Physiotherapy and Occupational Therapy Journal

Background and objectives: Early identification of postures and movements possibly associated with a poorer quality of developmental outcome is very desirable. Assessment of gestational age of the infant help to identify the developmental status of the infant . One of the widely used tools in gestational age assessment is the scarf sign . Recently, a new method of measuring scarf sign called scarf ratio was described. This scale being relatively new , the available literature reflects a need for estimating intrarater and interrater reliability of scarf ratio., Subjects and measurments : Thirty two preterm infants recruited from neonatal ICU at district maternity hospital who met the inclusion & exclusion criteria were examined to estimate interrater and intrarater reliability of scarf ratio . Intrarater reliability for scarf ratio was estimated with a second assessment following a brief interval. Simultaneously, interrater reliability of scarf ratio was estimated with second therapist, Conclusions : Scarf ratio can be used as an efficient individual tool to estimate gestational age in preterm infants. It is also a reliable measure when conducted by two different clinicians who are well versed with the method. 

Key words: Preterm infants, Gestational age assessment, scarf sign , scarf ratio.

This study compared the efficacy of Early Mobilization with routine Physiotherapy Technique (DBE + Splinted Cough) in 18 patients who had undergone upper abdominal surgery. Subjects were randomly allocated into two groups, following which one group received early mobilization and the other group received deep breathing exercises and splinted coughing. SpO2 was documented every day from the 1st to 3rd postoperative day of surgery. Forced Expiratory values (FVC, FEV1, and PEFR), Maximum Inspiratory Pressure and 2 minute walk test were measured on the 4th post operative day. All the parameters between two groups were compared and the results show similar values between two groups except PEFR which shows better results in Group 1. This study showed that early mobilization is as effective as routine physiotherapy in subject who underwent upper abdominal surgery and had a high risk of developing lung complications.

Key words: Early Mobilisation, Chest Physiotherapy, Pulmonary Complications, Upper Abdominal Surgery, General Anesthesia.

Objective: To compare the magnitudes of change in heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), arterial oxygen saturation(SpO2),rate pressure product(RPP) and rate of perceived exertion(RPE) during straight partial sit-ups and oblique partial sit-ups Design: Randomized controlled parallel design. Participants: Thirty male volunteers with mean age 23.7±1.9 years, height 5.5± 0.2 meters, weight 59.2+5.7 kg and BMI of 21.4 ± 2.1were included in the study. Methods: 30 male healthy volunteers were randomly assigned to two groups and they performed 30 repetitions of SPU and OPSU depending upon the group they were allocated to. After recording there baseline HR, BP, SpO2 for one minute same were recorded during and post exercise for 10 minutes with the help of monitors attached with a BP cuff and pulse oxymeter. Result: Data was analysed using SPSS 14.0 for window version. t-test was used to compare the pre-exercise, during-exercise and post-exercise effects on hemodynamic variables between SPSU and OPSU. Within group comparison was done using ANOVA. The level of significance was set at p< 0.05. Mean difference of pre and post exercise hemodynamic variables were compared and no significant difference was found between the two exercises at during exercise and post exercise levels However, within group analysis, a significant difference at pre exercise, during exercise and post exercise levels in each hemodynamic variables in both the abdominal exercises were found. Conclusion: The results suggest that there was no significant difference in rise in hemodynamic variables during the two exercises. However there was a significant difference between pre exercise and during exercise magnitude of hemodynamic variables of each exercise. This suggests that acute hemodynamic changes of these two abdominal exercises are clinically relevant, however both oblique partial sit-ups and straight partial sit-ups warrant same amount of concern.

Keywords: Hemodynamics, abdominal exercises, rehabilitation, blood pressure, rate pressure product

 Background and purpose: Mechanosensitivity of peripheral nerves was earlier demonstrated in animal models and in experimental human models of diabetic neuropathy and also in asymptomatic human subjects. The purpose of this study was to assess the immediate effects of nerve sliders and nerve massage on vibration perception thresholds (VPT), heat perception thresholds (HPT) and cooling perception thresholds (CPT) in patients with painful diabetic peripheral neuropathy.,Materials and methods: The study was an observer-blinded pilot randomized sham-controlled clinical trial with concealed allocation on 34 patients (22 male, 12 female) of mean age 53.86 ± 9.85 years with type-2 diabetes mellitus, neuropathic pain for more than one-year, VPT > 25 volts in feet and positive lower extremity neurodynamic testing in bilateral lower limbs suggestive of distal symmetric type of diabetic neuropathy. The tester administered nerve sliders and nerve massage to one lower limb while sham intervention of passive joint movements was performed for the other limb. The choice of first limb was chosen randomly and block randomization was performed to minimize between-side confounding differences. The three outcomes of VPT, HPT and CPT were assessed pre, immediate post and 15 min-post intervention on both feet using a biothesiometer., Data analysis and results: The data was analyzed using repeated measures analysis of variance at 95% confidence interval using SPSS 12.0.1 for Windows. Secondary analysis was done using independent t-test for gender and choice of first side. The experimental side had a greater reduction of VPT (12.40 ± 4.90 volts), HPT (7.63 ± 5.18 degree Celsius) and CPT (8.02 ± 5.97 degree Celsius) from pre-treatment to 15- min post-treatment compared to the sham side (p<.05). The changes between immediate post-treatment and 15- min post-treatment was not significant (p>.05) for all three measurements., Conclusion: Neurodynamic mobilization comprising of nerve sliders and nerve massage was effective on short-term in reducing VPT, HPT and CPT in patients with painful diabetic peripheral neuropathy compared to a sham intervention. These immediate effects were maintained at 15 min post-treatment.

Key words: Neurodynamics, mechanosensitivity, diabetic neuropathy, manual therapy, quantitative sensory testing.