Middle East Journal of Rehabilitation and Health Studies
Volume:6 Issue: 2, Apr 2019

Synkinesis refers to an involuntary movement accompanying a voluntary one that is a consequence of facial paralysis. The cosmetic procedure is used for the management of synkinesis that results in facial symmetry. Botulinum A toxin (BTX-A) has been used for more than two decades for resolving asymmetry and synkinesis. However, the endpoints remain to be further explained. The purpose of this study was to analyze research trends in facial synkinesis and asymmetry after facial nerve palsy (FNP).

 The databases Medline, PubMed, ScienceDirect, CINHAL, Scopus, and ProQuest were searched for articles published between 1970 and 2017 using the keywords, ‘facial paralysis’, ‘Bell’s palsy’, ‘synkinesis’, and ‘Botulinum A toxin’.

In total, 13 eligible articles, cumulatively examining 332 patients, entered the analysis. They were divided into three groups as follows. Eight articles in group I were taken as case series with 181 patients. Two articles in group II compared BTX-A and neuromuscular rehabilitation with 61 patients. Both these groups concluded that BTX-A injection could help reduce synkinesis. In group III, only were three randomized clinical trials retrieved with 90 patients that reported disparate findings.

BTX-A injection cannot yet be proposed as a solution for synkinesis reduction to achieve symmetry and overcome this complication of facial nerve palsy because of the small number of randomized clinical trials available on the subject. Further studies are recommended to be able to make a firm conclusion.

Physical activity (PA) has a wide range of beneficial effects on the overall health and quality of life (QOL) of breast cancer survivors (BCS).

The aim of this study was to determine the relationship between PA and health-related QOL in Malaysian BCS.

This is a cross-sectional survey involving 334 BCS. In addition to socio-demographic information, participants’ PA was assessed using the international physical activity questionnaire (IPAQ-SF). Health-related QOL was assessed using the functional assessment for cancer treatment-breast (FACT-B) version 4 questionnaire. Pearson’s correlation was used to explore the relationship between PA and QOL of the participants.

The mean age, weight, and body mass index (BMI) of the participants were 51.9 ± 8.3 years, 60.1 ± 11.4 kg, and 25.1 ± 4.6 kg/m2, respectively. The majority of the participants were Malays (71.0%), married (83.8%), and had secondary education (52.7%). The mean total PA was 660.2 ± 797.2 whereas the mean overall QOL was 79.6 ± 17.7. Moderate-intensity PA was significantly correlated with physical well-being (r = 0.39, P = 0.009) and overall QOL (r = 0.49, P = 0.002). It was also significantly correlated with functional well-being (r = 0.57, P = 0.054) and breast cancer concern (r = 0.48, P = 0.019). Meanwhile, the total PA was correlated positively and significantly with functional well-being (r = 0.78, P = 0.041).

This study found a significant relationship between the moderate-intensity PA and the overall QOL among the participants. The result also showed a significant relationship between moderate-intensity PA and breast cancer concern. The total PA showed a significant relationship with functional well-being. The breast cancer survivors needed to be encouraged to remain physically active.

A randomized parallel controlled trial was designed to compare efficacy of ozone (O2-O3) against platelet-rich plasma (PRP) as intra-articular infiltrations in knee osteoarthritis (OA) patients.

Tertiary-level outpatient rehabilitation service. Subjects: Fifty-four patients with knee OA grades 2a - 4a according to Kellgren-Lawrence scale were included after obtaining an informed consent. The target sample size was 27 patients per group. Intervention: Patients received four ozone (intervention group) or three platelet-rich plasma (control group) intra-articular infiltrations at a one-week interval. Outcome measures: Patients were clinically and functionally evaluated by visual analogue scale (VAS pain) and by Western Ontario and Mac Master index for osteoarthritis (WOMAC) at baseline and at two months follow-up. Pain, stiffness, function, and quality of life (QoL) were evaluated outcome variables.

Overall, 27 patients were randomly allocated to the intervention group (ozone) and 27 to the control group (PRP). Improvement in pain, function, and QoL were observed in both groups without a statistical difference (P > 0.05). Stiffness improvement was significant between similar and different treatment groups (P < 0.05). No side-effects were observed in either group.

Ozone (O2-O3) is as effective as PRP in the management of knee OA. Both interventions improved pain, function, and QoL with no statistical difference between them.

Neck pain is one of the most common and painful musculoskeletal conditions. It is a problem in societies probably due to the widespread use of electronic gadgets such as computers, mobile phones, and tablets. It causes pain, functional disability, depression, and sleep disturbances. Therapeutic exercises have been known to be one of the major interventions to improve chronic neck pain.

This randomized controlled study aimed to compare the efficacy of muscle energy technique (MET) and neck stabilization exercise (NSE) on pain, neck disability, depression, anxiety, and sleep disturbance in patients with non-specific chronic neck pain (NSCNP).

Thirty-five participants participated in this study. They were recruited from two hospitals in Lagos state and randomly assigned into 3 groups using computer-generated random number sequence. Group 1 (n = 12) received MET, neck care education (NCE), and infra-red radiation (IR), group 2 (n = 12) received NSE, neck care education (NCE), and IR, and group 3 (n = 11) received NCE and IR. Assessment of pain, neck disability, depression, anxiety, and sleep disturbance were done using numerical pain rating scale (NPRS), neck disability index (NDI), hospital anxiety depression scale (HADS) and Insomnia severity index (ISI) at baseline, end of 4 weeks and 8 weeks post-intervention. This study lasted for a period of 5 months (May - September, 2017).

The participants in the 3 groups (MET+NCE+IR, NSE+NCE+IR, NCE+IR) indicated significant improvement in all the outcome parameters; pain (P = 0.001, 0.001, 0.001, respectively), disability (P = 0.002, P = 0.002, P = 0.003, respectively), depression (P = 0.02, 0.002, 0.003, respectively), anxiety (P = 0.01, P = 0.002, P = 0.03, respectively), and sleep disturbance (P = 0.01, P = 0.002, P = 0.01, respectively) post-intervention. Significant differences were observed in all outcome parameters except for depression (P = 0.456) and anxiety (P = 0.179) when across group comparisons were performed.

Muscle energy technique and neck stabilization exercises and neck care are all effective in managing pain, neck disability, depression, anxiety, and sleep disturbance in NSCNP patients, but neck stabilization exercises have a better effect than a muscle energy technique

Since the test of muscle strength needs a person’s maximum exertion, the objective assessment of muscle size is often used. Among the imaging techniques for assessing muscle size, muscle thickness is easy to measure by ultrasonography. However, little is known about the associations of trunk muscle thickness and muscle strength.

This study aimed to investigate the correlation between trunk muscle thickness and muscle strength.

Seventeen healthy male university students participated in this study (20.8 ± 0.6 years). Abdominal (rectus abdominis, external oblique, internal oblique, transverse abdominis) and low back (lumbar erector spinae, lumbar multifidus) muscle thickness were measured at rest using B-mode ultrasonography. Maximum voluntary isometric trunk flexion, extension, and rotation torque were measured using dynamometers. The relationships between all tested variables were investigated using the Pearson’s correlation coefficient.

A significant positive correlation was found between flexion and extension torque (r = 0.664, P = 0.004), flexion and right rotation torque (r = 0.565, P = 0.018), flexion and left rotation torque (r = 0.641, P = 0.006), extension and right rotation torque (r = 0.844, P < 0.001), extension and left rotation torque (r = 0.784, P < 0.001), and between right and left rotation torque (r = 0.982, P < 0.001). However, there was no significant correlation between trunk muscle thickness and torque.

This study provides basic information about trunk muscle thickness and muscle strength in healthy male adults. The associations of trunk muscle thickness and muscle strength could not be identified through our measurements

Unhealthy lifestyle and lack of readiness to modify are some of the most important factors in the development of chronic diseases such as cardiovascular diseases (CVDs).

To investigate the correlation of heart knowledge, perceived heart risk factors (PHRFs), and risk perception of heart disease with readiness for lifestyle modification in companions of patients with cardiovascular diseases.

In this cross-sectional study, 200 companions of patients with CVDs at Imam Ali Hospital in Kermanshah city were selected by convenience sampling. The data were collected using the heart disease knowledge questionnaire (HDKQ), perception of risk of heart disease scale (PRHDS), perceived heart risk factor scale (PHRFS), and readiness for lifestyle modification questionnaire. Data were analyzed using the Pearson correlation coefficient and linear regression analyses.

The participants had a moderate level of readiness for lifestyle modification, PHRFs, and risk perception; while the level of participants’ heart knowledge was weak. Moreover, there was a significant relationship between heart knowledge and readiness for lifestyle modification (P = 0.001); however, there was no significant relationship between the risk perception (P = 0.404) and PHRFs (P = 0.073) with readiness for lifestyle modification.

The companions of the patients with CVDs have a moderate level of readiness for lifestyle modification. Considering the existence of a significant relationship between readiness for lifestyle modification and heart knowledge, it can be concluded that a higher level of heart knowledge can play an important role in the increased readiness for lifestyle modification by the family members of the patients with CVDs.

Classification of high-risk behaviors such as aggression and identifying social, medical, and psychological factors related to it can help the emergence and development of the strategies to prevent these destructive behaviors.

Thus, the present study was done with two

(i) cluster analysis of the aggression components and partitioning cardiac rehabilitation (CR) patients and (ii) determining the demographic, medical, and psychological correlations of each cluster.

The sample of this cross-sectional study was 167 CR patients in western Iran examined from June to December 2017. Demographic and risk factors checklist, Beck anxiety inventory (BAI), Beck depression inventory (BDI), and Buss-Perry aggression questionnaire (BPAQ) were used for data collection. The data were analyzed using hierarchical and k-means cluster analysis, Cramer-V test, analysis of variance (ANOVA), and analysis of binary logistic regression.

The mean age of the participants (66.5% male) was 59.14 ± 9.03. The model proposed two clusters: (i) patients with mild aggression and (ii) patients with severe aggression. Occupation (P = 0.048), marital status (P = 0.048), anxiety (P = 0.006), and depression (P = 0.001) were the most essential predictors of the unhealthy cluster. Our model could explain 30.7% to 41% of the variance of the unhealthy cluster.

Cluster analysis divided patients into two groups with mild and severe aggression. Marital status and occupation are the most important demographic correlates, and depression and anxiety are the most important psychological predictors of the cluster with high aggression. The results of the present study can provide a map of the focus of attention on harm reduction interventions by health professionals.

Adenofibroma is a type of mixed mesodermal tumor that both epithelial and stromal components are benign, and often originate from endometrium at postmenopausal age. Uterine adenofibroma is an extremely rare tumor and this lesion must be differentiated from some benign or malignant lesions of the uterus, particularly adenosarcoma. Because of the rarity and importance of such histopathology at post-menopausal age, this case is presented.

A 63-year-old woman, parity 9, who was at menopause period with a history of prolonged and severe no bloody vaginal discharge during the past 3 months was referred to our center. Transvaginal ultrasonography revealed a hyperechoic area with the dimensions 65 × 37 × 33 mm inside the endometrial cavity, that was suspicious to severe endometrial hyperplasia or malignancy. Tumor marker tests (BHCC, LDH, αFP, CA125, CA19-9, and CEA) were in normal limit. Endometrial biopsy by pipelle was unsatisfactory for diagnosis. Total abdominal hysterectomy was done, and the result of histopathology confirmed endometrial adenofibroma with the dimensions 70 × 47 × 40 mm.

The presence of a hyperechoic area of the endometrium with complain of prolonged vaginal discharge in post menopause subjects could attribute to endometrial adenofibroma.

Cerebral palsy (CP), a non-progressive brain disorder, occurs due to the destruction of the brain during its development and causes neuro-muscular disturbances. CP patients are highly susceptible to dental disorders. Here, we present a case of eosinophilic ulcer in the tongue of a boy who had CP with multiple carious teeth, for whom oral rehabilitation was carried out under general anesthesia.

A 16-year-old boy with CP presented to the Oral Medicine Department of Dental School of Semnan University of Medical Sciences with the chief complaint of chronic traumatic ulceration of the tongue. Because of the lack of his cooperation, after obtaining his parents’ informed consent, we decided to do the dental treatment under anesthesia. The intraoral examination showed that all of his teeth had severe caries with almost lost crowns. There was a horizontal incisor erupted toward his tongue leading to the tongue ulceration since two months ago. We started the extraction of the exposed roots of the mandibular teeth and then the maxillary roots. The antibiotics, analgesics, and mouthwash were prescribed. In a recall session two weeks later, the ulcer totally disappeared, but the contour of the tongue was depressed with the intact mucosa and no color changes.

Oral health problems in patients with CP may be neglected compared to their overall health management. The multidisciplinary approach is necessary for oral health care and may be defined as an essential scheme for improving their quality of life