Routine Physiotherapy Research Articles

Effect of Orofacial Myofunctional Therapy along with BiPAP on Pathophysiological Parameters of Obstructive Sleep Apnea: A Case Study

Background: Obstructive Sleep Apnea (OSA) is an increasingly common form of sleep-disordered breathing (SDB), with an incidence of 15% in men and 5% in women in adults. Itis characterized by repetitive collapse or obstruction of the pharyngeal airway during sleep. OSA is a multi-factorial disorder, where anatomical and non-anatomical factors can contribute to determine different pathophysiological traits. Obstructive sleep apnea (OSA) is the periodic transitory decline (hypopnea) or complete interruption (apnea) of breathing due to reduction or blocking of the upper airway during sleep. Aim: This study aims to investigate the Effect of Orofacial myofunctional therapy along with BiPAP on pathophysiological parameters of Obstructive sleep apnea. Case description: A 75 year old male presented with the history of Asthma and Hypertension & Diabetes Mellitus-II. He was diagnosed with Type 2 Respiratory Failure with Obstructive Sleep Apnea with Obesity. Orofacial Myofunctional Therapy (OMT) has been recently introduced as an OSA treatment option for patients with Obstructive Sleep Apnea. An One week exercise programme containing OMT with the routine physiotherapy (Breathing exercises, Active ROM for bilateral upper and lower extremities and functional activities) was given. The Epworth Sleepiness Scale assessing for patient’s sleepiness, Pittsburgh Sleep Quality Index (PSQI) used for assessing sleep quality of patient and SPO2 assessing for oxygen saturation levels in the blood. An One week exercise programme effectively improves changes in weak and dysfunctional upper airway muscles. Conclusion: Our present study concluded that Orofacial Myofunctional Therapy had proven to be effective in patient with OSA with BiPAP. Keywords: Obstructive Sleep apnea, Orofacial Myofunctional Therapy, BiPAP

Critical Care Cycling to Improve Lower Extremity Strength (CYCLE): protocol for an international, multicentre randomised clinical trial of early in-bed cycling for mechanically ventilated patients

IntroductionIn-bed leg cycling with critically ill patients is a promising intervention aimed at minimising immobility, thus improving physical function following intensive care unit (ICU) discharge. We previously completed a pilot...

Comparison of Corticosteroids vs Conventional Physical Therapy for Management of Adhesive Capsulitis

Objective: To compare the role of corticosteroids and conventional physical therapy for management of adhesive capsulitis Methodology: This comparative study was conducted in Orthopedic Department, Combined Military Hospital Abbottabad. March 2022 to February 2023. Patient of active adhesive capsulitis of shoulder joint diagnosed by orthopedic surgeon were recruited. Patients in group A received single shot of methylprednisolone with local anesthesia with in the joint cavity while group B received conventional physical therapy at rehab department of our hospital. Pain scores via visual analogue scale and range of motion via goniometer was compared in both groups at baseline and at 8 weeks of treatment. Results: A total of 160 patients of adhesive capsulitis were recruited. Mean age was 42.55±10.96 years. 70 (43.7%) patients were female while 90 (56.3%) were male. Baseline pain scores and range of motion parameters were not statistically significant between the two comparison groups. At the end of 8 weeks mean pain scores were statistically significantly low in patients who took intra-articular corticosteroids as compared to those who underwent physiotherapy sessions (p-value<0.001). Range of motion parameters were also statistically significantly better in patients who took corticosteroids as compared to those who underwent physiotherapy (p-value<0.001). Conclusion: Use of corticosteroids emerged as a better option for treatment of pain and restricted range of motion in patients of adhesive capsulitis when compared to routine physiotherapy offered in our clinical settings. Keywords: Adhesive Capsulitis; Corticosteroids; Efficacy; Physiotherapy

Effect of Video Games for Rehabilitation on Mobility in Autonomous Older People

BACKGROUND: Autonomous elderly are generally healthy persons in stable clinical status, who do not have any exacerbations, despite of the presence of chronic polymorbidity. Video games for rehabilitation (VGR) could provide more fun and emotion in the routine physiotherapy (PT) sessions and to attract more people stay physically active. AIM: The aim of the study was to evaluate the effect of self-designed 3D camera VGR on mobility and motor abilities in generally healthy older people. MATERIALS AND METHODS: The type of the research is an experimental single-centered study, pre-test and post- test design, conducted at a physical rehabilitation outpatient center. The study is conducted with fifty healthy older people, divided into two groups. The assignment into two groups was according to the preference of the participants to attend video games after routine PT sessions for 7 weeks, 3 times weekly. The experimental group (EG) included 24 women (mean age 76.75 ± 6.89) and the control group consisted of 26 women (mean age 73.69 ± 6.89). The persons were allocated according to their willingness to participate in the study and inclusion (age above 65 years, cooperative, agreeing to participate, and willing to sign a consent form) and exclusion criteria (current exacerbation of a chronic disease, sudden onset of an acute illness, or trauma). The effect on the calf muscle mass, balance, and gait in both groups after the intervention, was evaluated by calf centimetry, Romberg test, functional reach test, 5 times sit-to-stand test, and 10-m walk test. RESULTS: The applied video games positively affected the functional mobility, strength, and endurance of the lower limbs in the EG. Significant differences between the groups were found regarding static standing balance (p < 0.01), functional balance (p < 0.05), and maximum speed gait (p < 0.05) assessed by Mann–Whitney U-test, Wilcoxon, and Student’s t-test. CONCLUSION: The present self-designed video game applied as an additional intervention was more effective than conventional PT alone in mobility, balance, and gait in apparently healthy older people.

Effects of Power Ball Exercises in Addition to Routine Physical Therapy on Pain, Grip Strength and Functional Disability in Patients with Carpal Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy that often presents with pain, numbness, tingling, and weakness in the hand and arm. Delayed treatment in CTS may worsen the symptoms and progresses to permanent sensory loss and thenar paralysis in some cases.
 Objective: To determine the comparative effects of power ball exercises & strength training on pain, grip strength and functional disability in patients with carpal tunnel syndrome.
 Methodology: This randomized clinical trial was conducted from December 2021 to May 2022 at Badar Medical Complex on 86 patients that were recruited through purposive sampling technique. Group A received routine physical therapy only while Group B received Power Ball Exercise and routine physical therapy. Participants of both gender with aged 45-60 years, clinically diagnosed CTS with duration of more than two months, tingling sensation and numbness over the dorsum surface of thumb, index, middle, and lateral 1/3rd of ring fingers and positive Tinel’s sign with Phalen’s Maneuver were included in the study. Pain, grip strength and functional status were the outcome measures, observed through Numeric Pain Rating Scale, Hand Held Dynamometer and Boston Carpel Tunnel Syndrome Questionnaire at baseline, 2nd and 4th week. Independent t-test and mixed design ANOVA were used for between and within-group differences respectively.
 Results: The results showed significant between-group difference in pain, and functional disability (p<0.05). However, no significant difference was observed for grip strength. Within-group difference was found significant in both group A and group B for all variables (p<0.05).
 Conclusion: The addition of Power Ball Exercises with routine physical therapy is more effective in reducing pain, and functional disability in patients with carpal tunnel syndrome than physical therapy alone.

Cognitive Correlates of a Large Time Differential between Timed Up and Go and Gait Speed during Inpatient Stroke Rehabilitation

Purpose: Cognitive impairment is highly prevalent after stroke but can be difficult to identify acutely. We aimed to study if a large difference between two common, routine physical therapy assessments (Timed Up and Go [TUG] test and 10-Meter Walk Test [10MWT]) could identify patients with subtle cognitive difficulties post-stroke. Method: An observational study was conducted in 141 individuals admitted to acute inpatient rehabilitation after stroke. We computed the percent difference between TUG and 10MWT performance. Cognitive outcome measures were the Trail Making Test A and B (TMT-A and -B) and the Functional Independence Measure (FIM)-Cognition subscale. Linear and logistic regression analyses were conducted to evaluate if the difference between TUG and 10MWT was associated with cognitive functioning. Results: After adjusting for covariates, there was no significant linear association between TUG-10MWT discrepancy and cognition; however, stroke patients with the largest difference between TUG and 10MWT (highest quartile of scores) exhibited significantly worse attention on the TMT-A (adjusted odds ratio = 2.46, p = 0.04). Conclusions: A large difference between TUG and 10MWT may reflect deficits in complex sustained attention in individuals with stroke. Physical therapy staff may use this difference score to identify patients with potential cognitive deficits and refer them for comprehensive neuropsychological evaluation.

Effects of manual therapy combined with therapeutic exercise versus routine physical therapy on brain biomarkers in patients with chronic non-specific neck pain in Thailand: a study protocol for a single-blinded randomised controlled trial

IntroductionStructural brain alterations in pain-related areas have been demonstrated in patients with non-specific neck pain. While manual therapy combined with therapeutic exercise is an effective management for neck pain, its...

‘I can feel myself coming out of the rut’: a brief intervention for supporting behaviour change is acceptable to patients with chronic musculoskeletal conditions

AimTo a) understand the perceptions and experiences of patients with musculoskeletal (MSK) conditions in relation to their physiotherapy care and their acceptability of ‘Making Every Contact Count Healthy Conversation Skills’ (MECC HCS) as a brief intervention within this care and, b) explore the mechanisms through which MECC HCS might facilitate behaviour change and enhance self-management in patients with MSK conditions.MethodsThis study adopted an exploratory qualitative design, in which individual, semi-structured interviews with participants were conducted. Eight participants were interviewed. Five had been engaging with physiotherapists trained in and delivering MECC HCS within their routine physiotherapy appointments and three had been engaging with physiotherapists who had not received this training and were instead delivering usual care. MECC HCS is a person-centred approach to behaviour change that aims to empower individuals to take control of their health behaviours by building self-efficacy. The MECC HCS training programme helps healthcare professionals to develop skills in i) using ‘open discovery’ questions to explore context and allow patients to identify barriers and generate solutions; ii) listening more than giving information/ making suggestions; iii) reflecting on practice and iv) supporting Specific, Measurable, Action-oriented, Realistic, Timed, Evaluated, Reviewed (SMARTER) goal setting.ResultsThose who had engaged with MECC HCS trained physiotherapists found their physiotherapy care highly acceptable and felt that their physiotherapist listened to them, tried to understand their context and world, and helped them plan for change. These individuals experienced increases in self-efficacy and motivation for self-managing their MSK conditions. A need for continued support following physiotherapy treatment was, however, emphasised for long-term self-management.ConclusionsMECC HCS is highly acceptable to patients with MSK conditions and pain and may successfully facilitate health-promoting behaviour change and enhance self-management. Providing opportunities to join support groups following physiotherapy treatment may promote long-term self-management and provide social and emotional benefits for individuals. The positive findings of this small qualitative study warrant further investigation on the differences in experiences and outcomes between patients engaging with MECC HCS physiotherapists and those receiving treatment as usual during routine physiotherapy care.

Effects of Routine Physical Therapy with and Without Home-based Exercise Manual on Pain and Disability in Patients of Postural Neck Pain: A Randomized Controlled Trial

Effects of Routine Physical Therapy with and Without Home-based Exercise Manual on Pain and Disability in Patients of Postural Neck Pain: A Randomized Controlled Trial

Effect of Transcranial Direct Current Stimulation on Motor Recovery in Altered Conscious Patients after Traumatic Brain Injury and Cerebrovascular Accident: A Randomized Clinical Trial

Abstract Background and Purpose Altered levels of consciousness resulting from a vascular insult to the brain can vary from confusion to coma. A disruption in the function of the brain stem reticular activating system in the brain stem or both cerebral hemispheres and thalami causes coma. This study is aimed at finding the effect of transcranial direct current stimulation (tDCS) on motor recovery in altered conscious patients after traumatic brain injury and cerebrovascular accident. Materials and Methods A total of 100 patients admitted to the neurology and neurosurgery unit of the university hospital were screened and 40 subjects who satisfied inclusion criteria were recruited and randomly divided into two groups, group A (experimental; n = 20) and group B (control; n = 20), by computerized randomization. Written informed consent was taken from all the caregivers before recruitment. After taking the preliminary assessment, anodal tDCS is given to the motor area (C3/C4 ipsilesional), sensory area (P3/P4 ipsilesional), and left dorsolateral prefrontal cortex (F3) according to the 10/20 electroencephalogram montage for two sessions of 20 min/day for 7 consecutive days. Routine physiotherapy was also given the same as group B. Results At baseline, there were no significant group differences in the baseline characteristics. The groups passed the normality test. The results were tested for statistical significance between the groups by Mann–Whitney U-test and by one-way analysis of variance and Tukey Honest Significant Difference for post-hoc comparison; the results were statistically different with p-value less than 0.05 with a large effect size. Conclusion We conclude, based on the results of this study, that tDCS can be effective in motor recovery in altered consciousness patients. It is noninvasive, cost-effective with minimal contraindications, and does not interfere with other modalities in the intensive care unit. Hence, it can be administered safely under the supervision of a qualified therapist.

Effects of Functional Electrical Stimulation with and without Kinesiotherapy on Pain, Range of Motion and Quality of Life in Patients with Cervical Dystonia; A Randomized Clinical Trial

Methods: This study was a Randomized Controlled Trial conducted at The University of Lahore Teaching Hospital, University Institute of Physical Therapy, Lahore. n= 84 patients with Cervical Dystonia were recruited in this study using non- probability convenient sampling technique. Patients suffering with Cervical Dystonia who aged between 30 till 50 years were randomly assigned into two groups, 42 patients in each group. First Group A which was the control group which was treated with Functional Electrical Stimulation and routine physical therapy only while Group B was the Experimental group which was treated with Functional Electrical Stimulation also with kinesiotherapy and routine physical therapy. Both the groups were evaluated and assessed using the Toronto Western Spasmodic Torticollis Rating Scale, the Pain Numerating Scale, the 36- item short form health survey( SF-36), Neck Disability index and range of motion of neck flexion, neck extension and neck rotation was measured using universal goniometer. Results: Functional Electrical Stimulation combined with kinesiotherapy given to the experimental group showed more improvement in range of motion, quality of life , functional disability and the symptom of the pain also was reduced in the experimental group as compared to the control group. The mean values showed that there was a statistically significant difference in different variables between both the groups. When the scores( scores at baseline and at 16th week) for Toronto Western Spasmodic Torticollis Rating Scale for both the groups were compared it showed statistical difference between both the groups(p<0.05). Conclusion: Despite the fact that cervical dystonia has central neurological etiology, this study concludes that multimodal kinesiotherapy program which included stretching and relaxation, active exercises in addition to Functional Electrical Stimulation and Routine Physical Therapy tempts to have beneficial effects on a patient suffering from Cervical Dystonia. It showed beneficial effects on pain, quality of life, functional disability and range of motion of patients with cervical dystonia. Key Words: Functional Electrical Stimulation, Kinesiotherapy, Cervical Dystonia, Pain, Rang of Motion, Quality of life

Effectiveness of Home Based Telerehabilitation for Forward Versus Backward Stepping Strategy in Ground Walking Training on Functional Mobility and Balance Among Spastic Diplegic Cerebral Palsy-- A Simple Experimental Study

Background: The primary focus of physiotherapy interventions for children with CP is to improve locomotor function and functional activities. It is suggested that walking training activates neural circuits that mediate central pattern generators to activate limb muscles repetitively and produced rhythmic movements. Additionally, it adjusts control between agonist and antagonist muscles, leading to enhanced walking speed, and static and functional balance. The purpose of the study is to find out the effectiveness of home based telerehabilitation for forward stepping vs backward stepping strategy in ground walking training on functional mobility and balance among spastic diplegic cerebral palsy. Methodology: A simple experimental study was conducted on 24 spastic diplegic cerebral palsy who fulfill the selection criteria were selected for this study at the telerehabilitation Unit. A clear explanation was given to every subject and parents/guardian about the procedures and a written consent was obtained from them. Twenty spastic diplegic children were evaluated in person in the department for pre-training and post-training were used as a study design with total study duration was six weeks. (from April 2021 to May 2021). The subjects in group A&B were consisting of 12 subjects and they were treated with home based telerehabilitation for forward and backward ground walking training. Along with that both the group children received routine physiotherapy. Both the groups were received intervention for 15-30 minutes per session, 5 days in a week for a period of 6 weeks. The pre and post score values of balance and functional mobility were measured by using, GMFM walking dimension, modified timed get up and go test and Pediatric Berg balance scale. The values were recorded and documented. Result: In the statistical analysis of pretest values of both group A and group B were calculated. The pre mean values of PBS for both groups were 33.33 and 33.38. The T-value was 0.3721 the obtained t-value is lesser than the table value and the P-value showed there were no significant in pretest comparison. The posttest mean values of PBS for both groups were 46.08 and 46.33.The T-value was 2.38967,the obtained t-value is greater than the table value. and the P-value showed there were significant in posttest comparison. Alternative hypothesis was accepted. Hence the statistical report states that there were statistically significant differences in posttest comparison. The post score values of the Gross Motor Function Meaure-88, Pediatric Berg Balance Scale and TUG test score in all the variables showed significant difference. Conclusion: The study concluded that the 6 weeks of backward stepping strategy in ground walking home based telerehabilitation training program along with regular physiotherapy treatment showed statistically significant improvement in balance and functional mobility among spastic diplegic children when compared to forward stepping strategy in ground walking home based telerehabilitation training program.

The effects of a structured physiotherapy program on pulmonary function and walking capacity in obese and non-obese adults undergoing cardiac surgery

BACKGROUND: Obesity is thought to be a risk factor for cardiopulmonary diseases due to changed pulmonary mechanics. It also drastically lowers functional capability in both males and females. A routine physiotherapy program has been shown to be effective in the prevention and treatment of cardiopulmonary diseases. It also significantly increases functional capacity following coronary artery bypass grafting. However, the effect of a structured physiotherapy program in obese and non-obese patients has not been well explored. As such, the objective of this study is to determine the effect of a standardized physiotherapy program on pulmonary function and walking capacity in obese and non-obese patients undergoing coronary artery bypass grafting. METHODS: A prospective study was conducted on 50 obese (age 57.2 ± 6.3 Y) and non-obese (age 56.6 ± 5.7 Y) adults who were schedule for coronary artery bypass grafting. Their body mass index was used to separate them into two groups. Both groups followed a structured physiotherapy program from day 1 to day 7 post cardiac surgery. Both groups underwent spirometry test at baseline (preoperatively) and after day 4 and day 7 postoperatively as well as a six-minute walk test at baseline and on day 7 postoperatively. RESULTS: At baseline, obese individuals had significantly lower pulmonary and physical functioning. On postoperative day 4, both groups deteriorated, although the obese group deterioration was worse, in most of the pulmonary parameters. On postoperative day 7, both groups improved, though the non-obese group improved at a faster rate. In contrary, it was observed that the obese group improved more rapidly in terms of functional capacity. CONCLUSIONS: The study indicated that the outcomes of a structured physiotherapy program following coronary artery bypass grafting were different for persons who were obese compared to those who were not. Adipose tissue variations surrounding the rib cage, diaphragm, and visceral cavity may account for the observed rate of change between the two groups. Therefore, it is apparent that a new strategy for managing obese individuals who have undergone CABG is required.

Is mirror therapy combined with a routine physiotherapy protocol effective for children with obstetrical upper brachial plexus palsy?

Study designRandomized controlled study. IntroductionMirror therapy is a rehabilitation strategy based on the repeated use of the mirror illusion and also one of the treatment choice of brachial plexus injuries. PurposeWe aimed to determine the effects of mirror therapy combined with a routine rehabilitation program on upper limb motor function in children with obstetric brachial plexus injury. MethodsTwenty children with obstetric brachial palsy were included in this study. They were randomly allocated to either control (n = 10) or mirror therapy (n = 10) group. The following clinical tools were used to assess the upper extremity function: Active Movement Scale (AMS), Modified Mallet Scale (MMS), Hand Grip Strength (HGS) Test, Finger Grip Strength (FGSM) Test, Box and Block Test (BBT), Nine Hole Peg Test (9-HPT), and goniometric measurement. Both groups received the same routine physiotherapy program for 8 weeks. The study group underwent mirror therapy in addition to the rehabilitation program. ResultsThe mean age of the study population was 11.35 ± 4.12 years. There was no change in the goniometric values, AMS and MMS scores after the treatment in both groups (p > 0.05), except for the improvement of the wrist extension in the study group (p < 0.05). There was an increase in both HGS and FGS scores in the study group. Only FGS scores improved in the control group after the intervention (p < 0.05). 9-HPT and BBT scores improved in both groups (p < 0.05). All other parameters tested were comparable between the two groups after the treatment. ConclusionsThe results of this study did not show any additional benefits of mirror therapy combined with a rehabilitation protocol compared to routine physiotherapy treatment, but was not adequately powered to do so.

A novel radiofrequency modulation therapy versus routine physiotherapy modalities in treatment of myofascial pelvic pain syndrome: a pilot randomized trial.

The current study aimed to compare the effectiveness of novel radiofrequency modulation (RM) therapy with a tailored physiotherapy course for patients with chronic pelvic pain (CPP) of myofascial origin, also known as myofascial pelvic pain syndrome (MPPS). We enrolled 46 patients with myofascial CPP to compare the effectiveness of a 10-session routine physiotherapy course versus a 6-session RM with an integrated device (HIGGS) in alleviating MPPS morbidity and pelvic floor muscle (PFM) rehabilitation. The primary outcome was reduction in pelvic pain after the final session and in the follow-up period 3 months after the final intervention session. The 6-session therapy in the RM group and the manual, biofeedback, and transcutaneous electrical nerve stimulation therapies in the physiotherapy group were similarly effective in reducing pain and improving PFM endurance after the final intervention session in each group, whereas perineometer readings and PFM strength were associated with greater improvements in the physiotherapy group. The results of this study demonstrated comparable effectiveness of RM in the management of MPPS and improvement of PFM function compared to routine physiotherapy programs with fewer sessions of therapy.

Efficacy on gait and posture control after botulinum toxin A injection for lower-limb spasticity treatment after stroke: A randomized controlled trial.

To observe the efficacy of botulinum toxin type A (BoNT-A) for the spasticity of the lower-limb post-stroke on gait and posture control. A total of 46 patients with hemiplegia gait were randomly divided into the experimental group (23 patients) and the control group (23 patients). In patients in the experimental group received injections of BoNT-A by electrical stimulation-guided. At the same time, patients of the two groups received routine physical therapy. Gait analysis, plantar pressure analysis, lower-limb Fugl-Meyer assessment (L-FMA), 10 meter walking test (10MWT), timed "Up and Go" test (TUGT), and modified Ashworth Scale assess (MAS) of the lower limbs were performed at 0, 1, 4, and 12 weeks after treatment. At 1, 4, and 12 weeks after treatment, the L-FMA, stride length, speed, and TUGT significantly improved than 0 week in both groups. The L-FMA and peak of forefoot pressure, and MAS results in the experimental group were better than those in the control group at 4 and 12 weeks. The TUGT, speed, and stride length in experimental group was significantly shortened than that in control group at 1, 4, and 12 weeks. Botulinum toxin type A injection can improve motor functions of the lower limb, gait, spasticity, forefoot pressure, and posture control of patients after stroke.

Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review.

Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown. To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions. 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis. The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low. This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.

Effects of gait training with and without proprioceptive neuromuscular facilitation on balance and gait in chronic stroke patients

IntroductionTo compare the effects of gait training with and without proprioceptive neuromuscular facilitation (PNF) on balance and gait in chronic stroke individuals.MethodsIt was a double-blind randomized control trial conducted at University Physical Therapy and Rehabilitation clinic, Lahore, Pakistan from March 2020 to November 2020 using non-probability convenient sampling. Sixty patients in the chronic phase of a stroke, aged between 35 and 85 years, were randomly allocated into two groups. Group A received proprioceptive neuromuscular facilitation-based gait training along with routine physical therapy, while group B received only gait training and routine physical therapy. Berg balance scale (BBS) and GAITRite platinum were used as measuring equipment. The rules and regulations set by the ethical committee of the university of Lahore were followed. Data was analysed by a statistical package for social sciences, version 24.ResultsBalance improved more significantly in group A than in group B (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Participants improved significantly in terms of stride length (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), step length (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), % swing phase (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), BBS (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), cadence (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and velocity (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), and decreased significantly for ambulation time (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), and % stance phase of gait cycle (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), over the treatment period within both groups. The results of stride length, step length, ambulation time, cadence, velocity, % of swing and stance phase were insignificant for between-group comparisons.ConclusionsProprioceptive neuromuscular facilitation-based gait training along with routine physical therapy is more effective in improving balance as compared to routine physical therapy alone. However, for improving gait parameters, proprioceptive neuromuscular facilitation (PNF) proves to be as effective as routine physical therapy and gait training.

Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol

IntroductionBalance impairments frequently occur after stroke. Achieving effective core trunk stability is the key to improving balance ability. However, there is still a lack of advanced well-defined rehabilitation protocols for...

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.