International Journal of Physiotherapy

154-158

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

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

163-165

Authors: Vishakha Patil, Rajashree Naik, Avinash De Sousa

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

170-176

Authors: Arakkal Maniyat Shemjaz, Thakral Anuj, Meman Husain Saddam

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

182-185

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

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

193-196

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

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

204-207

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

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

214-217

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

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

222-227

Authors: Samahir Abuaraki Elbkheet, Mallikarjunaiah H S, Nagaraj S

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

233-237

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

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

242-245

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

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