Outcome measures used in patient with knee osteoarthritis: With special importance on functional outcome measures

Understanding the impact of evidence-based practice toward the rehabilitation of patients with knee osteoarthritis (PKOA) is possible with appropriate outcome measures. There is a definite need to summarize the available outcomes with reference to knee OA. This review summarizes the available outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA. Electronic searches of PubMed, Medline, CINAHL, PsycINFO, Google Scholar, and EBSCO were conducted using terms relating to outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA. Papers examining the relationship between psychosocial factors and pain and disability outcomes following physiotherapy were included. Two reviewers selected, appraised and extracted studies independently. The searched papers were classified under three classifications, radiological, arthroscopic, and functional knee OA outcome measures. 26 outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA were identified. Nine outcome measures were included under radiological, four under arthroscopic and remaining 13 under functional classification. Oxford knee score and WOMAC have excellent reliability and good validity among them. In developing countries, still, we use the scales validated and available from the developed countries. This will not reflect the actual treatment effect among PKOA. This review will assist in educating orthopedician, physiotherapist, academician, and researchers on the available in the diagnosis, prognosis, and rehabilitation of PKOA. This review highlight the need for patient-reported outcome measures from the developing countries to document actual treatment effect.

Impact of nomophobia: A nondrug addiction among students of physiotherapy course using an online cross-sectional survey

BACKGROUND

Smartphone addiction is known as nomophobia (NMP) which is a fear of not using mobile phone. More researches are available regarding NMP among the students of various professions. However, till date, to the best of our knowledge, there is no literature available on the impact of NMP on the academic performance among students pursuing physiotherapy course (SPPC).

AIM

To determine the impact of NMP among SPPC.

MATERIALS AND METHODS

An online cross-sectional survey was conducted by using Google Form platform utilizing validated NMP questionnaires (NMP-Q). A self-reported questionnaire regarding demographic data, information regarding smartphone use, last academic performance, and presence of musculoskeletal disorders was collected. A total of 157 students participated in this survey. Google Form automatically analyzed the collected data.

RESULTS

The mean age of students was 22.2 ± 3.2 years; among them, 42.9% were male and 57.1% were female. Nearly 45% of students have been using smartphone for >5 years and 54% students have musculoskeletal disorders during their prolonged smartphone use. The mean NMP score with 95% confidence interval was 77.6 (72.96-82.15). There exists an inverse relation between the NMP scores (NMPS) and student's academic performance and no significant difference between NMP scores, P = 0.152.

CONCLUSION

NMP among the SPPC have been established. There might be a negative impact between NMP and academic performance.

Multi-directional reach test in South Asian children: Normative reference scores from 5 year to 12 years old

Multi-directional reach test (MRT) emerged as a valid and reliable assessment tool for balance evaluation among elderly. The normative reference scores have been established in adults and elderly people, but they were not yet established for children. Hence, we aimed at establishing the normative reference scores of MRT among the school going children aged between 5 and 12 years. Children (N = 194; 124 males, 70 females) were recruited by the stratified random sampling for the normative study. MRT was performed by the custom made, multi-directional reach estimator. MRE device consists of three adjustable wooden frames with two metallic rulers each of 600 mm. Children were asked to reach maximum distance in forward reach (FR), backward reach (BR), right lateral reach (RLR) and left lateral reach (LLR) directions to obtain their maximum reaching ability. The mean of three readings were used to report the normative reference scores of MRT. Median age, height, weight and body mass index (BMI) were 8.5 years, 1240 mm, 27 kg and 17.24 kg/m² respectively. The normative reference scores [median (95% confidence Interval, CI)] of MRT among the children aged 5-12 years old were FR [169.7 mm (CI, 166.1-183.3 mm)], BR [77.7 mm (CI, 78.0-85.5 mm)], RLR [122.0 mm (119.6-130.9 mm)] and LLR [107.0 (105.8-119.3 mm)] respectively.

Feasibility online survey to estimate physical activity level among the students studying professional courses: a cross-sectional online survey

The aim of the study was to estimate the physical activity (PA) level among the professional college students in North India. One hundred three professional college students in the age group of 18–25 years were recruited by simple random sampling for this cross-sectional online survey. The survey was advertised on the social networking sites (Facebook, WhatsApp) through a link www.surveymonkey.com/r/MG-588BY. A Short Form of International Physical Activity Questionnaire was used for this survey study. The questionnaire included total 8 questions on the basis of previous 7 days. The questionnaire consists of 3 main categories which were vigorous, moderate and high PA. Time spent in each activity level was multiplied with the metabolic equivalent of task (MET), which has previously set to 8.0 for vigorous activity, 4.0 for moderate activity, 3.3 for walking, and 1.5 for sitting. By multiplying MET with number of days and minutes performed weekly, amount of each activity level was calculated and measured as MET-min/wk. Further by adding MET minutes for each activity level, total MET-min/wk was calculated. Total number of 100 students participated in this study, and it was shown that all professional course students show different levels in PA. The total PA level among professional college students, which includes, physiotherapy, dental, medical, nursing, lab technician, pharmacy, management, law, engineering, were 434.4 (0–7,866), 170.3 (0–1,129), 87.7 (0–445), 102.8 (0–180), 469 (0–1,164), 0 (0–0), 645 (0–1,836), 337 (0–1,890), 396 (0–968) MET-min/wk respectively. PA levels among professional college students in North India have been established.

Efficacy of Early Yakson Touch and Kinaesthetic Stimulation (Yakin) on the Development of High Risk Neonates: A Randomized Controlled Trial Protocol

Introduction: About 15 million babies are born preterm annually, with every year almost 1 million dying from complications and survivors prone to lifetime disability. Yakson touch and kinaesthetic stimulation techniques have proven effective in minimizing the complications and disability of preterm delivery, but presently there is no standardized protocol for their application. The aim is to investigate the efficacy of Yakson touch in combination with kinaesthetic stimulation (YAKIN) on the motor and behavioural development of neonates at high risk of development delay in comparison to conventional handling.Material and Methods: Neonates will be recruited via parental consent from a recognized tertiary care teaching hospital for this two-group pretest-posttest design of randomized controlled trial (RCT), with allocation into either a control group (n=14) or experimental group (n=14) by block randomization method. The experimental group will receive Yakson touch and kinaesthetic stimulation, whilst the control group will receive conventional handling inclusive of developmental positioning and Kangaroo mother care. The duration of intervention will be five out of seven days. Neonatal behavioural assessment scale (NBAS) will be performed at baseline and then on the 7th day to ascertain the intervention effectiveness.Results: Data analysis will be done by Wilcoxon signed rank test/paired t-test and Mann Whitney U test/independent t-test will be done to compare the pre and post intervention score of NBAS within and between groups. The level of significance will be set as p<0.05.Conclusion: The present study may provide valuable information about early intervention to the neonatal physiotherapist, intensivist, nursing staff and parents of neonates.

Increasing cardiopulmonary aerobic activity improves motor cognitive response time: An inference from preliminary one-group pretest-posttest quasi-experimental study

Motor cognitive response time (MCRT) is the time elapsed between presenting a stimulus and the time taken by that individual to respond to that stimulus through a motor performance. After completing aerobic exercise, there are various changes that takes place, one of which might be change in cognitive function. Whether cardiopulmonary aerobic activity/capacity has an impact on MCRT is not explored yet.

Impact of various foot arches on dynamic balance and speed performance in collegiate short distance runners: A cross-sectional comparative study

Objective

To compare the impact of foot arches on dynamic balance and speed performance.

Materials and methods

30 collegiate male short distance runners were divided into three groups based on foot arches, high, neutral and low. Balance and speed performance were estimated based on scores of star excursion balance test (SEBT), 40 yard dash test and vertical jump test (VJT).

Results

Significant improved scores (p < 0.001) were noted in SEBT, 40 yard dash test and VJT.

Conclusion

Short distance runners with high arch foot have improved dynamic balance and speed when compared to low and neutral arch foot.

Valuable Research in Fake Journals and Self-boasting with Fake Metrics

Valuable research works are getting wasted by publishing them in so called, fake journals (pseudo journals, hijacked or predatory journals). Fake journals are the journals which do not perform peer review or minimal language editing in the name of peer review. Unaware of negative consequences of publishing in fake journals, budding or novice academician/clinician/researcher continue to fall prey for them. Present scenario, forced them to get their valuable research published for promotion, pay hike, academic or research reputation, etc. But, they boast themselves by publishing them in fake journals with fake metrics. By making publication in fake journals, only the publishers make profit and pseudo enhance the bio-data of novice academician. It is becoming a big business. In this short communication, we have highlighted the most common prevalent issue among the novice or budding academician.

Does Kinesio taping correct exaggerated dynamic knee valgus? A randomized double blinded sham-controlled trial

BACKGROUND

Deficiency in hip girdle neuromuscular control can cause exaggerated Dynamic Knee Valgus (DKV) which afflicts the knee joint and lead to knee injuries especially ACL injury in sports. Though Kinesio taping (KT) is known to improve function, stability and proprioception, the evidence is inconclusive on its effectiveness in athletes. We hypothesized that kinesio taping could enhance neuromuscular control of the hip girdle there by causing a reduction in DKV.

AIM/OBJECTIVE

To determine whether KT on Gluteus medius can correct exaggerated dynamic knee valgus and improves hip abductor strength when compared to sham KT.

METHOD

40 collegiate level athletes, aged between 18 and 28 years, of both genders with presence of dynamic knee valgus (>8° for men and >13° for women) were recruited in the study. Athletes were excluded if they had history of lower back pain, history of any injury or surgery to the lower extremities during the past year. Subjects who met the inclusion criteria were randomized into kinesio taping (KT) group and sham taping (ST) group. The Drop Jump test and the Donnatelli Drop Leg Test (DDT) were performed before, and on the third day, immediately after the application of KT on them and documented.

RESULTS

There was a significant reduction in DKV among male [4.0° (95% CI 3.5-4.5); p < 0.001] and female [4.3° (95% CI 3.5-5.2); p < 0.002] immediately after application of taping but not on the third day after application of KT. There was a significant rise in DDT immediately and on the third day after application of KT between KT group and SC group.

CONCLUSION

There was a reduction in DKV immediately after the application of KT. However, there was no significant difference between KT group and SC group on the third day. Meanwhile, gluteus medius strength also showed significant improvement immediately after taping and it was maintained even on the third day.

Non-pharmacological therapies for primary open angle glaucoma: A quasi-experimental pilot study

Purpose: One of the major causes of blindness is Primary open angle glaucoma (POAG) and it has only surgical treatment and lifelong use of medication. Hence many side effects arise. To overcome this, the drugless approach is in practice but the importance of Muscle Energy Technique (MET) and Myofacial (MFR) Release is not explored. Hence, our objective was to determine the effectiveness of MET and MFR on POAG. Methods: A total of 12 patients with POAG were recruited from the tertiary care teaching hospital through criteria based convenience sampling for the study. But nine patients with POAG completed the study. The age of the patient with POAG ranges from 15 to 30 years. MET and MFR were given to the patient for 30 min/day, six days/week for three weeks. Intraocular pressure (IOP) was assessed with Tonometer as dependent variable by Ophthalmologist. Pre and post treatment IOP change was established. Result: Pre IOP and Post are 23.1 ± 1.9 mmHg and Post IOP is 20 ± 1.4 mmHg respectively. The mean pre-post difference is 3.1 ± 1.9 mmHg with significance difference of p = 0.002. Conclusion: MET and MFR reduce IOP. This proves to be one of the feasible and cost effective treatments in the management of POAG. Clinical Trial Registry: CTRI/2014/09/4986.

Motor cognitive processing speed estimation among the primary schoolchildren by deriving prediction formula: A cross-sectional study

OBJECTIVES

Motor cognitive processing speed (MCPS) is often reported in terms of reaction time. In spite of being a significant indicator of function, behavior, and performance, MCPS is rarely used in clinics and schools to identify kids with slowed motor cognitive processing. The reason behind this is the lack of availability of convenient formula to estimate MCPS. Thereby, the aim of this study is to estimate the MCPS in the primary schoolchildren.

MATERIALS AND METHODS

Two hundred and four primary schoolchildren, aged 6-12 years, were recruited by the cluster sampling method for this cross-sectional study. MCPS was estimated by the ruler drop method (RDM). By this method, a metallic stainless steel ruler was suspended vertically such that 5 cm graduation of the lower was aligned between the web space of the child's hand, and the child was asked to catch the moving ruler as quickly as possible, once released from the examiner's hand. Distance the ruler traveled was recorded and converted into time, which is the MCPS. Multiple regression analysis of variables was performed to determine the influence of independent variables on MCPS.

RESULTS

Mean MCPS of the entire sample of 204 primary schoolchildren is 230.01 ms ± 26.5 standard deviation (95% confidence interval; 226.4-233.7 ms) that ranged from 162.9 to 321.6 ms. By stepwise regression analysis, we derived the regression equation, MCPS (ms) = 279.625-5.495 × age, with 41.3% (R = 0.413) predictability and 17.1% (R² = 0.171 and adjusted R² = 0.166) variability.

CONCLUSION

MCPS prediction formula through RDM in the primary schoolchildren has been established.

Correct the smile of a child by neuromuscular facilitation technique: An interesting case report

Bell's palsy (BP) in children is a rare case with no documented evidence regarding its rehabilitation management. Till date, individuals with BP are being treated with electrical stimulation are proportionately greater than other conventional means such as facial exercise and massage. These conventional modes of treatment have proved to have less incidence of synkinesis with more benefits. Here, we report a case of a 7-year-old boy diagnosed clinically to have right idiopathic facial nerve paralysis, who underwent 14 days of facial proprioceptive neuromuscular facilitation exercises along with facial therapeutic massage. Documented improvements in facial grading system reveal promising outcomes. Hence, we propose the above technique might improve the functional outcome in the children with BP.

Efficacy of Osteopathic Manipulative Treatment Approach in the Patient with Pulmonary Fibrosis in Critical Care Outpatient Department

The purpose of the present case study was to explore the efficacy of osteopathic manipulative treatment (OMT) in patient with pulmonary fibrosis (PF) in the critical care outpatient department. Here, we present a 48-year-old male case with breathlessness, increased frequency of defecation, and pain in and around the nape of neck with diagnosed pulmonary fibrosis. He scored 3 on a patient-reported modified Medical Research Council (mMRC) dyspnea scale. Osteopathic examination reveals multiple somatic findings across the chest and abdominal region and treated by OMT. Pre- and post-intervention changes were assessed by the 13-item shortness of breath with daily activities (13iSOBDA). 27.2, 22, 16.4, and 11.8 were noted at the end of 1^st, 2^nd, 3^rd, and 4^th week of intervention, respectively, on 13iSOBDA while mMRC decreased from 3 to 1. OMT may be a feasible option in decreasing the symptoms of the PPF in the critical care outpatient department.

Reaction time norms as measured by ruler drop method in school-going South Asian children: A cross-sectional study

This study aimed to estimate normative range for reaction time using ruler drop method for school-going South Asian children between 6 and 12 years of age. A cross-sectional study was used to evaluate the reaction time for 204 children. Normal values for each age group were obtained. The results of multiple linear regressions showed a decrease in the reaction time values with age, and a significant change occurring between six and eight years of age. No difference in reaction time was obtained between boys and girls. Ruler drop method is an easy to use test and the results of this study provide a normative data for age groups 6-12 years ranging from 214.2ms to 248.8ms. These values can serve as a reference to screen children with delayed reaction time.

The effectiveness of osteopathic manipulative treatment in an abnormal uterine bleeding related pain and health related quality of life (HR-QoL) - A case report

Abnormal uterine bleeding is characterized by painful and/or excessive menorrhea, chronic pelvic pain due to the endometriosis (Em). Osteopathic treatment is commonly used in the gynecological dysfunctions. The aim of the present case study was to explore the effect of osteopathic treatment (OT) for a woman with abnormal uterine bleeding related pain and quality of life (QoL). We reported a case of 29 year old female who presented with chief complaints of increased flow during periods, lower abdominal pain, leukorrhoea, lower back pain and with occasional constipation for the last 3 years. Patient is a mother of 6 years old male child born with normal delivery. On diagnostic ultrasonography the uterus was found bulky with insignificant endometriosis and no other abnormality was detected. She did not have any relevant past medical and surgical history. The pre and post osteopathic treatment measurements were measured using Visual Analog Scale (VAS) and the health related quality of life (HR-QoL) questionnaire called short form Endometriosis Health Profile Questionnaire (EHP) - 5. In the present case the pain due to the endometriosis was treated with the osteopathic treatment consists of all the major diaphragms' release (release of pelvic diaphragm, abdominal diaphragm, thoracic outlet release and hyoid diaphragm) during the first session and in the second session gastro-esophageal (GE) junction release, sigmoid colon release, cranial therapy to the occiput, sacral release and dural tube rocking. Following that improvement of pain from VAS 8.3/10 to 3.9/10 and QoL improvement from EHP-5, 72/100 to 26/100 was noted. Osteopathic manipulative approach (OMA) in the patient with Em might improve the abnormal uterine bleeding related pain and health related quality of life (HR-QoL).

Yakson touch as a part of early intervention in the Neonatal Intensive Care Unit: A systematic narrative review

Yakson is a Korean therapeutic touch given to neonates and infants by caressing their abdomen with one hand while the other hand is placed on the back of the neonate\infant either to relieve their pain or to calm them down. It was traditionally used by Koreans by caressing the aching body part of their children with a belief that it would relieve their pain. In spite of clinical evidence of its usefulness, there is limited literature available on Yakson touch. A systematic narrative review (SNR) was undertaken on studies that were carried out on the effectiveness of Yakson touch on infants and neonates. Only seven studies were detected from five major electronic databases, searched with the keywords: “Yakson,“ “Yakson touch,” and “Yakson in neonates”. One of the studies has been included in two Cochrane reviews by the same group of researchers published in 2011 and 2015, respectively, and also in a literature review. The evidence from these articles suggests that Yakson touch is able to increase the sleep scores of infants, affects their behavioral response, decreases the stress levels, increases maternal attachment, and has calming effects on them. However, the number of studies is limited, and thus the efficacy of this intervention has not been sufficiently established. Hence, there is a definite need for future studies to prove the efficacy of Yakson to include it in the early intervention programs. This SNR is aimed at compiling the studies which determined to prove the efficacy of the intervention of Yakson.

Reliability and sensitivity to change of the timed standing balance test in children with down syndrome

Objective:

To estimate the reliability and sensitivity to change of the timed standing balance test in children with Down syndrome (DS).

Methods:

It was a nonblinded, comparison study with a convenience sample of subjects consisting of children with DS (n = 9) aged 8–17 years. The main outcome measure was standing balance which was assessed using timed standing balance test, the time required to maintain in four conditions, eyes open static, eyes closed static, eyes open dynamic, and eyes closed dynamic.

Results:

Relative reliability was excellent for all four conditions with an Interclass Correlation Coefficient (ICC) ranging from 0.91 to 0.93. The variation between repeated measurements for each condition was minimal with standard error of measurement (SEM) of 0.21–0.59 s, suggestive of excellent absolute reliability. The sensitivity to change as measured by smallest real change (SRC) was 1.27 s for eyes open static, 1.63 s for eyes closed static, 0.58 s for eyes open dynamic, and 0.61 s for eyes closed static.

Conclusions:

Timed standing balance test is an easy to administer test and sensitive to change with strong absolute and relative reliabilities, an important first step in establishing its utility as a clinical balance measure in children with DS.

The four square step test in children with Down syndrome: Reliability and concurrent validity

Purpose:

To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS).

Methods:

A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically.

Results:

The test-retest reliability and inter-rater reliability of FSST are ICC_(1,1) = 0.70 (0.64-0.90) and ICC_(2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearman's ρ = −0.58 (−0.86 to −0.13).

Conclusion:

FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome.