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BackgroundDiabetic foot is one of the most significant and devastating complication of diabetes. The objective of this study was to assess the prevalence of diabetic foot syndrome (DFS) and the associated risk factors among people with diabetes mellitus.MethodsA community based cross-sectional study was carried out among 620 subjects with diabetes mellitus (DM) in rural areas of Udupi district. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Ankle brachial index was used to identify peripheral arterial disease (PAD). Subjects with diabetic foot syndrome were classified according to the International Working Group on Diabetic Foot (IWGDF) classification system.ResultsThe overall prevalence of DFS was 51.8%. Among them 31.3, 11.9 and 8.5% belonged to category 1, 2 and 3 respectively. Multivariate logistic regression analysis showed advancing age, low socio-economic status, sedentary physical activity and longer duration of DM were significant independent correlates of DFS.ConclusionThe overall prevalence of DFS was high among the study population; hence the screening for foot complications should start at the time of diagnosis of diabetes integrated with sustainable patient education at primary care level by training of health care providers at primary care level.

Objectives The objective of this study was to assess the effects of home-based exercise training (HBET) on function and quality of life (QoL) in patients with pulmonary hypertension (PH). Methods A prospective, nonblinded, randomized clinical trial was carried out on 84 medically stable patients with PH belonging to any functional class or etiology and of either sex. Patients were randomized to either standard care or HBET. Both groups also received education using the Pulmonary Hypertension Manual (PulHMan). Outcomes included functional capacity from 6-min walk distance (6MWD), QoL using the Medical Outcomes Survey Short Form – 36, functional class (FC), and right heart indices (right ventricular systolic pressure [RVSP] and tricuspid annular plane systolic excursion [TAPSE]) and were assessed at entry and after 12 weeks. Results HBET improved 6MWD by 48.5 m and 13 m in the experimental and control groups, respectively ( p < 0.001). QoL showed statistical improvements after HBET between the groups for the physical and mental components and for the various subdomains (except body pain). Furthermore, FC improved by one grade with HBET ( p < 0.001). Conclusion HBET program improved functional capacity, QoL, and FC in patients with PH.

Background Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Therefore they are prone to develop frequent and often foot problems with a relative high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. Thus the review on study of foot kinematic and kinetic in type 2 diabetes mellitus to understand the biomechanical changes is important.Methodology Scientific articles were obtained using electronic databases including Science Direct, CINAHL, Springer Link, Medline, Web of Science, and Pubmed. The selection was completed after reading the full texts. Studies using experimental design with focus on biomechanics of diabetic foot were selected.ResultsThe meta-analysis report on gait velocity (neuropathy = 128 and non-diabetes = 131) showed that there was a significantly lower gait velocity in neuropathy participants compared to non-diabetes age matched participants at a high effect level (−0.09, 95 % CI −0.13 to 0.05; p < 0.0001). Regarding knee joint flexion range there was a significant difference between neuropathy and non-diabetes group (4.75, 95 % CI, −7.53 to 1.97, p = 0.0008).ConclusionsThe systematic review with meta-analysis reported significant difference in kinematic and kinetic variables among diabetic with neuropathy, diabetic without neuropathy and non-diabetes individuals. The review also found that the sample size in some studies were not statistically significant to perform the meta-analysis and report a strong conclusion. Therefore a study with higher sample size should be done.

Purpose: The purpose of this study was to fi nd what role physiotherapists play in the care of the critically ill in Indian Intensive Care Units (ICU). Materials and Methods: Study Design and Setting: Exploratory crosssectional survey Questionaires were sent to 260 ICUs in India. A stamped self-addressed envelope was enclosed with the questionnaire and a period of six weeks for completion were given in an attempt to ensure good response rates. If response was not obtained within six weeks, two subsequent reminders were sent to the hospitals with a further time gap of six weeks. Results: Eighty-nine completed questionnaires were received and analyzed, representing 35% of the questionnaires sent. The present study revealed that, 24% of ICUs had a resident physiotherapist available during the night and 79% of physiotherapists available on-call. In almost 90% of ICUs physiotherapists performed chest manipulations, mobilization, incentive spirometry and postural drainage. Correlation of physiotherapists' role between different states of India, were performed by Chi-square. Mann-Whitney U test was performed to compare, within each of the fi ve states for two types of postings in relation to the years of experience in ICU. Conclusion: All physiotherapists in ICU are routinely involved in chest physiotherapy and mobilization

Aims:To determine the effects of combined in-patient rehabilitation with a home-based program on function and quality of life.Setting and Design:Tertiary care, university teaching hospital, randomized controlled trial.Patients and Methods:Thirty admitted patients with congestive heart failure with New York Heart Association class II -IV. A five step individualised phase-1 cardiac rehabilitation program followed by a structured home based rehabilitation for eight weeks was given to the experimental group while the control group only received physician directed advice. Six minute walk distance was assessed at discharge and follow-up, while quality of life (SF36) was assessed at admission, discharge, and follow-up.Statistical analysis used:Independent t-test, paired t-test and repeated measures ANOVA with Bonferroni post-hoc analysis.Results:At admission patients in both the groups were comparable. After the phase-1 cardiac rehabilitation, there was a change in the six minute walk distance between control and experimental group (310 m vs. 357 m, respectively; P = 0.001). Following the eight week home-based program, there was a greater increase in six minute walk distance in the experimental group when compared to the control group (514 m vs. 429 m; P < 0.001). Quality of life as measured by the SF-36 at the end of 8-weeks showed a statistically significant difference (P < 0.05) in the experimental group for both the mental and physical components.Conclusion:Early in-patient rehabilitation followed by an eight week home based exercise program improves function and quality of life in patients with congestive heart failure.

Background:Exercise training as a part of cardiac rehabilitation aims to restore patient with heart disease to health. However, left ventricular ejection fraction (LVEF) is clinically used as a predictor of long-term prognosis in coronary artery disease (CAD) patients, there is a scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on LVEF.Objective:To investigate the effectiveness of exercise-based cardiac rehabilitation on LVEF in early post-event CAD patients.Patients and Methods:In a single blinded, randomized controlled trial, post-coronary event CAD patients from the age group of 35-75 years, surgically (Coronary artery bypass graft or percutaneous coronary angioplasty) or conservatively treated, were recruited from Golsar Hospital, Iran. Exclusion criteria were high-risk group (AACVPR-99) patients and contraindications to exercise testing and training. Forty-two patients were randomized either into Study or Control. The study group underwent a 12-week structured individually tailored exercise program either in the form of Center-based (CExs) or Home-based (HExs) according to the ACSM-2005 guidelines. The control group only received the usual cardiac care without any exercise training. LVEF was measured before and after 12 weeks of exercise training for all three groups. Differences between and within groups were analyzed using the general linear model, two-way repeated measures at alfa=0.05.Results:Mean age of the subjects was 60.5 ± 8.9 years. There was a significant increase in LVEF in the study (46.9 ± 5.9 to 61.5 ± 5.3) group compared with the control (47.9 ± 7.0 to 47.6 ± 6.9) group (P=0.001). There was no significant difference in changes in LVEF between the HExs and CExs groups (P=1.0).Conclusion:A 12-week early (within 1 month post-discharge) structured individually tailored exercise training could significantly improve LVEF in post-event CAD patients.

Present review suggests that the PA promotion and participation can help to slow down the progression of disease in individuals with prediabetes and thus reduces the morbidity and mortality associated with T2DM.