[International Journal of Physiotherapy 2014; 1(4) : 169-240] RSS

Rahul Shaik, Christie Kiran Gotru


Pages : 169

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Exactly one month back we, the physical therapists all over the world celebrated world physiotherapy day on 8th of September. The theme of world confederation for physical therapy (WCPT) for the year 2014 is “FIT TO TAKE PART”, concreting the role of physical therapists in helping the people with long term illness or disabilities, to become independent and fulfill their part in the race of life. In general, any disease that is persistent and manifests its effects over time can be called a chronic illness. Non Communicable Diseases like cardio-vascular diseases, cancer, hypertension, diabetes mellitus, and other conditions like autoimmune disorders, Alzheimer’s disease, chronic pain syndromes and the list keeps going as we try to name the conditions that can be counted as a long-term disease.

Y. Lokapavani, S. Ragava Krishna, K. Madhavi

DOI : 10.15621/ijphy/2014/v1i4/54556

Pages : 170-177

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Background: Modified radical mastectomy is a frequent surgery employed as a therapeutic procedure in patients with breast carcinoma with involvement of axillary lymph nodes. Many patients suffer from severe shoulder complaints after axillary lymph node dissection even with postoperative rehabilitation. Pre-operative exercise and education are recommended to reduce the incidence of breast cancer related upper limb dysfunction; it will shorten the recovery time. The objectives of the study are to determine the influence of pre-operative physiotherapy on shoulder ROM using goniometer in subjects with modified radical mastectomy and to determine the influence of pre-operative physiotherapy on functional activities using shoulder pain and disability index (SPADI) in subjects with modified radical mastectomy.
Methods: 30 Subjects of adult women included in the study who met the inclusion criteria, divided into 2 groups. Experimental Group received preoperative physical therapy education and exercises 1-2 weeks before surgery and routine physical therapy protocol after surgery. Control Group received standard education brochure preoperatively and routine physical therapy post operatively. Measurements included shoulder ROM and functional evaluation using goniometer and SPADI. Measurements were taken at baseline i.e., pre operatively, post operatively at 4th day after removal of drains, and 1month after surgery.
Results: All measures were significantly reduced after surgery, but most recovered after 1month of surgery and attained functional level in experimental Group.
Conclusion: This study provides experimental evidence that preoperative education and exercise influence the postoperative shoulder ROM and functional activities after modified radical mastectomy. 

S. Sethana, V. Sri Kumari, K. Madhavi.

DOI : 10.15621/ijphy/2014/v1i4/54557

Pages : 178-186

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Introduction: Stroke is an event caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or blocked by a clot. Biofeedback can be defined as the technique of using equipment usually electronic to reveal to human beings about some of their internal physiological events normal and abnormal in form of auditory and visual signals.
Method: The stroke patients diagnosed by neurologist were recruited from physiotherapy department and inpatients from neurology and general wards of SVIMS hospital, Tirupathi Andhra Pradesh. In the present study 30 subjects were randomly assigned to 15 experimental and 15 control groups. The subject was made to sit comfortably and the Surfaces electrodes were placed on Extensor carpi radialis, Extensor digitorum communis muscle belly and for 30minutes patient voluntarily contracts until signals displayed on screen for which visually and auditory cues are given. In control group placebo EMG where machine is turned away & has no cues. Both groups received CONVENTIONAL PHYSIOTHERAPY; for 30 minutes at a Frequency: 1 hour per day for 5days in a week, for 6weeks.
Results: There was statistically significant (p<0.05) improvement in both variables from baseline to 6thweek in experimental group compared to control group.
Conclusion: Our study demonstrates the potential benefits of EMG BF in improving hand function in subjects with stroke. 

Dhvani N Shah, Annamma Varghese

DOI : 10.15621/ijphy/2014/v1i4/54563

Pages : 187-194

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Background: Balance is a key component of normal daily activities. Therefore, it is necessary to find various programs to improve balance. The core functions to maintain postural alignment and balance during functional activities. The purpose was to study the effects of the core stability training on dynamic balance in healthy, young adults.
Methods: It was an interventional study, in which 60 healthy young adults were selected. They were randomly divided into two groups of 30 each, one being experimental group and other control group. Measurement of their height, weight, BMI and leg length was taken. Subjects in both the groups were assessed for core stability with pressure biofeedback unit (PBU) and dynamic balance using Star Excursion Balance Test (SEBT) pre and post intervention. Subjects in the experimental group underwent progressive core stability training program for six weeks (3days/week) and control group was refrained from any type of structured training program.
Results: There was statistically significant improvement in core stability and dynamic balance of the experimental group after six weeks of intervention.
Conclusion: It is concluded that core stability training of six weeks duration is effective in improving dynamic balance in healthy, young adults.  

Jibi Paul, Pradeep Balakrishnan, Mohd Izham.

DOI : 10.15621/ijphy/2014/v1i4/54564

Pages : 195-199

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Background: Stretching exercises have been routinely used in persons with hamstring tightness and athletes to increase flexibility of muscle and to reduce joint injuries. Many studies have reported effect of static and dynamic stretching on flexibility of this muscle. Finding the best method to improve flexibility of hamstring muscle is important for athletes and individuals to reduce their injuries. Objective of the study was to find out the effect of static stretching exercise and dynamic stretching exercise on flexibility of hamstring muscle and also to compare the effect of static and dynamic stretching exercise on flexibility of hamstring muscle.
Methods: This was a comparative experimental study with seventy four female healthy subjects from physiotherapy department of KPJ Healthcare University College, Malaysia. Convenient sampling method used to select the samples. The subjects were selected by inclusion criteria and randomly divided equally in to two with 37 subjects in each group. Static stretching exercise and dynamic stretching exercise were given as intervention program for four weeks respectively for experimental and control group. Pre and post data of restricted range of movement for knee extension was measured using goniometry and documented separately for both group.
Result: In experimental and control group, pre-post statistical analysis found significant effect in increase of hamstring flexibility with P<0.0001, for right and left side. Comparative study between experimental and control group found that static stretching exercise have significant effect in increase of hamstring flexibility for right and left side with P<0.04.
Conclusion: This study concluded that static stretching exercise is more effective to improve hamstring flexibility compared to dynamic stretching exercise.

P. HimaBindu, A. Thiruppathi.

DOI : 10.15621/ijphy/2014/v1i4/54558

Pages : 200-204

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Background: Physiotherapists are known to incline work related musculoskeletal distress. In work put, the health awareness experts are defenseless against supporting the musculoskeletal issue amid the course of their work schedule, present study was a cross-sectional study completed among the physiotherapists in and around the Nellore town during 2010-2011.
Methods: A two-page poll with shut finished inquiries is utilized as the information gathered technique. Inquiries included word related history of physiotherapists and musculoskeletal side effects, exceptional regions, assignments, occupation related danger elements, damage counteractive action methods, and reactions to harm. Poll distributed to 40 physiotherapists in and Nellore region, among them 28 respondents returned their inquire form. Of them 20 faced work related musculoskeletal discomfort (WRMSD). Then the data was collected and analyzed.
Results: The result of present study showed high prevalence of injuries in physiotherapists. Prevalence of WRMSD's is higher among women (55%) compared to men (45%). The Physiotherapist respondents reported the highest level of work related musculoskeletal injury in the low back region. And next to the low back, most of the respondents reported the neck region and next to the neck, upper back, thorax, wrist and hands are affected.
Conclusion: Training and continuous professional development, physiotherapist still report on a high incidence of work related injuries during their professional practice. Therefore in workplace specific interventions to reduce work related musculoskeletal discomfort (WRMSD) developed and adequate prevalence and appropriate managing strategies are to be recommended to minimize the work related musculoskeletal discomfort (WRMSDs) in the practice. 

Shanthi C, Kamaraju B, Srikanth .I

DOI : 10.15621/ijphy/2014/v1i4/54559

Pages : 205-208

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Background: Numerous studies have documented on flexibility of muscles. Flexibility is defined as the ability of the muscles to lengthen allowing one joint or more than one joint in a series to move through a range of motion .Flexibility allows tissue to accommodate more easily to stress thus minimizing or preventing muscle injury. But this study sought to identify the study to compare the effectiveness of Static stretch and Hold relax technique over the hamstring flexibility.
Methods: 30 healthy male adults with Hamstring tightness aged 21 to 35 years selected from general population through simple randomized technique. Samples are divided into two groups, static stretch Group-I(no.15) and Group-II Hold relax (no.=15).The outcome was measured with help of sit & reach test to see the Hamstring flexibility.
Results: Comparison of the post test values of the group I and group II shows a significant difference between the outcomes of two groups with a “t” calculated value of 0.738 (unpaired “t” test).
Conclusion: Both static stretch and hold relax Technique can cause very highly significant result in Hamstring Flexibility, further comparison shows very high significant difference between two groups and concludes that hold relax is better than static stretch in Hamstring Flexibility. 

G. Hari Babu, Sreekar Kumar Reddy .R, A. Kiran Kumar, Dr. M. O. Krishna Murthy, J. Sushma Anand.

DOI : 10.15621/ijphy/2014/v1i4/54562

Pages : 209-214

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Background: Ligament injury accounts for nearly 40% of all injury problems in anterior cruciate ligament injury constitute nearly 50% of all knee ligament injuries. Anterior cruciate ligament deficiency affects not only the mobility, self-confidence and lifestyle of the affected persons in short term but also causes arithmetic changes in the affected knee in the long run. Purpose of study to find the effectiveness of concentric and eccentric for post anterior cruciate ligament reconstruction subjects on muscle strength, joint range of motion and pain.
Methods: 24 samples with age group of 35 years were randomly assigned to two groups Concentric and Eccentric groups. The Concentric group, performed 9 (3sets) concentric contractions for knee extensors and 9 concentric contractions for knee flexor muscles. The eccentric group done 9 (3 sets) eccentric contractions for knee extensors and 9 eccentric contractions for knee flexors.
Results: Pain is significantly decreased in concentric group. But not significantly decreased in eccentric group (t = 2.85, P = 0.009; and t = 1.40; P = 0.17). The range of motion is significantly increased in both concentric knee extension and flexion and eccentric knee extension and flexion (t = 3.53, P = 0.0023; and t = 4.55; P < 0.001). The quadriceps muscle strength is significantly improved in both concentric and eccentric groups at 60° / sec and 90° / sec.
Conclusion: The eccentric exercises are better than concentric exercises in improving the strength of hamstring and quadriceps muscles. 

Rajan Modi, Anjali Bhise, Fagun Patel.

DOI : 10.15621/ijphy/2014/v1i4/54561

Pages : 215-219

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Background: With the increasing number of cases for CABG, the cardiac rehabilitation has gained importance. The trends in rehabilitation of a coronary artery disease patient are changing by incorporating a variety of aerobic exercises and resisted training in to their rehabilitation program. The outcome of any exercise chiefly depends on the training parameters like intensity, frequency and duration. Hence the present study focused to know the effects of supervised moderate intensity exercises on patients during hospital discharge following CABG. The objective of is to study the effectiveness of supervised moderate intensity exercise on distance walked and Quality of Life at hospital discharge following CABG.
Methods: Study recruited randomly 46 patients between age group 40-65 years who were posted for non-emergency CABG for the first time. Pre-operative assessment was done thoroughly and was divided in to two groups, Group A conventional treatment and Group B Moderate intensity exercise group. The patients were treated using different protocols in terms of intensity for 8-10 days immediate post CABG. Then the outcome parameters of 6MWT and sf-36 were compared for analysis.
Results: Both groups individually showed extremely significant results for two outcome measures. 6 MWD difference between two treatment groups showed significant results with unpaired t test (t = 8.5720,p<0.001). Quality of life score difference within group showed very significant results but there is no difference found between both groups.
Conclusion: Moderate intensity exercises can also be included in the immediate post-operative phase of CABG, as they reduce the length of hospital stay and quicken the cardiac rehabilitation process. But there need to be a lot of randomized control trails to confirm the benefits of moderate intensity exercises in phase one rehabilitation program after CABG. 

Kiran Prakash Pappala, Pilladi R Sri Thulasi, Ch.Ashok Chakravarthi, Keerthi Chandrasekhar.

DOI : 10.15621/ijphy/2014/v1i4/54560

Pages : 220-226

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Background: The aim of this study is to evaluate the effect of modified constraint induced therapy on upper limb functional recovery in young stroke subjects. Most of the stroke rehabilitation units following conventional rehabilitation methods for treatment of the stroke patients where these methods have been proved to be less useful especially in the young stroke subjects. Hence the purpose of this study is to see the effect of modified constraint induced therapy which is a task specific training method for upperlimb in young stroke subjects.
Methods: Total of 40 young stroke subjects who is having minimal motor criterion and met other inclusion criteria were recruited from department of physiotherapy, g.s.l.general hospital. Pre and post intervention measures were taken using Wolf motor function test and Jebsen Taylor hand function test.
Results: In this study had shown significant improvements in the modified constraint induced therapy group when compared to the conventional rehabilitation alone. P value between groups was < 0.05.
Conclusion: In this study concludes that addition of 15 minutes modified constraint induced movement therapy to conventional physiotherapy is a useful adjunct in functional recovery of upper limb among young stroke subjects. 

Jibi Paul.

DOI : 10.15621/ijphy/2014/v1i4/54565

Pages : 227-232

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Background: Stroke is one of the most common neurological diseases that lead to disability in elderly population. Functional impairment of upper limb affects performance of activities in daily life. The primary objective of this study was to investigate and compare the effect of motor relearning program and thermal effect to improve upper limb motor function among stroke subjects.
Methods: Random sampling method was used to select subjects with right middle cerebral artery stroke. Twenty subjects were included and randomly divided into three groups by using lottery method, ten in each group A and B. Group A trained with MRP and group B with thermal stimulation. The outcomes were measured by the MMAS, and STREAM scale.
Result: Analysis of variance (ANOVA) used to find the significance of study parameters between the groups. Dependent t test was used to find the significance of study parameters between pre and post assessment within the group. According to the result Group A shows better improvement than group B, It shows that upper limb motor function improved significantly higher in Group A (P<0.001) when compared to Group B in MMAS and STREAM scale evaluation.
Conclusion: The present study concluded that physiotherapy treatment by the use of motor relearning program and thermal stimulation are effective technique in improvement of upper limb motor function among Stroke subjects. It has also proved that motor relearning program was more effective on improvement of motor functions in upper limb among MCA Stroke subjects. 

Priyesh P. Malgaonkar, Sai Kumar .N, Vinod Babu .K, Syed Rais Rizvi.

DOI : 10.15621/ijphy/2014/v1i4/54566

Pages : 233-240

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Background: Mulligan’s mobilization and Kinesio taping treatment techniques found to be effective on improving pain and functional disability for osteoarthritis of knee. Hence the purpose is to compare the effect of Mulligan’s mobilization and kinesio taping on improvement of pain and functional disability in subjects with osteoarthritis of knee.
Method: An experimental study design, 40 subjects with osteoarthritis of knee joint randomized 20 subjects each into Mobilization Group and Taping Group. Mobilization Group was treated with Mulligan’s Mobilization and Taping Group was treated with Therapeutic Kinesio Taping thrice a week for 2 weeks. Outcome measurements such as Visual analog scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional disability was measured before and after 2 weeks post intervention.
Results: Analysis using Paired ‘t’ test and Wilcoxon signed rank test found that there is a statistically significant improvement in VAS and WOMAC within the group. Comparative analysis using Independent‘t’ test and Mann Whitney U test found there is a statistically significant difference in post-intervention means between the groups.
Conclusion: The study concluded that both Mulligan’s Mobilization and Kinesio Taping techniques significantly shown short term effect on improvement of pain and functional disability for subjects with osteoarthritis of knee. However, there is no statistically significant difference in short term improvements between Mulligan’s Mobilization and Kinesio Taping. Among both, Mulligan’s Mobilization technique found clinically more effective with greater percentage of improvement than Kinesio Taping technique.