The purpose of this study was to investigate the outcomes of adding lumbar sustained natural apophyseal glide (SNAG) to a conventional therapy program for chronic nonspecific low back pain (LBP). Forty-two participants with chronic nonspecific LBP were randomly divided into 2 groups. The study group (aged 27.1 ± 8.3, 20 men, 3 women) received a conventional physical therapy program consisted of stretching and strengthening exercises plus SNAG (based on the Mulligan concept) on the affected lumbar levels, and the control group (aged 28.9 ± 7.7, 13 men, 6 women) received the same conventional program without SNAG 3 times per week for 1 month. Outcome measures were repositioning error (the primary outcome), pain, and function measured by an isokinetic dynamometer, visual analog scale, and the Oswestry Disability Index. Measurements were recorded before and after the end of the treatment period. The comparison between pretreatment and posttreatment test scores indicated that both study and control groups had significant improvement in all dependent variables (P > .001). However, adding SNAG to the conventional program resulted in higher improvement in terms of repositioning error, pain, and function (P = .02, .002, .008) respectively. This preliminary study indicated improvement in both groups. Adding SNAG to conventional programs in the treatment of chronic nonspecific LBP may result in greater improvement of repositioning error, pain reduction, and improved function.

Background: Range of motion (ROM) can be considered as one of the most commonly measured variables in musculoskeletal health care. When interpreting ROM, a common method is to compare obtained ROM values to normative data. So the current study aimed to establish (1) normative active ROM (AROM) values for lower extremity joints in young Egyptian adults, (2) compare the AROM between dominant and non-dominant lower extremity joints, and (3) compare between the values of AROM of lower extremity joints in both genders.Results: Pairedt-test demonstrated that there was statistical but not a clinical difference between the dominant and non-dominant ROM values of the lower extremity joints. Unpairedt-test revealed that there was statistical but not a clinical difference between male and female ROM values of lower extremity joints.Conclusions: This study summarized normative data of Egyptian young adults; there were statistical but not a clinical difference between dominant and none dominant lower extremity joints in AROM and between males and females.

Background/Objectives: Surgical treatment of breast cancer may lead to physical and psychological side effects. Exercises, especially those aided by virtual reality (VR), can improve both physical and psychological dysfunctions. To explore the effects of exercises using VR through Pablo games Technology on the function, grip strength, wrist ROM, fatigue, pain, activities of daily living (ADLs), and anxiety among post-operative breast cancer females. Methods: Forty post-operative breast cancer females participated in the current study: nineteen in the control group (CG), who received a standard treatment consisting of upper limb exercises plus intermittent compression therapy, and twenty-one participants assigned to the Pablo group (PG), who received the standard treatment plus additional training using the Pablo game training system. The intervention period was eight weeks long. The outcome measures were function, grip strength, wrist ROM, fatigue, pain, activities of daily living, and anxiety. Data were obtained at the baseline, after eight weeks, and at two months follow-up. Results: There were statistically significant declines in pain and fatigue, while there were statistically significant improvements in ADLs, grip strength, function, and ROM post-intervention and at two months follow-up in both groups (p < 0.001). Between-group comparisons demonstrated a statistically significant decrease in pain, anxiety, and fatigue and statistically significant improvements in function, ADLs, grip strength, and ROM in favor of the PG post-treatment and at the follow-up (p < 0.001). Conclusions: Adding VR using the Pablo game training system to the standard rehabilitation of post-surgical breast cancer patients can further improve their function, hand grip, wrist ROM, fatigue, pain, and ADLs.

Background: Virtual reality (VR) is used extensively for musculoskeletal conditions, but its efficacy in chronic low back pain still needs more investigation. Objective: To discuss the effectiveness of VR on selected outcomes in Chronic Non-Specific Low Back Pain (CNSLBP). Methods: Thirty-five patients with CNSLBP joined this study. Postural correction exercises using the TBed VR gaming system in addition to hamstring stretching were employed, and moist heat on the low back was applied. Pre- and post-intervention values of pain, ROM, function, and balance (overall stability index) were obtained using the numerical rating pain scale (NPRS), Oswestry Disability Index, back range of motion (BROM), and Biodex system. Satisfaction level on a 1–10 scale and the degree of commitment to the exercise sessions were assessed after the intervention. Results: The patients completed the intervention period and outcome measures sessions. Paired t-tests reported statistically significant improvements and high effect size in pain, ROM, function, and balance after the end of the treatment (p < 0.001, Cohen’s d > 0.69). The level of satisfaction was 9.25 ± 0.766, and the commitment to exercise sessions was high (98.75% attendance rate). Conclusions: Applying postural correction using TBed VR gaming in addition to heat and stretching may improve pain, range of motion, function, and balance in patients with chronic low back pain.

Objective: To compare the effect of mechanical traction from different knee angles on pain, physical function, and range of motion in patients with knee osteoarthritis. Design: A single-blinded, randomized controlled trial. Setting: Outpatient public and governmental Hospital clinics. Participants: One hundred and twenty patients with knee osteoarthritis were randomly assigned into 4 equal groups with 30 patients in each group. Interventions: Group (A) received conventional physiotherapy(CPT) treatment; group (B) received CPT with knee traction from full extension, group (C) received CPT with knee traction from 90° flexion, while group (D) received CPT with knee traction from 20° flexion. Interventions were applied 3 sessions a week for 4 weeks. Outcome measurements: Visual analog scale (VAS), knee passive range of motion and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured at baseline, immediately after 4 weeks of intervention, and after 4 weeks of no intervention as a follow-up. Results: After eight weeks, the mean (SD) for VAS scores were 30.97 ± 8.68, 24.0 ± 8.8, 15.43 ± 6.31, and 16.17 ± 6.11 mm; for total WOMAC scores were 26.77 ± 9.19, 20.3 ± 8.52, 13.27 ± 6.25, and 13.43 ± 7.14 for groups A, B, C and D, respectively. The three traction groups showed statistically significant changes in pain scores, physical function, and total WOMAC, but not for knee passive range of motion, in favor of traction groups C and D than the conventional group ( P < 0.05). Conclusions: Traction from 90°and 20° of knee flexion was found superior to full extension knee in improving pain and physical function, but not for knee passive range of motion, in patients with knee osteoarthritis.

(1) Background: Running is one of many sports that have increased in popularity since it can be conducted at any time or anywhere. Ankle instability is a common injury that usually occurs during running and is usually associated with abnormalities in postural stability. Recently, kinesio taping has gained increasing interest as a tool that can be used in rehabilitation, to improve stability, and to help in injury prevention. This study aimed to investigate the effect of Kinesio taping on balance and dynamic stability in recreational runners with ankle instability. (2) Methods: This randomized controlled trial recruited 90 RRs with ankle instability. The participants were randomly divided into three equal groups: a KT group (KTG) who received Kinesio taping on their ankle joints; a mixed group (MG) who received Kinesio taping and exercises; and an exercise group (EG) who received exercises only. Outcome measures (balance and dynamic stability) were assessed before and after the end of an 8-week treatment program using a Biodex balance system and a star excursion balance test, respectively. (3) Results: Within-group comparisons showed statistically significant improvements in most of the outcome values when compared to baseline. Overall stability index was statistically significantly better (with a high effect size) in the MG compared to KTG or EG (p = 0.01, Cohen’s d = 1.6, and p < 0.001, Cohen’s d = 1.63, respectively). A similar finding was evident in the anteroposterior stability index (p = 0.02, Cohen’s d = 0.95, and p < 0.001, Cohen’s d = 1.22, respectively). The mediolateral stability index of the KTG was statistically significantly better with a high effect size when compared to MG or EG (p = 0.04, Cohen’s d = 0.6, and p < 0.01, Cohen’s d = 0.96, respectively). The star excursion balance test values were statistically significant with high effect sizes in the posterior (p = 0.002, Cohen’s d = 1.2) and lateral (p < 0.02, Cohen’s d = 0.92) directions in the MG compared to KTG and EG. (4) Conclusions: Kinesiotape with exercises is superior to either kinesiotape alone or exercises alone in improving postural stability indices and dynamic stability in recreational runners with ankle instability. Recreational runners with ankle instability should be educated about practicing balance exercises and applying kinesiotape.