Physiotherapy and Occupational Therapy Journal

Stretching is traditionally used as part of a warmup to increase flexibility or painfree range of motion (ROM) about a joint in an attempt to promote better performances and/or reduce the risk of injury. Physiotherapist also recommend that their athletes or patients stretch before performing strengthening exercises or strength assessment tests. However, authors of recent systematic reviews have suggested that preexercise stretching may temporarily compromise a muscle’s ability to produce force and power output. This ‘‘stretchinginduced force deficit’’ has been reported to affect isometric force , Power, concentric isokinetic peak torque , dynamic constant external resistance (DCER) force , vertical jumping performance and balance different types of PNF techniques have been suggested like static, dynamic , Hold Relax and Contract–Relax, Agonist Contraction and Hold–Relax with Agonist Contraction . Effects of stretching on strength / torque and performance is still in inconclusive with studies showing both increase and decrease in both the variables. There is dearth of evidence related to the subject of peak torque after modal variants of stretching, hence in future there is need for randomized controlled trial on athletes and various patient populations. 

Keywords: Stretching; PNF; Torque; Performance. 

Aim and Objective: Shoulder joint is the most common joint to be effected by the degenerative process of the body. As it offers more mobility than stability, overuse injuries not only affect the shoulder joint but also exert their effect to distal segments of the limb. Due to the anatomical linkage with the spine, any abnormality at the shoulder is thereby suspected to affect the spinal biomechanics and the associated nervous system functioning. Researchers have postulated hand muscle weakness to be an associated finding in subjects with shoulder joint pathologies and thus the following study was aimed at determining the effectiveness cervicothoracic mobilization and hand grip exercise on grip strength in subjects with impingement syndrome. Method: 20 subjects with history of impingement syndrome for at least 4 weeks and positive Neers and Hawkins Kennedy test were randomly assigned into two groups of 10 subjects each. Group A underwent cervicothoracic mobilization and group B received hand grip strengthening protocol for 1 month, thrice a week and once a day. Readings for grip strength were taken by a hand held dynamometer before starting and after the intervention i.e. after one month. Data Analysis: Statistics were performed using Graph pad. Intra group and inter group analysis was done and Mann Whitney test was used to analyze and compare the intervention scores. Significance level was set at p d” 0.05. Results: Though both the groups improved significantly, group A, cervicothoracic mobilization group resulted in more significant hand grip strength improvement when compared with group B, the hand grip exercise group. Discussion and Conclusion: results conclude that apart from the standard hand grip exercises, cervicothoracic mobilization can be effectively used to enhance the grip strength in subjects with impingement syndrome. 

Keywords: Cervicothoracic junction; Hand grip; Supraspinatus tendinitis; Impingement syndrome. 

The PANDHARPUR WARI is distinct from all other forms of pilgrimages like the ‘yatra’ in a variety of ways. To begin with, it is a collective form of BHAKTI (worship) often undertaken as an extension of family tradition. It has a predetermined scheduled and route and has no purpose other than sheer worship. The ‘yatra’ on the under hand is undertaken by individuals at their convenience to a variety of deities for personal reasons. Participating in the WARI is its own reward and Panduranga the lone object of worship. The WARI is a microcosm of the vast sects, subsects, castes and trades that go into the making of the state of Maharastra – as men, women, young and old people from all walks of life, age and socioeconomic status walk alongside each other, never for a moment being aware of their differences or status. Most unconventional is the belief that the Lord Vithhal awaits this meeting with his devotees (bhaktas). The eagerness to meet Lord Vitthal and the repetitive chanting of RAMKRISHNAHARI refrain during the walk are unifying bonds among different peoples all termed WARKARIS. No other rituals dot the WARIKARI horizon unlike in the ‘yatra’ where host of rites and rituals are prescribed and have to be adhered to. In short, WARI is synonymous with annual pilgrimage on foot to PANDHARPUR and the WARKARI refers to the ardent devotee of Lord Vitthal.[1] 

Keywords: Pandharpur; Warkari; Worship; Social aspect; Complaints. 

Mechanical low back pain (LBP) is the most common complaints in the urban society causing to absent from the work and activity limitation. Its health, social and economic burden is hefty. Despite developments in modern medicine in general and growing knowledge of spinal diseases, problem of nonspecific low back pain remains unsolved. In India, occurrence of LBP is also alarming; nearly 60% of the people have significant back pain at some time or the other in the lives and responsible to cause workrelated disability in persons younger than 45 years. Even though there is ample evidence stating the efficacy of lumbar stabilization training but the evidence based practice are lacking that establish the role of pressure biofeedback training in lumbar stabilization. The present contribution intends to study whether pressure biofeedback in lumbar stabilization exercises has any role in the pain management and decreasing the relatedness disability as measured by Visual Analogue Scale (VAS) and Modified Oswestry Low back Pain Questionnaire (MOLBPQ) respectively. An intervention including lumbar stabilization exercises of 3 week protocol was given to 2 groups of 15 patients. Both groups showed decrease in pain and disability after intervention but the group involving lumbar stabilization exercises using pressure biofeedback group showed significant improvement as compared with the other group. Conclusively, lumbar stabilization exercises using pressure biofeedback are more beneficial than lumbar stabilization exercises alone in mechanical low back pain patients. 

Keywords: Lumbar stabilization exercises; Pressure bio feedback; Mechanical low back pain. 

Purpose:The purpose of this study was to evaluate the acute hemodynamic response to Acapella in patients underwent coronary artery bypass graft surgery (CABG). Methods: Fifteen (n=15, mean age: 57.6+9.8 years) post CABG patients were selected for this study from cardiothoracic unit of Safdarjung Hospital, New Delhi. All patients used Acapella during their phase 1 cardiac rehabilitation program. They were asked to breath from diaphragm taking in a larger than normal breath, hold breath for 2 to 3 seconds and exhale actively but not forcefully, through the device, exhalation lasted approximately 3 to 4 times longer than inhalation. It was performed 10 to 20 PEP breaths. Patients were instructed to remove the mouthpiece and perform 2 to 3 ‘huffs’ coughs to raise secretions as needed. These procedures had been repeated 3 to 4 times. Measurements of systolic blood pressure, diastolic blood pressure heart rate, rate pressure product, arterial oxygen saturation and respiratory rate were taken before, during, immediately after and 30 minutes after using Acapella. Rate of perceived exertion and sputum amount were taken after using Acapella. Data were analysed by SPSS (20) by comparing the means of outcomes, using repeated measure ANOVA. Results: As a result of use of Acapella during cardiac rehabilitation, a significant improvement was observed in the sputum volume mean (7.7 ml), respiratory rate (p<0.001) and SPO2 (p<0.001). Acapella caused no significant hemodynamic response such as systolic blood pressure (p=0.239), diastolic blood pressure (p=0.360), heart rate (p=0.60) and rate pressure product. Conclusion: Use of Acapella during phase 1 cardiac rehabilitation seems to be safe, without alteration on hemodynamic variables; in addition, it seems an effective adjunct for the removal of bronchial secretions in patients underwent coronary artery bypass surgery. 

Keywords: Acapella; hemodynamic; cardiac rehabilitation; Coronary artery bypass graft.