Physiotherapy and Occupational Therapy Journal

Introduction: Physiologically stroke is an acute, focal injury of the central nervous system of a vascular origin, contributing to a local or systemic neurological insult. Stroke one side of the upper and lower limbs are affected but trunk muscle are affected on both sides leading to insufficient trunk rotation and difficulty in maintain balance. Restoration of trunk control and balance is one of the important goals in rehabilitation of stroke patients. Neuro developmental therapy (NDT) is one of the preferred methods of stroke rehabilitation, also known as bobath concept. With the fine control and proper weight transfer, it is possible to secure and protect the body in upright posture and in the achievement distal functional movements. Purpose of Study: In comparison to limb muscles weakness, trunk muscle are also impaired in both ipsilateral and contralateral side of the body, thus weakness of the trunk muscle leads to loss of balance, stability and increase functional disability. This limits the patient’s activities, such as rolling in bed, transferring, putting on a shirt and bending to reach his feet to put on shoes and socks, etc. So my aim is to focus on the trunk function and balance in stroke patient in order to eliminate individual trunk impairment affecting various functions performed by the patients. Hence the purpose of the study to evaluate the effectiveness of the stroke patient. Methodology: Total 15 patients were included in the study by simple random sampling method. Group A (Experimental group) was received bobath approach and core stability training exercises. Conclusion: Bobath approach along with core stability training shows more improvement in trunk function and sitting balance after 4 week therapy.

Background: During the functional rehabilitation program (FRP), the significant difference in the speed and pulse rate between two walking mechanisms (with and without a windlass mechanism) on two different terrains, randomized cross-over trial. Methods and materials: Twenty two students aged 18-22 years with normal physiques. Students in both groups were instructed to walk in bare foot with and without the windlass mechanism on floor and treadmill. The primary outcome was to increase the speed and decrease the time with the windlass mechanism in barefoot walking during the FRP. The secondary outcome was to reduce the effort by using the windlass mechanism in barefoot walking during the FRP. Findings: The average time to complete 50 meters on the floor with a windlass mechanism is 30.7 seconds with a standard deviation of 0.91 seconds, whereas the average time without a windlass mechanism is 38.4 seconds with a standard deviation of 1.39 seconds. This difference in the mean is statistically significant (p <0.001). After walking, the average post-radial pulse rate with and without mechanism was 120.3 bpm and 131.4 bpm, with standard deviations of 2.87 bpm and 1.09 bpm, respectively. This difference in the mean is statistically significant (p <0.001). The average speed achieved for 120 seconds (2 minutes) with the windlass mechanism is 0.095 m/s with a standard deviation of 0.008 m/s, whereas the average speed achieved without the windlass mechanism is 0.066 m/s with a standard deviation of 0.007 m/s. This difference in the mean is statistically significant (p <0.001). After walking, the average post-radial pulse rate with and without mechanism was 129.8 bpm and 135.1 bpm, with standard deviations of 2.33 bpm and 3.34 bpm, respectively. This difference in the mean is statistically significant (p <0.001). Interpretation: This study finds that there is an increase in speed with less effort (lesser pulse rate) while using a windlass mechanism on both terrains. This research study suggests that the windlass mechanism can be used during the FRP. BKL Walawalkar Hospital’s Ethics Committee (EC/NEW/INST/2020/320) approved this study.

60 Patients included in the study as per inclusive and exclusive criteria. Subjects were included after the ethical committee approval. Informed consent obtained to conduct the study. Subjects were randomly divided in to three groups Group A, Group B and Group C with 20 subjects in each group. Group A and B assessed for neural and contralateral neural mobility and Group C assessed for hamstrings mobility. Four weeks interventions had given to each groups. Group A had given Hamstrings stretch + neural mobilization, Group B had given Hamstring stretch + contralateral neural mobilization, Group C had given Hamstring stretch. Five subjects dropped out, 2 males from Group A and 3 males from Group B. All the subjects reassessed by active knee extension test. Mean of the readings taken for final analysis. Results were calculated using 0.05 level of significance. When comparing the pre and post intervention hamstring mobility between the Group A, B and C results, it was found that hamstring mobility increased more in Group A as compared to Group B and C. From this we can infer that ipsilateral neural stretch accompanied with hamstrings stretch releases ipsilateral hamstrings restriction more compared to contralateral neural stretch accompanied with hamstrings stretching and isolated hamstrings stretch.