Thesis (M.Sc)-Cairo University, 2025.

Bibliography: pages 67-76.

Background
Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal and
paranasal sinus mucosa, often leading to a significant reduction in quality of life and
frequently associated with impaired pulmonary function. The interplay between upper and
lower airway inflammation—the "united airways" concept—suggests that effective
management of CRS could have beneficial effects on pulmonary health. This study evaluates
the efficacy of intra-nasal low-level laser therapy (LLLT) combined with Bhramari Pranayama
breathing exercises on sino-nasal symptoms, pulmonary function, and sleep quality in CRS patients.
Subjects: Fifty-four patients (both genders, aged 20–40s) diagnosed with moderate to severe
chronic rhinosinusitis without nasal polyps (CRSsNP), as assessed by the Sino-Nasal Outcome
Test (SNOT-22) with scores above 20. They were selected from the outpatient clinics of the
Faculty of Medicine, Cairo University. Duration: From June to September 2024. Methods:
The patients were randomly allocated into two equal groups (n = 27 each). Group A received intra
nasal LLLT (650 nm, 288J/cm², 3×/week) combined with a daily Bhramari Pranayama breathing
exercise regimen for four weeks. Group B practiced the daily Bhramari Pranayama breathing exercise
for the same duration. All patients underwent measurements of pulmonary function tests
(FEV1/FVC, FEV1, VC, and MVV), the Sino-Nasal Outcome Test (SNOT-22), the
Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS), and the Pittsburgh
Sleep Quality Index (PSQI). All parameters were evaluated in both groups at baseline and
after the completion of the treatment program. Results from both groups demonstrated
statistically significant improvements in all parameters following treatment. However, group
A showed a greater and significant improvement in pulmonary function tests, as evidenced by
increased FEV1/FVC, FEV1, VC, and MVV compared to group B (p < 0.05). Also., The
results of the SNOT-22 and QOD-NS questionnaires also improved significantly more in
group A (P> 0.001), while the P= 0.125 for the PSQI questionnaire between groups in favor
of group A. This demonstrates improvements in sinus symptoms, olfactory function, and
sleep quality.
Conclusion
This suggests that intra-nasal low-level laser therapy (LLLT), as a non-invasive and low
risk intervention, may provide additional therapeutic benefits by enhancing patient-reported
outcomes in chronic rhinosinusitis. Not only alleviating sino-nasal symptoms but also
contributing to improved sleep quality and pulmonary functions.

اشتملت هذه الدراسة على 44 مشاركا في الدراسة. تم تقسيم المشاركين إلى مجموعتين: 22 تلقوا تمارين الثبات الجذعي وتمارين المركزة للورك والركبة و22 تلقوا تمارين المركزة للورك والركبة فقط. تم اختيارهم من العيادة الخارجية لكلية العلاج الطبيعي بجامعة مصر للعلوم والتكنولوجيا. تم تقييم شدة الألم باستخدام مقياس التناظرية البصرية. تم تقييم القدرة الوظيفية بواسطة استبيان مقياس ألم الركبة الأمامي. وقوة العضلات تم تقييمها باستخدام مقياس الديناموميتر المحمول باليد وتم تقييم الاستقرار الوضعي الديناميكي باستخدام نظام توازن بيدوكس ومن نتائج هذه الدراسة يمكن استخلاص أن اضافة تمارين الثبات الجذعي الي التمارين المركزة للورك والركبة تؤدي الي تحسنًا في تقليل الألم، وقوة الجذع، والقدرة الوظيفية، والتوازن الديناميكي أكثر من تمارين المركزة للورك والركبة فقط على متلازمة آلام الرضفة وأسفل عظمة الفخذ.

Issues also as CD.

Text in English and abstract in Arabic & English.