[International Journal of Physiotherapy 2015; 2(5) : 677-875] RSS



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Adamu Ahmad Rufa'i, Adetoyeje Yunoos Oyeyemi, Adewale Lukman Oyeyemi, Raqeebah Sali Bello, Muhammad Usman Ali

DOI : 10.15621/ijphy/2015/v2i5/78219

Pages : 677-684

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Background: Attire is one of the major determinants of appearance and a key element of non-verbal communication that plays a critical role in the establishment and sustainability of therapeutic relationships. This study aimed to determine the patients’ preferred physiotherapists’ attire and the effect of physiotherapists’ attire on patients’ confidence, comfort and patient-therapists relationship.
Methods: A questionnaire was used to collect data in this cross sectional study design. Patients (N=281) attending outpatients physiotherapy clinics in six selected tertiary health institutions in North-eastern Nigeria completed a questionnaire consisting of two sections. Section one solicited sociodemographic information while in section two patients rated their level of confidence and comfort with physiotherapists based on a photo pictures of a male and a female physiotherapists models in four different attires. Descriptive statistics were performed to characterize participants and the differences in patients’ confidence and comfort level by different types of attire were assessed using chi-square. The correlation between physiotherapists’ attire and patient-physiotherapist relationship was determined using spearman rank correlation.
Results: Overwhelming majority of the participants were more comfortable (91.1%) and more confident (89.0%) with the physiotherapists dressed in white coat, while they were less comfortable and less confident when their therapists are dressed in suit, native or casual wear. Positive patient-therapist relationship was observed with white coat dressed physiotherapists; while the relationship with business, native and casual wears were inverse.
Conclusion: The study supports for continuing recommendation of lab coat as a professional dressing for physiotherapists in Nigeria and affirms the importance of professional dressing in patient-therapists relationship.
Keywords: patient-therapist relationship; professional appearance; patient trust; therapist dress




Urvashi Bhattacharya, Ujwal Bhattacharya, Barnali Bhattacharjee

DOI : 10.15621/ijphy/2015/v2i5/78220

Pages : 685-690

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Background: ICU is a specially staffed and fully equipped unit of the hospital where patient requiring intensive care is kept. In order to meet the demand of seriously ill patients a numbers of sophisticated equipments and gadgets are used. Studies have shown that there is a need for knowledge about the operating system of these machines used in ICU to execute the treatment protocols by the ICU staff. Various therapeutic procedures are done depending on the readings of the machines and monitoring of the values is required before and after the treatment sessions. So it becomes mandatory for the ICU staff to have good command over the parameters of the equipment. The objective of the study is therefore to find out the awareness of two important machines namely the Mechanical ventilator and Pulse oximeter among the ICU staff including the physiotherapist in north eastern states of India.
Methods: An observational cross section study has been done with 200 subjects who is working in ICU for more than 6 months.
Result: The data of 200 subjects were analyzed and the scores of the questionnaire was estimated using Karl Pearson Correlation Coefficient which has shown that there is a significant (p value =0.00) awareness of pulse oximeter displayers and ventilators among physiotherapist and other ICU staff in the north eastern states of India.
Conclusion: Based on the results, it is concluded that 72.5% of the subjects were well aware and 27.5% of the subjects were least aware about the ventilators and pulse oximeter, hence it can be considered that there is an acceptable knowledge among the ICU staff including physiotherapist in north eastern states of India about the ventilator and pulse oximeter displayers.
Key words: ICU- intensive care unit, Continuous mechanical ventilation(CMV), Synchronized intermittent mandatory ventilation (SIMV),Positive end-expiratory pressure (PEEP), Continuous positive airway pressure (CPAP). Pressure support ventilation (PSV), Light emitting diode (LED).

Abhijit Kalita, Andrew Milton

DOI : 10.15621/ijphy/2015/v2i5/78221

Pages : 691-697

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Background: Frozen shoulder is an insidious condition that begins with pain and gradual restriction of movement in the shoulder region. There are various methods of treating frozen shoulder (both surgical and non-surgical).Among the non-surgical methods there is no specific method accepted universally. Purpose of this study is to determine the combined effectiveness of Glenohumeral End-Range Mobilization and Contract-Relax technique for glenohumeral internal rotators in patients with adhesive capsulitis.
Methods: 60 frozen shoulder patients randomized 30 subjects into each experimental and control group. Group A (experimental group) received Glenohumeral End-Range Mobilization, Contract-Relax Technique for glenohumeral internal rotators and Shoulder Pendular Exercises 2 times a week for a period of 4 weeks (8 sessions).Group B (control group) received Shoulder Pendular exercises 2 times a week for a period of 4 weeks (8 sessions). Outcome measures included are VAS, SPADI and goniometry for assessing pain, functional ability and ROM for the shoulder joint.
Results: The average improvement of VAS for Group A and Group B were 4.5 and 3 respectively using median. The U-value was 176, which is statistically highly significant (p value = 0.000).The average improvement of Shoulder Pain and Disability Index for Group A and group B were 56.9333 and 10.3667 respectively using mean and Standard Deviation. The t-value was 35.91181, which is statistically highly significant (p value = 0.000).
Conclusion: The results indicated that both Group A and Group B had significant improvement in the scores of VAS, SPADI and GONIOMETRY scores at the 4th week when compared to base line values, but when comparing the end results of group A and group B it has been found out that group A intervention is more effective then Group B in treating the internal rotators of patients with adhesive capsulitis
Keywords: Adhesive capsulitis; pain; range of motion; Glenohumeral End-Range Mobilization; Contract-Relax Technique; Shoulder Pendular Exercises.

Bruno Corrado, Gianluca Ciardi

DOI : 10.15621/ijphy/2015/v2i5/78222

Pages : 698-704

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Background: Parkinson’s Disease (PD) causes increasingly significant disability and functional impairment, negatively influencing the quality of life of those affected by the disease. The tool widely adopted for assessment of quality of life in Parkinson’s disease patients is the Parkinson’s Disease Questionnaire (PDQ- 39). Study objectives: to assess the level of correlation of the PDQ-39 questionnaire with the clinical severity of PD patients; to assess changes in quality of life following home-based rehabilitation treatment.
Methods: Thirty patients residing in the province of Naples were enrolled in the study; the inclusion criterion was the presence of Parkinson's Disease, whilst patients with other neurodegenerative or chronic disorders were excluded. The participants were assessed utilizing: the medical history questionnaire, the Hoehn and Yahr scale to rate disease severity, the PDQ-39. They contemporaneously followed a home-based physiotherapy programme for 18 months. The readings were carried out in three stages: time zero, nine months, eighteen months.
Results: The Pearson test indicates a close correlation between clinical severity and quality of life (QoL) ( 0.76 ≤ R ≤ 0.85). Following rehabilitation treatment, the patients reported some improvement in quality of life, particularly in the psychological dimension: the stigma areas and psychological well-being had significantly improved (p < 0.05), whereas the mobility areas and Adl showed only a short-term improvement (p > 0.05). No significant change was found in the areas of cognitive impairment in the Parkinson’s Disease patient.
Conclusion: HRQOL strongly correlate with disease progression; home physiotherapy can improve patients condition, especially from emotional point of view.
Keywords: Parkinson’s Disease, quality of life, rehabilitation

Muzaffar Mairaj, Hamdani Nusrat, Walia Shefali

DOI : 10.15621/ijphy/2015/v2i5/78223

Pages : 705-711

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Background: Balance emerges from the interaction of multiple systems that are organized to meet functional task goals and that are constrained by environmental context, but is often compromised with advancing age. At least 30% of older people experience decline in physical activity after entry into residential care. Participation in activity is more difficult for older people because of fear, lack of motivation, depression and poor understanding of the long term benefits of physical activity. Thus our purpose was to investigate effect of specific balance strategy training programme as compared to general balance training in improving balance in institutionalized elderly population.
Methods: 26 institutionalized elderly subjects participated in the study. Participants in group A were given specific balance strategy training programme and those in group B were given general balance training. Intervention was for 40 min per day, thrice a week for 4 weeks. Balance was assessed using Berg balance scale and Timed up and go test.
Result: Both the interventions showed marked improvement in balance when assessed on Berg balance and Timed up and go test. The group having specific balance strategy training programme proved to be significantly better than general balance training programme.
Conclusion: Specific balance strategy training programme being more effective than general regimens should be incorporated in addressing balance related problems of institutionalized elderly population.
Keywords: Specific Balance Strategy, General Balance stratergy, Institutionalized, Elderly, Falls, Physical activity

V. B. Geethika, G. Kameswari, V. Srikumari, K. Madhavi

DOI : 10.15621/ijphy/2015/v2i5/78224

Pages : 712-717

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Background: Low back pain is a common, benign, and self-limiting disease that affects almost all persons, with a lifetime prevalence of up to 84%. In contrast, sciatica affects only 40 % of all persons in the Western industrialized countries. In sciatica, pain radiates down the legs, below the knee along the distribution of sciatic nerve. Nerve root compression is the most common cause of sciatica. Neuro dynamics or Neural Tissue Mobilization is relatively new approach in treatment of neuro musculoskeletal disorders. The aim of the study to determine the effectiveness of Neural Tissue mobilization on pain, pain free passive SLR ROM &functional disability in LBA subjects with Sciatica. Objective of the study is to study and compare the effectiveness of Neural tissue mobilization in LBA subjects with sciatica in terms of pain, pain free SLR ROM and Oswestry Disability Index.
Methods: 30 subjects were selected by simple random sampling and assigned in to Control(n=15) &Experimental group(n=15).The subjects in control group were given conventional physiotherapy and those in Experimental group were given Neural Tissue Mobilization in addition to conventional therapy. All the participants were assessed with VAS, ODI and pain free passive SLR ROM.
Results: After the analysis, the results were found to be significant improvement in pain, pain free SLR ROM, ODI in both groups (p< 0.00).But there is a high significance in Experimental group when compared to control group.
Conclusion: Results suggest that NEURAL TISSUE MOBILIZATION along with conventional therapy is more effective in reducing pain, decreasing disability and improving SLR ROM.
Keywords: NTM, sciatica, Oswestry Disability Index, Universal Goniometer, Low Back Ache, Intermittent Lumbar Traction.

M. Prasad Naik, A. Viswanath Reddy, K. Madhavi

DOI : 10.15621/ijphy/2015/v2i5/78225

Pages : 718-723

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Background: Muscle energy technique is used for restoring normal tone in hypertonic muscles, strengthening weak muscles, preparing muscle for subsequent stretching, one of the main uses of this method is to normalize joint range which may help in increase flexibility and performance in sprinters. The aim of the study is to evaluate the effect of muscle energy technique on flexibility of hamstrings and calf muscles and sprinting performance in sprinters. The objective of the study is to determine the muscle energy technique on hamstrings and calf muscle flexibility and sprinting performance in sprinters by using goniometer and timing of sprinting performance.
Method: The study design is an experimental study in which 30 male sprinters were recruited in this study. The study sample included all male healthy sprinters, aged between 15 -30 years. All subjects received warm up, muscle energy technique and cool down exercises daily for a period of 6weeks.The outcome measures are 90°-90°popliteal angle for assessing hamstring flexibility and ROM of ankle joint for calf muscles by universal goniometer and sprinting performance time by using stopwatch.
Results: Independent t-test and paired t- test are used to analyse the data. A significant difference was found between pre and post values of hamstring and calf muscle flexibility and sprinting performance after the analysis in this study.
Conclusion: This study shows that there was a significant effect of MET on hamstring and calf muscle flexibility and sprinting performance.
Keywords: Muscle energy technique, 90°-90°poplitealangle, flexibility, Range of motion, Sprinting.

Pranjal Gogoi

DOI : 10.15621/ijphy/2015/v2i5/78226

Pages : 724-730

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Background: Mechanical neck pain commonly arises insidiously and is generally multifactorial in origin. Regardless of the primary source of pain, the prognosis for individual experiencing chronic neck pain is poor. Exercise interventions are important for effective management of patients with neck pain.the objective of the study is to compare the efficacy of cervical endurance training programme with cervical isometric exercise in alleviating symptoms of mechanical neck pain.
Methods: 40 subjects were assessed and identified with Mechanical Neck Pain and recruited for the study and were randomly divided into two groups. In one group endurance training for cervical muscles and in another group resisted isometric had been given for 3 weeks. The post treatment scores regarding endurance, pain intensity, disability, Range of motion and muscle power were compared with the pre treatment scores.
Results: Paired‘t’ test was done to compare the pretreatment scores with the post treatment scores .Unpaired ‘t’ test was done to compare the post treatment scores of both the groups. The pain intensity, disability were found to be significantly decreased in experimental group than the control group (p<0.001). While the endurance was found to be significantly increased in experimental group than the control group (p < 0.001). The muscle power was found to be slightly increased in the control group than the experimental group .The post treatment cervical range of motion does not have significant difference in between the groups (Flexion- p=0.35 and Extension-p=0.40).
Conclusion: This study showed that the progressive endurance exercise is beneficial in alleviating mechanical neck pain and should be incorporated along with the conventional physiotherapy treatment for mechanical neck pain.
Keywords: Mechanical neck pain, endurance, Craniocervical flexion, Training, Deep neck flexors

Madhusmita Koch, Manjeshwar Sahana Kamath, Biju Chetri

DOI : 10.15621/ijphy/2015/v2i5/78227

Pages : 731-737

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Background: Lateral Epicondylitis is the most common lesion of the elbow, affecting the tendinous origin of the wrist extensors. Although conservative treatment of this condition has been the subject of numerous studies, there is no agreement as to the most effective management strategy. Therefore, this study was designed to compare the efficacy of Cyriax physiotherapy Versus Eccentric Strengthening and Stretching exercises in reducing the pain and improving the grip strength and functional status of the affected extremity in chronic lateral epicondylitis.
Method: An experimental study design, 60 subjects meeting the inclusion criteria were selected for the study and were randomly assigned into two groups: Group A (N=30) received Cyriax Physiotherapy and Group B(N=30) received Eccentric strengthening and static stretching of Extensor Carpi Radialis Brevis. Low Level Laser Therapy was a common treatment for both the groups. After 4 weeks of treatment, assessment was performed using Visual Analogue Scale (VAS), Hand Held Dynamometer (HHD) and Patient Rated Tennis Elbow Evaluation Questionnaire (PRTEE) at 0 week and at the end of 4 weeks.
Results: Data analysis revealed that there is no statistically significant difference between the groups in VAS, HHD and PRTEE scores i.e. average improvement post treatment in both the groups are equal, but within group comparisons showed significant improvements in both the groups.
Conclusion: The efficacy of Cyriax Physiotherapy is equal to Eccentric Strengthening and Stretching Exercises in chronic lateral epicondylitis.
Keywords: Lateral epicondylitis, Deep Transverse Friction, Mill’s Manipulation, Low Level Laser Therapy, Patient Rated Tennis Elbow Evaluation Questionnaire.

K. Sai sudha, Dr. A. Viswanath reddy, Dr. K. Madhavi

DOI : 10.15621/ijphy/2015/v2i5/78228

Pages : 738-744

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Background: Cricket is one of the most popular game in India played by men and women of all ages. The increased physical demands on the players may be associated with an increased risk of injuries. Core muscle strength is important to prevent risk of injuries in elite cricketers. The beginners in the cricket must have enough strength of core muscles, as core is the bridge between upper and lower limbs. So, it should be strong enough to prevent low back and lower limb injuries in cricketers. The aim is to determine the effectiveness of swiss ball exercises versus floor exercises on core muscle strength in elite cricketers. The objective is to study and compare the effectiveness of swiss ball exercises and floor exercises in elite cricketers in terms of back strength.
Method: The total number of students in this study were 30 eilte cricketers between 16-25 years out of which 15 subjects were included each in floor exercise(n=15) and swiss ball group(n=15). Back strength was measured before and after the intervention of 6 weeks using isokinetic analyser.
Results: After the analysis, the results revealed significant improvement of back strength in both the groups(p< 0.00). The swiss ball group showed significant results when compared with floor exercise group.
Conclusion: Although the study showed beneficial results in both the groups, the results reflected that swiss ball group had better improvement of core muscle strength than the floor exercise group.
Keywords: Swiss ball, core muscles, cricketers, isokinetic analyser.

Hannah Rajsekhar, P. Sumalatha

DOI : 10.15621/ijphy/2015/v2i5/78229

Pages : 745-750

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Background: It’s a well-known fact that exercise is good for the mind and body making it beneficial for expectant and new mothers. The challenge of pregnancy, labor and looking after a new born is not an easy task. So the fitter you are the better you will cope with this life changing event.
Method: Aerobic and strengthening exercises help in adjusting to the increasing weight and posture changes to cope effectively with the labor and the postnatal period. Although exercises in pregnancy are extremely beneficial, they can cause more harm than good if not done correctly. Medical screening for exercise should be done by the Doctor as well as the Physiotherapist to ensure that the patient underwent a basic screening, assessment or continued monitoring for the right exercise protocol for avoidance of any complications and to ensure the benefits of staying healthy and fit.
Results: Evidence shows that exercise training programs designed and delivered by the Physiotherapists can relieve the prenatal post natal problems.
Conclusion: Number of studies has shown the positive effects of aerobic and strengthening exercises on pregnant women. The physical changes to a pregnant woman’s body are multiple. There are center of mass changes, pressure on the organs and increased weight gain. In fact, over two thirds of pregnant women experience back pain, one fifth experience pelvic pain and over 40% experience urinary incontinence in their first pregnancy.
Keywords: Pregnancy, benefits of Exercises, Aerobic and strengthening exercises, kegel exercises.

Hatem A. Emara

DOI : 10.15621/ijphy/2015/v2i5/78230

Pages : 751-758

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Background: The most critical feature of motor development is the ability to balance the body in sitting or standing. Impaired balance limits a child’s ability to recover from unexpected threats to stability. The functional reach test (FRT) defines the maximal distance an individual is able to reach forward beyond arm’s length in a standing position without loss of balance, taking a step, or touching the wall. The Purpose of this study was to establish the normal values for FRT in Saudi Arabia school children with typical development and to study the correlation of anthropometric measures with FRT values.
Methods: This cross-sectional study was conducted in Almadinah Almonawarah, Kingdom of Saudi Arabia. A total of 280 children without disabilities aged 6 to 12 years were randomly selected. Functional reach was assessed by having subjects extend their arms to 90 degrees and reach as far forward as they could without taking a step. Reach distance was recorded by noting the beginning and final position of the subject's extended arm parallel to a yard stick attached to the wall. Three successive trials of FRT were performed and the mean of the three trials was calculated. Pearson product moment correlation was used to examine the association of FR to age, and anthropometric measures.
Results: Normal mean values of FR ranged from 24.2cm to 33.95cm. Age, height and weight significantly correlate with FRT.
Conclusion: The FRT is a feasible test to examine the balance of 6-12 year-old children. FRT may be useful for detecting balance impairment, change in balance performance over time.
Keywords: Functional reach, Typical development, Balance.

B. Jyothirmai, K. Sentil kumar, S. Raghavkrishna, K. Madhavi

DOI : 10.15621/ijphy/2015/v2i5/78231

Pages : 759-764

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Background: Upper trapezius trigger points is a common cause for neck pain, decreased cervical range of motion and functional activities. The purpose of the study was to evaluate the effectiveness of integrated neuromuscular inhibitory technique (INIT) along with specific strength training exercises in reducing pain, improving ROM and functional activities in subjects with upper trapezius trigger point.
Methods: Thirty subjects were diagnosed with upper trapezius trigger points were included in the study. These patients were randomly allocated to intervention group (n=15), which underwent a 4- weeks training program of INIT along with specific strength training & control group (n=15) that received INIT alone. The outcome measures were taken before and after treatment. Outcomes were measured by visual analogue scale, cervical range of motion and neck disability index. Within the groups VAS, NDI, and cervical lateral flexion and rotation showed significant change in the mean value. The comparison of pre and post VAS in experimental group and control group showed a significant change in the experimental group .Paired sample t- test was used to analyze changes from before and after intervention programmed.
Results: There is a statistically significant (p<0.00) improvement in both variables from baseline to 4th week in experimental group and control group but compared to control group, experimental group shows highly significant values in all parameters.
Conclusion: INIT along with specific strength training is proved to be effective in reducing pain, decreasing disability and improving range of motion in individuals with upper trapezius trigger points.
Keywords: Myofascial pain, trigger point, INIT (integrated neuromuscular inhibitory technique), MET.

Ningombam Geetanjali Devi, Abhijit Dutta

DOI : 10.15621/ijphy/2015/v2i5/78232

Pages : 765-771

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Background: Neck pain is a common global problem, an important source of disability Bad posture of neck with respect to chest is one of the commonest causes of chronic neck pain. This is common to the job related (e.g. computer professionals, clerks, bank employees) where the neck is kept in a flexed position for long periods of time. The objectives of the study is to compare the effectiveness of self SNAGs with dynamic isometric exercise in chronic neck pain.
Methods: It is a comparative experimental study. This study includes (N=40) desk job people with chronic neck pain subjects with age group of 25-45 years. They were randomly assigned into 2 groups (Group A and B). Group A had 20 (N=20) subjects who are treated with self SNAGs, Group B had 20 (N=20) who are treated with dynamic isometric exercise using resistance band. The subjects were given intervention once a day for 6 weeks.
Results: At the end of 6 weeks, both neck pain and disability decreased in both groups, range of motion had also improved statistically significantly in both groups, but the results showed that the pain scores are significantly improved in group A( t = -2.707) which is significant at 5% level of significance (p = 0.01). It has been inferred that VAS decreases more when self SNAGs was applied and the difference of means of NDI, t = -4.468 which is highly significant (p = 0.00) implying that NDI decrease more when self SNAGs was applied as compared to dynamic isometric exercise.
Conclusion: From the above study it is concluded that, self SNAGs is an effective way of decreasing pain and increasing functional ability when compared to dynamic isometric exercise using resistance band.
Keywords: Neck pain, Self SNAGS, Dynamic isometric exercise, Resistance Band.

Himashree Das, Abhijit Dutta

DOI : 10.15621/ijphy/2015/v2i5/78233

Pages : 772-777

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Background: In the recent industrial set up, plantar fasciitis is one of the commonest problems faced by workers. It occurs mainly in the prolonged standing workers. There are some studies where some authors mentioned about interferential therapy as a treatment modality in plantar fasciitis but there is no such evidence supporting the use of IFT. Here comes the need of the study to find out the effects of the interferential therapy and also to find out whether the conventional therapy and interferential therapy are effective in plantar fasciitis for industrial workers. The aim of the study is to find out the benefit of the interferential therapy with the conventional therapy and also use conventional therapy alone for industrial worker in case of planter fasciitis.
Methods: A sample of 30 subjects were distributing randomly in two groups. These subjects were referred by the consultant physician and orthopedic surgeon. All the subjects were signed a consent form prior to participation in the study. Before receiving any intervention, on day zero outcome measures assessment were carried out for both groups subjects by VAS (Visual analog scale) for pain measurement, FFI (Foot Function index ) scale for activity limitation scores and goniometric measurement of active dorsi-flexion of ankle joint. Range of Motion (ROM) measurement for both group A and B were taken usual in slandered goniometry according Martin and White. On day 15th, all outcome measures re-assessment will be carried out for the result.
Results: In comparison of both interventions group B (IFT with conventional therapy) is more effective in decreasing pain (p = 0.00) improving functional ability (p = 0.00) than group A (only conventional therapy). For ROM, t = -0.642 the difference is not significant (p = 0.526). It has been inferred that conventional therapy and IFT with conventional therapy are equally effective for improving ROM.
Conclusion: In conclusion, this study indicating that there is a significant difference in the effectiveness of Interferential therapy over conventional therapy in plantar fasciitis for industrial workers. Even though improvement in range of motion is not differing in both group, pain and functional improvement is more in the group treated with IFT.
Keywords: plantar fasciitis, interferential therapy, industrial workers.

Trupti Jadeja, Neeta Vyas, Megha sheth

DOI : 10.15621/ijphy/2015/v2i5/78234

Pages : 778-785

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Background: Back pain is a prevalent and expensive problem in society. 60-80% of people will suffer at least one episode of low back pain sometime in their lives and 30-40% of these will experience low back pain each year. Therefore the need of the following study is to see the effect of proprioceptive neuromuscular facilitation on back muscle strength, pain and QOL in subjects with Chronic Low Back Pain.
Methods: Ethical approval was taken before study. Forty patients with chronic low back pain (28 male, 12 female) were included in the study and divided into two groups each containing 20 subjects. All the participants were signed written consent after being informed in detail about the study. Group A has been given the proprioceptive neuromuscular facilitation exercises including Rhythmic Stabilization (RST) and Combination of Isotonics (COI) and Conventional back exercises. Group B was given conventional back exercises only. Outcome measures were taken at the end of one month i.e. after the treatment protocol. VAS, SF-36Questionnaire and Core stability gradation were taken in both groups.
Results: There is significant improvement in VAS score in both groups but Group A was having more significant improvement than Group B. Also there is significant improvement in core stability grading and SF 36 score in Group A.
Conclusion: It is concluded that proprioceptive neuromuscular facilitation exercises on back is effective in reducing pain and improving core muscle strength in subjects with Chronic Low Back Pain.
Keywords: Chronic low back pain, Proprioceptive neuromuscular facilitation, Quality of life, Core stability, Back muscle strength, Rhythmic Stabilization, Combination of Isotonics

Salwa El-Gendy, Riziq Allah Gaowgzeh, Amer Al Saif, Khaled Mamdouh, Mohamed Faisal Chevidikunnan, Nervana Gheith,Gamal Karrouf

DOI : 10.15621/ijphy/2015/v2i5/78235

Pages : 786-790

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Background: Low-back pain (LBP) is one of the highest common and costly musculoskeletal conditions in current society. Seventy to 85% of the populations will exhibits LBP at some time in their lives. There is little known about specific manual therapy techniques used to treat chronic LBP. Reflexology is a treatment that involves using gentle pressure to reflex points located on all of the outsides of the feet and hands. The aim of the study was to investigate the efficacy of reflexology technique in subjects with chronic low back pain (CLBP).
Methods: Twenty patients with nonspecific chronic low back pain were included in the study and were assessed regarding range of motion via goniometer and pain threshold (via modified Oswestery scale and visual analogue scale), the 20 patients were allocated into two groups 10 patients in each group. Group A received reflexology sittings at rate of 3 days per week, and the duration of each sitting was 30 minutes. While group B were control. The study was continued for 3 weeks
Results: According to VAS, the results revealed a non-significant variance between the study group and control group before intervention (p= 0.43). While after intervention, there was a significant decline of pain in the study group compared to that of the control group (p=0.000). Moreover, there was a very highly significant decrease in pain within the study group after treatment (p= 0.005).
Conclusion: The present study indicated that the reflexology technique was effective and safe to be applied for cases of mechanical low back pain. It results in a significant decrease in pain within the study group after treatment.
Keywords: Mechanical low back pain, reflexology, reflex points, gentle pressure, feet and hands, Oswestery scale

Abhijit Dutta, Anjali Suresh, Simson K. S

DOI : 10.15621/ijphy/2015/v2i5/78236

Pages : 791-797

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Background: Mechanical Low back pain is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance. Both male and female populations are affected; however, there is a tendency towards a higher incidence in male patients. Mechanical low back pain is associated with pain and clinical instability in lumbar motion segments. Exercises play an important part in the rehabilitation of low back pain. The aim of this study was to compare the effectiveness between Core stabilization vs McKenzie exercises in the treatment of patients with mechanical low back pain.
Methods: 30 patients were selected between the age groups of 20 yrs to 50 yrs and having a past history of low back pain for one month. 15 patients were allotted to each group of experiment. Group I was given Core stabilization exercises and Group II with McKenzie exercises. Interferential therapy was a common treatment for both the groups. Evaluations of the subjects were done using the Revised Oswestry Disability Index and Dynamic Endurance tests.
Results: Data analysis revealed statistically significant difference between both the groups (p<0.05) and proved that Core stabilization exercises is more effective than McKenzie exercises in mechanical low back pain.
Conclusion: This study shows that core stabilization exercises  possess a greater potential over McKenzie exercises in treating Mechanical Low back pain patients.
Keywords: Mechanical low back pain, Core stabilization exercises, McKenzie exercises, Neutral zone theory, Revised Oswestry Disability Index, Dynamic Endurance Tests

Avi Saraswat, Deepak Malhotra, C. Sivaram

DOI : 10.15621/ijphy/2015/v2i5/78237

Pages : 798-803

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Background: Athletes focus their training on two major goals, i.e., avoidance of the injury and increasing the performance. Balance training has been widely used in competitive sports to improve the balance and thus reduce the risk of injury, for example, ligamentous sprains, which are very common in Basketball. On the other hand, various drills are being used to improve the performance parameters such as agility. Our effort is to find out an exercise program which focuses on balance training and see whether it has any effect on agility.
Methods: The study design was a Pretest-Posttest Control-Group Design. 30 healthy school level Male Basketball Players were selected from V-One Basketball Academy, Don Bosco Basketball Academy, Modern School Basketball Academy, New Delhi. They were randomly divided into two groups. Group A performed dynamic balance training 3 sessions per week for 4 weeks. Group B performed conventional exercises throughout the duration of the study. Outcome measure, i.e., T- test was measured pre and post 4 week period.
Results: Data analysis was done by Independent t test and Paired t test for between group analysis and within group analysis respectively. There was a significant reduction in T-test times in the experimental group as compared to the control group (‘p’ value <0.05) while there was no significant improvement in the control group.
Conclusion: Four weeks of dynamic balance training significantly improved agility as detected by T-test. Thus it can be concluded that the used protocol can be incorporated in the training regimes to reduce the risk of injury as well as improve the performance.
Keywords: Dynamic balance, Agility, Basketball, Balance training, T-test, sports injury

Aliaa Rehan Youssef, Ahmed Moursi Ahmed Ibrahim, Khaled ElSayed Ayad

DOI : 10.15621/ijphy/2015/v2i5/78238

Pages : 804-810

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Background: Patients with frozen shoulder suffer from significant pain and progressive limitation of shoulder active and passive movements. Such clinical problems are primarily treated conservatively. Physical therapy is an integral part in treatment of frozen shoulder. Rehabilitation may include various manual mobilization techniques in order to relieve pain and restore mobility and function. Therefore, this study aimed at comparing the effects of two different mobilization techniques (Mulligan Mobilization with Movement and Maitland end range mobilization) on improving shoulder pain, function and mobility in patients with diabetic frozen shoulder.
Methods: Thirty patients were randomly and equally distributed into two groups: (1) Mulligan group receiving mobilization with movement, and (2) Maitland group receiving end range oscillatory mobilization. Treatment was given 3 times per week, for 6 consecutive weeks. Patients were evaluated before and after treatment with regards to shoulder pain severity and functional disability using the Shoulder Pain and Disability Index as well as for shoulder flexion, abduction, external and internal rotation range of motion using a digital level inclinometer.
Results: Patients in the two groups showed significant improvement in all the measured variables over the treatment period (p<0.01), however, patients who received the Mulligan technique showed greater improvement (p<0.05). Between group comparisons showed that patients in the Mulligan group significantly improved than those in the Maitland on all measured variables (p<0.05), except for the internal rotation range of motion (p>0.05).
Conclusion: Mulligan and Maitland end range mobilization are effective in decreasing shoulder pain and dysfunction as well as in increasing shoulder mobility in all directions. However, the Mulligan mobilization is more effective when treating patients with diabetic frozen shoulder.
Keywords: Mobilization; Mulligan; Maitland; Diabetic frozen shoulder; Adhesive capsulitis; Shoulder pain

Lipika Boruah, Abhijit Dutta, Pritam Deka, Jeutishree Roy

DOI : 10.15621/ijphy/2015/v2i5/78239

Pages : 811-818

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Background: Joint mobilization is an effective intervention for adhesive capsulitis. Scapular mobilization in shoulder adhesive capsulitis is used to decrease intra articular pressure by increasing mobility of the joint capsule and its surrounding soft tissue that results in a reduction of pain and increase range of motion and shoulder function. At the same time the use of mobilization with movement (MWM) for peripheral joints was also used clinically. This technique combines a sustained application of a manual technique ‘gliding’ force to a joint with concurrent physiologic motion of joint, either actively performed by the subject or passively performed by the therapist. So far there is no study which is done on comparison between both of these techniques. The aim of the study is to find out whether the scapular mobilization or mobilization with movement technique improve gleno-humeral range of motion and reduce pain in patients with shoulder adhesive capsulitis.
Methods: 50 subjects with adhesive capsulitis were randomly divided in to two groups and one group was treated with mobilization with movement and another group treated with scapular mobilization technique. Each group consist 25 patients. Both groups were given hot packs and pendular exercises as conventional therapy procedures. Treatment was given 5 days a week for 3 weeks. Restricted joint range of motion and severity of pain were measured before and after treatment completion by using goniometer and SPADI pain score respectively.
Result: Results of the present study revealed that there was a significant difference in SPADI pain score(%), AROM-GH-Flexion and AROM-GH-External rotation who were treated in group A(MWM) with mean being 44.00, 102.24 and 46.08 respectively compared to group B (SM) with mean being 54.00, 81.00 and 35.84 in 3 weeks. Comparisons between these three parameters used in two treatment techniques were extremely significant (p= 0.000 for all).
Conclusion: On the basis of the results, it can be concluded that, the present study provided evidence to support the use of physical therapy regimen for shoulder adhesive capsulitis in the form of mobilization with movement and scapular mobilization in reduction of pain and improvement of glenohumeral range of motion in terms of SPADI pain scale(%) and AROM respectively. In addition results support that mobilization with movement showed better result as compared to scapular mobilization in 3 weeks.
Keywords: Adhesive Capsulitis, Movement with Mobilization, Shoulder, Mobilizations.

Salwa R. El-Gendy

DOI : 10.15621/ijphy/2015/v2i5/78240

Pages : 819-823

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Background: DRX9000 spinal decompression is slightly known for treating chronic lumbar disc prolapse. The aim of the study was to examine the effectiveness of DRX9000spinal decompression on pain in chroniclumbar disc prolapse (CLDP).
Methods: twenty male subjects with chronic lumbar disc prolapse,aged between 40:60 years were included in the study. They were assessed forpain intensity byslump test,straight leg raising test (SLR),modified Oswestery questionnaire (OQ) and visual analogue scale (VAS). The study continued forsix weeks, the 20 patients were equally divided into two groups. Group A (experimental) received spinal decompression, stability and McKenzie exercises; and ice, at a rate of 3 days per week, the duration of each session was 60 minutes. While group B (control) were treated by exercises and ice only.
Results: Majority of patients had positive findings in reducing pain clinically; however, statistically there was no significant difference.
Conclusion: It can be concluded that spinal decompression has an effect, but not statistically significant in decreasing pain on patients with lumbar disc prolapse. This may be due to limited number of patients. We can recommend increasing the sample size to generalize the results, MRI scan follow up should be done after one year to determine if the effects are permanent or transient, comparing the effects of decompression between acute & chronic cases of lumbar disc prolapse, also male & female patients.
Keywords: DRX9000spinal decompression, chronic low back pain, lumbar disc prolapse, exercises.

Thara. N, Sai Kumar. N, Vinod Babu. K, Akshata Akalwadi

DOI : 10.15621/ijphy/2015/v2i5/78241

Pages : 824-833

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Background: Task specific training of upper limb may result in learning of new motor task through transfer after repeated practice. Mirror therapy and motor imagery are effective emerging techniques used as an adjunct in rehabilitation of upper limb function in hemiplegia. The purpose of the study is to find comparative effects of task specific motor imagery with mental practice over task specific mirror therapy on upper limb functional activities for subjects with sub acute hemiplegia.
Method: An experimental study design with two groups conducted on 30 subjects with sub-acute hemiplegic. Thirty subjects randomised, 15 subjects into group A and 15 into group B. Group A subjects received task specific motor imagery with mental practice thrice a week for 10 weeks and Group B received task specific mirror therapy thrice a week for 10 weeks. In both groups, each session consisted of 60 minutes. The outcome measure such as Action Research Arm Test (ARAT) was measured before and after 10 weeks of intervention.
Results: Comparison of post intervention means of ARAT using Independent t test and Mann-Whitney Test showed that there is no statistically significant difference in grasp and gross movement between the groups and there is a statistically significant difference in grip, pinch and total score between the groups.
Conclusion: The present study concludes that 10 weeks of task specific motor imagery with mental practice and task specific mirror therapy both shown significant effect on improvement of upper extremity function. However, greater percentage of improvement was found using task specific motor imagery with mental practice in hand function when compared to task specific mirror therapy.
Keywords: Motor imagery, mental practice, mirror therapy, task specific exercises, sub-acute hemiplegia, hand function, action research arm test

Jeutishree Roy, Abhijit Dutta, Madhusmita Koch, Lipika Boruah

DOI : 10.15621/ijphy/2015/v2i5/78242

Pages : 834-839

Abstract Fulltext Download PDF RSS Download Statistics(581) Views (645)


Background: Primary osteoarthritis is more commonly found in post menopausal women; Secondary osteoarthritis had an underlying cause such as trauma, obesity or inflammatory arthritis. It is characterized by a progressive degeneration of the articular cartilage with subsequent remodeling and hypertrophy of the bone at the joint margins. Muscle weakness is associated with increased functional limitation, disability. Muscle strengthening through resistance exercises increases physical function; decreases pain due to osteoarthritis and reduces self reported disability. Agility is the ability to change direction and maintain stability and is more often important in changing direction and speed; In order to train muscle to react quickly neuromuscular training is essential; Perturbation enhances the ability of the proprioceptor signals to the muscle and prevent injuries and enhances performance. The aim of this study is to compare the effectiveness of agility training and dynamic resistance training in patients with primary osteoarthritis.
Methods: 50 subjects were assigned in two groups 25 each group and subjects were selected by convenient sampling method. Group A with agility training and Group B with dynamic resistance training. The treatment session was performed 3 days a week for 3 weeks lasting for 45minutes. Day 0 is the starting day of the session and Day-21 last day of the session. Each subject performed all the measurement with knee function assessed by Timed up and Go test (TUG) and Lower extremity function Scale (LEFS). Both outcomes were tested at starting day and at the end of 21st day.
Results: All the analysis was carried out in PASW version 21.0. An alpha level of 0.05 was used to determine statistical significance. The between group analysis of agility training and dynamic strengthening for LEFS and TUG in evaluation of knee function was done using independent ‘t’ test showed statistically very significant (P=0.000).
Conclusions: The effectiveness of Agility and Perturbation exercises improvement was considerably more than Dynamic resistance exercises. Therefore it is concluded that Agility and perturbation exercises is a better treatment approach than Dynamic resistance exercises.
Keywords: Oateoarthritis, agility training, dynamic strengthening exercises, TUG test

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