Rakesh Krishna Kovela

• Masters in Neurosciences
• Associate Professor at Nitte University

Background and aim: Cervicogenic headache (CGH) is a complicated and common headache disorder that may present itself with cervical spine dysfunction, irritation of the nerves, central sensitization, and muscular tension. Theoretically, this diagnosis should be an exclusionary diagnosis, considering the fact that it requires extended clinical asses...

Background Today, stroke is the principal cause of demise in both developed and developing countries. There are different techniques used to treat patients with sub-acute stroke. Trunk muscles play a key role, i.e. in keeping the spine and trunk in place. This stabilization requires moving the head and extremities freely and selectively. The aim of...

Introduction: Low Back Pain (LBP) is the most common health problem among elderly individuals, leading to pain and disability. Alongside pain, psychosocial factors have a significant impact on patients with LBP. Kinesiophobia is defined as a fear of physical movement and activity, which can result in avoidance of activities and movement, leading to...

Background A set of non-progressive brain abnormalities and nervous system dysfunctions are referred to as cerebral palsy (CP). Due to this, the child's mobility, eyesight, learning, and thought processes are affected. It can evolve before, through birth, or the first year of a child's life. The activity through which the brain organizes and analy...

Background Spastic diplegic cerebral palsy is the type that is most frequently seen in clinical settings. Spastic diplegic children have trouble maintaining their balance, gait, and gross motor function. This study investigated the effects of the Neurodevelopmental Technique (NDT) and Sensory Integration Technique (SIT) on balance, gross motor func...

Survival reflexes, originating from the brainstem, are involuntary motor responses that are present at birth and facilitate the survival of the neonate. The age of the baby is critical enough to give information about the maturation of these reflexes. In the case of preterm babies, the delayed maturity of these reflexes may pose a threat to the lif...

Background Individuals with overweight and obesity (OW/OB) have poor performance in weight-bearing exercises, resulting in low functional capacity. The dynamic neuromuscular stabilization (DNS) technique was created to engage the core-postural chain in conjunction with the core muscles, generating enough intra-abdominal pressure to dynamically supp...

Training to improve the stability of the core is a routine component of the injury prevention regimen in the musculoskeletal conditions. The strength of the core muscles is significantly impacted by obesity. Obesity is linked to several physiological changes that reduce flexibility and cardiovascular fitness and slow down a person’s activities. Dyn...

Despite widespread computer use, legible handwriting remains an important common life skill that requires more attention from schools and health professionals. Importantly, instructors and parents typically attribute the difficulties to laziness or a lack of effort, causing the youngster anger and disappointment. Handwriting issues are a public hea...

Introduction: The Dynamic Neuromuscular Stabilisation (DNS) technique uses feed forward feedback to involuntarily activate the diaphragm and deep abdominal muscles prior to purposeful movement in humans. It is an efficient approach for facilitating deep core muscle activation of the underactive muscle chain consisting of the Internal Oblique (IO),...

Altered biomechanics is defined as the acquired alteration in the mechanics of the musculoskeletal system that leads to improper movement patterns. Hemiplegia is the reduction in strength or paralysis of one side of the body due to a stroke. The amount of involvement post stroke depends on the site of the lesion. There are various other neurologica...

Acute demyelinating inflammatory polyneuropathy is a variant of Guillain-Barre syndrome (GBS) - an asymmetrical condition that primarily affects the segment of the peripheral nervous system. Weakness or tingling sensations that be commenced in the inferior limbs and progress to the brachium and face are early signs of this condition. Physiotherapy...

Introduction The COVID-19 pandemic has posed an unparalleled threat to all dimensions of human health and well-being. The Pan American Health Organization has acknowledged the crucial role of rehabilitation therapies for COVID-19 and emphasised the importance of exercise programmes for COVID-19 survivors. This scoping review outlines our strategy f...

Ischaemic stroke is caused by a sudden decrease in blood flow to the areas of the brain that leads to severe impairment if left untreated. The impairments include contralateral loss of motor and sensory functions, along with affection on the ipsilateral side. There is a reduction in strength on the unaffected side of stroke, due to the fact that on...

Background and objective While designing the rehabilitation regime of a hemiplegic patient, most physiotherapists focus on the affected/hemiparetic side. The less affected/unaffected side remains unused and loses its properties, i.e., muscle strength, girth, balance, and gait, thus causing deconditioning effects in patients’ overall rehabilitation....

Multiple sclerosis (MS) is a chronic neurological disease that has an impact when they are at the most susceptible aspects of personal, professional, and social development. MS affects about 2.2 million individuals worldwide, with the majority of individuals experiencing relapses regularly. The progression of the disease's complex nature, the chall...

Cerebral palsy (CP) refers to a group of non-progressive brain disorders. Several different approaches are used to treat cerebral palsy children like neurodevelopmental therapy (NDT), sensory integration therapy (SIT), and hippotherapy. Sensory integration therapy is a clinically based approach that places an emphasis on the relationship between th...

Background Stroke is the second leading reason for death and the third most common reason for disability. Stroke is a source of possible substantial harm and is often more disabling than lethal. Common stroke defects include stiffness, tiredness, loss of balance on the afflicted side, as well as gait impairment, resulting in an inability to sustain...

Background Among several variants of Cerebral Palsy, Spastic Diplegic is encountered most commonly in clinical setups. A majority of children with Spastic Diplegia manifest themselves with a disturbance in the geometrical orientation of their pelvis, which imposes an effect on their functional capabilities like walking with independence. This rese...

Albinism is a group of heritable illnesses defined by a lack or loss of melanin in tissues originating from the ectoderm (most notably the skin, hair, and eyes). The most common kind of albinism is oculocutaneous albinism (OCA). Clinical evidence of less pigmentation of the hair and skin, as well as the characteristic ocular symptoms, are used to d...

Here we present a case study of a 75-year-old hypertensive elderly male suffering from right-sided malignant otitis externa with right-sided grade V facial nerve palsy. Malignant otitis externa is an uncommon but critically and extremely challenging kind of disease, along with the involvement of cranial nerves. The main aim of our case study is to...

Astrocytomas are one of the most common primary tumours of central nervous system seen in paediatric population. Although it is treatable and has a good prognosis, some individuals suffer from motor dysfunction following brain tumour resection which could result in decreased mobility, difficulty with daily tasks, increased risk of immobility-relate...

Traumatic nerve damage or compression neuropathy is the most common cause of unilateral weakness in an upper extremity. Rarely, a central nervous system lesion may cause syndromes that initially appear to indicate peripheral nerve injury. The most well known of these is pseudoperipheral hand palsy, which is typically brought on by a minor brain les...

Among the different variants of cerebral palsy (CP), spastic diplegia has a greater frequency than the other variants, with each subtype having a diverse clinical presentation. Pelvic asymmetry is observed frequently in children with spastic diplegia which influences the functional abilities of the child such as balancing abilities and independent...

Stroke is one of the most disabling conditions affecting the middle-aged population all around the world. This study aims to explore the rehabilitation of stroke patients using bibliometric analysis, which includes statistical analysis of recent articles, books, and other kinds of publications, to assess scientific output and determine the signific...

Cerebral palsy (CP) is a condition caused by a non-progressive lesion in the developing brain. CP has a wide range of prevalence, ranging from 1.5 to three cases per 1,000 persons. Newborns weighing less than 2,500 grams now account for half of all incidences of CP. Clinical management in physical therapy is a paradigm for enhancing organizational...

A fluid-filled hole inside the parenchyma or central canal of the spinal cord causes syringomyelia, a neurological condition. It is most frequently linked to type 1 Chiari malformations. Syringomyelia can be caused by tumors in the spinal cord, trauma, and post-traumatic or infectious adhesive arachnoiditis. Syringomyelia is shown to have a prevale...

The most known of all primary cardiac tumors is myxoma, which is most usually detected in the left atrium. As there are no physical signs or symptoms, a diagnosis is rarely made purely based on clinical evidence. Our study aims to investigate the case of post-operative left atrial myxoma with cerebellar signs. A 50-year-old woman complained of dizz...

Coronavirus disease 2019 (COVID-19) has spread around the globe. The most common symptoms associated with this are usually respiratory, but different central nervous system manifestations have been reported. There are many cases of Guillain-Barre syndrome (GBS) post-COVID-19. However, only a few simultaneous afflictions of COVID-19 with GBS have be...

Background and objectives One of the most frequent conditions for which people seek physiotherapy treatment is low back pain (LBP). When the aetiology of low back pain is whittled down to mechanical factors, pelvic tilting becomes apparent. The iliopsoas muscle is the key to relieving LBP in such circumstances, and since it is tightened, we concent...

Acute bacterial meningitis (ABM) is a condition with a high incidence, high fatality and morbidity rates. The phenomenon Hydrocephalus, periventricular infarcts, optochiasmatic and spinal arachnoiditis, and tuberculous mass lesions in the brain are just a few of the consequences associated with tuberculous meningitis. We conducted a full neuro phys...

Stroke is a neurological condition that causes damage to the brain tissue caused by the cutoff of normal blood flow due to vessel collapse or thrombosis. Depending on the areas affected, size, and the cause of injury, motor, sense, recognition, language, and perception deficits are common symptoms of the disease. Patients with stroke often presents...

Spinal Tuberculosis (TB) is also known as a disorder that typically leads to a progressive onset of neurological deficits. The anterior part of the vertebral body adjacent to the subchondral plate is the usual involvement site which occurs most often in the lower thoracic vertebrae. Vertebral collapse is a potential consequence of this disease and...

Distal radius and ulnar fractures usually have a significant role in affecting the functions of hand. They are the most common fractures of the forearm caused by either direct trauma (hit by bat) or indirect trauma (fall). Important clinical features are pain, swelling and decreased forearm and hand functions. These fractures are diagnosed by X-ray...

Shoulder flexion, abduction, and external rotation at 90 degrees of abduction are affected after breast cancer surgery. Rehabilitation is often customised to the individual needs of every patient. Not every patient experiences the same rehabilitation, and as such, physiotherapists are able to support patients with a variety of symptoms. When select...

Cruciate ligaments and menisci are intracapsular ligaments in the knee joint which plays a major role in stabilizing the knee and promoting activities without any discomfort. Uneven inward forces on the knee joint usually causes injuries to Medial collateral ligament, Medial Meniscus and Anterior Cruciate Ligament. Usual symptoms are Swelling and t...

According to the Schatzker-developed method, tibial plateau fractures are usually graded. Schatzker fractures of type VI are high-energy fractures often accompanied by other accidents and complications, such as postoperative inflammation, injuries, infections, and recovery. Physical therapy is a very necessary part of the recovery of patients on th...

Skeletal muscles must generate and distribute energy properly in order to function perfectly. Mitochondria in skeletal muscle cells form vast networks to meet this need, and their functions may improve as a result of exercise. In the present review, we discussed exercise-induced mitochondrial adaptations, age-related mitochondrial decline, and a bi...

Exercise being a potent stimulator of mitochondrial biogenesis, there is a need to investigate the effects of high-intensity interval training (HIIT) among older adults. This review explores and summarizes the impact of HIIT on mitochondria and various cardio-metabolic health outcomes among older adults, healthy and with comorbid conditions. Electr...

Injuries to the soft tissue of ankle are very common and often present in the emergency room. The diagnosis is typically clinical, and 3-5 days after injury, delayed examination and reassessment is recommended as pain and swelling impede accurate evaluation immediately after injury. Treatment is normally non-operational with an emphasis on controll...

Constraint-induced movement therapy (CIMT) is one of the most popular treatments for enhancing upper and lower extremity motor activities and participation in patients following a stroke. However, the effect of CIMT on balance is unclear and needs further clarification. The aim of this research was to estimate the effect of CIMT on balance and func...

Due to its widening geographical range, Japanese encephalitis (JE) has lately been named a notifiable disease in India. The disease notification makes it easier to put preventive measures in place and manage cases. JE is a vector-borne disease that is preventable with vaccination. The virus that causes it is the Japanese encephalitis virus (JEV), w...

Stroke is the world's second leading cause of death and the third leading cause of disability. Ischemic strokes account for 68 percent of all strokes worldwide, while hemorrhagic strokes account for 32 percent. A stroke is a medical emergency that requires immediate attention. Early intervention can help to prevent brain damage and other problems....

Background: The majority of stroke survivors suffer from a lifelong disability. Spasticity on the affected side and loss of balance are the common deficits mainly responsible for the impaired postural alignment, trunk control, and gait in stroke patients. Earlier studies have proven that Proprioceptive Neuromuscular Facilitation (PNF) is not much e...

Cerebral palsy (CP) is a collection of conditions that impact a person's ability to move, balance, and maintain posture. Cerebral palsy is a disorder that affects the motor portion of the brain's outer layer, which controls muscular movement. The cerebral motor cortex hasn't formed normally in some situations throughout fetal development. In certai...

Background: In Cerebral Vascular Disease when one or more arteries are thrombosed it results in Cerebral Venous Sinus Thrombosis (CVST) and affects in all ages. This condition is very challenging as it is not diagnosed early due to diverse signs and symptoms and involvement of extensive collateral circulation. Superior sagittal sinus is a large sin...

Background: Stroke is the sudden loss of neurological function caused by an interruption of blood flow to the brain. Hemorrhagic stroke occurs when a blood artery ruptures in the brain, causing bleeding into the brain leading to hemiplegia. Hemiplegia is a paralysis of the face, arm, and leg on one side. Aim: To study the effect of early Propriocep...

Background: A stroke is a medical emergency that requires immediate attention. Early intervention can prevent brain damage and other adverse outcomes. An ischemic stroke occurs when a blood clot stops or narrows in a blood vessel that leads to the brain. Presentation of Case: In the present case, a 63-year-old retired Zila Parishad worker came to o...

Low back pain is a common condition due to many possible causes. The causes include improper lifting, improper posture, lack of regular exercise and fracture. Low back pain is experienced by everyone at least once in their lifespan. Proper management of low back pain is very important to prevent further complications. Low back pain can be managed b...

Stroke is defined as a clinical illness characterised by a sudden onset of cerebral impairment that lasts more than 24 hours or results in death with no obvious explanation other than a vascular origin.Every year, around 800,000 people have a stroke, or one every 40 seconds. Strokes are caused by difficulties with the brain's blood supply: either t...

Background: One of the significant causes of morbidity worldwide and an essential contributor to disability is Stroke. As said by the National Stroke Association, nine post-stroke survivors out of 10 experience some degree of weakness post-stroke. The hemiplegic patients with sub-acute stroke, who will undergo training to both the lower limb overtr...

Background: Despite the most significant efforts of many experts to provide natural therapeutic therapies, spinal cord injury (SCI) is a traumatic event with limited functional recovery. After a spinal cord injury, paraplegia can develop. Damage to the ligaments, vertebrae, or discs of the spinal column causes this. Paraplegia is the loss of muscle...

Introduction: Developmental Coordination Disorder (DCD) is a neurodevelopmental disease that inhibits muscle coordination that affects everyday life tasks and academic achievement. Children with DCD are often characterized as "clumsy" and "uncoordinated" and often lead to performance problems that most often create (TD) children can easily execute....

Background: Cerebral Palsy is a spacious term which highlights an extensive gamut of motor affliction which has a stagnant tendency. The estimated Cerebral Palsy is indeed very prevalent in developed nations 2 out of the next 1000 live births and neonatal survivors. Among several Cerebral Palsy comes in a variety of manifestations. Spastic Diplegia...

Introduction: Acoustic neuromas are most common tumors of CP angle, accounting more than 90% of all such tumors. Meningioma, primary cholesteratoma and facial nerve schwanoma are the different type of tumors. Acoustic neuroma is a benign tumor situates in CP angle which has a fibrous growth and originates from the division of vestibulochochlear ner...

Introduction: Measurement of hand grip strength is the basic criteria for the evaluation of hand structure and function. The human hand serves various dynamic purposes in day to day activities of an individual. Infact, the entire upper limb is functional because of the hand. This study was carried out to find out if there is any relation between th...

Introduction: Telephysiotherapy (TPT) is provision of physiotherapy services using telecommunication technology such as audio call or video call to facilitate the physiotherapy management of patients within their own homes. In the absence of which the patients may have to discontinue physiotherapy treatment that may result into poor motor outcomes...

Rubinstein-Taybi syndrome (RSTS) is a chromosomal segment 16p13.3 microdeletion syndrome and is characterized by CREBBP gene mutations, delay in the development of height and weight, distinctive facial features, broad and sometimes angulated thumbs and halluces, short stature, and intellectual impairment that is mild to extreme. Current literature...

Introduction: Patellar injuries are usually caused while a person slips or falls on a flexed knee and when the forces from the extensors surpass the inherent strength of patella. As the bony failure advances, it concurs or follows injury to medial and lateral extensions of quadriceps mechanism. This happens by pulling mechanism of the muscles. The...

The Trunk Impairment Scale (TIS) is a valid and reliable tool to assess trunk impairment in children with heterogeneous cerebral palsy. The purpose of this study was to determine the reliability and validity of the TIS in assessing children with spastic diplegic cerebral palsy. The sample was a total of 30 subjects (15 = boys, 15 = girls). All subj...

Guillain - Barré syndrome (GBS) is a rare neurological condition described as demyelination of the peripheral nervous system (PNS) as a result of an immune system attack. In about 70 percent of patients, it is characterized by acute paralysis, and when the respiratory system is involved, it could become more life threatening for the patient. A furt...

Background: The cerebrovascular episode is one of the significant causes of adult injury. This research will aim to investigate the effect of MRP along with FES on ankle dorsiflexors of improving gait parameters for functional mobility and enhancing quality of life in stroke survivors. Method: The participants will be enrolled in experimental or co...

Cerebral Palsy (CP) is considered as a neurological condition caused by a non-progressive damage ormalformation of the brain that occurs during the developmental process. Body movement and musclesynchronization are mainly impaired in children with Cerebral Palsy. Each cerebral palsy case is uniqueto the person. One person may have complete paralysi...

Spastic Paraplegic Cerebral Palsy (CP) involves both the lower limbs which effects balance and gait in children. These individuals are treated by physiotherapy with various means like Stretching, Strengthening, application of Neurodevelopmental Therapy (NDT), Task oriented approach and Proprioceptive Neuromuscular Facilitation (PNF) but there is no...