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   Table of Contents - Current issue
July-December 2022
Volume 6 | Issue 2
Page Nos. 33-92

Online since Tuesday, January 3, 2023

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Statistical inference through estimation: Recommendations from the International Society of Physiotherapy Journal Editors p. 33
Mark R Elkins, Rafael Zambelli Pinto, Arianne Verhagen, Monika Grygorowicz, Anne Söderlund, Matthieu Guemann, Antonia Gómez-Conesa, Sarah Blanton, Jean-Michel Brismée, Shabnam Agrawal, Alan Jette, Sven Karstens, Michele Harms, Geert Verheyden, Umer Sheikh
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Perpetuating chronic injuries in the young sports’ person? p. 39
Raju K Parasher
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Identifying the relationship between upper limb dysfunction and balance in subacute and chronic stroke hemiparetic patients: A cross-sectional study p. 41
Ranju Kumari Sharma, Deepanjali Rai, Saumen Gupta, Tittu Thomas James, Shubham Menaria, Pradnya Dhargave
Background: Balance deficits in patients with stroke hemiparesis impair functional performance. Influence of the upper limb dysfunction on balance impairments is least studied in this population. The aim of this study was to identify the relationship between the upper limb dysfunction and balance deficits in patients with stroke hemiparesis. Materials and Methods: A multi-center cross-sectional study was undertaken by recruiting patients with subacute or chronic stroke hemiparesis above the age of 35 years. Patients those who fulfilled the study criteria were recruited and were assessed for their upper and lower limb dysfunction and balance using the following outcome measures; Fugl–Meyer Assessment Scale for Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE), Trunk Impairment Scale (TIS), and BESTest scale. Spearman correlational analysis and linear regression were performed to identify the relationship between the variables. Results: A total of 22 patients were recruited with a mean age of 53.55 ± 11.26 years. A significant correlation was identified between all outcome measures assessed except between FMA-UE and TIS (ρ = 0.394, P = 0.069). Regression analysis identified 25% changes in the BESTest scores can be explained by FMA-UE score (P = 0.018). Conclusion: The study found a relationship between the upper extremity motor function and the balance in the subacute and chronic stroke patients.
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Comparison of the effect of group vs. individual exercises on balance, gross motor function, and participation in children with cerebral palsy spastic diplegia p. 46
Susan Jose, Sandhya Wasnik
Background: Groups exercise platforms provide a wide range of visual and auditory feedback that can be used to facilitate desirable movement patterns. Positive and negative reinforcement strategies are given as feedback when working in a group setting. Hence, group exercises accelerate motor learning and provide a controlled environment to socialize and mutually support one another. Aim: The aim of this study was to compare the effect of group exercises vs. individual exercises on balance, gross motor function, and participation in children with cerebral palsy spastic diplegia. Materials and Methods: The study included 30 participants over a period of 4 weeks. Participants were randomly allocated to both the groups. Post and follow-up assessments were done. Statistical Analysis: Friedman test and Mann–Whitney U test was used for intragroup and intergroup comparison. Results: Statistically significant improvements were noted in the group exercises, in Gross motor function measure (P = 0.002), Paediatric Balance Scale (P = 0.002), CPQ–ADL (P = 0.02), and IADL (P = 0.004), which was also maintained over a follow-up period of 4 weeks. Conclusion: Group exercises are more effective than individual exercises in improving balance, gross motor function, and participation in children with cerebral palsy spastic diplegia, which is also maintained over a follow-up period of 4 weeks.
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Usefulness of National Service Scheme in physiotherapy curriculum: A mixed-methods study p. 54
Snehal Dharmayat
Background and Objectives: National Service Scheme (NSS), as an elective subject in higher education, was introduced in the year 2016 by the University Grants Commission (UGC). From being a practical/activity done by students, it was changed to a theory subject. Ascertaining its acceptance and usefulness becomes essential in the process of program evaluation and for implementing curricular reforms. Materials and Methods: Evidence related to students’ awareness of NSS, its importance in the curriculum, and their perception of the subject were obtained from 279 undergraduate and postgraduate physiotherapy students combined and analyzed. Results: 99.6% of students were aware of NSS. 98.99% responded that it was important in the curriculum, whereas 79.2% of participants reported that they would choose it as an elective subject. The common explanations cited by the students included “helping them understand community better” (98.56%) and “helping them become better individuals” (personality development) (98.92%). Conclusion: NSS finds more acceptance as an activity performed by students (community awareness programs) rather than as a theory subject. It has better acceptance among students inclined toward community/social service.
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Importance of wearable devices in generating quantitative data in stroke rehabilitation: An observational case study p. 59
Vineela Kaarengala, Vijay Battina, Swikruti Singh, Mythreyi Kondapi, Suresh Susurla
Background: Use of digitalized methods in stroke rehabilitation is increasing. However, its effect on treatment decisions made by the physiotherapists and perceptions of patient has not been discussed extensively. Aim: The aim of this study was to understand the clinical relevance of objective data generated using wearable technology and its impact on treatment decisions made by the therapist for stroke patients. Materials and Methods: This was an observational clinical report of patients diagnosed with hemiplegia for whom a prognostic tool, Pheezee, was used to assess motor information on joint range of motion (ROM) and muscle electromyography of upper limbs. The clinical information generated by the device was used for further analysis and assessment. Results: A significant difference in motor parameters has been noticed between weak and healthy limbs. The data for motor parameters were severely low for weaker limbs. Discussion: Clinical data extracted on motor parameters from the wearable device are noncomplex to visualize and analyze and ease understanding prognosis for the patient. It strengthens the evidence available for physiotherapists to make specific treatment decisions and readily make the needed modifications in the therapy.
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Physiotherapy in musculoskeletal Conditions: AB No: 27: Relationship between clinical variables and high sensitive C reactive protei in stratified groups of low back pain p. 66
P. Antony Leo Aseer
Purpose: The broad aim is to analyze the relationship between clinical variables and high-sensitive C reactive protein (hs-CRP) in stratified groups of low back pain. Relevance: The study was to evaluate the magnitude of effect between the biomarkers of inflammation and clinical variables in stratified groups of nonspecific low back pain. Participants: 50 subjects (aged between 30–45 years) with the diagnosis of non-specific low back pain using convenient sampling were included. Participants with history of diabetes and cardiovascular diseases were excluded. Methods: Correlational study design. All subjects were screened and stratified using STarT back screening tool. Clinical variables of pain severity, functional disability using Oswestry Disability Index-Tamil (ODI-T) and blood samples for analyzing the levels of hs-CRP were collected. Analysis: Pearson correlation coefficient was used to analyze the relationship between clinical variables and hs-CRP in low, medium and high risk groups. Results: High risk group (mean-12.17 mg/L) exhibited greater serum hs-CRP levels than other groups.There exist a significant positive moderate correlation (r = 0.55, p < 0.007) between pain severity and hs-CRP levels in high risk group. Moreover, moderate positive correlation was also observed between functional disability and hs-CRP levels in all risk categories. Conclusion: There is a six fold increase in serum hs-CRP levels in high risk group predicting poor outcomes. There exist a positive relationship among hs-CRP, functional disability and pain severity in high risk group in nonspecific low back pain. Prospective longitudinal studies can be carried out to further establish the study findings. Implications: High sensitive C - reactive protein served as a novel tool in detecting the presence of inflammatory mediators and further drives for more individualised treatment approach. Establishing treatment strategies (biopsychosocial approach) in high risk group using biomarkers is of paramount importance.
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Physiotherapy in musculoskeletal Conditions: AB No: 115: A pilot study on the effect of custom made orthotic insoles on plantar peak pressure in athletes p. 66
Humeira Payak
Purpose: To conduct a complete podiatry assessment in athletes who had complaints of foot, ankle and knee pain. To administer an appropriate custom designed orthotic intervention. To study the effect of custom made insole on the peak plantar pressures of the foot using in shoe insole sensor podiatry assessment. Relevance: Due to the load bearing nature of the knee and foot musculoskeletal injuries are common in knee and foot region. A physiotherapist needs to understand the loads and forces acting on the knee and foot, tissue-healing capacity, surrounding structural compensations and requirements of their sport. Participants: A group of 20 athletes across various sports like shooter, sprinter, cricketer and footballers. Methods: We got informed consent from athletes. These players underwent clinical podiatry assessment, static foot pressure and dynamic foot plantar pressure analysis. We assessed plantar pressure with pre and post custom-made insole. Analysis: The peak pressures and their regions of peak pressures were identified. Dynamic in-shoe assessment with Medilogic software during treadmill activity was done using pressure sensing. insoles. Using the clinical and instrumental data, CAD based design software was used to design the necessary orthotic insole, and manufactured using milling machines. The insole was made out of EVA composite material. Results: Data was analysed using t test. P value: 0, 95% CI, MD- 26.6176, SED- 3.7496. Conclusion: The custom designed orthotic insoles in this study had a significant influence on reducing the peak pressures of the plantar regions of the feet in Athletes. Implication: To design a management plan to efficiently return to sport and minimise the risk for further injury.
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Physiotherapy in musculoskeletal Conditions: AB No: 82: Thoracic spine manipulation as an adjunct in the treatment of Cervical radiculopathy- A Randomized Controlled Trial p. 67
Anand Heggannavar, Yesha Parikh
Background: Cervical radiculopathy is a common condition occurring as a result of compression of cervical nerve roots that causes pain radiating from the neck into the distribution of the affected root. Various physical therapy treatment options available, one of which is the thoracic spine manipulation. As cervical spine is the most sensitive segment, there are few risks associated with, therefore, thoracic spine manipulation can be considered as a treatment option as there is a biomechanical association between the cervical and thoracic spine. Purpose: To determine the long term effect of thoracic spine manipulation in patients with cervical radiculopathy. Methods: An experimental study with 34 participants within the age group of 25 to 60 years with neck pain radiating to unilateral or bilateral upper extremity were recruited in the study. Participants were randomly assigned to either of two groups using envelop method. The outcome measure used were numeric pain rating scale, Northwick park neck questionnaire, cervical ROM and neck muscle strength using pressure biofeedback. Control group received conventional therapy and experimental group received thoracic manipulation along with conventional therapy and the effect seen after 1 month was compared. Results: Statistical analysis revealed significant differences (p <0.001) in pre and post values of numeric pain rating scale, Northwick park neck questionnaire, cervical ROM and neck muscle strength using pressure biofeedback in both the groups Between group significance was found in the components of pain rating scale; worst pain right now (p=0.01024). Conclusion(s): Long term effect of thoracic spine manipulation when given as an adjunct therapy to conventional therapy proved to provide significant improvements in pain in subjects with cervical radiculopathy ie in terms of worst pain right now. Implications: Thoracic spine manipulation can be used as an adjunct therapy with conventional therapy for pain relief in subjects with cervical radiculopathy.
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Physiotherapy in musculoskeletal Conditions: AB No: 90: Tactile Acuity and Temporal Summation as a Measure of Central Sensitization in Individuals with Adhesive Capsulitis-A Cross Sectional Study p. 67
Shobhalakshmi S, Sayli Rajadhyaksha, Ramya H S
Background and Objectives: Adhesive capsulitis is a condition in which individuals have pain and restricted range of motion of the shoulder. In the early stages, there is also continuous nociceptive barrage, which may lead to peripheral and subsequently central sensitization. Central sensitization is an amplification of neural signalling within the central nervous system that elicits pain hypersensitivity. The presence of central sensitization can be assessed through temporal summation and tactile acuity. Determining the presence of central sensitization in adhesive capsulitis could direct physiotherapy interventions towards central nervous system focused approach such as pain neuroscience education and graded motor imagery along with conventional therapy. Hence the purpose of this study is to determine the alteration in tactile acuity and temporal summation in individuals with adhesive capsulitis as compared with healthy individuals. Methodology: Cross-sectional research design was used. The participants were recruited from M S Ramaiah Hospitals. Participants were selected based on the inclusion exclusion criteria. The study consisted of two groups with 16 participants in the adhesive capsulitis group and the control group consists of 16 age and gender-matched healthy individuals. Assessment of tactile acuity was done using a two-point discriminator and assessment of temporal summation using a monofilament. Results: Mann-Whitney U test was used to analyse the data. The result of the study showed that there was a significant difference in tactile acuity anterior valve (p= < 0.001), tactile acuity middle valve (p=0.001), tactile acuity posterior value (p=0.001) and temporal summation valve (p= < 0.001) in adhesive capsulitis group compared with the control group. Interpretation and conclusion: In this study individuals with adhesive capsulitis had higher tactile acuity and temporal summation value as compared with the age and gender-matched healthy individuals. As there was an alteration in tactile acuity and temporal summation, this study concluded that central sensitization is present in an individual with adhesive capsulitis.
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Physiotherapy in Neurological Conditions: AB No: 174: Prevalence of Psychosomatic Pain and Its Correlation with Anxiety, Depression and Insomnia in Young Adults � An Observational Study p. 68
Sailee Pai Kane, Basavaraj Motimath, Gaurang Baxi, Tushar Palekar
Background and Purpose: Research has shown that mental health disorders manifest as significant physical health symptoms. Previous studies suggest that individuals with chronic pain are 18 times more likely to suffer than those without pain. Methods: 201 participants in the age group 18-35yrs were selected from various colleges and work places. Participants who complained of having undiagnosed pain for more than 6 months were screened for anxiety, depression and insomnia using self-administered questionnaires. Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Depression Rating Scale (HAM-D), Insomnia Severity Index (ISI), Numeric Pain Rating Scale (NPRS), & Patient Health Questionnaire (PHQ-15) were administered. Analysis: Statistical Package of Social Science version 23 was used for data analysis. Descriptive statistics and Pearson’s correlation test were used. Results: PHQ-15 scoring is divided into four categories depending upon the level of somatic symptoms severity. From the 201 samples collected 48.3% fall into minimal category, 33.3% in low category, 13.4 in medium category and 5.0% in high category. Correlational analysis ofNPRS and Patient Health Questionnaire-15 was done with ISI, HAM-A, HAM-D. PHQ_15 correlated well with ISI (r=0.575), HAM-D (r=-0.616), and HAM-A (r=0.544). There was a weak correlation of NPRS with ISI (r=0.396), HAM-D (r=0.351), and HAM-A (r=0.405). All values were significant (p< 0.05). Conclusion: As per the result of the present study done there was a positive correlation seen between psychosomatic pain and anxiety, depression and insomnia; with anxiety showing the maximum prevalence. Implications: The study has revealed a significant relation between psychosomatic pain and anxiety, depression and insomnia. The findings suggested that there is a correlation between pain and the mentioned mental health condition with anxiety having the maximum prevalence rate.
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Physiotherapy in Neurological Conditions: AB No: 179: Is Assessment of Balance Important in SARS �CoV-2 Survivors before discharge? p. 68
Jaquiline Nongpoh, Nischitha R.Rao, Rejisha T.R
Purpose: To emphasize the importance of Balance assessment as integral part of SARS SARS-CoV-2 rehabilitation so that a ‘’future pandemic” of falls can be prevented. Relevance: Balance assessment in acute-care setting can help prevent falls and subsequent consequences complication during the course of rehabilitation. Participants: SARS –CoV-2 recovered survivors (n=130), who were admitted for a minimum of 7 days and on O2 support. Methods: Institutional Ethic committee approval was obtained. Patients admitted to the hospital with a confirmed diagnosis of SARS-CoV-2 who were on O2 support and minimum duration of hospital stay>7 days were recruited for the study. Balance impairment was assessed using Tinette POMA and the obtained data was analyzed. Analysis: DescriptiveResults: A total of (n=130) patients were identified, 54 patients were at risk of falls, 36 were at high risk and 18 were at moderate risk of fall. In the results, there is a significant balance impairment in O2 dependent SARS-CoV-2 survivors. Conclusion: Balance Assessment should be included in SARS-CoV-2 survivors so that a tailored exercise prescription can be formulated that will not only enhance their functional activities but also reduce the risk of falls and may prevent further complications. Implications: Balance Assessment will help to identify the patient who are at high risk of falls and effective rehabilitation can be planned. Early detection of fall risk through balance assessment paves way for targeted, integrated intervention through a tailored exercise program based on the findings thus, reducing the burden of the patient and healthcare system in general.
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Physiotherapy in Neurological Conditions: AB No: 168: Effect of Moon Salutations on Balance and Flexibility in Young Adults – A Pilot Study p. 69
Mayuri Khatavkar, Pothiraj P, Vrushali Panhale
Purpose: Moon Salutations have been introduced in late 20th century which said to have effects on Ida Naadi and has a predominant effect on parasympathetic nervous system & it was assessed the effects of moon salutations on anxiety and aggression in adolescents and premenstrual syndrome. Extensive positions involved in this are likely to have effect on flexibility and balance. Thus, this aims at to find out and assess the effect of moon salutations on balance and flexibility in young adultsRelevance: This study put forth a protocol which can be used to improve balance and flexibility as a part of regular physical activity & focusing on activation of parasympathetic system. Methods/Procedure: By purposive sampling technique, 42 participants in the age group of 18–30 years were screened. Those currently having any musculoskeletal and cardiorespiratory impairments were excluded. 15 participants were finally enrolled for the study and their informed consent was obtained. Demographic data was recorded and baseline assessment in the form of Y-balance test and Sit & reach test (SRT) was taken. Moon Salutation protocol that consists of 28 positions was explained to participants and carried out for thrice a week for 4 weeks via online platform. After 4 weeks, post intervention assessment was taken. Analysis: Data was subjected to normality test and Wilcoxon test was taken for further within group analysis via SPSS software. Result: All parameters for Y balance test were improved. Pre and post interventional mean (SD) for SRT were 14.8(+5.4) and 22.9(+7.1) respectively. Statistically significance was seen in parameters of both outcome measures with p value less than 0.001. Conclusion: This study demonstrates positive effect of Moon Salutations in improving balance and flexibility in young adults. Implications: This protocol can be implicated in health promotional physical activities as a regular practice in young adults so as to help to improve flexibility and balance.
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Physiotherapy in Neurological Conditions: AB No: 150: Effect of bioenergy LASER along with activity-based therapy and surface spinal stimulation in sub-acute cervical compressive myelopathy in middle-aged population: A Randomised Controlled Trial p. 69
Sharanjeet Kaur, Narkeesh Arumugam
Background: The term “Myelopathy” is included under the broad umbrella of non-traumatic spinal cord injuries together with vascular, inflammatory, neoplastic and congenital (Badhiwal et al., 2020). It is the static compression of the thecal sac, due to narrowing of spinal canal that leads to a decrease in blood flow to neural parenchyma and neural degeneration in the cervical region (Fehling et al., 2017). It is a special form of non-traumatic spinal cord injury (Wang et al., 2018). Study Design: A Randomized Controlled Trial. Purpose of the Study: To study the combined effect of Bio-energy Laser along with Surface Spinal Stimulation and Activity-Based therapy in Sub-acute Cervical Compressive Myelopathy in middle-aged population. Methodology: Nature of the study-Two group, Experimental design. Assessments were taken at Day 0, Day 7 and Day 15 for all the participants of both the groups. Study Participants- Individuals within 20–65 years of age-group diagnosed with CCM. Study Settings- Neuroots-, Patiala. Sampling Method- Purposive Sampling. Sample Size- Total 20 Individuals with thecal sac compression at cervical region were included in the study. Each group has 10 participants. Randomization- The computer generated random sampling method Interventions- Experimental group received Bio-energy Laser at lesion site of 1500 joules at 5 watts,SSS at 20–40 Hz modulated at 2500 Hz frequency and ABT for 30 minutes for 5 Sessions/week for 3 weeks. The control group received SSS for 20 minutes and ABT for same duration. Outcome Measures- Hoffmann’s-reflex, Modified- Clinical Testing for Sensory Integration and Balance (m-CTSIB), Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) And Neck Disability Index (NDI). Conclusion: There are significant changes in the outcome measures of the study and significant improvement in functional status the individuals with CCM. This protocol might reactivate the central pattern generator (CPG) that influence the previously silent spared neural circuits or promote plasticity.
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Physiotherapy in Neurological Conditions: AB No: 153: Effect of Integrated Approach in Feeding Difficulties in Children with Developmental Delay: Case Series p. 70
Madhulika Sethiya, Narkeesh Arumugam
Background: Feeding difficulty is an umbrella term that comprises of all feeding problems, leading to substantial consequences especially in GDD children. As, persistent feeding difficulty will lead to nutritional deficiency and may aid to lack of activeness & hamper bodily growth of a child so an integrated approach towards better management of such children will be of great benefit. Purpose: Purpose of this paper is to present an integrated approach towards assessment & management of children with feeding difficulties in GDD (Global developmental delay). Participants: Ten GDD kids with 1–3 years of age group have been taken, ruling out any specific feeding disorder. Methods: Total twenty kids (age group 1 to 3 years) were examined out of which 12 were selected for the present study, in between two kids dropped out, so total 10 kids were taken for the present study. Participant’s parents are asked to answer several question using PediEAT (PEDIATRIC EATING ASSESSMENT TOOL). Various parameters i.e., physiologic symptoms, problematic mealtime behaviour, selective/restrictive eating and oral processing were measured on PediEAT scale. Data was collected and analysed using SPSS version 16 at 0.05 level of significance. Implications: As a pediatric physiotherapist dealing with kids require a wide vision that looks into the problem as a whole & uses a management strategy that integrates all the aspect of development (In relation to feeding). Result: The 10 children with age 1–3 years were analysed using Wilcoxon’s test and found to have significant difference between PRE and POST values of PediEAT scale with p value of 0.005 having Mean difference and SD of 304.5 and 35.86 respectively. Conclusion: The study concludes that integrated approach (using oromotor therapy, cranial osteopathy, tapping, sensory play, body alignment, rainbow food in diet, parental counselling & use of assistive devices) proved to be highly significant in GDD children with feeding difficulties.
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Physiotherapy in Health, Physical activity, fitness, Education & Rehabilitation: AB No: 161: Identification of Graduate Attributes and Core Competencies for an Indian Physiotherapist: A Modified Delphi Survey p. 70
Gaurang Baxi, Tushar Palekar, Seema Saini, Sudhir Jadhav
Purpose: Physiotherapy Curriculum across Universities articulate knowledge and skills for a Physiotherapist. Generic skills like professionalism, communication skills, leadership, are not formally taught. This project was undertaken to identify the graduate attributes and competencies required of a physiotherapist in the Indian context, through National consensus. Participants: 174 Clinicians and Academicians with more than 5 years’ experience were contacted for round 1 of Delphi. There was a rich heterogeneity in geographical distribution, educational qualification, professional profile, designation and experience of experts. 20 experts were invited for personal interviews in second round. Methods: This was a modified Delphi survey. SURGE guidelines for reporting surveys were followed. 46 competencies classified under 10 categories were identified from regulatory bodies of USA, Canada, New Zealand and Australia. Through a google form, respondents rated all 46 items on a 10-point scale for their suitability for an Indian Physiotherapist. Response rate was 79%. Analysis: Exploratory Factor Analysis was performed. Extraction Method used was Principal Component Analysis, Rotation Method used was Varimax with Kaiser Normalization. Three rounds of Factor Analysis were done for identifying and removing redundant items. Results: After three rounds, Rotation converged in 7 iterations, the number of items reduced to 36. In the round 2 of Delphi process, experts deliberated on appropriate titles for these seven categories, proposed as the Graduate Attributes for an Indian Physiotherapist. The 36 items grouped under the seven graduate attributes were the proposed Core Competencies. Conclusion and Implications: Regulatory Bodies and Universities can structure Physiotherapy curriculum and teaching learning around these Graduate Attributes and Core Competencies. Learning of these should begin early in students’ learning programmes. This will help ensure more competent physiotherapists are produced who are more fit to practice in the society and ready to accept all challenges, beyond the scope of academic knowledge and skills. Acknowledgement: This project was funded by the Society of Indian Physiotherapists.
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Physiotherapy in Health, Physical activity, fitness, Education & Rehabilitation: AB No: 83: What is the Scope of Physiotherapy in Research Grants for PhD in India? p. 71
Jharbade Meenakshi, R. Sivakumar, V. Shankar, Solomon John
Introduction: Research grants play a crucial role in conducting research efficiently and successfully in today’s era. High quality research foundation and adding new knowledge to specific science fields is dependent on implementation of research which requires monetary support. Research in Physiotherapy is an emerging field which is contributing scientific knowledge to patient related outcomes in rehabilitation. But there is a lack of research grants available for Physiotherapy subject for doing PhD which hinders the research pathway. Aim: To find out the major funding agencies in India which provide research grants applicable for research in Physiotherapy. Methodology: Search was conducted on Google and specific source websites for retrieving the information for research grants. Keywords used are Research grants, Fellowships, Physiotherapy, India. Results: Few major funding agencies for research in Health and Medical sciences are Indian council of Medical Research and University Grant Commission National Eligibility Test – Junior Research Fellowship, Department of Science and Technology Inspire fellowship programme, Maulana Azad National fellowship, National Research foundation. Discussion: Physiotherapy is not included as a core subject in any major schemes of fellowships in India. Oppurtunities for conducting researches in Physiotherapy is dependent on applying for allied health science subjects. So, there is a need of Physiotherapy subject specific grant to encourage the young scholars for clinical research.
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Physiotherapy in Health, Physical activity, fitness, Education & Rehabilitation: AB No: 170: Knowledge, Attitude and Practice of Pain Neuroscience Education Among Physiotherapists: A Cross Sectional Survey p. 71
Anand Heggannavar, Shreya Deshmukh
Purpose: To determine the Knowledge, attitude and Practice of Pain Neuroscience Education among physiotherapists through a questionnaire based survey. Relevance: A significant population in India suffers from chronic pain and it is one of the commonest symptoms managed by physiotherapists. Pain neuroscience education has been found to be effective in pain management when included in a multimodal treatment. A number of misconceptions about this concept are prevailing. Participants: Qualified practicing physiotherapists and physiotherapy academicians in India. Methods: A cross-sectional study was conducted among physiotherapists across India. Data was collected using an online self-reported questionnaire constructed on Google Forms Application. The link of the questionnaire was circulated among the physiotherapists via various social media platforms. Analysis: Percentage analysis of the responses was done using MS excel. Results: 411 responses were subjected to statistical analysis. Only 50% of the respondents were aware of the term pain neuroscience education. Most of the questions in the knowledge domain received correct responses from more than 50% respondents. Most of the respondents have a negative attitude towards Pain Neuroscience Education. There is poor practice of Pain neuroscience education among physiotherapists in India. Conclusion: There is lack of awareness about pain neuroscience education among physiotherapists in India. Physiotherapists having good knowledge about pain neuroscience, don’t have a positive attitude towards it and show poor practice. Implication: Awareness about pain neuroscience education should increase among physiotherapists which can be done by including it in the syllabus of physiotherapy students and conducting workshops.
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Physiotherapy in Musculoskeletal and Sports conditions: AB No: 127: Restricted Lumbar Range of Motion- Can it be a predictor of Early Lumbar Injury in adolescent Cricketers? p. 72
Sinduja Dochibatla, Geethasudha Umapathy
Purpose: The lumbar spine is subjected to considerable stress and varied degree of motion during multiple actions (bowling, batting, and fielding) in cricket. The purpose of this study was to identify if restricted lumbar range of motion, can be a predictive of development of lumbar injury. Relevance: Lumbar spine ROM is the most under looked component in athletes, as major focus is seldom on strength and muscular endurance. Studies suggest significant issues in cricketers are commonly seen due reduced lumbar spine mobility/range leading to compensations on musculo-fascial systems causing increased lumbar loads and abnormal biomechanics. Participants: 30 adolescent cricketers with mean age of group of 14.75 ±2.55 attending centre for sports sciences, Chennai with and without history of LBA participated in the study. All the participants provided consents. Methods: A comprehensive musculoskeletal screening was conducted for 2 consecutive days where the lumbar ranges flexion, extension, lateral flexion and thoraco-lumbar rotation were recorded using a baseline bubble inclinometer. A pre-participatory injury surveillance questionnaire was administered prior to the assessment. Analysis: The ratios of lumbar ROM data was extracted and analysed using SPSS software to its mean values and interpreted with the normative values of lumbar ROM. Results: Upon data extractions significant reductions were noted in side flexion> thoraco lumbar rotation than lumbar extension/flexion with their SMD 19.48±6.6(R), 18±5.07(L), 22.9±5.86(R), 20.48±6.32(L), 21.38±6.49, 44.41±6.92 respectively of notable difference from normative ranges and 5/30 players reported previous histories of LBA. Conclusion: In summary, the study concludes that 24/30 participants presented with restricted lumbar side flexion and thoraco-lumbar rotations which can be associated to predict the development of lumbar injury, as most of injuries in cricket (bowling) seldom occur as a result of abnormal force productions due to restrictions in side flexion and thoracic rotation contributing to stress fractures and other spinal injuries. Future research should aim to co-relate restricted LROM to lumbar injury qualitatively and quantitatively as cohort
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Physiotherapy in Musculoskeletal and Sports conditions: AB No: 70: Association of Musculoskeletal Pain, Body Part and Posture with Use of Various Electronic Devices in Students of Age 14–18 Years-A Cross Sectional Study p. 72
Shukra Chivate, Ruchita Jamnani, Rutuja Balolia, Kaustubh Jadhav
Purpose: To determine association of musculoskeletal pain, body part and posture due to the use of various electronic devices in higher secondary school students. Relevance: The present situation of COVID-19 has show increased use of electronic devices for studies in students’ life. Children using gadgets for long duration attain improper posture which are associated with musculoskeletal disorders. Participants: High school students of age between 14–18 years with a minimum use of electronic devices for 6 months. Methods: An observational study design was conducted at various schools in Belagavi city for a sample of 388 students. Data collection was based on an E-form (Google form) which included informed consents, informed assents and assessment tool Adolescent pediatric pain tool (APPT). Analysis: Standard descriptive statistics were used for the data, frequency tables and percentage analysis for categorical variables. Pearson Correlation test were used. Result: The results of study showed that pain in the right and left knee was associated with use of television and significantly corelated to assumption of certain positions. Neck pain was associated with the use of laptops and assuming particular positions. The duration of time spent using an electronic device and the severity of pain were found to have a strong positive correlation. Conclusion: There is significant association present between pain, body part and posture due to the use of electronic device in students of age 14–18 years. Implications: The knowledge about the improper posture and its musculoskeletal consequences can help minimize and prevent further complications associated with it by ergonomic advice.
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Physiotherapy in Musculoskeletal and Sports conditions: AB No: 180: Effects of Static versus Dynamic Myofascial Decompression on Gastrosoleus Muscle Power and Latent Trigger Point Pain p. 73
Gaurang Baxi, Keerthana R, Divya Gohil, Tushar Palekar
Purpose: Muscle performance is an essential functional component, influenced by physiological, anatomical, psychological and biomechanical factors. It includes flexibility, muscle strength, agility and cardiovascular and aerobic endurance. Treatment approaches like stretching and myofascial decompression help improve flexibility and thereby muscle performance. This study explored the effects of static and dynamic myofascial decompression on gastrosoleus trigger point pain and power. Participants: 105 healthy normal individuals in the age group of 20-30yrs having gastrosoleus latent trigger points volunteered to participate in the study. Methods: The subjects were divided in to three groups by simple random sampling using the chit method. Group A received static myofascial decompression, dynamic stretching and cryotherapy. Group B received dynamic myofascial decompression, dynamic stretching and cryotherapy. Group C received dynamic stretching and cryotherapy. Lower extremity muscle power and functional performance were tested by Vertical jump height. Gastrosoleus muscle’s myofascial trigger point pain sensitivity was measured with a pressure algometer. Analysis: Data was analyzed using SPSS. Difference in the mean Vertical jump height and pain pressure threshold values between the groups were analyzed using one way ANOVA. Intra group analysis was done using Repeated Measures ANOVA. A value of p<0.05 at 95% confidence interval was noted to be statistically significant. Results: Participants in all three groups showed clinical improvement, however the differences in the three groups were not statistically significant. In the dynamic myofascial decompression group a significant (p<0.05) carry-over effect was seen in the vertical jump height test post 5 days of intervention. Conclusions: Static and Dynamic myofascial decompression are equally effective in reducing pain and improving gastrosoleus muscle power in subjects with latent trigger points. A sustained carry over effect was seen in the vertical jump height test in the dynamic myofascial decompression group after 5 days. Implications: Myofacial restrictions affect the muscle power and function. This aspect needs to be kept in mind in rehabilitation.
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Physiotherapy in Musculoskeletal and Sports conditions: AB No: 46: Effect of Low Intensity Transcutaneous Electrical Nerve Stimulation (TENS) on Vastus Medialis Obliques Muscle Activation for Reduction in Pain and Improvement in Function in Patients with Chronic Osteoarthritis of Knee Joint p. 73
Mamta Shetty, Rucha Pradhan
Purpose: Knee osteoarthritis is a leading cause of disability resulting in significant reduction of knee function and quadriceps strength with increase in pain. This study focuses on effects of low intensity TENS with exercises on Vastus medialis obliques muscle activation for osteoarthritis knee versus conventional exercises. Relevance: TENS is known to be an effective modality used to alleviate pain, improve muscle strength, and function. Participants: Study comprised of 38 participants with osteoarthritis knee (19 in each group) between 50–70 years age group as per ACR diagnostic criteria, selected by purposive random sampling. Methodology: Group A received conventional exercises. Group B received TENS on Vastus Medialis Obliques muscle additionally. They were assessed pre intervention, 6th week and 12th week of study using NRS, Modified WOMAC, Bergs Balance Scale and 30 Second Chair Stand TestAnalysis: Data was analyzed using SPSS software (Version 24; USA, 2019) and Shapiro- Wilk test was used to assess normality. Results: Intra group analysis reported reduction in pain (p=0.00) level (on NRS- 63.6% in group A and 39.6% in group B; on WOMAC- 72.4% in group A and 36.6% in group B), increase in function by 56.4% in group A and 33% in group B (p=0.00), and improvement in strength by 35% in group A and 0.2% in group B (p=0.00). No significant improvement was noted on inter group comparison in pain (p= 0.086), function (p= 0.066) and strength (p=0.190) post 12 weeks of intervention. Conclusion: Findings from present study report application of Low Intensity TENS for Vastus Medialis Obliques muscle activation along with exercise versus conventional exercises demonstrated no significant difference on chronic osteoarthritis knee patients for pain, function and strength. Implications: TENS would act as an adjunct to conventional treatment of osteoarthritis in not only chronic stage but also in early stages. It could also be implied to any age group having osteoarthritis
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Physiotherapy in Musculoskeletal and Sports conditions: AB No: 175: Effect of Matrix Rhythm Therapy on Pain and Hand Intrinsic Muscle Strength in Students with Nomophobia p. 74
Tushar Palekar, Sanjana Chakrabarty, Pramod Palekar, Gaurang Baxi
Background and purpose: Matrix Rhythm Therapy (MRT) is a new electrotherapy modality which provides effective treatment for the conditions related to disturbance in the microcirculation. It is effective in pain management as it helps the cells to restore its original frequency between 8-12Hz. In the modern era, smartphone have become a very intrigue part of human life, 74% population uses smartphone worldwide. There is risk of developing various repetitive strain injuries in smartphone users. The aim of this study was to evaluate the effectiveness of Matrix Rhythm Therapy on hand pain in excessive Smartphone users. Methodology: 140 students in age group of 18–25 years were screened on basis of Smartphone Addiction Scale: Short Version to assess the addiction towards smartphone. The participants having the score more than 25/60 were included in the further study which turned out to be 90 students. These participants were told to install My Addictometer application in their smartphone, the participants using their smartphone for more than 3 hours per day were further assessed for hand pain using Cornell Hand Discomfort Questionnaires (CHDQ). 30 participants having hand pain were given MRT for three sessions, spread across one week. MRT was given to lumbricals, thenar and hypothenar muscles. Outcome measures were visual analog scale (VAS) at rest and on activity, pinch strength and grip strength. All outcome measures were assessed pre & post treatment. Results: Results showed significant improvement in VAS on activity and rest (p<0.001), grip strength (p<0.001) and pinch strength (p<0.001) after application of Matrix Rhythm Therapy. Conclusion: From the findings of this study, we can conclude that MRT is effective in reducing hand pain. Also, there is significant improvement in grip and pinch strength in individuals who are using smartphones for more than 3 hours a day.
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Stroke Rehabilitation: AB No: 11: Identifying Post-Stroke Physiotherapy Practice in India using a Delphi approach p. 74
Harpreet Singh, Sampada Jahagirdar, Jaspreet Singh Vij
Background: A competent workforce and a uniform code of practice are cornerstones of good quality healthcare. Knowledge of current practices is a prerequisite for quality of post stroke rehabilitation in India. It is thus, important to address and determine, on a regular basis, the competencies of physiotherapy clinicians delivering post stroke therapy. Purpose: To design a validated questionnaire for determining current physiotherapy practices that are utilized by Indian Physiotherapists involved in post stroke rehabilitation. Relevance: A strong objective evidence on current physiotherapy practices in India can determine the quality of post stroke care, help establish future guidelines and training programs. Participants: Nine expert physiotherapists practicing in the field of stroke rehabilitation pan India, including both clinicians & academicians were selected by convenience samplingMethods: A total of 40 practice competencies were listed in a questionnaire format by the Authors from the literature. This list was then validated by a panel of expert Neuro-physiotherapists within India using a Delphi process. A minimum of 80% agreement amongst the experts was considered to essential for a competency to be finally included in the survey questionnaire. Analysis: Content validity of the questionnaire was established by Lawshe’s method. Results: Three rounds of Delphi process were necessitated to reach a consensus on the final set of 29 competencies. The competencies were then categorized in ‘Quality of care’, Assessment and treatment’ and ‘updating of knowledge’ domains. Implications: This questionnaire will help evaluate current physiotherapy practices of Indian physiotherapists delivering post-stroke therapy. Based on the knowledge gained through this, uniform practice guidelines can be laid down for improved quality of care in future.
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Stroke Rehabilitation: AB No: 103: Correlation between Functional Independence, Depression Anxiety and Community Integration in subjects with Post Stroke Hemiparesis p. 75
Priya Darji, Shraddha Diwan
Purpose: To correlate functional independence, depression anxiety and community integration in post stroke hemiparesis. Relevance: In subjects with post stroke due to primary and secondary impairments there may be restriction in functional independency also may have depression anxiety and problem in community participation. Hence it is necessary to find out correlation between functional independence, depression anxiety and community integration. Participants: 67 participants from SBB college of physiotherapy, SVP hospital. Post stroke males and females of age 35 to 75 years, both ischemic and haemorrhagic stroke subjects were included and visual auditory deficits subjects were excluded in the study by convenient sampling. Methodology: Cross sectional study was conducted. After taken a consent, fill up the scales by asking questions to the subjects. Functional independence measures scale, Depression, anxiety and stress scale and Community integration questionnaires. Analysis: Data analysis for 15 subjects was done using SPSS version 20 and Microsoft excel 2019. For data screened nonparametric Spearman correlation coefficient test was used. Level of significance kept at 5 %. Results: Results show that there is moderate negative correlation between FIM and DASS (r = -0.571, r = < 0.05) moderate positive correlation between FIM and CIQ (r = 0.535, r = 0.05) and moderate negative correlation between DASS and CIQ (r = -0.526,r = < 0.05) in subjects with post stroke hemiparesis. Conclusion: functional independence measures (FIM) is positively correlate with community integration (CIQ) and negatively correlate with depression anxiety (DASS) and depression anxiety (DASS) is negatively correlate with community integration (CIQ).
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Stroke Rehabilitation: AB No: 176: Influence of Information Processing Speed (IPS) on Gait Asymmetry in Unilateral Stroke Survivors p. 75
Ananya Rakesh Sharma, Ramesh Debur Visweswara, Aditi Bhandarkar
Purpose: Gait abnormalities are a prevalent dysfunction in stroke patients. Even post-rehabilitation more than half of them experience gait asymmetry. It is often a result of slow and insufficient activation of muscle on the hemiplegic side. Gait abnormalities are also seen as a sequel to cognitive impairment. One of the most severe cognitive impairments in stroke patients is the decline in Information Processing Speed/Time (IPS). Processing speed decline has been seen to influence gait parameters in various populations. The neural correlates of gait and processing speed are interlinked. The study would test the hypothesis if increased IPS of the affected hemisphere influences gait asymmetry. Thus the study aims to measure the processing speed deficit of the affected side, and secondly to assess if it influences gait asymmetry. Relevance: To assess if gait asymmetry in stroke patients is a function of cognitive processing. Participants: 23 left hemispheric stroke patients. Methods: Visual Reaction Time (VRT) was taken to measure IPS. Gait (Stride velocity and step time) was assessed through GaitRite. Analysis: Spearman Correlation was performed between VRT variable and Gait variables. Results: Affected hemisphere was 337milliseconds slower. VRT had negligible correlation (r=0.106, 0.631) with asymmetry. High-moderate correlation (r=0.661, 0.001; r=-0.514, 0.01) with unaffected velocity and step time and weak-negligible(r=0.473, 0.02; r=0.067, 0.7) correlation with affected side. Conclusion: Stroke patients suffer from increased processing time of the affected side. The increased processing time doesn’t influence the gait asymmetry, although processing of the unaffected hemisphere does influence the gait. Implications: Improving processing time might not reduce gait asymmetry. Further studies are required to understand the relationship between lateralization of IPS and gait retraining.
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Stroke Rehabilitation: AB No: 124: Do Kinematic variables have an added advantage over clinical variables in Predicting Upper Extremity Motor Recovery Post-Stroke? p. 76
Sanjukta Sardesai, John M Solomon, Elton Nazareth, Senthil D Kumaran
Purpose: Measurement of movement quality is essential to distinguish motor recovery patterns and optimize rehabilitation strategies post-stroke. The purpose of this study was to assess the added advantage of kinematic over clinical measures for predicting post-stroke upper extremity (UE) recovery by developing a regression model comprising of bothRelevance: Meticulously formulated prognostic models could be used by rehabilitation specialists for improving prediction accuracy in stroke survivorsParticipants: This study comprises of 89 acute to early sub-acute stroke survivors (58.8 ± 11.8 years, 61 males)Methods: Baseline characteristics, demographics, grip and pinch strength were measured within 7 days and 3D kinematic analysis of a simulated drinking task was performed within 1-month post-stroke. The sensorimotor impairment through Fugl Meyer Assessment of Upper Extremity (FM-UE) was assessed at 3-months. Kinematic metrics of time, displacement, velocity, shoulder and elbow angles and reaction time were determined. Results: Clinical variables were available for 89 participants by 7 days and kinematic for 50 individuals at 1 month. A strong correlation was found between FM-UE at three months with Shoulder Abduction Finger Extension (r=0.84), Nottingham Sensory Assessment (r=0.84), Motricity index (r=0.82), National Institutes of Health Stroke Scale (r=0.75), and moderate with pinch (r=0.69) and grip strength (r=0.62) measured within 7 days post-stroke. We found a weak correlation between FM-UE at 3 months with velocity (r=0.53), time (r= -0.43) and displacement (r=0.38). However, on combining clinical and kinematic variables the linear regression model was found to have an R2 value of 0.85. Conclusion: This model would help us predict impairment at 3 months for 85% stroke survivors with similar characteristics. However, kinematic variables should be used as an adjunct to clinical variables in order to comprehensively predict UE recovery in stroke survivors. Implications: Predicting the amount of post-stroke recovery would enable us in realistic goal formation and for planning rehabilitation to improve recovery potential.
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Stroke Rehabilitation: AB No: 148: Therapeutic effect of Multi-target non-invasive Cortical Stimulation on Cognitive, Motor Domains and Gait in Sub acute Stroke Survivors- Case Series p. 76
Divya Midha, Narkeesh Arumugam
Background: The optimum recovery in a stroke individual cannot be expected by ignoring the impact of simultaneous cognitive deficits. Identification of involved networks in a patient-specific context along with the deeper understanding of interconnected neuronal network may yield better outcomes when applied with conventional rehabilitation. Aim: Therapeutic effect of multitarget cortical stimulation on cognitive domains, motor functions of paretic hand and gait in subacute stroke survivors. Methodology: Study was randomized sham controlled, parallel Groups trial registered with the clinical trial registry of India (CTRI/2020/01/022998). A total of 06 Sub- acute Stroke patients were randomly allocated to both the groups. Intervention: Experimental group participants received Multichannel Transcranial Direct current stimulation (M-tDCS) over the primary motor cortex i.e. C3/C4 point and dorsolateral prefrontal cortex i.e. F3/f4 point with 1.2 mA intensity for 20 minutes. SaeboFlex-assisted training, functional electrical stimulation over the lower extremity and conventional physiotherapy rehabilitation for 5 sessions/week for total 4 weeks. Control group received sham M-tDCS in which stimulation was ramped off to zero after 30 seconds of stimulation. Outcome Measures.EEG Fugl-Meyer assessment scale for the upper and lower extremity, Wisconsin Gait Scale and the Stroke Specific Quality of Life measures. Assessment was taken at Day 0, 15 and 30 post interventions. Results: Experimental group: Mean and Standard deviation scores FMA-UE varied from 67.00±5.56 to 93.00±2.64. FMA-LE from 57.00±10.14 to 74.67±12.66. NHPT from 257.33±48.38 to 167.33±41.48, WGS from 38.41±2.63 to 30.98±1.51, SSQOL from 87.00±12.53 to 136.00±12.66 on Day 0 and Day 30 respectively. Control Group scores FMA-UE varied from 77.66±11.50 to 108.00±4.00, FMA-LE from 66.33±4.50 to 82.33±7.09, NHPT from 178.00±9.16 to 152.00±3.46, WGS from 34.78±4.27 to 28.08±1.51, SSQOL from 105.30±6.11 to 159.67±16.8. Conclusion: Application of M-tDCS induced improvements in motor functions of the UE and LE, gait parameters with significant improvement in overall quality of life.
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Physiotherapy in medical conditions, Gynaecological conditions, sleep and cardio-respiratory conditions: AB No: 159: Development and Validation of a Screening Tool to Determine the Prevalence of Urban Women Predisposed to Poly Cystic Ovary Syndrome (PCOS) p. 77
Jeyanthi S, Raju K Parasher
Background/Relevance: Poly Cystic Ovarian Syndrome (PCOS) is one of the most common reproductive endocrinological disorder with broad spectrum of clinical manifestations. In order to address the problem of PCOS it is imperative that we first identify the women that are predisposed to develop PCOS. Aim: To develop and establish content validity of the newly designed self-report questionnaire to identify women with predisposition to polycystic ovary syndrome, also to establish item-reliability (internal consistency) of the self-report Questionnaire. Participants: The content validity was established with a panel of eleven (11) experts. The experts were Gynaecologist, who had minimum of three years of experience in clinical practice/academic experience. The item-reliability was established with hundred (100) healthy females within age group 15–40 years. Materials and methods: The draft questionnaire were formulated by the investigator after extensive literature review and through in depth qualitative interviews. The identified domains were General Health Practices, Menstrual history, Clinical signs of hyperandrogenism, Sleep profile, Physical Activity Profile, Psychological profile, Nutrition / Dietary Profile, sexual function, social function, Perceived Stress. Content validity of the questionnaire was established through Delphi procedure. Then the questionnaire was administered to establish item-reliability. Statistical analysis: The content validity ratio (CVR) was calculated for each item based on the responses of the experts with Lawshe table. The Chronbach’s alpha was calculated for item-reliability by using Microsoft Excel 2010. Results: The domain wise CVR was between 0.85 to 1. Content Validity Index (CVI) was 0.84, which suggest the questionnaire has excellent validity. The Chronbach’s alpha (ICC) was 0.85, which suggest that the questionnaire has very good item-reliabilityConclusion: The questionnaire can be used as an effective valid and reliable tool to identify women with predisposition to PCOS. Implication: This screening tool will create awareness and reduce the prevalence of this reproductive age disorder. Hence, prevent early and late sequel of the syndrome.
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Physiotherapy in medical conditions, Gynaecological conditions, sleep and cardio-respiratory conditions: AB No: 68: Functional Disability in patients after Chikungunya – An Observational Study p. 78
Rachana Pandya, Megha Sheth
Purpose: To assess the functional disability due to pain in the upper and lower limbs in patients after chikungunya. Relevance: Patients with chikungunya fever have involvement of the both small and large joints of upper and lower limbs. After chikungunya, patients have difficulty in doing essential activities in daily life. So, there is a need to assess the severity of functional problems in these patients. Participants: 87 patients, males and females aged 18–65 years, diagnosed with chikungunya fever within last 3 months were included using convenience sampling. Patients with known and severe musculoskeletal conditions, cardio-respiratory conditions, systemic conditions, neurological conditions, and malignancy were excluded. Methodology: An observational study was conducted at SBB college of physiotherapy. To assess disability for upper limb DASH (Disability of Arm, Shoulder & Hand) was used and LEFS (Lower Extremity Functional Scale) was used for assessing function of lower limbs. Pain was assessed as mild, moderate or severe. The participants were explained the study and were asked to fill up the two scales. Analysis: Data was computed on Google spreadsheets and descriptive analysis was done. Result: Mean age of participants was 43.22±14.16 years. 63.2% were females and 36.8% were males. 91% people had pain post the fever. Pain intensity was found mild (28.4%), moderate (51.9%) to severe (19.8%). 61% patients have pain and functional problems in upper limb with median (IQR) for DASH score 34.17(28.75). 68% patients have functional problems in lower limb with median (IQR) LEFS score 28(35). Conclusion: After chikungunya fever functional problems are prevalent in upper and lower limbs. The disability scores are high for upper and lower limbs 3 months post chikungunya. Implications: Further studies should be designed for relieving pain and improving function by physiotherapy for patients of chikungunya.
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Physiotherapy in medical conditions, Gynaecological conditions, sleep and cardio-respiratory conditions: AB No: 107: Immediate effect of KAZOO on Lung Function, Rate of Perceived Exertion and Oxygen Saturation in Obese Collegiate Students: A Pre- and Post- Clinical Trial p. 78
Ganesh B.R., Ria Gondhali
Purpose: Previous studies show the use of various wind instruments in respiratory conditions to change and/or affect the lung functions, although a very few studies talk about the use of Kazoo instrument. This study was undertaken to evaluate the short-term effects of Kazoo playing for 5-minutes and its affection on the lung function, perceived physical exertion and oxygen saturation. The study also helps understand if Kazoo playing can be used as an adjunct therapy in relieving dyspnea in patients. Relevance: Obesity is known to affect the lung function, along with the level of perception of exertion in an individual. This study helps find the effect of playing Kazoo in affection to the lung functions and level of exertion. Participants: Twenty- two participants from healthcare universities of all genders in the age group of 18–29 years, of BMI more than or equal to 30kg/m2 were included in the study. Methods: A pre- and post- clinical trial was conducted using convenience sampling. Analysis: Continuous variables are given as means ± SDs and categorical data as percentages. Comparisons were done using Kolmogorov-Smirnov test, of the paired sample t-test, when parametric test assumptions were met, and the Non- Parametric Wilcoxon paired test was used for non-parametric data. Results: Participants showed a significant improvement in Forced Vital Capacity, Forced Expiratory Volume in 1 second and peak expiratory flow rate along with perceived level of exertion on the Modified Borg Scale (p<0.05). However, there is no improvement observed in the values of oxygen saturation (p>0.05). Conclusion: In conclusion, there is a significant positive immediate effect of Kazoo on lung function and rate of perceived exertion in obese collegiate students. Although there is no consistent increase in oxygen saturation after the intervention. Implications: Playing of Kazoo instrument can be a viable option in improving pulmonary functions in obese individuals.
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Physiotherapy in medical conditions, Gynaecological conditions, sleep and cardio-respiratory conditions: AB No: 125: Impact of Nomophobia (NMP) on Insomnia and Physical Activity Levels among Physiotherapy Undergraduate Students p. 79
Tejuvarshini V, Veena Kiran Nambiar, Diana Rodrigues
Purpose: To determine the impact of nomophobia on insomnia and physical activity (PA) levels among physiotherapy undergraduate students. Relevance: We are living through a period where technology is the only connection to normalcy. Reports indicate increased screen time during the COVID-19 pandemic, also due to significant disruption in routine, nocturnal media use has been increased leading to insomnia. As the total screen time increases, users have decreased physical activity, which can lead to sedentarism. Participants: All undergraduate physiotherapy students of Ramaiah Medical College (Department of Physiotherapy), Bengaluru, India were invited to participate in an online survey. 95 participants who gave the consent were enrolled. Methods: Nomophobia- questionnaire (NMP-Q), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Insomnia Severity Index (ISI) were distributed to the participants as Google forms via WhatsApp. The participant was asked to give the best response of his experience. Data collected was subjected to analysis. Analysis: Responses obtained via Google-forms were screened. The data was categorized and analyzed using Google spread- sheet and descriptive statistics using percentage and frequency distribution was performed. Results: 72(75.78%) students were categorized with moderate-severe nomophobia. 25(26.31%) students had moderate-severe nomophobia suffered from clinical insomnia. However, they demonstrated moderate-high PA level. 21(22.10%) students had mild nomophobia with subthreshold insomnia and low PA level. The results demonstrate significant impact of nomophobia on insomnia, however not on PA level among physiotherapy undergraduate students. Conclusion: The burden of nomophobia and impaired control that compromises the health and wellness were prevalent in physiotherapy undergraduate students. Measures need to be taken to address clinical insomnia in view of the current era of growing information technology. Implications: This study will pave a path for the need of exercises to improve the sleep quality and duration of students who have nomophobia.
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Physiotherapy in Musculoskeletal conditions: AB No: 8: Effectiveness of Holistic approach an Osteo-Fascial Remodeling in adolescent Idiopathic Scoliosis – Single Case Study p. 79
Diksha Saini, Narkeesh Arumugam
Purpose: To evaluate the efficacy of holistic approach formed by Schroth exercises along with soft tissue elongation and Matrix Rhythm Therapy (MRT) in treatment of AIS (Adolescent Idiopathic Scoliosis). Relevance: Integration of corrective exercises and soft tissue elongation methods might lead to reversal of underlying pathological osteo-fascial derangements in idiopathic scoliosis. Participants: A 13 years old female with left thoracolumbar scoliosis of idiopathic nature. Methods: Nature of the Study: A case-report. A single scoliotic curve extending from T1 to L4 was seen on X-ray with a Cobb’s angle measurement of 25.24°. Static EMG (sEMG) of paraspinal musculature was carried out. Holistic treatment comprising myofascial release directed to the identified shortened musculature along with MRT was administered twice daily for 4 days. This was combined with home exercise program designed on Schroth’s approach. The exercises were aimed at active correction of thoracolumbar concavo-convex regions, ribcage rotation and asymmetries of shoulder and pelvis, along with rotational breathing. Outcome Measures: Cobb’s angle, sEMG using Myovision. Results: Repeat radiograph after 5 months of regular exercises revealed significant improvement in lateral curvature with reduction of Cobb’s angle from 25.24° to 14.46°. A considerable improvement in level of shoulders was also observed. sEMG re-test reflected rise in stress score from 508 to 763 microvolt ascribable to activation of electromyographically silent and weak musculature with retrieval of nearly symmetrical paraspinal muscle activation. Conclusion: Holistic approach of scoliosis correction might expedite rectification of muscle imbalance by activating electromyographically silent musculature along with lengthening of shortened muscles hence correcting scoliotic spine deviations in all the three planes. Implications: Holistic treatment of scoliotic deviations indeed contribute to enhance osteo-fascial remodeling of curvatures with resolution of potentially etiological muscle imbalances.
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Physiotherapy in Musculoskeletal conditions: AB No: 12: Clinical Tests used to measure Positional Faults of the Shoulder Girdle: A Reliability Study p. 80
Neeraj Singh, Pragya Kumar, Raju Parashar
Purpose: Sustained, repetitive, prehensile activities that require precision and stability, necessitate a sustained static shoulder girdle posture over long periods of time, which can results in abnormal activation of the shoulder girdle musculature and consequent scapular misalignments. Relevance: This study was to establish test-retest and inter tester reliability of six clinical tests commonly used to measure parameters related to shoulder girdle positional faults and or asymmetries. Participants: A convenience sample of 50 healthy 18–25-year-old, male college students were evaluated on the following tests: Pectoralis minor index, Lateral scapular slide test, Posterior capsular tightness, Forward shoulder posture, cervical range of motion and shoulder muscle Isometric strength. Methods: Participants were tested twice one week apart by one tester for test- retest reliability and for inter-rater reliability four testers measured participants on each test independently. Analysis: Intra class correlations (ICC) were calculated across trials (test-retest) and across testers (inter-rater) in a repeated measure ANOVA. Result: Test-retest ICC for forward shoulder posture was 0.998, while the inter-rater reliability was 0.628. Cervical range of motion test-retest reliability ranged from 0.987 to 0.999, while inter-rater reliability was 0.281 to 0.619. Test-retest reliability values for isometric shoulder strength were excellent (0.986–0.997), however the inter-tester values were in the poor range (0.31–0.34). Test-retest ICC values for Pectoralis minor index (0.982 to 0.984), Lateral scapular slide test (0.997- 0.969) and Posterior Capsular Tightness (0.967 to 0.974) were found to be excellent but Inter-rater and reliability values were in the poor to moderate range. Conclusion: Clinical tests used to measure parameters relevant to shoulder girdle positional faults and or asymmetries met the criteria for excellent test-retest reliability by one tester. Implications: It is thus recommended that these tests can be reliable used by a single tester over several trials.
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Physiotherapy in Musculoskeletal conditions: AB No: 28: Study on Correlation 0f upper quarter Y Balance Test with Shoulder Range of Motion and Core Strength among Young Cricketers p. 80
Venippriya Neelakandan
Background: Upper extremity closed kinetic chain exercise has been a common place in most rehabilitation program. Despite of it, there is no clear universally accepted clinical testing tool. A well-designed assessment should gauge dynamic unit in sports and activities of daily living. Because of the limited knowledge regarding UQYBT. The study aims to analyze the impact and effect of shoulder range of motion and core strength in UQYBT. Objective: The primary purpose of the study is to determine the relationship between upper quarter Y balance test to the other component such as posterior capsule tightness, shoulder range of motion, core strength and impact of hand dominance. Method: A sample of 30 young cricketers from MSD academy at Chennai performed the upper quarter y balance test and 7 auxiliary tests. Each subject performed 3 trials. Best of 3 is taken for the calculation. The relationship between the auxiliary test and upper quarter y balance test were analyzed. The difference between the dominant and non-dominant hand functioning were calculated. Result: Thirty subject (29 male and 1 female) with the mean age of 14.75±2.597 completed the test. One participant data was excluded from analysis as he had previous history of injury. Collected data were statistically analyzed using Pearson’s correlation test. Conclusion: A significant moderate correlation was present between the UQYBT and core stability (P < 0.05). no significant correlation between the shoulder range of motion and UQYBT. Discussion: The study does not provide significant ground to prove the reliability of the test. And there only moderate correlation found between UQYBT and core strength. Smaller size of sample is one of the major factors for the discrepancy. Further research with large sample is needed to determine the relevance of UQYBT. Level of evidence: 2b
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Physiotherapy in Musculoskeletal conditions: AB No: 87: Influence of Different Walking Surfaces (Soft, Cement, Tar, Grass, Mixed) on Symptoms and Functional Disability Assessed Using CRD WOMAC in Knee Osteoarthritis Patients Wearing Sport Shoes of Age 55–75 Years: An Observational- Cross Sectional Study p. 81
Pooja Patil, Namrata Bhadbhade
Aim: To estimate the influence of different walking surfaces (soft, cement, tar, grass, mixed) on symptoms and functional disability assessed using CRD Western Ontario and McMaster osteoarthritis index (WOMAC) in knee osteoarthritis patients wearing sport shoes of age 55–75 years. Objectives: This observational- cross sectional study estimated the influence of different walking surface on symptoms and functional disability assessed using CRD Western Ontario and McMaster osteoarthritis index (WOMAC) in knee osteoarthritis patients wearing sport shoes of age 55–75 years. Method: 158 participants were selected according to the inclusion criteria. Inclusion of hill climbing in the walking exercise, past medical history, addiction histories along with shoe characteristics measurements such as heel height and collar height were taken. General instructions regarding self-administration of CRD WOMAC were given and CRD WOMAC was filled by each participant in their respective language. (English, Marathi, Hindi)Results: After analysis it was observed that almost 50% of the study population walked on major hard surface, followed by about 25% using major soft surfaces. Only few used tar surface. CRD WOMAC scores were higher for harder surfaces as compared to those when the surface was softer. The difference was statistically significant (F = 89.674, p<0.0001).Average CRD WOMAC score was higher (48.15 ± 1.493) among those who did hill climbing as compared to those who did not (37.27 ± 0.698). Heel height (r=0.05, p= 0.488) and collar height (r= 0.054, p= 0.054) were not significantly correlated with CRD WOMAC score. Conclusion: The present study indicates that major hard walking surfaces have the highest influence on the symptoms and functional disability followed by tar, major soft, soft and least on grass surface. Inclusion of hill climbing influences symptoms and functional disability but heel height and collar height does not have any influence on OA knee patients.
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Physiotherapy in Neurological conditions: AB No: 66: Knowledge, Attitude and Practice of Parent towards Prevention of COVID-19 in Children with Special Needs: A Cross Sectional Study p. 82
Vinuta Deshpande, Sweety Agarwal, Shweta Ukkojikar, Shriya Kale
Purpose: To assess the knowledge, attitude and practice of parents towards prevention of COVID-19 in children with special needs. Relevance: The coronavirus disease 2019 (COVID-19) has had a rapid global spread. Children with special need are more susceptible to viral infection. Participants: All parents of children with special needs visiting Paediatric Department in tertiary care hospital, Belgavi. Method: An institution based study for sample of 450 participants. Data collection was based on direct interview using a structured questionnaire consisting Knowledge (10 questions), attitude (6 questions), and practice (5 questions). Analysis: Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result: Almost all the participant (100%) knew about the present scenario of COVID-19. Majority of the participants were about how COVID-19 spreads and its preventive measures. Most of the parents (72.4%) knew that the children with special needs are more risk of infection. Almost all of the participants (95.8%) knew that their child must wear a mask in public places. Most of the participants (64.9%) did not know that mask should not be worn by children less than two years. Almost 242 parents practiced the all preventive measures for COVID-19. Conclusion: The parents of children with special needs have good knowledge, attitude and practice regarding the prevention of COVID-19 in children with special needs. Implication: Knowledge, attitude and practice of parents will help control epidemic in children.
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Physiotherapy in Neurological conditions: AB No: 81: Tele-rehabilitation program for Balance and Coordination training in Cerebral Palsy Children: A Pilot Study p. 82
Deepa Metgud, Akshata Tadvalkar
Purpose: To evaluate the effect of tele-rehabilitation on balance and coordination training in cerebral palsy children. Relevance: COVID-19 pandemic had significant impact on children with disability due to prolonged confinement at home which influenced negative physical status of children. Tele-rehabilitation can play a major role in the maintenance of function, prevention of worsening disability, and follow up of patient. It can proves beneficial to the family by decreasing time and costs related to travelling, family centered service, home based model of delivery of care which leads to being less prone to infection. Participants: 9 Children with cerebral palsy in the age group of 6–12 years with GMFCS level I and II were recruited from the paediatric out-patient department and child developmental centre of a tertiary care hospital and special schools in Belagavi. Methods: In this pre-post pilot study, pre-treatment and post-treatment outcomes were taken by using balance and bilateral coordination subtest of Bruininks Oseretsky Test of motor proficiency 2 (BOT2). The physiotherapy treatment consisted of conventional balance training exercise via tele-rehabilitation through Whats App video call. The intervention was carried out thrice a week for 4 weeks for one hour which was monitored by the therapist and assistance was provided by the parent. Statistical Analysis: The data was analysed using paired t test. Results: The results indicated a significant improvement in balance (P =0.042) with mean difference-4.25 ± 3.20 and coordination with mean difference-4.25 ± 1.50 (P=0.011). Conclusion: This study showed that tele-rehabilitation as a mode of treatment for children with cerebral palsy is useful for training balance and coordination. Implications: Tele-rehabilitation can be considered as an effective mode of delivering rehabilitation for children with cerebral palsy and that the effect must be studied in a larger sample size.
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Physiotherapy in Neurological conditions: AB No: 100: Factors contributing for decreased fine motor skills in Autism Spectrum Disorders p. 83
Rajeswari Muthusamy, Ramachandran Padmanabhan, Binu Ninan, Sailakshmi Ganesan
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Physiotherapy in Neurological conditions: AB No: 108: Effect of Motor Skill training programme through Tele-Rehabilitation versus Home Exercise Program to improve Motor Proficiency in children with Suspected Developmental Coordination Disorder: A Randomized Controlled Trial p. 83
Prachi Mukkannavar, Shukra Chivate
Purpose: To assess the effect of motor skill Training Programme through tele rehabilitation to improve the motor proficiency in children with suspected developmental coordination disorder. Relevance: The execution impairments in suspected DCD leads to associated problems. A meta-analysis in these children found deficient in visual–spatial processing which strongly attributed to clumsy motor performance. Due to pandemic, the on-going rehabilitation of patients have been altered leading to the adaptation of tele-rehabilitation as an alternative and new normal approach. Participants: Age group of children between 05-15 years with Cut-off scores on DCDQ-07 questionnaire: < 47 for 4.6–7.11years, < 56 for 8–9.11 years & < 58 for 10–15 yearsMethods: A total of 30 children were randomly allocated into interventional group (n=15) and control group (n=15). Interventional group received motor skill training programme (MSTP), through tele-rehabilitation for 45–50 minutes per session, three times /week for 6 weeks and control group received demonstration of MSTP as home programme for 45–50 minutes daily for 6 weeks. Motor proficiency for both the groups were measured at baseline and post intervention using BOT-2. Analysis: The between the groups analysis of BOT-2 was done using an independent t-test, within-group analysis was done using a paired t-test. Results: Between group analysis showed significance (p<0.05) in manual coordination (p=0.001) and total motor composite (p=0.005). Conclusion: The motor skill training programme through telerehabilitation significantly improved motor proficiency in suspected developmental coordination disorder. Implications: The study adopted unique mode of delivery of intervention, and found overall improvement in total motor composite score on BOT-2.
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Physiotherapy in Neurological conditions: AB No: 110: Determinants of Motor Development in Infants: A Cross Sectional Study p. 84
Vinuta Deshpande, Deepa Metgud
Purpose: To identify the determinants of motor development in South Indian infants. Relevance: An estimated 63.4 million Indian children under 5 years are at risk of poor development. Early childhood development is fundamentally important phase and is influenced by the stimulus and nurturing. Environment influences, particularly the home environment is considered as the critical factors for optimal growth and development. Participants: Apparently healthy infants between 1 and 11 months residing in Belagavi city. Method: 164 infants were recruited with probability proportional to population size sampling method, as part of larger sample size of 1170. Information on child and family characteristics, home environment and play materials were recorded using a structured questionnaire. Analysis: In a manual stepwise forward procedure, association between each independent variable and outcomes was assessed in unadjusted models. Variables, significant at P < 0.05 were kept in multiple models while non-significant variables were re-introduced one at a time into the multiple models. Result: Gestational age was positively associated, while duration of breast feeding, hospitalization and present weight (-1.17, p= 0.03) had negative association with the fine and total motor quotient respectively. Father’s education (0.0352 coefficient), occupation and income had significant positive effect on total and fine motor quotients respectively. Outside space to play had positive association with fine motor quotient (2.28, p= 0.0154). Conclusion: The research was able to highlight the impact of home environment and early exposure to the play materials on the motor development of infants. Implication: The study findings have significant implications for early identification of multidirectional factors influencing the infant development and propose to implement effective and impact full early childhood intervention in India that would complement existing services and will improve developmental outcomes of Infants.
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Cancer Rehabilitation, Diabetes, Haemodialysis: AB No: 160: A Framework for Cognitive Rehabilitation for Cancer Survivor Reporting Cognitive Deficits: A Systematic Review p. 84
Nidhi Singh, Anchit Gugnani, Raju K. Parasher
Background: Chemotherapy-related mild-to-moderate cognitive decline has been demonstrated to impact over 75% of cancer patients at some point throughout their treatment and recovery. Patient’s quality of life suffers the most after a cancer diagnosis. Exercise routines have been shown to be beneficial to cancer survivors in terms of both physical and psychological benefits. Studies on the impact of physical activity on cancer-related cognitive deficits have a big future for improving the lives of cancer survivors. Purpose: This study helps to aggregate findings from studies that evaluated the effect of exercises on deficits associated with cognitive deficits in cancer survivors. Relevance: The high prevalence of these impairments in cancer survivors suggests that these domains should be assessed addressed to avoid feelings of physical incompetence, inadequacy, depression, frustration, and anxiety in this population, as well as long-term negative effects on their physical and social development. Participants: Cancer survivors with cognitive impairments were studied. Methods: The database literature search was carried out in the PubMed, research gate, Physiotherapy Evidence Database (PEDro), CINHAL, Scopus database, Google Scholar and bibliography for Randomized Control Trials (RCTs) form January 2015 to March 2020. Analysis: Preferred reporting items for systematic reviews (PRISMA) & Physiotherapy Evidence Database (PEDro)Results: 10 randomized control trials were included in our final systematic review with PEDro score >5 with a focus on the effects of physical exercise on cognitive impairments in cancer survivors were evaluated. Conclusion: Increasing physical activity improves cognitive functioning in cancer survivors such as visual-spatial processing, attention, working memory, verbal memory, and memory with no negative side effects reported. Implication: Studies on the impact of physical activity on cancer-related cognitive deficits have a big future for improving the lives of cancer survivors.
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Cancer Rehabilitation, Diabetes, Haemodialysis: AB No: 49: Disability among Patients with Head and Neck Cancer Using ICF-Based Framework: A Cross-Sectional Study p. 85
Aishwarya A, Sundar Kumar V, Aravind Kapali, Palani Ramanathan
Purpose and Relevance: Patients with Head and Neck Cancer (HNC) are known to experience high burden of Disability. However, most disability assessments in the past have used unidimensional approaches focusing on domains such as physical, functional or work-related disability. Though World Health Organization, using ICF framework, developed WHODAS 2.0 as a generic tool for multidimensional assessment of disability in 2010, it has not been commonly used in patients with HNC. Multi-dimensional assessments provide deeper understanding of the problem and subsequent opportunities for appropriate solutions. This study aimed to determine the extent of disability in patients with HNC using WHODAS 2.0. Participants & Methods: Using a cross-sectional design, 70 participants diagnosed with HNC across the cancer care continuum were recruited using convenience sampling from the in-patient and out-patient oncology facility of a large tertiary care hospital. Following informed consent, medicodemographic details were collected using a structured pro forma and WHODAS 2.0 administered by the researcher. Analysis and Results: All 70 participants (age: 55.9±10.3 years; 67% men) were recruited while undergoing their primary cancer therapies and the duration ranged from three to 30 months since diagnosis. The participants reported wide variability in disability (10.8±10.2%; range=58.3%). Maximum disability was seen in mobility domain (24.1%) followed by participation (22.2%), life activities (18.1%), cognition (13.4%), getting along (12.9%) and self-care (9.3%). Conclusion: Disability levels varied across domains and contrary to previous reports, the mean disability was found to be low. Assessing disability during primary cancer therapies rather than after their completion (as done in previous studies) could have contributed to lower levels of disability. This indicates a need for longitudinal studies evaluating multidimensional disability across the cancer care spectrumImplications: Multidimensional disability assessment is needed to provide a person-centric approach for optimal management of disability.
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Cancer Rehabilitation, Diabetes, Haemodialysis: AB No: 152: How active are Indian Chronic Kidney Disease patients undergoing Hemodialysis? p. 85
Sridevi S, Soundarrajan P
Purpose: To find the physical activity level of Indian Chronic Kidney Disease (CKD) patients undergoing hemodialysis. Relevance: Prevalence of CKD has increased to 17% in India as there is an increase in diabetes and hypertension. Patients on hemodialysis experience side effects of dialysis thus reducing their physical activity level. Participants: 200 consented subjects were recruited from dialysis unit of Indian tertiary care hospital. both genders, 40–65 years, minimum dialysis vintage of 6 months were included. Subjects with physical impairment, recent cardiac or neurological event, hemodynamic instability during the last hemodialysis were excluded. Method and Materials: The Physical activity level of CKD patients has been assessed through Human Activity Profile. The HAP is a self-report instrument 94 daily activity items ordered according to metabolic demand; respondents require to indicate which activities they still undertake, those they have stopped doing and those they have never undertaken. Analysis: Of the 200 recruited subjects 65% were male, 35% were female, age 53(9), dialysis vintage 28(21), MAS 57 (11), AAS 50(14), 42% hypertensive,41% were diabetic,17% were diabetic and hypertensive. Results: The mean number of activities done by the participants were 53 and as per previous studies the mean number of activities engaged by normal individuals was 83, thus it shows that the CKD patients on hemodialysis have low physical activity. Women were less active when compared to men. Conclusion: Indian CKD patients undergoing hemodialysis have low physical activity level. Relevance to clinical practice. Physiotherapists should understand the impact of chronic illness on physical activity in this cohort. Physical activity Assessment for this group is mandatory.
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Cancer Rehabilitation, Diabetes, Haemodialysis: AB No: 23: Development, Validation and Establishing Internal Consistency of Knowledge, Attitude, and Barriers towards Tele Physiotherapy Questionnaire p. 86
Lalli Singh, Kshitija Bansal, Tarun Kumar
Background: During unprecedented times of COVID- 19, continuing Physiotherapy through conventional mode is tough and limited to certain extent. To overcome the current situation, WCPT has strongly suggested the implementation of Tele-physiotherapy. Many studies have proven efficiency of Tele-rehabilitation in delivering rehabilitative services; still its use is limited in India may be due to knowledge and attitude of physiotherapists. Currently, no valid tool is available for assessing the attitude, knowledge and barrier of tele physiotherapy among Indian physiotherapist. Thus, the aim of the current study is to develop, validate and establish internal consistency of the questionnaire for the same. Participants: 60 physiotherapists with minimum of 1 year of and those who were willing to participate were included. Non-Practicing Physiotherapist were excluded from the study. Method: Questionnaire was drafted on the basis of previous studies under 4 domains: Demographics, Knowledge, Attitude and Barrier. A panel of 5 experts was formulated. A Delphi process was carried out to validate the developed questionnaire. The content validity ratio (CVR) was calculated. The questionnaire was sent to physiotherapists electronically/ physically and data of 60 Physiotherapist was analysed for Cronbach alpha coefficient using SPSS version 20. Results: The content validity ratio for the complete questionnaire was 0.98. 66.7 % of our sample was between the age of 25–35 years with 82.2% Physiotherapists were postgraduate and 26.2% being experienced for more than 10 years. The Cronbach alpha coefficient for internal Consistency of the questionnaire was good (0.77). Conclusion: The questionnaire is as an effective valid and reliable tool to assess knowledge, Attitude, and Barrier towards Tele physiotherapy. Implications: Developing and validating Questionnaire will help us measure the knowledge, Attitude and Barriers towards Tele- Physiotherapy amongst Physiotherapists across India in a comprehensive way. This in turn will help policymakers and Authorities to make new policies/ modify existing ones for effective use of Tele- Physiotherapy.
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Poster Presentation: AB No: 41: Exergaming to improve Dynamic Balance in Elderly using Virtual Reality p. 86
Mugundan L, Rajeshwari M.
Purpose: Reduction in physical activity impairs balance and increases the risk for falling in aging population. Falling due to reduced balance is the most common issue that significantly impairs quality of life. Hence, balance training can prevent serious health issues and improve wellbeing. Relevance: Research has shown that exercise improves balance among older adults. However, older adults often find it challenging to adhere to exercise programs. Virtual reality programs provide multisensory feedback such as visual, auditory, vestibular, and tactile which results in cognitive and neuromuscular training with entertainment value, thus allowing the patient to exercise more regularly, effortlessly, and effectively. Virtual Reality technology provides the user with opportunities to interact with virtual objects which can be used in framing exercises for active participation in the elderly which will improve balance and reduce fear of falling. Though there are many literatures on virtual reality based treatment, they are costly and not user-friendly. This study aims at providing a virtual reality based program for improving balance which could be portable, user friendly and cost efficient. Participants: Aged more than 60, MMSE scores more than 21, Berg balance scale score within 42–51, Corrected visual or auditory impairment, No neurological or musculoskeletal diagnosis that accounts for possible imbalance or fall and history of fall less than two in past six months. Methods: Thirty older adults aged more than 60 will be randomly assigned to either the Virtual reality group or conventional physiotherapy group with each 15 participants. The two groups will undergo a 4-week program with three sessions per week. Each session will consist of 5 minutes of warm-up and 40 minutes of training. The outcome measures that will be used pre and post-program are Berg Balance Scale, Timed up and go test, and Fall efficacy scale. Results: This study is ongoing and after completion analysis would be done and results would be projected.
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Poster Presentation: AB No: 47: Force Sense – Is it to be assessed and trained? – A Literature Review p. 87
V Logeswari, J Kanimozhi, R Sivakumar
Background: Human movements are controlled by efferent input from the central nervous system and afferent feedback from the periphery. Joint proprioception is commonly spoken as the key afferent feedback. Sense of muscle contraction or force sense (FS) is a less explored component of feedback. FS has been tested in stroke, sports personal, and the elderly for its impact on force production, acuity inability to sense, and its relationship with joint proprioception. However, testing is limited to research, and training in clinical setup is not reported. Aim: To understand the physiology, testing, clinical implication, and method of training Force Sense. Methodology: PubMed and Scopus database will be screened with keywords “Proprioception”, “Muscle contraction”, “Force matching task”, “Force sense”, “Sense of effort”, “Muscle proprioception” along with filters for studies in English language and period 2000 to 2021. Results: The study results will be presented under the heading physiology of muscle sense, methods used in testing, population tested, and clinical implication reported. Conclusion: The possibility of clinical testing and application will be highlighted.
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Poster Presentation: AB No: 50: Prevalence of Kinesiophobia after Total Hip Replacement (THR) p. 87
Shobhalaxmi S, Ruth Boyle, Jahnavi Hariyani
Background and Objective: Total Hip Replacement is a common surgical intervention in individuals with various hip pathologies. According to fear avoidance model, due to pain there is presence of psychosocial factors leading to affection of various outcomes. There is abundance of research on various populations like Total Knee Replacement, Low back Pain, Neck Pain, Older individuals but paucity in individuals with Total Hip Replacement. Hence, the objective of this study was to assess Kinesiophobia among individuals who have undergone Total Hip Replacement. Methods: Patients who had undergone THR in M S Ramaiah Hospitals and other Hospital were considered and those who fit in the inclusion criteria were recruited. Patients were briefly evaluated and assessed for Kinesiophobia by Tampa Scale for Kinesiophobia – 11 between post-operative days between 4 – 7. Results: Proportion of Kinesiophobia was present among these individuals. Among the data collected 54.5% individuals had kinesiophobia higher than median value. Interpretation and Conclusion: There was presence of Kinesiophobia in individuals who have undergone Total Hip Replacement suggestive of presence of psychosocial component along with structural involvement impacting outcomes.
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Poster Presentation: AB No: 56: Combined effect of Physiotherapy and Dental treatment on Drooling in Children with Developmental Disorders: A Pilot Study p. 88
Deepa Metgud, Richa Lahiri
Purpose: To study the combined effect of physiotherapy and dental treatment on drooling in children with developmental disorders using Drooling Impact Scale and 5-Minute Drooling Quotient. Relevance: Drooling is the involuntary, passive spillage of saliva due to inability to handle oral secretions, normally occurring in infants and young children. It is considered abnormal to have problems with saliva control beyond the age of 4 years. Physiotherapy treatment including oral motor stimulation has been regularly used to decrease drooling but its effect along with dental treatment is unknown. Participants: 10 children with developmental disorders in the age group of 4–12 years with a complaint of drooling were recruited from the paediatric out-patient department and child development centre of a tertiary care hospital and special schools in Belagavi. Methods: A pre-post pilot study was conducted to study the combined effect of physiotherapy and dental treatment. Pre and post-treatment outcomes were taken by drooling impact scale and 5- minute drooling quotient. The physiotherapy treatment consisted of oral motor stimulation thrice a week for 4 weeks and the dental treatment included oral prophylaxis followed by fluoride application. Analysis: Data was analyzed using paired sample t-test. Results: The results indicated a significant improvement in drooling with a mean difference of 11.20 ± 4.87 and p-value=0.001 on the drooling impact scale and mean difference of 23.66 ± 6.07 and p-value= 0.001 on the 5- minute drooling scale. Conclusion: This study showed that combination of physiotherapy and dental treatment is useful for the treatment of drooling in children with developmental disorders and the effect must be studied in a larger sample size. Implications: Physiotherapy treatment combined with dental treatment can be helpful to reduce the stigma related to drooling as well as feeding difficulties in children with developmental disorders.
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Poster Presentation: AB No: 62: Comparison of Functional Capacity and Peak Expiratory Flow Rate in Covid-19 survivors with Healthy Individuals – A Pilot Study p. 88
Manthan Purohit, Megha Sheth
Purpose: To compare functional capacity and peak expiratory flow rate in COVID-19 survivors and healthy individuals.Relevance of study: COVID 19 has shown to affect the lung parenchyma. For physiotherapists, as they deal with maximising functional potential of patients, knowing status of functional capacity and lung function of COVID-19 survivors may help in understanding patients’ problem more effectively and also in making appropriate clinical decisions. Participants: Fifty participants from community of Ahmedabad, males and females of age group 50–65 years, with (group A) & without (group B) history of COVID-19 in the past 12 months, will be included in the study by convenience sampling. Patients with severe musculoskeletal, neurological & cardiac problems, recent injury, fever, cough & cold are excluded. Method: Observational analytical study was conducted. 6minute walk distance for functional capacity and peak expiratory flow rate with a peak flow meter, was obtained. Analysis: Data analysis for 14 participants was done using SPSS version 16 and Microsoft excel 2019. Data was screened for normality using Levene’s test. Between group comparison for 6MWD and PEFR was done using Mann-Whitney U test. Level of significance kept at 5%. Results: Mean age in group A was (58.0 + 4.47) years, and in group B was (59.2 + 5.49)years. Difference in mean+SD for PEFR in L/min for group A (414.29 + 186.44) and Group B (344.29 + 66.29) was not significant (U=20, p=0.562). Difference in mean + SD for 6MWD group A (414.76 + 101.99), Group B (481.69 + 90.24) was not significant (U= 13.5, p=0.15). Conclusion: Study is still going. Implications: If the peak expiratory flow rate and functional capacity are reduced post COVID, there will be a need to manage the same.
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Poster Presentation: AB No: 128: Effects of Posture Correcting Exercises on Respiratory Parameters in Individuals with Upper Crossed Syndrome p. 89
Akshita Maheshwari
Purpose: Various studies were found on UCS, poor posture and resultant respiratory dysfunction but there exists lack of literature on comparison of posture correcting exercises on respiratory functions in UCS led to curiosity of finding the results on same led to this study. Relevance: The results and methods of this study can be effectively applied in clinical practice in both the patients of respiratory and postural dyfunction for correction of one another. Participants: 15 college students with defined upper crossed syndrome fulfilling the inclusion and exclusion criteria were selected. Methods: Pectoralis major and minor, levator scapulae and upper trapezius muscles stretching exercise, middle and lower trapezius strengthening exercise and mcKenzie exercise. These interventions were provided for 30 minutes a session, once a day, five times a week and for 3 weeks. Chest expansion and Peak Expiratory Flow (PEF) were assessed using an inch tape and peak flow meter respectively on the first visit and after completion of exercise protocol. Analysis: Statistical analysis was done by SPSS version 20 and Mann Whitney U Test was used. Results: There is statistical significant improvement in Chest expansion (p<0.05) and peak expiratory flow (p<0.05). Conclusion: There is significant effect of posture correcting exercises on respiratory functions in individuals with upper crossed syndrome. Implication: It may be recommended as effective exercises to improve posture as well as respiratory functions in adults.
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Poster Presentation: AB No: 106: The Prevalence of Neck Pain among Adolescents and Yound Adults due to Increased Screen Use during COVID -19 Lockdown – A Descriptive, Cross Section Study p. 89
Priyanshu Gupta, Ramhari Meena, Vijay Kaushik
Background: Since the use of smart phones, laptops etc. has increased recently, their impact on people individual’s health is not well established. Smartphone use had been remarkably increased during the COVID-19 lockdown due to different unexplained reasons.It is important and critical to examine and rule out the presence, absence or the magnitude of this impact, especially among young people and adolescents. Relevance: To find out the prevalence of neck pain among adolescents and young adults and its correlation with the duration of screen use. Study Design: A descriptive, cross sectional study. Settings: online platformMethods: This cross-sectional study was conducted using an online google survey form, which was distributed through social media to 300 participants to find out the prevalence of neck pain among younger population and its relationship with screen use. Results: Our study showed that the mean age of the study population having neck pain associated with screen use is 24 year. More of the female than male subjects reported neck pain.The prevalence of pain increased with increase in duration of screen use. Conclusion: The research sample reported that people use of electronic devices showed a close association with neck pain and the more the people spends time using an electronic device the greater is the complaint of neck pain. We found that there is a positive correlation between long time screen use and neck pain.
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Poster Presentation: AB No: 75: A study to analyse the effectiveness of Communication Skills among Physiotherapy Interns and Post Graduate Students p. 89
B Sangeetha, CM Radhika
Background: Communication skills is essential in physiotherapy practice. It is a vital skill that physiotherapist need in practice to improve the quality and efficiency of care. Communication with patients is the core clinical skills for the practice of Physiotherapy. It can be defined as specific tasks and observable behaviors that include interviewing to obtain a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions and information needed for informed consent to undergo therapeutic procedures, exercises and providing counselling to motivate participation of patients and care givers in the therapy. No studies till date have been done to demonstrate the effectiveness of training and no objective assessment of patient education skills have been employed to assess outcomes, so we have planned to evaluate the effectiveness of communication while providing patient family education. Furthermore, the effect of specific training on patient education skills will be analyzed. Objective: To evaluate the effectiveness of communication skill training among physiotherapy Interns and Post graduates. Methods: Male and Female post graduates (MPT) and Interns (BPT) from SRIHER will be recruited for the study. Pre assessment score will be marked by a senior physiotherapist on the basis of RANZCOG Assessment of communication Skills during provision of patient family education by the physiotherapy students. Following the evaluation they will receive a brief training for a week on patient education by means of video simulation, pamphlets and role play. Post assessment will be taken with RANZCOG Assessment of communication Skills from the physiotherapy students. Effectiveness of the training program on self-efficacy and performance in the area of patient education will be analysed. Results: Since it is an ongoing study the result will be displayed later.
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Poster Presentation: AB No: 80: Self-Perception of Community Participation in Children with Disability - A Literature Review p. 90
Nikhat Naaz, Kirti Joshi
Purpose: To review and explore self-perception of community participation in children with disabilities. Relevance: Participation (i.e involvement in life situations) is a core concept within the ICF framework. Community Participation amongst children with disability is an emerging topic of research. Many of the studies have reported parental, caregiver and therapist perceptions. As every child has a unique perception, it is important to report children’s perception of community participation. Participants: Articles reporting community participation in perception of children with disability were included and articles reporting perceptions of parents, caregivers and therapist were excluded. Method: Comprehensive literature search was performed using the search engines PubMed and Google scholar. Search strategy was devised and articles selected based on the inclusion and exclusion criteria. Results: 2837 articles were screened and 17 were included in the review. 6 were qualitative studies, 10 were descriptive studies and 1 systematic review on psychometric properties of children self-report measures. Most of the studies explored children’s perception of participation in community using interview and questionnaire method. CAPE and Picture my Participation were the most commonly used questionnaires. Conclusion: Majority of the studies are descriptive and qualitative studies. Hence there is limited data available in literature, as most of the studies are in the process of exploring and developing scales to understand the self-perception of community participation in children with disabilities. Implications: This experience-based participation model if implemented in Paediatric Physiotherapy may provide personalized perspectives which might be key to community participation.
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Poster Presentation: AB No: 96: Impact of COVID-19 on pregnant mothers and its effect on Infant’s Development -Literature Review p. 90
Krishna Tejaswi Konduri, Kirti Joshi
Purpose: To review and understand the impact of COVID-19 on Pregnant mothers and its effect on Infant’s development. Relevance: Postpartum health of the mother is affected in terms of their mental well-being, separation period and stress which may lead to indirect effect on infant’s brain development. Therefore an appropriate developmental screening must be done to these infants so that early intervention plan can be done if required. Participants: Studies reporting about pregnant women infected with COVID-19 and their infant were included and women not tested positive for COVID-19 were excluded. Methodology: Comprehensive literature search was performed using the search engines PubMed, Google scholar. Search strategy was devised, articles were selected based on the Inclusion and Exclusion criteria. Analysis: 81 articles were screened and 8 were included in the review. 2 were Observational Studies, 4 were reviews,1 was cohort study and other was longitudinal study. Results: Majority of the studies reported delivery occurred in isolation room with 14 days separation period, Postpartum practices like breastfeeding, KMC are safe to be practiced with appropriate precautions. Longitudinal study in China found negative association after evaluating the impact of COVID-19 on mother’s psychological status and infant’s early development, by using ASQ Questionnaire upto 3 months. Conclusion: Many articles spoke about the postpartum health of the mother being affected following COVID-19, not much emphasis was given on infant’s development. Implications: Since adversity and stress during prenatal period are associated with later impairments in the infant, long term impact of COVID-19 during pregnancy on infant’s development is an important area for further studies.
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Poster Presentation: AB No: 142: Biological markers as an outcome measure of exercise in Osteoarthritis Rehabilitation: A Scoping Review p. 91
Aravind B, Angeline R, Venkatesh N, Sweatha Nathan R
Background: Knee osteoarthritis characterized by degeneration, loss of articular cartilage, and osteophyte formation. The presentation includes pain, tenderness, stiffness, joint swelling, limited mobility, joint deformities, and intermittent periods of synovial membrane inflammation and release of biomarkers of inflammation. Change in cartilage volume and circulating biomarker levels may be influenced by therapeutic exercise. Exercise therapy has been proved to improve joint function, physical function and quality of life. Biomarkers helps to determine the benefits of exercise in knee osteoarthritis this information can be a measurable indicator to document the therapy benefits. This study aims to perform a scoping review of the rehabilitative biomarkers used to measure the therapy outcomes in knee osteoarthritis. Objectives: To analyse and identify the biomarkers used to measure the therapy outcomes in knee osteoarthritis by conducting a scoping review. Methodology: Literature search up to October 2021 in databases like MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Data was extracted from the available literature. A narrative synthesis of the various markers and its efficacy in measuring the therapy benefits in knee osteoarthritis was performed. Results: Ten of the seventeen studies were randomized control trail, three cohort studies, two pilot study, two cross sectional studies and three pilot studies at 4-to-24-weeks following exercises were included. A total of 1897 sample were included. Out of 17 biomarkers 3 studies investigated cartilage synthesis, 16 studies investigated markers of cartilage degradation, 2 studies investigated synovial synthesis, 1 studied using markers of synovial degradation, 2 investigated using extracellular matrix, 8 investigated using inflammatory markers. All were found to be potential markers to measure the therapy benefit. Conclusion: The information provided from 17 studies, exercise was proven to be a safe, acceptable, and effective method of intervention for certain health outcomes and the biomarkers used were found to be potential markers to objectively document therapy outcomes.
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Poster Presentation: AB No: 63: Role and impact of Structured Exercise Interventions on Hepatic Triglycerides for Non Alcoholic Fatty Liver Disease Patients- A Scoping Review p. 91
Sedhunivas R, Mrs S. Sridevi Moorthy
Purpose: To investigate on impact in hepatic triglycerides levels as a result of various structured exercise interventions prescribed as a treatment for NAFLD patients. Relevance: Exercise prescription in Non-alcoholic fatty liver disease patients gains the topmost importance, provided already there is existing absence of effectiveness of pharmacotherapy drugs in treatment of NAFLD. Exercising daily can improve the exercise capacity of the individual and can reduce the progression of NAFLD disease into Non-alcoholic steatohepatitis and cirrhosis. Participants: Since it is a scoping review, there are no participants (NOT APPLICABLE)Methods: A scoping review was conducted using PubMed, Hepatology journals, Google scholar database during the time period of (2013–2020) and 26 literature evidences related to the topic were found and further analyzed. Analysis: Statistical Analysis Not ApplicableResults: A total of 26 Randomized control trial articles were included in the review,which studied on effectiveness and impact of exercise interventions on liver enzymes.we could found 12 articles focusing on aerobic protocols and 6 articles focusing on resistance exercises and 8 literature evidences focusing on both aerobic and resistance protocols. Conclusion: Taking into consideration the available evidence till date, we conclude that,exercise protocols consisting of aerobic and resistance were equally effective on hepatic triglycerides levels,but more improvement was found in patients on Liver enzymes in combined aerobic and resistance protocols. Also Exercise interventions in NAFLD patients aren’t sufficient and feasibility of the available protocols is poor and thus there exists lacunae for protocols for common population are yet to be addressed. Implications: Understanding the available various exercise protocols and its effectiveness devised for NAFLD patients will help in future progression of exercise protocols and can lead to advancement in protocols and also it will benefit the patients
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Poster Presentation: AB No: 99: Comparative Study: on Comparative Analysis Between Core Strengthening Exercise with Diaphagmatic Breathing and Core Strengthening Exercise alone in the Treatment of Stress Incontinence in Postmenopausal Women p. 92
Jyoti Sahu, Priyanshu Joshi, Usha Patel
Background: Stress Urinary incontinence (SUI) affects 25% of premenopausal women and 50% of postmenopausal women and can be a contributing factor to reductions in quality of life (QOL)Relevance: Diaphragmatic breathing along with core strengthening is an effective structured exercise protocol for post-menopausal women in treatment of stress incontinence. Study design-Comparative study. Setting: Department of Physiotherapy and Gynecology in M.Y. HOSPITAL Indore (M.P)Methods: Sampling technique was used.Interventions-60 patients participated in the study were divided into two groups using simple random sampling. Group A received core strengthening exercise with diaphragmatic breathing whereas Group B receives core strengthening exercise alone. Results: There were significant improvement in PAD test and IIQ questionnaire score Intervention analysis showed significant difference between group A and group B (P= 0.0191) The mean age of the participants in group A was 59.63±7.260 and in group B 59.63±5.63. The statistical analysis shows significant difference between pre and post test of core strengthening exercise with diaphragmatic exercise and core strengthening exercise alone in the treatment of stress incontinence in postmenopausal women.(p<0.001). Conclusion: It is concluded that core strengthening with diaphragmatic breathing is more effective than core strengthening alone in the treatment of stress incontinence in postmenopausal women. There were significant improvement in the PAD test and IIQ questionnaire score which shows the improvement quality QOL. Implication: Future research is needed to create a high variety of methods to assess SUI and more adequate treatments.
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