Five hundred and forty four cases of cerebral palsy were studied to find the etiology. Male to female ratio was 1.9:1. Prenatal, natal and postnatal factors were found in 42 (7.72%), 238 (43.75%) and 142 (26.1%) cases respectively. Only 79 (14.52%) cases were found to have more than one factor which could have contributed to brain damage. In 43 (7.9%) cases the prenatal, natal and postnatal history were normal and the cause was not known. Toxemia (1.29%) cases and microcephaly (1.84%) cases were the most common etiological factors in the prenatal category. Among the natal causes, birth anoxia was the most common etiological factor and was observed in 24.45% cases. Infections of the central nervous system comprised the major etiopathogenetic factors of the postnatal causes--11.95% cases had encephalitis, while 5.15% cases had meningitis. In cases where more than one etiology was present, the most frequent causes were a combination of prematurity or birth anoxia in association with toxemia, antepartum hemorrhage, prolonged labour, twins, forceps or caesarean delivery. Anoxia was consistently the most common etiological factor in those cases of monoplegia paraplegia, quadriplegia, diplegia, and ataxia, i.e. in 0.55%, 1.29%, 11.76%, 6.07% and 0.55% cases respectively. The present study reveals that majority of the cases were found to have natal or post natal etiology.

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Peri-arthritis (PA) shoulder is a common cause of shoulder pain and disability. The optimum management of periarthritis shoulder has been the subject of great debate, particularly since the condition tends to resolve spontaneously over months to years leaving behind stiff shoulder. Objectives of this study was to prospectively evaluate the comparative efficacy of intra-articular steroid (methylprednisolone) injection, intra-articular sodium hyaluronate injection and deep heat in patients with peri-arthritis shoulder who were also taught a simple home exercise programme. A total of 75 subjects were enrolled in the study. Patients of peri-arthritis of shoulder joint were randomly assigned to three groups: Inj. sodium hyaluronate 20mg (group1), inj. methylprednisolone 40mg (group2), ultrasonic therapy (group3). Evaluation was done at 3 weeks, 6weeks and 12 weeks and 24 weeks after starting the treatment. Outcomes were determined by the assessment of subjective and objective parameters viz. shoulder pain and disability index (SPADI), range of motion. All three groups showed improvement with respect to time. Steroid group and sodium hyaluronate group showed significant improvement as compared to other ultrasonic group (p=0.02) with respect to shoulder pain and disability index and range of motion. Improvement in pain was equal with all three types of treatment..

Background: Musculoskeletal Disorders (MSDs) are prevalent across the globe and are one of the commonest causes of long-term pain and disability, affecting millions of people all over the globe. Objective: To review the literature on studies conducted in India regarding prevalence of Musculoskeletal disorders and its associated factors in adult population in India. Methods: The review of literature was done using various online sites such as PubMed and Google Scholar. The National Medical Library was also searched and relevant papers from different journals were selected. Key words used in search included: Musculoskeletal disorders or pain, General population, Rural area, India. Result: The prevalence of MSD's among the adult population was found to range between 6.92%-76.8%. The studies have shown rural-urban difference in the prevalence as well as the health seeking behaviour for MSD's. There is hardly any screening program existed. The review also shows that factors such as female gender, middle age, lower education status, performing moderate work and repetitive hand movements at work were significantly associated with musculoskeletal pain. Conclusion: A large proportion of the adult population who suffers from various MSD's goes unrecognized either due to poor understanding of the various factors associated with it or due to less efficient screening and treatment opportunities. Therefore, a clear understanding of the various factors is must to identify these disorders in their earlier course and suitable treatment options to be provided along with the follow-up care.

Introduction: Stroke is a leading cause of long-term disability worldwide. Neuroimaging plays a critical role in diagnosing and planning the treatment of stroke. Early prognostic markers help in predicting the prognosis after stroke. Aim: To correlate the motor recovery and functional outcome with Computed Tomography (CT) brain findings using Alberta Stroke Programme Early Computed Tomography Score (ASPECTS) in patients with ischaemic stroke. Materials and Methods: This observational cross-sectional study was conducted in Department of Physical Medicine and Rehabilitation at Vardhman Mahavir Medical College and Safdarjung Hospital (tertiary care centre), from October 2016 to March 2018. A total of 45 patients diagnosed with Middle Cerebral Artery (MCA) territory Ischaemic Stroke were included. Motor and functional assessment were done using Fugl-Meyer Assessment (FMA), and Barthel Index (BI). FMA and BI were correlated with the radiological assessment using ASPECTS on Non Contrast Computed Tomography (NCCT) of head. Results: The mean age of the study population was 60.98±8.61 years. The mean BI score was 70.34± 25.2, and FMA score was 61.56±32.8. The mean ASPECTS was 7.5, with 26 patients having ASPECTS 8-10 and 19 with ASPECTS 0-7. Patients with higher ASPECTS (8-10) had moderate to no dependence in Activities of Daily Living (ADL) and mild to no motor impairment respectively (p-value<0.0001). Patients having lower ASPECTS (0-7) had severe dependency in ADL and motor impairment (p-value<0.0001). Conclusion: Alberta stroke programme early computed tomography score has a significant correlation with motor and functional recovery and is a strong predictor of outcome after ischaemic stroke. The higher the score on ASPECTS, the better will be the motor and functional outcome. The computed tomography findings of brain will help in stroke rehabilitation by enabling to set realistic goals at an early (acute) stage poststroke.

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There is a need for appropriate classification to describe gross motor function status in a child with cerebral palsy (CP). It was hypothesised that: greater the number of limbs involved, higher would be the Gross Motor Function Classification System (GMFCS) level; and, there would be spectrum of GMFCS level for each of the topographical types of the cerebral palsy. A cross-sectional study of 182 children of both sexes in the age group of 7 months to 30 years having spastic CP who attended CP clinic from 2008 to 2009 in tertiary care hospital were assessed for topographical diagnosis and GMFCS levels. Topographical distribution showed diplegia (42%), quadriplegia (30%), hemiplegia (23%), triplegia (4%) and monoplegia (1%). GMFCS levels were almost evenly distributed, level II (26%) was most common followed by level V (23%). Statistical analysis was done using Cramer's ratio and Pearson's Chi-square test. Cramer's ratio of 0.277 showed fairly weak correlation between GMFCS levels and topographical CP types. Pearson's Chi-square (12) =41.7, p=0.000 indicates that there is significant difference between expected and observed values of number of limbs involved in GMFCS levels, further substantiating the weak correlation. These results mean that GMFCS in different topographical groups have different distributions. It was also observed that GMFCS had weak correlation with the number of limbs involved, thus reflecting that the GMFCS is a better indicator of gross motor function impairment than the traditional topographical categorisation of CP that specifies the number of limbs involved. 10 System (GMFCS), and its correlation with the topographical diagnosis in CP. CP describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain. The motor disorders of CP are often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour; by epilepsy, and by secondary musculoskeletal problems. 1 CP is a clinical description and by itself is not informative about the outlook of these infants. The lesions in the developing brain or CP aetiology alone also do not provide information about function and prognosis. In our day to day practice of CP rehabilitation, it is important to follow a classification system that tells the parents and patients about the functional status and future prognosis, at the same time helping the managing team to plan intervention for the CP child, as well as for measuring the