[International Journal of Physiotherapy 2016; 3(4) : 395-508] RSS



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Swatia Bhise, Jui Bane, Shilpa Parab, Snehal Ghodey

DOI : 10.15621/ijphy/2016/v3i4/111042

Pages : 395-400

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Background: Efficacy of rehabilitation program for subjects with orthosis with objective measurement. The study aiming to objectively compare the PCI and walking speed of normal children with ambulatory spastic diaplegic. Also we aimed to analyze whether BMIhad impact on energy cost.
Methods: 41 normal children and 41 community walking spastic diaplegic aged between 6 to 18 yrs. were assessed to compare the PCI. Speed of walking and heart rate were checked constantlyboth barefoot and in shoes in normal children and with and without conventional AFO in children with spastic diaplegic at their chosen velocities over four consecutive lengths of a 12.5m walkway i.e. total 50m.,Pre and Post readings are taken. Heart rate is affected by speed; PCI with speed of walking and heart rate was calculated for each child.
Results: The mean PCI in shoes and barefoot was same in normal children i.e. 0.05 ±0.039beats/meter. The PCI for children with pathological gait i.e. spastic diaplegic without orthosis and with orthosis is 0.199 ±0.176 and 0.104±
0.093beats/meter appreciably greater than that for normal children(p less than 0.05).
Conclusion: This study showed that walking with orthosis in spastic diplegic CP children showed higher costs of energy and slower walking speed compared normal children with age matched. The PCI of walking, with orthosis in children with spastic Diplegic cerebral palsy is less as compared to without orthosis i.e. gait is more energy efficient with orthosis. BMI doesn’t show any correlation with PCI further study may require.
Keywords: Cerebral Palsy (CP), physiological cost index (PCI), Energy Expenditure, Gait, Ankle Foot Orthosis (AFO), Spastic Diaplegic, Body Mass Index(BMI).

Kristina Schmidt, Norbert Kersten, Ute Pohrt

DOI : 10.15621/ijphy/2016/v3i4/111043

Pages : 401-408

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Background: Physiotherapists have an occupationally elevated risk of dermatoses. One aim of skin care seminars for specific professional groupsin individual prevention programme in Germany is to ensure appropriate use of safety measures during patient treatment. Initially physiotherapists often think skeptically about the use of gloves and patients’ acceptance of this protective measure. So the objective of this study was to assess the practicality of glove use during physiotherapy (qualitative investigation) and customer acceptance of them during massage (quantitative investigation).
Methods: Structured problem-focused interviews about glove usage were held with 20 skin diseased physiotherapists and masseurs after skin care seminars. The data was evaluated inductively using Mayring’s qualitative content analysis. The clients’ acceptance was tested in a controlled randomized three setting study with 120 subjects who received a back massage and evaluated quality aspects of their massage in a questionnaire. The physiotherapist was wearing either gloves of PVC, gloves made of nitrile rubber or no gloves at all. A non-inferiority test was used to test group differences.
Result: The majority of participating physiotherapists considered the use of protective gloves a practical and useful measure. However, occasional problems in everyday practice and in special therapy methods were reported. The analysis of 120 questionnaires (100% response rate) for quality aspects and the willingness to pay regarding client acceptancein a massage - with or without gloves -showed a non-inferiority result for massages with gloves.
Conclusion: Convincing individual physiotherapists of the benefits of wearing gloves is crucial for implementation of this preventive measure. It is improbable that patients would refuse services because therapists wear gloves during treatments. Consequently, the usage of gloves is unlikely to result in a loss of practice custom.
Keywords: gloves, individual prevention, hand eczema, massage,occupational exposure, occupational health, occupational
skin diseases,protection measure

Ganesh Sundaram Subramanian, Vivek Perumal

DOI : 10.15621/ijphy/2016/v3i4/111044

Pages : 409-414

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Background: Basic sciences like gross anatomy and physiology are the building blocks for all clinical courses. In the traditional physiotherapy curriculum, these basic medical subjects are covered in the first year of university course, whereas the clinical papers are pushed towards the final years, in conjunction with clinical practice. The time gap between these modules needs to be minimized to apply the basic science knowledge and achieve a strong understanding of the clinical conditions and treatment procedures. To bridge this gap, we tried to reintroduce these basic science concepts, including anatomy, imaging and biomechanics during the clinical modules.
Methods: An online pack of ‘pre-clinical revision tasks’ was created using the students’ learning management system-Moodle for the 3rd semester physical therapy students in Universiti Kuala Lumpur - Royal College of Medicine, Perak. The students were asked to undertake a self-directed, learning and evaluation task before each clinical module. The online resource usage was monitored periodically within Moodle. A focus group interview was conducted and a 5 point Likert scale questionnaire feedback was obtained.
Results: 83 students from the third semester participated in the study. Overall, 87% of the students utilized the resource,mainly after regular class hours. The students felt that the resource was useful (79%), made the clinical concepts simple (72%) compared to previous semesters.
Conclusion: Such online resources tailor-made for each course and well integrated to the curriculum would definitely allow the students refresh their basic sciences knowledge essential for clinical practice.
Keywords: E-learning, anatomy, physiotherapy students, self-directed learning.

Awad Mohamed Elkhadir,Saddig D. Jastaniah, Amer Al Saif, Khalid Khashoggi, Mohamed Faisal Chevidikunnan

DOI : 10.15621/ijphy/2016/v3i4/111045

Pages : 415-419

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Background: Shoulder pain is the second most common musculoskeletal disorder treated by physical therapists. The cause for the shoulder pain is multifactorial. However, a specific diagnosis is crucial in the right management of shoulder dysfunction. Therefore, the aim of this study was to find out the efficacy of integrating the MRI for the accurate diagnosis and impact of this on rendering the effective physical therapy interventions in shoulder dysfunction patients.
Methods: A retrospective study conducted on 14 patients who undergone an MRI with a 1.5 T unit MAGNETOM Symphony (Siemens), for their shoulder pain, where the diagnosis might be Muscle tears like, subscapularis, infraspinatus,supraspinatus and teres minor muscles; subacromial or subdeltoid bursitis and labral tears were included. All the subjects were then continued with usual physical therapy treatments for four weeks depending on their diagnosis which includes; advice, stretching, mobilization and strengthening exercises, manual therapy, massage, strapping, and electrotherapy . The outcome measures documented from the case sheet were; Visual Analogue Scale grade and passive range of motion of shoulder external / internal rotation and abduction.
Results: Paired t test was used to compare the PROM between pre rehabilitation and post rehabilitation testing and the non parametric test, Mann Whitney U test was used for the comparison of VAS. All patients showed a significant improvement in VAS and PROM of abduction, internal and external rotation following physical therapy (P≤ 0.05).
Conclusion: MRI is found to be a reliable method of diagnostic procedure for the shoulder pain and the integration of MRI and physical therapy to treat shoulder dysfunction leads to a better outcome.
Keywords: Shoulder Pain, MRI, Physical Therapy, Visual Analogue Scale, Shoulder Range of Motion.

J. Mohanakrishnan, Bhanumathy Mohanakrishnan

DOI : 10.15621/ijphy/2016/v3i4/111046

Pages : 420-424

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Background: Adhesive capsulitis (AC) of shoulder is a common condition encountered by physical therapists in their routine outpatient care services; AC of shoulder is as by itself being a self limiting disorder lasts from months to years causing pain and discomfort to the patients. The condition is commonly associated with Diabetes mellitus or other co morbidities. The incidence of AC is high among diabetic individuals and it becomes mandatory on the part of physical therapists and other health professionals to approach this issue on a holistic manner. This paper deals with the importance of a physiotherapist role in prevention and dealing with the causative factors of AC and not merely its symptom.
Methods: Extensive literature review was done from the electronic data bases, Systematic reviews and critical reviews from Pub med indexed journals and other peer reviewed publications across the globe.
Results: It was not the type of diabetes but the duration of the disease and the glycemic index, marking the causative factor for adhesive capsulitis of shoulder.
Conclusion: It may be concluded that physiotherapist play a vital role in identifying the pre-diabetic or a diabetic state of an individual reporting in a multi disciplinary set up with a AC of shoulder, and also has a role in the prevention of AC by helping the individual to maintain a good glycemic control with a holistic approach which includes aerobic exercises, General Flexibility exercises, Weight management and Yoga therapy.
Keywords: Shoulder Adhesive capsulitis, Type-II Diabetes, pain, Irritability, Exercises, Yogasanas

Mohankumar Thekkinkattil,T. S. Muthukumar,R. Monisha

DOI : 10.15621/ijphy/2016/v3i4/111047

Pages : 425-429

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Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The major manifestation of COPD includes dyspnea, decreased oxygenation and reduced exercise tolerance. The other manifestations such as urinary incontinence are less noted and treated inadequately. The prevalence of urinary incontinence in Indian COPD population has not been well documented. The treatment of urinary incontinence includes pelvic floor exercises (Kegel’s exercises), biofeedback, and acupuncture etc.
Methods: Forty female moderate COPD patients diagnosed according to American Thoracic Criteria with a complaint of urinary incontinence were selected for the study. Pelvic floor therapy exercises were given daily 5 sets per day (1 set =1-3 counts) for seven days. Baseline evaluation was done using International Consultation on Incontinence Short Form (ICIQ-SF) on the day of referral for physiotherapy and the post study measurements were taken on 7th day of hospital stay. Wilcoxon Signed Rank calculator was used to assess the data collected.
Results: The z value of ICIQ-SF questionnaire was 5.5109 ( p≤ 0.05) based on Wilcoxon Sign rank test and it was significant when we compared the pre and post test mean difference. The pre test mean score of ICIQ-SF was 14.175 and post test mean score was 4.4.Based on the findings, the results showed significant improvement in patient symptoms and reduced stress incontinence post pelvic floor therapy exercises.
Conclusion: The study emphasizes the importance of pelvic floor therapy in treating stress urinary incontinence among COPD patients and it should also be included in a comprehensive pulmonary rehabilitation program.
Keywords: COPD, Kegel Exercises, ICIQ-SF, Wilcoxon Sign Rank test, dyspnea, urinary incontinence

Vinod Kumar, Farhan Ishaque, Amna Sheraz, Saima Asghar Ali, Ferkhanda Imdad, Irfan Ali Bozdar, Wakash Lal, Shireen Khanzada

DOI : 10.15621/ijphy/2016/v3i4/111048

Pages : 430-434

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Background: Functional impairment is one of the complicated mechanisms which reflect an association between the different aspects of a person’s body parts and features of the community of knowledge, behavior and intervention. Around 10 % of people around the world are estimated as functional impairment. The aim of this study is to explore the level of understanding and awareness about the functional limitations and their observations in the common people as well as to uncover the provision of medical facilitations for functionally impaired people in rural areas.
Method: This study was conducted in Larkana and Mirpurkhas districts of Sindh, Pakistan. It was carried out from August 2013 to December 2013. It was a cross sectional survey study in which around 102 participants were recruited. A self formulated questionnaire was implemented to assess the knowledge, attitude and practice regarding physical limitations.
Results: Results Indicates 71.6% respondents have knowledge regarding to functional limitations or impairments whereas 42.2% views it a settlement to one’s sins from Almighty super power. The second aspect of this study in which we wanted to disclose the factors of medical negligence and improper facilitations in which we found out that 85.3% people recommended that government should take serious actions to open more Rehabilitation centers.
Conclusion: This study helped us to generate recommendations to make people aware about the increasing ratio of functional disabilities and to highlight the root causes. On the basis of this study we also introduced the concept of community based rehabilitation services as well.
Keywords: Impairment, Rehabilitation, Disability, Facilitation, Psychiatric Limitations, Sensory Integration.

Manpreet kaur, Sonia Singh

DOI : 10.15621/ijphy/2016/v3i4/111049

Pages : 435-438

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Background: Obesity is increasing at an alarming rate across the world. Obesity has great impact on quality of life of individuals. Due to the fact that there is global increase in obesity, knowledge about the effect of obesity on quality of life in middle aged females is of great importance for physicians and physiotherapists with regard to improve the quality of life. Therefore, the purpose of study was to investigate the impact of obesity on quality of life in middle-aged females.
Methods: Forty females participated in the study with a mean age of 48.05 years. According to their body mass index (BMI), Group 1 consists of normal weight females (n=20, BMI=18.5 -24.9) and Group 2 consists of obese females (n=20, BMI = >30). The Impact of Weight on Quality of Life (IWQOL) Questionnaire was used to assess the impact of obesity on quality of life.
Results: There were significant differences (P<0.05) in quality of life among normal weight and obese females. There was a positive significant correlation between the BMI and the QOL and all scales of quality of life.
Conclusion: The present study concludes that obesity is an important factor responsible for deterioration in quality of life of middle aged females.
Keywords: Obesity, Health, Body mass index (BMI), Quality of life, Impact of weight on quality of life questionnaire (IWQOL), Activities of daily living (ADL’s)

Narkeesh Arumugam, Parneet Kaur Bedi, Gurpreet Kaur

DOI : 10.15621/ijphy/2016/v3i4/111050

Pages : 439-444

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Background: Spasticity is one of the major neurological complications occurring in people with Spinal Cord Lesions due to loss of supra-spinal and spinal control over alpha motor neuron activity. Its accurate assessment is necessary for tailoring patient specific rehabilitation program. Clinical assessment is commonly done through Modified Ashworth Scale where in the examiner subjectively judges resistance to passive range of motion whereas, electrophysiological quantification of spasticity can be done through Hoffman’s Reflex which is an estimate of alpha motor neuron activity.
Methods: This co-relational study establishes an association between MAS and H reflex in a sample of both traumatic and non-traumatic Spinal Cord lesion patients. A sample of 22 patients was obtained who were rated for MAS grades 0,1,1+,2 and 3 in bilateral gastro soleus and consequent H reflex elicitation was done.
Results: Karl Pearson Correlation coefficient was calculated between MAS and H amplitude (r = 0.342, p<0.05); MAS and h latency (r = 0.013, p>0.05) ; MAS and H/M ratio (r=0.190 ,p>0.05).
Conclusion: It was concluded that there exists a weak but significant correlation between MAS and H amplitude but non-significant relationship between MAS and H latency; MAS and H/M ratio.
Keywords: Spasticity, Modified Ashworth Scale, Alpha motoneuron Excitability, H reflex, Spinal Cord Lesions.

Subhanjan Das, C. K. Senthil Kumar, Abhijit Dutta

DOI : 10.15621/ijphy/2016/v3i4/111052

Pages : 445-450

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Background: Endurance of the back muscles is important for stability of the trunk and therefore essential for normal functioning of an individual. Prone back extension exercises are traditional measures to improve back endurance. More recently Swiss ball exercises have become popular as a means to improve back endurance. Purpose of this study is to compare Prone back extension exercises with back extension exercise on Swiss ball on the improvement of the back extensor muscles performance, and thereby to find out which one is more appropriate for the prevention of back pain resulting from low extensor endurance. Back endurance can be measured by Bierring Sorensen endurance test. A low Sorensen score indicates low back endurance, which is associated with incidence of back pain.
Methods: This study included 60 undergraduate students aged 18 to 23 years. The subjects were randomly divided into 2 equal groups. Pretest assessment was done by measurement of endurance of back extensors using Sorensen test. One group was given a series of prone back extension exercises on floor consisting of 5 levels. The second group was given a series of 5 exercises on Swiss ball. Each subject was assessed at the end of six weeks of intervention and after two weeks of finishing the regime (follow up) to compare the effectiveness of Prone back extension exercises with Swiss ball exercises.
Results: The results indicated that both the groups showed improvement in Sorensen score after 6 weeks of exercise. The average improvements of Prone back extension exercises and Swiss ball groups were 60.83 seconds and 66 seconds respectively. At two weeks follow up there is a slight change in the Sorensen score, with an average reduction of 1.34% and 0.95% for Prone back extension exercises and Swiss ball group respectively. However comparison of improvements in Sorensen score of Prone back extension exercises with Swiss ball exercises showed there is no significant difference between the effectiveness of these two exercises programs (P = 0.26).
Conclusion: There is no difference in the effects of Prone back extension exercises and Swiss ball exercises on the performance of back extensors and their endurance level were not significantly differing with the protocol used.
Keywords: Back extensor endurance, prone back extension exercise, Swiss ball exercise, Sorensen score.

Muruganandam Periyasamy, Paul Chandanshive, Pasupuleti Visweswara Rao

DOI : 10.15621/ijphy/2016/v3i4/111053

Pages : 451-455

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Background: Respiratory problems are usual in upper thoracic spinal cord injuries when compared to Lower thoracic spinal cord injuries. Generally there are frequent respiratory complications in the individuals with spinal cord injuries. The complications of the respiratory system are severe and more prevalent source of morbidity and mortality after the spinal cord injury due to the inefficient breathing capacity including inspiratory and expiratory abilities. The present study represents the inspiratory muscle training especially in upper thoracic spinal cord injury patients to assess the improvement in the pulmonary functions.
Methods: Twenty five patients with the age between 25 -40 years with the upper spinal cord injuries were selected in the present study in order to assess the efficacy of the training. Several types of exercises were practiced including diaphragmatic breathing exercises, incentive spirometry, active cycle of breathing technique and weight training. COPD Conditions, Chest wall deformities, Hypertensive patients, Cardio vascular problems were excluded in the study.
Results: The results from the study showed that significant changes were found in the patients treated with all the above mentioned techniques. Axillary level, nipple level, Xiphisternum levels were analysed and the results found to be significant after the treatment. Incentive spirometry and peak flow meter observations were also found to be significant when compare to the pretreatment.
Conclusion: The present study conclude that the combined effect of incentive spriometry, diaphragmatic breathing exercises, and active cycle of breathing technique is more effective in improving the pulmonary functions in upper thoracic spinal cord injuries than single method efficiency.
Keywords: Muscle training, spinal cord, pulmonary, injury, breathing exercise, Xiphisternum.

Suneel Kumar, Varalakshmi, Kiran Kumar, Sreekar Kumar Reddy, Tirupati

DOI : 10.15621/ijphy/2016/v3i4/111054

Pages : 456-459

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Background: Vertigo is perception of motion, when no movement is present or abnormal perception of motion in response to movement. Vertigo is usually due to a disturbance in the vestibular System. Physical therapy plays an important role in reducing vertigo and nystagmus in benign paroxysmal positional vertigo subjects. Benign paroxysmal positional vertigo(BPPV) comes under the peripheral Vertigo which is the most common disease causing vertigo.
Cawthrone and cooksy were the first clinicians to advocate exercises for persons suffering from vertigo. Canalith repositioning procedure was effective in treating BPPV. Brandt Daroff exercises were designed to habituate the central nervous system to provoking position and they dislodge and move the debris out of canal which is effective in treating BPPV. Hence this study compares the effectiveness of these two techniques in treating BPPV.
Methods: Total number of 30 subjects was taken and they were divided into two groups by simple random sampling method with Pre test and post test experimental design . Group A subjects were treated with Canalith repositioning procedure and Group B subjects were treated with Brandt Daroff exercises. Outcome measure is dizziness handicap inventory (DHI)
Results: P-value is less than 0.05 which shows that there is significant difference between Canalith repositioning procedure and Brandt Daroff exercises.
Conclusion: Canalith repositioning procedure is most effective and less time consuming procedure in treating the Benign Paroxysmal positional vertigo subjects and found to have less reoccurrence.
Keywords: Benign paroxysmal positional vertigo, Canalith repositioning procedure, Brandt Daroff exercises, Dizziness handicap inventory.

Asmaa A. Abo Nour,Muhammad G. Saleh, Emam H. Elnagmy

DOI : 10.15621/ijphy/2016/v3i4/111055

Pages : 460-468

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Background: hemiparetic children usually tend to avoid the use of their impaired arm and are remarkably tend to perform inherently bimanual tasks of daily living with the less impaired arm only rather than with both arms. In fact, these children actually may have never learned to use their impaired arm for certain motor tasks or may only use it in the simplest manner, so the purpose of the study was to determine the impact of combining HABIT and mirror therapy on hand grip in hemiparetic children.
Methods: A total of 30 hemiparetic children divided randomly into two groups (A and B) of equal number, (N of each =15). Eligibility criteria to our study were age ranged from 4-8 years, ability to score more than 50 % of grasps and associated domains of quality of upper extremity skills test (QUEST) and grade 2 in manual ability classification system (MACS), assessment done by baseline hand held dynamometer for hand palmar & pinch grasp strength (in pounds) at start (0 week), reassessed at 4 & 8 weeks. The treatment protocol for two groups include: 2 months total time, 3 sessions\ week, 1.5 hour\session. Children in study group (A) received selected occupational therapy program with modified mirror apparatus while children in control group (B) Children received the same occupational therapy program as in study group but without modified mirror apparatus.
Results: there is significant improvement in both groups when comparing the pre and post I & II treatment mean values. However comparing the post treatment results of both groups were statistically non-significant.
Conclusion: This study confirmed that combining mirror therapy and HABIT is effective in improving hand function.
Keywords: Hemiparesis, QUEST, MACs, Palmar grasp, Pinch grasp, HABIT, Mirror therapy.


DOI : 10.15621/ijphy/2016/v3i4/111056

Pages : 469-472

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Background: Miller-Fisher syndrome (MFS) is characterized by gait ataxia, external ophtalmoplegia and areflexia and thought as an uncommon variant of Guillain Barre syndrome. Miller-Fisher syndrome is observed in about 5-8% of all Guillain Barre syndrome (GBS) cases. In MFS patients, spontaneous improvement was observed in the first 3 months and these improvements were started by the 2nd week.
Methods: This case was referred to physiotherapy and rehabilitation program at the 4th week since the appropriate medical treatments were unsuccessful after the attack. The patient was evaluated generally before physiotherapy program, and muscle length, strength loss, deep tendon reflexes, postural impairments and daily difficult activities and positions were assessed. Besides, the desired daily activities were identified by The Canadian Occupational Performance Measure (COPM). Treatment program was adjusted according to the patient and changes during treatment period were observed. Physiotherapy program included classical physiotherapy methods: posture correction, correction of short muscles, muscle strengthening, flexibility increase, balance/coordination, sitting and standing functions and walking improvement and climbing up stairs.
Results: After the treatment, lower extremity muscle shortness decreased and muscle strength, standing on one foot duration, independent walk speed increased in time. Before treatment, he could not climbing upstairs, but it was achieved 1 year after the treatment. Berg balance score increased in time and his most desired activities by COPM (10/10) were could be performed after the treatment.
Conclusion: The case improved with physiotherapy and rehabilitation program gradually with years.In the treatment of MFS patients, physiotherapy and rehabilitation being part of the treatment will be useful.

Key words: Miller-Fisher syndrome (MFS), muscle strength, therapy, syndrome, rehabilitation, GBS

Paramasivan Mani, Balaji Rajasekaran, Hisham Habib

DOI : 10.15621/ijphy/2016/v3i4/111057

Pages : 473-477

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Background: Back pain is the common musculoskeletal condition with a high prevalence of up to 80% among the general and work force population at some times in their lives.Muscular injury, fatigue, or facet or disc degeneration can compromise the stabilizing effects resulting in shearing forces that cause pain.Abdominal drawing in maneuver is used to facilitate the re-education of neuromuscular control mechanisms provided by local stabilizing muscles. Objective of the study is to measure the gait parameters and pain control before and after abdominal drawing in maneuver in patient with chronic mechanical low back pain.
Methods: Total number of 30 consecutive patients and they were divided into two groups by purposive sampling. Group A is subjects with low back pain and Group B is subjects without low back pain. Outcome measures were average step cycle, average step length, coefficient of variation, time on each foot, Ambulation index measured with Biodex gait trainer. Pain is measured with Revised-Oswestry low back pain questionnaire.
Results: Significant difference between gait parameters were observed in both low back pain group and the group without low back pain group with abdominal drawing in maneuver and the changes without abdominal drawing in maneuver was minimal. There was no significant difference found between both groups with or without abdominal drawing in maneuver.
Conclusion: Gait parameters and Pain control can be improved by training with abdominal drawing in maneuver thereby it reduces pain and improves gait symmetry in subjects with low back pain.
Keywords: Low back pain, Abdominal drawing in maneuver, Gait parameters, Biodex gait trainer 2, Transverse Abdominis.

Parneet Kaur Bedi, Narkeesh Arumugam

DOI : 10.15621/ijphy/2016/v3i4/111058

Pages : 478-481

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Background: Irrespective of the severity of the spinal injury, time after lesion and age at time of injury, the restoration of walking is given high priority by subjects with SCI. There is ample amount of literature with gait training methods for restoration of locomotion from other parts of the world. Rehabilitative training is currently one of the most thriving treatments to promote functional recovery following SCI. Many strategies exist to enhance locomotion, such as treadmill training with and without body weight support, robotic-assisted gait training, functional electrical stimulation, epidural stimulation and surface spinal stimulation. Pertaining to developing countries, this case study is an attempt to determine the effect of Locomotor Training with Body Weight Support on Gait and Muscle Strength in Incomplete
Spinal Cord Injury.
Methods: Single case design, Body weight support treadmill training for over a period of 12 months for an Individual with SCI (ASIA C) in a private clinic set up for SCI rehabilitation. ASIA lower extremity muscle strength, Spinal Cord Injury Functional Ambulation Inventory and Walking Index for Spinal Cord Injury –II.
Results: Significant change in lower extremity muscle strength, gait parameters and temporal parameters of SCI-FAI. Though, no change was observed in score of assistive devices and similarly WISCI-II scoring.
Conclusion: Single participant case study provided us with vital evidence for locomotor training with Body weight support in incomplete SCI. Further research in to the field shall yield valuable clinical findings.
Keywords: Locomotor Training, Body Weight Support Treadmill Training, Incomplete Spinal Cord Injury, Central Pattern Generator.

Naveed Anwar, Kehkshan Khalid, Arif Ali Rana, Muhammad Khizer Hayat, Muhammad Qasim Idrees, Salman Zafar

DOI : 10.15621/ijphy/2016/v3i4/111059

Pages : 482-486

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Background: Physiotherapy is an essentialtreatment in the management of Mechanical Neck ache, still there was lack of literature seen supporting the effectiveness of Physiotherapy interventions with their doses targeting specific group of population. The focus of study was to see the effectiveness of Kaltenborn Grade III mobilization, Muscle Energy Techniques and their combination to improve range and functional ability in patients with Mechanical Neck ache.
Methods: 72 patients with Mechanical Neck achewere randomly categorized in 3 groups (Mobilization, METs and Combination group. NDI scale and goniometry was used as an assessment tool to measure the outcome before and after treatment (follow up 1 week).
Results: According to the results there was significant improvement seen in Combination group (Mobilization and METs) in terms of pain, which decreased from 7.70±0.69 to 1.25±1.93 (p=0.00), gain in ROM e.g. Cervical Flexion (27.29±2.38 to 37.54±3.14). Whereas, marked significance (p=0.00) was seen in the NDI score and percentage of Combination group. ANOVA tells us that difference was significant in all three groups in categories of pain (VAS), gain in cervical ranges and NDI score and percentage as p=0.00. Combination group had significant difference within the groups then METs and Mobilization group in all categories of VAS, Cervical ranges, NDI score and percentage.
Conclusion: Combination of (Grade III Kaltenborn and METs) was seen more effective in terms of improving Mechanical Neck Pain, in smaller treatment session (7 days only).
Keywords: Neck pain; Cervicalgia; Cervical Pain; Chronic; Manual Therapy; Functional Ability

Ankur Jyoti Bora, Prasenjit Bhattacharyya

DOI : 10.15621/ijphy/2016/v3i4/111061

Pages : 487-493

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Background: PFPS commonly leads to anterior or retro patellar knee pain. The etiology of PFPS is multi-factorial and various studies have identified abnormal patellar tracking, patellar malalignment, abnormal subtalar motion, decrease in navicular angle as some of the possible factors which might lead to PFPS. This comparative study investigates the lower extremity alignment during stance phase of gait cycle in subjects with and without patellafemoral pain syndrome.
Methods: In this experimental study 14 male subjects suffering from PFPS were taken into Group A and 20 asymptomatic male subjects were taken into Group B. Video analysis of both groups were done in anterior, posterior and sagittal view. Still frames of initial contact, mid stance and terminal stance phases of the gait cycle and five angles i.e. standing foot angle, navicular angle, Q angle, A angle and rear foot angle for each of three phases were measured with image tool software.
Results: The mean data showed that the standing foot angle, navicular angle, Q angle, A angle were increased in asymptomatic group when compared to the PFPS group in initial contact, mid stance and terminal stance but these increase in angles were not statistically significant. However the increase in rear foot angle in terminal stance of normal subjects compared to PFPS group was statistically significant (p value= 0.047)
Conclusion: There exists an association of lower extremity angles with PFPS. Significant difference exists with respect to rear foot angle between PFPS and asymptomatic individuals. Rear foot angle decreases during the terminal stance in the PFPS subjects when compared to asymptomatic subjects
Keywords: Patellofemoral Pain Syndrome, Standing foot angle, Navicular angle, Q angle, A angle, Rear foot angle

Magda Gaid Sedhom

DOI : 10.15621/ijphy/2016/v3i4/111062

Pages : 494-499

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Background: Osteoarthritis (OA) is the most common type of joint disease. Pain is the most common symptom of knee osteoarthritis. Also it characterized by sign, symptoms of inflammation, pain, stiffness and loss of mobility. This study was conducted to explore the efficacy of kinesio taping (KT) versus Aescin, Diethylamine Salicylate gel phonophoresis (PH) on pain level, range of motion (ROM), and proprioceptive accuracy on mild to moderate knee OA patients.
Methods: Forty females with knee OA from Outpatient Clinic of Physical Therapy Faculty participated in the study with mean age (49±5.82) years. They were randomly assigned into 2 equal groups. Group I: received Aescin, Diethylamine Salicylate gel PH with pulsed ultrasound therapy and group II received KT. All patients received hot packs and selected exercise program for four weeks; three sessions per week. Visual analogue scale was used in assessment of pain level. Electronic digital goniometer was used in assessment of knee flexion ROM. Iso-kinetic daynamometer was used in assessment of knee proprioceptive accuracy.

Results: There was a significant relieving of pain perception, increasing of knee flexion ROM and improving proprioceptive accuracy in knee joint post-study in both groups. But application of Aescin, Diethylamine Salicylate gel PH had significant relieve of knee pain than KT.
Conclusion: Using of Aescin, Diethylamine Salicylate gel PH is more effective than KT application in reliving knee pain in knee osteoarthritic patients.
Keywords: Osteoarthritis- Knee - Kinesio taping- phonophoreses- pain

Hany M.I. Elgohary, Sayed A. Tantawy, Hadaya M. R. Eladl

DOI : 10.15621/ijphy/2016/v3i4/111063

Pages : 500-504

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Background: Scrotal discomfort can contribute to unusual impact on body scheme and result in behavioral alterations, as well as changes in sexual function such as delay of sexual ability that may affect both man and his companion. There are many physiotherapy modalities to reduce the intratesticular pain such as pelvic floor muscle training, hydrotherapy, ultrasound and electrotherapy. Interferential current therapy is a noninvasive therapy used to reduce acute and chronic, post-operative and post-trauma acute pain. It provides a safe and effective alternative to pharmacological approaches to pain control. The purpose of the current study was to investigate the efficacy of interferential current in alleviating testicular pain.
Methods: Randomized clinical study conducted on 50 participants. They divided into two equal groups: Group A received interferential current with two electrodes placed over the upper medial aspects of thighs and the other two electrodes were positioned over the suprapubic area. While group B received placebo interferential current. The treatment protocol was applied 3 times/ week for six successive weeks, in a total of 18 sessions. Patients were evaluated before and after the six weeks of the treatment by visual analogue scale and pain intensity while pain relief scale was measured after the treatment.
Results: Group A showed a significant pain improvement in both inter and intra group comparison in all measured parameters (visual analogue scale and pain intensity while pain relief scale) (p <0.05).
Conclusion: The findings show that interferential current is an effective modality and can be recommended for the treatment of testicular pain.
Keywords: Interferential current, Orchialgia, Visual analogue scale, Pain intensity, Pain relief, Sexual ability

Kashmala khan, Shireen Rahat khanzada, Atiq ur Rehman Memon, Jam Feroz, Hafiz Muhammad Hussain, Imran Ahmed, Bahadur Ali, Saifullah Khalid

DOI : 10.15621/ijphy/2016/v3i4/111064

Pages : 505-508

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Background: School going children is important part of our society. Their growth, development and body weight is of utmost significance and presents general health status of a community and nation as a whole. For the assessment of nutritional status WHO Asian cuts-off BMI for age recommended BMI less than 18.5 kg/m considered underweight, 18.5-24.9 normal weight, more than 25 overweight. The objective of this study is to access body mass status among primary school going children of Hyderabad.
Methods: The study design was cross sectional study in which different school of Hyderabad were selected to collect data (semi government and private sector).This study has assessed the body mass index between 7-14 years old age group of both genders of primary school going children of Hyderabad. BMI has calculated with the help of weight and height of the body.
Result: In this study out of 100 children 10%were 7-8 year old 20% were 9-10 year old, 20% were 11-12year old and 30% were 13-14 year old. The analysis shows 80% were underweight (below 18.5), 18% were normal weight (18.5-24.9) and only 2% overweight (above 25) according to the Asian cut-off value of BMI for Asian children. When it was analyzed by gender 62% of the boys and 18% of the girls were underweight, 6% of boys and 12% out of girls were normal weight, 2% of the boys were overweight no girl found overweight in the study. In the above study 80% found underweight, 18% normal weight, 2% overweight.
Conclusion: Under nutrition among the school going children is currently a health problem faced by Hyderabad school going children. There is need to be taken address these problems in order to prevent nation from nutritional deficiency among school going children and buildup a strong and healthy nation in future.
Keywords: Malnutrition, BMI, school children, growth retardation, Anthropometric measurement.