Dr Walaa Ragab | Cairo University (original) (raw)

Papers by Dr Walaa Ragab

European Journal of Molecular & Clinical Medicine, Dec 5, 2020

Background and Purpose: The aim of this study was to assess the effect of different approaches of... more Background and Purpose: The aim of this study was to assess the effect of different approaches of task oriented training on sensory area excitability (i.e. neuroplasticity) in the chronic stroke patients. Methods: Forty five male chronic stroke patients with moderate impairment of function of the left UE were assigned into three equal groups. The changes of sensory area excitability were assessed before , immediately and long term(retention effect after two months of stopping training program) after arm training by spectral analysis of digital Electroencephalography (d-EEG). Patients in group 1 (G1) received task oriented in form of unilateral arm training , patients in group 2 (G2) received task oriented in form of bilateral weighted arm training and patients in group 3 (G3) received task oriented in form of bilateral arm training without weight . Results: A significant immediate and long term increase was seen in excitability at P4 area in G3 and G2 compared to G1 (P≤ .001 and P≤ ...

Healthcare, 2021

Inability to use the affected upper extremity (UE) in daily activities is a common complaint in s... more Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the ...

International Journal of Medical Research and Health Sciences, 2016

Scoliosis is a lateral curvature of the spine and it is a common cause of back pain especially my... more Scoliosis is a lateral curvature of the spine and it is a common cause of back pain especially myofacial pain. Cognitive functional therapy is a novel challenges pain-related behaviors in a cognitively integrated, functionally manner. To study the effect of cognitive functional therapy in treatment of back pain due to postural scoliosis. Thirty Egyptian female patients were assigned randomly in to two equal groups. Patients in the control group received traditional therapeutic exercises (myofacial release, stretching and strengthening exercises of the back muscles), while patients in the experimental group received the same program of control group in addition to cognitive functional therapy. Each group received the program three sessions/week for six weeks. The severity of pain, functional disability, cobb's angle, and lumbar range of motion (flexion, extension, side bending to convex side of scoliosis) were measured before and after 6 weeks of treatment. The statistical analys...

International Journal of Environmental Research and Public Health, 2021

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to c... more Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the...

Objective: Cognitive impairemnt is an important feature in patients with parkinson’s diesease. Co... more Objective: Cognitive impairemnt is an important feature in patients with parkinson’s diesease. Cognition is assessed through many validated psychometric batteries as Montreal cognitive assessment (MOCA) and Clinical Dementia Rating Scale (CDRs). Subjective nature of these batteries has an impact on their reliability. An objective measure of cognitive function minimizes this defect. Rehacom cognitive assessment is an objective way of cognitive assessment. Subjects and Methods: Twenty three male subjects ;twelve patients with parkinson’s disease and eleven normal age matched subjests participated in this study.the age ranged from 50 to 70 years old. Subjects were assessed by the MoCA and CDRs and rehacom device for attention and concentration and memory domains (attention level, minimum reaction time, median reaction time and maximum reaction time, while the varaibles of figural memory modules that were measured were memory level, acquisition time and solution time). This study is a c...

Physical Therapy Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza... more Physical Therapy Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt Vice Dean for Educaton and Student Affairs, Deraya University, New Minya, Egypt. Department of Physical Therapy for Neuromuscular Disorder and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt. Department of Orthopedic Physical Therapy, Faculty of Physical Therapy, Beni Suef University, Egypt. Department of Physical Therapy for Neuromuscular Disorder and its Surgery, Faculty of Physical Therapy, Beni Suef University, Egypt. Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Saudi Arabia. Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Saudi Arabia. Department of Anatomy, Faculty of Medicine, Sohag University, Egypt. . *Correspondence: wanees.alamir@pt.cu.edu.eg Accepted: 05 Dec. 2018 Published online: 31 Dec. 2018

International Journal of Environmental Research and Public Health, 2020

Functional impairment of the upper limb (UL) after stroke is a great problem. Finding methods tha... more Functional impairment of the upper limb (UL) after stroke is a great problem. Finding methods that can improve UL function after stroke is a major concern to all medical service providers. This study was intended to compare the effect of upper limb task specific training (TST) on brain excitability of the affected hemisphere and motor function improvements in patients with left and right stroke. Forty male patients with mild impairment of UL functions were divided into two equal groups; G1 consisted of patients with left hemisphere affection (right side stroke) while G2 consisted of patients with right hemisphere affection (left side stroke). All patients received TST for the affected UL for one hour, three sessions per week for six consecutive weeks. Evaluation was performed twice, pre-, and post-treatment. Outcome measures used were Wolf Motor Function Test (WMFT) and Box and Block Test (BBT) as measures of UL motor function and Quantitative Electroencephalogram (QEEG) of motor an...

Annals of Health and Health Sciences, 2018

Background and Objectives: Pain estimation remains a difficult medical problem. Many subjective a... more Background and Objectives: Pain estimation remains a difficult medical problem. Many subjective and objective methods were tried. Subjective methods depend on personal difference to a good extent and cannot be accurate. The aim of this work was to evaluate the validity of using electrical stimulation (ES) as an objective and valid method in quantitating the pain intensity and, consequently, the intensity of needed treatment. Methods: Twenty chronic low back pain (LBP) patients with sciatica and 20 normal subjects participated, and they were compared in this study. Electrical threshold and pain tolerance were recorded from the most painful site in the study group and from the corresponding matching site in the control group. Blood analysis for β-endorphin was done to objectively determine the intensity of pain as well as the objectivity and validity of ES in the assessment of pain. Pain intensity was also recorded by the visual analogue scale for each subject. Results: Significant differences between both groups regarding the threshold and pain tolerance to electrical current were noted. A significant positive correlation was also observed between β-endorphin level as well as the threshold and pain tolerance intensity in the patient group. Non-significant correlation was also observed between the visual analogue scale and β-endorphin level. Conclusion: ES is an objective and valid method, whereas visual analogue scale is a subjective method in the assessment of pain intensity in chronic LBP patients.

International Journal of Therapy and Rehabilitation, 2018

Background/Aims: The ability to maintain a standing and dynamic posture is a problem in patients ... more Background/Aims: The ability to maintain a standing and dynamic posture is a problem in patients with diabetic peripheral neuropathy. The objective of this study was to investigate the effect of core stability exercises and desensitisation therapy on posture stability in patients with diabetic peripheral neuropathy. Methods: A total of 60 patients diagnosed with diabetic peripheral sensory motor neuropathy with average age from 55–70 years were involved in this study. Patients were assessed for posture stability before and after treatment using the Biodex Balance System. The patients were randomly divided into four equal groups. Group 1 (the control group) received a selected physical therapy programme for diabetic peripheral neuropathy patients. Group 2 received core stability exercises in addition to the same selected physical therapy programme for Group 1. Group 3 received desensitisation therapy in addition to the same selected physical therapy programme for Group 1. Group 4 rec...

Journal of Health and Medical Sciences, 2019

The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied,... more The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied, and distributed free of charge according to the conditions of the Creative Commons Attribution 4.0 International license.

Journal of Clinical and Analytical Medicine, 2019

Aim: The ultimate goal for many stroke patients is to achieve maximum level of functional indepen... more Aim: The ultimate goal for many stroke patients is to achieve maximum level of functional independence that enables them to return home and reintegrate into community life as fully as possible. There are variable levels of impairment in stroke patients. Detecting the suitable type of feedback (visual or auditory) is important for improvement the impairment of stroke patients. Material and Method: Sixty left chronic stroke patients were representinging the samples of the study. The patients were assigned into four equal groups; The patients in group1(G1) and group 2 (G2) were of mild impairment of upper limb function while patients in group3 (G3) and group4 (G4) were of moderate impairment of upper limb function. Each group was tested by WMFT for detecting the function and time of motor performance of upper extremity(UE). G1 and G3 received visual feedback training while G2 and G4 received auditory feedback training. Results: There was a significant increase in the degree of motor performance in all of the four groups G1, G2, G3 and G4 P value was less than with more evidence for .05 with more evidence for G1. Also there was a significant decrease in the time of motor performance in all the four groups P value was less than .05 with more evidence for G3. Discussion: Visual and auditory feedback have an effect on improving the motor performance of UE in mild and moderate impairment stoke patients with more evidence for visual feedback.

International Journal of Physiotherapy and Research, 2017

Background: Hand dysfunction is a common problem of stroke patients and it is the main cause of i... more Background: Hand dysfunction is a common problem of stroke patients and it is the main cause of impairment of the upper limb. Finding new method to improve hand performance will decrease the disability of chronic stroke patients. Aim of the study: to study the effect of bilateral hand training with weight on the non paretic hand on the hand performance and time of performance in chronic stroke patients. Materials and Methods: Thirty left chronic stroke patients participated in this study. The patients were assigned randomly into two equal groups. Group one (G1) received unilateral hand training and group two (G2) received bilateral hand training with weight on non affected hand. Both groups assessed two times before starting training program and after two months of training by Fugl meyer assessment scale, Wolf motor function test and hand dynamometer for the motor performance, time of performance and hand grip respectively. Results: the patients in G2 showed significant improvement in the hand performance (P<.0001) and significant decrease in the time of performance (P<.001) and also significant improvement of hand grip (P<.0001). Conclusion: Bilateral hand movement with weight on the non affected hand has a significant effect on improving hand performance and decreasing the time of performance and increasing hand grip than unilateral hand movement.

Clinical Neurophysiology, 2017

Objectives: Physical therapy exercises that do not enhance motor areas neuroplasticity lead to mo... more Objectives: Physical therapy exercises that do not enhance motor areas neuroplasticity lead to motor impairment especially at the upper extremity (UE) in the chronic stroke patients. The aim of this study was to assess the effect of using bilateral arm training on motor areas excitability (neuroplasticity) in the chronic stroke patients. Methods: Thirty male chronic stroke patients with moderate impairment of UE were assigned into two equal groups. The changes of motor areas excitability (neuroplasticity) were assessed before and after arm training by spectral analysis of mapping electroencephalogram (EEG). Delta, theta, alpha, beta 1 and beta 2 waves were recorded. The equation which was used to detect the neural plasticity and the changing at motor areas excitability was dividing the fast wave/slow waves or detecting the ratio of mean frequency of (beta 2 + beta 1 + alpha/theta + delta). Results: Patients in group 1 (G1) received unilateral arm training and patients in group 2 (G2) received bilateral arm training. The Results: Showed significant increase in the excitability (neuroplasticity) at (F4 + F8) and (C4) motor areas in G2 comparing to G1 (p! 9 .006) and (p!9 .036) respectively. Discussion: Bimanual training leads to activation of extensive networks in both hemispheres. Conclusions: It was concluded that bilateral arm training is a recommended method to enhance the motor areas excitability (neuroplasticity) in the chronic stroke patients. Significance: Post stroke physical therapy can make use of bimanual training for better rehabilitation.

Journal of Taibah University Medical Sciences, 2021

Objectives This study examines the effect of behavioural therapy (biofeedback) and interferential... more Objectives This study examines the effect of behavioural therapy (biofeedback) and interferential current on bladder dysfunction in multiple sclerosis patients. Methods Fifty patients with secondary progressive type multiple sclerosis (SPMS) suffering from bladder dysfunction were divided equally into two groups randomly. Group A (GA) received behavioural therapy (biofeedback training), while Group B (GB) received interferential current training. Both groups were assessed by urodynamics for detrusor pressure and maximum flow rate before and after eight weeks of behavioural therapy and interferential training. Results Both groups, GA and GB, showed significant increase in the detrusor pressure and maximum flow rate after eight weeks of training. There was no significant difference between both methods. However, GA showed more improvement by close observation. Conclusions Both behavioural therapy and interferential current training effectively managed bladder dysfunction in patients with SPMS, with more evident effects in behavioural therapy patients by close observation.