Background: Autologous bone marrow mesenchymal cells that include stem cells (MSCs) are a clinically attractive cellular therapy option to try to treat severe spinal cord injury (SCI). Objective: To study the possible value of MSCs injected intrathecally to enhance rehabilitation. Methods: This case control, convenience sample included 64 patients, at a mean of 3.6 years after SCI. Forty-four subjects received monthly intrathecal autologous MSCs for 6 months and 20 subjects, who would not agree to the procedures, served as controls. All subjects received rehabilitation therapies 3 times weekly. Subjects were evaluated at entry and at 12 months after completing the 6-months intervention. By the ASIA Impairment Scale, ASIA grading of completeness of injury, Ashworth Spasticity Scale, Functional Ambulation Classification, and bladder and bowel control questionnaire. Results: No differences were found in baseline measures and descriptors between the MSC group and control group. Although a higher percentage of the MSC group increased motor scores by 1-2 points and changed from ASIA A to B, no significant between-group improvements were found in clinical measures. Adverse effects of cells included spasticity and, in 24 out of the 43 patients developed neuropathic pain. One subject with a history of post-infectious myelitis developed encephalomyelitis after her third injection. Conclusion: Autologus MSCs may have side effects and may be contraindicated in patients with a history of myelitis. Their utility in treating chronic traumatic SCI needs further study in pre-clinical models and in randomized controlled trials before they should be offered to patients.

Diabetic neuropathy is the most common complication and greatest source of morbidity and mortality in diabetic patients. Thirty male and female patients with painful diabetic neuropathy and abnormal results from nerve conduction studies participated in this study. Their ages ranged from 45 to 60years with a mean of 52.1±SD 4.7years. Patients were randomly assigned into two equal groups of 15, an active laser group (laser group) and a placebo laser group (control group). The laser group received scanning helium neon (He–Ne) infrared laser with wavelength 850nm and density of 5.7J/cm2, applied to the lumbosacral area and the plantar surface of the foot for 15min each site/session three times per week for four weeks (i.e. 12 sessions). Pain intensity via visual analogue scale, bilateral peroneal motor nerves, sural sensory nerves conduction velocity and amplitude and foot skin microcirculation, were measured pre- and post-treatment for both groups. Pain was significantly decreased (p⩽0.05) and electrophysiological parameters and foot skin microcirculation were significantly improved (p⩽0.05) in the laser group, while no significant change was obtained in the control group. Low level laser therapy within the applied parameters and technique could be an effective therapeutic modality in reducing pain and improving neurovascular function in patients with diabetic polyneuropathy

[Purpose] To determine which of the transcranial electromagnetic stimulation or low level laser therapy is more effective in the treatment of trigeminal neuralgia of multiple sclerosis patients. [Methods] Thirty multiple sclerosis patients of both sexes participated in this study. The age of the subjects ranged from 40 to 60 years and their mean age was (56.4-6.6). Participants were randomly selected from Dental and Neurology Outpatient Clinics at King Khalid Hospital, Najran University, Saudi Arabia. Patients were randomly divided into two equal groups of 15. The Laser group received a low level laser therapy, 830 nm wavelength, 10 Hz and 15 min duration, while the Electromagnetic group received repetitive transcranial electromagnetic stimulation at a frequency of 10 Hz, intensity of 50 mA and duration of 20 minutes. Patients were assessed pre and post treatment for degree of pain using a numerical rating scale, maximal oral mouth opening using a digital calibrated caliper, masseter muscle tension using a tensiometer and a compound action potentials of masseter and temporalis muscles. [Results] There were significant improvements after treatment in both groups, with a significant difference between the Electromagnetic and Laser groups, in favor of the Electromagnetic group. [Conclusion] Repetitive transcranial electromagnetic stimulation at 10 Hz, 50 mA, and 20 minutes duration is more effective than low level laser therapy at reducing trigeminal pain, increasing maximum oral mouth opening, masseter and temporalis muscle tension in multiple sclerosis patients.

BACKGROUND: Freezing of gait (FOG) is one of the major debilitating motor symptoms that affect Parkinson’s disease (PD) patients’ gait, OBJECTIVE: To investigate the effect of dancing on FOG, motor symptoms, and balance in patients with Parkinsonism. METHODS: Eight databases were searched for full-text English randomized control trials (RCTs). The freezing of gait (FOG) was the primary outcome while the balance and Unified Parkinson Disease Rating Scale (UPDRS-3) were the secondary outcomes. Methodological quality was evaluated by the Physiotherapy Evidence Database (PEDro) scale. Level of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. A random-effect model of meta-analysis was used to calculate the standardized mean difference (SMD) at a 95% confidence interval (CI), and the effect size. RESULTS: A total of nine studies (263 patients) were included. Qualitative data related to participants, dancing type, measured outcomes, and follow-up were extracted. PEDro scale showed one fair-quality and eight high-quality studies. GRADE showed a low to very low level of evidence with moderate effect size on both UPDRS (SMD –70 [–1.04, –0.36]) and Balance (SMD 0.35 [0.08, 0.63]). CONCLUSION: Dance is an effective modality on improving UPDRS and balance with small effect on FOG. Further high-quality studies with high-quality of evidence are recommended to increase the confidence to the effect estimate and support the finding results.

OBJECTIVE: To compare between selected post-operatives physical therapy modalities after transverse carpal ligament release. DESIGN: Double blind, randomized controlled trial. SETTING: Health insurance hospital outpatient clinic in Cairo, Egypt. SUBJ