bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profile of Traumatic Spinal Cord Injury Patients Admitted in Physical Medicine and Rehabilitation Department of a Tertiary Care Hospital: A North East India Experience
Authors: Chanu A R , Zonunsanga C , LNU Hmingthanmawii , Pertin M 
Published: July 2019

Abstract

Study Design
Retrospective Descriptive Study.

Setting
Physical Medicine and Rehabilitation (PMR) Department, Regional Institute of Medical Sciences (RIMS), Imphal, a tertiary care teaching hospital in North East India

Study Duration
1st November 2011 to 31st October 2012.

Study Duration
1st November 2011 to 31st October 2012.

Objective
To study the profile of traumatic spinal cord injury (SCI) patients admitted in PMR Department, RIMS.

Materials and Methods
Neurological profile of traumatic SCI patients admitted in PMR Department, RIMS was recorded using a structured proforma and analysed. Demographic profile of the patients, time since injury, functional status and complications were also recorded.

Results
Among all 22 patients, 16(72.7%) were tetraplegics with C5 (59.09%) as the most common neurological level involved. Twelve (54.5%) were American Spinal Injury Association (ASIA) grade A. The mean motor and sensory scores were 45±24.97 and 157.50±69.53 respectively. The mean FIM score (at admission) was 71.50±23.40 and FIM (at discharge) was 82.35±20.72. Spasticity was present in 16 cases (72.7%) with gastrosoleus as most common site. There were 14 patients (63.6%) who had urinary tract infection (UTI). Only 5(22.7%) underwent urodynamic study and all had hyperactive detrussor. The most common mode of bladder management was clean intermittent catheterisation (CIC) which was done in 16 patients (72.7%). Pressure sore was seen in 14(63.6%) of patients with sacrum (78.57%) as the most common site.

Conclusion
Majority of traumatic SCI inpatients were of ASIA grade A and tetraplegics were commoner. Fall from height was the comonest cause of injury. Spasticity, UTI and pressure sores were common complications.
Anatomic Reconstruction of the Distal Radio-ulnar Ligament for Distal Radio-ulnar Joint Instability : A Case Report
Authors: Sahoo Jagannatha 
Published: July 2019

Abstract
Stability of the distal radio-ulnar joint (DRUJ) is provided by bony architecture and by soft tissues such as the triangular fibrocartilage complex (TFCC), the joint capsule, and surrounding muscles. Many authors have made various attempts to restore DRUJ stability surgically following trauma. The objective of this study was to analyse clinical outcomes after anatomic reconstruction of the distal radio-ulnar ligaments in a 26 years male with post-traumatic chronic instability of the DRUJ. Anatomic reconstruction of the major structures responsible for joint stability is the most important principle for the treatment of instability of an injured joint with an intact articular surface by using a palmaris longus tendon graft whose ends were anchored in pre-drilled holes in the radius and the ulna. Anatomical reconstruction of the distal radioulnar ligaments is thought to be an effective procedure for treating post-traumatic DRUJ instability.
A Case Report of Hirayama Disease
Authors: Kumar Deepak , Singh Gogia Virinder 
Published: July 2019

Abstract
Hirayama disease is also known as juvenile muscular amyotrophy of distal upper limb. This type of condition is rare and difficult to differentiate this disease from other disease with similar symptoms such as motor neuron disease. Very few cases reported in Medical science and its management is not much proved. But in our case a 20-year-old male came to department with complaint of slowly progressive muscle atrophy and weakness in distal U/L of right side. This disease had confirmed by MRI of flexed cervical region. Patient was managed by similar protocol: Vitamin B12, exercise of hand, cervical collar and isometric neck muscle exercise. Got benefit to patient for cessation of progressive of disease. It is necessary to early diagnosis of Hirayama disease so that patient got early management. Surgical management is preserved to late stage. In case of similar symptoms of cold paresis, amyotrophy, weakness of distal upper limb then a flexion MRI study should be performed to confirm the diagnosis.
A Multidisciplinary Rehabilitation Approach for Writer's Cramp: A Case Study
Authors: Tripathi D R , Kumar Amod , Talele Mahesh , Singh Suryabhan 
Published: July 2019

Abstract
A 61 year-old male was referred from neurology to PMR department RML hospital, New Delhi, with difficulty in writing for 2 years prior to consultation. Initially difficulty in writing which is accompanied with pain after prolonged writing. Also he noticed tremor and stiffness while writing. Disability progressed and he was unable to write even a few words legibly and cannot hold object (spoon) which leads to anxiety and dependency.
When the patient was examined at PMR OPD, EMG/NCV study was advised, which showed normal sensory and motor nerve functions.
The present treatment involved the use of a multidisciplinary therapeutic approach with Physical Medicine and Rehabilitation Specialist, Clinical psychologist and Occupational Therapist which gave us satisfactory results within 6- 8 months. The findings in this case is very encouraging and studies with large sample sizes can be considered for further conclusive evidence on the treatment of writer's cramp.
Plexiform Neurofibromatosis with Abnormal Pachydermatocele: A Rare Case Report
Authors: Agarwal AK , Kumar Dileep , Gupta Anil Kumar , Yadav Ganesh 
Published: July 2019

Abstract
Plexiform neurofibromatosis, also known as pachydermatocele, is a rare type of neurofibromatosis, caused by excessive growth of the neural tissue in the subcutaneous fat. This condition is rare in Indian subcontinent but when it occurs, it causes cosmetic as well as functional disability. The optimal management of plexiform neurofibroma is not well defined and surgery is often delayed. We report a rare case of neurofibromatosis with pachydermatocele involving the nerves of the left thigh and leg with disfigurement and associated disability.
Spinal Cord Injury in Decompression Sickness: A Case Report
Authors: Henry Prakash M , Hariharan Ramaswamy , Chandy Bobeena 
Published: July 2019

Abstract

Study Design
Case report.

Objective
To describe an unusual case of deep diving followed by spinal cord injury due to decompression sickness (DCS).

Setting
Princess Royal Spinal Injuries Centre, Sheffield Teaching Hospitals NHS Foundation Trust, England.

Method
Description and observation of management and outcomes, of spinal decompression sickness (DCS).

Results
The patient's symptoms and signs developed after she surfaced after a deep sea diving event. She was managed and treated in a tertiary level care hospital. MRI performed within 24 hours, showed signs of increased signal intensity in the cervical and thoracolumbar regions. She was treated with hyperbaric oxygen which improved her pain symptoms but there was no immediate resolution in motor sensory deficits. Repeat MRI done after a week showed resolution if hyperintensity in the cervical region but not in the thoracolumbar region. Patient progressed to have significant neurological recovery in the next 6 months. She became ambulant with unilateral ankle foot orthotic and a pair of crutches, she continued to have bladder incontinence at 1 year follow-up interval.

Conclusion
Central nervous involvement is not uncommon in decompression sickness in divers. Early diagnosis and proper management can reduce acute symptoms and prevent further complications of permanent neurological disability. Primary prevention by education and adhering to standard diving guidelines is needed to reduce mortality and morbidity in decompression sickness.
Effectiveness of the Home-based Habilitation Programme for Children with Cerebral Palsy
Authors: Racic Maja , Kusmuk Srebrenka , Krstovic-Spremo Vesna 
Published: July 2019

Abstract

Objective
This study was undertaken with the aim to compare the effects of home-based habilitation programmes with the effects of hospital-based habilitation programme for children with cerebral palsy (CP) on motor performance and daily functioning.

Patients and methods
The study was conducted on a sample of 60 children with cerebral palsy. First group included 30 children, 5 to 12 years old, who had a continued physical home treatment and education in public/special school. The second group consisted of 30 children, from Banja Luka region, who continued inpatient habilitation programme and training. Habilitation outcomes were analysed by measuring muscle tone (using original Tardieu Scale), muscle strength, range of motion (ROM), gross motor functions (gross motor function measure-88) and the Barthel Index of activities of daily living (ADL).

Results
The proportion of clinically significant change in gross motor functions, ADLs, ROM and muscle strength didn't show major differences between the two groups.

Conclusion
There were no significant differences in effectiveness between home-based and hospital-based habilitation programmes according to the treatment outcomes. The effectiveness of home-based programme increases when supplemented by frequent consultations with the rehabilitation team members and occasional out-patient physical therapy treatment, education as well as counselling and support for parents.
Assessment of Autonomic Dysfunction in Chronic Complete Spinal Cord Injury by Heart Rate Variability
Authors: Navin BP , Dube Amitava 
Published: July 2019

Abstract

Objectives
Non-invasive assessment of cardiac autonomic dysfunction in spinal cord injury (SCI) by means of heart rate variability analysis (HRV). Also, to assess the effect of postural change on neural outflow.

Setting
Rehabilitation research center, Sawai Man Singh Hospital, Jaipur.

Participants
110 patients with SCI were screened, of whom, 12 patients aged between 20 and 30 years with chronic complete SCI and neurological level of T6 or above were included. An equal number of age and sex matched healthy individuals were the controls.

Interventions
Five minute ECG recording, first in supine position and then in sitting position was done.

Outcome measures
Frequency domain measures of heart rate variability.

Results
No significant differences were observed between both the groups in supine rest. On sitting, the absolute power of the low frequency (LF) and high frequency (HF) components were significantly less in the SCI patients than that in the controls. A significantly increased LF-to-HF ratio along with a higher mean heart rate (HR) was observed in the controls on postural change.

Conclusion
On change of posture, the controls showed a physiologically patterned response, which was not observed in the SCI patients. The loss of this homeostatic mechanism in the SCI subjects was observed, which may reflect a dysfunctional autonomic nervous system interplay in patients with complete SCI.
Tibialis Posterior Tendon Transfer in Post Injection Common Peroneal Nerve Palsy in a Paediatric Patient–A Case Report
Authors: Sudesh Pebam , Kumar Deepak 
Published: July 2019

Abstract
Post injection foot drop is due to common peroneal nerve damage at site of injection (gluteal region) in which dorsiflexor of foot EHL, EDL and tibialis anterior are weakend or paralysed. It can be managed by reconstructive surgery; tibialis posterior tendon transfer to EHL, EDL and 2nd metatarsal. Here objective is rehabilitation of post injection common peroneal nerve palsy foot drop in a paeditaric patient. Our method and outcome measure as first rehabilitation programme for foot drop paediatric patient (common peroneal nerve palsy) thereafter reconstructive surgery of tibialis posterior transfer to EHL, EDL and 2nd metatarsal. Last we re-educate them to tibialis posterior contraction for dorsiflexion of foot. Our result was patient was able to walk similar as normal, able to elevate her toes and foot. Patient was happy and confident with her functional foot. But patient was advised to avoid heavy work, sprinting, and active aggressive game (like foot ball). Our conclusion is patient gets benefited by this procedure.
Clinical and Imaging Evaluation of Efficacy of Viscosupplementation in Degenerative Osteo-arthritis Knee – A Prospective Interventional Study
Authors: Gupta Rohini , Kothari SY , Nandi Jaydeep , Borah Diganta , Thukral BB 
Published: July 2019

Abstract
In this study 30 patients with osteo-arthritis (OA) knee (total 55 knees) were given weekly injections of high molecular weight (HMW) hyaluronic acid (HA) for 3 weeks. The subjective parameter was Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) score which improved from 97.67±21.4 at baseline to 61.03±24.8 at six months follow-up (p=0.0001). Also the mean range of motion (ROM) of the involved knees was 125.73± 10.8 degrees at baseline and it increased to 132.64±5.2 degrees after six months (p=0.0001) of injection treatment. The objective parameter of disease modification was MRI based semi-quantitive Whole-organ Magnetic Resonence Imaging Score (WORMS) score. The mean of total WORMS score in medial femorotibial joint (MFTJ) and patellofemoral joint (PFJ) improved from baseline (28.382±10.446; 22.64±5.969) to final follow up (27.46±10.32; 21.76± 6.182) which was quite significant (p=0.0321; p=0.0294) and implies a reduced rate of cartilage destruction after injection HA though there is no regrowth of cartilage as such.
Concurrent and Discriminative Validity of the Mini Balance Evaluation Systems Test (miniBESTest) in People with Parkinson's Disease
Authors: Mak Margaret KY 
Published: July 2019

Abstract

Purpose
To examine the concurrent and discriminative validity of the miniBESTest in individuals with Parkinson's disease (PD).

Method
Thirty-four individuals with PD participated in study 1. Thirty-one healthy subjects and 127 individuals with PD completed study 2. All participants were assessed at the University Balance and motion analysis laboratory. Balance performance was assessed using the miniBESTest and Berg's balance scale (BBS). Self-perceived balance confidence level of subjects was measured by the activities-specific balance confidence (ABC) scale.

Results
In study 1, results of Pearson's correlation showed that the scores of the miniBESTest correlated well with BBS (r=0.765; p<0.001) and moderately well with ABC scores (r=0.587; p<0.001). For study 2, results of one-way analysis of variance demonstrated significant differences in miniBESTest scores among healthy subjects, PD non-fallers (PD-NF) and PD fallers (PD-F). Healthy subjects obtained the highest mini-BESTest score of 88.2 ± 8.9%, followed by PD-NF (73.6 ± 14.7%) and PDF (57.1 ± 17.0%) (all p<0.001). Significant differences were also observed among healthy subjects, PD-NF and PD-F for each miniBESTest domain score (all p<0.05).

Conclusion
The miniBESTest is a valid method to document balance performance in individuals with PD. Both total and domain miniBESTest scores could differentiate between healthy subjects, PD-NF and PD-F.
Evaluation of the Effects of Lumbosacral Corset on the Patients with Chronic Non-specific Low Back Pain
Authors: Shakoor Md. Abdus , Islam Mohammad Tariqul , Rahman Md. Muhibbur , Rahman Md. Shahidur , Moyeenuzzaman Md. 
Published: July 2019

Abstract
A randomised clinical trial was conducted in the Department of Physical Medicine & Rehabilitation (PMR), Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total of 81 patients having chronic LBP were included according to the selection criteria. Out of them, 31 (38.3%) were male and 50 (61.7 %) were female in a ratio of 1: 1.61. The mean age of the patients in study was 41.65 ± 8.41years. Female persons were affected in their earlier ages (between 30 and 45 years) than male. Most of the patients were housewives (54.3%). The patients were divided randomly into two groups by the way of lottery for the clinical trial. Group-A patients were treated with NSAIDs, activities of daily living instructions (ADLs) and lumbosacral corset and group-B patients were treated with NSAIDs and ADLs. The patients were followed up weekly for five weeks and significant improvement was recorded after the treatment in both the groups (p=0.001). In comparison between two groups, it was found that there was no significant improvement in pre-treatment, after 1st week and after 3rd week. A little bit improvement was found in group-A patients than group-B after 4th week (p= 0.06). But finally, there was significant improvement in group-A than group-B patients after 5th week (p=0.005). So, it may be concluded that both the treatment is effective for the patients with chronic non-specific LBP. But the patient may be more benefited if lumbosacral corset is used as an adjunct to NSAIDs.
The Role of Physiatrist in the Diabetes Healthcare Team
Authors: Veyilmuthu Ramamoorthy 
Published: July 2019

Abstract
The physiatrist is an important member of the diabetes healthcare team. His/her primary role is to provide physical activity counselling for the diabetics after thorough evaluation. Exercise is a primary component of diabetes management together with diet plan and antidiabetic drugs. The physiatrist, with his/her background knowledge in exercise physiology, is the most appropriate person for this job. Regular exercise has been shown to improve blood glucose control, reduce cardiovascular risk factors, contribute to weight loss and improve well being. Furthermore, regular exercise may prevent type 2 diabetes in high risk individuals. Thus physical activity plays a pivotal role in health promotion and diabetes control. People with diabetes should be advised to perform at least 150 minutes per week of moderate intensity aerobic physical activity using ‘FITT Principle’. In the absence of contra-indications, people with type 2 diabetes should be encouraged to perform resistance training three times per week. DeLorme resistance exercise improves power, strength, endurance and burns more calories. Cross training is the term used to describe the use of a variety of activities during exercise. Interval training is the variation of intensity during one or more aerobic activities. Circuit training is the combination of aerobic exercise and weight training (anaerobic exercise). Before recommending a programme of physical activity, the physiatrist should assess diabetics for coronary artery disease and other complications of diabetes.
Hitchhiker's Toe and Lumbar Disc Lesion: A Strange Coincidence in a Patient with Idiopathic Dystonia Treated with Botulinum Toxin Injection
Authors: Baqer Ayyoub , Jai Shanthini S , Gawad Wael Abdul 
Published: July 2019

Abstract
A 40 years old female with generalised dystonia and chronic low back pain was injected with botulinum toxin injection to extensor hallucis longus(EHL) for management of Hitchhiker's toe. The patient benefited functionally but later developed EHL and extensor digitorum (ED) weakness. Further workup revealed degenerative L4/5 disc lesion causing L5 root affection as the cause for the weakness. This coincidental occurrence of EHL and ED weakness due to L4/5 disc lesion in a patient with generalised dystonia, following botox injection to EHL for management of Hitch hiker's toe, has not been reported before.
A Study of Effects of Intervention of Botulinum Toxin- A on Lower Limb in Children with Spastic Cerebral Palsy
Authors: Singh U , Kumar Raj , Wadhwa Sanjay , Yadav SL 
Published: July 2019

Abstract

Objective
Analysis of clinical gait pattern, change in spasticity and range of motion (ROM) in cerebral palsy patient (CP) with spastic lower limb muscle after injecting botulinum toxin- A.

Study Design
Prospective study

Methods
28 children (18 male and 10 female) with spastic CP had problems in normal walking, aged 2–9 years (mean age 4.65 years), consecutively treated in the PMR department over a 2-year period, were prospectively followed-up and clinically assessed pre- and post-treatment (at 2 weeks and 2 months) both objectively and subjectively. Objective assessment included gait parameters -- stride length, cadence, velocity, step length, base of support; active and passive range of motion (ROM), (measured by goniometry) and spasticity on modified Ashworth scale. Subjective assessment was done by asking questionnaire in terms of comfort, ease of care, perineal hygiene, walking. Injections were given using clinical palpatory method on OPD basis. All patients received botulinum toxin-A injections, followed with exercises and activities and orthosis as needed.

Results
Significant improvement was achieved for spasticity reduction in gastrocnemius (p< 0.001), hamstring and adductor (p=0.050), ankle AROM & PROM (p< 0.001), active knee extension (p=0.009), popliteal angle (p=0.015) and percentage left and right foot contact (p< 0.001), whereas non-significant change was observed in step length, cadence, velocity, stride length, and base of support. Parents felt subjective improvement in most of the cases (>90%).

Conclusions
Botulinum toxin- A injection is effective in the treatment of spastic lower limb muscles for equinus/ crouching/scissoring gait in cerebral palsy children. The treatment was feasible and easily implemented. Botulinum toxin- A injections were well tolerated, yielded no serious treatment-related adverse events.
Electrodiagnosis of Medial Pectoral Nerve Mononeuropathy
Authors: Gupta Sunny , Patel Mitesh , Sinha Anupam , Karech Charles Wow 
Published: July 2019

Abstract
With an increased awareness to maintain physical fitness, weight training has become increasingly popular. Neurologic injuries are one of many injuries which can occur accidentally or with improper technique. We present a case of an isolated right medial pectoral nerve mononeuropathy in a 48-year-old male weightlifter.
Idiopathic Scoliosis: A Case Report
Authors: Bhuniya Sourin , Pampa De , Mandal P K 
Published: July 2019

Abstract

Introduction
Scoliosis is defined as a lateral curvature of spine greater than 10 degrees as measured by the Cobb method. Idiopathic scoliosis is the most common form of scoliosis and adolescent idiopathic scoliosis is the commonest presentation which is detected after 10 years but prior to skeletal maturity. The treatment depends on the measurement of Cobb's angle and subsequent exercises, bracing and surgery.

Case report
A 13 years girl presented with idiopatic scoliosis, pes cavus and hand knee gait which incapacitated her ambulation. Her spine radiograph revealed thoracic scoliosis with apex T8. She was given Boston brace with corrective exercises for scoliosis both in and out brace and a pair of floor reaction AFO's with modifi cations in footplate for pes cavus. There was signifi cant improvement in the gait and posture of the girl and she started going to school after a few months.

Conclusion
Conservative management in the form of bracing can prevent curve progression and floor reaction AFO's can indirectly affect the remote body segments and improve gait and posture.
Does Radiologic Grading Predict Severity of Osteo-arthritis Knee
Authors: Naorem Ajit Singh , Ningthoujam Jugindro Singh , Wangjam K , Rajesh RK 
Published: July 2019

Abstract

Objective
Evaluation of association between pain and functional limitation of osteo-arthritis knee with radiographic features.

Methods
Total of 123 knee OA patients diagnosed on the basis of American College of Rheumatology Classification (ACR) Criteria for knee OA, attended in Physical Medicine and Rehabilitation (PMR) OPD, JNIMS, were included. Pain and disability were measured using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiological grading by Kellgren-Lawrence (KL) grading from x-ray of weight bearing antero-posterior and lateral views. Correlation between WOMAC score and KL grading analysed.

Results
Sex distribution M:F=9:32, mean age 59.48 (+ 9.8), mean disease duration 4.79 (+ 0.41) months. Correlations of WOMAC pain and KL grading and WOMAC disability and KL grading were insignificant (p > 0.05).

Conclusions
There is discordance between radiographic findings and clinical features of OA knee and we should not plan treatment on the basis of radiologic grading rather on the functional status and symptoms.