[International Journal of Physiotherapy 2015; 2(2) : 391-464] RSS



Pages : 391

Khushwant Kaur, Jaspal Singh Sandhu

DOI : 10.15621/ijphy/2015/v2i2/65248

Pages : 392-398

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Background: The primary driver of the epidemic of diabetes is the rapid epidemiological transition associated with changes in dietary patterns and decreased physical activity as evident from the higher prevalence of diabetes in urban population. Diabetes mellitus is increasing at an alarming rate in India. It is evident that physical activity (walking) is beneficial in management of this disease. Walking can be effective in reducing weight, body mass index, waist hip circumference, body fat, blood pressure and thus cholesterol, high density lipoproteins ratio and may be effective in improving mood and quality of life. The objective of the present study was measuring the normal physical activity in terms of step counts done by the type-2 diabetes mellitus (T2DM) patients and analyse the dietary pattern followed by T2DM.
Methods: Eighty adults with type-2 diabetes mellitus were randomly allocated for observation of their normal daily physical activity using pedometer for whole day which means starting from early morning get up till bedtime in night. The subjects had been asked to count their steps in a particular activity also.
Results: The mean value of step count with standard deviation among females (n=31) was found to be 9173.23 ± 3862.025 which was lesser than that among males (n=49) that is 9695.49 ± 5221.291. After measuring step count in any particular activity task, the mean value 2583.35 ± 2562.08 was found to be more in males than females where mean value was found to be 2197.13 ± 1732.75. The mean step count among total sample (n=80) was 9493.11 ± 4721.626 and mean particular activity step count was 2433.69 ± 2272.541.
Discussion: This study showed that some subjects were so aware of their disease that they were found to be highly active after knowing their disease and condition. On other hand, there were some subjects having sedentary lifestyle with their HbA1c at the high risk level. They thought it to be as it is for the rest of their life that it is incurable so this study helps them to make aware of the modified lifestyles and dietary habits with which they can control their glucose level, cholesterol by having a routine of some physical activity.
Conclusion: It can be concluded from the present study that physical activity among the subjects with Type II diabetes was very low and it supports the clinically proven facts by other studies that more the physical activities, more is the control in blood sugar level and cholesterol level in subjects with Type II diabetes.  

Brian T. Swanson, Robin R. Leger

DOI : 10.15621/ijphy/2015/v2i2/65249

Pages : 399-406

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Background: Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure. However, there is substantial debate regarding the role of physical therapy following this procedure. Therefore, we sought to determine current physical therapy practice following ACDF surgery, as well as determine physical therapists beliefs regarding rehabilitation following ACDF.
Methods: One hundred and eighty three licensed Physical Therapists were invited to participate in a descriptive internet based survey; a total of 53 (29%) completed the survey. Physical Therapists were assessed for their current practice, asked to rate the clinical usefulness of various treatment modalities, and indicate their recommendations regarding post-operative physical therapy for subjects following anterior discectomy and fusion. Results were then assessed for frequency distributions, with chi-square analysis for association between demographic data and practice recommendations.
Results: The results indicate that Physical Therapists believe patients achieve superior outcomes with the inclusion of post-operative physical therapy, with a low risk of harm. Specific treatments indicated as most useful included endurance exercise (60.4%), isometric strengthening (56.6%), and stretching (45.3%). Other treatment options are discussed in detail.
Conclusion: Physical Therapists identified specific activities that they felt were most appropriate for rehabilitation following ACDF surgery. These findings may help to direct both appropriate therapy prescription following ACDF, as well as future research. 

Jibi Paul

DOI : 10.15621/ijphy/2015/v2i2/65250

Pages : 407-415

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Background: Ankle sprain is one of the major causes of disability in professional footballers. Objective of this study was to find out the effectiveness and to compare the effectiveness of the proprioceptive training and technical training immediately after the end of the treatment and after three months follow up in prevention of recurrent ankle sprain among professional footballers.
Methods: 30 subjects with previous history of grade I or grade II ankle sprain, within one year were selected for the study. They were randomly divided into two groups equally treadmill 15 in each group A and group B. Group A and B received five minutes of warm-up by brisk walk on treadmill. Group A and B underwent 20 minutes of unilateral balance board training and unilateral vertical jump respectively.
Results: Pre and post data were analyzed using Mann-Whitney test, Wilcoxon’s sign rank test, paired‘t’ test. Intra group analysis showed that both groups have shown significant improvement with P < 0.001, after the treatment. Inter group were analyzed the post scores of both groups and found no significant difference on proprioceptive training over technical training on recurrence of ankle sprain among professional footballers.
Conclusion: The study concluded that proprioceptive and technical training are equally effective on prevention of recurrent ankle sprain among professional footballers with previous history of grade I or grade II ankle sprain.   

Dr. A. Viswanath Reddy, Dr. B. C. M. Prasad, Dr. G. Ravindra Reddy, Dr. Arun G. Maiya

DOI : 10.15621/ijphy/2015/v2i2/65251

Pages : 416-420

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Background: Pressure ulcers are injuries to skin and underlying tissues resulting from prolonged pressure on the skin which often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and sacrum. Without care, pressure ulcers continue to grow in diameter and depth and are exceptionally difficult to heal. Therefore, enormous effort is required to find effective and reliable techniques for preventing the initiation of ulcers and eliminating them once they develop. This study has been done to assess the efficacy of low intensity laser therapy (LILT) on the wound healing dynamics in human subjects with pressure ulcers using Bates Jensen wound assessment tool.
Methods: A total of 130 subjects were enrolled for the study and after randomization the subjects were allocated to control and experimental groups each consisting of 65 subjects. The subjects of the control group received conventional wound dressing for the pressure ulcer for 3 weeks where as the subjects of the experimental group underwent LILT and conventional wound dressing for 3 weeks. On Day 1 and after 3 weeks, the BWAT score of the pressure ulcer was recorded.
Results: The results showed a significant difference between pre and post intervention values in experimental group compared to control group (p< 0.05).
Conclusion: The study has brought out that LILT has better healing of pressure ulcers when compared to the conventional wound management to compare the wound healing dynamics among the subjects in the control and experimental groups. 

Dr. Vivek H. Ramanandi, Dr. Brinda Rao

DOI : 10.15621/ijphy/2015/v2i2/65252

Pages : 421-428

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Background: Parenting is inherently stressful at times and several studies have shown that being a caregiver of a child who is disabled is even more stressful. A number of studies have identified the factors which exacerbate or mediate parenting stress in caregivers of children who are disabled. The aim of this study was to assess the parenting stress levels in parents of children who have cerebral palsy as compared to parents of normal children. Further objectives were to ascertain variables predictive of parenting stress levels.
Methods: The Gujarati translated version of Parenting Stress Index/Short Form was first validated and was given to 49 parents of children with cerebral palsy (Group-A) who were attending Varun Mahajan Apang Shishu Mandal, Vadodara and to the 50 parents of normal children(Group-B). Caregivers also completed a demographic questionnaire. 43 questionnaires from Group-A and 45 from Group-B were returned to the researcher. Means and frequencies were used to summarise the demographic data. T-tests were performed to establish whether there was any significant difference between the parenting stress levels in Group-A and Group-B.
Results: The parents in Group-A showed clinically significant, and in many cases, pathological levels of parenting stress as compared to the parents in Group-B.
Conclusions: The results of this study confirm that parenting stress is complex matter and it is important to predict the parenting stress levels of caregivers of disabled children. Therapists should evaluate the needs of each family individually and follow a family centred approach when managing children with cerebral palsy. 

P. Chinna Reddemma, Dr. K. Madhavi

DOI : 10.15621/ijphy/2015/v2i2/65247

Pages : 429-433

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Background: A sedentary life style is a type of life style with no or irregular physical activity. It is a leading cause for reduced cardio - respiratory fitness and physical activity. The most of the employees working as computer personnel’s for more than five hours in a day is leading to altered physical activity and fitness. To study the effect of aerobic exercise programme on the cardio - respiratory fitness in computer using sedentary individuals.
Methods: As per the inclusion criteria the thirty subjects were selected for the study, all the selected subjects were given aerobic protocol for 12 weeks. Pre and post therapeutic outcome measures were assessed for Body Mass Index was calculated using weight (kg)/ height (m2). Waist- hip ratio was measured using inch tape in centimeters, pre and post therapeutic values of Body Mass Index, Waist Hip Ratio, VO2 peak were assessed.
Results: According to the data analysis, a significant difference was found between the pre and post test values of Body Mass Index, Waist- hip ratio and Vo2peak in both experimental and control groups (p<0.05), but comparatively more significant changes were found in the experimental rather than the control group(p<0.05).
Conclusion: Aerobic exercise had significant influence in computer using sedentary individuals. There was a significant change in physical factors like body mass index, waist-hip ratio, and functional factors like vo2peak. Hence, it is concluded that 12weeks of aerobic exercises is effective in improving cardio vascular factors computer using sedentary individuals. 

Divya .P, Veena K. N

DOI : 10.15621/ijphy/2015/v2i2/65253

Pages : 434-440

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Background: Cardiovascular changes to daily activity and stressors have been proposed as a mechanism for promoting the progression of atherosclerosis and coronary heart diseases. Hence, purpose of the study with objective is to assess the cardiovascular parameters such as heart rate, blood pressure and rating of perceived exertion responses to verbal communication in Business process outsourcing (BPO) employees.
Method: A cross sectional survey design, selected 150 healthy subjects between age group of 25 to 35 years from BPO industry, Bangalore. Subjects who fulfilled inclusion criteria were included into the study. Heart rate and blood pressure were recorded before and after shift. The Borg rating of perceived exertion scale was also administered to find the difference of amount of exertion, which was felt by subjects before and after shift.
Results: The analysis of measured variable shown that before shift the means Heart rate was 81.76 beats, the mean systolic blood pressure is 117.82 the mean diastolic blood pressure is 80.69 and the mean rate of perceive d exertion is 7.19. After shift the means of Heart rate was 83.02 beats, the mean systolic blood pressure is 120.32 the mean diastolic blood pressure is 83.26 and the mean rate of perceive d exertion is 10.65. When analysed using paired t test there is a statistically significant difference in before and after shift means of heart rate, blood pressure and rate of perceived exertion.
Conclusion: It was concluded that in BPO employees in response to their verbal communication there was significant increase in cardiovascular responses including Heart Rate, Systolic Blood Pressure and Diastolic Blood Pressure. There was also a significant increase in Borg rating of perceived exertion before and after shift 

Suresh Babu Reddy .A, Einstein Jerome, Sai Kumar. N

DOI : 10.15621/ijphy/2015/v2i2/65256

Pages : 441-447

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Background: Conventional back care exercises are advocated to treat the pain and to strengthen the involved muscles. There will be 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.
Objective: To find the efficacy of the concept of core stabilization when compared to conventional back care exercises in patients with chronic mechanical low back pain.
Methods: Forty patients with chronic Mechanical Low back pain were selected through purposive sampling and were randomly assigned into control group who received conventional back exercises and SWD (n=20), experimental group who 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 three days a week for 6 weeks. The treatment outcome was assessed using visual analogue scale, Rolland Morris Disability Questionnaire and Lumbar range of motion using goniometer.
Results: After a 6 weeks training period the core stabilization group scored significantly higher than the conventional group for VAS (p=0.05) RMDQ (p=0.05) whereas 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. 

P. Khyathi, Vinod Babu .K, Sai Kumar .N, Asha D

DOI : 10.15621/ijphy/2015/v2i2/65255

Pages : 448-458

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Background: Among many interventions for subjects with frozen shoulder, mobilization techniques are the important techniques of intervention. However the opinions about efficacy of mobilization techniques differ. Hence, the purpose of this study to compare the effectiveness of Mulligan’s mobilization with movement with that of Spencer technique on improving pain, abduction and external rotation ROM and functional disability in subjects with frozen shoulder.
Method: An experimental study design, 40 subjects with unilateral frozen shoulder were randomized into 2 groups with 20 subjects each in Mulligan and in Spencer group. Subjects in Mulligan group received Mulligan mobilization with movement (MWM) and subjects in Spencer group received Spencer technique and conventional exercises was given for both the groups. The duration of intervention was one treatment sessions per day for five days. Outcome measurements such as pain using VAS, shoulder abduction and external rotation ROM using goniometer and functional disability using SPADI were measured before and after five days of intervention.
Results: Analysis using paired ‘t’ test and wilcoxon signed rank test found that there is a statistically significant improvement (p<0.05) in pain, shoulder mobility and functional disability within the groups. Comparative analysis using independent ‘t’ test and Mann Whitney U test found that there is no statistically significant difference in improving pain between MWM and Spencer group. However MWM group found significantly greater improvement in shoulder mobility and functional disability comparative with Spencer technique.
Conclusion: It is concluded that both MWM and Spencer technique are shown to have short term effect on improving pain, shoulder mobility and functional disability. However, MWM was found clinically more effective with greater percentage of improvement on improving shoulder abduction, external rotation ROM and functional disability than Spencer technique in subjects with frozen shoulder. 

Vadivelan .K, Priyaraj .B

DOI : 10.15621/ijphy/2015/v2i2/65254

Pages : 459-464

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Background: Children adopting different styles of sitting in class rooms may have an influence over the hamstring length which indirectly produces an effect on posture, gait and musculoskeletal problems. Hence, physiotherapists play an important role in preventing the problems that are to be developed due to the sitting posture adopted at school. Hence, it is important for all the health professionals to understand and know about the effect of different sitting styles of children in school over the children health.The purpose of this study was to determine the influence of two sitting postures (crossed leg sitting and bench sitting) on hamstring flexibility in school going children. Aim of the Study to observe the influence of bench sitting and crossed-leg sitting on hamstring flexibility in school going children.
Methods: 200 school children (105 boys and 95 girls) from private schools (those who are bench sitting) and 200 school children (109 boys and 91 girls) from government schools (those who are crossed leg sitting) aged 6-10 years were included in this study. Active Knee Extension (AKE) test with the aid of a simple and economically cheap stabilizing apparatus was used to determine hamstring flexibility. Measurements were taken for both right and left knee.
Results: The mean Active Knee Extension (AKE) score for bench sitting children was 132.4 and for crossed leg sitting children was 130.1. The difference observed in knee extension range of motion between the groups was statistically significant (p<0.05).
Conclusion: Hamstring flexibility was greater in bench sitting children as compared to crossed leg sitting children.