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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 1 | Issue 2
Page Nos. 69-134

Online since Monday, December 23, 2019

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EDITORIAL  

Awareness of physiotherapy among other health professionals in India: Current scenario p. 69
Renu Pattanshetty, Deepa C Metgud
DOI:10.4103/ijptr.ijptr_74_19  
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REVIEW ARTICLE Top

Effectiveness of cognitive behavioral therapy on generalized anxiety disorder in college and graduate students: Literature review p. 71
Shreya Donadkar, Nandakumar
DOI:10.4103/ijptr.ijptr_75_19  
There has been a significant increase in the incidence of mental disorders in young adults and often been neglected due to social stigma. However, due to the increased awareness, there has been increased demand for services and counseling centers which often have long waiting lists. Due to the limited resources available, the effectiveness of the therapy method to provide “best” available treatment is needed. In this literature review, the effectiveness of cognitive behavioral therapy (CBT) on generalized anxiety disorder in college and graduate students, a systematic review and meta-analysis of randomized controlled trials (RCTs) and two RCTs are included. The selected studies suggested significant improvement in general anxiety disorder in college or graduate students by providing CBT. The literature reviewed indicates improvement in generalized anxiety in graduate students' population by CBT, limited studies have been conducted specifically to this population, and since young adults constitute majority of the world population suggesting economic growth, there is a need for more research on the effectiveness of the therapy in this specific population per se.
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ORIGINAL ARTICLES Top

Impact of a multicomponent strategy on utilization of cardiac rehabilitation services in a tertiary care hospital from a lower middle-income Country: A retrospective analysis p. 75
Veena Kiran Nambiar, UN Nagamalesh, Mukta Pitambare, Gloria Alva
DOI:10.4103/ijptr.ijptr_65_19  
Context: Globally, uptake of cardiac rehabilitation (CR) is low, more so in lower middle-income countries (LMICs) compared to developed nations. LMICs share a greater burden of cardiovascular diseases, and hence, there is an urgent need for enhancing CR services. Aims: The objective of this retrospective study was to describe a multicomponent strategy employed in a tertiary care hospital from an LMIC and to improve CR services and its impact on CR availability, uptake, and barriers. Materials and Methods: To ensure the CR availability and uptake, a multi-component strategy involving sensitization of all concerned health-care team members about the importance and need of CR, strengthening infrastructure and resources, laying down appropriate clinical pathways, and culturally adapting standard guidelines and protocols were put in place. For the present retrospective analysis, utilization of CR services by patients diagnosed with coronary artery disease (CAD) was extracted from the medical records of the hospital. Results: Between February 2017 and December 2017, a total of 629 patients with diagnosis of CAD underwent percutaneous transluminous coronary angioplasty (PTCA) (78%) or coronary artery bypass grafting (CABG) (22%). All patients (629) received Phase I rehabilitation (rehab) (100%), 145 patients (23%) received Phase 2 rehabilitation, and 44 patients (7%) received Phase 3 rehabilitation. Residence location, gender, dependency on caregivers, and employment status were identified as barriers to Phase 3 CR uptake. Conclusion: This multi-component strategy positively influenced CR uptake, and a few barriers were identified that need to be addressed. Clinical Implication: Importance of multidisciplinary and multicomponent strategic management to increase the uptake in a CR program.
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Comparative effect of mat pilates and egoscue exercises in asymptomatic individuals with lumbar hyperlordosis: A randomized controlled trial p. 79
Gayatri S Kudchadkar, Peeyoosha Gurudut, Aarti Welling
DOI:10.4103/ijptr.ijptr_38_19  
Context: Correcting lumbar hyperlordosis, a main cause of back pain, will reduce the stress on the lumbar spine thereby preventing future problems in back and lower limb. Clinical trials are lacking where mat Pilates, Egoscue exercises and lumbar stabilization exercises are compared for their effect on spinal malalignment. Aims: This study aims to compare the effectiveness of Pilates, Egoscue, and lumbar stabilization exercises for reducing hyperlordosis angle in asymptomatic individuals with lumbar hyperlordosis. Settings and Study Design: A randomized controlled trial conducted on volunteer participants from Health Science University of Belagavi. Materials and Methods: Asymptomatic individuals with lumbar hyperlordosis (n = 51) were randomly allocated to Pilates, Egoscue and Lumbar stabilization groups. Outcomes assessed were index of lumbar lordosis, pelvic tilt, and tolerance to exercise performance which was measured at baseline and after 4 weeks. Results: There was significant reduction in the hyperlordosis score (P < 0.001) in the three study groups when compared for pre-and post-intervention scores. However, more reduction was seen in the Pilates and Egoscue groups compared to the lumbar stabilization. Pilates and Egoscue groups were equally effective in Lumbar lordosis angle (P = 0.68) and pelvic tilt (P = 0.51). Participants of Pilates group graded the exercises with superior tolerance to performance (P < 0.0006) than Egoscue and Lumbar stabilization. Conclusion: Pilates group and Egoscue group were equally effective and superior to lumbar stabilization group in correction of hyperlordosis. Further, ease of performance of exercise was rated high for Pilates than the Egoscue exercise. These exercises should be included by the clinicians in preventive or corrective rehabilitation towards spinal posture malalignments.
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Concurrent validity of the gross motor component of ages and stages questionnaire-3 with the motor scales of Developmental Assessment Scales for Indian Infants (DASII) in risk infants < 6 Months p. 89
Deepa C Metgud, Manisha Bhandankar, Divya M Madhale
DOI:10.4103/ijptr.ijptr_10_19  
Objective: Global developmental delay is the term used when a child lags or has a delay in all the domains of development. Early detection of this delay is a necessity to commence with early intervention. This study aimed to determine the concurrent validity of gross motor component of Ages and Stages Questionnaire-3 (ASQ-3) with the motor scales of Developmental Assessment Scales for Indian Infants (DASII) in risk infants <6 months. Materials and Methods: This cross-sectional study included risk infants in the age group of 1–6 months (n = 97). They were assessed using the age-appropriate ASQ-3. The parents/caregivers of the children filled in the child-appropriate responses. The children were then assessed using the DASII. The scores of ASQ-3 and DASII were recorded as per the instructions in their respective manuals. Results: One hundred and fifty infants were screened for eligibility, of which only 97 were eligible according to the study criteria. Fifty-four children failed on the gross motor domain of ASQ-3, whereas sixty children failed on the motor scales of DASII. The overall sensitivity and specificity of the ASQ-3 were found to be 73.80% and 89.83%, respectively. The sensitivity of the ASQ-3 at 2 months was 75% and 66.67% at 4 and 6 months. The specificity of the ASQ-3 at 2, 4, and 6 months was 88%, 90%, and 93.33%, respectively. Conclusion: ASQ-3 has strong characteristics to detect motor developmental delay in infants at risk for developmental delay.
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Effect of retro-walking on treadmill on hamstring flexibility, gait, kinesiophobia, and psychometry in individuals with chronic knee osteoarthritis p. 93
Peeyoosha Gurudut, Rajvi Patel, Prachi Mukkannavar, Prina Vira
DOI:10.4103/ijptr.ijptr_29_19  
Background and Objective: The purpose of the study was to evaluate and compare the immediate- and short-term (five sessions) effects of retro-walking (RW) on treadmill along with conventional treatment and conventional treatment alone on hamstring flexibility, gait velocity, cadence, kinesiophobia, and psychometry in individuals with chronic knee osteoarthritis (OA). Materials and Methods: The present study was a randomized controlled trial. Twenty-eight individuals clinically diagnosed with Grade 2 or 3 knee OA between the age group of 40 and 70 years participated in the study. The individuals were randomly allocated to two study groups. Control group received conventional treatment of transcutaneous electrical nerve stimulation (TENS) and exercises, whereas experimental group received RW on treadmill along with TENS and exercises for five sessions. Outcome measures were assessed using popliteal angle measurement, walking velocity, cadence, Tampa Scale for Kinesiophobia 11, and Self-efficacy for Managing Chronic Disease 6-item scale. Results: Between-group analysis showed that RW was superior to control group (P < 0.005) in terms of improvement in walking velocity, cadence, and reduction in kinesiophobia in individuals with chronic knee OA. However, immediate effect was statistically significantly better in RW group only in terms of walking velocity (P < 0.005). Conclusion: The RW group demonstrated to be more effective than conventional physiotherapy group on walking velocity, cadence, and kinesiophobia. Hence, RW may be considered as part of the treatment protocol of OA knee patients with mild-to-moderate degenerative changes.
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Comparison of dynamic balance between deaf and normal children using the functional reach test: An observational study p. 100
Deepa C Metgud, Yesha Parikh, Yogita Kharith
DOI:10.4103/ijptr.ijptr_5_19  
Background: Deafness refers to complete loss of hearing ability. Children with hearing impairment have deficits in motor development majorly in balance. Vestibular system maturation is achieved by age of 10-14 years which is related to motor development. As dynamic balance is more affected than static balance in deaf children, Functional Reach Test (FRT) is used to measure dynamic balance. Hence there was a need to compare dynamic balance in deaf and normal children in the age group 7-18. Objectives: To compare dynamic balance in normal and deaf children using FRT and to find the common strategy used by these children for dynamic balance. Materials and Methods: An observational study with 191 deaf and normal children in age group of 7-18 years with no physical impairments were recruited in the study using convenience sampling as per the inclusion criteria. The outcome measure used for the study was FRT. It is the maximum distance one can reach beyond arm's distance while maintaining a fixed base of support in standing position. The test was administered in both the groups and their results were compared and the most common strategy used to perform the test was noted. Results: There was significant difference in dynamic balance between both the groups (P = 0.006). Normal children used hip strategy more frequently as compared to deaf children while ankle strategy was used twice as much in deaf children compared to normal children. Conclusion: The present study concluded that dynamic balance is reduced in deaf children in the age group 7 to 18 years.
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Effects of matrix rhythm therapy (MaRhyThe) in plantar fasciitis – An experimental study p. 105
Varun Naik, Mohit Singh
DOI:10.4103/ijptr.ijptr_4_19  
Introduction: Plantar Fasciitis (PF) is common musculoskeletal condition associated with difficulty in performing activities of daily living. The aim of the study is to investigate the effectiveness of single session of Matrix Rhythm Therapy (MaRhyThe) in Plantar Fasciitis. Methods: It was an experimental study conducted on 17 subjects diagnosed with plantar fascitit in the age group of 18-35 years. One session of MaRhyThe was given to calf and plantar aspect of foot for 45 – 60 minutes. Pre and post intervention outcome was measured in terms of pain using pressure algometer (PPA), local skin temperature using non-contact infrared thermometer (IRT) and functional activities using Foot and Ankle Ability Measures (FAAM) scale. Results: Pre Post intervention demonstrated statically significance in terms of reduced pain (P < 0.001), increased local skin temperature (P < 0.001) and improved scores of Foot and Ankle Ability measure (P < 0.001). Conclusion: Single session of MaRhyThe treatment was found to be effective in reduction of pain, improved skin temperature and functional activities in patients with plantar fasciitis.
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Screening of children for autism spectrum disorders using Modified Checklist for Autism Spectrum Disorders (MCHAT) in toddlers in the age group 16-30 months: An observational study p. 110
Deepa C Metgud, Sherin Paulose
DOI:10.4103/ijptr.ijptr_3_19  
: Background and Purpose: Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders characterized by impaired speech and communication and repetitive behavior. In the past few decades, there has been a gradual increase in the prevalence rates of ASD. The present study intends to find the prevalence of ASD in children between 16 and 30 months in Belagavi using Modified Checklist for ASD in Toddlers (MCHAT) questionnaire. Materials and Methods: This cross-sectional study was conducted on 510 children in the age group of 16–30 months in the Anganwadis and playschools of Belagavi using cluster sampling. The teachers were explained about the details of the study and were asked to gather children between 16 and 30 months along with their primary caretaker. The caretaker were explained about the details of the study, and participants were recruited based on the inclusion and exclusion criteria. Demographic data such as age, gender and socioeconomic status were recorded. The caretakers were given translated Kannada version of MCHAT-revised questionnaire to record their responses based on their child's behavior, and the total score was calculated by the primary investigator. Results: Among the 510 children screened for the risk of ASD, the prevalence was found to be 0.19%. The mean age of the participants was 24.5 ± 5.04 months. The prevalence was found in the upper-middle class in the age group of 28–30 months.Conclusion: The prevalence of ASD in Belagavi was 0.19% in children in the age group of of 16–30 months.
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Effect of myofascial release versus muscle energy technique on trapezius spasm in head and neck cancer patients: A randomized clinical trial p. 114
Anjali Avinash Parab, Renu Pattanshetty
DOI:10.4103/ijptr.ijptr_27_19  
Objectives: Variety of physiotherapy interventions have proven to be efficient in reducing pain and neck disability, to improve range of motion (ROM) which results in the improvement in quality of life (QoL) in head and neck cancer (HNC) patients. The aim of this study was to determine the effect of myofascial release (MFR) versus muscle energy technique (MET) on trapezius spasm for pain, disability, ROM, and QoL in postoperative HNC patients. Materials and Methods: Twenty-four patients with HNC cancers who underwent surgery were recruited in the study. The pre–post assessment for neck disability, pressure pain threshold, cervical and shoulder ROM, and QoL was done at baseline and after 6 days of intervention using Neck Disability Index, pressure algometer, universal goniometer, and Functional Assessment of Cancer Therapy - Head and Neck scale, respectively. Results: MFR and MET groups are effective for pain reduction P = 0.0001 and neck disability P = 0.0022 when compared within the groups. Cervical and shoulder ranges showed significant improvement in cervical flexion (P = 0.0162), cervical extension (P = 0.0096), shoulder flexion (P = 0.0205), shoulder extension (P = 0.0408), shoulder abduction (P = 0.0037), and shoulder adduction (P = 0.0037) when compared between the two groups. When compared within the two groups cervical and shoulder ranges showed significant improvements (P = 0.0001) in both the groups. Conclusion: MFR and MET are effective when applied individually to reduce pain and neck disability and increase cervical and shoulder ROM in HNC patients.
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CASE REPORTS Top

Physiotherapy during and after extracorporeal membrane oxygenation support p. 122
Khushbu Bhat, Veena Kiran Nambiar
DOI:10.4103/ijptr.ijptr_67_19  
Extracorporeal membrane oxygenation (ECMO) is a mechanical heart and/or lung support by a modified heart–lung machine, which enables blood circulation outside the body. The use of ECMO as rescue therapy for the patient in cardiac shock both before and following cardiac surgeries has been increasing over the past two decades. The purpose of this case study is to sensitize the role of the physiotherapist in interventions during and after ECMO in a postoperative cardiac surgery patient. Physical therapy interventions can be provided safely to patients on portable ECMO. These interventions were focused on preventing the negative sequelae of bed rest, improving strength and endurance, preventing ECMO complications as well as improving the level of consciousness and psychological well-being.
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Postoperative physiotherapy management for complications related to cancer of buccal mucosa (head and neck cancer) p. 126
Renu Pattanshetty, Oshin Diana Mathias
DOI:10.4103/ijptr.ijptr_52_19  
Buccal mucosa squamous cell carcinoma is rare and is considered as an aggressive form of oral cavity cancer. It is also associated with a high rate of local regional recurrence and is seen commonly in people who are habitual tobacco chewers and/or smokers with or without alcohol intake. This case report represents a 40-year-old, moderately built female of buccal mucosa carcinoma who visited the surgical oncology department with involvement of the underlying skin and underwent commando surgery with complaints of pain, restriction of movements at the operated site, chest pain and breathlessness, swelling of left side of cheek, and limited mouth opening as postoperative complications, highlighting on the postsurgical physiotherapy management in commando surgery for buccal mucosa carcinoma and alleviating symptoms that were apparent with improvement in the quality of life of the patient.
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CONTINUING PHYSIOTHERAPY EDUCATION Top

Patient-based bedside teaching for physical therapists: The need of the hour p. 131
Renu Pattanshetty
DOI:10.4103/ijptr.ijptr_35_19  
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LETTER TO EDITOR Top

Fractures: Avoidable complications of unsupervised knee manipulation p. 133
Ganesh Singh Dharmshaktu
DOI:10.4103/ijptr.ijptr_36_19  
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