeo® Robotic Therapy versus Conventional Therapy in Erb’s Palsy Children, , 2021.
Hassan, D. A. G., E. E. S. Salim, S. N. G. Bishay, and M. E. S. Fakharany, "Cobb angle measurement and pelvic inclination in children with spastic cerebral palsy: A cross-sectional study", Annals of Clinical and Analytical Medicine, 2021.