Effectiveness of Balance Exercise Program in Total Knee Arthroplasty: Meta-Analysis

Background: Balance is essential for maintaining postural stability while performing functional activities and for falls avoidance in patients with TKA.  There are very few RCTs done to assess functional improvement after TKA. Hence, this study was undertaken to find out evidence on physiotherapy treatment in TKA and analyze it.  Methods: We searched Medline, CINAHL, PEDro from the year 2001 to 2015 for RCT involving evaluations of physiotherapy exercise in adults with a knee replacement. Search criteria’s were pain, stiffness, adherence and attrition. The inclusion criteria were studies which included physiotherapy exercise for balance specific exercises which compared various functional training and functional training with balance exercise in TKA. Result: Searches identified 20 randomized trials related to TKA and physiotherapy. Only three were fulfilled the inclusion criteria. Functional training with balance exercises found to be effective in patients with total knee arthroplasty. Conclusion: After total knee replacement, interventions including physiotherapy along with balance exercises showed improvement in pain, stiffness and functional performance in mobility. Keywords: Osteoarthritis; Balance; Total knee arthroplasty physiotherapy

Prevalence Of Musculoskeletal Disorders In Patients Undergoing Haemodialysis in a Tertiary Care Hospital: A Cross-sectional study

Background: Chronic kidney disease (CKD) is a significant public health problem. Dialysis is the mainstream method of treatment in these patients. This causes the patients to have a monotonous and restricted daily life, joint pain, limiting their activities after treatment onset. Hence this study was carried out to find the prevalence of common musculoskeletal disorders in patients undergoing haemodialysis in a tertiary care hospital. Method: 50 participants undergoing dialysis in a tertiary care hospital under the age group of 18-70 years diagnosed with stage V CKD were included using convenient sampling. They were assessed using Nordic Questionnaire to locate the different areas of pain. Result: The first group consisted of 41 participants who underwent dialysis from 2- 41 months. Body regions commonly affected in the last 7 days were low back 25(60.97%); neck 21(51.21%); shoulder 15(36.58%); elbow 14(34.14%) in the extremity with arteriovenous fistula; upper back 14(34.14%); hips/thighs, knees 9(21.95); wrist/hands 7(17.07%) in the extremity with arteriovenous fistula; ankle/feet 6(14.63%). The second group consisted of 9 participants who underwent dialysis from 42-84 months. Body regions commonly affected in the last 7 days were low back 8(88.88%); upper back 7(77.77%); hip/thigh 6(66.66%); neck, knee 5(55.55%); elbow 4(44.44%) in the extremity with arteriovenous fistula; shoulder, ankle/feet, wrist/hands 3(33.33%). Conclusion: The study concluded that the highest prevalence of musculoskeletal disorders in the participants undergoing haemodialysis was low back pain (66%) followed by neck (52%), upper back (42%), shoulder (36%), elbow (36%), hips/thighs (30%), knees (28%), wrist/hands (20%) and ankle/feet pain (18%)

Effectiveness of Balance Exercise Program in Total Knee Arthroplasty: Meta-Analysis

Background: Balance is essential for maintaining postural stability while performing functional activities and for falls avoidance in patients with TKA.  There are very few RCTs done to assess functional improvement after TKA. Hence, this study was undertaken to find out evidence on physiotherapy treatment in TKA and analyze it.  Methods: We searched Medline, CINAHL, PEDro from the year 2001 to 2015 for RCT involving evaluations of physiotherapy exercise in adults with a knee replacement. Search criteria’s were pain, stiffness, adherence and attrition. The inclusion criteria were studies which included physiotherapy exercise for balance specific exercises which compared various functional training and functional training with balance exercise in TKA. Result: Searches identified 20 randomized trials related to TKA and physiotherapy. Only three were fulfilled the inclusion criteria. Functional training with balance exercises found to be effective in patients with total knee arthroplasty. Conclusion: After total knee replacement, interventions including physiotherapy along with balance exercises showed improvement in pain, stiffness and functional performance in mobility. Keywords: Osteoarthritis; Balance; Total knee arthroplasty physiotherapy

EFFECTIVENESS OF MULLIGAN MOBILIZATION WITH CONVENTIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS: - A CASE SERIES

Background: Osteoarthritis (OA) is the most common joint disease causing disability. Current Physical therapy management for knee OA is aiming to increase range of motion and improve functional performance. So the purpose of this study to assess the effectiveness of Mulligan Mobilization along with Conventional Physiotherapy in Knee osteoarthritis patients. Method: Patients of knee pain who fulfilled inclusion criteria were taken in study. Outcome like The Knee Injury & osteoarthritis Outcome Score (KOOS) Index, ROM with the help of Universal Goniometer, Manual muscle testing with Medical Research Council (MRC) scale & time up and Go test were taken at baseline and after 4 wks. Mulligan Mobilization along with conventional Physiotherapy was given to all patients for 4 wks. Result: Showed there was significant improvement 25.08% in Koos Index, while in knee flexion ROM, improvement on right side was 9.94% or in left side 6.20%. while muscle strength in MMT with 25% on right side or 4% on left side improvement seen for  knee flexor and 5% on right side or no any improvement seen on left side for knee extensor. Time up and go test also showed 10.89% improvement compared to baseline. Conclusion: Improvement is seen in patients with knee osteoarthritis by Mulligan Mobilization along with Conventional Physiotherapy

EFFECTIVENESS OF MULLIGAN MOBILIZATION WITH CONVENTIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS: - A CASE SERIES

Background: Osteoarthritis (OA) is the most common joint disease causing disability. Current Physical therapy management for knee OA is aiming to increase range of motion and improve functional performance. So the purpose of this study to assess the effectiveness of Mulligan Mobilization along with Conventional Physiotherapy in Knee osteoarthritis patients. Method: Patients of knee pain who fulfilled inclusion criteria were taken in study. Outcome like The Knee Injury & osteoarthritis Outcome Score (KOOS) Index, ROM with the help of Universal Goniometer, Manual muscle testing with Medical Research Council (MRC) scale & time up and Go test were taken at baseline and after 4 wks. Mulligan Mobilization along with conventional Physiotherapy was given to all patients for 4 wks. Result: Showed there was significant improvement 25.08% in Koos Index, while in knee flexion ROM, improvement on right side was 9.94% or in left side 6.20%. while muscle strength in MMT with 25% on right side or 4% on left side improvement seen for  knee flexor and 5% on right side or no any improvement seen on left side for knee extensor. Time up and go test also showed 10.89% improvement compared to baseline. Conclusion: Improvement is seen in patients with knee osteoarthritis by Mulligan Mobilization along with Conventional Physiotherapy

PREVALENCE AND SEVERITY OF HAMSTRING TIGHTNESS AMONG COLLEGE STUDENT: A CROSS SECTIONAL STUDY

Background: Flexibility is important for normal biomechanical function. Muscle tightness is caused by a decrease in the ability of the muscle to deform. Hamstring tightness leads to high risk of recurrent injury, decreases the performance in athletes, lead to post-exercise soreness and decreases coordination among athletes. Hence, the objectives of this study was to find out the prevalence and severity of the hamstring tightness among college going student. Method: In this cross sectional study 50 participants with hamstring tightness were included using purposive sampling. The tightness was measured by AKE test. Three measurement were taken and average of their reading was noted. Result: Analysis showed higher prevalence of hamstring tightness among college students. More students were affected with AKE angle between 30o-45o. Conclusion: Prevalence of hamstring tightness is very high in college going student of age group 18-25 years. Keywords: Prevalence; Active knee extension test; Hamstring Tightness severity

PREVALENCE AND SEVERITY OF HAMSTRING TIGHTNESS AMONG COLLEGE STUDENT: A CROSS SECTIONAL STUDY

Background: Flexibility is important for normal biomechanical function. Muscle tightness is caused by a decrease in the ability of the muscle to deform. Hamstring tightness leads to high risk of recurrent injury, decreases the performance in athletes, lead to post-exercise soreness and decreases coordination among athletes. Hence, the objectives of this study was to find out the prevalence and severity of the hamstring tightness among college going student. Method: In this cross sectional study 50 participants with hamstring tightness were included using purposive sampling. The tightness was measured by AKE test. Three measurement were taken and average of their reading was noted. Result: Analysis showed higher prevalence of hamstring tightness among college students. More students were affected with AKE angle between 30o-45o. Conclusion: Prevalence of hamstring tightness is very high in college going student of age group 18-25 years. Keywords: Prevalence; Active knee extension test; Hamstring Tightness severity

Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis

Background: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. Aim: Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. Methodology: Data was retrieved from the picture archiving and communication system (PACS) from 1st of February to 22nd of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased. Keywords: Osteoarthritis; Knee; Joint space width; Rural Maharashtra

Work related musculoskeletal disorders among hospital nurses in rural Maharashtra, India: a multi centre survey

Nurses have one of the highest rates of MSD of any occupation. Although en number of studies were done to find out prevalence of Work related musculoskeletal disorders (WMSDs) among nurses across the world, there is limited information on its prevalence in Rural Maharashtra. This study investigated prevalence of WMSDs, job risk factors and the coping strategies towards reducing the risk of development of WMSDs among nurses from selected hospitals in rural Maharashtra, India. Validated questionnaires were distributed to 250 nurses working rural hospitals across Maharashtra but only 228 questionnaires were returned and 212 complete questionnaires were included for study. On Analysis we found that 89.1% nurses had experienced work-related musculoskeletal pain or discomfort at sometime in their occupational lives. WMSDs was highest in the low back (48.2%), followed by the shoulder (34.6%), neck (33.1) and knee (29 %). Other regions with less prevalence were Thoracic (10.5%), Feet and ankle (7.6%), Elbow ( 1.88%) and Hip (1.6 %). Priority was given to getting help to handle heavy patients ( 57.1 %), nursing procedure modification in order to avoid stress injury ( 50.2 %) coping strategies. Our study Concluded that high prevalence of LBP, Shoulder, neck and Knee pain  over a 12-month period among nurses working in Rural hospitals in Maharashtra state , and certain risk factors  like working in same position for long time, bending, twisting, lifting and treating excessive number of patients were strongly associated with WMSDs

Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis

Background: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. Aim: Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. Methodology: Data was retrieved from the picture archiving and communication system (PACS) from 1st of February to 22nd of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased. Keywords: Osteoarthritis; Knee; Joint space width; Rural Maharashtra