[International Journal of Physiotherapy 2016; 3( 3) : 252-394] RSS
Volume 3 Issue 3 Index
Enas ELsayed Mohamed Abutaleb
DOI : 10.15621/ijphy/2016/v3i3/100820
Pages : 252-257
Background: Control of balance is a complex motor skill that involves integration of sensory inputs and the planning and execution of flexible movement patterns. Carrying side packs is famous in our society especially shoulder side packs. Most students carry shoulder side packs and they don't care about the way to carry them to be more balanced. The purpose of the study is to investigate the effect of carrying shoulder side pack on dynamic postural stability and to determine the best way of carrying a shoulder side pack either on the dominant side or non-dominant side that doesn’t affect dynamic postural stability in young healthy female.
Methods: Sixty female volunteers aged from 18 to 25 years old participated in the study. Biodex balance system was used to measure the dynamic postural stability in three different occasions (without carrying a shoulder side pack, with carrying a shoulder side pack on the dominant side, and on the non-dominant side) with a rest period in between.
Results: Repeated measure analysis of variance (ANOVA) followed by Bonferroni post hoc test were used to compare dynamic posture balance without carrying and during carrying a shoulder side pack on dominant and non-dominant sides. Analysis revealed that overall, anteroposterior and mediolateral stability indexes reduced significantly (P<0.0001) when carrying shoulder side pack on dominant side in comparison with when carrying shoulder side pack on non-dominant side and without carrying bag.
Conclusion: It was concluded that carrying a shoulder side pack on the non-dominant side didn't disturb the postural stability when compared to carrying on the dominant side so, we recommend the students to carry shoulder side packs on the non-dominant side.
Keywords: balance, biodex balance system, dynamic postural stability, shoulder side pack, stability index, young healthy
Vijay Samuel Raj V
DOI : 10.15621/ijphy/2016/v3i3/100822
Pages : 258-262
Background: Osteoporosis is a metabolic bone disease that progress silently leading to loss of bone mass. The fractures caused because of osteoporotic bones are widely prevalent in India and are one of the common causes of morbidity and mortality in elderly population. The Health care providers and Physiotherapist have a specific role in osteoporosis through exercise prescription, education and strategies to maximize function, reduce the risk of falls and manage pain. There are various treatment protocols involved treatment and prevention of osteoporosis, among which the exercises have an impact on the bone mineral density. The studies have presented the importance of exercises in improving the bone mass apart from improving function and reducing the risk of fractures. The various type and intensity of exercises vary with age and it is important to understand the benefits and adverse effects. There are few studies emphasizing on the regimes and type and intensity of exercises. This manuscript provides an overview of physiotherapy management for bone health with an emphasis on the clinical recommendations and exercise prescription. The effects of exercise and its evidence in prevention and treatment of osteoporosis are also discussed.
Methods: The article was framed with the Data sourced from electronic database, systematic reviews, meta-analyses from pub med, Medline, science direct and Cochrane library.
Result: Early intervention and exercise has a positive correlation against BMD and bone health.
Conclusion: Various exercises have their benefits in osteoporosis and a combination of exercises must be recommended based on a methodical assessment.
Keywords: Osteoporosis, exercises, physiotherapy, bone mass density, Bone mass density, management. (Included
Boolean operators “and”, “in”)
Mohammad Habibur Rahman, Md. Shofiqul Islam, Ehsanur Rahman, Samena Akter Kakuli, Shamima Islam Nipa, Md. Obaidul Haque
DOI : 10.15621/ijphy/2016/v3i3/100824
Pages : 263-266
Background: Clinical reasoning is a process by which physiotherapists interacted with patients, their family and other health- care professionals. It is the thinking process that professionals tend to apply in clinical practice. Given that novice as well as expert practitioners prefer to go through some steps while they were dealing with unfamiliar cases. This process is known as hypothetico deductive reasoning. This reasoning approach involved the generation of hypothesis based on clinical data and knowledge and testing of hypothesis through further inquiry. We are expert in musculoskeletal physiotherapy treatment and favoring the atypical history of patient we went through step by step from assessment to discharge
Methods: A case based study through hypothetico deductive reasoning model of clinical reasoning. The objective of the study was to investigate the physiotherapy management strategies of an atypical ankle sprain patient through hypothetico deductive reasoning which comprised of cue acquisition, hypothesis generation, cue interpretation and hypothesis evaluation by implementing International Classification of Functioning, Disability and Health (ICF).
Results: The patient responded well to treatment as patient reported that 100% swelling decreased, could bear more weight (95%) on foot, decrease pain (1 cm on 10 cm VAS scale), improved muscle strength by manual muscle testing by grade V in ankle planter flexors (PF) as well as dorsiflexors (DF), invertors as well as evertors and the functional status of patient was improved by 80% according to lower extremity functional scale.
Conclusion: Clinical reasoning is an important approach in physiotherapy. It helps the practitioners in decision making and choosing the best alternative options for the well being of patients. We think it is necessary for all practitioners to have sound propositional and non-propositional knowledge in order to provide effective management protocol for patients focusing ICF. Even though we have been treating patients with musculoskeletal problems on regular basis, the atypical pattern of this patient give us the impression not to use pattern recognition all time for all patients rather using hypothetico deductive reasoning (HDR) where appropriate.
Keywords: Clinical reasoning, ankle sprain, hypothetico deductive reasoning, cue acquisition, hypothesis evaluation and ICF.
Naomi Wanjiru, Dr. Samuel Kabara, Johnstone Milimo
Pages : 267-272
Background: The application of the concept of Evidenced Based Practice into clinical decision-making and practicehas outstanding benefits both to clinicians and the patient. However, the utilization of this concept has not been copiously utilized in most health facilities by the physiotherapists in Kenya. Therefore, the objectives for this study was to determine the level of awareness of evidence based practice among Physiotherapist, establish the availability of resource for Evidence Based Practice and to assess the challenges encountered by physiotherapist in engaging in evidence based practice at Moi Teaching and Referral Hospital.
Methods: All physiotherapists working in Moi Teaching and Referral Hospital (42) took part in a cross-sectional descriptive survey. Questionnaires were used for data collection and analyzed by SPSS version 22.
Results: there was high level of awareness on Evidence Based Practice (95 %) and confidence in EBP (72.5 %). However, lack of information resources, poor skills to implement EBP, poor organization support 90%, insufficient authority to induct change in the practice setting 85%, inadequate facilities 74% and lack of time were identified as the major challenges in implementation of EBP
Conclusion: Strategies should be developed to provide PTs with EBP resources, such as access to databases or links to guidelines, and continuous education regarding specific topics. Professional organizations and Associations should aim at changing the current practice to ensure full utilization of EBP.
Keyword: Evidenced based practice, physiotherapy, patient, management, outcome, knowledge, challenges, implementation,
FumikoKamijo, Sumiko Yamamoto
DOI : 10.15621/ijphy/2016/v3i3/100826
Pages : 273-279
Background: Trunk function is considered important for stroke patients in rehabilitation, but the significance of this factoris unclear. In this study, we examined trunk function, defined as the ability to keep the trunk stable against gravity during movement. In addition, we aimed to elucidate the relationship between gait performance and trunk function.
Methods: The subjects were 14 hemiplegic men and 20 healthy elderly men. Movement was assessed by a three-dimensional motion analysis system focusing on the trunk. The trunk was divided into three parts: the pelvis, the middle trunk, and the upper trunk. The parameters assessed were static standing, anterior tilt of the trunk in the standing position, and gait. We examined the relationship of each of these trunk movement factors with gait speed. All data was analyzed using SPSS program version 21 (p < 0.05).
Results: Comparing data of hemiplegic patients to that of normal subjects, during trunk bending, a large rotation angle toward the non-affected side was found and that toward the affected side of the middle trunk at the toe off time of the affected limb during gait was found in hemiplegic patients (p < 0.01). The degrees of both rotation angles were related to the gait performance.
Conclusion: The movement of the middle trunk during bending in hemiplegic patients affected gait performance. The results indicated that gravity and movements of lower limbs easily affected the middle trunk. This is an important factor to consider in the rehabilitation of hemiplegic patients.
Keywords: kinematics, stroke patients, trunk function, gait performance, motion analysis, rehabilitation.
Nevein Mohammed Mohammed Gharib, Reham Hussein Diab
DOI : 10.15621/ijphy/2016/v3i3/100827
Pages : 280-285
Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women.
Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device) in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week). All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index.
Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05).
Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks) have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.
Keywords: Vacuum therapy, Abdominal Exercises, Aerobic Exercises, Abdominal Obesity, Women, Obesity.
Kanwal Khan, Samreen Yasmeen, Farhan Ishaque, Ferkhanda Imdad, Wakash Lal, Saeed Ahmed Sheikh, Narendar Kumar, Shireen Khanzada
DOI : 10.15621/ijphy/2016/v3i3/100829
Pages : 286-290
Background: Cervical radiculopathy, generally entitle as pinching of the nerves which causes severe shooting pain which mostly pass through the shoulder. Along with it causes muscle weakness and numbness into the arm and hand. In majority of the cases, cervical radiculopathy responds well to conservative mode of treatments which incorporate physical therapy with medical management. The aim of this study is to uncover the effective and evidence based conservative treatment of cervical radiculopathy.
Method: Randomized controlled trial study conducted from January 2014 to December 2014. Participants were recruited from physiotherapy OPDs of tertiary care hospitals. A total number of, 100 subjects with a ratio of 50 men and 50 women were recruited between the ages of 25 and 55 years with unilateral cervical radiculopathy. Control group received combination of conventional AROM exercises and modalities including TENS and superficial thermotherapy as a treatment while experimental group received manual cervical traction and combination of conventional AROM exercises, modalities including TENS and superficial thermotherapy. For both groups, treatment was designed for two weeks (6 sessions/ week). Improvement in symptoms was assessed by evaluation of both groups on the basis of visual analogue scale (VAS).
Results: After 2 weeks of treatment, patients with neck pain showed marked decreased in pain as compared with the control group (P<.001).For pre and post level a paired sample t-test was used and the results with p-value less than 0.05 were considered as significant. Mean difference of 0.94 (VAS) with a significant p-value (P<0.01) was obtained shows the respective improvements in the
numeric pain scale scores.
Conclusion: Manual cervical traction when used with conventional AROM exercises and modalities were effective methods for decreasing pain in cervical radiculopathy. Recent literature supports such protocols involving multiple interventions. Results of this study also supported the treatment options in cervical radiculopathy in a multimodal approach.
Keywords: Cervical Radiculopathy, Manual Cervical Traction, Multimodal Approach, Pain.
Meghan Metha, Kiran Pawar
DOI : 10.15621/ijphy/2016/v3i3/100830
Pages : 291-296
Background: COPD is the second most common lung disorder. Respiratory mechanics of COPD is altered. Lung volumes & biomechanical changes lead to weak & ineffective expiratory maneuvers.
Methods: 40 COPD subjects above the age of 45years were selected through purposive sampling. The subjects were placed in seven different positions namely Standing, Chair sitting, Long sitting, Semi fowler’s position, Supine, Side lying, Head down. Following this the subject performed three tests of PEFR with intermittent rest period as preferred by the subject between each trial.
Results: PEFR achieved by subjects with COPD were significantly affected by body position. Standing (161.82) led to results which were significantly higher than all other positions followed by chair sitting (150.079), long sitting (141.495),semi fowler’s position (136.746), supine lying (126.829), side lying (120.162) and head low position (107.829) led to results which were significantly lower than all other positions.
Conclusion: More the upright position, higher the PEFR. PEFR is more in standing and Head down position has the lowest PEFR value. Increased lung volumes in standing position can be related to the increased thoracic cavity volume owing to the effect of gravity and the inspiratory muscles would be able to expand the unrestricted thorax in all directions in this position & expiratory muscles attain their optimal length during standing.
Keywords: COPD, PEFR, Dyspnoea, Body Positions, Airway clearance technique.
Gajanan Bhalerao, Dhanashree Parab
DOI : 10.15621/ijphy/2016/v3i3/100831
Pages : 297-303
Background: Stroke subjects face reduced tolerance to activity and sedentary lifestyle due to various impairments, such as muscle weakness, pain, spasticity, and poor balance. Thus, loss of independent ambulation especially outdoors is generally observed in them.
Methods: Chronic stroke patients (> 6 months) with Functional Ambulation Category score > 2 and able to walk at least 10 meters of distance with and without assistance from a tertiary healthcare centre were selected and treated. Subjects were randomly divided into 2 groups control group (n=14) and experimental group (n=13). Each group received Motor Relearning Programme for 60 minutes, 6 times a week for 4 weeks. The experimental group received an additional shoe-raise of 1 cm on the unaffected side along with while ambulating during therapy as well as at home. Pre and post treatment the patients were assessed for spatio-temporal parameters using foot print analysis method and Rivermead Visual Gait Assessment (RVGA) Score using RVGA scale.
Results: There was significant improvement seen in almost all the spatio-temporal gait parameters and RVGA score in within group analysis. Whereas on between group the results from between group comparison suggests that subjects in MRP with shoe-raise group showed better results in spatio-temporal parameters of gait than subjects receiving MRPalone. But there was no additional benefit of shoe-raise seen on RGVA score and angle of toe-out parameter.
Conclusion: Additional use of shoe-raise helps to improve spatio-temporal gait parameters. However, there was no additional change seen in RVGA score.
Keywords: Stroke; Motor Relearning Programme; Shoeraise; Ambulation; Gait training; Foot Print Analysis
Maria Ragnarsdottir, Helga Bogadottir, Steinunn Unnsteinsdottir, Bjarni Torfason
DOI : 10.15621/ijphy/2016/v3i3/100832
Pages : 304-309
Background: Patient benefit from repair of pectus excavatum has mainly been considered psychological although some evidence of physiological benefit has emerged. The purpose of this study was to investigate lung function, respiratory movement and physical fitness together with the patient’s satisfaction with the look of the chest one year following modified Nuss procedure.
Methods: In this prospective cohort follow-up study eighteen boys and young men who underwent modified Nuss procedure participated. Measurements of lung volumes using spirometry, respiratory movements using Respiratory Movement Measuring Instrument, and physical fitness using Aastrand ergometer bicycle test were performed pre- and one year post-operatively. Assessment of participants’ opinion of the looks of their chest was made at the same point in time.
Results: Participants mean age was 16±3 years, their mean BMI was 20.8±3.5 kg/m2 and mean Haller Index was 3.9±0.7. Significant changes one year following modified Nuss procedure were found in mean abdominal- and upper thoracic respiratory movements during deep breathing (p≥0.001, p≥0.05, respectively), mean physical fitness (p=0.01) and mean satisfaction with chest looks in general and without shirt (p=0.03, p=0.001 respectively).
Conclusion: Increased physical fitness, abdominal- and upper thoracic respiratory movements one year following modified Nuss procedure together with high level of patient satisfaction supports the argument that patients benefit from undergoing the repair is physical as well as cosmetic.
Keywords: Pectus excavatum, modified Nuss procedure, lung function, respiratory movement, physical fitness.
V.V. Senadheera, B.M. Nawagamuwa, K. Nidhya, S. Sivappriyan, W.M.S. M. Warnasooriya, P. M. Madhuranga, H.R.D. Peiris
DOI : 10.15621/ijphy/2016/v3i3/100834
Pages : 310-315
Background: Prevalence of flatfoot is highly variable in different world populations. Previous studies have found that many factors are associated with flatfoot. The objective of the present study was to investigate the prevalence of flatfoot and its association with age, gender and BMI in group of 6-10 aged children in Central province of Sri Lanka.
Methods: A total of 722 children aged 6 to 10 were used to assess normalize navicular height using two clinical measurements (navicular height, truncated foot length). Weight and height of the subjects were measured to calculate body mass index. Age and gender of the children were also recorded. Calculated normalize navicular heights were plotted in a distribution curve and area under the curve between +1SD and -1SD was considered as normal foot. Area under the curve which is left to the -1SD was considered as flatfoot.
Results: Overall prevalence of flatfoot among 6-10 aged children in the present sample was 16.06%. The prevalence of flatfoot in 6,7,8,9 and 10 aged children were 26.35%, 16.19%, 12.75%, 13.57% and 11.1%, respectively. Prevalence of flatfoot was high in overweight children (21.05%). Prevalence of flatfoot among males and females were 47% and 53%,respectively.
Conclusion: This study suggests that there is a significant association between flatfoot and age (p<0.05). Prevalence of flat foot decreases with advancing age. Furthermore, there is a significant association between flatfoot and body mass index (p<0.05). Prevalence of flatfoot is higher in overweight children than normal weight and underweight children. There is no significant association between flatfoot and gender.
Keywords: Flatfoot, navicular height, truncated foot length, age, gender, body mass index
Muhammad Junaid, Syed Ijaz Ahmed Burq, Shazia Rafique, Salman Malik, Akhtar Rasool, Iqra Mubeen, Saifullah Khalid
DOI : 10.15621/ijphy/2016/v3i3/100836
Pages : 316-319
Background: Froze shoulder in other words adhesive capsulitis is a condition characterized by progressive loss of shoulder mobility with general symptoms of pain, limited range of motion and altered scapula thoracic rhythm. The condition is mostly treated by using traditional physical therapy measures the study was conducted with the aim to determine the efficacy of routine physical therapy treatment with and without Kaltenborn mobilization in reducing pain and increasing shoulder mobility in frozen shoulder
Methods: The study was conducted in the department of Physiotherapy mayo Hospital Lahore. A sample of 60 patients was collected by using non-probability, convenience sampling without any discrimination regarding, social economic status, education, out of which there were 8 drop outs. Sample was distributed in two groups (26 participants each) i.e. experimental group receiving routine physical therapy and Kaltenborn Mobilization technique and control group receiving the routine physical therapy only. Participants were recruited based on the inclusion and exclusion criteria. Demographic data and data regarding pain relief was collected using self-made questionnaire and penn shoulder scale questionnaire respectively.
Results: Results were evaluated by using SPSS version 19.1 it was seen that range of motion of cervical region was greater for the experimental group than control group. The maximum PENN score achieved in control group were 51 however for experimental group the value was 64.
Conclusion: It was concluded that kaltenborn mobilization is an effective means of treating frozen shoulder and when combined with routine physical therapy gives better results.
Keywords: Kaltenborn mobilization (KM), routine physical therapy, Adhesive capsulitis, Mobilization, PENN scale, visual analogue
Muneeb Iqbal, Imtiaz Rabani, Salman Malik, Amir Saeed, Muhammad Akhtar, Shumaila Ehsan, Iqra Mubeen, Saifullah Khalid
DOI : 10.15621/ijphy/2016/v3i3/100837
Pages : 320-325
Background: Diabetes has become a very common disease all over the world since last few decades and is now perceived as a global health disorder. Diabetes mellitus is identified on the basis of constant high concentration of blood glucose level and it mainly occurs due to deficiency of the pancreatic hormone insulin. High-intensity interval training (HIIT) is an improved form of interval trainings, and exercise strategies which alternate the periods of small intense anaerobic exercise by less-intense regaining periods. The study aimed to compare the hematological parameters associated with diabetes and muscle activity between healthy humans and diabetic type-1 patients when subjected to HIIT and regular aerobic exercises.
Methods: A convenience sample of total 60 participants was taken it comprised of thirty healthy individuals taken from the department of Physical Therapy, University of Sargodha, Lahore campus and thirty diabetic type-1 individuals of age 15-30 years taken from Akhuwat health services clinic Township, Lahore. Participants were divided into four groups of fifteen individuals each. Group one was the diabetic HIIT (DH) group with diabetic type-1 patients subjected to HIIT. Group two was the diabetic aerobic (DA) group with diabetic type-1 patients subjected to regular aerobic exercises. Group three was control High intensity interval training (HH) that consisted of fifteen healthy individuals to be subjected to High intensity interval training exercises (HIIT). Group four (HA) was the control aerobic group with fifteen healthy individuals of average lifestyles subjected to regular aerobic exercises.
Results: Aerobic exercise was found to be more effective in reducing glucose level, lowering exogenous insulin and glycated hemoglobin, however HIIT proved to be more effective in lowering blood cholesterol level and decrease LDL level and increase HDL level.
Conclusion: It was concluded that aerobic exercise program in comparison to high intensity interval training showed better results in lowering blood glucose levels and HbA1c levels. So we may suggest aerobic exercise program along with drugs as a synergic therapy to control diabetes and its complications.
Keywords: Sprint interval trainings (SIT), High-intensity intermittent exercises (HIIE), Diabetes mellitus, Aerobic exercise, Glycated hemoglobin, Low density lipoproteins, High density lipoproteins
Aliaa Rehan Youssef
DOI : 10.15621/ijphy/2016/v3i3/100838
Pages : 326-331
Background: Forward head is a common postural fault of the cervical spine that can be assessed using the photogrammetry method. This is a valid, popular and feasible clinical method. Although forward head is primarily a sagittal plane postural fault, deviations in other planes may result in measurement errors when photos are captured from only one side. Therefore, the purpose of this study was to investigate whether forward head assessment by photogrammetry taken from the right (Rt) or left (Lt) sides of the body would differ.
Methods: One hundred thirty two healthy adults were assessed from standing and 90 were assessed from sitting positions. In addition, 41 patients with mechanical neck pain were assessed from standing and 56 from sitting positions. Three profile photos were captured from each side in standing and sitting positions. Photos were then digitized before they were analyzed using the kinovea software to measure the craniovertebral (CVA) and gaze angles.
Results: In healthy adults, the CVA was not significantly different across sides (p>0.05) whereas the gaze angle was different regardless of the testing position (p <0.05). For patients with mechanical neck pain, CVA differed in standing (p <0.05) but not in sitting position (p >0.05), whereas the gaze angle did not differ regardless of the testing position (p >0.05).
Conclusion: Measurement of CVA and gaze angles in sitting and standing is not consistent across sides, depending on the population tested. Assessors should be conservative and consider taking photos from both sides to assess the severity of forward head position using the photogrammetric method.
Keywords: Forward head posture, Photogrammetry, Craniovertebral angle, Gaze angle, Mechanical neck pain, postural faults.
Kamaljeet Singh, Lalit Arora, Reena Arora
DOI : 10.15621/ijphy/2016/v3i3/100840
Pages : 332-336
Background: Diabetic Mellitus is a group of metabolic disease characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. Distal Sensorimotor Polyneuropathy is the most common complication of diabetes which mainly affects the lower limbs. Most of the studies aimed at individually increasing muscle strength or sensation but not on overall performance enhancements of the diabetic lower limbs. The evidence supporting the effectiveness of PNF in diabetic neuropathic patients is scarce.
Methods: 30 patients, with age between 50 to 70 years, diagnosed with Diabetic Sensorimotor Polyneuropathy (DSP) were selected from the department of Medicine and department of Neurosurgery Guru Gobind Singh Medical College and Hospital. Patients were evaluated at the beginning and at the end of the intervention using Diabetic Neuropathy Examination scores. Patients received 3 sets of exercises one hour/day with 3 days/week for 3 months. Each set of exercises consists of 5 repetitions of PNF patterns (alternate day) and techniques.
Results: D1 & D2 patterns of PNF are effective in improving both motor and sensory functions of diabetic patients with neuropathic symptoms. Improvement in muscle strength, reflex and sensations occurred to a greater extent after the treatment of three months in these subjects. This study shows that PNF patterns were effective at enhancing sensorimotor problems of lower limbs.
Conclusion: This study concluded that PNF is found to be effective in improving sensorimotor functions of diabetic neuropathic patients affecting lower limbs.
Keywords: Diabetes, Diabetic neuropathy, Propriception Neuromuscular Facilitation (PNF), Diabetic Neuropathy Examination
score, Sensorimotor, Polyneuropathy.
Eman Mohamad Abd Al-Gawad, Eman Ahmed Embaby, Magdoline Michael Samy, Salwa Fadl Abd-Almageed
DOI : 10.15621/ijphy/2016/v3i3/100841
Pages : 337-345
Background: Rigid and kinesio tapings are commonly used in the rehabilitation of subacromial impingement syndrome (SIS). Yet; the effect of postural correction with the two taping materials in SIS has not been extensively studied. The purpose of the study is to examine the effect of postural correction with two different taping materials on scapular kinematics and electromyography of scapular upward rotators in patients with SIS.
Methods: Twenty female patients with SIS participated in this study. Their age ranged from 30-60 years. Participants were randomly assigned into: Group I (Kinesio tape, n=10) and Group II (rigid tape, n=10). Thoracic and scapular taping with posture correction was applied to both groups. Scapular upward rotation at 0˚, 60˚, 90˚ and 120˚ of shoulder elevation and the activity level of the upper fibers of trapezius (UT), lower fibers of trapezius (LT) and serratus anterior (SA) muscles were measured before and immediately after taping application.
Results: Both taping materials significantly increased scapular upward rotation at 60°, 90° and 120° angles (P =.004,.002 and .047 respectively) after the application of tape as compared to the before. In addition, significantly greater muscle activity of the LT and SA muscles (P =.027 and 0.05 respectively) were demonstrated by the kinesio-taping group as compared to rigid taping group during real taping condition.
Conclusion: Both taping materials are effective in restoring scapular kinematics. Furthermore, kinesio taping has a facilitatory effect on the LT and SA muscles. Kinesio taping may be considered an alternative to rigid taping in patients with SIS.
Keywords: electromyography, subacromial impingement syndrome, scapular kinematics, serratus anterior, taping, trapezius
Ankush Sharma, Saurabh kumar, Jayaraman G, Surinder Pal Singh
DOI : 10.15621/ijphy/2016/v3i3/100842
Pages : 346-350
Background: Chronic obstructive pulmonary disease is a progressive disease characterized by airflow limitation or obstruction that is either not reversible at all or only partially reversible. The purpose of the present study was to compare oxygen saturation, pulmonary function and quality of life in the sample population from hill and plain area.
Methods: A survey study, total sample size was of 100 patients of COPD (age between 40-70years) in which 50 each from hill and plain area. To find out desired result Oxygen saturation with pulse oximeter, pulmonary function test with spirometer and HRQOL with the SF-36 questionnaire was assessed.
Result: Analysis using independent t- test to evaluate the significance of difference between means of two quantitative variables. The cut off level of significance was set at α = 0.05. And it has been found that the influence of COPD in hill and plain on oxygen saturation and HRQOL was significant for physical component score (4.08). There was minor and not significant for pulmonary function (1.77).
Conclusion: From the results we concluded that COPD patients residing at hill has greater decline in SpO2 but the HRQOL in COPD patients residing at hill was better than patients residing at plain. There was little or no difference in pulmonary function by FEV1among COPD patients of hill and plain.
Keywords: COPD, HRQOL, SpO2, FEV1, SF-36 questionnaire, Pulse oximeter, Spirometer.
Nadia Ishtiaq, Junaid Gondal, Salman Malik, Akhtar Rasul, Saad Kamal Akhtar, Amirah Zafar, Muhammad Asif, Iqra Mubeen, Saifullah Khalid
DOI : 10.15621/ijphy/2016/v3i3/100843
Pages : 351-354
Background: Urinary incontinence is a common condition among females and it is estimated that 20-40% females of age under 60 years suffer with urinary incontinence however for the females above 60 years the percentage is 30-50%. Keegal exercises are used to strengthen pelvic floor muscles which ultimately treats and reduces urinary incontinence. It is pretty definite that women with diabetes mellitus at advanced phases of age suffer with urine incontinence, but the severity of matter has yet been considered enough to put forth the cautionary measures to evade such concerns. Purpose of the study is to analyze the effect of pelvic floor exercises on the urinary incontinence in diabetic women.
Methods: To evaluate the effect of Keegeal exercises (pelvic floor muscle exercises), quantitative research approach has been opted, in which patient were advised to perform the keegeal exercise for 3weekswith 4 weeks follow up. 45 diabetic women were recruited to analyze the effect of keegal exercises to minimize the risk of urine incontinence. In due course, three types of keegeal exercises have been proposed to analyze their effect on urine incontinence i.e. adductor strengthening, pelvic bridging, and draw in maneuver with a follow up of 4 weeks.
Results: Reliability test was performed to evaluate the dependency between independent and dependent variable. Through ANOVA with Friedman's Test, it was observed that the data of correlation between the suggestive variables is highly significant. Cronbach’s Alpha test was performed which has concluded the results to 0.753 which is quite significant in context of research hypothesis and approving the fact the with keegeal exercise, urine incontinence can be reduced.
Conclusion: With subjective research it was concluded that if the patient efficiently performs the exercise the urine incontinence can be improved.
Keywords: Diabetes mellitus (D.M), urinary incontinence (U.I), pelvic bridge (P.B), adductor strengthening (A.S), draw in maneuver (D.I.M)
Jaspreet Kaur, Manoj Malik, Monika Rani
DOI : 10.15621/ijphy/2016/v3i3/100846
Pages : 355-361
Background: Most common complaint of an individual is pain, which can be with or without injury. It is the key that enables human being to figure out disease ordisorders that is interfering normal life. Pain can be because of numerous reasons but known pathways for pain can be physiological, nociceptive, neuropathic or mixed, which may be experienced as aching pain, burning pain, stabbing pain, etc. Although there are various clinical methods to reduce pain but the main objective of present study was to find if taping can reduce pain be it musculoskeletal or neurological pain. Also to summarise all evaluated work done in various studies.
Methods: various studies have been taken from pub med, Google scholar that includes relief of pain with application of taping irrespective to technique used. Study selection, data extraction, and assessment of methodological quality and clinical relevance were performed independently by two reviewers. All the data extracted from randomised controlled trials included in the review has been used to synthesise the results. Therefore the results are based on facts laid down by the articles included.
Results: Pedro scoring has been used to asses various studies which show the use of taping for relief of pain on various musculoskeletal disorders and neurological disorders.
Conclusions: Although there are various modalities which can help in reducing pain but present review shows that taping can be used as very useful tool for reducing pain. Further it is cheap, less time consuming and easy to manage with excellent results. taping can be used as an adjunct to modalities present to reduce pain.
Keywords: pain, taping, kinesiotaping, adhesive tape, visual analogue scale, physiotherapy.
Mohamed Taher Mahmoud ELDesoky, Enas ELsayed Mohamed Abutaleb
DOI : 10.15621/ijphy/2016/v3i3/100847
Pages : 362-370
Background: A definite conclusion about the effectiveness of neural mobilization on patients with radiculopathy can’t be reached because of the lacks of well designed randomized controlled trials. The purpose of the study to investigate the effects of neural mobilization on low back pain subjects with S1 radiculopathy.
Methods: Sixty chronic low back pain subjects with S1 radiculopathy participated in this study. The participants were suffering from varying degrees of unilateral pain and paresthesia in the lumbosacral region and lower limb. The causes of radiculopathy were bulged disc, herniated disc or neuroforaminal stenosis at L5-S1 level.The participants were randomly assigned into two equal groups with 30 participants in each group. The experimental group received neural mobilization and conventional rehabilitation program in the form of infrared, ultrasonic and general exercises that involved stretching and strengthening exercises for the back muscles for 6 weeks. The control group received the same conventional rehabilitation program only for 6 weeks. The outcome measures were H-reflex latency, amplitude, and H/M ratio for assessing S1 nerve root function, visual analog scale (VAS) for assessing pain level, and Oswestry Disability Index (ODI) for assessing functional disability. All the participants were evaluated pre and post 6 weeks of treatment.
Results: Both groups showed significant improvements in all measured variables after 6 weeks, but neural mobilization showed more beneficial and statistically significant effect in all measured variables than the control group.
Conclusion: Neural mobilization technique is an effective intervention for reduction of pain, functional disability and enhancing physiological function of the nerve root in low back pain with lumbosacral radiculopathy.
Keywords: Neural mobilization, Low back pain, functional disability, Lumbosacral radiculopathy,nerve root function,
Warda Hassan, Salman Malik, Junaid Gondal, Muhammad Akhtar, Saad Kamal Akhtar, Amirah Zafar, Sidra Anmol, Iqra Mubeen, Farah khali
DOI : 10.15621/ijphy/2016/v3i3/100848
Pages : 371-375
Background: Cervical pain is a common condition and almost two thirds of population suffers with this condition. Cervical region is the commonest region for non-traumatic neck pain. Neck pain generates many muscular disturbances in the neck region and may result in tightness of muscles of cervical region. Stretching is considered as an effective mean of treating cervical pain. Isometric exercise is used to enhance the performance of muscles because it provides strength required to perform dynamic exercise. Both of the regimens either separately or combined are used in clinical settings to treat nonspecific cervical pain. This study aims to compare the results of cervical isometrics with and without stretching exercises in reducing non-specific cervical pain
Methods: A randomized controlled trial research was performed at physiotherapy department of Mayo Hospital Lahore, Pakistan. A convenience sample of 40 participants was divided into two groups. The cervical isometric exercise was applied to group A and stretching plus isometric exercise to group B for 3 weeks. Nonspecific neck pain was analyzed by using visual analogue scale and goniometry for pre and post treatment assessment.
Results: Isometric exercises play an effective role in relieving pain (p value is 0.03) and minimizing inability of the body to perform functional activities (p value is 0.004) in contrast to the patients of group A. Isometric exercises were applied to the patients of group A (Level of pain: pain value is 0.172) and (physical inability to perform functional activities has P value 0.201).
Conclusion: The result showed that the patients with the complain of non-specific neck discomfort who were treated by cervical isometric alone, showed less improvement in pain relief in contrast to the patients who were treated by the cervical isometric long with stretching.
Keyword: Visual Analogue scale (VAS), Range of Motion (ROM), Stretching, Isometric Exercise, Golgi Tendon Organ, Manual Muscle Testing
Gurkirat Kaur, Pravin Kumar
DOI : 10.15621/ijphy/2016/v3i3/100850
Pages : 376-380
Background: Low Back Pain (LBP) is a health related problem than affects 80% of the population within the age limit of 15 to 45 years. The primary treatment used for patients with LBP includes muscle strengthening along with thermotherapeutic modalities. Thus the purpose of the study is to see the efficacy of EMG biofeedback assisted core stability exercises versus core stability exercises alone in patients suffering from pain and disability.
Methodology: A total of 30 patients were divided through convenient sampling method into two group- A and B. Each group had 15 patients. In Group A-SWD, traction, IFT and core stability exercises were given where as in Group B EMG biofeedback assisted core stability exercises were given for 5 treatment session per week for 2 weeks and reassessment was done on 5th and 10th day post treatment.
Result: The result of the study showed that there was statistically significant (p<0.05) improvement in both Group A and B in terms of pain (NPRS) and disability (ODQ) after 10th day of treatment. Whereas on comparison within groups the result showed that there was significant (p<0.05) improvement in Group B 10th day post treatment rather than Group A on day 10th.
Conclusion: The study supports that EMG biofeedback assisted core stability exercises are helpful for treating patients with LBP to reduce their pain as well as disability.
Keywords: Core stability exercises, EMG biofeedback, Pain, Disability,SWD,NPRS.
Iqra Mubeen, Salman Malik, Waseem Akhtar, Muneeb Iqbal, Muhammad Asif, Adil Arshad, Sobia Zia, Saifullah Khalid
DOI : 10.15621/ijphy/2016/v3i3/100851
Pages : 381-384
Background: Upper cross syndrome is becoming more prevalent in today’s population. The syndrome is expressed as a postural disorder presenting with over active pectoralis musculature and upper trapezius musculature. Also there is inhibition of lower and middle trapezius musculature, which results in winging of scapula, elevated and abducted scapula. This scapulardyskinesia there by resulted inrounding of shoulders. The syndrome is often associated with bad posture in routine life oroccupation of a person.The purpose of the study is to determine the prevalence of upper cross syndrome in medical students of Lahore.
Methods: A convenience sample of 384 medical students was selected from university of Lahore, based on inclusion and exclusion criteria. Medical students of age between 17 to 2 years with sound physical and mental state were included. Students with any trauma, recent injury, recent fracture or surgery and any serious underlying pathology that may interfere with mobility of upper limb were excluded from the study. The research was a cross sectional observational study and self-administered questionnaires were circulated among participants and the data was analyzed using SPSS version 21. Reed-co scale was used to analyze the proper alignment of head, neck and shoulder; where as wall push test was used to assess the abnormal protrusion of scapula.
Results: The study have revealed that48.7% population of the students haveneck pain;and the results have concluded that high prevalence of upper cross syndrome in medical students of university of Lahore and a 66.8% of population was found to have poor studying posture.
Conclusion: In this study relation between upper cross syndrome and bad posture were seen and it was found that the individuals suffering with upper cross syndrome were somehow related to bad posture or indulge in activities which make individual to adopt a posture of high physiologic cost there by leading to muscular imbalance that will yield upper cross syndrome and prevalence of upper cross syndrome in medical students of University of Lahore was found to be 37.1%.
Keywords: Mid-Pectoral Fascial Lesion, Upper cross syndrome, Torsional upper cross syndrome, over inhibition, over facilitation, Thoracic kyphosis, Winging of scapula.
Mohansundar Sankaravel, Jeffrey Low Fook Lee, Ong Kuan Boon, Sanmuganathan Jeganathan
DOI : 10.15621/ijphy/2016/v3i3/100855
Pages : 385-389
Background: Proprioceptive deficiency followed by lateral ankle sprain leads to poor balance is not uncommon. It has been linked with increased injury risk among young athletes. Introducing neuromuscular training programs for this have been believed as one of the means of injury prevention. Hence, this study was aimed to determine the effects of six weeks progressive neuromuscular training (PNM Training) on static balance gains among the young athletes with a previous history of ankle sprains.
Methods: This study was an experimental study design, with pre and post test method to determine the effects of PNM Training on static balance gains. All data were collected at university’s sports rehabilitation lab before and after six weeks of intervention period. There were 20 male and female volunteer young athletes (20.9 ± 0.85 years of age) with a previous history of ankle sprain involving various sports were recruited from the University community. All the subjects were participated in a six week PNM Training that included stability, strength and power training. Outcome measures were collected by calculating the errors on balance error scoring system made by the athletes on static balance before and after the six weeks of intervention period. Static balance was tested in firm and foam surfaces and recorded accordingly.
Results: The researchers found a significant decrease (2.40 ± 0.82) in total errors among the samples at the post test compared with their pre test (P >0.05).
Conclusions: The study demonstrates that a PNM Training can improve the static balance on both the firm and foam surfaces among the young athletes with a previous history of ankle sprains.
Keywords: lateral ankle sprains, static balance, BESS, neuromuscular