Background: Upper limb paresis is a common problem in patients with stroke. Objectives: To determine the effect of core stability exercises on upper limb function and trunk balance in hemiparetic patients. Subjects: Thirty patients with hemiparesis, with age between 45 and 60 years, and with illness duration of more than 6 months. They were assigned into two equal groups, the control group, Group A: with 15 patients who received only conventional physical therapy program; the study group, Group B: with 15 patients who received conventional physical therapy program and additional core muscle training. Patients received 18 sessions for 6 weeks, three sessions/week. Methods: The upper limb function was assessed using Wolf motor function test with subscales (function ability scale, time, and grip strength), the range of motion of shoulder flexion and abduction was measured by using goniometer, trunk balance was assessed using the trunk impairment scale with subscales (static sitting balance, dynamic sitting balance, and coordination). All measurement outcomes were assessed before and after applying the treatment program. Results: There was no statistical significant difference between two groups in pretreatment assessment using wolf motor function test, trunk impairment scale, and shoulder range of motion. In post treatment assessment, there was no statistical significant difference between group A and group B in all the outcome measures, except for trunk impairment subscale (dynamic sitting balance); the statistical significant difference was in favor of group B. Conclusion: Core muscle training is similar to conventional physical therapy program in improving upper limb function in hemiparetic patients, and has beneficial effect on improving trunk balance.

Background: Disturbance of balance and falls are commonly observed in people with multiple sclerosis (MS). Objectives: The aim of this study is to assess the postural balance in patients with MS by using clinical and instrumental methods and to specify the most direction of balance instability among MS patients using Biodex stability system (BSS). Methods: Fifty ambulatory individuals with MS [42 relapsing-remitting (RRMS) and 8 secondary progressive (SPMS)] were evaluated for balance using quantitative Berg balance scale (BBS) and BSS. Twenty healthy volunteers were selected as a control group. Results: There was a statistically significant difference between the patient and control groups assessed by BBS. Moreover, patients with SPMS had worse postural balance when compared with RRMS. According to BSS, MS group showed more sway in the three limits of stability (mediolateral, antroposterior, and overall) when compared to the control group. The least stability level was observed in mediolateral direction in the patient group. The degree of tilt was higher in SPMS than RRMS as regard the three limits of stability. The BBS was significantly negatively correlated with age, Expanded Disability Status Scale (EDSS), duration of illness, and the Biodex tilt. Also, there were positive significant correlation between age, EDSS score, and the duration of illness of the disease with parameters of BSS (mediolateral, antroposterior, and overall). Conclusion: BSS was significantly correlated with clinical balance measurement scale using BBS in MS patients. Moreover, BSS can provide more objective, quantitative measures of postural imbalance.

Background: Approximately half of stroke patients show impaired upper limb and hand function. Task-oriented training focuses on functional tasks, while joint mobilization technique aims to restore the accessory movements of the joints. Objective: To investigate the effect of adding joint mobilization to task-oriented training to help the patients in reaching a satisfactory level of recovery for their hand function. Patients and methods: Thirty chronic stroke patients with paretic hand participated in the study; they were divided equally into study and control groups. The study group received joint mobilization followed by taskoriented training for the affected hand. Meanwhile, the control group received task-oriented training only. Both groups received their treatment in the form of 3 sessions per week for 6 successive weeks. The primary outcome measures were hand function that was assessed by Jebsen-Taylor hand function test (JTT) and active and passive wrist extension range of motion (ROM) that was measured by a standard goniometer. The secondary outcome measure was the grip strength of the hand that was assessed by a JAMAR adjustable hand dynamometer. Results: There was a significant improvement in all the outcome measurements in both groups that were more evident in the study group. Conclusion: Combining joint mobilization with task-oriented training had a highly significant effect in improving the hand function in chronic stroke patients compared to task-oriented training alone.

Background: Multiple sclerosis (MS) is the most common permanent neurological disorder affecting young adult causing strength deficits. Aim of the study: This study was conducted to investigate influence of selected aerobic exercises on serum Vitamin D level and lower limb performance in patients with multiple sclerosis. Subjects and methods: 30 patients with relapsing remitting MS recently diagnosed with early stage of MS, vitamin D insufficiency less than 20-30 ng/mL, age from 20 to 40 years old and body mass index less than 25 kg/m² were recruited, assessed for and assigned into 2 groups. They received treatment program as follows: control group (A) received conventional medical treatment (Corticosteroids, Interferon beta medications, Dimethyl fumarate, muscle relaxants, medications to reduce fatigue) in addition to vitamin D supplementation only, while experimental group (B) received conventional medical treatment, vitamin D supplementation in addition to selected aerobic exercises. The outcome measures included serum vitamin D level by lab test, timed 25 walk test by measure timing of performance of lower limb gait in multiple sclerosis. Results: both groups showed significant difference in the outcome measures in the post treatment assessment, but the selected aerobic exercises (B) showed a more significant improvement over the control group at p-value >0. 001. Conclusion: selected aerobic exercises is an effective physical therapy modality when added to the conventional medical treatment, so it may provide better outcomes for serum vitamin D level and lower limb performance in patients with MS.

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