Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Cardiopulmonary and Geriatrics Disorders

Background and Objective: This study targeted at finding out the response of the vertebral artery (VA) blood flow to Low Level Laser therapy (LLLT) versus pulsed electromagnetic field therapy (PEMFT) in elderly with cervical spondylosis (CS). Subjects and Methods: Research involved 60 patients, both genders, aged (60 to 75) years, diagnosed as chronic CS associated with vertigo, selected from the outpatient clinic of Elmatareya and Ahmed Maher Teaching Hospitals, as well as Elmahaba Specialized Polyclinics. Patients were assigned to 3 equivalent groups. Group (1) received (LLLT) (830 nm wavelength, 200 mW power) on VA bilaterally in addition to myofascial release (MFR). Group (2) received (PEMFT) (rectangular pulse, 50 mT, 20 Hz, 30 minutes/session) plus same technique of myofascial release. Group (3), control group, received MFR only. Groups received 3 sessions per week for 2 months. Blood flow in both VAs was estimated pre and post treatment by measuring Resistivity Index (RI), time averaged mean blood velocity (TAMV), & blood flow volume (VF) using ultrasound Doppler and vertigo was assessed by visual vertigo analogue scale (VVAS). Results: Highly significant difference resulted between pre & post treatment values of all measured variables in G1 and G2 (p<0.05) while no significance in G3 (p>0.05). Percentages of improvement of (RI, TAMV & VF) in G1 were ({u2193}12.28%), ({u2191}17.24%) & ({u2191}20.34%) respectively for the Lt VA, and ({u2193}13.98%), ({u2191}19.01%), & ({u2191}27.84%) respectively for the Rt, while ({u2193}64.24%) improvement in vertigo. Similarly, in G2, (RI, TAMV & VF) improved by ({u2193}11.73%), ({u2191}20.23%) & ({u2191}22.93%) respectively for the Lt VA, and ({u2193}10.69%), ({u2191}26.35%), & ({u2191}20.25%) respectively for the Rt, while vertigo improved by ({u2193}50.35%). On the other hand, there was some improvement in G3 with no statistical significance, where (RI, TAMV & VF) improved by ({u2193}0.73%), ({u2191}1.15%) and ({u2191}1.86%) respectively in Lt VA, and ({u2193}1.06%), ({u2191}2.84%), & ({u2191}5.38%) in the Rt, while vertigo improved by ({u2193}10.22%). Additionally, no significant difference detected in any group between men and women (p>0.05) whether pre or post treatment. Meanwhile, no significance detected in post treatment results between G1 & G2 (p>0.05), while highly significance (p<0.05) between G1 & G3 as well as between G2 & G3. Conclusion: Both LLLT and PEMFT with parameters used in this study, improved blood flow through vertebral artery bilaterally and decreased vertigo in elderly with cervical spondylosis

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