Mobile device goniometer has high intra-rater reliability. The inter-rater reliability was moderate. This device can be used to assess range of motion of spine flexion, representing uni-planar movement.
OBJECTIVES:Epidemiology has taken on new roles in the management of health care services. In this study, we developed a non-pharmacological self-management modular program group intervention and evaluated its efficacy as an adjunct therapy in patients suffering from early rheumatoid arthritis (RA).METHODS:Patients were randomized to either participate in a non-equivalent intervention group along with the standard of care or only receive standard-of-care treatment at a community rheumatology center. The outcomes measured were a pain visual analog scale (VAS), patient general health (GH) on a VAS, and the Short Form 36 Health Survey version 2 scale measuring quality of life. These parameters were evaluated in the first week to obtain baseline values, and at 20, 32, 48, and 60 weeks to evaluate the efficacy of the intervention group.RESULTS:The patients were randomized, with 100 patients in the intervention group and 106 in the control group. The intervention and control groups were similar with regard to the percentage of women (86% vs. 89.6%), tobacco usage (25% vs. 19.8%), mean age (42.6±13.2 years vs. 46.6±10.9 years), and disease duration (15.3±6.7 months vs. 14.5±6.6 months). The mean outcomes were significantly different between the two groups, and post-hoc pairwise analysis demonstrated significant deterioration in the control group in contrast to improvement in the intervention group at the second, third, fourth, and fifth evaluations. Improvements were often seen as early as the 12-week and 24-week follow-up visits.CONCLUSIONS:Epidemiology contributes to the evaluation of how well specific therapies or other health interventions prevent or control health problems. The modular program group intervention implemented in this study appears to be a suitable and feasible method to facilitate much more comprehensive management of early RA in socioeconomically challenged communities.
Background: Elbow is a very functional joint. Elbow stiffness is a significant cause of disability hampering the function of the upper extremity as a whole. Muscle Energy Techniques (METs) are relatively pain-free techniques used in clinical practice for restricted range of motion (ROM). Objective: To study the effects of MET on pain, ROM and function given early in the rehabilitation in post-surgical elbow stiffness. Methods: An RCT was conducted on 30 patients post elbow fracture fixation. Group 1 was given MET immediately post removal of immobilization while Group 2 received MET 1 week later along with the rehabilitation protocol. Pain (Visual Analogue Scale), ROM (goniometry) and function (Disability of Arm, Shoulder and Hand questionnaire) were assessed pre and post 3 weeks. Results: Group 1 showed greater improvement than Group 2, mean flexion and extension change between groups being [Formula: see text], 95%CI(5.9,17.4) and [Formula: see text], 95%CI(4.4,12.7), respectively. VAS and DASH scores improved better in Group 1, mean change being [Formula: see text], 95%CI(0.6,1.8) and [Formula: see text], 95%CI(13.5,22.8) for VAS and DASH scores, respectively. Conclusion: MET can be used as an adjunct to the rehabilitation protocol to treat elbow stiffness and can be given safely in the early stages of post elbow fracture rehabilitation managed surgically with open reduction and rigid internal fixation.
Background:Osteoporosis is commonly encountered by postmenopausal women. There is an increased need for a low cost and efficient treatment alternative to address this population.Aims:To study the effects of integrated yoga on bone mineral density (BMD) in postmenopausal women with osteoporosis.Settings and Designs:Experimental pre-post study conducted in a community setting.Materials and Methods:30 females in the age group of 45–62 years suffering from postmenopausal osteoporosis with a dual-energy X-ray absorptiometry (DEXA) score of ≤−2.5 underwent a 6 months fully supervised yoga session. All the participants completed the study. Pretraining and posttraining BMD was calculated. Outcome measure: DEXA score at the lumbar spine.Statistical Analysis:The study was statistically analyzed using paired t-test to see the significance of pretraining and posttraining effects of a yoga session.Results:Improvement in T-score of DEXA scan of −2.55 ± 0.25 at posttraining as compared to a pretraining score of −2.69 ± 0.17.Conclusions:Integrated yoga is a safe mode of physical activity which includes weight bearing as well as not weight bearing asanas, Pranayama, and suryanamaskar, all of which helps induce improvement in BMD in postmenopausal osteoporotic females.
Background:Amongst various modalities of post operative rehabilitation in a total knee replacement (TKR) surgery, this study focuses on evaluating the effect of additional yoga therapy on functional outcome of TKR patients.Materials and Methods:A comparative study was done to compare the effects of conventional physiotherapy and additional yoga asanas, on 56 patients undergoing total knee arthroplasty due to osteoarthritis. After obtaining written informed consent, the patients were alternately assigned to two groups: Conventional and experimental. Baseline WOMAC scores for pain and stiffness were taken on third post operative day. The subjects in conventional group received physiotherapy rehabilitation program of Sancheti Institute where the study was conducted, the experimental group received additional modified yoga asanas once daily by the therapist. After discharge from the hospital, patients were provided with written instructions and photographs of the asanas, two sets of WOMAC questionnaire with stamped and addressed envelopes and were instructed to perform yoga asanas 3 days/week. Subjects filled the questionnaire after 6 weeks and 3 months from the day of surgery and mailed back. The primary outcome measure was WOMAC questionnaire which consists of 24 questions, each corresponding to a visual analog scale, designed to measure patient's perception of pain, stiffness and function.Results:The results suggest that there was a significant change (P<0.05) for all the groups for pain, stiffness and function subscales of WOMAC scale. The pain and stiffness was found to be less in experimental group receiving additional yoga therapy than in conventional group on 3rd post operative day, 6 weeks and 3 months after the surgery.Conclusion:A combination of physiotherapy and yoga asana protocol works better than only physiotherapy protocol. Larger and blinded study is needed.
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