[International Journal of Physiotherapy 2014; 1(2) : 32-99] RSS

Srikanth Babu Venga

DOI : N/A

Pages : 32

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ABSTRACT

ADDRESSING THE CHALLENGES OF LIFE AFTER STROKE

Shilpa Dugani Burji, Pravin Aaron, Subin Solomen, Mallikarjunaiah .H .S.

DOI : N/A

Pages : 33-39

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ABSTRACT

Background: WII Balance Board (WBB) being one of the latest, advanced technologies of high sensitivity in monitoring change in balance over time and owing to, ease of use, and portability, it is being used in physical therapy clinics as a popular substitute for the expensive and complicated force plates to improve dynamic strength and balance. Despite its growing popularity, the WBB’s reliability as an intervention and assessment tool for balance is still being investigated. So this study aims in finding the accuracy of WBB. The objectives of the study are to find the Intraclass Correlation Coefficient and Standard Error Measurement on both day 1 and day 2 with eyes closed and eyes open in older adults.
Method: 30 subjects over the age of 65 years were assessed for balance using WBB. Subjects were measured in double limb stance with eyes open and closed with feet comfortably distant apart on the board. The same procedure was repeated after 24 hours.
Results: The study showed to be statistically significant for eyes open on day 1 and day 2, but was not statistically significant for eyes closed on day 1 and day 2.
Conclusion: The study suggested that the WBB was reliable for eyes open and not reliable with eyes closed.
Keywords: WBB, Balance, Double limb stance, Nintendo, Older Adults.
 

Sandesh Rayamajhi, Dipika Khanal , Mallikarjunaiah H S

DOI : N/A

Pages : 40-45

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ABSTRACT

Background: Stroke has been considered to be the most common cause of neurological disability with very high prevalence rate. The recovery of independence following stroke is a complex process requiring the reacquisition of many skills. Since controlling the body’s position in space is essential part of functional skills, restoration of balance is a critical part of the recovery of ability after stroke. Most of the work done regarding balance training in stroke subjects has focused on task-oriented activities and training under varied sensory input and found them to be effective. Studies have also compared the effect of stable and unstable surfaces on balance in stroke subjects and found that balance training on unstable surfaces is more effective in improving static and dynamic balance. There has not been any study till date investigating the effectiveness of balance training program on rocker board which is specific for stroke subjects who have difficulty in standing. Since balance training on rocker board in sitting has proved to be effective in improving balance in subjects with spinal cord injury who have difficulty in standing, there is a need to find out if similar balance training program on rocker board in sitting is also effective for improving balance of stroke subjects.
Method: A Pilot study was performed on 10 stroke subjects selected through purposive sampling. Subjects were divided into two groups by randomization as control (CG) and experimental group (EG). EG received balance training on a rocker board along with conventional physiotherapy program. The CG received only conventional physiotherapy program.
Results: Post-intervention Berg balance scale score of EG and the CG was statistically significant (p < 0.05) in both the groups as compared to pre-treatment depicted through Wilcoxon signed rank analysis within the groups. Greater improvement was observed in the EG compared to the CG post-treatment, analysed through Mann-Whitney U test with statistically significant results (p < 0.05).
Conclusion: The new balance training program on rocker board in sitting is effective for improving balance of stroke subjects. 

Jibi Paul

DOI : N/A

Pages : 46-53

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ABSTRACT

Background: The dramatic increase in the incidence and prevalence of neurological disorder like stroke has always demanded the need of new interventions in limiting the disability outcome. Disturbed balance is one of the common difficulties in stroke subjects. Several researches have conducted with the process of limiting the disability but still not controlled fully. The objective of the study is to find out the effect of balance exercise with deprivation of visual feedback in stroke subjects.
Method: Total number of thirty subjects participated in the study. The duration of study was four weeks with five sittings in a week and with duration of sixty minutes in each training session. Data was collected using Berg balance scale and the get up and go test, statistical analysis using the Wilcoxon’s signed rank test and paired T-test.
Result: The mean value of timed get up and go test in group A was 16.93 with a standard deviation of ±3.86. The t-value of the study was 2.63 with P-value of 0.007.The study found significant difference in effect as the calculated P < 0.05. The results showed that the conventional therapy along with masked vision could bring about significant changes in balance, mobility and function of patients suffering from balance impairment among post stroke. The data analysis found the significant difference between the visions deprived balance training to that of free vision balance training.
Conclusion: Subjects with masked vision showed better outcomes on balance and get up and go test. Balance performance and movement was found better in subjects with deprived vision than those with free vision. 

D Varalakshmi, Madhavi .K, P. Sumalatha

DOI : N/A

Pages : 54-57

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ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is the only cause of death from chronic disease that will increase worldwide until 2020 and it represents a big burden for patients and society. Patients with COPD characteristically show poor exercise performance indicated by a marked reduction in both peak pulmonary 02 uptake and work rate at peak exercise. The sequelae of exercise intolerance include increased difficulty in performing daily tasks, etc. The objective of the study is to investigate the influence of thoracic and upper limb muscle function on 6-min walk distance (6MWD) in patients with COPD.
Method: Thirty eight COPD patients were included if they fulfilled the criteria for COPD according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. Prospective, cross-sectional design with sample size of 38 patients. All patients performed 6MWD and 1RM exercises.
Results: To study the correlation between variables, Pearson or Spearman coefficients of correlation were used with the level of statistical significance set at 5%.Results of this study suggested for the first time that thoracic muscle strength is a predictor of 6MWD in COPD patients. It also confirms the influence of respiratory muscle strength (Pimax), dyspnea, on the 6MWD of these patients.
Conclusion: It is concluded that peripheral muscle strength, respiratory muscle strength, and the sensation of dyspnea all have an influence on the capacity of COPD patients to perform exercises. 

Key Words: COPD, dyspnea, max. Inspiratory pressure, 6MWD, peripheral muscle strength.

Hazel Denzil Dias, Pravin Aaron, Subin Solomen, Mallikarjunaiah .H .S

DOI : N/A

Pages : 58-65

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ABSTRACT

Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS) which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history.
Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn), specificity (Sp), and positive (+LR) and negative (-LR) likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis.
Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837). A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824). hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5.
Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in the elderly with a cut off of 6.5. 

Key Words: Elderly, geriatric, balance, falls, Berg Balance Scale, diagnostic tests, test and measures

Srikant Sikatia, Prabhu .C, Suchetha .P.S, Mallikarjunaiah .H .S

DOI : N/A

Pages : 66-73

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ABSTRACT

Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS) which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history.
Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn), specificity (Sp), and positive (+LR) and negative (-LR) likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis.
Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837). A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824). hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5.
Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in the elderly with a cut off of 6.5. 

Key Words: Cognitive function, Motor Assessment Scale, Problem Oriented Willed Movement, Traumatic Brain Injury.

Pallavi Shridhar Thakare, Vinod Babu .K, Sai Kumar .N, Ayyappan .V.R

DOI : N/A

Pages : 74-82

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ABSTRACT

Background: The purpose is to find long term effect of Cyriax physiotherapy with supervised exercise program in the reduction of pain and improvement of functional ability for subjects with tennis elbow. Method: An experimental study design, 30 subjects with Tennis Elbow randomized 15 subjects each into Study and Control group. Control group received Supervised Exercise program while Study group received Cyriax Physiotherapy with Supervised exercises program thrice in a week for 4 weeks and post intervention follow up after 2 weeks. Outcome measurements were measured for pain using Visual analogue Scale (VAS) and Patient Rated Tennis Elbow Evaluation (PRTEE) for functional ability.
Results: There is no statistically significant difference in pre- intervention means of VAS and PRTEE when compared between the groups using independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test. When means of post intervention and follow-up measurements were compared there is a statistically significant (p<0.05) difference in VAS and PRTEE scores between the groups. However greater percentage of improvements was obtained in study group than control group.
Conclusion: It is concluded that there is significant long term effect with greater percentage of improvement in pain and functional ability up to 2 weeks follow-up following 4 weeks of combined Cyriax physiotherapy with supervised exercise program than only supervised exercise program for subjects with tennis elbow.  

Key words: Cyriax Physiotherapy, Mills manipulation, Deep Friction massage, supervised exercise program, Tennis Elbow, Pain, Visual analogue scale, functional ability, lateral epicondylitis, PRTEE.

Bhavana Dattaram Desai, Vinod Babu .K, Sai Kumar .N, Asha .D

DOI : N/A

Pages : 83-90

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ABSTRACT

Background: Medial to lateral tapping and exercise programme has been found to be effective in Lateral epicondylitis. The purpose to find the combined effect of Medial to lateral tapping with exercise programme for subjects with lateral epicondylitis on pain intensity and functional ability.
Method: An experimental study design, selected 40 subjects with Lateral epicondylitis randomized 20 subjects each into Study and Control group. Control group received only exercise programme while study group received combined medial to lateral tapping with exercise programme thrice a week for 4 weeks. Pain intensity was measured using Visual analogue scale and functional ability was measured using Patient Rated Tennis Elbow Evaluation questionnaire before and after 4 weeks of treatment.
Results: When the post-intervention means were compared between Study and Control group after 4 weeks of treatment found statistically significant difference in the improvement in outcomes measures in means of VAS and PRTEE before and after intervention within the groups.
Conclusion: It is concluded that the Medial to lateral tapping with exercise programme is more effective than the exercise programme in reduction of pain and improve functional abilities for subjects with Lateral epicondylitis. 

Key Words: Lateral epicondylitis, Medial to lateral tapping, Exercise programme, Pain, Functional ability, Tennis Elbow.

Sweety Charles Carvalho, Vinod Babu .K, Sai Kumar .N, Ayyappan .V .R

DOI : N/A

Pages : 91-99

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ABSTRACT

Background: Trapezius stretching combined with positional release technique (PRT) have found effective in trapezitis, studies are limited to find which technique has shown effective over the other due to lack of control group. The purpose of the study is to find the effect of PRT on pain intensity, functional disability and range of motion in subjects with subacute trapezitis.
Method: An experimental study design, selected subjects with subacute trapezitis was randomized into Study and Control group. Total 40 subjects, 20 subjects in each group; data was collected who completed the study. Control group received passive trapezius muscle stretching while Study group received positional release technique with passive trapezius muscle stretching for 8 sessions in 2 weeks. Outcome measurements such as Visual Analogue scale, Neck disability index and cervical Range of motion were measured.
Results: There is statistically significant difference (p<0.05) showing improvement in means of VAS, NDI and Range of motion before and after intervention within the groups and there is statistically significant difference when the post-intervention means after 2 weeks of treatment were compared between Study and Control group.
Conclusion: It is concluded that the Positional Release Technique with trapezius stretching found to be significantly more added effect than trapezius stretching alone in improving pain, functional disability and cervical movements for subjects with subacute trapezitis. 

Key Words: Trapezitis, muscle pain, stretching, positional release technique, visual analog scale, neck disability index, range of motion.