Physiotherapy Department Research Articles

Effect of Dual Task Training, Gait Training and Vestibular Rehabilitation on Balance and Quality of Life in Post Stroke Adults

OBJECTIVE: To investigate the effectiveness of dual task training, gait training and vestibular rehabilitation on balance and quality of life in post stroke adults. MATERIALS AND METHODS: This Pilot study was carried out on 45 post stroke participants both male and female who fulfilled the inclusion criteria were recruited for the study with age group between 40 to 60 years from out-patient physiotherapy department of Dr. M.G.R. Educational and Research Institute, Deemed to beUniversity. The subjects were randomly assigned into 3 groups, each group consisting of 15 subjects. Group A received dual task training for thrice a week of 45 minutes per session for 4 weeks. Group B received gait training program for thrice a week of 30 minutes per session for 6 weeks. Group C received Cawthorne and Cooksey exercises of vestibular rehabilitation for thrice a week of 60 minutes per session for 8 weeks. The outcome measures used were Global Quality of Life Scale (GQOL) and Berg Balance Scale (BBS). RESULT: When the mean values of GroupA, Group B and Group C were compared on GQOL and BBS scale revealed significant increase in the post test mean value with Group C showing 87 and 55 on GQOL and BBS respectively, which was higher than Group A mean values 84.1, 52.33 and followed by Group B mean value 80, 53.3 at p ≤ 0.001. Hence, Group C which received vestibular rehabilitation was more effective than other groups.

물리치료학과 학생들의 재활필라테스에 대한 인식도와 선호도 조사

This study was to identify the awareness and preference of rehabilitation Pilates of university students majoring in physical therapy. from August 25 to September 7, subjects completed a survey which conducted on 204 students from the Department of Physical Therapy at six universities nationwide. The questionnaire consisted of questions about the recognition level and preference of rehabilitation Pilates. The results of this study showed that the higher the level of conceptual awareness of rehabilitation pilates, the higher the level of desire to participate in lectures (p<.05). In conclusion, these findings suggest that if the university's physical therapy department can provide students with accurate information about rehabilitation pilates, it can induce a lot of participation, which will help more active physical therapy professionals enter the rehabilitation pilates field. This study might be useful for further studies that university education institutions consider reflecting rehabilitation pilates in their subjects.

Effects of Iliotibial Band Myofascial Release with/without Stretching with Iliotibial Band Tightness Secondary to Knee Osteoarthritis

Background: Knee osteoarthritis (OA), also referred to as degenerative joint disease of the knee, is brought on by wear-and-tear and the slow loss of articular cartilage. The term "iliotibial band" (IT band) also refers to the iliotibial tract or Maissiat's band. Methodology: This study was conducted using randomized clinical trial, quasi experimental research design as we need to make 2 groups and evaluate the effects of Iliotibial band myofascial release and stretching on the patients of knee OA. Study population was 36 individuals of ages 50-70 having knee osteoarthritis grade II or III characterized by Kellgren-Lawrence grades, visiting the physical therapy department of Mumtaz physiotherapy clinic. It was a randomized clinical trial with convenient sampling where participants were randomly allocated in two groups by simple random sampling, one group was experimental that received IT band myofascial release other than the stretching and baseline treatment and second group received the myofascial release and baseline treatment only. Data collection tools were Visual Analogue Scale (VAS) and Woman Osteoarthritis index. For the within group analysis of VAS, Friedman test was used and wilcoxon signed rank test was used for the within group analysis of the WOMAC. For the between group analysis of variables, Mann-whitney U test was used. Results: Both groups showed some significant improvement in all outcome measures (p&lt;0.05), but the results produced by IT band Myofascial release along with stretching group was statistically significant in terms of reduced pain and disability (p&lt;0.0005) as compared to myofascial release alone group. The iliotibial band myofascial release along with stretching has statistically significant effect in improving the pain and disability among knee osteoarthritis patients. Practical Implication: Iliotibial band tightness can potentially lead to the alterations in the mobility of patella and disturb the overall knee complex. Proper arthrokinematics of joint is necessary for ambulation. So, this study focused to draw results from combined therapy of IT band myofascial release and stretching will redound to the benefit of physiotherapy field considering that knee plays an important role in better Quality of life. Conclusions: The iliotibial band myofascial release along with stretching has statistically significant effect in improving the pain and disability among knee osteoarthritis patients. Keywords: IT Band; Myofascial Release; Stretching; WOMAC; VAS.

Effectiveness of Plantar Fascial Mobilization and Static Stretching on Hamstrings Flexibility among Overweight Individuals

Background: Hamstrings tightness is commonly found among obese individuals and athletes. Many factors can result in hamstrings tightness such as overuse, bad posture and sports activities. It can result in major muscle imbalance which can predispose a person to muscle injuries. Objective: To evaluate the effectiveness of plantar fascial mobilization and static stretching on hamstrings flexibility in overweight individuals. Methods: This quasi-experimental study was conducted at the Physiotherapy department of Shalamar Hospital, Lahore for 6 months. About 50 participants were selected after meeting the eligibility criteria through non-probability purposive sampling. Participants were divided into two equal groups, Group A received static stretching of the hamstrings and Group B received plantar fascial mobilization for three consecutive days. Pre and post-treatment readings of the numeric pain rating scale and active knee extension were recorded in this study. Overweight individuals with having body mass index between 25 to 30 and age ranging from 18 to 35 years presented with hamstring tightness (at least 20 degrees of active knee extension were included in this study). Patients were excluded if they showed any red flags such as rheumatoid arthritis, fracture, tumor, osteoporosis, history of steroid use, lower limb injuries or surgery. The normality of data was assessed through the Shapiro-Wilk test. The difference between pre and post-treatment readings was calculated using paired sample t-test for this parametric data. Independent sample t-test was estimated for finding difference between groups. Results: Patients presented in both groups had an age between 18 and 50 with a mean age of 38.56+9.243. Data were analyzed through independent sample t-tests and paired sample t-tests. The results showed that plantar fascial mobilization along with static stretching was superior in improving hamstring flexibility (83.20+1.65) and reducing pain (1.96+1.48) than static stretching alone in improving hamstring flexibility (76.40+0.02) and in reducing pain (3.45+1.45). Conclusion: It concludes that both the treatment techniques, plantar facial mobilization and static stretching were effective in improving hamstring flexibility by increasing active knee extension and decreasing pain intensity however plantar fascial mobilization along with static stretching was superior to static stretching alone in improving the hamstring flexibility in overweight individuals.

Development and implementation of a training package to improve the confidence, skills and knowledge of multi-disciplinary clinicians in the use of telepractice for outpatient services

Introduction: Telepractice is recognised as an effective and efficient medium of service delivery; however, despite this evidence, implementation has been inconsistent. Clinician confidence and perceptions are integral factors to the successful implementation of telepractice in routine care. This study aimed to develop, implement and evaluate a telepractice training package for clinicians in a single hospital service. Methods: Forty-one clinicians from Speech Pathology, Physiotherapy and Chronic Disease departments participated in a training package with a specific focus on staff skills training, access to resources and embedding telepractice models of care into organisational culture. Questionnaires were used to evaluate clinician self-reported skills and confidence at baseline, post-training and 6-months post-training. Thematic analysis of open-ended questions was used to glean a deeper understanding of perceived barriers and facilitators to using telepractice. Results: Participants’ perceived knowledge and confidence significantly increased from baseline to immediately post-training ( p &lt; .001) and increased further to 6-months post-training ( p &lt; .001). Thematic analysis revealed three main enabling themes: (a) perceived benefits to patient care; (b) training and practice; and (c) resources and support; and four main barriers: (a) staff knowledge and training; (b) staff confidence; (c) client factors; and (d) infrastructure and resources. Conclusion: The telepractice training package improved staff skills and confidence which was sustained over time. Facilitating the uptake of telepractice is multidimensional and it is integral to address all relevant factors to ensure its success.

The Psychological Impacts of Taking Physiotherapy Teaching Online in 2020: What Did We Learn?

The rapid shift to online learning due to the COVID-19 pandemic presented challenges for physical therapy (PT) education worldwide. This article aims to explore the factors influencing the well-being of the PT faculty and department chairs involved in delivering PT programs during the initial stages of the COVID-19 pandemic. The literature has focused on the pedagogical impacts of the rapid shift to online learning. Little is known about the social and psychological impacts of this rapid transition on the well-being of the faculty involved in implementing PT programs. Physical therapy faculty and department chairs at 3 universities in metropolitan Sydney, Australia who taught into or led PT programs in 2020. Focus group methodology was used to explore the experiences of PT faculty and department chairs during the initial stages of the COVID pandemic. The focus groups were digitally recorded and transcribed verbatim and the transcripts analyzed thematically. The main finding of this study was the extent of stress experienced by PT program faculty and chairs during this period. Both work-related institutional and faculty factors and non-work-related personal factors contributed to perceived high levels of stress. Overall, there was a feeling that the stressors had not improved over the duration of the pandemic and that this had left the faculty and chairs feeling more fatigued, less collegiate, and may have ongoing impacts on their mental health. The pandemic created stresses for faculty and program chairs over and above the usual stress of faculty and college work. The reality of taking steps to reduce the stressors in the current climate is very difficult. Moving forward, it is vital to secure increased institutional support, including the support for creating realistic boundaries without the risk of penalty, to address the psychological health and well-being of PT faculty and chairs to enable high-quality education in the future.

Changes in the Status of Spastic Diplegic Children in Terms of Gross Motor Function Classification System and Functional Mobility Scale Following Surgical Intervention: A Single Centre Experience.

Introduction Most centers in low- to mid-income countries (LMICs) lack facilities for a comprehensive instrumented gait analysis (IGA) which is often considered the preferred method for assessment of the functional results of surgery in children with spastic diplegia. We aimed to study if there wereany changes in the Gross Motor Function Classification System (GMFCS) levels and Functional Mobility Scale (FMS) scores after surgery and whether they can be used as an indirect indicatorofchange in the functional status of a child. Methods This prospective study was conducted at the Pediatric Orthopedic unit of a teaching hospitalon spastic diplegic children requiring surgical intervention. GMFCS levels and FMS scores were recorded before the surgery and at each follow-up visit,with the latest recordbeingtwo years post-surgery. The change in the scores was indicated as an improvement, deterioration, or no change from the baseline and compared to thescore of the preceding visit. In addition, it was examined whether the age at surgery had any effect on the temporal change in the scores. Results A total of 25children were included for analysis after excluding those who failed to fulfill the predefined inclusion and exclusion criteria. Both the GMFCS levels and FMS scores improved from the third month toone-year post-surgery, after whicha few patients had a worsening of their scores at the two years follow-up visit. The age at which surgery was performed had no significant effect on the pattern of change in the scores. Mostchildren soughtconsultations with the physical therapy department only when they visited the surgical team for follow-up. Conclusion This study shows that surgical interventions doimprove the functional outcomes in children with spastic CP when assessed using FMS scores while maintaining an undeteriorated GMFCS level in most children. While a peak improvementcan be expected one year after surgery in most patients, possible of worsening from baseline scores doexist, and the parents must be informed of the same. Any decision for surgery must involve the parents, and the usefulness of postoperative physical therapy must be impressed upon them before the surgery and during each follow-up visit too.

COVID-19 related risk perception and altruistic response amongst undergraduates on reopening of educational institutes.

To determine the coronavirus disease-2019-related risk perception and altruistic response among undergraduate medical students post-lockdown. The analytical cross-sectional study was conducted from October 1, 2020, to March 31, 2021, at the Baqai Medical University, Karachi, and comprised undergraduates aged 16 and above, studying in medical, dental, physiotherapy, pharmacy and Information technology departments. Data was collected using a structured and standardised online questionnaire. Positive responses led to a perceived risk score ranging 0-9, with a higher score indicating a greater perception of risk. The score was corelated with demographic variables. Data was analysed using SPSS 21. Of the 743 subjects, 472(63.5%) were females. The overall mean age of the sample was 21.34±1.8 years. The mean risk perception score was 3.8±2.5, and it was significantly associated with disease exposure (p<0.001). Altruism had a strong association with the perceived risk score (p<0.001), indicating lower risk perception. The risk perception among the students was low, pointing towards a need of psychological assistance programme for the students.

Forearm Muscles Electromyography Analysis for Cylindrical Grip Sizes in Stroke

Purpose: To analyze the electrical activity of Flexor digitorum superficialis and extensor digitorum communis for cylindrical grip sizes of 30 mm and 40 mm in stroke patients. Methodology: 10 MCA affected stroke subjects and 10 normal subjects of same dominance, age and occupation were taken by purposeful sampling from physiotherapy department of M.M. Institute of Physiotherapy &amp; Rehabilitation. They were asked to grip two wooden cylinders of size 30mm and 40mm and electrical activity of Flexor digitorum superficialis and extensor digitorum communis i.e. amplitude and duration were analyzed during maximal contraction. The readings were statistically analyzed to compare the difference of activity in the proposed muscles for two different cylinders. Results: The statistical tests revealed that the differences between the amplitude and duration of the proposed muscles in hemiplegic and normal subjects are statistically significant. However, the difference of amplitude and duration of “Flexor digitorum superficialis” and “Extensor digitorum communis” are not statistically significant within the hemiplegic subjects for both the cylindrical diameters but the prolonged duration of Extensor digitorum communis in 40 mm cylinder was significant statistically. Conclusion: There is a significant difference in the amplitude and duration of forearm muscles i.e. flexor digitorum superficialis and extensor digitorum communis when compared with normals. However, only duration of extensor digitorum communis show significant change among the hemiplegic subjects with the change in grip size. The amplitude and duration of flexor digitorum superficialis and amplitude of extensor digitorum communis does not change significantly.

Physiotherapy-Led Musculoskeletal Telephone Triage and Advice Service: A Valid Option for Patients Referred From the Emergency Department.

Introduction Musculoskeletal (MSK) conditions create a significant demand for healthcare services in the United Kingdom. The emergency department is one of the main providers of initial care for patients with MSK disorders or injuries. As attendances increase within the emergency department the demand for MSK physiotherapy services also increases. The MSK physiotherapy department at Queens Hospital, Burton, GBR introduced a telephone triage and advice (TTAD) service for patients referred from the emergency department to try and reduce waiting times and the number of initial appointments not attended. The primary outcome of the study was to investigate the number of patients discharged via the TTAD service. Secondly, the study aimed to assess if the TTAD service eased the pressures of face-to-face appointments as well as analyze the effects on the number of failed attendances and canceled appointments for both initial and follow-up face-to-face appointments. Method Data were collected retrospectively from the electronic medical records system Meditech Version 6 (Medical Information Technology, Inc., MA) from the months of August, September, and October in 2017 (pre-TTAD) and 2018 (post-TTAD). Once the data had been collected, analysis was performed comparing results from 2017 to 2018 using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY)analysis software. Results The overall number of referrals from emergency to MSK physiotherapy increased by 11.2% between 2017 and 2018. Following the introduction of the TTAD service, 59.8% of the total referrals were offered a face-to-face initial appointment with 40.2% of patients referred being discharged via the TTAD service in 2018. The percentage of patients that failed to attend the initial appointment in 2018 also fell by 4.9%. Conclusion The introduction of a TTAD service for referrals from the emergency department has been demonstrated to be effective in reducing the number of face-to-face appointments required in the MSK physiotherapy management of these patients. Both initial and follow-up face-to-face appointments were lower in 2018 when compared to 2017, this is despite an 11.2% increase in the number of referrals throughout August, September, and October. It can therefore be concluded that the TTAD service also had a positive impact on the failed attendance rate of initial face-to-face appointments.

OUTCOMES OF THE FIRST 570 PATIENTS SEEN THROUGH A NOVEL SPORTS INJURY PATHWAY AT FIONA STANLEY HOSPITAL

Traditionally, sports Injuries have been sub-optimally managed through Emergency Departments (ED) in the public health system due to a lack of adequate referral processes. Fractures are ruled out through plain radiographs followed by a reactive process involving patient initiated further follow up and investigation. Consequently, significant soft tissue and chondral injuries can go undiagnosed during periods in which early intervention can significantly affect natural progression. The purpose of this quality improvement project was to assess the efficacy of an innovative Sports Injury Pathway introduced to detect and treat significant soft tissue injuries.A Sports Injury Pathway was introduced at Fiona Stanley Hospital (WA, Australia) in April 2019 as a collaboration between the ED, Physiotherapy and Orthopaedic Departments. ED practitioners were advised to have a low threshold for referral, especially in the presence of a history of a twisting knee injury, shoulder dislocation or any suggestion of a hip tendon injury. All referrals were triaged by the Perth Sports Surgery Fellow with early follow-up in our Sports Trauma Clinics with additional investigations if required. A detailed database of all referrals was maintained, and relevant data was extracted for analysis over the first 3 years of this pathway.570 patients were included in the final analysis. 54% of injuries occurred while playing sport, with AFL injuries constituting the most common contact-sports injury (13%). Advanced Scope Physiotherapists were the largest source of referrals (60%). A total of 460 MRI scans were eventually ordered comprising 81% of total referrals. Regarding Knee MRIs, 86% identified a significant structural injury with ACL injuries being the most common (33%) followed by isolated meniscal tears (16%) and multi-ligament knee injuries (11%). 95% of Shoulder MRI scans showed significant pathology. 39% of patients required surgical management, and of these 50% were performed within 3 months from injury.The Fiona Stanley Hospital Sports Injury Pathway has demonstrated its clear value in successfully diagnosing and treating an important cohort of patients who present to our Emergency Department. This low threshold/streamlined referral pathway has found that the vast majority of these patients suffer significant structural injuries that may have been otherwise missed, while providing referring practitioners and patients access to prompt imaging and high-quality Orthopaedic sports trauma services. We recommend the implementation of a similar Sports Injury Pathway at all secondary and tertiary Orthopaedic Centres.

Effectiveness of Maitland Mobilization versus Pain release phenomena for pain, range of motion and disability in early knee osteoarthritis

Aim: To compare the effectiveness of Maitland mobilization and pain release phenomena for Pain, Range of motion disability in early knee osteoarthritis. Methodology: Randomized control trail was conducted at Department of Physical Therapy, Railway General Hospital, Rawalpindi, Pakistan within a duration of 6 months. Participants aged between 35-60 years including both genders, diagnosed with stage 1 and 2 knee osteoarthritis were included. Range of motion (ROM) was assessed by Goniometer, Numeric pain rating scale(NPRS) used for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores used for knee disability. IBM SPSS 24 was used for statistical analysis. Non-parametric tests were used for NPRS while parametric test were used for knee ROM and knee disability . Results: Total 47 participants, were analyzed in which mean age in Experimental Maitland mobilization group A was 45.3±6.06 while mean age in experimental pain release phenomena group B was 45.4±4.59. Between-group analysis for NPRS was significantly improved at post intervention having p value (0.03). Between group comparison of knee ROM and WOMAC also showed significant p value. (p value=&lt;0.05). Conclusion: It is concluded that both techniques are equally effective in decreasing pain, improving knee ROMs and functional mobility in early knee osteoarthritis. Keywords: Knee Osteoarthritis; Early Mobilization ; Knee Joint Pain; Knee Joint Range Of Motion; Knee Disability.

HISTORY OF THE DEVELOPMENT OF THE DEPARTMENT OF CLINICAL REHABILITOLOGY AND PHYSIOTHERAPY OF KYRGYZ STATE MEDICAL ACADEMY BY NAME OF I. AKHUNBAEV (to the 65th anniversary of the department)

История кафедры клинической реабилитологии и физиотерапии при Кыргызской государственной медицинской академии начинается с 1957 года. В историю развития кафедры огромный вклад внесли известные клиницисты: Бабаханов Б.В., Тельтаева Г.К., Алымкулов Д.А. и Алымкулов Р.Д. На кафедре ведутся занятия по физиотерапии, врачебному контролю, лечебной физкультуре, классическому лечебному массажу, спортивной медицине и медицинской реабилитации для студентов лечебного, педиатрического, стоматологического, медико-профилактического факультетов, лечебного дела для иностранных граждан и высшего сестринского образования на русском, кыргызском и английском языках. Основным направлением научных исследований кафедры является изучение эффективности применения природных и искусственных физических факторов в лечении, профилактике и реабилитации больных различного профиля. Кыргыз мамлекеттик медициналык академиясынын клиникалык калыбына келтирүү жана физиотерапия бөлүмүнүн өнүгүү тарыхы 1957-жылдан башталат. Бөлүмдүн өнүгүү тарыхына зор салым кошкон атактуу клиницисттер: Б.В. Бабаханов, Г.К. Тельтаева, Д.А. Алымкулов жана Р.Д. Алымкулов. Бул бөлүмдө физиотерапиялык, классикалык дарылоочу массаж, спорттук медициналык жана дарылоо, педиатрия жана тиш дарылоо, медициналык профилактика факультетинин, дарылоо иштери боюнча чет тилдүү жарандарга жана жогорку медициналык айым орус тилдүү, кыргыз жана чет тилдүү студенттер үчүн медициналык реабилитация боюнча сабактар өткөрүлөт. Ар кандай профилдеги оорулууларды дарылоодо, алдын алууда жана калыбына келтирүүдө табигый жана жасалма физикалык эффективдүүлүгүн изилдөө бөлүмдүн эӊ негизги багыты болуп саналат. The history of the Department of Clinical Rehabilitation and Physiotherapy of the Kyrgyz State Medical Academy begins since 1957. A huge contribution to the history of the department was made by well-known clinicians: Babakhanov B.V., Teltaeva G.K., Alymkulov D.A. and Alymkulov R.D. The department conducts classes in physiotherapy, medical control, exercise therapy, classical therapeutic massage, sports medicine and medical rehabilitation for students of medical, pediatric, dental, medical and preventive faculties, general medicine for foreign students and higher nursing education in Russian, Kyrgyz and English languages. The main direction of scientific research of the department is the study of the effectiveness of the use of natural and artificial physical factors in the treatment, prevention and rehabilitation of patients with various profiles.

Predictive utility of commercial grade technologies for assessing musculoskeletal injury risk in US Marine Corps Officer candidates.

Recently, commercial grade technologies have provided black box algorithms potentially relating to musculoskeletal injury (MSKI) risk and functional movement deficits, in which may add value to a high-performance model. Thus, the purpose of this manuscript was to evaluate composite and component scores from commercial grade technologies associations to MSKI risk in Marine Officer Candidates. 689 candidates (Male candidates = 566, Female candidates = 123) performed counter movement jumps on SPARTA™ force plates and functional movements (squats, jumps, lunges) in DARI™ markerless motion capture at the start of Officer Candidates School (OCS). De-identified MSKI data was acquired from internal OCS reports for those who presented to the Physical Therapy department for MSKI treatment during the 10weeks of training. Logistic regression analyses were conducted to validate the utility of the composite scores and supervised machine learning algorithms were deployed to create a population specific model on the normalized component variables in SPARTA™ and DARI™. Common MSKI risk factors (cMSKI) such as older age, slower run times, and females were associated with greater MSKI risk. Composite scores were significantly associated with MSKI, although the area under the curve (AUC) demonstrated poor discrimination (AUC = .55-.57). When supervised machine learning algorithms were trained on the normalized component variables and cMSKI variables, the overall training models performed well, but when the training models were tested on the testing data the models classified MSKI "by chance" (testing AUC avg = .55-.57) across all models. Composite scores and component population specific models were poor predictors of MSKI in candidates. While cMSKI, SPARTA™, and DARI™ models performed similarly, this study does not dismiss the use of commercial technologies but questions the utility of a singular screening task to predict MSKI over 10weeks. Further investigations should evaluate occupation specific screening, serial measurements, and/or load exposure for creating MSKI risk models.

Association of muscles length and strength with balance and functional status among children with diplegic spastic cerebral palsy.

To determine the correlation of muscle length and muscle strength with balance and functional status among children with diplegic spastic cerebral palsy. The cross-sectional study was conducted from February to July 2021 at the Physical Therapy Department of Chal Foundation and Fatima Physiotherapy Centre, Swabi, Pakistan, and comprised children aged 4-12 years with diplegic spastic cerebral palsy. The strength of back and lower limb muscles was assessed through manual muscles testing. Lower limb muscle's length, indicating tightness, was assessed using goniometer. Paediatric balance scale and gross motor function measure scale-88 were used to assess balance and gross motor function. Data was analysed using SPSS 23. Of the 83 subjects, 47(56.6%) were boys and 36(43.4%) were girls. The overall mean age was 7.31±2.02 years, mean weight was 19.71±5.45kg, mean height was 105.5±14cm and mean body mass index was 17.32±1.64 kg/m2. There was a positive and significant correlation of all the lower limb muscles' strength with balance (p<0.01) and functional status (p<0.01). The correlation between the tightness of muscles and balance was significant and negative for all lower limb muscles (p<0.005). The correlation between the muscles' tightness and functional status was negative and significant for all lower limb muscles (p<0.005). Good muscle strength and appropriate flexibility of lower limb muscles enhanced functional status and good balance in children with diplegic spastic cerebral palsy.

Comparison of Respiratory Proprioceptive Neuromuscular Facilitation and Segmental Breathing on Pulmonary functions, Dyspnoea and Exercise Tolerance in COPD Patients: A Comparative Study

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease marked by airflow limitation, destruction of lung parenchyma and other associated respiratory symptoms (e.g., dyspnoea and coughing). Pathological changes and symptoms do not appear altogether, symptoms may not appear but pathological changes are likely to be present. Segmental breathing and Proprioceptive Neuromuscular Facilitation (PNF) techniques are both effective techniques in improving pulmonary functions in COPD patients. Aim: To compare PNF and Segmental breathing with respect to pulmonary functions to relieve dyspnoea and improve exercise capacity in COPD patients. Materials and Methods: This was a comparative study conducted from July 2020 to June 2021 at Department of Physiotherapy, SGT University, Gurugram, Haryana, India. On 30 in-patient aged between 40-60 years with Forced Expiratory Volume in 1st second/Forced Vital Capacity (FEV1/ FVC) &lt; 0.7, hospitalised clinically stable patients . Out of these, 15 were allocated in the segmental breathing group and another 15 participants were allocated into the respiratory PNF group through the sealed envelope. The session was of 10-15 minutes under the protocol of 18-20 repetitions of each technique in segmental breathing and respiratory PNF in either respective group. The dyspnoea was assessed by Modified Borg Scale, pulmonary functions was done with spirometry, followed by the 6-Minute Walk Test (6-MWT). The data was statistically analysed using Statistical Package for Social Sciences(SPSS) version 24.0. Paired t-test was used to compare the means of measurements within the groups. The independent t-test was used to compare the means of all the variables between the groups. Results: Both of these techniques improved SpO2 (change in mean from 81.27 to 86.20 and 82.13 to 90.67 in segmental and PNF group, respectively) and relieve dyspnoea post-exertion (8.33 to 6.60 and 8.0 to 5.67 in segmental and PNF groups) within 1-week of intervention (p &lt; 0.01). There was improvement seen in pulmonary functions (FEV1 from 0.87 to 0.95 and 0.78 to 1.02 in segmental and PNF groups) and exercise tolerance (6- Minute Walk Test (MWT) from 149.47 to 204.80 and 151.77 to 242.20 in segmental and PNF groups) as well. And out of both, respiratory PNF is more efficient in improving pulmonary function, dyspnoea and exercise tolerance in a week (p&lt;0.01) which makes the master improvement and pulmonary rehabilitation can proceed with further advancement. Conclusion: Segmental breathing and respiratory PNF are effective techniques for patients with COPD admitted to hospital whose modified Borg’s dyspnoea score is higher even at rest and intolerant to physical exercise and peripheral capillary oxygen saturation is lower than 88%.

Effect of Central Fatigue on Dynamic Balance and Knee Joint Proprioception in Recreational Athletes: An Experimental Study

Introduction: The salient constituent of physical activity is fatigue that can influence execution of sports as well as it can also affect the activities of daily living. Abundant conventions are being used to magnify the fatigue, resisting dimension of the individual but none has proven to be effective. Therefore, this research will give perception about the central fatigue, that can affect dynamic balance and knee joint proprioception in healthy individuals. This can further be related in athletes also; in designing their training protocol to minimise the fatigue level and thus enhancing the performance of an individual. Aim: To study the effect of central fatigue on dynamic balance and knee joint proprioception in recreational athletes. Materials and Methods: This experimental study was conducted at the Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India from 25th March 2022 to 25th June 2022. Twenty-five subjects were recruited in the study on the basis of inclusion and exclusion criteria. Star Excursion Balance Test (SEBT) and proprioception were measured before and after inducing central fatigue. The paired t-test was used to compare pre and post values of SEBT and proprioception. Results: There was significant effect of central fatigue in different excursion reach of dynamic balance from pre to post, anteromedial (p-value &lt;0.001), medial (p-value &lt;0.001), posterolateral (p-value &lt;0.001), lateral (p-value &lt;0.001) and anterolateral (p-value &lt;0.001) directions. In addition, the knee joint proprioception was significantly reduced following central fatigue was initiated. Conclusion: Dynamic balance and knee joint proprioception reduced when the individual was undergoing central fatigue.

Correlation between BMI and Static Biomechanical Lower Extremity Kinetic Chain Variables in Overweight Young Adults: A Cross-sectional Study

Introduction: Lower Extremity Alignment (LEA) is a main influencing cause in the active motion of the human body. Changes in the lower limb kinetic chain can be pushed by Body Mass Index (BMI). The gait may be impacted, which may result in more energy usage. However, little is known about how BMI and other static alignment parameters such as Quadriceps (Q)- angle, tibial torsion and plantar arch index are related. Aim: To determine the correlation between BMI and lower extremity kinetic chain variables such as pronated feet, femoral anteversion, Q-angle, tibial torsion, plantar arch index, angle of toe and pelvic inclination. Materials and Methods: The present cross-sectional study was conducted in the Department of Physiotherapy, Santosh Hospital Ghaziabad, Uttar Pradesh, India, from January 2021 to December 2021. A total of 160 participants age ranged between 18 years and 30 years with a BMI between 25 kg/m2 and 29 kg/m2 were included in the study. The following parameters were measured: pronated foot, angle of toe, plantar arch index, pelvic inclination, femoral anteversion, Q-angle and tibial torsion. Correlation between BMI with the seven static alignment parameters mentioned above was statistically analysed by using Pearson’s correlation coefficient and Spearman’s correlation test. Results: The mean age of the subjects was 23.82±2.021 years and mean BMI of the participants was 26.37±1.501 kg/m2 . There was significant correlation between BMI and pronated foot of both sides (r-value=0.256, 0.199, p-value=0.001, 0.012), BMI and plantar arch index of both sides (r-value=0.198, 0.161, p-value=0.013, 0.043). However, no significant correlation was found between BMI and Q-angle (r-value=0.137,0.144, p-value=0.087, 0.72), BMI and tibial torsion (r-value=0.024, 0.066, p-value=0.766, 0.413), BMI and anteversion (r-value=0.111, 0.134, p-value=0.164, 0.92), BMI and angle of toe (r-value=0.127, 0.139, p-value=0.111, 0.081) and, BMI and pelvic inclination (r-value=0.012, 0.013, p-value=0.885, 0.870). Conclusion: BMI was positively correlated with the pronated feet and plantar arch index, and this relationship was statistically significant. However, no statistically significant relationship between BMI and pelvic tilt, femoral anteversion, Q-angle, tibial torsion and angle of toe.

The Effect of Aerobika Device and Acapella Device on Rehospitalisation and Pulmonary Functions in Patients with Chronic Obstructive Pulmonary Disease-A Systematic Review

Introduction: Controlling and preventing symptoms of exacerbations, shortness of breath, cough and mucus in the lungs are important goals of Chronic Obstructive Pulmonary Disease (COPD) treatment. Oscillating Positive Expiratory Pressure (OPEP) devices have been shown to improve clinical results. The conservation of energy and oxygen, as well as, the prevention of lung infections and reducing rehospitalisation may be facilitated by clearing the lungs. There are several airway clearance devices, that can be used to help clear excessive sputum. Aim: To identify the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Materials and Methods: This systematic review was conducted in the Department of Physiotherapy at Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India. The duration of the study was three months, from march 2022 to june 2022. Five databases (PubMed, scopus, web of science, google scholar) were searched from 2012 to 2022. Inclusion criteria consisted of studies on the effect of aerobika device and acapella device on rehospitalisation and lung functions only in COPD patients. Data extraction included baseline features, treatment intervention, training frequency, supervision level, breathlessness, acute exacerbation, and outcomes. High quality experimental trials and comparative studies were chosen for the study. Results: A total of 20 articles were extracted; five were utilised for the purpose of writing the review, emphasising the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Studies had showed inconsistent results on the effect of aerobika device versus acapella device on rehospitalisation and lung functions in COPD patients. Conclusion: Rehospitalisation, readmission and length of the stay can be reduced by using both, aerobika and acapella devices. Both devices are effective in improving lung function in COPD patients.

Role of Instrument-assisted Soft Tissue Mobilisation in Text Neck Syndrome: A Quasi-experimental Study

Introduction: Text Neck Syndrome occurs due to sustained Forward Head Posture (FHP) when smartphones are used constantly without any breaks for more than five hours and with improper posture. Long-term untreated text neck can cause inflammation of the neck’s ligaments, muscles, and nerves, leading to chronic arthritic changes. Literature provides studies evaluating the effects of physical or manual therapy, but there is a lack of studies investigating the effects of Instrument-assisted Soft Tissue Mobilisation (IASTM) treatment in individuals with text neck syndrome. Aim: To determine the added effect of IASTM on text neck syndrome. Materials and Methods: This quasi-experimental study was conducted at Department of Physiotherapy, Dr. D.Y. Patil College of Physiotherapy, Pune, Maharashtra, India, from August 2022 to December 2022. A total of 22 subjects, with a mean age of 21.58±1.18 years, participated in the study. The subjects were then divided into two treatment groups (n=11 each). The experimental group (Group-A) received stretching, strengthening exercises with IASTM, while the control group (Group-B) received only conventional physical therapy (stretching and strengthening). The treatment was delivered for a twoweek period. The data were analysed using MedCalc statistical software version 20.210. Significance was set at a p-value less than 0.05. For within-group analysis, Wilcoxon’s signed-rank or paired t-test was used depending on the normality distribution, and for between-group comparisons, Mann-Whitney tests were used for skewed variables. Results: The pain severity (p-value=0.0063) and neck disability (p-value=0.0008) were significantly lower in the IASTM group than the control group. Additionally, the Craniovertebral Angle (CVA) (p-value=0.0001) significantly increased with IASTM (Group-A) compared to the control group. Conclusion: The study concluded that IASTM and conventional therapy are individually effective in improving pain, disability, and FHP in text neck syndrome. However, adding IASTM to routine physical therapy showed statistically more significant results compared to physical therapy alone in reducing neck pain, disability, and FHP.