Physiotherapy

Due to multiparity, woman face abdominal weakness due to consecutive increase of size of uterus and hormonal
changes and this can be measured using peak expiratory flow rate (PEFR). That force of expiration is less in
multipara women than uniparous or nulliparous women since abdominal muscle are responsible for it. To evaluate
the presence of abdominal muscle weakness in multipara woman by measuring peak expiratory flow rate. 100
participants were selected who were multipara women from 18-45 years of age and with postpartum period of at
least one year women who were known case of hernia, stress incontinence, musculoskeletal disorder of spine,
respiratory disorder or facial palsy. Material-Airflow® Peak flow meter, Peak flow meter measurement and Manual
Muscle testing of abdominal muscle were done and then the results were co related. By the acquired statistics it was
concluded that there is no co-relation between the measurement of PEFR and prediction of abdominal weakness
in multipara women. In future PEFR can be used as a test to detect abdominal weakness and further preventive
measures can be taken.

Background: Dynamic Neuromuscular stabilization is an evolving concept in the field of rehabilitation. It works on the entire stabilizing system of the spine along with optimal activation of the diaphragm enabling the appropriate movement of the extremities. This review article is designed to give an insight on Dynamic Neuromuscular Stabilization technique and its clinical application. Methods: A range of databases including Google Scholar, Pubmed and Medline were searched to identify articles on core stabilization, integrated spinal stabilization system, Vojta's reflex locomotion, dynamic neuromuscular stabilization. Results: According to the searched literature Dynamic neuromuscular stabilization is an evolving concept given by PavelKolar. It is based on the principles of developmental kinesiology focus on correct breathing pattern and stabilizing role of the diaphragm and correct activation of the integrated spinal stabilization system before any movement at the extremities. Now, it has been used successfully in clinical practice for the rehabilitation of a wide variety of neurological and musculoskeletal conditions. Conclusion: Dynamic neuromuscular stabilization is a technique which focuses on activation of the intrinsic stabilizers of the spine along with correct breathing pattern before any purposeful functional movement. It is used for the rehabilitation of various musculoskeletal, neurological, pediatric as well as sports injury cases.

Background: Frozen shoulder is defined as an idiopathic condition of the shoulder characterized by the spontaneous onset of pain in the shoulder with restriction of movement in every direction. Several studies have proved the effect of various electrotherapeutic modalities on adhesive capsulitis. Studies have also been done on effects of different manual techniques, but there are very few studies done on effect of muscle energy technique in adhesive capsulitis. Aims and Objectives: To study the effect of Muscle Energy Technique on pain in adhesive capsulitis and to study the effect of Muscle Energy Technique on function in adhesive capsulitis. Methodology: Ethical committee approval was taken prior to the study. Patients who were diagnosed with adhesive capsulitis and fulfilling inclusion and exclusion criteria were selected for the study after obtaining informed written consent. The patients were divided randomly in control group and interventional group. In control group patients received only conventional physiotherapy in the form of hot packs for 10 minutes, Codman"s exercise, finger ladder exercises, wand exercises, active exercises and capsular stretching. In interventional group patients were treated with MET for shoulder flexion, abduction and external rotation along with conventional treatment. The protocol for MET includes 5 repetitions/set, 3 sets/session, 1 session/day for 15 days. Treatment was given once a day for 15 days except Sunday to both groups. VAS score, shoulder ROM and shoulder pain and disability index was taken before and after the treatment in both groups. Results: Non-parametric tests were used to analyze the data. Within the Group data was analyzed with Wilcoxon Signed Ranks Test. Between the Group data was analyzed with Mann Whitney U Test. Result was found to be significant, p value <0.001 for within group and between group VAS and ROM. Between group analysis revealed that percentage of improvement in pain and ROM in group B was greater than group A. Within group and between group analysis of SPADI revealed that it is not statistically significant, although it is significant clinically. Conclusion: Conventional physiotherapy and MET along with conventional physiotherapy, both are individually effective in relieving pain, improving range of motion and functional ability in patients with adhesive capsulitis, but among these two, the group which received MET along with conventional physiotherapy is found to be more effective in relieving pain, improving range of motion and functional ability in patients with adhesive capsulitis.

Background of the study: Walking aids are sometimes prescribed after stroke with the aim of improving safety and walking ability. The prescription of single point cane could be more helpful to post stroke people who already have some ability to ambulate around their community. Objective: To find the effect of single point cane on walking adaptability and willingness to use the same in community dwelling post stroke patients. Design: Repeated measure design Setting: Department of Neurology and Stroke rehabilitation centre, PSG Hospitals, Coimbatore. Participants: 52 post stroke patients. Experimental conditions: Walking with and without cane Main outcome measures: Time taken to complete 6 meter walk test and TUG test with and without cane and the willingness of patients to use cane is considered. Results: Wilcoxon signed rank test "z" value for all participants in TUG test with and without cane is 2.36 (p<0.05) therefore, there is significant difference in TUG test with and without cane. For slow walkers calculated paired "t" test value for TUG test with and without cane is 0.239 (p>0.05) therefore, there is no significant difference in TUG test with and without canes. For intermediate and fast walkers calculated paired "t" test value and Wilcoxon test "z" for TUG test with and without cane is 2.24 and 2.93 respectively (p<0.05) therefore, there is a significant difference in TUG test with and without cane. Among 52 participants 63.46% were not willing to use cane for their day to day activities and 36.54% were willing to use cane for their day to day activities. Conclusion: In conclusion this study found that the provisions of cane have both positive and negative impact on functional mobility in independent community ambulatory post stroke patients. For slow walkers the provision of cane resulted in more benefit by decrease in time taken for completion of task therefore, cane may be recommended for their functional activities For intermediate and fast walkers the provision of cane resulted in increase in time taken for completion of task therefore, cane may not be recommended for their functional activities. Even though using cane can have impact on walking adaptability, willingness of the patients to use cane should be considered.

Background: Calf muscle is important in the typical gait cycle, jumping, running, and maintaining balance. Tightness limits movement, which can result in injuries or a reduction in task efficiency. Calf muscles flexibility is therefore crucial. No normative range is available for calf muscle flexibility in its functional position. As a result, the goal of this study is to provide normative data using weight bearing lunge test that evaluates tightness in functional position. Results of males and females were compared. Methods: A cross-sectional pilot study was conducted on 215 people aged 20 to 30 years (males=100, females=115). Each participant completed a weight-bearing lunge test after giving consent. For each limb, three trials were given, with the best of the three findings used to analyze the data. Using descriptive analysis, a normative range was produced for both limbs of each gender. The Mann-Whitney test was used to compare the normative ranges. Results: Females' normative ranges are 12.1-13.4 cm and 12.7-13.9 cm with a mean and standard deviation of 12.7 ± 3.3 and 13.3 ± 3.4 for the right and left limb respectively. Males' typical ranges are 13.6cm to14.9 cm and 13.9cm to 14.9 cm with a mean and standard deviation of 14.2 ± 3 and 14.4 ± 2.7 for right and left limb respectively. Male and female normative ranges were found to differ significantly: right (p=0.0068) and left (p=0.0331). Conclusion: Our findings give normative data for calf muscle flexibility in both genders, as well as a comparison of these findings.

Introduction: Currently no any standard medical, surgical, or therapy regimen is universally accepted as the most efficacious treatment for restoring motion in patients with shoulder adhesive capsulitis. Present study was planned to check the short term effectiveness of anterior and posterior Kaltenborne joint mobilization techniques for improving shoulder external rotation range of motion in patients with shoulder adhesive capsulitis. Methodology: Total of 40 patients diagnosed with shoulder adhesive capsulitis were recruited and randomly allocated into two groups. In Group A (n= 20) subjects were treated with Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn anterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff using theratubes, whereas subjects in Group B (n= 20) received Therapeutic ultrasound (8mins,2w/cm2 ,3Mhz),Kalternborn posterior mobilization techniques ,Stretching exercises and strengthening exercises for roatator cuff ...

Purpose: Evidences show that childhood obesity is significantly associated with presence of many musculoskeletal, neurological and cardiovascular risk factors in childhood. Most common issue caused by functional problems related to childhood obesity is physical imbalance causing fall. Repeated falls lead to physical injury which may result into painful movements of injured joints, inadequate strength to perform activities or altered biomechanics of the injured joints which minimizes participation in social and sports activities. This has a negative impact on quality of life of that respective obese child. Thus, the present study is done to survey the balance among obese children between age group of 8 to 12 years and to form baseline for estimation of frequency of fall among them. Aim and objective: The aim and objective of the study is to survey balance among healthy school going obese children and find out which component is most commonly affected in pediatric balance scale. Method: Cross sectional study. Result: Results indicate that average mean of PBS score of healthy obese children is 19.71 with mode of 17 with median of 20. Conclusion: This study concludes that PBS scores of healthy obese children remain on lower side in most cases. Item analysis showed that domain including standing on one foot is severely affected followed by domain including alternate foot on stool.

Background: Posture and balance play a important role in the overall health of the body. Dynamic posture could depends on leg strength muscle, core strength muscle, proprioceptive abilities, age, sex, body height, body mass etc and ofcourse, dorsiflexion range of motion (DROM) as a measure of flexibility of the ankle joint is one of them.
Objective: The purpose of the study was to examine the correlation of ankle dorsiflexion range of motion and dynamic balance in young males and females.
Methodology: 60 healthy young adults (both male and females) fulfilling the inclusion criteria were selected randomly. Ankle dorsiflexion and dynamic balance were assessed by performance based measures. The Pearson’s correlation test was used to examine the correlation of Ankle dorsiflexion Range of motion with dynamic balance.
Results: There is significant correlation of Ankle dorsiflexion range of motion and dynamic balance in young males in medial direction (+0.25,+0.38) and females in anterior and posterolateral direction(+0.05,+0.15 and +0.12,+0.24). But there is weak correlation in Anterolateral(L), Lateral(L), Posterior(L), Medial (L) and Anteromedial(L) in Females and in lateral(L), posterolateral(L), posterior(L), Anteromedial(L) in males.
Conclusion: It can be concluded from the study that Ankle dorsiflexion range of motion is associated with dynamic balance in young adults.

Background: The world health organization estimates that approximately 15% of the world's population has a few forms of disability. Rehabilitation has a key role in reducing the level of disability. Application of robotics devices in rehabilitation help to achieve this goal. Robot-mediated neurorehabilitation is a growing and advanced field for treating neurological disease. The effectiveness of robotics therapy is ambiguous. Robotics therapy is a novice treatment in the physiotherapy profession and not that much-studied are executed in the field of robotics. Aims and Objective: To determine the attitude towards the role of robotics in neurorehabilitation among physiotherapists of Ahmedabad. Methodology: A cross-sectional observational study was conducted in 128 physiotherapists of Ahmedabad and snowball sampling was used. An online survey becomes executed with a self-reliant questionnaire. The questionnaire contains questions associated with perspectives about the role of robotics in neurorehabilitation. The statistical evaluation became accomplished with Microsoft Excel 2019. Result: Our finding suggests that from the 128 subjects, 95(74%) were agreed robotics play important role in neurorehabilitation, 22(17%) were Neutral, and 11(9%) disagreed. Conclusion: We found that most of the physiotherapists think robotics devices play important role in neurorehabilitation. 17% of physiotherapists are not sure and the rest of the physiotherapists think robotics devices do not play important role in neurorehabilitation.

This article presents a critical review of the literature concerning the use of the lower limb strength training in improving the mobility of children and adolescents with cerebral palsy (CP). We also focus on the effectiveness and safety of the training. Medical databases were searched using keywords sequence: cerebral palsy, strength training, progressive strength training or resistance training. The 41 identified publications had been selected for the analysis; 19 of the studies met our inclusion criteria. Accepted studies were divided on randomized and non-randomized controlled trials. Level of evidence was rated. The results were presented according to the International Classification of Functioning, Disability and Health at three levels: structure, activity and participation. The strength training in children and adolescents with CP results in an increased muscle strength in the the lower limbs and improves patient’s activity and participation without adverse effects such as t...

Physiotherapy interventions have been evidenced to assist early liberation from ICU in COVID-19 patients. This case series of three COVID patients admitted to the COVID ICU, explains the physiologic rationale of physiotherapy intervention in acute care of COVID patients. Early mobilization is seen to help early recovery. KEY WORDS: Physiologic rationale, COVID, physiotherapy, crocodile breathing.

Background: Cardio respiratory fitness in childhood is an important predictor of morbidity and mortality in adulthood. Overweight and Obesity are the major health concerns that the adolescents are facing globally. Obesity is the root cause for various cardiovascular, metabolic and musculoskeletal disorders that are life threatening ailments. There are no studies that have documented the cardio respiratory fitness in adolescent girls of Hyderabad. The objective of this study is to know the Cardio respiratory endurance (VO2max) among normal, overweight and obese adolescent girls of Hyderabad. To find the changes in VO2max with increase in body fat mass. Materials & Methodology: This is a cross sectional study involving 60 girls with an age group of 14-16 years and were categorized into 3 groups (n=20) based on their BMI and WHR. All three groups were assessed for Cardio respiratory fitness using 20m shuttle run test. Results: The data was analyzed using ANOVA and (P< 0.05) in all the 3 groups. This suggests the significant difference of VO2max in all the 3 groups. Conclusion: VO2 max was higher in normal group which suggests a good cardio vascular profile. VO2 max in overweight was better than obese group and less than in control group. VO2 max was poor in obese group indicating that increase in fat mass has a negative relationship with cardio respiratory fitness and the low VO2max is associated with many cardiovascular risk factors in later life.

Introduction: Since lectins are widely found in Leguminosae family due to their high protein content, in the present study, an attempt has been made to identify such legume lectins which have the agglutination properties with the red blood cells from normal individuals. Methods: Normal blood samples were collected, using the finger-prick technique. All blood samples were washed thrice in physiological saline and re-suspended at a concentration of 2% in normal saline. For ABO typing, standard serological procedure were followed. Results: In the results, various lectins showed the hemagglutination reaction pattern with human ABO blood groups. The lectin reacted with various blood groups with the strength of 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, and 1:128. Conclusion: The research findings were considered as the first step towards the field of sports nutrition. The lectin seeds are collected from the daily routine of the sports person, without knowing the effect of seeds on the body. Properly denaturized seeds should be consumed.

Background: A child's risk of dying is highest in the first 28 days of life (the neonatal period). The central function of Chest physiotherapy in ventilated neonates is to assist in the removal of tracheobronchial secretions, remove airway obstruction, reduce airway resistance, enhance gas exchange, and reduce the work of breathing. Positioning is used with the aim to improve of ventilation/perfusion (V/Q) matching, lung volumes and mucociliary clearance and to reduce the work of breathing (WOB). Objective: To find out effectiveness of Chest Physiotherapy in prone Position on Respiratory Functions in Ventilated Neonates. Method: 6 ventilated Neonates (n=6) between day 1-day 28 fitting the inclusion criteria were selected. They received chest physiotherapy in prone position which was given to each participant in for 240 minutes/day in two divided sessions of 120 minutes each with a gap of 6 hours (10am-12 pm & 6pm-8pm) for consecutive three days. (i.e. six intervention sessions). Primary outcomes were Oxygen saturation (SpO2), Partial pressure of arterial oxygen (PaO2) & Peak Inspiratory Pressure (P.I.P.). Outcomes were recorded Pre & Post of Last (6 th) 120 minutes session (0 Min & 120 Mins). Results: On comparison of three parameters in two groups using paired t test we found that there was significant difference (p < 0.05) in SpO2, PaO2 and P.I.P at baseline and post intervention. Conclusion: The study concluded that chest Physiotherapy combined with prone positioning is a cost effective, non-invasive and affordable intervention which has a significant impact on improvement of SpO2, PaO2 and PIP in ventilated neonates. A randomized clinical trial evaluating the efficacy of this intervention seems warranted.

Background: Spinal cord injuries (SCI) may cause neurological problems such as muscle weakness, sensory disorders, and incontinence. This case report aims to investigate the effectiveness of the sensorimotor rehabilitative physiotherapy program in a dog with paraparesis. Case Description: A 1-year-old, 27 kg male dog was brought to Near East University, Animal Hospital, after a motor vehicle accident. The dog was diagnosed as a T13 vertebral fracture and luxation at the T13-L1 spinal level according to the clinical and radiological examination performed by a veterinary physician. The dog showed; poor standing, weakness in the hind limbs and back muscles, urinary and fecal incontinence at the clinical examination. The physiotherapy program included; massage, sensory stimulation applications, Neuromuscular Electrical Stimulation (NMES), joint mobilizations, standing-balance exercises, and gait training. Outcome Measures: Consequently, improvements were obtained in standing and sitting...

Cervical myelopathy is a disorder most commonly seen in the elderly population due to spondylosis with resultant cord compression. There is a growing trend towards successful conservative (nonsurgical) treatment for shoulder subluxation. There is a limited amount of literature describing kinesio taping as an effective treatment option. A participant with shoulder subluxation was included in this single case design which was conducted in a neurological physiotherapy outpatient department. The aim of this study was thus to document that kinesio taping can be effective in the treatment of shoulder subluxation in cervical spondylotic myelopathy. This case study describes the initial assessment, treatment progression leading to positive outcomes of a patient with CSM. A combination of kinesio taping and conventional therapy was used effectively to treat the patient. There was also a large emphasis on patient education and rehabilitation. Numerical Pain Rating Scale (NPRS) & Sulcus sign w...

Corona virus disease 2019 (COVID-19) caused by SARS-CoV-2 is a new corona virus that was first identified in Wuhan city of China in December 2019. In the wake of COVID 19 affecting India, the worst affected is the state of Maharashtra accounting for one third of all cases in the country. Physiotherapy is beneficial in the treatment and physical rehabilitation of patients with COVID-19. Patient presenting with productive cough and with underlying respiratory conditions benefit from the Physiotherapy. "Expert consensus and recommendation for Physiotherapy management for COVID 19 in Indian set up" guidelines approved by Maharashtra State Council for Occupational Therapy and Physiotherapy, Mumbai will help physiotherapists in decision making and treatment planning.

Background: Restless leg syndrome is a common sensory motor neurological disorder that is an unpleasant creeping sensation deep in lower limb causing an irresistible desire to move the leg and relieve the sensation. The most common sensations have been described as cramping, soreness, creeping or crawling sensation in the calves or feet which can vary in severity from mild discomfort to severe pain. Various studies have described the presence of Restless Leg Syndrome during pregnancy the causes of which may be iron deficiency, peripheral neuropathy, increased BMI and high number of previous pregnancies. Symptoms are more strong and frequently seen in third trimester and may disappear after parturition. The prevalence of restless leg syndrome in pregnancy in Indian population is unknown. Methods: Observational prevalence study where women between the ages of 20-29years with gestational age 20-40 weeks (N=225) were screened for RLS. The study was performed at a tertiary hospital in Pune, India. Results: 36 women (16%) among the 225 screened were found to have restless leg syndrome. Further their severity was graded, 23 (10.7 %), 12 (5.3%) and 1 (0.4%) had mild, moderate and severe symptoms respectively. Among the women who were diagnosed with RLS, 66.5% (24/36) had complaints of sleep disturbance Conclusion: The study was conducted to find prevalence of RLS in pregnant women in their third trimester at a Tertiary hospital which was found to be as high as 16%. RLS was previously undiagnosed in this population. Further, severity of RLS was graded. It was observed that most of the women experienced mild symptoms. It was also found that, among the women who had RLS, majority (66.5%) of them experienced sleep disturbance.

Abstract
Objective: The study was done to find out the “Effects of Balance Training on Foam Platform in
Geriatric Population”. Methods: The study was of control design, with 30 subjects, 15 subjects in each,
according to the inclusion and exclusion criteria, from Old Age Home, Jai Physiotherapy and Dental
Clinic, Residential Care Centre and Physiotherapy O.P.D. of CSS Hospital, Meerut. These subjects were
than conveniently divided into 2 groups,(Group A and Group B), Group A consisting of 15 subjects (7
males and 8 females) received the balance training on foam platform, Group B also consisting of 15
subjects (6 males and 9 females) received same balance training on floor. Demographic details of subjects,
sex, age, height, and weight was collected following Berg Balance Scale (BBS), Functional Reach Test
(FRT). After assessing the initial balance scores, the balance training on foam platform for group A and
same balance training on floor, were given for a period of four weeks for each subject in 3 days a week
approximately for 30 minutes. Both the groups were assessed on the above mentioned balance scales
after four weeks of exercises. The collected data was of mean and standard deviation and has been
analyzed using SPSS software. The t-test was used to analyze the difference in the balance improvements
in Group A and Group B. Intra group analysis between pre-intervention and post-intervention scores
was also done for both the groups. Results: The results of my study showed that there is a significant
improvements in balance control after receiving short term balance training program that specifically
emphasize for experimental group i.e. Group (A). Several balance specific exercises à shifting their body
weight from foot to foot, standing on one foot, and standing with the feet in a series of positions, including
side by side, and heel to toe, while standing on foam pad. On comparing the BBS at day 30 of group A
(mean = 55.26, SD = .96) and of Group B (mean = 52.26, SD = 2.91) and its corresponding P value (0.001)
is significant. So, it showed that there is a significant improvement in Group A.
Keywords: Balance; Berg Balance Scale (BBS); Functional Reach Test (FRT); Foam Platform.
Sanjai Kumar*, Meenu Singh**, Avikirna Pandey*** Shivanjali Shrivastava****