| Expanding the horizon of physiotherapy profession Sanjiv Kumar Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):49-52 |
| Cognition and quality of life in older adults Dhara Abhinav Sharma, Megha Sandip Sheth, Disha Janak Dalal Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):53-57 BACKGROUND: According to the recent report by the Ministry of Statistics in India, number of elderly accounts for 8.6% of the country's population. Aging causes biological as well as psychological changes. Decline in cognitive functions is one of the normative changes of aging; however, this may impact both physical and mental health of an individual. Quality of Life (QoL) is one of the prime features of successful aging. Hence, this study was undertaken to correlate the level of cognition and QoL in older adults. METHODOLOGY: One twenty-nine males and females of age 60–75 with or without cognitive impairment were selected using convenience sampling, those who could not read Hindi, who had any unstable medical condition, whose vision could not be corrected to normal level, and those with impaired speech were excluded from the study. Montreal cognitive assessment (MoCA) was administered to assess the cognitive level. QoL was assessed by QoL-Alzheimer's disease (AD) scale. RESULTS: Result indicated that there is a moderate positive correlation between MoCA and QoL-AD with r = 0.465 and P < 0.05. CONCLUSION: The study concludes that the level of cognition and QoL of older adults are moderately in positive correlation with each other. |
| Reaction time in sitting and standing postures among typical young adults MN Anitha, Vijay Raj V Samuel Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):58-62 CONTEXT: Reaction time (RT) is one of the important components of physical fitness. Evaluation of RT is vital to understand and plan a training program. There is a need to comprehend the normative values of RT in young adults in different functional postures, which will enable the clinician to plan the fitness program effectively. AIMS: The aim of this study was to observe the RT in sitting and standing postures among typical young adults. SETTINGS AND DESIGN: This was an observational study. SUBJECTS AND METHODS: Sixty-five young Indian men and women students from a college at Mysore were included in the study. The participants' dominant hand was used to assess the RT in standing and sitting postures with their dominant hand. With the given distance, the RT was then calculated using standard conversion formulae. STATISTICAL ANALYSIS USED: The RT between standing and sitting was analyzed using mean, standard deviation (SD), and paired t-test. RESULTS: The RT analyzed for 22 men in sitting showed excellent RT with a mean 0.1188 (SD 0.0455) and 0.0929 (SD 0.0385) in sitting and standing postures, respectively. Women (n = 43) in sitting had a good RT with a mean of 0.1401 (SD 0.0314) and in standing an excellent RT with a mean of 0.1092 (SD 0.0323). Men had better performance when compared with women, both in standing and sitting postures. Paired test for standing and sitting showed significant difference with t value of 5.364 and P < 0.005, with reduced RT in standing. CONCLUSIONS: The study concludes that the RT is comparatively reduced in standing than in sitting among the young adults. |
| Comparative effects of Stratified Back care approaches in individuals with nonspecific low back pain Bashir Bello, Muhyiddeen Suleiman Bichi Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):63-72 BACKGROUND: Stratified Back care is a recently developed method for treating low back pain. PURPOSE: This study compared the effects of two stratified care approaches (sub-grouping for targeted treatment [STarT] and specific treatment of the problems of the spine [STOPS] in patients with nonspecific low back pain [NSLBP]). MATERIALS AND METHODS: Forty-six individuals, with NSLBP, participated in this single-blinded, randomized clinical trial. Participants were randomly assigned into one of the two groups: STarT Back Group (n = 23) or STOPS group (n = 23). Treatment was applied twice weekly for 8 weeks. Outcomes assessed pre- and post-interventions were pain intensity (PI) using numeric pain rating scale and functional disability (FD) using the Oswestry Disability Index. Participants in both groups were comparable in age (44.65 ± 9.03 vs. 46.40 ± 7.39) years. At baseline, PI, FD, and anthropometric values were comparable in both groups. RESULTS: The Results showed a significant difference in PI between the STarT and STOPS with a mean difference of −1.24 and 95% confidence interval (−0.86 to −0.04), P < 0.05, with no significant difference in FD, P > 0.05 between the groups. However, there was a significant difference within each group in pain and FD with P < 0.05. CONCLUSION: It was concluded that STarT Back approach was more effective in reducing PI only than STOPS approach in individuals with NSLBP. |
| Enhancing professionalism in physiotherapy interns using a structured teaching and assessment module Mariya Jiandani, Amita Mehta Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):73-78 INTRODUCTION: Professionalism describes the skills, competency, attributes, and behavior of an individual belonging to a profession. The physiotherapy graduate on completion of internship has direct access with the community as a professional. Hence, there is a need to explicitly teach and assess professionalism. The purpose of this study was to prepare a module to enhance professionalism and use tools to assess the professional attributes uniformly. MATERIALS AND METHODS: A module was formulated with the help of experts, literature review, and guidelines of various physiotherapy regulatory bodies nationally and internationally. Focused group discussions were used as a method to identify competencies. After designing the module, a prospective intervention trial was conducted wherein 40 students who joined the internship program of a tertiary care hospital of India, were enrolled for the study. A participatory approach was used which included an interactive workshop on “ethics in clinical practice, communication skills, and professionalism.” A written pre-post evaluation and workplace-based assessment were carried out in four core physiotherapy areas. Competencies and attributes were measured using tools such professional mini-evaluation exercise (P-MEX), prevalidated checklist for clinical reasoning, patient feedback form, and a retro-preevaluation of self-assessment form of the American Physical Therapy Association. RESULTS: A total of 34 students completed the module. Data were analyzed using SPSS 16 software. Nonparametric Wilcoxon Signed Rank test was used to analyze the descriptive data. The statistical significance was kept at P < 0.05 at a confidence interval of 95%. There was a statistically significant increase in the knowledge component pre-post analysis (P < 0.00). Change in professional attributes as measured by P-MEX showed a significant change in Doctor-patient relationship (P < 0.01) and interprofessional skills (P < 0.001) followed by reflective skills (P < 0.007) and time management skills (P < 0.003). There was also a significant difference in total patient feedback scores from baseline (P < 0.01). CONCLUSION: The module helped students gain the knowledge and skills required to communicate and handle difficult situations relevant to physiotherapy practice. |
| Cross-cultural adaptation, reliability, validity, and factor analysis of the Gujarati version of the Tampa scale of kinesiophobia in chronic low back pain Dibyendunarayan Dhrubaprasad Bid, A Thangamani Ramalingam, Saumi R Sinha, Payal B Rathi, Vidhi N Patel, Jainab M Rajwani, Krutika N Patel Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):79-86 BACKGROUND: Nowadays more attention is being given to standardizing the outcome measures for improving treatment methods for chronic low back pain (CLBP). The Gujarati translation of the Tampa scale of kinesiophobia (TSK) in patients with CLBP has never been validated in the native Gujarati population. PURPOSE: Translating, culturally adapting, and validating the Gujarati version of the TSK-Gujarati (TSK-G) to allow its use for Gujarati-speaking patients with CLBP. MATERIALS AND METHODS: The development of the TSK-G questionnaire involved its translation and backtranslation, a final review by an expert committee, and testing of the pre final version in establishing its correspondence to the original English version. The psychometric testing included reliability by internal consistency (Cronbach's α), test-retest reliability (intraclass coefficient correlation [ICC]), convergent and divergent validity (Pearson's correlation) by comparing TSK-G to a numerical pain rating scale, fear-avoidance beliefs questionnaire (FABQ), the Roland Morris disability questionnaire (RMDQ), and patient health questionnaire-9 (PHQ-9); and factor analysis. RESULTS: Factor analysis indicated a 6-factor 17-item solution (64.07% of explained variance). The questionnaire showed satisfactory internal consistency (0.639) and moderate test-retest reliability (ICC 0.696). Divergent validity showed low correlations with numerical pain rating scale (r = 0.044), the RMDQ-G (r = 0.06), and PHQ-9-G (r = 0.269); but convergent validity showed highly significant correlation with FABQ-G (r = 0.407, P = 0.001). CONCLUSION: The successful translation of TSK questionnaire into the Gujarati language shows good psychometric properties and factorial structure and approximates the results of the current English version of the TSK questionnaire. |
| Long-term effectiveness of physiotherapy in a case of ankylosing spondylitis Ratan P Khuman Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):88-92 Ankylosing spondylitis (AS) is a relatively uncommon inflammatory arthritis that affects the axial joints. The diagnosis is often missed and markedly delayed. Here, we report a delayed diagnosis of AS in a 47-year-old male, 10 years after the onset of back symptoms, using the modified New York criteria. The objective of this case report is to outline the long-term effectiveness of physiotherapy interventions. The condition was managed with supervised physiotherapy intervention and unsupervised home exercises for 3 months and was followed for 1 year to investigate the long-term effectiveness of the interventions. It was found that the combination of supervised physiotherapy interventions and unsupervised home exercises had promising short term as well as long-term effects without deterioration in AS symptoms with increased patient satisfaction and confidence. |
| Feasibility of application of constraint-induced movement therapy in a child with hemiplegic cerebral palsy: A single-case study Darshanaben J Tadvi, Vasanthan Rajagopalan Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):93-97 Children suffering from hemiplegic cerebral palsy (CP) develop developmental disregard (DD). In addition, they fail to comprehend the consequences of nonuse. The utility of affected upper limb is jeopardized. Current evidence supports the use of constraint-induced movement therapy (CIMT) for upper limb function in individuals with hemiplegia. This single-case study attempts to identify feasibility of application of pediatric CIMT on a child with hemiplegic CP. The aim of this study is to identify the benefits and feasibility of application of CIMT for improving quality of the upper limb movement in a child with hemiplegic CP. A 2½-year-old girl with hemiplegic CP visited the outpatient department (OPD) with the problem of lack of use of the right upper limb for activities and play along with the poorer quality of the upper limb movement. Disregard index was calculated to identify the presence of DD. CIMT was chosen as the child had above minimal ability to open fingers and extend the wrist. A 2-week intervention was designed based on the goal-oriented, ability-specific, child-specific practice of functional tasks. A rigid tape was used to provide constraint. The child was motivated to play with the affected hand for 2 h in the OPD and 2 h at home. Tasks of incremental difficulty were utilized as shaping method. The improvement in the quality of movement was measured using quality of upper extremity skilled test (QUEST) and Assisting Hand Assessment (AHA). The score on QUEST improved from 66.35 to 72.1, AHA improved from 66 to 73, and the disregard index score improved from 42.75 to 26.3 in 2 weeks. The treatment was adjusted to accommodate the behavior of the child. |
| Providing cancer rehabilitation services: Are there some guiding principles? Tan Yeow Leng, Saw Hay Mar Physiotherapy - The Journal of Indian Association of Physiotherapists 2018 12(2):98-99 |
Δευτέρα 17 Δεκεμβρίου 2018
The Journal of Indian Association of Physiotherapists (Physiother - J Indian Assoc Physiother)
The prognostic impact of pathologic lymph nodes in HPV-positive oropharyngeal cancers
Publication date: February 2019
Source: Oral Oncology, Volume 89
Author(s): Margueritta El Asmar, Hua-Ling Tsai, Carole Fakhry, Christopher A. Maroun, Rajarsi Mandal, Drew M. Pardoll, Hao Wang
Abstract
Purpose
Recent pathologic staging of HPV-positive oropharyngeal squamous cell carcinomas (OPSCC) is solely dependent on number of pathologic nodes. Using a large dataset, we aimed to understand how increase in pathologic lymph nodes (LN) associated with overall survival.
Materials and methods
National Cancer Database was queried for HPV-positive OPSCC patients undergoing primary surgery with LN dissection between 2010 and 2013. Kaplan-Meier, univariate and multivariate Cox models were used to evaluate overall survival. Interaction between nodal status and radiotherapy was examined.
Results
Implications of pathologic LN on overall survival differed according to receipt of post-operative radiotherapy (p-valueinteraction = 0.008). In patients who did not receive adjuvant radiotherapy, there were no significant differences in risk of death from 0 to 2 pathologic nodes (adjusted HR (aHR) 0.92, 95%CI 0.61–1.4). However, risk increased by 18% on average with each additional LN thereafter (aHR 1.18, 95%CI 1.1–1.27). Among radiotherapy patients, after adjusting for other variables, patients with 1 pathologic LN had 70% lower risk of death than those with 0 pathologic LN (aHR 0.30, 95%CI 0.14–0.64). Thereafter, risk increased on average by 7% with each additional LN (aHR 1.07, 95%CI 1–1.14).
Conclusion
The prognostic impact of pathologic nodes in resected HPV-positive OPSCC differs by receipt of radiotherapy, with better outcomes in post-operative radiotherapy treated patients with one pathologic LN than none. These findings suggest that LN involvement may improve anti-tumor immune responses following radiotherapy, or result in earlier detection and treatment of disease. These results merit further studies to corroborate these findings and establish the underlying mechanism.
https://ift.tt/2SSGYLE
Bringing benign ectomesenchymal odontogenic tumours to the lab: an in vitro study using an organotypic culture model
Abstract
Background
Benign neoplasms exhibit most of the cellular phenomena considered hallmarks of cancer, except the capacity to metastasize. Thus, the elucidation of the mechanisms associated with the progression of benign neoplasms may complement and clarify the mechanisms involved in carcinogenesis. Benign odontogenic tumours often result in facial deformities and morbidities, and have complex pathogenesis, mainly due to the diversity of interactions between the odontogenic epithelium and the ectomesenchyme. Primary cell culture of such tumours is not only difficult to be established and maintained, but also tumour cells lose characteristic cellular morphology. Considering gene expression, growth, migration, proliferation and cellular morphology are controlled by cell‐cell interactions and cell‐extracellular matrix interactions, cell culture in 3D substrates has gained space as a way to overcome some of the limitations of traditional monolayer cell culture systems.
Methods
In this study, fragments obtained from mesenchymal odontogenic tumours were cultured in collagen type I scaffolds. Invasion tests were performed in these models, as well as phenotypic characterization of the cultured tumours.
Results
The results obtained for the odontogenic myxoma and the cemento‐ossifying fibroma demonstrate a good reproduction of the growth pattern of these tumours under ex vivo conditions. Microscopic evaluation showed maintenance of cell viability in the explants for more than 30 days, without the presence of necrosis.
Conclusion
This is the first study involving long‐term 3D primary cultures of benign odontogenic tumours, which is expected to support complex approaches to cell and molecular biology, and serve as an experimental model for testing molecular therapies.
This article is protected by copyright. All rights reserved.
https://ift.tt/2A1NsB4
Integrative Medizin bei Patientinnen mit Ovarialkarzinomen
Zusammenfassung
Hintergrund
Unter integrativer Medizin versteht man die Kombination von Methoden der konventionellen Medizin mit anderen Methoden, die primär dem Umfeld der komplementären und alternativen Medizin entstammen und sich in Studien nachweislich als sinnvoll erwiesen haben.
Ziel
Dieser Beitrag versucht die Frage zu beantworten, ob und ggf. welche Methoden sinnvoll mit den Strategien der konventionellen Medizin bei Patientinnen mit Ovarialkarzinom kombiniert werden können.
Ergebnisse
Unter Berücksichtigung der Aspekte Effektivität, Sicherheit, Kosten und Verfügbarkeit finden sich z. T. aus Metaanalysen stammende Daten, die zeigen, dass sich das Management der Behandlung des Ovarialkarzinoms im Hinblick auf supportive Maßnahmen begleitend zu OP und Chemotherapie verbessern lässt. Kaugummikauen führt dazu, dass die Darmtätigkeit früher wiederhergestellt wird, Eiswürfellutschen und Honig können eine chemotherapieinduzierte Mukositis verringern, um nur einige Beispiele zu nennen. Ergänzende Maßnahmen, die die Prognose des Ovarialkarzinoms verbessern würden, sind weniger gut erforscht.
Schlussfolgerung
Wenngleich bislang keine Behandlungskonzepte offiziell als integrativ gelten dürfen, so gibt es doch Ansätze, die sinnvoll die Behandlung bei Patientinnen mit Ovarialkarzinom ergänzen können. Hinweise, dass alternative oder esoterische Therapiekonzepte sinnvoll sein könnten, finden sich nicht.
https://ift.tt/2BrGXaH
Algorithmus Tumorschmerztherapie
Zusammenfassung
Um Krebspatienten mit Tumorschmerzen im stationären Rahmen zeitnah Linderung zu verschaffen, wurde ein Algorithmus als Handreichung für alle primär behandelnden Teams entworfen. Aus stationsinternen Standards wurde ein kurzer Leitfaden entwickelt, der insbesondere im Krankenhaus sowohl bei palliativen wie auch sterbenden Patienten eingesetzt werden kann. Hierbei werden kurze Hilfestellungen in übersichtlicher tabellarischer Form gegeben, jedoch ohne ein Lehrbuch ersetzen zu wollen. So werden Patienten nach opioiderfahren und opioidunerfahren unterschieden und eine kurze Therapiemöglichkeit für die unterschiedlichen Stadien der Erkrankung dargestellt.
https://ift.tt/2QAFzgo
Effect of Red Light Rhinophototherapy on Nasal Patency in Patients with Allergic Rhinitis
Purpose. The effect of red light rhinophototherapy (RLRPT) on nasal patency in patients with a clinical diagnosis of allergic rhinitis was investigated. Materials and Methods. Subjects were randomly divided into 2 groups, with patients in one group given one treatment session of RLRPT, followed by medical treatment. Those in the second group were treated with medical treatment only. The rhinitis symptoms were evaluated both before and 30 minutes after RLRPT and 2 days later. The nasal patency was objectively measured through the use of both active anterior rhinomanometry and acoustic rhinometry before and 30 minutes after RLRPT. Results. All rhinitis symptoms, including nasal congestion, significantly improved 30 minutes after a single RLRPT treatment, but worsened again, particularly for sneezing, 2 days later. Nasal resistance slightly decreased 30 minutes after RLRPT. The first minimal cross-sectional area did not change after RLRPT, but the second minimal cross-sectional area with the volume of the nasal cavity between 2.0 and 5.0 cm from the tip of the nosepiece significantly lessened. Conclusions. This study showed that RLRPL did not objectively improve patient's nasal patency. Registration Number. The trial is registered with NCT03752645.
https://ift.tt/2UPevIz
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