Physiotherapy and Occupational Therapy Journal

Background: Obesity is the over accumulation of fat in the body and represents a major priority for healthcare systems due to its social, clinical and economic burdens. The prevalence of obesity in India is 40.3% which is increasing faster than the world average and it is higher among middle aged adults over 40 than under 40, where as in Kerala the prevalence rate is about 40.7% with a female preponderance. Midlife obesity is associated with decrements in cognitive function as well as motor function, and this could potentially compromise a person’s memory, attention, concentration and decision-making abilities that impacts daily functioning. Dual task involves the simultaneous incorporation of cognitive as well as motor components and it is found to be affected in obese adults. So there may exist a scope of association between the cognition and dual task performance of obese patients, and thus this study aims to find out the association between cognition and dual task performance in sedentary middle aged obese adults. Objective: To find out the linear relationship between cognition and dual task performance in sedentary middle aged obese adults. Methods: Community dwelling sedentary middle aged obese individuals with MoCA score between 18 - 30 were recruited for the study. They were instructed to perform two single tasks: six-meter self-selected walking speed test and the timed up and go test. Each single task was then repeat under two dual task conditions: self-selected walking speed test and verbal fluency test, self-selected walking speed test and serial 3 subtraction test, timed up and go test and verbal fluency test, and timed up and go test and serial 3 subtraction test. Dual task cost was calculated for each dual task to explore the percentile decline in dual task performance. ((difference between dual task and single task motor erformance)/single task motor performance] ×100) Results and Discussion: Regression analysis was done and found a significant linear relationship of cognition with dual task performance and dual task cost in sedentary middle aged obese adults (p<0.05). Moderate linear relationship (β=0.65) was found for timed up and go serial 3 subtractions which was the most difficult task and a weak linear relationship (β=0.22) for self-selected walking speed verbal fluency the simplest one. The results concluded that as the task complexity increases dual task cost increases which indicates a direct relationship between cognition and dual task performance. The prefrontal cortex plays a major role during single and dual-task gait functions and this activation corresponds to the complexity of the task. Reduced brain volume, grey matter atrophy, impaired synaptic plasticity, all of which may contribute to changes in cognitive and motor domain. These evidence may correspond to the linear relationship exists between cognition with dual task performance and dual task cost in the current study. Conclusion: Findings of this study implies that there is a linear relationship between cognition and dual task performance in sedentary middle aged obese adults.

Background: Chronic low back pain (CLBP), with or without central sensitization (CS), is a common musculoskeletal condition that impairs quality of life and daily function. While standard physiotherapy is widely used, adjunctive therapies such as Transcutaneous Electrical Nerve Stimulation (TENS) and acupuncture are gaining recognition for their potential benefits. However, limited research has directly compared their effectiveness alongside physiotherapy, particularly in patients with or without CS. Objective: To compare the effectiveness of TENS and acupuncture as adjuncts to standard physiotherapy in improving pain intensity, functional impairment, central sensitization, and quality of life in patients with CLBP. Methodology: A clinical trial involving 52 CLBP patients was randomly assigned to two groups: Group A received TENS with physiotherapy, and Group B received acupuncture with physiotherapy. Interventions lasted six weeks, with assessments at baseline, three weeks, and six weeks. The primary outcomes included the Numerical Pain Rating Scale (NPRS) and Oswestry Disability Index-Gujarati (ODI-G), and the secondary outcomes were the Central Sensitization InventoryGujarati (CSI-G) and Short Form-12 (SF-12). Results: Both groups showed significant improvements; however, acupuncture yielded superior results. At six week s, acupuncture showed greater reductions in NPRS (1.31 ± 1.19 vs. 3.04 ± 1.43), ODI-G (3.15 ± 2.31 vs. 8.88 ± 5.43), and CSI-G (6.81 ± 5.33 vs. 16.81 ± 12.25) (p < 0.05). Quality of life improved in both groups, with acupuncture offering faster benefits. Subgroup analysis revealed greater CS reduction with acupuncture.

Introduction: Pulmonary Function Tests (PFTs) spirometry helps in evaluation of the mechanical function of the lungs. They are based on research norms of gender, height & age, where predicted values compared with actual values. The normal spirometric values vary considerably according to ethnicity and the absence of spirometric reference values in a specific population result in the misinterpretation of spirometric results. Need of study: There are various Spirometric software available & it’s important to utilize the software which is most appropriate for particular ethnicity. Amis & objectives: To identify the knowledge and use of Spirometric software by healthcare workers. Methodology: Cross-sectional online questionnaire-based study was conducted across Gujarat from. The study involved health care workers including doctors, nurses, physiotherapists etc. The structured questionnaire was disseminated via Google forms. The questionnaire contains 25 questions. For statistical analysis done by applying independent sample t-tests and ANOVA. Result: A total of 50 responses were received. 55 % of healthcare workers not aware which software are they using when performing PFT. 80% are not aware about availability of Indian software and 87% of health workers believed to develop new Indian software for interpretation. Conclusion: Overall knowledge and use of spirometric software in certain component were unsatisfactory and inadequate among healthcare workers of Gujarat. There is need to develop spirometric software based on Indian ethnicity. And awareness should increase related to important of choosing appropriate software according to population for better interpretation.

Neck pain is felt in the muscles and structures of the back of the neck or shoulders, without involving nerve issues or serious conditions like tumors, fractures, or infections. Factors like sitting for long periods, poor posture, repetitive tasks, workrelated stress, and job strain can contribute to neck pain. These factors combine biological and psychosocial elements, including physical, emotional, and social aspects. Certain jobs, such as dentistry, nursing, office work, computer users have high rates of neck pain, it is essential to recognize the effectiveness of physiotherapy interventions in pain management. This manuscript comprehensively reviews the literature examining the effectiveness of Physiotherapy interventions in reducing neck pain. A thorough search of literature database was conducted to identify relevant articles published between 2013 and 2023. Six studies were selected for analysis, illustrating various interventions for neck pain. Further research is warranted to elucidate the underlying mechanisms and optimal physiotherapy treatment strategies presenting with neck pain.

Context: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that typically emerges early in life, characterized by social withdrawal, communication difficulties, and repetitive behaviors. These traits can hinder children’s ability to access transportation and participate in community activities, posing challenges for caregivers. Aims: To explore transportation-related difficulties faced by caregivers of children with ASD. Settings and Design: A methodological study conducted in two phases: questionnaire development and validation, followed by a cross-sectional caregiver survey. Methods and Material: A 60-item questionnaire covering three domains was developed and validated by eight occupational therapy experts, yielding a Content Validity Index (CVI) of 0.93. The tool was administered to 50 caregivers of children aged 4–10 years with ASD, via interviews and phone calls. Only caregivers involved in regular transportation were included. Descriptive statistics were used to calculate percentage scores reflecting caregiver difficulties. Results: Caregivers frequently reported temper tantrums, self-injurious behaviors, and stress during transportation. Most preferred private modes and used distraction strategies such as toys and snacks. Key concerns included lack of danger awareness, difficulty sitting near others, and social isolation. Conclusions: The findings provide valuable insights for occupational therapists in addressing caregiver challenges and planning effective interventions to support transportation and community mobility for children with ASD.

Background: The One-Leg Stance (OLS) test is a simple, cost-effective, and reliable tool used in clinical settings to assess static balance, particularly in those with musculoskeletal problems such as ACL or ankle injuries. It also holds prognostic value in sports. Aim: This study aimed to establish normative values for One-Leg Stance (OLS) in urban adults aged 20–40 years. Objectives: To assess balance with both eyes open and eyes closed in males and females. Material: A total of 284 healthy participants were recruited from community settings. Balance was evaluated by measuring the duration each participant could maintain a stance on their dominant leg. Result: Statistical analysis was done using an Unpaired t-test, and the findings revealed that males aged 20–40 years achieved a mean OLS time of 111.81 ± 6.76 seconds with eyes open and 35.65 ± 2.89 seconds with eyes closed. In comparison, females recorded a mean OLS time of 92.32 ± 5.84 seconds with eyes open and 22.06 ± 1.72 seconds with eyes closed. A statistically significant difference was observed between genders in the eyes-closed condition, with males demonstrating superior balance performance. Conclusion: This study provides normative data for OLS in urban adults aged 20– 40 years and highlights a gender-based difference in balance ability, particularly under eyes-closed conditions.

Virtual Reality (VR) has restructured the comprehension of neuroplasticity and opened new pathways for rehabilitation. It can transform the mundane conventional Physiotherapy treatment into an interactive and motivating tailored program which is target and task specific, thereby improving the efficiency as well as the effectiveness of the Physiotherapy treatment. Neural plasticity is cardinal to VR which works by altering synaptic connections, neural circuitry, and functional brain networks. It is effective in promoting motor recovery in conditions such as stroke, Parkinson’s disease, and spinal cord injury by helping patients relearn movements and improve balance & coordination. It provides a safe, user friendly environment which helps regain confidence and motor control.

Background: Patients with ataxia tend to have most issues with balance as people disturb the path of cerebellar or sensorial communication. Conventional treatment procedures primarily involve individual activities and cannot entirely deal with everyday functioning problems. To evaluate and compare the effects of Dual Task Training (DTT) and Task-Oriented Circuit Training (TOCT), both incorporated with Conventional Therapy (CT) on improving balance and quality of life in ataxic patients, the study was carry out a crossover clinical trial. Objective: To evaluate the comparative effectiveness of dual task training and task-oriented circuit training combined with conventional therapy for enhancing balance in patients with ataxia. Methods: Fifty-eight subjects with ataxia were randomly selected and divided into two groups. Group A was given DTT conjoined with CT, whereas Group B was given TOCT with CT. Both groups had three sessions per week for 12 weeks. The Berg Balance Scale (BBS), Scale for the Assessment and Rating of Ataxia (SARA), and EQ-5D-5L to measure quality of life were used at baseline, week 6, and week 12. Results: Both groups experienced significant improvements in balance and quality of life throughout the 12-week intervention. Nevertheless, the group undergoing Task-Oriented Circuit Training along with Conventional Therapy showed significantly superior gains in balance measures and EQ-5D-5L index scores compared to the group receiving Dual Task Training with Conventional Therapy at the 12-week. Overall, the Task-Oriented Circuit Training group demonstrated greater enhancements in both balance and quality of life. Conclusion: Task-Oriented Circuit Training along with Conventional Therapy improved balance and quality of life more than Dual Task Training. These findings justify using task-based circuit training in rehabilitation to achieve better functional results. Future studies should target larger samples and further follow-ups.

Background: Chronic neck pain (CNP) is a prevalent musculoskeletal condition that significantly affects quality of life and functional capacity. Among the various physiotherapy interventions available, Mulligan Sustained Natural Apophyseal Glides (SNAGs) and the McKenzie Method (Mechanical Diagnosis and Therapy) are commonly employed manual therapy techniques. However, direct comparisons of their clinical effectiveness remain limited. Objective: To compare the effectiveness of Mulligan SNAGs and the McKenzie Method as adjuncts to standard physiotherapy in reducing pain, improving function, enhancing range of motion (ROM), and promoting psychological wellbeing in patients with CNP. Methods: A randomized clinical trial was conducted on 56 participants with chronic neck pain, divided equally into two intervention groups: Mulligan SNAGs and McKenzie Method, both combined with standard physiotherapy. Interventions were applied five times weekly for four weeks. The outcome measures included the Numerical Pain Rating Scale (NPRS), neck pain and disability scale-Gujarati version (NPAD-G), WHO-5 Well-Being Index, cervical ROM, and Global Rating of Change (GRoC). Assessments were conducted at baseline, 2 weeks, and 4 weeks. Results: Both groups showed statistically significant within-group improvements across all outcome measures (p < 0.05). Pain intensity, functional disability, and psychological well-being improved notably with increased cervical ROM and high patient satisfaction. However, the between-group differences were not statistically significant (p > 0.05). Conclusion: Mulligan SNAGs and the McKenzie Method are both effective adjuncts to standard physiotherapy for managing chronic neck pain. Both techniques can be selected based on patient preference, therapist expertise, and clinical presentation.

The interplay between stress, anxiety, and central pain mechanisms is a critical consideration in modern physiotherapy. Emerging evidence underscores the neurobiological convergence of stress-related systems, such as the hypothalamicpituitary-adrenal (HPA) axis and sympathetic nervous system, with pain processing pathways. Chronic stress induces neuroinflammatory responses, disrupts inhibitory neurotransmission (e.g., GABA), and heightens excitatory mediators, such as Substance P, collectively amplifying pain sensitivity. Anxiety further intensifies pain through mechanisms such as catastrophizing, attentional bias, and anticipatory fear, often leading to maladaptive avoidance behavior. These psychological states not only exacerbate pain, but may also contribute to the development and persistence of chronic pain. Effective assessment and intervention require a multidisciplinary approach that integrates physical and psychological strategies, including physiotherapy, cognitive-behavioral therapy, mindfulness, and patient education. Understanding this bidirectional relationship is essential for personalized treatment planning and improved clinical outcomes. Addressing both emotional and physiological contributors to pain offers a comprehensive path to recovery and long-term management.