Physiotherapy and Occupational Therapy Journal

Constraint-Induced Movement Therapy (CIMT), a therapy regime proposed by Taub and colleagues for rehabilitation of the upper extremities are being utilised for lower limb rehabilitation as modified-CIMT (mCIMT). The recent literatures on mCIMT for lower limbs did not use the concept ‘constraint’ in their methodology. Restraining of the less affected lower limb as similar to that of upper limbs are not possible when providing CIMT because of the bipedal nature of lower limb tasks. Shaping-Induced Movement Therapy (SIMT) which focuses on shaping the behaviour through internal constraints such as feedback and reassurance can be considered as the better alternative to mCIMT in the rehabilitation of lower limbs in patients with stroke.

Physiotherapy education in India is at a crossroads, facing numerous challenges that hinder its progress and impact on healthcare. Despite the significant growth in the number of institutions offering physiotherapy programs, several factors undermine the quality of education and professional development in this field. Key issues include the lack of a central regulatory framework, inconsistent curricula, inadequate infrastructure, and insufficient clinical training opportunities. These problems are compounded by a shortage of qualified faculty, limited research emphasis, outdated teaching methods, and socio-cultural barriers. Additionally, physiotherapy graduates in India face limited job prospects, low salaries, and unclear career progression, which contribute to a brain drain of talented professionals seeking opportunities abroad. This article highlights the urgent need for a comprehensive overhaul of physiotherapy education in India, emphasizing the establishment of a national regulatory body, enhancement of educational standards, integration of modern technologies, and fostering of a more inclusive and supportive professional environment. Addressing these challenges is critical for producing competent physiotherapists who can meet the evolving healthcare needs of India and contribute to the global physiotherapy community.

Background: Diaphragmatic breathing, also known as deep breathing, involves the diaphragm to enhance oxygen exchange and has shown various physiological benefits. This study aims to investigate the effect of diaphragmatic breathing on serum hemoglobin levels in healthy vegetarian adults. Understanding this relationship could provide insights into non-pharmacological interventions for improving respiratory efficiency and blood oxygenation.  Methods: This randomized controlled trial included 100 healthy vegetarian adults aged 20- 50 years from Anand City, Gujarat, India. Participants were randomly assigned to either the intervention group (n=50), which performed diaphragmatic breathing exercises, or the control group (n=50), which did not receive any specific breathing exercises. The intervention consisted of daily 30-minute sessions, 5 days a week, for 8 weeks. Serum hemoglobin levels were measured at baseline and post-intervention. Statistical analysis was performed using paired t-tests to compare pre and post-intervention hemoglobin levels within each group and independent t-tests to compare changes between groups. A p-value of less than 0.05 was considered significant. Results: The intervention group showed a significant increase in serum hemoglobin levels from 13.8 ± 1.2 g/dL to 14.4 ± 1.1 g/dL (p=0.03), while the control group showed no significant change (13.7 ± 1.3 g/dL to 13.6 ± 1.2 g/dL, p=0.67). The change in hemoglobin levels was significantly greater in the intervention group compared to the control group (p=0.03). Conclusion: Diaphragmatic breathing exercises significantly increased serum hemoglobin levels in healthy vegetarian adults. This non-invasive intervention could be a potential strategy for enhancing respiratory function and overall health. Further research is warranted to explore the underlying mechanisms and long-term benefits.
 

 

Introduction: This study compares the effectiveness of two therapeutic interventions in patients with upper trapezius myofascial pain syndrome: Group A (Proprioceptive Neuromuscular Training) and Group B (Conventional Functional Training). A total of 30 participants were divided equally into both groups. The study evaluated demographic factors, pain reduction, functional improvement, and range of motion (ROM) over the course of treatment. Purpose of the Study: To compare the effectiveness of proprioceptive exercise with neuromuscular training versus conventional training with functional training in subjects with osteoarthritis of the knee. Methodology: A total of 30 subjects will be taken for the study by convenience sampling method. Subjects will be divided into 2 groups, with 15 subjects in each group. Group A will receive proprioceptive exercise with neuromuscular training exercises. Group B will receive conventional training with functional training exercises. Both groups received their respective intervention for a duration of six weeks, with pre and post treatment evaluations conducted. Conclusion: These findings suggest that clinicians can utilize either approach, depending on patient preferences or specific clinical circumstances, as both interventions appear to provide comparable outcomes in pain relief, functional enhancement, and range of motion improvement. Keywords: Proprioceptive Neuromuscular Training; Conventional Functional Training; Pain reduction; Range of motion (ROM); Functional improvement; NPRS; WOMAC.

Introduction: Hamstring flexibility is crucial for athletic performance and injury prevention. Various therapeutic techniques have been explored to improve hamstring flexibility, with dynamic cupping and Active Release Technique (ART) being two popular methods. However, limited research exists comparing the efficacy of these interventions. Need to Study: Need of study is to compare that which technique is more effective on enhancing hamstring flexibility in recreational athletes either dynamic cupping or active release technique. Method: This study involved 30 recreational athletes randomly divided into two groups. Group A (n=15) received dynamic cupping therapy, while Group B (n=15) underwent Active Release Technique (ART). Both groups received three treatment sessions over three days. Hamstring flexibility was assessed using a goniometer, and pain intensity was measured using the Numeric Pain Rating Scale (NPRS). Conclusion: In summary, this study indicates that both dynamic cupping and Active Release Technique (ART) effectively improve hamstring flexibility and reduce pain in recreational athletes. However, ART demonstrated slightly greater effectiveness in enhancing flexibility compared to dynamic cupping. These findings suggest that while both techniques are viable options, ART may be the preferred choice for athletes aiming to optimize hamstring flexibility and prevent injury. Future research should explore larger sample sizes and longer follow-up periods to further elucidate the comparative benefits of these interventions.

Introduction: The 6-Minute Walk Test (6-MWT) is a simple and commonly used functional performance test that assesses an individual's aerobic capacity and endurance of the lower limb. In knee osteoarthritis, the 6-MWT is often employed as a clinical assessment tool to evaluate functional capacity and monitor changes in physical performance over time. Individuals with knee osteoarthritis may experience pain, stiffness, and reduced mobility, significantly impacting their ability to walk and engage in daily activities. Aim: This study determines the reliability, construct validity, and minimal detectable change of 6-MWT in patients with knee OA. Materials and Method: This was an Observational Cross-sectional study. This study was conducted at The Sarvajanik College of Physiotherapy, Surat for a period of one year i.e. from July 2022 to June 2023. A total of 90 patients with knee OA were selected as participants, and the study used outcome measures such as mWOMAC to assess the level of disability and 30s SST to examine the Functional capacity and Strength of the lower limbs. Only 44 of 90 participants performed 6-MWT again after 48 hours for reliability. Data obtained were analysed in SPSS version 20.0. Intra-class correlation coefficient (ICC) values were derived for test-retest reliability, Pearson's correlation was seen for validity assessment, and standard error of measurement (SEM) and minimum detectable change (MDC) were also calculated. Results: The mean age of the patient was 59.66±8.237, and the mean pain score was 6.04±1.805. The ICC values for test-retest reliability were 0.992, which showed excellent reliability. The SEM and MDC values were 9.018 meters and 24.92 meters, respectively. 6-MWT showed a high-level positive correlation with the 30sSST (r = 0.821) and a moderate negative correlation with the mWOMAC and NPRS (r = -0.593 & r = -0.537), respectively. Conclusion: The 6-minute walk test is a reliable, valid test to assess the functional capacity in knee OA patients.

Context: Respiratory failure, atelectasis, pneumothorax, pleural effusion and sputum retention are all possible pulmonary complications, especially in children in post-operative phase. The objectives of blow bottle PEP are to maximise gas exchange, lessen blockage and enhance ventilation. Aim: To analyse how blow bottle-positive expiratory pressure affects the pulmonary functions of the children who underwent a median sternotomy. Methods and Material: A pilot study was carried out on six children, where both groups underwent deep breathing exercises. Additionally, the experimental group received blow bottle expiratory therapy over a period of post-operative 5 days (from 3rd to 7th POD). The deep breathing exercises were performed in four sessions daily, while the blow bottle positive pressure expiratory therapy was given for 4 sessions, each session consists of 3 sets of 10 repetitions, with rest intervals of 5-10 minutes between sets. Following the pilot study, a main study was conducted on 28 additional children, who were randomly assigned to either the experimental or control groups. The same procedures were applied, and no complications were observed during the therapy sessions. Statistical analysis used: PEFR (p<0.001), CE (p<0.001)and spo2 (p<0.004) all showed substantial improvement within the group as well as between-group analysis. Conclusions: To improve the pulmonary function of the children who had median sternotomy, deep breathing exercise combined with blow bottle-positive expiratory pressure was more effective than deep breathing exercise alone.

condition of the human body. Temporomandibular joint (TMJ) dysfunction is a challenging and often unbearable condition characterized by pain in the joint and surrounding muscles, often resulting in stiffness, complications, earache, malocclusion, clicking sounds, and trismus. TMJ dysfunction is frequently linked to imbalances in the body, particularly in the neck and shoulders. Misdiagnosis or inadequate management can lead to chronic pain syndromes, which can be distressing for patients. This condition may present as acute or chronic; while acute TMJ dysfunction is commonly managed with manual reduction, chronic cases are more complex. Case Description: We report the case of an 18-year-old male athlete referred by his dentist for conservative management of TMJ dysfunction. He presented with left jaw pain for the past four months, limited mouth opening, jaw clicking, and difficulty chewing hard foods, accompanied by tenderness in the neck, mouth, and cheek muscles. We assessed, diagnosed, and proposed treatment options for this patient. Management & Outcomes: The patient’s TMJ dysfunction was managed conservatively through physical therapy as the first line of treatment. By the end of the intervention, he reported being pain-free and had regained normal TMJ function. This case highlights the role of physiotherapy in managing TMJ disorders. Although various treatments exist, evidence for their efficacy in TMD remains limited, and no standard protocol is established. Common treatment options include occlusal splints, cognitive behavioral therapy, and pain medications. Result: Non-invasive physiotherapy treatments have proven effective in alleviating symptoms of TMJ dysfunction. The initial focus is on pain relief and muscle spasm reduction, employing techniques such as pulsed ultrasound and manual therapy, including dry needling to address trigger points. Discussion: TMJ dysfunction may be associated with overall body imbalances, as increased muscle tension in the upper body can lead to compensatory adjustments affecting spinal muscle tension. A conservative management strategy centered on physical therapy is recommended. Physical therapists are well-positioned to provide clinical support for TMD patients, creating rehabilitation plans tailored to each individual’s impairments. Conclusion: This case report suggests that a conservative management approach, incorporating pain management strategies, muscle strengthening, and the release of trigger points and tight muscles, may significantly benefit individuals suffering from TMJ dysfunction.