International Journal of Physiotherapy and Research

1105-1110

Authors: R. Vinodh Rajkumar.

Introduction: Assessment of the jumping ability and prescription of jump tasks are integrated in the field of fitness training and physiotherapy rehabilitation. Different kinds of researches on jump analysis have been pursued to gain in-depth knowledge about the kinetics and kinematics of jump biomechanics, in particular, the standing long jump. Standing long jumps can be tested or performed in various ways with alterations in direction of jump (forward, sideward and backward) and leg participation (single leg, double leg). The objective of this article is to share the reports of three types of standing long jump tests conducted for fitness evaluation of clientele; Single Leg Forward Jump (SLFJ), Double Leg Side Jump (DLSJ) and Double Leg Forward Jump (DLFJ), and discuss the accidentally observed trigonometric relationships between these jumps. Methodology: The data of three types of standing long jump were collected from 10 subjects (males = 7, females = 3) who have been exercising at least 2 - 3 times per week since last six months and they also belonged to different countries like India, Australia, Spain and Israel. All the subjects were allowed to jump with shoes on and all the jumps were done on wooden flooring with a height scale (measuring 0 to 205 cm) kept horizontal to mark the point of take-off and landing. A minimum of three chances were given for each jump and strong verbal encouragement was given to extract the best jumps from the subjects because the best jumps were taken for statistical analyses. After gathering the jump performance data, efforts were made to establish possible unexplored links between these three types of standing long jumps. Results: A surprising trigonometric relationship between SLFJ, DLSJ and DLFJ was an unexpected finding and accordingly, a formula was devised on the basis of Pythagorean theorem; DLFJ = √ (mean DLSJ2 + mean SLFJ2). Pearson correlation coefficient test was done to understand the degree of relationship between this formula-projected DLFJ and actual DLFJ displayed by the subjects, through which it was found that r = 0.9987. Conclusion: The theorem for standing long jump introduced by this study using an inexpensive technique has been shown highly positively correlating with actual double leg standing long jumps. This theorem can be stated as ‘double leg forward standing long jump is equal to or almost equal to the square root of the sum of the squares of standing side jumps (mean of right and left side jumps) and single leg forward standing long jump (mean of right and left single leg forward jumps)’. This study will continue to explore the deeper interconnections of different types of single leg and double leg jumps to contribute further advanced insights to the field of biomechanics and exercise. KEY WORD: Theorem for standing long jump, Standing long jump, Side jump

1117-1121

Authors: Anand B Heggannavar *1, Swathi Kandada 2.

Relevance: Plantar fasciitis, the most common cause of heel pain, is due to repetitive strain injury to the medial arch and the heel, causing functional disabilities. Any biomechanical alteration in the lower extremity has its effect on plantar fascia. Kaltenborn mobilization techniques have been proved effective in improving the range of motion of the affected joints. There is a need to evaluate these techniques in plantar fasciitis by treating whole lower extremity. Participants: 20 subjects with the mean age (23.80±2.71) with primary heel pain are recruited in the study. Method: Subjects of randomized controlled trial were randomly allocated into two groups, Group A (n=10) received therapeutic ultrasound, stretching’s and exercises and Group B ( n=10 ) received therapeutic ultra sound, Kaltenborn mobilizations to the affected joints of lower extremity, stretching and exercises. The outcome measures are visual analogue scale ( VAS ), foot function index ( FFI ) and range of motion measured by Goniometer assessed on day 1 pre-treatment and day 12 post treatment. Analysis: It was done using Mann Whitney U test and Wilcoxon matched pairs test using SPSS software. Results: The intra-group mean differences in pre and post values for group-A are 1.80±2.39, 2.50±2.64, 3.40±1.84, and 19.75±8.16 for ankle dorsiflexion, plantarflexion, VAS and FFI respectively, and in group-B are 1.00±2.11, 10.50±8.32, 4.70±0.67and 28.07±8.26 for ankle dorsiflexion, plantarflexion, VAS and FFI respectively. The intra-group comparison had shown statistical significance with p<0.05 and whereas in between comparison group-B had shown better improvement than group-A. Conclusion: Kaltenborn mobilizations along with therapeutic ultrasound, stretches and exercises have shown better improvement compared to the control group. KEY WORDS: Kaltenborn mobilizations, plantar fasciitis, impairment-based.

1126-1132

Authors: R.Vinodh Rajkumar

Blood pressure measuring represents a routine investigation in general medicine. Nokolai Korotkoff was only 31 years old when he made a short presentation to the Scientific Meeting of the Military Hospital of the Academy on 5 November 1905 concerning an easy non-invasive method of blood pressure (BP) measurement, entitled ‘Concerning the problems of the methods of blood pressure measurement’. If the pressure in the cuff is relieved, blood starts coming through the compressed arterial segment during systole and causes auscultatory sound and, the first sound, which, in Korotkoff’s opinion, is a measurement of systolic blood pressure. In the same BP measurement, when normal blood flow is fully restored, the auscultatory sounds disappear and, the last sound, which, in Korotkoff's opinion is a measurement of diastolic blood pressure. Listening to Korotkoff sounds (K-sounds) to determine systolic and diastolic blood pressure (BP) has been the standard for noninvasive BP measurement in medical practices for nearly 100 years and it is the essential tool used for evaluation and assessment of patients with hypertension and risks of cardiovascular diseases (CVD) by physicians and nurses despite limited understanding of the nature of K-sounds. This article focuses particularly on the cardiovascular biomechanics of the first and last auscultatory sound and suggests two new terminologies; Highest systolic blood pressure and Baseline systolic blood pressure to represent the systolic pressure and diastolic pressure, respectively. Experimenting blood pressures on the basis of these two new suggested terminologies may reveal various additional undiscovered aspects of normal BP and abnormal BP. KEY WORDS: Highest systolic blood pressure, Baseline systolic blood pressure, Korotkoff sounds

1138-1141

Authors: Vishnu Priya 1, Rekha K *2.

Background: An intentional tremor is one of the most untreated causes in patients with cerebellar ataxia. Upper limb tremors decreases the performance of many activities of daily life Thus treatment of patients with tremor probably implies better functional ability. It is one of the major areas of concern to improve functional independence hence, this study proposed to know the effects of wrist weighing in reducing upper limb tremors in cerebellar injury patients. Materials and Methods: A total number of 21 patients with various abnormalities of cerebellum were selected depending on selection criteria. These patients were randomly divided into two groups. One group was treated with wrist weighing by using Velcro weight cuffs for 15 minutes along with conventional physiotherapy for 5 days a week for 2 months & other group is treated with conventional physiotherapy for 5 days in a week for 2 months. The objectives were tested by using tremor rating scale and nine hole peg test. The values are collected before and after the treatment Results: In the group treated with wrist weighing the improvement in the tremor rating scale is very significant (p: 0.0001) and in nine hole peg test is extremely significant (p: 0.0001). In conventional therapy group the improvement in the tremor rating scale is not significant (p: 0.0051) and in nine hole peg test is very significant (p: 0.0002). Conclusion: Incorporation of wrist weighing along with conventional therapy reduced the intensity of upper limb tremors in patients with cerebellar injuries but both the treatments are effective in improving upper limb functions. KEY WORDS: Intentional tremor, Rehabilitation, Wrist weighing

1150-1155

Authors: Camy A. Bhagat *1, Paras Bhura 2, Binti Patel 3, Jeemesha Patel 4.

Background: Osteoarthritis also known as degenerative joint disease it is a most common form of arthritis and a leading cause of disabilities word wide. Osteoarthritis results from cartilage destruction, progression deterioration of osteoarthritis causes the normally smooth, white, translucent articular cartilage to become dull, yellow, and granular. That exercise provision for patients with knee OA reduces the pain experienced and the functional incapacity suffered by a small to moderate degree. Objective: To compare the effectiveness of Impairment based exercises and resisted exercise on pain, functional task in individual with knee OA. Methods: 30 patients with knee osteoarthritis were randomized into three groups: group A (Impairment based exercise)(no of patients 10), group B (Resisted exercises)(no of patients 10), group c (control group) (no of patients 10) for 6 weeks exercise program. The outcome measures were VAS, WOMAC, LEFS. Result: The experimental group A showed significant more improvement in VAS, LEFS and WOMAC compared with group B and C after intervention. Conclusion: Impairment based exercises found to be more effective in improvement of function and reduction of pain in patients with knee OA. KEY WORDS: Impairment Based Exercise, Resisted Exercise, Osteoarthritis.

1163-1170

Authors: PatitapabanMohanty *1, Nishitha Meshram 2, Monalisa Pattnaik 3.

Background: The impairments in cerebral palsy can limit a child’s ability to play and exercise at intensities necessary to develop cardio respiratory fitness. Objective: To compare the effects of dynamic cycling, static cycling and conventional exercises in cardiovascular endurance, balance and walking ability in cerebral palsy children. Materials and Method: A total of 30 subjects were recruited in an experimental pre-post-test study design. Subjects were randomly assigned to 3 different treatment groups. The following outcome measures were measured: resting Heart Rate, 3 Minute Walk Test, GMFM-66, and Pediatric Balance Scale. All the three groups received conventional exercises. The experimental group 1 in addition received dynamic cycling protocol and experimental group 2 received static cycling protocol. The outcome was again evaluated at 6 weeks. Results: All the 3 groups showed significant pre to post improvement for the entire outcomes measured but GMFM-66. Results of the studied showed more significant improvement in both the cycling groups compared to the control group; Dynamic cycling group showing better response than static cycling group. Though all the groups showed improvement in GMFM-66, the dynamic cycling group showed better improvement followed by control group. Conclusion: Dynamic cycling incorporated with conventional exercises improves the cardiovascular endurance, balance and functional abilities than conventional exercises only. KEY WORDS: Cerebral Palsy, Dynamic Cycling, Static Cycling, Balance, Exercise, Walking, Endurance, Ability.

1175-1179

Authors: Madhuri Gaur*, Kunjal Parekh.

Background: The incidence of obesity is increasing in younger adults, with associated worsening of disability. Little is known about the impact of body mass index (BMI) on performance-based balance and mobility measures in younger adults. Objective: The purpose of this study was to examine the association of BMI with measures of balance and mobility. Methods: Young adults who participated in the study (N=50) were classified as normal weight, overweight, moderately obese, or severely obese. Mobility and balance were assessed by performance-based measures. Pearson correlation test was used to examine the association among BMI, mobility, and balance after controlling for potential confounding variables. Results: There is a significant correlation between mobility and BMI at 0.01 levels. There is also a significant correlation between balance and BMI, though there was no correlation found between standing with narrow base balance and BMI. Conclusions: Higher BMI levels are associated with poorer mobility and balance. Furthermore, individuals classified as being of normal weight and those classified as overweight were similar in mobility and balance, whereas individuals with obesity had greater impairments in mobility and balance. KEY WORDS: Balance, Mobility, Body Mass Index (BMI), Weight, Obesity, Impairment.

1184-1187

Authors: Pranali Suryavanshi 1, Ajay kumar 2, Parag Kulkarni 3, Prakash Patel *4.

This study was to examine correlation of ankle dorsiflexion range of motion with dynamic balance in young normal individuals. A cross sectional study has been done on 60 females by convenient sampling. The study was to examine dorsiflexion ROM by using star excursion balance test. It was performed in all directions for three trials. Distance was recorded with measure tape. Ankle ROM was performed by weight bearing lunge. Individuals who demonstrate impairments in dorsiflexion ROM may also demonstrate difficulty with portions of the SEBT. There is significant positive correlation in between dorsiflexion range of motion and star excursion balance test in anterior and postero lateral direction. KEY WORDS: Star Excursion Balance Test (SEBT), Dorsiflexion range of motion (DROM), WBLT, Dynamic balance.

1024-1031

Authors: Anwar Abdelgayed Ebid *1, Ahmed Mohamed Elsodany 2.

Background: Severe burn leads to marked and prolonged skeletal muscle catabolism and weakness. Objective: The aim of this study was to investigate the long term effect of severe burn injury on eccentric, concentric, isometric muscle torque, average power, lean body mass, six minute walk and 8-foot walk. Design: Eccentric, isometric and concentric muscle torque and average power were assessed at 24 months in burned adult with 40%-50% total body surface area (TBSA) at 150 o/s by using isokinetic dynamometry, Total lean body mass (TLBM) and lower limb mass (LLM) measurements were assessed for both groups using dual energy X-ray absorptiometry. Functional capacity was assessed using six minute walk test (6MWT) and 8-Feet walk test. Lean body mass (LBM) was determined via dual energy X-ray absorptiometry. Nonburned adult was assessed similarly, and served as controls. Results: severely burned adult (n=35), relative to nonburned adult (n=42) had significantly lower peak torque of eccentric, isometric, concentric muscle strength, average power and functional capacity. The most affected type of muscle strength after burn was concentric, isometric then eccentric. Conclusions: Our results serve as an objective data for assessing the three modes of muscle strength and functional capacity in severely burned adult population. KEY WORDS: Burned Adult, Muscle Strength Assessment, Functional Capacity.

1037-1041

Authors: Ashwini Chougala 1, Vidit Phanse *2, Erohit Khanna 3, Sudipta Panda 4.

Background: There is a relation between flatfoot and increased Body Mass Index (BMI). Increased weight leads to increase plantar pressure causing reduced distance between ground and arches of the foot. The purpose of the present study is to estimate the prevalence of flat feet in college going students, to determine the relationship between flat foot and Body Mass Index (BMI), and to compare prevalence of flat foot among college boys and girls. Materials and Method: Samples were taken according to willingness for participation; informed consent was given and signed from them. Height and weight of subjects were measured by using standard apparatus. Total numbers of males screened were 46 and females were 182. BMI was considered as the index of obesity .The international BMI cut–off values were used to determine obesity (BMI> 95th percentile), and foot structure assessment was performed with Denis Method. Significant relationship between obesity and flatfoot was observed. Result: A significant relationship (P≤0.01) was found between the prevalence of flatfoot and BMI. Also males were found to have higher prevalence of flatfoot than women in the age group of 18-25 years. Conclusion: The results of this study suggest that there is relationship between increased weight of person and structure of the foot. Males are more prone to flatfoot than females in the age group of 18-25 years. KEY WORDS: Flat foot, Body Mass Index, Obesity.

1048-1052

Authors: Verma Chhaya 1, Vijaya Krishnan *2.

Background: A job is a piece of work done as a part of the routine of one’s occupation for an agreed price. Every occupation is associated with one or more ill effects on the health of the worker. Musculoskeletal morbidity is the commonest cause for occupational health problems & accounts for large number of workers’ compensation days & disabilities. Aim: To conduct a survey on prevalence of musculoskeletal pain & dysfunction in class 4 female hospital employees Materials & Methodology: Settings & Design: Interview based randomized cross sectional survey. 80 female class 4 employees working at the Lokmanya Tilak municipal medical college & general hospital (LTMMC & LTMGH) participated in the study. Based on work pattern, a semi-structured questionnaire was prepared and validated. An informed consent was obtained before the interview. The data thus collected over a period of 3 months was analyzed to determine the prevalence & intensity of musculoskeletal dysfunction, pain & its influence on daily activity. Data was spread in Microsoft Excel 2010 & statistically analyzed using percentages. Results & Conclusion: This study shows that considerable musculoskeletal pain & dysfunction was observed among the women sweepers & aayabai. The back & the knee appear to be affected more than rest of the joints mainly attributed to the combined effect of occupational & psychological stress. KEYWORDS: Pain, Ergonomics, Class 4 employees, Psychosomatic stress, Tertiary hospitals.

1059-1064

Authors: Devangi S. Desai *1, Amruta S. Chauhan 2, Maharshi N. Trivedi 2 .

Background: Benign paroxysmal positional vertigo (BPPV) defined by Dix and Hallpike is one of the most common disorders causing vertigo. BPPV is more prevalent in adults and in women. BPPV mostly develops in the posterior semicircular canal. The main symptom of BPPV is vertigo induced by a change in head position with respect to gravity. The Dix-Hallpike test is the most commonly used test to confirm the diagnosis of posterior canal BPPV. Treatment options for posterior canal BPPV are Epley's maneuver, Liberatory maneuver and Brandt-Daroff exercises. In modified epley’s maneuver few modifications were done in original epley’s maneuver without affecting outcome. Objective: To assess effectiveness of modified epley’s maneuver as well as combination of modified epley’s maneuver with Brandt-Daroff exercise in patients with posterior canal BPPV and to compare both treatment protocols. Methodology: All patients were examined by Dix-Hallpike test (D-H Test) and those suffering from posterior canal BPPV and fulfilling inclusion criteria were taken up for the study. Total thirty five patients took part in this study on a voluntary basis after signing consent form. The patients were randomly assigned to two groups. In group 1, combination of modified epley’s maneuver and Brandt-Daroff exercise were given and in group 2 only modified epley’s maneuver was given. All patients were reexamined after 1 week of treatment and were asked to come for follow up after 1 month. In follow up visits response to Dix – Hallpike maneuver and Dizziness Handicap Inventory(DHI) were assessed as outcome measures. Result: Data collected through this study showed highly significant improvement in DHI score and response to D-H test when intragroup comparison is made in both the groups after 1 week and 1 month of treatment at 1% level of significance. When intergroup comparison is made we found better improvement in group 2 after 1 week and in group 1 after 1 month of treatment. Conclusion: The conclusion of the study is that both treatment approaches are effective in reducing symptoms and improving independence level but combined approaches can give better result. KEY WORDS: Canalith repositioning maneuver, vertigo, nystagmus, DHI, Dix-Hallpike test.

1068-1074

Authors: R. Vinodh Rajkumar

Introduction: Body composition and fitness testing for non-athlete population is being implemented only to those who take memberships in health clubs but still amidst various limitations like expertise and instrumentations, so the quality of fitness evaluation process remains substandard in many health clubs. At one point, for personal learning purpose and at the same time, to improve the quality of fitness evaluation and training services, data of somatotype variables were collected using Heath-Carter somatotype method to enhance the understanding of the somatotype, physical efficiency parameters and outcomes of exercise participation and life style modifications of personal clientele. Objectives: The objective of this research study was to subject the collected data of somatotype variables of about 77 non-athlete subjects (males = 44, females = 33) into statistical analyses, interpret the somatotype diversity among the thirteen established somatotypes, compare the findings with the somatotype data of Olympic athletes obtained from Encyclopedia of International Sports Studies, relate the anthropometric variables with BMI classification and stimulate further researches. Results: Out of 77 non-athlete subjects, it was found that approximately 87% were mesomorphic endomorph, 5% were ectomorphic endomorph, 7% were balanced endomorph, 1% was mesomorph endomorph and zero representation for other 9 somatotypes. This is chiefly because their endomorphy component was greater than the mesomorphy and ectomorphy components, regardless of BMI, as detected by Heath-Carter anthropometric somatotype method. Conclusion: Heath-Carter anthropometric somatotype testing should be considered indispensable in Physiotherapy curriculum and practice. Sustained applications of somatotype test in all clinical and fitness evaluations have the potential of enhancing public awareness about measuring health through periodical somatotype testing not just only by BMI and laboratory testing of physiologic parameters because very high endomorphy component and its health risks may be hidden inside various accepted non-obese body frames as well. KEY WORDS: Heath-Carter anthropometric somatotype, Body mass index, Endomorphy dominance.

1081-1085

Authors: Rathod Shivanand Shriram *1, Nagose Vaishali Baburao 2, Purna Singh A 3, Annepaka Eliya Raju 1, Ankur 1, Praveen K Kodumuri 1, Jhansi K 1.

Background and objective: Obesity itself is believed to be a morbid condition by many and it is also thought to be a cause of many health problems and chronic diseases like type 2 diabetes mellitus, coronary heart diseases. Regular physical exercise has got many health benefits including its effect on metabolism particularly on lipids. The objective of present study is to assess the effect of exercise training on lipid profile. Materials and Methods: We followed up 40 male students of Physical education aged between 18 to 25 years, for the period of nine months. Those with history of inborn errors of metabolism, those having endocrine disorders, those with diagnosed familial hyperlipidemia are excluded from our study. Their lipid profile parameters were measured in the beginning of exercise training period and then at the interval of every 3 months, with the first reading taken as baseline. Result: when we compared the readings with each other as well as with the baseline reading, we found that the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and very Low density lipoprotein cholesterol (VLDL-C) decreased significantly while high density lipoprotein cholesterol (HDL-C) increased as the duration of exercise training period progressed. Significant reduction was also observed in TC/HDL-C ratio as the duration of physical training progressed. Conclusion: Findings of our study suggest that, regular physical exercise has possible effect on improving lipid metabolism as lipid profile improved with increase in duration of exercise training period. Regular physical activity may be associated with decreased risk of chronic diseases like diabetes mellitus type 2, coronary heart disease. KEY WORDS: Exercise training, obesity, lipid profile, chronic diseases.

1091-1097

Authors: Santosh Metgud 1, Pranata Dalal 2, Pavan Joshi *3.

Introduction: Quadriceps is one of the strongest muscle of the body that is required for knee mobility. Quadriceps plays a crucial role in many daily activities such as walking, twisting, running, jumping, and controlling the movement of knee. Since it’s a two joint muscle, they tend to become very to tight leading to imbalance, which can give rise to a number of postural problems and common musculoskeletal disorder causing pain in the knee joint. It could be acute, subacute and chronic in its clinical presentation. Hence strengthening of quadriceps femoris is necessary. Materials and Methods: a total of 90 participants within age of 21 to 29 years and BMI 19.9 to 24.9 having no neurological, cardiopulmonary and musculoskeletal disease were selected. Results: of the total 90 subjects, the mean age of the participants in group A 21.67±0.88 the mean age of participants in group B was 22.23±1.33 and the mean age of participants in the group C was 22.03±1.27. The result showed high significance in the group B. Conclusion: the study showed increase in the quadriceps muscle strength in group B. KEY WORDS: Trainer, Elastic Band, Quadriceps femoris, Muscle strength, Musculoskeletal disorders.

919-927

Authors: Archana C. Mehta *1, Sonia Bhatia 2.

Objective: To evaluate the effects of short – term comprehensive pulmonary rehabilitation program in improving Exercise Capacity & Quality of Life in patients with severe COPD. To compare effectiveness of comprehensive pulmonary rehabilitation over education based program in patients with severe COPD. Method: 14 Subjects in group A with mean age 60.64±3.23 received comprehensive pulmonary rehabilitation with education based program and 15Subjects in group B with mean age 60.64±3.09 received education program for 5days per week for 4weeks. The outcome was measured in terms of 6MWT and CRQ. Result: Unpaired student t-test and paired t-test was used for statistical analysis. Statistically significant improvement in 6MWT and the quality of life measures found in group A than group B. Conclusion: Short-term Comprehensive pulmonary rehabilitation program will be more effective than education based program in patients with severe COPD

938-946

Authors: Hesham Galal Mahran *1, Ashraf Hassan Mohammed 2, Shimaa Nabil Aboelazm 3.

Background: Carpal tunnel syndrome is considered the most common compression neuropathy of the upper extremity. It may lead to work disability and functional impairment. Burns are associated with swelling and eschar which forms a tight band constricting the circulation distally. Purpose: To investigate the effect of shockwave therapy on the carpal tunnel syndrome post burn. Subjects: Thirty male and female patients selected with manifestation of carpal tunnel syndrome post burn evaluated by electromyography, patients were divided randomly into two equal groups (A & B); group (A) received shockwave therapy plus traditional physical therapy, while group (B) received only traditional physical therapy (heating and stretching); Shock wave therapy protocol was two sessions per week for 12 weeks. Traditional physiotherapy was applied for both groups, 20 min for session 3times per week for 12 weeks. Evaluation: Electro diagnostic evaluation was done before treatment, one and three months post treatment. Results: There were improvement and significant increase in motor and sensory conduction velocities in shockwave group compared to those in the control group (p<0.05), also there were improvement and significant decrease in motor and sensory latencies in shockwave group compared to those in control group (p<0.05). Conclusion: Extracorporeal shockwave therapy provided a non-invasive, satisfied treatment option for carpal tunnel syndrome post burn.

955-959

Authors: Rohit Subhedar *1, Pallavi Dave 2, Priyanka Mishra 3, Shailee Jain 4.

Objective: To investigate the effects of (BHP-Program) on geriatric patients with calf pain. Method: This research was designed by evaluating the progress report of Geriatric Physiotherapy patients at Multi-specialty Department of Physiotherapy- Bombay Hospital-Indore. The subjects were the patients receiving Physiotherapy at Multi specialty Physiotherapy Department - Bombay Hospital, Indore. VAS scale was used for the pain evaluation. Pain Scale parameters of 30 Patients of age group 60-65 years presenting with calf pain and treated at our Department were included in Data Collection and Data Analysis. Results: Statistical analysis showed highly significant (p<0.001, t = 6.81) reduction in pain among Treated group compared to control group with 5.13 ± 0.91 and 1.93 ± 1.57 mean pain score of control and treated group respectively. Conclusion: It has been concluded from the results that BHP Program is more effective and beneficial in reducing calf pain among geriatric population. BHP Program, which includes specialized exercises in form of Dr. Subhedar’s Dynamic Combined Quadriceps and calf Drills with ankle toe exercises, isometric and isotonic quadriceps & straight leg raise, proved to be an important protocol for geriatric patients presenting with calf pain.

966-970

Authors: Sivakumar.R *1, Meenakshisundaram. U 2, Shankar. V 3, Arun Maiya 4, Rajeswaran. R 5.

Introduction: The knowledge on effect of location of infarct and volume of infarct on motor and functional outcomes is ambiguous due to variations in methodology and outcome measures used. This narrative review is aimed to summaries the studies on infarct location and volume related to motor and functional outcome, for a better understanding of the conclusions and limitation of the studies. Methodology: Literature search was done with key words of location of infarcts, size of infarct, motor recovery and functional recovery with Boolean term AND. Studies using outcome measures of multiple domain was not considered for inclusion. Results: 13 studies were identified in an extensive search without a time limit. Studies were categorized under location and volume with motor and functional recovery as variables. Majority of studies were done in isolation to any two variables, location outnumbered volume. The relationship with location and motor outcome was inconclusive, though two studies concluded that cortical infarcts had better scores than sub cortical. Volume was moderately associated with motor and functional recovery. Majority of the studies concluded a relationship between location and functional outcome, however the results are variable. Conclusion: Only few studies have analyzed the impact of infarct in different location and results were inconclusive. Outcome measures were summative in nature, not reflecting recovery in upper and lower extremities in isolation. The amount of recovery is analysed with initial deficits. We suggest more studies are required in this area to provide clarity.

978-985

Authors: Kadrya H. Battecha 1, Elsadat Saad Soliman *2.

Background and Objectives: Pulsed electromagnetic field (PEMF) has been suggested as a treatment method for musculoskeletal system disorders. The present study was conducted to determine whether the addition of PEMF to traditional physiotherapy produces better clinical outcomes than traditional physiotherapy alone in the management of moderate knee osteoarthritis (OA). Design: A single-blinded, randomized controlled study Methods: Twenty subjects (5 men and 15 women) with unilateral moderate knee OA (Kellgren-Lawrence criteria grade 2). They were randomly allocated in 2 groups to receive: group (A) PEMF plus ultrasound plus exercises; or (B) ultrasound plus exercises. Both groups received the respective treatments 3 times per week for 4 weeks and underwent the same pretreatment and post treatment evaluation that included active knee range of motion (ROM) by universal goniometer, knee pain score by visual analogue scale (VAS) and knee functional performance by Western Ontario and McMaster Universities osteoarthritis index (WOMAC). Result: There was an improvement in both groups in active knee flexion ROM, reduced VAS score and improved WOMAC index , however, all outcomes were significantly better in group (A) (p <0.05). Moreover, the percentages of outcomes improvement were in favor of group (A). Conclusion: The addition of PEMF to traditional physiotherapy in managing Knee OA produced a greater improvement in pain relief, range of motion and resulted in better functional performance than did traditional physiotherapy alone. The improvement in current study should be limited to short term outcomes of PEMF.

992-998

Authors: Anand B. Heggannavar *1, Preeti R. Ramannavar 2, Satyam S. Bhodaji 3.

Relevance: Heel pain is one of the most common conditions leading to functional disabilities seen worldwide. There are different methods to manage heel pain, conservatively, and/or surgically. Physiotherapy treatment, as a part of conservative management, involves reduction of pain and improvement of functional ability by various approaches like exercise therapy, electrotherapy and manual therapy techniques. Various studies have shown that Diadynamic current and MENS along with conventional treatments give significant beneficial effects in pain reliving. Hence the present study was undertaken to compare and see the effect of Diadynamic current and MENS in heel pain. Participants: 30 subjects (mean age 25.73 ± 6.56) diagnosed with heel pain were recruited from Out-Patient Department of Physiotherapy of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Method: Subjects were randomly allocated into 2 groups namely Group A (n=15) who received Diadynamic current along with conventional treatment as Therapeutic ultrasound and strengthening and stretching exercises and Group B (n=15) who received MENS with conventional treatment same as in group A for 7 days. The outcome measures were Visual Analog Scale (VAS) for pain, Pain disability index (PDI) and foot disability index (FDI) for functional disability. Analysis: Within group and between group analyses after intervention was done to assess changes using paired t-test and unpaired t - test. Result: Mean difference of VAS scores for Group A was 6.9 ± 1.48 and for Group B was 4.3 ± 2.43. Mean difference of PDI scores for Group A was 274 ± 117 and for Group B was 171 ± 99.Mean difference of FDI scores for Group A was 0.36 ± 0.24 and for Group B was 0.15 ± 0.15. Intra group comparison was statistically significant with p= <0.001 for both the groups in terms of VAS, PDI and FDI respectively. Inter group comparison was statistically significant with p= 0.005, 0.031, 0.007 for VAS, PDI and FDI respectively. Conclusion: Diadynamic current is effective in reducing pain and secondarily improving the functional ability in subjects with heel pain.

1006-1011

Authors: Eruva Indira 1, Rajeswari.M *2

Background: Hand grip strength is an important quantitative measure in evaluation of hand which is also considered as a predictor of general health status. Influence of various anthropometric variables on Hand Grip Strength has been studied in adult population. Martin Vigorimeter is a simple instrument which is considered to be appropriate for measuring hand grip strength in the age group 3-5.5 years for which norms have been established in Caucasian population. This study aims to analyse the correlation of hand grip strength with anthropometric variables and to quantify grip strength in children of age 3-5.5 years using Martin Vigorimeter in Indian population. Methods and Methodology: 211 children from five schools were included in this cross sectional study after getting consent from the principal of the schools. The anthropometric variables height, weight, BMI, hand anthropometric variables were measured. Hand grip strength was measured using Martin Vigorimeter, three trials were measured and best of the three was taken as the standard grip strength on both right and left sides. Results: Pearson’s correlation was used to analyse the relation between hand grip strength and anthropometric variables which showed a positive correlation between BMI and hand grip strength and independent t-test was used to compare hand grip strength of Indian and Caucasian population which showed a significant decrease in hand grip strength in Indian population with a p value <0.05. Conclusion: The study concludes that anthropometric variables should be considered while quantifying hand grip strength. A significant decrease in hand grip strength in Indian population when compared to Caucasian population demands a need to evaluate the cultural sensitivity of such instruments prior to clinical usage and to interpret clinically.

839-844

Authors: Rashi Goel, Ganesh Balthilaya, Ravi Shankar Reddy

Lateral epicondylalgia is a degenerative musculoskeletal pain state characterised by pain over the lateral humeral epicondyle resulting in absenteeism from work and daily living activities. It is most prevalent in jobs requiring repetitive manual activities of the upper extremity. Literature describes different treatment options for lateral Epicondylalgia but there is no consensus about the most efficacious intervention strategy. Taping (athletic/kinesio) has been used successfully in various musculoskeletal conditions with successful results. To date, no study has investigated the effect of kinesio taping in lateral epicondylalgia. The purpose of the study was to investigate and compare the effects of kinesio taping and athletic taping on pain and muscle performance in patients with lateral epicondylalgia. 16 patients (9 males, 7 females) within age group of 18 – 50 years participated in the study. It was a cross over design. VAS, digital al goniometer and Jamar Dynamometer were used to quantify pain, pressure pain threshold and pain free grip strength. These were evaluated pre taping, immediately after taping and after 30 minutes of each taping application selected randomly for two consecutive days. Repeated measures ANOVA and percentage change were used to examine differences in outcome measures. Bonferroni correction was applied to correct for repeated testing. The results showed significant pain reduction and increase in grip strength after both the taping techniques but no statistically significant differences for any outcome measure between the two taping techniques (p>0.05). Also the immediate pain reduction was more after athletic taping (21%) than kinesio taping (10%) that corresponded to the immediate increase in pain free grip strength more after athletic taping (14.5%) than kinesio taping (9.7%). 30 minutes later both the outcome measures gave similar percentage changes . The present study concludes with the recommendation of both athletic taping as well as kinesio taping for gaining short term improvements in pain and muscle performance in patients with lateral epicondylalgia.

855-862

Authors: R.Vinodh Rajkumar

Physiotherapists must learn the biomechanics of lunge in detail to clearly understand its significance in human life and implement effective training measures to overcome the limiting factors of proper lunge of their clientele. To understand the biomechanical value of every movement, interesting experimental learning methods must be employed to kindle the Physiotherapists to actively take part in research activities from the under-graduate level onwards. Lungeometry is a novel, simple and inexpensive experimental investigation of lunge, applying basic geometrical methods taking near normal lower limb length dimensions and rationale approaches into consideration. Lungeometry can give a foundation to learn other forms of lunges like forward lunge, weighted lunges, lateral lunges. This model of learning biomechanics of movements using fundamental geometry techniques is expected to strongly connect with any futuristic Physiotherapy curricular structure.

868-874

Authors: R.Vinodh Rajkumar.

Humeral head spinning styles on glenoid fossa during various upper extremity movements are not fully explored. Multiple strengthening exercises and hands-on techniques have been evolved in treating shoulder joint dysfunctions to reestablish the axis of humeral spinning and kinetic maneuvers for normal shoulder joint functions. This innovative article elucidates the scopes of different types of perfect humeral head spinning to give new researching foundation for valid exercise innovations in the domain of shoulder strengthening and rehabilitation.

885-888

Authors: Gokarakonda Sree Vamsi, Antony Leo Aseer.P

Background: The most common approaches used in Total Knee Replacement surgery are Midvastus, subvastus, median parapetellar, lateral patellar and trivector approach. There is uncertainty as to the best surgical approach to the knee joint for knee replacement. Median parapetellar approach is the standard of practice, but off late quadriceps sparing approaches as like subvastus and midvastus are performed. Subvastus approach has its own limitation of less joint exposure. In our clinical setup, orthopaedic surgeons perform median parapetellar and midvastus approach. The present study has compared outcome of knee function between a standard median parapetellar arthrotomy and mid vastus arthrotomy for patients undergone primary total knee arthroplasty. The post op quadriceps function depend on the type of surgical approach Materials and methods: 30 subjects were recruited who had undergone Total knee arthroplasty with Median parapetellar and Midvastus approach at Sri Ramachandra medical hospital; received standard physiotherapy care. The pre-op and post quadriceps angle were measured and the quadriceps, hamstrings isometric muscle strength and 6 minute walk test of the patients were recorded at the time of discharge and after one month of follow-up, and the data were statistically analyzed. Results: Median parapetellar and Midvastus approach were significant within the groups; with respect to quadriceps angle (QA) (p<0.05), isometric strength of quadriceps (QS) (p<0.05) and 6 minute walk test (WT) (p<0.05). On comparing between the groups at one month follow-up isometric strength of hamstrings (HS) (p<0.01) and 6 minute walk test (p<0.01) were found to be significant. Discussion: Findings show that Mid-vastus approach provides better results in terms of quadriceps angle, isometric strength of quadriceps and 6 minute walk test compared to median parapetellar approach. Conclusion: Study concludes that, the isometric strength of quadriceps and hamstrings has improved at the time of discharge and after one month of follow up (within the group). However no much significant changes seen between the groups.

894-904

Authors: Jayanta Nath

Background and Objectives: The study was carried out to find out the effect of hip abductor strengthening among non-professional cyclists with iliotibial band friction syndrome. Subjects: 40 non-professional cyclists with ipsilateral ITBFS subject including male and female age between 18 to 50 with positive ober’s and nobble test were included in this study. Methods: 40 subject were selected according to the inclusion criteria and they were assessed pre and post for ROM (hip adduction, IR), hip abductor strength and pain using goniometer,sphygmomanometer and VAS. Subject were assign experimental group(group A 20 subject) who received IT band stretching,US,and hip abductor strengthening exercise and control group (group B 20 subject) who received same treatment except hip abductor strengthening. Data Analysis and Results: Based on statistical analysis using Wilcoxon test to compare the pre and post test pain in both group,Mann- whitney U- test to compare the post test pain scores of between groups ,Paired t - test to compare the pre and post ROM and strength in both groups, Unpaired t – test to compare post test ROM in between groups showed that pre post difference within group A there was significant difference for adduction ROM (p value <.0001),IR (p value <.0001),VAS(p value <.0001),and strength improve pre mean 40.80 to post mean 66.30 (p value <.0001).However in group B adduction ROM and VAS were found to be significant. In comparision in difference between groups it was found that adduction ROM,IR ROM,VAS and strength all were significant. Baseline data for outcome variable were not statistically significant. Conclusion: Based on outcome variable there was significant difference of hip abductor strengthening among non-professional cyclist with iliotibial band friction syndrome.

751-756

Authors: K. Pujitha *1, G. Parvathi 2, K. Muni Sekhar 3.

Introduction: The change in arterial blood pressure and heart rate is one of the generally known physiological changes in aging of man. The present study was intended to evaluate BP and HR changes with age. Aim The objective of the study is to know the prevalence of orthostatic hypotension in healthy geriatric subjects. Materials and Methods: The subjects selected are 120 in number with age group 35 to >65 years of both sex and they are categorized into 4 groups based on their age. Group- I: The age of 35-45 years; Group-II: The age of 45-55 years; Group-III: The age of 55-65 Years; Group-IV: The age of >65 years. Blood Pressure is recorded by using manual sphygmomanometer and orthostatic test was conducted in all the subjects. Heart Rate was calculated by using R-R interval by ECG machine. Results: The examination of parameters, body mass index, Heart Rate, systolic and diastolic Blood Pressure during resting, immediate standing, after three minutes of standing i.e., postural variations were estimated for all subjects. The data was analyzed by using descriptive and inferential statistics. Discussion: The findings suggested that the mean SBP and DBP are higher in Group IV compared to Group I which is statistically highly significant. After immediate standing in all the subjects the SBP is decreased and DBP is increased and this variation is variable in different groups. The Heart Rate in all four Groups increases. And this variation is also variable in different groups. Conclusion: This study concluded that BP increases with increase in age due to stiffening of Blood vessels but the postural decrease in SBP in standing from lying down posture was more in elderly. Orthostatic Hypotension was found in only one elderly. So Orthostatic Hypotension was less prevalent in healthy elderly. KEYWORDS: Blood Pressure, Heart Rate, Body mass index, Orthostatic Hypotension.

762-765

Authors: Ravi B. Solanki *1, Anjali R. Bhise 2.

Arthrofibrosis following total knee arthroplasty is an uncommon complication defined as less than 80 degrees of knee flexion 6-8 weeks post operatively. It is characterized by abnormal scarring of the joint in which the formation of dense fibrous tissue and tissue metaplasia prevent normal range of motion. Clinical features include limited knee Range of motion with extension deficit, pain with activities of daily living and unusual amount of pain and swelling post operatively in the absence of infection, bleeding or mechanical complications. We present case of 55 years old female who undergone for total knee replacement before 3 months and presented to our department with complain of knee pain and swelling with activities of daily living. She was diagnosed on the basis of clinical examination. Her detailed evaluation was carried out and Physiotherapy treatment was started. KEYWORDS: Arthrofibrosis, Total knee arthroplasty, Metaplasia, Range of motion, Physical therapy treatment.

772-776

Authors: R.Vinodh Rajkumar.

For easy and clear understanding of biomechanics, the inter-relationships of simple machines and musculoskeletal functions have always been attempted and established. The masticatory biomechanics is still under research because there is wide range of findings on masticatory muscles including the lack of complete clarity on their line of actions and lever arms too. As a prospective contribution to advanced research on mastication and management of Temporomandibular joint, there are two innovative concepts discussed in this article; (1) Strong correlation between stapling mechanics and Temporomandibular joint biomechanics at molar region (2) Scope for a new unidentified lever system named as fourth class lever. The principal intent of this article is to share these two innovative concepts to be explored further for practical applications in the field of Physical therapy, Dentistry and Engineering. KEYWORDES: Stapling mechanics, Mastication at molar region, unidentified lever system.

781-786

Authors: Jeba Chitra 1, Siddharth Mishra *2.

Introduction: Stroke related hemiparesis also exhibit asymmetry in standing posture and walking. Chronic stroke survivors represent with asymmetric gait pattern due to altered weight distribution. Altered weight distribution of lower limbs that is less weight is taken on affected side, fewer excursions on the weaker side, is seen during static and dynamic balance as well as external perturbation. Objective: To evaluate the effect of Compelled Body Weight Shift Therapy on weight bearing symmetry and balance in post stroke patients. Methods: Total 22 participants were included in the study. All patients received 10mm shoe insole which is to be used on their unaffected side and along with this conventional rehabilitation program were given for 1 hour per day for 2 weeks. Results: There was significant difference in pre-post weight bearing distribution (p<0.001) and balance (p<0.001). There was also significant difference in all the component of Berg Balance Scale (p<0.001). Conclusion: Compelled Body Weight Shift Therapy can be easily administrated in the daily rehabilitation protocol, while treating stroke patients with balance problems due to asymmetrical weight bearing. With more symmetrical weight bearing, balance can be improved for better ambulation and reduced risk of falls. KEYWORDS: Compelled Body Weight Shift Therapy; stroke, weight bearing symmetry, balance, Berg Balance Scale.

793-798

Authors: Sandipkumar Parekh *1, Keyur Patel 2, Jyoti Chauhan 3.

Background: The ability to jump plays an effective and important role in volleyball, Because jump skills are greatly complicated that it is nearly the outcome of vertical force and horizontal speed besides harmony and synchronization of the work of arms and feet. There is also total harmony related to the skill and plan achievement during attack and block. The purpose of this study was to examine the Effect of Plyometric VS. Pilates Exercises on the Muscular Ability and Components of Jumping in Volleyball Players. Study Design: Experimental design. Methods: 30 subjects were selected randomly from the population using simple random sampling procedure and were divided into two equal groups. Group A was given plyomeric training and Group B was given Pilate training. Outcome measures were taken before and after the Program Schedule of 3 Sessions alternately in 1 week for 6week. Outcome measures: Vertical Jump height, Block jump, and the attack jump, Agility T test, Results: In Group-A (plyometric ) and Group-B (Pilate), all data was expressed as mean ± , SD and was statistically analyzed using paired ‘t’ test and independent ‘t’ test to determine the statistical difference among the parameters at 0.5% level of significance. Statistical data of agility t test, vertical jump height, the Block jump, and the attack jump in volley ball players showed that, there was no significantly difference between groups. And both were effective with p<0.05; i.e 95% of significance. Conclusion: In this study, we concluded that both groups (A & B) were effective in agility t test, improving vertical jump height, the Block jump, and the attack jump in volley ball players. But we recommend use of plyomertic training in volleyball players. KEYWORDS: Volleyball players, Plyometric training, Pilate training.

806-814

Authors: Mukesh Goyal *1, Salil Jandyal 2.

The present review study is carried out in order to study various practices in physiotherapy across different places. Physiotherapy is the health care profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential through examination, evaluation, diagnosis and physical intervention. Physical therapy is a professional career which has many specialties including sports, neurology, woundcare, cardiopulmonary, geriatrics, orthopedic and pediatrics. The study concluded different practices in physiotherapy treatment across various places. Some authors mentioned very clearly the under utilization of physiotherapists in providing rehabilitation services and were of the strong opinion that the physiotherapists should be actively involved as they could play an important role in the implementation of a cost-effective rehabilitation service paradigm. One author examined the origin of physiotherapy and particularly its relation with the nursing. Some authors studied the trends and the desirability of specialization in physiotherapy practice, opportunities for individual practitioners to gain recognition as specialists, and the Scope for achieving greater harmonization of specialist practice and recognition across the EU. Few authors were of the view that as a profession integral to health promotion, prevention, acute care and rehabilitation, physiotherapy plays an essential role in the health care system. Some researchers pointed out the lack of evidence of use of tilt tables by physiotherapists in Intensive Care Units (ICUs) in Australian Hospitals. A group of researchers also threw a light on the practice and research of complementary and alternative medicine (CAM) in Canada and few discussed how physiotherapists might respond to the challenges of health care reform which took place in New Zealand some eight to ten years back. A group of authors brought to the limelight a very important observation which stated that the Physiotherapists are known to be prone to Work- related musculoskeletal disorders (WRMDs) but its prevalence among physiotherapists in Nigeria has not been reported. KEYWORDS: Physiotherapy & Practices, Musculoskeletal, Alternative Medicine, Health Promotion, Complementary Medicine.

824-830

Authors: Rohit Subhedar *, Vaibhavi Subhedar, Pallavi Dave, Priyanka Mishra, Ankit Kaur.

Enormous use of sophisticated technology in daily living has resulted in lifestyle disorders in form of obesity, hypertension, cardiac disorders and musculoskeletal problems in a community as a whole. This significant rise in physically unfit community prompted us to find a most cost-effective, simple, and reliable mode of physical fitness evaluation in form of Bioelectrical Impedance technology. An observational randomized experimental study was conducted at Multispecialty Department of Physiotherapy, Bombay Hospital-Indore-India. Tanita BC-418 working on the principle of Bioelectrical Impedance Technology was used for Body composition Analysis of 100 male and females with age group 40-50 years. Conclusion: BIA has proved to be an advanced diagnostic technology for evaluating human body fitness in today’s fast and rapidly advancing life style. The Body Composition Parameters important in evaluating physical fitness such as Body fat%, Fat Free Mass, Total Body Water%, BMR, segmental fat distribution can be easily assessed with this technique. Multi-frequency segmental Bioelectrical Impedance analysis identifies the Differences in segmental body fat% distribution and these differences signify the presence of regional pain, having musculoskeletal origin. KEYWORDS: Bioelectrical Impedance Technology, Human Body Composition parameters, Body Fat (BF) %, Fat Free Mass (FFM), Total Body Water (TBW) %, BMI, Basal Metabolic rate (BMR) and segmental Fat % Distribution.