The Journal of Indian Association of Physiotherapists (Physiother - J Indian Assoc Physiother)

Expanding the horizon of physiotherapy profession Sanjiv Kumar Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):49-52

Cognition and quality of life in older adults Dhara Abhinav Sharma, Megha Sandip Sheth, Disha Janak Dalal Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):53-57 BACKGROUND: According to the recent report by the Ministry of Statistics in India, number of elderly accounts for 8.6% of the country's population. Aging causes biological as well as psychological changes. Decline in cognitive functions is one of the normative changes of aging; however, this may impact both physical and mental health of an individual. Quality of Life (QoL) is one of the prime features of successful aging. Hence, this study was undertaken to correlate the level of cognition and QoL in older adults. METHODOLOGY: One twenty-nine males and females of age 60–75 with or without cognitive impairment were selected using convenience sampling, those who could not read Hindi, who had any unstable medical condition, whose vision could not be corrected to normal level, and those with impaired speech were excluded from the study. Montreal cognitive assessment (MoCA) was administered to assess the cognitive level. QoL was assessed by QoL-Alzheimer's disease (AD) scale. RESULTS: Result indicated that there is a moderate positive correlation between MoCA and QoL-AD with r = 0.465 and P < 0.05. CONCLUSION: The study concludes that the level of cognition and QoL of older adults are moderately in positive correlation with each other.

Reaction time in sitting and standing postures among typical young adults MN Anitha, Vijay Raj V Samuel Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):58-62 CONTEXT: Reaction time (RT) is one of the important components of physical fitness. Evaluation of RT is vital to understand and plan a training program. There is a need to comprehend the normative values of RT in young adults in different functional postures, which will enable the clinician to plan the fitness program effectively. AIMS: The aim of this study was to observe the RT in sitting and standing postures among typical young adults. SETTINGS AND DESIGN: This was an observational study. SUBJECTS AND METHODS: Sixty-five young Indian men and women students from a college at Mysore were included in the study. The participants' dominant hand was used to assess the RT in standing and sitting postures with their dominant hand. With the given distance, the RT was then calculated using standard conversion formulae. STATISTICAL ANALYSIS USED: The RT between standing and sitting was analyzed using mean, standard deviation (SD), and paired t-test. RESULTS: The RT analyzed for 22 men in sitting showed excellent RT with a mean 0.1188 (SD 0.0455) and 0.0929 (SD 0.0385) in sitting and standing postures, respectively. Women (n = 43) in sitting had a good RT with a mean of 0.1401 (SD 0.0314) and in standing an excellent RT with a mean of 0.1092 (SD 0.0323). Men had better performance when compared with women, both in standing and sitting postures. Paired test for standing and sitting showed significant difference with t value of 5.364 and P < 0.005, with reduced RT in standing. CONCLUSIONS: The study concludes that the RT is comparatively reduced in standing than in sitting among the young adults.

Comparative effects of Stratified Back care approaches in individuals with nonspecific low back pain Bashir Bello, Muhyiddeen Suleiman Bichi Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):63-72 BACKGROUND: Stratified Back care is a recently developed method for treating low back pain. PURPOSE: This study compared the effects of two stratified care approaches (sub-grouping for targeted treatment [STarT] and specific treatment of the problems of the spine [STOPS] in patients with nonspecific low back pain [NSLBP]). MATERIALS AND METHODS: Forty-six individuals, with NSLBP, participated in this single-blinded, randomized clinical trial. Participants were randomly assigned into one of the two groups: STarT Back Group (n = 23) or STOPS group (n = 23). Treatment was applied twice weekly for 8 weeks. Outcomes assessed pre- and post-interventions were pain intensity (PI) using numeric pain rating scale and functional disability (FD) using the Oswestry Disability Index. Participants in both groups were comparable in age (44.65 ± 9.03 vs. 46.40 ± 7.39) years. At baseline, PI, FD, and anthropometric values were comparable in both groups. RESULTS: The Results showed a significant difference in PI between the STarT and STOPS with a mean difference of −1.24 and 95% confidence interval (−0.86 to −0.04), P < 0.05, with no significant difference in FD, P > 0.05 between the groups. However, there was a significant difference within each group in pain and FD with P < 0.05. CONCLUSION: It was concluded that STarT Back approach was more effective in reducing PI only than STOPS approach in individuals with NSLBP.

Enhancing professionalism in physiotherapy interns using a structured teaching and assessment module Mariya Jiandani, Amita Mehta Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):73-78 INTRODUCTION: Professionalism describes the skills, competency, attributes, and behavior of an individual belonging to a profession. The physiotherapy graduate on completion of internship has direct access with the community as a professional. Hence, there is a need to explicitly teach and assess professionalism. The purpose of this study was to prepare a module to enhance professionalism and use tools to assess the professional attributes uniformly. MATERIALS AND METHODS: A module was formulated with the help of experts, literature review, and guidelines of various physiotherapy regulatory bodies nationally and internationally. Focused group discussions were used as a method to identify competencies. After designing the module, a prospective intervention trial was conducted wherein 40 students who joined the internship program of a tertiary care hospital of India, were enrolled for the study. A participatory approach was used which included an interactive workshop on “ethics in clinical practice, communication skills, and professionalism.” A written pre-post evaluation and workplace-based assessment were carried out in four core physiotherapy areas. Competencies and attributes were measured using tools such professional mini-evaluation exercise (P-MEX), prevalidated checklist for clinical reasoning, patient feedback form, and a retro-preevaluation of self-assessment form of the American Physical Therapy Association. RESULTS: A total of 34 students completed the module. Data were analyzed using SPSS 16 software. Nonparametric Wilcoxon Signed Rank test was used to analyze the descriptive data. The statistical significance was kept at P < 0.05 at a confidence interval of 95%. There was a statistically significant increase in the knowledge component pre-post analysis (P < 0.00). Change in professional attributes as measured by P-MEX showed a significant change in Doctor-patient relationship (P < 0.01) and interprofessional skills (P < 0.001) followed by reflective skills (P < 0.007) and time management skills (P < 0.003). There was also a significant difference in total patient feedback scores from baseline (P < 0.01). CONCLUSION: The module helped students gain the knowledge and skills required to communicate and handle difficult situations relevant to physiotherapy practice.

Cross-cultural adaptation, reliability, validity, and factor analysis of the Gujarati version of the Tampa scale of kinesiophobia in chronic low back pain Dibyendunarayan Dhrubaprasad Bid, A Thangamani Ramalingam, Saumi R Sinha, Payal B Rathi, Vidhi N Patel, Jainab M Rajwani, Krutika N Patel Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):79-86 BACKGROUND: Nowadays more attention is being given to standardizing the outcome measures for improving treatment methods for chronic low back pain (CLBP). The Gujarati translation of the Tampa scale of kinesiophobia (TSK) in patients with CLBP has never been validated in the native Gujarati population. PURPOSE: Translating, culturally adapting, and validating the Gujarati version of the TSK-Gujarati (TSK-G) to allow its use for Gujarati-speaking patients with CLBP. MATERIALS AND METHODS: The development of the TSK-G questionnaire involved its translation and backtranslation, a final review by an expert committee, and testing of the pre final version in establishing its correspondence to the original English version. The psychometric testing included reliability by internal consistency (Cronbach's α), test-retest reliability (intraclass coefficient correlation [ICC]), convergent and divergent validity (Pearson's correlation) by comparing TSK-G to a numerical pain rating scale, fear-avoidance beliefs questionnaire (FABQ), the Roland Morris disability questionnaire (RMDQ), and patient health questionnaire-9 (PHQ-9); and factor analysis. RESULTS: Factor analysis indicated a 6-factor 17-item solution (64.07% of explained variance). The questionnaire showed satisfactory internal consistency (0.639) and moderate test-retest reliability (ICC 0.696). Divergent validity showed low correlations with numerical pain rating scale (r = 0.044), the RMDQ-G (r = 0.06), and PHQ-9-G (r = 0.269); but convergent validity showed highly significant correlation with FABQ-G (r = 0.407, P = 0.001). CONCLUSION: The successful translation of TSK questionnaire into the Gujarati language shows good psychometric properties and factorial structure and approximates the results of the current English version of the TSK questionnaire.

Long-term effectiveness of physiotherapy in a case of ankylosing spondylitis Ratan P Khuman Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):88-92 Ankylosing spondylitis (AS) is a relatively uncommon inflammatory arthritis that affects the axial joints. The diagnosis is often missed and markedly delayed. Here, we report a delayed diagnosis of AS in a 47-year-old male, 10 years after the onset of back symptoms, using the modified New York criteria. The objective of this case report is to outline the long-term effectiveness of physiotherapy interventions. The condition was managed with supervised physiotherapy intervention and unsupervised home exercises for 3 months and was followed for 1 year to investigate the long-term effectiveness of the interventions. It was found that the combination of supervised physiotherapy interventions and unsupervised home exercises had promising short term as well as long-term effects without deterioration in AS symptoms with increased patient satisfaction and confidence.

Feasibility of application of constraint-induced movement therapy in a child with hemiplegic cerebral palsy: A single-case study Darshanaben J Tadvi, Vasanthan Rajagopalan Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):93-97 Children suffering from hemiplegic cerebral palsy (CP) develop developmental disregard (DD). In addition, they fail to comprehend the consequences of nonuse. The utility of affected upper limb is jeopardized. Current evidence supports the use of constraint-induced movement therapy (CIMT) for upper limb function in individuals with hemiplegia. This single-case study attempts to identify feasibility of application of pediatric CIMT on a child with hemiplegic CP. The aim of this study is to identify the benefits and feasibility of application of CIMT for improving quality of the upper limb movement in a child with hemiplegic CP. A 2½-year-old girl with hemiplegic CP visited the outpatient department (OPD) with the problem of lack of use of the right upper limb for activities and play along with the poorer quality of the upper limb movement. Disregard index was calculated to identify the presence of DD. CIMT was chosen as the child had above minimal ability to open fingers and extend the wrist. A 2-week intervention was designed based on the goal-oriented, ability-specific, child-specific practice of functional tasks. A rigid tape was used to provide constraint. The child was motivated to play with the affected hand for 2 h in the OPD and 2 h at home. Tasks of incremental difficulty were utilized as shaping method. The improvement in the quality of movement was measured using quality of upper extremity skilled test (QUEST) and Assisting Hand Assessment (AHA). The score on QUEST improved from 66.35 to 72.1, AHA improved from 66 to 73, and the disregard index score improved from 42.75 to 26.3 in 2 weeks. The treatment was adjusted to accommodate the behavior of the child.

Providing cancer rehabilitation services: Are there some guiding principles? Tan Yeow Leng, Saw Hay Mar Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):98-99

Towards fast and reliable simultaneous EEG-fMRI analysis of epilepsy with automatic spike detection

Publication date: Available online 17 December 2018

Source: Clinical Neurophysiology

Author(s): Amir Omidvarnia, Magdalena A. Kowalczyk, Mangor Pedersen, Graeme D. Jackson

Abstract

Objective

The process of manually marking up epileptic spikes for simultaneous electroencephalogram (EEG) and resting state functional MRI (rsfMRI) analysis in epilepsy studies is a tedious and subjective task for a human expert. The aim of this study was to evaluate whether automatic EEG spike detection can facilitate EEG-rsfMRI analysis, and to assess its potential as a clinical tool in epilepsy.

Methods

We implemented a fast algorithm for detection of uniform interictal epileptiform discharges (IEDs) in one-hour scalp EEG recordings of 19 refractory focal epilepsy datasets (from 16 patients) who underwent a simultaneous EEG-rsfMRI recording. Our method was based on matched filtering of an IED template (derived from human markup) used to automatically detect other 'similar' EEG events. We comprehensively compared simultaneous EEG-rsfMRI results between automatic IED detection and standard analysis with human EEG markup only.

Results

In contrast to human markup, automatic IED detection takes a much shorter time to detect IEDs and export an output text file containing spike timings. In 13/19 focal epilepsy cases, statistical EEG-rsfMRI maps based on automatic spike detection method were comparable with human markup, and in 6/19 focal epilepsy cases automatic spike detection revealed additional brain regions not seen with human EEG markup. Additional events detected by our automated method independently revealed similar patterns of activation to a human markup. Overall, automatic IED detection provides greater statistical power in EEG-rsfMRI analysis compared to human markup in a short timeframe.

Conclusions

Automatic spike detection is a simple and fast method that can reproduce comparable and, in some cases, even superior results compared to the common practice of manual EEG markup in EEG-rsfMRI analysis of epilepsy.

Significance

Our study shows that IED detection algorithms can be effectively used in epilepsy clinical settings. This work further helps in translating EEG-rsfMRI research into a fast, reliable and easy-to-use clinical tool for epileptologists.

from Physiology via xlomafota13 on Inoreader https://ift.tt/2BzF3F9
via IFTTT

Do Non-Responders to Exercise Exist—and If So, What Should We Do About Them?

Abstract

It is well established that exercise is an important component in the maintenance of good health, and yet recent studies have demonstrated that a sub-section of individuals experience no significant improvements following an exercise training intervention. Such individuals are commonly termed "non-responders". However, recently a number of researchers have taken a skeptical view as to whether exercise non-response either exists, or is clinically relevant. Here, we explore the research underpinning exercise response, to determine whether non-response to exercise actually exists. We discuss the impact of measurement error and assessment type on the identification of "non-responders", and whether such non-response is global- or modality-specific. Additionally, we discuss whether, if non-response to an exercise intervention is meaningful and relevant, certain additional interventions—in the form of increasing exercise intensity, volume, or duration—could be made in order to enhance training adaptations. Consequently, based on our interpretations of the available evidence, we suggest that it is unlikely that global non-responders to exercise exist. Furthermore, we suggest this realization effectively counters the perception that some individuals will not positively respond to exercise, and that in turn, this insight serves to encourage health professionals to create more nuanced, efficacious, and individually-focused exercise prescriptions designed to circumvent and overcome apparent non-responsiveness. Adopting a more individually-adaptive approach to exercise prescription could, subsequently, prove a powerful tool in promoting population health.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2S4EmdS
via IFTTT

The Immediate Effects of Acute Aerobic Exercise on Cognition in Healthy Older Adults: A Systematic Review

Abstract

Background

Age-related cognitive decline is a worldwide challenge, highlighting the need for safe, effective interventions that benefit cognition in older adults. Harnessing the immediate and long-term pleiotropic effects of aerobic exercise is one approach that has gained increasing interest.

Objective

The aim of this review is to provide knowledge on the immediate effects of acute aerobic exercise on cognitive function of healthy older adults and to assess the methodological quality of studies investigating these effects.

Methods

A database search in PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, Web of Science, ClinicalTrials.gov and Google Scholar was conducted using a systematic search strategy.

Results

Fifteen studies were identified and cognitive domains investigated included executive function and visual perception. Results from 14 of 15 studies showed that an acute bout of aerobic exercise can enhance at least one subsequent cognitive performance of healthy older adults when measured within 15 min post-exercise.

Conclusion

The small number of studies available, the limited domains of cognition investigated, the great variability between research protocols, and the low overall quality rating limits the conclusions that can be drawn. More comprehensive randomised controlled trials are needed to address these limitations and verify the potential benefits of acute aerobic exercise.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2A47wmg
via IFTTT

Exercise Dose and Weight Loss in Adolescents with Overweight–Obesity: A Meta-Regression

Abstract

Background

A recent meta-analysis reported that exercise interventions are effective for promoting weight loss in adolescents with overweight–obesity. However, the meta-analysis did not investigate whether there is an optimal exercise dose for promoting weight loss in overweight and obese adolescents. A common method of expressing exercise dose is the calculation of metabolic equivalents (METs), expressed as MET-h/week.

Objectives

The objective of this study was to determine the association between exercise dose (MET-h/week) and weight loss [body weight, body mass index (BMI)] in adolescents with overweight–obesity.

Data Sources

Trials included in the original meta-analysis were extracted, and a subsequent search to identify studies published between May 2015 and May 2018 was conducted. The search included electronic databases (PubMed, Web of Science SPORTDiscus, Google Scholar) and the reference lists of eligible articles and relevant reviews.

Study Selection

The inclusion criteria were as follows: (i) randomized controlled trial; (ii) structured exercise intervention, alone or combined with other intervention components; (iii) control group received no structured exercise or behavioral modification designed to increase physical activity; (iv) participants overweight or obese (BMI ≥ 85th percentile); and (v) participants aged between 10 and 19 years.

Appraisal and Synthesis Methods

Fifteen trials were extracted from the original meta-analysis. The current search identified an additional five trials (three articles). Data from 20 trials (16 articles) involving 1091 participants (54% female, 17% not reported) were included in the analysis. Effect sizes were reported as mean difference, and random effects meta-regression quantified the association between exercise dose and weight loss. Study quality was assessed using a modified Jadad's scale.

Results

Total body weight change (decrease) ranged from − 2.7 to 19.3 (median 2.5) kg, and BMI change (decrease) ranged from − 1.6 to 6.3 (median 0.9) kg/m². MET-h/week ranged from 5.4 to 36.0 (median 6.0). Each MET-h/week was associated with a 0.13 kg/m² (95% confidence interval [CI] 0.08–0.19) and 0.33 kg (95% CI 0.08–0.59) decrease in BMI and body weight, respectively.

Limitations

The prescribed exercise dose for the majority of trials was low. As such, we were unable to discern whether there was an optimal exercise dose for weight loss (i.e., if the association between dose and weight loss was non-linear). Additionally, most trials had small sample sizes (median n = 34) and 17 trials had methodological limitations.

Conclusions

Each MET-h/week was associated with a 0.13 kg/m² and 0.33 kg decrease in BMI and body weight, respectively. While this relationship appears to be linear, i.e., no optimal exercise dose, it should be emphasized that the exercise prescription dose for the majority of trials was low. Subsequent trials, with greater exercise dosage, are required to determine whether there is an 'optimal' dose for promoting weight loss in adolescents with overweight–obesity. However, the current findings lend support to the use of exercise prescription for promoting weight loss and improving health outcomes in this population.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2S4Egmw
via IFTTT

Pegbelfermin (BMS-986036), a PEGylated fibroblast growth factor 21 analogue, in patients with non-alcoholic steatohepatitis: A randomised, double-blind, placebo-controlled, phase 2a trial

The Lancet

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2QCZXxe
via IFTTT

Association between aspirin use and risk of hepatocellular carcinoma

JAMA Oncology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2Bt42tI
via IFTTT