Indian Journal of Physical Medicine and Rehabilitation

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Volume 31, Number 2, April-June 2020

EDITORIAL

Dr Rajesh Pramanik

New Rehabilitation Challenge During Ongoing Pandemic

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:00 - 00]

PDF  |  DOI: 10.5005/ijpmr-31-2-iv  |  Open Access |  How to cite  | 

Original Article

Ayan Ghosal, Saumen Kumar De, Siddhartha Sinharay, Biman K Ray, Rajesh Pramanik

Improvement Pattern of VFSS due to Swallowing Maneuvers in Patients of Dysphagia with Posterior Circulation Stroke

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:7] [Pages No:24 - 30]

Keywords: Mendelsohn maneuver, Post-stroke dysphagia, Swallowing maneuvers, Videofluoroscopic swallowing study

PDF  |  DOI: 10.5005/jp-journals-10066-0081  |  Open Access |  How to cite  | 

Abstract

Background: Post-stroke dysphagia is a leading cause of morbidity and prolonged hospitalization in stroke patients. The videofluoroscopic swallowing study (VFSS) is one of the gold standard techniques, designed to define the anatomy and physiology of a patient\'s oropharyngeal swallow and examine the effectiveness of selected rehabilitation strategies designed to eliminate aspiration or excess oral or pharyngeal residue (the symptoms of patient\'s dysphagia). Objective: To quantify the improvement of patients’ subjective and objective symptoms. Materials and methods: Institutional ethics committee clearance was taken. Fifteen patients were selected who satisfy our inclusion criteria. A prospective interventional study was done in the Department of PMR, IPGME&R, Kolkata over 12 months. Videofluoroscopic swallowing study was done on all these patients at baseline and at 3 months interval and swallowing technique of head rotation to the paretic side applied at baseline and Mendelsohn maneuvers were applied for 3 months duration. Changes in VAS of swallowing (VASs) and videofluoroscopic dysphagia scale (VDS) were noted. Inclusion criteria: Clinical dysphagia in a patient with confirmed posterior circulation stroke, after 2 weeks of stroke. Exclusion criteria: Anterior circulation stroke, Other pertinent neurological diseases, any structural abnormalities in head-neck region, medically unstable patient. Results: Statistically significant improvements of both VASs and VDS were seen in all the patients in follow-up visits with the application of selected swallowing techniques and maneuvers. Conclusion: This study concludes that: • Simple swallowing techniques and maneuvers can improve the symptoms of dysphagia in patients with posterior circulation stroke. • Videofluoroscopy is helpful to diagnose and objectively quantify the improvement of dysphagia symptoms with different swallowing techniques and maneuvers.

Original Article

Utpalendu Debnath, N Romi Singh, Jotin S Yengkhom, Kaustav Basuthakur, Ranjan K Lisham, Obit Jerang

Efficacy of Ultrasound-guided Autologous Blood Injection in Chronic Lateral Epicondylitis: A Randomized Controlled Trial

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:7] [Pages No:31 - 37]

Keywords: Autologous blood injection, Lateral epicondylitis, Musculoskeletal ultrasonography, Patient-rated tennis elbow evaluation, Tendinopathy

PDF  |  DOI: 10.5005/jp-journals-10066-0078  |  Open Access |  How to cite  | 

Abstract

Introduction: Tendinopathy is common in professional athletes as well as in sedentary people. It occurs in 30–50% of all sports-related injuries. Injection of autologous blood has been reported beneficial for the treatment of tendinopathy. It is hypothesized that transforming growth factor-β and basic fibroblast growth factor carried in the blood will act as humoral mediators to induce the healing cascade. Musculoskeletal ultrasound can document the pathology before the injection and accurately identify the site for injection. It also helps in monitoring tendon healing. Materials and methods: This randomized controlled trial was carried out after obtaining permission from Research Ethics Board between September 2016 and August 2018 in the Department of Physical Medicine and Rehabilitation (PMR), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. Ninety-two patients with lateral epicondylitis were included in this study. The independent variables considered were age, sex, occupation, duration, and side of affection. The intervention group received autologous blood injection (ABI), whereas the control group received Inj. triamcinolone acetonide 40 mg under musculoskeletal ultrasound guidance. Results and observations: Out of 92 patients recruited, 54 patients were females (58.69%) and 38 were males (41.33%). The intervention group consisted of 26 females and 20 males with a mean age group of 47.20 ± 10.06 years while the control group consisted of 28 females and 18 males with a mean age group of 46.20 ± 8.79 years. There was a significant improvement in the visual analog scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) score in the ABI group compared to the control group in 6 months follow-up. There was also a significant improvement in neovascular, echotexture grading, and tendon size in the ABI group compared to the control group in 6 months follow-up. Conclusion: The study showed that a single injection of ultrasound-guided ABI is significantly more effective in reducing pain and disability in resistant lateral epicondylitis at 6 months as compared to steroid injection. This study also confirmed that there was significant improvement of ultrasound parameters in the ABI group compared to the steroid injection group and may be considered as an alternative to surgery in resistant lateral epicondylitis.

Original Article

Ishita Dey, Vasundhara Ghosal, Ambar Konar, Rajesh Pramanik

Comparison of the Therapeutic Efficacy of TENS vs Ultrasound-guided Genicular Nerve Block in Patients with Knee Osteoarthritis

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:4] [Pages No:38 - 41]

Keywords: Genicular nerve, Knee pain, Osteoarthritis, Transcutaneous electrical nerve stimulation, Ultrasonography

PDF  |  DOI: 10.5005/jp-journals-10066-0073  |  Open Access |  How to cite  | 

Abstract

Introduction: Osteoarthritis (OA) knee is a common disease of the aged population and one of the leading causes of disability. There are various treatment modalities to manage the pain in this condition including transcutaneous electrical nerve stimulation (TENS) and genicular nerve block (GNB). Aims and objectives: To assess and compare the effect of ultrasound-guided GNB and repeated daily TENS for 3 weeks in chronic knee pain in patients with OA knee. Materials and methods: The study is a randomized clinical trial done over duration of 18 months in the Department of Physical Medicine and Rehabilitation; IPGMER and SSKMH with a total sample size of 64 patients (32 in each group). Patients of age 40–80 years suffering from symptomatic primary OA knee with K/L score 3 and 4, poorly responding to conservative treatments and devoid of any exclusion criteria were included in the trial. After ethics committee clearance and obtaining informed consent, 64 patients were randomized into 2 treatment groups. Transcutaneous electrical nerve stimulation was applied for 3 weeks in the first group. In the second group, a US-guided GNB was done. Pain and knee function were assessed with visual acuity scale (VAS) and Western Ontario and McMaster Universities index at baseline, 1, and 3 months. Results: Statistically significant reduction in VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) detected over time in both groups. WOMAC was significantly better in the GNB group than in TENS at 1-month follow-up. Conclusion: Both TENS and GNB have good clinical effects on knee OA with the superiority of GNB.

REVIEW ARTICLE

Monika Saini, Anup K Kapoor

Perception, Attitude, and Behavior toward Persons with Disabilities in India

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:4] [Pages No:42 - 45]

Keywords: Attitude, Behavior, Disability, Perception, Society

PDF  |  DOI: 10.5005/jp-journals-10066-0074  |  Open Access |  How to cite  | 

Abstract

Disability in India has largely been characterized as a medical problem that majorly focuses on the “abled bodies”. The concept of disability in India is associated with many irrational beliefs and perceptions ingrained in our sociocultural beliefs and ideologies. Only a handful of Indian studies have attempted to review the scant data on perception, attitude, and behavior toward persons with disabilities in India. The current piece of work presents a coherent literature review on people\'s perception and attitude toward various types of physical and mental disabilities in India. This article also endeavors to understand disabled person\'s own attitudes toward their disability and attempts to delineate how familial and social perception influences their self-esteem and confidence level. The final section of this article also suggests few positive steps that can be taken to improve societal attitude, perception, and behavior toward persons with disabilities in India.

MISCELLANEOUS

Philately

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:46 - 46]

PDF  |  DOI: 10.5005/jp-journals-10066-0085  |  Open Access |  How to cite  | 

MISCELLANEOUS

Rehab Quiz

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:47 - 47]

PDF  |  DOI: 10.5005/jp-journals-10066-0077  |  Open Access |  How to cite  | 

MISCELLANEOUS

PG Forum

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:48 - 48]

PDF  |  DOI: 10.5005/jp-journals-10066-0076  |  Open Access |  How to cite  | 

MISCELLANEOUS

Siddhartha Sinha Ray

Unilateral Swelling of Right Lower Limb

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:49 - 49]

PDF  |  DOI: 10.5005/jp-journals-10066-0086  |  Open Access |  How to cite  | 

MISCELLANEOUS

Rehab Challenge

[Year:2020] [Month:April-June] [Volume:31] [Number:2] [Pages:1] [Pages No:51 - 51]

PDF  |  DOI: 10.5005/jp-journals-10066-0087  |  Open Access |  How to cite  | 

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