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   Table of Contents - Current issue
Coverpage
January-June 2019
Volume 1 | Issue 1
Page Nos. 1-68

Online since Wednesday, July 3, 2019

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EDITORIAL  

Developing professionalism – The physiotherapy way p. 1
Deepa C Metgud, Renu B Pattanshetty
DOI:10.4103/ijptr.ijptr_21_19  
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REVIEW ARTICLE Top

Caregiver's burden of persons with stroke in India: A narrative review p. 3
Vimal M Telang
DOI:10.4103/ijptr.ijptr_18_19  
The caregiver (CG) of a stroke survivor (SS), usually a family member needs to cope up with the challenges of the new role. “Immediate family” who more often than not is the primary CG is included in the “support and relationships” chapter of the environmental factors of the International Classification of Functioning. An insight into the burden of care on the CG in India necessitates a review so as to address it. Publications were overviewed from the search engine “PUBMED” and “Google Scholar” for studies in Indian urban/rural/slum settings either hospital or community based having outcome measures for CG burden, quality of life (QOL), health issues, and CG satisfaction. Interventional studies on CG, hired CG, or with more than one CG were excluded. Seven cross-sectional studies from North, Western, and South India met the inclusion criteria. Sample size ranged from 54 to 201 SSs of duration 28 days to >1-year poststroke. Majority of the CG s were females. The mean score was lowest in physical health and highest in social health in all the studies for WHO-QOL. CG burden was high in all the studies. Burden perceived by female CGs was more than males. The CGs services impacts the treatment outcome hence there is a need to educate and sensitize healthcare professionals to treat CG with dignity and empathy so that caregiving is less stressful. Physiotherapists while being actively involved in rehabilitation of individuals with stroke should train the CG in appropriate home exercises and management, which is ergonomically effective to both SS and CG, cost-effective, and practically feasible so that CG strain and stress can be reduced.
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ORIGINAL ARTICLES Top

Effect of agility training exercise on motor proficiency and anthropometry in 6–10-year-old children with obesity p. 11
Subhadip Bera, Snehal Dharmayat
DOI:10.4103/ijptr.ijptr_13_19  
Background: Increased body weight, termed as Obesity, has emerged as one of the major problems in children in recent times. These children are also prone to have lower physical activity/ physical fitness levels. They are also known to have poor motor proficiency during development as well as later life if obesity continues. Early intervention is necessary to promote healthy life style & improve fitness. This study was, therefore, undertaken to determine the effect of agility training exercise on motor proficiency & anthropometry in 6 to 10 year old obese school children. Materials and Methods: Twenty children with BMI ≥25 as per Asian criteria were recruited for this pre-post experimental study from randomly selected schools. Demographic profile of the children was collected & an assessment of their skin fold thickness (triceps, abdomen & thigh), lower extremity strength (quadriceps, hamstrings, hip extensors, hip abductors and dorsiflexors), agility (modified T test) and motor proficiency (Test of Gross Motor Development-3) was performed prior to & at the end of 2nd and 4th week of training. Agility training exercises were administered to all children three times a week for 4 weeks. Results: Statistically significant changes from pre to post 4 weeks intervention were noted in most of the outcome measures, most notably motor proficiency (both locomotor & object control components; P = 0.0001), body weight (P = 0.0004), triceps skin fold thickness (P = 0.0033), strength of hip extensors (P = 0.0002) and agility (P = 0.0003). Conclusion: A school based 4 week agility training program of low to moderate intensity (contextual interference) has shown to be effective in improving motor proficiency & also altering anthropometric parameters in obese children aged 6-10 years.
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Effect of mulligans mobilization versus manipulation, along with mulligans taping in anterior innominate dysfunction – A randomized clinical trial p. 17
Saviola Ribeiro, Anand Heggannavar, Santosh Metgud
DOI:10.4103/ijptr.ijptr_20_19  
Background and Objective: Low back pain is one of the major causes for disability and absenteeism at workplace. The anterior innominate dysfunction is a common type of dysfunction leading to low back pain in which the joint adapts to an abnormal position locking it in an anterior pelvic tilt thus leading to low back or buttock pain that may radiate to lower extremity pain. Mulligan mobilization particularly helps restoration of joint movement in a pain free manner and has reported to be effective in increasing range of motion and reducing pain. Manipulation, on the other hand has also proved to be effective in inhibiting pain receptors causing relaxation of muscle and increasing range of motion. Since there is a dearth of literature stating the comparative effects of both techniques, the current study has aimed at finding out the effectiveness of both techniques on anterior innominate dysfunction. Materials and Methods: A clinical trial conducted on 30 subjects with a mean age of 37.57±10.32 years were randomly assigned into two groups, Group A (n = 15) received Postero-medial SI Mulligan mobilization and Mulligan taping technique + Conventional Therapy and Group B (n = 15) received SI Manipulation and Mulligan taping technique + Conventional Therapy. Patients were assessed at baseline and on 6th day of therapy using Visual Analogue Scale (VAS), Modified Oswestery Disability Questionnaire (MODQ), Modified Schober's lumbar range of motion and Pelvic Inclinometer scale Results: Pre and post mean difference in group A were 6.56±1.01 cm for VAS, 27.33±7.76 for MODQ, 1.90±0.68° for lumbar flexion range, 2.19±0.45° for lumbar extension range and 2.00±1.46 mm for pelvic tilt. While the pre and post mean difference in group B were 6.56±1.01 cm for VAS, 27.33±7.76 for MODQ, 1.90±0.68° for lumbar flexion range, 2.19±0.45° for lumbar extension range and 2.00±1.46 mm for pelvic tilt. The intra-group comparison was statistically significant with P = 0.0001 (VAS, MODQ, Lumbar flexion and extension ROM) and P < 0.05 (Pelvic tilt), the inter-group comparison was also statistically significant with P = 0.0001 (VAS and lumbar extension ROM), P = 0.0005 (Lumbar flexion ROM). Conclusion: The present study concluded that Mulligan mobilization with Mulligan taping technique showed superior effects than Manipulation with Mulligan taping technique.
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Immediate effect of kinesio taping on pain and grip strength in individuals with lateral epicondylitis p. 24
Alisha Gracias, S Shobhalakshmi
DOI:10.4103/ijptr.ijptr_19_19  
Background: Lateral epicondylitis (LE) of elbow, involves tendinitis of the extensor carpi radialis brevis(ECRB). LE is characterised by superficial or deep macroscopic and microscopic tears at the tendinous origin of ECRB. Rigid taping has been proved effective in alleviating pain, improving muscle function and restoring functional movement patterns. Kinesiology taping (KT) has roughly the same thickness as the epidermis and can be stretched between 30% and 40% of its resting length longitudinally. Since KT is more user friendly and it support functions by maintaining active range of motion and without the circulation being repressed as compared to rigid taping, there is a need to study the effect of KT on grip strength and pain in subjects with LE. Aims and Objectives: 1. To report the pain pressure threshold of subjects in experimental and control groups before and after application of KT. 2. To determine the grip strength of subjects in experimental and control groups before and after treatment using KT. 3. To compare the values of pain pressure threshold and grip strength between experimental and control groups. Materials and Methods: Subjects satisfying the inclusion criteria were taken for the study by convenience sampling. The subjects of both groups were then assessed for pain and grip strength prior to the application of tape using a pain-pressure algometer and hand-held dynamometer respectively. Subjects in the experimental group were then applied with KT using muscle and space correction technique and the control group received sham taping. The outcomes were then re-assessed immediately after taping. Results: From the results obtained it was seen that there was a statistically significant difference (P < 0.001) in the pain pressure threshold and grip strength between the both groups indicating that KT was effective in reducing the pain and increasing the grip strength in individuals with lateral epicondylitis. Conclusion: The findings of the study indicates that, there is a significant improvement in pain pressure threshold and grip strength after the immediate application of KT in the experimental group as compared to the control group.
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Effect of therapeutic ultrasound versus shortwave diathermy combined with suboccipital release and manual drainage techniques for chronic sinusitis: A randomized clinical trial p. 29
Sharon Kalekar, Peeyoosha Gurudut
DOI:10.4103/ijptr.ijptr_12_19  
Background: The repeated occurrences of sinusitis hinders patients from carrying out their daily life activities efficiently. The successful application of therapeutic ultrasound and shortwave diathermy (SWD) with the addition of suboccipital release and manual techniques could develop a new paradigm in the treatment of chronic sinusitis. Objectives: The aim of the study was to compare the effect of therapeutic ultrasound versus SWD combined with suboccipital release and manual drainage techniques in chronic sinusitis in terms of pain intensity, tenderness, and quality of life. Materials and Methods: Forty-six patients with chronic sinusitis were randomly assigned to therapeutic ultrasound and SWD groups consisting of 23 patients each. Both groups received suboccipital release and manual drainage techniques and the outcome measures were assessed at baseline and after five sessions. Results: Compared with the baseline levels, pain intensity, tenderness, and quality of life significantly reduced in both the study groups (P < 0.05) at the end of five sessions. Further, the ultrasound group showed to be better as compared to SWD group. Conclusion: Both therapeutic ultrasound and SWD combined with suboccipital release and manual drainage techniques improve pain intensity, tenderness, and quality of life in chronic sinusitis. However, ultrasound therapy showed quicker and better effects as compared to SWD along with suboccipital release and manual drainage techniques.
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Preference of physiotherapeutic treatment over oral analgesics by Young Indian football players: A survey p. 37
Vedang Vaidya, Ankit Srivastava, Anand Gangwal
DOI:10.4103/ijptr.ijptr_17_19  
Background: Nonsteroidal anti-inflammatory drugs are widely consumed among athletes worldwide in relation to muscle injury and soreness. Physiotherapy provides effective nonpharmacological, noninvasive interventions for various musculoskeletal problems. Thus physiotherapy is an effective treatment but without the toxic buildup. This study establishes the need to educate the players about physiotherapy and the harmful effects of regular analgesic consumption. Objective: The objective of the study is to analyze the perception of football players with injuries between physiotherapy and oral analgesics for pain reduction. Materials and Methods: Data were collected from 107 football players by a questionnaire. Qualitative analysis of data was done. Results: Pie diagram of all the results was made. Results showed a higher shift toward the preference of oral analgesics than physiotherapy. Conclusion: Football players prefer oral analgesics over physiotherapeutic treatment for early symptomatic relief to hasten return to play.
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Balance and agility testing in normal and hearing-impaired children: A Case–Control study p. 42
Deepa C Metgud, Pushkar Topkar
DOI:10.4103/ijptr.ijptr_14_19  
Background: Hearing is one of the most important sensation that collect the information of surrounding environment. Impairment in this sensation can affect the development of the motor skills such as balance and agility. Balance impairment can lead to fall and impairment in agility leads to poor movement efficiency and may be associated with unbalanced posture, lack of coordination and poor reaction time. Materials and Methods: A case control study done on children aged 9-14 years were recruited from special schools for hearing impaired and regular schools from Belagavi. Out of 198 children, 130 were normal hearing children and 65 were hearing impaired children. The balance and agility was measured with the help of Pediatric Berg [Add about agility test][]Balance Scale (PBBS) and T- test respectively. Results: The mean scores for PBBS was 55.81 ± 0.68 for normal hearing children and 47.11 ± 4.05 in hearing impaired children which was compared using independent t-test which was statistically significant (P = 0.0001). The mean of agility scores was 11.14±1.47 seconds in normal hearing children and 17.86 ±1.72 seconds in hearing impaired children and it was also compared using independent t-test which showed highly significant difference (P = 0.0001). Conclusion: The present study concludes that hearing impaired children have poor balance and agility as compared to the normal children.
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Perception of Indian physiotherapists to the application of physiotherapeutic intervention on animals p. 47
Dakshayani Nandkishor Gholap, Shyam D Ganvir
DOI:10.4103/ijptr.ijptr_11_19  
Background: Animal rehabilitation is very well known and practiced in foreign countries with lot of literatures and research; on the contrary there is less research on animal rehabilitation in India. In new era demand and awareness about physiotherapy in animals has increased. Aims and Objectives: To know the perception of Indian physiotherapists to the application of physiotherapeutic interventions on animals & to have knowledge of the level of awareness of animal rehabilitation among qualified Indian physiotherapists. Materials and Methods: Self-structured questionnaire regarding the awareness of animal physiotherapy was developed and validated. The questionnaire was distributed through a link to the Indian Physiotherapists who belonged to registered association /council of physiotherapy from different states. Result: Of the many questionnaires distributed, 178 people responded in which 94 (52.8%) were Private practitioners, 31(17.4%) were Teachers and 53 (29.8%) were PG students.40.4 % (n:70) PT's were aware of PT's practicing on Animals but had never seen. 69.1% (n:121) PT's said that there is a need to create a new branch in Physiotherapy related to Animals. Conclusion: The result of this study concludes that for animal physiotherapy to be widely used, more awareness should be created among Indian physiotherapists as this field is still in infancy in India.
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CASE REPORTS Top

Effect of Class IV LASER on Bell's Palsy: A case series p. 55
Sanjiv Kumar
DOI:10.4103/ijptr.ijptr_15_19  
This case series describes the use of Class IV LASER in the treatment of Bells' palsy in five participants. Patients were given 7 days of physiotherapy intervention in the form of Class IV LASER for three sessions alternatively and four sessions of conservative physiotherapy based on history and clinical examination. The House-Brackmann Facial Nerve Grading System was used for the pre–post assessment. Majority of the participants showed a change with one patient returning to the normal grade. Three others had a good outcome with mild dysfunction with Grade II and one patient showed only a functional change from Grade VI to Grade IV.
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Effectiveness of physiotherapy rehabilitation on hysterical trismus p. 59
Suchit S Shetty, Sanjiv Kumar, Jorida Fernandes
DOI:10.4103/ijptr.ijptr_16_19  
Trismus, known as difficulty in mouth opening, commonly occurs due to disturbances in the trigeminal nerve resulting in spasm of masticatory muscles. With a literature review on rehabilitation of hysterical trismus, it was observed that there were different electrotherapeutic modalities and exercises which have their individual benefits for trismus. However, there is a lack of a set structured exercise and electrotherapy protocol for the rehabilitation of this condition which may help for better and faster prognosis. A 62-year-old female with hysterical trismus was assessed using dial caliper for mouth opening and was treated using physiotherapeutic approaches. Pre- and postintervention values were recorded. Physiotherapy interventions included hot moist pack therapy, myofascial release, goldfish exercises for the temporomandibular joint (TMJ), TMJ mobilization with distraction, ultrasound, and maintenance of mouth opening using ice cream sticks. Aerospace 200-mm dial caliper was used to measure mouth opening. The present report emphasis on the effect of 2 weeks of physiotherapy intervention using a combination of electrotherapy and exercise has benefited the patient in improving the mouth opening and overall quality of life.
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INVITED EDITORIAL Top

Health and built environment: Promoting accessibility to the persons with disabilities p. 63
Harihara Prakash
DOI:10.4103/ijptr.ijptr_22_19  
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CONTINUING PHYSIOTHERAPY EDUCATION Top

Assistive technology in locomotor disability: Physiotherapy and rehabilitation perspectives p. 66
Arun G Maiya, A Sampath Kumar, Parameshwar Anche, Hrishikesh Yadav
DOI:10.4103/ijptr.ijptr_23_19  
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