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   Table of Contents - Current issue
Coverpage
July-December 2016
Volume 21 | Issue 2
Page Nos. 61-98

Online since Tuesday, December 27, 2016

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ORIGINAL ARTICLES  

Resisted breathing exercise versus incentive spirometer training on vital capacity in postoperative radical cystectomy cases: a pilot randomized controlled trial Highly accessed article p. 61
Eman M Othman, Shaimaa A Abaas, Hamada H Hassan
DOI:10.4103/1110-6611.196776  
Background Radical cystectomy at times involves respiratory physical therapy aiming to reverse pulmonary dysfunction, thus avoiding postoperative pulmonary complications that increase hospital morbidity. Objective The aim of this study was to investigate the effects of resisted breathing exercise versus incentive spirometer (IS) training on vital capacity (VC) outcomes in postoperative radical cystectomy cases. Patients and methods Forty male and female patients between 40 and 80 years of age who had undergone radical cystectomy participated in this study. Patients were randomly assigned into two equal groups of 20 each; both groups received traditional physical approaches. In addition, group A (19 men and 1 woman) received IS training for 15 min daily for 6 weeks, and group B (16 men and 4 women) received resisted breathing exercise for 15 min daily, for 6 weeks. The primary outcome was VC, which was measured using an electronic spirometer. Results This study showed a significant increase (P<0.05) in VC in both groups on comparing pretreatment and post-treatment values within each group. After 6 weeks of treatment, between-group statistical analysis showed equal improvements in VC (P=0.52). Nevertheless, the percentage of improvement in VC was 43.5% (2.46±0.64), higher than that in the resisted breathing exercise group at 23.9% (2.34±0.53). Conclusion IS produced better objective improvement in VC compared with the usage of resistive breathing exercise. However, both are considered as a gold therapeutic tool in the management of pulmonary complication after radical cystectomy.
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Effect of trunk belt on function in children with diplegia p. 68
Hend A Wahsh, Kamal E Shoukry, Nanees E Mohamed
DOI:10.4103/1110-6611.196777  
Background and purpose Trunk control can offer many solutions for posture and movement. The purpose of this study was to determine the effect of using modified trunk belt on sitting and standing in diplegic children. Patients and methods Thirty diplegic cerebral palsy children from both sexes participated. Their ages ranged from 3 to 6 years. They were divided randomly into two groups: control and study. The control group received a designed physical therapy program, and the study group received a designed physical therapy program in addition to proprioceptive training using a modified trunk belt. The sitting and standing domains were evaluated using the Gross Motor Function Measure for both groups before and after 3 successive months of treatment. Results The Wilcoxon test revealed that the gross motor function of children from both groups improved significantly after 3 months of treatment in both the sitting and standing domains. The Mann–Whitney test revealed that children in the study group showed a significantly greater improvement in both domains compared with the control group. Conclusion Proprioceptive training using trunk belt with physical therapy program could be used as an effective method for improving gross motor function of both sitting and standing in children with diplegia.
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Assessment of lumbar proprioception in participants with functional ankle instability: a cross-sectional study p. 74
Olfat Ibrahim Ali, Sahar Abdallah Alasar
DOI:10.4103/1110-6611.196780  
Background Functional ankle instability (FAI) represents 40–75% of residual disability after acute lateral ankle sprain. FAI has been associated with impaired muscle strength and postural and neuromuscular control. Purpose The aim of this study was to investigate the association between FAI and lumbar proprioception. Patients and methods Thirty individuals of both sexes (17 female and 13 male) were selected. The FAI group included 15 participants (nine female and six male) and the control group included 15 normal individuals (eight female and seven male). Lumbar proprioception was assessed using the Biodex system 3 pro isokinetic dynamometer. Results There was a significant increase in repositioning error in the FAI group compared with the control group (P<0.001). Conclusion There was an association between FAI and an increase in lumbar reposition error compared with healthy individuals. This effect should be considered in the rehabilitation protocol of patients with FAI.
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Inter-rater and intra-rater reliability of Kinovea software for measurement of shoulder range of motion p. 80
Reham M Abd Elrahim, Eman A Embaby, Mohamed F Ali, Ragia M Kamel
DOI:10.4103/1110-6611.196778  
Background Goniometry is a tool used frequently for measuring and documenting range of motion (ROM) during a physical therapy examination. With modern innovations in technology, new methods other than the universal goniometer have been applied. Kinovea software is a recent video-based method that uses a virtual goniometer to obtain values for the ROM of joints. However, the software’s reliability in measuring shoulder joint ROM has not been studied. Purpose This study was conducted to investigate the inter-rater and intrarater reliability of Kinovea software for measuring shoulder joint ROM in healthy individuals. Materials and methods Shoulder joint ROM was measured in 52 healthy individuals (mean±SD age was 26.7±4.2 years) using Kinovea photographic measurements by three trained raters. Intrarater reliability was examined by a single rater within the same day. Shoulder flexion, abduction, and external and internal rotation ROM were measured with the patient in supine position. Results The inter-rater reliability ranged from an intraclass correlation coefficient value of 0.95 to 0.98, whereas the intrarater reliability ranged from an intraclass correlation coefficient value of 0.98 to 0.99. Conclusion This study showed highly reliable shoulder joint ROM measurements in healthy adults using the Kinovea software.
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Comparison of stair walking mechanics between adult males and females p. 88
Ahmed Farrag
DOI:10.4103/1110-6611.196781  
Background Stair negotiation is a daily functional activity that poses greater mechanical burden as compared with level walking. Few studies have investigated the biomechanical demands of stair walking tasks. However, sex-based biomechanical differences of such tasks, in terms of joint movement and muscle activity, have not been previously reported. Purpose The aim of this study was to investigate sex-based differences in lower extremity joint kinematics and muscular electromyography (EMG) in healthy adults during stair ascent and descent. Materials and methods A total of 20 participants (10 males and 10 females), with mean±SD age of 21.7±2.7 years, ascended and descended a two-sided staircase. Sagittal movements of the hip, knee, and ankle joints were measured using a Qualisys motion analysis system. Peak amplitude of surface EMG activity for gluteus medius, rectus femoris (RF), vastus lateralis, and soleus muscles was collected using a Biopack EMG system. Each participant performed three repetitions, and an average was calculated for analysis. Results Female participants demonstrated significantly higher hip and knee angles (P=0.01) during stair ascent and higher hip angles and ankle dorsiflexion (P=0.01) during stair descent than male participants. Female participants also exerted higher normalized muscular activity than male participants for RF, vastus lateralis, and soleus muscles during ascent. However, only RF muscle had significantly higher readings for female participants during stair descent. Conclusion Female participants perform stair negotiation using greater angular excursion and muscle activation than male participants. This could impose greater mechanical burden on lower extremity structures and, consequently, increase energy consumption. Therefore, sex-based differences should be considered when planning a stair-negotiation rehabilitation program.
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CASE REPORT Top

Early strength training using theraband exercises for phase-1 cardiac rehabilitation in a patient with a fractured femur: a case report p. 94
Rashida Y Bookwala, Abraham S Babu, Arun G Maiya, Tom Devasia, Barry A Franklin
DOI:10.4103/1110-6611.196779  
The effectiveness of exercise-based cardiac rehabilitation (CR) following an acute coronary syndrome (ACS) is well established. However, ACS complicated by an orthopedic limitation, poses greater challenges to early mobilization. Thus, there is a need for an alternative rehabilitation approach to improving exercise capacity and in preventing and reducing associated complications during convalescence. This case report highlights the value and utility of using low level resistance exercises to the upper limb with theraband exercise during an inpatient or phase-1 CR program. A low intensity theraband regimen for the upper limb was administered based on the number of repetitions performed to fatigue. The functional improvements observed and the ability of the patient to tolerate the therapy suggests a potential role for theraband exercises in phase-1 CR in ACS patients with selected orthopedic limitations.
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ERRATUM Top

Erratum: Effect of kinesio taping therapy combined with breathing exercises on childbirth duration and labor pain: a randomized controlled trial p. 97

DOI:10.4103/1110-6611.196782  
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