Physiotherapy and Occupational Therapy Journal

Introduction: WHO (1970 and still used) defined it as “A stroke is a clinical syndrome characterized by rapidly developing clinical symptoms or signs of focal, and at times global (applied to patients in deep coma and those with subarachnoid hemorrhage), 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”. This definition includes stroke due to cerebral infarction, primary intracerebral hemorrhage (PICH), intraventricular hemorrhage, and most cases of subarachnoid hemorrhage (SAH); it excludes subdural hemorrhage, epidural hemorrhage, or intracerebral hemorrhage (ICH) or infarction caused by infection or tumor.1–3 Aim of the Study: mCIMT on upper extremity and hand functions among individuals with stroke based on the severity as assessed by the UEFM and ARAT. Methods: The mCIMT was given as treatment intervention for stroke patients. The participants were asked to wear padded safety mitt on their less affected hand during treatment and at least 3 hours at home. All subjects were instructed to take the mitt off during certain activities mainly involving coordinated movements of both the hands simultaneously for example, when driving a car or riding a bike or reading a newspaper. Discussion: The present study “Efficacy of modified constraint induced movement therapy in improving upper extremity and hand functions in stroke patients” has been started with aim to find out the effectiveness of mCIMT in different severity of stroke. Rinskinijl et al. 2013. Level 3a involves in-hand manipulation exercises, essential for regaining dexterity and bridging the gap between levels 2 and 3b, the latter involving activities of daily living. A database of exercises that can be used for both the dominant and non-dominant hands has been created for each aim at each level. Joachim Liepert et al., 2000. The mechanism of this massive cortical reorganization probably reflects either an increase in the excitability of neurons already involved in the innervation of more-affected hand movements or an increase in excitable neuronal tissue in the infarcted hemisphere, or both. Conclusion: This study concluded that the patients from moderate to severe post-stroke disability improved better than the mild sever stroke patients so in this case the hypothesis can be rejected and it is accepted that CIMT can be used more beneficially in moderate and severe disability post stroke than the mild post-stroke disability.

Keywords: mCIMT; UEFM; Visual Analog Scale (VAS); Fugl-Meyer Assessment scale and Action research arm test (ARAT) scores.

Background: Mechanical neck pain is defined as pain experienced anywhere in the base of skull at ear level to the upper part of back or shoulder. It affects 2/3 of population, usually those employed in desk jobs with a sustained neck posture. The prevalence of neck pain has found to be increasing and is mainly found in female population. The contributing factors for neck pain are poor posture, strenuous activities related to sports or occupation. Mechanical neck pain has an impact on our daily living and cause limitations in activities and work capacity, and induces economic and medical burden on individuals and is a major health issue. There is need to identify the effect of mechanical neck pain on muscular strength and ROM. Methods: Total 50 subjects (male and female) with unilateral mechanical neck pain (duration 3 or more months) with NDI Score ≥10 from age group 18–28 years were recruited in this study. A written consent was taken from all the subjects. General Assessment of the subjects was performed to meet the inclusion criteria. Prior to test subjects were informed about the procedure. To assess the cervical flexor strength, a modified sphygmomanometer was used. The ROM of cervical flexion, extension, lateral flexion and rotation was measured by using a universal goniometer. Result: The result of this study was analyzed using the Pearson correlation coefficient. The study concludes that there is no significant effect of mechanical neck pain on cervical flexor strength but there is significant effect of mechanical neck pain on cervical flexion and lateral flexion range of motion. Conclusion: Proper biomechanics help the students to work effectively and for longer duration without any neck pain. Any alteration in the biomechanics affecting ROM and strength will lead to pain and affect ADLs. So regular stretching of muscles and neck ROM exercises must be continued especially by students and working people in order to avoid any neck pain and to improve quality of life.

Keywords: Mechanical neck pain; Range of motion; Strength.

Twenty hemiplegic cerebral palsy subjects with mean age of 9.33 years included in the study. As per the inclusion criteria, subjects were included after the ethical committee approval. Informed consent obtained to conduct the study. Twenty hemiplegic cerebral palsy subjects were assessed for fine motor function using HELP. The children were divided into two groups based on random sampling. Group 1: NDT, N = 10. Group 2: conventional physiotherapy N = 10. Outcome data Assessments were performed at baseline and after 12 sessions. Within group analysis revealed that there is a significant improvement in balance (p-value <0.0001) and reduction of fear of fall (p-value < 0.0001) in subjects with Parkinson’s disease after balance training. The correlation between the scores of Berg balance scale and fall efficacy scale are strongly negative (–0.921) before treatment and after treatment also there is a negative correlation (–0.699) but it is weak statistically.

Keywords: HELP; Hemiplegic cerebral palsy; Fine motor function.

Background: Pleural effusion is an abnormal accumulation of fluid in the intra-pleural space. The relative annual incidence of pleural effusion is estimated to be 320 per 100,000 people in industrialized countries. In pleural effusion positioning may be used to optimize gas-exchange. The therapeutic body positioning is a primary non-invasive physical-therapy intervention. Methodology: The presence of pleural effusion was assessed by physical examination and chest X-ray. Pulmonary function testing (RMS HELIOS Spirometer) was conducted in sitting, right and left lateral decubitus positions. A forced expiratory maneuver was performed three times in each position after maintaining that position for 20 minutes and with rest as needed by the patient, between trials. It was made sure that subjects understood the instructions and performed the test with standard guideline (ATS Guidelines). The best values of forced vital capacity (FVC) and forced expiratory volume (FEV) were analyzed. Results: No significant difference (p >0.10) was noted in FVC, FEV1 and FEV1/FVC values between the three positions. Although, mean values of FVC, FEV1 in sitting position (41.6 ± 12.20) was higher than mean value of FVC, FEV1 of lateral positions. In lateral decubitus position the mean FVC, FEV1 value of effusion lung upper most (37.8 ± 11.50) was slightly higher than effusion lung dependant (36.5 ± 12.8). Conclusion: Position does not appear to have a significant effect on PFT in unilateral effusion patients.

Keywords: Pleural effusion, PFT (pulmonary function test), body position.

Background: Swiss ball exercise is used as a rehabilitative tool to correct posture and to treat and prevent pain in neck and waist, because it can increase muscle strength, endurance, flexibility, and coordination and be used to improve perceptual balancing ability. In the present study, we aimed to investigate the effects of activities on different sizes of Swiss ball on balance in geriatric population. Method: In this experimental study 30 elderly people in the age of 65–80 years participated. Subjects were equally divided in 2 groups. Group A having 15 subjects are given Swiss ball exercises on 55 cm Swiss ball for 4 weeks (4 days/week). Group B having 15 subjects are given exercises on 75 cm Swiss ball for 4 weeks (4 days/week). Berg Balance Scale (BBS) scores were noted both before and after the 4 weeks exercises session on Swiss ball. Pre-exercise evaluation was done. Then the post-exercise evaluation was done. Subjects were evaluated using BBS. Result: Thirty patients in the age range 65–80 years participated in the study. Patients were given Swiss ball activities. Within the group the pre-intervention BBS was 36.2 ± 5.11 and the post-intervention was 41.4 ± 6.32 (t-value is 3.25, p-value is 0.05) for 55 cm diameter Swiss ball. There is significant difference with in the groups with respect to mean BBS scores. Within the group pre-intervention BBS was 37.6 ± 5.40 and post-intervention was 45.6 ± 4.27 (t-value is 1.94, p-value is 0.05) for 75 cm Swiss ball. There is no significant difference with in the groups with respect to mean BBS scores. Between the two groups the post intervention BBS was 41.4 ± 6.32 the Swiss ball of 55 cm and 45.6 ± 4.27 for Swiss ball of 75 cm (t-value is 0.041, p-value is 0.05). There is no significant difference in the BBS scores. Conclusion: There was positive improvement in Berg balance score by Swiss ball training on 55 cm diameter of swiss ball. There was no positive improvement in Berg balance score by Swiss ball training on 75 cm diameter of swiss ball. There was no improvements seen when both the Swiss ball regimes are compared.

Keywords: Berg balance scale; Central nervous system; Swiss ball; Balance; Geriatric population.