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Effectiveness of Tailored Exercise Protocol on Functional Independence in Post Laminectomy Induced Paraparesis â€“ A Case Study

2023-05-01T00:00:00Z

Title: Effectiveness of Tailored Exercise Protocol on Functional Independence in Post Laminectomy Induced Paraparesis â€“ A Case Study Authors: Krishna, Anand.; Kavitha Rani, N Abstract: The compression and decompression junction are a potential site for spinal cord distortion. Cord compression could result from the changed cerebrospinal fluid flow dynamics. Para paresis will occur due to direct trauma sustained during surgery or postoperative hematomas and there is 16% of secondary disease, because of non-traumatic injuries and 84% of spinal cord injury are due to trauma and 2 to 5 times the individuals will die prematurely due to spinal cord injury. Case report of a patient, having D8-L1 wedge compression fracture undergone surgical laminectomy, for which specific exercise protocol designed to improve muscle strength, activities of daily living and reduce clonus. post-operatively patient complained of weakness in bilateral lower limb, and he was dependent on others for his daily life activities, so our aim was to make the patient independent and he should be able to transfer from bed to wheelchair and reduce clonus. Tailored protocol was designed for patient’s functional independence by bed mobility, transfer skills, muscle strengthening by using different scales, and he was trained five sessions in a week for three months. After implementing the exercise program like strengthening exercises for bilateral upper limbs, bed mobility training, stretching of bilateral lower limb muscles for clonus and transfer skills using tailored protocol for twelve weeks there was improvement in all parameters.

Blinding Induced Risk of Bias in Randomized Controlled Trials of Physiotherapy Interventions-A Retrospective Study

2023-05-01T00:00:00Z

Title: Blinding Induced Risk of Bias in Randomized Controlled Trials of Physiotherapy Interventions-A Retrospective Study Authors: Joseph, John; Naveen Kumar, I Abstract: In randomized clinical trials, the methodological idea of preventing bias by withholding knowledge of the allocation status is known as blinding. Blinding refers back to the concealment of group allocation from one or extra individuals concerned in scientific studies, most commonly arandomized controlled trial (RCT). Even though randomization minimizes variations among treatment groups on the outset of the trial, it does nothing to prevent differential treatment of the groups later within the trial or the differential assessment of outcomes, either of which may also bring about biased estimates of treatment outcomes. The most beneficial strategy to limit the chance of differential remedy or assessments of results is to blind as many individuals as viable in a trial. To study the extent of blinding induced bias in RCTofphysiotherapyinterventions andtoevaluate theextentofinterpretative consideration it the trials are not blinded in the sample of RCT included. We conducted a retrospective analysis to estimate the blinding bias in the randomized controlled trials published in physiotherapy interventions from 2016 to 2022. We included 50 RCTs for blinding assessment. About 88% of included articles were not having participants blinding 90% has not done therapist blinding andnearly50%ofstudieswereconductedwithoutassessors blinding. Based on the results of this study blinding of important participants were infrequently reported in the included studies.

Progressive Dual Task Training for Improving Physical Performance in Older Adults with Impaired Balance.

2021-03-01T00:00:00Z

Title: Progressive Dual Task Training for Improving Physical Performance in Older Adults with Impaired Balance. Authors: Sarulatha H. M.Manikumar, Vasanthan R, Vijayaraghavan, Ramesh kumar J Abstract: The elderly population is swiftly growing and expected to reach 198 million in 2030, which implies a huge burden on the health care facilities required to treat and sustain the quality of life of older adults. Further elderly individuals demonstrate difficulty to execute motor tasks due to age related cognitive declines. To address the essential components of functional problems of this population, an effective exercise program was explored to improve their functional abilities. The study analysed the effects of progressive dual task training on physical performance in elderly people with impaired balance. Older adults between 60 to 75 years were trained with Progressive dual task exercise (DT).The effects of DT on functional performance measured as physical performance was analysed using short physical performance battery (SPPB). It was observed that dual task training group showed significant improvement on functional performance measures. (p<0.001).This study highlights the importance and benefits of dual task exercises trained in a progressive manner with sequentially planned challenging tasks in improving functional performance.

Influence of cognitive status on motor ability, balance and functional independence in post stroke patients in rural Bangalore.

2021-01-01T00:00:00Z

Title: Influence of cognitive status on motor ability, balance and functional independence in post stroke patients in rural Bangalore. Authors: Raavi Abhinandhana, Sarulatha H, Ramesh Kumar J. Abstract: Background: Stroke results in problems with attention, memory, language, balance disability, motor ability and functional independence. Apart from decline in physical functions, the cognitive impairments cause serious functional consequences. Intact Cognitive functions are considered as distinct factors to identify the performance outcome of activities of daily living. Cognitive impairment can result in significant disability in all aspects of patient life with self-care, independent living skills, work and leisure, social and interpersonal skills in acute as well as chronic stroke patients. Aims: To explore and analyze the relationship of Cognitive Status on Motor Ability, balance and functional independence in acute post stroke patients. Settings and Design: Epidemiological – observational study conducted in community nursing homes. Methods and Material: 66 participants who were willing to involve in the study were enrolled with respect to the inclusion and exclusion criteria. The cognitive status, motor ability, balance and functional independence were measured with MMSE (mini mental status examination), FMA (Fugel Meyer Assessment Scale- motor component), and BBS (berg balance scale, FIM (Functional independence measure) respectively after one month and again repeated after 3 months post stroke. Statistical analysis: chi square test with Pearson product correlation & regression used to analyse the impact of cognitive ability on motor activities, balance and functional independence. Results: Among the three variables balance ability showed stronger co relation with cognitive status in stroke patients, with every unit of change in cognition there was 0.307 unit (B value in regression analysis) increase in balance measures. The scores of functional independence showed positive correlation with Pearson product correlation r = 0.698. Conclusions: Cognitive functions were found to have better association on balance related activities. However the changes in cognitive status demonstrated higher influence on functional independence than balance parameters in post stroke patients.