Indian Journal of Physical Medicine & Rehabilitation最新文献

{"title":"Effect of ultrasound-guided genicular nerve block in knee osteoarthritis with neuropathic pain","authors":"Rajshree Rathore, M. Joshi, Anchin Saharan, Himanshu Agrawal","doi":"10.4103/ijpmr.ijpmr_9_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_9_22","url":null,"abstract":"Introduction: Osteoarthritis (OA) remains one of the most common musculoskeletal disorders. It was thought to be a non-inflammatory, wear and tear disorder, but recent studies have suggested the presence of a neuropathic pain component. Genicular nerve block has emerged as a new intervention to manage the neuropathic component of pain in knee OA. Materials and Methods: We conducted a prospective, hospital-based descriptive interventional study. Persons having OA with neuropathic pain component were identified using PainDETECT scale. We randomised the participants meeting the inclusion criteria into two groups. In the study group with thirty participants, we performed an ultrasound-guided triple-site genicular nerve block. The control group of equal size underwent conservative management. Participants were assessed using PainDETECT scale, Visual analogue scale (VAS) and Western Ontario McMaster Universities Arthritis Index (WOMAC) at baseline, 2 weeks and 4 weeks. Results: In the study group, PainDETECT score decreased from 24.93 ± 1.99 at baseline to 8.07 ± 2.97 at 2 weeks and 7.9 ± 2.87 at 4 weeks. WOMAC significantly improved in the study group from 94.27 ± 8.35 to 48.43 ± 10.14 at 4 weeks. VAS score also decreased in the study group from 9.2 ± 0.71 to 4.73 ± 1.44 at 2 weeks and 4.53 ± 1.28 at 4 weeks. The control group also showed a significant decrease in PainDETECT score from 24.13 ± 1.17 to 12.07 ± 1.36 at 4 weeks. However, a decrease in VAS score (from 9.13 ± 0.68 to 7.67 ± 0.67 at 4 weeks) and WOMAC (from 97 ± 4.49 to 88.5 ± 4.93 at 4 weeks) was less significant. Conclusion: Genicular nerve block provides significant pain relief and improved functional outcome in OA knee with neuropathic pain component. Furthermore, it is more effective than conservative management.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125392982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder ultrasound – Protocols and pitfalls","authors":"K. Sreejith","doi":"10.4103/ijpmr.ijpmr_16_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_16_22","url":null,"abstract":"Musculoskeletal ultrasound of shoulder is an important tool for physiatrist in diagnosing and treating patients with shoulder pain. Here a brief anatomy and sono anatomy of rotator cuff tendons is mentioned. Protocols of Shoulder Ultrasound and the common pitfalls are described.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134155357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of quadruple limb amputation due to factor V leiden mutation","authors":"A. Zachariah, Ravi Sankaran","doi":"10.4103/ijpmr.ijpmr_15_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_15_22","url":null,"abstract":"Factor V Leiden, an autosomal dominant gene mutation that leads to increase risk of forming thrombophilia. Amputation in patients with Factor V leiden mutation is known but none describe quad-limb amputation in this setting. We present a case of a quad-limb amputee due to sepsis with factor V Leiden mutation and how he was rehabilitated.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122520520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Look before you leap: When ITB pumps fail","authors":"Ravi Sankaran, G. Varun","doi":"10.4103/ijpmr.ijpmr_14_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_14_22","url":null,"abstract":"A 32-year-old male presented with uncontrolled hip flexor spasms. He suffered a spinal cord injury and was put on an intrathecal baclofen pump. Despite escalating doses, his spasticity was not controlled. On further investigation, femur neck fractures were found. One should find all the triggers for spasticity before inserting a pump.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"76 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128368739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability following COVID-19: A cross-sectional study at an apex COVID care hospital of central India","authors":"Jaydeep Nandi, R. Yadav, R. Lakhiya, Anusree Akshay","doi":"10.4103/ijpmr.ijpmr_10_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_10_22","url":null,"abstract":"Purpose: This study was done to assess the extent of disability in COVID-19 survivors using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and to identify the predictor variables. Methodology: Patient recruitment for this cross-sectional study started after ethical clearance. Most of the recruited patients were telephonically invited from medical records data of institutional COVID-19-admitted patients. All patients aged 18 years or above, who recovered from COVID-19 infection at least 3 months back, were recruited in the study after fulfilment of other inclusion and exclusion criteria. Informed consent of each recruited patient was taken and disability assessment was done using WHODAS 2.0. Results: Fifty patients were enrolled in the study, and the mean WHODAS 2.0 score was found to be 35.49 (0 = no disability; 100 = full disability), the most involved subdomains being getting around (mean = 45.524), life activities (mean = 42.8692), societal participation (mean = 42.8095) and understanding–communicating (33.568). The overall WHO DAS-2 score was significantly higher in the above 45-year age group, recent follow-up patients (3 months completed but <4 months) and those having comorbidities (all comorbidities combined as well as diabetes alone). On the other hand, no such relationship could be established with gender, educational status, duration of COVID-19 admission, smoking history, body mass index categories, family size or family income. Furthermore, the effect of age and follow-up interval to the severity of disability was contributing only 6.58% on multiple linear regression analysis. Seventy per cent of respondents had moderate-to-extreme difficulty with walking a long distance, 60% had similar difficulty in standing for long periods, 54% in day-to-day work/school responsibilities, 60% in joining community activities and 58% were emotionally affected by their health problems. Conclusion: COVID-19 survivors suffered from significant disability even after 3 months of disease, especially amongst aged persons with pre-existing comorbidities; the severity of disability was significantly higher in those who have just completed 3 months in comparison to higher follow-up intervals. It was concluded that recognising post-COVID-19 sequelae and the initiation of rehabilitation services can be beneficial in preventing disability after acute COVID-19.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130278540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation in Coronavirus Disease 2019 positive post-partum haemolysis, elevated liver enzymes and low platelet count syndrome","authors":"S. Pandey, Deepak Kumar, Anurug Biswas, Renu A Johnson, Madhulika Rani","doi":"10.4103/ijpmr.ijpmr_7_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_7_22","url":null,"abstract":"Haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome is a rare condition associated with cerebrovascular accidents. It usually happens in the third trimester, although it can also present in the early weeks of pregnancy or the postpartum period. A 24-year-old female presented with 39 weeks of gestation. After 2 days of delivery, she developed generalised convulsions and following that she had burst abdomen with sepsis. She was diagnosed with a case of HELLP syndrome. After that she became coronavirus disease 2019 (COVID-19) positive and was shifted to a COVID-intensive care unit (ICU) where she was provided ventilator support. After 3 months of ICU stay, she was shifted to the rehabilitation unit. In the meantime, she had an episode of stroke with associated quadriparesis, impaired cognition, loss of vision, dysphagia and bladder-bowel involvement. Rehabilitation outcome was partially successful in her case. Post-partum HELLP syndrome associated with COVID-19 can develop severe complications. Medical management combined with goal-oriented customised rehabilitation can lead to a better outcome.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130017611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenously prepared intermittent negative pressure wound dressing: Effective and economic in Indian scenario","authors":"Aayushi Choudhary, M. Joshi, Nitesh Lamoria","doi":"10.4103/ijpmr.ijpmr_5_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_5_22","url":null,"abstract":"Introduction: Intermittent negative pressure wound treatment (INPWT) is a proven way to accelerate wound healing by increasing blood flow, promoting angiogenesis and suction removal of matrix metalloproteinases. The purpose of the study was to evaluate the use of INPWT in pressure sores. In our study, we have used very low-cost locally available material for INPWT in place of commercially available costly vacuum-assisted closure (VAC) machine and dressing. Materials and Methods: This was a prospective study conducted in the department of plastic and reconstruction surgery and physical medicine and rehabilitation at a tertiary level facility. Eighty patients of spinal cord injury with 70% of ASIA Grade A and B with pressure ulcer most commonly at sacral and ischial regions with National Pressure Ulcer Advisory Panel Grade 3 and Grade 4 pressure sore were treated. Patients enrolled included 57 males and 23 females. The study employed locally manufactured low-cost materials such as foam, Ioban tape, Room Vac drain and suction machine (easily and locally available at any primary, secondary as well as tertiary healthcare centre) for INPWT in patients with pressure sores. Dressing was changed every 4th day till desired granulation tissue was formed. Results: Out of patients who were treated with INPWT, 30% achieved direct closure, 49% required split skin grafting and 21% required reconstruction by local flaps. Commercial available VAC machines available in the market cost around 300,000–500,000 INR, and the cost of single dressing is around 7000–15,000 INR. This may not be economically feasible, especially in patients having large wounds which require multiple applications of these dressings with our indigenous dressing; there is a 95%–98% decrease in pricing of dressing. Conclusion: The study concluded that low-cost indigenously prepared INPWT dressing produced effective results at minimum cost that were at par with commercially available costly VAC dressing. This low-cost indigenously prepared INPWT can be groundbreaking in treatment of patients with pressure ulcer in developing country like India in both rural and urban settings.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121441617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To determine the effectiveness of artificial intelligence in neurorehabilitation and in poststroke psychological impact ‒ A pilot study","authors":"R. Kamakshi","doi":"10.4103/ijpmr.ijpmr_2_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_2_22","url":null,"abstract":"Background: Patients with CVA have multiple complications, one among them is psychological problem. Various studies showed incidence of anxiety (20–25%) and 1 in 3 stroke survivors have depression. In traditional rehabilitation approach, patitent needs attendant who should be supporting full time. Due to changing time and busy schedule of atttendants ensuring the effective rehabilitation is challenging. Thereby active participation in rehabilitation is impaired. Effective rehabilitation can be assisted through emerging technologies like Artificial Intelligence (AI) and AI enabled devices. Literature review showed that AI is applied in various branches of medical science. Aim and Objectives: To assess the effectiveness of AI enabled devices in rehabilitation of patients with CVA and in post stroke psychological impact. Materials and Methods: This study is undertaken with sample population categorized into two groups by using, one of the AI enabled devices like Alexa[© Amazon] that has inbuilt capability for routine activity remainders, graded exercise, speech and music therapy for rehabilitation along with routine physical therapy and at the end psychological impact of CVA is assessed using Hamilton scale for anxiety and depression. Results: Depression is more prevalent than anxiety in the study group. Anxiety score remained same in both the groups before and after study. Depression score changes noted in both groups before and after the study. Conclusion: From the study it is found that AI assisted rehab program is more effective in reducing the psychological stress.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125430158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of balance impairments in early and advanced osteoarthritis of the knee","authors":"Noufal Ali, U. Singh, S. Venkataraman, S. Wadhwa, G. Handa","doi":"10.4103/ijpmr.ijpmr_4_22","DOIUrl":"https://doi.org/10.4103/ijpmr.ijpmr_4_22","url":null,"abstract":"Background: Studies which have compared the extent of balance impairment in various grades of primary osteoarthritis (OA) knee have got contradictory findings. Here, we compare static and dynamic balance indices and measure of mobility between radiological early and advanced OA knee patients. Materials and Methods: In this observational cross-sectional study, the participants were primary OA knee patients, fulfilling inclusion and exclusion criteria, classified into early (Kellgren-Lawrence Grade 1 and Grade 2; n = 40) and advanced (Grade 3 and Grade 4; n = 40) OA groups. Outcome measures were static balance, dynamic balance, and risk of fall assessed using Biodex Balance System (Overall Stability Index, Antero Posterior Index, and Medio Lateral Index) and mobility assessed using the Timed Up and Go Test (TUG). Results: The Overall Stability, Antero Posterior and Medio Lateral indices, when compared for static balance, dynamic balance and risk of fall, did not show any statistically significant difference between the two groups. However when TUG scores were compared, the difference in the scores was statistically significant. Conclusion: Our study did not show any change in balance impairment or risk of fall with advancing knee OA. However, mobility did show deterioration with the advancement of OA possibly because of more pain, muscle weakness, stiffness, and reluctance to move.","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127262803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CME Lectures","authors":"","doi":"10.4103/0973-2209.352463","DOIUrl":"https://doi.org/10.4103/0973-2209.352463","url":null,"abstract":"","PeriodicalId":220492,"journal":{"name":"Indian Journal of Physical Medicine & Rehabilitation","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134147140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}