SD: Standard deviation. Table 1: Percent of using each computer activity, comparison by gender Fig. 1: Means of physical discomforts between levels of weekly computer use. Table 3: Significant predictors of each physical complain via logistic regression Table 2: Percent of students who reported computer-related discomfort, by gender Table 4: Percent of parents reporting perceived psychological changes in children Fig. 1: Trivially made Swaymeter Fig. 4: Patient receiving Trunk Control Retraining Therapy Fig. 5: Showing comparison of Mean for AP and ML sways within whole group. Table 2: Comparison of Mean for Anteroposterior (AP) & Mediolateral Sway (ML) at Pre Vs Post interval within Right Hemiparetic group: upright equilibrium index scores were taken first and then were included in the study. Their postural graphs were taken with trivially made swaymeter on the same day i.e. assessment day. Table 3: Comparison of Mean for Anteroposterior (AP) & Mediolateral Sway (ML) at Pre Vs Post interval within Left Hemiparetic group: Results and discussion Fig. 6: Showing comparison of Mean for AP and ML sways within the group. Table 1: Between group post hoc Bonferroni analysis for PPT Fig. 2: Application of Strain-counterstrain technique on upper trapezius myofascial trigger point. Table 3: Between group post hoc Bonferroni analysis for NDI this supposition, especially when the positional release method is combined with other approaches such as ischaemic compression, MET, etc. which have good track record in trigger point deactivation. invited to participate in the study and informed consent was taken from them. The pressure threshold meter (“WAGNER FORCE DIAL FDK 20” was used in this study, It was used to assess the pain pressure sensitivity of myofascial trigger point pain as Fig. 1: Wall mounted cervical traction Mechanical traction is often used as part of a comprehensive program in outpatient rehabilitation. The value of this treatment has often been questioned because studies of its usefulness have generally been inconclusive'?. It involves a traction force applied to the neck by a mechanical system which can be applied intermittently or continuously. Traction has also been reported to decrease pain by providing muscle relaxation, stimulation of mechanoreceptors, and inhibition of reflex muscle guarding’. Instrumentation and tools Procedure Fig. 4.1: Showing the comparison of mean values of neck disability index (NDI) at Oth, 8th and 16th session. Sanduja A. / Indian Journal of Physiotherapy and Occupational Therapy. April - June 2010, Vol. 4, No. For cervical hydro collateral pack, the position of patient was supine lying with pillow under the head. Position of the patient for mechanical cervical traction was sitting on a stool with pillow on thighs and under forearms. Group A and group B by convenient sampling method. There demographic profile and detailed medical history were collected through individual interviewing. A signed consent was taken from each of the patient. There VAS scores as well as NDI scores were taken on the day of assessment i.e. day 0. Table 2: Comparison of mean value for VAS at Oth, 8th and 16th sessior within Group A and Group B (Paired t test) Table 1: Comparison of mean value for NDI at 0, 8th and 16th session within Group A and Group B (Paired t test): Fig. 4.2: Showing the comparison of mean values of Visual Analogue Scale (VAS) at Oth, 8th and 16th session. For neck isometric exercises, the position of the patient was high sitting. Ergonomic advice:Patient was instructed to avoid any painful activity like cross legged sitting and sleeping on affected side, prolonged sitting on examination chair for 2 weeks. Treatment Table 1.1: Pre values of outcome variables of both the groups Table 3.1: Pre — post isokinetic concentric peak torque of hamstrings of both groups Table 2.2: Inter group comparison of isokinetic concentric peak torque of quadriceps. Table 3.2: Inter group comparison of isokinetic concentric peak torque of hamstrings. Table 1: Correlation between self motivation inventory scores and each of motor function, age and time since onset of stroke (N=30). Participants who reported to KLES Dr. Prabhakar Kore Hospital and MRC, KLES Ayurved Hospital and Research center, Belgaum with non specific low back ache with duration of less than 3 weeks were screened for their eligibility depending on inclusion and exclusion criteria to participate in this study. After finding their suitability, they were requested to participate in the study. Then they were requested to give informed consent. After obtaining their The patient is then asked to release the breath, completely relax and to look towards the direction in which Duration of the symptoms and the side affected was noted and initial evaluation of the pain profile was done using Visual Analogue Scale (VAS).The pain was recorded by 10 cm horizontal visual analogue scale (VAS), the participants were asked to mark their intensity of pain on a 10 cm long line in the data collection sheet with numbers 0 to 10 where 0 symbolized no pain, and 10 was severe pain. Active range of lumbar extension was measured with the participant standing on the floor, a pen was used to mark the midpoint between the posterior superior iliac spines (PSIS). Then tape measure was used to identify and mark two points that is 10 cm superior to the PSIS, and 5 cm inferior to the PSIS. Distance between the superior and Graph No.1: Within group comparison of BBS The diagnosis, age, gender and duration of onset of stroke were obtained from patient’s interviews and medical chart. All those who met inclusion criteria were randomly assigned into either group A (experimental group) — received sitting balance training under varied sensory input or in Group B (control group)-received sitting balance training without varied sensory input. A detailed assessment of every subject was done by me. On the day of initial assessment a pre score of Berg balance scale and Stroke specific quality of life questionnaire and MAS sitting and MAS sit to stand were taken for all the selected subjects and again a post score for both the scales were collected at the end of training session which was at two weeks. Graph No. 3: Within group comparison of MAS sitting Graph No. 4: Within group comparison of MAS sit to stand Graph No. 6: Between group comparison of SSQOL Graph No. 7: Between group comparison of MAS sitting Graph No. 8: Between group comparison of MAS sit to stand Fig. 3: Comparison of Males between Group A and Group B on MAS on First and last day of intervention (Bohannan and Smith 1987) Fig. 2: Comparison of Diplegic Patients between Group A and Group B Fig. 4: Comparison of Females between Group A and Group B and right pre MAS score, left post and right post MAS score after 45 minutes of prolonged muscle stretch in group A and 45 minutes of conventional therapy in Group B. There is no significant difference seen between the MAS score of diplegics and Quadriplegics.Although this scale is of ten used in clinics, Tsai et al (2001) revealed that it could not reflect any neurophysiological changes in spastic muscle. However there is some evidence to suggest that passive stretching can reduce spasticity in children with cerebral palsy as those studies showing favorable outcome after prolonged muscle stretch were mainly of higher levels of evidence and more rigorous methodology. The effect size was fairly small and it was difficult to judge that whether it was Clinically significant (Tamis pin et al, 2006). In present study no significant difference between the males and females were also seen. Limitations Table 3: Correlation of lumbar lordosis with extensibility of muscles. Table 2: Extensibility of various parameters investigated in Group A and B For the Gastrocnemius extensibility, a standard tape used to ensure that the subjects positioned prone on the testing table with their lateral malleolus 9 inches beyond the table edge. All subjects wear shorts and secured to the table with waist and knee straps. The stationary arm of goniometer along the line made at axis of fibula by using the mark on the fibular head and lateral malleolus. The unmovable arm of goniometer placed parallel to the lateral border of the foot by using the marks on the base and head of 5th metatarsal. The axis of goniometer then felt on the lateral border of the foot. The zero position of the dorsiflexion defined as the 90-degree angle between the long axis of the fibula and the lateral border of foot. All measurements recorded immediately as the subjects achieved maximum active dorsiflexion. This procedure was used by many researchers for several studies, with reference to study done by Wessling et.al*®. While holding this position one lower limb released, allowing the hip to extend towards the table while resting the ipsilateral arm on the contra lateral knee. The leg and knee of the limb being measured were unsupported while the subject maintained a posterior pelvic tilt and ensure that the lumbar spine was flat, preventing the limb from abducting. Hip range of motion measured 2 times and average value was calculated. Measure the distance between plinth and lower end of thigh as tightness of iliopsoas*°. Reliability of this test for inter-rater (ICC) it is 0.96 and intra-rater r = 0.84. Fig. 1: Measurements of Lumbar Lordosis Table 1: Average age, weight and height of two groups of subjects studied. All the subjects who met the criteria for inclusion in the study were measured for flexibility of the dominant side. Hip flexor tightness in the limb measured with the modified Thomas test?° using the following procedure. The subjects instructed to sit as close to edge of the table as possible. Subjects hold the opposite knee to their chest with their hands and then asked to roll backward slowly on the table. Table 5.4: Between the group comparison of the number of trials required by patients in each group for improving proficiency of the skill. Table 5.3: Between group comparison of the number of days required by patients for improving proficiency of the skill. Fig. 5.2: Between the group comparison for mean number of days Table 5.5: Between group comparison of Retention Test after two days PECTENTIONTECT out to be significantly less than PBU group for learning the correct performance. Fig. 5.3: Between the group comparison of the number of days taken by patients in each group for correct performance. A study performed by Teyhen 2005,'? did not detect the benefit of ultrasound biofeedback for low back pain patients who had difficulty in preferentially activating TrA at the baseline. Thereby, benefit from ultrasound biofeedback could not be achieved for such patients who theoretically are, potential candidates for lumbar stabilization training. In the present study, however, the focus of treatment approach was to improve activation patterns of TrA by facilitating faster motor learning. Clinical prediction rule, by Hicks,22 was used in the study to assist in the clinical decision making for classification of patients for ADIM. Fig. 5.4: Between the group comparison of the number of trials taken by patients in each group for correct performance. Bajaj S. / Indian Journal of Physiotherapy and Occupational Therapy. April - June 2010, Vol. 4, No. | Fig. 5.5: Between the groups comparison for Retention Test after two days useful to consider how visual feedback may enhance the process of learning to contract a muscle. The results of the study indicated (Table5.3) that LBP patients in both the groups, learnt the skill, mostly on the second day of training, which could be explained on the basis that during the initial stages of learning(cognitive stage), time is spent trying to understand the demands of the task, what to do, what to feel and to “get the idea’ of isolating the correct contraction. This is because, subjects with LBP have shown to have decreased proprioception?’, which affects their ability to provide and process internal feedback, thereby augmented feedback is indicated. Both the tools used in this study proved advantageous and important in providing visual feedback of muscle action and as a result enhanced learning in LBP patients where internal representation of movement pattern gets affected because of pain. As it is clearly highlighted in the results,(Table5.2) that the mean number of days and trials required for skill acquisition using RUSI were, 1.9 and 12 respectively, whereas for PBU group, it were 2.72 and 21.45 respectively. From these findings, it is clearly evident that more time was required by patients in PBU group to learn the skill in contrast to patients in RUSI group who learnt in almost half the time. This could be explained with the concept of knowledge of performance (KP) and knowledge of results (KR) feedback, which were given to the subjects during and after every trial. bape Table 2: Comparison of strength between the groups Fig. 1: Comparison of strength between the three groups Fig. 2: Comparison of VAS score between the three groups Table 4: Comparison of Reduced WOMAC scores between the groups. Table 3: Comparison of VAS between the groups Fig. 3: Comparison of Reduced WOMAC score between the three groups Table Il: Between the group comparison of vas at rest *denotes that the t-value is significant at p < 0.05. N.S. denotes that the t-value is non-significant at p < 0.05. N: Number of patients. S.D.: Standard deviation. VASR: Visual analogue scale score at rest. VASRO: Pre-intervention visual analogue scale score. VASR1: Visual analogue scale score at week1. VASR2: Visual analogue scale score at week2. VASR3: Visual analogue scale score at week3. VASR4: Visual analogue scale score at week4. VASR8: Visual analogue scale score at week5. VASRE: Visual analogue scale score at week6. Table |: Baseline characteristics of the experimental and conventional groups N.S. denotes that the t-value is non-significant at p < 0.05. Fig. |: Between the groups comparison of Vas at rest: *denotes that the t-value is significant at p < 0.05. N.S. denotes that the t-value is non-significant at p < 0.05. N: Number of patients. S.D.: Standard deviation. NDI: Neck disability index score. NDIO: Pre-intervention neck disability index score. NDI1: Neck disability index score at week 1. NDI2: Neck disability index score at week 2. NDI3: Neck disability index score at week 3. NDI4: Neck disability index score at week 4. NDI5: Neck disability index score at week 5. NDI6: Neck disability index score at week 6. by superficial muscles. The patients were trained to sustain progressively inner ranges of craniocervical flexion using visual feedback from the pressure sensor. For each target level the patient was trained to perform ten repetitions with ten seconds hold each. Fig. Ill: Between the group comparison of neck disability index scores Table Ill: Between the group comparison of vas on activity Fig. IV: Pre- and post-intervention comparison of Vas score at rest in the conventional group Table IV: Between the group comparison of ndi scores Table VI: Pre- and post-intervention comparison in experimental group * denotes that the t-value is significant at p < 0.05. VASR: Visual analogue scale score at rest. VASA: Visual analogue scale score on activity. NDI: Neck disability index score. *denotes that the t-value is significant at p < 0.05. VASR: Visual analogue scale score at rest. VASA: Visual analogue scale score on activity. NDI: Neck disability index score. Fig. V: Pre- and post-intervention comparison of vas score on activity in the conventional group Table V: Pre- and post-intervention comparison in the conventional group Discussion Fig. VI: Pre- and post-intervention comparison of ndi score in the conventional group Fig. Vill: Pre- and post-intervention comparison of vas score on activity in the experimental group taken at the face value. The sample size of the study was small. Fig. IX: Pre- and post-intervention comparison of ndi score in the experimental group Fig. VII: Pre- and post-intervention comparison of vas score at rest in the experimental group training, the craniocervical flexor endurance training group showed significant improvement in patient reported pain scores which increased throughout the treatment period of six weeks. The craniocervical flexor endurance regime emphasizes on retraining the altered motor control'*. Pain relief is concomitant with patient mastering isolation of correct muscle action and developing holding ability**. Re- establishment of motor control induces local afferent input into the system to modulate pain perception". It has been suggested that the induced afferent input may stimulate neural inhibitory system at various levels in spinal cord and may also activate descending inhibitory pain pathways. It is also possible that early intervention to reduce the barrage of nociceptive input may reduce potential motor control dysfunction'’. These proposed explanations serve as a platform to justify the effects of endurance training on chronic neck pain in cervical spondylosis in the present study. Fig. 1: Shows the mean baseline score of CSAS for the two groups. Fig. 1: Determination of Index of Kyphosis and Index of Lordosis by flexicurve tracing. Table 1: Summary of all the KT-1000 anterior absolute and side-to-side difference measurements (mm) for the patients with a right-sided ACL injury, in the pre-operative and the post-operative group. Table 2: Summary of all the KT-1000 anterior absolute and side-to-side difference measurements (mm) for the patients with a left-sided ACL injury, in the pre-operative and in the post-operative group The RPT/L measured significantly higher laxity values in the left knee than RPT/R. This was found in the injured and non-injured knees in both the ACL-deficient group and the post-operative group. Table 3: Summary of all the KT-1000 anterior absolute and side-to-side difference measurements (mm) in the healthy control group (n = 20) The RPT/R measured significantly higher laxity values in the right knee compared with the RPT/L The RPT/L measured significantly higher laxity values in the left knee compared with the RPT/R The RPT/R measured significantly higher laxity values in the right knee compared with the left knee * A significant difference was found between the right and left knee (P < 0.01); ** (P < 0.001) Fig. 1 a: KT-1000 arthrometer measurements as performed by one right- hand dominant physiotherapist. b: KT-1000 arthrometer measurements as performed by one left-hand dominant physiotherapist absolute KT-1000 measurements were between 0.71 and 0.86. The intra-reliability for the absolute measurements on the right and left knee in the healthy control group were 0.83-0.94 for RPT/L and 0.71—0.86 for RPT/R. Subscription Information
