Rehabilitation Institute Research Articles

Determinants of Type 2 Diabetes Mellitus among Children and Adolescents Attending A Tertiary Specialized Hospital in Bangladesh

Background: Type 2 diabetes in children and adolescents has increased in frequency around the world over the past two decades. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes in children and adolescents. Objective: To observe the determinants of type 2 diabetes mellitus among children and adolescents attending a tertiary specialized hospital in Bangladesh. Methods: This cross-sectional, descriptive study was done on a total of 151 children and adolescents attending the pediatric diabetic outpatient department (OPD) of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh. The sampling technique was purposive. All patients who came to the hospital between July to December 2017 were included. Data was collected through a structured questionnaire. Results: Among 151 respondents, 98 were in the age group of 10-14 years (64.9%), female to male ratio of 1.22:1. The majority belonged to a high used to lead socio-economic class. Regarding food habits, 55.6% had a history of eating fast food regularly and used to lead a sedentary lifestyle with a lack of exercise. 43.7% of children and adolescents were obese 76.8% had high cholesterol and 84.1% had high triglyceride levels. Most of the children had a positive family history of type 2 diabetes mellitus (74.8%). Conclusion: Our study reflects that determinants like obesity, physical inactivity, eating habits, and family history are important factors in the development of type 2 diabetes mellitus in children and adolescents. Mugda Med Coll J. 2023; 6(2): 51-56

Techniques for designing inclusive buildings using the example of theater architecture

In the article, the author examines the use of the concept of "healing architecture" in order to organize inclusive spaces in such facilities, such as cultural and entertainment institutions, as well as methods used in the design of inclusive theaters designed for people with physical or psychological disabilities, the main techniques used to create a comfortable environment in such projects. The main object of this research is inclusive theater spaces. The main purpose of the study is to explore the possibility of organizing inclusive theaters using the methods of the "Healing Architecture" concept used in the organization of medical and rehabilitation institutions. In the course of the work, the method of analyzing research on the topic and existing projects was used, as well as theoretical analysis, identification and consideration of the main techniques for designing inclusive spaces and the possibility of their use in the design process of inclusive theaters. The novelty of this study lies in the consideration of the concept of healing architecture, from the side of using its techniques in the design of cultural and entertainment institutions, such as inclusive theaters. As a result of the research, the main methods of organizing space used to create a "healthy" environment in medical buildings were considered, as well as their benefits in organizing inclusive theatrical institutions designed for multi-group visitors, projects designed for people with physical and psychological health characteristics were selected and studied, and the basic techniques of organizing space in the buildings selected for analysis. The result of the study was a number of proposals for the organization of the theater space, taking into account the concepts of inclusive and rehabilitation architecture, for groups of people with increased needs.

Analysis of the Path of Educational Rehabilitation of Inmates in the Context of the "Five Reforms"

Citizens' illegal and criminal behaviors should be sanctioned by law, and prison serves as a vital institution for both punishment and rehabilitation of inmates. After imprisonment, inmates undergo a long-term reform process aimed at transforming their mindset and behavior. Education plays a crucial role in this process, serving as the catalyst for implementing positive changes. In light of the current era, the "Five Reforms" proposal serves as the logical starting point for this study. The aim is to analyze the significance of educational rehabilitation for the inmates within this context, identify and refine the new characteristics of such programs, and propose practical paths for their education and reform. The findings from this study hold significant practical implications and provide valuable guidance for the practice of inmate rehabilitation.

Physical activity and sleep quality in association to mental health among physical therapy students in different universities of Karachi: A cross sectional survey

Background: Quality sleep is vital for mental function, with its deprivation reducing alertness and impairing concentration. Similarly, a lack of physical activity leads to problematic living and mental health issues such as depression and anxiety. Therefore, the main reason of this study was to solely focus on physiotherapy students and the effect of sleep and physical activity on their mental health. Objective: The research project aimed to observed physical activity and sleep quality in association to mental health among physical therapy students in different universities of Karachi Methods: A cross-sectional study on 360 DPT students in various. Karachi universities was conducted after obtaining approval from the Institute of Physical Medicine and Rehabilitation. The participants, DPT undergraduates aged 18-28 years, were selected through convenient sampling. Exclusion criteria included diagnosed systemic diseases or psychological conditions. The study utilized PSQI, DASS-21, and IPAQ shortform tools. Fisher's exact test was employed to analyse variable associations. Result: The sample's mean age was 21.75 years, Range= 18-28 years. Most (80.60%) were females. Almost all were single (94.90%), and 97.5% were poor sleepers. However, no association was found between sleep quality and depression, anxiety, or stress levels (p values = 0.117, 0.181, 0.293). Conclusion: The study revealed no association was found between poor sleep and physical activity levels with depression, anxiety, and stress in physiotherapy students, even though many face poor sleep. Students with poor sleep quality had higher physical activity levels than those with good sleep quality.

Violations of the Persons with Disability in Kerala, the Need for Community Based Rehabilitation: A Comparative Approach

Disability is a human rights issue because those with functional difficulties endure stigmatization, discrimination, inequalities, violation of their rights, abuse, prejudice, and denial of autonomy. Since different demographic groups exist in a developing nation like India, rehabilitation institutions and C.B.R. models encounter several challenges and practical obstacles. Persons with disabilities lead a challenging life and belong to stigmatized groups. Therefore, people with disabilities suffer enormous difficulties throughout their lives, which also involve abuses of their human rights. Hence, this paper aims to examine human rights violations affecting persons with disabilities as a marginalized group living in Kerala, focusing on three aspects: • Institutionalization and follow-up process • The importance of a multidisciplinary team • The importance of C.B.R. within Kerala culture

Functional Outcome of Primary Repair of Long Flexors of Finger at Zone V with Early Mobilization

A prospective, observational study was conducted in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh, between September 2019 and March 2021, to observe the functional outcome of primary repair of long flexors of finger at zone V with early mobilization. Our study included 51 patients, who had follow-up visits up to 12 months after operation. Tendon functionality was assessed by Buck-Gramcko score, while grip strength was assessed by modified sphygmomanometer. The mean age was 30.08±13.38 years. Middle and index fingers were most involved with both flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) injury. In this study, most of the patients had excellent or good outcomes. The average return to work time was 32.82 weeks. 9.8% of the patients developed post-operative complications like infections, adhesion, and rupture. Most of the patients obtained good to excellent results (90%), while 3.92% had fair and only 2% had poor outcome. Early motion of the fingers seems to improve outcome in these patients. However, worse outcomes were seen in patients with a greater number of damaged structures, especially in concomitant nerve injury. CBMJ 2024 January: vol. 13 no. 01 P: 83-88

Hand assistive device with suction cup (HADS) technology for poststroke patients.

A stroke is a neurological disease that primarily causes paralysis. Besides paraplegia, all other types of paralysis affect the upper extremity. Advanced technologies, such as wearable devices and rehabilitation regimens, are also being developed to enhance the functional ability of a stroke person to grasp and release daily living objects. In this research, we developed a rehabilitation functional assist device combining a flexion and extension mechanism with suction cup technology (hybrid technology) to help post-stroke patients improve their hand grip strength in day-to-day grasping activities. Ten poststroke hemiplegia patients were studied to test the functional ability of the impaired hand by wearing and not wearing the device. The outcomes were validated by three standard clinical tests, such as the Toronto Rehabilitation Institute - Hand Functional Test (TRI-HFT), the Chedoke Arm Hand Activity Inventory (CAHAI-9), and the Fugl-Meyer Assessment (FMA) with overall score improvements of 14.5 ± 3.8-25 ± 2.2 (p = 0.005), 5.4 ± 2.8-10 ± 1.6 (p = 0.008), and 9.6 ± 2.6-17 ± 2.4 (p = 0.005) respectively. The p-value for each of the three evaluations was less than 0.05, indicating significantly improved results and the average feedback score of the participants was 3.8 out of 5. The proposed device significantly increased impaired hand functionality in post-stroke patients. The subjects could complete some of the grasping tasks that they could not grasp without the device.Clinical trial registrationThe Clinical Trial Registry of India approved the work CTRI/2022/02/040495 described in this manuscript.

Relationship between Perceived Maternal Rejection and Neuroticism Delinquency Risk Trait among Female Juvenile Delinquents in Selected Rehabilitation Institutions in Kenya

Juvenile delinquency has been a major problem in most parts of the world including Kenya due to its complexities attributed to its dynamic nature among different categories of children. Gender-based delinquency prevalence studies have identified female juvenile delinquency to be a developing key delinquency challenge as compared to male juvenile delinquency. In addition, research indicates that female juvenile delinquents are more prone to mental health problems attributed to incarceration experiences as compared to male juvenile delinquents. The need to focus more on female juvenile delinquency risk and protective factors studies is thus crucial so as to unravel the prevailing juvenile female delinquency complexities. The purpose of the study was therefore to examine the relationship between perceived maternal rejection and neuroticism delinquency risk trait among female juvenile delinquents in selected rehabilitation institutions in Kenya. Interpersonal Acceptance-Rejection Theory (IPARTheory) was identified to be the key theory that provided the theoretical framework for this study. The research was a correlational study and employed a survey research design in data collection. The study involved 186 female juvenile delinquents incarcerated in selected rehabilitation institutions in Kenya. Purposive sampling was used to select the three government girls’ rehabilitation institutions in Kenya involved in this study. Maternal Acceptance-Rejection Questionnaire and Neuroticism Questionnaire were used to collect data. The Statistical Package for Social Scientist (SPSS) version 25 aided in the analysis of quantitative data. To establish the levels of perceived maternal rejection and neuroticism, the data were subjected to descriptive statistics analysis for calculations of percentages, means and frequencies. The data was also subjected to inferential statistical analysis and employed Spearman’s Rank correlation to establish the relationship between maternal rejection and neuroticism. The analyzed data was then presented in form of tables. The study findings indicated that the participants perceived more of maternal rejection than acceptance (M = 163.8) and significantly high levels of neuroticism (M = 28.33). The study found that there was a moderate positive correlation between the perceived maternal rejection and neuroticism [rs(186) = .565, p < .001] among its participants. Understanding of this relationship and its moderators can help in designing accurate female juvenile delinquency prevention and treatment programs.

Normative Reference Value of Four Square Step Test among School-going Children

Introduction: Dynamic Balance (DB) is the ability to maintain balance while the body is moving. The Four-Square Step Test (FSST) is a reliable and valid tool to assess DB in older populations. Previous research demonstrated the normative score of FSST for the community-dwelling older population. Aim: To estimate the reference score of FSST among 8 to 15-yearolds. Materials and Methods: FSST is a test that can be used for both therapeutic and diagnostic purposes to evaluate an individual’s dynamic standing balance. A total of 90 School goers were recruited for this research. Participants had to cross the four sticks in a predetermined order. The sticks were each 90 cm long and were positioned in a cross pattern on the ground. They were instructed Shiwangi, BPT Intern UG Student, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Sunanda Bhowmik, Assistant Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Normative Reference Value of Four Square Step Test among School-going Children Abstract ID-UG 10 not to touch any sticks when they were crossing them. The amount of time it took to complete the test was recorded. Results: The normative value of FSST was (mean±SD 11.43±1.24) Geometric mean (11.37), skewness (0.30), kurtosis (0.65), median (25, 75 IQR) 11.25 (11.25,12.07), range (8.00-15.00). Conclusion: The total time taken by the participants to finish the test was 9 to 12 seconds. Analysing these results against findings to previous research, children between the ages of 8 and 15 were found to finish the FSST faster than average adults. In clinical practice, the standard reference score may be employed to rule out abnormalities related to children’s DB.

A Literature Review on Graston-assisted Soft Tissue Mobilisation Technique in Patients with Plantar Fasciitis

Introduction: Plantar fasciitis is a common condition characterised by inflammation and microtears of the plantar-fascia, resulting in heel pain and impaired foot function. Traditional treatments include stretching, orthotics and physical therapy. Graston-assisted soft tissue mobilisation has emerged as a promising adjunctive therapy for plantar fasciitis, aiming to improve outcomes through targeted tissue manipulation. Aim: To critically evaluate existing research on the effectiveness of Graston-assisted Soft Tissue Mobilisation (GASTM) techniques in treating patients with plantar fasciitis. Materials and Methods: A literature search was conducted from Pubmed, Cochrane Library, and Google Scholar from year February 2014 to February 2024. The search utilised MeSH key terms such as “Plantar fasciitis”, “Graston technique”, “Soft tissue mobilisation”, “Quality of life”, “Range of motion” employing Sanam Maurya, Postgraduate Student, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Sunita Sharma, Associate Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. A Literature Review on Graston-assisted Soft Tissue Mobilisation Technique in Patients with Plantar Fasciitis Abstract ID: PG-43 Boolean operators (AND, OR). A total of 2642 articles were found from different databases. Duplicate articles was removed. A total of six articles fulfilled the eligibility criteria and were included for the present review. Results: The reviewed literature primarily employed outcome measures like Numeric Pain Rating Scale (NPRS), Visual Analogue Scale (VAS), Foot and Ankle Disability Index (FADI) and Foot Function Index (FFI). Out of 2642 articles, only six met the criteria in which Graston technique effect on plantar fasciitis was evaluated and were included in the review. The review demonstrated that the Graston therapy significantly improves plantar fasciitis. Conclusion: The GASTM can effectively reduce soft tissue restriction, alleviate plantar-fascia pain, increase dorsiflexion range, and improve foot and ankle function.

Reference Score of C7 Angle among College Students of North India

Introduction: The sagittal shoulder C7 angle is specialised to analyse shoulder posture in the sagittal plane. the curvature of the cervical spine can influence the location and movement of the shoulder girdle like, a higher C7 angle leads to greater cervical lordosis, whereas a lower C7 angle leads to forward head posture and changes in shoulder blade position, affecting shoulder function and biomechanics. Aim: To establish normative score of C7 angle among college-going students of North India. Materials and Methods: A total 57 college-going male students with any musculo-skeletal condition in neck and head are included in this study to establish the normative score of C7 angle. The C7 angle was calculated in two phases. Firstly, the authors here took photographs of neck and head of participants in sagittal plane and angle was calculated by Kinovea software which were reliable methods. Results: Normative was establish for the participants which came to be abmormal. The p-value obtained was less than 0.05. Hence Subhi Kumari, BPT Student, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Joydip Saha, Assistant Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Reference Score of C7 Angle among College Students of North India Abstract ID-UG 11 the normative value is represented in terms of median and IQR. The p-value <0.05 indicates a non-normal distribution. The researchers most likely performed a normality test on the C7 angle measurements collected from the individuals. A p-value <0.05 indicates that the data deviates from a normal distribution. To put it simply, the C7 angle scores were not distributed uniformly, as a conventional bell curve would be. Traditionally, the average (mean) serves as the normative value. However, extreme values in non-normal distributions have a significant influence on the mean. Because the C7 angle scores were not normally distributed, taking the mean as the normative value could be deceptive. It may be skewed to greater or lower values based on the data. Conclusion: The analysis was successful and normative score for C7 angle was 55.03 as well as results will help to determine normal value of C7 angle among college-going students.

Involvement of minors in the criminal process: procedural regulation according to the legislation of the Republic of Kosovo

This study explores the significance of juvenile personality in criminal proceedings within Kosovo’s legal framework, emphasising juveniles' unique psychological, social and biological development stages and their impact on criminal behaviour. Despite the global interest in juvenile justice, there is a notable gap in literature specific to Kosovo, particularly concerning the consideration of personality traits and cognitive maturity in legal processes. Through an analysis of the Code of Juvenile Justice and the Code of Criminal Procedure, along with case studies and interviews with police, prosecutors, judges and psychologists, the research addresses this gap. Key findings highlight that while Kosovo’s legal framework provides robust protections for juveniles, practical challenges include delayed identification, insufficient privacy enforcement and resource constraints. The study underscores the importance of psychologist involvement during interrogations and the need for age-appropriate communication. Additionally, it points out the limited number of specialised personnel and rehabilitation institutions as major obstacles. The research advocates for enhanced training, increased resources and a review of current sanctions to ensure the juvenile justice system prioritises rehabilitation over punishment. This study aims to improve the understanding of juvenile personality in legal proceedings, promoting fair and just treatment for young offenders. Keywords: Criminal Process; Juvenile Personality; Kosovo Juvenile Justice.

Pulmonary Embolism Post-Femoral Neck Fracture Surgery: A Critical Predictor of Five-Year Mortality.

This study examines the impact of pulmonary embolism (PE) on mortality among patients with femoral neck fractures, exploring the predictive value of preoperative PE for postoperative occurrences and associated mortality over a 5-year follow-up period. We analyzed 2256 patients over 60years old admitted with femoral neck fractures, focusing on those who developed DVT or PE postoperatively. Surgical intervention aimed within 48hours without pharmacological thromboprophylaxis, utilizing mechanical prophylaxis instead. Postoperative management included Enoxaparin administration. Data analysis employed SPSS 21, with chi-squared tests, T-tests, and multivariate logistic regression to explore mortality and PE incidence. PE was diagnosed in 1.4% of patients, with a notable mortality contrast between patients with PE (87%) and those without (59.7%) over 5years. A history of preoperative PE emerged as a significant risk factor for postoperative PE. Despite surgical variations, no significant correlation was found between surgery type and PE incidence. Early postoperative weight-bearing and institutional rehabilitation did not significantly alter PE incidence rates. The study underscores the significant mortality risk associated with preoperative PE in femoral neck fracture patients. It highlights the necessity for vigilant PE risk assessment and management, challenging assumptions about the protective role of early mobility and rehabilitation in PE incidence. Further research is essential to refine patient care strategies and improve outcomes.

Interpretation of Normative Score of Hamstring and Quadriceps Isokinetic Peak Torque among University Students: A Pilot Study

Introduction: Understanding normative scores can help in identifying individuals who may be at risk of injury due to muscle imbalances or weakness. By comparing an individual’s scores to the normal, interventions can be implemented to address any deficits and reduce the risk of injuries, particularly in physically active populations like college students involved in sports or physical activities. Aim: To evaluate the normative reference score of isokinetic peak torque of hamstring and quadriceps muscles among healthy college-going students from the age group 18-25 years. Materials and Methods: This pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India and enrolled 50 healthy college-going students. Permission was taken from participants in the Institutional Research Laboratory for data collection. Students aged 18 to 25 years were enlisted for the research. All participants were sensitised about the procedure before they participated in the study. The participants were provided consent form. Results: The normative reference value of RHq_R was mean±SD 1.18±0.61, median (IQR) was 1.07(0.76, 1.43), skewness was 1.26, kurtosis was 1.37 and for the LHq_L mean±SD was 1.35± 0.71, median {Interquartile Range (IQL)} was 1.21(0.83, 1.80) and the skewness, kurtosis was 1.18 and 0.97, respectively. Conclusion: The study found that college students had weak quadriceps and hamstring strength. It also revealed that these students had a bad Hamstring:Quadriceps strength (H:Q) ratio and were more likely to have hamstring injuries.

Impact of Stationary Cycling on Clinical Outcomes in Patients with Tibiofemoral Osteoarthrosis: A Pilot Study

Introduction: Knee osteoarthrosis (tibiofemoral) is one of the most common forms of arthritis and a significant contributor to disability in the elderly. It has a notable impact on the muscle strength and lower limb biomechanics. The pain and stiffness associated with osteoarthrosis knee can significantly hinder daily activities and work potential in affected individuals. Aerobic exercises have demonstrated positive outcomes for these patients. Aim: To evaluate the effectiveness of forward and backward cycling with knee osteoarthrosis ranging from grade 1-3. Materials and Methods: A prospective, randomised clinical trial and single-blind pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. The compared two groups: one adding static cycling to regular treatment, the other receiving only regular treatment. Both groups got treatment three times a week for four weeks. Quality of Life (QoL) and pain were assessed using the Comprehensive Knee Osteoarthritis Index (CKOAI) scale, while isokinetic strength was measured with an isokinetic dynamometer. Evaluation at both baseline and endpoint was conducted by the same assessor. Results: Significant improvements were shown at the 4-week follow up for QOL, pain and isokinetic strength (p<0.02) with stationary cycling. The CKOAI, an indicator of pain intensity and QOL showed significant improvement (p=0.02). Conclusion: The research affirms the findings from the earlier Randomised Controlled Trials (RCTs) and indicated that engaging in stationary cycling leads to significant enhancement in individuals with osteoarthrosis knee. Participants expressed their appreciation for the program and proved to be safe, effective and feasible in primary care.

Effect of Soft Tissue Mobilisation on Somatic Symptoms in Chronic Low Back Pain Patients: A Pilot Pretest Post-test Randomised Clinical Trial

Introduction: Numerous studies suggest a significant correlation between Chronic Low Back Pain (CLBP) and somatic symptoms. These symptoms often stem from altered fascial biomechanics. Implementing Soft Tissue Mobilisation (STM) techniques aimed at restoring fascial biomechanics can markedly alleviate somatic symptoms associated with CLBP. Aim: To assess the efficacy of STM in alleviating somatic symptoms in patients with Chronic Low Back Pain (CLBP). Materials and Methods: A pilot pretest post-test randomised clinical trial was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, from July 2023 to December 2023, on participants diagnosed with Non Specific Chronic Low Back Pain (NSCLBP) accompanied by somatic symptoms. The experimental group (Group 1), n=6 (41.00±6.29 years), received myofascial unwinding and myofascial release. In contrast, the clinical group (Group 2), n=6 (43.83±11.20 years), received conventional physiotherapy care, including structured exercises and electrophysical modalities, over 4 weeks. Both groups underwent three sessions per week, amounting to 12 sessions in total. The evaluation of somatic symptoms was conducted using the Hamilton Depression Rating Scale (HDRS) at baseline and after the 4 weeks. Results: The statistical analysis demonstrated significant withingroup differences in HDRS (p-value=0.002) in Group 1, and no statistically significant difference in Group 2 (p-value=0.749). The between-group analysis demonstrated a statistically significant difference in HDRS (p=0.035) with a large effect size (d=1.4). Conclusion: STM effectively improves somatic symptoms in NSCLBP patients. The beneficial effect of STM on somatic symptoms can be translated into clinical practice after strengthening results in the larger population.

Effectiveness of Tactile and Kinaesthetic Stimulation on Hyperbilirubinemia: A Feasibility Study

Introduction: Neonatal hyperbilirubinemia is common among newborns, often necessitating hospitalisation and posing a risk of neural complications. Phototherapy, commonly used to treat hyperbilirubinemia, also has side effects, including eye and genital harm, dehydration, diarrhoea, and bronze baby syndrome. Therefore, there is a need to find alternatives or reduce treatment duration. Aim: To investigate the efficacy of tactile and kinaesthetic stimulation as adjunctive therapies with phototherapy for reducing bilirubin levels in preterm neonates with hyperbilirubinemia. Materials and Methods: A randomised controlled feasibility study, including 12 preterm neonates with hyperbilirubinemia, was conducted in the Neonatal Intensive Care Unit (NICU) of a Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Mullana, Ambala, India. The experimental group (n=6) received three sessions of tactile and kinaesthetic stimulation for 15 minutes per session alongside phototherapy, compared to a control group (n=6) receiving phototherapy alone for three days. Results: While no significant differences (p>0.05) in demographics of neonates were observed, both groups experienced significant reductions (p<0.001) in Total Serum Bilirubin (TSB) and Transcutaneous Bilirubin (TCB) levels, with change scores of 7.88±2.29 (TSB experimental), 7.84±2.85 (TSB control), 6.63±2.77 (TCB experimental), and 6.27±1.92 (TCB control). However, the change in mean levels of TSB and TCB was not significantly different when compared between the two groups (p>0.05). Conclusion: There were significant reductions in TSB and TCB levels from Day 1 to Day 3 within each group. Both interventions were equally effective in reducing the bilirubin levels in the neonates.

Correlation between Hamstrings-quadriceps Strength Ratio and Lumbar Flexibility of College-going Students: A Pilot Study

Introduction: The concept of myofascial chains or meridians emphasises the interconnectedness of the musculoskeletal system. There is a correlation between the counteracting forces applied by the knee and lower back regions. Fatigue in the quadriceps femoris muscle can lead to increased activation of the lumbar muscles. Accelerated exhaustion of the lumbar muscles during isometric trunk extension correlates with heightened suppression of the quadriceps muscles. The strength of the quadriceps muscles sets a limit on the ability to lift objects or sustain back injuries. Aim: To establish relationship between hamstring-quadriceps strength ratio and lumbar flexibility among college going individuals. Materials and Methods: A pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, from October 2023 to November 2023. The study comprised 15 volunteers, aged 18 to 25, who were regular college-going students with a normal Body Mass Index (BMI) and have no active cardiovascular or musculoskeletal conditions. An evaluation was made that included isokinetic dynamometer strength ratio (duration for strength ratio evaluation was 10 minutes for each subject) and Schober test (duration for flexibility evaluation was 5 minutes for each subject). Participants followed test thrice at the same time. Results: Normality of data was determined by using Shapiro–Wilk test which showed not normal distribution. The peak hamstringquadriceps ratio was generated from bilateral limb, which showed fair correlation to performance of composite score of Schober test in individuals going college regularly (r=-0.594; p<0.05). Conclusion: Lumbar flexibility can be dependent on Hamstring and quadriceps strength ratio among healthy individuals. The clinical implication of the present study is improving strength ratio of Hamstring and quadriceps can be an effective measure to increase lumbar flexibility and reduce low back injuries.

Normative Reference Value of Proprioception and Reaction Time among Females with PMS- A Cross-sectional Study

Introduction: Premenstrual Syndrome (PMS) encompasses physical, emotional, and behavioral changes prior to menstruation. While hormonal fluctuations during PMS may affect neurological processes, direct links to alterations in proprioception and reaction time are not firmly established. Normative reference scores have not been established for proprioception and reaction time among females with premenstrual syndrome. Aim: To determine the normative reference score of proprioception and reaction time among females with PMS using the Sensbalance MiniBoard. Materials and Methods: A cross-sectional study was conducted at the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, recruited females aged 18 to 40 years, with regular menstrual cycle, and with Premenstrual Syndrome (PMS), diagnosed according to Premenstrual Dysphoric Disorder (PMDD) criteria (≥5 out of 11 symptoms). The study aimed to establish normative values for these measures in PMDD individuals. Results: The normative data for proprioception in four directions i.e. front, back, left, and right were 19.47±18.26°, 7.59±3.66°, 11.94±12.93°, 10.99±8.02°. The normative data for the reaction time in front, back, left and right was obtained as 0.94±0.32 s, 0.79±0.16 s, 0.91±0.27 s and 0.93±0.50 s, respectively. Conclusion: The results suggest the feasibility of conducting an extensive study with a larger sample size to facilitate the generalisation of data to a global population.

A Comparison of Myofascial Release and Positional Release in Conjunction with Static Stretching for Treatment of Upper Trapezius Trigger Points among University Students: A Pilot Study

Introduction: Myofascial trigger points are considered to be a major cause of neck pain and shoulder muscle tenderness among the working population. Aim: To investigate the efficacy of combining Myofascial Release Therapy (MFR) and Positional Release Therapy (PRT) on pain intensity and pain tolerance for managing neck pain caused by Myofascial Trigger Points (MTrPs) of the upper trapezius muscle. Materials and Methods: A pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India on a total of 16 participants were randomly assigned to Group A (MFR) and Group B (PRT), receiving treatment 3 days a week for two weeks. Both groups also received conventional treatment (such as static stretching of the upper trapezius along with a cold pack). The Numeric Pain Rating Scale (NPRS) and the Pain Pressure Threshold (PPT) were employed to compare the pre- and postintervention assessment of the participants. Results: As the baseline data were normally distributed, the statistical analysis used independent t-tests for between-group comparisons and paired t-tests for within-group analysis. For within-group analysis, both groups revealed highly significant improvement (p<0.05) in all the outcome measures such as (NPRS and PPT). However, upon comparing both groups, the between-group analysis showed significant improvement across all parameters (p<0.05). Conclusion: Both PRT and MFR combined with static stretching were found to be effective in reducing pain and raising the pain threshold; however, comparing patients who received MFR combined with static stretching had more significant results.