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CONFERENCE PROCEEDINGS National Conference of “Physiotherapy & Rehabilitation

Evidences leading to new Horizons”

th st20 to 21 Sept. 2019

College of Physiotherapy, SVDU, Vadodara, INDIA.

National Conference on Physiotherapy & Rehabilitation

NJIRM 2019; Vol.10(4.1) July-August eISSN: 0975-9840 pISSN: 2230 - 9969 1

About the Conference……….. The conference ‘Physiotherapy & Rehabilitation: Evidences Leading to New Horizons’ is the first of its kind in Western part of India, especially in Gujarat state. The term Rehabilitation encompasses a larger context,

of bringing one to normal or near normal status, in all dimensions of Health, namely Physical, Mental, Social

and Emotional dimensions as defined by WHO.

Although all dimensions need a perfect balance for a good health it is the Physical dimension that has been

paid more attention as it directly affects an individual’s productivity and contribution to the society. So, in many ways Physiotherapy also known as ‘Physical therapy’ which deals with Physical rehabilitation has almost become synonymous with the term rehabilitation.

‘Rehabilitation’ however, in its true sense involves all dimensions of health and many professionals who look after these dimensions work as a rehabilitation team member and work tirelessly to achieve this

greater goal of bringing someone to a normal or near normal status in all the dimensions.

It is also an accepted fact that each profession has grown dramatically in the area of their specialty over

these years and this development has significantly contributed in achieving greater heights in

rehabilitation.

Staying true to the holistic meaning of the term Rehabilitation, this Conference brought all the members of

rehabilitation under one roof and encouraged each and every member of the team to know the success

achieved by other members.

Eminent speakers from various branches of rehabilitation team enlightened the audience with their talks

/speech, sharing their experiences. This conference was supported by Gujarat Council of Science and

Technology- GUJCOST

This conference provided a platform for many to showcase their researches which is considered as the

surrogate marker for the quality of research carried out in rehabilitation field and would ignite the future

researchers with innumerable questions that are yet to be answered and also promote good quality

researches.

- Organizing Team PARCON 2019



:Keynote Address I:

Rehabilitation in India-Past, Present & Future Dr. B D Athani*

*Master in Physical, Medicine & Rehabilitation and MS Ortho

*Principal Consultant, Directorate General Health Services, Govt. of India, Delhi

I am extremely glad to be present amidst you for the Inaugural ceremony of National conference on

Physiotherapy and Rehabilitation: Evidences Leading to New Horizons being organised by the College of

Physiotherapy, Sumandeep Vidyapeeth and to be privileged to deliver key note address.

Let me say at the outset, the role of physiotherapy in the setting of secondary care, tertiary care including

care in Emergency and Intensive Care Units in healthcare setups has come to be well recognised by now

and even their role as a valuable team member in rehabilitation team in the management of impairments,

disability causing functional incapacities. Convincing evidence have been emerging that therapy measures

improve rehabilitation outcomes, for example simple exercise therapy in broad range of health conditions

has contributed to increased strength, endurance, and flexibility of joints. Therapy interventions are also

found most suitable for long term care of chronic illnesses, the incidences of which are increasing. On the

other hand, number of physiotherapists qualifying is few, causing mismatch between demand and supply,

more so for rehabilitation side as most of the physiotherapists are preferring to align with hospital and

medical side than on the disability and rehabilitation Institute, CBR.

In view of phenomenal advancements in the medical sciences, one of the necessary paradigm to be

adapted is principle of inter-disciplinary team approach for drawing necessary inputs from the various

disciplines for customising interventions for a given patient/individual in health care set ups, going beyond

even to multi-sectoral team of professionals for channelizing the individual for psycho-social rehabilitation

as well. Therefore, physiotherapists cannot afford to remain only tied to biomedical model.

Subsequently full-fledged Rehab departments came to be established in various cities, like Kolkata, Vellore

and Chennai. In the year 1969, WHO expert committee on medical rehabilitation defined Rehabilitation as

the process of medical care aiming at developing the functional, psychological abilities of individuals and if

necessary compensatory mechanisms so as to enable him to attain self-independence and lead active life.

Rehabilitation being very sound, holistic concept, practice of it therefore demands broad understanding of

inter disciplinary team approach, comprehensiveness for improving quality of life which has been

attributed as traditional medical model.

Policy makers’ attention was drawn towards it in 1981, when international year of disabled was observed

throughout the world.

WHO, in the year,2001 published International classification Functioning, Disability and Health which is

based on biopsychosocial model and is now widely accepted as the framework for disability and

rehabilitation. Rehabilitation within this frame work includes a full range of bio-psycho-social

interventions on the components of ICF that will improve functioning activities and participation minimising

the impact of diseases and impairments.

The WHO Regional Office for Western Pacific region developed Western Pacific Regional framework on

Rehabilitation which was adopted by member States in 2018, emphasizing the need to build strong

foundation for rehabilitation that is person cantered focussing on people’s day-to-day functioning rather

than diseases.

Accordingly, traditionally evidence or outcome measures focussed only on the individual’s impairment levels have been extended to include individual activity and participation outcomes across range of areas

more recently.

Passing of persons with disabilities act in the year 1995 by Parliament of India was a landmark event for

adequate development of resources, institutions at all levels, leading to formulation of National Policy for

persons with disability in February 2006, which is replaced by the policy recently enunciated.

India is passing through demographic, epidemiologic and economic transitions and consequently bearing

double/triple burden of communicable non-communicable diseases and re-emerging disorders. Non

communicable diseases account for more than 60% of mortality, injuries account for nearly 12% of



mortality Non Communicable Diseases tend to be long term illnesses and entail serious morbidities and

disabilities. In many countries long term management of Non Communicable Diseases include

rehabilitation and in developing countries such services are too scanty Rehabilitation services are critical for

Management of Non Communicable Diseases. It is estimated that 2 million people in India have disabilities

due to RTA which are growing astronomically, making up to 13.5 % of locomotor disability with objective of

prevention and early institution of treatment and rehabilitation National trauma care programme was

launched in the year 2010.

National programme for prevention and control of cancer diabetes& stroke launched in the year 2010 is

scaled up now to include 616 districts and is integrated with NHM. Programme infrastructure includes

setting up of the NCD Cells/ Clinics at all levels. There is provision to provide rehabilitation services at

district NCD clinics and one Physiotherapist is appointed to extend such services. NPCDCS strong

component of rehabilitation services is included especially patients suffering from stroke.

Number of patients attending NCD clinics for physiotherapy services in the last year is 9.7 lakhs in 62

district level clinics.

As per census 2011, the number of elderly people is 103.83 million and is projected to increase to 198

million by 2030, nearly 45% of them have one or other disability and 6% have multiple disabilities in

addition to non-communicable diseases affecting functionality. In the National programme for health care

of elderly, it is envisaged to introduce comprehensive health care set up and interventions are designed to

capture the preventive, curative, and rehabilitative aspects of geriatric field in an integrated manner

includes domiciliary visits. Rehab services would be provided by physiotherapist /rehab worker placed at

CHC.

In so far as programmes for childhood disabilities are concerned, RBSK, which is an innovative initiative

envisaging, child health screening and early intervention services covering all 4 DS Defects at birth, diseases

in children, deficiencies, and developmental delays including disabilities. Children in the age group are

specifically managed in DEIC.

Ministry of SJ&E being the nodal ministry has enacted the RPWD Act replacing the earlier Persons with

Disabilities Act, 1995 where in 21 categories of disability have been included. Guidelines for estimation of

disabilities for the purpose of various concession and benefits are notified, I am sure you will have referred

to by now.

There are various schemes and programmes run by the nodal ministry some by reputed NGOs which you

may like to collaborate with, notable amongst them are DRC scheme, ADIP etc.

Rehabilitation should be an integral part of health care and continuum of care for everyone. However,

rehabilitation is still often seen as a specific service for only PWDS but non-essential for all.

Therefore, there is strong case to build necessary evidence and understanding for the implementation of

cost effective rehabilitation care and research in our country and evolve standard practise and guidelines

for interventions for various common ailments and disabilities.



:Keynote Address II

Overview of Physiotherapy and Rehabilitation - Current scenario in Gujarat

Prof. Dr. M. M. Prabhakar*

*Director Medicity, Ahmedabad-Civil Hospital.

Medical superintendent-Civil hospital, Ahmedabad,

Prof. Orthopaedics, Civil Hospital, Ahmedabad

Rehabilitation is the action of restoring someone to health or normal life through training and therapy after

illness. The word rehabilitation comes from the Latin prefix re-meaning “again” and habitat meaning “make it”.

The Rehabilitation is team approach which includes clinician, Physiotherapist, Occupational Therapist,

Prosthetic &Orthotic professional, Speech and Language Pathologist / Speech Therapy & Audiology,

Medical Social Worker, etc.

The goal of Rehabilitation is to help person learn how to care for a body that now may work differently and

to reintegrate a person into the community. The basic goal of Rehabilitation is to assist patients to achieve

their maximum potential for physical, cognitive, social and psychological function, so as to be able to

participate concretely in society and lead life of quality. The purpose is to return a patient back to a normal

healthy condition, whether it is following an illness, injury, surgery or certain disorders.

Rehabilitation professionals primarily the Physiotherapists, Occupational Therapists and Speech Therapists

play a major role. In Orthopedic, Neurological, Cardio-Pulmonary, Obstetrics & Gynecology, Psychiatry,

medical & surgical conditions in the neonates, pediatric, adults and geriatric populations of the community

rehabilitation is an inseparable component. Physiotherapy plays very major role in Rehabilitation program,

working from womb to tomb.

The Govt. (CL & SC) Spine Institute Ahmedabad.(formerly known as Paraplegia hospital) where I was

director for 25 years, is a destination for excellent and comprehensive rehabilitation of persons with spinal

cord related injuries and various other disabilities. It has contributed to bring smile on face of thousands of

people from across rural & urban areas of Gujarat and many States. It has not only continued its

contributions in the field of treatment and rehabilitation of patients with spinal cord injuries and Paraplegia

through strengthening its service delivery mechanisms, but the Government (CL & SC) Spine Institute is a

leading institute of not only medical services, but also comprehensive rehabilitation services of national

repute. It supports patients by developing their vocational skills in collaboration with NGOs and corporate

houses.

The vision of Government Spine Institute is to be recognized globally as one of the best spine institute and

complete rehabilitation center. The mission of Government spine institute is to provide the best quality

service at free of cost to all spine and physically disable patients around the globe irrespective of religion,

age, sex, etc. with compete rehabilitation including vocational rehabilitation. The motto is to provide

comprehensive patient care under one roof with complete rehabilitation and vocational reestablishment.

Government spine institute is NABH accredited, vocational training to spinal cord injury patients is given as

per patient need and assessment by vocational trainer. At Govt. spine institute ‘Vocational’ training is given for making paper bows, decorative materials, sewing machines, etc. All patients are given mobility and

vocational aids at the time of discharge e.g. Grocery kit, Toys kit, Vegetable handcart etc.

Till date Sewing machine-445,Hand cart-218, Foot wear business kit-25, Wheel chairs-1579,Tricycles-326,

Paper plate machine-15, Idli machine-5,Computer-1,Hearing Aids-200, Air bed-343 and Walker-158 , Total-

3315 vocational Aid is provided by the institute.



The wheelchair clinic is a project of this institute where wheelchair is modified according to need of an

individual so that independent living is empowered with maximum comfort.The wheelchair clinic provides:

Assessment of patients need

Assembling of customized wheelchair.

Training to the patient and their relatives.

Distribution of customized wheelchair.

Counseling of issues pertaining to use and maintenance of wheel chair.

Under this project patients with disability are provided customized wheelchair totally free of cost.

To ensure complete recovery, the Government (CL & SC) spine institute has introduced a noble concept.

“Paraplegia safari program” is for patients with spinal cord injury, who requires long term treatment and care. After discharge many patients may have complications like urinary tract infection, bladder and bowel

diseases, bedsores, joint stiffness and deformity. Poor economic condition and limitations in accompanying

the patient for regular follow up from remote and rural areas; there is hindrance in recovery of patient.

Under SAFARI program instead of patient visiting the hospital, rehabilitation team consisting of orthopedic

surgeon, Physiotherapist, Occupational therapist, Prosthetic and Orthotics, Nurse, medical social worker

visits the patient at their door step. Along with medical checkup, the team guides the patient and family

members for adequate home care. The team also assesses and reviews patient’s Aids, appliances and vocational kits given and take corrective actions if require. Till date around 100 such SAFARI programs are

conducted in various districts of Gujarat.

Vocational aid

Vocational aid Rehabilitation



Rehabilitation patient using vocational aid

Safari home visit Gait trainer



There are 1000 spine surgeries done per year. Recently one female patient name was operated for

kyphosis. The patient developed gradually back deformity which was progressive in nature since 10 years.

Patient was already operated for coccytectomy before 10 years. Pre and post surgery neurology of patient

was Normal.

Preoperative x-ray Post-operative x-ray Preoperative posture postoperative posture

In Gujarat, the first physiotherapy college was established in 1969 at S.S.G. Hospital, Baroda. Then second

Physiotherapy College at Govt. Spine Institute, Ahmedabad, in 1992 and first post-graduation course

started in 2005 at Govt. Physiotherapy College and Govt. Spine Institute. At present, in Gujarat, there are

79 Undergraduate Physiotherapy Colleges with intake total capacity of 4500 students. There are five

Government Colleges at Ahmedabad, Baroda, Surat, Jamnagar, Dahod and rest of colleges are self finance

colleges. There is one Govt. Prosthetic and Orthotic College with intake capacity of 10 students and one

Govt. Occupational Therapy College with intake capacity of 10 students. The Gujarat University offers

program for Ph.D.in Physiotherapy subject. Many private universities also offer Ph.D. program. Post-

graduate programs offered by various universities in the subjects like MPT in Musculo- Skeletal Sciences,

MPT in Neuroscience, MPT in Cardio-Pulmonary, MPT in Rehabilitation, MPT in Sports, MPT in Pediatrics,

etc. First Govt. Prosthetic and Orthotics College started in 2005. The Speech and Audiology Rehabilitation in

2014 and first Government Occupational Therapy College was established at this institute in 2018.

Gujarat State Council for Physiotherapy was established in 2011by Government of Gujarat. (www.gscpt.in).

In January 2001, there was an earth-quake in Gujarat, 109 spinal cord injury patients were admitted at

Govt. Spine Institute. 13 years of long term follow-up of patients on their Rehabilitation status and

survivorship has been done. The result was found that both Rehabilitation and Survivorship status was

significantly much better as compared to document evidences. The patients Rehabilitation status at the

time of discharge, out of 109, was independent-59, ambulate independently with or without support-26,

wheelchair dependant-18, bed ridden-6. Rehab status in 2013 was independent-21, ambulate

independently with or without support-22, wheelchair dependant-25, bed ridden-7, total survivals-75

which is 68.80 %. (The study is published in IJPOT journal).

Due to early spinal stabilization and decompression with excellent rehabilitation care, Vocational, Monitory

support, and frequent follow-up gave long, good quality of life. This long-termfollow-up of 13 years is

biggest evidence that with Good, efficient Rehabilitation team the quality of life of patients is benefited.

Four women of earthquake victim with spinal cord injury delivered child.

Nowadays there is subject specialist in Physiotherapy profession which makes them work more focused in

one field. I can see the future of Physiotherapist is very bright.

http://www.gscpt.in/



:Plenary Session I:

The role of Ergonomics in the prevention of Work-Related Musculoskeletal

Disorders in Healthcare Professionals Dr Deepak Sharan*

*Consultant in Orthopaedic Surgery, Rehabilitation, Ergonomics, Occupational Safety and Health,

RECOUP Neuromusculoskeletal Rehabilitation Centre, Bengaluru, Karnataka, India

International statistics state that healthcare professionals are among those at highest risk for of Work-

Related Musculoskeletal Disorder (WRMSD), especially of the low back and shoulder. The high prevalence

of WRMSD in health care professionals such as Surgeons, Dentists, Radiographers, Laboratory Workers,

Nurses, Massage Therapists and Physiotherapists/Occupational Therapists, has forced them to reconsider

their career and even leave their current jobs in many countries. The purpose of applying the science of

Ergonomics in healthcare sector is to support people in all possible ways that makes their workplace safe

and comfortable.

When reviewing the literature, it was found that the prevalence rate for physiotherapists developing a

WRMSD during the course of their profession was between 32% and 91%. The areas most commonly

affected were the lower back and the wrist/hand. Prevalence for neck and shoulder pain ranged from 4.2%

to 69%. Similar research performed on osteopaths showed a 69.23% WRMSD prevalence rate and reported

the most commonly injured areas to be lumbar spine/sacrum, followed by the wrist and upper

back/thoracic spine. Nursing homes have been a particularly hazardous environment for health care

workers; back and shoulder injuries from moving patients account for the majority of problems in nursing

homes, even with two-person lifts. Other problems occur as a result of bending and carrying/lifting.

Identification of risk factors is a vital part in prevention and so assessment using valid ergonomic tool is

essential to know the risk involved. Identification of the risk factors associated with the development of

WRMSD among healthcare professionals is possible by knowing the nature of the job and using various risk

assessment tools. Menoni et al. (1999) developed the MAPO (movement and assistance of hospital

patients) method practical tool for analysis and intervention and prevention. The PTAI (Patient Transfer

Assessing Instrument; Karhula, Ronnholm & Sjogren 2009) is a practical tool that occupational safety and

occupational health professionals can use to evaluate the risk of patient transfers in the unit. The

TilThermometer (Knibbe et al 1999) is an instrument to assess exposure for physical overload for carers /

nurses who are carrying out basic care and assess compliance with the Guidelines for Practice.

The aim of this session is to discuss various risk assessment methods that may help in estimating the risk

involved in health care work and may help in risk modification.

Whilst the methods used to evaluate risk and preventive capabilities differ widely throughout the world,

there is general agreement over the need for an approach that begins by assessing risk, and then envisages

an integrated process for analysing work organisation, environment, aids and training, and ultimately

assesses effectiveness.

The methods used for assessing patient handling risk can be categorised as follows:

1. Individual Patient Handling Risk Assessments and Plans, e.g., safe system of work (SSOW)

2. Physical Environment Risk Assessments

i. Criteria Based Assessments, e.g., Lite Workplace Profile, Hoist Identification Tool, Quick Scan

ii. Residual Risk Scores/Evaluations, e.g., MAPO tool, Lift/Care Thermometer, Patient Transfer

Assessment Instrument (PTAI)

3. Individual observational tools for specific handling tasks

i. Postural Analysis Tools, e.g., REBA, OWAS, People Environment Risk tool

ii. Biomechanical Assessment Tools, e.g., The Dortmund Approach

iii. Exposure Measures: self-reported exposure methods

iv. Subjective Appraisal Measures, e.g., Borg scales for the rate of perceived exertion, likert scales for

comfort and ease of use for equipment

v. Methodological Observation Tools, e.g., PATE, DINO

4. Specific tool for risk assessment for biomechanical overload in Physiotherapists and Surgeons:

Timing Assessment Computerised System (TACOs)

https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi3_fu1vvTKAhXP1I4KHRE0A3YQFggeMAA&url=http%3A%2F%2Fwww.ergonomiesite.be%2Fzorg%2FPTAI%2FPTAIchecklist.pdf&usg=AFQjCNEUyOpE4-XgiLHyh23DPiVjvcRkag

https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi3_fu1vvTKAhXP1I4KHRE0A3YQFggeMAA&url=http%3A%2F%2Fwww.ergonomiesite.be%2Fzorg%2FPTAI%2FPTAIchecklist.pdf&usg=AFQjCNEUyOpE4-XgiLHyh23DPiVjvcRkag



:Plenary Session II:

Emerging Trends in the Rehabilitation of Speech & Hearing Impaired Dr. B. Rajashekhar*

*Founding Dean & Professor (Speech& Hearing), Manipal College of Health Professions,

Manipal Academy of Higher Education (DU), Manipal-576104; India

___________________________________________________________________________________________________

Rehabilitation has long lacked a unifying conceptual framework. Last decade has witnessed a sea change in

the processes encompassing rehabilitation with more research, newer assessment tools and intervention

based on evidence based outcomes. The specialty of Speech & Hearing is no exception. Speech, Language &

Hearing rehabilitation has reflected positive strides, thanks to dedicated research & evolution of newer

technologies. Speech and language therapy has come a long way since the days of ‘The King’s Speech’. Technology has been woven into the treatment methods that neither patient nor therapist has seemed to

skip a beat. Speech and language therapy, until a few years ago, was not synonymous with technology.

Now however, there is an app for just about any problem an individual suffers. Hearing impairment is one

of the most critical sensory impairments with significant social and psychological consequences. Failure to

detect children with congenital or acquired hearing loss may result in lifelong deficits in speech and

language acquisition, poor academic performance and personal-social and behavior problems. Over the last

two decades, universal newborn hearing screenings (UNHS), more sophisticated hearing assessment

methods, and advanced hearing technologies such as digital hearing aids and cochlear implants,

significantly contributed to the interest in research on outcome studies for children with hearing loss whose

intervention and rehabilitation emphasizes developing listening and speaking skills. The ultimate goal for

these interventions and rehabilitation procedures is for a child with hearing loss to develop language and

speech through listening, receive a mainstream education, acquire social skills with normal hearing

children, and potentially have a career among the normal hearing population. Audiology and aging has

been recognised as a key factor in rehabilitation with appropriate research & intervention strategies being

envisaged.



:Plenary Session III:

Advances in Occupational Therapy: Role in Sleep Deprivation Dr. Amitabh K Dwivedi*

*Dean, Jaipur Occupational Therapy College, Maharaj Vinayak Global University, Jaipur

Sleep is a state where awareness to environmental stimuli is reduced. It is different from states of coma,

hibernation and death by the fact that it can be rapidly reversed. Quality sleep – and getting enough of it at

the right times -- is as essential to survival as food and water. Without sleep you can’t form or maintain the pathways in your brain that let you learn and create new memories, and it’s harder to concentrate and

respond quickly.

We all need sleep – children need 11-12 hours of sleep, adolescents 9-10 hours and adults 7-8 hours of

sleep to function safely and be awake in passive situations. Inadequate sleep can occur if insufficient time is

allowed for it or if a disorder is present that disturbs sleep quality. It is only recently that we have begun to

understand the scale of the health and social consequences of insufficient sleep and sleep disorders. People

vary in how little sleep is needed to be considered sleep-deprived. Some people such as older adults seem

to be more resistant to the effects of sleep deprivation, while others, especially children and young adults,

are more vulnerable. The internal and external changes in adolescent sleep patterns lead to problems

related to insufficient sleep, increased daytime sleepiness and complaints of fatigue. These problems, in

turn, are associated with a variety of negative outcomes of safety, health, and performance.

There are several types of sleep disorders. Insomnia, sleep apnea, and restless leg syndrome are some

examples of clinical sleep disorders that can affect adults and interfere with normal functioning. These

sleep disorders can contribute to medical or emotional problems.

In India, 93% of the populations is sleep-deprived, but only 2% Indian discuss their sleep issues with

physicians. Ancient Indian practices have laid a lot of importance on sleep. According to Ayurveda, the best

time to go to bed is right around, or just before, 10:00 p.m., when Kapha gives way to Pitta. And it is

important to get about 7-8 hours of sleep daily.

Lack of sleep not only impacts the overall quality of life and productivity of a person’s life but also leads to serious health issues such as increased risk of diabetes, weight gain, high blood pressure and irregular

heartbeat. Heart and lung function can be disrupted when you’re not getting good sleep, and tissues in your muscles or GI tract may not be properly repaired.

Sleep deprivation will also cause issues with sight and hearing. An affected person may experience burning

sensation in eyes, tingling and redness of eyes, light flashes and even hallucinations. He or she may also

find it difficult to gauge distance at which a sound is originating. The most common effect of sleep

deprivation is drowsiness, tiredness, mood swings, irritability and reduced alertness. During sleep,

regeneration of neurons happens in the cerebral cortex. Thus in a sleep deprived individual the brain fails

to function optimally.

It is also a growing problem among teenagers and college-aged young adults too. Sleep deprivation

negatively affects their performance in school, moods and behaviors. Studies have found that college

students tend to sleep less during the weekdays and then sleep more on weekends to try and compensate

for their accumulated sleep debt. However, there is some evidence that this approach isn’t undoing the damage associated with daily sleep deprivation. Even after sleeping in on the weekends, many teens report

still waking up fatigued most days and struggling through the demanding school day.

Many of us toss and turn or watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine. Insomnia is the clinical term for people who have trouble falling asleep, difficulty staying

asleep, waking too early in the morning, or waking up feeling unrested.

High stress and lack of sleep both contribute to greater risks for mental and physical illness. Stress and

insufficient sleep are each independently linked to obesity and weight gain, anxiety and depression, Type 2

diabetes and other metabolic disorders, cardiovascular disease, and cognitive dysfunction.

https://www.thehindu.com/tag/1073/health/?utm=bodytag

https://www.psychologytoday.com/us/conditions/obesity

https://www.psychologytoday.com/us/basics/depression

https://www.psychologytoday.com/us/basics/cognition



There are some effective relaxation exercises that can quieten your busy mind and help you fall asleep

easier. They have been shown highly effective in reducing stress and improving sleep. Scientific studies

show the benefits of these relaxation techniques in managing stress and promoting sound and restful sleep.

Controlling stress and getting sufficient high-quality sleep are two important components of health, so by

employing relaxation techniques to help in these areas, you’re making an investment in your fundamental well-being. As our nation continues to look towards medication to help them sleep, new research has

shown that a holistic mental approach is a more effective and less costly method for tackling sleep

problems. These techniques are:

Autogenic training which focuses the mind on cultivating sensations of warmth and heaviness in different

regions of the body. These exercises use both visual imagery and verbal cues to relax physically as well as to

quiet and calm one’s thoughts. Biofeedback techniques in which information about the body is collected

that alerts you to stress and allow you to take steps to relax, mentally and physically. Breathing which is an

ancient and powerful way to clear the body of stress and tension, and a great way to relax as part of a

nightly transition to sleep. Deep breathing kicks off a series of physiological changes that aid relaxation,

including reducing muscle tension, slowing breathing rate and heart rate, and lowering blood pressure and

metabolism. Guided imagery which is considered to be powerful mind-body tool helps to connect the

conscious and unconscious mind and helps the mind to direct the body toward positive and desirable

responses. It engages all the senses in a focused period of imagination. Progressive muscle relaxation is a

simple and practical technique which works well for various reasons. For example it reduces tension in the

muscles that in turn reduces the tension in the mind. It also promotes focusing on your body that can stop

you focusing on your thoughts. Guided Meditation is another technique which involves listening to a

meditation video or audio track through phone. Mindfulness Exercise is based on certain Buddhist

principles, such as living in the moment and the acceptance of how things are. It’s growing in popularity, partly because the techniques are practical and work without needing to attribute any spiritual meaning to

them. Day Review technique helps us to realize how much we have achieved in a day. By looking over what

we have achieved and allowing future time for the inevitable tasks that have yet to be completed, we can

become at peace that now is time to sleep, and provide our next day with the best possible start.

Many evidence-based sleep interventions already fit within Occupational Therapy scope of practice (such as

behavioral-based strategies), and Occupational Therapy models of practice can be effectively applied to

sleep problems. For the majority of sleep issues that Occupational Therapists address, cognitive behavior

therapy for insomnia (CBTi) provides the clearest evidence base for guidelines of treatment. CBTi contains

several key elements that, when used in different combinations, provide a platform to address the bulk of

sleep concerns.

Consumer-based sleep technologies can be great tools for engaging clients in their own health and self-

management. These technologies can even provide valuable information for OTs, in the form of objective

data on sleep habits and activity routines. OTs can then integrate this material with subjective self-reports

from clients to create a clearer picture of their patients’ sleep patterns and behaviors. This can even help determine which CBTi strategies to use or modify.

Occupational Therapists are involved in prevention, promotion of health and rehabilitation. Where

possible, an Occupational Therapist’s first goal will be that of prevention. As a result, an Occupational Therapist will use his/ her knowledge about the benefits of effective sleep, sleep physiology and the

negative effects of sleep deprivation to assist in preventing problems from arising. These problems could

result in the risk of injury to the person or to others, risks of the potential to develop a chronic illness or

health problem and a difficulty in carrying out their daily tasks effectively. An Occupational Therapist will

therefore use observation, evaluation and interview in order to determine the factors that contribute to

the sleep problem together with the impact that the sleep deprivation is having in the person’s life.

http://www.independent.co.uk/life-style/health-and-families/health-news/insomniacs-should-be-given-therapy-not-sleeping-pills-8057372.html

https://www.psychologytoday.com/us/basics/unconscious



:Plenary Session IV:

Recent Advances in Prosthetics and Orthotics with Special Reference to India

*Dr. Veerendra K. Shandilya

*Director, REHABS, Vadodara, Gujarat

India is a country with a huge population of Disabled Persons. According to the 2011 census a total of 26

million are disabled. Out of these 26 million, almost 5 million have disability related to movement. Those

who have disability related to movement need some artificial appliances to correct their disabilities. The

disability may be Prosthetic or Orthotic Prosthetic disability results due to the amputation of a limb.

Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used

to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it

is carried out on individuals as a preventative surgery for such problems. Orthotic disability is due to sub-

optimal functioning of a body part. Both these disabilities can be dealt with through Prosthetics and

Orthotics. Prosthetics is a part of medical science concerned with making and fitting artificial body parts.

Orthotics is support to existing body/organ which is performing ub-optimally. Any physical disability is a

devastating and life-changing experience. Apart from severely restricting the person’s mobility and dexterity, it has significant psychological and emotional effects on the amputee. Apart from the physical

accommodations, people with physical disabilities have to overcome huge mental hurdles in order to live

their lives to the fullest.

The vast number, the typical socio-economic conditions, and the medical service delivery system makes it

imperative that serious and concerted efforts are made to mitigate the problems caused by physical

disabilities. Fortunately, technological advancements in robotics, artificial intelligence, and material science

have now made it possible for the P&O community to help the disabled significantly in dealing with

disability problems. With the help of these new advanced Orthoses and Prostheses, it is now possible for a

disabled person to overcome both physical as well as emotional trauma and join the mainstream. This

purpose of this article is to give information on the advancements in the Prosthetic and Orthotic field in

India and comment on its suitability for India.



:Plenary Session V:

Community Based Early Intervention and Rehabilitation Dr. Gaurij Hood*

*Consultant and Head, Shrimad Rajchandra Rural Healthcare Program & Early Intervention Centre, Dharampur, Gujarat

I) Rationale for Early Intervention and Rehabilitation : Disability does not occur in a day or two, there are

underlying multiple factors many of which if tackled at right time, can prevent the lifelong pain and

suffering of the affected person and family and help them achieve their highest potential and functional

rehabilitation.

Premature and Low Birth Weight babies face serious life-threatening problems during or immediately after

birth like respiratory distress, hypothermia, jaundice, septicaemia, convulsions etc. and require immediate

treatment in the Neonatal Intensive Care Unit (NICU).

Unfortunately, even after saving their lives, the babies could eventually suffer from many serious, long-

term complications such as Cerebral Palsy, Blindness due to Retinopathy of Prematurity, hearing loss,

Physical Disabilities, Cognitive Impairment, Neuro-motor Impairment, Attention Deficit Disorder, learning

difficulties etc. which are diagnosed and managed at state of the art “Model learning”, Shrimad Rajchandra District Early Intervention Centre(SRDEIC), Dharampur, Valsad, Gujarat over the last five years.

Most of the above mentioned long-term complications can be prevented, if children undergo Early

Intervention procedures i.e. they are given appropriate treatment as early in their lives as possible even at

the time of birth before discharge from the hospital.

Motor development, language, personality, temperament, attachment, social development is achieved in

the first 2 years of child's development. It is an accepted fact that if the child misses out on opportunities of

learning during this period, further learning may be delayed and deficient. Therefore, it is of utmost

importance and urgency to implement early intervention in the first few years of the child's development.

II) WHAT IS EARLY INTERVENTION? -Early intervention is defined as the introduction of planned

programming deliberately timed and arranged in order to alter the anticipated or projected course of

development (Siegal - 1972).It is a comprehensive, coordinated, multi-disciplinary approach with range of

services designed to intervene at the early stages of newborn, infant or toddler's disability to achieve their

maximum potential and thereby promoting their early inclusion into the mainstream.

III) OBJECTIVES of EARLY INTERVENTION AND REHABILITATION:1.To provide holistic health services and

support for children (0-18 years with special focus on 0-6 year age-group for early intervention)through

early identification and treatment of four D’s : Birth Defects ,Diseases, Deficiencies and Developmental delays

2. To provide essential health services for children under one roof with a team of specialists with multi and

inter disciplinary approach

3.To improve cognition in children by intervening early, thereby minimizing morbidity, preventing disability

and ensuring a child’s development to the highest potential 4. To minimize any disability and help the children and adults in complete rehabilitation through organized

efforts of the individuals, family members, community health workers and members

IV) How do we practise Early Intervention and Community based rehabilitation?:Holistic approach is

followed where each child is screened by the team comprising of specialists including Pediatrician,

Physiotherapists and Occupational Therapists, Audiologist and Speech Therapist, Pediatric Neurologist,



Pediatric Orthopedic Surgeon, Clinical Psychologist, Psychiatrist, Special Educator, Paediatric

Ophthalmologist and Optometrist, Dentist, etc.

1. Each specialist assesses the child and set goals for them and active involvement of family members

, mothers ,community members and is ensured to achieve maximum potential for a particular child.

2. Newborn Screening is carried out routinely for congenital hearing impairment, early signs of

neurological impairment and thus each newborn delivered or admitted in the Neonatal Intensive Care

Unit(NICU) at Shrimad Rajchandra Hospital undergoes evaluation by Pediatrician, Physiotherapist and

Audiologist before getting discharged and advised follow up if needed thus practicing early intervention in

true sense. Retionapthy of Prematurity Screening is actively done through DEIC and many children have

received timely intervention thus saving their vision for life. Pediatric Optometrist actively imparts visual

therapy and exercise to the needy children. Highly sophisticated tests such as Visual Evoked Potential (VEP)

and Electro-retinogram(ERG) are also performed on newborns to assess function of visual pathway.

3. Hundreds of general pediatric and orthopaedic surgeries and adult surgeries for disability limitation

and carried out free of cost at Shrimad Rajchandra Hospital.

4. Prosthetic and Orthotic department is fully functional and augments the rehabilitation of children

and adults with disabilities with custom made prostheses and orthoses, assistive devices etc. is done free of

cost and helping them for vocational training for self-sufficiency and mainstreaming.

5. Community members, key stakeholders, community health-workers like ASHA,ANMs are actively

involved in early identification, referrals and rehabilitation of children and adults in need of Early

Intervention and Rehabilitation through robust Medical Outreach Program, multi-specialty and free camps

for disabled .

6. Sensitization, Screening and management of children is done through Shrimad Rajchandra School

Health Checkup and Education Program.

360 Degree Healthcare Program of Shrimad Rajchandra Hospital-

For Early Intervention and Rehabilitation



COMMUNITY BASED SENSITIZATION ON EARLY INTERVENTION & REHABILITATION BY SRDEIC

FEW OF THE MANY SUCCESSFUL REHABILITATIONS OF SHRIMAD RAJCHANDRA REHABILITATION CENTRE



SERVICE IS LOVE IN ACTION at SHRIMAD RAJCHANDRA DISTRICT EARLY INTERVENTION AND

REHABILITATION CENTRE,DHARAMPUR



:Plenary Session VI:

Role of Assistive Technology in Rehabilitation: Focus on Seating & Mobility Dr. Nekram Upadhyay*

*Head, Department of Assistive Technology, Indian Spinal Injuries Centre, New Delhi

Assistive Technologies provide opportunities to people with disabilities to lead a quality life within their

living and working environment. Assistive Technology (AT) is not just a product; it is an approach which

plays an even more significant role in the life of someone with a severe disability. Assistive Devices are

designed to increase an individual's level of function and independence can be instrumental in providing a

person with disability the highest possible level of function. PWDs in less resourced environment like India

are not able to achieve maximum functional level of independence due to various factors. Lack of proper

Assistive Technology provisions within the existing rehabilitation facilities and lack of trained professional in

this area are the significant factors. Assistive Technology Service Provision for various disabilities and

ailments should be established within their acute and chronic rehabilitation process to achieve their better

quality of life with maximum independence. For example AT services could include proper Seating and

Mobility systems, communication and visual assistive devices, adaptive home/work environment, modified

transportation, computer accessibility, environmental control systems and assistive devices for activities of

daily living etc.

AT services must be based on a client-centered approach in which the recommended device should be

made available within the process of integrated service delivery while keeping in mind various factors such

as affordability, usability, acceptance, and appropriateness to the environment.

Generally, those who need mobility devices do not have any idea where to go for a wheelchair assessment.

Most of them buy from local market or online without any trial and fitting. Wheelchair user and their care-

givers or family members visit to a doctor or therapist to ask for their mobility solutions but most of them

are not specialized in wheelchair and seating services. There are various government schemes through

which users get wheelchairs and tricycles for free but those wheelchairs are not customized as per the

requirement of the user.

For selection of an appropriate wheelchair there are many factors to consider. For example, what are the

current health concerns, including past medical history, progressive nature of the disease process, recent or

upcoming surgeries, postural deterioration from the last seating evaluation, and history of wounds? Other

considerations include the patient’s lifestyle.

As per the World Health Organization, in developing countries less than 10% of people who require a

wheelchair have access to one.

In this session, participants will be able to learn, how to prescribe (select) a wheelchair through a detailed

assessment; how to take the most important body measurements to help select the correct size wheelchair

for a wheelchair user; benefits of appropriate posture in wheelchair; how to record the presence, risk of or

history of pressure sores for a wheelchair user; how to select an appropriate cushion and other postural

supports; about the local market; government schemes and policies; learn about environmental barriers

and accessibility standards.



:Plenary Session VII:

Emergence of Medical Social Work as a Profession in Health Care System Dr. M.N. Parmar*

*Professor, Faculty of Social Work, The Maharaja Sayajirao University of Baroda

Since the turn of the 20th century, social workers have been involved in the health care of individuals and

communities. In the book Social Work in Hospitals: A Contribution to Progressive Medicine (Cannon, I. M.

(1913)which was published more than 100 years ago captured the essence of how the profession has

connected social and environmental conditions to physical health outcomes. Today’s literature is equally

compelling in emphasizing the importance of the social determinants of health and the significant role

social workers play in addressing people’s complex and often intersecting needs.

The connection between physical health and social conditions is illuminated by the Los Angeles County

Department of Public Health (2013) suggested that, “A population’s health is shaped 10% by the physical environment, 20% by clinical health care (access and quality), 30% by health care behaviors (themselves

largely determined by social and physical environments), and 40% by social and economic factors.”

With the fast pace of development, professional social work has emerged as an area having a great

potential. “Everyone has a purpose in life, a unique gift or special talent to give to others. And when we

blend this unique talent with service to others, we experience the ecstasy and exultation of our own spirit,

which is the ultimate goal of all goals.”

Health problems of a community are seen as outcomes of interaction between certain causative agents and

individuals, which are mediated by the environmental conditions. In other words, the malfunctioning of

social system in terms of population explosion, unemployment, poverty, ignorance, old age, unhygienic

living conditions, bad housing, poor nutrition, incompatible dietary habits, poor quality of sanitary facilities,

lack of safe drinking water, etc. are the causes of ill health. Thus, it is assumed that ill health is only a

symptom of social disequilibrium. In medical science, curing illness or good health has been postulated as a

result of application of medicine. Many social scientists are of the opinion that health is misunderstood

with treatment, which is not a precondition for good health. Thus, it is clear that social forces or factors are

very vital for the health of the masses.

World Health Organization has rightly defined Health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Medical science diagnoses the physical health of the people, but medical social worker diagnoses the social

aspect of illness. Nowadays Social worker are one of the important member of team doctors who plays an

integral part in social diagnosis.

Social work is different than most other professions, as it not only involves one’s knowledge and skills but also values, beliefs and feelings. Social workers seek to help people in a way so that they are able to fulfil

their roles by enhancing their capabilities. It aims at helping people improve their quality of life by making

appropriate changes in their social circumstances.

Though historically Medical Social Work in India began in hospitals, it has gradually spread over a period of

time to Clinics, dispensaries, rehabilitation center, Research institutes, Public Welfare agencies and

Community & Public Health Programmes. However, a majority of them still work in hospitals. Due credit

must be given to the pioneering social workers who demonstrated the valuable contribution they can make

in prevention and treatment of illness and rehabilitation and who paved the way for the growing body of

professionals in this field.



Medical Social Work & Physiotherapy : As Helen Keller said, “Alone we can do so little; together we can do

so much”, hence as a team we can achieve larger goals that are not limited to one aspect of the problem or illness but many.

In some environments, such as hospitals and health care centers, social workers and physical therapists

(PTs) may be two of many professionals who work together as a care service team.

Social workers often take the lead on multi-service teams on behalf of their clients. This involves working

with other professionals, such as physical therapists, to bring in expert help as needed.

They may refer clients with eligible medical conditions to a physiotherapist, prepare discharge plan for

patients, bringing in a physical therapist to assess the patient's ability to live independently and/or help

regain lost mobility before discharge.

Although social workers and physical therapists offer different types of services, they both provide care to

individuals, and their paths often cross professionally.

Medical Social Work may take lead role in delivering following services: Updating people with disabilities

with new technologies that are improving the effectiveness of rehabilitation services such as better

wheelchair design, tele-rehabilitation (telemedicine applied to rehabilitation), improved prosthetics, new

treatments for bowel and bladder control, and more accessible transportation systems, Computer

technology applied to electric powered wheelchairs has allowed independent mobility for people with

more severe impairment.

Social Workers in Inpatient Rehabilitation Facilities:

Social workers are key contributors in the rehabilitation and recovery of patients in inpatient rehabilitation

facilities. Their roles may include:

1. To work as a team member in the multidisciplinary team consisting doctors, nursing and paramedical

staff. To coordinate and help the patients, family and other team members. Maintain liaison with the

hospital team.

2. To make the patient and his family understand the medical problem or disability he is suffering from, in a

language the patient and his family can understand. To help the patient cope with the disability/illness and

make him adjust to it emotionally.

3. To assess the social condition of the patients and provide appropriate counseling.

4. To help the patient find ways and means to financially manage with the illness/disability. Making the

patient manage and tap resources for carrying out his treatment and support the family.

5. To help arrange financial support, for carrying out patients’ treatment where needed from Governmental and Non-governmental organizations. In addition suggest ways to the patient and his family to reduce

economic burden on the family.

6. To advice the patients/persons with disability on available disability benefits from the government and

help them to get those benefits.

7. To help the patient/persons with disability and his family sort out inter-personal problems as a result of

illness/disability. To help restore the role of such a person, such as a father, son, mother, daughter,

husband or wife etc. in the family.

8. To help the person with disability/illness to adjust to his environment, including issues of removal of

architectural barriers and encouraging independence in patients.

9. To assist with the doctor in the discharge planning, making protocols, and to involve patient and family

members in the social work.

10. To help the patient in smooth transition from hospital to the community and maintain the link with the

patient, the community and the health services. To do follow up with family so as to stabilize the gains



made during treatment. This may involve Case Work, one to one counselling method, Group Work and

Community Organization’. 11. To reach out to the people in their homes to convince them about the preventive measures and explain

nature of illness and treatment involved.

12. To create awareness among the people to stimulate people’s participation in health care programme. 13. To educate/interact with the community to help the community adjust with patients having disability

or illness. To make the community adaptive for the disabled to help them integrate the disabled with them.

14. To work in community based rehabilitation programme.

Serving as a Patient/Family Advocate in rehabilitation

One of the key roles that social workers serve in an inpatient rehabilitation setting is as a patient advocate.

The importance of helping the patient understand and adjust to hospital procedures, understand medical

plans, and assisting the patient’s family with financial planning is crucial. The social worker’s role as an advocate also includes maintaining open lines of communication between the patient, family, and other

members of the health care team. Social workers ease this pressure on all levels, whether it regards the

plan of treatment or financial needs. Studies have shown that the more informed the patient, the better

healthcare decisions he or she will make during their treatment and post-recovery. In turn, this results in

better long-term health outcomes while also saving money.

Conclusion :Today social worker are fundamental performers in health care system, they supports social

functioning of individuals, families and communities apply a holistic and rational approach instead of

considering one-dimensional approach to human. In this approach the other dimensions of human such as

social, cultural, environmental, physical, emotional, value and dignity of human beings is also scrutinize.

Accepting the clients and professional attitude are the prominent characteristics of social workers that

cause them to assess the clients in three situations: Needs assessment, the condition of the client, the

interaction between person and community. While other professions concentrate on certain aspects of a

person's life, medical social focus all dimensions which plays a vital role in health management.



ABSTRACTS



Prevalence of Neck and Low Back Pain and its Effects on Quality of Life (QOL) in

Tailors of Ahmedabad

Krishna R. Chaudhari*, Payal Gahlot**

*1st

year MPT community health and rehabilitation

**Lecturer, SBB College of Physiotherapy

Abstract: Background & Objective: Low back pain is ranked first as a cause of disability and inability to

work, and expected to affect up to 90% of the world’s population at some point in their lifetime. Physical

risk factors such as prolonged sitting and neck flexion have been reported as predictors of neck pain in a

mixed population of workers from various industry, health and professional settings. Many studies have

been done to see prevalence and risk factors of neck and low back pain in various population, but

considering difference in work conditions in Indian workers compared to others it is needed to see

prevalence, quality of life associated with work related neck and low back pain. The objective was to find

the prevalence of neck pain and low back pain, their associated risk factors and the quality of life in tailors

of Ahmedabad. Methods: The study was conducted on 80 tailors in Ahmedabad. Subjects with 20-50 years

age, both males and females, working as tailor for at least more than 1 year were included. Subjects with

spinal fractures, congenital conditions and anomalies, adhesive capsulitis of shoulder, tumours, pregnancy,

systemic illness, etc. were excluded. Neck pain disability index, Modified Oswestry low back pain index and

WHO-QOL brief questionnaires (in Gujarati) were filled. Results: There is 84% prevalence of neck and back

pain amongst tailors, with 6% having only neck disability, 13% back disability and 81% with both.

Interpretation & Conclusion: Prevalence rate is high for neck and back pain amongst tailors. [Chaudhari K

NJIRM 2019; 10 (6)]

Key words: prevalence, neck pain, low back pain, quality of life

Author for correspondence: Krishna R. Chaudhari. Postal Address:- B-41 Kalpana society, part - 2, Adajan

Road ,Surat-395008.Email ID:- [email protected] No:- 9408563524

mailto:[email protected]



Lower Limb Flexibility, Muscle Strength and its Association with Multidirectional

Reach Test in Elderly Subjects

Hunita Dhanju*, G Palani Kumar

**

*PG student, College of physiotherapy, Sumandeep Vidyapeeth Deemed to be University Vadodara, Gujarat,

**Professor College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

Abstract: Background & Objective: Ageing leads to many physiological changes in body. Lower limb

flexibility, muscle strength is required in reaching activities. Age related loss of flexibility and muscle

strength can lead to difficulty in reach in forward, backward and lateral directions causing balance

problems leading to risk of fall, So the aim of the study is to find association of lower limb flexibility, muscle

strength with multidirectional reach test. Methods: Lower limb flexibility was measured with chair sit and

reach test, lower limb muscle strength with five times sit to stand test and single limb stance test and reach

in forward, backward and right and left lateral directions with multidirectional reach test. Inclusion criteria

were healthy elderly age>60 years both gender able to ambulate with or without walking aids. Exclusion

criteria were MMSE score<24, any recent musculoskeletal surgery injury fall, neurological disorder affecting

voluntary control grading auditory visual and vestibular impairments, unable to lift dominant arm

outstretched at 90°. Results: 240 elderly subjects 164 males 76 females were enrolled with mean age of

64.05±4.505, majority subjects (83.8%) were in 60-69 age groups. Interpretation & Conclusion: The study

concluded that Lower limb flexibility shows statistically significant reduction in forward reach, reduction in

muscle strength when tested both legs together shows in all directions. However, when tested unilaterally

with ipsilateral leg is significantly associated only with forward and backward reach. [Dhanju H NJIRM 2019;

10 (6)]

Key Words: Elderly, Flexibility, Muscle strength, balance, senior citizens, risk of falls, Multidirectional reach

test

Author for correspondence: Hunita Dhanju, College of physiotherapy, Sumandeep Vidyapeeth Deemed to

be University Vadodara, Gujarat. Email: [email protected].



Comparison of Efficacy of High Voltage Pulsed Current and Zinc Iontophoresis in

Healing of Pressure Ulcers in Patients with Spinal Cord Injury Vandana Patel*,Monalisa Pattnaik**, Pattitpaban Mohanty***,

*Assistant Professor, Government Physiotherapy College,Raipur(C.G),

**Assistant Professor, S.V.NIRTAR,Cuttack(Orissa)

***Associate Professor, , S.V.NIRTAR,Cuttack(Orissa)

Abstract: Background & objective: Pressure ulcer causes significant impairment to the patient in terms of

bed mobility and delayed rehabilitation, therefore a proper treatment is needed to gain speedy healing of

pressure ulcers. The purpose of this study was to investigate the relative efficacy of high voltage pulsed

current (HVPC) and zinc Iontophoresis in the healing of pressure ulcers. Methods: Thirty patients with grade

II and III pressure ulcers participated in the study. Subjects were randomly assigned to either HVPC group

(n=10),Zinc Iontophoresis group(n=10) and control group(n=10).Treatment were given for 60 minutes in

HVPC group and for 15 minutes in Zinc Iontophoresis group for five consecutive days/week for four weeks.

Control group received only daily wound dressing. Outcome measures were percentage healing of area of

pressure ulcers which was recorded three times, initially before treatment, on second week and at the end

of fourth week. Results: Data were analyzed using a 3x2 ANOVA, Both the treatment groups showed

greater healing after 2nd

weeks and 4th

weeks of treatment than the control group. However, the rate of

healing in Iontophoresis group (71.93%) at 2nd

and (83.10%) at 4th

week was greater than HVPC group

showing healing rate (43.42%) at 2nd

week and (71.99%) at 4th

week respectively. Interpretation and

Conclusion: It was found in this study that both HVPC and Iontophoresis have been found effective in the

healing of pressure ulcers. It is concluded that both these modalities can be used in pressure ulcers

treatment, however, as healing effect of Iontophoresis was found to be better than HVPC, Iontophoresis for

pressure ulcer healing should be selected over HVPC where both the modalities are indicated. [Patel V

NJIRM 2019; 10 (6)]

Key Words: Pressure Ulcers, HVPC, Iontophoresis, Healing

Author for correspondence: Dr. Vandana Patel. Address: L-11, Sai Villas, Bhatagaon, Ring Road no.1,

Raipur(C.G).Email-Id: [email protected] No: +919302202121.




A Systemic Review to Find Out Most Reliable Management to Treat Rheumatoid

Arthritis (RA) Patients and See Effects of Same on Pain, Aerobic Capacity, Strength,

Psychological Health and Functional Capacity. Heta Kotak *, Prem Jiteshkumar**

*1st

MPT student, Ahemdabad Physiotherapy College, Bopal, Guma, Ahmedabad,

**Assistant Professor, Ahemdabad Physiotherapy College, Bopal, Guma, Ahmedabad

Abstract: Background & objective: Rheumatoid arthritis is an autoimmune chronic and inflammatory

disease causes pain, joint destruction and disability. Different treatment can be given are aerobics exercise,

resistance exercise, aquatics exercise, yoga, stretching and strengthening, tai chi, siwan therapy, orthoses,

galvanic current, TENs and thermotherapy. Method: Articles were searched from Google Scholar and Pub

Med since 2015 to since now (2019). Total 25 articles were taken in this review to find best management

for RA patients. After collecting all articles they were categorized according to management given in each

researches and all the positive or negative findings for each treatment were evaluated. Result: In 85.72 %

cases of aerobics exercises alone are beneficial to improve physical fitness in terms of aerobic capacity,

endurance, psychological health and reduces pain and fatigue. In 100% cases aerobics and resisted

exercises improves physical fitness and strength. Management showed good improvement in different

factors but the number of evidence were very less. Interpretation and Conclusion: By this review we can

conclude that most of the aerobic exercise with resistance exercises protocols have shown maximum

positive effects on different factors in patients with RA. [Kotak H NJIRM 2019; 10 (6)]

Key Words: RA, aerobics, resistance, aquatics exercise, yoga, stretching and strengthening, tai chi, siwan

therapy, orthoses, galvanic current, TENs and thermotherapy.

Author for correspondence: Dr Heta Bipinbhai Kotak.Email I'd: [email protected] address: 83,

shyam villa-2, gala gymkhana read, South bopal, bopal, Ahmedabad.




A Study to Find Out Relation Between the House Brackmann Facial Nerve Grading

Global Score with Electrophysiological Parameters (Latency and Amplitude of

Compound Motor Action Potential) of Facial Nerve in Patients with Bell’s Palsy – A

Co-Relational Study

Krina Ved* *Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth, Piparia, Vadodara, Gujarat

Abstract: Background & objective: Bell’s palsy is the most common frequent acute cranial mono-

neuropathy, with rapid/sudden onset of unilateral weakness or paralysis of face for which no cause can be

found. Bell’s palsy causes distressing disfigurement and inability to communicate by Facial expression and

articulation. Measurement of Facial nerve damage can be done by use of clinical assessment by House

Brackmann Facial Nerve Grading Global System (HBFNGS) and electrodiagnostic investigations by Latency

and Amplitude of Facial nerve CMAP. The aim of present study is to correlate the HBFNGS with Latency and

Amplitude for Facial Nerve CMAP in patients with Bell’s palsy. Methods – It was an observational study of

34 patients with Bell’s palsy of age group 20- 55 years. After the approval for study from ethical committee,

34 patients with Bell’s palsy who were diagnosed as having Facial nerve involvement and were selected for study that fulfilled the inclusion criteria and written consent was taken who were willing to participate in

study. Results - Statistical analysis was done using SPSS 20 for windows. The correlation between HBFNGS

with Latency of Facial nerve CMAP and HBFNGS with Amplitude of Facial nerve CMAP was evaluated using

Spearman’s correlation coefficient test. It was suggestive of statistically significant, results were moderately

negative correlation (r=-0.285) (p>0.05) between HBFNGS and Amplitude of Facial nerve CMAP in patients

with Bell’s palsy and low negative correlation (r=-0.199) (p>0.05) between HBFNGS and Latency of Facial

nerve CMAP in patients with Bell’s palsy. Interpretation and Conclusion – HBFNGS with Latency and

Amplitude of Facial nerve CMAP can be reliably use in assessment of Facial nerve dysfunction in patients

with Bell’s palsy. Also provide good electrophysiological evidence to assess Facial nerve dysfunction in

patients with Bell’s palsy. [Ved K NJIRM 2019; 10 (6)]

Key Words – Bell’s palsy, HBFNGS, Electrodiagnosis

Author for correspondence: Krina Ved, Assistant Professor, College of Physiotherapy, Sumandeep

Vidyapeeth, Piparia, Vadodara, Gujarat Email ID: [email protected]



Correlation of Pain and Kinesiophobia in Tailors with Neck Pain

Aastha Bodade*, Gira Thakkar**, *1

st year MPT, JG College of Physiotherapy,

**Senior Lecturer, JG College of Physiotherapy

Abstract: Background & objective: As the tailoring profession needs highly monotonous repetitive work in

sitting position with bent neck & upper part of neck curved on sewing machine for longer duration.

Avoidance of pain because of fear & the avoidance of painful activities lead to physical & psychological

consequences. The fear avoidance model proposes that elevated fear avoidance beliefs result in altered

movement patterns & reduced physical activity which in turn contribute to muscle guarding & persistent of

pain & disability. Methods: 40 tailors with neck pain between 20-55 years of age were included induced in

tailoring for minimum 4-6hrs daily. Subjects with neurological, psychological, orthopaedic and cardiac

disorders as well as having limb length discrepancy were excluded. Kinesiophobia was examined by using

TAMPA scale. Pain was examined by numerical pain rating scale. The analysis was done using spearman

correlation test. Results: The r value was 0.483 showing moderate positive correlation and the p value was

0.002 stating the result to be significant. Interpretation and Conclusion: The study concludes that there is

moderate positive correlation between pain and kinesiophobia in tailors with neck pain. [Bodade A NJIRM

2019; 10 (6)]

Key Words: Neck pain, tailors, kinesiophobia.

Author for correspondence: Aastha Vikashkumar Bodade, Plot no;1060, Sector:2/D, Gandhinagar.382007.

Email: [email protected]



Measurement of Lumbar Lordosis Angle Using Fl exible Ruler in College

Going Students With or Without Non-Specific Low Back Pain

Nidhi Patel*, Kalpesh Satani**, *PG student, College of Physiotherapy, Sumandeep Vidyapeeth,

**Associate Professor, College of Physiotherapy, Sumandeep Vidyapeeth

Abstract: Background & objective: In college students low back pain is very common because

of heavy weight bags, styles of carrying bags, type of the bags and continuously sitt ing

and standing for a long t ime. These can lead to change in lumbar lordosis and can low

back pain. The object ive was to measure the angle of lumbar lordosis in college going

students with the use of f lexible ruler and correlate with back pain. Methods: 304

students were partic ipated in this study among them 154 were males and 150 female.

The examiner evaluated the angle of lumbar lordosis three t imes by using f lexible ruler

and average of these angles was recorded. SPSS 16 was used for data analysis . Results:

Mean angle of lumbar lordosis in males with and without back pain was 29.34 and 25.6 4

respectively whereas in females it was 35.82 and 33.08 respectively. There was a

signif icant di fference in angles of lumbar lordosis between males with and without back

pain (p=0.001). There was no signif icant dif ference in angle of lumbar lordosis betwe en

females with and without back pain (p=0.087). Interpretat ion and Conclusion : Mean

angle of lumbar lordosis was more in subjects with non -specif ic low back pain in both

genders. But there is no association between angle of lumbar lordosis and non -specif ic

low back pain in female whereas there is a signif icant associat ion between angle of

lumbar lordosis and non-specif ic low back pain in males. [Patel N NJIRM 2019; 10 (6)]

Key Words: Lumbar lordosis , f lex ible ruler, Non -specif ic low back pain, College

students.

Author for correspondence: Nidhi Patel, A/Ashutosh nagr i, jahangirpura, olpad road, surat -

395005; Email: [email protected]




Cardiopulmonary Resuscitation Knowledge/Awareness among Final Year B.

Physiotherapy Students: A Questionnaire Based Study

Himadri Tripathi*, Harita Vyas**, *First year MPT, SBB College of Physiotherapy


Abstract: Background & objective: Sudden cardiac arrest (SCA) is a medical emergency. Early and effective

CPR increases both survival rate and post-arrest quality of life. Quality CPR consists of providing an

appropriate frequency and depth of compressions, minimised interruptions and non-exceeded appropriate

volume of ventilations. Students of medical and para medical courses should be thorough with the

knowledge of CPR. This study is aimed to determine the current level of knowledge /awareness of

Cardiopulmonary Resuscitation (CPR) among Final Year B. Physiotherapy students. Methods: This cross-

sectional study involved final year B. Physiotherapy students from different colleges of Ahmedabad. A

questionnaire that sought information on knowledge of CPR was used as the survey instrument. Data was

analysed using descriptive and inferential statistics. Results: Total data of 200 students will be collected. At

present, data of 82 students was collected. A Questionnaire containing 14 Questions was given to the

students and were ask to tick the most appropriate answer. The average score is 47.50% (N=82). While only

26.8% of them were completely aware about the universal compression ventilation ratio, 67.1% were

aware of the compression depth in adults whereas only 23.17% were aware of the compression depth in

infants. Interpretation and Conclusion: This questionnaire survey demonstrated that CPR skills in

physiotherapy students were insufficient, which could be improved by well-designed certified training

programs. At least, certified programs training basic skills of CPR should be a mandatory component in the

all health-associated fields like medical, paramedical, and nursing colleges and faculties. From this study,

we suggest that all members of our community and especially health care professionals should join CPR

training programs. [Tripathi H NJIRM 2019; 10 (6)] Key Words: Cardiopulmonary resuscitation, final year B physiotherapy students

Author for correspondence: Himadri Tripathi. Postal address : 25, Hariharanand tenement, Opp. Rajwadu

hotel, Jivrajpark, Ahmedabad-380051.Email ID : [email protected] no: 8733882535,

9712390773




Relationship between Transversus Abdominis Strength and Lumbar Lordosis in

Young Adults: A Pilot Study

Deepali Patil*, Niketa Patel**, *PG Student, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat,

**Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat

Abstract: Background & objective:Recently the researchers are emphasizing on function of Transversus

Abdominis (TrA) which is a deepest abdominal muscles because there is evidence that TrA is recruited

independently of other abdominal muscles in many different tasks including upper and lower limb movements and

ambulation.Anteriorly, as TrA muscle fibers crosses the midline, can be considered as digastric. When both sides of

the TrA contracts, the circumference of trunk reduces as well as it flattens the abdominal wall in the lumbar region

leading to increase of intra-abdominal pressure, tensions in the thoracolumbar and anti fascias resulting in spinal

stability. So, there is significant evidence that TrA muscle plays a crucial role in spinal control. However, the

relationship between TrA strength and lumbar lordosis in young adults has been insufficiently studied; we

aim to assess the relationship between TrA strength and lumbar lordosis in young adults. Methods: Total 10

healthy subjects (5 M, 5 F; 18-23 yrs) who were willing to participate and eligible as per the inclusion

criteria were recruited for the study. Lumbar lordosis and TrA strength were measured with Flexicurve and

Pressure Biofeedback unit respectively. The lumbar lordosis curve was plotted on the plain white paper

using flexicurve and Theta (degree) was calculated. The data were tabulated in excel sheet and analysed.

Results: Mean age was 20.1 yrs. Mean scores of lumbar lordosis curve was 29° in males and 38.4° in

females which were in the normal limits. The mean of TrA strength was 56.2 mmHg in males and 61.4

mmHg in Females showed good correlation with the lumbar curve angles. 01 subject showed decrease in

both lumbar lordosis and TrA strength. Interpretation and Conclusion: The pilot study showed that there

was a significant correlation between TrA muscle strength and lumbar lordosis. But to generalise this result

it requires bigger sample size. [Patil D NJIRM 2019; 10 (6)]

Key Words-Lumbar Lordosis, Flexicurve, TrA, Pressure Biofeedback Unit

Author for correspondence: Deepali Patil, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to

be University, Vadodara, Gujarat.Email ID : [email protected]



Analysis of Disability in Community Dwelling Ischemic Heart Disease Individuals

Using WHODAS 2.0- A Cross Sectional Survey Varoon Jaiswal*, Ankita Talreja**, Snehal Ghodey***,

*Professor, Cardiorespiratory Physiotherapy Dept. (Ph.D. Scholar SVDU), MAEER’s Physiotherapy College, Talegaon (D), Pune

**Assistant Professor, Community Physiotherapy dept., MAEER’s Physiotherapy College, Talegaon (D), Pune

*** Principal & Professor, MAEER’s Physiotherapy College, Talegaon (D), Pune

Abstract: Background & objective: Alarming increase in death and disability due to Ischemic heart disease is

well documented in the literature. Although disability is documented but it is not well analyzed using a

specific instrument, literature is still deficient in this context. Analyzing the disability will also help in guiding

the rehabilitation programs and to understand the barriers faced by the individuals in the community with

ischemic heart disease. The objective was to analyze disability in patients with stable ischemic heart disease

(IHD) using WHODAS 2.0 Methods: Community dwelling Adult individuals with IHD was consecutively

enrolled. Disability Assessment Schedule II (WHODAS 2.0) was administered in individual sessions by

interview method. Patients’ clinical status was described following NYAH criteria (New York Heart Association). Descriptive analysis was performed to report WHODAS 2.0scores. Results: 50 patients (mean

age 62.9; 91% males, 71% in NYHA class II) were enrolled. Mean WHODAS 2.0 Score was 23.9, and the most

severe limitations are reported in life activities, getting around and in participation to social situations.

Interpretation and Conclusion: Analysis of disability in community dwelling individuals with IHD enables to

enlarge the perspective on their health status, and provide useful information to follow the healthcare

process from the acute setting to the outpatient management. [Jaiswal V NJIRM 2019; 10 (6)]

Key Words: Ischemic heart disease, disability, WHODAS 2.0, NYHA

Author for correspondence: Dr. Varoon C Jaiswal, Professor, Cardiorespiratory Physiotherapy Dept. (Ph.D.

Scholar SVDU), MAEER’s Physiotherapy College, Talegaon (D), Pune. Email ID: [email protected] .Contact Number: 8999926162



Assessment of Functional End Ranges of Lower Limb Joints in Positions Commonly

Used for ADL’s in India: A Pilot Study

Lavina Khatri*, Niketa Patel**, *PG Student, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat,

**Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat

Abstract: Background & objective: Culture has a significant impact on how ADL’S are performed. In Asia floor-sitting, such as cross-legged sitting and squatting are the positions more commonly used. The rural

and urban population also have cultural differences, where the urban population does not uses squatting

and cross-leg sitting as part of their ADL’S compared to rural population. In elderly, squatting and cross-leg

sitting are generally more restricted as, joint motion is known to vary with age because of the numerous

changes occurring during the aging process. Compensatory movements or positions must also be

considered as they may be used to help an individual to achieve a specific position. Measuring ROM during

ADL’S is a difficult task. This explains why few studies have been done that quantitatively investigated

ADL’S. So, the aim of our study was to find the association between the functional end ranges of lower limb joints and position used in ADL’S (Squatting, Cross-leg sitting position). Methods: Total 10 healthy subjects

(5M, 5F; 30-50yrs) from rural population who were willing to participate and eligible as per the inclusion

criteria were recruited for the study. All the subjects were examined and their LL end ranges of hip, knee

and ankle were measured using universal goniometer. Squatting and cross-leg sitting were analyzed with

the help of grades and pictures were taken. The data was tabulated in excel sheet and analyzed. Results:

Mean age was 40.8 yrs. L.L. ranges showed normal limits. All subjects were able to squat and sit in cross leg

positions without any complaints or compensatory movements. Interpretation and Conclusion: All the

subjects in this pilot study performed squatting and cross-leg sitting multiple times in a day as part of their

ADL’s and showed independent and symptomless squatting and cross-leg sitting. To generalize this result it

requires bigger sample size. [Khatri L NJIRM 2019; 10 (6)]

Key words: Indian; hip; knee; ankle; range of motion; activities of daily living; squatting; cross-legged

sitting posture.

Author for correspondence: Lavina Khatri, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to

be University, Vadodara, Gujarat. Email ID: [email protected]



Normative Data of Hand Grip Strength in Various Age Groups of Adult

Pinal Modi*, Lata Parmar** *Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat

**Principal, College of Physiotherapy, Sumandeep Vidyapeeth, Deemed to be University, Vadodara, Gujarat

Abstract: Background & objective: Many daily activities involve interaction with objects that are grasped in

the hand. The manipulative ability of the human hand requires effective force and dexterity. Analysis of grip strength is an important index of hand rehabilitation programmes as because it assesses the patient’s initial limitation and can be compared with normal. The aim of this study was to establish normative data

of hand grip strength and find relationship within Age groups, Gender, Dominance and BMI. Methods:

Cross sectional and descriptive study where 308 normal healthy individuals between 18-50 years of age

were recruited from college, hospital and community. The Mean age of men and women was 34.80 &

34.65 respectively. Jamar hand held dynamometer was used to assess for hand grip strength on both the

hands while subjects were in sitting position. Results: The results were analyzed by using SPSS 14.0. And

the average hand grip strength of both hands in age groups was 25.97 kg for the age of 18-30, 28.35 kg for

the age of 31-40 and 25.03 kg for the age of 41-50. There was statistically significant difference found in

right (0.035) and left (0.004) hand between the groups. The average hand grip strength in genders was 32.42 kg (male) and 20.47 kg (female) which was statistically significant (p 0.000). And lastly, the mean

hand grip strength for both sides of right dominant and left dominant were 26.78 kg (right), 26.09 kg (left)

and 25.62 kg (right), 27.29 kg (left) respectively. Interpretation and Conclusion: Hand grip strength has

curvilinear relationship between the age groups and is higher at 31 – 40 years of age; males have greater

hand grip strength in all ages. Dominant side showed increase in strength irrespective of age and gender

however Left dominant side was higher than right side in present study. [Modi P NJIRM 2019; 10 (6)] Key Words: Hand grip strength, Age groups, Gender, Dominance.

Author for correspondence: Pinal Modi. Assistant Professor, College of Physiotherapy, Sumandeep

Vidyapeeth. Email ID : [email protected]



To Establish Norms of ‘Unipedal Stance Test’ with Eyes Open in Healthy Adults

Anishma Chungath*, Lata Parmar**, *Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth, , Deemed to be University, Vadodara, Gujarat

**Principal, College of Physiotherapy, Sumandeep Vidyapeeth, , Deemed to be University, Vadodara, Gujarat

Abstract: Background & objective:There is notable decrease in ability to balance oneself as age advances.

Unipedal Stance Test is one of the clinical measures to assess balance in static conditions. Due to lack of

limited data available for norms of UPST, there arises need to establish normative values for UPST with

eyes open in healthy adult population. The aim of the study was to observe changes in UPST values in

adults with eyes open as age advances and establish normative values for the same. Methods: 457 self-

declared healthy adults, aged 18-80 years were recruited in the study after screening through the inclusion

criteria. Each participant was checked for leg dominance before the test. The UPST was performed three

times on each limb barefoot with eyes open with a cut off of 45 seconds. The time was recorded using a

stopwatch. Results: Mean age of participants was 43.34(±16.02).The mean range of the UPST values was

29.10 sec (±4.77) to 43.32 sec (±2.30). There was an inverse correlation between age and UPST values (r=-

0.925, p=<0.001). There was no significant difference in UPST values of dominant/non dominant limbs

(p=0.330 for rt. side and p=0.099 for lt. side). Also there was no significant difference between genders.

Interpretation and Conclusion: The current study confirms that as age progresses the values of UPST

decreases. Also normative reference values for the UPST with eyes open were established in adult

population. There was no significant correlation found between genders or dominant/non dominant limbs.

[Chungath A NJIRM 2019; 10 (6)]

Key Words: Unipedal stance test, UPST in adults, balance tests, equilibrium tests

Author for correspondence: Dr.Anishma Chungath, College of Physiotherapy, Sumandeep Vidyapeeth.

Email: [email protected]



Quality of Life Assessment in Night Shift Watchmen – An Observational Study

Bansari Patel*, Sadhna Mukhi**, *1

st year MPT, JG College of Physiotherapy,

**Lecturer, JG College of Physiotherapy

Abstract: Background & objective: Economical and social conditions may require to work not only at

daytime but also at shift-work containing night hours . Night shift watchmen are prone to several

physical and mental problems due to disruption of the sleep-wake cycle . Multiple dimension of

quality of life including physical functioning , bodily pain , general health perceptions , mental health ,

vitality , physical role functioning , emotional role functioning and social role functioning . So this

exploratory study is aimed to assess quality of life in night shift watchmen. Methods: 60 night shift

watchmen were included working at 12 hour (two-shift system) cycles . Double shift working were

excluded. Quality of life was assessed using one of the most reliable questionnaire i.e. SF 36 in night

shift watchmen. Results: Results shows that the average mean score of Quality of life of night shift

watchmen is 51.7254, while most night shift watchmen have Quality of life score (mode) of 33.875

with median of 51.65. Interpretation & Conclusion: This study concludes that Quality of life score of

night shift watchmen remain mostly on lower side. Component analysis shows that emotional

problem domain is severely affected ( avg. Mean=41.27) followed by physical health domain (avg.

Mean=45.63). [Patel B NJIRM 2019; 10 (6)] Key Words: Quality of life, night shift watchmen , Short form-36

Author for correspondence: Bansari Patel, B- 204, Green city, Opp. Science city, Sola, Ahmedabad-

380060. Email: [email protected]



Physical Activity of Community Dwelling Elderly Population - A Survey

Samira S. Patel*, Nalina Gupta

**, Lata Parmar***

*PG student, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat;

** Associate professor, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

***Principal, College of Physiotherapy, , Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

Abstract: Background & Objective: Ageing is an integral natural part of life. With ageing almost every organ

or system undergoes a change which limits capacity of body to perform functions. Physical activity is

important for health ageing. Compared to all age groups throughout the world, older adults have the

lowest rate of participation in recommended Physical Activity.The aim of the study is to find out the

physical activity of community dwelling elderly population and their perception of physical activity in

healthy ageing.Methods: Door-to-door survey was conducted and participants were included in the study

based on our inclusion criteria (Age≥60years, MMSE-≥24). Participants from the study were taken from Bahadarpur and Waghodia Community near Vadodara City.Data was collected using various questionnaires

like GPAQ, GDS-5 item, SF-12 and self-drafted questionnaire on perception & barriers of physical activity.

Results: In total, 347 older adults (age≥60years, mean age- 67.43 years, 159 males and 188 females)

participated in the study. Out of 347, 125 participants (36%)were physically active,155 participants

(44%)reported barriers,72 participants(21%) had depression,298 participants (86%) had positive perception

,190 participants (55%) had good physical health and 231 participants (67%) had good mental health. There

was a significant associations found among GPAQ, GDS,SF-12 and perceptions and barriers to physical

activity. Interpretation & Conclusion: In the present study only 36% of the participants were physically

active based on WHO recommendation contrary to 86% of the total participants had positive perception

about physical activity in ageing. Females were more physically inactive than males. Physically inactive

group was more sedentary, depressed, had poor mental health, poor physical health and barriers to

physical activity. [Patel S NJIRM 2019; 10 (6)]

Key Words: Elderly, Physical activity, WHO recommendation, Perception, Barriers, Depression, Quality of

life

Author for correspondence: Samira S. Patel. College of Physiotherapy, Sumandeep Vidyapeeth Deemed-

to-be-University, Vadodara, Gujarat. Email: [email protected].



Effect of mirror feedback on multidirectional reach- A Pilot Study Shruti Talnikar*, G Palani Kumar

**

*PG student, College of physiotherapy, Sumandeep Vidyapeeth Deemed to be University Vadodara, Gujarat,

**Professor College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

Abstract: Background & Objective: Multidirectional reach test is an inexpensive, valid and reliable screening

tool for measuring limits of stability and identifying the risk of fall in elderly. While performing the

Multidirectional reach, no visual feedback is available. Methods: After obtaining approval from Sumandeep

Vidyapeeth Institutional Ethical Committee, 5 normal healthy adults of both genders were recruited. Two

stations were used for study purpose, one for conducting the regular multidirectional reach (Station 1) and

other for multidirectional reach with mirror feedback (Station 2). The subjects were asked to perform any

one test in any one station first and then proceed to the other station. The order was randomly generated

in excel sheet. After completion of first method they were provided 5 minutes of rest and were asked to

perform the second method. Reach distance was calculated by subtracting initial and final reading in

centimeters. Three trials were recorded for each direction and average was calculated. For multidirectional

reach with mirror feedback, a 4ft by 4ft mirror was mounted in front of the subject at a 6ft distance and

same procedure as above was repeated. The data from both methods were compared and analyzed.

Results: Compared to multidirectional reach without mirror feedback, there was improvement in

performing multidirectional reach with mirror feedback, particularly in the right and left lateral reach and

forward reaches in the respective order. Little improvement was seen in the backward reach.

Interpretation & Conclusion: The results of this study shows that use of mirror feedback in multidirectional

reach test improves the reach distance particularly in right lateral reach, left lateral reach and forward

reach. [Talnikar S NJIRM 2019; 10 (6)]

Key Words: Multidirectional reach test; limits of stability; visual feedback

Author for correspondence: Shruti Talnikar. PG student, College of physiotherapy, Sumandeep Vidyapeeth

Deemed to be University Vadodara, Gujarat. Email ID : [email protected]



Translation and Cultural Adaptation of SIO Obesity-Related Disability Test (TSD-OC)

for Gujarati Population Chaitali Bhatt*, Megha Sheth**,

*First year MPT, SBB College of Physiotherapy, Ahmedabad

**Lecturer, SBB College of Physiotherapy, Ahmedabad

Abstract: Background & objective: Obesity is a health condition that, through a complex interaction of

biopsychosocial and environmental factors, is associated with mobility disability. SIO Obesity-Related

Disability Test (TSD-OC) is a valid instrument for measuring self-reported disability in subjects with obesity.

The Questionnaire consists of 36 items distributed in 7 dimensions (pain, stiffness, functionality and

autonomy in daily activities, housework, outdoor, occupational activities, and social life). The aim of the

study was to translate & test the validity of the Gujarati version of the SIO Obesity-Related Disability Test.

Methods: The TSD-OC was translated into Gujarati from English after taking authors permission according

to the guidelines using forward-backward-forward method. An expert committee of 7 members including

physiotherapists and physiologists evaluated the Gujarati version. Changes suggested were made and a

final draft was prepared by mutual consensus. Twenty two subjects with obesity (Body Mass Index >=25

kg/m2) were enrolled. Each question was examined by the group of 22 subjects knowing both English and

Gujarati language and analysed for content, meaning, wording, format, ease of administration and scoring.

Spearman’s correlation coefficients were used to assess the strength of association between the measures

of both the versions. Results: Data of 22 subjects was analysed. Fifteen Female and Seven Male with mean

age 47.9±6.8 years were taken. In validation process of Gujarati version of TSD-OC, Mean total score for

Gujarati version was 57.45±51.75 and Mean Percentage was 15.96±14.38 and English version was

55.23±54.94 and Mean Percentage was 15.34±15.26. The total score was significantly and positively

correlated (ƥ=0.92) where p<0.001 between the TSD-OC Gujarati and original English version of TSD-OC.

Interpretation and Conclusion: Gujarati version of SIO Obesity-Related Disability test(TSD-OC) for

disabilities in obesity has a good validity to be used in Gujarati population. [Bhatt C NJIRM 2019; 10 (6)]

Key Words: Obesity, Disability, Validity, TSD-OC

Author for correspondence: Chaitali J. Bhatt. Postal Address:- 13, Bansidhar Appartment, Dalal Colony,

Ramannagar, Maninagar, Ahmedabad-08.Email-ID:- [email protected] no.:- 8866141997,

9558837833




Correlation of BMI to Tandem Stance and Unipedal Stance in School Children, Age

Group between 6 to 12 Years Dhwani Chanpura*, Lata Parmar**

*Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth.

**Professor & Principal,College of Physiotherapy, Sumandeep Vidyapeeth.

Abstract: Background & Objective: Balance is very important and is said to be an integral part of all

movements. Physical therapist have historically placed high priority on the treatment of patients with

postural control problems. With regards to unipedal and tandem stance in children 6-12 years school going

children. Methods: There were eight schools selected from Vadodara city. Total 10 students were selected

from each class randomly, the anthropometric measurements of the students were taken. Each participant

then completed timed unipedal balance test on both right & left foot, and tandem stance on child’s dominant leg. For two balance tests, each subjects completed 3 trials on each leg. A 60 seconds rest was

given between trails set to avoid fatigue. Results: In the present study, the total numbers of normal school

children taken up for analysis were 556 of that 282 were males & 274 were females.278 students were

from government and private school each. From that total right dominant 518 & left dominance 38

students. In the present study mean of total BMI was 15.4283 of normal school going children. The results

of present study shows the significant difference in mean of BMI between students from standard 2nd

- 8th

students (p value<0.01), also Mean BMI was significantly higher in private school as compare to

Government school (p value<0.05).Also there was no significant difference found between BMI and Gender

(Male& Female).Interpretation & Conclusion: There was significant difference in mean of Tandem stance

and Unipedal stance between students from standard 2nd

-8th

. Mean value of tandem stance for 2nd

– 5th

&

6th

-8th

standards was 118.445&282.280seconds.Mean value of Unipedal stance right side for 2nd

-5th

& 6th

-

8th

standard was 44.988 & 88.872.Mean value of Unipedal stance left side for 2nd

-5th

& 6th

-8th

standard was

43.837 & 85.515. [Chanpura D NJIRM 2019; 10 (6)]

Key Words: Balance, BMI, balance testing.

Author for correspondence: Dr.Dhwani Chanpura, Email: [email protected], Postal

Address: College of Physiotherapy, Sumandeep Vidyapeeth,At &Po.Piparia, Waghodia ,Dist. Vadodara,

Gujarat-391760.Contact Number:9974704464




Effect of Electrical Stimulation in Spasticity in Spinal Cord Lesion Patients

Pawan Kumar*, G Palani Kumar** *PG student, College of physiotherapy, Sumandeep Vidyapeeth Deemed to be University Vadodara, Gujarat,

**Professor College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat Abstract: Background & Objective: Spasticity is a common complication after spinal cord lesion. Various

treatments have been recommended to reduce spasticity. exercise techniques likedeep inhibitory pressure,

prolonged stretch, neural warmth, positioning, weight bearing and electrical stimulation to antagonist is

used for reducing spasticity. The study was done assess the changes in spasticity in spinal cord lesion

subjects with conventional physiotherapy. And electrical s1timulation along with conventional

physiotherapy and to compare the changes in spasticity. Methods: It is interventional and non- randomized

trial. After getting approval from SumandeepVidyapeeth Institutional Ethical Committee, total 4 adult

patients with spinal cord lesion with spasticity were included in this study. Subjects were divided in two

groups. Experimental group received both conventional physiotherapy and electrical stimulation to

dorsiflexors twice a day for 30 minute for minimum 10 days. Control group received conventional

physiotherapy and use modified ashowth scale, composite spasticity scale, ankle dorsiflexion range of

motion,changes in ankle reflex and both patellar and ankle clonus. The assessment was done on 1st

, 5th

and

10th

or day of discharge. Results: After 20 sessions of treatment, there was reduction in composite

spasticity score in both the experimental and control group. In experimental groupthere was more

reduction in muscle tone, ankle clonus and MAS score as compared to control group. Interpretation

&Conclusion: Addition of ES for antagonist muscle for plantarflexors to standardized physical therapy

provides more effective reduction of spasticity. [Kumar P NJIRM 2019; 10 (6)]

Key Words: spasticity .electrical stimulation

Author for correspondence: Pawan Kumar. PG student, College of physiotherapy, Sumandeep Vidyapeeth

Deemed to be University Vadodara, Gujarat. Email ID: [email protected]



Correlation of Fears and Beliefs about Knee Osteoarthritis with Balance in Patients

with Osteoarthritis of Knee

Priyal Bhatt*, Megha Sheth**, *First year MPT, Community Health and Rehabilitation, SBB College of Physiotherapy,


Abstract: Background & objective: Fears and beliefs about knee osteoarthritis in patients with knee

osteoarthritis are found to have an adverse impact on their function. Knee osteoarthritis (OA) damages the

proprioceptors within the joint cavity which in turn may lead to impairment of balance which is an integral

part of mobility. Fear of movement could be acquired over time through repeated painful stimulus. Various

psychosocial factors mainly related to a fear-avoidance model may have important implications in the

balance and stability of patients with osteoarthritis of knee. Fears and beliefs of patients concerning knee

osteoarthritis management have been less studied. The study aims to evaluate the correlation between

fear and beliefs about knee osteoarthritis and balance in patients with osteoarthritis of knee. Methods:

Forty-six males and females aged >40years having unilateral/bilateral osteoarthritis of knee were

evaluated. Fears and beliefs were assessed using the Knee Osteoarthritis Fears and Beliefs Questionnaire

(KOFBeQ), balance was tested using the Functional Reach Test (FRT) and pain was assessed by Visual

Analogue Scale (VAS). Level of significance was kept at 5%. Results: Data of 23 patients has been collected.

Eighteen females and 5 males with mean age 62.0 ± 10.8 years participated. Eight had unilateral and 15 had

bilateral knee OA. Mean pain score 5.7±1.6, Mean FRT score 9.7±2.4 inches, Mean KOFBeq score 36.0±12.8.

Correlation was found using Spearman coefficient r=-0.01, p=0.94 for balance and KOFBeq, r=-0.28, p=0.19

for pain and balance, r=-0.17, p=0.42 for pain and KOFBeq was seen. Interpretation and Conclusion:

Moderate pain was seen, with reduced functional balance and less affected fears and beliefs. Weak

correlation were found between pain and balance and pain and fears and beliefs and no correlation was

found between balance and fear and beliefs in the present study. [Bhatt P NJIRM 2019; 10 (6)]

Key Words: Knee OA, Functional Reach Test, KOFBeQ, pain

Author for correspondence: Priyal P. Bhatt. Postal Address: 51, Pankaj Society, Opp. Tushar Book Store,

Bhattha, Paldi, Ahmedabad -380007.Email id: [email protected] No : 9408705938 ,

7990328542




The Knowledge of Mothers Regarding Infants Developmental Milestones in Four

Domains Gross Motor, Fine Motor, Language, Personal & Social- A Pilot Study Pooja Thakur*, Nalina Gupta**, Lata Parmar***

*PG student, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat;

**Associate professor, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

***Principal, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

Abstract: Background & Objective: In India, Children with neuro-developmental disabilities are being

referred late leading to loss of opportunity for early intervention, the conditions with developmental

disability lack in services. Hence the purpose of this study is to assess the knowledge of mothers regarding

infants developmental milestones in four domains i.e. gross motor, fine motor, personal & social and

language. Methods: This study was a pilot study where data was collected using a self-drafted

questionnaire. This questionnaire consisted of demographic information and questions related to four

domains: gross motor milestones, fine motor milestones, language and personal-social. Face validity of the

questionnaire was also done. Then, it was administered on eight mothers with age range of 18-40 years.

Mothers’ responses were noted, and compared with the reference range to ascertain their knowledge. Results: Among eight mothers, almost all the mothers knew about the age the child holds his/her head but

milestone such as crawling was known to 25% of mothers. Only 12.5% and 37.5% of mothers had

knowledge of the age the baby babbles and gives responsive smile respectively. None of them had a

knowledge regarding the pincer grasp/fine motor. Interpretation & Conclusion: Mothers were aware more

of the gross motor milestones and personal-social as compared to that of language and fine motor. This

was a pilot study; hence the results cannot be generalized. [Thakur P NJIRM 2019; 10 (6)]

Key Words: Developmental milestones, infants, Mother’s knowledge, domains, cognitive development,

motor development.

Author for correspondence: Pooja Thakur.PG student, College of Physiotherapy, Sumandeep Vidyapeeth

Deemed to be University, Vadodara, Gujarat. Email ID: [email protected]



Prevalence of Medial and Lateral Epicondylitis and Its Effect on Upper Extremity

Function In Garage Workers of Ahmedabad Payal Bhardiwala*, Payal Gahlot**

*First year MPT, SBB College of Physiotherapy, Ahmedabad,


Abstract: Background & objective: To find prevalence of medial and lateral epicondylitis in garage workers

of Ahmedabad and to assess their upper extremity function. The work of garage worker is to repair cars and

automobile vehicles, which requires working for long duration in awkward posture that can cause

biomechanical stresses on various parts of body. There are plenty of studies done to assess prevalence of

musculoskeletal injuries in hand and wrist of garage workers but there is paucity of literature on prevalence

of epicondylitis and its effect on the upper extremity function in them. Methods: 100 male Garage workers

were selected according to inclusion criteria like age between 20-50 years, work experience of minimum 1

year and minimum working hours at least 5 hours per day. Subjects having recent trauma, surgery and

fracture over forearm < 6 months, any neurological, medical conditions like malignancy and psychological

conditions were excluded. Assessment was done by using Maudsley’s and Cozen’s test for lateral

epicondylitis and Golfer’s elbow test for medial epicondylitis. Upper extremity function was assessed using

upper extremity function index in workers having epicondylitis. Results: The tests was positive in 36% of

total population. Out of 36 subjects, 67% had lateral epicondylitis and 33% had medial epicondylitis. 47% of

garage workers showed mild affection, 53% showed moderate and 0% had severe affection in their upper

extremity function. Interpretation and Conclusion: This study concludes that there is 36% prevalence of

epicondylitis in garage workers with mild to moderate affection in their upper extremity function.

[Bhardiwala P NJIRM 2019; 10 (6)]

Key Words: Garage workers, Epicondylitis, Maudsley’s test, upper extremity function index

Author for correspondence: Payal U. Bhardiwala. Postal Address: 401, Celebrity Aura, near hotel oasis,

stadium cross road, Navrangpura, Ahmedabad. Email-ID: [email protected] No:

7283829327, 6353552440




Lower Limbs Flexibility, Muscle Strength and Power and their Association with

Agility in Non Specific Recreational Sport Players Mayuri Saxena*, G Palani Kumar**

*PG student, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

** Professor, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat

Abstract: Background & Objective: Sports is one of the most common recreational activities among

majority of the people in the world. Factors like flexibility, muscle strength, power and agility are required

in any form of sports whether it is professional, amateur or recreational. Agility is one of the important

physical components necessary for successful performance in recreational sports with benefits of

decreased risk of injury or reinjures. A reduction in lower limb muscle flexibility, strength and power can

affect agility which can affect participation and could lead to injury. This study aims to find association

between lower limbs flexibility, muscle strength and power with agility in non specific recreational sport

players. Methods: Lower limb flexibility was measured by V sit and reach test, muscle strength by single leg

squat test, power by vertical jump test and agility by T-test. Inclusion criteria was recreational sport players

between 18-39 age group of both genders .Exclusion criteria was amateur and professional sport players,

history of musculoskeletal injuries in past 6 months, any cardio respiratory or neurological problem that

may affect the performance in tests, metabolic disorders and uncooperative subjects .Results: The data of

292 recreational sport players aged 18-32 years was collected. Interpretation & Conclusion: The study

concluded that there was significant correlation of lower limb flexibility and power with agility in non

specific recreational sport players. [Saxena M NJIRM 2019; 10 (6)]

Key Words: Non specific recreational sport players, agility, flexibility.

Author for correspondence: Mayuri Saxena. College of Physiotherapy, Sumandeep Vidyapeeth Deemed to

be University, Vadodara, Gujarat. Email: [email protected].



Reference Values for Trunk Mobility in Normal Adults Purvi Patel*, Lata Parmar**

*Assistant Professor, College of Physiotherapy, Sumandeep Vidyapeeth

**Professor & Principal, College of Physiotherapy, Sumandeep Vidyapeeth

Abstract: Background & Objective: Assessment of back function is limited due to lack of reference values

and depending on the existing principle standard. For proper diagnosis of spinal impairments and in the

monitoring of effect of treatment and patients’ recovery, normative values of spine range of motion (ROM) are essential. The objective of present study was to establish reference values for trunk mobility in normal

adults.Methods: In this cross sectional study, 137 self-reported healthy subjects were assessed using Tape

method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse).Results: The mean

values by tape method and goniometry for flexion with stabilization were 6.95±0.64 cm and 74.68±5.670,

(for flexion without stabilization 9.59±0.73 cm and 99.33±5.530,) for extension 4.71±0.51 cm and

26.03±3.290, for Rt. Lateral flexion 17.28±2.59 cm and 32.95±3.38

0, for Lt. lateral flexion 17.06±2.54 cm and

32.60±3.440, for Rt. Rotation 5.49±0.55 cm and 41.93±3.35

0, for Lt. rotation 5.38±0.55 cm and 41.65±3.39

0

respectively. The study showed that the difference for all spinal movements between genders was not

statistically significant except in lateral flexion (p value 0.009 & 0.008) and rotation (p value 0.023 & 0.004)

where females are more mobile than males. The difference between goniometry and tape method was

statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Interpretation &

Conclusion: This study has established reference values for trunk mobility in normal adults. Females found

to have greater mobility for lateral flexion and rotation than males. Goniometry was not as good as tape

method for all movements except forward flexion where both can be equally used. [Patel P NJIRM 2019; 10

(6)]

Key words: Trunk mobility, spine range of motion, tape method, goniometry

Author for correspondence: Dr. Purvi Patel. Email: [email protected] Postal

address: College of Physiotherapy, Sumandeep Vidyapeeth, At & Po. Piparia, Taluka Waghodia, Dist.

Vadodara, Gujarat- 391760. Contact number: 9638394494



Patient’s Adherence to Physiotherapist Prescribed Self-Management Strategies: A

Physical Therapist’s Perspective

Heta Baxi*, Megha Sheth**, *1

st year MPT, Community Health and Rehabilitation, SBB College of Physiotherapy, Ahmedabad


Abstract: Background & objective: Self-management is “the ability to manage the symptoms, treatment, physical and psychosocial consequences, and lifestyle changes inherent in living with a chronic condition.” Adherence is the extent to which a person's behaviour corresponds with agreed recommendations from a

healthcare provider. Few studies have been done in India about the factors which can influence a patient’s adherence and a physiotherapist’s view on the subject. Methods: This cross-sectional study was conducted

via a self-made questionnaire. Fifty final BPT and 1st

year post graduate students participated in this survey.

The questionnaire consisted of 20 items. The participants were asked to fill the questionnaire by choosing

the most appropriate answer from the options given. Descriptive analysis was done using Google Forms.

Results: 62% strongly agreed that self-management is important.68% believed that patients will adhere

partially to self-management strategies. Good self-management strategies should have clarity of

instructions (66%), proper therapist support and communication (56%) and should be easy to follow (50%).

86 % believed that proper communication skills, strategy prescription, knowledge, monitoring and follow

up by the therapist will help the patient adhere to the strategies. Willingness to exercise (48%), Positive

belief in exercise (44%) and Age (56%) were thought to influence patient adherence. Stigma associated with

disability (52%), poor inter-professional relation (86%), are barriers. Properly educating the patient about

his condition (96%), involving the family members (92%) were believed to be facilitators.90% believed that

patient’s adherence to physiotherapist prescribed self-management strategies is essential for clinical

practice. Only 46% therapists agreed that too much of a passive approach should not be used. Only 54%

strongly disagreed that they don’t have time to assess patient adherence. Interpretation and Conclusion:

Physiotherapists agree that self-management by patients is important. There is a need to use different

approaches to increase patient adherence. [Baxi H NJIRM 2019; 10 (6)]

Key Words: Patient adherence, Self-management, Physiotherapist, Review.

Author for correspondence: Heta Baxi, 1st

year MPT, Community Health and Rehabilitation, SBB College of

Physiotherapy, Ahmedabad. Email ID: [email protected]

Natl J Integr Res Med 2019; Vol.10(4.1) July-August

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