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Coronavirus disease also referred to as COVID-19 is an infectious disease which is highly communicable. The World Health Organization has declared the COVID-19 outbreak as a pandemic. In India, Maharashtra is one of the worst impacted states and Mumbai has emerged as a hotspot. There is a nationwide lockdown imposed, and there are several containment zones in Mumbai to make sure that the virus does not spread any further. With increase in the number of admissions in intensive care unit, there is a need to define the role of a physiotherapist in the current scenario of a pandemic. The aim of this article is to provide guidelines for clinical practice, as well as to safeguard the health of COVID duty-assigned physiotherapists in acute care setup.

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Background: Kinesio taping (KT) has emerged as a popular treatment for several health conditions. It is suggested that application of K-tape may prove beneficial in relieving symptoms of shin splints. Objective: The aim of this pilot study was to gather preliminary evidence about the effectiveness of KT in shin splints. Methodology: This prospective case–control study was conducted for 3 days on thirty active sports persons afflicted with shin splints (M = 22, F = 8; mean age 19 ± 2.59; duration of symptoms 48.16 ± 13.42 days) assigned randomly into three equal groups. The intervention in control group consisted of 10 min of ice massage followed by 10 min of transcutaneous electrical nerve stimulation. In KT group, Y-strip K-tape was applied to the lower leg using the technique described by Griebert et al. that had shown a reduction in medial loading in medial tibial stress syndrome. In rigid tape (RT) group, white nonelastic adhesive tape cut into a Y-shape similar to KT strip was applied. Outcome measures were duration of 50 m sprint, volume of limb, and pain response at rest, during resisted isometric contraction (RIC) of select muscles, and after completion of 50 m sprint. Two ways repeated measure ANOVA with time as the repeated factor was conducted for each outcome measure with level of significance set at 0.05. Results: Between the group difference for age (F = 0.35, P = 0.70) and duration of symptom (F = 0.40, P = 0.67) were not significant. The day-by-group interaction was not significant for any outcome measure. For the patient-reported parameters, i.e., pain at rest, pain at RIC, and pain at 50 m sprint, the main effects were significant (P ≤ 0.05) for time but not for groups. Conclusion: Any benefits of KT over and above RT and control group were not observed in active players presenting with symptoms of shin splints.

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BACKGROUND: The Fear-Avoidance Components Scale (FACS) is a relatively new patient-reported outcome measure to measure pain-related fear avoidance (FA). OBJECTIVES: The aim of this study was to translate and culturally adapt the FACS into the Gujarati language and to determine the test–retest reliability and cross-cultural validity of the FACS-G in Gujarati-speaking Indian patients. METHODS: Translation and cross-cultural adaptation of the original English version of the FACS were performed according to published guidelines. Test-item comprehension was verified in a group of 20 patients with chronic musculoskeletal pain disorders (CMPDs) with a written survey and cognitive debriefing interview. The content validity of the final version of the FACS-G was then ascertained from a survey of 30 health-care professionals. A cohort of 150 CMPD patients completed the FACS-G and other FA-related patient-reported outcome measures to determine internal consistency, test–retest reliability, agreement, minimal detectable change (MDC), and construct validity. RESULTS: In the opinion of the health-care professional panel, the content validity was very good. The internal consistency (Cronbach's α = 0.827) and test–retest reliability (intraclass correlation coefficient = 0.923 [95% confidence interval = 0.837–0.963]) were both excellent. The MDC was found to be 13.27 points (scale range = 0–100). The FACS-G correlated most strongly with the FA Beliefs Questionnaire-G (r = 0.705), which supports the concept of convergent validity. It showed a weaker association with the depressive symptom subset of the Patient Health Questionnaire (r = 0.461), which supports the concept of divergent validity. It correlated moderately with the Roland-Morris Disability Questionnaire-G (r = 0.615) and Numerical Pain Rating Scale score (r = 0.521; P < 0.01). CONCLUSION: The FACS-G showed strong psychometric properties, providing evidence of the conceptual equivalence with the original English version. The FACS-G appears to be a reliable instrument for measuring FA in Gujarati patients with CMPD.

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BACKGROUND: Among vestibular functions benign paroxysmal positional vertigo (BPPV) is one of the common conditions leading to dizziness, visual vertigo, and postural instability. PURPOSE: The purpose of this study was to find the effect of postural stability exercises on postural instability in BPPV patients. DESIGN: This was pre–post experimental study. SETTING: The study was conducted at a tertiary healthcare center, Belagavi, India. PATIENTS: A total of 12 patients positive for Dix-Halpike test between the age group of 20 and 60 years of both the genders were included in the study. INTERVENTION: Postural stability exercises were given for postural instability in BPPV patients. Treatment was administered for 2 weeks. MEASUREMENTS: Patients were assessed at baseline using libra electronic balance master, dizziness handicap inventory, visual vertigo analog scale, and Berg Balance Scale, and re-assessed after 2 weeks. RESULTS: Mean, standard deviation, independent t-test, and dependent t-test were used. There was statistically significant change in terms of dizziness, postural stability, visual vertigo, static, and dynamic balance with the value of P < 0.05 CONCLUSION: Improvement in postural stability was seen in the participant receiving postural stability exercises. The exercises were found effective in reducing postural instability among BPPV patient. The study also concluded that BPPV was found common among females and in the age group of 30–40 years.

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Ankylosing spondylitis (AS) is a relatively uncommon inflammatory arthritis that affects the axial joints. The diagnosis is often missed and markedly delayed. Here, we report a delayed diagnosis of AS in a 47-year-old male, 10 years after the onset of back symptoms, using the modified New York criteria. The objective of this case report is to outline the long-term effectiveness of physiotherapy interventions. The condition was managed with supervised physiotherapy intervention and unsupervised home exercises for 3 months and was followed for 1 year to investigate the long-term effectiveness of the interventions. It was found that the combination of supervised physiotherapy interventions and unsupervised home exercises had promising short term as well as long-term effects without deterioration in AS symptoms with increased patient satisfaction and confidence.

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OBJECTIVE: The objective of the study is to correlate maximum oxygen uptake (VO₂ max) obtained from subjective measure using Duke Activity Status Index (DASI) scale with objective assessment of aerobic capacity measured by VO₂ max during submaximal exercise testing in young healthy individuals. MATERIALS AND METHODS: Fifty-eight young healthy nonexercising individuals were recruited in the study according to inclusion and exclusion criteria. The participants were made to undergo exercise testing on treadmill using modified Bruce protocol and maximal aerobic capacity was calculated. The participants were made to answer DASI questionnaire, and VO₂ max was calculated using the questionnaire. RESULTS: There was a statistically significant but moderate correlation (r = 0.339 and P= 0.001) found between VO₂ max obtained from DASI scale and VO₂ max obtained from exercise testing. CONCLUSION: The subjective functional scales (DASI) used to assess basic physical capacity have moderate ability to predict actual functional capacity as measured by VO₂ max achieved by objective assessment of aerobic capacity by exercise testing in young healthy individuals.

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INTRODUCTION: Scapula forms the basis of upper-extremity posture, and any alteration in the position of the scapula is a predisposing factor for musculoskeletal aches and pain. STUDY OBJECTIVE: The study's objective was to find the association between scapular position and mobile phone usage in college students. MATERIALS AND METHODS: It was a cross-sectional correlation study conducted at a tertiary care government hospital. On receiving approval by the Institutional Ethics Committee, participants of both genders between the age group of 18–25 years and using mobile phones for at least more than 1 year were included in the study. Participants were screened for their mobile phone usage using the Problematic Mobile phone usage questionnaire (PMPUQ) with due permission received from the original author of the scale, and their scapular region pain was assessed using Numerical Rating Scale (NRS). All participants were assessed for their scapular position using lateral scapular slide test (LSST) and acromion to table test. RESULTS: Data were analyzed using SPSS 16.0 version. As the data did not pass normality, nonparametric test of correlation, i.e., Spearman's bivariate correlation test, was applied. No significant correlation with P > 0.05 was found between problematic mobile phone usage score (PMPUQ) and pain (NRS), and no significant correlation was found with P > 0.05 between problematic mobile phone usage score and acromion to table test bilaterally and LSST for inferior angle at 0°, 45°, and 90° position. CONCLUSION: This showed that pain in the scapular region was not related to an individual's mobile phone use and can have various other contributory factors.

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BACKGROUND: The effects of baseball pitching on the glenohumeral joint (GHJ) range of motion (ROM) have been widely studied. Specifically, internal rotation (IR) ROM reduction of the pitching arm, an adaptation to repeated overhead throwing, is linked to increased risk of injuries in baseball pitchers. However, there is a lack of literature on the effects of softball pitching on the GHJ ROM. HYPOTHESIS: Softball pitching to fatigue will result in significant reduction of GHJ supine IR ROM. DESIGN: Test–retest, quasi-experimental study. METHODS: Twelve softball pitchers (age: 19.5 ± 1.8 years) volunteered to participate in this study. GHJ ROM in supine IR, horizontal adduction, low flexion (shoulder joint flexed to 60°; added IR), extension with IR (shoulder joint abducted to 60° in the plane of scapula and then horizontally abducted 90° with the elbow maintained in 90° flexion; add GH IR), and supine external rotation were compared before and after a single bout of softball pitching to fatigue or a maximum of 100 pitches, whichever occurred first. RESULTS: Maximum ROM change post softball pitching was observed in horizontal adduction but not in supine IR. CONCLUSIONS: Maximum ROM change was observed in horizontal adduction. Supine IR ROM measurement may not be appropriate for assessing softball pitchers' shoulder ROM because this measurement was not affected by the softball pitching.

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BACKGROUND AND PURPOSE: Cognition is the mental action on the process of acknowledge and understanding through thought, experience, and sense. A glowing body of literature is binding that being overweight (OW) or obese (O) has an effect on cognition as well as on physical functioning. A better understanding of this relationship could help target psychological services and public health strategies more effectively. The aim of the present study was to find out the impact of body mass index (BMI) on cognitive function among young adults. MATERIALS AND METHODS: A convenient sample of 300 participants aged between 18 and 24 years was selected for the study. Demographic data and anthropometric measurements were taken. After that, BMI was calculated for all participants and participants were divided into two groups: Group A (normal BMI, n = 150) and Group B (OW/O, n = 130). Twenty students were excluded from the study because of their underweight. Rest of the participants (n = 280) were asked to performed Rey Verbal Auditory Learning test (RVALT), Stroop test, and Trail Making test A and B. STATISTICAL ANALYSIS: Unpaired t-test was used to find out a significant difference in cognitive functions among two groups. RESULTS: It was found that cognition score (all three tests) obtained by normal BMI group was higher than score obtained by OW/O group (RVALT: P<0.0001, Stroop test: P<0.0001, Trail Making Test: Part A: P < 0.04 and for Part B: P < 0.0001). CONCLUSION: The present study concluded that high BMI individuals have lower cognitive functions.

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Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a progressive condition, often irreversible. The chances of peripheral nervous system getting affected by the antineoplastic drugs are very high as compared to that of the central nervous system. Hence, this study is planned to assess the occurrence among cancer patients. Purpose: The objective of the present study was to screen patients undergoing cancer treatment for CIPN. Design: This was an observational study. Setting: The study was conducted at a tertiary care cancer hospital. Patients: Twenty-six individuals with CIPN, 30 years and above, were assessed using the modified total neuropathy score (mTNS) of >5. Measurements: Patients were assessed using mTNS. Results: Statistical analysis was done and it was found that 20% who received the drug cisplatin and 32% who received paclitaxel had CIPN. Forty-eight percent (48%) of the participants with CIPN received a combination of drugs. Conclusion: The drug paclitaxel was a major source for causing neuropathy. Neuropathy was seen when paclitaxel was given as the soul drug and also when given in combination with carboplatin.

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BACKGROUND: Impaired trunk control is common in most of the hemiplegic patients during subacute stage that interferes with daily activities and worsens quality of life (QOL) of patients. PURPOSE: The purpose of the study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) techniques on trunk control and QOL in subjects with hemiplegia. DESIGN: This was a pre-post design. SETTING: The study was conducted at a tertiary care hospital in Belagavi. PATIENTS: Totally, 16 hemiplegic patients were recruited between the age group 18–65 years having trunk control test score ≥50 and were given PNF techniques. INTERVENTION: PNF techniques for 45 min, three times in a week for 4 weeks. MEASUREMENTS: Patients were assessed at baseline using Trunk Impairment Scale (TIS) and Stroke Specific-QOL (SS-QOL) and reassessed after 12 sessions. RESULTS: Statistical analysis was done using paired t-test. PNF showed significant results (P < 0.05) for both outcomes, i.e., TIS and SS-QOL scale. CONCLUSION: The study concludes that PNF techniques are beneficial in improving trunk control and QOL in hemiplegic population. Hence, this costless technique, which does not require any equipment, can be regularly incorporated to all hemiplegic patients in any setup or at home.

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BACKGROUND: Musculoskeletal injuries are common among physiotherapy students and these are increasing nowadays. In the recent years, there has been an increase in musculoskeletal complaints, work-related stress, and reduced quality of life among physiotherapy students. OBJECTIVES: This study was conducted to identify the prevalence and associated risk factors of musculoskeletal health and health-related quality of life of physiotherapy students. METHODS: A cross-sectional study was conducted among physiotherapy students from three different physiotherapy colleges of Surat, India, from November 2013 to January 2014. A total of 457 physiotherapy students (22 males and 435 females) completed the demographic and personal data along with questionnaires such as Cornell Musculoskeletal Discomfort Questionnaire, International Physical Activity Level Questionnaire, Quality of Life Short-Form Questionnaire, and Brief Multidimensional Students' Life Satisfaction Scale. RESULTS: Most of the students had experienced some kind of a musculoskeletal pain in the past 6 months. On comparing different locations of pain (neck, shoulder, upper back, lower back, and lower legs), the lower back was found to be most commonly affected location (29.1%) followed by the neck (13.4%) and lower legs (13.8%). CONCLUSION: Musculoskeletal pain is prevalent among physiotherapy students, and mostly, back, neck, and lower leg pains are very common among them. Moreover, these pains reduce the physical and mental health of the students and also affect their life satisfaction.

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BACKGROUND: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is the most widely used condition-specific self-reported multidimensional instrument for the assessment of hip or knee osteoarthritis (OA). OBJECTIVE: The objective of this study is to translate and to investigate the reliability and validity of modified WOMAC (mWOMAC) Gujarati version in participants with knee OA. MATERIALS AND METHODOLOGY: The Indian version mWOMAC English questionnaire was translated into Gujarati with forward and backward method, and its psychometric properties were analyzed on 230 Gujarati-speaking participants with knee OA (mean age = 58.4 years). The visual analog scale (VAS) for pain and handheld dynamometer (HHD) for isometric quadriceps strength along with mWOMAC was recorded twice within 2 days, and data were used to assess the reliability and convergent validity. RESULTS: The mWOMAC Gujarati version questionnaire was internally consistent with Cronbach's alpha 0.936 (test), 0.940 (retest), respectively. Test-retest reliability was analyzed using mixed model intraclass correlation coefficient (ICC) and found satisfactory with ICCs of 0.986. Convergent validity was analyzed using Pearson's correlation coefficient between mWOMAC and VAS (P < 0.05, r = 0.716); mWOMAC and HHD (P < 0.05; r = −0.915) and significant correlation was found. CONCLUSION: The mWOMAC Gujarati version is a reliable and valid self-rated clinical instrument for the assessment of symptoms and function in OA knee.

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BACKGROUND: According to the recent report by the Ministry of Statistics in India, number of elderly accounts for 8.6% of the country's population. Aging causes biological as well as psychological changes. Decline in cognitive functions is one of the normative changes of aging; however, this may impact both physical and mental health of an individual. Quality of Life (QoL) is one of the prime features of successful aging. Hence, this study was undertaken to correlate the level of cognition and QoL in older adults. METHODOLOGY: One twenty-nine males and females of age 60–75 with or without cognitive impairment were selected using convenience sampling, those who could not read Hindi, who had any unstable medical condition, whose vision could not be corrected to normal level, and those with impaired speech were excluded from the study. Montreal cognitive assessment (MoCA) was administered to assess the cognitive level. QoL was assessed by QoL-Alzheimer's disease (AD) scale. RESULTS: Result indicated that there is a moderate positive correlation between MoCA and QoL-AD with r = 0.465 and P < 0.05. CONCLUSION: The study concludes that the level of cognition and QoL of older adults are moderately in positive correlation with each other.

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BACKGROUND: Fencing is an Olympic game, played in three disciplines of the Epee, the Foil, and the Saber. Despite the long history and international scope, very few epidemiological studies on injuries in modern competitive fencing are available. A study on the injury patterns of Indian fencing players is not yet reported. OBJECTIVE: The objective of this study is to explore the injury pattern among fencing players and to examine the association of occurrence of injury with certain risk factors. METHODS: The sample comprised 113 fencers (79 males and 34 females). Scheduled questionnaire was the tool of data collection. RESULTS: Point prevalence and 2 years prevalence of injuries were 12.38% and 13.27%, respectively. Acute injuries more common (78.5%) than the injuries of gradual onset (21.42%). Lower limb (100%) was the most common site of injuries. The ankle was the most frequently injured body part (64.28%). The event of the Epee had the highest proportion of injuries (15.69%) followed by the Foil (10.36%) and Saber (9.09%). Injured players were found to have spent significantly more time in footwork; although; the age, level of play, sex, and type of events, previous injuries, and training habits were not found significantly associated with the occurrence of injuries. Conclusion: It is concluded that Indian fencing players presented with a less prevalence of injury, out of which majority of injuries were in the lower limb.

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BACKGROUND: Primitive reflexes are stereotypic motor behavioral responses that are necessary for the normal development of infants. Retention of these reflexes is mostly pathological and can lead to developmental delays. Few reflexes are also seen in normal adults, and the influence of the retained reflexes on functional activities is evident. This study identified the effect of the asymmetric tonic neck reflex (ATNR) on handgrip. MATERIALS AND METHODS: One hundred adults within the age group of 18–25 were selected for the study. Handgrip strength was measured using hand-held dynamometer on the dominant hand in three different neck positions, neck in neutral, neck actively rotated to the right, and rotated to the left. Data collected were statistically analyzed to identify the difference between the three mean values. RESULTS: The Friedman test performed to analyze the handgrip strength between the groups of three head positions demonstrated a statistically significant difference, χ² = 110.479, P = 0.000. Post hoc analysis with the Wilcoxon signed-rank tests was conducted with a Bonferroni correction applied, resulting in a significant level set at P < 0.017. There was a significant difference in the handgrip measured between the group of head rotated to the left with head in neutral (P = 0.000) and head rotated to the right and the left (P = 0.000), but failed to demonstrate a significant difference between the groups of head in neutral and head rotation to right (P = 0.041). The results of this study thus infer a significant increase in handgrip of the right hand when head is rotated toward the left side. CONCLUSION: The study identified that there is an increased handgrip power on the dominant side when the head is rotated to the opposite side. This can be attributed to the increased flexor tone due to the retained effects of ATNR. Effects of ATNR can be seen in normal adults while assessing handgrip strength. This must be taken into consideration while assessing the same during diagnostic, prognostic, and rehabilitation purposes.

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Injuries to anterior cruciate ligament (ACL) are common in sports. The treatments prescribed for torn ACL are surgical reconstruction (ACLr) and conservative management. While both treatments do not offer relief from long-term osteoarthritis (OA), the choice of the best treatment for athletes remains unclear. To assess the effectiveness of surgical versus conservative treatment for treating torn ACL in sports, a literature search in PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Library Central Register of Controlled Trials was done for randomized controlled trials/quality randomized controlled trials (RCTs/QRCTs) that compared surgical reconstruction with conservative treatment of ACL rupture in active participants. Studies were assessed for quality using PEDro clinical appraisal tool. Since the studies were heterogeneous, meta-analysis was not performed, and a “best evidence synthesis” was reported. There were four studies (RCTs/QRCTs), which met the inclusion criteria. The mean age of participants in ACLr group ranged 25.3–45.8 years, while in CON group, it was 25.5–49.3 years. Tibiofemoral OA ranged from 23% to 80% in surgery group and 28%–68% in conservative group. Three studies reported no difference between surgical and conservative group in terms of long-term OA at 10–20 years' follow-up. When assessed in terms of functional knee outcomes (Lysholm score, IKDC score, and Tegner score) and knee laxity, ACLr group showed significantly better outcomes. Thus, it may be suggested, based on functional knee outcome scores, that ACLr may help athletes resume their sporting career postinjury. Further good quality RCTs involving a large number of participants are required to strengthen the claim.

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