International Journal of Physiotherapy and Research

1379-1388

Authors: Eman A. Embaby *1, Eman M.A. Abdalgwad 2.

Background: Rigid and kinesio taping is commonly used in the rehabilitation and prevention of subacromial impingement syndrome (SIS). It is proposed to have positive effects on shoulder function and scapular kinematics. However, there is a paucity of literature regarding the effectiveness of rigid versus elastic taping on scapular upward rotation and forward head posture (FHP), which is commonly adopted in SIS. Purpose: This study was designed to investigate the effect of taping with postural correction on the scapular kinematics and forward head angle (FHA) in patients with SIS when two different taping materials are used: rigid versus a kinesio tape application. Methods: Eleven female patients with SIS participated in this study. Their age, weight and height ranged from 30 to 60 years, 56 to 90 kg and 155 to 175 cm, respectively. The participants were randomly assigned to Group I (Kinesio tape (KT), n=6) and Group II (Rigid tape (RT), n=5). Thoracic and scapular taping with posture correction was applied to both groups. Scapular upward rotation at 0°, 60°, 90° and 120° and FHA were measured before and immediately after the taping. Results: Both taping materials significantly increased the scapular upward rotation at 90° and 120° shoulder elevation. Additionally, there was a significant decrease in the FHA in the RT group. Conclusion: Both tapings are effective in restoring scapular kinematics. The corrective effect of rigid taping on FHA is substantiated. KEYWORDS: Subacromial Impingement Syndrome, Scapular Kinematics, Posture, Taping.

1394-1400

Authors: Hafizur Rahman 1, Pilladi A Charturvedi *2, Patchava Apparao 3, Pilladi R Srithulasi 4.

Background and Purpose: Lateral epicondylitis commonly referred to as lateral elbow Tendinopathy or tennis elbow is one of the most common lesions of the arm. Men and women are equally affected. There are many treatment options available for tennis elbow; an exercise program is used as the first treatment option. Mulligan has proposed the use of mobilization with movement for lateral epicondylitis. The main Purpose of the study is to compare the effects of mulligan mobilization with movement and supervised exercise program in subjects with lateral epicondylitis. Materials and Methods: 60 Subjects fulfilled the inclusive criteria and were randomly assigned into two groups. Group A were given Mobilization with movement and Group B performed Supervised Exercise Program. Both groups performed three sessions per week for the duration of 4 weeks. After the treatment, subjects were evaluated for their pain profile using visual analogue scale, and grip strength by Hand grip dynamometer. Results: Paired t-test analysis is used within group and Independent t-test is used for between group comparisons. At the end of 4 weeks Mulligan mobilisation with movement group showed significant improvement in VAS and hand grip strength scores than the supervised exercise program group (P<0.000). Conclusion: It is concluded that both techniques showed improvements in hand grip strength and VAS. The group that performed mulligan mobilisation with movement showed significantly greater improvement in reduction of pain and increase in hand grip strength than the supervised exercise program. KEYWORDS: Mulligan Mobilization with Movement (MWM), Visual Analogue Scale (VAS), Hand Grip Dynamometer (HGD).

1408-1414

Authors: Gitanjali Sikka

Background: Snakebite is an environmental hazard associated with significant morbidity and mortality. Neurotoxic envenomations have the potency to cause a broad spectrum of presentations starting from ptosis and ophthalmoplegia to respiratory arrest. These patients require ventilatory assistance in addition to administration of anti-snake venom (ASV) and other supportive measures. Mechanically ventilated patients are at risk for retained secretions due to endotracheal intubation disrupting mucociliary escalator, relative immobility of mechanically patient confined to bed can lead to postoperative atelectasis, impaired cough, and retained secretions and thereby physical therapy may be indicated for patients in the intensive care setting. Materials and Methods: A total of twenty four consecutive patients ranging in age from 25-45 years, who required, mechanical ventilation for respiratory muscle paralysis, secondary to snake envenomation, seen during three months period, recruited from various ICU’s were included in the study. All the patients included were mechanically ventilated on Hamilton Evita ventilator, on volume control (CMV) mode with PEEP<10 cmH2O and had stable hemodynamics with heart rate = 60-100 beats/min; MABP = 70-110mm Hg. Patients received chest physiotherapy intervention twice in a day. Effects of physiotherapy treatment were studied on static lung compliance (CST), oxygenation ratio (PaO2:FiO2 ratio), partial pressure of carbon dioxide in arterial blood (PaCO2) , cologarithm of activity of dissolved hydrogen ions in arterial blood (pH) and chest X-rays. Measurements of dependent variables were recorded (PRE) before commencement of treatment, 30 minutes and 60 minutes after treatment. Physiotherapy intervention included bronchial hygiene therapy and manual hyperinflation using Mapleson-C circuit. Results: Analysis of variance showed that there was highly significant improvement in CST mean values (p<0.01) and significant improvement in PaCO2 mean values (p<0.05). However, pH and PaO2:FiO2 ratio could not reach statistical significance. Comparing mean values with critical difference, significant critical difference was observed between mean values at PRE and Post-30, and between PRE and Post-60 time intervals (p<0.05) for CST, PaO2:FiO2 ratio and PaCO2, respectively. Conclusion: Respiratory rehabilitation of patients with neuroparalytic snake envenomation can be effectively achieved with employment of various physiotherapeutic techniques including manual hyperinflation and bronchial hygiene therapy. KEYWORDS: Respiratory Rehabilitation, Neuroparalytic Snake Envenomation, Bronchial Hygiene therapy.

1423-1428

Authors: Manali S. Desai *1, Vishakha Patil 2, Rajashree Naik 3.

Background: Functional Performance is one’s ability to participate and move through different planes of movement in safe and timely manner without functional limitations. Square hop test, type of Functional Performance test aims to measure neuromuscular coordination by placing combined frontal and rotational stress on the lower extremity. Sedentary population may develop significant bilateral asymmetry in lower limbs due to constant overload on the jumping leg depending upon different kind of daily activities. Clinicians often use functional performance test (FPT) in lower extremity rehabilitation without taking limb dominance into consideration. Objectives: To determine time taken to complete square hop test in young asymptomatic individuals and to observe the effect of dominance on square hop test. Study Design: Observational, Cross sectional study Method: 60 healthy, asymptomatic individuals between 18- 25 years were selected using systematic sampling. Time taken to complete the square hop test was noted , first with dominant leg followed by non-dominant leg with a rest pause of 4 minutes. Two trials of each leg were noted and mean time taken by both dominant and non-dominant leg was used for statistical analysis. Results: There was significant statistical difference in time taken for performing Square hop test between dominant and non-dominant legs (5.11 + 14.06) using Unpaired t test (p<0.05). Again moderate (0.31) clinical difference in time taken to complete the test using Cohen et al Phenomenon of effect size. Conclusion: we found that the subjects performed the test for more time on the dominant leg as compared to the non-dominant leg and observed that leg dominance had an effect on performance of square hop test. KEY WORDS: Functional Performance Test, Square hop test, Leg Dominance, Effect Size.

1436-1443

Authors: Karthikeyan Rajendran *, Ilayaraja Alagia Thiruvevenkadam, Arunkumar Nedunchezhiyan.

Objective: This study was design to determine the either the static stretching or Proprioceptive Neuromuscular Facilitation (PNF) stretching technique have the greater effect on improving hamstring muscle flexibility and maintaining the gain flexibility after a one time stretching on sedentary living college student’s population. Materials and Methods: After the university research ethical committee have given the approval for the study those who fulfilled the selection criteria were invited to participate in this experimental study. This study design was Quasi experimental study where the 2 groups (Group A: Static stretching, n=15 and Group B; PNF stretching, n=15) of sedentary living subjects underwent one-time stretching. This study was conducted at Asia Metropolitan University, Cheras, Selangor, Malaysia. Hamstring tightness was determined as knee extension deficit (KED) using the active knee extension test (AKET) for pre-test and post-test using universal goniometer. Inclusion criteria were active knee extension test (AKET) of 20 degree and above, right side hamstring tightness, both sex and age group between 18-25 years. They did not have any history of neurological abnormality, and previous injuries or disorders of the lower back or lower extremities. Results: Paired ‘t’ test of stretching group shows that there was a significant improvement in the hamstring flexibility after 1 time static stretching for right leg among sedentary lifestyle college students. Here, the t-value of 3 post-test measurement; t-value of 1st minute = -8.814 (p<0.05), t-value of 15th minute = -2.884 (p<0.05) and t-value of 30th minute = -2.609 (p<0.05). Paired ‘t’ test of stretching group shows that there was significant improvement in the hamstring flexibility after 1 time PNF stretching for right leg among sedentary lifestyle college students. The t-value of 3 post-test measurement; t-value of 1st minute = -10.252 (p<0.05), t-value of 15th minute = -7.939 (p<0.05) and t-value of 30th minute = -4.837 (p<0.05). Independent ‘t’ test was used to compare between groups the result shows there was no significant difference in hamstring muscle flexibility when compared between Static Stretching and PNF Stretching of 3 post-test measurements. The significant of ‘t’ value of 1st minute = 0.144 (p>0.05), 15th minute = 0.649 (p>0.05), and 30th minute = 0.319 (p>0.05) Conclusion: This study concluded that static and PNF stretching significantly effective in improving hamstring muscle range of motion when compared from pre-test with 1st minute post-test. However, the gained hamstring flexibility does not sustain longer on 15th minute and 30th minute measurement it gradually reduces when compared with post-test 1st minute. There was no significant effect between both the stretches by one-time stretching session. KEY WORDS: Static stretching, hold and relax, hamstring flexibility, active knee extension test, knee range of motion.

1451-1458

Authors: Vijay Kage 1, Nishita Y. Patel *2, Mangala P. Pai 2.

Background: Forward Neck Posture also called as Protracted neck, is one in which the head is positioned anteriorly and the normal anterior cervical convexity is increased with the apex of the lordotic cervical curve at a considerable distance from the LOG in comparison with optimal posture.Nowadays texting may play a significant role in forward neck posture. According to Wellness Centre “It is the repetition of forward head movements combined with poor ergonomic postures and/or trauma that causes the body to adapt to forward head posture. Purpose: To compare effects of deep flexor strengthening exercises and McKenzie neck exercises in subjects with forward neck posture. Materials and Methods: 30 Subjects clinically diagnosed with FNP meeting the inclusion criteria were randomly assigned into three groups. Group A received McKenzie neck exercises, Group B received Deep Neck Flexor Strengthening Exercises and both the groups commonly went for pectoralis minor stretching respectively for once daily for a total of 6 sessions. Results: The results suggested that all the outcome measure i.e Forward Neck Posture, flexibility of pectoralis minor and CROM values showed significant differences among both the groups. Conclusion: The present study concluded that the comparison of McKenzie neck Exercises and Deep Neck Flexor Strengthening Exercises revealed no statistically significant differences, However each group showed improvement in cervical range of motion and forward neck posture with increase in the pectoralis minor flexibility. KEY WORDS: Forward Neck Posture, Deep Neck Flexor Strengthening, McKenzie Neck Exercises.

1468-1475

Authors: Shivani Chowdhury Salian *1, Jyoti Singh 2.

Background: Electrotherapy like other area of physiotherapy is a rapidly advancing field. To keep abreast of changes, curricula need regular evaluation and updating. The curriculum consists of many components that may vary from content to time tabling. Methodology: The aim of the present study was to determine the perception of the graduate students for electrotherapy curriculum with regards to content, teaching method and clinical learning. This information will contribute to an overall evaluation of the present electrotherapy curriculum. A cross-sectional survey was conducted amongst graduates (BPT) passed out in the year 2013 until 2015. Validated Questionnaire was used to gather the information. The questionnaire was validated in the School of Physiotherapy, D.Y.Patil University, Nerul, Navi Mumbai. Data was collected and tabulated and statistical analysis was done using SPSS and Microsoft Excel software. Results: Results indicated that 52 % found that more information should be included on the machines like Laser, EMG, NCS and magnetic field. Almost every respondent felt that they would have like more information about electrotherapy and electro diagnosis related alternative technique e.g. Acupuncture TENS, Shock wave diathermy, EMG, NCS and Dry needling etc. 48% disagreed that the third and fourth year curriculum content was adequate for clinical practice. 50% disagreed that the third and fourth year curriculum content was relevant to clinical practice. Most of the respondents felt that Ultrasound, Hot packs, Cryotherapy, SWD, Paraffin Wax bath, TENS, IFT, Direct current, Iontophorosis, EMG, NCS were very important topics being taught in entry level training for beginning level practice. IR, UVR, Static magnets and Micro current were not important topics while biofeedback, laser therapy were somewhat important. Conclusions: It was evident from the survey that the BPT curriculum of Electrotherapy was relevant to current practice but inadequate in certain specific areas for example hands on practice of newer equipments, clinical practice in EMG, NCS, Laser and Micro current. KEY WORDS: Undergraduate Curriculum, Electrotherapy, Relevance.

1345-1351

Authors: M.Seshagirirao *1, Sudesh Thalathoti 2, Sumaiya Kauser Shaik 3.

Background and Purpose: The most common form of meniscal injury is mechanical failure of the tissue due to degeneration or trauma resulting in a tear. In a recent study by Shaji et al (2013) states that OKC and CKC are used often in clinical settings to treat patient’s lower extremity injuries. No study is there on effect of OKC and CKC on strength and stability of knee in meniscal instability. Materials and Methods: Thirty athletes were randomly selected into two groups of fifteen each based on inclusion and exclusion criteria and were given OKC exercises in one group, CKC exercises in another for one month. Pre-treatment and post-treatment values of hamstrings and quadriceps muscle strength and knee function score were measured and analysed statistically. Results: Results showed that P value is < 0.0001 for strength in hamstrings (OKC) extremely significant and P value is 0.0080 for quadriceps (OKC) very significant and P value is 0.0004 for stability in both groups is extremely significant. Conclusion: OKC and CKC exercises both were effective in improving knee strength and stability, but in OKC strength improvement is better than CKC and in CKC stability is better improved. KEYWORDS: OKC, CKC, Knee Strength, Lysholm knee scoring system, Meniscal instability.

1360-1364

Authors: Shah Ravi Jyotikant

Background: Neuromuscular Electrical Stimulation (NMES), splinting and Neurodevelopmental Therapy techniques are frequently used by the physiotherapist as an intervention for patients with stroke ( Cerebrovascular accident )with limited or impaired functional ability, ROM and pain. Hence the present study was done to compare the effectiveness between NMES and splinting, both administered along with NDT for improving hand function in hemiplegic patients. Materials and Methods: Out of 30 subjects who were diagnosed as having sub acute stroke and who showed a typical restriction of functional ability, ROM and pain of hand, 15 were administered NMES along with NDT for 4weeks and the other 15 were administered splinting along with NDT for 4weeks. Analysis was based on the improvement of the motor function of hand using ARAT Score. Results: The improvement in functional outcome showed a mean of 15.133 with t-value 18.824 in Group A ( NMES along with NDT ) and a mean of 18.0000 with t-value 31.632 in Group B ( splinting along with NDT ); comparison showed to be highly significant with p=0.007. The result indicates that both NMES and Splinting with NDT are effective in improving motor function of hand in patients with stroke, however, Splinting with NDT seems to be better compared to NMES with NDT. Conclusion: In conclusion the treatment programme consisting of Splinting with NDT may be more effective in improving motor and functional recovery of hemiplegics than NMES with NDT KEY WORDS: Hemiplegia, motor recovery, electrical stimulation.

1370-1377

Authors: Sam Thamburaj A1, Karthikeyan Rajendran *2, Rajeev Kuppalagan Rajendran 3.

Objective: The objective of this study was to find out whether there is any significant difference between the functional training program and standardized rehabilitation program in improving functional performance of anterior cruciate ligament reconstructed (ACLR) football players. Methods: A total of 30 subjects who met the selection criteria were divided into two groups respectively (15 per group). Subjects were randomly assigned in to two groups: a functional training group A (FTG, n = 15) and a control group B (CG, n = 15) at 3 months post- Anterior Cruciate Ligament Reconstruction (ACLR). The FTG participated twice per week in the functional training program (4hrs/week) including: a variety of intense, more aggressive and complex exercises designed to specifically increase neuromuscular control, muscle strength and power, proprioception, speed, and agility of the lower limbs, combined with an aerobic running training. The CG did not participate in any exercises performed by the FTG, following the standardized rehabilitation protocol, i.e., 3 sessions per week (6hrs/week) (consisting of running and strengthening, a few plyometric exercises with low intensity and slow progression, very few exercises of directional changing but no horizontal jump nor agility exercises. The two groups were assessed at 3rd and 6th month post-ACLR and the effects of training were measured using the following assessments: the functional performance done by standing long jump test and 3 hop test. Results: Paired t-test was used to compare the effect within the group and paired t-test of statistical analysis shows that the pre and post comparison for the standing long jump score (Group A: p=0.000, Group B: p=0.000) and three hop test score (Group A: p=0.000, Group B: p=0.000) shows significant difference (p<0.05). Independent ‘t’ test used to compare the difference between two groups. Result shows that there is statistical significant difference in the result in which the p-value is less than 0.05. This indicates that the functional training group have more effect on physical performance of subjects than the control group. Conclusion: The results of the study made us to conclude that functional training program was effective than the standardized rehabilitation program in improving functional performance of anterior cruciate ligament reconstructed (ACLR) of football players. KEY WORDS: ACL reconstruction, Knee Injury, Functional Training, Functional Performance.