VIMS JOURNAL OF PHYSICAL THERAPY

Recent Advances For Upper Extremity Rehabilitation In Acute And Subacute Post Stroke Survivors : A Narrative Review

Chotai Nandinee — 2024-12-31

Background: Post-stroke survivors experience motor impairments and poor arm recovery, necessitating early rehabilitation. Robot-assisted therapy is being explored for improved outcomes, but is not feasible for all clinics. So this review aims at different effective UE rehabilitation interventions.

Method: This study aimed to identify relevant articles on UE, acute and subacute stroke & Rehabilitation using search engines- Google Scholar, PubMed, Scihub from year 2019-2023 focusing on published articles in indexed journals,English language and UL rehabilitation among acute and subacute stroke patients.

Result: Eleven studies, including 10 randomized control trials and 1 systematic reviews, found that various techniques like Robotics Assisted Therapy ,CIMT, EMG biofeedback, and Mirror therapy improved motor control, functional independence, and muscle tone.

Conclusion: Limited resources in rehabilitation centers and clinics hinder intensive treatment, reducing stroke patients' recovery. Other techniques may improve functional independence, muscle tone, and quality of life.

Keywords: Stroke, acute, subacute, upper extremity, Early rehabilitation.

Clinical, Electro diagnostic & Prognostic review of Radiculopathy, Myopathy & Neuropathy

Toshniwal Gaurav — 2024-12-31

Neuromuscular disorders, such as radiculopathy, myopathy, and neuropathy, are conditions that significantly impair motor and sensory functions. Differentiating between these conditions is crucial for proper diagnosis and treatment. Radiculopathy arises from spinal nerve root compression, presenting as radiating pain, numbness, and muscle weakness. Myopathy, a disease affecting muscle tissue, leads to muscle weakness, cramps, and fatigue, often affecting the proximal muscles. Neuropathy involves peripheral nerve damage, causing pain, tingling, and muscle weakness, especially in the distal extremities.

Electrophysiological studies, including Nerve Conduction Velocity (NCV) and Electromyography (EMG), are key diagnostic tools used to evaluate neuromuscular function. These tests help differentiate between nerve and muscle disorders by analysing nerve impulses and muscle electrical activity.

This paper provides a comprehensive review of the clinical presentations, diagnostic approaches, and physiotherapy interventions for these disorders. The review highlights the importance of early diagnosis and tailored rehabilitation programs to improve functional independence, relieve pain, and enhance quality of life for patients suffering from these conditions.

Association between BMI and Quadricep strength on function, health related quality of life and progression of condition in a patient with osteoarthritis of knee joint: A cross-sectional study

Thakkar Kruti — 2024-12-31

Background:

Knee OA is a leading cause of pain, disability, and reduced QoL globally, especially in aging. BMI is a critical risk factor for OA. Quadriceps strength plays a crucial role in joint stability and function, with weaker quadriceps associated with poorer outcomes in OA patients.

Methods:

A total of 200 patients with knee OA were recruited. BMI recorded physical examinations, Quadriceps strength measured using handheld dynamometer, and OA severity using the KL grading system. Functional ability through the WOMAC, and HRQoL using SF-36 questionnaire.

Results:

Higher BMI was significantly correlated with worse knee function, poorer HRQoL, and advanced OA progression. Quadriceps strength showed significant positive correlations with knee function and slower OA progression, but no significant correlation with HRQoL.

Conclusions:

The findings suggest that high BMI negatively impacts function, quality of life, and disease progression in knee OA patients, while stronger quadriceps are associated with better function and slower OA progression.

Keywords:

Osteoarthritis, BMI, Quadricep Strength, WOMAC, HRQoL

Prevalence of Benign Paroxysmal Positional Vertigo Among Individuals Of 35-55 Years - A Cross sectional Study

Rane Kalpita — 2024-12-31

Aim- To study the Prevalence and Sex wise distribution of Benign Paroxysmal Positional Vertigo among individuals of 35-55 years. Relevance of study - People between the ages of 35 and 55 years tends to overlook dizziness problems because of their hectic lifestyles and busy schedules. This issue might in some way disrupt their daily routine, but they might also go unnoticed. Early diagnosis of BPPV may help to improve quality of life of patients and may reduce the risk of injury. Methodology- In this cross-sectional study 105 participants experiencing dizziness were selected according to inclusion & exclusion criteria. Evaluation of dizziness was done using the Dizziness Handicap Inventory Scale and then Dix Hallpike Test was carried out. Result- Among 105 participants suffering from dizziness, 13 were diagnosed with BPPV. The study resulted that 12.38% of individuals were prevalent for BPPV, of whom 8 were females (62%), and 5 were males (38%). Conclusion - The prevalence of Benign Paroxysmal Positional Vertigo among individuals of 35-55 years is 12.38%. Females were more affected as compared to males.

Integrated Teaching in Physiotherapy on Spinal Cord Injury for Final year Undergraduate Students: 8 years longitudinal study.

Ganvir Suvarna — 2024-12-31

Introduction: For acquiring clinical skills of treating various aspects of disease based on strong foundation of knowledge of disease, Integrated teaching is the need of time. However, it cannot be one time experiment. For successful cultivation of expected clinical skills, it is imperative that a continuous effort is made for providing this integration on a regular basis. This report is based on the experiences of successful implementation of Integrated Teaching of ‘Spinal Cord Injury Physiotherapy management’ for final year UG students of Physiotherapy course.

Methodology: It is an 8 year study of implementation of Spinal cord Injury Management for final year students implemented since 2016 at our institute. After a preliminary FGD in 2016 about the content of module, a revision meeting is conducted every 2 years to review the content. Students and faculty feedback is obtained about the experience of being a part of this module is obtained every year. Post test is conducted after every module to assess the knowledge and skill gained by participants.

Results: There is consistent positive feedback about the content of module form faculty and students since 2016 measured in terms of satisfaction index of equal to or more than 80 for each parameter of questionnaire. Parameters from students questionnaire include knowledge and skill gain, interactivity, optimal balance between theory and practical and time management. From those of faculty include interdepartmental interaction, facilitation of requisite knowledge and skills, optimal challenge of implementation.

Conclusion: This Longitudinal study implementing Integrated Teaching in Physiotherapy provides a strong evidence for incorporating this method of teaching learning in the curriculum.

Key words: Integrated Teaching, Education, Physiotherapy, TL methods.

Immediate effect of Positional release therapy vs Ischemic compression therapy for gastrocnemius latent trigger point to reduce pain and improve active ankle dorsiflexion in football players: A comparative study

Bagdadi Arshee — 2024-12-31

Background: Football is moderate contact sport. Correspondence to FIFA world cup survey, the injuries most frequently affected was lower extremity (65.4%). Maximum injured site was found to be the calf (29.62%). Latent MTP’s are those that are clinically dormant with regards to spontaneous pain and pains only on palpation. Ischemic Compression is the application of progressively strong, painful pressure on trigger point to eliminate the trigger point. On performing ischemic compression, tissue attains recovery by reperfusion thereby relieving transient blood flow occlusion. PRT is indirect and passive treatment also known as strain counter stain therapy which positions the muscle in position of comfort for a period (POC) for 90 seconds while maintaining a sustained manual pressure. Both techniques have been proven to improve pain and ROM

Methodology: 38 individuals of 18-30 years having latent trigger point in gastrocnemius were randomly divided between 2 groups included in the study and single intervention of PRT to group 1 and ICT to group 2 was given. Pain and Ankle Dorsiflexion was measured pre and post intervention using VAS and weight bearing lunge test respectively.

Results: A significant difference was found in both the groups, for pain VAS score pre intervention is 6.52 and post is 5.39 with p<0.05, ICT (p= 0.0003) for ankle dorsiflexion WBLT score PRT (p= 0.0019) ICT pre intervention is 14.91 and post is 15.73 with p<0.05. A non-significant difference was found between both the groups, for pain VAS score (p= 0.655) for ankle dorsiflexion WBLT score (p= 0.082)

Conclusion: There was no statistically significant difference between PRT and ICT and both treatments showed significant improvement in pain and ankle dorsiflexion equally.

The prevalence of musculoskeletal injuries among novice karate players

Kale Shraddha — 2024-12-31

Aim-The aim of this study was to access the prevalence of injury pattern among novice karate players. Relevance of study - There are many benefits of practicing karate as it improves psychological health by promoting relaxation, self-esteem, balance, development of the discipline, strength and mind-body coordination. Participation in the sport like karate or any sport is not without risk, and injuries can be an adverse outcome. Methodology-In this cross-sectional study 89 participants were selected according to inclusion and exclusion criteria. The Nordic musculoskeletal questionnaire is used in the study to access the injury pattern according to body region and Dr buckleys injury severity classification is used to access the severity of injury. The injuries were classified as major, moderate, severe according to the classification. Result- The most common causes of direct contact injuries were found to be punches and kicks. It was observed that, in present as well as past, the most common location of injury were found in lower limb that is hips/thighs (33.7%), knees (33.7%), ankle (25.84%) followed by head and face (22.47%). The severity of injury was graded by Dr Buckleys injury severity classification, where the participants suffered from major injuries(56.17%), moderate injuries (35.9%), and severe injuries(6.74%). Conclusion – From this study it is concluded that mostly, lower and upper limb injuries, followed by head and face are found to be affected mostly in novice karate players. Karate is associated with a relatively high injury rate but mainly for minor injuries, with a relative risk lower than in most sports; severe injuries are rare.

National Assessment and Accreditation Council: Awareness & Perception of Physiotherapy Faculty

Choudhary Avi — 2024-12-31

Background: In India, the National Assessment and Accreditation Council (NAAC) is an autonomous body under the University Grant Commission (UGC), ensuring continuous quality improvement and quality assurance in higher education institutions. Despite facing challenges, many institutes in India seek accreditation from NAAC. Given the growing field of physiotherapy education in India, it is crucial to evaluate the awareness and perception of faculty members working in physiotherapy colleges about NAAC accreditation.

Methods: A cross-sectional E-survey study was conducted using a purposive snowball sampling method for physiotherapy faculty members practising within Indian Physiotherapy Colleges or universities, irrespective of whether their institutes were NAAC accredited or not included in this study.

Results: the survey found that 75% of respondents were from Delhi NCR while only 25% were from outside Delhi, with half having 5-10 years of experience. Only 25% worked at NAAC-accredited institutes, although all recognised the accreditation process’s significance. They understood the steps for accreditation; key challenges included data collection, limited resources, and infrastructure. Overall, faculty awareness of NAAC accreditation’s importance is excellent, highlighting a need to ease the evaluation process.

Conclusions: The study revealed that physiotherapy faculties recognise the importance of NAAC accreditation in improving institute quality and are well-informed about its benefits and challenges.

Effect of different phases of menstrual cycle on cardiorespiratory fitness (vo2max) and physical fitness index in physiotherapy students age group between 18 to 25 years

Choube Rashmi — 2024-12-31

AIM-To study the effect of different phases of menstrual cycle on cardiorespiratory fitness (VO2 max) and physical fitness index in physiotherapy students age group between 18 to 25 years . RELEVANCE OF STUDY– This study is necessary to determine the changes in the cardiorespiratory system in the women during different phases.The VO2 max is important to calculate because it represents how much oxygen body uses during exercise at a maximum effort and physical fitness index will measure the cardiovascular efficiency. This study will help to find effect on VO2 max and PFI in different phases of menstrual cycle in young females between age group of 18 to 25 years. METHODOLOGY- In this cross-sectional study 41female participants were selected according to inclusion & exclusion criteria. VO2 max (maximum oxygen uptake) was directly assessed by Bruce treadmill test method and PFI (Physical fitness index) was assessed by Harvard step test during all three phases of menstrual cycle RESULTS-VO2 max in menstrual phase (20.653±2.052)and in follicular phase VO2 max is (22.283±2.184) and in luteal phase (22.437±2.250).PFI (physical fitness index) in menstrual phase is (89.406±5.281)and in follicular phase is (92.018±3.762) and in luteal phase (94.471±4.761) after applying repeated measures of ANOVA the P value is 0.0001 which is less than 0.5this indicate that there is extremely significant difference between three phase of menstrual cycle. CONCLUSION - The study conclude that there is extremely significant difference in cardiorespiratory fitness level VO2max and PFI (Harvard step test) during three different phases of menstrual cycle

Effect Of Cervical Stabilization Exercises Versus Cervical Headache SNAG Following Sensorimotor Retraining On Pain And Functional Disability Among Cervicogenic Headache Patients: A Comparative Study

Dixit Shrushti — 2024-12-31

Aim- To study the effect of Cervical Stabilization Exercises versus Cervical Headache SNAG Following Sensorimotor Retraining on Pain & functional disability among Cervicogenic Headache Patients. Relevance of study – CEH leads to important deteriorations in patient’s quality of life. Manual cervical therapy has shown improvement in headache symptomatology. Methodology- In this study 30 patients with CEH were selected, Group ‘A’ (n=15) & Group ‘B’(n=15). The Cervical Stabilization Exercises Following Sensorimotor Retraining was given to Group ‘A’ & Cervical Headache SNAG Following Sensorimotor Retraining was given to Group ‘B’. Result- On intergroup comparison Group-A pre and post diff mean of NPRS was 2.4±0.7, NDI was 4.8±3, HDI was 8.1±3.8 this compared with Group B pre and post diff mean of NPRS was 1±0.4, NDI was 2.7±1.11, HDI was 5.4±2.5 with p value of NPRS was <0.0001, NDI was 0.0168, HDI was 0.0313. Conclusion - Cervical Stabilization Exercises following sensorimotor retraining was more effective than Cervical Headache SNAG following sensorimotor retraining.

Mckenzie approach for quadratus lumborum dysfunction in patients suffering from chronic low back pain with borderline BMI

K Askal Ali — 2024-12-31

Background: Low back pain is the common condition people with borderline mckenzie

Method are popular active treatment approach that include both exercise and information for patient with chronic LBP.

Objectives: To assess the effectiveness of mckenzie approach for quadratus lumborum

Dysfunction in people with borderline BMI.

Design: Single group, pre and post experimental study, single centre included patient with

LBA.

Methodology; The experimental study included 26 people with low back pain based on the Inclusion and exclusion criteria. Subjects were explained about the mckenzie exercises. Oswestry disability index and VAS scales was taken as outcome measures and checked before and after completion of 4 weeks.

Result: The study shows significant improvement when assessed post study used in VAS scale and OSWESTRY scales with P<0.005. Hence reject the null hypothesis and accept alternate hypothesis. Which states that significant effect of Mckenzie protocol reducing severity of back pain and improving functional activity.

Conclusion: The study has concluded that mckenzie approach for quadratus lumborum

dysfunction in patients suffering from CLBP with borderline BMI has shown great improvement by reducing pain and improving functional activity.So, further effort should be forward promoting mckenzie approach as a part of physiotherapist rehab service whenever necessary with goal of reducing LBP.

Techniques in Cardiopulmonary Physiotherapy by Subin Soleman

Nagargoje Archana — 2024-12-31

In 2018, the book Techniques in Cardiopulmonary Physiotherapy was released. Evidence-based practice continues to be the cornerstone for the best care in the rapidly changing area of physiotherapy, especially cardiopulmonary physiotherapy. Techniques in Cardiopulmonary Physiotherapy by Subin Soleman is a notable resource that skillfully blends the academic foundation with real-world applications of cardiopulmonary rehabilitation. This book skilfully closes the gap between theory and practice by giving medical professionals the means to implement excellent theoretical ideas in practical clinical settings.

Role of physiotherapists in Early detection and intervention of disabilities

Anap Deepak — 2024-12-31

Physiotherapists are indispensable in the early detection and intervention of disabilities. Their expertise in human movement, rehabilitation, and functional recovery enables them to identify and address potential issues long before they evolve into full-fledged disabilities. By embracing a more proactive, preventive approach to healthcare, physiotherapists can significantly reduce the burden of disability, improve patient outcomes, and contribute to healthier, more active communities. It is time to recognize and harness the potential of physiotherapists as key players in the early intervention and prevention of disability.

Modified portable model Functional Reach Test Tool.

Ganvir Shyam — 2024-12-31

The Modified portable model Functional Reach Test tool is a single item test developed as a quick screening for balance problems in community dwelling older adults.

It is also an objective measurement tool for checking dynamic balance and also it predicts fall risk in elderly.

The drawback of this tool is there are chances of subjective error. The height differences of individual height may lead to errors in measurements.

Effectiveness of Kinetic Control versus Mckenzie Execises on Functional Outcomes in patients with lumbar radiculopathy – A single blinded randomized pilot study.

Joshi Kanchan — 2024-12-31

Background: The term lumbar radiculopathy (LR) is a condition caused by compression and/or irritation of lumbar nerve roots by intervertebral disk degeneration or herniation, degenerative arthritis, lumbar stenosis, and other conditions like bone or muscle tumors, infections, or inflammation.¹^,² Physical therapy techniques to treat lumbar radiculopathy includes, Neural tissue mobilization exercises, Stabilization, Kinetic control exercises for lumbar spine, manipulation technique, Direction based Mckenzie exercises along with conventional physiotherapy. There is lack of literature on effectiveness of kinetic control and Mckenzie exercises in patients with Lumbar Radiculopathy. Hence this study is conducted to find out the which treatment will be more effective.

Methodology: Study was conducted among 8 individuals of age 25-45 years having Lumbar Radiculopathy who were divided into two groups. 4 individuals of group A received Motor Control Exercises and 4 of group B received Mckenzie Exercises. Pain, Range of Motion of Lumbar Spine, Strength of Trunk muscles and Back Disability were assessed pre-intervention and immediate post-intervention.

Result: A significant difference was found in both the groups for Pain (p=0.0319), Disability (p=0.018) & Flexion Range of motion of lumbar spine (p=0.002) except all other Range of motion & strength of trunk muscles (p=0.2070). When comparison done after 4 weeks the percentage of improvement in group A was much higher than group B.

Conclusion: Kinetic control exercises showed significant improvement in reducing pain, disability and improving lumbar spine flexion range of motion when compared to McKenzie while there is no any difference in extension, lateral flexion range of motion and strength of trunk muscles.