| Control Group |
the selected traditional physical therapy rehabilitation program only |
Treatment duration was about for eight weeks (12 sessions; three times per weekday after day and each session for 30 min for both groups). |
Treatment duration was about for eight weeks (12 sessions; three times per weekday after day and each session for 30 min for both groups).
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1- Conventional gait training (10 min): as Circuit training (reaching in sitting and standing, sit-to-stand, step-ups, heel lifts, walking over obstacles and up and down slopes).8
2- Balance exercise on balance board (10 min) (Tilt board Balance Training) The subject stands on a tilt board or balance board with both feet on the board. The therapist perturbs the tilt board in forward and backward and side-to-side directions for approximately 30 seconds each.9
3- Diaphragmatic breathing (10 min): is a type of breathing exercise that helps strengthen his diaphragm, an important muscle that helps you breathe as it represents 80% of breathing. The aims of this exercise are to mobilize secretions, teach effective coughing and remove secretions, teach relaxation, teach breathing control, teach postural awareness and mobilize thorax and shoulder girdle.10
Technique: ask patient to
- Lie on his back on a flat surface (or in bed) with his knees bent. You can use a pillow under his head and his knees for support if that's more comfortable.
- Place one hand on his upper chest and the other on his belly, just below his rib cage.
- Breathe in slowly through his nose, letting the air in deeply, towards his lower belly. The hand on his chest should remain still, while the one on his belly should rise.
- Tighten his abdominal muscles and let them fall inward as you exhale through pursed lips. The hand on his belly should move down to its original position. |
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Active-Treatment of Control Group |
| Experimental Group |
The visual biofeedback training in addiotion to traditional physical therapy |
eight weeks (24 sessions; three times per week). |
eight weeks (24 sessions; three times per week). |
received visual biofeedback training, on Biodex balance system, in addition to the selected traditional physical therapy rehabilitation program. The visual biofeedback training simulates specific movement patterns or strategies by placing markers on specific locations on the screen grid. The platform stability was set to level 8 (more stable). The foot angle for each patient was detected by using the alphanumeric grid on the foot platform (15-20o). All patients were standing on both feet and grasped the handrails. Once the platform had a motion, the patient was instructed to achieve a centered position. The hand support was released gradually, and the patient continued the training without support. The patients attempted to touch targets nine times using an on-screen cursor maneuvered by the subjects’ legs on the device’s platform. |
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