Indian Journal of Physical Medicine and Rehabilitation

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2019 | July-September | Volume 30 | Issue 3

EDITORIAL

Dr Rajesh Pramanik

Swallowing Rehabilitation: Challenges and Need of the day

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/ijpmr-30-3-iv  |  Open Access |  How to cite  | 

Original Article

Smita Nayak, Prasanna K Lenka, Ameed Equebal, Abhishek Biswas

Impact of Silicone Finger Prosthesis in Activities of Daily Living and Passive Function in Proximal Phalanx Index Finger Amputation

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:7] [Pages No:59 - 65]

Keywords: DASH questionnaire, Finger amputation, Grip strength, Hand function, Pinch strength, Silicone finger prosthesis

   DOI: 10.5005/jp-journals-10066-0052  |  Open Access |  How to cite  | 

Abstract

Background: The index finger plays a major role in hand function. Subjects who sustain traumatic amputation of the single index finger also suffer both psychological and functional loss. Most of previous studies primarily focused on psychological benefits with finger prosthesis; however, it is essential to identify the functional benefit of the silicone finger in respective activity spectrum. Objectives: To determine the improvement in function and activities with silicone finger prosthesis in proximal phalanx index finger amputation. Materials and methods: Sixteen subjects were evaluated for the grip strength, pinch strength, and activities with dynamometer position II, pinchometer, and DASH questionnaire, respectively. Results: Significant improvement of grip strength revealed in dynamometer position II (p = 0.041) when tested without and with silicone finger prosthesis. The overall abilities in activities of daily living were improved significantly (p = 0.005) as assessed by disability of arm, shoulder and hand questionnaire. Large effect sizes were noted in some activities like writing, jar opening, and carrying heavy object. Conclusion: Silicone finger prosthesis provides a functional benefit to the subjects in multiple activities. Clinical relevance: Partial loss of a finger has a relationship in limitation of hand function. Generally, clinicians prescribe silicone prosthesis for rehabilitation of finger amputee to restore the cosmetic purpose; however, functionality of the finger is also required to be restored. This study describes the role of silicone finger prosthesis on function and different activities for the subjects suffering from the index finger proximal phalanx amputation.

Original Article

Sudhir Mishra, Dileep K Kumar, Anil K Gupta, Vijay K Singh

Lower Limb Stump Infection Management among Rural North Indian Population

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:3] [Pages No:66 - 68]

Keywords: First-line drug therapy, Levofloxacin, Lower limb amputated stump infection

   DOI: 10.5005/jp-journals-10066-0054  |  Open Access |  How to cite  | 

Abstract

Introduction: In India, the most common complication of lower limb amputated stump is infection, and it accounts 53.5% of total amputation. The published studies on prevention and management of such infection are very few. Materials and methods: All the patients presenting with infection of amputated lower limb stump between 2010 and 2015 were included in this descriptive study. Diagnosis was confirmed by clinical, hematological, radiological, and microbiological test, i.e., culture and sensitivity of wound. Based on sensitivity report, treatment was started. Result: There were 62 patients with 80 amputated lower limb stump infections. The most common presentation was sinus tract (54.8%). The most common cultured pathogen was Pseudomonas aeruginosa (39%). The most sensitive antibiotic was Piperacillin + Tazobactam (82.25%), followed by imipenem (75%), and levofloxacin (58.75%). Conclusion: More than 60% of Indian population lives in rural area. The primary mode of healthcare services in India is peripheral health centers. The first choice of drug therapy in management of amputated lower limb stump infection can be levofloxacin.

Original Article

Piyali Sengupta, Kiran Mondal, Hiranmoy Mahata, Sujaya De, Prakash C Dhara

Evaluation of Existing Walking Sticks and Recommendations for Modified Walking Stick

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:5] [Pages No:69 - 73]

Keywords: Designing approach, Elderly, Subjective evaluation, Viewpoints of ergonomics, Walking stick

   DOI: 10.5005/jp-journals-10066-0056  |  Open Access |  How to cite  | 

Abstract

Purpose: Evaluation of the existing walking stick and recommendations for modified walking stick from the viewpoints of ergonomics. Materials and methods: Subjective evaluation was used by preparing a standard questionnaire. Results: 100% patients need modification in existing walking stick, 30% reported that the stick is too long to use, 30% reported that the handle was slipping out while in use, 26% felt that the stick is too heavy to them, whereas others reported palm and figure injury in long-term use of walking stick. In all, 54% reported slipping out of the stick on the floor, and 66% preferred cane as the stick material. Conclusion: The present study concluded that the elderly population need modification in existing walking sticks. The slipping rate of the stick could be minimized by adapting some modifications in the stick. Cane is preferred as the stick material in the studied population.

Original Article

Souvik Dubey, Ritwik Ghosh, Subhankar Chatterjee, Durjoy Lahiri, Samya Sengupta, Subham Chatterjee, Goutam Das, Samar Biswas, Biman K Ray

Pediatric Stroke: The Clinical and Etiological Spectrum: An Observational Study from a Tertiary Care Stroke Clinic, Kolkata, India

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:7] [Pages No:74 - 80]

Keywords: Hemiplegia, Infections, Outcome, Pediatric stroke outcome measure, Vasculopathy

   DOI: 10.5005/jp-journals-10066-0058  |  Open Access |  How to cite  | 

Abstract

Background: In different geographical regions, the clincoetiological spectrum of childhood stroke varies widely and studies from Eastern India is lacking. Objective: To determine the clinicoetiological spectrum of childhood stroke and their outcome. Materials and methods: This study was conducted in a stroke clinic of a tertiary care hospital of Kolkata over a period of 18 months. All children below 12 years diagnosed as stroke were included. On the basis of clinical examination, relevant laboratory investigations and radioimaging etiologies were determined. Appropriate statistical methods were used to analyze the data gathered from these patients using a preformed proforma. Results: Among the 70 pediatric stroke patients, the most common clinical presentation was found to be hemiparesis (61.42%) followed by seizure (30.00%) and aphasia (25.71%), respectively. Vasculopathies (30.00%) were found to be the most common etiology of childhood stroke followed by infective meningoencephalitis and craniocervical trauma (14.28% each). Ischemic stroke comprised 71.4% of cases. During discharge, 20 cases (28.57%) showed complete recovery, whereas 40 cases (57.14%) had persistent neurodeficit [Pediatric Stroke Outcome Measure (PSOM) score >1], 12 cases (17.14%) had recurrent stroke, 8 cases (11.42%) died, and only 2 (2.85%) patients were lost to follow-up. Out of those 40 cases having persistent neurodeficits during discharge had recovered too at follow-up at 18th month. At presentation PSOM score in 40 cases (57.14%) was >5 and at follow-up at 18th month, only 8 cases (11.42%) had PSOM score of >5. Conclusion: The commonest etiologies of stroke in pediatric patients presenting at our hospital were found to be intracranial vasculopathies, infection, and trauma. Ischemic stroke was the predominant type. Eighteen-month follow-up showed complete recovery from acute neurological deficits in most of the patients.

Original Article

Ashish Srivastava, Dr Sanjay K Pandey

Management of Myofascial Pain Syndrome: A Randomized Control Trial

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:4] [Pages No:81 - 84]

Keywords: Myofascial pain, Trigger point, Visual analog scale

   DOI: 10.5005/jp-journals-10066-0061  |  Open Access |  How to cite  | 

Abstract

Background: Myofascial pain syndrome is collection of sensory, motor, and autonomic symptoms that include local and referred pain, decreased range of motion, and weakness. Objective: To compare outcome of physical therapy alone and physical therapy with trigger point injection in the management of myofascial pain syndrome. Materials and methods: This prospective randomized control study was performed in a tertiary-care teaching institution of North India. Age- and sex-matched subjects with myofascial pain syndrome were enrolled in this study. Subjects were assessed by cervical ROM parameters, numerical pain rating scale, and pressure pain threshold at third day, 1 week, and fourth week. Results: Sixty patients were included in this study with mean age-group of 25.93 + 4.65 years and 26.60 + 4.99 years, respectively, and median of 22 years and 23 years in control and intervention groups, respectively. The female–male ratio was 1.5:1 and 1.3:1, respectively. Using CF, CE, NPRS, and PPT as outcome parameters were 39.00 ± 2.49, 8.60 ± 0.62, and 1.00 ± 0.00, respectively, which improved to 66.17 ± 4.09, 67.33 ± 3.65, 1.17 ± 0.65, and 5.00 ± 0.00, respectively, at fourth week of trigger point injection. Conclusion: Combined approach of trigger point injection with physical therapy is more effective and safe to be administered in outpatient as very good alternative for oral drugs and physical therapy alone.

MISCELLANEOUS

Postgraduate Forum

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:85 - 85]

   DOI: 10.5005/ijpmr-30-3-79  |  Open Access |  How to cite  | 

MISCELLANEOUS

Medical Philately

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:86 - 86]

   DOI: 10.5005/ijpmr-30-3-78  |  Open Access |  How to cite  | 

MISCELLANEOUS

Pictorial Continuing Medical Education

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:87 - 87]

   DOI: 10.5005/ijpmr-30-3-77  |  Open Access |  How to cite  | 

MISCELLANEOUS

Rehab Challenge

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:88 - 88]

   DOI: 10.5005/ijpmr-30-3-81  |  Open Access |  How to cite  | 

MISCELLANEOUS

Rehab Quiz

[Year:2019] [Month:July-September] [Volume:30] [Number:3] [Pages:1] [Pages No:89 - 89]

   DOI: 10.5005/ijpmr-30-3-80  |  Open Access |  How to cite  | 

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