[International Journal of Physiotherapy 2015; 2(1) : 310-390] RSS

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DOI : N/A

Pages : 310

Neelam Nayak, Pranali Mahajan.

DOI : 10.15621/ijphy/2015/v2i1/60032

Pages : 311-316

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ABSTRACT

Background: Mobility impairments seen after Stroke impact walking speed, endurance and balance. Almost all the individuals with Stroke have fear of fall. The physical impairments in balance and gait along with individual’s perception about his/her own abilities to maintain balance might have an impact on level of activity and participation in the community. The association of these variables with recovery of Stroke has been well studied. However, it is currently unknown which of these variables are most associated with activity and participation in the community. This study aimed to identify the correlation of walking capacity and perception of fall with activity & participation.
Methods: 30 Subjects were assessed for - walking capacity (6 minute walk test) & Self-efficacy for falls (Modified Falls Efficacy scale). Level of Activity Limitation (AL) & Participation Restriction (PR) was graded on validated ICF Measure of Participation and Activities. (IMPACT-S)
Results: Data was analyzed using Pearson's correlation coefficient & regression model. Walking distance and Falls-efficacy is significantly correlated (r=-0.751 and -0.683, respectively) with Participation restriction. Walking distance correlated with Activity Limitation (r=-0.714) significantly. Falls efficacy has a correlation coefficient of -0.642 with Activity Limitation. When put into Regression models, Walking Capacity & Gait Velocity was found to be independently associated with AL &PR.
Conclusion: There is significant relationship between falls self-efficacy, walking capacity and Post-stroke activity & participation. Participation can be impacted by factors such as self-motivation and confidence about one's balance abilities. This is reflected by the correlation between falls efficacy and participation. Physical parameters such as the distance walked can contribute to participating in the community, and can predict variation in AL-PR
Keywords: Falls efficacy, Activity Limitation & Participation restriction, IMPACT(S)

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Dr. Rohit Subhedar, Dr. Pallavi Dave, Dr. Priyanka Mishra, Dr. Dirgha Mehta

DOI : 10.15621/ijphy/2015/v2i1/60034

Pages : 317-326

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ABSTRACT

Background: This study deals with the evaluation of body composition and fitness of individuals who differ in their physical characteristics viz. weight, height, Age, Sex, Body Frame and physical activity levels viz. Heavy, Moderate, Light, and thereby identify the ideal combination of physical characteristics and physical activity required in Prescribing Exercises for attaining “THE PERFECT BODY COMPOSITION”.
Method: Assessments of physical characteristics, physical activity and body composition was done for 88 subjects of age group between 20-40 years. Body composition analyzer used was Futrex-5000/XL based on near infrared inheritance light technology. Total data was divided into 5 test groups according to their BMI.
Results: Results showed that overweight individuals were classified into individuals having risky health status due to excess amounts of fat mass (28.45), higher BMI and lower physical activity. The study also showed greater body frame size in overweight individuals when compared to underweight or normal weight individuals. Whereas Lean individuals possessed very low percent body fat and high levels of physical activity. LBM% showed alarming increase among abnormally underweight males (94%) and females (91.3%) due to abnormal decrease in fat% making them physically unfit.
Conclusion: It is concluded that, physical fitness of an individual depends upon his/her physical characteristics and also upon the level of physical activity performed. Body composition can be considered as an ideal parameter for evaluating physical fitness with special emphasis on physical characteristics and Individualized Prescription of physical activity and Physical exercises in Physiotherapy.
Key words: Body composition, Physical characteristics, Physical activity, Body fat, Lean Body mass, BMI
 
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Shefali Gambhir, Narkeesh Arumugam

DOI : 10.15621/ijphy/2015/v2i1/60035

Pages : 327-332

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ABSTRACT

Background: Focal hand Dystonia is shown by involuntary muscle contractions in the arm or hand while writing with a disordered neuroplastic changes in the brain. Symptoms can include lack of co-ordination, cramping and tremor and tend to be specific for each individual. So, the present study evaluates the effect of an integrated approach that is employed to improve functional independence in a patient suffering from focal hand dystonia.
Case Description: The benefits of sensorimotor task specific training along with electrical muscle stimulation in the rehabilitation of focal hand dystonia is reported in this study. The treatment protocol is planned according to the problem list of the patient and an intervention of 20 days (1 hour per day, 5 days per week for 4 weeks) is given to the patient.
Outcome Variables: Prognosis is observed in Burke-Fahn-Marsden scale, global dystonia scale, Jedynak’s protocol and unified dystonia rating scale before & after the intervention. A Depression anxiety stress scale is also used to assess the psychological status of the patient.
Conclusion: Considerable improvement is seen in writing and fine motor skills after the rehabilitation. It is observed that the electrical muscle stimulation in conjunction with sensiromostor task specific training induces excitability in the muscles and improve the clinical function in patient with focal hand dystonia.
Keywords: dystonia, hand, sensiromotor training, Handwriting, Electrical Stimulation
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REFERENCES
1. Farlex. The Free Dictionary [online]. USA: Huntingdon Valley; © 2010 [cited 2010 January 6].URL: www.thefreedictionary.com.
2. Mitchell F. Brin, Cynthia L. Comella, Joseph Jankovic, Dystonia: etiology, clinical features and treatment.2004.
3. Fahn et al., Classification and investiga-tion of dystonia. In Marsden, C. D. and Fahn, S. (Eds.), Movement Disorders 2.London: Butterworths, 1987.
4. Fahn et al., Classification of dystonia. Adv Neurol, 1998; 78: 1–10.
5. Rosenkranz et al. Pathophysiological differences between musician’s dystonia and writer’s cramp. Brain.2005; 128: 918–931.
6. Rose, Neurology of music, Focal Hand Dystonia Affecting Musicians, Chapter 24, Imperial College Press, 2010.
7. Delnooz and Warrenberg, Current and future medical treatment in primary dystonia, Ther Adv Neurol Disord, 2012;5(4):221–240.
8. Okun MS. The dystonia patient. A guide to practical management. New York: Demos Medical Publishing, LLC; 2009:122-142.
9. Hallett, Pathophysiology of writer’s cramp. Hum Movement Sci.2006;25:454–463.
10. Meesen et al., The Effect of Long-Term TENS on Persistent Neuroplastic Changes in the
Int J Physiother 2015; 2(1) Page | 332
Human Cerebral Cortex, Human Brain Mapping, 2010;1-11.
11. Singam et al., Writing orthotic device for the management of writer’s cramp, Frontiers in Neurolog., 2013;4:1-4.
12. Waissman et al., A new therapeutic proposal for writer’s cramp: a case report, Sao Paulo Med J. 2010; 128(2):96-8.
13. Byl et al., Effect of Sensory Discrimination Training on Structure and Function in Patients With Focal Hand Dystonia: A Case Series, Arch Phys Med Rehabil.2003;84:1505-1514.
14. Waissman et al., Sensitive training through body awareness to improve the writing of patients with writer’s cramp, Neurology International, 2013;5:84-88.

 

M. Srikanth, Dr.V.Srikumari, Dr.K.Madhavi

DOI : 10.15621/ijphy/2015/v2i1/60040

Pages : 333-340

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ABSTRACT

Back ground: Myofascial trigger point (MTPt) can be defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. MTPt is associated with pain on compression, the pain is typically of a referred type. MTPt symptoms, cause severe discomfort and inability to work. The pain is aggravated with activity or stress. Untreated, chronic cases might lead to symptoms like depression, fatigue and behavioural disturbances. The objective of the study is to examine the effectiveness of MET on pain with VAS and cervical ROM with inch tape method in patients with myofascial pain in upper trapezius.
Methods: participants were randomized into intervention group (n =15) and control group (n = 15).The intervention group was given muscle energy technique, ischemic compression and ultrasound. The control group was given only ischemic compression and ultrasound. Ultrasound 1 MHz continuous mode, intensity 1.5W/cm2 for 5 minutes. Home exercises taught to both the groups. This program designed for daily for 1 week. Outcome measures: Pain-VAS, ROM-Inch tape method (cervical lateral flexion).
Results: values within the groups were compared by using paired `t` test. According to obtained values, the pre & posttest values of pain and ROM had an significant effect on p-values 0.00 in experimental group. The difference between the pretest and posttest scores of 95% confidence intervals for each outcome variable was reported.
Conclusion: After 1 week of intervention protocol, the present study concludes that MET has significant improvement in pain, ROM in intervention group.
Keywords: MET, Ultrasound, ischemic compression, myofascial trigger point, trapezius.
 

Jaisinghani Nami Suresh, Jiandani Mariya Prakash, Mehta Amita Anil

DOI : 10.15621/ijphy/2015/v2i1/60037

Pages : 341-346

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ABSTRACT

Background: Pain has been pointed out as one of the chief concerns of patients following a cardiac surgery. Adjunctive methods of postoperative pain control that may limit narcotic side effects are of considerable interest. The study aimed to evaluate the effectiveness of Transcutaneous electrical nerve stimulation (TENS) for treatment of post-operative pain in patients who underwent cardiac surgery using a median sternotomy. In addition, we sought to compare effectiveness of TENS and SHAM (placebo) TENS on
1. Pain at rest
2. Duration Of analgesia following the intervention.
Methods: Twenty patients (8 females and 12 males) each during the 24-96hr post-operative period were a part of the study. They were randomly allocated to two groups: TENS & pharmacological analgesia (n=10) and SHAM & pharmacological analgesia (n=10). The Visual Analogue Scale (0-10) was used to assess the post-operative peri- incisional pain.
Results: It was seen that both TENS and SHAM TENS (P value is 0.0917) were almost equally effective in reducing peri- incisional pain following a cardiac surgery through a median sternotomy. However, the duration of analgesia following treatment with TENS was significantly greater than that with SHAM TENS.
Conclusion: Therefore both TENS and SHAM TENS can be used as a valuable strategy to alleviate post-operative suture site pain following a cardiac surgery, both clinically and statistically, but the duration of analgesia following TENS is significantly greater than that following SHAM.
Key words: Transcutaneous Electrical Nerve Stimulation, TENS, Pain
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REFRENCES
1. Xavier M. Mueller, MD; Francine Tinguely, MD; Hendrick T. Pain, Location, Distribution, and Intensity after Cardiac Surgery. Chest. 2000 ;118(2):391-6.
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4. And Paulo Alberto Tayar Peres. Short-term transcutaneous electrical nerve stimulation after cardiac surgery: effect on pain, pulmonary function and electrical muscle activity. Interact Cardiovasc Thorac Surg. 2008 ;7(4):539-43
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Uday Raj J, Prof. Srikanth R, Khyati G, Balakrishna G

DOI : 10.15621/ijphy/2015/v2i1/60039

Pages : 347-351

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ABSTRACT

Background: Tendon transfer surgery is usually done to improve function, following damage to either major nerve trunks or peripheral nerves. Re-education of the muscle is of utmost importance to gain functional activity.To achieve this, along with re-education exercises, faradic stimulation is usually used. Unipolar Acu-Stim (UAS), is an innovative technique where an acupuncture needle is used to stimulate the transferred tendon with Surged Faradic Currents (SFC). The objective of the study is to identify if the application of SFC using UAS method, is effective to re-educate a transferred muscle.
Case Description: The subject was a 24 year old male who had a loss of finger and thumb extension following Posterior Interosseous Nerve (PIN) palsy, for which Flexor Carpi Radialis (FCR) was transferred to Extensor Digitorum Communis (EDC) and Palmaris Longus (PL) was transferred to Extensor Pollicis Longus (EPL). Following removal of the POP, UAS with surged faradic current was applied for 4 weeks along with re-education exercises. Prognosis of finger extension was assessed by goniometry and video recordings.
Outcome: At the end of 8th week, as observed on goniometry and video recordings, complete finger extension was achieved.
Discussion: UAS with SFC, is useful in re-education of a transferred muscle, as desired movement can be achieved with low intensity.
Keywords: Acu-Stim, Surged Faradic Current, Electric Stimulation, Tendon Transfer, Electroacupuncture, Muscle Re-education.
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Dr. Venkata Naga Prahalada Karnati, Sreekar kumar reddy.R

DOI : 10.15621/ijphy/2015/v2i1/60041

Pages : 352-360

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ABSTRACT

Background: Conventional back care exercises are advocated to treat the pain and to strengthen the involved muscles. There will always be the possibility of the pain getting recurred due to disproportionate balance and stability in the muscles. The core stabilization is major trend in rehabilitation. It aims at improving stability during functional activities, balance, flexibility, strength training and effectively manage the pain as well.
Methods: Forty patients with chronic Mechanical Low back pain were randomly assigned into control group that received conventional back exercises and SWD (n=20), experimental group received core stabilization and SWD (n=20). Both the groups received SWD, along with conventional back exercises for one-group and core stabilization for the other group 3 days a week for 6 weeks .The treatment outcome was assessed using visual analogue scale, Rolland Morris Disability Questionnaire and Lumbar range of motion by using goniometer.
Results: After a 6 week training period the core stabilization group scored significantly higher than the conventional group for VAS (p=0.05) and RMDQ (p=0.05) where as ROM improved higher in conventional group (p=0.05)
Conclusion: After the treatment sessions Core stabilization group registered a significant improvement when compared to conventional back care exercises in improving function and in relieving pain.
Key words: core stabilization, conventional exercises, Mechanical low back pain, Physio ball, VAS, RMDQ, and ROM.
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3. Carpenter DM, Nelson BW: Low back strengthening for the prevention and treatment of low back pain, Med Sci Sports Exerc.1999; 31(1): 18-24.
4. Panjabi MM: Clinical spinal instability and low back pain, J Electromyogr Kinesiol.2003;13(4): 371-9.
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8. Granata KP, Wilson SE: Trunk posture and spinal stability. Clin Biomech (Bristol, Avon). 200;16(8): 650-9.
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10. Van Dieen JH, Cholewicki J, Radebold: A. Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine. Spine.2003; 28(8): 834-41.
11. Akuthota V, Nadler SF: Core strengthening, Arch Phys Med Rehabil. 2004;85(3 Suppl 1): S86-92.
12. Yilmaz F, Yilmaz A: Efficacy of dynamic lumbar stabilization exercise in lumbar microdiscectomy, J Rehabil Med.2003; 35(4): 163-7.
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16. R S Jemmett: Rehabilitation of lumbar multifidus dysfunction in low back pain: strengthening versus a motor re-education model. Br J Sports Med.2003 37(1):91.
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Jibi Paul, Dr. M S Nagarajan

DOI : 10.15621/ijphy/2015/v2i1/60042

Pages : 361-364

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ABSTRACT

Background: Football is the world's most popular sport. There are over 240 million registered players worldwide and many more recreational footballers. The knee is a complex joint with many components making it vulnerable to a variety of injuries. The study has investigated the effect of knee proprioception error on injured and uninjured male professional footballers.
Methods: This was a cross sectional comparative study with hundred and six (106) male professional footballers were selected for the study as per the selection criteria. Hundred and eighteen injured and ninety four uninjured knee samples were analysed for this study. Photographic analysis method was used to evaluate proprioception error at inner, middle and outer range of knee joint. Proprioception error of knee joint was measured at inner range, middle range and outer range for injured and uninjured groups. Data analysis found that there is significant difference in proprioception error between the groups.
Result: Comparative study was performed using independent t’ test for proprioception error between knee injured and uninjured groups. P<0.05 were considered as significant difference in effect for this study. The means of knee injured and uninjured groups were 6.08 and 5.55 respectively with t’ value 2.21 and degree of freedom 634. The study found that proprioception error has significant difference in effect on knee injury, with P< 0.03*.
Conclusion: The study concluded that proprioception error was varied between knee injured and uninjured groups. Proprioception error of knee joint was more among injured male professional footballers compared to the uninjured footballers. 

Niha Siraj Mulla, Vinod Babu. K, Sai Kumar. N, Syed Rais Rizvi

DOI : 10.15621/ijphy/2015/v2i1/60050

Pages : 365-375

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ABSTRACT

Background:A temporo-mandibular joint dysfunction or TMD is a group of conditions characterized by pain in the muscles of mastication, the temporo-mandiblar joint or both. Rocabado has described techniques includes the Rocabado’s manipulation and Rocabado’s exercises which have both been individually advocated for treatment of TMD. The purpose of study is to determine the effectiveness of Rocabado’s techniques on TMJ dysfunction symptoms, pain, TMJ Range of Motion (ROM) and jaw functional limitation for subjects with temporo-mandibular joint dysfunction.
Method: Pre to post test experimental study design, subjects with temporo-mandibular joint dysfunction randomized into two groups with 15 subjects into each group with total of 30 subjects in Study and control group, respectively. The study group received the Rocabado’s technique which consisted of Rocabado’s non-thrust TMJ manipulation and Rocabado’s exercises along with conventional TMJ exercises and the control group received only conventional TMJ exercises. The exercises were performed for 6 times per each session, six times in a day, one session under supervision and remaining five sessions by the subject at home for 6 days in a week for duration of 2 weeks. The outcome measurements such as VAS for pain, TMJ ROM, Fonseca’s questionnaire rating for TMJ dysfunction symptoms and jaw function limitation score (JFLS) was measured before and after two weeks of intervention.
Results: Comparative analysis, using Independent ‘t’ test and Mann Whitney U- test found that the means of VAS, TMJ ROM, Fonseca’s questionnaire and JFLS scores showed statistically significant difference (p <0.05) when the pre-intervention means and post-intervention means were compared between two groups.
Conclusion: It is concluded that Rocabado’s technique found to have statistically and clinically significant added effect with conventional TMJ exercises shown greater percentage of improvements obtained in reducing TMJ dysfunction symptoms, pain, jaw functional limitation and increasing TMJ ROM comparing with only conventional TMJ exercises in subjects with Temporamandibular joint dysfunction with restricted mouth opening mobility. 

Chintan Patel, Vinod Babu .K, Sai Kumar .N, Asha .D

DOI : 10.15621/ijphy/2015/v2i1/60052

Pages : 376-385

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ABSTRACT

Background:There is a basic assumption from the studies on hip–LBP relationship that suboptimal function of the hip might result in an alteration of the mechanics of the lumbopelvic region. Evidence is mounting to support the possibility that low back pain may be result of hip rotation deficits. The excessive or limited hip rotation range of motion could be a predisposing factor for low back dysfunction. Exercises and hip joint mobilization, individually found to be effective in chronic nonspecific low back pain with hip impairment. Hence, the purpose is to find the effect of hip joint mobilization with stretching exercises on intensity of pain and functional disability for subjects with chronic nonspecific low back pain associated with hip impairment.
Method: An experimental study design selected 30 subjects with chronic low back pain associated with Hip impairment randomized 15 subjects each into Study and Control group. Control group received stretching exercises while Study group received hip joint mobilization with stretching exercises thrice a week for 3 weeks. Pain intensity was measured using Visual Analogue Scale and Functional disability was measured by Modified Oswestry Disability Index for LBP before and after 2 weeks of treatment.
Results: There is statistically significant difference in improvement in means of VAS and Modified ODI when analyzed within the group. When the post-intervention means were compared between Study and Control group there is a statistically significant difference in means after 2 weeks of treatment.
Conclusion: The present study concluded that the two weeks duration of combined hip joint mobilization with stretching exercises significantly effective on improving pain and functional disability than only stretching exercise regimen for chronic non-specific low back pain associated with Hip impairment. 

Suneel Kumar Immadi, Kiran Kumar Achyutha, Dr. Amaranth Reddy, Krishna Priya Tatakuntla

DOI : 10.15621/ijphy/2015/v2i1/60047

Pages : 386-390

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ABSTRACT

Background:More than decades Stroke is one of the most frequently occurring disabling disease in the world. Reduced upper extremity function affects the ability to perform activities of daily living, which is likely to reduce independence, function of upper extremity is more difficult than the lower extremity. It can seriously impact the progress of rehabilitation.
Methods: 60 outpatients are identified irrespective of hemorrhagic or thrombotic stroke, among those 30 patients received 40 1-h sessions in eight weeks (5 days/week) of conventional physiotherapy programme taken as group-A and another 30 patients were received 40 1-h sessions in eight weeks (5 days/week) of Motor relearning programme taken as group-B.
Results: After the treatment sessions Patients who received motor relearning programme showed significantly better functional ability when assessing their functional status by task oriented performance than the conventional physiotherapy programme in both outcome scoring values, mean age of the subject who participated in study is 51 years. FMA (n=30 post-test mean=32.27 GROUP-A post-test mean=43.80 GROUP-B T test value t = 5.3743, p- value= < 0.0001) WMFT (n=30 post-test mean=39.80 GROUP-A, post-test mean=71.45 GROUP-B T test value t = 10.3401, p- value= < 0.0001)
Conclusion: Motor relearning programme is found to be effective than the conventional physical therapy programme for enhancing functional recovery of the upper limb in stroke patients.