J Med Rehab Sci

Impact of Cardiac Rehabilitation including Deep Breathing on Endurance Level in Patients with Mild Heart Failure

2025-05-01T07:15:27+00:00

Background: Heart failure (HF) is a morbid illness with high mortality rate. Patients with HF necessitate a cardiac rehabilitation (CR) that is a planned, lasting care, which is highly cost effective in lowering hospital admission and improving quality of life. Objective: The aim of the study was to compare the effects of diaphragmatic breathing and incentive spirometer on endurance level in patients with mild heart failure. Methods: An experimental study, single-blinded design. Forty-five patients (25 males and 20 females) diagnosed with mild HF were nominated from the cardiac unit in king Abdulaziz University Hospital, Jeddah, KSA. Age range was 45-75, subjects were randomly allocated to three equal groups: the diaphragmatic breathing (DB), the incentive spirometer, and the control group. They were evaluated pre- and post-cardiac rehabilitation. Results: The results displayed a statistically significant rise in the six-minute walk test (6MWT) post-intervention vs pre-intervention in DB group (p=0.03), showing the efficacy of DB based on 6MWT results. Though there was a significant improvement in the rating of perceived exertion Borg scale post-intervention compared to pre-intervention in DB (p=0.01). As well, there was a statistically significant improved oxygen saturation post-intervention in the control group. Indicating efficacy of training on oxygen saturation. Conclusion: The results revealed the DB great effect on hemodynamic indices and improving cardiac function.

Keywords: Heart failure, cardiac rehabilitation, diaphragmatic breathing and incentive spirometer

Gastroesophageal Reflex Disease among patients with Chronic Obstructive Pulmonary Disease in Saudi Arabia: A single center experience in Makkah

2025-04-06T09:46:22+00:00

Background: This study aimed to investigate the prevalence of Gastroesophageal Reflux Disease (GERD) and its predictors among patients with Chronic Obstructive Pulmonary Disease (COPD) in Saudi Arabia.

Methods: Analysis was conducted using electronic health records (EHR) of 706 adult COPD patients who visited outpatient pulmonary clinics between 1 August 2023, and 14 September 2024. GERD diagnosis was collected from EHR as well as endoscopic results, symptoms, and medication use. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Data on demographics, pulmonary function tests, comorbidities, and hospital admissions were collected. Statistical analyses included Chi-Square tests, Kruskal-Wallis tests, and binary logistic regression.

Results: Among the 706 COPD patients, 186 (26.3%) had a diagnosis of GERD. The mean age of patients with GERD was 66.92 years, with equal gender distribution. Significant predictors of GERD included older age (OR: 1.60, 95% CI: 1.11-2.29), smoking (OR: 1.98, 95% CI: 1.37-2.87), presence of comorbidities (OR: 0.09, 95% CI: 0.04-0.17), and history of Acute Exacerbation of COPD (AECOPD) admissions in the previous year (OR: 0.35, 95% CI: 0.25-0.50).

Conclusion: The study found that over a quarter of patients with COPD also had GERD. Key predictors of GERD in this patient population included older age, smoking, comorbidities, and recent AECOPD admissions. These findings highlight the importance of monitoring and managing GERD in patients with COPD to improve clinical outcomes.

Effective Non-Operative Management of Lacertus Syndrome: Two Case Reports and A Review of Literature

2025-05-12T09:03:41+00:00

Lacertus syndrome (LS) is a condition characterized by median nerve entrapment at the Lacertus Fibrosus (LF), a fibrous band distal to the elbow joint, presenting with pain, numbness, and weakness in the forearm and hand. Due to its rarity, LS is often overlooked in the diagnosis of these symptoms. Management can be surgical or non- surgical, depending on preference and symptom severity. Most studies published on this syndrome showed symptom relief only after surgical intervention. We present two case reports describing the successful non-surgical management of lacertus syndrome in two males in the dental field who presented with bilateral and unilateral LS. Grip strength, pain score, and functional scores were used to assess pre- and post- treatment outcomes. Treatment involved a combination of myofascial release, nerve gliding exercises, and strengthening protocols. The grip strength of the affected hand improved significantly in both patients. In the first patient, the grip strength of the right hand increased from 12 kg to 38 kg, while the left hand's grip strength improved from 36 kg to 48 kg. In the second patient, grip strength progressed from being unable to perform any grip strength to 46 kg. Additionally, the Visual Analog Scale (VAS) score improved for both patients, decreasing from 8/10 to 1/10. To our knowledge, these are the first two cases in the literature managed successfully without surgical intervention. The successful management of lacertus syndrome in both patients illustrates the importance of a multifaceted, non-surgical approach. This report supports the notion that tailored conservative treatments can lead to significant improvements in function and quality of life.

Perceptions and clinical practice around use of airway clearance devices in chronic obstructive pulmonary disease

2025-05-11T10:08:19+00:00

Background: Effective airway clearance is a critical component of COPD management. Airway clearance devices (ACDs) can assist this, but their effectiveness relies on consistent use in clinical practice.

Objectives: To identify awareness and clinical practice related to device use for people with COPD among respiratory therapists and physiotherapists in Saudi Arabia.

Design: A cross-sectional survey.

Setting: Primary and secondary care in Saudi Arabia

Material and Methods: An online survey was conducted among respiratory care and physiotherapy practitioners working in various healthcare settings across Saudi Arabia. The survey assessed familiarity with, attitudes towards, and utilisation of different types of ACDs in different clinical scenarios.

Results: A total of 423 healthcare practitioners were invited to complete the survey, which included 43% female participants, a median age range of 20-30 years, 89.4% Saudi citizens, 82.5% with a bachelor’s degree, 84.2% who are respiratory therapists, and 58.9% employed in governmental hospitals. Almost all participants were aware of at least one ACD, with Flutter devices (58%) being the most recognised, followed by Acapella (30%). 77.5% of participants reported always or usually using devices in patients with daily difficulty in clearing thick sputum, but there was less consistency where the sputum burden was not as severe. The Acapella device was preferred by 56%, with 18% preferring the Flutter. 85% of participants reported basing device use on clinical practice guidelines, with the GOLD guidelines being the most cited.

Conclusion: Awareness of sputum clearance devices is high among this group of healthcare professionals in Saudi Arabia, but variation in practice highlights the need for further research.

Keywords: Chronic Obstructive Pulmonary Disease, Airway Clearance Devices, Adjunct for Sputum Clearance, Respiratory Therapy, Physiotherapy, Saudi Arabia

The Validity and Reliability of Box and Blocks Test on Children with Traumatic Elbow Injury

2025-05-22T11:57:18+00:00

INTRODUCTION: The Box and Blocks Test (BBT) is a widely used measure of manual dexterity, but its validity and reliability as an outcome measure for upper extremity function in children with Traumatic Elbow Injuries (TEI) require further investigation. This study aimed to evaluate the BBT's test-retest reliability, sensitivity to functional change (construct validity), and discriminative validity in this specific pediatric population.

METHOD: Twenty-nine children (75.9% male; age range: 6-16 years) with TEI participated in a prospective study. BBT scores for both hands were assessed pre- and post- an eight-week physiotherapy intervention. Test-retest reliability was evaluated via Cronbach's Alpha, and discriminative validity using Receiver Operating Characteristic (ROC) curve analysis of pre-intervention scores.

RESULTS: Excellent test-retest reliability was found (Cronbach's Alpha = 0.991). Significant improvements in BBT scores occurred post-intervention for both right (p<0.001) and left hands (p<0.001), indicating sensitivity to change. However, discriminative validity of pre-intervention BBT was limited, with low Area Under the Curve (AUC) values (Right: 0.435, Left: 0.425). These AUCs suggest the test performed worse than random chance in differentiating specified outcomes at baseline.

CONCLUSION: The BBT is a sensitive and reliable tool for detecting functional improvements in children with TEI post-physiotherapy. Its limited discriminative validity at baseline warrants cautious interpretation. Future research with larger, diverse samples should investigate age and gender effects, and explore broader functional outcomes to fully establish BBT's comprehensive role as an assessment tool in this population.

The Multifaceted Impact of Mindfulness on Chronic Diseases: A Comprehensive Review of Its Relationship with Diabetes Mellitus, Hypertension, Insomnia, Obesity, Gastrointestinal Disorders, and Migraine

2025-05-28T11:04:03+00:00

Mindfulness has emerged as a holistic approach that enhances psychological well-being and physiological functioning. This comprehensive review explores the relationship between mindfulness and major chronic conditions, including Diabetes Mellitus (DM), Hypertension (HTN), Insomnia, Obesity, Gastrointestinal Disorders (such as Irritable Bowel Syndrome and Inflammatory Bowel Disease), and Migraine. Evidence suggests that mindfulness-based interventions (MBIs) significantly improve disease management and quality of life across various patient populations. The review highlights recent randomized controlled trials, systematic reviews, and meta-analyses to provide an updated synthesis of the impact of mindfulness on symptom severity, metabolic parameters, inflammatory markers, and behavioral outcomes. Furthermore, the paper discusses underlying mechanisms, clinical implications, and future research directions, emphasizing mindfulness as an integrative strategy in chronic disease prevention and treatment. In particular, this review aims to explore recent innovations in mindfulness-based interventions—including digital delivery, VR applications, and condition-specific adaptations—as well as examine the contributing psychosomatic, behavioral, and physiological causes linking chronic disease with psychological distress.