EFFECT OF STRENGTH TRAINING, FUNCTIONAL TASK RELATED TRAINING AND COMBINED STRENGTH AND FUNCTIONAL TASK RELATED TRAINING ON UPPER EXTREMITY IN POST STROKE PATIENTS
Co- Author: Vivek Kulkarni
Background: Weakness presents serious compromise to movement function in hemiplegics. Despite the correlation between weakness and impaired function, a clear relationship between strength and function needs more exploration. This study evaluated compared to strength and functional training alone with combined strength and functional training in rehabilitation of upper extremity in stroke patients.
Methods: Forty-five patients with history of stroke of duration 3weeks-6months who could initiate shoulder flexion, abduction, elbow flexion and extension, wrist and finger movements were included in the study and randomized into three groups
Group-I – Strength-training
Group-II – Functional-task-related training
Group-III – Combined Strength and Functional-task-related training for the upper extremity
Patients with cognitive impairments, musculoskeletal complications and with the previous history of hemiplegia were
excluded.
Outcome Measures used: Fugl-Meyer, Chedoke-Arm and Hand-Inventory, Dynamometer and MMT Interventions were given 3days/week for 6weeks. Subjects were evaluated at 0, 3 and 6weeks.
Result: All the three groups showed improvements in Fugl-Meyer (p<0.005). Group, I showed improvements in Dynamometer and MMT (p<0.005), but less functional gain, whereas group II showed improvement in Chedoke (p<0.005), but without adequate strength gain. Group III showed improvements in MMT (p<0.005), Dynamometer (p<0.005) and Chedoke (p<0.005), suggesting increased strength with improved functional performance.
Conclusion: Combined strength and functional task related training improved both functional motor performance and strength and led to more effective rehabilitation.
https://www.ijphy.org/index.php/journal/article/download/301/290
INFLUENCE OF FEAR OF FALL ON SPATIAL AND TEMPORAL
PARAMETERS OF GAIT IN COMMUNITY-DWELLING ELDERLY
Co- Author: Riddhi Doshi
Background: Aging is a gradual deterioration of physiological function.It is a multidimensional process involving various systems of the body.Out of the various problems faced by the geriatric age group “falls” are one of the
major problems faced by the elderly.Fear of fall and associated avoidance of activity may lead to functional decline, restriction of social participation and hence affection of quality of life.This fear can also affect the gait pattern of an individual.Therefore the purpose of this study was to find out the influence of fear of fall on the spatial and temporal gait parameters in elderly.
Materials and Methods: 100 community dwelling elderly were made to walk 10 meters and their gait parameters
were noted.The participants were classified into fearful and fearless groups on the basis of the MFES, before the test.
Result: The statistical analysis of the study was done using the mann-whitney test and a significant difference was found between the gait parameters of the fearless and fearful group.
Conclusion: There is an influence of fear of fall on the gait parameters of elderly. Fearful participants were shown
to have a significantly slower gait speed,shorter stride length and step length,lesser cadence and increased stride width when compared to fearless participants.
Click to access 260caa1664948a2c73d052507901489d2708.pdf
AWARENESS OF PHYSIOTHERAPY AMONG GENERAL PRACTITIONERS: A PILOT STUDY
Co- Author: Sneha Battin
Background: Physiotherapy is a form of rehabilitation science which helps to make a difference in an individual’s ability to live an active and healthy lifestyle. For many physiotherapists working in India, the primary source of reference is a physician. An aware physician can timely refer patients for physiotherapy who can in turn plan an effective management without making the rehabilitation journey taxing. This article will serve us to know about the interest and acceptance of physiotherapy and also to determine the extent of awareness among general practitioners.
Methods: A sample size of 150 subjects were randomly chosen. The study was conducted in a questionnaire based interview format. All willing general practitioners from various streams along with super specialists were included, whereas interns and unwilling practitioners were excluded.
Subjects were briefed about the study, written consent was taken before hand, and a validated questionnaire was personally given to fill in the details. The response thus obtained, was taken up for further analysis.
Result: From the study, it was learned that there is awareness regarding physiotherapy among general practitioners. With regards to the different streams of physiotherapy, the Orthopedic (36%) and Neurological fields (24%) are the most popular, followed by Cardio respiratory (16%), Sports rehabilitation (14%) and only 6% aware of community-based rehabilitation.
Conclusion: The study revealed that there is full awareness of physiotherapy among general practitioners. Musculoskeletal Physiotherapy showed good awareness among the study subjects. This was followed by NeuroPhysiotherapy, Cardio respiratory and Sports Physiotherapy. However, community-based rehabilitation was least known. Also, physicians believe that prescribing exercises is the main intervention used by a therapist and there is less information regarding the recent advances in rehabilitation.
https://www.ijphy.org/index.php/journal/article/download/374/362
Impact of Caregiver Strain on the Quality of Life of
Stroke Patients
Co- Author: Kamilah Lokhandwala
Background: Stroke patients may remain physically or cognitively impaired. Caring for a family member takes time and can
be burdensome, resulting in feelings of depression and stress. Hence from study we try to find out if there is a correlation between
burden on the care taker and quality of life of the stroke patient.
Aim: To study the impact of caregiver strain on the Quality Of Life of
stroke patients.
Objectives: To assess the quality of life in stroke patients, strain on the caregiver of the stroke patient and find the
correlation of caregiver strain on the quality of life of stroke patients. Outcome Measures: Functional independence measure, Modified
caregiver strain index, SF 36. Methodology: SF-36 was performed on the stroke patient (FIM 18-90) and modified caregiver strain
index on the informal caregiver of the patient.
Results: There is mild correlation between care giver strain and the quality of lives of
stroke patients.
Conclusion: This study found a mild correlation between caregiver strain and quality of life of stroke patients. A shift
from patient-centered approach to a patient- and caregiver-centered approach will have better long-term outcomes.
Click to access efaddbd8088a4b6cc8b304c6264255c98820.pdf
Effect of Mulligan Bent Leg Raise Versus PNF
Agonist Contraction on Hamstrings Flexibility in
Healthy Females
Co- Author: Varsha Venkitaraman
Aim & Objective: To compare the effect of Mulligan Bent leg raise versus PNF Agonist contraction on hamstring extensibility in healthy adult females. Methodology: Interventional study was done on 30 healthy adult females, aged 20-30 yrs with an inclusion criteria of <75̊Active Knee Extension measurement. The measurement was taken pre and post intervention bilaterally. The subjects were divided in 2 groups, first group being given Mulligan bent leg raise and second group being given Agonist Contraction technique(Proprioceptive Neuromuscular Facilitation) The treatment was given for 6 days. Pre and post AKE readings intra-group and inter-group were analyzed statistically. Results & Conclusion: The study concludes that Mulligan Bent Leg Raise and PNF Agonist contraction interventions both significantly improve hamstrings flexibility confirmed by appropriate statistical tests, with a P value of < 0.0001. Also inter-group comparisons showed that Mulligan BLR technique had better efficacy than PNF Agonist contraction in improving hamstrings flexibility. Clinical Implication: Mulligan BLR and PNF Agonist contraction can be good adjuncts for improving hamstrings flexibility.
Click to access ART20176893.pdf
Effect of Core Training Using Stable V/S Unstable
Surface on Strength, Balance and Endurance in
Normal Individual
Co- Author: Manasi G. Srivastav
: Background: Core is the kinetic link that facilitates transfer of torques and angular momentum between lower and upper
extremities. Objective: To study the effect of core training on core strength, endurance and balance using stable v/s unstable surface.
Outcome measure: Biofeedback, SEBT. Methodology: 30 participants were divided in two groups for stable and unstable training, 4
weeks intervention was carried out. Result: statistically significant improvement of core strength, endurance and balance was seen on
stable and unstable surface training. Conclusion: Stable and unstable surface training both are effect in improving strength, endurance
and balance , unstable surface training was better.
Click to access ART2018164.pdf
Impact of knee osteoarthritis and its correlation with balance, fear of falls and quality of life – a pilot study
Co- Author: Priyanka Purohit
Impact of knee osteoarthritis and its correlation with balance, fear of falls and quality of life – a pilot study
Objective: To correlate balance, fear of falls and quality of life in individuals with knee Osteoarthritis and age – matched controls using CBMS, FES, SF-36.
Methods: Fifty participants in the age group of 40 – 60 years were divided into Group A with diagnosed participants with knee OA using Kellgren-Lawrence scale and American college of Rheumatology (ACR) guidelines and Group B with age matched controls. The balance, fear of falls and quality of life was assessed using CBMS (Community Balance and Mobility scale), FES (Falls Efficacy Scale) and SF-36 respectively.
Results: Balance was affected more in Group A (p value- 0.165). Group A participants depicted more fear of falls (p value- <0.0001).The quality of life was poorer in Group A participants rather than matched controls (P value- <0.0001). Significant correlation was found between balance and fear of falling (r value: -0.4191). The affection of mental domain could be related to poor balance scores (r value: 0.01049). The fear of falling could be related to poorer quality of life (r value: -0.1352).
Conclusion: Knee osteoarthritis causes significant changes in the patient’s balance which is directly related to fear of falling which in turn has a negative impact on quality of life.
Click to access 6324-A-018.pdf
Early Intervention as an Agent for Recovery of Function After Spinal Cord Injury- A Single Case Study
Co- Author: Ankita Bhanushali
This case study describes a task-specific training program for working and functional recovery in a young man with incomplete cervical spinal cord injury. The subject was 20 year old male with traumatic spinal cord injury after a fall from height. Prior to intervention, he was quadriplegic with severe motor and sensory impairment. Our goal was to recover the function. The subject underwent disectomy for anterolisthesis of C6 over C7. Acute spinal cord management was started followed by locomotor training, electrical stimulation, orthoses, specialised assistive devices. Outcome measures used were ASIA scale, walking index for SCI, SCIM, Fatigue severity scale, Beck depression scale, SCI-FAI. It was found that specific interventions were intentionally selected in the development of treatment program which helped in the functional recovery of the patient. After 3 and half months treatment, the subject was able to walk with the assistance of AFOs and walker, and was able to perform ADLs independently. The magnitude of his functional improvements could be attributed to early intervention and neuroplasticity.
Click to access 10.11648.j.ijnpt.20180402.12.pdf