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   Table of Contents - Current issue
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July-December 2022
Volume 16 | Issue 2
Page Nos. 41-92

Online since Tuesday, January 31, 2023

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EDITORIAL  

Nourishing the art of clinical documentation – First step towards research Highly accessed article p. 41
Suvarna Ganvir, Rajeev Aggarwal
DOI:10.4103/pjiap.pjiap_77_22  
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ORIGINAL ARTICLES Top

Effect of multimodal sensorimotor training on the stereotypical behavior in children with autism spectrum disorder p. 43
Himani Bhagwasia, Baljeet Kaur
DOI:10.4103/pjiap.pjiap_40_22  
OBJECTIVE: To analyze the effect of multimodal sensorimotor training on the stereotypical behavior in children with autism spectrum disorder (ASD). MATERIALS AND METHODS: A group of 60 children with autism were taken in the study who met the inclusion and exclusion criteria and were grouped into two groups using simple random sampling. Group 1 was the interventional group with 30 participants and Group 2 was control group with 30 participants. A 12-week multi-modal sensorimotor training program was given to Group 1. The control group (Group 2) was also given a 12-week conventional physiotherapy intervention. The outcome measure used was the Indian Scale for Autism Assessment (ISAA). Pretest and posttest findings on ISAA were noted for both groups. RESULTS: Multimodal sensorimotor training program has good results compared to the control group in improving the stereotypical behavior in children with ASD. Children who were given conventional physiotherapy programs also showed improvement in their posttest results. On comparing the two groups, multimodal sensorimotor training was found to be more effective in children with ASD. CONCLUSION: There is a significant improvement in stereotype behavior, such as head banging, hand flapping, and repetitive behavior. Multimodal sensorimotor training helps to improve the stereotypic behavior in children with ASD. The present study gives a promising intervention program for children with ASD.
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Teaching bioethics needs more than just a module: A comparison of knowledge and attitude of bioethics principles in 1st- and 3rd-year physiotherapy undergraduates p. 48
Mariya Prakash Jiandani, Nidhi Mahesh Ranka, Omkar M Thakur
DOI:10.4103/pjiap.pjiap_12_22  
CONTEXT: Ethics is a building block of health-care practice. Medical ethics is values and behavior applied during patient care. It may be ingrained through culture, education, upbringing, and observation. Learning by observation during a clinical posting is a hidden part of the curriculum. With experiential learning, the students may change their attitude and behavior. Whether physiotherapy students have adequate knowledge of principles of bioethics and if it changes with clinical exposure is not known. AIMS: The aim of this study was to evaluate the perception of bioethics at entry level and post clinical exposure in physiotherapy students. SETTINGS AND DESIGN: This was a cross-sectional study carried out in physiotherapy school of tertiary care hospital. SUBJECTS AND METHODS: Sixty-five first-year (Group A) and 65 third-year (Group B) physiotherapy undergraduates participated after institutional ethical approval. The knowledge and attitude of medical ethics was evaluated using a prevalidated structured questionnaire. RESULTS: Descriptive analysis and responses of Group A and Group B were compared using Mann–Whitney U-test using SPSS 16 software. There was a felt need of more than 90% of students in both the groups for sound knowledge and training in bioethics. A statistically significant difference was obtained in domains of consent, privacy, confidentiality, honesty, and integrity between 1st- and 3rd- year students. There were mixed responses in principles of autonomy, shared decision-making, and professional boundaries. Many respondents were neutral and many statements showed mixed responses indicating lack of knowledge. CONCLUSIONS: The study concludes a need for sensitization in bioethics during clinical training to reinforce the principles in physiotherapy undergraduates beyond a formal module.
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Association of respiratory muscle strength with glycosylated hemoglobin (HbA1c) levels, duration of disease, and physical activity levels in patients with type 2 diabetes: A cross-sectional study p. 54
Shrikant Ramkrishna Sahu, Shreya Rahul Dhake
DOI:10.4103/pjiap.pjiap_27_22  
CONTEXT: Type 2 diabetes is a systemic disorder that propagates several pathological processes leading to a plethora of complications including those on skeletal muscle strength and lung function. AIMS: This study aims to evaluate the association of glycemic control, duration of disease, and physical activity level on respiratory muscle strength (RMS). SETTINGS AND DESIGN: A cross-sectional study was conducted in the outpatient department setting after approval from the institutional ethics committee. SUBJECTS AND METHODS: The Hemoglobin A1c (HbA1c) level of recruited participants was recorded from a recent laboratory test and they were interviewed with the Rapid Assessment of Physical Activity (RAPA) tool to obtain their current physical activity levels. The evaluation of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) was performed using the MicroRespiratory Pressure Meter (MicroRPM) device. STATISTICAL ANALYSIS USED: Pearson's correlation coefficient (r) was calculated for the RMS variables (MIP and MEP) against HbA1c, duration of disease, and RAPA Score. RESULTS: Twenty-six participants were evaluated. Significant correlations were found HbA1c with MIP (r = −0.45, P = 0.02) and RAPA Score with MIP (r = 0.42, P = 0.03) at P < 0.05. CONCLUSIONS: Inspiratory muscle strength is well associated with glycemic control and physical activity of the individual.
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Effectiveness of dynamic strength-endurance training of the neck and scapular muscles in reducing pain and improving function in nonspecific neck pain p. 60
S Priya, S Haripriya, Milan Dhungana
DOI:10.4103/pjiap.pjiap_57_22  
BACKGROUND: Nonspecific neck pain is a common musculoskeletal disorder causing disability among the general population. Specific dynamic strength-endurance exercises may help maintain improved posture, which in turn can lessen or eliminate recurrent flare-ups of pain. The effect of exercise on patients with chronic nonspecific neck pain has been investigated in several studies. The efficacy is, however, questionable. AIM: The aim of the study is to find the effectiveness of dynamic strength-endurance training in reducing pain and improving function in nonspecific neck pain. DESIGN: This study was a pre- and postintervention design. SETTING: This study was conducted in tertiary care hospital in Mangaluru. MATERIALS AND METHODS: In this pre- and postexperimental study, dynamic strength-endurance training for cervical and scapular muscles was given to 24 adults fulfilling inclusion criteria for 4 weeks. The Neck Disability Index (NDI) was used for pain and disability assessment, and the Neck Bournemouth Questionnaire (NBQ) and the Northwick Park Neck Pain Questionnaire (NPNQ) were used for pain assessment. RESULTS: There was a significant reduction in NDI, NBQ, and NPNQ scores exceeding minimal clinically important difference (NDI >7.5 points, NBQ >5.5 points, and NPNQ >7.6 points) after 4 weeks of strength-endurance training of cervical and scapular muscles. There was significant improvement in hold time. Statistically, a significant difference was observed in pre- and posttreatment effect comparison of all outcome measures (P > 0.01). CONCLUSION: A dynamic strength-endurance training program is effective in reducing pain and disability in a patient with nonspecific neck pain.
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Balance training in individuals with Parkinson's disease: Biodex Stability System versus supervised exercise program p. 65
Gurpreet Singh, Tarang Kumar Jain, Yvonne M Colgrove, Neena K Sharma, Rajesh Pahwa, Kelly Lyons
DOI:10.4103/pjiap.pjiap_41_22  
OBJECTIVE: The objective of this study was to evaluate the effect of balance training, using the Biodex Stability System (BSS) or supervised exercises, on balance and gait in individuals with Parkinson's disease (PD). DESIGN: This was a prospective, pilot interventional cohort study. PARTICIPANTS: Twenty individuals with PD at Hoehn and Yahr stages I–III were included in the study. INTERVENTIONS: Ten subjects in the BSS group and 10 subjects in the non-BSS group (supervised balance exercise training without BSS) participated in 55-min exercise sessions 3 times a week for 4 weeks. OUTCOME MEASUREMENTS: Postural sway measures-sway area, anterior-posterior (AP) and medial-lateral (ML) center of pressure path length, and root mean square velocity in AP and ML directions were collected at baseline and postintervention. Secondary outcome measures of the Berg Balance Scale (BBS), spatiotemporal gait measures-gait velocity, step length, and stride length, Timed Up and Go, and 6-min walk test data were also collected at baseline and postexercise intervention for both the groups. RESULTS: Improvements in postural sway were seen in the BSS group postintervention (sway area mean change = −435.3 mm2; 95% confidence interval = −818.5, −52.2). Postural sway data from the non-BSS group were unavailable, due to a technical failure. All secondary outcome measures improved in both the groups; however, we did not find any significant between-group differences in any of the secondary measures. CONCLUSIONS: A 4-week exercise training using BSS improved measures of balance and gait in individuals with PD. However, improvements were also seen after an exercise program that did not use BSS. This suggests that at least for the measures used in this study, there were no differences between BSS training and supervised exercise balance training.
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Awareness about text neck syndrome amongst adolescents p. 72
Pranita Rathi, Jaspreet Kaur Talwar, Neeraj Athavale, Rachana Dabadghav, Ashok Shyam, Parag Sancheti
DOI:10.4103/pjiap.pjiap_33_22  
BACKGROUND: Neck pain nowadays is the most prevalent symptom in adolescents due to increased frequency of smartphone usage in improper postures. Consequence of this can lead to complex set of symptoms such as neck pain, upper back pain, tingling numbness in upper limb, thumb pain which is commonly termed as "text neck syndrome" (TNS). AIMS: To determine the awareness, perception, and knowledge regarding preventive measures, health hazards, and causes of TNS in adolescents. SETTINGS AND DESIGN: An observational cross-sectional study; subjects were recruited from Pune city during the months of December to March 2022. SUBJECTS AND METHODS: Examination of 302 adolescents was done using the convenience sampling method. A prevalidated self-made questionnaire for data collection using was administered on online platform. STATISTICAL ANALYSIS USED: Descriptive statistical method. RESULTS: 86.4% population use their smartphone for >1 h/day. 67.2% have heard, 32.8% have never heard about TNS. 47.70% population is aware about all the mentioned causes. 20.50% population is aware about holding smartphones at eye level. Preference of only 11.60% of adolescents is fingers for texting on smartphones 67.2% who have heard about TNS, 58.30% are aware about preventive measures. CONCLUSIONS: The awareness, knowledge, and perception regarding causes, health hazards of TNS is good. There is a lack of knowledge about preventive measures; hence, the practice of the same is poor. There is a need to create the awareness regarding text neck in adolescents in terms of preventive measures.
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Awareness and attitude of first-aid seizure management among physiotherapy undergraduate students p. 77
Sanskruti Sehul Modi, Dinesh Chavhan, Rachana Dabadghav, Ashok Shyam, Parag Sancheti
DOI:10.4103/pjiap.pjiap_26_22  
BACKGROUND: Epilepsy is a chronic brain disorder. In Indian society, there are various misconceptions and practices performed while an individual is having an epileptic seizure and social acceptance is poor and stigmatized. As health-care professionals, physiotherapists need to know the first-aid management for seizures to prevent further harm caused by the episode. By increasing awareness, prompt treatment can be administered, which will subsequently lead to better survival rates. AIMS: The aim of this study was to find out the awareness and attitude of first-aid seizure management among physiotherapy undergraduate students. SUBJECTS AND METHODS: Approval from the institutional ethical committee was obtained for the study and validated by three experts in the field. Two hundred and five students in the age group of 20–24 years from 3rd year to 4th year and interns were included through convenience sampling. Subjects were recruited from various physiotherapy colleges through Google Forms. A Google Form link constituting the information and description of the study, and a self-made questionnaire were circulated to the subjects. Consent was taken before participating in the study. The responses were recorded, and descriptive analysis was done using SPSS software version 26. RESULTS: Participants were in the age group of 20–24 years, of which awareness toward first-aid management is lacking as 35% agree to hold them and help to restrict movement during a seizure, and 27% agree to insert a spoon or metal into his mouth. Attitude is positive toward first-aid seizure management. CONCLUSIONS: This study suggests that physiotherapy undergraduate students lack awareness of management and attitude positive toward first-aid seizure management.
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Profile of functional limitation using Screening of Activity Limitation and Safety Awareness Scale in leprosy population of Mysore district p. 81
Preethi Hassan Shivanna, RT Shruthi
DOI:10.4103/pjiap.pjiap_17_22  
INTRODUCTION: Leprosy is known as Hansen's disease, a chronic disease caused by Mycobacterium leprae. It can be seen in all ages, from early infancy to old age. It is a significant cause of preventable disability. The impairments give rise to disabilities, such as limitations in performing activities involving using hands, feet, and eyes and restrictions in social participation. Functional movements are most important to fulfill one's activities of daily living. OBJECTIVES: The objectives of this study were to identify the functional limitations using the Screening of Activity Limitation and Safety Awareness (SALSA) Scale in the leprosy population of Mysore district. METHODS: This cross-sectional study included 92 participants diagnosed with leprosy and collected socioeconomic and clinical data. Each participant was evaluated for functional limitations using the SALSA Scale. RESULTS: The participants were mainly male (58) and fewer female (34) with a minimum of one impairment. The result is written based on the five primary domains of the SALSA Scale. The study showed that 39.65% of participants did not present significant functional limitations and 24.36% of participants reported mild functional limitations. In comparison, 12.35% were moderately functionally limited, 14.32% had severe functional limitations, and 9.32% showed extremely severe limitations which described the most difficult activity were fine motor activity. CONCLUSION: The study concludes that difficult functional activity reported by participants with leprosy was fine motor activity and hand sensation to carry the hot objects according to the profiling by SALSA Scale which intern leads to difficulty in quality of life.
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Prevalence of musculoskeletal disorders in students aged 13–18 years with the use of smartphones for online classes p. 84
Krutika Jatin Shah, Farheen Salim Patel, Rachana P Dabadghav
DOI:10.4103/pjiap.pjiap_25_22  
CONTEXT: Smartphones are a common gadget used by individuals in day-to-day life for various purposes. Especially in the lockdown period, the use of gadgets increased tremendously for the purpose of attending online classes. Inefficient use of smartphones by students for attending online classes may lead to several long-term musculoskeletal disorders. AIMS: The aim of this study was to find the prevalence of musculoskeletal disorders with the use of smartphones during online classes. SETTINGS AND DESIGN: Community setup, cross-sectional Study design. SUBJECTS AND METHODS: The approval of the Institutional Ethical Committee was obtained. Informed consent was obtained from the participants and a self-made validated questionnaire was circulated to 202 students through online mode. STATISTICAL ANALYSIS USED: This was a descriptive data analysis. RESULTS: Two hundred two students participated in the study with a mean age of 15.5 ± 2.58 years. The mean hours of use of smartphones for attending online classes were 4.81 h ± 2.18 h and the mean hours of use of smartphones for other purposes such as gaming and social media was 2.69 h ± 1.79 h. Neck pain showed the most prevalence among other joints which was supported by the finding that 34.74% of students complained of pain in the neck. CONCLUSIONS: The prevalence of musculoskeletal disorders is common after smartphone use for online classes and was found to be in the neck, shoulder, upper back, and lower back.
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The prevalence of reduced upper cervical mobility and neck disability among taxi drivers in Mumbai p. 89
Yashvi Sudhir Shah, Ramandeep Kaur Saini
DOI:10.4103/pjiap.pjiap_47_22  
AIM: The aim of the study is to find the prevalence of reduced upper cervical mobility and neck disability among taxi drivers. MATERIAL AND METHODOLOGY: An observational study was carried out among 120 taxi drivers in the age group of 40–50 years. The assessment was carried out using cervical flexion-rotation test and neck disability index (NDI) questionnaire to assess restriction in the cervical range of motion (ROM) and disability caused in the taxi drivers due to cervicogenic headache (CGH) respectively. RESULTS: The results revealed that 47.5% of taxi drivers have restriction in the cervical ROM whereas on NDI the taxi drivers had 18.33% of mild disability. Around 17.50% have reported moderate disability and 2.50% a severe neck disability. CONCLUSION: Thus to conclude the prevalence of reduced cervical mobility was high in taxi drivers that probably are due to long-term driving and bad posture. he prevalence of musculoskeletal disorders especially in low back and knee was high in taxi drivers that probably are due to long-term driving and bad posture. The disability could be prevented by education of correct sitting while driving, work station exercises, having sufficient rest in day and night and design of ergonomically seat based on Indian anthropometric sizes.
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