Lived experiences of caregivers and survivors of paediatric spinal cord injury: A scoping review of qualitative studies

CONTEXT

Paediatric Spinal Cord Injury (SCI) has an impact on a child's dynamic development, disrupting their participation in school, community, and social relationships while simultaneously causing repercussions on their caregiver's life. The rare nature of paediatric SCI calls for a detailed inspection of the literature from the perspective of children and their caregivers.

OBJECTIVE

This scoping review of qualitative research determines the extent of literature from perspective of caregivers and individuals with paediatric SCI.

METHODS

9351 full-text published articles were identified from CINAHL, Ovid, PubMed, and Scopus between 2001 and 2021. After duplicate deletion, 8354 articles were left, and 103 full-text articles were assessed for their eligibility. Finally, eight articles were assessed for their relevance. Key themes that emerged from the data were summarized, compared, and synthesized.

RESULTS

Six studies were from the perspectives of individuals with SCI and two from caregiver's perspective. Three major themes were identified from caregivers' opinion studies: "Obstacles to community participation"; "Unmet needs related to a child with SCI"; and "Radiating effect on caregivers' lives"; whereas five were obtained from individuals with paediatric SCI opinion studies: "Adjusting to life with SCI"; "Hardships & hardiness"; "Peers & family/emotional support"; "Perception of self & body-image post injury"; and "Transitioning into post-traumatic life".

CONCLUSION

There is a need for more specialized rehabilitation centers and an accessible environment in public spaces. Also, the review sheds some light on the discriminatory attitude of society as a whole, which can be improved by providing proper knowledge and awareness of SCI.

Web-based E-survey in identifying current physiotherapy practices in paediatric burns

INTRODUCTION

Physiotherapy practices in pediatric burns involves relaxation techniques and exercise training for attaining physical fitness, improving quality of life and, thereby to prevent primary and secondary complications. Physical activity and exercise act as a meaningful and purposeful tool for attaining physical fitness after burn injury.

AIM

The aim of this e-survey is to identify the current practices of physiotherapy interventions in pediatric burn rehabilitation among physiotherapy students and professionals.

METHODS

The e-survey was created with validated questionnaire using a Google Forms to gather the information related to current physiotherapy practices in pediatric burns. After the sample size estimation, survey link were sent to identified 144 physiotherapy students and professionals using social networking sites which includes, WhatsApp, Facebook and Instagram for this cross-sectional e-survey. The frequency and percentage of survey responses were analyzed.

RESULTS

Among 144 identified participants, 62 participants completed the survey, resulting in the response rate of (43.0%). The findings of this study revealed that> 50% of physiotherapy students, and professionals, are performing pain and scar assessment, along with their regular physiotherapy management in children with burns. In addition to these, they also practice physiotherapy for burn conditions in pediatric intensive care units (PICU), pediatric wards, and clinical outpatient department (OPD) settings.

CONCLUSION

Physiotherapy students and professionals have sufficient knowledge regarding pediatric burns complications, and also, they are well aware regarding recent physiotherapy practices in pediatric burn care management.

A Systematic Review of Multisensory Stimulation on Procedural Pain Among Preterm Neonates

PURPOSE

This systematic review aims to evaluate the quality of studies and synthesize the literature on multisensory stimulation (MSS) on procedural pain among hospitalized preterm neonates.

SUMMARY OF KEY POINTS

Search strategies were applied to PubMed/Medline, CINAHL, SCOPUS, and PEDro. A total of 414 studies were identified, 104 were screened, and 4 were included. Two independent reviewers extracted data from identified studies that were synthesized qualitatively and quantitatively.

CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE

There is strong evidence of MSS in decreasing procedural pain, but additional research is needed to identify the beneficial effects of MSS with a standardized protocol to promote good clinical practice in neonatal intensive care settings.

WHAT THIS ADDS TO THE EVIDENCE

High-quality evidence supports beneficial effects of MSS, but standardization of the MSS protocol and its administration needs to be established.

Neuropathy-and foot-ulcer specific quality of life instrument (NeuroQoL): Translation, cross-cultural adaptation and content validation in Hindi

BACKGROUND

Neuropathy-and foot ulcer-specific quality of life instrument (NeuroQoL) is not available in Hindi language which is one of the most spoken languages in the world. Hence, we aimed to translate, cross-culturally adapt and content validate NeuroQoL into Hindi language (NeuroQoL-H).

METHODS

NeuroQoL is translated and cross-culturally adapted into Hindi language (NeuroQoL-H) using the guidelines proposed by Beaton and colleagues. Both item and scale levels content validity index (I-CVI & S-CVI) were reported for the validation and pretesting was performed with, n = 51 patients with diabetes. Floor and ceiling effects were reported.

RESULT

Total score of content validated and pretested, NeuroQoL-H with, n = 51 patients with diabetes is, 60 (36,109). For all the items in NeuroQoL-H, I-CVI ≥ 0.8 and S-CVI = 0.95. The floor effect is (24 %) while the ceiling effect is (1 %).

CONCLUSION

NeuroQoL-H scale is a valid outcome measure among Hindi speaking patients with diabetes.

Multisensory stimulation as a non-pharmacological intervention for neonates undergoing painful procedures: A scoping review

AIM

The aim of this review is to identify available evidence on MSS practices as a pain-relieving intervention among neonates undergoing a repetitive painful procedure.

METHODS

Searches were performed in the following databases: PubMed/ MEDLINE, SCOPUS, CINAHL, and the physiotherapy evidence database (PEDro). A total of eight studies were identified, among them; studies related to MSS in relieving neonatal procedural pain were conducted only in three countries only.

RESULTS

Data collected from the identified studies were extracted by two independent reviewers, and were synthesized quantitatively, and qualitatively. Eight studies involving six hundred and eighty-six neonates in three countries were identified in the search. Among them, six were randomized controlled trials, and two were observational studies. The study results highlighted that implementation of MSS as a non-pharmacological pain-relieving intervention follows a similar protocol among the reviewed articles, but varies by who administers MSS (Physiotherapists/ Nurses/Mothers) in neonates undergoing repetitive painful procedures.

INTERPRETATION

Standardized MSS protocol should be followed globally along with its implementation for reducing procedural pain among neonates and also to promote good clinical practice in neonatal intensive care unit (NICU) settings. Future research could determine the effects of standardized MSS protocol either with or without other non-pharmacological interventions among neonates undergoing painful procedures.

Reliability and Reference Norms of Single Heel-Rise Test Among Children: A Cross-sectional Study

There is a lack of data regarding the single heel-rise test (SHRT) among children. Hence, we aimed to establish reliability and reference norms of SHRT among children aged 8 to 12 years. About 500 healthy children were randomly selected from the recognized school and community settings. After demographic measurements, SHRT was conducted to evaluate the strength of each plantar flexors. SHRT repetitions were assessed by the same rater on 2 occasions for intrarater (on the same day) and test-retest reliability (on different days) and by 2 raters for inter-rater reliability. Relative reliability was described in terms of the intraclass correlation coefficient (ICC) and Pearson correlation coefficient (r). Absolute reliability was indicated by the standard error of measurement (SEm), minimal detectable change (MDC), and Bland-Altman graph. The mean of the number of repetitions of SHRT was calculated to derive the reference norm of SHRT. The anthropometric parameters were correlated with SHRT for multiple regression analysis. Intrarater, test-retest, and inter-rater reliability of SHRT were, ICC = 0.81, ICC = 0.70, and ICC = 0.57, respectively. The Bland-Altman graph confirmed limits of agreement for intrarater, test-retest, and inter-rater reliability. The reference norm of SHRT is documented to be 20.6 ± 4.8. SEm and MDC are found to be 2 and 3, respectively. Multiple regression analysis predicted a correlation of age, weight, and calf muscle girth with SHRT. SHRT is moderate to good reliable in assessing the strength of plantar flexors. The reference norms of SHRT have been derived for healthy children aged 8 to 12 years.

Scoping out the scope of scoping reviews in neonatal and pediatric pain management: A scoping review methodological framework

PURPOSE

This methodological framework was purposed to discuss the considerations for conducting scoping review for neonatal and pediatric pain management (NPPM) from the perspectives of Arksey and O' Malley and Joanna Briggs Institute (JBI) framework. Till now, there is no scoping review or standard methods are available for identifying, prioritizing, or reporting research gaps in the area of NPPM.

METHODS AND RESULTS

Scoping reviews were utilized to map the literature comprehensively across a range of study designs in a particular area. This methodological framework describes the methods used to identify, prioritize, and display research gaps in the area of NPPM. Different methods to determine research gaps have been described in this framework. This scoping review methodological framework also discussed methods for conducting scoping review in two levels with methodological considerations given by Arksey and O'Malley, and JBI Institute. Search terms and search terminologies are described to conduct scoping review effectively for NPPM. Through, this standard scoping review methodological considerations, the general understanding and current advances in NPPM can be widened.

CONCLUSION

This methodological framework describes the methods for conducting scoping review effectively in the area of NPPM.

LEVEL OF EVIDENCE

Not applicable.

Diffusion tensor imaging in patients with diabetic peripheral neuropathy: Fractional anisotropy and apparent diffusion coefficient dataset of posterior tibial nerve

The data in this article described quantitative values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for 23 (46 extremities) normal healthy males and females, for 46 patients with bilateral diabetic peripheral neuropathy. 1.5 Tesla (T) MR System Multiva – Philips magnets (Baltimore, Netherland, Holland) imaging with axial T1WSE, sagittal T2WSE and STIR sequences by means of diffusion weighted neurography b values of 0 and 800 s/mm². The data obtained as FA and ADC values in healthy adults and patient population can be referred by researchers, clinicians for early diagnosis, to determine intervention effectiveness and patient management.

Letter to the editor, "High intensity aerobic exercise improves bimanual coordination of grasping forces in Parkinson's disease"

We have read with utmost interest the article entitled, "High intensity aerobic exercise improves bimanual coordination of grasping forces in Parkinson's disease" by Jansen et al. They have highlighted the importance and feasibility of providing high intensity aerobic exercise on improving the bimanual coordination of grasping forces for the patients with Parkinson's disease (PD). We would like to highlight few methodological and statistical issues with the study for more effective use of the study results among the medical fraternity involved in rehabilitating the patients with PD.

Repeated measures correlation between functional capacity, pulmonary function and chest expansion in children undergoing open abdominal surgery: Secondary analysis from randomized clinical trial

PURPOSE

Six minute walk test (6MWT), Spirometry and chest expansion are used regularly to investigate the status of functional capacity and pulmonary function pre and post operatively. We assessed whether Functional capacity Ten meter walk test (10mWT), Nine stair climbing test (9SCT), pulmonary function [Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR)] and chest expansion have correlation in children undergoing open abdominal surgery.

METHODS

Total 18 children aged 5-17 years old undergoing open abdominal surgery participated in the study. The study follows secondary analysis from randomized clinical trial. 6MWT, Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR), 10mWT, 9SCT, and Chest expansion measures were taken before [Preoperative day (Pre-OP)] and after open abdominal surgery [postoperative day one (POD1) and postoperative day five (POD5)].

RESULTS

Bivariate analysis showed no correlation (r_s <0.25; p>0.05) between Functional capacity and pulmonary function preoperatively, on POD1, and on POD5. 9SCT (Functional capacity) showed moderate to good correlation (r_s= 0.742; p<0.05) with pulmonary function at the Pre-OP. Chest expansion parameters also showed moderate to good correlation (r_s = 0.50-0.75; p<0.05) with the pulmonary function on Pre-OP, POD1, and POD5.

CONCLUSION

There is moderate correlation exists between pulmonary function and chest expansion, but poor correlation of functional capacity with pulmonary function and chest expansion. Hence, all the outcome measures (6MWT, 10Mwt, 9SCT, Spirometry, and Chest expansion) are having individual importance.

A randomized clinical trial in improving pulmonary function and functional capacity in pediatric open abdominal surgery

PURPOSE

Pulmonary function and functional capacity gets compromised and reduced after open abdominal surgery. We assessed whether Preoperative physiotherapy education (POPE) along with postoperative physiotherapy (POP) preserve pulmonary function and functional capacity after open abdominal surgery among Pediatric population. Hence, the goal of this study was to determine the effectiveness of POPE combined with POP against the standard treatment care of, Postoperative physiotherapy (POP) only in improving pulmonary function and functional capacity in pediatric open abdominal surgery.

METHODS

Twenty one children aged, 5-17 years old undergoing the open abdominal surgery were randomized to POPE and POP group (Intervention arm 1) and Postoperative physiotherapy group (POP) only group (Intervention arm 2). Primary outcome measure was pulmonary function measured by computerized spirometry. Six minute walk test (6MWT), Ten meter walk test (10mWT), Timed up and go test (TUGT) and Nine stair climbing test (9SCT) were used as secondary outcome measures to measure functional capacity along with chest expansion. Pulmonary function measured by spirometery, 10mWT, TUG and chest expansion were measured 1 day before undergoing abdominal surgery (Pre-OP), post-operative day 1 (POD1) and post-operative day 5 (POD5) while 6MWT and 9SCT were measured only at POD1 and POD5.

RESULTS

Eighteen children who were undergoing open abdominal surgery completed this trial. No statistical difference were noted in Spirometric parameters from Pre-OP to POD5 in both the groups, they are almost approximate to preoperative values, but from POD1 to POD5, statistical difference were noted in all the Spirometric parameters in Intervention arm 1 as compared to Intervention arm 2. Statistical significant improvement (p < 0.05) were noted in TUGT, 10mWT, 9SCT from Pre-OP to POD5 and from POD1 to POD5 also in Intervention arm 1 as compared to Intervention arm 2.

CONCLUSION

There is sufficient evidence to confirm that POPE combined with POP might improve pulmonary function and functional capacity in children undergoing open abdominal surgery.

TYPE OF STUDY

Treatment study.

LEVEL OF EVIDENCE

Level I.

Mobile-Based Health Apps to Promote Physical Activity During COVID-19 Lockdowns

Objective

Periods of lockdown due to coronavirus disease 2019 (COVID-19) have a negative effect on individuals’ physical health and quality of life, and may result in a weakened immune response, leading to enhanced risk of infection. Due to lack of access to public resources during periods of lockdown many individuals cannot perform their usual daily physical activities. The aim of this short report is to discuss the use of mobile-based health applications and virtual reality systems for promoting physical activity at home through an interactive and motivating digital environment.

Methods and results

Information on tele-health, available from the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), and data on physical activity during lockdowns were reviewed. A list of mobile-based health applications suitable for use in promoting physical activity at home was compiled.

Conclusion

This report makes recommendations for mobile-based health applications to promote physical health, which can be used at home during periods of lockdown.

Normative Reference Value for Tactile Localization Acuity among School-going Children: A Normative Research

Background and Aim:

Tactile localization (TL) is one of the standard assessments to be performed under combined cortical sensory assessment. TL is the ability to locate the point of sensory contact and surprisingly, till date there is no normal reference available for estimating TL. Hence, there is a need to calculate the normative reference of TL among school-going children aged between 8 and 13 years.

Materials and Methods:

A total of 365 healthy school-going children aged between 8 and 13 years were included in this cross-sectional observational study. Children with any neurological condition and other conditions, which prevent them from taking part in the study were excluded. The sample was recruited by stratified random sampling method from the recognized schools in Ambala district, Haryana, India. After the anthropometric measurements, TL acuity was established by point-to-point tactile localization (PPTL) technique. In this technique, the children were asked to relocate the point of contact made by the investigator over identified 15 areas, and after that the distance between the point of contact made by the principal investigator and the relocation point made by the children is measured in centimeters (cm). The mean of three readings were used to estimate TL acuity.

Result:

TL acuity ranges from 0.9 (0.5, 1.5) cm in little finger of palm to 1.5 (1.0, 2.5) cm in middle of posterior arm. TL acuity increases with increasing age. There exist no significant (P ≥ 0.05) difference in the normative reference value between male and female among the identified 15 areas.

Conclusion:

Normative reference values of TL acuity have been established among school-going children between 8 and 13 years.

Investigate Correlation between Diastasis of Rectus Abdominis Muscle and Low Back Pain in Obese Women

Background

Rectus abdominis is the main core muscle. Weakness or any alteration in it may increase the pressure over the lower back, in obese women diastasis of rectus abdominis muscle found to be very common condition. Therefore, there may be a correlation between diastasis of rectus abdominis muscle and low back pain in obese women that needs to be explored, as there is no literature available.

Methods

In this study, 72 female subjects with Body Mass Index <30 kg/m² were recruited by snowball sampling method. Demographic (name, age) and anthropometric characteristics (height, weight and body mass index) were recorded. The separation in the rectus abdominis muscle was assessed with vernier calliper.

Results

Total subjects were included in the study; all the subjects were Female without any recent abdominal surgical history. The subjects included in the study with age of 30 years to 55 years old with body mass index of the included females must be (30-30.9) kg/m² i.e. women must come under obese category. Diastasis of rectus abdominis muscle was another variable used that must be present in each women. Low back pain was also used as the variable that may be present or may not be present in the women with diastasis of rectus abdominis muscle. The collected data were analysed by the appropriate statistical analysis tools. The p-value was found more than 0.05 (the alpha level set was less than 0.05) which is non-significant.

Conclusion

The study concluded a non-significant correlation between the diastasis of rectus abdominis muscle and low back pain in obese women. The present study concludes that it is not necessary that all obese women with low back pain always propose to have diastasis of rectus abdominis muscle.

Preserving pulmonary function and functional capacity in children undergoing open abdominal surgery: A one group pretest-posttest, quasiexperimental pilot trial

PURPOSE

The aim of this trial was to determine the effects of Preoperative physiotherapy education (POPE) and Postoperative physiotherapy (POP) maintaining pulmonary function and functional capacity in children undergoing open abdominal surgery.

METHODS

A total of eight children aged, 5-17 years old posted for open abdominal surgery received POPE and POP. Spirometry, 10 m walk test (10mWT), timed up and go test (TUGT) and chest expansion were taken preoperatively and postoperatively on day one and five. Six minute walk test (6MWT), and Nine stair climbing test (9SCT) were taken preoperatively and postoperatively on day five.

RESULTS

No statistical significant difference were noted in FVC, FEV1, PEFR, FEV1/FVC Ratio, chest expansion levels and Borg scale but in TUGT, 10mWT, 6MWT and 9SCT significant difference was noted. Effect size were calculated and post hoc power analysis revealed that the power of the study is >90%.

CONCLUSION

POPE might have positive effects in preserving pulmonary function and functional capacity.

TYPE OF STUDY

Treatment study.

LEVEL OF EVIDENCE

Level II.

Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol

STUDY DESIGN

Two-group, pretest-posttest randomized clinical trial.

PURPOSE

To evaluate the efficacy of the muscle energy technique (MET) and Kinesiotaping (KT) in addition to conventional physiotherapy among patients with mechanical sacroiliac joint dysfunction (SIJD).

OVERVIEW OF LITERATURE

Patients with SIJD suffer from lower back and gluteal pain, as well as stiffness, due to restricted pelvic joint movement. To restore function and reduce pain among individuals with mechanical SIJD, the MET and KT may be helpful. However, a limited number of studies have compared MET and KT in mechanical SIJD.

METHODS

A total of 40 male and female participants aging between 30 and 50 years experiencing unilateral pain around the gluteal area, groin area, and lower limbs for more than 4 weeks but less than 1 year will be selected. Patients will then be randomized into two groups: METCp (n=20) and KTCp groups (n=20). The METCp group will receive MET along with conventional physiotherapy, while the KTCp group will receive conventional physiotherapy with KT. Both groups will receive three alternating days of treatment per week that will continue for 4 weeks. The modified Oswestry Disability Index, a digital pressure algometer, and sacroiliac joint motion testing will be used for evaluation. Between- and within-group pre- and post-intervention results for mechanical SIJD were compared using the Wilcoxon signed-rank test/paired t-test and Mann-Whitney U -test/independent t -test.

RESULTS

Modified Oswestry Disability Index, digital pressure algometer, and sacroiliac joint motion will be measured at baseline, 2nd week during intervention, and 4th week at the end of intervention.

CONCLUSIONS

The present study will provide data regarding the effects of MET and KT among patients with mechanical SIJD.

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.