Indian Journal of Physical Medicine and Rehabilitation

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2015 | June | Volume 26 | Issue 2

RESEARCH ARTICLE

ARTICLE NEWS

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/ijopmr-26-2-54a  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Medical Philately

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/ijopmr-26-2-56a  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

RN Srivastava, Dileep Kumar, Anil Kumar Gupta, VP Sharma, Javed Ahmed, Sanjai Singh

Traumatic Thoracolumbar Spine Injury –A Demographic Study

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:4] [Pages No:27 - 30]

   DOI: 10.5005/ijopmr-26-2-27  |  Open Access |  How to cite  | 

Abstract

Study design and subjects

Cross-sectional descriptive analysis of data of patients with thoracolumbar SCI admitted for rehabilitation at a tertiary care centre from January 2011 to September 2014.

Objectives

To identify the demographic pattern of TLSCI admitted to this centre.

Setting

Department of PM&R, King George's Medical University, Lucknow.

Methods

One hundred and thirty-three consecutive patients of traumatic TLSCI admitted for rehabilitation were included in the study. Detailed demographic, clinical, neurological evaluation as per ASIA scale and radiological assessment done and analyzed.

Results

Mean age of our sample was 29.62±5 years. There were 21.05% females and 78.95% males. A significant percentage (36.84%) was farmers/labourers, followed by students 26.31%. Majority (67.67%) had fall from height followed by road traffic accidents (21%). Only 3.76% received ambulance for transport and majority (87.22%) of the cases transported by hired four wheelers. Only 18.78% cases came to tertiary center within 2 hours and majority (70%) came after 8 hours of injury. Ratio of complete and incomplete injuries being 1.7:1. Most common vertebral involvement in 58.64% cases were of T12 and L1.

Conclusions

Majority of Indian population live in rural areas which have minimal accessibility to even primary care. This disparity should be removed by even distribution of specialty hospital and trauma care centres in rural areas with better transportation with trained staff for trauma care. A national SCI registry system is needed and SCI case should be reported from all hospitals so that rehabilitation programme planning can be done accordingly.

RESEARCH ARTICLE

R Pramanik, A Basak, A Ballav

A Comparative Study on Effectiveness of Intra-articular Injection of High Molecular Weight Hyaluronate, Steroid and High Molecular Weight Hyaluronate plus Steroid in Osteo-arthritis Knee

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:7] [Pages No:31 - 37]

   DOI: 10.5005/ijopmr-26-2-31  |  Open Access |  How to cite  | 

Abstract

Background

Although primary osteo-arthritis is well known as a benign degenerative condition, the impact of this disease course is becoming terribly disabling day to day in our community possibly because of increasing life expectancy. After lots of search regarding the role of intra-articular hyaluronic acid plus steroid in osteo-arthritis knee it is noted that scarcity of literature regarding conclusive evidence for the above. There is a grey zone regarding the combined role of these two agents in patients with primary osteo-arthritis. This project is a humble sincere attempt to find out the role of high molecular weight hyaluronate plus steroid in osteo-arthritis knee and to compare the effectiveness of this with intra-articular steroid, and intraarticular HMW hyaluronic acid.

Methods and Design

This is a single blind randomised controlled parallel group study conducted in the department of physical medicine and rehabilitation, IPGME & R, SSKM Hospital, Kolkata for a period of 18 months taking 27 subjects in each group. All patients with primary osteo-arthritis knee with grade two or grade three were included in the study group. And those who did not want to get incorporated in the study, patients with secondary osteo-arthritis knee, grade one or grade four osteo-arthritis knee, with gross knee instability, patients with contra-indications of intra-articular injections or intra-articular injection of steroid or with history of allergy to a viscosupplementation solution and patients received intra-articular injection in knee within last one year were excluded from the study. WOMAC pain, stiffness and functional subscales, VAS pain, ROM of knee joint, 50 feet walk time, Patients global assessment scale, Physicians global assessment scale were the parameters studied. After taking clearance from the institutional ethical committee, patients were selected based on the inclusion and exclusion criteria, and baseline (visit-1) assessment was done on the parameters. The selected patients have been divided into three groups randomly. Written informed consent was taken from all patients before interventions. One group received intra-articular injection of methylprednisolone, second group received intra-articular injection of high molecular weight hyaluronoic acid, and third group received intra-articular injection of high molecular weight hyaluronate plus methylprednisolone in the knee joint. The injections administered under strict aseptic condition. After administering injections, the patients assessed at the interval of 6 weeks (visit-2) and 12 weeks (visit-3) using the parameters mentioned above. The results have been analysed according to the standard statistical methods to fulfill the aims and objectives of the study.

Discussion

Majority of patients were female and more than 50 years of age with K-L radiological grade of 3. At the baseline visit, the WOMAC pain was comparable in all the three groups. It has been seen that, there was statistically significant improvement in all the parameters at the 2nd visit (6 weeks) from the baseline in all groups, and at the 3rd visit (12 weeks) though there was improvement on all the parameters from the 2nd visit in all groups, it was not statistically significant. Steroid, high molecular weight hyaluronate and steroid plus HMW hyaluronate all are effective in osteo-athritis knee in terms of reduction of pain, reduction of stiffness of knee joint, increase of range of motion of knee joint, reduction of 50 feet walking time, reduction of patients and physicians global assessment score. No treatment regime is statistically significantly better than the other group after 6 and 12 weeks of postinjection. Adverse effects of any treatment regime is negligible.

RESEARCH ARTICLE

Dinesh Kumar, P Bansal, Ashok Kumar Bhardwaj

A Feasibility Assessment of International Classification of Functioning, Disability and Health (ICF) Tool for Locomotion in Rural Community of Northern India

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:5] [Pages No:38 - 42]

   DOI: 10.5005/ijopmr-26-2-38  |  Open Access |  How to cite  | 

Abstract

Background

ICF is a valid tool to assess the degree and extent of disability, functioning, and health among patients. Its use in population to assess the disability is often limited.

Aim

To assess the feasibility of ICF tool in community settings among patients with any signs and symptoms of locomotion.

Design

Community based survey was carried out to assess the disability.

Setting

The studied individuals were assessed during house to house survey in a rural area of Himachal Pradesh, India. Any individual with any signs and symptoms of disability associated to locomotion was interviewed by the trained medical social worker at their home.

Population

Total 82 individuals were interviewed to study the degree and extent of disability related to locomotion.

Methods

An ICF tool version 2.1a as recommended by World Health Organisation was used for assessment.

Results

A total 82 people whom 58.5% were assessed using ICF tool and 40.0% of males and 50.0% of females observed with no problem of impairment for locomotion. Among those who reported, moderate level of impairment related to joints was observed among 32.4% females and 31.3 % males. Mild impairment for muscle power was present among 31.3% males and 29.4% of females. Assessment of extent of impairment observed that the lower limb was most commonly (about 40.0%) involved in both males and females. Both males and females were mostly observed with restricted performance for daily activities like using transportation, lifting/carrying of objects, walking and moving around using assisted equipment. About 47.9% and 31.3% of males responded that the design of building and technology for public use, as mild and moderate barrier respectively. Design of building for public use was observed as severe barrier among 38.2% of females.

Conclusions

Disability related to locomotor system involving lower extremities is most common form of disability. Mild to moderate level of impairment was observed among individuals with locomotor disability to carry out day to day activities.

Rehabilitation impact

ICF tool can be used to study the degree and extent of disability. A standard pattern of analysis and reporting the results would help to assess the effect of rehabilitative interventions in community settings.

RESEARCH ARTICLE

Margaret KY Mak

Concurrent and Discriminative Validity of the Mini Balance Evaluation Systems Test (miniBESTest) in People with Parkinson's Disease

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:6] [Pages No:43 - 48]

   DOI: 10.5005/ijopmr-26-2-43  |  Open Access |  How to cite  | 

Abstract

Purpose

To examine the concurrent and discriminative validity of the miniBESTest in individuals with Parkinson's disease (PD).

Method

Thirty-four individuals with PD participated in study 1. Thirty-one healthy subjects and 127 individuals with PD completed study 2. All participants were assessed at the University Balance and motion analysis laboratory. Balance performance was assessed using the miniBESTest and Berg's balance scale (BBS). Self-perceived balance confidence level of subjects was measured by the activities-specific balance confidence (ABC) scale.

Results

In study 1, results of Pearson's correlation showed that the scores of the miniBESTest correlated well with BBS (r=0.765; p<0.001) and moderately well with ABC scores (r=0.587; p<0.001). For study 2, results of one-way analysis of variance demonstrated significant differences in miniBESTest scores among healthy subjects, PD non-fallers (PD-NF) and PD fallers (PD-F). Healthy subjects obtained the highest mini-BESTest score of 88.2 ± 8.9%, followed by PD-NF (73.6 ± 14.7%) and PDF (57.1 ± 17.0%) (all p<0.001). Significant differences were also observed among healthy subjects, PD-NF and PD-F for each miniBESTest domain score (all p<0.05).

Conclusion

The miniBESTest is a valid method to document balance performance in individuals with PD. Both total and domain miniBESTest scores could differentiate between healthy subjects, PD-NF and PD-F.

RESEARCH ARTICLE

R Sharma, SY Kothari, BB Thukral, S Chaudhary

Effect of Caudal Epidural Steroid Injection in Chronic Low Back Pain due to Prolapse Intervertebral Disc

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:4] [Pages No:49 - 52]

   DOI: 10.5005/ijopmr-26-2-49  |  Open Access |  How to cite  | 

Abstract

Background

Low back pain (LBP) due to disc herniation is a frequent cause of back pain. It is a debilitating condition having enormous medical and socio-economic effects. Epidural injection of steroids has been used to treat LBP for many decades. Despite widespread use and numerous publications there is significant controversy with regards to the medical necessity and indications for epidural injections, hence we planned this study.

Materials and methods

This was a prospective follow-up study. Forty-one patients of confirmed diagnosis of prolapse intervertebral disc (PIVD) were included. Caudal epidural steroid injection (CESI) of 80 mg methylprednisolone acetate diluted in 20 ml of 0.9% saline was given. Outcome was assessed by Numeric Pain Rating Scale (NRS), Oswestry Disability Index (ODI), Straight Leg Raise (SLR) and Modified Schober Test (MST) at baseline, one, three, six and twelve weeks follow-up.

Results

Thirty-seven patients completed the study. Significant improvement in patient's status was observed after CESI, as measured with MST, SLR, NRS and ODI at one and three weeks post injection and the improvement were maintained till 12th week. Eighty-three per cent of patients were satisfied at the end of the study and side-effects reported were mild.

Conclusion

CESI is a simple, safe and cost effective intervention procedure for the treatment of chronic LBP due to PIVD. It provides rapid pain relief and improvement of physical function starting within a week of injection.

RESEARCH ARTICLE

R Pramanik

Camptodactyly – A Rare Condition for Hand Rehabilitation

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:53 - 53]

   DOI: 10.5005/ijopmr-26-2-53  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

BOOK NEWS

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:54 - 54]

   DOI: 10.5005/ijopmr-26-2-54  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

REHAB QUIZ

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:55 - 55]

   DOI: 10.5005/ijopmr-26-2-55  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

REHAB CHALLENGES

[Year:2015] [Month:June] [Volume:26] [Number:2] [Pages:1] [Pages No:56 - 56]

   DOI: 10.5005/ijopmr-26-2-56  |  Open Access |  How to cite  | 

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