How to cite this article:
Banerjee S, Khade A, Aijaz MY, Mishra M, Shende T, Gaikar R. It is Never Too Late to Start: Functional Outcomes Following a Delayed Comprehensive Rehabilitation Program for Traumatic Spinal Cord Injury Patients. Indian J Phy Med Rehab 2019; 30 (4):91-95.
Background: The incidence of spinal cord injury (SCI) varies but is estimated at 10–83 per million per year with most injured under the age of 25 years. Rehabilitation constitutes an important element of management of traumatic SCIs. However, due to lack of resources and awareness, this aspect is often neglected in developing countries. This results in poor functional outcome. Objectives: The study was conducted to assess functional improvement, in the form of self-care, transfer, and mobility pre and post a multipronged rehabilitation program in patients with SCI. The study also evaluated the impact of rehabilitation program in achieving different levels of independence, in SCI patients. Materials and methods: A prospective observational study carried out over the period of 1 year at a tertiary teaching hospital. Twenty patients with traumatic SCIs were included in the study and underwent a multipronged rehabilitation program. The program was specifically designed and tailored to ensure bedside mobility initially and then progressing to transfer and ambulatory training, and activity of daily livings (ADLs). Results: All patients showed improvements in functional outcome. The spinal cord independence measure (SCIM) showed a significant improvement in all areas of self-care, sphincter management, indoor and outdoor mobility. Ambulation status improved as a result of the program. Conclusion: A well-designed rehabilitation program has a significant impact on the functional outcome of patients with SCI. Rehabilitation should be promoted even if delayed in such patients.
How to cite this article:
Konar A, Pramanik R, Kamal F, Ghosal V, Dey I. A Comparative Study on Efficacy of Suprascapular Nerve Block vs Subacromial Steroid Injection in Shoulder Impingement Syndrome. Indian J Phy Med Rehab 2019; 30 (4):96-100.
Introduction: Shoulder impingement syndrome is one of the most common musculoskeletal injuries of upper limb leading to physical medicine & rehabilitation (PM&R) OPD visit. Over decades of use, literature shows lower infiltration and efficacy of intra-shoulder joint steroid in some etiological subtypes of impingement syndrome. Interestingly, major afferent supply around shoulder joint is by suprascapular nerve. This study is a sincere attempt to look for efficacy of suprascapular nerve block (SSNB) over subacromial corticosteroid injection in shoulder impingement syndrome. Aims and objectives: To look for improvement in visual analog scale (VAS) and shoulder pain and disability index (SPADI) after subacromial steroid injection or SSNB in shoulder impingement syndrome and to compare efficacy of both the approaches. Materials and methods: A randomized control trial was performed in the Department of Physical Medicine and Rehabilitation, IPGMER; SSKM Hospital, West Bengal, India from August 2017 to February 2018 recruiting total 70 patients with conservative treatment failed, ultrasonography (USG) confirmed Neer stage I and II symptomatic (VAS >5) impingement patients without any coagulopathy, supraspinatus tear or history of intra-articular steroid injection in the last 3 months. After Ethics Committee clearance, two groups of 35 patients each were made randomly. Group I received steroid injection by subacromial approach. Suprascapular nerve block was performed in the second group of patients. Assessment by VAS and SPADI was performed before intervention, 2 weeks, 4 weeks, and 12 weeks after injection. Results: Statistically significant improvement was seen in both the groups with better outcome with SSNB at longer follow-up (p = 0.003). Conclusion: Suprascapular nerve block is a better alternative both in short- and long-term to subacromial steroid injection in the management of shoulder impingement syndrome.
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Srivastava A, Pandey SK, Sinha S. Effect of Intra-articular Triamcinolone vs Hyaluronate Injection in Zygapophyseal Joint Arthropathy: A Prospective Randomized Controlled Trial. Indian J Phy Med Rehab 2019; 30 (4):101-104.
Objective: To compare the effect of triamcinolone with hyaluronate injection in low back pain due to zygapophyseal joint arthropathy. Materials and methods: This was a prospective, single-blind, randomized controlled trial. Twenty-nine subjects were randomly assigned to receive bilateral L3-S1 zygapophyseal joint injections with triamcinolone or hyaluronate (HA). Pain (visual analog scale) and disability (Oswestry Disability Index, ODI) scores were evaluated at 1, 4, and 12 weeks. Results: No significant intergroup differences in outcomes were noted in 29 subjects. For triamcinolone/HA (baseline; 1 month; 3 months; and 6 months), visual analog scales were as follows: 77.07/76.14; 62.93/63.71; 43.47/43.14; and 44.27/59.57, respectively. ODI scores were as follows: 52.53/52.71; 37.60/37.14; 23.73/23.71; and 41.07/50.57, respectively. Conclusion: The response of patients with chronic low back pain suggestive of lumbar zygapophyseal joint arthropathy was almost similar to triamcinolone or hyaluronate injection. Triamcinolone showed both short- and long-term improvement in both short- and long-term pain and function.
Lahunlang M Sohliya,
Pamidipani Samuel Sundar Rao
How to cite this article:
Sohliya LM, Thomas R, Rao PS. Randomized Controlled Trial of Rhythmic Auditory Stimulation for Gait Training in Persons with Unilateral Transtibial Amputation. Indian J Phy Med Rehab 2019; 30 (4):105-111.
One of the major needs of a person who has undergone a lower limb amputation is to regain the ability to walk again. Rhythmic auditory stimulation (RAS) is believed to be based on the mechanism of rhythmic entrainment and priming of auditory pathway. Based on this concept, a randomized controlled trial was carried out using RAS for prosthetic gait training of amputee patients admitted to a rehabilitation unit in south India during 2014. CONSORT guidelines for RCT were used and minimum sample size determined as 16 in each group. Forty-four patients (24 in the RAS and 20 in the control group) were recruited, and due to dropouts, complete data were available for only 13 patients in the RAS and 16 in the control group. Baseline parameters were similar in both the groups. Beats were made on Acoustica Beatcraft, a drum machine software program on the Internet. Three primary outcomes and five secondary outcomes were objectively assessed. Although not statistically significant, those in the RAS group completed training faster than those in the control group. There were some factors that hindered therapy and delayed time to completion which are discussed in the article. We conclude that RAS can be used as a cost-effective home-based rehabilitation method for gait training.
Background and purpose: Reduction in gait ability is considered the most common problems in patients with traumatic brain injury (TBI). Approximately 83% of patients with moderate to severe TBI continue to demonstrate impairments in balance and gait after discharge from rehabilitation that affect their independence in activities of daily living (ADL). This case report aimed to examine the impact of task-oriented circuit class training on gait ability focusing on balance, gait speed, and gait endurance (functional capacity) in a 34-year-old man with TBI. Case description: The patient was a 34-year-old man with 1-year post-TBI. Twelve sessions of the task-oriented circuit class training were provided. Outcome measures included the six-minute walk test (6-MWT) and Berg Balance Scale (BBS). Outcomes: His BBS score improved from 34/56 to 41/56. Six-minute walk distance increased by 62.9 m, and gait velocity increased by 0.25 m/second. Conclusion: The use of the task-oriented circuit class training protocol may be feasible in patients with TBI. Through 12 sessions, the patient showed improvement in gait ability resulting from increased balance ability, gait velocity, and endurance. Future high-quality studies with a large sample size are strongly needed to verify our findings.