Jamal Ali Moiz

Comparison of effects of manual versus ventilator hyperinflation on respiratory compliance and arterial blood gases in patients undergoing mitral valve replacement

OBJECTIVE To compare the effects of manual hyperinflation (MHI) and ventilator hyperinflation (VHI) delivered to completely sedated and paralyzed patients undergoing mitral valve replacement (MVR) while maintaining minute ventilation. METHODS This was a randomized study with a 2-group, pre-test, post-test experimental design. Effects of hyperinflation were studied on static compliance (C(stat)), dynamic compliance (C(dyn)), oxygenation (Pao(2):Fio(2)), partial pressure of carbon dioxide in arterial blood (Paco(2)), and cologarithm of activity of dissolved hydrogen ions in arterial blood (pH). A sample of 30 patients in the immediate postoperative phase of MVR surgery were included in the study. RESULTS No significant differences were found between the groups. Significant improvements were found in oxygenation at both 1minute and 20minutes after MHI, but only at 1minute after VHI (P < .05). VHI led to improved C(dyn) (P < .05). CONCLUSION In the immediate postoperative phase of MVR, both techniques produced similar effects on respiratory compliance and oxygenation. MHI produced longer lasting improvements in oxygenation than VHI, whereas VHI produced better improvements in dynamic compliance. Paco(2) and pH were maintained by both.

Validity of the Pittsburgh Sleep Quality Index in Indian University Students

OBJECTIVES Despite the demonstrated utility of the Pittsburgh Sleep Quality Index (PSQI) in various demographic groups, it has never been validated in a sample of Indian subjects. To extend and confirm the PSQIs applicability for South Asian subjects, this preliminary study aimed to assess its psychometric and diagnostic validity in a sample of university students. METHODS Forty-seven male students were recruited from Jamia Millia Islamia, a public central university in New Delhi, India. The mean age of the students was 23.4±3.9 years, and they had a mean body mass index (BMI) of 23.3±3.3kg/m(2). The PSQI was administered to all subjects and overnight polysomnographic testing was carried out as a concurrent validation measure. RESULTS Cronbachs alpha for the questionnaire was found to be 0.736. Internal homogeneity was high, with the majority of correlations between questionnaire component scores and the summed global score being significant (p<0.010). Criterion validity-correlations between the PSQI global score and polysomnography (PSG) measures were low. However, the questionnaire component scores and the related polysomnographic measures did show some significant relationships. The optimal cut-off scores for distinguishing students with/without sleep problems was >6 and was generated using receiver operating characteristic curve analysis. The area under the curve, sensitivity, specificity, positive and negative likelihood ratios at the cut-off score were 0.838 (p<0.0001), 75.0%, 88.9%, 6.75, and 0.280, respectively. CONCLUSION The study found evidence that the PSQI had internal consistency, internal homogeneity, and diagnostic characteristics that compared well with PSG among a sample of young adult male students in India. This supports the applicability and certain aspects of the validity of the PSQI in the population.

Factor scoring models of the Pittsburgh Sleep Quality Index: a comparative confirmatory factor analysis

Abstract The Pittsburgh Sleep Quality Index (PSQI) is a rigorously validated questionnaire with extensive use in sleep assessment. Findings from numerous factor analytic studies of the PSQI have been interpreted to support a heterogeneous factor structure model for the test. Nevertheless, the literature continues to lack a focused evaluation of whether this heterogeneous factor structure is justified. A consideration of this issue led to a conclusion that a closer analysis of the PSQI’s factor structure was merited. To address this need a comparative confirmatory factor analysis for assessing the performance of the accepted factors models of the PSQI was conducted. A sample of university students (n = 418), age = 20.92 ± 1.81 years, BMI = 23.30 ± 2.57 kg/m2 completed the multi-structured sleep survey at Jamia Millia Islamia, New Delhi, India. Seventeen putative factor structures (three 1-Factor, eight 2-Factor, and six 3-Factor) of the PSQI from the existing literature were selected for analysis. Fourteen models (82.35%) had almost similar values for model fit indices. Two models were misfits, and one model was a poor fit. The two misfit models incorporated gender and age as covariates. The third poor fit model was used to produce a unique path diagram, which made it distinct from the remaining 16 models. The overlapping values in the fit range of the model fit indices did not support the often projected heterogeneous factor structures of the PSQI for the vast majority of the models.

Psychometric Analysis of the Pittsburgh Insomnia Rating Scale among University Population of Poor Sleepers in India.

Background: Pittsburgh insomnia rating scale is a 65 item self administered open source questionnaire. The scale is widely used in clinical practice but its psychometric properties are not well established. Therefore keeping in mind this lacuna the current study was designed for university population of poor sleepers in India. Aims: The purpose of this study was to establish the Pittsburgh sleep Quality Index test- retest reliability, validity and internal consistency of Pittsburgh insomnia rating scale. Materials and Methods: Twenty five subjects were randomly chosen from the screened population of poor sleepers. Pittsburgh insomnia rating scale, Pittsburgh sleep quality index and Insomnia severity index were administered on test day. Retest was administered after one week. Results: Eight males and seventeen females with mean age 24 + 7.04 were recruited. The test retest reliability for Pittsburgh insomnia rating scale total score showed excellent reliability (ICC2,1-0.93). The results also show that the total score is moderately correlated with Pittsburgh sleep Quality Index (r-0.31) and moderately correlated with Insomnia severity index (r-0.49). Internal consistency for the test was excellent (Cronbachs alpha- 0.930) Conclusion: The study findings suggest that Pittsburgh insomnia rating scale has excellent internal consistency, test-retest reliability and good validity for university population of poor sleepers in India. It is an important first line of assessment scale for screening of sleep problems.

Physical and balance performance following exercise induced muscle damage in male soccer players

[Purpose] The present study aimed to determine the changes in physical and balance performance following exercise-induced muscle damage using a sport-specific protocol. [Subjects and Methods] Fifteen collegiate soccer players were asked to perform a sport-specific sprint protocol to induce muscle damage. The markers of muscle damage (soreness, range of motion, limb girth, muscle strength, creatine kinase and lactate dehydrogenase), physical performance (speed, agility and power) and balance (static and dynamic balance) were assessed at baseline and 24, 48 and 72 hours following the sprint protocol. [Results] All variables, including the markers of muscle damage, physical performance and balance showed a significant difference when assessed at the 4 time points. [Conclusion] The study demonstrated that both the physical and balance performance were affected following repeated sprint protocol in soccer players. It is recommended the balance performance of an athlete be continually assessed following exercise-induced muscle damage so as to determine the appropriate return to sport decision thereby, minimizing the risk of further injury.

Comparison of different volumes of high intensity interval training on cardiac autonomic function in sedentary young women

Abstract Purpose The present study was conducted to compare the effects of low volume of high intensity interval training (LVHIIT) and high volume of high intensity interval training (HVHIIT) on heart rate variability (HRV) as a primary outcome measure, and on maximum oxygen consumption (VO2max), body composition, and lower limb muscle strength as secondary outcome measures, in sedentary young women. Methods Thirty-six participants were recruited in this study. The LVHIIT group (n = 17) performed one 4-min bout of treadmill running at 85%–95% maximum heart rate (HRmax), followed by 3 min of recovery by running at 70% HRmax, three times per week for 6 weeks. The HVHIIT group (n = 15) performed four times 4-min bouts of treadmill running at 85%–95% HRmax, interspersed with 3-min of recovery by running at 70% HRmax, 3 times per week for 6 weeks. All criterion measures were measured before and after training in both the groups. Results Due to attrition of four cases, data of 32 participants was used for analysis. A significant increase in high frequency (HF) power (p < 0.001) and decrease in the ratio of low frequency to high frequency power (LF/HF) ratio (p < 0.001) in HRV parameters, was observed post-HVHIIT, whereas, these variables did not change significantly (HF: p = 0.92, LF/HF ratio: p = 0.52) in LVHIIT group. Nevertheless, both the interventions proved equally effective in improving aerobic capacity (VO2max), body composition, and muscle strength. Conclusion The study results suggest that both LVHIIT and HVHIIT are equally effective in improving VO2max, body composition, and muscle strength, in sedentary young women. However, HVHIIT induces parasympathetic dominance as well, as measured by HRV.

Reliability of Electromyographic Assessment of Biceps Brachii and Triceps Brachii in Cricketers

Objective The purpose of this study is to determine the intraexaminer and interexaminer reliability of electromyographic assessment of biceps brachii (BB) and triceps brachii (TB) muscles in cricketers. Methods Sixteen healthy male cricketers (ages 14‐35 years) recruited from Jamia Millia Islamia, New Delhi, India were tested on 2 occasions that were held 1 week apart. On the first occasion, only examiner 1 performed the testing; on the second occasion, examiner 1, examiner 2, and examiner 3 all performed testing. While testing for surface electromyography (sEMG) activity of BB and TB muscles, participants were asked to produce maximal voluntary isometric contraction (MVIC), which was to be held for 5 seconds against the resistance provided by an examiner. Participants performed 3 MVICs per muscle per examiner, with a rest interval of 3 minutes between consecutive contractions. Intraclass correlation coefficient, standard error of measurement, and minimum detectable change were calculated to determine the reliability of repeated sEMG measurements. Results Nonsignificant differences were observed for the 2 trials completed by examiner 1 (paired t test) and testing done by all 3 examiners (repeated measures analysis of variance) at P < .05 for both BB and TB. Intraclass correlation coefficient values ranged from .84 to .86 for BB and .89 to .98 for TB. Standard error of measurement (minimum detectable change) was .052 (.144) mV and .041 (.114) mV for BB intraexaminer and interexaminer reliability testing, respectively, and .018 (.051) mV and .043 (.119) mV for TB intraexaminer and interexaminer reliability testing. Ninety‐five percent of the mean differences between almost all of the repeated measurements were found to lie within the agreement intervals estimated by Bland‐Altman plots. Conclusion This preliminary study suggests that sEMG is a reliable tool with excellent intraexaminer and interexaminer reliability for assessing the activity of BB and TB muscles in male cricketers. These findings suggest that sEMG can be used to assess MVIC activity of these muscles in clinical settings, as well as in research area.

Postactivation Potentiation Following Acute Bouts of Plyometric versus Heavy-Resistance Exercise in Collegiate Soccer Players

Postactivation potentiation is referred to as an acute and temporary enhancement of muscle performance resulting from previous muscle contraction. The purpose of this study was to compare the acute effect of plyometric exercise (PLY) and heavy-resistance exercise (RES) on the blood lactate level (BLa) and physical performance. Fourteen male collegiate soccer players were randomized to perform either RES or PLY first and then crossed over to perform the opposite intervention. PLY consisted of 40 jumps, whereas RES comprised ten single repetitions at 90% of one repetition maximum. BLa and physical performance (countermovement jump height and 20-m sprint) were measured before and at 1 and 10 min following the exercise. No significant difference was observed in the BLa for both exercises (PLY and RES). Relative to baseline, countermovement jump (CMJ) height was significantly better for the PLY group after 1 min (P = 0.004) and after 10 min (P = 0.001) compared to that of the RES group. The 20-m sprint time was significantly better for PLY at 10 min (P = 0.003) compared to that of RES. The present study concluded that, compared to RES, PLY causes greater potentiation, which leads to improved physical performance. This trial is registered with NCT03150277.

Preconditioning by light-load eccentric exercise is equally effective as low-level laser therapy in attenuating exercise-induced muscle damage in collegiate men

Background/objective Previous studies have already reported an independent effect of light-load eccentric exercise (10% eccentric exercise contraction [EEC]) and low-level laser therapy (LLLT) as a protective measure against more strenuous eccentric exercise. However, the difference between these two interventions is largely unknown. Therefore, the present study aimed to compare the preconditioning effect of 10% EEC vs. LLLT on subjective, physiological, and biochemical markers of muscle damage in elbow flexors in collegiate men. Methods All 36 enrolled subjects were randomly assigned to either 10% EEC or LLLT group. Subjects in 10% EEC group performed 30 repetitions of an eccentric exercise with 10% maximal voluntary contraction strength 2 days prior to maximal eccentric exercise bout, whereas subjects in LLLT group were given LLLT. All the indirect markers of muscle damage were measured pre-exercise and at 24, 48, and 72 hours after the exercise-induced muscle damage protocol. Results The muscle soreness was reduced in both groups (p = 0.024); however, soreness was attenuated more in LLLT group at 48 hours (33.5 vs. 42.7, p = 0.004). There was no significant difference between the effect of 10% EEC and LLLT groups on other markers of muscle damage like a maximum voluntary isometric contraction (p = 0.47), range of motion (p = 0.16), upper arm circumference (p = 0.70), creatine kinase (p = 0.42), and lactate dehydrogenase (p = 0.08). Within-group analysis showed both interventions provided similar protection over time. Conclusion This study indicated that light-load eccentric exercise confers similar protective effect against subsequent maximal eccentric exercise as LLLT. Both the treatments could be used reciprocally based on the patient preference, costs, and feasibility of the equipment.

Transcultural adaptation and validation of Hindi version of Quebec Back Pain Disability Scale

Abstract Purpose: To transculturally adapt the Quebec Back Pain Disability Scale for Hindi-speaking population and examine its psychometric properties in patients with low back pain. Materials and methods: The Quebec Back Pain Disability Scale was translated and cross-culturally adapted into Hindi following international guidelines. Hindi version of the scale was completed by 120 patients with low back pain and 60 healthy controls. Patients with low back pain were also administered the Hindi-Roland Morris Disability Questionnaire and Visual Analog Scale. Psychometric evaluation included test–retest reliability, convergent and discriminative validity. Exploratory factor analysis was carried out to determine the factor structure. Results: The factorial analysis revealed a four-factor solution (bending/carrying, ambulation/reach, prolonged postures and rest). Convergent validity was confirmed by high correlation of Hindi Quebec Back Pain Disability Scale to the Hindi version of Roland Morris Disability Questionnaire (r = 0.77 and p < 0.001) as well as Visual Analog Scale (r = 0.682 and p < 0.001) scores. Discriminative validity was established by significantly different scores for patients with low back pain and the healthy controls (35.36 ± 18.6 vs. 9.13 ± 6.08 and p < 0.001). The translated version of the scale showed remarkable internal consistency (Cronbach α = 0.98) and the intraclass correlation coefficient of test–retest reliability was excellent (ICC2,1=0.96). MDC95 and SEM scores obtained were 10.28 and 3.71, respectively. Conclusion: The Hindi version of Quebec Back Pain Disability Scale has good test–retest reliability, discriminative and convergent validity and is appropriate for clinical and research use in Hindi-speaking low back pain patients. Implications for rehabilitation Linguistically and culturally adapted questionnaires help researchers make adequate inferences about instruments measuring health and quality of life. The translated version would serve as a valid research tool allowing comparability of data across cultures thus, providing opportunities for large multicenter, multicountry trials. A Hindi Quebec Back Pain Disability Scale version will help to improve the quality and efficacy of assessment of low back pain by developing in patients, a better understanding of the items which can be easily correlated with the activities of daily living.