[International Journal of Physiotherapy 2017; 4(1) : 1-62] RSS



Pages : 1-62

Hikmat Hadoush, Toru Sunagawa, Kazuyoshi Nakanishi, Mitsu Ochi

DOI : 10.15621/ijphy/2017/v4i1/136153

Pages : 1-5

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Background: Following peripheral nerve lesion, the adult somatosensory system showedcortical reorganizational abilities.Previous studies identified the digits' somatotopy map changes and somatosensory cortical plasticity in response to the Carpal Tunnel Syndrome (CTS) that affected the dominant hand only. Objective: Answering the remained question is that what the extent of the cortical plasticity would be in left and right somatosensory cortices in response to CTS affecting the right and left hands simultaneously.
Methods: Cortical representations activated by tactile stimulation of median nerve (index) and ulnar nerve (little) of both dominant and non-dominant hands were evaluated by Magnetoencephalography (MEG) systemfor healthy participants and patient with bilateral moderate CTS. index – little fingers'somatotopy map and inter-digit cortical distance was then mapped and calculated for each participant on the real MRI data and the 3D brain surface image.
Results: in healthy participants, index – little inter-digit somatosensory cortical distance of right hand (dominant) was significantly larger than the index – little inter-digitsomatosensory cortical distance of left hand (11.2±2.1mm vs.7.0±2.9mm, P = 0.006). However, in patient with bilateral CTS, the index – little inter-digit somatosensory cortical distance of righthand (dominant) was significantly smaller than the index – little inter-digit somatosensory cortical distance of left hand (5.8mm vs. 7.4mm).
Conclusion: our data could be interpreted as the hand use – dependency served more median nerve – cortical territory from the ulnar nerve invasion in the right somatotopy map (left hand) than the left somatotopy map of the right hand.
Keywords: Carpal tunnel syndrome, cortical plasticity, hemispheric asymmetry, use-dependency, Magnetoencephalography

Niyati N Khona, Arun G Maiya, Kiran Acharya, Stephen Rajan Samuel

DOI : 10.15621/ijphy/2017/v4i1/136154

Pages : 6-11

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Background: Due to the hormonal changes in postmenopausal women they are prone for many complications like increased CVD risk factors, osteoporosis, obesity, mood swings and urinary incontinence. Physical inactivity in postmenopausal women leads to higher risk of developing CVD and osteoporosis. The objective was to find out the correlation of physical activity level with BMD, cardio-respiratory fitness and body composition in post-menopausal women
Methods: 42 postmenopausal women were included. A detailed clinical evaluation with physical activity level (IPAQ-METS-mins/week), , BMD ( T-Scores), body composition (BMI, waist circumference, BIA & Skin fold calliper for fat %), cardio-respiratory fitness was measured by Balke protocol and VO2peak (ml/kg/min) is estimated. Correlation of physical activity level with BMD, cardio-respiratory fitness and body composition were analysed using “Pearson’s product moment correlation co-efficient and Spearman’s rho.”
Results: Spearman’s rank correlation rho for IPAQ with VO2 peak was 0.420,BMI was -0.388 and visceral fat was -0.384 indicating moderate positive correlation between IPAQ and cardio-respiratory fitness and weak negative correlation between IPAQ and BMI and visceral fat. Pearson’s product moment correlation coefficient of IPAQ with BMD was 0.147, body fat was -0.234 and waist circumference was -0.256 indicating no correlation. P value was significant for correlation of IPAQ with CRF (0.006), BMI (0.011) and Visceral fat (0.012).
Conclusion: There is moderate positive correlation between IPAQ and cardio-respiratory fitness, weak negative correlation between IPAQ and BMI and visceral fat and no correlation between IPAQ and BMD, body fat and waist circumference.
Keywords: physical activity, postmenopausal women, CVD risk, BMD, body composition, visceral fat, body fat %.

Azza Atya, Mahmoud Nasser, Aisha Hagag

DOI : 10.15621/ijphy/2017/v4i1/136157

Pages : 12-18

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Background: Rotator cuff tendinopathy is a significant problem among diabetics that frequently restricts patient’s activity in terms of pain and disability. The purpose of this study was to compare between the effect of Astym therapy and kinesiotaping in treating diabetic patients with chronic rotator cuff tendinopathy.
Methods: 56 diabetic patients diagnosed with chronic rotator cuff tendinopathy were randomly assigned into Astym therapy group (n=28) or kinesiotaping group (n= 28). All patients received conventional program in addition to Astym treatment or Kinesiotaping for 24 sessions (2times/week). Patients were assessed at baseline and at the end of corresponding intervention with visual analogy scale (VAS) for pain intensity, shoulder disability questioner (SDQ) for shoulder disability, and electrogoniometer for shoulder range of motion.
Results: For the 56 study participants (21 males and 35 females; mean age=41.9±6.9) years there were significant differences in all measuring outcomes in both group when compared to baseline measurements (p<0.05). Post treatment comparison showed a significant reduction in pain score in favour of kinesio taping group with no significant differences in SDQ score or active shoulder range of motion between the two groups (p > 0.05).
Conclusion: kinesiotaping appears to be more effective than Astym therapy in reducing pain for diabetic patients with chronic rotator cuff tendinopathy.
Keywords: Diabetes, Rotator cuff tendinopathy, Astym Therapy, Kinesiotaping.

Ozge Cankaya, Mintaze Kerem Gunel

DOI : 10.15621/ijphy/2017/v4i1/136158

Pages : 19-24

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Background: It was indicated in many studies that verticalization have positive effects such as preventing fractures,regulating cardiopulmonary functions, increasing the head control, and the facilitation of postural muscles in pediatric patients, however, no study showing the effect of supported standing in patients with myelomeningocele on body functions and activity was encountered. The aim of this study is to examine the effects of structured supported standing training in children with myelomeningocele on body functions and activity according to ICF-CY.
Methods: Twenty-five children with MMC aged between 3 and 17, who were divided into two groups-SST and control. The supported standing training was given to supported standing group 2 hours a day for 8 weeks in addition to the routine physical therapy program. Body functions were assessed with the Trunk Impairment Scale, and activity levels were assessed with the Gross Motor Function Measurement-88 and Pediatric Functional Independence Measurement at the beginning of the study, at the end of 8 weeks and at the end of 12 weeks from beginning.
Results: The results of the structured supported standing training program during 8 weeks showed that children’s body functions and activity increased statistically significantly in SST group (p<0.05) but no difference was found between the two groups (p>0.05).
Conclusion: The results show that supported standing training effects the body functions and activity positively. It is recommended to educate the families for the supported standing training to be added to the routine physiotherapy and rehabilitation program for children with MMC and continue the training at home.
Keywords: Myelomeningocele, Spina Bifida, Supported Standing, ICF-CY, Verticalization, Home-based training.

Muhammad Zia ul Haq, Low Jeffrey Fook Lee, Bendri Bin Dasril

DOI : 10.15621/ijphy/2017/v4i1/136159

Pages : 25-32

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Background: Many cricket experts have explained the pull shot technique but could not quantify the kinematics of the stroke. This study was aimed to quantify the coaching description and compare the pull shot technique of the senior, under-19 and under-16 cricket batsmen.

Methods: Eighteen Malaysian national cricket batsmen were selected for this study. Two high speed video cameras were used for capturing the pull shot action and Aerial Performance Analysis Software was used for the kinematics analysis. One way ANOVA with repeated measure was applied to examine between groups difference in biomechanics of the pull shot. 

Results: Results showed the senior batsmen were significantly higher in the extension of the right knee (P < .03) than under-16 batsmen and the extension of the left hip (P < .04) than under-19 batsmen.  The under-16 batsmen were significantly faster in the linear velocity of the left hip (P < .04) than senior and left elbow (P < .05) than under-19 batsmen.

Conclusion: This study confirms some coaching descriptions such as the bat angle was lesser than the 90° and higher than the 45° degrees and straighter position of the arms at bat-ball impact. The under-16 batsmen were faster in the linear velocities of the left hip and left elbow because they used light weight bat for the execution of the pull shot than the seniors and under-19 batsmen. This study will help the coaches and cricketers to understand the kinematics of the body segments during the execution of the pull shot. Future study should be conducted to investigate the effect of the anthropometric measures on the kinematics of the pull shot.

Keywords: Pull shot, Cricket batsmen, short pitch ball, kinematics, body segments.

Magda Gaid Sedhom

DOI : 10.15621/ijphy/2017/v4i1/136161

Pages : 33-37

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Background: Walking is a popular, convenient, and relatively safe form of exercise. Humans generally learn walking in forward direction with little difficulty, while walking in backward direction is necessary for normal activities of daily living and accommodates the body with different tasks. This study was conducted to compare between forward and backward walking training on peak torque of Quadriceps and Hamstring muscles and their effect on knee proprioception.
Methods: Forty non athletic males, with mean age (21.87±1.76) years participated in this study, and were classified into two equal groups. Group (A) walked forward on treadmill while group (B) walked backward three times/week for a total six weeks. They were assessed by using Biodex system 3 to measure the concentric peak torque of Quadriceps and Hamstring muscles at angular velocities 60 and 180°/sec and the knee joint proprioception. The assessment was done twice for every subject (pre-study and after six weeks of gait training).
Results: t-test revealed statistical significant increase in peak torque of Quadriceps and Hamstrings muscles in both groups after training at 60 and 180°/sec (p-value < 0.05). There was statistical significant improvement in knee proprioception in group B only p-value was (0.000).
Conclusion: Both forward backward walking training improving the peak torque of quadriceps and hamstring muscles, while backward walking is better in improving knee proprioception accuracy.
Keywords: Backward Walking- peak torque - Quadriceps- Hamstring- knee Proprioception.

Roopika Sabharwal, Sonia Singh

DOI : 10.15621/ijphy/2017/v4i1/136163

Pages : 38-43

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Background: Kathak is a very complex dance form in which greater emphasis is laid on foot work thus putting substantial amount of stress over the feet. The purpose of this study was to investigate the foot postural deviations amongst the Kathak dancers.
Methods: Screening of 40 Female Kathak Dancers was done for the study from Department of Dance, Punjabi University, Patiala on the basis of inclusion criteria. Subjects were assessed for Postural deviations via. Foot Posture Index, Medial Longitudinal Arch Angle, Navicular Drop, Rearfoot angle and Forefoot angle.
Results: Percentile analysis of Foot Posture index scores suggested that a large population of kathak dancers (approx 92.5 %) have pronated feet. Most of the Kathak dancers showed increase in Rearfoot angle (approx. 90%), Forefoot angle (approx.75%) and Navicular drop (approx. 97%) and decrease in Medial Longitudinal Arch angle (approx. 95%). Analysis of Coefficient of Correlation suggested a significant positive relationship of Foot Posture Index scores with Rearfoot angle (r = 0.40, p= 0.0087), Navicular Drop (r = 0.62, p= < 0.0001) and Forefoot angle (r = 0.51, p=0.0007) and a significant negative correlation with Medial Longitudinal Arch angle (r = -0.42, p= 0.0059).
Conclusion: From the observations, it can be concluded that with time kathak dancers start developing certain Postural Deviations at Foot which can lead to hyperpronation. These changes if not treated on time may lead to various degenerative changes in the Foot and Ankle thus leading to the instabilities and can also make them susceptible to foot and ankle injuries, shin pain, etc. Thus, the study recommends that the dancers should be educated and trained about the foot problems associated with kathak dance and their prevention.
Keywords: Kathak dance, complex postures, Foot problems, Foot Postural deviations, Biomechanical Changes, Assessment.

Animesh Hazari, Kalyana C.B, Rohini Gupta, Pushkar Deokule, Sampath Kumar Amaravadi

DOI : 10.15621/ijphy/2017/v4i1/136164

Pages : 44-48

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Background: Postural drainage is used exclusively or in combination with other airway clearance techniques in the management of chronic pulmonary diseases. Postural drainage therapy helps to prevent accumulation of secretions in patients who are at high risk for pulmonary complications. It also helps to remove accumulated secretions from the lungs.The role of body positioning on lung function and the clinical implications of postural drainage has been identified in a variety of settings including intensive care units. There is dearth in literature on effects on postural drainage on vital parameters. Thus the objective of the study was to measure the vital parameters at different postural drainage positions in healthy asymptomatic adults.
Methods: Twenty healthy subjects participated in the study. The instruments used in the current study included a Pulse oximeter, Sphygmomanometer, Stethoscope, Postural drainage table.The outcome measures of interest were heart rate, respiratoryrate, oxygen saturation, blood pressure and Borg’s scale of rate of perceived exertion. The changes in the vital signs were recorded at different head down titling position of 0°, 15° & 30° in both supine and prone lying positions
Results: Statistical significant difference was found for Systolic Blood Pressure in prone lying at different degrees of tilt (p=0.001) and Diastolic Blood Pressure in prone lying (p=0.000).
Conclusion: Postural drainage positioning should be given with caution and under proper monitoring as there is a risk of change in the blood pressure even in asymptomatic elderly population. The monitoring of vital signs should be done during the therapy to decrease the risk of complications.
Keywords: Postural Drainage Technique, Tilt Table, Vital Parameters, Healthy, Asymptomatic, Body positioning

Ghazala Noor Nizami, Nazish Rafique, Anum Rafique, Asia Sheikh, M. Sarfaraz, Kanwal Khan

DOI : 10.15621/ijphy/2017/v4i1/136166

Pages : 49-54

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Background: During lectures, usually students sit in an awkward position, for prolonged period of time and that may cause postural instability. For a good posture, bilateral landmarks should be on same level, when viewed from front or behind. Therefore, both shoulders should also be on same level as well. Any alteration in level of shoulders in healthy individual may lead to deformity in spine or extremity. The objective of this study was to analyze the level of both shoulders in the physical therapy students and to find its correlation with the perception of students about their shoulder balance.
Methods: An observational (cross – sectional) study was conducted on students of Doctor in Physical Therapy (DPT) from colleges of Physical Therapy, Karachi. 100 Students were selected by Simple Random Sampling technique. Data from students was collected by administering a questionnaire. It includes close-ended questions. Afterwards, the level of both shoulders of the students, were assessed by using Scoliosis Meter.
Results: Response from students showed that 79% of them assumed that both shoulders are in same level. When level of shoulder of students was assessed by scoliosis meter, it showed that 37% students have absolute level shoulder. Spearman’s Correlation coefficient (r = 0.046, p= 0.65) showed a weak, positive correlation between perception of the students about shoulder level and assessment of shoulder tilt.
Conclusion: This showed that the perception of students about level of both shoulders was not correlated to the actual levels of the shoulders. Hence, as they were not assuming it uneven, so they may not pay any attention to keep themselves straight.
Keywords: Shoulder level, Physical Therapy Students, Perception, Scoliosis Meter, Posture, Shoulder Tilt.

Yasmine S Gomaa, Salah A Sawan, Joanne E Wittwer, Meg E Morris

DOI : 10.15621/ijphy/2017/v4i1/136167

Pages : 55-62

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Background: Movement disorders and non-motor problems such as cognitive decline, anxiety, depression and behavioural problems, are common in people with dementia and can progress over time. Exercise coupled with music is a promising form of therapy designed to improve both the motor and non-motor manifestations of this debilitating neurological condition.
Objectives: To present a protocol for a systematic review and critical analysis of the literature to answer the following questions:
(i) Is music-cued exercise more effective than usual care for the treatment of motor and non-motor symptoms of dementia?
(ii) What are the outcomes of music-cued exercise for people living with dementia?
Methods: We provide the protocol for a systematic review and critical analysis of the literature using the PRISMA guidelines. Studies shall be reviewed that use music cued exercises aimed at improving the management of physical and non-physical problems associated with dementia. Eligibility criteria will be applied to the title and abstract of each citation as a first step followed by full text screening. Data extraction and quality appraisal are to be performed by two reviewers.
Data sources: This protocol documents the comprehensive search strategy to be performed using MEDLINE, CINAHL, EMBASE, PSYCHINFO, PUBMED, SCOPUS and web of science databases. Science, technology and engineering databases will also be searched.
Eligibility criteria: All study designs incorporating data will be included in this review. The following selection criteria shall be applied:
• Participants will be people diagnosed with dementia, including Alzheimer’s disease, of any stage and severity, all ages, any range of co-morbidities, any medications.
• Interventions will use rhythmic music with any physical exercise or rehabilitation program.
• Outcomes shall include motor impairments such as gait, postural stability and general mobility. Studies considering non-motor
signs such as anxiety, depression, behavioural disturbances and cognitive decline will also be included.
Results: Evidence will be built from this review regarding the effectiveness of using music-cued exercises to optimise physical abilities and improve non-motor disorders in people with dementia.
Conclusions: This protocol paper documents the methods that we shall use for a forthcoming systematic review. The knowledge obtained from the review will provide guidance to people with dementia, caregivers and clinicians by clarifying the strength of the evidence for music-cued movement rehabilitation.
Keywords: Dementia, Alzheimer’s disease, Music, Exercise, Motor, Non-motor.