Important Risk Factor For Prediction Of Varicose Veins In General Population - Pune Based Study - Anagha Akare, Dr. Anushree Narekuli (PT)

Quality Of Life After Unilateral Lower Limb Amputation - An Observational Study - Ms. Prachi B. Sapkal, Dr. Parag Ranade (PT)

Performance Related Physical Fitness Levels In School Going Children Correlated With BMI .-pilot Study - Ms. Madhura Joshi, Dr. Rahul Bisen (PT)

Effect Of Aerobic Training Versus Resistance Training In Obese Adult - Dr. Nisha Shinde (PT) , Harshada Fulsunder

Does Tightness Affect Dynamic Balance And Agility In Recreational Collegiate Athletes? - Dr. Pallavi Wakode (PT)

Correlation Of 6mwd With Waist-hip Ratio And Rate Pressure Product (RPP) In Community Dwelling Elderly Individuals. - Dr. Prajakta Patil(PT), Saifina S Momin

Effect Of Anulom Vilom On Ventilatory Functions Of Lungs, Blood Pressure Respiratory Rate & Pulse Rate In Healthy Individuals.-an Interventional Study - Ms. Riddhi Vora, Dr Prajakta Patil (PT)

Effect Of Proprioceptive Neuromuscular Facilitation On Pain,rom, Strength And Neck Diasbility In Cervical Spondylosis - Dr Seema Saini (PT)

Comparative Study On Effects Of Kinesio Taping Versus Conventional Treatment In Cervical Spondylosis. - Dr Shweta Pachpute (PT)

Study Of Common Musculoskeletal Pain In Auto-rickshaw Drivers. (Pune Based Study) - Shivani Deshmukh, Dr. Parag Ranade (PT)

Study The Clinical Effectiveness Of Kinesio Taping Combined With Conventional PT and NSAIDs In Patients With First Stage Of Frozen Shoulder - Anagha Akare, Dr. Anushree Narekuli (PT)

Smt. Kashibai Navale e – Journal of Physiotherapy

Publication of

Sinhgad Technical Education Society's

Smt. Kashibai Navale College of PhysiotherapyNarhe, Pune – 41.Sinhgad Institutes

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It is with a great pleasure and honor; I welcome you to the second

issue of the Sinhgad e-journal of Physiotherapy. Physiotherapy profession

though is very old. There is a great change in the academic attitude due to

its research vision in the last 15 years. Due to the Health Sciences

Universities in many states of India, and specially Maharashtra University

of Health Sciences, Nashik, there is more awareness and opportunities in

the field of Teaching Technology and Research Methodology for

Physiotherapy teachers and students. Improved healthier academic environment and inter faculty

communication has helped the teachers and students to get involved in many more research studies,

independently as well as inter faculty projects.

Though the research studies are done much more in not only the numbers but of much better quality,

there is dearth of opportunities to present their work exclusively in Physiotherapy research conferences

or to publish their work in Physiotherapy journals.

Goals to start this e-journal are, firstly to establish and promote a collegial research culture and secondly,

to provide opportunities for facilitation for the physiotherapy professional communication.

We wish to encourage more contributions from the Physiotherapy Community to ensure a continued

success of the journal. Authors, reviewers and guest editors are always welcome. We also welcome

comments and suggestions that could improve the quality of the journal.

Dr. A. V. Patil, (P.T)Managing Editor

PrincipalSKNCOPT, Pune.

WELCOME MESSAGE

01

IntroductionVenous inadequacy is a circulatory condition in which there is diminished return of blood from the leg veins up to the heart, and pooling of blood in the veins.

At the point when the valves in the vein get less competent this results in blood to stream in reverse, or reflux. Varicose veins are noticeable veins that have lost their valve viability.

The etiology of varicose veins is still not well understood in spite of this condition being common among all ages from adolescents to elderly individuals.The prevalence of varicose veins varies substantially in different parts of the world ranging from 10% to 30% in men and from 25% to 55% in women in population-based studies (Callam 1994, Beebe-Dimmer et al. 2005, Robertson et al. 2008).

Other factors are pregnancy, obesity, menopause, sedentary standing or sitting, age (Ng M Andrew T et.al 2005).

In some people varicose veins are asymptomatic or cause only mild symptoms, but in others they cause pain, aching or itching .Hence, having a significant effect on their quality of life.(NICE Guidelines 2013)

Aim and ObjectivesAim:To find out most significant risk factor for prediction of varicose veins in general population.

Objectives :¡ To classify the sample in pre-determined risk factor

groups.

¡ To analyze various signs and symptoms of varicose veins in the respective risk factor groups. .

¡ To compare signs and symptoms among different risk factor groups.

METHODOLOGY

¡ Study area : Pune

¡

¡ Sample size: 100

¡ Study material: Pen and paper.

Inclusion criteria:

1. Age group- above 40 yrs. (both Male and Females)

2. Long standing occupation.

3. Obesity

4. Pregnancy

5. Parity (having 3 or more then3 children)

Exclusion Criteria:

1. History of DVT, Thrombophlebitis

2. History of leg injury

3. Thromboembolism

4. Peripheral vascular disease other than varicose veins

Procedure :

¡ Prior permission was taken from the principal of SKNCOPT to conduct the study.

¡ Subjects were selected according to inclusion criteria.

¡ There were five groups , Age group above 40 yrs, long standing occupation, obesity, pregnancy and parity.

¡ Each group contained 20 no. of people.

¡ People who already had varicose veins, those were also included.

¡ The subject was informed and explained about the need of the study and written consent was taken from the patient.

¡ Verbal interview of prevalidatd questionnaire was done and data was analyzed according to response.

RESULTSvarious signs and symptoms of varicose veins in the respective risk factor groups.

Study design : Cross sectional study Survey

IMPORTANT RISK FACTOR FOR PREDICTION OF VARICOSE VEINS IN GENERAL

POPULATION - PUNE BASED STUDY1 2 Anagha Akare , Dr. Anushree Narekuli (PT)

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Asst. Professor, Dept. of Community Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

Age group above 40 yrs.

Fig 1

The above pie diagram shows that, 15%of people of Age group above 40 had risk for varicose veins.

Long standing occupation

Fig 2 The above pie diagram shows that 75% people are who have a long standing occupation are at the risk of varicose veins

Obesity

Fig 3

The above pie diagram shows that 30% people who were obese had the risk of varicose vein

Parity

The above pie diagram shows that 20% of women with parity were at the risk of varicose veins

Fig 4

Pregnancy

Fig 5

The above pie diagram shows 55% of pregnant females had the risk of varicose veins

Mean of Age and Duration of Pain Inrelation to Risk Factors

Table 1

From the categories taken into consideration, the maximum number of people who were positive for the occurance of varicose veins was from those having the presence of obesity and pregnancy.

Total of 100 people were screened out of which 5 groups were made and 20 people were included in each group. This data was analysed and the results are as below:

02

Sr.No Groups

Duration of pain

in months Age

Positive forVaricose veins

1

Age group above 40

7.6±38.57(n=3) 49.65±3.96(n=20) 2

2

Long standing occupation 37.33±39.86(n=15) 41.35±4.06(n=20) 6

3 Obesity 76±49.06(n=6) 59.05±2.98(n=20) 3

4 Pregnancy 56.83±10.59 (n=10) 23.85±3.13(n=20) 4

5 Parity 63±30(n=4) 51.75±4.89(n=20) 1

Important Risk Factor For Prediction Of Varicose Veins In General Population - Pune Based Study

Fig 6

The above bar diagram shows that , there are 2 people in age group above 40 yrs,6 people in long standing occupations,3 people in obesity,4 people in pregnancy and 1 person in parity who already have varicose veins.

Among these people, Long standing occupation has higher risk for developing varicose veins, which is followed by pregnancy, obesity, age group above 40years and parity, which is affected the least

Fig 7

The above bar diagram shows that there is 1 person in Age group above 40years, 9 people in long standing occupation, 3 people in obesity ,7 people in pregnancy and 3 people in parity who do not have varicose veins.

Among these people, Long standing occupation has higher risk for developing varicose veins, followed by pregnancy, parity and obesity, and age group has least chances .

Fig 8

In long standing occupation group, maximum people gave positive response for signs and symptoms of varicose veins.

Fig 9

The above diagram shows people who are positive and negative for signs and symptoms of varicose vein in pregnant women

Fig 10

The above diagram shows people who are Positive and negative for signs and symptoms of varicose veins in obese group

Fig 11

The above diagram shows the people who are positive and negative for signs and symptoms for varicose veins in parity.

SEJOP E-journal Volume-1, Issue -1, January 2017

03

Fig 12

The above diagram shows the people who are positive and negative for the signs and symptoms for varicose veins in age group above 40 years.

DiscussionAim of the study was to find out most significant risk factor for prediction of varicose veins¡ A study of 100 samples was carried out¡ Data obtained was analyzed ¡ In age group above 40, 15% people showed signs &

symptoms for varicose veins, 75%in long standing occupation,30% in obese people,55% in pregnancy and 20% in parity.

¡ Thus , in this study Long standing occupation is a major risk factor for the occurence of varicose veins followed by pregnancy, obesity, parity and age group of 40 years being a minor one.

¡ Findings of this study was supported by the study done by Kriestensen TS et al ,they concluded that working mostly in standing position , the risk ratio

for varicose vein was (95%) in comparison with all other working people.

ConclusionThus finding of this study concluded that long standing occupation is more significant risk factor for varicose veins.

References : [1] Ng M Andrew T. et al; causes of varicose veins

;journal of varicose veins ; Pg no .423-430 Thayes E. Scott et al , Risk factors for chronic venous insuffienciency ; journal of vascular surgery ;Volume 22.pg no.622-628

[2] Mount sinhai , New york,Epidemiology of varicose veins;volume 22 Pg no. 22-24

[3] Peter Gloviczki et al , The care of patients with varicose veins and associated chronic venous diseases ; journal of vascular surgery ; Volume 53.Pg. no.428-448

[4] C J Evans et al , Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population ; journal of epidemiol health ; Volume 53.Pg. no.149-153.

[5] Shikshasharmaet.al ,Certain profession of working as Risk Factors for varicose veins;IOSR j o u r n a l o f f a r m a c y a n d b i o l o g y o f science;volume7 ,Pg no. 56-59

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Important Risk Factor For Prediction Of Varicose Veins In General Population - Pune Based Study

05

Introduction Amputation is a dramatic, life-altering event that typically results from either disease or trauma.

Amputation could be described as the removal of a body extremity by surgery or trauma. The number of amputations appears to be on the rise despite advances in vascular surgery and diabetes management, and mortality following lower limb amputation is high .

Limb loss can be the result of trauma, malignancy, disease, or congenital anomaly. Vascular disease is the most common cause of limb loss overall, with the rate of dysvascular amputation being nearly 8 times greater than the rate of trauma related amputations, the second leading cause of limb loss (Amputee Coalition of

1America 2010) .

What is Quality of life….?Quality of life (QOL) is the general well-being of individuals and societies. Quality of life should not be confused with the concept of standard of living, which is based primarily on income. Instead, standard indicators of the quality of life include not only wealth and employment but also the built, environment, physical and mental health, education, recreation and leisure time, and social belonging.

Quality of life (QoL) is increasingly being recognized as an important outcome for rehabilitation programs, and has mainly been used to compare the efficacy of interventions or to compare amputees with other diseased populations6.

AIMTo study the quality of life after unilateral lower limb amputation.

OBJECTIVETo find out the most affected domain in the quality of life.

MATERIALS USEDSF-36 questionnaire,pen and pencil

METHODOLOGY¡ Study design: Cross-sectional observational study¡ Study area: Pune city(rehabilitation centres).¡ Study population: Patients between age of 20 - 60

years.¡ Duration: 3 months..¡ Sample size: 24.

INCLUSION CRITERIA¡ Lower limb unilateral amputees ,trans femoral and

trans tibial(3-6 months after amputation)with prosthesis

¡ Both males and females¡ Age group-20-60yrs

EXCLUSION CRITERIA¡ Bilateral or unilateral Upper limb amputees¡ Bilateral lower limb amputees(AK and BK)¡ Patients with chronic disabilities such as stroke

PROCEDURE¡ Ethical clearance was obtained from the ethical

clearance committee.¡ Duration of the study was 3 months.Subjects were

selected according to the inclusion criteria.¡ Written consent letter was taken from the subjects.¡ Amputee patients were given SF-36 questionnaire

and was asked to select the option which best suited them.

¡ Scoring of the questionnaire was done and data was analyzed.

STATISTICAL ANALYSISTo find out the most affected domain, scoring of the questionnaire was done and interpretations were analyzed.

The 8 domains were further clubbed into 4 domains each and were divided into 2 scales:

QUALITY OF LIFE AFTER UNILATERAL LOWER LIMB AMPUTATION - AN OBSERVATIONAL STUDY

1 2Ms. Prachi B. Sapkal , Dr. Parag Ranade (PT)

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Professor, Dept. of Neuro Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

¡¡ Mental component scale

Physical component scale consists of following domains:¡ Physical functioning¡ Bodily pain¡ Role limitations due to physical health¡ General health

Mental component scale consists of:¡ Role limitations due to emotional health¡ Energy/fatigue¡ Social functioning¡ Emotional well being

The components affected are depicted in the graphs and pie diagrams below

Graph 1

Physical Component Scale

o Total no of subjects : 24o AK amputees:6(25%)o BK amputees:18(75%) o Where X axis= domainso Y axis=total no of subjects

Components affected in percentage

Physical component scale

Graph 2

Mental component scaleo Total no of subjects : 24o AK amputees:6(25%)o BK amputees:18(75%) o Where X axis= domainso Y axis=total no of subjects

Components affected in percentage

Graph 3

Comparison between physical and mental component scaleo Total no of subjects : 24o AK amputees:6(25%)o BK amputees:18(75%) o Where X axis= domains

06

Quality Of Life After Unilateral Lower Limb Amputation - An Observational Study

o Y axis=total no of subjects

DISCUSSIONAfter amputation, victims face a number of challenges both within himself and in the environment.

Besides, Victims have problems with returning to work after lower limb amputation(Burger & Marincek 2007,

61328.)

As time passes, the individual discovers how well he or she can cope with the newly found limitations and

7restrictions (Horgan & MacLachlan 2004, 841.)

Previous studies conducted commented on comparison between unilateral and bilateral amputees and its affection on quality of life, also comparison of the affection quality of life between normal individuals and amputees. In my study individual domain of quality of life was highlighted among amputees.

In the physical component scale: Role limitations due to physical health was the most affected domain-14 subjects; physical functioning affected in 6 subjects; general health affected in 2 subjects and bodily pain affected in 2 subjects.; each out of 24 subjects.

In the mental component scale:Role limitations due to emotional well being was the most affected domain-10 subjects ; social functioning in 8 subjects ; energy and fatigue in 4 subjects and emotional well being in 2 subjects ; each out of 24 subjects.Thus in thus study ,The physical component was affected by 58.3% and mental component was affected by 41.6%In physical component role limitations due to physical health was affected by 62.5% and in mental component of quality of life role limitations due to emotional health was affected by 38%. As with other physically challenged individuals, those with amputations need to be accepted and integrated into the community because of their abilities not their disabilities.Quality of life was affected as amputation took a toll on vocational abilities, recreational activities, physical performance & physical health of the amputees.

CONCLUSIONFrom this study it can be concluded that Physical component is the most affected domain than the mental component of quality of life in unilateral lower limb amputation.

REFERENCES 1. Jibby E. Kurichi, MPH University of

Pennsylvania School of Medicine Philadelphia, PA, USA

2. Barbara E. Bates, MD, MBA Assistant Professor, Physical Medicine and Rehabilitation, Albany Medical College Albany, NY, USA

3. Margaret G. Stineman, MD Professor of Physical Medicine and Rehabilitation and Epidemiology University of Pennsylvania School of Medicine Philadelphia, PA, USA

4. Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.

5. International Institute for Population Sciences (IIPS), Mumbai, India.

6. Richa Sinha, Care and Public Health Research Institute, Maastricht University

7. Williams. M. R, Ehde. M. D, Smith. G. D, Czernieck. M. J, Hoffman. J. A & Robinson. R. L. 2004 .Journal of disability and rehabilitation. A two-year longitudinal study of social support following amputation. 26 (14/15), 862-874

8. h t t p : / / w e b . e b s c o h o s t . c o m . e z p r o x y. turkuamk.fi/ehost/pdf Retrieved on 20.12.2009

9. Pieter U Dijkstra Department of Rehabilitation, University Hospital Groningen, 9700 RB Groningen, The Netherlands.

10. American Congress of Rehabilitation Medicine. Published by Elsevier Inc.

11. Hospital, T?bbiye Caddesi, Selimiye Mahallesi, 34668 Uskudar, Istanbul,

12. Turkey1GMMA Haydarpasa Training Hospital, Istanbul, Turkey

13. 2TAF Rehabilitation and Care Center, Ankara, Turkey

14. Selim Akarsu, Gulhane Military Medical Hospital, Haydarpasa Training

15. Bosma J, Vahl A, Wisselink W.

16. Amputee Coalition of America. 2010. ACA's Limb Loss Task Force warns of increasing limb loss in the U.S.

17. Aulivola B, Hile CN, Hamdan AD, Sheahan MG, Veraldi JR, Skillman JJ, et al. 2004. Major lower extremity amputation: Outcome of a modern series. Archives of Surgery 139(4):395-399; discussion 399.

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INTRODUCTION Childhood health is an emerging area of public health . Morbidities associated with the childhood obesity are increasing. Some of the reasons attributed to the increase in obesity are decrease in fitness levels, improved economic status, better lifestyle choices etc.

1which decreases the time spent in physical activity .

There are also children with poor nutritional status thus poor fitness levels , reason may be any cultural belief

3,poverty or lack of awareness.

Studies have reported that there is decrease fitness level amongst urban population

What is physical fitness ??Physical fitness is a set of attributes that people have or achieve. Being physically fit has been defined as an ability to carry out daily tasks with vigour and alertness, without undue fatigue, with ample energy to enjoy leisure time pursuits (presidents council on physical therapy on fitness and sports.: physical fitness research digest . series -1,no.-1. Washington DC,1971)

PERFORMANCE RELATED COMPONENTSSpeed: The ability to move quickly from one point to another in a straight line.Agility: The ability of the body to change direction quickly.Balance: The ability to maintain an upright posture while still or moving.Coordination: Integration with hand and/or foot movements with the input of the senses.Reaction Time: Amount of time it takes to get moving.Power: The ability to do strength work at an explosive pace.Health related componentes : cardiovascular fitness, body composition, flexibility, muscular strength and endurance.

AIMTo find out level of physical fitness in school going children between the age of 10 to 12 years.

OBJECTIVE¡ To find out performance related physical fitness in

10-12years children.¡ To find out performance related physical fitness in

girls and boys.¡ To find out performance related physical fitness

correlated with BMI.

MATERIALS USED¡ Medicine ball¡ Chalk¡ Measuring tape¡ Ruler

METHODOLOGY¡ Study area- Sinhgad spring dale school playground.¡ Study design- Observational study.¡ Sample size- All the children between 10 to 12 years.¡ Sample type- Simple random sampling

INCLUSION CRITERIAChildren between the age 10 to 12 years.

EXCLUSION CRITERIAChildren with cardiovascular, respiratory, musculoskeletal, and neurological problems

PROCEDURE¡ Ethical Permission is taken from the principal of

SKNCOPT

¡ Permission from the principal of school is taken

¡ Ethical committee's approval is taken. Students were explained about the procedure and their assents are taken.

¡ Subjects were selected according to the inclusion criteria. Three components are checked 1)speed 2) power 3) agility.

¡ The weight and the height were in kg and centimeters measured and BMI is calculated.

PERFORMANCE RELATED PHYSICAL FITNESS LEVELS IN SCHOOL GOING CHILDREN

CORRELATED WITH BMI .-PILOT STUDY1 2Ms. Madhura Joshi , Dr. Rahul Bisen (PT)

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Asst. Professor, Dept. of Neuro Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

¡ Analysis is done according to the percentile values for each age group.

¡ The performance related parameters were checked by performing these three tests

¡ Medicine ball throw test- The child will be instructed to stand with feet apart, knees bent in a forward bent posture Thechild will be then instructed to grasp the medicine ball with both hands and throw it over head and backwards using the thrust from the knees straightening back and the upper limbs. The distance will be measured in meters.

¡ Vertical jump test-The child will be instructed to stand with one arm raised overhead. The point of the tip of the middle finger was marked. The child will be then instructed to jump as high as possible. The distance from the initial point to the tip of the middle finger reached during the jump will be measures in centimetres.

¡ 30m run test- the child will be instructed to run as fast as possible for a distance of 30m and the time taken will be measured in seconds..

STATISTICAL ANALYSISChildren were divided into age groups consisting of 1-year intervals. Values were computed for each genderThe tests were classified as mean ± 2 standard deviation (SD)-average; mean <-2 SD as poor and mean >+2 SD as good fitness levels and the children were scored accordingly. The physical fitness of girls and boys is calculated and its correlation with BMI is seen.

The BMI for children is categorised according to the percentile ranges <5%- underweight, 5%-85% is healthy, 85%-95% - at high risk of over weight, >95%overweight.

GRAPH 1 and 2 BMI OF GIRLS AND BOYS

Graph-1

Graph-2

Graph-3

GRAPH-4 and 5 RESULTS OF VERTICAL JUMP TEST.

Graph-4

Graph-5

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SEJOP E-journal Volume-1, Issue -1, January 2017

GRAPH 6 and 7 RESULTS OF MEDICINE BALL THROW TEST

Graph-6

Graph -7

GRAPH 8 and 9 RESULTS OF 30 M RUN TEST

Graph-8

Graph-9

GRAPH 10 and 11 RESULT OF COMPARISON BETWEEN GIRLS AND BOYS.

Graph-10

Graph-11

CORELATION WITH BMIWhen the statistical analysis was done there was no significant statistical correlation found with the BMI.

DISCUSSIONThere are reported studies suggesting that decreasing levels of fitness are on an alarming rise in India. Reasons attributed to this trend are increasing affluence, and academic competitiveness, which forces the child to devote very little time to physical activity. Some of the problems due to decreased physical fitness in the growing years are early onset of diabetes, hypertension,

1childhood asthama. The children had an average level of physical fitness this might indicate that lack of basic exercises. The 12 year boys performed slightly better than the 11 and 10 years boys in all the three tests. Whereas the girls of all the age groups performed equal in all the three tests. When the activities were correlated with the BMI there was no significant difference seen as the children coming in obese category were zero so we can say that the majority of children were healthy. The girls performed equally well as the boys in terms of agility. Whereas in terms of power in medicine ball throw test and speed in 30mtr run test the boys were slight better than the girls. The reason could be that the puberty begins at the age of 9 or 10 when the hypothalamus starts to release GnRH and andrenal

9glands produces androgens. EstrogenB seems to have

10

Performance Related Physical Fitness Levels In School Going Children Correlated With Bmi .-pilot Study

an effect in muscle contractile speed, making boys more efficient in producing power and testosterone is important in muscle-building thus developing more

10muscle mass than girls.

CONCLUSIONOverall the components of performance related physical fitness level which are speed, power, agility of the children in Sinhgad School was average and It is necessary to increase awareness of physical activity among school children, parents, teachers so that fitness programs can be incorporated in the schools

REFERENCES1. Zwiren LD. The public health perspective:

Implications for the elementary physical education curriculum. In: Leppo ML, editor. Healthy from the Start: New Perspectives on Childhood Fitness. Washington, DC: ERIC Clearinghouse on Teaching and Teacher Education; 1993. p. 25-40. ED 352 357.

2. Kaur S, Kapil U, Singh P. Pattern of chronic diseases amongst adolescent obese children in developing countries. Curr Sci 2005;88:1052-6.

3. Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Sood NK, et al. Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J2004;56:310-4.

4. Khadilkar VV, Khadilkar AV. Prevalence of obesity in af?? uent school boys in Pune. Indian Pediatr 2004;41:857-8.

5. Chhatwal J, Verma M, Riar SK. Obesity among pre-adolescent and adolescents of a developing country (India). Asia Pac J Clin Nutrition 2004;13:231-5.

6. Kapil U, Singh P, Pathak P, Dwivedi SN, Bhasin S. Prevalence of obesity amongst af?? uent adolescent school children in Delhi. Indian Pediatric 2002;39:449-52

7. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the centers for disease control and prevention and the American C o l l e g e o f S p o r t s M e d i c i n e . J A M A 1995;273:402-407

8. Khadilkar VV, Khadilkar AV, Choudhury P, Agarwal KN, Ugra D, Shah NK. IAP growth monitoring guidelines for children from birth to 18 years. Indian Pediatric 2007;44:187-97.

9. 2004 study published in American physiology society.

10. Medicinenet.com puberty stages and signs for boys and girls

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INTRODUCTIONObesity is defined as abnormal or excessive fat accumulation that may impair health. It is most commonly caused by combination of excessive food energy intake and lack of physical activity. Body mass index of weight for height that is commonly used to classify overweight and obesity in adults. It is defined as person's weight in kilograms divided by the square of his height in meters (kg/m2). BMI greater than or equal to 30 is obesity. Obesity is the 5th leading risk for global

1death.

A fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expanded. Globally there has been-

¡ An increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transformation and increasing urbanization.

¡ An increase intake of energy dense foods those are high in fat.

¡ Increase BMI is a major risk factor for non communicable diseases such as: cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death, diabetes, muscu loske le ta l d i so rde r s (espec ia l ly osteoarthritis- a highly disabling degenerative disease of the joint), some cancers (endometrial,

2breast and colon)

Physical activity is a component of energy balance that is particularly important in pathogenesis of obesity and in its treatment. Physical exercise and activity are also important for maintaining long term weight loss. There are several ways to prevent obesity and exercise is one of the most effective. The best way to lose weight is to do so gradually by engaging in regular physical activity. There are also several benefits to becoming physically active, such as reducing your risk of certain medical conditions, improving self esteem, and reducing

3anxiety and depression. The goal of treatment for obesity is weight loss. Exercise is an essential part of any weight-loss program and should become a

permanent part of your lifestyle. The benefits of exercise can include: ¡ burning off calories and losing weight ¡ maintaining muscle tone ¡ increasing your metabolic rate (the amount of

calories your body burns 24 hours a day) ¡ improving circulation ¡ improving heart and lung function ¡ increasing your sense of self-control ¡ reducing your level of stress ¡ increasing your ability to concentrate ¡ improving your appearance ¡ reducing depression ¡ suppressing your appetite ¡ helping you sleep better ¡ preventing diabetes, high blood pressure, and high

cholesterol ¡ decreasing your risk of some cancers, such as

4breast, ovary, and colon cancer.

Aerobic and resistance exercise have independent effect on obesity. Aerobic training is carried out with large muscle group contraction, for long period of time. On the other hand resistance training consist of specific body segment contraction, against a force that opposes

5the movement.

Aerobic training is characterized by the execution of cyclic exercises that carried out with large muscle groups contracting at mild to moderate intensities for a long period of time. On the other hand resistance exercise training is characterized by the execution of exercises in which muscles from a specific body segment are contracted against a force that opposes

6themovement.

For the treatment of the obesity, physical exercise (PE) for longer than 30 minutes every day is recommended by the US department of health and human services, and specifically aerobic exercise with the moderate intensity of 40-70 % of the maximal heart beat, for at

7least 150 minutes per week.

EFFECT OF AEROBIC TRAINING VERSUS RESISTANCE TRAINING IN OBESE ADULT

1 2Dr. Nisha Shinde (PT) , Harshada Fulsunder

1Asso Professor, Dept. of Community Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune2Intern - PIMS, COPT, Loni

AIMS AND OBJECTIVEAim: To compare the effectiveness of Aerobic Exercise to Resistance exercise in Obese Adults.

Objectives: 1. To evaluate the individual effect of aerobic and

resistance exercises in obese adults.2. To compare, which intervention is beneficial. METHODOLOGYSource of Data: Department of Cardio-respiratory Physiotherapy, KEM Hospital, Pune.Method of collection of data (including sampling procedure if any):Type of data: Data will be Primary collected by the Principal investigator Study design: Randomized Controlled TrialSample size: 30Participants: Male and Female individuals with clinical diagnosis of obesity who were referred to Cardio-respiratory physiotherapy Department and Medicine department and who were willing to participate in the study from KEM Hospital, PUNE.

Sampling Method: Simple random sampling by tossing the coin and allocation of the participants to the two groups: group A (Aerobic exercises) group B (Resistance exercises)

Equipment Used: Treadmill, Static bicycle, Thera bands, Thera tubes, Dumbbells, weight cuffs.Materials used for the study:¡ Stool / chair¡ Consent form¡ Data collection sheet¡ Evaluation chart¡ Weighing machine

SELECTION CRITERIA:Inclusion criteria:¡ Age 20 to 60 years.¡ Adults with BMI ? 30 kg/m2¡ Patients clinically diagnosed with obesity.¡ Both male and female participants.

Exclusion criteria:¡ Heart disease¡ Pulmonary disease¡ Uncontrolled hypertension¡ Kidney failure¡ Musculoskeletal and/or neurological limitations to

exercise

OUTCOME MEASURES:¡ BMI of participants pre and post exercise

intervention ¡ Waist hip ratio

PROCEDURE: ¡ Total 30 individuals, 15 in each group divided

randomly into two groups.All the participants with clinical diagnosis of obesity were screened for the study. As per the suitable inclusion and exclusion criteria, participants were randomly allocated to any one group and an informed written consent was obtained.

¡ Group A: in aerobic training initially HR max was calculated and the exercises started with intensity of 50% HR max. The session was started with initial warm up than followed by skipping rope, spot jogging, brisk walking, cycling and stair climbing were the choice of exercise. The session end with slowing down the exercise.5

¡ Group B: In resistance training warm up includes stretching exercises, spot jogging, and brisk walking for 3 to 5 minutes. In this mainly large groups of muscles were exercised with a intensity of 60% of 1 RM, 12 TO 15 repetitions, rest interval (2 to 3 sets with 1 to 2 minutes of rest period and short rest periods between exercise and rest is < 30 seconds was considered for each muscle group by 1.4 kg once they completed 15 repetitions.) 5

DATA COLLECTION AND ANALYSIS Table 1: Group A- Aerobic Training BMI Pre-training BMI Post-training34.644 32.112

Result: Table no 1 shows that there is difference in the BMI of the participants doing aerobic exercises, i.e., earlier the mean BMI was 34.644 kg/cms2 and after doing exercises for 6 weeks, the mean of BMI of 15 participants reduced to 32.112 kg/cms2.

Table no. 2: Group A-Aerobic Training

Waist-Hip Ratio Waist-Hip RatioPre-training Post-training1.080 1.0726

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Result: Table no. 2 shows waist hip ratio in the participants performing aerobic exercises, i.e. the mean of the waist hip ratio was 1.080 which reduced to 1.0726 after 6 weeks of aerobic training.

Table no. 3: Group B- Resistance Training

BMI Pre-training BMI Post-training32.1 31.37

Result: Table no 3 signifies a marked change in the mean of BMI of 15 participants selected for resistance training, i.e. before the training the mean BMI was 32.1 kg/cms2 and after 6 weeks of the treatment protocol, it reduced to 31.37 kg/cms2.

Table no. 4: Group B- Resistance Training

Waist-Hip Ratio Waist-Hip RatioPre-training Post-training1.087 1.081

Result: Table no.4 gives a view of decreased waist hip ratio in the participants who performed the exercises for 6 weeks and showed that the mean waist hip ratio got reduced from 1.087 to 1.081 in 6 weeks of resistance exercises.

Table 5: BMIAerobic trainingResistance trainingPre-Training Training Training Training34.644 32.112 32.1 31.37

Result: Table no. 5 gives an overview that there is mild difference in the BMI of the participants who were performing aerobic exercises as compared to resistance exercises.

Table no. 6: Waist-Hip ratioAerobic trainingResistance trainingPre- Post- Pre- Post-Training Training Training Training1.080 1.0726 1.087 1.081

Result: Table no.6 gives an overview that there is minimum difference in the waist hip ratio of the participants who were performing aerobic exercises as compared to resistance exercises.

DISCUSSIONMany a times we go un-noticed about the consequences of overweight and obesity or even the sedentary lifestyle due to the busy and hectic life of modern world. Also there is not much awareness of its management or protocol to control it. Parmer S. compared the effectiveness of Aerobic Exercises versus Resistance Training in Overweight and Obese Adolescents. In his study there were 25 adolescents in each group with age of 10-16 in resistance group and in aerobic group. He conclude that aerobic group showed more difference than resistance group in outcome measures.

Post- Pre- Post-

14

Effect Of Aerobic Training Versus Resistance Training In Obese Adult

Sarsan A. et al made a study on Effects of aerobic and resistance exercises in obese women In his study 60 obese women were assigned to one of three groups: Aerobic exercise, Resistance exercise and control group for 12 week intervention study and he conclude that both aerobic exercise and resistance exercise are beneficial in obese women. While aerobic exercise appeared to be beneficial with regard to improving depressive symptoms and maximum oxygen consumption, resistance exercise was beneficial in increasing muscle strength.

In this study 30 obese participants were included, which were divided into two groups. Group A had received aerobic exercises and group B had received resistance exercises. For group A on 1st day mean BMI was 34.644 and after 6 weeks of treatment protocol it was 32.112 and mean waist hip ratio on 1st day was 1.08 and after 6 weeks it was 1.0726. For group B on 1st day mean BMI was 32.1 and after 6 weeks of treatment protocol it was 31.37 and mean waist hip ratio on 1st day was 1.08 and after 6 weeks it was 1.0726.

Hence found that there is marked difference in the patients performing the aerobic exercises than in the patients performing resistance exercises.

CONCLUSIONAerobic exercises have a favorable effect on the BMI and waist hip ratio of the participants with obesity and there was lowering of the levels of these values, but there was a large significant difference in these values in the patients performing aerobic exercises. And hence, we can conclude that there is more effect of aerobic exercises in decrease the body mass index and waist hip ratio of the patients with obesity.

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16

Abstract: Athlete requires Flexibility, Balance and Agility for a better sporting performance. Recreational athletes are not involved in routine exercise regime are more prone for having tightness in lower limbs and Inability of an athlete to control the position of their centre of gravity is a potential risk factor for lower extremity injury. Aim of the study was to identify the influence of lower limb tightness on dynamic balance and agility in recreational collegiate athletes. All the participant were measured for lower limb tightness and were asked to perform Star Excursion Balance Test (SEBT), T Test Procedure, Illinois Agility Test procedures and Force Plate Agility Procedure. p value was set at 0.005 and was found to be significant for force plate agility procedure and Anterior, Anterolateral, Lateral and PosteroLateral direction on SEBT. Current study did not show any statistical significance for T drill and Illinois agility test but mean and S.D showed difference in all agility tests. Statistically lower limb Tightness has no significant affect over dynamic balance and agility but clinically it showed a relative difference in dynamic balance and agility in recreational athletes.

INTRODUCTION: According to NASM's Essential's of Personal Fitness Training textbook, poor flexibility is a contributor to poor posture and dysfunctions in the kinetic chain. These dysfunctions can lead to what is known as the cumulative injury cycle. This cycle is initiated by the body as a repair process and it works as follows: cumulative injury cycle > tissue trauma > inflammation > muscle spasm > adhesions > altered neuromuscular control > muscle imbalance > cumulative injury cycle repeats itself.

Obviously the effects of poor flexibility will cause a decrease in athletic performance and little is known about this correlation in recreational athletes. In order to perform optimally, the body must function correctly.

In athletic events the athlete sprints, stops and changes direction rapidly so as the demands for balance and agility are high.1 Professional athletes have superior

balance & agility compared to Recreational athletes due to repetitive training. Performance on field and risk of injury also changes depending on various individual factors like age, sex, fitness level and tightness. Since recreational athletes are not involved in regular exercise regime are more prone for having tightness in lower limbs. Inability of athlete to control the position of their centre of gravity is a potential risk factor for lower extremity injury.

AIM: To identify the influence of lower limb tightness on dynamic balance and agility in recreational collegiate athletes

OBJECTIVES: 1. To find out Dynamic Balance performance in

athletes with Tightness2. To find out Dynamic Balance performance in

athletes without Tightness3. To find out Agility performance in athletes with

Tightness4. To find out Agility performance in athletes without

Tightness

HYPOTHESIS: H0 = There is no correlation between Lower limb tightness with Dynamic balance & AgilityH1 = There is significant correlation between Lower limb tightness with Dynamic balance & Agility

MATERIALS & METHODS:MATERIALS: Paper, pen, Stopwatch, Cones, Measuring tapeMETHOD:STUDY DESIGN: Cross-sectional Survey.STUDY SETTING: SKNCOPT & SKNMCSAMPLING: Purposive Sampling.SAMPLE SIZE: 62

INCLUSION CRITERIA: ¡ Age: 18 - 30 years.¡ Both male & female.¡ Athletes involved in sports activities atleast once a

week

DOES TIGHTNESS AFFECT DYNAMIC BALANCE AND AGILITY IN RECREATIONAL

COLLEGIATE ATHLETES?

Dr. Pallavi Wakode (PT)Asst. Professor, Dept. of Community Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

EXCLUSION CRITERIA:¡ Free from lower limb injury for at least 6months

prior to the study. ¡ Any lower limb fractures or lower limb deformity. ¡ Any neurological disorders.

PROCEDURE:¡ Screening of participants as per inclusion criteria

and written informed consent was performed¡ All the participant were measured for lower limb

tightness

Physiotherapist checking for Hamstring TightnessParticipants were asked to perform Star Excursion Balance Test (SEBT), T Test Procedure, Illinois Agility Test procedures and Force Plate Agility Procedure

Athlete performing SEBT

Athlete performing T drill

Athlete performing Illinois Agility Test

Athlete performing Force Plate Agility Procedure

¡ Measurements were noted for all the participantsin with Tightness and Without Tightness groups

¡ Assumption of paired t test was performed¡ SPSS version 16 .0 was used for statistical analysis

RESULT: Total 62 subjects were evaluated. 30 in No tightness group and 62 Tightness group. Lower limb Muscle tightness was observed to be in Hip Flexors, Hip Abductors, Hip Adductors, Hamstring and Tendoachillis.

p value was set at 0.005 and was found to be significant for force plate agility procedure and Anterior, Anterolateral, Lateral and Posterolateral direction on SEBT.

P value was not found to be significant for T drill and Illinois Agility Test and Posterior, Postero Medial, Medial and Mediolateral direction.

DISCUSSIONCurrent study did not show any statistical significance for T drill and Illinois agility test but mean and S.D showed difference in all agility tests.

Hip Flexor and Hamstrings Tightness account for this which plays crucial role in running whereas Adductor tightness could have affected the performance of shuffling in T drill.

Hoch reported that Ankle dorsiflexion had significant correlation with Anterior reach distance & the participants in current study did not have any deficit in ankle dorsiflexion resulting maximum reach distance.

Flexibility is highly related to performance of an athlete. If a muscle is excessively tight it is also shortened and not as strong as it can ideally be.

When one muscle is weak and shortened another

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muscle must do more work and becomes fatigued and weak as well. In athletes this leads to decreased speed of movement, decreased strength and power, and can lead to injuries.

Regular flexibility training helps maintain range of motion, strength of muscles, and prevent injury. It 's important to stretch all major muscles groups daily before work outs or practice and again after if you're an athlete.

Increased flexibility has a posit ive relationship to i n c r e a s e d a t h l e t i c pe r fo rmance . Ba lanced muscles increase a joint's range of motion, which improves the surrounding muscles' suppleness and contractibility, decreases wear and tear on the articular structures encapsulating the joint, promotes healing of stressed tissue, and assists in motor-learning processes to ensure more effective and c o r r e c t p e r f o r m a n c e techniques.

An optimal flexibility program utilizes an assessment to determine which muscles need to be stretched due to potential muscle imbalances. Stretches should also be applied along with specific strengthening exercises to create balance and promote safe movement for newly established joint ranges of motion.

LIMITATIONS1. Deg ree s o f musc l e

tightness was subjective2. Categorization according

to sport was not done3. SEBT was performed

only with dominant leg4. Sample Size was less

Star Excursion Balance Test

DIRECTION

DISTANCE (cms)

P value

No Tightness Tightness

ANTERIOR

111.58 =/-

14.13

100.03 +/-

11.37

0.00**

ANTEROLATERAL

101.10 +/-

12.79

97.41 +/-

10.74

0.03*

LATERAL

109.98 +/-

12.08

103.87 +/-

10.75

0.02*

POSTEROLATERAL

100.10 +/-

12.04

96.92

+/-

12.90

0.01*

POSTERIOR

97.32 +/-

10.85

97.47 +/-

15.86

0.14

POSTEROMEDICAL

85.65 +/-

14.04

85.81 +/-

16.99

0.94

MEDIAL 81.90 +/-

15.04

74.95 +/-

17.42

0.06

ANTEROLATERAL 89.67 +/-

15.64

88.59 +/-

14.33

0.67

No Tightness

Tightness

P value

T Drill (sec)

17.01+/-

2.13

17.64+/-

2.28

0.28

Illinois Agility Test (sec)

17.53 +/-

1.39

18.11 +/-

1.83

0.24

Force Plate Agility Procedure (sec)

3.01 +/- 0.48 3.39 +/- 0.58 0.009*

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Does Tightness Affect Dynamic Balance And Agility In Recreational Collegiate Athletes?

CONCLUSION: Statistically lower limb Tightness has no significant affect over dynamic balance and agility but clinically it showed a relative difference in dynamic balance and agility in recreational atheletes.

FUTURE SCOPE OF STUDYExtensive research can be performed by correlating degree of tightness to dynamic balance and agility by using distal goniometry and force platform.

Categorization of athletes according to sport of interest Electomyographical Analysis of lower limb muscles can be performed for digitalized imprint of muscle tightness during various activities.

REFERENCES:1. Yasuhiro Endo, MasaakisakaMoto: Relationship

between Lower Extremity Tightness and Star Excursion Balance Test Performance in Junior High School Baseball Players. J. Phys. Ther. Sci. 26: 661-663, 2014

2. D F Murphy, D A J Connolly. Risk factors for lower extremity injury: A review of Literature. Br J Sports Med 37:13 -29.2003

3. Hoch MC, Staton GS, McKeon PO: Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport, 2011, 14: 90-92.

4. Robinson R, Gribble P: Kinematic predictors of performance on the Star Excursion Balance Test. J Sport Rehabil, 2008, 17: 347-357.

5. Michele A. Raya, Robert S. Gailey, Comparison of three agility tests with male servicemembers: Side Step Test, T-Test, and Illinois Agility Test. JRRD, Volume 50, Number 7, 2013

6. Torii S: Management and prevention for injuries of adolescent athletes in track and field. Orthop Surg Traumatol, 2000, 43: 1311-1318.

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Abstract : Introduction: field walking test that is 6 MWD-test is simple, safe, low cost, valid and reliable tool to evaluate fitness at levels corresponding to the efforts commonly performed in daily life activities of elderly. . Waist-hip ratio has been used as an indicator or measure of health, and the risk of developing serious health conditions. Rate pressure product is also known as cardiovascular product or double product used to determine myocardial workload. Study design: cross sectional observational study. 30 community dwelling elderly individuals were selected.

Method 6 minute walk test was performed. 10 minutes of warm up was given before the test. Waist-hip ratio was measured and resting rate pressure product (RPP) was calculated. After completing 6MWT, 6MWD was calculated. ( laps covered*30).

Results: 6MWD correlates with rate pressure product in community dwelling elderly individuals but 6MWD strongly correlates with waist-hip ratio.

Conclusion: Based on the study findings, it is concluded that there is correlation of 6MWD with RPP and waist-hip ratio in community dwelling elderly individuals, and that 6MWD can be useful prognostic marker of mortality in CVD patients.

Keyword: 6 minute walk distance (6MWD), Rate pressure product (RPP), Waist-hip ratio, Community dwelling elderly individuals.

INTRODUCTION:Cardiovascular disease (CVD) and its related comorbidities remain a signi?cant and growing public health problem, especially in older individuals .

Recent emphasis has been placed on the understanding of risk factors role for CVD progression and in predicting CVD morbidity and mortality (christou et al., 2005).

Several studies have found an interaction of many

factors associated with aging that may contribute to the high prevalence of CVD observed in older adults. These factors include increased general and central adiposity, decreased physical activity, and progressive arterial stiffening.

Aging and/or inactivity leads to increased arterial stiffness that could explain increase in blood pressure (BP) levels and high prevalence of hypertension in old individuals. Hypertension associated with an increased incidence of all-cause and CVD function are equal.

Aging results in an important decrease of muscle power and exercise capacity. therefore, elderly often function at the limit of their capacity in order to fulfil the activities of daily living.

6 minute walk distance- 6 MWD-test is simple, safe, low cost, valid and reliable tool to evaluate fitness at levels corresponding to the efforts commonly performed in daily life activities of elderly. The 6-minute walk (6mw) is a well-established measure of aerobic capacity in elders with cardiorespiratory and peripheral vascular disease and may be an accurate measure of functional performance in healthy elders. In mobility-limited elders, a population at risk for disability, impairments in strength and power are predictive of performance-based measures of function.

WAIST- HIP RATIO- It is the ratio of the circumference of the waist to that of the hips. Waist-hip ratio has been used as an indicator or measure of health, and the risk of developing serious health conditions. WHR has been found to be a more efficient predictor of mortality in older people than waist circumference or Body mass index.

RATE PRESSURE PRODUCT (RPP)- It is also known as cardiovascular product or double product used to determine myocardial workload.

RPP= SYSTOLIC BLOOD PRESSURE*HEART RATE/100. It will be a direct indication of the energy

1 2Dr. Prajakta Patil (PT) , Saifina S Momin

CORRELATION OF 6MWD WITH WAIST-HIP RATIO AND RATE PRESSURE PRODUCT (RPP) IN

COMMUNITY DWELLING ELDERLY INDIVIDUALS.

1Asso. Professor, Dept. of Cardio-Respi Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune2Intern - Smt Kashibai Navale College of Physiotherapy, Pune

demand of the heart and thus a good measure of the energy consumption of the heart.

RPP allows to calculate the internal workload or hemodynamic response.

NEED OF STUDY:As it is important to find out risk factors to prevent morbidity and mortality in elderly population, this study will find out correlation of 6MWD with waist-hip ratio and rate pressure product which will help us for early detection and accordingly modification of risk factors and appropriate intervention

AIM: To find correlation of 6MWD with waist-hip ratio and rate pressure product (RPP) in community dwelling elderly individuals.

OBJECTIVE:To measure 6 minute walk distance of community dwelling elderly individuals.To measure waist -hip ratio of community dwelling elderly individuals.To calculate rate pressure product of community dwelling elderly individuals.

METHODOLOGY:Study design: Cross Sectional Observational Study.¡ Study area: Narhe, Pune. ¡ Study population: Community dwelling elderly

individuals between 60-75 years.¡ Duration: 3 months.¡ Sampling: Convenient sampling.¡ Sample size: 30 community dwelling elderly

individuals.

Inclusion criteria:¡ Subjects between ages of 60-75 yrs.¡ Both gender.1. Exclusion criteria: Subject who is having 2. severe musculoskeletal disorders ( example severe

osteoarthritis, fractures , contractures or any deformity of lower extremity etc).

3. Severe cardiovascular disorders ( recently CABG done, uncontrolled hypertension, acute myocardial infarction etc)

4. Neurological disorders.5. Individuals who need severe assistance while

ambulation.6. Visual impairment.

Materials:Stop watch, B.P apparatus, Borg index scale, Measuring tape,Two small cones, Chair, Pen, paper.

PROCEDURE:Ethical committee approval was taken. After taking written consent from the subjects, Proper medical history was taken and checked for contraindications to exercise testing was done. Subject's usual medications were kept continued. Subject were allowed to wear comfortable clothes and footwear. Subjects were given prior instruction, not eat anything at least one hour before the test. Warm up of 10 minutes was given before the test. The study procedure was explained in detail to the subject. Patients were instructed to stop the test in between or take rest if they experience shortness of breath, giddiness, leg cramps etc.Vital parameters ( B.P, heart rate, respiratory rate), were recorded before and after the test. 6MWT was performed in a spaced out corridor.

6 Minute walk test:As per ATS (American thoracic society) guidelines, 6 minute walk test was performed and 6MWD was calculated. Waist-hip ratio and rate pressure product was calculated.

STATISTICAL ANALYSIS:Statistical analysis was done using spearman rank correlation test.

DATA INTERPRETATION AND RESULT:

Graph no.1Correlation of 6 MWD with RPP.

Graph no.1 implies that 6MWD correlates with rate pressure product in community dwelling elderly individuals. (p value:0.750)

Graph no.2

Correlation of 6MWD with waist-hip ratio.

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SEJOP E-journal Volume-1, Issue -1, January 2017

Graph no 2.implies that 6MWD strongly correlates with waist-hip ratio.(P value:0.889)

DISCUSSION:According to the previous Study by Flavia A C Wanderley et all in 2011, showed that there is a strong correlation between 6MWD with % body fat and RPP, which is consistent with the present study also.

But the study conducted by, Runella D'Souza et all showed that, there is no significant correlation of 6MWT with waist hip ratio.

Many of the previous studies also shows that there is a correlation of 6MWD with RPP and waist hip ratio.

The 6MWT presents several interesting advantages for the evaluation of the exercise capacity in elderly people. A study was conducted by Timothy R et al which showed the relationship of physical fitness and waist hip ratio which suggested that self reported level of physical activity and functional capacity are more important than weight status or body habitus for cardiovascular risk stratification whereas our study conducted a 6 minute walk test to see the functional capacity of the elderly individuals .

Aging is accompanied by increase in body fat content and taking into account the close relationship between body fat, in special, central fatness, with other metabolic CVD risk factors (Williams et al.1997; Krause et al., 2007),

Study conducted by Flavia A C Wanderley reinforces the idea that a worse cardiovascular pro?le namely a higher %BF, trunk fat, SBP, is related with lower ?tness in older adults.

Furthermore, our ?ndings support the potential of 6MWD to identity adverse outcomes such as %BF, increased SBP and higher

RPP (rest) in community-dwelling older adults.

In the present study there is a good correlation between all the 3 parameters as the subjects were physically active, had appropriate body weight and fat which showed more functional capacity.

CONCLUSION: Based on the study findings, it is concluded that there is correlation of 6MWD with RPP and waist-hip ratio in community dwelling elderly individuals, and that 6MWD can be useful prognostic marker of mortality in CVD patients.

CLINICAL IMPLICATION:As these both the tests are simple, requiring little technology, with good reproducibility, easy to calculate, it can be widely used to assess functionality in older "healthy" individuals.

FUTURE SCOPE:In future, same study can be conducted after implementation of good exercise programme to see the responses of 6MWD, RPP and Waist-hip ratio in specific diseased condition.

LIMITATION:Small sample size. Physical activity part of the subject was not taken into consideration.

REFERENCES: 1. Flavia a c wanderley, Jose Oliveira, Jorge Mota in

march 2011, Six minute walk distance(6MWD) is associated with body fat, systolic blood pressure and rate pressure product in community dwelling elderly individuals.

2. M. Dalton1, A. J. Cameron1, P. Z. Zimmet1,J. E. Shaw1, D. Jolley2, D. W. Dunstan1, T. A. Welborn3 and On behalf of the AusDiab steering committee1 Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. Volume 254, issue-6, pages 555-563, December 2003.

3. Ivan Bautmans, Margareta Lambert and Tony Mets. The six-minute walk test in community dwelling elderly: influence of health status. BMC Geriatrics 2004, 4:6 doi:10.1186/1471-2318-4-6.

4. Runella D'Souza .relationship of 6 minute walk distance,BMI and Waist to height ratio in south

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Correlation Of 6mwd With Waist-hip Ratio And Rate Pressure Product (rpp) In Community Dwelling Elderly Individuals.

indian men and women in coronary artery disease. september 2015.

5. S.J Singh, M.D morgan, S.Scott, D Walters, A.E Hardman,development of shuttle walk test of disability in patients with chronic airways obstruction,thorax 1992.

6. Peter Ronai, M.S, FACSM,RCEP, CES,CSCS-D, the incremental shuttle walking test,oct-dec 2012, vol. 22,issue.4.

7. Sian E. Turner, BSc; Peter R. Eastwood, Phd; Nola M Cecins; physiologic responses to incremental a n d s e l f - p a c e d e x e r c i s e i n COPD,September,2004.

8. Soraia Pilon Jurgensen,Leticia Claudia De Oliviera Antunes, Suzana Erico Tanni, the incremental shuttle walking test in older Brazilian adults, respiration,july 17,2010.

9. S.Revill, M.Morgan, S Singh, J Williams, A Hardman, the endurance shuttle walk: a new field test for the assessment of endurance capacity in c h r o n i c o b s t r u c t i v e p u l m o n a r y disease,thorax,march 1999.

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24

IntroductionPranayama, meaning 'breathe control', is an ancient technique involving slow and rhythmic breathing. It is known that the regular practice of pranayama increases parasympathetic tone, decreases sympathetic activity, improves cardiovascular and respiratory functions, decreases the effect of stress and strain on the body and

1-4improves physical and mental health.

With increased awareness and interest in health and natural remedies, breathing techniques are gaining importance and becoming increasingly acceptable to the scientific community. Hence, in the present study, we investigated the beneficial effects of pranayama with reference to FEV1, FVC and FEV1 / FVC ratio.

Pulse rate & blood pressure is related with cardio vascular system, which is controlled by autonomic nervous system (ANS). Pranayama accompanied by breath control increases cardiac output.Short term training of anulom vilom shows significant effect on digestive power & mental freshness. Few min of daily practice of pranayama helps to distress human at their work place & also help in maintaining better physical health by controlling vital parameters.

Anulom Vilom Pranayam Anulom Vilom Pranayam is one of the best and easy most breathing exercises for complete purification of body as well as mind. It completely cures most of the internal body diseases without any medicine. It vanishes stress of body and mind. If practiced regularly with devotion, anulom vilom not only intensifies the inner strength of body but also enhances the divine powers. It is extremely helpful for awakening of "Kundalini Power?. The anulom-vilom practitioner experiences his life happy and full of optimism. This is also known as Nadi Shuddhi.

According to various studies it has been found that stress is one of the leading risk factors affecting cardio respiratory status due to current lifestyles of the individuals. Hence to maintain a good CV status, Pranayama could prove to be effective.

Aim & objectivesAim : To study Effect of Anulom Vilom on Ventilatory Functions of Lungs, blood pressure Respiratory rate & pulse rate in healthy individuals.

ObjectiveTo see the changes in ventilator functions Pulse rate & Blood pressure (systolic & diastolic) anulomvilom .

REVIEW OF LITERATUREShivraj P Manaspure1*, Ameet Fadia2, Damodara Gowda KM Effect of Specific Pranayama techniques on Ventilatory Functions of Lungs the mechanical factors of the Lung -Thoracic System like FVC, FEV1, FEV1/ FVC did show statistically significant changes. Hence we concluded that the therapeutic exercise programs for sedentary young adults can be best designed to delay the onset of fatigue and improve the mechanical efficiency of Lung- Thoracic System.

Dandekar Pradnya Deepak*. Impact of short tern training of Anulom vilom pranayam on blood pressure & pulse rate in healthy volunteers. Significant decline in systolic blood pressure in anulom vilom pranayam practice due to parasympathetic control over heart. Diastolic blood pressure varies with the degree of peripheral resistance & heart rate. Few min of daily practice of anulom vilom help to distress human mind at work place & also help in maintaining better mental & physical health.

Dipak B. Chavhan(Research Scholar) J.J.T. University. The effect of anulom-vilom and kapalbhati pranayama on positive attitude in school going children. It is noticed that practice of Anulom-Vilom and Kapalbhati Pranayama helped to improve Positive Attitude of obese school going children.

Baljinder Singh Bal Effect of anulom vilom and bhastrika pranayama on the vital capacity and maximal ventilatory volume. They concluded that eight week pranayama training programme showed significant improvement in maximal ventilatory volume. As per the study the above remark can be given at 95%

1 2Ms.Riddhi Vora , Dr Prajakta Patil (PT)

EFFECT OF ANULOM VILOM ON VENTILATORY FUNCTIONS OF LUNGS, BLOOD PRESSURE

RESPIRATORY RATE & PULSE RATE IN HEALTHY INDIVIDUALS.-AN INTERVENTIONAL STUDY

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Asso. Professor, Dept. of Cardio-Respi Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

confidence.

Latha Rajendra Kumar. Role of anuloma viloma pranayama in reducing stress in chronic alcoholics. The effects of yoga and counseling on reducing alcohol consumption have been worked on.

P. RAGHURAJ, A. G. RAMAKRISHNAN*, H. R. NAGENDRA AND SHIRLEY TELLES** effect of two selected yogic breathing techniques on heart rate variability. After kapalabhati, there was a significant reduction in high frequency power and an increase in low frequency power.

Sivapriya D V1, Suba Malani S2, Shyamala Thirumeni1. Effect of nadi shodhana pranayama on respiratory parameters in school students. significant improvement in PEFR after the practice of pranayama

Methodology:Study design & Methodology:Study design: Interventional studyStudy setting: SKNCOPT yoga hall Study population: Female Physiotherapy Students & interns.Sample size: 30 samplesStudy Duration: 3 weeksSampling: Convenient sampling.Inclusion criteria-Age 17-24 yearsExclusion criteria- Those who are having cardio respiratory problems such as valvular heart disease, upper respiratory tract infection, gastroenteritis, Smokers.Material - Pencil, stopwatch, sphygmomanometer, stethoscope, Cosmed Microquark PC spirometer

Procedure: ¡ Ethical clearance was taken. ¡ Permission from principal of SKNCOPT & HOD

of cardio respiratory PT to conduct project was taken.

¡ 30 volunteers were selected. ¡ After taking consent from the volunteers pulse

rate, Respiratory rate, blood pressure & ventilator function with the help of spirometer was checked.

¡ Volunteers were explained that they are supposed to perform anulom vilom pranayam at home once in a day for 10min every day for 3weeks.

¡ Volunteers were trained about the technique of anulom vilom pranayam.

¡ Individuals were asked to slowly inhale through the left nostril, till the lungs are completely filled (Puraka) & simultaneously close the right nostril. Then they were asked to close the left nostril with

the second and third fingers and open the right nostril to exhale slowly (Rechaka). They had to exhale till the lungs were completely empty.

¡ At the end of the 3 weeks pulse rate, blood pressure & ventilator function with the help of spirometer was been checked.

RESULT AND ANALYSISStandardization of data is done by calculated mean, standard deviation & by using pair t-testIn table below values are expressed as Mean± Standard Deviation.

Table 1

DISCUSSION¡ Observations were made by James M, et.al in his

study, they concluded that during pranayama, the compliance of the lung thoracic System increases and the air - way resistance decreases. Hence forceful expiration becomes more efficient. Delayed onset of fatigue in subjects who were trained individual as compared to their non-regularly exercising students and sedentary peers.

¡ Also a study conducted by Dandekar Pradnya Deepak concluded that their was significant effect on systolic BP is observed after short term training of anulom vilom Pranayam

¡ In study conducted previously by Shivraj P Manaspure concluded that FVC, FEV1, FEV1/ FVC did show statistically significant changes.

¡ In present study after 3 weeks all parameters were

BEFORE INTERVENTION

AFTER INTERVENTION

Confidence interval

T value

DF P VALUE

FEV1

79.53±9.372

84.83±11.411

-6.848 to -3.752

-7.003

29 ≤0.0001

FEV1/FVC

102.07±6.186

105.37±5.786

-4.361 to -2.239

-6.359

29 ≤0.0001

FVC

77.73±8.444

83.67±10.145

-7.320 to -4.547

-8.752

29 ≤0.0001

HR 99.40±7.370 96.97±7.132 1.474 to 3.393

5.188 29 ≤0.0001

RR 15.63±1.45 14.00±1.640 1.247 to 2.019

8.657 29 ≤0.0001

BP SYSTOLIC

117.27±10.123 114.00±9.924 2.447 to 4.087

8.147 29 ≤0.0001

BP DIASTOLIC

80.00±1.661 80.00±1.390 -0.340 to 0.340

0.00 29 1.00

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SEJOP E-journal Volume-1, Issue -1, January 2017

checked & data was calibrated statistically & P-value was found.

¡ P value was significant for FEV1, FVC, FEV1/FVC, HR, RR, systolic BP & non-specific for diastolic BP.

¡ During pranayama, the compliance of the lung thoracic System increases and the airway resistance decreases, hence forceful expiration becomes more efficient and delayed the onset of fatigue in subjects who were trained as compared to their previous non-regularly exercising and sedentary status.

¡ All the parameters were measured before & after performing Anulom vilom pranayam , showed significant decline in systolic BP & there was no significant change in diastolic BP that is because diastolic BP controlled by parasympathetic nervous system which needs long term practice of any physical or breathing exercise since it was short term practice of 3 weeks dint show any significant change.

¡ Various mechanisms have been proposed to explain this decrease in sympathetic tone, and the associated increase in parasympathetic tone following pranayama. These include an increase in vagal tone following the slow breathing exercise an increase in baroreflex sensitivity, an increase in tissue oxygenation, and interaction of pranayamic breathing with the nervous system affecting metabolism and autonomic functions.

Limitations of the study¡ Only female volunteers were included ¡ Only 3 weeks intervention was conducted¡ Study can be supervised.

Conclusion Present study concludes that Anulom Vilom has significant Effects on Ventilatory Functions of Lungs, Systolic blood pressure, respiratory rate& pulse rate & no effects on diastolic blood pressure in normal Individuals

Bibliography1. Bhargava R, Gogate MG, Mascarenhas JF.

Autonomic 1. responses to breath holding and its variations following pranayama. Indian J Physiol Pharmacol 1988; 42 : 257-64.

2. Telles S, Nagarathna R, Nagendra HR. Breathing through 2. a particular nostril can alter metabolism and autonomic activities. Indian J Physiol Pharmacol 1994; 38 : 133-7.

3. Mohan M, Saravanane C, Surange SG, Thombre DP, 3. Chakrabarty AS. Effect of yoga type breathing on heart rate and cardiac axis of normal subjects. Indian J Physiol Pharmacol 1986; 30 : 334-40

4. Pramanik T, Sharma HO, Mishra S, Mishra A,

Prajapati R, 4. Singh S. Immediate effect of slow pace bhastrika pranayama on blood pressure and heart rate. J Altern Complement Med 2009; 15 : 293-5.

5. Shivraj P Manaspure1*, Ameet Fadia2, Damodara Gowda KM1. Effect of Specific Pranayama techniques on Ventilatory Functions of Lungs. Research Journal of Pharmaceutical, Biological and Chemical Sciences. ISSN: 0975-8585

6. Dandekar Pradnya Deepak/ Int.J.Res. Ayurveda Pharma.4(2),Mar-Apr2013.Impect of short term training of anulom vilom Pranayam on blood pressure & pulserate in healthy volunteers.

7. P. RAGHURAJ, A. G. RAMAKRISHNAN*, H. R. NAGENDRA AND SHIRLEY TELLES**. Effect of two selected yogic breathing techniques on heart rate variability. Indian J Physiol Pharmacol 1998; 42 (4) : 467-472

8. Dipak B. Chavhan (Research Scholar) J.J.T. University. The effect of anulom-vilom and kapalbhati pranayama on positive attitude in s c h o o l g o i n g c h i l d r e n . E d u b e a m multidisciplinary- online research journal vol-vii, issue-1, september-2013 issn 2320 - 6314

9. Baljinder Singh Bal. Effect of anulom vilom and bhastrika pranayama on the vital capacity and maximal ventilatory volume. Journal of Physical Education and Sport Management Vol. 1(1) pp. 11-15, July 2010

10. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation, and clinical use. Circulation 1996; 93: 1043-1065.

11. Nagendra HR. Mohan T, Shriram A. Yoga in education. 1st ed. Bangalore, Vivekananda Kendra Yoga Anusandhana Samsthan, 1988.

12. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991; 84: 1482-1492.

13. Saul JL, Cohen RJ. Respiratory sinus arrhythmia. In: Levy MN, Schwartz PJ (Ieds). Vagal control of the heart: experimental basis and clinical implications. Futura Publishing. New York, 1994, pp 511-535.

14. Korbel H. A polygraphic study of nadisuddhi pranayama. Yoga Therapy Instructors course dissertation, Indian Yoga Institute, Bangalore, India, 1993.

15. Papillo FJ, Shapiro D. The cardiovascular system. In: Cacioppo TJ, Tassinary GL (eds). Principles of psychophysiology: physical, social, and inferential elements. Cambridge University press, New York.

26

Effect Of Anulom Vilom On Ventilatory Functions Of Lungs, Blood Pressure Respiratory Rate & Pulse Rate In Healthy Individuals.-an Interventional Study

27

INTRODUCTIONCervical spondylosis is a condition caused by degenerative changes of soft tissues, discs or vertebrae of the cervical spine. These changes lead to gradual narrowing of disc space, loss of normal square shaped bone and formation of bone spurs. Neck and shoulder pain , limited ROM at the cervical spine , tingling are the symptoms presented by a patient suffering from cervical spondylosis. Prevalence of cervical spondylosis is 3.5 in every 1000. Primary goal of PNF technique is to help a patient achieve highest level of function. The techniques of PNF integrate principle of motor learning and motor control. PNF enhances the response of neuromuscular mechanisms by stimulation of proprioceptors. PNF technique produces brief and strong neuromuscular inhibition which enhances the proprioception.PNF may be used to improve strength and muscle endurance.

Problem Statement- To find the effect of proprioceptive neuromuscular

facilitation on pain, ROM, strength and neck diasbility in cervical spondylosis.

OBJECTIVES- To find the effect of conventional treatment on pain,

ROM, strength and neck diasbility in cervical spondylosis

- To find the Effect of Proprioceptive Neuromuscular Facilitation on pain, ROM, strength and neck diasbility in cervical spondylosis.

- To compare the effect of PNF versus conventional treatment on pain, ROM, strength and function in cervical spondylosis.

Research DesignExperimental study designSample: 30 Subjects Sampling Technique: Purposive sampling technique

Criteria for selection of sample:

INCLUSION CRITERIA- Patient diagnosed with cervical spondylosis in age

group 50-60 years.

EXCLUSION CRITERIA- Patients with radiculopathy- H/O spinal surgery, fracture, dislocation.- Tumors or malignancy- Presence of congenital deformity. e.g. cervical rib.

Instruments used for the study and outcome measure:Bubble inclinometer - to measure ROM ,Pressure biofeed back device- to measure strength, Neck disability index and Visual analog scale.

Description- Permission from principal of SKNCOPT and from

HOD of the physiotherapy OPD is taken. Ethical clearance is taken. Subjects fulfilling the inclusion criteria is taken in the study and divided into two groups by random sampling. Informed and written consent is taken from subjects in the study.

- In Conventional group, Moist Heat, Exercises such as Chin tucks, Stretching, Neck isometrics, ROM exercises and Ergonomic advice are given.

- In interventional group, Moist Heat, Exercises such as Chin tucks, Stretching, PNF, ROM exercises and Ergonomic advice are given.

- Pre and Post values of each outcome measure is taken and compared.

Score Interpretation

COMPARISON OF POST VALUES OF GROUP A AND GROUP B

Dr Seema Saini (PT)

EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION ON PAIN,ROM, STRENGTH AND NECK

DIASBILITY IN CERVICAL SPONDYLOSIS

Asso. Professor, Dept. of Musculo Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

Table 1

- On the comparison between the two groups with Unpaired T test the difference between flexion,extenxion,strenght and NDI shows the highly significant results with p value < 0.001. On comparison between the two groups with Unpaired T test the differences between VAS, Right lateral flexion, left lateral flexion ,Right Rotation, left Rotation shows not significant result with p value >0.001

- In this study both the groups i.e. groups receiving conventional treatment and group receiving treatment with cervical PNF showed improvement in all the out coming measures. It also shows that the group receiving cervical PNF showed more improvement in flexion, extension,strenght and NDI. The pattern of motion for proprioceptive neuromuscular facilitation are mass movement patterns and are basic to all other techniques. Mass movement is a characteristic of normal motor activity and is in keeping with Beevor's axiom that the brain only knows of movement, this requires shortening and lengthening of muscles, in varying degrees hence helping in improvement of ROM. In PNF the individual muscle contracts from its completely shortened state to its completely lengthened state and with the resistance it helps in improving muscle strength. In isometric muscle

training the lenght of the muscle remains same through out the work and no movement results.Static work of the postural muscles is used to tain the pattern of good posture.Posture is maintained by muscle work which is somewhat similar.Static muscle work against maximal resistance provides the most rapid method for gaining strenght of muscles at PARTICULAR POINT OF RANGE because it demands greatest possible increase in intramuscular tension, which is not achevied in conventional treatment.

CONCLUSIONThis study concludes that both the treatment methods are effective but the Cervical PNF in cervical spondylosis shows more improvement than conventional method.

REFERENCES : 1. Binder AI. Cervical pain syndromes. In: Isenberg

DA, Maddison PJ, Woo P, Glass DN, Breedveld FC, eds. Oxford textbook of rheumatology. 3rd ed. Oxford: Oxford Medical Publications, 2004:1185-95.

2. Aker PD, Gross AR, Goldsmith CH, Peloso P. Conservative management of mechanical neck

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Effect Of Proprioceptive Neuromuscular Facilitation On Pain, Rom, Strength And Neck Diasbility In Cervical Spondylosis

pain: systematic overview and meta-analysis. BMJ 1996; 313:1291-6.

3. Philadelphia Panel. Evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain. Phys Ther 2001;81:1701-17

4. Hoving J, Koes B, de Vet H, van der Wildt DA, Assendelft WJ, van Mameren H, et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial. Ann Intern Med 2002;136:713-22

5. Voss, D. E., Ionta, M. K., Myers, B. J. (Ed. 3). (1985) . Propriocept ive Neuromuscular Faci l i tat ion: Pat terns and Techniques. Philadelphia, PA: Harper & Row.

6. Saliba, V., Johnson, G., Wardlaw, C. Proprioceptive Neuromuscular Facilitation. In: Basmajian J., Nyberg R. (1993). Rational Manual Therapies. Baltimore, MD: Williams & Wilkins.

7. Prentice, W. E. & Voight, M.I. (2001). Techniques in Musculoskeletal Rehabilitation. New York, NY: McGraw Hill.

8. Vos CJ, Verhagen AP, Passchier J, et al; Clinical course and prognostic factors in acute neck pain: an inception cohort study in general practice. Pain Med. 2008 Jul-Aug;9(5):572-80. Epub 2008 Jun 28.

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30

INTRODUCTIONCervical spondylosis is a condition caused by degenerative changes of the soft tissues, discs or vertebrae of the cervical spine. These changes lead to gradual narrowing of the disc space, loss of the normal square shaped bone and formation of bone spurs. [1] Neck and shoulder pain ,limited ROM at the cervical spine ,tingling are the symptoms presented by a patient suffering from cervical spondylosis. Prevalence of cervical spondylosis is 3.5 in every 1000. [2]

In most patients neck pain is not due to a serious disease, but rather due to postural or mechanical factors. [1]

Kinesio taping is a therapeutic modality that corrects and treats many musculoskeletal disorders which is based on natural healing process. Kenzo Kase, the creator of Kinesio tape, proposed the following mechanisms for the effects : If there is altered muscle function - the tape acts on weakened muscles, improves circulation of blood and lymph by eliminating tissue fluid or blood beneath the skin, decreases pain through neurological suppression, repositioning of the subluxed joints by relieving abnormal muscle tension, and helping to affect the function of fascia and

[3]muscles. When joints or ligaments are injured, they lose their ability to stabilize and provide proper functional control to a segment and thereby relying on the stretched tape for this correction . [3] Therefore ,In this situation the tape should be STRETCHED before applying it to the skin. The muscles are elongated and then the tape is applied? as the muscles return to their normal position the taped skin will begin to form convolutions (ripple effect). The convolutions that it creates in the skin helps increase interstitial space (space between the skin and muscles), allowing for better drainage of the swelling which results in pressure and irritation being removed from

[4]neural sensory receptors and ultimately relieving pain.Kinesio Taping is based on a different philosophy that

aims to give free range of motion in order to allow the body's muscular system to heal itself bio-mechanically through continued use.

Advantages of using a K Tape:1. Durable. 2. Elasticity equals to human skin.3. Economical.4. 100% cotton (no skin irritation)

NEED OF THE STUDY.o Physical therapy is usually the first non invasive

treatment given to the patient to help alleviate pain , maintain mobility, strength and function.

o Therefore, it is important from physiotherapeutic point of view to use the best effective approach, that gives highest pain relief, restores mobility and thereby helps in achieving maximum restoration of function.

o Various conventional methods have been proved to be effective , but there are less studies explaining the effect of taping in cervical spondylosis.

o Hence , this study is intended to compare the effect of taping versus conventional treatment.

AIM:To study and compare the effect of kinesiotaping with conventional treatment on pain, ROM, strength and function in cervical spondylosis.

OBJECTIVES:To study the effect of conventional treatment on pain, ROM, strength and function in cervical spondylosis.To study the effect of Kinesio taping along with conventional treatment on pain, ROM, strength and function in cervical spondylosis.To compare the effect of kinesiotaping versus conventional treatment on pain, ROM ,strength and function in cervical spondylosis.

METHODOLOGY AND MATERIALS.o STUDY AREA: Smt .Kash iba i Nava le

physiotherapy and orthopaedic OPD

Dr Shweta Pachpute (PT)

COMPARATIVE STUDY ON EFFECTS OF KINESIO TAPING VERSUS CONVENTIONAL TREATMENT IN

CERVICAL SPONDYLOSIS.

2Asst. Professor, Dept. of Musculo Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

o STUDY DESIGN: Interventional Studyo SAMPLE POPULATION: Patients with neck

pain.o SAMPLE SIZE: 30

Group A (n=15)= conventional treatment.Group B (n=15)= conventional treatment + kinesiotaping.

SAMPLING METHOD: Simple Random Sampling.

INCLUSION CRITERIA:Patients with neck pain and restricted ROM.Grade 2,3 Kellgren classification for degenerative changes in cervical spine. (X-Ray)

EXCLUSION CRITERIA:Patients with radiculopathiesH/o spinal surgery, fractures, dislocations.Tumours or malignancy.Presence of congenital deformities eg, cervical rib.

For pain intensity ? Visual Analogue Scale.For measuring Cervical ROM ? Bubble inclinometer.For assessing strength ? Pressure Biofeedback.For assessing functional capability ? Neck Disability Index

NECK DISABILITY INDEX.(NDI)o The NDI is a modification of the Oswestry Low

back Pain Disability Index . It is a condition-specific, functional status questionnaire with 10 items.

o The NDI has a fair to moderate test-retest reliability of 0.85.

o Each section is scored on a 0 to 5 rating scale, in which zero means 'No pain' and 5 means 'Worst imaginable pain'. All the points are to be summed to a total score.

o 0-4points (0-8%) no disability, 5-14points ( 10 - 28%) mild disability,

15-24points (30-48% ) moderate disability, 25-34points (50- 64%) severe disability,35-50points (70-100%) complete disability [3]

PROCEDURE:o Permission from the ethical committee and the

HOD of the musculoskeletal department was obtained.

o Participants were randomly selected according to the inclusion criteria, and were separated in two groups by random sampling .

CONVENTIONAL GROUP INTERVENTIONAL GROUP

Step 1.ROM,VAS, NDI, Strength.(pre)

Step 1.ROM,VAS, NDI, Strength.(pre)

Step 2. Protocol :

•

Moist heat.

•

Exercises such as :

1.

Chin tucks.

2.

Stretching.

3.

Neck isometrics.

4.

ROM exercises.

5.

Ergonomic Advice.

Step 2. Protocol:

•

Moist heat.

•

Exercises such as :1.

Chin tucks.

2.

Stretching.

3.

Neck isometrics.4.

ROM exercises.5.

Ergonomic Advice.6.

Kinesio taping

Step 3.Measure

ROM,VAS,NDI,Strength.(post)

Step 3. Measure

ROM,VAS,NDI,Strength.(post)

Step 4. Pre and Post values of each

outcome measure were compared using

Paired t test.

Step 4. Pre and Post values of each

outcome measure were compared using

Paired t test.

Step 5. Pre and post values of the 2 groups were compared using Unpaired t test

o Wri t ten consent was o b t a i n e d b y t h e participants.

Exercise protocol:

1. Isometric exercises: 5 reps 3 sets.2. chin tucks: 5 reps 3 sets.3. ROM exs: 5 reps 3 sets.4. Stretching : 5 reps with 5 secs hold 2 sets

K I N E S I O T A P I N G APPLICATION:

Kinesiotape will be applied to support the core muscles of the cervical spine, It will support the Semispinalis Capitus, Splenius Cervicis , Levator Scapulae, Rhoboidus minor and Upper Trapezius.

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SEJOP E-journal Volume-1, Issue -1, January 2017

IMAGES:

RESULTS

1. Flex the neck and apply two vertical I strips adjacent to the spinous process.

2. Maintain neck in flexion apply one horizontal I strip over the upper trapezius.

3. Ask the patient to attain neutral position of neck and check for convolutions on the tape.

MEAN PRE AND POST VALUES OF THE CONVENTIONAL GROUP. (USING PAIRED t TEST)

M E A N P R E A N D P O S T VA L U E S O F INTERVENTIONAL GROUP(USING PAIRED t TEST)

COMPARISON BETWEEN PRE AND POST VALUES IN CONVENTIONAL GROUP. (PAIRED T TEST)

COMPARISON BETWEEN PRE AND POST VALUES IN INTERVENTIONAL GROUP (PAIRED T TEST)

Sr.no

Variab

le

Mean SD pre Mean SD

post

T P value

1

.

Flexion 38.27±5.063 43.4±4.867 -17.665 0.001

2

.

Extensi

on

59.2±4.586 64.4±3.641 -6.703 0.001

3

.

S.F.

(Rt)

34.13±3.248 36.8±3.189 -10.583 0.001

4

.

S.F.

(Lt)

32.93±2.604 336.13±2.77

4

-12.22 0.001

5

.

Rot

(Rt)

60.6±7.059 68.67±6.619 -4.219 0.001

6

.

Rot (Lt) 62.47±7.19 67.2±5.894 -0.798 0.001

7

.

VAS 6.33±1.676 4.4±1.957 12.641 0.001

8

.

NDI 37.2±6.826 30.93±5.23 6.313 0.001

9

.

Strengt

h

23.6±12.19 58.13±21.44 -7.214 0.001

32

Comparative Study On Effects Of Kinesio Taping Versus Conventional Treatment In Cervical Spondylosis.

COMPARISON BETWEEN CONVENTIONAL AND INTERVENTIONAL GROUP POST VALUES (UNPAIRED T TEST)

DISCUSSIONo This study was carried out to compare the effect of

kinesiotaping versus conventional treatment on various parameters affected in Cx spondylosis.

o The results indicated that: both the groups showed significant improvement in strength ,ROM, pain intensity and function. (Since the P value is less than 0.005) On comparison interventional group showed better results than conventional group.

o The results of this study coincide with the findings of Gonzalez Iglesias study which showed a significant improvement in Cx ROM and in pain

[6]after application of K tape for a short term period.

o These findings maybe attributed to the effect of Kinesio taping on proprioception as Kinesio taping has an effect on cutaneous mechanoreceptors through stretching the skin. Richman and Lephart confirmed the role of cutaneous mechanoreceptors in detecting joint movement and position resulting from stretching the skin just like the joint mechanoreceptors.

Sr.No

Variable

Mean SD pre Mean SD post T P value

1.

Flexion

39.73±6.453 48.8±4.033 -7.55 0.001

2.

Extension

60.2±5.8 71.6±6.75 -11.24 0.001

3.

S.F. (Rt)

32.4±2.414 38.0±1.87 -12.475 0.001

4. S.F. (Lt) 31.87±3.137 37.2±2.366 -9.419 0.001

5. Rot (Rt) 66.93±6.96 78.6±5.83 -9.291 0.001

6. Rot (Lt) 66.27±3.615 74.8±2.908 -12.911 0.001

7. VAS 6.46±2.031 2.733±1.71 12.433 0.001

8. NDI 35.4±6.28 26.07±5.65 7.641 0.001

9. Strength 26.67±16.38 87.87±22.76 -10.664 0.001

Sr.No

Variable

T P value

1.

Flexion

1.044 0.001

2.

Extension

-3.645 0.001

3.

S.F. (Rt)

-1.327 0.003

4.

S.F. (Lt)

-1.133 0.004

5.

Rot (Rt)

-5.353 0.001

6. Rot (Lt) -2.95 0.004

7. VAS 2.484 0.001

8. NDI 2.448 0.001

9. Strength -5.181 0.000

o Studies show that the convolutions formed on the tape due to stretching gives a rippling effect, i.e. It increases interstitial space allowing for better drainage of the swelling which results in pressure and irritation being removed from neural sensory receptors and thereby relieving pain and resulting in increase in ROM, improving strength, since used along with exercises and ultimately improving Neck Disability Index.

o In agreement with the results of the study, Ylinen , Salo P in 2007 ,evaluated the effect of isometric exercises on chronic neck pain and found significant difference in Muscle Strength and Neck Pain before and after treatment, [7]

o Therefore, kinesiotaping can be used as an adjunct with other conventional treatment in Cervical Spondylosis.

CONCLUSIONKinesiotaping along with conventional treatment showed better improvement in strength, ROM, pain intensity and function than conventional treatment alone.

CLINICAL IMPLICATION:Kinesiotaping can be used along with conventional physical therapy treatment for better and earlier results.

REFERENCES 1. Cotep, Cassidy, Carrole, Kristman, the annual

incidence and course of neck pain in the general population:a population - based chort study.

2. G. Salemi*, G. Savettieri, Prevalence of cervical spondylosis: a door-to-door survey in a Sicilian municipality, Acta Neurologica Scandinavica

3. Kase K, Tatsuyuki H, Tomoki O (1996): Development of Kinesiotape. KinesioTaping Perfect Manual.

4. Journal of Manipulative and Physiological Therapeutics. 14, 409-415

5. Raj D. Rao, Bradford L. Currier, 2007 Jun;. Degenerative Cervical Spondylosis:. J Bone Joint Surg Am, 89 (6): 1360 -1378.

6. Manuel Saanedra, 2012; Therapy level 1b J.Orthop Sports Physical therapy 42(8):724-730.

7. Gonzalez Iglesias ,Fernandez-de-las-Penas, 2009; Therapy level 1b,J Orthop Sports Physical therapy 39(7);515-521.

8. Ylinen J, Salo P, ,Decreased isometric neck strength in chronic neck pain and repeatability of neck strength measurements. Arch Phyical Med Rehabilitation 2004;85;1303-1308

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34

INTRODUCTIONo Auto-rickshaws are one of the most common

means of transportation in India.o Auto- rickshaw drivers are prone to develop

musculoskeletal disorders and sit awkwardly because of small size driver cabin, long handle, type of seat and duration of work.

o As auto rickshaw drivers are one of the most vulnerable groups to develop musculoskeletal disorders due to their working environment, there exists a need and background for the genesis of this study..¹

o A musculoskeletal disorder is a condition where a part of musculoskeletal system is injured over a period of time. The disorder occurs when the body part is called on to work harder, stretch further, Impact more directly or otherwise functions at a greater level than it is prepared for. The immediate impact may be minute, but when it occurs repeatedly the constant trauma causes damage.²

o Studies have shown that when a vehicle is in motion, the body is subjected to different forces: accelerations and decelerations, lateral swaying from side to side, and whole-body up and down vibrations. Also, when feet are active [ i.e. When they are actively being used - on the clutch], Exposure to vibrations is the cause of some occupational injuries and diseases.

o Being a driver is a high - risk job with a variety of physical and psychological hazards. Many researchers have concluded that exposure to whole body vibrations, postural stress from awkward and sedentary positions may contribute to an increased risk of low back pain. It has been proved that commercial drivers are more prone to spinal injury due to physical load and psychological risk factors.

AIM AND OBJECTIVESAIM:To study common musculoskeletal pain in auto-rickshaw drivers.

OBJECTIVES:1 . To find out different pain affected regions.

2 . To find out aggravating and relieving factor associated with pain.

METHODOLOGY Study design: observational study.Study population: Auto-rickshaw drivers in pune .Sample size: 50 auto-rickshaw drivers in Pune .Study material- pen and paper

Inclusion criteria:1. Male subjects in the age group of 26-40yrs.2. Driving for more than 5 years.

Exclusion criteria:1. Females.2. Recent trauma (like fractures.)3. Neurological condition.4. Any deformities.5. Non-cooperative subjects.6. Subjects doing other part time jobs.

PROCEDURE1. Prior permission was taken from the Principal of

SKNCOPT to conduct the study.2. The subject was explained and informed about the

need of the study.3. A written consent was taken from the patients who

were fulfilling the inclusion criteria. 4. Verbal interrogation of questions from a

predecided questionnaire was done and data was analyzed according to responses .

RESULTS

1 2Shivani Deshmukh , Dr.Parag Ranade (PT)

STUDY OF COMMON MUSCULOSKELETAL PAIN IN AUTO-RICKSHAW DRIVERS.

(Pune based study)

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Professor, Dept. of Neuro Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

Relation of age group with affected musculoskeletal region

Aggravating factor

Relieving factor

DISCUSSIONo In the study of 50 auto rickshaw drivers who were

driving autos for more than 5 years, Data was analyzed according to different age groups and according to aggregating and relieving factor.

o It was found that mean hours of rickshaw driving was 8.2 hours.

o It was found that 78% of people have low back pain followed by 36% have shoulder pain.

o Most commonly affected age group was 36-40 years followed by 31-35 years.

o Aggravates on long hours of rickshaw driving and relieves on rest.

o Umang Arora conducted a study to investigate the risk factors of musculoskeletal disorders among auto-rickshaw drivers in Mangalore. And results showed, all the auto-rickshaw drivers were suffering from musculoskeletal disorders and at high risk of having low back pain followed by neck pain. Likewise in the present study showed that maximum musculoskeletal pain is in lower back region followed by shoulders , reasons can be different roads, different hours of driving or different environment.

o Nhattacharjee, Ispita Prevalence of neck and low back disabilities in auto rickshaw drivers - a survey based study.

Conclusions: o The study concluded stating that there is a

prevalence of neck and back pain among auto rickshaw drivers who is driving more than 3 years. Also the subjects who had neck disability were not necessarily having back disability too. But the present study showed that there is also prevalence of shoulder pain after low back pain.

o Long term sitting without proper back support can lead to posterior pelvic tilt and flat back which increases pressure in the disc of the spine and also in this position the disc are less prepared to handle the vibrations from the vehicle. This can lead to low back pain.

o Continuous upper back and neck muscles are required to hold the head in position, especially if vibrations are present. Continuous muscle activity can lead to muscle sprain.

o Sustained posture and mental stress like (judgment of other vehicles, traffic, and noise pollution) can give rise to physical stress.

CONCLUSIONFrom this study it was concluded that most common musculoskeletal pain is low back pain.

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SEJOP E-journal Volume-1, Issue -1, January 2017

REFERENCES :1. Umang Arora-a study to investigate the prevalence

and risk factors of musculoskeletal disorders among auto-rickshaw drivers

2. Chris Adams. "what is a musculoskeletal disorder?”

3. Laura Punnett, David H Wegman. "work related musculoskeletal disorders: the epidemiologic evidence and the debate". Journal of electromyography and kinesiology 14(2004)13-23

4. Doodebiyi, Dcogwezi , Boa Adegoke. The prevalence of low back in commercial motor

drivers and private automobile drivers Nigerian j o u r n a l o f m e d i c a l r e h a b i l i t a t i o n ( N J M R ) ; V O L . 1 2 , N O . 1 & 2 , ( I s s u e No.20)Dec.2007

5. Orthopedic physical assessment by David J. Magee

6. E.N.C de BarrosRN & N.M.C AlexandreRN . C r o s s - c u l t u r a l a d a p t a t i o n o f N o r d i c musculoskeletal questionnaire, 2003 International Council of Nurses page 101

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Study Of Common Musculoskeletal Pain In Auto-rickshaw Drivers (pune Based Study)

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INTRODUCTIONAdhesive capsulitis or frozen shoulder is a common painful condition characterized by severe loss of

[1]mobility and shoulder pain. This condition results in formation of adhesions between the capsule, neck of the

[1]humerusand inferior capsular recess

Frozen shoulder is reported to affect 2% to 5% of the [2]general population .Individuals with primary frozen

[2] shoulder are commonly seen between 40 and 65 years.Patients with this condition have a painful active and passive range of motion restriction leading to loss of

[3]shoulder movement in all planes. There is slow onset of pain felt near the insertion of deltoid, which affects sleep when lying on the affected side, painful and restricted elevation and external rotation, with a normal

[3]radiological appearance.

1st stage of frozen shoulder is freezing stage; there is severe pain in the shoulder even at rest. There is also a decrease in shoulder ROM which is secondary to the

[4]pain and is not true capsular contractures. The pain and lack of range of motion ultimately lead in alteration

[4]of posture, directly affecting quality of life.

Kinesio Taping is a elastic cotton adhesive tape that is applied to stretched skin to support and

[5]rehabilitate. Ligaments and joints that become damaged , lose their ability to stabilize and hence unable to provide proper functional control to a segment, resulting in dependence on stretched tape for

[5]the correction. The function of kinesio tape is to provide assistance to the joint during movement, enhance the proprioceptive input which would help to

[6]reduce the occurrence of injuries. Kinesio taping will provide support to the shoulder joint and proprioceptive stimulation helps in reducing pain by correcting the

[6]altered posture and increasing Range of Motion.

AIM AND OBJECTIVESAIM:-To study the clinical effectiveness of kinesio taping combined with conventional PT and NSAIDs in

patients with first stage of frozen shoulder

OBJECTIVES :-1. To study the effectiveness of kinesio taping in

reducing pain combined with conventional PT and NSAIDs

2. To study the secondary effects of kinesio taping in improving the ROM combined with conventional PT and NSAIDs

3. To measure the amount of change in the scores of SPADI pre and post

METHODOLOGY¡ STUDY DESIGN : Pilot study¡ STUDY POPULATION : Frozen shoulder

patients(stage 1)¡ SAMPLING: Purposive sampling ¡ STUDY AREA : SKNGH¡ STUDY MATERIAL: Kinesio tape, Paper, Pen,

and Goniometer.¡ SAMPLE SIZE :30o Group A (15) = NSAIDS along with conventional

PTo Group B (15) = NSAIDS along with conventional

PT + Kinesio taping

INCLUSION CRIETERIA¡ Patient with resting pain ¡ Patient age, 40-65 years¡ Pain intensity >6/10¡ Intermittent, constant or resting pain.¡ Pain prior to or end ROM¡ Duration of symptoms from 0-3 months¡ Moderate to high irritability phase¡ Active ROM is less than PROM

EXCLUSION CRITERIA¡ Patients with frozen shoulder stage 2 and 3¡ Recent fractures or surgery.¡ Patients with any kind of upper limb injury¡ Patient with skin conditions that can interfere

with kinesio taping¡ Patients with shoulder dislocation

STUDY THE CLINICAL EFFECTIVENESS OF KINESIO TAPING COMBINED WITH CONVENTIONAL

PT AND NSAIDS IN PATIENTS WITH FIRST STAGE OF FROZEN SHOULDER

1 2Anagha Akare , Dr. Anushree Narekuli (PT)

1Intern - Smt Kashibai Navale College of Physiotherapy, Pune 2Asst. Professor, Dept. of Community Physiotherapy - Smt Kashibai Navale College of Physiotherapy, Pune

PROCEDURE¡¡ Patients from the OPD were selected according to

the inclusion criteria.¡ A written consent from the subjects who are willing

to participate in the study was taken.¡ Patients were divided alternately into two groups,

group A and Group B.¡ VAS, ROM, SPADI were measured before

treatment.¡ Group A received Conventional PT and NSAID

Conventional Group(Group A)1.Moist heat (10 - 15 mins)2.Shoulder pendulum exs (10 rep, thrice a day)3.Active assisted exs(10 reps ,thrice a day)4.Medications(NSAIDs)

Ethical committee approval was taken.Interventional Group(Group B)1.Moist heat (10 - 15 mins)2.Shoulder pendulum exs (10 rep, thrice a day)3.Active assisted exs(10 reps ,thrice a day)4.Medications(NSAIDs)5.Kinesiotaping

Treatment protocol was given for three weeks following which post assessment were done.

Application of kinesio tape

1st tape-subscapularis muscle Y tapePlace undivided base of Y tape on coracoids process then protract the scapula and external rotation of the shoulder. Place one end of Y tape on upper border of scapula and other end on lower border of scapula.

Study The Clinical Effectiveness Of Kinesio Taping Combined With Conventional Pt And Nsaids In Patients With First Stage Of Frozen Shoulder

38

5th tape-supraspinatus I tapePerform abduction of shoulder joint up to 5-10? then place one end on humeral head and other end goes posteriorly to origin.

RESULTS

The above pie diagram shows 53% of affection of shoulder on dominant side whereas 47% of affection is on non dominant side in Conventional group.

The above pie diagram shows 60% of affection of shoulder on dominant side while 40% of affection is seen on non dominant side in Interventional group

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SEJOP E-journal Volume-1, Issue -1, January 2017

2nd tape-deltoid muscle Y tapePlace undivided end of Y tape on Upper 1/3rd of humerus on deltoid tuberosity. Perform flexion of shoulder up to 90? then apply one end to the origin of the deltoid, for the other end of tape perform extension of the shoulder 20-30.

3rd tape-coracobrachialis muscle I tape.Place lower end of I tape on medial upper 1/3rd of the humerus, then extend the shoulder up to 20-30? and apply the upper end to its origin. (Be careful not to irritate armpit)

4th tape-pectoralis minor Y tapePlace undivided end of Y tape on the coracoid process then perform retraction of scapula and apply both the ends.

Table 2:MEAN AND STANDARD DEVIATION OF INTERVENTIONAL GROUP PRE AND POST TREATMENT

Table 3: PAIRED T TEST OF CONVENTIONAL GROUP PRE AND POST TREATMENT

Variables Mean± SD (Pre) Mean± SD(Post)

Flexion

97.07±11.9 (n=15) 129.07±19.19 (n=15)

Extension

34.53±11.07 (n=15) 46.07±9.684 (n=15)

Abduction

91.67±8.91 (n=15) 135.3±17.09 (n=15)

Adduction

91.67±8.91 (n=15) 135.3±17.09 (n=15)

Int.Rotation

25.67±8.666 (n=15)42.4±12.43

(n=15)

Ext Rotation 24.73±7.314 (

n=15)44.8±14.26

(n=15)

VAS 7.653±0.9486 (n=15) 4.227±1.985 (n=15)

SPADI 75.12±6.508 (n=15) 33.09±7.236 (n=15)

Age 52.06±5.43 (n=15)

Variables

Mean SD (Pre) Mean SD(Post)

Flexion

93±12.79

(n=15)

152.9±24.42 (n=15)

Extension

28.4±10.25

(n=15)

45.4±9.03(n=15)

Abduction

87.67±12.65 (n=15)

147±24.28(n=15)

Adduction

87.67±12.65 (n=15)

147±24.28(n=15)

Int. Rotation

26.2±9.578

(n=15)

49.8±8.85(n=15)

Ext Rotation

28.27±10(n=15)

64.53±13.41 (n=15)

VAS

7.693±0.9617 (n=15)

2.433±1.115 (n=15)

SPADI

75.08±7.295 (n=15)

19.23±5.224 (n=15)

Age

50.6±5.87(n=15)

Variables

T value

P value

Flexion

-7.202

0.000

Extension

-9.527

0.004

Abduction

-10.632

0.000

Adduction -10.632 0.002

Int.Rotation

-5.705 0.000

Ext Rotation -5.346 0.001

VAS 7.715 0.000

SPADI 18.378 0.002

40

The above pie diagram shows that17% patients were in the age group of 40-45yrs while 30% were in the age group of 46-50yrs, 27%in 51-55 yrs, 23% in 56-60 yrs & 3% in age group of 61-65yrs.

The above pie diagram shows that in a sample of 30, 57% were male and 43% were female.

Table 1:MEAN AND STANDARD DEVIATION OF CONVENTIONAL GROUP PRE AND POST TREATMENT

Study The Clinical Effectiveness Of Kinesio Taping Combined With Conventional Pt And Nsaids In Patients With First Stage Of Frozen Shoulder

In above table, ROM, VAS and SPADI showed a statistically significant difference pre & post conventional treatment

Table 4: PAIRED T TEST IN INTERVENTIONAL GROUP PRE AND POST TREATMENT

In above table, ROM, VAS and SPADI shows statistically significant difference pre & post interventional group.

Ta b l e 5 : C O M PA R I S O N B E T W E E N C O N V E N T I O N A L G R O U P A N D INTERVENTIONAL GROUP (UNPAIRED T TEST)

In above table, ROM, VAS and SPADI signified that there is statistically significant improvement in interventional group when compared with conventional group.

DISCUSSION¡ The findings of present study reveal that , there is a

statistically significant improvement in the functional outcome of both Conventional and Interventional group in first stage of frozen shoulder patients

¡ Comparison between conventional group and interventional group p value is highly significant i.e.(p<0.001)

¡ In both the groups i.e. conventional and Interventional group, NSAIDs give analgesic effect through peripheral inhibition of prostaglandins synthesis and also through other peripheral and central mechanism.

¡ In conventional PT, Range of motion exercises help to improve joint and soft tissue mobility to minimize loss of tissue flexibility and contracture formation.

¡ Stretching exercises were also incorporated at the end range limits helping in breaking the collagen bonds and realignment of the fibers for permanent elongation or increased flexibility and mobility of the soft tissues that have adaptively shortened and become hypo mobile over time in Frozen Shoulder.

¡ The other Group i.e. the Interventional group also showed extremely significant results in pain reduction and ROM improvement because the patients here received conventional treatment benefitted with the same physiological effects as the other Group.

¡ As the is pain is major factor in reducing ROM and functioning in first stage of frozen shoulder,in Interventional Group patients received additional benefit of Kinesiotaping. The corrective taping technique helped in postural correction and provided postural cues and the joint was held in correct position which helped in reducing pain. Kinesiotaping approach in Frozen Shoulder improves joint mobility & relieves pain making patient more functionally independent.

¡ Kinesio Tape has expanding and contracting properties which provides gentle sensory stimulation to various types of sensory receptors in the skin during movement. This activates the spinal inhibitory system by stimulating the touch receptors thereby activating the descending inhibitory system to decrease pain via the Gate Control Theory; hence Interventional Group has benefitted from this effect and showed more decrease in pain as compared to control Group.

Variables

T value P value

Flexion

-10.872

0.003

Extension

-14.883

0.000

Abduction

-10.094

0.001

Adduction

-10.94

0.000

Int.Rotation

-10.658 0.001

Ext Rotation -8.7 0.002

VAS 19.49 0.000

SPADI 34.889 0.000

Variables

T value P value

Flexion

-5.207 0.000

Extension -1.836 0.0001

Abduction -4.998 0.000

Adduction -4.998 0.000

Int.Rotation

-1.878 0.003

Ext Rotation -3.905 0.000

VAS 3.872 0.000

SPADI 6.002 0.000

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SEJOP E-journal Volume-1, Issue -1, January 2017

Joint function was improved by stimulating the proprioceptors in the joints with the application of tape.

¡ ErmirSinaj, Feb 2015 in Albania studied that effects of taping compare to physical therapies modalities in patients with adhesive capsulitis of the shoulder. The result showed that the combination of taping with stretching exercises program leads to better outcomes in rehabilitation of patients with frozen shoulder especially when an immediate effect is needed.

¡ The study held in sept 2014 by Smita Bhimrao Kanase, studied compare effectiveness of Maitland mobilization and kinesiotaping on functional outcome in frozen shoulder. They concluded that Maitland mobilization with Kinesiotaping along with conventional therapy improves the pain and disability in patients with frozen shoulder.

CONCLUSIONThus, this study confirms that, there is positive effect of kinesiotaping when combined with conventional PT and NSAIDs in reducing pain, increasing ROM and functioning in patients with first stage of frozen shoulder.

REFERENCES 1] Emir Sinaj European Scientific Journal February

2015; SPECIAL; edition vol.2

[2] SmitaBhimrao Kanase1, S. Shanmugam2; Pg no .423- 430; Volume 3 Issue 9, September 2014

[3] Martin j. Kelley; journal of orthopedic & sports physical therapy; volume 39; number 2; February 2009

[4] Mark d. Thelen, The Clinical Efficacy of Kinesio Tape for Shoulder Pain; journal of orthopaedic& sports physical therapy; volume 38; number 7; July 2008.

[5] Bridgman JF. Journal of orthopedic & sports physical therapy; volume 38; number 7; July 2008 Pg no. 74-82, 2013

[6] Donatelli RA. Physical Therapy of the Shoulder.4th edition.St. Louis, Missouri; 2004.

[7] Donald D. Price, Patricia A. McGrath Pain, 17 (1983) 45-56 21 February 1983)

[8] Michael J MullaneyPhysiotherapy Theory and Pract ice: An Internat ional Journal of Physiotherapy Volume 26, Issue 5, 2010

[9] Williams JW Jr., Holleman DR Jr., Simel DL: Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol1995; 22 (4); 727-732

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Study The Clinical Effectiveness Of Kinesio Taping Combined With Conventional Pt And Nsaids In Patients With First Stage Of Frozen Shoulder

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