Physiotherapy and Occupational Therapy Journal

Background: In Chronic Kidney Disease (CKD), the kidney doesn't function, and Hemodialysis (HD) is the only treatment choice. However, patients undergoing HD have significantly reduced cardiorespiratory fitness and quality of life. HIIT elicits a more significant change in cardiorespiratory fitness. However, literature is insufficient on intradialytic exercises and HIIT for patients undergoing hemodialysis. Hence, this study aims to determine the immediate effects of HIIT on vital parameters in patients undergoing hemodialysis. Methods: In this pilot study, nine patients with CKD undergoing HD for more than three months with age ranging between 20- 75 years and who were vitally stable were included from the Dialysis Unit of Tertiary care teaching hospital. Patients with acute infection, unstable angina pectoris, severe arrhythmias, uncontrolled hypertension were excluded. After obtaining written consent from every participant, they performed HIIT on the bed cycle ergometer for 20 minutes on the bed in the supine position during dialysis. Efficacy was measured at baseline and immediately after the intervention from the change in Heart rate, Blood pressure and Oxygen Saturation. Results: All the participants completed the HIIT exercise without any complication in the given time. A significant change in HR values with a P-value of <0.006 was observed as HR increased within the target heart rate limits. However, there was no statistically significant change in values of SpO2 and BP with a P-value of <0.8 and < 0.6, respectively. Conclusions: This study demonstrated HIIT as a feasible and safe method for intradialytic exercise and emphasizes the importance of intradialytic exercises.

Keywords: HIIT; Intradialytic Exercise; CKD.

Introduction: Lower back pain (LBP) is a condition that restricts occupational activities of the patients suffering from it owing to pain and its perception, thus severely impacting functional capacity. The economic burden of LBP could be represented directly by the high costs of health care that one has to spend for the symptomatic relief from pain and indirectly due to decreased productivity owing to absenteeism. Material & Method: LBP can be acute, subacute or chronic in duration, however, with conservative measures that includes timely diagnosis and right treatment, the symptoms of low back pain typically improved within a few weeks from onset. Common attributes of LBP are muscular tension and spasms. Result: Pharmacological interventions for the treatment of LBP generally includes non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants, wherein both muscle relaxants and NSAIDs have proven efficacy and safety. Studies have shown that combining NSAIDs with a muscle relaxant could be a better treatment option than NSAIDs alone. One such example is Robi D, which is a combination of muscle relaxant methocarbamol and NSAID diclofenac, indicated for the relief of pain and inflammation associated with LBP along with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis. Conclusion: Although there are no individual studies that have assessed the efficacy and safety of Robi D, the individual efficacy and safety of its components speaks volumes of its durability both in real world and clinical trial. Robi D Injection may be administered during acute or severe phase up to a maximum of 3 days or less until amelioration of acute symptoms, post while the patients could be kept on a maintenance therapy with oral Robinaxol D tablets that contain methocarbamol (muscle relaxant) + diclofenac potassium (analgesic) + paracetamol (analgesic).

Keywords: Methocarbamol; Diclofenac; Low Back Pain.

Introduction: Ninety-nine percent of newborn deaths are in low- and middle-income countries and prematurity, intrapartum-related neonatal deaths (‘birth asphyxia’), sepsis and meningitis account for 75% of these.1 Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in "language, mobility, learning, self-help, and independent living".2 Aim of Study: 1.To explore the relationship, when early stimulation is provided to infants at high-risk and the stress experienced by parents. 2. To study the changes in quality of life of families when required stimulation is provided for high-risk infants. Method: 81 families recruited for this study recruitment Criteria: families of Infants who were at high-risk at birth. A low-cost, family of high-risk infants intervention programme to promote child and family wellbeing is provided at an Early Intervention Centre in Latika Roy Foundation, Dehradun, India. It follows a family-cantered approach of empowering families through respect, collaboration, information, training and support. Discussion: This study evaluates the effectiveness of family high-risk infants, required stimulation early intervention for leads to reduction of stress and improved quality of life. This study explores, for the first time in a resource limited country, the relationship between the reduction of stress and improved quality of life. Families of High-risk infants enrolled at the Centre during January 2015 through July 2017, who were in NICU for 5 or >5 days are partners in the study. Conclusion: Early intervention services and support to families can significantly improve quality of life of highrisk children. Intervention studies for children with disability state that the best way of improving children’s outcomes is by empowering parents through a structured learning programme.

Keywords: Enabling families of High-risk infants; Development outcomes; Early intervention and stimulation.