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   Table of Contents - Current issue
July-December 2020
Volume 2 | Issue 2
Page Nos. 69-148

Online since Monday, January 4, 2021

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”Publish or Vanish” – A new mantra for physiotherapists p. 69
Renu B Pattanshetty, Deepa C. Metgud
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Role of physiotherapist in health literacy p. 71
Robins Kumar, Alakananda Banerjee, Vinuta Deshpande
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Effects of body-weight-supported treadmill training in persons with spinal cord injury – A scoping review p. 73
Wilhelmus Johannes Andreas Grooten, Prachi Mahesh Borawake, Joseph Conran
Body-weight supported treadmill training (BWSTT) is used in rehabilitation of persons with complete and incomplete spinal cord injury (SCI), but the effectiveness of this intensive training method is still disputed. The present scoping review aimed to determine the effects of body-weight supported treadmill training in persons with spinal cord injury. The databases PUBMED and CINAHL were searched for clinical trials, and from the initial 350 papers retrieved, 14 papers fulfilled the inclusion criteria. Quality of the studies was assessed using the PEDRO score, and the outcomes of interest were cardiovascular function, psychological and emotional factors, gait, balance, muscle strength and additionally, pulmonary function, health-related quality of life (HR-QoL), as well as adverse events. In total, 374 patients with complete and incomplete SCI included in the 14 studies (PEDRO 4-8) had used the intervention. The training dose was varying largely across the different studies, but on average most studies applied around 50% of the participants' body-weight with 3-5 sessions a week, lasted for 40± 20 minutes and continued for 4.3±3.6 months. There were positive effects of BWSTT on cardiovascular function, gait, balance, psychological and emotional factors, and muscle strength. This study conclude that BWSTT appears to be a safe and useful treatment in persons with spinal cord injury; however more randomized controlled trials are needed to assure these effects and to establish the evidence of BWSTT on complementary outcomes, as well as finding evidence for the most suitable dose.
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Symptom clusters in men with prostate cancer: A pilot assessment using salivary measures p. 85
Darpan I Patel
Context: Symptom clusters are an underutilized method for assessing cancer burden among men treated for prostate cancer (PCa). Aim: The present study aimed to investigate associations between physiological and psychosocial symptoms that could better inform oncologists and family caregivers on how best to manage the care for men with PCa. Settings and Design: Cross-sectional study design was implemented at a National Cancer Institute designated outpatient cancer center. Subjects and Methods: Thirty men treated for PCa are included in this analysis (age: 70 ± 10; BMI: 29 ± 4.3). Participants completed the Brief Fatigue Inventory, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and the Short Form (SF)-36. The patient demographic data were extracted from medical records and salivary cortisol and C-reactive protein were quantified. Statistical Analysis Used: Correlations and hierarchical cluster analysis were performed. Statistical significance was considered as P < 0.05. Results: Fatigue had significant negative correlations with multiple subscales of the SF-36. Increased BMI was negatively associated with SF-36 subscales of physical function (−0.621; P = 0.001), energy/fatigue (−0.449; P = 0.02), social function (−0.409; P = 0.04), pain (−0.422; P = 0.04), and FACIT-F subscales of functional well-being (−0.546; P = 0.006), general health (−0.494; P = 0.01), and total score (−0.458; P = 0.02). Cluster analysis revealed 2 categories of clusters, both including fatigue as a central symptom. Conclusion: The results of this study conclude that fatigue is associated with multiple QoL indicators in men with PCa. The management of this symptom cluster has the potential to improve QoL.
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A study on the relationship between median nerve mobility and cervical core muscle endurance among asymptomatic young adults using smartphone Highly accessed article p. 92
Swati Vilas Kubal, Danielle Malcolm Dsouza
Background and Objectives: The posture adopted when using a smartphone is a major cause for concern. The objective of the study was to find the correlation of neural tissue mobility of the median nerve and cervical core muscle endurance with smartphone use in asymptomatic young adults. Materials and Methods: This was a cross-sectional observational study conducted in a tertiary care hospital. A total of 75 asymptomatic young adults were assessed for the frequency and intensity of smartphone use, cervical core muscle endurance, and neural tissue mobility of the median nerve. Statistical Analysis Used: Spearman correlation test was used in this study. Results: The study showed a significant correlation of median nerve mobility with the Problematic Mobile Phone Use (PUMP) Scale score (P = 0.00, r[dominant], r[nondominant] =0.588) and the duration of smartphone use. In terms of number of years, r (dominant) =0.516, r (nondominant) = 0.413. In terms of number of hours/day, r (dominant) = 0.776, r (nondominant) = 0.597. Furthermore, a significant correlation of cervical core muscle endurance with the PUMP Scale score [P = 0.00, r = −0.730] and duration of smartphone use exists. In terms of number of years, P = 0.00, r = −0.534. In terms of number of hours, P = 0.00, r = −0.791. Conclusion: The neural tissue mobility of the median nerve is hampered with increased smartphone use in terms of duration of use. Furthermore, the cervical core endurance is less in individuals who use their smartphone for longer durations and in those who are more addicted.
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Effect of integrated neuromuscular inhibition technique on trigger points in patients with nonspecific low back pain: Randomized controlled trial p. 99
Santosh C Metgud, Sarana Souza Monteiro, Anand Heggannavar, Pamela Virgil D'Silva
Background and Objective: Trigger points in the myofascial system form the major reason for pain and tenderness in nonspecific low back pain (NSLBP). These points can be treated using manual therapy techniques such as integrated neuromuscular inhibition technique (INIT). Due to lack in the literature about its effect in NSLBP condition, the present study was undertaken to evaluate the effects of INIT on trigger points in patients with NSLBP. Materials and Methods: Forty-four patients with NSLBP were randomly assigned to either of the two study groups using envelope method. Group A (n = 22) was treated with stretching and strengthening exercises, whereas Group B (n = 22) was treated with INIT. Both the groups received hot moist pack and therapeutic ultrasound as common treatment. Five consecutive sessions of intervention were given over 5 days. Outcome measures in terms of pain pressure threshold (quadratus lumborum [QL] and erector spinae [ES]), lumbar range of motion (ROM), and disability were measured at baseline and end of the fifth session of treatment. Results: The within-group analysis showed a reduction in pain, improved ROM, and disability in both the study groups (P < 0.001). However, the between-group analysis reported that INIT was more effective than the control group in terms of reducing trigger point tenderness of QL (P = 0.0011) and ES (P = 0.0001) as well as reducing functional disability (P = 0.0481) but not the ROM (P > 0.05). Conclusion: The present study concluded that INIT is superior to stretching and strengthening exercises in reducing trigger point tenderness and better functionality in patients with nonspecific low back pain.
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Prevalence of limb deformities among children having cerebral palsy in Jalandhar District of Punjab p. 106
Raju Sharma, Akhoury Gourang Sinha
Introduction: Cerebral palsy (CP) is a nonprogressive disorder of the developing brain. The newborn child with CP usually has no deformities or musculoskeletal abnormalities at birth. However, the distribution and prevalence of deformities in CP is a less researched area. Most of the studies have dealt with the correction of deformities. The purpose of this study is to determine the prevalence of deformities in CP and explore the relationship between their impairments and function. Methodology: A database of 248 children with CP between the age group of 3 and 13 years in a survey conducted in Jalandhar District of Punjab constituted the population of this study. Each child was physically examined by the researcher to assess primary and secondary impairments using standard clinical tests, such as Gross Motor Function Measure (GMFM-88), Quality of Upper Extremity Skill Test (QUEST), Gross Motor Function Classification System (GMFCS), and passive range of motion. Cross tabulation with Chi-square and correlation was a tool of statistical analysis for categorical variables, whereas t-test was used for continuous variables. Results: Equinus deformity of the ankle was most common followed by knee flexion, forearm pronation, and wrist flexion deformities. Deformity score showed statistically significant negative correlation with GMFM score (r = −0.43, P < 0.001) and QUEST score (r = −0.42, P < 0.01) and positive correlation with GMFCS levels (r = 0.42, P < 0.001) and all domains of self-care. Conclusions: Occurrence of deformities is the most common secondary impairment observed in children with CP. Deformities limit gross as well as the fine motor activities and hence the overall functional outcome in these children.
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Effect of MaRhyThe versus myofascial mobility tool in female individuals with or without neck pain having forward head posture and buffalo hump – A randomized clinical trial p. 113
Nikita Shamine Miranda, Vijay Kage
Background and Objectives: Prolonged forward head posture (FHP) leads to the development of buffalo hump (BH) at the base of the posterior neck, predominantly seen in females. MaRhyThe (MRT) and myofascial mobility tool (M2T) are novel physiotherapy methods applied in various soft-tissue disorders. A dearth of literature exists about using these methods for the treatment of BH and FHP. Hence, the aim of the present study was to compare the effects of MRT and M2T in female individuals having FHP and BH. Materials and Methods: The study was a randomized clinical trial. Twenty female were randomly allocated to Group A (n = 10) and Group B (n = 10) who received MRT and M2T, respectively. The primary outcomes assessed included craniovertebral angle (CVA), neck circumference (NC), and skinfold measure. The secondary outcomes were cervical endurance and range of motion that were assessed on day 1 (pre) and day 10 (post). Exercise and study intervention (MRT/M2T) were given alternately for 10 days. Results: All the primary and secondary outcome parameters analyzed at days 1 and 10 showed statistically significant results for both the study groups (P < 0.001). However, analysis between the two study groups showed no statistically significant difference for Northwick Park Neck Pain Questionnaire (P = 0.08), NC (P = 0.56), and skinfold measure (P = 0.72) except for CVA (P = 0.03). Conclusion: Both MRT and M2T interventions were effective in reducing the BH and correction of FHP in addition to improving cervical mobility and endurance. However, MRT proved to be superior to M2T in terms of correction of FHP and reduction of the BH.
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An observational pilot study to compare the strength and endurance of neck muscles of chronic neck pain patients as compared to age- and gender-matched controls using a handheld dynamometer p. 121
Bharati D Asgaonkar, Vaibhavi Bhupendra Rathod, Chhaya V Verma
Context: Neck pain is a common musculoskeletal disorder. Strength and endurance measurements of neck muscles can be of substantial help to evaluate the basic condition and examine whether the rehabilitation protocol has been beneficial or not. Aims: The aim was to propose a technique to use handheld dynamometer for measurement of strength of neck muscles and study the strength and endurance of neck muscles in chronic nonspecific neck pain patients as compared to age- and gender-matched controls. Settings and Design: It is a cross-sectional observational study. Materials and Methodology: Neck muscle strength and endurance was measured in patients with neck pain (n = 30) and without neck pain (n = 30). Statistical Analysis Used: Test–retest reliability, Man–Whitney U-test, and ratio analysis were used for statistical analysis. Results: Inter-rater and intra-rater reliability for the technique used to measure neck muscle strength was found reliable and valid. The mean of neck flexor and extensor strength in neck pain patients was 2.97 ± 1.09 kg and 4.70 ± 0.87 kg (P < 0.05), respectively. The mean of neck flexor and extensor endurance in neck pain patients was 22 ± 12.21s and 52.57 ± 45.07s (P < 0.05), respectively. The ratio of the strength of neck extensors to neck flexors in neck pain patients was 2:1 and that of controls was 1.5:1. Conclusions: Handheld dynamometer is a reliable tool to measure the strength of neck muscles. Strength and endurance of neck muscles chronic neck pain patients is significantly lower as compared to age- and gender-matched controls.
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Chemotherapy-induced peripheral neuropathy and its correlation with activities of daily living, psychological well-being, grip strength, and quality of life in cancer subjects: An observational study p. 127
Renu B Pattanshetty, Anagha Kulkarni, Chinmayi Kulkarni, Manjiri Kulkarni
Background and Objective: The incidence of cancer is rapidly rising, resulting in an increase in the number of patients opting for chemotherapy. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the adverse and long-lasting side effects which evidently affects the activities of daily living (ADLs), quality of life, and psychological status. The objective of the present study was to assess for CIPN and find its correlation with grip strength, ADL, psychological variables, and quality of life. Settings and Design: This was an observational study undertaken in a tertiary care centre and cancer hospital for a period of 6 months. Materials and Methods: 102 subjects aged between 18 and 70 years were recruited. Subjects were evaluated using Modified Total Neuropathy Score (mTNS), Hand dynamometer, KLE University Institute of Physiotherapy (KLEU-IPT) Objective Functional Assessment Scale, Depression Anxiety Stress Scale (DASS-42), and functional assessment of cancer therapy-general (FACT-G). Results: CIPN seemed to be more evident in lower limbs than the upper limbs when assessed using mTNS scale. There was a statistical significance in reduction of grip strength (P = 0.00), KLEUIPT-OFS, DASS-42, and FACT-G with significant positive correlation (r = 0.05) with mTNS scores. Conclusion: CIPN demonstrated to be more pronounced in lower limbs than upper limbs. CIPN has shown to have significant correlation with the grip strength, quality of life, ADLs, depression, and anxiety, suggesting an early physical therapy intervention to avoid such complications.
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Effect of myokinetic stretching technique and spinal mobilization with arm movement in subjects with cervical radiculopathy: A randomized clinical trial p. 134
Apeksha Hungund, Santosh C Metgud, Anand Heggannavar
Background and Objective: Literature suggests spinal mobilization with arm movement (SMWAM) individually is effective in treating cervical radiculopathy. There is paucity of literature on myokinetic stretching technique (MST) and evidence which compare MST and SMWAM. The aim of the present study was to evaluate the effect of MST and SMWAM on range of motion (ROM), pain, functional disability, and grip strength in subjects with cervical radiculopathy. Materials and Methods: A randomized clinical trial with thirty two subjects diagnosed with cervical radiculopathy were included in the study and randomly divided into two groups of 16 subjects each where, Group A received MST and Group B received Mulligan's SMWAM along with the conventional treatment. Outcome measures were assessed on the 1st day preintervention and 6th day postintervention where pain intensity was assessed using visual analog scale, ROM using universal goniometer, grip strength using hand dynamometer, and functional performance using neck disability. Results: Within group analysis showed pain relief, improvement in ROM, and reduced disability which was statistically significant in both the groups (P < 0.0001) whereas the between group analysis revealed no statistical significance. There was no significant difference in grip strength scores between the groups (P = 1). Conclusion: The study concluded that MST and SMWAM are equally effective in relieving pain, improving ROM, and functional disability in subjects with cervical radiculopathy.
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Application of matrix rhythm therapy (MaRhyThe©) as a novel treatment in trigeminal neuralgia p. 141
Varun Naik, Basavaraj Motimath, Tanvi Pathania
Trigeminal neuralgia (TN) is one of the most excruciating painful conditions that is generally referred and treated in the physiotherapy outpatient department (OPD). It is described by generalized bouts of paroxysmal pain enduring from a brief moment to as long as 2 min and is situated along the course of the trigeminal nerve in the orofacial region. Matrix Rhythm Therapy (MaRhyThe©) is a new tool to treat pain and restricted joint mobility. However, its effectiveness is yet to be established in myofascial pain syndromes. A case of TN was reported in the OPD with complaints of the right side intraoral and jaw pain for 2 years, lasting for 3–5 min with 15–20 episodes of pain every day. Three sessions of MaRhyThe© once a week for 3 weeks was administered as an intervention to the affected side. Pain intensity, duration of pain, and the number of episodes per day were recorded by the patient in the logbook provided to the patient. After the intervention by 3rd week, the subject reported decrease in intensity of pain, reduction in duration, and episodes of pain in the consecutive days. The effect of MaRhyThe© was encouraging on TN and its symptoms.
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Competency-based physiotherapy education p. 144
Gaurang Baxi, Tushar Palekar
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An unusual cause of neck pain in the physiotherapy clinic: Neglected clay-shoveler's fracture p. 147
Ganesh Singh Dharmshaktu
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