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   Table of Contents - Current issue
July-December 2021
Volume 5 | Issue 2
Page Nos. 35-67

Online since Tuesday, October 12, 2021

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Physiotherapy education in India: Is it time for reform? p. 35
Narasimman Swaminathan
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Immediate effects of toe spreader on balance in subacute and chronic stroke patients p. 38
Kavya Milind Shetty, Dinesh Gulab Chavhan, Ashok K Shyam, Parag K Sancheti
Background: Stroke is one of the commonest neurological disorders causing functional disability. Toe spreader is proven to improve gait in these patients but a study of its effect on balance was yet to be performed. Objective: The purpose of the study was to find out effect of toe spreader on functional and dynamic balance in subacute and chronic stroke patients. Materials and Methods: Thirty subjects were recruited in the study. Balance assessment was performed using Berg Balance Scale for functional and timed up and go test for dynamic balance. Both being tested first without the toe spreader and then immediately after toe spreader application and documented, respectively. Results: This study found out that around 87% of the subjects showed a reduction in time in the timed up and go test scores post-usage of toe spreader, whereas all subjects showed an enhancement in the total berg balance scale score. Paired t test was used for parametric data analysis whereas Wilcoxon signed rank test was used for non-parametric data analysis (level of significance being *P ≤ 0.05). The obtained *P value for Berg Balance Scale was 0.000 and timed up and go test was 0.001. Conclusion: The conclusion drawn from the results of this study is that toe spreader has a significant effect on improving the balance in subacute and chronic stroke patients.
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Immediate effect of therapeutic positioning and breathing exercises on oxygen saturation in critically ill non-intubated COVID-19 patients: A retrospective study p. 43
Mariya P Jiandani, Urvi B Parmar, Reema S Rajam, Ekta N Patil, Santosh B Salagre
Background: COVID-19 presents with symptoms of fever, headache, dry cough, and dyspnea. Acute hypoxemic respiratory failure is the most common complication occurring in 60%–70% of patients admitted to the intensive care unit (ICU). Positioning and breathing exercise formed the mainstay of physiotherapy intervention in patients admitted to COVID ICU. This was primarily aimed at reducing the ventilation/perfusion mismatch. The aim of this study was to retrospectively analyze the immediate effect of breathing exercise and positioning on oxygen saturation (SpO2). Materials and Methods: The available data of COVID-19 patients admitted to an ICU of a tertiary care hospital in Mumbai from June 5 to July 5, 2020 were retrospectively analyzed. Demographics and mode of oxygen delivery were noted. Changes in SpO2 after positioning and breathing exercises during a single session of treatment were analyzed using Wilcoxon paired signed-rank test with a level of significance at P < 0.05. Results: There was a statistically significant improvement in SpO2 after breathing exercises and prone positioning in all patients on oxygen supplementation. Side-lying positioning showed an improvement in oxygen saturation in patients who were on non-invasive ventilation and facemask. Conclusion: Both breathing exercises and positioning show an immediate improvement in oxygen saturation in patients with COVID-19.
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Awareness of ergonomics among remotely working information technology professionals during COVID-19 pandemic: A cross-sectional survey p. 47
Nishi Madan Dugar, Nikita Rajendra Dodwad, Ashok Murari Shyam, Parag Kantilal Sancheti
Background: Ergonomics is the scientific study of human work. The objective of ergonomics is to obtain an effective match between the user and workstation to improve working efficiency, health, safety, comfort, and ease of use. Aim: The aim of this article is to assess ergonomic awareness among information technology (IT) professionals who are working remotely. Materials and Methods: A cross-sectional survey was conducted among IT professionals through a self-administered questionnaire. A total of 150 subjects were recruited in the study. The results were summarized using descriptive statistics. Results: Majority (75%) of the total subjects work for 7–9 h in a day for 6 days in a week without taking breaks at regular interval. Only 7% of the total participants utilized break for stretches and 21% participants walk around during break. The distance of monitor from the eyes of 18.66% of the participants was between 21 and 30 inches and for 2% of the participants it was greater than or equal to 31 inches; this shows that the majority of the participants did not place their monitor at appropriate distance. The study showed that there is lack of knowledge of sitting posture among the IT professionals working from home: 9% of the participants were lying on bed, 16% were seated on sofa, and 17% were sitting on bed. Chairs used by the participants in the study were 15.33% wooden, 19.33% plastic, and 13.33% other types. Conclusion: It was found that those majorities of the participants were unaware about the correct ergonomics and were unable to make modifications in their workstation.
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Perception of neurophysiotherapists in Maharashtra about scope of teleneurorehabilitation in chronic conditions p. 52
Shubham Khemchand Joshi, Dinesh Chavhan, Ashok Shyam, Parag Sancheti
Background: Telerehabilitation is a key component in the evolution of healthcare; so it is important to understand the scope and potential of telerehabilitation systems to meet as full a range as possible of user needs. Obstacles of telerehabilitation must be addressed before its implementation. So considering the above points, this study will help to find perception of neurophysiotherapist about scope, limitations, and obstacles of teleneurorehabilitation while treating chronic patients and the results of the study will help other clinicians in proper and accurate application of telerehabilitation for treating patients in future. Methods: After taking verbal consent from neurophysiotherapists in Maharashtra, a Google Form-based questionnaire about scope of teleneurorehabilitation was sent to them through their emails and social websites that were accessible to them and 134 neurophysiotherapists who fitted in inclusion criteria filled the Google Form. The responses were collected then descriptive analysis was done and results were obtained. Results: About 11.9% neurophysiotherapists feel that teleneurorehabilitation can be preferred over face to face visits while 88.1% do not feel it. About 55.2% agree that tele-neurorehabilitation can be used in stroke, 35.1% agree that it can be used in spinal cord injury, 62.7% agree that it can be used in Parkinsonism, 56% agree that it can be used in peripheral nerve injury. Discussion: According to this study, there is positive perception of teleneurorehabilitation among neurophysiotherapists in Maharashtra as it can be used in stroke, Parkinsonism, peripheral nerve injury but not spinal cord injury and they all agreed with effectiveness of teleneurorehabilitation in patient and family education, bed transfers, balance training, co-ordination training, environmental modifications of patient and motor learning but not in gait training. Conclusion: Neurophysiotherapists in Maharashtra have good perception about scope of teleneurorehabilitation but according to them, teleneurorehabilitation cannot substitute face to face rehabilitation but can be used as an adjunct.
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Submaximal exercises cause immediate reduction in the visual reaction time in normal individuals p. 59
Jui Dave, Pranjal Ashish Grover, Medha Deo
Context: Reaction time (RT) is the time taken by an individual to respond suitably and quickly to an appropriate stimulus. It is an objective indicator of the ability of the central nervous system to receive information and coordinate the most appropriate response. It is an important part of inherent balance response in a human being. Our sensory faculties of vision, hearing, and their respective RTs form the basis of our feedback mechanisms required for balance. Both are important factors in fall prevention strategies for the elderly. Physical exercises have innumerable benefits that are well documented except the possible effects on RT. This study is designed to see immediate effects of submaximal exercises on visual RT in healthy adults. Aim and Objectives: The aim of this article is to study the immediate effect of submaximal aerobic exercises on visual RT in healthy adults. Settings and Design: The study was a clinical trial with pre-test-post-test design conducted in community centers with convenient sampling. Materials and Methods: One hundred healthy adults in the age group of 18–55 years were selected. RT at rest was assessed using Inquisit 4.0 by Millisecond Software. There was 30 min of aerobic exercise in the form of walking with 70% heart rate response as submaximal aerobic exercise. Immediately after the RT was noted, analysis of data was done using the paired t-test. Results: There was a statistically significant reduction in visual RT after exercise from 293.16 to 272.78 ms (P < 0.01). Conclusion: Submaximal aerobic exercises reduce the visual RT immediately.
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Physical activity self-efficacy and its correlation with cardiorespiratory fitness, physical activity levels, and sedentary time among urban school going adolescents: A cross-sectional analysis p. 63
Rajitha Alva, Sundar Kumar Veluswamy, Ridhi Verma, Priyanka Malla, Shalini Shivananjiah
Background: There is growing concern about reduction in physical activity and increase in sedentary time among children and adolescents. School health programs are being promoted by our government, but the usually suggested behavioral change interventions (BCIs) to improve physical behavior have not been tested in our school population. The BCIs are built on the premise that there is a relationship between constructs such as self-efficacy with physical activity and sedentary time. This study represents the pre-intervention data of an ongoing randomized controlled trial (RCT). Aim: The study aims to assess the relationship between physical activity self-efficacy and cardiorespiratory fitness (CRF), physical activity levels, and sedentary time. Participants: Participants were students of grades 7–9 from three private schools. Methods and Analysis: Following ethical approval, CTRI registration, and school and parent consent, 272 adolescents volunteering to participate in the RCT completed Self-Efficacy for Daily Physical Activity Questionnaire (SEPA), Physical Activity Questionnaire for Adolescents (PAQ-A), and Adolescent Sedentary Activity Questionnaire (ASAQ). CRF was assessed using a 20-m multistage shuttle run test and VO2 max was estimated using Leger’s formula. Descriptive statistics and correlation (Pearson’s and Spearman’s rank) between the variables were done in SPSS v.20. Results: Children (54% boys) had a mean age and body mass index of 12.8±0.9 years and 20.7±5 kg/m2, respectively. Mean of SEPA, ASAQ, and VO2 max were 58.2±23.2, 2662±1024 min, and 41±5.2 mL/kg/min, respectively. Majority (51%) had moderate levels of PA. There was a weak correlation of SEPA with PAQ-A (rs=0.31; P < 0.001), whereas there was no significant correlation of SEPA with other variables. Conclusion: Contrary to studies from western societies, SEPA did not correlate with CRF and sedentary time. There seems to be limitations in the construct of questionnaires in capturing self-efficacy and sedentary behavior in this population.
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