[International Journal of Physiotherapy 2016; 3(2) : 147-251] RSS



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Mohammed Ismael Elsepaee, Eman Ibrahim Elhadidy,Hatem Abd Al-Mohsen Emara, Elham Abd Elghaffar Nawar

DOI : 10.15621/ijphy/2016/v3i2/94869

Pages : 147-153

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Background: Hemiparetic and hemiplegic cerebral palsy(CP) constitute at least a third of all people with CP. Children with hemiparesis are suffering from weak hand muscles and retarded hand use.Mirror therapy is a relatively new approach in rehabilitation used in different neurological disorders. In mirror therapy a mirror is positioned orthogonally in front of the center of the patient’s body. The less-affected (healthy) extremity is moved and observed in the mirror. The purpose of this study was to determine the effect of mirror visual feedback on improving hand functions in children with hemiparesis.
Methods: Forty children with hemiparesis of both sexes, ranged in age from five to seven years old, participated in this study. They were divided randomly into two groups of equal number (control and study). The control group received a specially designed physical therapy exercise program for four successive weeks while the study group received mirror exercise program in addition to the same program of the control group. Hand functions assessments was done using grasping and object manipulation subtests of Peabody developmental motor scale (PDMS-2). Evaluation was performed pre and post treatment program.
Results:There was no significant difference between both groups in the pre-treatment mean values of all measured variables. Also, the results of this study revealed a significant improvement in the scores of the PDMS-2 andin grasp strength of the 2 groups. Post treatment results revealed more improvement in favor of the study group as compared with the control group.
Conclusion: Using the mirror visual feedback could help in improving hand functions in children with hemiparesis.
Keywords: Cerebral palsy, Mirror visual feedback, Hand functions, Hemiparesis.

G. Shine, Shaikhji Saad, Shaikhji Nusaibath, Abdul Rahim Shaik, S. Padmakumar

DOI : 10.15621/ijphy/2016/v3i2/94871

Pages : 154-158

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Background: Asthma is growing problem in India and throughout the world. Breathing exercises are commonly incorporated in overall pulmonary rehabilitation program of patients with bronchial asthma. However there is a lack of awareness regarding following a specific exercise prescription which is based on individual’s requirements. Physiotherapist can help in designing an exercise prescription specific to an individual possibly to achieve more control over bronchial asthma.
Methods: Thirty patients both male and female aged between 20 and 40 years diagnosed with bronchial asthma by the physician were assigned in two groups. Group-1 patients were given diaphragmatic breathing exercises and group-2 patients were given pursed-lip expiration exercises. Both groups received selected intervention for 6 weeks, 5 days in a week, 2 times in a day, and 20 minutes per session. Pre and post-test measures of forced expiratory flow rate were taken by peak expiratory flow meter and chest expansion was measured by inch tape. Data were analysed using Statistical Package for Social Sciences (SPSS) version 17.0 software. The analysis was performed by using students paired t-test.
Results: The study shows statistically significant improvement in diaphragmatic breathing exercise group when compared to pursed-lip expiration exercise group. The value of chest expansion has shown 2.04 % improvement in group1 and 1.01 % in group 2 whereas peak expiratory flow rate (PEFR) showed 16.9 % improvement in group 1 and 2.27 % in group 2.
Conclusion: Diaphragmatic breathing exercises play a vital role in rehabilitation of asthmatic patients to gain functional improvement and independence.
Keywords: Bronchial asthma, Diaphragmatic breathing exercise, Pursed-lip expiration exercise, Forced expiratory flow rate, Chest expansion

Aftab Ahmad, Muhammad Daud

DOI : 10.15621/ijphy/2016/v3i2/94873

Pages : 159-162

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Background: Osteoarthritis (O.A.) is an active disease process involving articular cartilage destruction, subchondral bone thickening and new bone formation. Worldwide osteoarthritis is estimated to be the fourth leading cause of disability, in which 10% are males and 13% are females. Studies from china, Bangladesh and Pakistan have shown high prevalence of knee osteoarthritis. Pharmacological interventions, surgical procedures and Physiotherapy management play important role in knee Osteoarthritis. In Physiotherapy management of osteoarthritis, manual therapy along with thermotherapy and/or electrotherapy is used. Current study was to evaluate the effectiveness of joint mobilization in knee osteo-arthritis.
Methods: Comparative study was undertaken on 50 patients with osteoarthritis of the knee who were randomly assigned to one of two groups that received Joint mobilization alone (n = 25; mean age, 53 years) or Conventional Physiotherapy (n = 25; mean age, 50 years).Both groups were received their programs for 8 weeks; two sessions per week. Analysis of data within group and between groups of the pre and post treatment values of the function and pain was done using pair t test and independent t test.
Results: Both groups showed significant improvement in ISOA score and VAS. There was statistical significant difference between the two groups (Group A and B) i.e. p < 0.005.
Conclusion: Manual joint mobilization improves the effectiveness of the treatment program in treating symptoms of knee OA and improves function in elderly people with knee OA.
Keywords: Knee Joint, Osteoarthritis, Manual Joint Mobilization, Conventional Physiotherapy, Visual analogue scale, Index of Severity of Osteoarthritis

Vishakha Patil, Rajashree Naik, Avinash De Sousa

DOI : 10.15621/ijphy/2016/v3i2/94874

Pages : 163-165

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Background: Physiotherapy is a branch of medicine where development of a good rapport between patient and therapist coupled with presence of a caring attitude and emotional understanding of patients would facilitate faster recovery. This study assessed the effect of Emotional Intelligence (EI) training in physiotherapy interns to help them understand their patients better and enhance their self awareness while patient’s perceived change in care was examined.
Methods: 8 physiotherapy interns completed an EI scale at the start and end of the study. A scale assessing change in Consultation and Relational Empathy (CARE) was administered to patients prior to and after the EI training. A retrospective pre and post questionnaire was helped assess change in personal attitude and awareness for the interns. All interns were trained using 6 modules on EI via lectures, case vignettes and discussions.
Results: Statistically significant differences in scores were noted on the EI scale, retrospective pre and post questionnaire and the CARE questionnaire (p< 0.05). A correlation done between the retro-post questionnaire and post training CARE scale scores revealed a positive correlation between patient perception of better care and enhanced self awareness in interns (r = 0.88847, p = 0.00318).
Conclusion: EI training helped improving patient care and self awareness in physiotherapy interns leading to better care being perceived by patients. This study demonstrates the educational value of EI training emphasizing the need for the regular inclusion of EI training in physiotherapy training curriculums. Further studies to validate these findings are warranted.
Keywords: emotional intelligence, physiotherapy, interns, self awareness, patient care, CARE questionnaire.

Dinesh Sorani, Sheshna Rathod

DOI : 10.15621/ijphy/2016/v3i2/94876

Pages : 166-169

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Background: Hamstring length assessment has an important value in Physiotherapy assessment and better outcome of patients. Purpose of the study was 1) To compare Active SLR and Active knee extension test values as per Kendall’s muscle-range assessment, 2) To compare Passive SLR and Passive knee extension test values as per Kendall’s muscle range assessment.
Methods: Total 100 healthy individuals (age 20.83±1.17, 14 males, 86 females) participated in study. Goniometric assessment of hip flexion-extension and knee flexion was assessed followed by active and passive straight leg raising (ASLR and PSLR) and knee extension tests (AKE and PKE). Kendall’s formula was used to find hamstring muscle-range. ASLR and AKE results were compared for means and correlation was assessed. PSLR and PKE results were compared for means and correlation was assessed.
Result: The average hamstring-range is about 79.34% (ASLR), 83.67% (PSLR), 77.92% (AKE), and 81.43% (PKE) of total joint range of hamstrings. There is significant difference between ASLR and AKE values and between PSLR and PKE values.
Conclusion: Total hamstring excursion in all methods confirms Kendall’s statement. However difference between SLR and knee extension tests suggest that SLR values of hamstrings length and knee extension values of hamstrings length cannot be used interchangeably. Other mechanical factors may play role for the difference between these values. Implications: Sequence of Hip flexion and Knee extension for hamstring length assessment has a significant effect on results and it should be considered by therapist before clinical decision making.
Keywords: Hamstrings length;ASLR; PSLR; Activeknee extension test; Passive knee extension test; Muscle length

Arakkal Maniyat Shemjaz, Thakral Anuj, Meman Husain Saddam

DOI : 10.15621/ijphy/2016/v3i2/94879

Pages : 170-176

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Background: The changes happening in the physical therapy education and the profession should be reached and demand to be seen by the other medical professionals to benefit the health care process. At the same time, if attempts are to be prepared to elevate the degree of awareness of physical therapy, it is necessary to evaluate the current attitude and knowledge of the medical interns. So the aim of this study was to find out the current level of awareness and knowledge about physical therapy among the M.B.B.S. medical interns.
Methods: An institution based cross sectional study, carried out purely based on the questionnaire method which consist of sets of questions. Prior to the data collection the researcher explained about the study to the subject and an informed consent was obtained from them. The researcher gave the questionnaire form to the subject and was required to fill the frame. The data collected was analysed by using frequency and percentage in IBM SPSS statistics V 19.
Results: Only 45% of medical interns had awareness and 42% had knowledge about physical therapy.
Conclusion: The results of the study provide information regarding the lack of awareness and knowledge among medical interns about physical therapy. Hence there is a need of educating the future medical professionals about the physical therapy, thereby reaching a better patient care.
Keywords: Physical therapy, Interns, Awareness, Medical, Knowledge, MBBS

Kshipra Baban Pedamkar, Aditi L. Soman

DOI : 10.15621/ijphy/2016/v3i2/94880

Pages : 177-181

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Background: The normal inspiratory to expiratory ratio is 1:2.However, the duration of inspiration can be increased voluntarily till the ratio becomes 2:1.This is called as inverse ratio breathing. The effects of inverse ratio ventilation have been studied on patients with respiratory failure and Acute Respiratory Distress Syndrome. No studies have been carried out to study the effects of inverse ratio breathing in voluntarily breathing individuals. Hence this study was carried out to find the immediate effects of inverse ratio breathing versus diaphragmatic breathing on inspiratory vital capacity and thoracic expansion.
Methods: 30 healthy adult females in the age group 20-25 years were included in the study. Inspiratory vital capacity and thoracic expansion at 2nd, 4th and 6th intercostal space was measured using a digital spirometer and an inelastic inch tape respectively. Diaphragmatic breathing was administered for one minute and the same parameters were measured again. A washout period of one day was given and same outcome measures were measured before and after individuals performed inverse ratio breathing with the help of a visual feedback video for one minute.
Results: Data was analysed using Wilcoxon test. There was extremely significant difference between the mean increase in the inspiratory vital capacity and thoracic expansion at the 2nd, 4th and 6th intercostals space after inverse ratio breathing as compared to diaphragmatic breathing (p < 0.0001).
Conclusion: Inspiratory vital capacity and thoracic expansion increase significantly after inverse ratio breathing.
Keywords: I:E ratio, Inverse ratio breathing, diaphragmatic breathing, inspiratory vital capacity, voluntary breathing, thoracic expansion.

Prem Kumar B N, Harish Shetty, Harsha Biliangady, Dhanesh Kumar

DOI : 10.15621/ijphy/2016/v3i2/94882

Pages : 182-185

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Background: Low back pain is the most undesirable phase of women. Every pregnant woman would suffer from low back pain with mild or severe intensity. Various methods and forms of treatment have been practised to relive low back pain during child bearing phase without causing any harm to the developing foetus. This study has focussed on yoga to relieve the pain and disabilities due to low back pain in primi gravida women.
Objective: To evaluate the effectiveness of yoga postures in reducing the low back pain and disability due to low back pain in second trimester of prima gravidas.
Methods: Primi gravida women with low back pain were randomised to 2 groups, group-1 and group-2. The study was conducted for 8weeks and included 70 patients with 35 in group-1 and 30 in group-2. There were 5 drop outs. The selection criteria were based on patients suffering from low back pain which was further restricting their normal daily activities. The pain was assessed with VAS score of 0-10 with mean of 5.6 and 6.2 respectively in experimental and control group respectively before the treatment and disabilities were assessed with MODI with mean score 52% and 57 % respectively before treatment. The Group-1 was treated with yoga postures and group-2 by gynaecologists’ advice with acetaminophen, external topical gel and moist heat modalities.
Results: The study concluded that there was significant reduction of pain on VAS score (p<0.001) and reduced disabilities on MODI (p<0.001) in both the groups. The statistical analysis showed there was significance within the interventional group and also within control group. Whereas the analysis done between the groups showed high significance of the interventional group having better recovery than the control group at the end of 8 weeks.
Conclusion: Yoga postures had higher benefits in alleviating the low back pain and reducing disabilities related to low back pain in primi gravidas.
Keywords: Yoga, low back pain, pregnancy, primi gravida, 2nd trimester, MODI, VAS.

Pragnya Ravichandran, H Karthika Ponni, P Antony Leo Aseer

DOI : 10.15621/ijphy/2016/v3i2/94883

Pages : 186-192

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Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression) on functional outcome in neck pain.
Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis.
Result: There was no statistical significance between groups (p≥0.05). But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01) in relation to all parameters.
Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in
pain pressure threshold and functional outcome in neck pain.
Keywords: Myofascial trigger points, Trapezius muscle, Ischemic compression, Pressure Algometer, cervical lateral flexion and neck disability index

Trishna Saikia Baruah, Pallabi Goswami, Ranjeet Singha, Abhijit Dutta

DOI : 10.15621/ijphy/2016/v3i2/94886

Pages : 193-196

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Background: Cerebral Palsy (CP) describes a non- progressive but not unchanging disorder of movement and posture due to an insult to or anomaly of the developing brain. People with spastic diplegia typically walk slowly and have difficulties in performing activities such as walking running or jumping. Children with spastic diplegic cerebral palsy are relied more on cadence to increase speed. Hence, the purpose of this study is to compare the effectiveness of open and closed kinetic chain (OKC and CKC) exercises in improving gait in spastic diplegic cerebral palsy.
Methods: 30 children with spastic diplegic cerebral palsy of both genders with age 4-12 years was taken. Cadence and distance covered in 1Minute Walk Test was calculated before and after the test. The intervention for group A was CKC exercises and group B was OKC exercises for 3 days a week for 6 weeks and each session lasted for 30-45 minutes was given for both the groups.
Results: Paired t-test was performed to find effectiveness of CKC and OKC improving gait in spastic diplegic CP to see the difference of means of 1minute walk, t = 10.789 which is significant (p = 0.000) and for cadence, t = 3.37 which is highly significant (p = 0.00) implying that cadence and distance covered in1minute walk was more with CKC exercises.
Conclusion: Based on the result it is concluded that CKC exercises are effective in improving gait than OKC exercises in spastic diplegic cerebral palsy.
Keywords: CP, CKC, OKC, 1MWT, Cadence, GMFCS.

Deepmala Thakur, Basavraj Motimath, Raghavendra M

DOI : 10.15621/ijphy/2016/v3i2/94887

Pages : 197-203

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Background: Forward head posture (FHP), the most common deviation from the normal curvature in cervical spine. Craniocervical flexor muscle strengthening is frequently used treatment for FHP. Scapular dykinesia (SD) is the alteration in the normal static or dynamic motion of the scapula during coupled scapulohumeral movements. Shoulder stabilization exercises are an effective treatment for SD. As both FHP and SD are related to each other, the objective of the study was to find and compare the effect of FHP correction and shoulder stabilization exercises on SD and shoulder proprioception.
Methods: 40 athletes (18-30yrs) were recruited. Subjects were randomly allocated into two groups. Group A received deep neck flexor strengthening and anterior scalene stretch, group B received shoulder stabilizing exercises. Paired t test and chi-square test were used to judge the statistical significant difference. The level of significance was set at p <0.05. All data was analyzed using SPSS program version 12.
Result: No statistical significant difference was found between the groups for the 4 outcome variables, but significant improvement was seen within the groups. Shoulder proprioception was found to be significant between the groups where group B (p =<0.001) showed better improvement than group A (p = <0.017).
Conclusion: Both FHP correction as well as shoulder stabilization exercises were equally effective in correction of scapular dyskinesia and shoulder proprioception. Shoulder stabilization exercises showed slightly better improvement than FHP correction group in reducing proprioception errors. Also neck strength values were found to be clinically significant for deep neck strengthening group.

Keywords: Posture, Shoulder Stabilization exercises, Scapula, Dyskinesia, Proprioception

Mohammad Sarfaraz khan, Rubina Kanwal, Erum Naz, Umesh kumar, Saadia Pervaiz, Saifullah Khalid, Neelam Noor Gichki, Shireen khanzada

DOI : 10.15621/ijphy/2016/v3i2/94888

Pages : 204-207

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Background: Obesity is now so common within the world’s population that it is beginning to replace under nutrition and infectious disease as the most significant contributor to ill health. Exercise plays significance role with dietary control in weight reduction. The aim of our study is to find out the efficacy of weight reduction interventions and role of exercise.
Methods: The study was conducted on 60 participants, subjects or participants were randomly divided. It is an experimental study which was completed in the duration of about six months. The study was based on two groups that are group A (exercise plus dietary) and group B (only dietary) consisting of sixty participants after filling the consent form.
Result: Result shows out of these sixty only fifty eight participants completed the study and were observed for four months. Is has been found comparable weight loss relatively fewer in the dietary group Body weight before (80.1±2.7) after (78.1±2.5)and BMI before (32±2) after (30±2) it shows significant results but less significant than group A body weight which was before(78.6±2.6) after(64.0±2.3) and BMI before (33±1) after (39±1). Therefore the results shows that the group A shows more significant outcomes as compare to the other group included in the study.
Conclusion: The results shows that (exercise plus dietary) more significant outcomes as compare to the other group included in the study
Keywords: Anne Collins, weight reduction, exercises plus dietary, dietary, BMI and body weight.

Mukadas Akindele, Maryam Buari, Andy Uloko

DOI : 10.15621/ijphy/2016/v3i2/94891

Pages : 208-213

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Background: The prevalence of type 2 diabetes mellitus has been on the increase both in high and medium/low income countries. This increase is associated with health and economic consequences, especially in low sub-Saharan Africa that is resource stricken. Availability of affordable and easy to implement treatment intervention will surely reduce these health and economic sequealae of type 2 diabetes mellitus. This study was carried out to investigate the effects of plyometric exercise on concomitants of fitness and metabolic profile in type 2 diabetes patients.
Methods: Simple random sampling technique was employed to recruit participants (n=27) for this study after meeting the inclusion criteria. Physical and physiological measurements were taken from the participants before and after six weeks of plyometric exercise for the experimental group and the control who did not participate in plyometric exercise.
Results: A total number of twenty seven (control= 13) participated in the study and there are not significant differences in the physical and physiological parameters of the two groups. There are significant differences in the physiological parameter after six (6) weeks of plyometric exercise among the experimental groups while there are no significant differences among the control group. The eta squared statistics of few parameters show that the effect sizes range between medium and large association.
Conclusion: It is concluded that among the concomitants of fitness, plyometric exercise is effective only in improving muscle fitness and body composition.
Keywords: Plyometric, exercise, diabetes mellitus, strength

Kashmala Khan, Shireen Khanzada, Wardah aijaz Qazi, Saifullah Khalid, Anum Mawani, Farah Khalid

DOI : 10.15621/ijphy/2016/v3i2/94894

Pages : 214-217

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Background: Children were major part of our society and their health issues were too much, so it’s necessary that child should b healthy so their health assessment is important worldwide the acceptable method for assessment of health status is anthropometry (weight & height). This study was done to assess the anthropometric measurement of primary school going children of Karachi, sindh Pakistan, and evaluate how much students were underweight.
Methods: The study was done in different primary school of Karachi including private semiprivate and government. The study design was cross sectional study. The sample size of our study was 240, including both genders male& female with range between 7-12 years.
Result: The result shows that 34.9% were underweight (below 5th percentile), 63.44% were normal weight (between 5-95th percentile) and only0.8% overweight (above 95th percentile).The result showed male-female ratio was 51.5% boys and 48.5% were underweight. The prevalence of underweight in private sector was only 9.5% but in government it was 45.5%.The height of student also calculated and 26.3% children were below the 5th percentile of height for the age, 62.8% were between 5th to 95th percentile and 10.9% above 95thpercentile.
Conclusion: The prevalence of underweight in primary school going children in Karachi shows the dietary requirements of children are not fulfilled properly and this may lead to many sever pathological conditions, so it is necessary to take positive steps regarding awareness of proper diet, hygiene and growth & development of child.
Keywords: Underweight, Karachi, Anthropometric, School, Height

Shweta P Pachpute, Nancy Patel, Seema Saini

DOI : 10.15621/ijphy/2016/v3i2/94895

Pages : 218-221

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Background: Flexibility is an indisputable component of fitness defined as the ability to move a single joint or series of joints through an unrestricted pain free range of motion. Static stretching consists of stretching a muscle or group of muscle to its farthest point and then maintaining or holding that position. The literature supports that muscles are capable of exerting their greatest strength when they are fully lengthen. Hence this study was conducted to find the effect of static stretching on hamstring muscle.
Methods: The study was experimental study design. 40 samples were selected by purposive sampling method. Flexibility of the hamstring muscle unilaterally right side (arbitrarily chosen) was measured by active knee extension test of all the subjects who met the inclusion criteria of the study. After measuring the flexibility of hamstring muscle, strength was measured by 1RM for the same side (right) hamstring muscle. Static Stretching Protocol was given for 5 days per week for 6 weeks to all the participants. After the 6 weeks of training, knee extension deficiency and 1RM was documented.
Result: Statistical analysis using Paired t-test was done. The t-test showed that there was significant effect of static stretching on 1RM of hamstring muscle (p<0.05) & active knee extension test (p=0.000).
Conclusion: Static stretching showed significant change in pre and post 1RM of hamstring muscle and active knee extension test. There was significant improvement of hamstring muscles flexibility and strength after giving static stretching in female population. So it is possible that females who are unable to participate in traditional strength training activities may be able to experience gains through static stretching.
Keywords: Flexibility, static stretching, Strength, Hamstring, 1RM, Active knee extension test

Samahir Abuaraki Elbkheet, Mallikarjunaiah H S, Nagaraj S

DOI : 10.15621/ijphy/2016/v3i2/94897

Pages : 222-227

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Background: Piriformis syndrome is a commonly overlooked specific cause of low back pain. Apart from mimicking the sciatica-like symptoms, unilateral piriformis tightness can cause rotational dysfunction and pain in the lumbar region. This could lead to low back pain which is a common musculo skeletal problem and a major reason for activity limitation. Stretching the piriformis tightened muscle is a preferred choice of treatment against surgical intervention to release the muscle. Mulligan’s mobilization is based on movement with mobilization which is proven to be effective in many musculo skeletal dysfunctions including the lumbar spine. The purpose of this study is to explore and compare the two treatment methods in relieving the low back pain in clinical conditions with piriformis syndrome.
Methods: In this experimental study, 40 patients with piriformis syndrome were selected and divided into two groups. One group was given only piriformis stretching for the tightened muscle and the other group given Mulligan mobilization for lumbo sacral joints. VAS and lower limb functional index were taken to compare before and after the treatment regime of 4 weeks.
Results: There was no significant difference between the two groups in both pain scale and lower limb mobility and function. But there was significant improvement in pain relief and LLFI after the treatment regime in both groups compared to the pre-treatment status.
Conclusion: Even as the piriformis syndrome is caused by the tightness of the muscle, the consequence in the lower back and lumbar spine mobility can be improved by a Mulligan mobilization as a single mode of intervention .
Keywords: piriformis syndrome, lower limb functional scale, low back pain, Mulligan’s mobilization

Shamik Bhattacharjee, Masih Muhammad Khan, Pritam Deka, Abhijit Dutta

DOI : 10.15621/ijphy/2016/v3i2/94898

Pages : 228-232

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Background: Healthy individuals, to ease and accomplish their activities of daily living they need flexible body without any tightness in the muscles, particularly those used for a definite function. Cooling soft tissues in a lengthened position after stretching has been shown to promote more lasting increases in soft tissue length and minimize post stretch muscle soreness. There are less documented studies which compared modified proprioceptive neuromuscular facilitation (PNF) stretch over passive manual stretch with cold application commonly after the interventions.
Methods: Thirty high school going healthy students were divided into two groups- Group I received Passive Manual stretching (n=15) and Group II received modified PNF stretching (n=15) and both groups received cold application after the interventions for 10 minutes commonly for 5 days. ROM was taken on day 1, day 5 and day 7.
Results: After day 7, Group II with Modified PNF stretching along with cold application showed a significant increase in range of motion tested with active knee extension test (AKET).
Conclusion: Modified PNF stretching is considered to be the effective intervention in increasing and maintaining ROM in AKET over passive manual stretching with cold applications commonly after the interventions.
Keywords: AKET, modified PNF, passive manual stretching, cold application, hamstring flexibility etc.

Ferkhanda Imdad, Samreen Yasmeen, Farhan Ishaque, Wakash Lal, Umair Nawaz Baloch, Saeed Ahmed Sheikh, Narender Kumar

DOI : 10.15621/ijphy/2016/v3i2/94901

Pages : 233-237

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Background: Low back pain has been found to be the most prevailing musculoskeletal condition as well as a common cause of absence from workplace. Studies report that low back pain is common and accounts for a large number of reported disabilities among nurses. In fact nursing have one of the highest levels of back injury in all occupation groups. The aim of this study is to determine the prevalence of low back pain among nurses in a public sector teaching hospital of Karachi. This study has mainly focused on confounding factors leading to low back pain and level of education among nurses regarding patients handling or shifting techniques.
Methods: A self-administered questionnaires comprises of three sections, were used to collect data. The first section requested for socio-demographic information, followed by medical history of back pain during last month and during last year.The second section assessed the medical history of LBP in two categories i.e. during last month and during last year.The third and last section inquired about participants’ level of education about ergonomics with simply in yes or no pattern.The questionnaires were given to 100 nurses. All questionnaires were completed in the presence of theresearcher. Out of 100 questionnaires distributed and recorded, only 47 participants returned the questionnaire.
Results: Statistical Package for the Social Sciences (SPSS) version 19.0 was used for statistical analysis. Relationship between
the prevalence of low back pain and training in patient moving techniques, manual material handling techniques is significant (p=0.017,p= 0.068). There is a weak relationship with the knowledge of ergonomics, biomechanics and back pain preventive measures (p=0.719,p=0.457,p=0.704).
Conclusion: More than two third of the participated nurses were well trained in transfer techniques, manual material training and preventive measures of back pain. But they lack the biomechanical knowledge. The prevalence of back pain is more in the nurses and nursing students in public sector teaching hospitals of Karachi.The relationship between level of education about manual material handling/shifting techniques and frequency of low back pain has been established as well. Key words: back pain, prevalence,patient handling/shifting techniques.
Keywords: back pain, prevalence, patient handling/shifting techniques, nurses.

Biju Chetri, U.T. Ifthikar Ali, Madhusmita Koch, Abhijit Dutta

DOI : 10.15621/ijphy/2016/v3i2/94902

Pages : 238-241

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Background: Plantar fasciitis is a painful condition caused by microtrauma to plantar fascia due to overuse. It is a most common cause of heel pain in runners. Various studies proved taping and Iontophoresis as effective in the treating plantar fasciitis. But there are no studies comparing the combined effect of iontophoresis with taping and taping alone in the treatment of plantar fasciitis.
Methods: 50 patients suffering from plantar fasciitis who met the inclusion criteria were selected. The subjects were randomly divided into two groups i.e. Group A and Group B. Group A received taping, iontophoresis with plantar fascia stretching. Group B received taping and plantar fascia stretching. A total of 6 treatment sessions were given on alternate days over a period of two weeks for both the groups.
Results: VAS and FFI scores across baseline and post intervention showed a significant improvement statistically in their mean scores between Groups A and B (P<0.05). Between group comparison of VAS and FFI scores, it showed that subject treated with Iontophoresis in combination with taping and plantar fascia stretch (Group A) had significant improvement in VAS and functional ability when compared to subjects treated with taping and plantar fascia stretching alone (Group B).
Conclusion: Iontophoresis along with Taping and plantar fascia stretching gave an additional benefit when compared with Taping and plantar fascia stretching alone in reducing pain and improving function in plantar fasciitis.
Keywords: Plantar Fascitis, Taping, Stretching, Iontophoresis, VAS, FFI

Pritam Deka, Mrs. Sarulatha, Shamik Bhattacharjee, Dr. Abhijit Dutta

DOI : 10.15621/ijphy/2016/v3i2/94904

Pages : 242-245

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Background: Cervical radiculopathy occurs annually in 85 out of 100,000 people. It is very disabling and interferes with the ADL of the patients. Many studies had shown the effectiveness of neural mobilization and TENS in reduction of pain and disability in patients with cervical Radiculopathy. But there are less documented studies that had shown the combined effect of neural mobilization and TENS and effectiveness of both over only neural mobilization in patients with cervical radiculopathy.
Methods: 30 male and female subjects were assessed as cervical radiculopathy and selected for the study. This includes unilateral cervical radiculopathy. They were categorized randomly into two groups as group receiving neural mobilization and TENS (experimental group I) and group receiving only neural mobilization (experimental group II) with 15 patients in each group. Assessment was taken using VAS and NDI prior to treatment. Treatment was continued for 14 days and at the end of 14 days patients were reassessed using the same scales.
Results: Group 1 receiving both the treatments had shown more significant reduction in pain and disability compared to Group 2 receiving only neural mobilization after 14 days of treatment.
Conclusion: Both neural mobilization and TENS are effective in reduction of pain and disability in patients with cervical radiculopathy. And when compared, combined treatment is more effective than only neural mobilization.
Keywords: Cervical radiculopathy, neural mobilization, TENS,VAS, NDI

Ahmed Ebrahim Elerian, Tamer Mohamed Ahmed Ewidea

DOI : 10.15621/ijphy/2016/v3i2/94906

Pages : 246-251

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Background: knee Osteoarthritis is the most common cause of musculoskeletal pain and disability. Shockwaves have been used as an alternative treatment for musculoskeletal disorders; intra-articular injection of steroid is a common treatment for osteoarthritis of the knee. This study aimed to investigate the efficacy of Shock wave therapy versus Corticosteroid intra articular injection in case of knee osteoarthritis.
Methods: Sixty patients were diagnosed mild to moderate knee osteoarthritis; they were included in the study. Their ages were 43:65 years with mean age 50 ± 3.5 years. Patients were divided randomly into three equal groups, group (A) received shock wave therapy, group (B) received two intra-articular injections of corticosteroid at 1-month intervals and group (C) received sham shock wave. The outcome measurements were Western Ontario and McMaster Universities arthritis index (WOMAC) values, knee ROM, and pain severity using the visual analogue scale (VAS) were recorded. The patients were evaluated for these parameters before allocated in their groups then after 1, 2, and 6months later.
Results: compared to sham group there were significant improvement of VAS and ROM of shock wave group and corticosteroid injection group than sham (placebo) group (p<0.000), (p<0.006, and 0.02) respectively. Furthermore there was significant improve of shock wave group than corticosteroid injection group where p was <0.000 for VAS, ROM and (WOMAC).
Conclusion: The results of this study suggested that shock wave therapy may provide effective modality for relieving pain, increase Range of motion and improve function in knee osteoarthritis patient than intra articular corticosteroid injection.
Keywords: Shock wave, Corticosteroid, Intra articular, injection, Knee joint, osteoarthritis.