Divya Midha

The California tri-pull taping method in the treatment of shoulder subluxation after stroke: A randomized clinical trial

Background: Shoulder subluxation is a frequent occurrence in individuals following a stroke. Although various methods of treatment are available, none of them address all possible consequences of the subluxation pain, limited range of motion, the subluxation, and decreased functional use of the arm. Aims: The purpose of this study was to evaluate the effectiveness of California tri-pull taping (CTPT) method on shoulder subluxation, pain, active shoulder flexion, and upper limb functional recovery after stroke. Materials and Methods: This was a randomized control study on 30 participants. All participants received conventional neurorehabilitation 5 days a week over 6 weeks. Half of the participants also received the CTPT. Pre- and post-assessment scores were taken on all participants for the amount of shoulder subluxation, pain, active shoulder flexion, and functional recovery. Results: The CTPT method demonstrated a significant reduction of pain in the treatment group from baseline, a significant improvement in active shoulder flexion and a significant improvement in proximal arm function as measured on the proximal subscale on the Fugl-Meyer upper extremity functional Scale but not the distal or total Fugl-Meyer subscales. Shoulder subluxation was not statistically significant. Conclusions: The CTPT method is an effective treatment for the hemiplegic subluxed shoulder.

A preliminary report on physical activity patterns among children aged 8–14 years to predict risk of cardiovascular diseases in Malwa region of Punjab

OBJECTIVE To determine the pattern of physical activity specific to age and gender among young Indian school going girls and boys aged 8-14 years. DESIGN Cross-sectional study. SETTING Private and government sponsored schools in Patiala and Mansa District of Punjab, India. PARTICIPANTS Two hundred thirty four school going girls and boys aged 8-14 years. METHODOLOGY A structured questionnaire recorded the various forms of daily physical activity, sedentary activity as well as physical activity level of all the participants. The energy expenditure was also calculated using the standard metabolic equivalent index. RESULTS There is a significant difference between mean weights of participants belonging to different physical activity levels (p<.04). In comparison to boys, the girl participants have significant lower values of physical activity duration as well as total metabolic equivalent expenditure (p<.05). The total duration of moderate/vigorous physical activity declined in both girls and boys as the age increased. CONCLUSION Physical activity among children in Northern regions of India is on decline as their age increases especially among girls. It is important to determine physical activity duration in early age groups and motivate children for daily physical activity.

Multi-directional reach test in South Asian children: Normative reference scores from 5 year to 12 years old

Multi-directional reach test (MRT) emerged as a valid and reliable assessment tool for balance evaluation among elderly. The normative reference scores have been established in adults and elderly people, but they were not yet established for children. Hence, we aimed at establishing the normative reference scores of MRT among the school going children aged between 5 and 12 years. Children (N = 194; 124 males, 70 females) were recruited by the stratified random sampling for the normative study. MRT was performed by the custom made, multi-directional reach estimator. MRE device consists of three adjustable wooden frames with two metallic rulers each of 600 mm. Children were asked to reach maximum distance in forward reach (FR), backward reach (BR), right lateral reach (RLR) and left lateral reach (LLR) directions to obtain their maximum reaching ability. The mean of three readings were used to report the normative reference scores of MRT. Median age, height, weight and body mass index (BMI) were 8.5 years, 1240 mm, 27 kg and 17.24 kg/m2 respectively. The normative reference scores [median (95% confidence Interval, CI)] of MRT among the children aged 5-12 years old were FR [169.7 mm (CI, 166.1-183.3 mm)], BR [77.7 mm (CI, 78.0-85.5 mm)], RLR [122.0 mm (119.6-130.9 mm)] and LLR [107.0 (105.8-119.3 mm)] respectively.

Journey of a child with spastic diplegic cerebral palsy from doldrums to hope

This case study describes the physical therapy of a 9-year-old male child with spastic diplegic cerebral palsy with the aim to improve his gross motor function and social skills. The child had severe impairments across the full spectrum of developmental functions, especially affecting the gross motor and self-care functions at Stage V of gross motor function classification system (GMFCS) in spastic diplegic cerebral palsy. His body was completely stiff with marked asymmetrical spasticity in lower limbs, truncal dystonia, and chest deformity with cardio respiratory complications. The physical therapy was performed by giving sessions of Roods approach, sensory integration, and static weight-bearing exercise for a period of 9 months. Pre- and post-therapy evaluation of child was done using GMFCS. There was an improvement in the child with his social skills, transitional activities, activities of daily living, and gross motor skills, reaching to Stage IV with the 9 months physiotherapy intervention given by a neurological physical therapist.