[International Journal of Physiotherapy 2014; 1(5) : 241-309] RSS



Pages : 241

B. Deekshita, V. Srikumari, K. Madhavi

DOI : 10.15621/ijphy/2014/v1i5/55273

Pages : 242-247

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Background: Stroke is an acute onset of neurological dysfunction resulting in the most common disability. Balance among these stroke subjects is impaired. To determine the effect of task oriented exercises on standing balance in subjects with stroke using performance oriented tinetti assessment score and single leg stance time is the need if the study.

Methods: Participants were taken from outpatient department of physiotherapy and neurology department in the institute. Randomized controlled trial with Prospective experimental design with simple random sampling including 30 subjects. An inclusion criterion includes stroke subjects with age 40- 75, both genders who were confirmed as stroke subjects by MRI n CT scan investigations. Right or left hemiplegia who are conscious and coherent were included. Subjects with spinal injuries, cognitive, perceptual disorders, shoulder subluxations, cardiac problems were excluded. Participants received daily 45 minutes of task oriented exercises protocol for 6days a week for 6weeks for study group and conventional physiotherapy for control group.

Results: Performance oriented tinetti assessment score and Single leg stance time which is valid and reliable measure for balance in stroke subjects was used. There is a significant improvement in performance oriented tinetti assessment score and single leg stance time from baseline to the end of intervention with significance (P<0.01) existing between the baseline and 6th week in both variables.

Conclusion: Task oriented exercises appeared effective in improving standing balance in subjects with stroke. Single leg stance duration improved on task oriented exercise approach.
Keywords: Stroke, standing balance, task oriented exercises, single leg stance.

N. Vamsidhar, A. Thiruppathi, R. Sreekarkumar reddy, Dr. Y. Sivaprasad, K. Suneelkumar.

DOI : 10.15621/ijphy/2014/v1i5/55275

Pages : 248-251

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Background: Flexibility is important in prevention of injury, muscular and postural imbalance more over the Hamstring flexibility has a lion share in sports performances and preventing DOMS. Stretching procedures increases the ROM by embarking on biomechanics and Neurologic and molecular mechanics. Hamstrings, the two joint muscle plays a crucial role in two joints integrity and also spine as they are in closed kinematic chain. The hamstring muscles represent the primary flexors of Knee. Hamstrings tightness results in Limits Knee extension when hip is flexed, Posterior Pelvic tilt, and flatten the lumbar spine.
Methods: The subjects selected randomly and divided into two groups (Experimental group and control group).30 samples in One group applied with Static Stretch once a day for 3 repetitions 5 days a week for six weeks and 30 samples in other group applied with Hold relax technique once a day for 4 repetitions 5 days a week for six weeks. The knee joint range of motion was measured at the end of every week with Universal goniometer.
Results: By comparing the means of Group – I, given Static Stretch and Group – II, given Hold relax Technique for six weeks implied that there is improvement of flexibility in Group – II and the ‘P’ value < 0.01 shows the difference is highly significant.
Conclusion: This study concludes that the hold relax Technique method has proved to be better technique then the static stretch for improving hamstring flexibility.
Keywords: Static stretch, Hold relax, Hamstring flexibility.

Vivek Sharma, Harraman Kaur, Dwivedee S

DOI : 10.15621/ijphy/2014/v1i5/55276

Pages : 252-254

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Background: Functional Electrical Stimulation (FES) can be used as an alternative to ankle foot orthosis (AFO) for foot drop following upper motor neuron lesions. A few patients with stroke might experience dystonia as part of its symptomatology. Dystonia can appear at presentation of the stroke or they may be delayed. Post stroke dystonia can affect either one side of the body (hemidystonia) or can be segmental or focal.
Method: A 20 year old male, known case of post stroke right foot dystonia was put on Functional Electrical Stimulation (FES) for walking. The ODFS pace device was used for stimulating his right evertors and dorsiflexors while walking. He was made to practice walking with the help of FES for 30 minutes every day, 6 days a week for 4 weeks. The outcome measures were 10 meter walk test, Berg Balance Score (BBS) and ankle range of motion.
Result: Despite using the FES, patient continued to experience the same gait difficulty i.e. twisting of right leg while walking although he reports having gained confidence while walking.
Conclusion: FES could be used as a novel symptomatic treatment for the abnormal contractions present during dystonia. There, however, is limited data for the role of FES in treating dystonia.
Keywords: Functional Electrical Stimulation, FES, Stroke, Dystonia, Foot Dystonia

Heba M Youssr El-Basatiny, Mahmoud Fathy El-Sharkawy

DOI : 10.15621/ijphy/2014/v1i5/55282

Pages : 255-264

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Background: To study the effect of indoor air pollution levels on postural balance control among Saudi school students.
Methods: Ninety healthy students (age from 12-16 years) were selected randomly from several preparatory schools representing two areas of different air pollution load and sources in the Eastern Province of Saudi Arabia (group A and B). Levels of carbon monoxide gas (CO), volatile organic compounds (VOCs) and particulate matter less than 10 microns (PM10) were measured at different sites inside the selected schools. The postural control was measured for each participant using Biodex Balance System in bipedal stance with eyes open at the most and least stable levels for 20s.
Results: There was no statistical significant difference for the mean values of overall stability index between both groups A and B at the most stable level (p=0.17), while there was a statistical significant difference at the least stable level with mean ± SD of group A and B 2.01±0.48 and 2.61±0.68 respectively. In addition, there were statistical significant differences between the mean levels of all measured air pollutants and overall stability index at the two stability levels in both groups (p<0.01).
Conclusion: Indoor air pollution, particularly exposure of students to VOCs, PM10 and CO, has an adverse effect on postural balance control among school students even at low exposure levels.
Key words: Postural stability, indoor air quality, air pollutants, school students.

Hritvansingh Parmar

DOI : 10.15621/ijphy/2014/v1i5/55284

Pages : 265-268

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Background: Osgood Schlatter disease (OSD) now classified as an apophysitis of the anterior aspect of the tibial tuberosity (ATT) is a common condition in an active youth athletes and is associated with growth spurts. The symptoms of Osgood Schlatter Disease mimics different condition and thus it has to be diagnosed rationally. Clinical features include mild to severe and intermittent or continuous pain, tenderness, swelling and limp while walking. Radiological features include enlarged and fragmented tibial tubercle. Treatment of Protection, Rest, Ice, Compression and Elevation (PRICE) protocol is generally given in the initial stages followed by the complete rehabilitation of athlete into sports.
Methods: I present the case of a patient, fifteen year old boy presenting the symptoms of pain, tenderness, swelling and limp while walking. He was referred by Orthopedician and he was on diclofenac medications. His detailed evaluation was carried out and was diagnosed on the basis of history, clinical findings and radiographic investigations as Osgood Schlatter Disease.
Treatment: A three phase rehabilitation treatment plan was developed which was typically aimed at return of athlete as early as he can to the sports circuit. In Acute phase, Ice and rest was given; In Recovery phase, strengthening of surrounding musculature was given; In Maintenance phase, changes were made to athlete’s playing style with the help of Coach.
Conclusion: Initial assessment, PRICE Protocol and making changes in playing style of the athlete helps in treating Osgood Schlatter Disease. The causative factor has to be looked upon while treating this condition.
Keywords: Osgood Schlatter disease, Young athletes, PRICE protocol, Patellar tendon, Tibial tuberosity, Sports.

Virali R. Raval, Vinod Babu, Sai Kumar. N, Amrita Ghosh

DOI : 10.15621/ijphy/2014/v1i5/55287

Pages : 269-278

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Background: Cervical Traction and Neural Mobilization both have been individually advocated for treatment of Cervical radiculopathy due to their various effects. But the combined effect of these techniques applied simultaneously has not been explored in studies. Hence the purpose is to find the effect of simultaneous application of cervical traction and neural mobilization on improvement in neck pain, radicular symptoms and neck disability in subjects with Cervical Radiculopathy.
Methods: An experimental study design, 60 subjects with Unilateral Cervical Radiculopathy and ULTT1 positive for median nerve bias, randomized 20 subjects each into three groups- Group A, B and C respectively. Group A received both Cervical Traction and Neural Mobilization. The Group B received only Mechanical Cervical Traction. The Group C received only Neural Mobilization. The duration of intervention was given 3 treatment sessions per week for four weeks. Outcome measures such as Numerical Pain Rating Scale, Global Rating of Change Scale, Neck Disability Index were measured before, at the end of 2nd and 4th week post treatment.
Results: Comparison of post intervention means at 2nd and 4th week of treatment there is a statistically significant (p<0.05) difference in improvement in outcome measures between three groups. Group A subjects shown greater percentage of improvement than Group B and Group C.
Conclusion: The present study concludes that simultaneous application of mechanical cervical traction with neural mobilization is more effective in improving pain, functional disability and severity of radicular symptoms than mechanical cervical traction and neural mobilization alone for subjects with Unilateral Cervical Radiculopathy.
Key words: Cervical Radiculopathy, Neck Pain, Median Nerve, Cervical Traction, Neural Mobilization, Pain, Neck Disability, Global Rating.

L. V. S.Pravallika, C. Shanthi, K. Madhavi

DOI : 10.15621/ijphy/2014/v1i5/55272

Pages : 279-285

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Background: Chronic nonspecific low back pain (CNSLBP) i.e., low back pain of at least 12 weeks duration without a specific cause is a major cause of activity limitation, absenteeism , and high health care expenses. The prevalence of CNSLBP is estimated approximately 23% and activity limitation due to LBP have been found to be 11% to 12% of the population. Previous studies comparing the efficacy of postero-anterior mobilisation and prone-press ups were done and revealed statistically significant improvements in extension ranges but not clinical relevant improvements. This is possibly attributable to single session of interventions. So long term gains in pain reduction and lumbar extension cannot be assumed. Hence this study would be intending to prove the effect of postero-anterior mobilisation and prone press ups on chronic non-specific low back pain after 6 weeks and their clinical application.
Methods: 30 subjects who met the inclusion criteria were selected randomly from the department of physiotherapy, SVIMS and BIRRD, Tirupati. The study conducted for a period of 6 weeks.2 groups were formed with 15 in each group. PA lumbar glide and prone press up's was given to group I and only prone press up's was given to group II. Subjects were evaluated pre and post treatment for VAS, extension ROM of lumbar spine and functional disability.
Result: Results showed that there exists a statistical significance between the groups in all the 3 parameters. Present randomized clinical trial provided evidence to support the use of postero-anterior mobilisation and prone press-ups in relieving pain, improving ROM and reducing disability in subjects with non-specific low back pain. In addition, results supported that postero-anterior mobilisation was more effective than prone press-ups.
Keywords: Nonspecific low back pain, prone press up, postero anterior spinal mobilizations.

Samuel Kirubakaran Durairaj, Divya Singh, Nishad Kassim

DOI : 10.15621/ijphy/2014/v1i5/55269

Pages : 286-298

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Background: Physiotherapy is a well-accepted modality in the rehabilitation process of cerebellar dysfunction. Despite being commonly accepted as rehabilitation measure there is a need for scientific evidence to prove role of Physiotherapy in persons with cerebellar dysfunction. This study is an effort to systematically review the literature investigating the effectiveness of physiotherapy in adults with cerebellar dysfunction and to document treatment strategies currently employed in the physiotherapy management of this patient population.
Methods: Four electronic databases were searched to source English language studies published up to 30th April 2014. Secondary searching of reference list was also undertaken. Studies were included in this review if their primary intervention was physiotherapy on adults with cerebellar dysfunction. Three independent reviewers were involved in this study. Each contributed to the study by analyzing data related to participants, interventions received and effectiveness of each intervention as measured in research articles. The relevant outcomes were described adopting a narrative synthesis.
Results: Eleven studies were reviewed. Majority of studies (n=10) were case studies or case series. The average quality score was 1.9 (range 1-10). All studies reported positive outcomes of rehabilitation measures both from the scientific point of view and also from participants’ perspective. No meta-analysis was undertaken in this study.
Conclusion: There is modest evidence that physiotherapy may have a positive effect on the various limited abilities of adults with cerebellar dysfunction. The outcome measures however need cautious interpretations due to otherwise low volume, quality and clinical applicability of the this aftermath as per the available evidences analyzed by the researchers. There is also a need of high-quality researches to be carried out.
Keywords: Cerebellar dysfunction, Physical Therapy, cerebellar, dysfunction.

V. Kiran, Bhimasen .S, E. Mastanaiah, A. Thiruppathi

DOI : 10.15621/ijphy/2014/v1i5/55267

Pages : 299-303

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Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD) and autogenic drainage (AD) on level of oxygen saturation in blood, and amount of sputum recovery.
Methodology: The study was done on 60 patients with COPD. Dividing Patients into two group and patients were treated with PD or AD in separate Groups. The effectiveness of the treatment was measured up to 6 days. Pulse oximetry was monitored and sputum was collected immediately after treatment and 15 minutes following each treatment.
Results: The results of the study shown that there was significant difference in the amount of sputum recovered with AD (14.0±3.5 g) vs PD (24.4±3.0 g) and significant differences in Oxygen saturation; during PD fell from 93.3±0.7% to 91.2±0.8% (p<0.01) and required 15 min following treatment to return to baseline. Oxygen saturation did not fall during AD and increased to gradually following complete treatment days (baseline, 93.3±0.8%; p<0.01).
Conclusion: Hence this study concludes that Autogenic drainage is more effective in improving spo2 in COPD & does not cause a sudden fall in spo2 as occurs in Postural drainage immediately after therapy. And it can be better tolerated by patients with COPD while producing fewer benefits in sputum clearance. In concern to mean amount of secretion removal Postural is found to be more effective.
Keywords: autogenic drainage, postural drainage, oxygen saturation, chronic bronchitis

Ganesh Sundaram Subramanian, Vengata Subramani Manoharan

DOI : 10.15621/ijphy/2014/v1i5/55268

Pages : 304-309

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Background: Childhood obesity has reached epidemic proportions worldwide and is associated with increased cardio vascular mortality and morbidity in adult life. In children, obesity correlates strongly with a progressive reduction in the level of physical activity and changes in food habits.
Methods: This study is a qualitative research study. A secondary data collection technique was utilized and conducted through a search of articles published between 2005 and 2014 in PubMed and Google scholar databases. The objective of the present study is to provide a systemic review of the available literature and outline the factors in early life that are associated with an increased risk of obesity in children there by leading to poor gross motor skill performance with the help of Anthropometric assessment, Body composition and Motor skills proficiency.
Results: Importantly recent studies have demonstrated that exercise training improves vascular endothelial function and stimulation of pressure receptors leading to increased vagal activity in obese children. The current literature highlights the importance of adding exercise programs to clinics, schools and families for the physical and psychological wellbeing of children.
Conclusion: Overall findings from the present review showed that normal children with physical exercise are more superior in motor skills compared to other peers. Results of the previous studies indicated that normal children’s are more efficient in bilateral coordination in greater balancing, efficient upper limb coordination and greater strength.
Keywords: Children, obesity, physical activity, fine motor skills.