International Journal of Physiotherapy and Research

3521-3525

Authors: Bijal Pasad, Anagha Palkar, Ajay Kumar.

Background: Expiration is a passive process with active muscle contraction being used more during forceful activities such as coughing or sneezing. The abdominal muscles are major muscles of diaphragm. So it improves the efficiency of expiration. In obese individuals there is deposition of fat around the rib cage and the chest wall. Studies have shown that there is a decrease in the functional residual capacity and expiratory reserve volume in obese individuals. The expiratory flow limitation is important determinant of breathlessness in obese individuals. Abdominal and thoracic fat have direct effects on downward movement of diaphragm and chest wall. Abdominal muscles are powerful expiratory muscles whose actions help to force the diaphragm back to its resting position. Aim: This present study was done to determine the effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals. Methods: In this experimental study 30 obese subjects with decreased peak expiratory flow rate who fulfilled the inclusion and exclusion criteria having a Body mass index of more than 30kg/cm2 were selected for abdominal muscle exercise program for 4 weeks, 2 sets of each exercise, thrice a week for 10 repetitions for each set. The pre and post peak expiratory flow rate were measured by peak expiratory flow meter. Statistical analysis was done using one sample t and Wilcoxon test. Results: There was a significant increase in post peak expiratory flow rate compared to pre peak expiratory flow rate. Conclusion: This study showed that there is significant effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals.

3533-3536

Authors: Anas Alhakami *1, Mohammed Qasheesh 2, Senthilkumar Cennappan Bose 3.

This case report describes a clinical case of a 53 years aged male with Low Back Pain (LBP) at Sacro Iliac Joint (SIJ). Patient referred to physical therapy department with LBP over the past 3 weeks. Pain extended to posterior aspect of left thigh and worsening with prolonged standing, sitting and with stair climbing. Moreover, he found difficulty to ride his car or going from sit to stand. He had a history of road traffic accident 30 years ago that led to severe pain in his lower back area, he was a farmer as well and was working hardly more than 8 hours daily by lifting heavy objects. Patient came to the department by walking with assistive cane. By palpation, there was a local tenderness at the posterior aspect of the SIJ. Range of motion was limited by pain in lumbar flexion, extension, rotation and bilateral side bending movements. Pain scored 7 out of 10 on Numerical Pain Rating Visual Analogue Scale. Functional disability scored 19 out of 24 on Roland-Morris Disability questionnaire. Patient underwent special test of FABER, SLR and sacroiliac stress tests and Physical therapy modalities of TENS, dry cupping, myofascial release technique and manipulation, medical taping, hot packs applied before and after exercise. Stretching exercises included single knee to chest, trunk rotation, child’s pose and stabilization exercises of bird dog pose, superman’s, bridge, ball squeeze. Outcomes of treatment were assessed with same pretest measures. At the end of 3 weeks, patient improved in all symptoms of reduced pain to 2 out of 10 on Numerical Pain Rating, 3 out of 24 on Roland-Morris disability questionnaire. Post rehabilitative findings on all provocative tests were negative. Evidence on physical therapy management of patients with SIJ pain appears underreported. Patients presenting with SIJ pain should be routinely screened for sacroiliac component in LBP. Physical therapists are encouraged to report their findings so as to strengthen the evidence available for physical therapy for SIJ pain.

3547-3553

Authors: Mayank Shukla *1, Sakshi Jain 2, Meenakshi Rajput 3.

Introduction: The usage of smartphone (SP) has dramatically increased among young University students for their daily work and social media connect. It affects hand functions, and the present study was aimed at checking for chronicity of SP use and their effect on hand function. Methods: Using a cross-sectional study design ─ N=150 university students in the age group of 18-35 years were involved, after taking informed consent. They were using smartphone chronically (>12 months minimum). Hand functions were checked using Smartphone addiction scale (SAS) and Boston Carpal Tunnel Questionnaire (BCTQ). To check the effect of chronicity the participants were grouped based on daily usage (3-6hrs; 6-9hrs & >9hrs per day of SP use), and usage over a period of months (12-60 months; 60-120 months & >120 months of SP use). One - way ANOVA was used to check significant difference taking p=0.05 as the level of significance. Results: For all participants Mean values were ─ SAS = 22.63 ± 4.075, BCTQ FSS = 11.41 ± 3.784, BCTQ SSS= 15.053 ± 4.32. Significant differences were seen in daily usage of SP on BCTQ FSS (p=0.00097 & f ratio=5.73) and BCTQ SSS (p=0.032 & f ratio=2.99). ANOVA for SAS was significant (p<0.05) for daily usage groups but not for usage over a period of months. Conclusion: Excessive daily usage of smartphone for more than 3 hours, chronically leads to hand symptoms among University students, and it is addictive as seen here, however chronicity of use over months in non-addictive. It has implications during daily extended uses like working on SP for official work and gaming. Introduction: The usage of smartphone (SP) has dramatically increased among young University students for their daily work and social media connect. It affects hand functions, and the present study was aimed at checking for chronicity of SP use and their effect on hand function. Methods: Using a cross-sectional study design ─ N=150 university students in the age group of 18-35 years were involved, after taking informed consent. They were using smartphone chronically (>12 months minimum). Hand functions were checked using Smartphone addiction scale (SAS) and Boston Carpal Tunnel Questionnaire (BCTQ). To check the effect of chronicity the participants were grouped based on daily usage (3-6hrs; 6-9hrs & >9hrs per day of SP use), and usage over a period of months (12-60 months; 60-120 months & >120 months of SP use). One - way ANOVA was used to check significant difference taking p=0.05 as the level of significance. Results: For all participants Mean values were ─ SAS = 22.63 ± 4.075, BCTQ FSS = 11.41 ± 3.784, BCTQ SSS= 15.053 ± 4.32. Significant differences were seen in daily usage of SP on BCTQ FSS (p=0.00097 & f ratio=5.73) and BCTQ SSS (p=0.032 & f ratio=2.99). ANOVA for SAS was significant (p<0.05) for daily usage groups but not for usage over a period of months. Conclusion: Excessive daily usage of smartphone for more than 3 hours, chronically leads to hand symptoms among University students, and it is addictive as seen here, however chronicity of use over months in non-addictive. It has implications during daily extended uses like working on SP for official work and gaming.

1389-1393

Authors: Samiah F. Alqabbani 1, Eric G. Johnson *2, Noha S. Daher 3, Shilpa B. Gaikwad 4, SukrutDeshpande 5.

Background: Proprioception plays an important role in sensorimotor control of posture and movement. Impairments in cervical proprioception have been demonstrated in subjects with whiplash-associated disorder, patients with age-related degeneration, and patients with articular diseases or spondylosis. The joint position error test is widely used to measure head repositioning accuracy. Objective: The purpose of this pilot study was to compare cervical spine joint position error in females who routinely wear headscarves to females that do not wear headscarves. Methods: Twelve females with mean age 27.5±4.0 years were divided into two groups: females who routinely wear headscarves (n=6), and females who never wear headscarves (n=6). Joint position error was measured using a head-mounted laser while subjects were seated. The tasks involved relocating the head to neutral after flexion, extension, right rotation, and left rotation. A total of six trials were done for each direction. Results: The joint position error was higher in females wearing headscarves compared to females who do not wear them in the cumulative joint position error score (8.2±1.0 vs. 4.4±1.0, p=0.06) as well as during head rotation to the right (9.3±1.6 vs. 3.1±1.6, p=0.06). Conclusion: Wearing headscarves may increase the cervical joint position error and can negatively impact postural control. However, further studies are needed to confirm this finding. KEY WORDS: Cervical spine, proprioception, joint position error, headscarves.

1401-1407

Authors: Dheli Kadachha *1, Neela Soni 2, Ankur Parekh 3.

Background: Geriatric population is defined as population aged 60 years and above. Currently, India has the second largest aged population in the world. Due to aging processes, diseases and inactivity, balance often is impaired among older people. The impairment can lead to dramatic consequences such as dependency in ADL, administration to nursing homes, falls and fractures. Complementary and alternative therapies, such as yoga, are theorized to be more therapeutic than traditional exercise because of the mind-body component. Yoga requires the stretching of major muscle groups to improve physical strength and flexibility. Yoga, with its gentle movements, can address known fall risk factors like poor balance, impaired mobility, reduced strength and flexibility and focus on increased awareness and proprioception, resulting in improved balance in older adult. Objective: The objective of the study was to see the effects of yoga on balance in geriatric population. Materials and Methodology: 60 healthy elderly volunteers aged 60 years and above both male and female were selected from different old age homes of ahmedabad city and randomly divided in to 2 groups. Group A: experimental and group B: control. General characteristics (age, gender) were collected. Experimental group performed yoga for 6 weeks,six days in a week for 45 to 50 minutes; including 5-10 minutes of warm up focused on slow dynamic muscle movements with shoulder/arm circling, neck rolling. This was followed by 25-30 minutes of asanas consisting of following poses: pavanmuktasana, sputa matsyendrasana, setu bandha sarvangasana, bhujangasana, ardh-paschimottasana, paschimottasana, parvatasana, marjarasana, trikonasana, virbhadrasana, uttkatasana, and vrikshasana. Session was ended with 5-10 min of relaxation with savasana. Subjects of control group were asked to report after six weeks. BBS and TUG scores were taken as pre and post data. Result: The result shows that there is statistically significant improvement in balance after 6 week of yoga practice in elderly individuals compared to a control group at 5% significance level. Conclusion: Yogasana is effective in improving balance in elderly individuals compared to control group. It can be applied clinically for improving balance in geriatric population. KEY WORDS: Geriatric, Elderly, Balance, Yogasana, BBS, TUG Test.

1415-1422

Authors: Aline A. Vepo, Caroline S. Martinez, Giulia A. Wiggers, Franck M. Peçanha *.

Background: Water decreases vital capacity during immersion. Several chest diseases can reduce pulmonary volumes and capacities which could be at least in part similar to that happen in healthy individuals during water immersion. Objectives: To investigate if respiratory effects of water immersion are partially due to enhanced return venous from legs and arms and if physiotherapeutic techniques incentive spirometry (IS) and breathing exercises (BE) are able to improve pulmonary volumes and capacities in healthy subjects during water immersion. Design: Randomised, within-participant experimental study. Participants: 18 healthy subjects. Intervention: Stage 1 was realized to investigate the cardiorespiratory effects of water immersion with and without a cuff-induced venous compression. Stage 2 was conducted to explain the effects of physiotherapeutic techniques IS and BE during water immersion. Main outcome measures: The pulmonary function (forced vital capacity - FVC, forced expiratory volume the first second - FEV1, ratio of FEV/FVC, peak expiratory flow rate - PEFR and forced expiratory flow of 25-75% FVC - FEF25-75%) was evaluated. Results: Water immersion decreased FVC and FEV1 after 10 minutes of immersion. After a total compression of arms and legs the reduction on FVC and FEV1 was not observed, even with only partial compression of legs (P>0.05). Conclusions: Water immersion promotes pulmonary restrictive characteristics due to increased venous return mainly from legs. The application IS and BE did not normalize the spirometric values. KEY WORDS: Chest physiotherapy, Respiratory techniques, Breathing exercises, Pulmonary function.

1429-1335

Authors: M. Seshagiri Rao *, Swathi Tejitha.

Background and Purpose: Posterior shoulder tightness (PST) can result due to abnormal humeral head motion which decreases subacromial space during overhead activities leading to compression of tissues causing limited shoulder flexion, internal rotation and horizontal adduction. Recently, some authors have expressed belief about cross body stretch and sleeper stretch. The need of this study is to know the effectiveness between three stretching protocols in PST. Materials and Methods: 45 PST throwers were randomly selected into three groups, A Modified cross-body stretch (MCBS; n=15), B Modified sleeper stretch (MSS; n=15), and C Horizontal adduction stretch (HAS; n=15) and three stretching’s were given in respective groups for 4 weeks, 5 repetitions once daily. Pre and post-treatment values of Range of motion (ROM) with goniometry and actively moving the thumb up the back(TUB), shoulder disability with PENN Shoulder score were noted and statistically analyzed. Results: The difference between three groups was significant. ROM (0.0003), TUB (0.0085), PENN Shoulder score (P<0.0001) which is considered significant in Modified cross-body stretch. Conclusion: Results concluded that Modified cross-body stretch was beneficial in increasing Range of motion (ROM), decreasing pain, improving functional ability, and satisfaction levels. KEYWORDS: Modified cross-body stretch, Modified sleeper stretch, Horizontal adduction stretch, Range of motion, Posterior shoulder tightness.

1444-1450

Authors: S. Felix Renald 1, J. Raja Regan *2.

Background: Stroke is a global health problem. It is the second commonest cause of death and fourth leading cause of disability worldwide. Along with hemiplegic limb muscles, trunk muscles are also impaired multidirectional in stroke patients. Trunk control is important for functional outcome and also an early predictor for activities of daily living after stroke. Treatment focusing on this aspect in stroke patients is needed. Since sufficient literatures are not available in comparing the effect of trunk exercises on bed and Swiss ball in trunk control among hemi paretic patients, there is a need for incorporating it in this study. Objectives: To compare the efficacy of trunk exercises performed on Swiss ball versus bed in trunk control among hemi paretic patients. Materials and Methods: Study was conducted as a Quasi Experimental Design – Pretest and Posttest Designs with Two Comparison Treatments. at Department of Physiotherapy, PSG Hospitals, Coimbatore, Tamil Nadu, India. A total of 16 stroke patients in the age group of 45 to 60 years participated in the study. The participants who satisfied the selection criteria were selected by convenience sampling and randomly assigned into two groups. Group A received trunk exercises on Swiss ball and Group B received trunk exercises on bed for 12 days [6 sessions per week for 2 weeks (45minutes/session)]. Outcomes were measured with Trunk Impairment Scale score and Motor Assessment Scale score. Results: All participants in group A and group B showed significant improvement in TIS scores with a mean difference of 6.5 and 4.38 respectively. The calculated ‘t’ value using the paired test for group A and B were 9.96 and 8.21(P<0.001) respectively. In MAS scores group A and group B showed significant improvement with a mean difference of 2.12 and 1.25 respectively. The calculated ‘t’ value using the paired test for group A and B were 9.34 and 7.83(P<0.001) respectively. When comparing between the groups using independent ‘t’ test, the TIS scores showed mean difference of 2.12 and ‘t’ value of 2.56 (P<0.005) and MAS scores showed mean difference of 0.87 and ‘t’ value of 3.22(P<0.05). Conclusion: This study revealed that there was significant improvement in trunk control following trunk exercises on Swiss ball than on bed among hemi paretic patients. KEYWORDS: Swiss Ball, Hemi Paretic, Trunk Control, Trunk Exercises, Functional Outcome, Trunk Impairment, Bed Exercises.

1459-1467

Authors: Mohammed A. Fakhro 1, Nancy Wehbe 2, Khodor Haidar Hassan *3.

Background: After an anterior cruciate ligament reconstruction (ACLR), athletes return to full sports activities based ona clinical decision following postoperative rehabilitation. The purpose of this study wasto find if clinical decision to releaseathletes back to unrestricted sports activities afterACLR matches the findings of objective criteria of muscle strength and lower limb symmetry. Materials and Methods: The study used a cross-sectional observational design.Thirty-two athletes who were released within 1 to 7 months to full sports activities were recruited from Lebanese first, second and third sports divisions. Participants performed a battery of tests including: knee extension/flexion, single leg press to assess muscle strength and single leg hop, triple hop, cross-over hop, timed hop and single hop after fatigue for distance to assess lower limb symmetry. Results: Demographic results showed thatmean age of participants was 24.37 years. Bone-patellar tendon bone (BPTP) autograft was the most used surgical technique for ACLR. Ten athletes passed the muscle strength testing, whereas twelve athletes had passed that of lower limb symmetry. Therefore, only 18.75% (six athletes) out of thirty-two could be released back to full sports activities following the combined testing of muscle strength and lower limb symmetry, whereas, they all had been released previously to full sports activities based on clinical decision. Discussion and Conclusion: Despite that athletes have been released by a clinical decision in a range of one to seven months, there were still significant deficit in muscle strength and lower limb symmetry. The results of this study show noteworthy problems in muscle strength and lower limb symmetry following ACLR. Use of objectives criteria might be a useful adjunct to clinical decision before release of athletes to unrestricted sports activities. KEY WORDS: Anterior cruciate ligament reconstruction, Clinical decision, Return to athletics.

1352-1359

Authors: Harshika Bhanusali 1, Vishnu Vardhan *2, Tushar Palekar 3, Shilpa Khandare 4.

Background: Balance is a complex process involving the reception and integration of sensory inputs and the planning and execution of movement to achieve a goal requiring upright posture. The need of the study is to compare the effect of square stepping exercises versus balance exercises on fear of falling and balance in elderly. Aims and Objectives: 1. To study the effects of square stepping exercise on older adults to improve balance impairments and reducing fear of falling. 2. To identify the effects of balance exercise on fear of falling and balance in elderly. 3. To compare effect of balance exercise and square stepping exercise and in older adults to improve balance and reducing fear of falling. Materials and Methods: 36 elderly individuals with age 60 year and above having MMSE score >24 and BBS scores of more than 41/56 with vital signs within normal range for elderly population were included in the study. Subjects with history of any neurological disease and musculoskeletal impairment that could account for possible balance impairment like CVA, Parkinson's disease, vestibular disorder, joint replacement, fractures etc, diagnosed with visual and auditory impairment, uncontrolled diabetes mellitus, unstable cardio-respiratory condition, which may affect the training procedure were excluded. Purpose of the study was explained to the subject. Written consent was taken. All participants were selected by simple random sampling and randomly divided into two groups. Group A received Square stepping exercises and group B received Balance training exercises for a period of 30 minutes with appropriate rest pause, 3 times per week for 4 weeks. Mini Mental State Examination (MMSE), Berg Balance Scale (BBS), Timed Get Up Go (TUG) were used to assess cognition, balance respectively and Fall Efficacy Scale (FES) was used to assess fear of falling Result: Participants in both the groups improved on BBS and TUG (p<0.0001) scores. Conclusion: The study concluded that square stepping exercise group exhibited statistically significant improvement on BBS and TUG test score and Fall Efficacy Test scores compared to the balance training exercise group. KEY WORDS: Elderly population, balance, Square stepping exercise Training, Balance training exercises.

1365-1369

Authors: Dhargave Pradnya *1, Atchayaram Nalini 2, Meghana Adoor 3, Raghuram Nagarathna 4, Trichur R. Raju 5, Kandhavelu Thennarasu 6, Talakad N. Sathyaprabha 7.

Aim: The prognosis for Duchenne Muscular Dystrophy (DMD) life depends to a large extent on the respiratory function. Inspiratory and expiratory muscles are affected and respiratory problems occur with or without spinal deformities. It is important to characterize the respiratory function in DMD to facilitate decision of timing of the intervention. Methodology: 124 DMD male children whose parents gave written consent were recruited. The Pulmonary function tests were performed using Spirometry kit (Spiro instrument’s software) (Microquark Cosmed, Italy). The values of Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF) and Peak Inspiratory Flow (PIF), Tidal Volume (TV) and Maximum Voluntary Ventilation (MVV) were analyzed. These results were compared with the healthy children and correlated with semiology of the disease. Results: One twenty four subjects with mean age at presentation were 7.9 ± 1.5 years. Mean age of onset was 2.8 ± 0.6 years (1.5 - 4.0 years). Mean duration of illness was 5.1 ± 1.5 years (1 - 8 years). The respiratory functions were poor in DMD compared to healthy controls. Age and duration of illness were positively correlated with pulmonary function. Conclusion: Our study enlightened large number Indian DMD children’s pulmonary function parameters. Characterization of the pulmonary dysfunctions helped us in improving the quality of life in DMD children, by timely modifying the rehabilitation regime. This study also explained about the respiratory dysfunction in DMD in Indian population that can be used for choosing the suitable rehabilitation programs, targeted towards the symptomatic treatment of DMD children. KEY WORDS: Pulmonary function, Duchenne Muscular Dystrophy.

1284-1287

Authors: Pooja Kumari Digra *1, Manoj Kumar Deshmukh 2, Divya Midha 3, Yogita Verma 4, Senthil P Kumar 5.

Various motor and sensory deficits prevail in stroke patients which have significant effect on their walking ability, which further affects overall independence of the patient in daily activities. Cognitive task performance along with the conventional physiotherapy treatment may cause profound effect on various gait parameters in stroke. The main purpose of the study is to evaluate the effects of dual task training along with conventional physiotherapy on gait parameters in patients with ischemic stroke. Assessment and treatment was given at baseline and after 6 weeks. Before and after intervention spasticity was measured by Modified Ashworth Scale (MAS), Functional performance by Dynamic Gait Index (DGI) and Gait Parameters. The finding of the study showed that there was improvement in functional performance but not in spasticity. KEY WORDS: Sub acute ischemic stroke, Dual task cognitive training, Gait parameters, Dynamic Gait Index (DGI).

1294-1300

Authors: Santosh Metgud *1, B.B. Putti 2.

Background: Osteoarthritis is a degenerative joint disease involving thinning or destruction of the smooth cartilage that covers the ends of bones and changes to the bone. Joint arthroplasty is an intervention for those patients who have severe disease, with severe pain and radiographic evidence. Objective: To compare the effect of proprioceptive exercises in osteoarthritic and total replaced knees using the Knee Society Score and Joint Position Sense. Design: A randomised clinical trial. Subjects: A total of 95 subjects were selected based on the inclusion and exclusion criteria. Intervention: Participants were divided into two groups; Group A comprised of the Total Knee Replacement and Group B was the osteoarthritic group. Group A was given exercises along with ambulation and static and resistance cycling and training of functional activities. Group B was given exercises and seven proprioceptive exercises followed by continuous short wave diathermy cross-fire method for 15 minutes. Outcome measure: Pain Intensity, Functional Outcome and Joint Position Sense (JPS) were measured by using Visual Analog Scale (VAS), Knee Society Score (KSS) and Absolute angle of error, respectively. Results: The results show a significant difference between the two groups using VAS and JPS whereas showed no significant difference between the two groups on using the KSS. Conclusion: Based on the results of this study, it was observed that proprioceptive exercises are beneficial in improving the joint position sense in patients with osteoarthritis as well as total knee replacements. KEY WORDS: Joint Position Sense, Total Knee Athroplasty, Ostoearthritic Knee, Knee Society Score, Proprioception.

1307-1311

Authors: Mullai Dhinakaran *1, Jugesh Chattwal 2, Dheeraj K.V 3.

Background: The clinical education methods in undergraduate physiotherapy training are well integrated but the methodology of the clinical skill assessment still remains subjective. Due to lack of objective clinical assessment, competency in clinical skills becomes compromised. Aim and Objectives: To introduce Objective Structured Clinical Examination to Physiotherapy faculty, students and determine the perception of Physiotherapy faculty and students about OSCE method of clinical assessment. Methodology: OSCE was conducted to undergraduate physiotherapy 4th year students (n – 20) by OSCE trained staff members (n -8) of College of Physiotherapy. CMC &H, Ludhiana. By the end of exam, self-administered questionnaires were distributed and piloted to both faculty and students. They answered each item on 5- point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Results: The piloted data was analysed with descriptive statistics. The entire faculty perceived that OSCE helping to enhance the evaluation method of clinical assessment. More than 80% of the students felt that OSCE should be an effective clinical assessment tool. Both faculty and students felt that OSCE method of clinical assessment is less stressful but more exhausting and lengthy. Both groups were satisfied except more preparatory period for the exam as they expressed in open comments. Conclusions: This pilot study provided valuable feedback from faculty and students when OSCE assessment was introduced into undergraduate physiotherapy course. It helps for standardization of Physiotherapy clinical assessment. KEY WORDS: OSCE, Formative PT assessment, faculty perception, Students’ perception.

1318-1325

Authors: Jacob Isaac Jason *1, Ganesh Sundaram S 2, Vengata Subramani M 3.

Objective: The purpose of this study was to conduct a systematic review on various physiotherapy management for adhesive capsulitis of shoulder. Methods: A search of the literature was conducted using Clinical Key, ProQuest and PEDro databases up to September 2015. Search limits included the English language and human studies. Search terms included adhesive capsulitis, frozen shoulder, Physical therapy, Physiotherapy etc. Inclusion criteria: Systematic reviews and randomised controlled trials (RCTs) in English language were included if they fulfilled the following criteria: (a) patients with adhesive capsulitis were included, (b) results on pain and function were reported, and (c) a study period of at least two weeks was reported. Articles were assessed using the Jadad (1) scale and Physiotherapy Evidence Database (PEDro) scale. ‘High-quality’ was defined as a “yes” score of 50% in Jadad scale and a PEDro rating of 5 out of 10. Totally 17 studies were selected for this systematic review. Conclusion: This study has found sufficient level of evidence for physiotherapy in the treatment of adhesive capsulitis the shoulder. In particular, manual treatment must be combined with commonly indicated exercise or conventional physiotherapy, as it remains the standard care. KEY WORDS: Adhesive capsulitis, frozen shoulder, Physiotherapy.

1336-1343

Authors: Roshini Rajappan 1, Karthikeyan Selvaganapathy *1, Lola Liew 2.

Background and Objective: Physical inactivity is the fourth leading risk factor for global mortality. Physical inactivity levels are rising in developing countries and Malaysia is of no exception. Malaysian Adult Nutrition Survey 2003 reported that the prevalence of physical inactivity was 39.7% and the prevalence was higher for women (42.6%) than men (36.7%). In Malaysia, the National Health and Morbidity Survey 2006 reported that 43.7% (5.5 million) of Malaysian adults were physically inactive. These statistics show that physically inactive is an important public health concern in Malaysia. College students have been found to have poor physical activity habits. The objective of this study was to identify the physical activity level among students of Asia Metropolitan University (AMU) in Malaysia. Materials and Methods: The study design was a cross sectional survey. A total of 100 participants comprising of 50 male and 50 female students were selected for the study by means of convenience sampling. International Physical Activity Questionnaire (IPAQ) short form was used to identify the physical activity level. Results: A greater percentage of males (56%) showed high physical activity level than females (24%). In contrast, females showed high percentage of low physical activity level. Students in the age range of 22-25 years depicted more percentage (43.5%) of high physical activity level. When comparison of physical activity levels were done among different races, Indian students showed greater percentage (61.8%) of high physical activity level. Furthermore, students who were underweight and overweight had 50% and 46.7% of high physical activity levels respectively which are greater than the values observed in normal body weight students. Conclusion: The physical activity level among students was found satisfactory although the percentage of low level of physical activity was found higher in female students. KEY WORDS: Physical activity level, Metabolic Equivalent, Body Mass Index.

1208-1214

Authors: T. Krishna Priya 1, Shaswat Verma *2.

Background: The use of functional scales to assess the prognosis of the individuals is widely being encouraged by the International classification of Functioning, Disability and Health. Two, six and twelve minute walk tests are the existing functional walk tests, among which 6MWT is being considered as the gold standard. Patients in acute stages of illnesses and early stages of recovery, it is difficult and tiring to accomplish a 6MWT. 2MWT is presently being used as a pre and post-test. To comment on the status of the patient and the test results in the first attempt, it is necessary to look at the reference values of 2MWT. Purpose of the study: This study aims to establish reference values for 2MWT in healthy Indian adults. Objective of the study: To establish reference values for 2 minute walk distance in healthy Indian adults of 20-80 years age. Methods: Three hundred subjects met the inclusion criteria through convenience sampling. Two trials of 2MWT were administered. Instructions for the test were adopted from American Thoracic Society guidelines for 6MWT. Out of the two trials, the one in which more distance was covered by the subject was taken for the analysis. Descriptive statistics were used to analyse the data. Results: The mean 2MWD was 182.69 + 32.40 meters. 2MWD had shown moderate significant negative correlation with age (r = -0.58) and weak but significant positive correlation with height (r = 0.35). The correlations with weight (r= 0.1) and BMI (r= -0.13) were found to be negligible. It was also found that males walked 21.55 + 3.5 meters more than females and aye2MWD during the second trial was found to be 3.011 + 1.44 meters greater than the first trial. Conclusion: The average distance covered by a healthy Indian individual is approximately 182.69 + 32.40 meters in 2 minutes duration. Implication: Patients in early stages of rehabilitation, early post-operative period and patients with severe disability, found 6MWT difficult, intolerable, time consuming and too fatiguing. So, 2MWT is being used as an outcome scale of priority in these populations recently. It is clinically more useful when compared to 6MWT. KEY WORDS: 2 minute walk test, Functional capacity, Indian population, Exercise capacity, Functional walking test.

1221-1226

Authors: Prakash Patel *1, Namrata Patel 2 , Vandana Rathod 3.

Total Knee Replacement (TKR) is the standard treatment for patients with severe knee osteoarthritis (OA). Significant improvement in pain and function are seen after TKR and approximately 80% of patients are very satisfied with the outcome. Functional status prior to TKR is a major predictor of outcome after the intervention. However, results from several previous trials testing the concept have been inconclusive after surgery. There was a significant increase in functional status in subjects undergone TKR. Exercise training shows significant improvement in the functional outcome of knee KEY WORDS: Total Knee Replacement, Exercise training, Educational training.

1233-1238

Authors: Ankit kaur 1, Rohit Subhedar *2, Pallavi Dave 3, Priyanka Mishra 4, Dirgha Sharma 5.

Background: Influence of body composition on lung functions is of enormous clinical importance. Impaired lung functions particularly low forced vital capacity (FVC), low forced expiratory volume in 1 s (FEV1) and FVC & FEV1 ratio are associated with increased morbidity and mortality, and it is also well recognized that severe clinical obesity is associated with impairment of lung function. The aim of our study is to observe the correlation between pulmonary function and body composition parameters on individuals with different body mass index. Methods: 150 subjects consist of 75 males and 75 females in the age group of 40 to 60 years, were classified into normal weight, overweight and obese grade 1 groups according to the WHO guidelines. The body composition measured by using the Bioelectric Impedance based Tanita BC-418 and pulmonary functions assessed by using computerized Jaeger Master scope. Results: Results of statistical analysis showed that the fat free mass of normal male was identified as the strongly significant predictor of variation in pulmonary function parameters such as FVC (p<0.006) and FEV 1s (p<0.008) in comparison to normal female (p>0.05). The BMI (p<0.002) and FFM (p<0.001) detected as strongly significant while TF% (p<0.05) identified as significant predictor of variation in FVC of the obese grade 1 male (Group C). It was also found that the BMI (p<0.001), TF% (p<0.004) and FFM (p<0.001) of obese grade 1 male strongly impacted the FEV 1s. The ratio (FVC/FEV 1s) was less significantly (p>0.05) by BMI FFM and TF% of obese grade 1 male. Conclusion: A significant positive correlation was observed between fat free mass and FCV and FEV1. Body fat percentage and trunk fat percentage had a stronger correlation than BMI. KEY WORDS: Forced vital capacity, Forced expiratory volume in 1sec, Body mass index, Body fat percentage, Trunk fat percentage, Fat free mass.

1244-1249

Authors: Nidhi Kalra *1, Sanjeev Gupta 2, Charvi Vij 3, Ashu Gupta 4.

Introduction The syllabus is a description and plan for a course and, if well written, may be a tool that improves student learning, facilitates faculty teaching, improves communications between faculty members about their courses, and assists with monitoring program quality. The level of education for physical therapists should reflect the current and future needs of professional practice and society and changes in physical therapy roles and function as well as changes in the legislation that regulates physical therapy practice. Therefore, through our study, we would assess the existing contents and features of syllabi of various universities conducting Under-graduate Physical Therapy education program in Northern India and throw a light whether they are diverse or in consonance to each other. Aim and Objective: To study the contents and features of various syllabi for Under-graduate Physiotherapy education conducted by various Universities and Institutes of Northern India with special focus on Orthopaedics and relevant subjects. Materials and Methods: There are 24 universities conducting Undergraduate Physiotherapy program in Northern India, 20 universities were found suitable out of which data of 19 universities could be collected. The data was collected by personal visit, from official website of universities, via e-mail and by other sources. The data collected includes course scheme – syllabus, transcript, subject credits and examination scheme Results: The results of this study show that features of syllabi in these universities differ on the basis of total number of academic hours, subject allocation in various years, number of theory and practical hours allotted, percentage weight age of hours, maximum marks, and percentage weight age of marks of each subject. Conclusion: This study concludes that syllabus of the Bachelors of Physiotherapy program in Northern India is variable. The variability is not seen in the program structure rather in: Total number of subjects, Curriculum hours allotted to each subject, Subject allocation in various years, Examination system – annual or semester system, Maximum marks allotted to a subject in the university examination scheme, Total academic hours in a year, Hours allotted for clinical training. KEY WORDS: Physiotherapy Education; Syllabus, Curriculum, Transcript, Examination Scheme.

1258-1262

Authors: Mansi Shah *1, Pravin Aaron 2, Subin Solomen 3.

Background: Active hip abduction test (AHAbd) has previously been shown to be a reliable tool for predicting low back pain development during a prolonged standing exposure in previously asymptomatic individuals, but the reliability of AHAbd on patients with standing induced occupational low back pain has not been established. As it is an observation based test, reliability among different raters and same rater must be established. The purpose of this study was to investigate the inter-rater and intra-rater reliability of the AHAbd test as a diagnostic instrument in subjects with standing induced occupational low back pain. Materials and Methods: A total of 30 subjects were assessed with 1 day interval to find out intra-rater reliability and the same 30 subjects were examined independently on the same day by two therapists to get the inter-rater reliability. Intra-class correlation coefficients (ICCs) were calculated for reliability statistics. Results and Discussions: AHAbd test demonstrated higher intra-rater reliability that is 0.91 (95% CI: .82-.85) than inter-rater reliability which was 0.83 (95% CI: .82-.95), although both were moderate to good for patients with standing induced low back pain. Conclusions: AHAbd test may prove useful as part of an ergonomic assessment but its level of reliability warrants cautions for its sole use when assessing low back pain induced by prolonged standing. KEY WORDS: AHAbd test, low back pain, prolonged standing, reliability, teachers, lumbo-pelvic control.