Physiotherapy and Occupational Therapy Journal

  Introduction: A stroke is a clinical syndrome characterized by rapidly developing clinical symptoms and/or signs of focal, and at times global (applied to patients in deep coma and those with subarachnoid haemorrhage), loss of cerebral function, with symptoms lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin (Hatano, 1976) [1]. Need for Study: To compare two treatment protocols to improve hand functions in sub-acute stroke subjects. Methods: It is an experimental study design. Sample of convenience of thirty sub-acute stoke subjects are selected and divided into group A and group B. Group A receive Intermittent Pneumatic Compression combine with Mirror Therapy for their hemiplegic upper limb. Intermittent Pneumatic Compression is given for 30 minutes a day, 6 days a week for 4 weeks and Mirror Therapy is given for two hours a day, 6 days a week for 4 weeks. Group B receives ROM exercises, stretching; strengthen exercises for 60 minutes/day, 6 days a week for 4 weeks.

Discussion: Clinical Test for sensation (NSA), motor function (Brunstrom Motor Recovery Stages) and FIMS was used in this study to determine hand functions improved by Intermittent Pneumatic Compression and Mirror Therapy. The results obtained revealed interesting findings in sub-acute stroke subjects. Sensory as well as motor function improved by Intermittent Pneumatic Compression and Mirror Therapy. Sensory impairment is improved by Intermittent Pneumatic Compression. Conclusion: The study concluded that hand functions improved by Intermittent Pneumatic Compression and Mirror Therapy in sub-acute stroke subjects and interventions should
be emphasize to restore motor and sensory function. 

Keywords: Intermittent pneumatic Compression machine; Mirror (35x35cms); Plinth, Stepper; Table & Pillow.

  Introduction: The human body can adopt various types of postures. Typical examples of deviations from neutral posture around the low back are forward and backward bending, side bending and rotation [1]. Body part discomfort (BPD) scale has become a standard discomfort assessment tool. While performing a task, the worker indicates the body areas in which discomfort is felt as a result of the task, and assigns a severity to the discomfort of each body part [2,19,40,45]. Aims and Objectives: The main aim and objective of this study was to observe the effects of deviation from neutral position on the perceived joint discomfort rating in neck and back in sitting and standing position. Methods: A total of forty subjects were selected based upon the inclusion and exclusion criteria. The 20 out of the 40 subjects were asked to maintain static joint posture for the neck. The postures included were flexion, extension, right and left side flexion and right and left rotation. The subjects were asked to maintain these posture in the sitting position. The remaining 20 subjects were asked to maintain the same static joint posture in sitting position for the neck but in reverse order. The first 20 subjects were then asked to maintain static joint posture for the low back in sitting position. The postures included were flexion, right and left side flexion and right and left rotation. The remaining 20 subjects were then asked to maintain the same static joint posture for the low back in sitting position but in the reverse order. Discussion: These findings suggest as stated earlier that perceived joint discomfort has a direct correlation with the torque produced in the muscle around the joint and higher the torque more will be the discomfort. H. Monod reported that exhaustion of a muscle engaged in static activity is mainly due to ischaemia created inside the muscle by the contracting force [35]. Wilke et al. (1999) measured spinal disk pressure for various activities and found that there was a lower spinal load in sitting when compared to standing [25,70,72]. In our study flexion of the back produce second highest discomfort rating. This is born out on the basis that trunk flexion increases the load on the spine by increasing the forward bending moment on the spine [30]. Conclusion: Based on the finding of this study we can conclude that lateral bending of the cervical appears to cause more discomfort than the flexion, extension and rotation when performed in the standing position as compared to sitting. Similarly, lateral bending of the lumbar spine appears to cause more discomfort than any other static joint posture, when performed in standing position as compared to sitting. Limitation of the Study: 1. Small sample size. 2. Perceived joint discomfort scale is a subjective scale and its accuracy depends on the level of understanding of subject. 3. No blinding was done. 4. Lumbar extension in sitting position was not included in the study. 5. Lumbar rotation ROM was not measured. 

Keywords: Joint Discomfort Scale; Stop Watch; Perceived Joint Discomfort; Cervical; Lumbar; Static Posture; Sitting; Standing

  Introduction: Cerebral palsy is the most common neurological condition in pediatric age group. The worldwide incidence being 1.5 to 2.5 per 1000 live births [4,7,8]. Cerebral palsy in developing countries in most often attributed to birth asphyxia and birth Trauma and indeed birth asphyxia is still a leading cause of cerebral palsy in India [4]. Gait is one of the most important functional activity. It may be described as translatory progression of body as whole produced by coordinated rotatory movement of the body segment. Normal gait is rhythmic and characterized by alternating propulsion and retropulsion motions of the lower extremity and depends on the muscle strength of the lower extremities [1]. Need for Study: To compare two strengthening protocols to improve gait in spastic diparetic cerebral palsy subjects. Methods: 30 spastic diparetic cerebral palsy children took part in the study. The subjects were divided into two groups, group A and group B. Group A was given both closed kinematic and open kinematic chain exercise and group B was given only open kinematic chain exercise. Spasticity was evaluated by the Modified Ash worth scale. Following this, the subjects were asked to perform in randomized order. Discussion: Some studies proved that both closed kinematics chain and open kinematics chain strengthening exercise improve function in children and adolescents with Spastic cerebral palsy. Therefore, selecting different activities for training in both open and closed kinematics chain exercise improve more gait variables that using similar activities only in one kinematics chain exercise. Conclusion: The study concluded that although both groups group A and group B improves gait parameters, but Group A exercises shows better improvement in gait parameters as compared to Group B. Thus, the hypothesis that there is significant effect in improvement of gait parameters by using combined closed and open kinematic chain exercise in spastic diparetic cerebral palsy children holds true. Limitation of study: 1. Duration of gait training was small i.e. 5 weeks. 2. Time constrains meant that patients were only followed up for one month. Future research: 1. Further studies can be done with wider sample size including different subjects with different age groups. 2. Closed and open kinematic chain exercises can be applied in patient with different neurological condition such as muscular dystrophy, stroke, and multiple sclerosis. 3. Study can be conducted on cerebral palsy subjects with spasticity more than 1+. 

Keywords: CP; Closed Kinematic & Open Kinematic Chain Exercise; Stop Watch; Marker; Measuring Tape; Oil and Socks; Paper Walkway & Rowing Machine 

Carbohydrates are the most abundant biomolecule produced on the earth, photosynthetic plants and algae convert over 100 billion metric tonnes of CO 2 and H2O into sugar, starch and cellulose like substances. These are polyhydroxy aldehyde or ketones and their derivates or substances that yield such compounds on hydrolysis. Most carbohydrates have the empirical formula (CH2O) n, some do not conform to it while others contain in addition to C, H and O elements such as Nitrogen, Phosphorous or Sulphur. Three major size classes of carbohydrates are Monosaccharides, oligosaccharides and polysaccharides. The saccharide means sugar. Monosaccharides are simple sugars consisting of a single polyhydroxy aldehyde or ketone unit, oligosaccharides consist of short changes of few (2-8) mono saccharide units joined together by characteristic glyosidic linkage. The most abundant monosaccharide and disaccharide found in nature are glycose (fruit sugar) and sucrose (cane sugar) the later consists of two 6-carbonsugar, D-glucose and D-fructose joined covalently. All common mono and disaccharides have names ending with suffix “ose”.  

Keywords: Carbohydrates; Muscles; Joints.