International Journal of Physiotherapy

Background: Patients after breast cancer (BC) surgery have expressed the need for better care and instruction. This need is presently more evident than ever, with post-surgical hospitalization shortened to a minimum due to the Covid-19 pandemic. Online instruction may improve care for these women. Purpose: To develop a standard physical therapy instruction sheet for women after BC surgery, which can also be made available online. Methods: This clinical letter presents instructions based on a literature review, on recent recommendations to reduce the risk of side effects after BC surgery, and on the content of existing instruction forms. Appropriate versions were prepared for patients with high and low risk for side effects after surgery. The first drafts were validated by four experienced physical therapists certified in lymphedema treatments (PTCLTs). Then, pictures illustrating the exercises were added. The instruction forms were posted on physical therapy, BC, and lymphedema organization websites. Results: Information content includes the right of every patient to receive instruction after BC surgery followed by three sections: 1. exercise and early risk reduction for the first two days post-surgery; 2. instruction on exercise progression for the third day until the drains are removed, and the surgical scar has healed; 3. lifelong risk reduction recommendations. Conclusion: The development of standardized instruction forms up-dated to current evidence for patients after BC surgery answers a need expressed by patients and by physical therapists working in the field. The coincidence of the Covid-19 pandemic emphasized its relevance.

Background: Chronic neck pain is a common musculoskeletal dysfunction, and Manual Therapy is one of the effective treatment modalities, but underlying mechanisms of action are unclear. The study's purpose was to investigate the short-term effect of mobilization-manipulations on patient’s symptoms and to detect changes in the concentration of inflammatory biomarker interleukin-1b. Methods: Twenty-two patients aged 20-50 years with chronic neck pain, randomly assigned into two groups. The study group received nine sessions of a three-week Manual Therapy intervention. The control group received SHAM Manual Therapy of the same dosage. Pain and functionality measures conducted before and after the intervention via NPRS and NDI scales, respectively. Blood samples collected at baseline, after the first session and post-intervention, detecting IL-1β concentration, using the corresponding ELISA kit. Mixed ANOVA statistical analysis implemented for differences in the GROUP-TIME factors. Results: There was a significant statistical interaction between factors and significant main effects on pain, functionality, and IL-1β (p

Background: Neck pain is increasingly becoming a common problem. Cervicobrachial disorder is a dysfunction of nerve root of the cervical spine due to its compression which leads to ischemic changes that cause sensory and motor dysfunction. Many studies has been done on SLR test which affects upper limb sensitizing response by means of doing ipsilateral and bilateral SLR. The study revealed that the abduction ROM for shoulder was greater during contra lateral SLR with ULTT-2a when compared to ipsilateral SLR. Methods: 30 subjects (18 males and 12 females) were included in this study. The ULTT-2a is performed on each subject, following this ipsilateral and contra lateral SLR was performed. The sensitising response perceived by the subjects was recorded. Outcome measures were Range of Motion and sensation description. After the intervention the shoulder abduction and straight leg raising ranges were measured. Analysis was performed using independent t-test. Result: Significant difference was found in shoulder abduction (p< 0.001) and SLR (P< 0.002) but no considerable difference was found on the VAS. (P> 0.11). There was no difference in sensitizing response (Tingling, Burning, Sharp shooting) during ipsilatral and contra lateral straight leg raise. Conclusion: This study concludes that in order to obtain the same sensitizing response during ULTT-2a of contra-lateral SLR as during ULTT-2a of ipsilateral SLR, the angle of SLR and shoulder abduction during ULTT-2a of contra lateral SLR will be greater. This finding will be proved beneficial in the treatment of patients with cervico brachial disorders.

Background: The aim of this report was to determine the effects of electrical stimulation and laser radiation on non-small lung cancer (A549) and Chinese Hamster Ovary cell line (CHO AA8). Furthermore, we also analyzed viability and size of the extracellular spaces in CHO AA8 and A549 cells. Methods: In order to evaluate the cell viability Tali® Image-Based Cytometer was used. The material (non-small lung cancer cell – A549 and Chinese Hamster Ovary – CHO AA8) was evaluated by the light and confocal fluorescence microscope. Results: The data demonstrated that exposure to both electrical stimulation and laser radiation for 3 and 5 minutes showed non statistical differences in the percentage of live cells. The morphological abnormalities and microfilaments reorganization indicated induction non apoptotic type of cell death such as mitotic catastrophe. Moreover, CHO AA8 as non-cancerous cells exhibited lower sensitivity for laser and electrical stimulation in comparison to A549 cell line. Conclusions: Our results confirmed contraindicated the use of these methods, especially due to an increase of the risk of metastasis. Moreover, our study suggests that the laser radiation and electrical stimulation may have limited applications in the cancer patients and that choice of these treatment methods should be used in carefully selected patients.

Background: Back pain is the common musculoskeletal condition with a high prevalence of up to 80% among the general and work force population at some times in their lives.Muscular injury, fatigue, or facet or disc degeneration can compromise the stabilizing effects resulting in shearing forces that cause pain.Abdominal drawing in maneuver is used to facilitate the re-education of neuromuscular control mechanisms provided by local stabilizing muscles. Objective of the study is to measure the gait parameters and pain control before and after abdominal drawing in maneuver in patient with chronic mechanical low back pain. Methods: Total number of 30 consecutive patients and they were divided into two groups by purposive sampling. Group A is subjects with low back pain and Group B is subjects without low back pain. Outcome measures were average step cycle, average step length, coefficient of variation, time on each foot, Ambulation index measured with Biodex gait trainer. Pain is measured with Revised-Oswestry low back pain questionnaire. Results: Significant difference between gait parameters were observed in both low back pain group and the group without low back pain group with abdominal drawing in maneuver and the changes without abdominal drawing in maneuver was minimal. There was no significant difference found between both groups with or without abdominal drawing in maneuver. Conclusion: Gait parameters and Pain control can be improved by training with abdominal drawing in maneuver thereby it reduces pain and improves gait symmetry in subjects with low back pain.

Background: Retro walking has been shown to require increased metabolic cost and cardiopulmonary demand compared with forward walking at the same speeds. Levels of C reactive protein and abdominal adiposity are related directly to the risk of cardiovascular disease. The study aims to compare the effect of retro walking treadmill training and that of forward walking treadmill training on C-reactive protein levels and abdominal adiposity in untrained young adults. Methods: In this comparative experimental study, 250 participants will be recruited by using purposive sampling and allocated randomly to two groups. One group will undergo retro walking treadmill training for five sessions a week for six weeks, and the other group will undergo forward walking treadmill training for the same period. The waist-hip ratio will be calculated, and blood samples to measure CRP levels will be taken before and after the 6-week intervention. Results: The data will be tabulated and subjected to statistical analysis, by the paired and unpaired t-tests and the Wilcoxon Signed Rank test. Conclusion: To our knowledge, it is the first experimental study to compare the effect of retro walking treadmill training and forward walking treadmill training on C-reactive protein levels and abdominal adiposity in untrained young adults. The results of the study will throw light on which type of training, to what extent, might help lower cardiovascular4risk in young adults.

Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device) in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week). All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p

Background: All tasks require postural control. The appropriateness and adequacy of postural tone in the trunk muscles referred to as “Core muscles” is the key element for the control of normal postural stability in an erect position. From among the core muscles (local and global), Transversus Abdominis muscle is controlled independently of the other trunk muscles and its activation is associated with postural demand. The study aims to assess the TrA muscle endurance and Limits of Stability (Maximum Excursion-MXE and Directional Control-DC) and to determine the correlation between the two parameters. Methods: A Correlation study was performed on 100 asymptomatic healthy nulliparous urban women of 18-25 years’ age with Body Mass Index of 18.5- 27.9 kg/m². Participants performed two tests in random order; Prone Test for TrA muscle endurance using Pressure Biofeedback Unit and LOS Test using the NeuroCom Balance Manager®. The outcome measures were TrA endurance (Number of 10 seconds hold) and MXE (%) and DC (%) of the LOS test. Results: Mean (mean ± SD) values were TrA endurance: 4.93 ± 3.31, Maximum Excursion (%): 92.8 ± 7.69 and Directional Control (%): 84.53 ± 3.17. Results showed a significant positive correlation between TrA endurance and MXE whereas no significant correlation was observed between TrA endurance and DC (Pearson’s correlation test; r=0.201 and r= -0.084, respectively at p

Background: Growing childhood obesity epidemic is concerning the health of future generation in any country. Today’s competitive world is increasing the never ending pressure on children to excel in academic performance to ensure bright future. Hence, it is the need of the hour to understand the correlation between obesity and academic performance for implementation of the policies related to obesity prevention and treatment. Methods: 1034 school children were taken randomly according to inclusion and exclusion criteria, and they were divided into two groups: a) 5-11 years and b) 12-18 years. BMI (BMI), Waist Circumference (WC), the Waist-Height ratio (WHtR) and SSFT (Sum of Skinfold thickness) were taken to measure obesity, and the class teacher evaluated academic performance. Results: The prevalence of obesity when assessed by WC revealed highest values as compared to Waist-Height ratio, IOTF-BMI and SSFT. Spearman correlation between obesity (WC) and academic performance revealed that there was a significant negative moderate correlation in urban boys (r = -0.4, p

Background: In India, most of the physical therapy teaching institutions have traditionally used the conventional method of teaching because physical therapy is closely related to skills that were considered to be possible to teach only through hands-on training. But in recent times, because of the COVID-19 pandemic, which affected all walks of life in India and worldwide, educational institutions were forced to implement education through e-learning. The study's primary objectives were to investigate physical therapy academicians’ perceptions of e-learning and experience with technology and computers, identify differences in perceptions among faculty members, and identify the significant challenges and obstructions facing the implementation of e-learning. Methods: A cross-sectional survey was carried out among physical therapy academicians using a proper sampling frame obtained from a list of teaching institutes in Karnataka, India. Results: 32.5% of participants had no experience with course management systems, and 24.5% had low experience. 47.1% had no experience, and 35.4% had low experience in teaching via e-learning. 36.8% disagreed, and 39.6% disagreed strongly that they were satisfied with using e-learning for teaching. 28.3% disagreed, and 15.1% disagreed strongly that e-learning courses were easy to manage. Conclusion: Most academicians had the knowledge, willingness, and confidence to execute an e-learning program if given the opportunity, though some training and administrative support is warranted to ensure that they become highly competitive in executing such a program.

Background: Low back pain is a common, benign, and self-limiting disease that affects almost all persons, with a lifetime prevalence of up to 84%. In contrast, sciatica affects only 40 % of all persons in the Western industrialized countries. In sciatica, pain radiates down the legs, below the knee along the distribution of sciatic nerve. Nerve root compression is the most common cause of sciatica. Neuro dynamics or Neural Tissue Mobilization is relatively new approach in treatment of neuro musculoskeletal disorders. The aim of the study to determine the effectiveness of Neural Tissue mobilization on pain, pain free passive SLR ROM &functional disability in LBA subjects with Sciatica. Objective of the study is to study and compare the effectiveness of Neural tissue mobilization in LBA subjects with sciatica in terms of pain, pain free SLR ROM and Oswestry Disability Index. Methods: 30 subjects were selected by simple random sampling and assigned in to Control(n=15) &Experimental group(n=15).The subjects in control group were given conventional physiotherapy and those in Experimental group were given Neural Tissue Mobilization in addition to conventional therapy. All the participants were assessed with VAS, ODI and pain free passive SLR ROM. Results: After the analysis, the results were found to be significant improvement in pain, pain free SLR ROM, ODI in both groups (p< 0.00).But there is a high significance in Experimental group when compared to control group. Conclusion: Results suggest that NEURAL TISSUE MOBILIZATION along with conventional therapy is more effective in reducing pain, decreasing disability and improving SLR ROM.

Background: Motor control exercises are isolated strengthening exercise for the deep spinal muscles (transverse abdominus, multifidus) whereas Core stability is achieved by global strengthening of the core muscles. There are not much studies available in the literature done or studied the short term effect of the motor control and core stabilization on subjects with low back pain. Therefore, the purpose of this study to find the comparative effect of motor control exercises versus core stabilization exercises on improvement of pain and disability in subjects with mechanical low back pain. Method: An experimental study design, 30 subjects with non-specific mechanical low back pain were randomized into 2 groups with 15 subjects each in Group A and Group B. Subjects in Group A received Motor control exercises and subjects in Group B received Core stability exercises. Both the group received conventional exercises. The duration of intervention was given for two weeks. Outcome measurements such as pain using VAS, Functional disability using Oswestry Disability Index Questionnaire were measured before and after two weeks of intervention. Results: Analysis using paired ‘t’ test and wilcoxon signed rank test found that there is a statistically significant improvement (p

Background: Chronic low back pain remains a major health problem. Unfortunately, the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. At present, however, there are no guidelines regarding the best treatment to help clinicians. As a result, time and money are wasted on treatment which ultimately fail to help the patient. A backache is described as annoying and gripping pain. It can be caused by poor posture, lack of manual handling skills, change in the center of gravity due to expanding abdomen, lack of exercise, or the weight of the baby and the stretching ligaments. Pelvic floor muscle weakness is one of the major cause of chronic backache. Weakness in the pelvic floor muscles is common in females which can lead to debilitating urinary symptoms, affect sexual function and cause chronic backache. Methods: In 3 months, 31 female subjects with mean age of 28 who had taken treatment for their chronic backache, were improvised with pelvic floor strength at our setup, with dramatically good results. 31 subjects with non-responsive chronic back pain who had taken conventional physiotherapy were included in the study. Both married and unmarried were included. Any sign of radiculopathy or inflammation were excluded. After assessing pain using Visual Analogue Scale, the Dr Glazer’s program and Kegel’s contractions were taught. Results: There was significant improvement by 50% on reassessment after 7 days. Then exercises for transverse abdominals were included to get a better response. On completion of the treatment sessions, reduction in pain was 92% on VAS and functional abilities increased by 89%. There was a significant improvement in the quality of life and in pelvic-floor muscle strength. Conclusion: Non-responsive chronic back pain in females when treated with pelvic floor muscle strengthening program showed 40% improvement. This can be implemented in routine practice for the benefit of the patients.

Background: Reasoning refers to logical thinking involving problem-solving and decision-making skills. Physical Education teachers need to manage teaching and learning processes efficiently to build reasoning ability among students. The purpose of this study was to identify the students’ reasoning achievement level based on the net and wall category using RSAT in Physical Education. Methods: A quasi-experimental design was used in this study in four schools in the district of Hilir Perak, Perak. The sample of the study consisted of 240 Form 2 students who used RSAT instrument (validity, r = .78; reliability, r = .74) in the pre-test and post-test. The treatment group underwent teaching and learning programs based on the net and wall TGfU model while the control group underwent the badminton technical model. The subjects of the control group received six teaching and learning sessions based on the plans provided. Results: The pre-test result of treatment group showed overall (M = 2.21; SD = 0.30) compared to the control group (M = 2.18; SD = 0.43). The students of the treatment group (M = 3.64; SD = 0.67) showed higher mean score compared to control group (M = 2.88; SD = 0.82) in post-test. The achievement level of the treatment group students showed that the majority of respondents achieved good level (n = 85; 60.70%) while the control group achieved pass level (n = 62; 44.30%). Conclusion: The study concluded that the use of RSAT could improve the reasoning level among students holistically and comprehensively. The implication of the study suggested an RSAT instrument to be used as an alternative instrument for determining the level of the learning domain based on reasoning to achieve higher-order thinking skills.

Background: This study deals with the evaluation of body composition and fitness of individuals who differ in their physical characteristics viz. weight, height, Age, Sex, Body Frame and physical activity levels viz. Heavy, Moderate, Light, and thereby identify the ideal combination of physical characteristics and physical activity required in Prescribing Exercises for attaining “THE PERFECT BODY COMPOSITION”. Method: Assessments of physical characteristics, physical activity and body composition was done for 88 subjects of age group between 20-40 years. Body composition analyzer used was Futrex-5000/XL based on near infrared inheritance light technology. Total data was divided into 5 test groups according to their BMI. Results: Results showed that overweight individuals were classified into individuals having risky health status due to excess amounts of fat mass (28.45), higher BMI and lower physical activity. The study also showed greater body frame size in overweight individuals when compared to underweight or normal weight individuals. Whereas Lean individuals possessed very low percent body fat and high levels of physical activity. LBM% showed alarming increase among abnormally underweight males (94%) and females (91.3%) due to abnormal decrease in fat% making them physically unfit. Conclusion: It is concluded that, physical fitness of an individual depends upon his/her physical characteristics and also upon the level of physical activity performed. Body composition can be considered as an ideal parameter for evaluating physical fitness with special emphasis on physical characteristics and Individualized Prescription of physical activity and Physical exercises in Physiotherapy.

Background: The Achilles tendon rupture is a pathology of growing incidence due to the increase in the intensity of amateur sports practices and the continuation of this practice with the rise in age. The rupture follows a degradation of the tendon’s structure, known as degenerative tendinopathy, which is symptomatic only in rare cases. In the absence of prior pain, iterative rupture is the complication to be feared and prevented. Unfortunately, after orthopedic or surgical treatment, there is no consensus concerning criteria for returning to sports. Such criteria would aim to prevent the risk of recurrence and the appearance of other sports injuries. Methods: A current literature review using the PubMed database in June 2021. Results: The literature doesn’t show any validated criteria for returning to sport. Conclusion: Consequently, this work seeks to propose objective criteria for validating the return to sport in connection with the physical and psychological qualities of the subject, abrogating temporal criteria, too formal and remote from the clinical view. Thus, the physiotherapist is advised to take an interest in the ankle's range of motion and the stiffness of the tendon, strength and endurance of the calf muscle, the quality of the proprioceptive and postural functions on a more functional plan, based on the quality of the jumps and then on the subject's running pattern. Finally, a psychological assessment completes the battery of tests that will validate the return to sport.

Background: Autism Spectrum Disorder (ASD) is a disorder of neurodevelopment, which affects individuals across social, ethnic, and geographic groups. Autistic children have difficulty with gross motor and fine motor functioning difficulties, including a wide range of signs and symptoms. Toe walking due to TA tightness is commonly observed gait in autistic children altering foot posture in them. The knowledge about the abnormalities can be useful for the assessment and treatment planning of ASD children. We evaluated TA tightness, ROM of the ankle joint, and compare the effect of manual therapy (MET) and conventional therapy for improving TA flexibility and foot posture. Methods: An RCT included 20 diagnosed autistic children(13male,7female) as per inclusion criteria the subjects were divided into two groups, i.e., group A and B, the group A was given Conventional Therapy in the form of passive stretching whereas Group B was given Manual Therapy in the form Muscle Energy Technique. The participants were clinically examined and evaluate TA tightness in the form of Elastography, Range of motion, and foot posture. Data were taken as pre and after post-intervention. Results: There were significant changes in elastography readings, foot posture index, and range of motion in both groups post-intervention, but significant improvement was observed in group B as compared to group A, i.e., p>0.05. Conclusion: This has been concluded that there is a significant effect of Manual therapy in the form of muscle energy technique for improving TA flexibility and foot posture as compared to conventional treatment.

Background: Decreased core stability displaces center of gravity away from base of support reducing activity participation of athlete. Present study was conducted to study the effect of core stabilization exercises after reconstruction surgery of ACL on functional outcomes. Methods: 30 subjects following 5 months of ACL reconstruction were randomly assigned to either group that performed (study group) or did not performed (control group) additional core stabilization exercises in conjugation with standard rehabilitation protocol. Outcome measures were: activity level using Tegnar activity level scale and functional performance using triple hop test. Outcome measures were compared at day 1 and day 42 of the treatment. Result: Significant improvement was seen in the study group for Tegnar score with mean difference changing from 4.5 to 1.5 from day 1 to day 42 of treatment (p=0.039) while the control group showed improvement in mean difference changing from 3.8 to 1.4 (p=.045) from day 1 to day 42 of treatment. Highly significant improvement was seen in the study group for triple hop test with mean difference changing from 25 to 6.7 (p

Background: The Anterior Cruciate Ligament (ACL) injury is the most traumatic knee joint injury. Surgical reconstruction is the common standard treatment care to ensure an early functional gain. Active quadriceps exercises were introduced at early rehabilitation to prevent muscle lag. However, patients' pain, muscle compensation from other parts of the body, and rapid development of quadriceps weakness were factors that slow down the positive progression of post ACL rehabilitation. Therefore, a new exercise instrument is needed to facilitate muscle contraction during post ACL reconstruction exercise actively. The Myo-Tech is an instrument that helps the patient contract correct muscle during the early phase of rehabilitation. The purpose of this study is to investigate the reliability of the Myo-Tech instrument measuring quadriceps contraction on post ACL reconstruction. Methods: This is a cross-sectional study design and was carried out on patients with post ACL reconstruction. The patients were required to perform static Quadriceps exercises (SQE) for 10 seconds with Myo-Tech strapped at the upper thigh around the quadriceps area. Graph of muscle contraction was measured for the highest and lowest value in the 10 seconds. Results: A total of 29 male subjects were involved in this study. The reliability of Myo Tech assist patients in quadriceps contraction is good (r = 0.67). Conclusion: This study showed that Myo Tech is a promising instrument and can be integrated into clinical practice. The Myo-Tech can be used as an assessment tool to determine proprioceptive deficits following muscle weakness.

Background: Ligament injury accounts for nearly 40% of all injury problems in anterior cruciate ligament injury constitute nearly 50% of all knee ligament injuries. Anterior cruciate ligament deficiency affects not only the mobility, self-confidence and lifestyle of the affected persons in short term but also causes arithmetic changes in the affected knee in the long run. Purpose of study to find the effectiveness of concentric and eccentric for post anterior cruciate ligament reconstruction subjects on muscle strength, joint range of motion and pain. Methods: 24 samples with age group of 35 years were randomly assigned to two groups Concentric and Eccentric groups. The Concentric group, performed 9 (3sets) concentric contractions for knee extensors and 9 concentric contractions for knee flexor muscles. The eccentric group done 9 (3 sets) eccentric contractions for knee extensors and 9 eccentric contractions for knee flexors. Results: Pain is significantly decreased in concentric group. But not significantly decreased in eccentric group (t = 2.85, P = 0.009; and t = 1.40; P = 0.17). The range of motion is significantly increased in both concentric knee extension and flexion and eccentric knee extension and flexion (t = 3.53, P = 0.0023; and t = 4.55; P < 0.001). The quadriceps muscle strength is significantly improved in both concentric and eccentric groups at 60° / sec and 90° / sec. Conclusion: The eccentric exercises are better than concentric exercises in improving the strength of hamstring and quadriceps muscles.

Background: In physical therapy, usually the effects of treatment on any condition will be evaluated based on the mode of action on the target tissue. Some treatments will have direct and indirect effects. Due to indirect effects, there may be changes in other tissues or systems in and around the target tissue. The interaction between target, effect, and action was studied under TEA model. In sacroiliac joint dysfunction, Muscle Energy Technique (MET) and Spinal Manipulation Therapy (SMT) were proved as useful treatment approaches but one is targeted on muscles (MET) the other targets on joint (SMT). The indirect effects of both the approaches can’t be neglected. This study focused on evaluating indirect effects of SMT. Methods: A pilot study was conducted to see the effect of Spinal Manipulation Therapy on muscles (Transverse Abdominus, Internal Oblique) when applied in patients with sacroiliac joint dysfunction. 44 subjects diagnosed with sacroiliac joint dysfunction were recruited in the study. Resting thickness was measured by ultrasound before and after Spinal Manipulation Therapy. SPSS version 17 was used for statistical analysis. Paired t-test compared pre and post test results. Results: After conducting Pilot study revealed that Pre resting thickness of Transverse Abdominus and Internal Oblique is (3.5±0.10) and (5.47± 0.15) Post resting Thickness of TrA (Transverse Abdominus) and Internal Oblique (IO) is (3.90±0.12) and (7.63±0.80) Results are significant as P-Value 0.000 that is

Background: Patello femoral pain syndrome is one of the most common musculoskeletal disorders and is reported to affect 15% - 33% of an active adult population and 21%-45% of adolescents thereby decreasing the work capacity of an individual. Patello femoral pain syndrome as implicated is due to inappropriate neural control of the quadriceps femoris muscle. Since Vastus medialis muscle is regarded as the dynamic medial stabilizer of patella so it’s important to understand the activation of Vastus Medialis Oblique’s in patients with patello femoral pain syndrome The purpose of this study is to assess the activation of Vastus Medialis Oblique’s at different knee angles between closed kinetic chain position and open kinetic chain position and the information thus gained can be used to design training program aimed at controlling patello femoral joint dysfunction. Methods: Thirty subjects with patello femoral pain syndrome (assessed through history and examination) were assigned to two groups. Group A was made to perform open kinetic chain activity(i.e. sitting on high plinth) and Group B was made to perform a closed kinetic chain activity(i.e. standing) The outcome measure were amplitude and duration. Analyses were performed using independent t-Test. Results: Significant difference was found between the groups for amplitude and duration at varying angles. Amplitude: 0 degree (p=0.004), 60 degrees (p=0.015), 90 degrees (p=0.004). Duration: 0 degree (p=0.007), 60 degrees (p=0.008),90 degrees (p=0.002) Conclusion: Based on the outcome of the study it’s concluded that there is greater activation of Vastus Medialis Oblique’s muscle while performing close kinetic chain activity than in open kinetic chain.

Background: Modified radical mastectomy is a frequent surgery employed as a therapeutic procedure in patients with breast carcinoma with involvement of axillary lymph nodes. Many patients suffer from severe shoulder complaints after axillary lymph node dissection even with postoperative rehabilitation. Pre-operative exercise and education are recommended to reduce the incidence of breast cancer related upper limb dysfunction; it will shorten the recovery time. The objectives of the study are to determine the influence of pre-operative physiotherapy on shoulder ROM using goniometer in subjects with modified radical mastectomy and to determine the influence of pre-operative physiotherapy on functional activities using shoulder pain and disability index (SPADI) in subjects with modified radical mastectomy. Methods: 30 Subjects of adult women included in the study who met the inclusion criteria, divided into 2 groups. Experimental Group received preoperative physical therapy education and exercises 1-2 weeks before surgery and routine physical therapy protocol after surgery. Control Group received standard education brochure preoperatively and routine physical therapy post operatively. Measurements included shoulder ROM and functional evaluation using goniometer and SPADI. Measurements were taken at baseline i.e., pre operatively, post operatively at 4th day after removal of drains, and 1month after surgery. Results: All measures were significantly reduced after surgery, but most recovered after 1month of surgery and attained functional level in experimental Group. Conclusion: This study provides experimental evidence that preoperative education and exercise influence the postoperative shoulder ROM and functional activities after modified radical mastectomy.

Background: Gastric cancer is the second most common cancer among men and third most among women in world wide. For over 100 years, gastric cancer has remained one of the most important malignant diseases with significant, geographical, ethnic and socio-economic differences in distribution. The main aim of the study is to evaluate the effectiveness of supervised aerobic exercises on severity of fatigue, activities of daily living and aerobic fitness in post gastrectomy individuals undergoing chemotherapy. Methods: Total sixty patient’s age 30 to 68 years post gastrectomy individuals undergoing chemotherapy included for study. These patients were randomly allocated to intervention group (n=30), which underwent a 4- weeks training programme of supervised aerobic exercises & control group (n=30) that received standard care and unsupervised aerobic exercise protocol. Primary outcome was change in fatigue levels as determined by fatigue severity scale in before and after the intervention program. Secondary outcomes were activities of daily living and aerobic fitness as assessed by the dukes activity status index and six minute walk test by using cahalin formula. Paired sample t- test was used to analyse changes from before and after intervention programme. Result: There is a statistically significant (p

Background: Leisure activity helps the elderly to improve their physical and mental health. The purpose of this study is to determine the interlink between leisure activity and mental health in older people. Methods: We select 413 people over 60 years old(213 female and 200male).We collected data using GHQ 15-question survey, Nagi questionnaire, and a new reliable and validated the designed questionnaire. We analyzed our data utilizing spearman correlation, and regression analysis in SPSS21. Results: We report a relationship between recreational and religious activities in the absence of confounding factors but only religious activities were associated with mental health in the presence of confounding factors(p-value

Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined effectiveness & effects of kinesiotaping along with quadriceps strengthening in subjects with patellofemoral joint osteoarthritis. Methods: 30 subjects with symptoms of patellofemoral osteoarthritis fulfilled the inclusion criteria were randomly assigned into 2 groups of 15 in each group. Taping along with quadriceps strengthening program is compared to the quadriceps strengthening program alone. Pain were measured by Visual Analogue Scale (VAS), knee ROM were measured by Goniometer, Functional status were measured by Western Ontario McMaster Universities index (WOMAC), score. Measurements were taken pre & post intervention. Results: The results indicated that kinesiotaping along with quadriceps strengthening exercises showed there was statistically significant improvement in pain (

Background: Patellofemoral pain syndrome (PFPS) is a condition presenting with anterior knee pain or pain behind the patella (retro-patellar pain). The purpose of the study is to find the immediate effect of Kinesio taping versus McConnell taping in patellofemoral pain syndrome subjects during functional activities- stair ascent, stair descent and squat lift. Methods: An experimental study design with three groups, 45 subjects with patellofemoral pain syndrome was randomized. 15 subjects into each Kinesiotaping group, McConnell group and Sham group. Kinesiotaping group received patellofemoral kinesio taping technique, McConnell group received McConnell taping technique and Sham group received sham taping technique. Outcome measure pain was measured using visual analogue scale during pre and post taping pain levels that were measured during three functional activities: stair ascent, stair descent and squat lift. Results: When analysed within the group using paired ‘t’ test and wilcoxon signed rank test, there is statistically significant improvement in post pain levels in KT, MT and Sham group during stair climbing, stair descent and squat lift. When compared measuring of pre and post pain levels between three groups, there is no significant change in pain level between Kinesio taping and McConnell taping as also compared to sham taping. Conclusion: The study concluded that Kinesio taping, McConnell taping and sham taping shown immediate effect on reducing pain during functional activities such as stair climbing, stair descent and squat lift with greater percentage of pain reduction was found following Kinesiotaping and McConnell taping.

Background: Rigid and kinesio tapings are commonly used in the rehabilitation of subacromial impingement syndrome (SIS). Yet; the effect of postural correction with the two taping materials in SIS has not been extensively studied. The purpose of the study is to examine the effect of postural correction with two different taping materials on scapular kinematics and electromyography of scapular upward rotators in patients with SIS. Methods: Twenty female patients with SIS participated in this study. Their age ranged from 30-60 years. Participants were randomly assigned into: Group I (Kinesio tape, n=10) and Group II (rigid tape, n=10). Thoracic and scapular taping with posture correction was applied to both groups. Scapular upward rotation at 0˚, 60˚, 90˚ and 120˚ of shoulder elevation and the activity level of the upper fibers of trapezius (UT), lower fibers of trapezius (LT) and serratus anterior (SA) muscles were measured before and immediately after taping application. Results: Both taping materials significantly increased scapular upward rotation at 60°, 90° and 120° angles (P =.004,.002 and .047 respectively) after the application of tape as compared to the before. In addition, significantly greater muscle activity of the LT and SA muscles (P =.027 and 0.05 respectively) were demonstrated by the kinesio-taping group as compared to rigid taping group during real taping condition. Conclusion: Both taping materials are effective in restoring scapular kinematics. Furthermore, kinesio taping has a facilitatory effect on the LT and SA muscles. Kinesio taping may be considered an alternative to rigid taping in patients with SIS.

Background: Tendon transfer surgery is usually done to improve function, following damage to either major nerve trunks or peripheral nerves. Re-education of the muscle is of utmost importance to gain functional activity.To achieve this, along with re-education exercises, faradic stimulation is usually used. Unipolar Acu-Stim (UAS), is an innovative technique where an acupuncture needle is used to stimulate the transferred tendon with Surged Faradic Currents (SFC). The objective of the study is to identify if the application of SFC using UAS method, is effective to re-educate a transferred muscle. Case Description: The subject was a 24 year old male who had a loss of finger and thumb extension following Posterior Interosseous Nerve (PIN) palsy, for which Flexor Carpi Radialis (FCR) was transferred to Extensor Digitorum Communis (EDC) and Palmaris Longus (PL) was transferred to Extensor Pollicis Longus (EPL). Following removal of the POP, UAS with surged faradic current was applied for 4 weeks along with re-education exercises. Prognosis of finger extension was assessed by goniometry and video recordings. Outcome: At the end of 8th week, as observed on goniometry and video recordings, complete finger extension was achieved. Discussion: UAS with SFC, is useful in re-education of a transferred muscle, as desired movement can be achieved with low intensity.

Background: Acupuncture TENS is used to improve pain instead of invasive acupuncture. Acupuncture shown to improve dyspnoea and lung functions in COPD (Chronic Obstructive Pulmonary Disease) patients. The purpose of the study is to determine Short term effectiveness of Acupuncture-TENS in reducing dyspnea and improving lung functions for subjects with moderate COPD. Method: An experimental study design, selected 30 geriatric subjects with COPD randomized 15 subjects into each Study and Control group. Study group received Acu-TENS for 45 minutes for total 5 sessions, while control group received placebo TENS. Outcome measurements such as breathlessness using Modified Borg Scale (MBS), Lung functions using Pulmonary Function Test (PFT) was measured before and after intervention. Results: Analysis from pre-intervention to post-intervention within study group found that there is statistically significant change in means of MBS, FEV1, FEV1/FVC ratio and within control group there is a statistically significant change in means of MBS, but there is no statistically significant change in means of FEV1, FVC and FEV1/FVC ratio. When post-intervention means were compared between the groups there is no statistically significant difference in means of MBS and FEV1, FVC and FEV1/FVC ratio. Conclusion: It is concluded that one week of Acu-TENS on EXL1 point found no significant effect on improving dyspnea and lung functions in subjects with moderate COPD in geriatric populations.

Background: Acupuncture is an component of traditional Chinese medicine (TCM) that has been used for three thousand years to treat diseases and relieve pain. Pain is found to be the most common reason for people to use acupuncture. Due to recent scientific findings, acupuncture treatment has been accepted worldwide. Numerous trials have been conducted especially in analgesia. The mechanisms of acupuncture analgesia has been widely investigated, however, the underlying mechanism still not clear. This article summarizes the central mechanisms of acupuncture analgesia and reviews recent studies on the topic. Method: We have focused on examining the recent literature on acupuncture analgesia. The central mechanisms of acupuncture analgesia and reviews recent studies on the topic. We focused on the studies related to central mechanisms of acupuncture analgesia from these aspects: (neurophysiology, neurochemistry and neuroanatomy). Result: The result revealed that acupuncture act on various parts of the central nervous system, including the spinal cord, brain stem, cerebral ganglia and cerebral cortex to alleviate pain. The central mechanisms underlying the effects of acupuncture include neurohumors and neurotransmitters, which are involved in analgesia. At spinal level, Spinal opioids, glutamate, norepinephrine and serotonin are the key elements acupuncture-induced analgesia. At brain level, Endogenous opioid peptides, limbic system play essential roles in mediating the analgesia. Conclusion: Acupuncture is an effective approach to pain management. There is good evidence in both experimental and clinical research that supports acupuncture efficacy in management of chronic pain through central nervous system. Acupuncture should be strongly used as a part of pain management plans. This work helps in improving our understanding of the scientific basis underlying acupuncture analgesia.

Background: To evaluate the test-retest reliability of Jamar hand held dynamometer for measuring handgrip strength (HGS) in patients with acute and chronic cervical radiculopathy and to find out the difference in measurement of the handgrip strength between acute and chronic cervical radiculopathy. Methods: A prospective, observational and non-experimental, the comparative study design was used. A sample of 72 subjects (37 women and 35 men) suffering from cervical radiculopathy were divided into two groups i.e., Group A(acute) and Group B(chronic), handgrip strength was measured using Jamar hand held dynamometer on two occasions by the same rater with an interval of 7-days. Data collection was based on standard guidelines of American Society of Hand Therapists. Three gripping trials (measured in Kg) with patient’s arm in standardized arm position were recorded. The data was analyzed from the mean score obtained from the sample. Result: One-way Analysis of Variance(ANOVA) was used to evaluate test-retest reliability and Tukey-Kramer Multiple Comparison Test used to find the difference between handgrip strength among acute and chronic Cervical radiculopathy cases. Greater P-value (>0.05) in both testing session, as well as 95% of the confidence interval, shows the reliability of the instrument and lesser p-value (0.05) in female subjects shows no significant difference in handgrip strength between the two groups. Conclusion: Excellent test-retest reliability for hand grip strength measurement was measured in patients with acute and chronic cervical radiculopathy shows that the equipment could be used as an assessment tool for this patient and significant difference exists among male handgrip strength between acute and chronic cervical radiculopathy cases whereas no difference exists among female handgrip strength between acute and chronic cervical radiculopathy cases.

Background: This study might have been directed to some degree because of clashing results in the past studies regarding the impacts for different SS protocols on muscle strength and possibility for injury. The objective of the study was to investigate the acute effects of different static stretching (SS) durations (20, 30, and 60s) on isokinetic concentric quadriceps (Q) and hamstrings (H) peak torque (PT), eccentric H PT and conventional and functional H:Q ratios under different stretching conditions and angular velocities (60°and180°/s) in active women. Methods: Isokinetic tests were performed on 108 active women. A HUMAC system was used to measure unilateral concentric Q and H PT, and eccentric H PT at 60 and 180º/s at baseline and after a bout of H-only, Q-only, and combined H and Q muscles SS. The data were statistically treated using five separate three-way (time x conditions x velocity) ANOVA. Results: There were no significant differences among groups at baseline (P > 0.05). Significant reductions of all outcome measures have been shown to occur after 30 and 60s of SS (P < 0.05). The highest reductions of concentric Q and H PT, eccentric H PT and H:Q ratios were observed after 60s of SS. With no significant effects with the 20s SS (P > 0.05). Conclusion: Short-lasting stretching can be done before exercises that require strength. However, since 30s or 60s stretching protocols adversely affect the muscle strength, performance and lower H:Q ratios they are not recommended prior to activities demanding the production of high forces.

Background: Task specific training of upper limb may result in learning of new motor task through transfer after repeated practice. Mirror therapy and motor imagery are effective emerging techniques used as an adjunct in rehabilitation of upper limb function in hemiplegia. The purpose of the study is to find comparative effects of task specific motor imagery with mental practice over task specific mirror therapy on upper limb functional activities for subjects with sub acute hemiplegia. Method: An experimental study design with two groups conducted on 30 subjects with sub-acute hemiplegic. Thirty subjects randomised, 15 subjects into group A and 15 into group B. Group A subjects received task specific motor imagery with mental practice thrice a week for 10 weeks and Group B received task specific mirror therapy thrice a week for 10 weeks. In both groups, each session consisted of 60 minutes. The outcome measure such as Action Research Arm Test (ARAT) was measured before and after 10 weeks of intervention. Results: Comparison of post intervention means of ARAT using Independent t test and Mann-Whitney Test showed that there is no statistically significant difference in grasp and gross movement between the groups and there is a statistically significant difference in grip, pinch and total score between the groups. Conclusion: The present study concludes that 10 weeks of task specific motor imagery with mental practice and task specific mirror therapy both shown significant effect on improvement of upper extremity function. However, greater percentage of improvement was found using task specific motor imagery with mental practice in hand function when compared to task specific mirror therapy.

Background: Anxiety and depression are proven independent predictors of mortality, disability, and reduced health related quality of life (HRQoL). Hence, this study was undertaken with aim to find the prevalence of anxiety and depression in patients following acute myocardial infarction (AMI) and to find out its association with various psychosocial factors. Methods: Stable patients admitted during 3 month period in Cardiology Intensive care unit of tertiary care Hospital with the diagnosis of acute myocardial infarction were included in this cross sectional study. Data was collected using a Semi- structured questionnaire. Anxiety and depression were assessed using Hospital Anxiety and Depression Scale (HADS) .Scores were analyzed using SPSS version 16. Results: A total of 75 patients (73.3% men and 26.7% women) with mean age 54.86 ± 9.91 years were included. Mean scores of anxiety and depression were 4.49 and 4.0 out of 21, respectively. Probable cases of anxiety and depression as per HADS were 29.33% and 21.33% respectively. There was a statistically significant association of Anxiety and depression with gender (P= 0.004(A), P= 0.002(D); education [P=0.018(A), P= 0.002 (D)]; and pre-existing known stressor [P

Background: People with vestibular dysfunction complain of problems with balance and dizziness which creates a negative impact on the people and affects their quality of life. Medications help in the control of symptoms. There has been an increase in the implementation of many protocols for the rehabilitation of vestibular patients with follow up exercises for the treatment of BPPV. Methods: Thirty BPPV patients were identified by doing Dix- Hall pike positioning and their DHI scores were recorded. All patients were exclusively treated with Semont Liberatory maneuver. The effectiveness of the treatment was documented at 1 week and 1 month. Repeated procedures were performed if necessary. Results: After the treatment session of Semont Liberatory maneuver, the symptoms disappeared in 20 patients and have negative DHI test by 1st week, and of patients have negative DHI test by 1 month. The first success rate was 78% and the total success rate was 89%. Semont Liberatory maneuver also showed decrease in score of DHI [post-test] in 1 month duration. The patient who visited within one week after the onset of symptoms had good prognosis with Semont Liberatory maneuver. This protocol was ineffective in 4 patients. Conclusion: The Semont Liberatory maneuver is a safe and effective technique for treating BPPV patients.

Background: The aim of this study is to evaluate the effectiveness of trunk training and Swiss ball exercises in acute stroke subjects. Trunk is often neglected part in the stroke rehabilitation, trunk training exercises and Swiss ball exercises result in better recruitment of trunk muscles thus improving sitting balance and gait parameters in acute stroke subjects. However literature evidences for trunk training exercises and Swiss ball exercises in improving sitting balance and gait are scarce in acute stroke population. Methods: A total of 60 subjects who met the inclusion criteria were recruited from department of physiotherapy, G.S.L general hospital and were randomly allocated into 2 groups with 30 subjects in each group. Initially all of them were screened for balance and gait using trunk impairment scale and by assessing gait parameters, after that they were given a 30min of trunk training and Swiss ball exercises for 5 days a week for 4 weeks. Both the groups received conventional physiotherapy for 4 weeks. Results: Post intervention there was no significant difference between the two groups. There was improvement post treatment in trunk training group (P

Background: Non-specific low back pain (LBP) is defined as LBP that poses signs and symptoms which cannot be related to a recognizable cause, and Motor Control Exercise (MCE) usually is the choice of treatment for conditioning lumbar muscles for chronic LBP group. Limited information is available regarding their clinical application for participants with acute and sub-acute LBP. Hence, the main aim of this study is to find out this clinical utility. Methods: A quasi-experimental study with 30 participants of less than six weeks and twelve weeks duration of LBP were included in the study and are divided into an experimental and control group. Pain intensity using numeric pain rating scale (NPRS), lumbar range using modified Schober’s test, muscle function using surface electromyography (EMG) and functional disability using Roland Morris Disability Questionnaire (RMDQ) were recorded pre and post-treatment. The experimental group received lumbar MCE with general exercises and the control group received only general low back exercises aiming to improve lumbar range and muscle efficiency for six-session spread over three weeks duration along with therapy for pain reduction. Results: Subjects in both experimental & control groups had significant improvement in pain (p

Background: Mobile phone usage has become increasingly common in today’s youth. Its heavy use often leads to an addiction. Dependency on these devices could lead to postural dysfunctions as well as produce an adverse effect on psychology. Hence, this study is done to correlate mobile addiction with the craniovertebral angle, scapular index and Beck’s depression inventory score in young adults. Methods: An observational study was performed on 100 subjects out of which 51 were males and 49 were females in the age group of 18- 25 years who were pursuing their graduation and post-graduation courses. Mobile Phone Addiction Scale was used to determine the level of addiction. Craniovertebral angle, Scapular Index, and Beck’s Depression Inventory score were measured. Correlation of Mobile Phone Addiction Scale score with the above-mentioned parameters was done using GraphPad Instat Version 3.10 (Pearson correlation coefficient and Spearman correlation coefficient). Results: Mobile phone addiction was found low in 27%, moderate in 30% and high in 43% participants. There is significant correlation of mobile phone addiction scale score with Craniovertebral angle (r = -0.6470, p

Background: This study examined the effects of smartphones addiction on cervical posture, and compared the cervical range of motion (ROM) between addicted and non-addicted boys and girls 8 to 13 years of age. Methods: Twenty-four boys and 26 girls were assigned to 2 groups; addicted group (score > 32, n=32) and non-addicted group (score ≤ to 32, n=18). Craniovertebral Angle (CVA) was assessed using side view photographs, forward head posture (FHP) was measured using ImageJ 64 software, and cervical ROM in each direction was measured using a cervical (CROM) device. Results: A forward multiple regression showed that addiction score and body mass index (BMI) were significant predictors of CVA (R2 =0.31, p

Background: Patello femoral pain Syndrome is an over use injury and one of the commonest problems seen in adolescents who are physically active. Till date no study has been done comparing the effect of adding specific hip strengthening exercises (gluteus medius, gluteus maximus & lateral rotators) to conventional exercises in patients with Patello femoral Pain Syndrome (PFPS) while minimizing the effect of minimizing the activation of tensor fascia lata (TFL). Methods: 30 subjects were randomly allocated using convenience random sampling into 2 Groups Group A and Group B with 15 subjects in each group. Readings were taken for Numeric Pain Rating Scale (NPRS), Manual Muscle Testing (MMT) for hip abductors, extensors and external rotators muscles quadriceps and hamstrings, and Anterior Knee Pain Scale (AKPS) on baseline and at the end of 4th week. Results: Analysis of the data collected for NPRS, AKPS and MMT of Quadriceps, Hamstrings, Hip Abductors and Hip External Rotators of 30 subjects was done by statistical analysis tests using STATA and software version 11.2. Although improvement was seen in both the groups but group B improved better compared to group A. Conclusion: Group B treatment protocol i.e. Hip specific strengthening (gluteus medius and gluteus maximus) in addition to conventional treatment in patients with patello-femoral pain syndrome, was found to be effective in reducing pain, improving functional status and increasing muscle strength than Group A treatment protocol i.e. Knee strengthening and stretching.

Background: Total knee replacement (TKR) is a standard surgical option for advanced-stage knee osteoarthritis. The primary indication of TKR is incapacitating knee pain. 75% to 89% of patients undergoing TKR reports a satisfactory reduction in pain. However, some patients develop anterior knee pain post-TKR. Therefore, different treatment strategies are used for the management of pain post TKR. In the present study, we aimed to evaluate the additional effects of hip strengthening on pain, muscle strength, and health status in TKR patients. Methods: We randomized patients into two groups: knee group and knee hip group. The knee group (n=6) did knee flexors and extensors strengthening. The knee hip group (n=6) performed knee strengthening with additional hip abductors, lateral rotators, and extensors strengthening exercises. Both groups received four-session/week for six weeks. The pain was measured on NPRS, muscle strength on a hand-held dynamometer, and health status using the WOMAC scale. The data was collected at the baseline and post intervention (six weeks). Results: The knee hip group shows more marked improvements in pain than the knee group, t value =3.3 (p=0.012). The data did not suggest any difference in knee muscle strength between the groups. Hip muscle strength showed a significant difference. Health status significantly improved in the knee hip group compared to the knee group, t value = 4.68 (p=0.005). Conclusion: We can conclude that a six-week hip muscle strengthening exercise program effectively improves pain, muscle strength, and health status than a conventional knee strengthening program. Keywords: strengthening exercise, knee pain, health status, muscle strength, dynamic valgus

Background: The ability to tackle and dribble the ball swiftly past the rival player forms an important ball based football skill. Agility plays a crucial role for the players to gain good control over the ball. A combination of good agility with good sprint time is undoubtedly a distinguishing characteristic of elite level players. Football as a sport requires a rapid change of directions and speed several times during a match. This particular action requires the player to apply force rapidly into the ground, thereby putting a lot of stress on the adductor muscles. This research paper focuses on the impact of hip adductor exercises and their influence on agility and sprint time in football players. Methods: This interventional study was carried out on 131 male elite level football players playing from clubs and football academies in and around Mumbai city. All the players were assessed for 30 M sprint test, T-Test, and Dribble time test to assess sprint and agility pre and post-intervention. An adductor strengthening intervention consisting of 8exercises were performed for over four weeks. Results: Paired T-test was used to analyze the data, which showed statically significant improvement with p-value 0.000 (

Background: Sacroiliac joint dysfunction (SIJD) is a common problem that causes pain and disability. Adductor pull back exercise is widely used for treating sacroiliac joint dysfunction. No yet research has been directly examined the efficacy of adductor pull back exercise for sacroiliac joint dysfunction. The purpose of the study to find the efficacy of adductor pull back exercise on pain and functional disability for subjects with sacroiliac joint dysfunction. Methods: An experimental study design, 40 subjects with unilateral Sacroiliac joint dysfunction were randomized into two groups: study group (n=20), and control group (n=20). Subjects in study group received adductor pull back exercise along with conventional exercise and Subjects in control group received conventional exercise. The duration of treatment was given for two weeks, three times a day, total six days per week. Outcome measures such as pain was measured using Visual analog scale (VAS), and functional disability was measured using Oswestry Disability Index questionnaire (ODI) before and after 2 weeks of the treatment in both the groups. Results: When means were analyzed using Independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test, there is a statistically significant improvements in means of VAS, and ODI within the groups. When means were compared using Independent ‘t’ and Mann Whitney U test, there is a significant difference in post-means of VAS and ODI between the groups. Conclusion: The present study concludes that the 2 weeks of adductor pull back exercise along with conventional exercise found statistically and clinically significant effect on improving pain, functional disability for subjects with sacroiliac joint dysfunction. Adductors pull back exercise along with conventional exercise techniques shown to have greater percentage of improvement in improving pain and functional disability for subjects with sacroiliac joint dysfunction.

Background: Prior research has examined fall risks in the elderly Caucasian population, though research on this topic in the elderly Latino population is still emerging. This inquiry investigates whether there are distinct balance characteristics in the active elderly Latino population and whether demographic factors and lifestyle choices influence these characteristics. Methods: A total of 25 active participants who partake in Zumba and aqua aerobic classes at a community center participated in this study, with an average age of 71.6+/-7.2. A screening assessment tool (SAT) was administered to obtain demographic data. The Activities-specific Balance Confidence (ABC) scale and Mini-BESTest (MBT) were utilized to assess participants' balance. Results: The most prevalent comorbidities in the group include high blood pressure (76%) and arthritis (64%). The average scores include 86.4% on the ABC, 1.5 points on the MBT items on a 0-2 grading scale, and 14.6 seconds on the TUG cognitive task. A significant positive correlation between the number of medications and the number of comorbidities was identified (r=0.448, p=0.025). Conclusion: The acceptable balance scores among our participants surmise that engaging in physical activities improves perceived balance and balance performance, despite the prevalence of comorbidities or medication usage. Implementing fall prevention programs and balance assessments in community centers and clinicians explaining the importance of physical activity programs to both patients and physicians are strategies that can reduce the risk of falls in any elderly ethnic group.

Background: Adherence with the treatment has been identified as an essential factor that influences the success and outcomes of treatment. Undetected nonadherence is recognized as a reason for altered treatment programs and has been suggested as a reason for nonsignificant research outcomes. Methods: A total of 150 subjects (urban-30 females and 47 males, rural- 36 females and 37 males) were surveyed for information using structured self-questionnaire from outpatient physiotherapy centers, Punjabi University Patiala. Results: More than 95% (77 urban and 73 rural) of the elderly population. About 93.3% urban and 97.6% rural females were nonadherent whereas 91.4% urban and 100% rural males were nonadherent. Observations suggested a statistically significant relationship of barriers with adherence to physiotherapy treatment with location (p=0.0001*), physical therapy centre accessibility (p=0.0235*), difficulty travelling to physical therapy centre (p=0.0020*), paying expenses (p=0.0001*), longer treatment duration (p=0.0004*), less encouragement from family/spouse for exercise (p=0.0106*). A non-significant relationship was found with confidence to return to exercises once stopped (p=0.0998NS), difficulty in remembering exercises (p=0.7928NS), other medical condition (OA, incontinence) (p=0.0796NS), anxiety and depression (p=0.2860NS), ability to perform ADL/IDL (p=0.0888NS). Conclusion: The findings indicate that a very low level of adherence was observed among the elderly population to physical therapy treatment (6.6% urban, 2.7% rural females) and (8.5% urban, 0% of rural males). Elderly residing in rural areas are comparatively less adherent than urban elderly to physiotherapy treatment.

Background: The shoulder is a complex joint that plays a crucial role in many activities of daily living. Adhesive capsulitis is defined as a painful and disabling condition in which the capsule and the connective tissue surrounding the glenohumeral (GH) joint becomes inflamed, leading to restriction of range of motion in the joint. A wide range of physical therapy interventions are used to improve the joint range of motion in subjects with adhesive capsulitis. Earlier, isolated studies were done on the effectiveness of paraffin wax therapy and ultrasound therapy in subjects with adhesive capsulitis. The need of the present study was to compare the effect of paraffin wax therapy with manual mobilization and ultrasound therapy with manual mobilization on pain, shoulder ROM and functional status in diabetic subjects with adhesive capsulitis. Methods: Subjects for the study were recruited from the outpatient department of endocrinology and physiotherapy. The size of the sample is 80 (eighty subjects) 40 in each group, and study design is an experimental study design (Non-randomized open-label study). The pretreatment values of pain and functional status of the shoulder were assessed using Shoulder Pain and Disability Index (SPADI) scale and ROM was assessed using a universal goniometer. The subjects in the paraffin wax therapy group received wax therapy for 10 minutes and undergone manual mobilization. The subjects in the ultrasound therapy group received ultrasound therapy (3MHz) for 10 minutes and undergone manual mobilization. The treatment was given for 3 sessions per week for 6 weeks and post-treatment values were noted for the subjects of both the groups. Results: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group (p< 0.05). Conclusion: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group.