Effectiveness of lower limb rehabilitation protocol using mobile health on quality of life, functional strength and functional capacity among knee osteoarthritis patients who were overweight and obese: A randomized controlled trial

Objective: This study aimed to investigate the effectiveness of the lower limb rehabilitation protocol (LLRP) using mobile health (mHealth) on quality of life (QoL), functional strength, and functional capacity among knee OA patients who were overweight and obese. Materials and Methods: In the current trial, 114 patients were recruited and randomized into either the rehabilitation group with mobile health (RGw-mHealth) receiving reminders by using mHealth to carry on the strengthening exercises of LLRP and instructions of daily care (IDC), the rehabilitation group without mobile health (RGwo-mHealth) following the strengthening exercises of LLRP and instructions of daily care (IDC) and control group (CG) only following the IDC for duration of 12-weeks. The reminders for using mHealth were provided two times a day for three days a week. Primary outcome measures were QoL assessed by the Western Ontario and McMaster Universities Osteoarthritis Index summary score, and functional strength by Five-Repetition Sit-To-Stand Test. Secondary outcome measure was functional capacity assessed by the Gait Speed Test. The assessments of QoL, functional strength, and functional capacity were taken at baseline and posttest after 12-weeks of intervention. Results: After 12 weeks of intervention, patients in all three groups had statistically significant improvement in QoL within groups (p < 0.05). Furthermore, patients in the RGw-mHealth and RGwo-mHealth had statistically significant improvement in functional strength and walking gait speed within groups (p < 0.05). The pairwise between-group comparisons (Bonferroni post hoc test) of the mean changes in QoL, functional strength, and functional capacity at posttest assessments revealed that patients in the RGw-mHealth had statistically significant greater mean change in QoL, functional strength and functional capacity relative to both the RGwo-mHealth and CG (p < 0.001). Conclusion: Improvement in QoL, functional strength, and functional capacity was larger among patients in the RGw-mHealth compared with the RGwo-mHealth or CG. Keywords: Osteoarthritis, knee, overweight, rehabilitation. mobile health.

Short-Term Effects of Strengthening Exercises of the Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function, and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Background. Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of the cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. A single-blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the rehabilitation protocol group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the control group (CG) were provided with leaflets explaining the IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical function. The secondary outcome measures were BMI, exercise adherence, and patients’ satisfaction assessed by using the numeric rating scale ranging from 0 to 10. The paired-sample t-test was used to analyze the differences within groups from baseline to posttest evaluations. The analysis of variance 2 × 2 factor was used to analyze the differences in BMI, knee pain, stiffness, and physical function between the groups. Results. Participants in the RPG and CG reported a statistically significant reduction in knee pain and stiffness ( p ≤ 0.05 ) within the group. The reduction in the scores of knee pain was higher in participants in the RPG than that in participants in the CG ( p = 0.001 ). Additionally, participants in the RPG reported greater satisfaction ( p = 0.001 ) and higher self-reported exercise adherence ( p = 0.010 ) and coordinator-reported exercise adherence ( p = 0.046 ) than the participants in the CG. Conclusion. Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

A Case Report on Pelvic Floor Dysfunction

Background: Pelvic floor dysfunction and pelvic myofascial pain are treatable and common musculoskeletal conditions. Understanding the relationship between pelvic girdle and pelvic floor muscles (PFM), hips and spine will help the practitioner to diagnose and treat these conditions. Pelvic floor dysfunction and pelvic pain are treated with clinical examination and complete medical history of PFMs. Treatment is a in cooperatives approach, which consists of medications, pelvic floor physical therapy, injection and other treatment options. Case Presentation: We are presenting case of 40 female with complaints of pain in abdomen and discomfort during micturition. On evaluation she was diagnosed with the pelvic floor muscle dysfunction. For the management of same she was referred to physiotherapy department. Treatment: For the management of pelvic floor dysfunction, various levels of physiotherapeutic interventions were given to the patient, which includes strengthening exercises, endurance exercises to improve the overall functional capacity of the patient. Conclusion: This examines the physical and anatomical examination of the pelvic floor, discusses the epidemiology and definition of pelvic floor dysfunction and explains the physiotherapy approach to treating these common conditions.

EXPLORING APPROPRIATE EXERCISES FOR REHABILITATION IN A POST-STROKE PATIENT WITH IHD AND HYPOTHYROIDISM

According to a systemic analysis conducted in 2017, the blunt stroke incidence in various parts of India ranged from 44.29 to 559 per 100,000 people over the previous two decades. Stroke is the sudden loss of any neurological function due to a disturbance of blood flow. The majority of stroke victims suffer from long-term disability. We present the case of a 72-year-old woman who was admitted to the hospital with symptoms of fatigue on the left side of her body and facial palsy on the left side, on further assessment it was found that patient had coronary artery bypass grafting before 10 years with no post-operative complications and also had a history of hypothyroidism, this brings about the suspicion about the correlation between the stroke with the history of IHD and hypothyroidism. To manage these passive movements breathing exercises, bed mobility exercises, strengthening exercises followed by gait training was given which was highly effective to make the patient independent and return to her daily activities

Impact of Rehabilitation in a Complex Case of Intertrochanteric Fracture in Geriatric – A Case Report

Peri-trochanteric femoral fractures are among the most prevalent fractures in the aged population. Injury and trauma are the leading causes of intertrochanteric fractures. The intertrochanteric aspect of the femur is made up of dense trabecular bone and lies between the greater and lesser trochanters. The female to male ratio for sustaining these fractures is seen between 2:1 and 8:1.Patients with femoral neck fractures are usually in geriatric age group. The dynamic screw approach is used to treat intertrochanteric fractures surgically. An 88year old male patient with left intertrochanteric fracture, diagnosed on x-ray after a fall in toilet was operated and was referred immediately for physical therapy, which included strengthening exercises, balance retrainig, and breathing exercises. According to the case study, a physiotherapy treatment technique resulted in considerable and gradual improvement of functional goals.

Short-Term Effects of Strengthening Exercises of Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Background. Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. Single blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the Rehabilitation Protocol Group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the Control Group (CG) were provided with leaflets explaining IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness and physical function. The secondary outcome measures were BMI, exercise adherence, and patients satisfaction by the numeric rating scale ranging from 0 to 10. Paired Samples t-test was used to analyze the differences within groups from baseline to post-test evaluations. The analysis of variance was used to analyze the difference of BMI, knee pain, stiffness, and physical function between the groups. Results. Participants in the RPG and CG reported a statistically significant reduction in knee pain, and stiffness (p ≤ 0.05) within group. The reduction in the scores of knee pain was higher in participants of the RPG than the CG (p = 0.001). Additionally, participants in the RPG reported greater satisfaction (p = 0.001), higher self-reported exercise adherence (p = 0.010) and coordinator-reported exercise adherence (p = 0.046) compared to the participants in the CG. Conclusion. Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

A Study to Compare the Efficacy of Back Strengthening Therapy in Patients with Lower Back Pain on Analgesics to that of those on Placebo in a Tertiary Care Hospital in Chennai

Aim: Isometric and Core strengthening exercises for lower back pain provides relief to patients, whereas combing it with analgesics also provides relief of pain, thereby in this study the efficacy of isometric and core strengthening exercises alone is evaluated. Method: A cross-sectional study involving 200 subjects was conducted in the OPD of department of Orthopaedics, Saveetha Medical college and hospital. Assessment of lower back pain was done using ODI (Oswestry Disability Index) among patients receiving Isometric and Core strengthening exercises with and without analgesics for a period of 3 months. Results: There is no significance difference in the reduction of pain among group A who received analgesics along with isometric and core strengthening exercises and group B who received only isometric and core strengthening exercises. Conclusion: Isometric and core strengthening exercises alone is as effective as its combination with analgesics.