Indian Association of Physiotherapist

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Neurodegeneration with brain iron Results: Significant improvement in reading, spelling, writing accumulation: A rare and unique challenge errors were observed in Rx group compared to nonRx. Cortical reorganization understood with fMRI (English meaningful- in neurorehabilitation words and pseudowords paradigm) where the baseline activity observed in left postcentral gyrus, cingulate (BA 24), middle Sucheta Saha, Nonica Laisram frontal (BA 6), and bilateral insula. Post therapy (follow-up) activity observed in bilateral fusiform (BA 37), left inferior occipital Consultant Rehabilitation Physician, Institute of Neurosciences (BA 17), right inferior (BA 47), middle (BA 6) frontal gyri and Kolkata,Kolkata, India anterior cingulate (BA 32). In group B (nonRx) follow-up activity E-mail: [email protected] was in right insula (123 parietal), precuneus (133 parietal, 12 Introduction: Neurodegeneration with brain iron accumulation occipital), cuneus (10 clusters) and bilateral frontal (right superior, (NBIA) is a rare, heterogeneous group of neurologic disorders middle frontal and left BA 46) and left superior temporal (BA 22). characterized by abnormal accumulation of iron in the basal Conclusions: Therapy induced neuralplastic normalization ganglia. It is a relentlessly progressive neurodegenerative with significant improvement in performance. disorder, without any cure. Neurorehabilitation can play an important role in management of this rare disorder. Gait comparisons during the timed Case Description: An 18-year-old male patient presented to the up and go in elderly with and without Physical Medicine and Rehabilitation Outpatient Department of benign paroxysmal positional vertigo: Vardhman Mahavir Medical College & Safdarjung Hospital with features of gradually increasing involuntary movement of neck, A preliminary study speech and swallowing difficulties. He was a diagnosed case of NBIA with characteristic ‘Eye of the Tiger’ appearance in MRI. Haziqah Nasruddin, Haidzir Manaf, Maria Justine Pharmacotherapy did not show any significant improvement. Injection Botulinum toxin was given for his cervical dystonia and Department of Physiotherapy, Hospital Tuanku Ja’afar Seremban, he achieved remarkable improvement in the Fahn-Marsden Seremban, Malaysia. dystonia scale scoring 2 weeks after the injection. E-mail: [email protected] Discussion: Only a handful of cases are reported from India, Background and Aims: Turning while walking is an important who received mostly symptomatic treatment. Medications like functional mobility task. While there is a considerable body of Baclofen, Trihexyphenidyl has shown some effect. In this case, work on postural alteration in benign paroxysmal positional the effect of Botulinum toxin was noticeable and it improved vertigo, rarely study on gait has been done, especially among the quality of life of the patient in conjunction with supportive the elderly. This study aims to compare the gait parameters rehabilitation care. It can be used as an effective adjunct to the during the Timed Up and Go Test (TUG) (time to complete TUG, pharmacotherapy in this rare neurological disorder. steps taken to complete TUG, turning time during TUG, and turning steps during TUG) among elderly with BPPV (BPPV) Therapeutic neural normalization for and without BPPV(WBPPV). phonological judgment in developmental Methods: Thirty-four aged-matched participants (17 BPPV and 17 WBPPV) underwent gait assessment while performing dyslexia the TUG. Gait parameters 1) time to complete TUG 2) steps taken to complete TUG 3) time taken to complete turn during Sunita Gudwani, Manju Mehta, Rajesh Sagar, TUG, and 4) the number of steps taken during turning were Madhuri Behari, Vaishna Narang, recorded using a videotaped. Sadanad Dwivedi, N.R. Jagannathan, Results: A Mann-Whitney test indicated that time to complete S. Senthil Kumaran TUG (22.0 vs 13.0, p= 0.008), steps taken to complete TUG (21.8 vs 13.2, P=0.04), turning time during TUG (22.3 vs Department of Neuro Rehab, Speech Therapy and Audiology, 12.7, p= 0.005) and turning step (22.3 vs 12.7, p=0.01) were Escorts Heart Institute and Research Center, New Delhi, India. significantly greater in the BPPV than WBPPV. E-mail: [email protected] Conclusions: The result shows that BPPV altered gait function, Background and Aims: Reading and writing has specialized especially during turning. Furthermore, the elderly with BPPV cortical architecture. Children and adolescents with dyslexia is at risk of getting a fall while turning. All older people who have reading, spelling, writing problems and may involve presented with BPPV must be assessed and prescribed with phonological deficits. It’s reported that neural deficits may not gait training. directly reflect in behavior, and evidence-based interventions are critically needed. Hence in this study therapy was tailored on Aphasia with apraxia secondary to neurobiological parameters and remedial gains were measured. arteriovenous malformation rupture – Methods: After ethical approval 30 participants were randomly allocated to two groups Group A (therapy, Rx) and Group A case report B (wait-list, nonRx). Assessments were done at baseline and follow-up. Management for group A was tailored based Gomathi Saravanan, Athira P. Gopi, on (baseline) potential parameters (negative and positive) Rakesh C. Veerabhadrappa, Usha A. Dalvi evaluated with behavior and task evoked functional magnetic resonance imaging (task-fMRI). Final analysis of twenty-four Department of Audiology and Speech-Language Pathology, participants’ (Rx n=12; nonRx n=12) data was done with SPSS Aarupadai Veedu Medical College and Hospital, Puducherry, India. (behavioral performance) and SPM12 (fMRI). E-mail: [email protected] © 2022 Physiotherapy - The Journal of Indian Association of Physiotherapists | Published by Wolters Kluwer - Medknow S1

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Arteriovenous Malformation (AVM) is one of the manifestations between income and PCS score. The younger and female of vascular deformities in which normal separation of the arterial caregivers are more prepared than older and male family system from the venous system fails to occur. This kind of caregivers in stroke caregiving. PCS score are greater in higher aberration could be fatal when a high-pressure arterial system is income caregivers. directly connected to the low-pressure venous system without an Conclusions: The findings of this study could improve the interposing capillary bed affecting the venous walls, which leads delivery of services in terms of patient education and motivation to hemorrhage. In younger adults, brain AVM is the primary cause among stroke family caregivers. of cerebral hemorrhage. The incidence of AVMs is between 1.12 and 1.42 per 1,00,000 person/year (Abecassis et al., 2014). Dysarthria with oropharyngeal However, brain AVM incidence and prevalence rate are still dysphagia secondary to gangliocapsular uncertain as 88% of cases are presented asymptomatically intraparenchymal haemorrhage - A case (Shaligram et al., 2019). Symptoms of hemorrhage can vary from severe headache to unconsciousness. Brain tissue damage report in the hemorrhagic site can lead to sequelae such as seizures, hemiparesis, and language deficits. Data regarding the extent of Gopika B. Kumar, language deficits and speech motor deficits in brain AVM cases Rakesh Chowkalli Veerabhadrappa is lacking. The current case report focuses on a 22-year-old male who primarily presented with speech and language impairment. Department of Audiology and Speech Language Pathology, Imaging tests revealed a left frontal AVM with a subacute Aarupadai Veedu Medical College, Vinayaka Mission University, hematoma. Post medical management, the patient was referred Kirumampakkam, Puducherry, India. to the Department of Speech-Language Pathology for availing E-mail: [email protected] of rehabilitation services. A comprehensive evaluation was Intraparenchymal haemorrhage (IPH) is intracerebral bleeding carried out, and profiling of speech and language characteristics in which the bleeding is within the brain parenchyma. was done with standardized test materials. With diffuse nature, Capsulo-ganglionic haemorrhage is the most common form of the patient exhibited severe word retrieval deficit, articulatory intracerebral haemorrhage (ICH). A recent systematic review groping, and oro-motor deficits. Provisionally, the patient was showed that the prevalence of cerebrovascular accident (CVA) diagnosed with Broca’s Aphasia with Apraxia of Speech and in different parts of India ranged from 44.29 to 559/100,000 receiving therapy for the same. persons and its incidence ranged from 105 to 152/100,000 persons/year during the past two decades (Tangella, Iqbal, & Preparedness in stroke caregiving among Nayakar, 2020). ICH accounts for around 10%–20% of CVA. family caregivers The most important risk factor for ICH ishypertension. Other risk factors include tumour, trauma, cavernous malformation, Mohd Amirul Aizad Binbaharudin, and CVA (Voelker, 1997). Clinical signs include hemiparesis, Muhammad Arif Razak, Farrah Wahida Sulaiman, dysphagia, impaired speech and language skills, loss of Zulkanain Errie, Shamsulamri Mohd balance and coordination, confusion, and delirium. The present case report focuses on a 52-year-oldmalepatientwho reported Department of Physiotherapy, Training Institute of Ministry of Health to the speech-language diagnostics department with slurred of Malaysia, Sungai Buloh, Malaysia. speech andswallowing difficulties for four months following E-mail: [email protected] the IPH. CT scan revealed ICH in the right Capsulo-ganglionic Background and Purpose: The term cerebrovascular accident region. The clinical examination indicated inappropriate pauses (CVA) is used to interchangeably with stroke to refer to the and stress, imprecise consonants production, increased nasal vascular condition of the brain. This scenario also has put the airflow andspeech rate, reduced velocity and degree of velar immediate family members to become the family caregivers movement during speech. Swallowing difficulties were more without knowing whether they are well prepared or not. noticeable in liquids than solid or semi-solid foods. Also, Moreover, it is important to ensure that family caregivers are increased latency for chewing and immediate aspiration for ready to take care of stroke patients in order to increase their liquid foods were observed. The detailed case history revealed contribution to the rehabilitation of stroke patients. Therefore, restricted speech and swallowing skills with intact language this study is intended to highlight the preparedness in stroke and cognitive functions. Standardized tests such as Western caregiving among family caregivers. Aphasia Battery, Frenchay Dysarthria Assessment, and Objective: To determine the preparedness in stroke caregiving Swallowing Ability and Function Evaluation were administered. among family caregivers. Based on the test results, the patient was clinically diagnosed Methods: A cross-sectional study was carried out with a with Hypokinetic Dysarthria with oropharyngeal dysphagia. convenience sampling of 85 family caregivers of stroke patients using self-administered questionnaires, demographic data and Solat as a strategy to improve functional preparedness for caregiving scale (PCS) at Rehabilitation outcomes Medicine Department of Hospital Sungai Buloh, Selangor. Data analysis was based on Statistical Package for Social Sciences Intan Sabrina (SPSS) software version 21.0. Results: There are significant associations between Department of Rehabilitation Medicine, Ministry of Health, preparedness for caregiving scale (PCS) score with age (p Kuala PIlah, Malaysia. < 0.001) and gender (p < 0.05) but no significant association E-mail: [email protected] Introduction: Solat (Muslim prayer) has been recognised as a low to moderate intensity physical activity in recent publications. S2 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract The ability to perform Solat successfully requires physical, Introduction: Stroke often results in muscle over-activity which cognitive, psychological and emotional abilities. may cause deformity, gait disturbance and impaired motor Objectives: To review the current literature on the health control. Several studies focused on the therapeutic effects of benefits of Solat and classify them using the International intra-muscular (IM) Botulinum toxin type A (BTX-A) injection on Classification of Functioning, Disability and Health (ICF) lower limb spasticity and showed benefits in posture control and conceptual framework. spasticity reduction. Additionally, several therapeutic benefits Methods: A scoping review was performed using keywords like of robot-assisted gait training for stroke patients have been “Solat” OR “Salat” OR “Muslim prayer” AND “health benefits” reported as improvements in walking independence, functional on Google and Pub Med search engines published until May walking ability and gait speed. Therefore, the objectives of this 2021. Only full papers were included for the review. Duplicates, study are to investigate whether the treatment of combining promotional brochures, blogs, news articles and religious BTX-A injection with Robotic Gait Training can enhance the gait commentaries were excluded. Selected papers were screened performance of the patients with stroke during ambulation or not. for health benefits and sub-divided into the ICF domains: Materials and Methods: In this prospective, case-controlled body functions and structures; activity limitations; participation study, we recruited 19 patients with stroke, and they were restriction; personal and environmental factors. divided into 3 groups for BTX-A Injection (n=5), Robotic Gait Results: Out of 11,300 and eight articles identified from Google Training (n=10), and Combined Treatment (n=7). Each subject and PubMed search engines respectively, only 17 articles will undergo center of pressure measurement during ambulation fulfilled the selection criteria. Solat improves cardiovascular before the initiation of the therapeutic program and after that for and respiratory fitness; cognition, musculoskeletal flexibility 4, 8, 12 weeks. The robotic gait training is for 30 minutes a day, and strength; balance and coordination; and increased penile 3 to 5 days a week, for 4 weeks. The dosage of the BTXA will tumescence. Alpha wave amplitudes were increased in the be individualized according to the severity of muscle spasticity. parietal and occipital regions and heart rate was at its lowest Outcome: Measures We use the L2ens-B (Free4act walk, Italy) during prostration (sujud), suggesting heightened relaxation to get gait parameter of speed, cadence and stride length during state due to increased parasympathetic response. People who gait, and uses these parameters to calculate Symmetry index Solat regularly are more independent, mobile, less stressed (SI). The repeated measurement analysis of variance (ANOVA) and depressed. was used to compare the center of pressure data from center Conclusions: Solat is a low to medium intensity activity. of pressure assessment among each group. The independent It improves body functions and structures; activities and t test will be used to compare data among BTX-A injection, participation; and have psychological benefits. Solat may be Robotic Gait Training and Combined Treatment group. used as a strategy to improve functional outcomes. Result: In our study, all of groups improved in walking speed at the third follow-up assessment, the difference was statistically Delivering healthcare in rural areas significant only in Robotic Gait Training group (p=0.012). Otherwise, combined treatment group have lowest symmetry Intan Sabrina index in the stance phase and swing phase at the third follow- up assessment, which means combined treatment improve Department of Rehabilitation Medicine, Ministry of Health, Kuala balance and gait. Pilah, Malaysia. Conclusion: Robotic Gait Training might have a long-term E-mail: [email protected] effect in hemiplegic patients. In addition, combined with BTX-A There are many challenges in delivering healthcare in rural injection, balance and gait were improved in stroke patients. areas, especially when the information and communication technology (ICT) infrastructure is not as advanced compared Use of the Canadian occupational with urban areas. Mobile health (mHealth) using mobile phones performance measure for a patient with may be a solution for some population. Barriers to mHealth Guillain Barre syndrome: A client-centered include poor network coverage, low smart phone and internet penetration, lack of awareness and/or expertise in telemedicine Occupational Therapy program among healthcare providers and the community, preference for face-to-face consultation, lack of political will and competing Aparna Rao health priorities. This paper will discuss on the challenges and solutions in delivering healthcare in rural areas. Healthcare Department of Occupational Therapy, D Y Patil University, providers need to adapt to the local culture and demands in Navi Mumbai, Maharashtra, India. order to improve access to quality and equitable healthcare. E-mail: [email protected] The Canadian Occupational Performance Measure (COPM) Effects of combining Botulinum toxin type was used as a client-centred outcome measure in a client with A injection with Robotic Gait Training on Guillain Barre syndrome. The client was assessed using the gait performance in patients with stroke: COPM on admission, and his Occupational Therapy program incorporated activities that he identified as important for him A preliminary report to improve. Majority of the chosen activities were related to mobility, transfers and ambulation. The COPM was repeated at Shih-Ting, Huang, Simon Tang discharge. The results showed a statistically significant increase in the client ratings of performance and satisfaction. This study Department of Rehabilitation Medicine, Lotung Poh-Ai Hospital, showed the effectiveness of the COPM as an outcome measure Yilan, Taiwan of Occupational Therapy in a long term rehabilitation setting. E-mail: [email protected] Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S3

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Efficacy of ‘speech companion’ app in were recruited from Neurology and Medical Rehabilitation facilitating oromotor strength in adult Department outpatient clinic. TUG time and turn step were recorded on each subject. patients with flaccid dysarthria Results: Mean TUG time was significantly higher in stroke Noorain Alam, Sanjay Munjal, Naresh Panda, patients (p=0.007). Among stroke patients, turn step was Ramandeep Kaur, Gurmannat Kaur Shipra strongly correlated with TUG time (p=<0.001, r=0.746). By using linear regression test, it could be seen that besides age Department of ENT, Speech and Hearing Unit, PGIMER, (p=0.009) and gender (p=0.031), Brunnstrom stage <5 was Chandigarh, India. an independent factor (p=0.002) inversely related to turn step E-mail: [email protected] in stroke patients. Background and Aims: Dysarthria affects respiration, phonation, resonance and articulation. Speech Companion Discussion: This finding is parallel with the fact that higher is downloadable Android app with a minimal cost that has Brunnstrom stage relates to better neuroplasticity. a collection of short videos in which a speech therapist demonstrates an exercise. Conclusion: Turn step can be used as a simple screening Aim: To assess the efficacy of Speech Companion mobile examination for balance in stroke patients, especially in patients app to improve the oromotor strength and range of motion of with lower Brunnstrom stage (<5). Furthermore, the results articulators in patients with Flaccid Dysarthria. of this study could seamlessly be used in a telerehabilitation Methods: Total ten patients diagnosed with Flacccid Dysarthria setting for stroke patients. were assessed by using the FDA which assesses the oro-motor parts in terms of structure, function and speech functions. They Effect of additional kinesiotaping in chronic were divided into subject group and control group comprising stroke rehabilitation patients underwent of five participants each. Speech therapy program involved facilitation of normal respiratory, phonatory, resonatory and weight shifting training on balance function articulatory functions along with oromotor strengthening exercises. In Subject group participants were asked to install Ronni Untung Handayanto, Robby Tjandra, the Speech Companion app. The clinician demonstrated its A. P. Rahmi Isma, Tanti Ajoe Kesoema use in the therapy session. The control group practised the exercises demonstrated without the use of any app. FDA was Department of Physical Medicine and Rehabilitation, Kariadi General re-administered and the performance of the two groups were Hospital, Semarang, Indonesia. analysed after six months. E-mail: [email protected] Results: On pre post therapy comparison between the two groups using Mann-Whitney U Test a significant improvement Background: Approximately 75% stroke patients are suffering was found in both groups which could be seen by improvement on longterm balance problem. Balance restoration still be a of grade in the sub sections of Lips(In speech, at rest, spread, challenging in chronic stroke rehabilitation. In most cases seal), Jaw (alternate), Tongue (In speech, at rest, protrusion, conventional rehabilitation alone found insufficient to increase lateral and alternate) and Intelligibility(conversation) (p<.05). the balance function. Kinesiotaping has been given widely A significant more improvement was seen in the ‘Speech as an additional therapeutic on neuromuscular disorder. Companion’ group as compared to the control group. Kinesiotaping are effective to increase joint stabilization and Conclusions: Speech Companion facilitates improved strengthened the weak muscles, which can be applied to Oromotor strength in Flaccid dysarthria. improve the balance of stroke patients. Brunnstrom stage as an independent factor Aim/Objective: To prove the effect of additional kinesiotaping affecting turn step in ischemic stroke on functional balance in chronic stroke rehabilitation patients patients underwent weight shifting training. Kevin Triangto, Febrian Mulya Santausa, Methods: This is a research experimental with pre-post test Widjajalaksmi Kusumaningsih, Salim Harris group design. 18 subjects are divided into 2 separated groups with randomization. Control group received weight shifting Department of Physical Medicine and Rehabilitation, National training alone, while the intervention group received weight Cardiovascular Center Harapan Kita, Jakarta, Indonesia. shifting training with additional of kinesiotaping. Balance E-mail: [email protected] function was measured using Berg Balance Scale before and Introduction: Stroke patients are often classified to have high after finished the intervention in 4 weeks. risk of fall. Timed Up and Go (TUG) test has been used as a screening test for balance in elderly people and the result is Result: No significant difference on balance function between strongly associated with fall risk. Among the components of groups before intervention (p= 0,391). After finished the TUG, turn step – the number of steps taken to turn 180o – is intervention there were a significant change on balance function one of the simplest component to observe. This study aims on both groups with (p=0,006) and (p=0,007), with a significant to evaluate TUG time in stroke patients, whether turn step is difference on balance function improvement between groups correlated with TUG time, and other factors affecting it. (p=0,000). Methods: Stroke (n=24) and non-stroke (n=35) patients Conclusion: Additional kinesiotaping are found effective to improve the balance function in chronic stroke patients underwent weight shifting training. Keywords: Balance, kinesiotaping, stroke, weight shifting training S4 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Clinical practice guidelines for stroke Methods: A total of 162 TBI patients were involved in this cross- rehabilitation from low and middle income sectional study design. The translation and validation process was conducted based on Beaton guideline for cross-cultural countries translation. The original version of QOLIBRI was translated into the Malay language. Then, factor analysis was used to check Ivy Anne Sebastian, I. A. Sebastian, for the validity of the instrument. D. B. C. Gandhi, S. K. Kamalakannan, A. Hombali, Results: The Malay version of QOLIBRI (M-QOLIBRI) proved G. Urimubenshi, M. J. Solomon reliable, with an overall alpha value of 0.911. Overall, ICC for M-QOLIBRI also shows a good value (ICC = 1.00), making Department of Neurology, St. Stephen’s Hospital, Delhi, India. the translated version more reliable. No significant correlation E-mail: [email protected] shown between the M-QOLIBRI score with patients age (r = Background and Aims: Clinical practice guidelines (CPGs) -.111, p > 0.05) and time since injury (r = -.117, p > 0.05). provide an evidence-based foundation to build optimal services Conclusion: This study shows that the M-QOLIBRI is reliable for people with stroke. In comparison to High Income Countries and can be implemented among the Malaysian population. where many comprehensive stroke rehabilitation guidelines The finding of this study can help in planning the proper and exist, identifying evidence-based guidelines specific to Low- appropriate treatment plan for TBI patients. and-Middle-Income Countries (LMICs) is challenging. This project aims to: 1. Evaluate the quality and content of existing Functional assessment of the inspiratory CPGs for Stroke rehabilitation from LMICs 2. Develop LMIC- muscles by ultrasound and electromyogram specific CPGs based on findings identified. Methods: This project will be executed by a multi-disciplinary during maximal inspiratory load core team of stroke rehabilitation professionals, through a multi-phased process. An advisory board of global stroke Hiroyasu Iwatsuki, Toshihiro Haba, and rehabilitation authorities with expertise in guideline Toshiya Urushihata development will provide periodic inputs wherever essential. Phase I: A systematic review on the existing CPGs for stroke Department of Physical Therapy, Aomori University of Health and rehabilitation from LMICs will be conducted. Quality and Welfare, Aomori, Japan. methodological rigour of the CPGs will be assessed based E-mail: [email protected] on an identified cut-off on AGREE-II and AGREE-REX tools. Purpose: Because respiratory muscles are skeletal muscles, Phase II: CPGs meeting the essential criteria in Phase I will be measurement of their muscle thickness by ultrasonic image and compared for content with standardized WSO Global services muscle activity by electromyography (EMG) can be used for guidelines and action plan, to identify existing gaps. quantitative evaluation methods. The purpose of this study was Phase III: LMIC-specific stroke rehabilitation CPGs will be to clarify the relationship between muscle thickness, measured developed informed by the merits and demerits identified in by ultrasound image, and muscle discharge of inspiratory previous phases. muscles, measured using surface EMGs, during maximum Results: Through this project we intend to study the quality forced inspiration. and content of CPGs for stroke rehabilitation, identify the Methods: The subjects were twelve health men who were existing gaps and develop new evidence-based CPGs specific laid down in the Fowler’s position. Both muscles’ thicknesses to LMICs. (right) and surface EMGs (left) in the sternocleidomastoid (SM), Conclusions: This study is designed with the larger objective external intercostal muscle (EI), and diaphragm (DM) were of identifying existing gaps in availability and implementation of recorded 5 times at the same point during maximum forced CPGs, and to develop CPGs for stroke rehabilitation specifically inspiration. Both the EI and DM were measured on the anterior tailored to LMICs. axillary line of the eighth intercostal space. The discharges of each muscle were quantified by the root mean square (RMS). Translation and validation of the Malay Results: Both the muscle thicknesses and RMS in three version of quality of life after brain injury muscles during maximal forced inspiration were significantly increased compared to during resting inspiration. As a result questionnaire of the correlation analysis, the correlation coefficients were SM (0.42), EI (0.51) and DM (0.58), respectively, and a positive Maisarah Rafek correlation was found between muscle thickness and RMS during maximum forced inspiration. Department of Physiotherapy, Royal College of Medicine Perak, Conclusion: The associated increase in both the thicknesses University Kuala Lumpur, Ipoh, Malaysia. of the three inspiratory muscles and RMS during maximal E-mail: [email protected] inspiration suggests that respiratory muscle activities during Background and Aims: Traumatic Brain Injury (TBI) is the inspiration can be visualized in ultrasound images. world-leading cause of death among children and young adult worldwide. Individuals with post-TBI will face many problems The effects of additional radial shock wave that lead to activity restriction and may reduce their quality of therapy on spasticity of upper extermity life. Quality of life after brain injury (QOLIBRI) is a questionnaire muscle used to measure the level of health-related quality of life among TBI survivors. Therefore, the aim of this study is to translate Go Linda Sugiarto, K. Tanti Ajoe and validate the Malay version of the QOLIBRI. Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S5

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Neurorehabilitation, Dr. Moewardi Regional Public containment zones, only 5.6% of responders used complete Hospital of Central Java, Surakarta, Indonesia. protective gear. Across both groups, the major change found E-mail: [email protected] was opting for caregiver education to reduce contact time and Background: Spasticity is one of the most common problems the use of telerehabilitation for prescription and supervision. and greatly interfere with functional capacity of chronic stroke patients. The most treatment commonly used to deal with Conclusions: This study establishes need for development of spasticity are infrared therapy and stretching exercise, but they practice-guidelines for rehabilitation providers in a hospital and have not been reducing spasticity effectively. The addition of home-based care to improve safety and process-flow. Need Radial Shock Wave Therapy was expected to be more effective to actively include rehabilitation professionals in respiratory/ in reducing spasticity of chronic stroke patients. sensory/motor rehabilitation during such pandemics is Objective: The purpose of this study is to prove that the essential. Developing national policies towards this aim is addition of RSWT is more effective in reducing spasticity of necessary. chronic stroke patients. Materials and Methods: This study is a simple randomized Expert consensus for in-hospital controlled pre and post experimental design. Total sample of rehabilitation for stroke during the 30 chronic spastic stroke patients with a modified asworth scale COVID-19 pandemic in low and middle 2-3, devided into 2 groups, study group and control group. RSWT provided once a week at muscle belly of flexor wist income countries muscle on ventral aspect of forearm, intrinsic muscle of hand, and flexor digitorum tendon are added onto infrared therapy and Dorcas Gandhi, S. Kamalakannan, stretching exercises in upper extremity which provide 3 times a M. Chockalingam, I. A. Sebastian, G. Urimubenshi, week, 6 weeks consecutive. Level of spasticity is measured by M. Alim, H. Khatter, S. Chakraborty, Tardieu Scale which measures quality and angel of resistance J. M. Solomon at the beginning and end of study. Result: Significantly greater reduction was obtained (p<0.05) Department of Neurology, Christian Medical College & Hospital, from the level of spasticity measured by Tardieu Scale, both on Ludhiana, Punjab, India. the quality and angle of resistance in the study group. E-mail: [email protected] Conclusion: The conclusion of this study is the addition of RSWT has been shown to have a greater reduction in spasticity Background and Aim: People with neurological dysfunction of upper extremity muscle of chronic stroke patients. have been significantly impacted in receiving adequate, quality rehabilitation services due to the ongoing COVID-19 pandemic. Survey on changes in neuro physiotherapy The objective of this study was to systematically develop practice at a hospital\\clinic and home- consensus-based expert recommendations for hospital-based neurorehabilitation during the COVID-19 pandemic for low- and based settings in India during COVID-19 middle-income countries based on available evidence. pandemic Methods: A multidisciplinary group of experts in stroke Dorcas Gandhi, Komal Bhanot, Himani Khatter, rehabilitation (core group) initiated this task. A six-stage scoping Jeyaraj Pandian, Mridul Makkar review methodology was conducted using a comprehensive search strategy with MeSH terms related to the aim. Searches Department of Neurology, Christian Medical College & Hospital, were run in MEDLINE and CINAHL on 12th September 2020. Ludhiana, Punjab, India. Specific statements with level 2b evidence from studies E-mail: [email protected] identified, were developed and circulated to 13 experts for Background and Aims: Amidst COVID-19 pandemic, consensus. The statements that received 80% agreement neuro-physiotherapy services have evolved due to various were grouped into relevant themes and recommendations practical challenges in India. This survey aimed to analyse the were developed. quantitative and qualitative changes in neuro-physiotherapy practice during the pandemic. Results: The search yielded 51 relevant studies addressing Methods: A cross-sectional survey (validated and reliable) aspects of neuro-rehabilitation. After data extraction, targeted to collect 100 responses from working physiotherapists 75 recommendations were generated which were across India who managed neurological cases during the categorized under 5 themes: Recommendations relevant to current pandemic either at homes or in a hospital setting. Rehabilitation Providers, Tele-rehabilitation, Rehabilitation Results: The study records 141 responses representing near- service/Administration/Management, Patients, Informal/ equal participation from India. A majority of responders worked Formal Caregivers Awareness/Education. Out of these, 72 in hospital/private clinics (74.5%). This group of responders recommendations received an agreement score of 3 by 80% modified their practice by performing online assessment or more of the expert participants27. These statements were (52.1%), reducing manual contact (45.7%), reducing number compiled as the expert consensus statements. (52.4%) & duration (41.9%) of sessions per patient. 67.6% of Physiotherapists (PTs) were not posted in COVID-19 wards. Conclusion: Development of this consensus statement is of Home-based therapists (47% responders) experienced a significance to stroke rehabilitation service providers and people decrease in the number of referrals. 61% of them did not visit living with disability resulting from stroke. Stakeholders involved in upholding standards for stroke rehabilitation practices in low- and middle-income countries must consider conversion of the consensus statement to minimum requirements within the context of the pandemic as well as for the future. S6 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Case report: Rare case of contralateral Investigation of component wise affection hemiplegia in stroke in children with DCD in age group of 6 to Nirav Joshi, Akash Shridharani 12 years Department of Physical Medicine and Rehabilitation, Amrita Eram Nizam Kazi, Suvarna Ganvir Hospital, Cochin, Kerala, India. E-mail: [email protected] Department of Neurophysiotherapy, D.V.V.P.F’S College of Physiotherapy, Ahmednagar, Maharashtra, India. The patient with sub-acute stroke and clinical history suggestive E-mail: [email protected] of Covid 19 infection, though RT-PCR was negative, came for Background: There are many evidences which shows that evaluation of stroke. He had a right upper limb weakness and children with DCD have difficulties that has considerable impact left lower limb weakness. This type of presentation is called on children’s daily activities as they lack the ability to plan and contralateral hemiplegia. It is a very rare presentation of stroke. organize themselves. There is a need for a component wise Horner’s syndrome and cerebellar signs were positive. MRI was analysis of the DCD screening questionnaire in these children done and it showed right lower medullary and right cerebellar so as to frame a rehabilitative goals accordingly. sub-acute infarcts. Rehabilitation was started for the patient. Methodology: 60 children in the age group of 6-12 years were Stroke evaluation was done. Aim of this case presentation is screened for the presence of DCD, using DCD questionnaire to discuss how contralateral hemiplegia occurs in right lower in Ahmednagar. The Questionnaire consists of 15 questions, medullary stroke and treatment guidance of rare case. each of which is given maximum score is 5. Score of 15-46 indication of DCD (5 years-7 years 11 months), 15-55 indicated Co-relation of axonal loss with duration (8 years–9 years 11 months) and 15-57 indicated (10 years and muscle weakness in patients with to 15 years). Component wise analysis was done in each age group along with gender specific evaluation. neuropathy: A retrospective study Results: 11 children were found to be affected with DCD. The results shows that the scores of components like catching a Ashwini Mishra, Suvarna Ganvir1 ball, writing legibly, bull in a shop, learning new skills, quick and competent and does not fatigue was overall low in both Department of Neurophysiotherapy, Dr. Vitthalrao Vikhe genders among children in 6-12 years of age. On further age Patil Foundation, College of Physiotherapy, 1Department of wise analysis, in addition to above components, jumping Neurophysiotherapy, DVVPF’S College of Physiotherapy, over, writing fast, cutting and likes sports were affected in age Ahmednagar, Maharashtra, India. 6-7, running, efforts and pressure in age 8-9, throwing a ball, E-mail: [email protected] jumping, likes sports in age 10-12. Conclusion: Children with DCD shows the affection of fine Background: Electrodiagnostic test plays an important motor activities and general co-ordination which needs specific role in defining the presence of Neuropathy. Axon loss may focus of therapeutic Physiotherapy intervention. also contribute to the weakness. However, it has not been extensively studied that to what extent axon loss occurs and Stressors in parents of school going children to what extent it contributes to weakness. with ADHD aged 6–12 years and perceived barriers in Occupational Therapy program Aim: To correlate the Axonal loss with duration and muscle weakness in patients with Neuropathy. participation Methodology: In the present Retrospective Study, data Richa Deshmukh, Usha Kasar analysed was of previous two years and 26 Patient with lowerlimb neuropathy, age ranging from 20- 80 years including Department of Occupational Therapy, Seth G S Medical College and both Gender. Nerve conduction study were performed using KEM Hospital, Mumbai, Maharashtra, India. surface electrode and the axonal loss was calculated for Tibial E-mail: [email protected] and Peroneal nerves. Muscle strength was assessed using Background: Parents of children with ADHD could experience Manual muscle testing. And duration of the patient complaint some mental or physical exhaustion as they are required to be were noted. Logistic Regression analysis was used to assess hypervigilant, always. During treatment sessions, families could the axonal loss with the strength and the duration. experience barriers which could cause hindrance in regular participation, discontinuation, and dropouts from treatment. It is Result: The mean axonal loss for Tibial nerve and Peroneal necessary to identify personal, economical, logistical barriers; nerve was 53.1% and 67.2%. The overall strength was 2.8 determine stress levels in parents; and address them to prevent (Median) and mean duration of symptoms was 157 days. irregularities during therapy. Univariate analysis revealed that axonal loss was extremely Aim: To study stress levels in parents of school going children significantly associated with the strength of muscle (p<0.0001). with ADHD, aged 6-12 years and determine barriers in Axonal loss of Tibial nerve was significantly positively Occupational Therapy program participation. associated with the duration of the symptoms (p<0.01) and Methods: After Institutional Ethical permission and parents’ that of peroneal nerve was very significantly associated with consent, 74 parents of children with ADHD participated. the duration of symptoms (p<0.007). Demographic data was collected, parents were asked to mark responses on Kuppuswamy socioeconomic scale (2018), Conclusion: Axon loss occur in Neuropathy leading to the axonal degeneration and play an important role in affecting the strength of the muscle. And the axonal loss increases with the increase in the duration of the symptoms. Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S7

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract parental stress scale (PSS), Barriers to Treatment Participation many of which are directly related to loss of muscle and related Scale (BTPS)-parent version. motor functions. Results: On analysis following significant barriers were found: Objectives: 1. To find effect of 9 weeks rehabilitation training Competing life stressors: 35%, Relevance of treatment: 19%, on NCV and QOL in patients with spinal cord injury. 2. To Relationship with therapist- 11%, Treatment issues: 17%, determine the changes in functional activity after 9 weeks Critical events: 18%. PSS- mean score was 63.837. (Total-90) of rehabilitation training in patients with SCI. 3. To find the Positive correlation was seen between BTPS 4 categories association between functional activity, QOL and NCV after 9 & PSS using Spearman’s correlation coefficient. Negative weeks of rehabilitation training in patients with spinal cord injury. correlation was seen between BTPS-relationship with therapist Methods: The study included 10 participants with incomplete and parental stress score using ANOVA. In 7 categories level of injury with traumatic and non – traumatic SCI according to order of child birth, highest level of stress was participants aged between 18 to 55 years. seen in 3rd/3 order of birth, least was seen in 2nd/2 order. Study Design: Pre and Post study design. Inclusion and Conclusion: Findings of the study are suggestive of exclusion criteria were used for selection of patients with SCI. empowering &training parents, weekend training/treatment Outcome Measures: SCIM-III, WHOQOL & MNCV, SNCV programs so families can participate as per their convenience, were assessed while the recruitment and after 9 weeks of providing telerehabilitations, setting up mobile therapy vans, functional training. increasing the number of Government OT setups for easy Result: A Paired – t- test concerning Pre and Post values: availability & affordability of services. SCIM-III is statistically significant with P value is 0.0047, WHOQOL is statistically significant. A Pearson correlation for: Intrathecal baclofen pump in post-stroke SCIM-III with WHOQOL (Domain 1) r = 0.64 with P value (0.04), rehabilitation: Our experience 95% confidence interval, considered significant. SCIM-III with WHOQOL (Domain-2, Domain–3, Domain-4) 95% confidence Ramnarayan Ramachandran, Raju Raman, interval, considered not significant. P. Marimuthu Conclusion: We found out that positive relationship exists among physical activity and QOL. So, physical activity improves Department of Neurosurgery, New Hope Hospital, Chennai, the QOL and NCV of the patients with SCI. Tamil Nadu, India. E-mail: [email protected] DBS of amygdala in Autism – A case report Background and Aims: About 30 to 40% of stroke survivors are chronically crippled. The main reason for this is the Ramnarayan Ramachandran spasticity which appears after a stroke. The usual treatments for spasticity are not very useful in many patients. Here we Department of Neurosurgery, New Hope Hospital, Chennai, describe our experience of intrathecal baclofen pump insertion Tamil Nadu, India. for this problem. E-mail: [email protected] Methods: This is a retrospective case note plot study of Aim: Autism spectrum disorders are becoming a big problem seventeen patients with post stroke spastic hemiplegia of more nowadays. Atleast 50% of the patients present with severe than one year. Of these eleven underwent intrathecal baclofen aggressive behaviour as they grow up. pump surgery after trail and six did not. Comparison is made Methods: We describe our experience of a 30 year old man among these two gropus on the quality of life at 1 year. with severe aggressive behaviour and autism. He underwent Results: Ten of them were men and nine had right hemiplegia. DBS surgery in March 2020. Eleven were ischaemic stroke and six haemorrhagic strokes. Results: One year after surgery, patient had excellent reduction Modified Ashworth scale (MAS) 3 to 4 in all cases. Ten patients of the aggressive behaviour and also improved in some autistic underwent intrathecal baclofen pump after positive trail. Follow features like speech and attention span. up was upto an year. At one year the MAS scores and the Conclusion: DBS could be an option for selected patients with Stroke specific QOL was much better in the operated group autism associated aggressive behaviour. than in the non-operated group. Conclusion: Intrathecal baclofen pump may be beneficial in Development and validation of selected cases of post stroke sever spastic hemiplegia. Ahmednagar neuropathy screening instrument for diagnosing diabetic Long term effect of functional training on quality of life in patients with spinal cord neuropathy injury hyphen pilot study Aditi Hari Bhilwade, Suvarna Ganvir1 Rabina Sanjay Nayak, Maheshwari Harishchandre, Department of Neurophysiotherapy, DVVPFS College of Suvarna Ganvir Physiotherapy, Ahmednagar, Maharashtra, India, 1Department of Neurophysiotherapy Department of Neurophysiotherapy, DVVPFS College of E-mail: [email protected] Physiotherapy, Ahmednagar, Maharashtra, India. Background: Diabetic neuropathy is a leading cause for E-mail: [email protected] disability which leads to foot ulceration and amputation. There Background: Spinal cord injury is a common source of chronic is a need for robust, comprehensive screening instrument disability and is accompanied by a host of health-related issues, S8 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract which can cover all aspects related to clinical aspects of nerve recall of Japanese syllabary tasks compared to no load. During dysfunction and hence a new screening tool was developed. the VFT, a positive correlation was found between oxyHb in The aim of the study is to report development and investigation bilateral sides parts and trunk sway, lateral component of a of the psychometric properties i.e., Sensitivity and specificity force plate. of the newly developed screening instrument for diagnosing Conclusion: These results indicated the walking performance Diabetic Neuropathy. changed even during constant-speed walking under the Methodology: Thorough investigation of currently available activities of the prefrontal cortex increased. screening instruments was done. Component wise analysis was done it was found that components like temperature, sensation, Immediate effect of home made adaptive reflexes, muscle strength were missing, description are not seating device on functional performance properly given so there was difficulty in scoring the patient and in children with cerebral palsy colon a case after incorporating them ANSI was developed. The scale was reviewed by experts in the field of Neurophysiotherapy and series after appropriate modifications the components of tool were finalized. The Ahmednagar Neuropathy Screening Instrument Prachi Sanjeev Bhagat, Suvarna Ganvir scale consist of 5 domains that are Muscle strength, Reflexes, Sensation, Symptoms and Appearance of feet which are Department of Neurophysiotherapy, DVVPFS College of further classified into components. We have analysed 100 Physiotherapy, Ahmednagar, Maharashtra, India. patients using this screening tool, out of which 35 patients E-mail: [email protected] were diagnosed with diabetic neuropathy and also, we have Background: Inability to continue face to face treatment due compared with MNSI score. to lockdown resulted in poor functional performance at home Result: The total score of Ahmednagar Neuropathy Screening in children with postural instability. Hence as an alternative, Instrument including all the component is 68 and the score of home made adaptive seating device (ASD) was proposed to 45 shows 73% of Sensitivity and 50% of Specificity. enhance postural stability in these children. Conclusion: The accuracy of ANSI scoring makes it a useful Aim: To study the effect of Home made ASD on functional screening test for diabetic neuropathy and further investigations performance in children with cerebral palsy. on psychometric properties that is sensitivity, specificity & Methodology: In the present case series study, Parents and proper validation of the scale should be done. their children diagnosed as CP (n=6) mean age of 3 years participated. They required trunk support to maximize hand Effects of prefrontal cortex activity on function when sitting on chair. Demonstration of ASD with language fluency tasks (VFT) during anterior support to chest was given to parent through virtual platform and parents were asked to provide the same to their walking on a treadmill child. Canadian Occupational Performance Measure was used to evaluate immediate changes in activity performance Hiroyasu Iwatsuki, Toshihiro Haba, and satisfaction through parent ratings with and without ASD. Toshiya Urushihata Result: Parents identified 3-5 activity performance issues for their children. The mean performance scores was 4.04 and Department of Physical Therapy, Aomori University of Health and satisfaction scores was 4.64 without ASD. With ASD there welfare, Aomori, Japan. was increase in performance and satisfaction scores by an E-mail: [email protected] average of 5.6 and 5.9 respectively. Data analyzed using paired Purpose: Activation in the frontal cortex, including the t-test demonstrated significantly improved performance and premotor cortex and the supplementary motor areas, have satisfaction with p< 0.03 and p<0.04. been reported to increase during gait by studies using near- Conclusion: Parents reported that their children were more infrared spectroscopic imaging. The purpose of this study was able to engage in self-care and play activities using ASD and to clarify the relationship with changes of gait parameters when activity performance and satisfaction improved when using some tasks are applied to the prefrontal cortex activation while adaptive seating devices at their home. walking on a treadmill. Methods: 12 healthy young people with an accelerometer Development and validation of the attached to the 3rd lumbar vertebra walked (2 km / h) for educational handout (parent-mediated early 60 seconds on a treadmill with a force plate. At same time intervention) of caregivers in promoting 7 to prefrontal cortex activities were measured using a near- infrared photoimaging device. The tasks were no load, verbal 9 months baby’s development fluency task (VFT), and recall of Japanese syllabary, and each task was performed twice with a break. A 16-channel Manasa Kolibylu Raghupathy, probe was placed on both frontal regions to record changes Bhamini Krishna Rao, Leslie Edward Lewis in oxygenated hemoglobin (oxyHb). The analysis was divided into three regions: the central part, and the left and right parts. Department of Physiotherapy, Manipal College of Health All participants in the experiment received an explanation of Professions, Manipal Academy of Higher Education, Udupi, the experiment in advance from the researchers and signed Karnataka, India. the consent form. E-mail: [email protected] Results: The OxyHb and lateral component of a force plate Background and Aim: Preterm infants are at risk of global while walking were significantly increased in the both VFT and developmental delay in various domains. It is important to Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S9

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract keep these babies under constant surveillance and refer them ambulation were that walking was inconvenient, tedious and to early intervention services if needed. Educational handouts fatiguing; uneven terrain, fear of fall, back or shoulder pain. might empower/ motivate parents to deliver the intervention. There was a statistically significant decrease in percentage of Parents might act as a primary therapist while performing ambulators with increasing age and duration since the injury activities described in this handout and monitor the child’s and presence of co morbidities. growth creating an enriched stimulated environment (parent- infant interaction/bonding) at home. Conclusion: Most paraplegics trained in functional community Aim: To develop and validate an educational handout as a ambulation discontinue walking after a few years due to various guide for caregivers to promote their child’s development during reasons. It is essential to include wheel chair training and 7 to 9 months. achieve wheel chair independence for all complete thoracic Methods: The initial content of the leaflet was formulated level paraplegics. Ambulation training with focus on short by literature review and clinical experience of authors. The distances or therapeutic standing a few times a week can be framework consisted of an introduction, facilitation activities offered. with pictorial representation, instructions, do’s–don’ts, and disclaimer. The validation was conducted through a Recurring seizures in epilepsy and cognitive questionnaire (9 items): completeness, clarity, understandability, impairment; successfully using “brainnext” legibility of educational material for caregivers, and a section tools for cognitive rehabilitation at epilepsy for comments. The handout with the enclosed questionnaire was distributed to 5 validators (1 Pediatrician, 3 Pediatric foundation, Mumbai India Physiotherapists, and 1 parent) to score based on a 4 points Likert scale. Mangal Kardile, Nirmal Surya1 Results: Responses from 5 validators were collected and analyzed. Item Level Content Validity Index (I-CVI) was Department of Clinical Neuropsychology, Epilepsy Foundation, calculated for individual items which ranged from 0.89- 1. Scale 1Founder, Epilepsy Foundation, Mumbai, Maharashtra, India. Level Content Validity Index (S-CVI) was calculated for 9 items, E-mail: [email protected] and it was found to be 0.98. Conclusion: Handout for caregivers of 7-9 months infant’s Background and Aims: Epilepsy and Cognitive impairment development has been developed and validated. It can be have an important consideration in learning&memory. Mostly, distributed in low resource/ clinical settings to encourage Epilepsy population observed to be <45 years, compromising parent’s active participation in their child’s development quality-of-life with longest-YLD. Recurring seizures cause sensory-information loss, taking brain backwards in learning. Functional community ambulation and If these widespread-gaps not filled on-time, brain stagnates at its correlates in previously rehabilitated its baseline-condition. The study aims at sensory-information participants with complete spinal cord loss with recurrent seizures having bilateral-epilepsy, involving corpus-callosum in A, B, C persons-with-Epilepsy causing injury t 12 and above global cognitive decline and using ”BrainNext” program, based on Synaptic-plasticity, for successful memory, cognitive and Annabelle Prithwini Kaunds, Henry Prakash, behaviour rehabilitation, offline-online modes at Epilepsy A. Elango, A. Augustin, T. Senthilvelkumar Foundation, India. Department of Physical Medicine and Rehabilitation, Christian Methods: With consent A, B, C Male, persons with uncontrolled- Medical College, Vellore, Tamil Nadu, India. epilepsy, ages 11-17 years, tested offline with “BrainNext” E-mail: [email protected] tools for cognitive domain and given 15 days program. Three Background and Aims: Functional ambulation is the ability follow-ups with 15 days interval before Covid-19 and regular to walk safely and sufficiently to carry out mobility related weekly-follow-ups conducted online for 5 months during Covid. activities of daily living. In most Indian rehabilitation institutes, Caregivers reported patient’s progress online. On each follow- T8-T12 paraplegics are trained with KAFO (Knee Ankle Foot up previous exercises rehearsed, and new exercises added. Orthosis) for therapeutic and functional ambulation, while also Progress measured as 1 (10%), to 10 (100%) scale, 0% as being given wheel chair skills training. There is lack of evidence baseline condition. at the community level for functional ambulation in complete paraplegia. The aim was to study the community ambulation in Results: A, B, C persons with severe epilepsy, showed previously rehabilitated paraplegics T12 and above who were >10% recovery in two weeks, improved visual stability, functionally ambulant at discharge and the factors associated following simple instructions. Speech-Object recognition-facial with the outcome. expression, visual-motor-spatial coordination improved >25% Materials and Methods: Participants fulfilling inclusion criteria normalizing behavioural responses in 2 months. Overall >60% were recruited after informed consent, through Spinal Cord Injury improvement observed in 6 months from baseline condition Melas, Mini Melas, home visit or in the Out-Patient Department with offline-online follow-ups. and assessed using the SCIM, WISCI II and Proforma. Data was entered using EpiData and analysed with SPSS. Conclusions: Involvement of corpus-callosum with bilateral- Results: Of the 90 participants studied, 9% were observed cortical-deficit is unique, challenging hemispheric coordination functional community ambulators. The causes for non- in cognitive rehabilitation. Although uncontrolled seizures in patients A, B, C, having long term severe cognitive deficit, sensory-information gap could be retrieved > 60% from baseline condition with “BrainNext” rehab-program around 6 months. S10 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Botulinum toxin for post COVID-19 facial stroke, as compared to no treatment. However, the functional palsy with bogorad syndrome recovery is not always satisfactory as only 20% of patients fully resume their social life and job activities. Hence, the need of Ayush Dubey, Shubham Dubey more effective and patient-tailored rehabilitative approaches to maximize the functional outcome of neurological injuries Department of Medicine, GMC & Hamidia Hospital, Bhopal, Madhya as well as patients’ quality of life. Modern technological Pradesh, India. methodologies represent one of the most recent advances E-mail: [email protected] in Neuro Rehabilitation, and an increasing body of evidence Background and Aims: The current ongoing pandemic of supports their role in the recovery from brain and/or medullary Covid-19 infection has been responsible for a lot of morbidity insults. Orthoses and assistive devices are tools that assist in as well as mortality in the world. Out of the many neurological moving and performing tasks of daily activities. An Orthosis is complications of Covid-19, isolated facial palsy has also been a device that provides support to a weakened or paralyzed part seen and reported. Bogorad syndrome (gustatory lacrimation) of the body which includes static and dynamic splints. Assistive is a rare complication of facial palsy. We describe such a case devices include walkers, wheelchairs, long-handled reachers, who was treated successfully with botulinum toxin. crutches, canes, and mobility aids. The assistive devices and Methods: A 42 year male was diagnosed to be having Covid-19 Orthoses are generally used in combination with exercise. It infection after having symptoms of fever, breathlessness and helps to open and close things, transfer weight when shifting received treatment after hospitalization. Around 20 days after positions, hold objects or assist while walking. discharge, he developed facial deviation to left side with loss Methods: Robots for Neuro Rehabilitation are designed to of wrinkles over right side of forehead and obliteration of right support the administration of physical exercises to the upper or nasolabial fold. There was involuntary spillage of water from lower extremities, with the purpose of promoting Neuro-motor his right angle of mouth. It was diagnosed as LMN type of right recovery. This technology has a relatively long history, dating facial palsy and he was given steroids as well as antivirals back to the early 1990s. Robotic devices for rehabilitation differ along with physiotherapy. He had almost complete recovery widely in terms of mechanical design, number of degrees of in his facial deviation but developed a new complaint of having freedom, and control architectures. As regards the mechanical tearing while eating after around 4 months of facial palsy. He design, robots may have either a single point of interaction was diagnosed to be having Bogorad syndrome/ gustatory (i.e., end effector) with the user body (endpoint robots) or lacrimation/ crocodile tears. When his symptoms did not get multiple points of interaction (exoskeletons and wearable relieved after 15-20 days, we injected botulinum toxin 2.5 units robots) (A1) Endpoint robots: on the left the manipulandum, transcutaneously in the parotid gland. on the right the postural robot. A1 is a planar manipulandum Results: There was substantial benefit in his lacrimation as developed at Geneva, Italy, with 2-DOF it is equipped with ascertained by Schirmer’s test after 1 week and 1 month after direct-drive brushless motors and is specially designed to injection. minimize endpoint inertia. It uses the H3DAPI programming Conclusions: Post covid neurological complications include environment, which allows to share exercise protocol with facial palsy. If gustatory hypersalivation occurs, transcutaneous other devices. A1 is a robotic device that permits full-body botulinum toxin is an important tool for rehabilitation in such rehabilitation. It has two 2-DOF actuated and sensorized patients. platforms located under the seat and on the floor level that allow it to rehabilitate several body districts, including lower limb, the Advances in orthotics and assistive core, and the back, using the platform located underneath the technology in neuro rehabilitation seat. Different patient categories (orthopedic, neurological, and geriatric) can be treated, and interact with the machine Lukeshkumar Rajendra Bhuyar, Ashok G. Indalkar, through a GUI based on serious games. (A2) Wearable P. S. Dantala device: the recent exoskeleton Twin. Twin is a fully modular device developed at IIT and co-funded by INAIL (the Italian Department of Orthotics and Posthetics, All India Institute of Physical National Institute for Insurance against Accidents at Work). The Medicine & Rehabilitation, Mumbai, Maharashtra, India. device can be easily assembled/disassembled by the patient/ E-mail: [email protected] therapist. It provides total assistance to patients in the 5–95th According to the World Health Organization (WHO), percentile range with a weight up to 110kg. Its modularity is neurological disorders and injuries account for the 6.3% of implemented by eight quick release connectors, each located the global burden of disease (GBD). With more than 6% of at both mechanical ends of each motor that allow mechanical DALY (disability-adjusted life years) in the world, neurological and electrical connection with the rest of the structure. It can disorders represent one of the most widespread clinical implement three different walking patterns that can be fully condition. Among neurological disorders, more than half customized according to the patient’s needs via a GUI on mobile of the burden in DALYs is constituted by cerebral-vascular device, thus enabling personalization of the therapy. Steps disease (55%), such as stroke. Stroke, together with spinal can be triggered via an IMU-based machine state controller. cord injury (SCI), accounts for 52% of the adult-onset disability (B1) Repetitive transcranial magnetic stimulation (rTMS) and, over a billion people (i.e., about a 15% of the population representation. rTMS refers to the application of magnetic worldwide) suffer from some form of disability. These numbers pulses in a repetitive mode. Conventional rTMS applied at are likely to increase in the coming years due to the aging low frequency (0.2–1Hz) results in plastic inhibition of cortical of the population, since disorders affecting people aged 60 excitability, whereas when it is applied at high frequency (5Hz), years and older contribute to 23% of the total GBD. Standard it leads to excitation. rTMS can also be applied in a “patterned physical rehabilitation favors the functional recovery after mode.” Theta burst stimulation involves applying bursts of high Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S11

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract frequency magnetic stimulation (three pulses at 50Hz) repeated Background: Children with Autism spectrum Disorders (ASD) at intervals of 200ms. Intermittent TBS increases cortical have predominantly social impairment but significant physical excitability for a period of 20–30min, whereas continuous TBS features are also found which include hypotonia, motor apraxia, leads to a suppression of cortical activity for approximately the gross and fine motor delay. Smooth, targeted, and accurate same amount of time. (B2) Transcranial current stimulation movements require the harmonious functioning of sensory (tCS) representation. tCS uses ultra-low intensity current, to input, cognitive functioning for processing and coordination with manipulate the membrane potential of neurons and modulate cerebral functions. ASD children exhibit decreased cognitive spontaneous firing rates, but is insufficient on its own to functioning which is one of the basic component required for discharge resting neurons or axons. tCS is an umbrella fine motor skills (FMS), but the impact of cognitive functioning term for a number of brain modulating paradigms, such as on FMS and their level of Adaptive functioning is not clear. transcranial direct current stimulation, transcranial alternating Aim: The aim of this study is to explore the impact of cognitive current stimulation and transcranial random noise stimulation. functioning on FMS and level of Adaptive functioning in ASD. (C) A typical BCI system. Five stages are represented: brain- Methods: This cross sectional study was carried out in 65 ASD signal acquisition, preprocessing, feature extraction/selection, children who met the inclusion criteria in the age group of 3-4 classification, and application interface. In the first stage, years of age. Subjects were recruited from Vidyasudha – School brain-signal acquisition, suitable signals are acquired using an for children with special needs, Sri Ramachandra Institute of appropriate modality. Since the acquired signals are normally Higher Education and Research. Children diagnosed with ASD weak and contain noise (physiological and instrumental) and were quantified with Childhood Autism Rating Scale (CARS) artifacts, preprocessing is needed, which is the second stage. and assessed for the level of FMS with Peabody developmental In the third stage, some useful data or so-called “features” are motor scale (PDMS2). Cognitive and Adaptive functioning was extracted. These features, in the fourth stage, are classified assessed using Developmental assessment for young children using a suitable classifier. Finally, in the fifth stage, the classified (DAYC 2). signals are transmitted to a computer or other external devices Results: Pearson’s correlation showed positive correlation for generating the desired control commands to the devices. between FMS and Cognition with r value of > 0.5. FMS showed In neurofeedback applications, the application interface is a a strong positive correlation with Adaptive functioning with r real-time display of brain activity, which enables self-regulation value of > 0.8 at p 0.05. The results convey that decreased of brain functions. coginition affects the FMS which in turn has an impact on the Results: Here we tried to overview the developments adaptive behavior of the ASD children. of advances in Orthotics and Assistive devices in Neuro Conclusion: The study concludes that cognitive deficits Rehabilitation. We will describe more devices in final directly influence FMS and thereby the adaptive behavior of presentation. ASD children. The result of the study strongly emphasizes that Conclusions: The role of Orthoses and Assistive devices Paediatric therapist should individualize treatment based on relates to the overall rehabilitation goal of eliminating, cognitive levels which should be considered and simultaneously minimizing or helping patients to overcome the limitations addressed when training FMS and Activities of Daily Living in imposed by their underlying Neurological disorders across ASD children. areas of physical, cognitive, and psychosocial functions. While some Orthoses and Assistive devices allow a patient to achieve Effectiveness of stroke step down care a degree of independence in a single area of function (such (SSDC): Post Stroke care transitional as mobility). Pediatric rehabilitation seeks to treat that patient program - From Acute centre to community as a whole person across his or her activities of daily living, learning, leisure and recreation, and/or vocational functions. care Thus, the role of orthotic and assistive devices needs to be seen not just within the context of independence but also Nabilah Binti Abdul Rahman, Tan Hon Yin, within the context of interdependence with others in a person’s Fikriah Abdullah surroundings. The key to identifying the most appropriate Orthosis, augmentative communication or Assistive technology Department of Rehabilitation Medicine, Hospital Sultanah Bahiiyah, system is being creative and having a proper understanding of Alor Setar, Malaysia. the anatomical, biomechanical, language and communication, E-mail: [email protected] and social networking needs of the patient and being sensitive Introduction: Stroke is the third commonest cause of disability to the patient’s (or the parents’) preferences and desires. worldwide. It is important to form a coordinated transitional post stroke care program from acute center to community. Impact of cognitive deficits on fine motor Stroke Step Down Care (SSDC) program is aimed to improve skills and adaptive behaviour in autism continuation of medical and rehabilitation management, achieving treatment goals and optimizing functional ability spectrum disorders post stroke. Methods: This is a prospective cohort study (2015 -2019) Rajeswari Muthusamy, P. Ramachandran, evaluating effectiveness of medical and rehabilitations Binu Ninan, Sailakshmi Ganesan management of stroke patients that were discharged from acute care, then directly followed up at the community health Faculty of Physiotherapy, Sri Ramachandra Institute of Higher center near their locality. Patients undergo continuations of Education and Research. Chennai, Tamil Nadu, India. medical and rehabilitations management at the community E-mail: [email protected] S12 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract health center; under the community doctors and therapists; with speech and language disorders, but with few exceptions, with intermittent neurologist and physiatrist visits from acute it is most effective for less severe disorders. Nevertheless, hospital. The following parameters were monitored at the first even children with the most severe disorders can develop appointment and six months follow up ie: appointment default enhanced, functionally important communication skills that have rate, Modified Barthel Index (MBI), blood pressure control, lipid a meaningful impact on their lives even though their speech control, glycemic index (HbA1C), statin and antiplatelet usage. and language disorders have not been completely resolved. Results: We compared data on the initiation year (2015) with Keywords: Cognition, epilepsy, language, teletherapy subsequent year. There is reduction in default follow up cases from 23.5 % (2015) to 22.5% (2017), 20.6% (2018) and 20.0% The effect of placement tens electrode in in 2019. We also observed improvement in achieving target agonist muscle compare with antagonist control in the following parameters after 6 months of follow up ie; Modified Barthel Index (MBI - achivement >75/100) from muscle in stroke ankle plantar flexor 60.8%(2015) to 74.6% (2017) 85.7 % (2018) 87.0% (2019); spasticity Diabetic control (HBA1C <6.5%) from 36.1% (2015) to 52.1% (2018) 59.1 % (2019); Lipid control (TC < 4.0mmol) from Meisy Andriana, M. Andriana, Y. C. Suisan, 31.6% (2015) to 37.0% (2017) to 56.0 % (2018) 64.9 % (2019); R. Satyawati Blood pressure control (< 140/80mmHg) from 53.6 %(2015) to 65.3% (2017) 68.0% (2018) 71.4%(2019); prescriptions of Department of Physical Medicine and Rehabilitation, Medical antiplatelet from 85.0 % (2015) to 96.4% (2018) 99.5% (2019) Faculty, Academic General Hospital Dr Soetomo, Universitas and prescriptions of statin from 74.6 % (2015) to 75.1% (2017) Airlangga, Surabaya, Indonesia. 96.4% (2018) 100% (2019). All parameters monitored shown E-mail: [email protected] significant improvement throughout the years. Background: Spasticity in stroke especially in lower extremity Conclusion: SSDC is able to improve medical and rehabilitation result to pain, contractur, disturbance of postur control, care post stroke by increasing the compliance of follow up, mobilisation and increase of fall. Decrease spasticity in plantar achieving treatment goals and optimizing functional post stroke. flexor ankle connecting with stride length and walking speed and increase the quality of life in stroke. The effects of epilepsy on language Purpose: To determine the optimal location to placement TENS development and cognition in children and electrode to decrease spasticity in stroke ankle plantar flexor. Methode: Ten subject were randomly allocated into two groups. its persistence with tele-therapy Subject in group agonist was given TENS in Gastrocnemius muscle, and for group antagonist given TENS in Anterior tibialis Alifia Bharmal muscle. After wash out period 1 week. 10 subject allocated in group opposite. TENS was applied over belly of Gastrocnemius Department of Speech Therapy, Epilepsy Foundation, Mumbai, muscle for 45 minute, rectangular monophasicwaveform at Maharashtra, India. 100 Hz frequency, 125 ms pulse width, with intensity sensory E-mail: [email protected] threshold 2x. Background and Aims: The speed at which language Result: Group agonist show amplitudo sEMG significant and cognition is developing in children is truly remarkable. decrease, group antagonist also show amplitudo sEMG As the child is adding new language skills, the child’s brain significant decrease. Decreasing the spasticity until 30 minute undergoes changes. On the other hand cognition involves after receive TENS. Group agonist show more decrease sEMG memory, thought, learning problem solving, organization, amplitude compare with group antagonist. and storage. The interplay of all these factors results in Conclution: This research show that placement TENS language development. Epilepsy and language are linked electrode in group agonist improve spasticity in stroke ankle together as they both are generated in the brain. A connection plantar flexor more than in group antagonist. exists between children with epilepsy also having language Keywords: Agonist, antagonist, sEMG, spasticity, impairment. Seizures and any type of epilepsy diagnosed can transcutaneous electrical nerve stimulation cause such disturbance in the brain that can have lasting effects on language development and cognition in children. Effect of McConnell patellar taping for gait Methods: This study aimed to produce online teaching material velocity, step length, and stride length in in Speech language Therapy suitable for children age range subacute stroke patient 5-15 years on the online material, record their performance when taught through this innovative method. It also explored Cokorda Gde Bayu Baskara Putra, the relationship between engagement with the module and Cokorda Baskara, Yudith D. Prawitri, Alit Pawana, performance. Patient evaluations of the online therapy were Meisy Andriana also recorded as was their engagement with the online module. Results: Results revealed both telehealth made significant and Departement of Physical Medicine and Rehabilitation, Faculty similar improvements when treatment effects were measured. of Medicine, Dr Soetomo Academic General Hospital, Airlangga Findings showed there is limited but promising evidence to University, Surabaya, Indonesia. support telehealth for delivering speech-language pathology E-mail: [email protected] intervention services to school-age children with epilepsy. Background: Stroke: the most common cause of disability, Conclusions: Before beginning it is important to emphasize with gait disturbance as one of its main problems The use of that treatment is considered to be essential for all children Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S13

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract McConnell patellar taping for gait management in stroke is Efficacy of ultrasound guided steroid increasing and promising There is no data regarding use of injection in carpal tunnel syndrome - A McConnell Patellar taping in stroke patient in Indonesia. prospective comparative study Purpose: to investigate effect of McConnell patellar taping in gait velocity, step and stride length in subacute stroke Merrin Meria Mathew patient. Department of Physical Medicine and Rehabilitation, All India Methode: 8 subacute stroke patient with inclusion criteria was Institute of Medical Sciences, Jodhpur, Rajasthan, India. applied McConnell patellar taping with medial patella attraction E-mail: [email protected] for 30 minute. Gait analysis performed before and after the Background: Though widely used, there is no guideline as application of McConnell patellar taping. to which corticosteroid injection has to be used as standard treatment in CTS. Triamcinolone (most commonly used) and Result: These result showing McConnell patellar taping Dexamethasone (least neurotoxic with better safety profile) are increase gait velocity in sub acute stroke patient. Increasing being compared for their efficacy in CTS. gait velocity without increase step length and stride length may Aim: To compare the efficacy of Dexamethasone and be due to cadence. Gait velocity 0,80m/s is the velocity that Triamcinolone injection in patients with CTS. suggested to do effective ambulation in community. Methods: 69 patients who attended Out-patient clinic of PMR Department at AIIMS Jodhpur who were clinically diagnosed with Conclusion: McConnell patellar taping increase gait velocity in CTS and confirmed by electrophysiological studies, received sub acute stroke patient Further study with large sample size one-session of ultrasound-guided perineural injection by In-Plane and longer intervention period are needed. Axial Ulnar Sided Approach with 4ml of either Dexamethasone [8mg (2ml) mixed with 2 ml 0.5% bupivacaine] or Triamcinolone Keywords: Gait performance, McConnel patellar taping, [40mg/ml (1ml) mixed with 3ml 0.5% bupivacaine] and followed subacute stroke up with Visual Analog Scale (VAS) score at 0,2,4 months, Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score at 0,2,4 Genetic influences on response to months and Nerve Conduction Study (NCS) changes of the transcranial direct current stimulation in median nerve - Sensory Nerve Conduction Velocity (SNCV) and Distal Motor Latency (DML) at 0,4 months. Data analysis swallowing motor cortex was done using IBM SPSS version 26. Independent-Samples t-test was used for comparison between groups and paired t test Sun Im, Hyemi Hwang, Hae-Yeon Park, for improvement within each group. A p value < 0.05 has been Hyun-Mi Oh, Tae-Woo Kim, Geun-Young Park considered statistically significant. Results: There was significant improvement in VAS and BCTQ Department of Rehabilitation Medicine, Catholic University of Korea, scores after 2nd and 4th months and NCS changes at 4th month Seoul, South Korea. follow-up in both dexamethasone (P=0.00) and triamcinolone E-mail: [email protected] groups (P=0.00). But when comparing the two groups, there was no significant difference in VAS score at 2nd month Twenty healthy participants (mean age: 22.45±3.26 years (P=0.079), VAS at 4th month (P=0.319), BCTQ score at 2nd old; range: 19 29 years old; 12 males, 8 females) were recruited month (P=0.197), BCTQ score at 4th month (P=0.137), SNCV for the study. At the first visit, all participants underwent at 4th month (P=0.511) and DML at 4th month (P=0.753). No for genotype (COMT val158met) analysis. For each visit, major side effects or complications were noted. participants underwent inhibition to 1-Hz repetitive transcranial Conclusion: Dexamethasone is as effective as Triamcinolone magnetic stimulation (rTMS). After rTMS, anodal tDCS was in improving the symptoms of CTS and so can be preferred due performed at 1.5mA for 10 minutes in tDCS group. In the sham its least neurotoxicity compared to Triamcinolone. condition, 1mA stimulation lasted for only 30 seconds with the electrodes left in place for a further 10 minutes. For the Can virtual physiotherapy help in filling primary outcome, mylohyoid resting motor–evoked potentials treatment gaps during COVID-19 pandemic (MEP) were recorded at baseline, post rTMS inhibition and immediate and 30 minutes after tDCS. Regarding COMT in multiple sclerosis patients? genotype, 10 patients had the val/val allele (age: 21.00±1.56; 6 males, 4 females) and 10 were met carrier (age: 23.90±3.81; 6 Darshpreet Kaur, Nidhi Billore, Gunjan Kumar, males, 4 females). Patients treated with tDCS showed greater A. K. Singh improvement in amplitude of mylohyoid MEP than the sham group in immediate and 30mininute follow up. In subgroup Department of Physiotherapy, Bihar Neurodiagnostic Centre, Patna, analysis, both val/val and met carrier group amplitude of Bihar, India. mylohyoid MEP decreased significantly after rTMS inhibition E-mail: [email protected] (val/val group =-12.81(34.00) p=0.0052; met carrier group Objective: To determine the efficacy of telerehabilitation in =-31.84 and 0.037). Significant associations were found MS patients. The telerehabilitation was provided because of between tDCS response and COMT polymorphism. Only val/ the COVID-19 pandemic. val group showed significant increment of MEP amplitude Background: Published data demonstrate promising results in immediate and 30minute follow up (Immediate =30.42 of the rehabilitation in patients with multiple sclerosis (MS), (62.06) p=0.0020; 30minute =50.09 (65.88) p=0.0020). This including telerehabilitation technologies. study provides insight toward the understanding of response variability across COMT genes and highlights the need to create stratified approaches in tDCS treatments for dysphagia. S14 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Design/Methods: A total number of 42 patients participated in Keywords: COVID-19, neurorehabilitation, pandemic, virtual the study out of which 24 followed up till the end of 6 weeks. The consultation investigated group consisted: 15 females and 09 males, mean age was 42 ±10 years. The telerehabilitation was provided to Development of a comprehensive test for the group for 6 weeks at a frequency of 3 classes per week. agrammatism in Kannada The patients used either laptops or mobile phones. Inclusion criteria was 6 minute walk test (with or without assistance). Wasim Ahmed, Gopee Krishnan Motor function was evaluated using, Timed up and Go test, 30 second sit to stand test. Patients were required to fill two Department of Speech and Hearing, Manipal College of Health questionnaires also: 12 item MS walking Scale and Multiple Professions, Manipal Academy of Higher Education (MAHE), Udupi, Sclerosis Fatigue Impact Scale (MSFIS). All the patients data Karnataka, India. was examined by an independent physiotherapist before and E-mail: [email protected] after the intervention. Background and Aims: Agrammatism, characterized by Results: Statistically significant improvement in motor erroneous sentence production and poor grammar usage, is performance and MSFIS and 12 item MS walking Scale. common in persons with non-fluent aphasia. A comprehensive The following results were observed: statistically improved test is desirable to assess the nuances of agrammatism in parameters of TUG, 30 STS, 12 item MSWS and MSFIS. any language, which undoubtedly is a boon to clinicians and Conclusions: Based on the findings, it is reasonable to infer researchers. However, mere translation or adaptation of that the use of telemedicine in the rehabilitation of MS patients tests from another language is unfeasible. Considering the is very promising. unavailability of such tools in Kannada, we aimed to develop one based on the framework of the Northwestern Assessment Patient satisfaction with virtual consultation of Verbs and Sentences (NAVS) test. during COVID-19 pandemic: An experience Methods: This test contains six subtasks designed to assess comprehension and production of verbs, arguments and from Malaysia sentences. Further, four-sentences and three-interrogative types that Kannadigas colloquially use are included in a dialect Law Boon Sia, Ng Mei Wei, Natasia Kaur, neutral form. Test stimuli were adapted from a previously Norhayati Hussein, Azhari Nordin, Intan Sabrina developed dataset in our lab. Thirty-six (18 females) adult participants (Mean age=45.38; SD=18.98) and seven male Department of Rehabilitation, Hospital Rehabilitasi Cheras, Cheras, persons with aphasia (PWA: Mean age=64.57; SD=11.17 Malaysia. years) underwent this test along with Western Aphasia Battery E-mail: [email protected] in Kannada (WAB-K) and Syntax subtest of the Linguistic Profile Background and Aim: Virtual consultation (VC) is the Test (LPT) as the gold standard. use of information and communication technology (ICT) to Results: An overall significant difference (U=0.0, p=0.00) conduct medical consultation without direct contact between was observed between the normative and PWA across all healthcare providers and patients. VC is a useful medium to tests. The PWA performed better on comprehension tasks, ensure access and continuity of care for neurorehabilitation especially verb comprehension, on par with the normative patients during the Covid-19 pandemic. This study aims to group (U=94.0, p=0.27). Yet, PWA demonstrated considerable determine the patient satisfaction with VC during the pandemic difficulties in processing verb-argument structure and sentence at neurology rehabilitation clinic, Hospital Rehabilitasi Cheras, types especially, subject and object clefts and interrogatives. Kuala Lumpur, Malaysia. Conclusion: Preliminary findings from this ongoing study Methods: A retrospective cross-sectional study was conducted demonstrate the promising potential of this test to assess the at the neurology rehabilitation clinic in Hospital Rehabilitasi intricacies of agrammatism in PWA and its possible utility in Cheras, Kuala Lumpur, Malaysia from Jan 2021-May 2021. clinical and research domains. Feedback was asked for patients scheduled for VC during that period by using structured questionnaires after they completed Uptake of virtual consultation in neurology their VC sessions via telephone, Zoom or Google Meet. The rehabilitation clinic during the COVID-19 questionnaires assessed patient-satisfaction pertaining to the quality of the VC, technical issues, objectives and benefits of pandemic in Malaysia VC. Data were analyzed using Microsoft Excel Version 2016. Results: A total of 30.8% (290/941) patients received VC during Ng Mei Wei, Natasia Kaur, Law Boon Sia, the study period. The response rate was 100%. All responders Norhayati Hussein, Azhari Nordin, Intan Sabrina were satisfied with the quality of VC and understood the objectives of their VCs. Benefits of VC such as reducing cost, Derpartment of Rehabilitation, Hospital Rehabilitasi Cheras, Cheras, transport and time also scored 100%. The lowest satisfaction Malaysia. scores were reported in the technical components, whereby E-mail: [email protected] 1.4% of respondents experienced some form of technical Background and Aim: Covid-19 pandemic has transformed issues during VC. the landscape of healthcare delivery. Virtual consultation Conclusions: All neurorehabilitation patients were satisfied (VC) is no longer an option but a necessity to curb the with the quality, objectives and benefits of VC. More resources spread of Covid-19. Healthcare providers, patients and should be invested in technical support to ensure the success their caregivers have to adjust to the new way of accessing of VC during and after the Covid-19 pandemic. healthcare. This study aims to determine the uptake of VC in Neurology Rehabilitation Clinic compared with face-to-face Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S15

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract (F2F) consultations during the Covid-19 pandemic at Hospital Conclusions: Negative correlation suggests age as a Rehabilitasi Cheras, Kuala Lumpur, Malaysia. predictor for outcome indexes. CIRS-profiles relate to outcome. Methods: A retrospective cross sectional study was conducted Psycho-behavioural profile is predictive for REs-tot and from January-May 2021 during Covid-19 pandemic. Follow- REs-m, indicating possible involvement of “fatigue”. Nutrition up patients were screened for suitability of VC prior to their is critical for improving REs-m and REs-c, and likely shortens appointments. VC was conducted under the Government length-of-stay. Jamar-test is a candidate predictor for REs-tot Integrated Telecommunications Network (GITN) using and REs-d, while MRC and sit-to-stand are possible REs-m telephone, Google Meet or Zoom. Preference for VC or F2F predictors. Jamar-test is also a potential REs-c predictor, after consultation was asked at the end of the VC session. Data was regression analysis. We are conducting a follow-up with a wider analysed using Microsoft Excel 2016. population sample. Results: A total of 30.8% (290/941) neurorehabilitation patients received VC during the study period. The response Case series on the effects of Botulinum rate was 100%. From 290 neurorehabilitation patients, 165 toxin-A injection for individuals with (56.9%) preferred VC while 125 (43.1%) opted for F2F review. Out of total VC patients, 241 (83.1%) was conducted via cervical dystonia telephone, 42 (14.5%) through Google Meet and 7 (2.4%) with Zoom. Farah Inaz Khairuzzaman, Ng Mei Wei, Conclusion: Result shows that VC is still the preferred choice Norhayati Hussein for consultation especially during the Movement Control Order (February and May 2021) imposed by the government. Most Department of Rehabilitation Medicine, Neurological Rehabilitation patients preferred telephone consultations due to technological Unit, Hospital Rehabilitasi Cheras, Bandar Tun Razak, Kuala barriers. We foresee that VC will play a vital role in the future Lumpur, Malaysia. as a method of improving access to health-care services. E-mail: [email protected] Keywords: COVID-19, neurorehabilitation, pandemic, virtual Background and Aim: Cervical dystonia is characterized by consultation progressively worsening involuntary neck contraction causing the head to tilt to one side. This case series aims to highlight Study on predictive factors of the functional the clinical improvement in two individuals with cervical dystonia outcome in patients with “post COVID-19” after chemodenervation with Botulinum toxin -A to reduce pain and improve neck and head positioning. residual disability after intensive Methods: Single institution descriptive case series of two rehabilitation individuals with acquired cervical dystonia resulting from cerebral palsy and hypoxic insult. Valentina Barbieri, Paolo Rossi, Laura Perucca Results: Case 1: A 23-years old gentleman with Cerebral Palsy (GMFCS V) was referred for neurorehabilitation at 21 Centro di Riabilitazione Brissago, Clinica Hildebrand, Brissago, years of age. He had kyphoscoliosis, bilateral hip subluxation, Switzerland. generalized spasticity, and cervical dystonia (characterized E-mail: [email protected] by torticollis). Collateral history from mother reported pain, Background and Aims: We hypothesize functional outcome difficulty in wheelchair positioning, and inadequate feeding predictors after moderate-to-severe COVID-19, using clinical due to inappropriate position. Chemodenervation with and functional data on motor and cognitive skills. botulinum toxin-A injection resulted in reduced pain and Methods: 52 patients from Hildebrand and Novaggio Clinics improved positioning, which aids in feeding and non-verbal (39M-13F, mean-age 67.2) were recruited between May and communication. Case 2: A 38-years old gentleman was referred June 2020. Muscular deconditioning, nutrition and comorbidities for rehabilitation for hypoxic sequelae, sustained during surgical were considered to establish recovery degree. Patients motor complications for total thyroidectomy for malignant thyroid skills (Jamar-test, MRC-scale, Sit-to-Stand), nutritional state carcinoma. He developed cervical dystonia (characterized by (Kondrup-index, BMI, albumin, electrolytes) and Cumulative retrocollis and laterocollis), causing neck pain and difficulties in Illness Rating Scale (CIRS) were evaluated at admission. These positioning. Multiple modalities were given to improve dystonia. were related to outcomes, based on Functional Independence Chemodenervation with botulinum toxin-A injection resulted in Measure (FIM), normalized for maximum potential improvement pain reduction, with improved neck and head posture. and length-of-stay, defined as Rehabilitation Effectiveness Conclusion: Cervical dystonia can be a sequela in cerebral Score (REs-tot), divided in motor (REs-m), cognitive (REs-c), palsy and stroke. It can be amenable with Botulinum toxin-A and duration (REs-d). injection; however, results are variable depending on the Results: 8 comorbidity profiles based on the first 13 CIRS items etiology. Careful selection of target muscles and evaluation of were described: differences between REs-m and comorbidity patients for chemodenervation is important to ensure a good profiles were statistically meaningful. Psycho-behavioural outcome. CIRS was analysed separately, based on severity. REs-tot and REs-m were statistically different across profiles. Patient’s age Effect of platelet rich plasma injection as and REs-tot negatively correlate to length-of-stay. REs-m and additional intervention to suprascapular REs-c show meaningful differences with respect to Kondrup- nerve block in post stroke shoulder pain index. Regression models correlate motor tests with REs-tot, with Jamar-test having R=0.37. Azhar Kalliyath, Abhishek Srivastava, Navita Vyas S16 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Physical Medicine and Rehabilitation, Kokilaben Department of Physical Medicine and Rehabilitation, All India Hospitals, Mumbai, Maharashtra, India. Institute of Medical Sciences, Raipur, Chhattisgarh, 1Department E-mail: [email protected] of Neurology, MLN Medical College, Prayagraj, Allahabad, Background/Purpose: Stroke has a very high incidence Uttar Pradesh, India. of about 2.4% in general adult population and is one of the E-mail: [email protected] main causes of disability worldwide. Approximately 90% of Introduction: The unprecedented rise of patients presenting stroke survivors have compromised functions including motor, in intensive care due to Covid-19 pneumonia is resulting in sensory, cognitive and autonomic functions. Good shoulder overwhelming rise in cases of intensive care unit-acquired function is a prerequisite for effective hand function, as well as weakness. After discharge, Intensive care unit (ICU)-acquired for performing multiple tasks involving bed mobility, ambulation, weakness is on the rise and diagnosis as post covid critical and activities of daily living (ADL). A common sequel of stroke illness myopathy, critical illness neuropathy, critical illness is Post Stroke Shoulder Pain (PSSP) which is often precipitated polyneuromyopathy, Guillain-Barre syndrome have emerged with movements of the joint. The pain can compromise the as differentials in first examination. person’s participation in therapy and in severe cases, patients Aims and Objective: To determine the presence of myopathy, stop therapy and mobilization all together due to pain. This neuropathy or both in ICU patients affected with Intensive care can hamper the effective utilization of residual function, further unit acquired weakness (ICUAW), in a tertiary care hospital training and subsequently lead to disability. It also prolongs with post covid complication patients and to discuss role of rehabilitation of affected limbs and hospital stay thereby adding physiatrist in terms of examination, diagnostic work up and to the cost of rehabilitation. There are studies showing the rehabilitation. effectiveness of Supra Scapular Nerve Block (SSNB) in Post Methods: Data from patients reporting to PMR OPD for Stroke Shoulder Pain (PSSP). There are studies showing electrodiagnostic study for workup of post covid neuromuscular the effectiveness of Platelet Rich Plasma (PRP) injections in involvement and for rehabilitation. Shoulder pathologies. There are very few studies on effect of Results: Muscle dysfunction is the primary cause of ICUAW PRP in Post Stroke Shoulder Pain. No study has been done although in most cases, both neuropathy and myopathy coexist. comparing the benefits of giving Platelet Rich Plasma (PRP) Muscle charting and NCV studies helped in establishing for persisting shoulder pain even after Supra Scapular Nerve diagnosis by Physiatrist and Neurologists and in tailoring of Block (SSNB). individualized rehabilitation protocol. Methods: Post Stroke patients with shoulder pain, who Conclusion: Potential impact of CIM/CIP/CIPNM/GBS, and having pain score NRS>4/10 will be taken for shoulder the need for robust efforts to detect these syndromes can be Screening with Ultra sonography and will be assessed for much more efficient with involvement in Physiatrist alongside any Rotator cuff pathology and will be given Supra Scapular Neurologist in holistic care. Thorough clinical knowledge and Nerve Block. Patients will be assessed after 2 weeks for pain electrodiagnostic studies interpretation is must for better patient and range of motion. Patients having no marked change in outcomes. pain score, no marked improvement in ROM, ultrasound screening showing shoulder pathology and are willing for Utilizing rehabilitation efficiency index PRP procedure will be given Freshly prepared PRP injection (REI) as an outcome measure for inpatient and will be reviewed after2 weeks, 1 month and then after 3 months. Those who are not willing for PRP injection will be neurological rehabilitation considered as control. Results: Patients who received Platelet Rich Plasma injection Khaidatul Mohamed Zabidi, Aiman Dan Anuar, after receiving suprascapular nerve block (SSNB) consistently Norhayati Hussein demonstrated superior and statistically significant pain reduction at all follow up time points. Mean NRS reduction, Department of Neurology Rehabilitation, Hospital Rehabilitasi marked improvement in both active and passive ROM of Cheras, Kuala Lumpur, Malaysia. shoulder, improvement in SF8 score in those who received E-mail: [email protected] both PRP and SSNB group when compared to the scores of Background and Aims: Rehabilitation helps improve those who received only SSNB injection. Significant differences patient functional outcomes after an acute medical event, were noted between groups in regards to function or quality especially intensive inpatient rehabilitation. The Rehabilitation of life. No adverse events associated with the intervention Effectiveness Index (REI) is a rehabilitation impact index were reported. which demonstrates rehabilitation efficiency by calculating Conclusion: Platelet Rich Plasma Injection as additional the average functional increase per day. This paper’s aim is intervention to Suprascapular Nerve Block is safe and effective to review the use of REI to gauge the outcome of individuals in Post Stroke Shoulder Pain. who completed inpatient neurorehabilitation. Methods: This is a retrospective chart review of individuals with Surge of post covid neuromuscular neurological conditions who received inpatient neurorehabilitation involvement, influx of under investigation from 2017 to 2020 and completed intensive rehabilitation with admission and discharge Modified Barthel Index (MBI) scores. differential and role of physiatrists in 737 patients were selected. REI is calculated based on MBI scenario functional gain/length of stay, where 0-0.49= low efficiency, 0.5-1=moderate efficiency and >1 =high efficiency. Aradhana Shukla, Archana Ojha1, Jaydeep Nandi Results: Results showed an increase in the proportion of patients with REI>0.5 after 2017; from 50.0% (2017) to more Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S17

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract than 70% from 2018-2020 [75.2% (2018), 76.1% (2019), 73.3% Sheela Theivanthiran, N. Abdul Aziz (2020)]. There was a reduced proportion of patients with low REI from 50.0% (2017) to 31.0% (2020). Conversely, there Department of Rehabilitation Medicine, Acquired Brain Injury was a growth in the proportion of patients with high REI (>1) Rehabilitation Unit, Hospital Rehabilitasi Cheras, Ministry of Health, from 2017 to 2020; from 17.9% (2017), 41.2% (2018), 43.1% Kuala Lumpur, Malaysia. (2019) to 42.3% (2020), where scores ranged from 1.1 to 7. E-mail: [email protected] Conclusions: Results show a higher proportion of patients Background and Aims: Vestibular rehabilitation program (VRP) with high REI throughout the study period. This demonstrates advocated here, consists on a multi-disciplinary team to manage incremental success for the rehabilitation program. The REI people with vertigo. The team members include the patient, trend is useful to identify the timeline which demonstrated rehabilitation medicine physicians, physiotherapists, audiologists, outcome of inpatient rehabilitation. Further research is needed clinical psychologists and rehabilitation nurses. The goals of VRP to specifically identify potential beneficial interventions and are gaze stabilisation, postural stability, improvement in function program effectiveness. and management of aggravating factors such as vestibular migraine, anxiety, fatigue, cervical muscle tension etc. Development of leisure-time physical Methodology: Clients may present with symptoms arising activity and education program on level from a central, peripheral or mixed cause. During the intake of physical activity, walking performance, interview, clients are reviewed based on the inclusion criteria exercise self-efficacy and quality of life and medical stability. They are then assessed by the team members separately. The results of the assessments are among chronic stroke survivors discussed in the initial team meeting, to guide goal setting and allocation to the appropriate program. There are 2 options Fadia Razali, Haidzir Manaf, Maria Justine for VRP: An outpatient program (weekly therapy program for 8 weeks) or an inpatient program, daily review and therapy Department of Physiotherapy, University Selangor, Shah Alam, program for 3 weeks. In this series, we present 2 individuals Malaysia. with different central causes of vertigo. E-mail: [email protected] Results: Ms SA, 48 year old, has a history of right acoustic Background and Aims: Stroke has become a significant public neuroma, complained of worsening vertigo symptoms following discussion about the health consequences, which will increase tumour removal. She was unable to perform her activities over the next decades and will be one of the top public health of daily living (ADLs) and had vestibular migraine. Ms SA disability agenda in the 21st century. As a result, the number underwent inpatient VRP with a goal of return to work and of stroke survivors living with consequences is increasing. pain management. She improved in her ability of self care, Varieties types of physical activity (PA) among stroke patients ambulation, reduced in vertigo symptoms and headaches. had been stated to be effective such as treadmill training, She was able return to work to her previous job with targeted aerobic training, circuit training, home-based type of exercise breaks. Her initial assessment using Vestibular Nystagmogram programmed, structural type of exercise with physiotherapist- (VNG): indicated vertigo of central pathology. Post program monitored, prescription exercise with monitoring and without her outcome measurements results are as follows: Dizziness monitoring. Unfortunately, the studies unable to distinguish a Handicap Index (DHI) pre 14/100 to post 4/100 minimal proper dosage based on frequency, intensity, time, and type to impairment; Berg Balance Scale (BBS) improved from 31/56 suit PA’s long-term commitment based on lifestyle after stroke. to 55/56 and Dynamic Gait Index (DGI) improved from 8/24 Therefore, it is suggested that the change of PA should influence to 23/24 indicating low risk of falls and independent and and address conditions based on time and lifestyle after stroke, stable gait. Mdm AR, 53 year old, lady with a pontine intra- such as leisure leisure-time physical activity (LTPA). parenchymal hemorrhage treated in a conservative manner. Methods: This study design is integrating mixed methods She had mild right sided hemiparesis, vertigo aggravated with between qualitative and quantitative study. The method positional change and pain in the left side of her neck. Her ADLs includes Phase I: Identify issues and perspectives of physical were limited due to dizziness. She required dry needling into activity among stroke chronic stroke using systematic review the left trapezius group of muscles. This improved her neck and interview, development of the intervention program range of motion, she participated better in VRP. VNG indicated (program and education material), and acceptability of the vertigo of central cause. DHI improved from 22/100 to 16/100; intervention based on the Delphi study. Phase II: Pilot study BBS 50/56 to 56/56; DGI 18/24 to 22/24. of the intervention. Conclusion: VRP in a multidisciplinary, goal orientated, Conclusion: Declination of PA among stroke populations is individually tailored approach leads to functional improvements. the main factor secondary to cardiovascular diseases and It has a major role in enabling people with vertigo, even with a recurrent stroke. The ability to change PA into a lifestyle such from central pathology. as LTPA, which consists of freedom of choices and behaviour among stroke survivors, can help the stroke population increase Resource of spirituality in rehabilitation physical activity in the long term. towards integrative health Keywords: Home programme, leisure-type physical activity, physical activity Vidya Shenoy Vestibular rehabilitation program: Centre for Alzheimer’s and Dementia Therapy, Universe of Memory, A holistic approach Alzheimer’s & Related Disorders Society of India, Mumbai, Maharashtra, India. E-mail: [email protected] S18 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Aim: To improve coping mechanism of rehabilitation with practice values within both the Group 1 and 2.Using independent sample of Spirituality Therapy as complement to conventional medicine. t test it was found there was no significant differences found Method: One needs to be aware of the choice of belief that can between the booklet and video group. be practiced. Best to start with Universal Prayer that relaxes the Conclusion: Booklet and video instructions are equally recipient giving focus leading them into the session. Thereafter, effective mode of teaching mothers to handle their infants in recitation of AUM and Gayatri with a singular thought of invoking NICU. the Universal Cosmic Energy to rehabilitate oneself followed by meditation and then by singing or listening to religious Post-operative pediatric spina bifida songs or using the mode of movement and music. Session can rehabilitative management: A case report close with deep breathing or Three-Part Breathing followed by chanting of primordial, solar sound, AUM, three times to calm Ivan Triangto, Djoko Witjaksono, Eko Nugroho, down once again. Dwi Indriani, Gutama Arya Pringga Results: It lightens the mind, renews energy, builds confidence, helps in improvement on physical, emotional, mental, Department of Physical Medicine and Rehabilitation, RSUD Dr. psychological planes and cognitive abilities, reduces stress, Saiful Anwar Malang, Malang, Indonesia. for some it calms and, some builds stamina, increases focus, E-mail: [email protected] concentration and balance. Background: Spina bifida (SB), known as a common neural Conclusion: Spirituality therapy works as a catalyst in the tube defect in children occurring 3.4 cases per 10,000 live process of rehabilitation to offer untold catharsis. A win-win births. Several frequently encountered complications include situation, spirituality therapy though less explored and applied, neuromuscular disorders, bowel & bladder dysfunction, and interconnects and builds a bond between the therapist (healer) skin breakdowns. The following conditions could similarly and the subject (healed). Its impact is slow yet promisingly occur post-operatively. Thus, post-operative rehabilitative qualitative and is a special tool that gives a better coping management plays an important role to restore activity and mechanism of manage rehabilitation leading the giver and participation in SB. recipient on the therapeutic path towards inner peace and Case: A 14-year old boy was consulted to PM&R department complete wellbeing. with weakness of both lower extremities, accompanied with sensory deficit, bowel & bladder incontinence and sacral Mothers confidence regarding handling ulcer. Previously, patient underwent surgery for SB occulta their neonatal intensive care unit infants Th12-L1 and aperta L2-3. Physical examination revealed functional MMT for right knee extensor and bilateral ankle following an education program a plantar flexors, whereas left knee extensor, bilateral hip flexors, comparison of different delivery modes ankle dorsiflexors, and long toe extensors were nonfunctional. There was sensory & proprioceptive deficit of both lower Shruti Shantaram Kamath, Sumita Rege extremities with sacral sparing, absence of VAC & DAP, and grade III sacral ulcer measuring 2x2 cm. Functional examination Department of Occupational Therapy, MAHE, KMC Manipal showed inability to accomplish most ADLs independently, Hospital, Mumbai, Maharashtra, India. including ambulation, transfer, bathing, toileting, and dressing. E-mail: [email protected] Preoperative radiological study confirms diagnosis SB with Background: Multiple programs are used in the Neonatal lipomyelocele at Th12-L3 and tethered cord at L2. Rehabilitative Intensive Care Unit (NICU) and all these programs have treatment was prescribed with ADL modifications, NMES & different purposes, however one common idea that links all sensory stimulation of both lower extremities & sacral region, these programs is inclusion of parents and family members in LLLT for sacral ulcer, and a tilt table test. the intervention using education. Also, involvement of family Conclusion: Post-operative ambulation requires caregiver members in the NICU infant handling and care during their assistance, but is then expected to be able to ambulate NICU stay. The key technique being followed in the NICU is independently or with ambulatory aid. Thus, comprehensive that of handling and it has a major role in all the interventions. rehabilitative management with education, ADL modifications, Aim and Objective: The primary aim of this study was modalities & exercise, could help patient with SB to achieve to compare the modes for delivering on infant handling to return to activity and participation. primigravida mothers in the NICU and to develop and validate video of handling for mothers. The effects of closed kinetic chain and open Methods: A pre and posttest study design was used for a kinetic chain exercise in the lower extremity sample size of 70 mothers. Using convenience sampling 35 mothers were allocated in Group 1 (Manual demonstration and on the chronic stroke patients balance, booklet) and 35 in Group 2 (Manual demonstration and video). strength, and functional mobility After baseline competency assessment using the Karitane Parenting Confidence Scale (KPCS), mothers received Lisa Nurhasanah instruction according to their group. Two days before discharge KPCS was administered again to evaluate the confidence level Department of Physical Medicine and Rehabilitation, Diponegoro of mothers. University, Semaramg, Indonesia Results: Using dependent sample t test, it was found that there E-mail: [email protected] was significant difference between the pre and post KPCS Background: Stroke is the third prevalent disease to cause disablement. Muscle weakness is can limits the recovery of Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S19

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract physical functions such as balance, strength and functional test was done for disability level of stroke patient and quality mobility that interfere with activities of daily living. Closed of life of informal caregiver which resulted moderate positive Kinetic Chain (CKC) and Open Kinetic Chain (OKC) exercise correlation (r=0,6, p<0,001). as the progressive resistance training is one of the rehabilitation Conclusions: There is moderate positive correlation between approaches to correct strength, balance disorders and funtional disability level of stroke patient and quality of life of informal ability caused by paresis of the lower extremities of post-stroke caregiver. patients. Objective: The purpose of this study is to compare the Efficacy of dysphagia therapy in facilitating effectivity of CKC and OKC exercise in the lower extremities feeding and swallowing function in to the balance, strength and functional mobility of the chronic cerebral palsied childen stage post-stroke patients. Materials and Methods: This study is a quasi-experimental Jayasankar Panda pre and post controlled trial group design. Twenty chronic stage post-stroke patients divided into the CKC group and the OKC Department of Speech and Hearing, Swami Vivekanand National group had 6 weeks exercise. The assessment of balance, Institute of Rehabilitation Training and Research, Cuttack, Odisha, muscle strength and functional mobility is before and 1 day India. after the last session. E-mail: [email protected] Result: It is found that the CKC group has a significant Background: Presence of dysphagia has a profound impact difference in balance compared to the OKC group (p<0.05). on wellbeing and quality of life in children with cerebral Thus, Meanwhile, the lower extremities muscle strength in the OKC management of feeding and swallowing difficulties in cerebral group was has greater mean result than the CKC group. palsied children is critical for adequate development of speech, Conclusion: The conclusion of this study is CKC and OKC social, emotional, physical, and cognitive skills. exercises improve the balance, muscle strength and functional Aim: The current study explored the efficacy of a combination mobility of the chronic stage post-stroke patients. CKC exercise of three dysphagia therapy techniques (Non-Speech Oral- has been shown to have a better result in balance and functional motor exercises, Langmore Ice chip Protocol, Mendelsohn mobility. While in the muscle strength, OKC is better than CKC manoeuvre) in improving feeding and swallowing function in exercise. cerebral palsied children. Methodology: Participants were parents of 30 children Correlation between disability level of with cerebral palsy between the age range of 2-7 years. stroke patient and quality of life of informal The PediEAT (Thoyre et. al, 2018) checklist was used to measure the parental observations. The PediEat checklist was caregiver administered before initiation of therapy and after three months of post therapy. Descriptive statistics and total-item and inter- Ricky Gustian Halim, item correlations were calculated for each of the items across Widjajalaksmi Kusumaningsih, Wanarani Alwin, the pre and post therapy levels. Paired sample t-test was used V. S. Dhanasari to estimate significant differences between the pre and post therapy intervals. Department of Physical Medicine and Rehabilitation, Faculty Results: Results indicated strong inter-item correlation in the of Medicine, Cipto Mangunkusumo National General Hospital, pre and post therapy intervals. Comparison of responses in the Universitas Indonesia, Jakarta, Indonesia. pre and post therapy intervals yielded weak correlation across E-mail: [email protected] most of the items with parents scoring positive scores indicating Background and Aims: Stroke is a sudden and devastating better swallow function in the cerebral palsied children using condition for the patient and also for the family members that act the combination therapy. as the caregiver. Giving care requires the caregiver physically Conclusion: The results of the study strongly advocate and emotionally prepared due to the complexity of the stroke inclusion of dysphagia therapy along with speech and language patient. This study aims to determine the correlation between therapy in the treatment protocol for facilitating adequate the disability level of stroke patients and the quality of life of feeding and swallowing function. the informal caregiver. Methods: The research design is a cross sectional study using The effect of kolintang instrumental music Shah Modified Barthel Index to assess the disability level of therapy on improvement of cognitive stroke patient and SF-36 to assess quality of life of informal caregiver. Subjects of this study is 50 stroke patients and 50 function in a subacute stroke patients with informal caregivers. The interview was done by direct face to mild cognitive impairment: A randomized face setting (for 23 stroke patients and 23 informal caregivers) and indirect face to face setting using video call (for 27 stroke controlled trial patients and 27 informal caregivers). Results: The median score of disability level of stroke patient in Liana Dewi this study is 82,5 (16 – 100) and mean score of quality of life of informal caregiver is 69,69 + 20,32. The score for the subscales Department of Physical Medicine and Rehabilitation, Sam Ratulangi of quality of life are 73,7 (20,63 – 97,5) for physical components University, RSUP Prof. Dr. R. D. Kandou Manado, Manado, and 69,8 + 21,93 for mental components. Spearman correlation Indonesia E-mail: [email protected] S20 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Background and Aims: Stroke is second leading cause of chronic SCI were prone to develop severe Covid 19 disease death and third leading cause of disability. Cognitive impairment requiring medical attention. often occurs after stroke and as the determinants of poor long-term success of therapy. Mild Cognitive Impairment Preference of action observation training (MCI) often gets less attention even though it is a factor that video parameters in acute stroke survivors affects recovery after a subacute stroke. Instrumental music therapy has been used as part of music therapy. Kolintang is Arunima Biswas, Manikandan Natarajan, the traditional musical instruments from North Sulawesi. This John M. Solomon study aims to determine the effect of kolintang instrumental music therapy to improving cognitive functions in a subacute Department of Physiotherapy, Manipal Academy of Higher stroke patients with MCI. Education, Manipal, Karnataka, India. Methods: Twenty subacute stroke patients with MCI, between E-mail: [email protected] 30 and 65 years of age, were enrolled in the study and randomly Background: The current trend in stroke rehabilitation divided into 2 groups: the control group (CG; n=10) undergoing is focused on different forms of motor priming like action conventional therapy (CT) 3 times a week for 4 weeks, and the observation training (AOT). It is based on the neurophysiology intervention group (IG; n=10) undergoing CT 3 times a week for of activation of the same neural areas for observation and 4 weeks plus listened to kolintang instrumental music therapy, execution of movements. The specifications of constituent played for 20 minutes, 6 times a week for 4 weeks. MoCA-Ina video parameters could play a key role in motor recovery. assessment was carried out initially and immediately after the However, a uniform structuring of the content of videos used end of intervention. in AOT is lacking. Results: In particular, the IG showed better improvement in Aim: To determine the preference of acute stroke survivors in cognitive function (p < 0.001), as compared to the CG. The terms of recording and viewing parameters. mean increase of cognitive function score was higher in the Methods: Various lower limb activities were recorded using IG than the CG (3.8 and 1.8 respectively) with t value from normal individuals in various environments and different independent t test was 4.867; and p < 0.001. This increase views. The clips were processed to adjust the background light of cognitive function was statistically significant different in IG and noise along with modulation of the speed of movements compared to CG (p < 0.001). shown. The edited videos were then shown to ten acute Conclusions: Kolintang instrumental music therapy could be stroke survivors. Videos were shown on laptops and mobiles, considered a complementary approach to enhance cognitive with different angles from eye level, varying distance from function in a subacute stroke patients with MCI. the eye and using allocentric and egocentric perspectives of Keywords: Cognitive function, kolintang, MoCA-Ina, subacute movements. stroke Results: Self-held mobile devices were preferred over larger screens. A screen distance of less than 60 cm from the eye A case series of patients of spinal cord placed at an angle above eye level was found desirable. injury with COVID 19 Video duration of five minutes in total was found suitable with every movement repeated thrice. Egocentric perspective of Anyesha Saha, C. Chethan, Swapnil Sonune, movements shown at normal speed were favoured over half S. Y. Kothari speed. Conclusion: Video parameters for efficient administration of Department of Physical Medicine and Rehabilitation, AIIMS, Bhopal, AOT have been identified. Incorporation of these parameters Madhya Pradesh, India. in future trials may make the intervention program more robust. E-mail: [email protected] Introduction: Covid 19 had a varied presentation in different As far as the eye can see: Restoration of groups of population. Persons with Spinal Cord Injury (SCI) are visual loss in neurological disorders, is potentially at risk for severe Covid 19 disease as many of them have associated co- morbidities like hypertension, diabetes, neuroplasticity possible? cardiovascular disease, obesity and often have decreased lung capacity. Muhamad Faizal Zainudin, Alicia Dixie Abraham Aims and Objectives: To observe the presentation of Covid Nurul Diyanah Zenian, Mohd Razali Hasim 19 in patients of SCI. Methods: 3 patients with SCI who tested positive for Covid 19 Department of Rehabilitation Medicine, Queen Elizabeth Hospital, and were admitted in PMR ward were evaluated. Kota Kinabalu, Malaysia. Results: One patient with acute traumatic SCI had mild E-mail: [email protected] symptoms and was managed conservatively while other two Background: Visual loss following intracranial pathologies is patients with chronic SCI had severe ARDS and developed not uncommon. The three approaches of visual rehabilitation cardiovascular complications for which they required ICU are compensation (working with unaffected aspects of the visual admission. One patient with chronic SCI recovered while other system to make up for the damaged portions), substitution succumbed to death. (environmental adaptations and low vision devices such as Conclusion: In our observation, the patient with acute SCI prism glasses), and restitution (attempt to restore lost function). developed mild symptoms of Covid 19 while the patients with We present two cases of severe visual impairment with visual recovery following the restorative approach. Methods: Case A is a 58-year old lady who presented with left Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S21

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract hemiparesis and blurry vision, four years after the first stroke. Pre-injection of lipopolysaccharide into Urgent CT scan revealed acute right temporal and thalamic the mouse corpus callosum exacerbates infarct with encephalomalacic left parieto-occipital lobe. concussion TBI-induced sensorimotor Visually, she could only appreciate light and hand movement for both eyes. Case B is a 40-year old lady with parasagittal decline meningioma who presented with left hemiparesis and blurry vision. Post-operative CT brain revealed recent left occipital Sekwang Lee, Won-Ki Kim infarct. Visually, the left eye was completely blind while the right eye could only appreciate light. Both patients underwent Department of Neuroscience, Korea University, Seoul, South Korea. low vision rehabilitation for four weeks with low-technology E-mail: [email protected] instruments: light awareness training, stimulation with bright Background and Aims: Repetitive traumatic brain injury (TBI) colours, and contrast sensitivity training. is associated with impaired motor, cognitive and emotional functioning. It is known that in recurrent TBI, brain fragility is Results: In Case A, her vision evolved into left homonymous increased by the first TBI, resulting in increased damage by upper quadrantanopia. As for case 2, she could finger-count subsequent TBI. We evaluated whether activation of central and read large fonts of one-inch size with her right eye while immune cells via lipopolysaccharide (LPS) injection contributed her left eye remained blind. to worsening sensorimotor function. Methods: Male C57BL/6 mice were placed in a stereotaxic Conclusions: At present, there is still a lack of evidence for device under inhalation anesthesia. LPS (1 ug/1l) or saline was visual restitution following neurological disorders. We should injected to both sides of the corpus callosum at a rate of 0.2 ml/ attempt to restore the vision as visual recovery is possible with min by a microinfusiom pump. The next day after injection, a 50 neuroplasticity. g of metal weight was dropped vertically into a height of 1.7 m high pipe to induce a weight-drop injury to the mouse’s head. Aggravated neuroinflammation Post-injury assessments were performed 24 and 48 h after TBI. by traumatic brain injury after Results: In the Rotarod test, LPS/TBI group showed a lipopolysaccharide microinjection into the significantly decreased fall latencies compared to the Saline/ TBI and LPS/sham group at 24 h after TBI. Although the LPS/ mouse corpus callosum TBI group had significantly lower fall latencies compared to the LPS/sham group at 48 h after TBI, there was a trend toward Sekwang Lee, Won-Ki Kim increased fall latency. Conclusions: The results suggest that activation of central Department of Neuroscience, Korea University, Seoul, South Korea. immune cells by LPS microinjection increases bain vulnerability E-mail: [email protected] to subsequent TBI. This finding suggests that suppression of the central immune response may be a potential therapeutic Background and Aims: Activation of microglia and target to reduce functional impairment after TBI. macrophages may be implicated in the pattern and degree of various brain injury types by producing various proinflammatory SP-8356 alleviates repetitive traumatic brain cytokines. The present study investigated the changes of injury in mouse via inhibition of matrix neuroinflammatory responses that occur early after traumatic metalloproteinase-9 brain injury (TBI) by weight-drop in mice microinjected with lipopolysaccharide (LPS) into corpus callosum. Sekwang Lee, Won-Ki Kim Methods: LPS was microinjected into the right side of the Department of Neuroscience, Korea University, Seoul, South Korea. corpus callosum in the C57BL/6 mice. The next day after E-mail: [email protected] LPS injection, 50 g of metal weight was dropped vertically Background and Aims: Recent studies have emphasized into the pipe at a height of 1.7 meters to induce weight drop the importance of the brain extracellular matrix (ECM) in the damage to the head of mice. Mouse brains were harvested remodeling process after traumatic brain injury (TBI). SP-8356, 5 and 48 hours after the TBI. Immunohistochemical studies a (1S)-(–)-verbenone derivative, has an inhibitory effect on the were performed to examine the effects of LPS on microglia, major ECM enzymes, matrix metalloproteinases (MMP). We macrophages, neutrophils, and astrocytes. Regions of interest examined the effects of SP-8356 on a mouse model of repetitive (ROI) are as follows; medial prefrontal cortex, hippocampus, weight-drop injury using quantitative real-time polymerase chain striatum, cortex. reaction (qRT-PCR). Methods: C57BL/6 mice were anesthetized and placed on a Results: Intracorpus callosum injection of LPS increased floor made of Kimwipe. Weight-drop injuries were performed microglial activation after 24 hours in all measured ROIs twice 24 h apart at a height of 1.7 m using a metal of 50 g. SP- measured. TBI with LPS pre-injection group showed higher 8356 (50 mg/kg) or vehicle (normal saline) was administered activation compared to LPS/Sham group at 5 and 24 h after intraperitoneally 2, 7, and 24 h after TBI. Brain harvesting was TBI. The pattern of changes in neutrophils and macrophages performed 6 h after the second weight-drop injury. The target infiltration was the same as above. In contrast, astrocytes genes of qRT-PCR were as follows; MMP-2, MMP-9, CD147, showed increased activation by LPS and exacerbation by TBI TGF-1, TNF-, TNFR1, TNFR2, IL-6, IL-1, CD11b. only at 24 h after TBI, and not activated at 5 h after TBI. Results: The TBI group had higher gene expression of TGF- Conclusions: Our results suggest that TBI augments neuroinflammatory responses of LPS-preactivated mice brain. Thus, in the brain inflamed for various reasons, such as an infection, TBI may exacerbate the inflammatory response. S22 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract 1, TNF-, IL-6, and MMP-9 than the Sham group. MMP-9 was Background and Aims: This study aims to determine the the only one with a significantly lowered gene expression feasibility and the effects of Paraplegia Fitness Integrated in the SP-8356-treatet TBI group. CD11b expression was Training with the Education Program (PARAFiT) on physical lower in the TBI group than in the Sham group, but there was activity, exercise self-efficacy, physical fitness, and exercise no inhibitory effect by SP-8356 in the TBI group. The gene adherence. expression of other genes did not different between the Sham Methods: A total of 20 individuals with spinal cord injury and TBI groups. participated in this non-randomized controlled feasibility trial. Conclusions: SP-8356 effectively reduced the MMP-9 gene Participants were assigned to the intervention (PARAFiT expression increased by concussive TBIs. SP-8356 may be combined with conventional physiotherapy) or control group a potential therapeutic agent for repetitive concussive TBI by (conventional physiotherapy alone) with 10 participants in modulating the remodeling process after TBI. each group. Both groups completed the 8-weeks program with exercise adherence was monitored throughout the program Rehabilitation in patients with stroke using an exercise diary. The outcomes of this study were following COVID 19 pneumonia in a measures using The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Exercise Self-Efficacy Scale tertiary care center-case series (ESES), 6 Minute Push Test (6-MPT) for cardiorespiratory fitness (CRF), BIODEX isokinetic machine for shoulder S. Kalyaanasundhary strength, and JAMAR® handheld dynamometer for handgrip strength. The PA and ESE were measured at baseline and 8th, Department of Physical Medicine and Rehabilitation, AIIMS, Bhopal, week, while the measurement of CRF, shoulder, and handgrip Madhya Pradesh, India. strength was measured at baseline, 4th week, and 8th week. E-mail: [email protected] Results: During the program, mean adherence rates in the Introduction: There is a increased risk of stroke in patients PARAFiT group were 80% and the control group was 75%. The presenting with COVID 19 pneumonia which is attributable to 2-way repeated measure mix ANOVA showed no significant ACE2 receptor activation in the blood brain barrier by the virus differences in PA, ESES, and 6-MPT between both groups leading to hypercoagulable state and also due to microglial (all p > 0.05). There were significant differences between the activation. right shoulder internal rotators and right adductors, left internal Aims and Objectives: To study the presentation, clinical rotators between groups (all p < 0.05). However, there were features, area of involvement, type of stroke and associated no significant differences between groups of the right shoulder co morbidities among COVID 19 patients and their response external rotators (p=0.084) and the right abductors, left shoulder to rehabilitation. external rotators, abductors, and adductors (all p > 0.05). In Methods: There were three patients admitted with COVID19 addition, there were significant differences between groups pneumonia among which two patients had recurrent stroke on the right (p = 0.029) and left (0.0548) handgrip strength. and one had primary stroke. First patient developed right sided Conclusions: Overall, the study was feasible and safe to weakness after five days of testing COVID positive and is a conduct with no major injury complaints received from the case of recurrent stroke. The patient was managed and acute subjects. A more longitudinal study should be conducted to rehabilitation started with range of motion exercises and is investigate the effects of PARAFiT in a large sample and the asked to review in stroke clinic for further rehabilitation. Second long term effects patient presented with weakness of right upper limb and lower limb after three days of testing COVID positive. The patient Efficacy of non-speech oral motor exercises presented with septic shock and was admitted in ICU and was in facilitating articulation development in tracheostomized. Third patient is a case of primary stroke and the patient developed right sided limb weakness with altered children with cerebral palsy sensorium after two days and was shifted to ICU. Result: The above case series shows that there is increased Bibhu Prasad Hota, Jayasankar Panda risk of stroke in COVID 19 patients attributed to the hypercoagulation inducing mechanism of the virion. Department of Speech and Hearing, Swami Vivekan and National Conclusion: This case series shows that there is increased Institute of Rehabilitation Training and Research, Cuttack, Odisha, risk of stroke in patients with COVID 19 and them requiring India. ICU admission hinders with providing good rehabilitation care E-mail: [email protected] to patient. Background: Non-Speech Oral-motor exercises (NSOMEs) are used to strengthen and improve muscle coordination of the A feasibility and effects of parafit program jaw, lips, tongue, soft palate, larynx, and respiratory muscles on physical activity, exercise self-efficacy, (Landis,1994). and physical fitness among individuals with Aim: The purpose of the present study was to investigate the efficacy of NSOMEs in facilitating articulation development in spinal cord injury cerebral palsied children. Methodology: Participants were 60 children with cerebral Noor Hafifi Noor Hisham, Haidzir Manaf, palsy with a mean age of 4.2 years and within age range of 2-6 Maria Justine years. The participants were studied across two homogenous groups. Non-Speech Oral Motor Exercises (NSOMEs) apart Department of Physiotherapy, Kuala Terengganu, Malaysia. from motokinesthetic and sensorimotor therapy techniques E-mail: [email protected] Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S23

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract were administered to group 1 participants. Performance scores Post stroke depression and its effect on of Comdeall-Assessment of Oromotor Skills in Toddlers and functional outcomes during inpatient Photo Articulation Test in Odia were derived at 0, 3rd, 6th, and 9th month. Paired t-test was used to compare differences rehabilitation between therapy intervals in the two groups. Chi-square test was used to determine significant differences between scores B. P. Navin, G. S. Sonachand, Anupam Gupta of participants for each test across each interval. Department of Neurological Rehabiliation, National Institute of Results: Results indicated statistically significant differences Mental Health & Neurosciences, Bengaluru, Karnataka, India. (p<0.05) between the interval scores of Comdeall-Assessment E-mail: [email protected] of Oromotor Skills in Toddlers and Odia Photo Articulation Background and Aims: Neuropsychiatric disorders following Test in group-1 participants. Intergroup comparison indicated stroke have been commonly reported, which adversely significant differences between the final scores of Photo affect outcome. We aimed to observe the effect of post Articulation Test in Odia with Group-1 participants having better stroke depression on functional outcomes during inpatient performance scores. No significant differences (p>0.05) were rehabilitation. also found across the interval scores of Comdeall-Assessment Methods: Prospective observational study included first ever of Oromotor Skills in Toddlers (Archana, 2008) in group 2 stroke patients with duration of 1 year. They were assessed participants. at admission and after 14 days of inpatient rehabilitation using depression sub-scale of ‘Hospital Anxiety and Depression Conclusion: The results of the study stress the need of Scale HADS-D’ and Hamilton Depression Rating Scale implementing NSOMEs in the speech and language treatment (HDRS). The outcomes measures used were: Barthel Index regime of cerebral palsied children. (BI), Scandinavian Stroke Scale (SSS) and Modified Rankin Scale (MRS). Inter-intra rater reliability of Tinneti Results: Thirty participants (18 males) with median age of 58 Performance Oriented Mobility Scale and years and median stroke duration of 90 days were included. Dynamic Gait Index of balance and gait by Seventeen participants (57%) had symptoms of depression (HADS-D>7). Participants in both groups (with and without virtual method in stroke Pt depression) showed improvement in all the functional outcomes measures (BI, SSS, MRS) at the time of discharge Tejal Manohar Garud, Suvarna Shyam Ganvir as compare to admission. The difference in scores [median (Q3-Q1)] between discharge and admission in participants with Department of Neurophysiothrapy, Dr. Vitthalrao Vikhe Patil depression for BI was 10 (20-5), SSS was 3 (7-0) and MRS Memorial Hospital, Ahmednagar, Nashik, Maharashtra, India. was 0 (0,-1); in people without depression the difference in E-mail: [email protected] score for BI was 15 (25-15), SSS was 4 (8-2) and MRS was 0 (0,-1). The change in the outcome measures were statistically Background: With this pandemic era tele-rehabilitation significant within groups (p< 0.05) but not significant between has become a new normal in the treatment of patients with the groups (p>0.05). neurological dysfunction. So the tools used for assessment Conclusion: Post stroke depression is common among stroke needs revalidation while being used virtually. The aim is to survivors. There was no significant difference in the functional investigate Inter Rater and Intra Rater Reliability of Tinneti outcomes between stroke patients with depression and those Performance Oriented Mobility scale and Dynamic Gait Index without depression with inpatient rehabilitation program in the subscale and total score through virtual mode in patients with present study. stroke. Solo guidance of ultrasound for botulinum Methods: This is the observational study conducted on patients toxin injection in cricopharyngeus muscle: with stroke using virtual medium. Patients with gait and balance Successful treatment in a patient of chronic impairment were assessed using Dynamic Gait Index and Performance Oriented Mobility Scale. A round of demo video dysphagia following lateral medullary incorporating the components of scale, description of each with syndrome instructions was done before the actual assessment was given to the patients and care takers. 2 independent raters of similar Ayan Ghosal, Arindam Mitra, Rajesh Pramanik educational qualification scored the patients at the same time for inter rater reliability. First author scored the components on Department of Physical Medicine and Rehabilitation, IPGMER and the next day for intrarater reliability. SSKMH, Kolkata, West Bengal, India. E-mail: [email protected] Result: Agreement between Inter rater and Intra rater of POMA Background and Aims: Chronic dysphagia following lateral components wise was 71.47% it was from 52.94%- 88.23% medullary syndrome is a concern for the physiatrists, and Low to High. Inter rater and Intra rater reliability of individual the cricopharyngeus muscle spasticity has been found as items varied from poor to excellent. Agreement between Inter the main cause. Botulinum toxin injection is a widely used rater and intra rater of DGI was 58.9% and component wise it procedure for the treatment of the dysfunction of the upper was from 47.05%- 70.58% Low to High. Conclusion: The Inter oesophageal sphincter (UES). Although the injection can rater and Intra rater reliability of DGI and POMA is found to be be guided by ultrasound, electromyography, or computed good, when measured through virtual method. tomography, ultrasound guided injection is the easiest Keywords: Inter rater and intra rater reliability, POMA and DGI assessment, stroke, tele-neurorehabilitation. S24 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract and least invasive method. There are only few studies that with Life Scale (SWLS) to assess mood and satisfaction with observed the effectiveness of ultrasound guided botulinum life respectively. toxin (ONAbotulinum Toxin Type A, i.e. BTX-A) injection in Results: The mean global cognitive scores and satisfaction cricophayngeus muscle in patients of dysphagia following with life score showed improvement with both the CTR and lateral medullary syndrome. To our present knowledge no study IPCR group. However, there was a discrepancy between the has been done with solo guidance of ultrasonography. Our subjective mood assessment scores, in that the IPCR group purpose is to report the effectiveness of BTX given under solo showed fewer depressive and anxious features as compared guidance of ultrasound in cricophayngeus muscle in a chronic to the CTR group. dysphagia patient of Lateral Medullary Syndrome(LMS) and Conclusion: The present study provides preliminary evidence see the effect subjectively and objectively. in support of cognitive tele-rehabilitation and its efficacy in Methods: In a patient of right lateral medullary syndrome maintaining cognitive skills in early dementia, and should with chronic severe dysphagia, 50 U of BTX-A given in right pave the way for future studies aiming at designing treatment cricopharyngeus muscle under guidance of ultrasound. protocols for cognitive tele-rehabilitation for neurodegenerative Results: There was both subjective and objective improvement conditions. with DOSS score improve from 1 to 6, FOIS score improved from 1 to 6 and PAS Score improvedfrom 7 to 2 at two months Effectiveness of a comprehensive physical follow up and improvement sustained in up to 6 months of activity promotion program on physical follow-up. activity and quality of life among people Conclusion: Solo ultrasound guided BTX-A injection may be an effective and cost-friendly way for patient with cricophayngeus with stroke living in a south Asian country muscle dysfunction following Lateral Medullary Syndrome. Pradeepa Nayak, Senthil Kumaran, USG guided botulinum toxin for upper B. Unnikrishnan, M. John Solomon esophageal sphincter spasm in neurological Department of Physiotherapy, Manipal College of Health dysphagia Professions, MAHE, Manipal, Karnataka, India. E-mail: [email protected] Sabir Pottichi, Navita Vyas, Abishek Srivastava Background and Aims: Despite of proven health benefits of regular physical activity (PA), adults with stroke do not achieve Department of Physical Medicine and Rehabiliattion, Kokilaben recommended levels of PA. Therefore, we aimed to test the Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India. effectiveness of a comprehensive PA promotion program on E-mail: [email protected] PA levels measured with physical activity scale for individuals Cricopharyngeal Muscle (CP) or Upper Esophageal Sphincter with physical disabilities (PASIPD) and accelerometers, and (UES) spasm leading to Dysphagia and Aspiaration is very quality of life (QoL) measured with stroke specific quality of common problem in many neurologiacal diseases and can life (SSQoL) in adults with stroke. be treated by Botulinum toxin injection (BTX)in CP muscles. Methods: In a cluster randomized controlled trial four Injection can be given by EMG or Endoscopic guidance USG community centers of Udupi district, Karnataka were randomly guidance is a new strategy to guide the injection. allocated to experimental and control groups. Participants in the experimental group received 7 intervention sessions in The efficacy of cognitive tele-rehabilitation a period of 45 days. Sessions were focused on education, in maintaining cognitive skills in exercises, adaptive sports, and motivation to do PA. Control group participants received one session on education about neurodegenerative conditions: A pilot study stroke recovery. Participants’ PA levels and QoL were assessed at baseline and 3 months post-intervention. Karishma Jethmalani, Poonam Bajaj, Results: Mean age of the participants was 60.03 ± 9.68 in the Aashish Contractor control group (n=35) and 56.60 ±9.92 in the experimental group (n=35). Repeated Measures ANOVA revealed a significant Department of Rehabilitation and Sports Medicine, Sir H.N. Reliance improvement in the PASIPD scores (F= 8.34; df = 1, 64; Foundation Hospital, Mumbai, Maharashtra, India. p=0.005), average kilocalories per day (F=4.93; df = 1, 58; E-mail: [email protected] p=0.030), step counts per day (F= 4.46; df = 1,58; p= 0.039) Aim: The aim of this study is to test the efficacy of cognitive and SSQoL scores (F = 24.45; df = 1, 64; p<0.001) in the tele-rehabilitation (CTR) in maintaining cognitive skills, and to experimental group compared to the control group. further compare its effects with in-person cognitive rehabilitation Conclusion: Comprehensive PA promotion program improves (IPCR) in patients diagnosed with mild dementia. PA levels and QoL in community-dwelling adults with stroke. Methodology: Twenty-two participants with mild dementia (Mini-mental state examination score 21-25; Clinical Dementia Using “brainnext” for acute, severe brain Rating score 1) were divided into two groups. Five patients infection and profound global deficit; received CTR, and seventeen patients received IPCR. The intervention consisted of two weekly sessions of CTR and IPCR, giving quality of life to a child with rabies conducted over a span of three months. The main outcomes encephalitis measures used were the Addenbroke’s Cognitive Assessment (ACE-R) to assess cognitive functions, and the Hospital Anxiety and Depression Scale (HADS) and the Satisfaction Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S25

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Mangal Kardile with age, extent and duration of injury, initial management and Ranchos Los Amigos (RLA) stage at admission. Department of Clinical Neuropsychology, Mental Health Aims, Subjects and Methods: Severe TBI patients above 18 years Nashik, Maharashtra, India. of age, admitted during 2017-2019 were enrolled. Medical E-mail: [email protected] complications were retrospectively collected from records using Background and Aims: Rabies encephalitis is a rapidly- questionnaire and association with different variables studied. progressive-CNS-infection resulting from infection by a Results: 100 severe TBI patients, 81 males and 19 females, member of an RNA virus, mostly transmitted by infected animal mean age 35 years were included. Duration since injury was </= vectors to humans via bite, resulting in rapid neurological 6 months in 39%, 6 months to 1 year in 19%, and >than a year deterioration, mostly progresses to death. The case of in 42%. As per RLA staging, 17% were </= 2, 54% were within 17-years-old-young-boy “S”, had dog-bite when 10-years-old, 3 to 4 and 29% were above 5. 81% patients had complications. until Normal development, but went almost into-vegetative- Neurobehavioural issues (29%), genitourinary complications stage 1-and-half-month after acute-rabies encephalitis, with (18%), Heterotopic ossification (16%), dyselectrolytemia severe epilepsy. After trying all treatment-rehab options >7 (11%), respiratory infections (11%), tracheostomy related years, started ”BrainNext” rehab-program, recovered >55% complications (10%), seizures (8%), pressure ulcers (6%), in 14-months from baseline-condition, rehab continued by contractures (6%), fractures (4%), paroxysmal sympathetic caregiver at home. overactivity (3%), hydrocephalus (3%) and thromboembolic Methods: With caregiver’s consent, the young boy “S” in events (6%) were identified. Complications were more in vegetative state, supported at home after mother approached 36-55years of age with RLA stage 3-4 and in those admitted in the hospital OPD, author created special “BrainNext” tools within 6 months. Conclusion: Medical complications are very rehab-program to alert sensory-systems, follow-up continued common during rehabilitation and are associated with age, every 15 days revising and adding new exercises as applicable duration since injury and level of consciousness. for 14 months before covid-19-March’20 at his residence. Rehab continued online during Covid-19, for 6-months. Transcutaneous tibial nerve stimulation for Recovery recorded on hard copy-audio-video. Measured overactive bladder syndrome: A case study progress,1 to 10 scale-(1-10%,10-100%), baseline as 0%. Results: Sensory reflexes started >5% in 1st week, neuronal Aastik Pankajkumar Bhatt, Sabir Pottichi, pathways alerted >15% in 1st-month, eyelids-movement, little Navita Purohit, Abhishek Shrivastava speech, neck holding, neuromuscular flexibility improved>25% by 4 months, fine-motor grip, following-instructions subtly-facial- Department of Physical Medicine and Rehabilitation, Kokilaben expressions-speech, chewing, visual-focus, spinal-stability Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India. improved >40% by 10 months, although having seizures, overall E-mail: [email protected] sensory-responses improved >55% by 14-months, “BrainNext”- Background and Aims: Overactive bladder syndrome is rehab continued by caregiver at home. defined as a symptom syndrome which includes urinary Conclusions: “BrainNext” special rehab-tools developed for urgency, with or without urge incontinence, usually accompanied severe cognitive decline giving hope for caregivers with better by frequency (>8 micturitions/24 h) and nocturia. Tibial nerve quality of life for persons-with-rare-brain-infections, as rabies- stimulation is a novel and non-invasive treatment option for encephalitis, improving >55% in 14 months recovering almost overactive bladder syndrome. from vegetative-stage, besides severity and >7 years-lived- Materials and Methods: A 71 years old male patient of recurrent with-severe-disability, observed with increased responses to meningioma was given Tibial Nerve Stimulation for overactive other therapies after “BrainNext” program. bladder syndrome. A set parameters of transcutaneous electrical nerve stimulation (TENS) current was given. The patient was Medical complications among patients with assessed on Overactive Bladder Symptom Score (OABSS) severe traumatic brain injury admitted for developed by Yukio Homma et al and Overactive Bladder inpatient rehabilitation in a tertiary care questionnaire (OAB-q) developed by Coyne K et al. Result: OABSS (0-15) improved from 14/15 to 3/15. OAB-q centre in South India (33-198) improved from 117/198 to 48/198. Conclusion: These findings point towards transcutaneous Saumya Susan Zacharia, Raji Thomas, electrical nerve stimulation (TENS) as an alternate treatment Prashanth Chalageri option for overactive bladder syndrome management. Department of Physical Medicine and Rehabilitation, Christian Step length asymmetry and walking Medical College, Vellore, Tamil Nadu, India. performance in hemiplegic patients E-mail: [email protected] Background: Patients with Traumatic Brain Injury (TBI) Dhinla Sivadas, C. Ramesh, T. Jayakumar admitted for inpatient rehabilitation have several preventable medical complications that delay rehabilitation. Awareness of Department of Neurorehabilitation, NIMHANS, Bengaluru, these help in early diagnosis and timely intervention. There Karnataka, India. is scarcity of such studies in Indian literature and hence this E-mail: [email protected] study aims to identify medical complications during inpatient Background and Aims: Gait asymmetry in stroke patients is rehabilitation and to study associated factors. well documented and asymmetry in spatiotemporal parameters Aims: To study medical complications during inpatient rehabilitation of patients with severe TBI and their association S26 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract has been used commonly in clinical practice. Hemiplegic Shristi Shakya, Nayan Prakash, patients may walk with either relatively longer paretic or non S. Shamantha Madapura, paretic step length. However, this asymmetry in step length Harikishan Balakrishna Shetty, and its effect on walking performance is less documented. So Sivakumar Gopalakrishnan, Bhamini Krishna Rao, the aim of our study is to understand the relationship between V. S. Venkatesan step length asymmetry and hemiplegic walking performance. Methods: This observational study includes 20 chronic stroke Department of Physiotherapy, Manipal College of Health patients. Gait parameters such as step length asymmetry, Professions, Manipal Academy of Higher Education, Manipal, paretic leg propulsion and mean velocity were assessed in 3 Karnataka, India. D Motion Gait analysis lab. Stroke severity was assessed by E-mail: [email protected] Brunnstrom stages of motor recovery scale. Background and Aims: Poor postural control interferes with Results: Significant negative correlation was revealed between independence in Activities of Daily Living and mobility in CP step length asymmetry and propulsive force generation with children. Improving balance and equilibrium during different paretic leg and it also shows a strong correlation with stroke postures and gait is important in rehabilitation. Most of the severity and moderate negative correlation with walking speed. pediatric walkers are passive frames, which do not actively Conclusion: Step length asymmetry is a promising tool to facilitate gait training. SW is an innovative interactive gait understand the walking performance of stroke patients. trainer. It aims to determine the feasibility of SW in postural training of CP children. Sonographic evaluation of affected shoulder Methods: 2 typical and 3 CP children were enrolled after in patients with hemiplegia following consent. Camera with mounting device captured anterior, stroke lateral, and posterior view after the children were donned with SW at the ASIS level. Any one or combination of the walker’s Faiz Mohamed, Navita Vyas, Abhishek Srivastava legs was extended to tilt SW. Postural adjustments were captured and analyzed using kinovea software. Department of Physical Medicine & Rehabilitation, Kokilaben Results: Postural adjustments, following anterior-posterior tilts Dhirubhai Ambani Hospital, Mumbai, India. of SW were recorded and analyzed. The typically developed E-mail: [email protected] (TD) children were quick to learn and adapt to the controlled Objective: Hemiplegic shoulder pain is common in stroke. This imbalance compared to CP. The CP children were not able to study was performed to evaluate the sonoanatomy of affected remain stable/lost balance when the SW leg was raised beyond shoulder in hemiplegia and to assess correlation between 3 cm compared to 9 cm of TD. The Lumbopelvic (LP) angle was structural changes and Type of Stroke, Duration of stroke, Age 2.5 times higher in CP compared to TD children for anterior tilt of patient or Pain. and 2.25 times higher for posterior tilt. Materials and Methods: A Prospective study involving 70 Conclusion: Single session SW’s static standing intervention patients was done in Department of PMR, Kokilaben Dhirubhai was successful in triggering postural reactions and documented Ambani Hospital. Ultrasound evaluation of hemiplegic shoulder differences in LP angle in typical and CP children. However, was performed to assess for structural changes. Type and the beneficial effects of short and long-term training with the duration of stroke, Age of patient and presence of pain was SW in CP children are yet to be explored with EMG findings. recorded. Statistical Analysis was done using SPSS V21. Chi- Square/Fisher’s Exact test was used to find out non-random Walking speed and cadence as predictors of associations between two categorical variables. fall risk in chronic neurological conditions Results: One or more structural abnormalities were found in all hemiplegic shoulders. 65 % had Ischemic stroke while 35 % Poonam Bajaj, Shanaya Contractor had Haemorrhagic stroke. 34% were less than 3 months and 66 % were more than 3 months post stroke duration. 24% of Department of Rehabilitation and Sports Medicine, Sir H N Reliance patients were younger than 45 years, 76 % were older. 85% Foundation Hospital, Mumbai, Maharashtra, India. of them had pain in the shoulder while 15 % had no pain. E-mail: [email protected] The Sonographic evaluation showed: Supraspinatus tears in Background and Aims: Fall risk is highest in most chronic 87 %, Tenosynovitis of biceps tendon in 73%, SASD bursitis neurological disorders. It can lead to a downward cascade in 44%, Subscapularis tendinopathy in 38 %, Glenohumeral that leads to significant morbidity and mortality. Whilst there effusion in 20% and AC joint degeneration in 27%. There was are several standardized balance tests that can predict fall risk no correlation between structural changes and Type of Stroke, they are time consuming. This study seeks to analyse whether Duration of stroke, Age of patient or presence of pain. a quick and simple test of walking speed and cadence can Conclusion: Hemiplegic patients have significant structural screen for fall risk accurately. abnormalities in the affected shoulder irrespective of type, Methods: 10 subjects within the age group of 55 to 75 years duration, age or presence of pain. with a chronic neurological condition involving lower extremity weakness, such as stroke, Parkinsons Disease, traumatic brain Single session smart walker (SW) static and spinal cord injuries, were made to perform the 10 meter standing intervention in cerebral palsy (CP) walk test. Their walking speed and cadence were measured over three trials. Their values were compared to 10 age children – An observational study matched normal controls. Results: Statistical significance was calculated using a one- tailed t-test (using Social Science Statistics Calculator) for Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S27

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract cadence (steps/ minute) and walking speed (metres/ second). were weaned off from ventilator within range of 5 to 60 days, Results were found to be significant for walking speed in were decannulated and all were sent home without oxygen individuals with chronic neurological conditions when compared except 1 (0.04%) who required 0.5-1 lt of oxygen while mobile; to age matched normals (P 0.05). However results for cadence with Home rehabilitation Program. were found to be non-significant at P 0.05 in both groups. Conclusion: The patients who required prolonged Ventilator Conclusion: Walking Speed is a reliable, valid, responsive, support are the one who had severe Dyspnea, deconditioning, easy and safe, quick screening tool for fall risk prediction in the Depression, Fatigue, pain and cognitive impairments. clinic. Cadence was not found to be as efficient a parameter for screening fall risk in chronic neurological conditions. Gait characteristics following stroke: A prospective crossover study among users of Spectrum of COVID-19 in a tertiary care ankle-foot orthosis and functional electrical neuro rehabilitation centre stimulation J. Jeyakhar, Navita Vyas, Abhishek Srivastava Gourav Sannyasi, B. P. Navin, Rajdeep Ojha, Department of Physical Medicine and Rehabilitation, Kokilaben George Tharion Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India. E-mail: [email protected] Department of Neurological Rehabilitation, National Institute of Introduction: The coronavirus disease 2019 (COVID-19) Mental Health and Neurosciences, Bengaluru, Karnataka, India. caused by severe acute respiratory syndrome coronavirus 2 E-mail: [email protected] (SARS-CoV-2) first emerged in Wuhan city, China and has Background and Aims: Foot drop following stroke can be since spread to 215 countries including India. India a developing treated with ankle-foot orthosis (AFO) or functional electrical nation and densely populated country too has been affected stimulation (FES) to peroneal nerve. There is limited evidence COVID-19 19 pandemic. As on March 3rd, 2020 nearly 10 regarding the efficacy of FES as a substitute for a traditional million people were totally infected, death around 150 thousand ankle-foot orthosis. We aimed to compare the effect of FES dead and 9.9 million people recovered with Maharashtra state with AFO on gait parameters in individuals with foot-drop leading in the Number of cases. In Kokilaben Dhirubhai Ambani following stroke. Hospital & Medical Research Institute we have full-fledged Methods: Twenty individuals (ten per group) were enrolled in Rehabilitation department and patient have the best opportunity the prospective crossover trial. Participants in Group A received for the maximum best outcome from covid-19 disease and Post gait training with AFO for first week followed by FES during covid-19 complication. second week and vice-versa for group B. Outcome parameters Aims and Objectives: The aim of the study is to present included 10 meter and 6 minute walk test and spatiotemporal the demographic details, clinical features, severity of illness, gait parameters. Assessment was done on day one (barefoot) radiological findings, management and rehabilitation for and at the end of every week following AFO/FES training. In patients who were affected by COVID-19 and seen during July addition, the level of satisfaction was assessed using feedback 2021 to February 2021 in the Centre of Physical Medicine & questionnaire. Rehabilitation in Kokilaben Dhirubhai Ambani Hospital and Results: Nineteen males and one female with mean (SD) age Medical Research Institute. of 45.5 (9.45) years were recruited. Statistically significant Materials and Methods: It is a Cross Sectional Observational (p<0.05) improvement was observed in 10-meter and 6-minute Retrospective study. All the patient with history of COVID-19 walk test, gait speed, TUG test, stance-swing ratio and single- infection who attended/referred to Centre of Physical Medicine limb support among users of FES as compared to AFO and & Rehabilitation for Neuro Rehabilitation, Pain management barefoot. Physiological cost index (PCI) showed trend of and post COVID-19 Cardio - Respiratory rehabilitation for improvement among FES users. Patient satisfaction scores Inpatient, Outpatient and Day care management will be were higher with FES. included in the study. Detailed history of the patient including Conclusions: Quantitative and qualitative results were in the severity of the disease, reason for referral will be collected. favour of walking with FES as compared to AFO and barefoot The main disabling issues in the post COVID patients like walking. Results highlighted the need for a low-cost FES device Dyspnea, Deconditioning, Depression, Fatigue & Pain will be in the developing countries. graded using standard scales. Results: 97 patients were taken in the study out of which 75 Development and validation of FmAE (77%) were admitted due to covid/ with complications of covid, device for hand function training 10 (10%) had covid during hospital stay and remaining 12 (11%) had incidental finding of COVID. All the patients were evaluated Salim Babulal Shaikh, Suvarna Ganvir by Rehabiliation Physician and Started on Comprehensive Rehabilitation for Covid as well as other Neurological aspects Department of Neurophysiotherapy, DVVPF’S College of 18 (18%) were on ventilator support, 13(13%) required oxygen Physiotherapy, Ahmednagar, Maharashtra, India. (3-15 lts), 12 (12%)were on Tracheostomy Tube. 12 (12%) E-mail: [email protected] succumbed to the virus in course of time. 38 (37%) had Background: Hand dysfunction due to any cause results in a deconditioning due to the disease and 24 (24%) had severe significant impairment leading to functional inability. Very few fatigability; 80% had impaired mobility due to deconditioning, devices are available to measure individual finger performance fatigability and pre covid neurological issues. All who survived effectively, also the treatment devices that emphasize on individual finger activity are rare. S28 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Objective: To describe the development of FmAE Device for Comparison of activity levels between younger hand function training in functional position. In addition, its and elderly stroke survivors in hospital intra- and inter-rater reliability was examined. Methods: Thorough investigation of currently available grip Apoorva M. Shankaranarayana, Nikhil Hegde, measurement tools was done. Considering their limitations Pattan Yakub Sameer Khan, John M. Solomon, in terms of inability to provide immediate feedback, exact N. Manikandan gradation of individual finger muscle strength, FmAE was devised. Application of this device was done on 10 healthy Department of Physiotherapy, Manipal College of Health adults to figure out its reliability. Measurements of the Finger Professions, MAHE, India. muscle strength were obtained by two examiners for 20 hands E-mail: [email protected] of 10 healthy adults at two time points, with a one-day interval Background and Aim: Stroke survivors exhibit sedentary between measurements, to determine the inter- and Intra-rater behavior during hospital stay which could lead to development reliability. of complications, especially in older age groups. Aging can be a Results: The reliability of the device was excellent for both vital factor for reduced activity levels. Therefore, it is important intra- (intraclass correlation coefficients 0.94) and inter-rater to identify the difference in activity patterns between elderly and (intraclass correlation coefficients 0.96) comparisons. No fixed younger age group patients with stroke during hospitalization or proportional bias was observed between the two examiners. to plan the appropriate strategies. The aim of this study was Conclusions: The results indicate the excellent reliability and to compare the level of activity in hospitalized stroke patients responsiveness of our device. This reliable measurement tool during acute and subacute stages between elderly and young used for assessment of individual finger strength which can to middle aged. be quantified objectively and hence can be recorded easily. It Methods: A cross-sectional study was carried among stroke can be used for treatment purposes which will help to improve survivors admitted in hospital. Stroke patients of either gender the muscle strength. aged between 18 and 80 years were identified and monitored using an activity log chart from 8AM to 5PM. The observations Timed up and go test in chronic hemiplegic were done every 15th minute and the various activities stroke patients: A comparison of turning performed by the stroke patients were noted. Based on the direction age, participants were grouped either as elderly (>55 years) and young (<55 years). Satyanaya Widyaningrum, Results: Seventeen patients were included in the study. Widjajalaksmi Kusumaningsih, There were 9 male and 8 female participants. 9 patients were Herdiman B. Purba, Dewi Friska aged >55years and 8 were <55years. On an average, stroke patients’ in elderly group were active for 17.19% and sedentary Department of Physical Medicine and Rehabilitation, Faculty of for 75.28%. Patients <55 years were active for 41.55% and Medicine, University of Indonesia, DKI Jakarta, Indonesia. sedentary for 43.57% during the twelve hour period. E-mail: [email protected] Conclusion: Age is an important factor affecting activity levels Background: The Timed Up and Go (TUG) Test is strongly after stroke in hospital. Specific interventions and care towards correlated to level of functional mobility, to reflect the balance elderly may help meet the required activity levels in this group and gait maneuvers used in everday life. The most common and prevent complications. disability in stroke patients is hemiparesis which affect the ability to complete safe turning. Instability in performing a turn Interdisciplinary rehabilitation for can result in increasing risk of fall. Turning as performed during complicated pressure injury in complete the TUG can indicate mobility difficulties, in addition to the spinal cord injury due to neglected burst motoric recovery. This study aims to investigate the effects of the turning direction according to the affected and unaffected vertebral fracture: A case report sides of stroke on their TUG test. Methods: Thirty chronic stroke patients with hemiparesis were Nurrakhmanita Aziza, Indriati M. S. Tobing, asked to perform TUG test by turning two directions. Other Vitriana Biben parameters assessed were Functional independence (Barthel Index Shah Modification Indonesian version), Moc-Ina, and Department of Physical Medicine and Rehabilitation, Faculty of neuromuscular examinations. Medicine, Hasan Sadikin National General Hospital, Padjadjaran Result: Longer Timed Up and Go (TUG) test duration time University, Bandung, Indonesia. when turning with unaffected side (18.65±9.05 s) compared E-mail: [email protected] with the affected side (18.29±8.98 s). There were no Background and Aims: Spinal cord injury (SCI)-associated significant differences in turning direction in Timed Up and pressure injuries are common, especially in a developing Go test (p>0.05). Those who have reached Stage of recovery country. Interdisciplinary rehabilitation is mandatory to support Brunnstrom 6 has shorter TUG time compare to Brunnstrom 5. the management of complicated pressure injuries. Conclusion: Neither turning in affected nor unaffected side of Methods: A male, 31-years-old, diagnosed with SCI ASIA hemiparesis side seems to be safe in turning for daily activities. Impairment Scale (AIS) A with neurological level Thoracal Brunnstrom stage of recovery has strong correlation in affecting 10 due to neglected vertebral burst fracture referred from the TUG test. plastic surgeon with multiple pressure injury. The ulcers were unstageable at the sacrum and ischium tuberosity bilateral with the Pressure Ulcer Scale for Healing (PUSH) score was 17. It Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S29

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract had multiple drug resistance (MDR) Acinnobacter baumannii following instructions-speech-memory-fine-motor developed infection that indicated unhygienic wound care. He also had >15% by 2 weeks, >50% improvement observed by 6 weeks, malnutrition, catheter-associated urinary tract infection (CAUTI) for in-out-patients. Severe-in-patients improved >30% in 15- by MDR Escherichia coli, and urinary leakage that could worsen days, discharged and home-support continued along with the wound. Based on the resistance test, he got ampicillin- neurophysiotherapy. sulbactam to treat wound infection and CAUTI. The assessment Conclusions: “BrainNext”-rehab-sessions at Sancheti hospital of hemodynamic and cardiorespiratory endurance had been by trained-neurophysiotherapists and regular-follow-ups by done to assess the patient tolerance in prone position. The clinical neuropsychologist helped all-ages-varied-neurological- patient was positioned prone and side-lying alternately every 2 conditions, improving memory-cognitive-fine-motor deficit faster. hours and he got wound care. The patient also got high protein Besides varied years-lived-with-disability, quality of life improved and calorie diet, iron supplement, and interdisciplinary program for all patients. Post-stoke and Developmental gross-motor from the rehabilitation team to optimize his functional abilities deficit observed to be responded faster to neurophysiotherapy for supporting the wound healing. and occupational-therapy after “BrainNext” rehab, creating total Results: After 3 weeks of hospitalization, the PUSH score rehab-support-model at Sancheti hospital, Pune. became 13 and the caregiver could do the wound care with good hygiene. The CAUTI was healed, and he got an improvement Effectiveness of therapy in aphasia using in mobilization that will reduce the risk of worsening wound. a combination of principles of deblocking Conclusions: Comprehensive assessment, interdisciplinary and semantic naming – A single case study approach of rehabilitation including family collaboration is needed to manage complicated pressure injury. Archita Kumari, Mereen Rose Babu, Aishwarya Dinesh, Anita Reddy Memory and cognitive rehab at Sancheti hospital (Sior), Pune, India; application Department of Speech Language Studies, Dr. S.R. Chandrasekhar of “brainnext” tools for varied neurology Institute of Speech and Hearing, Bengaluru, Karnataka, India. E-mail: [email protected] patient populations Background and Aim: Severe comprehension impairments in Wernicke’s aphasia (WA) are often seen to be associated with Sonal Shah related auditory and phonological impairments, impairments in semantic and execution function. The present study aimed Department of Physiotherapy, Ancheti Institute for Orthopedics and at understanding effectiveness of combining principles of Rehabilitation, Pune, Maharashtra, India. deblocking and semantic naming treatment in a patient with E-mail: [email protected] acute infarct on left temporo-parietal lobe and chronic infarct Background and Aims: Other neurological disorders, excluding with encephalomalacia involving left fronto-temporal lobe. Alzheimer and Dementia show significant memory and cognitive Materials and Methods: A 41 years old male diagnosed with impairment, observed in the research of standardized memory Severe Wernicke’s aphasia, attended 14 tele therapy sessions and cognitive screening tool “UMACE”-Universal-Memory- through Zoom platform. The therapy was focused on increasing And-Cognitive-Exam. Sancheti Hospital, Pune, specializes in his auditory comprehension, production of meaningful sentence orthopedics rehabilitation and adding “BrainNext” rehab-model formulation, and meaningful usage of words preserved in his for neurology population, successfully achieves complete vocabulary. The therapeutic strategies adopted for deblocking rehabilitation model. The study focuses on varied-neurological- and semantic naming were reading and production of semantic population, children-to-elderly, in/out-patients given rehab attributes, respectively. sessions at Physio-dept., Sancheti Hospital using “BrainNext” Results: The outcome of this approach is reflected with program before and after Covid-19 emerged in India. increase in the percentage of meaningful words from 57 % in Methods: With consent and consulting with Clinical- the first session to 86 % for objects naming and 90% for action Neuropsychologist, ”BrainNext” rehab-program by trained- verbs after 14 sessions and an improvement in his auditory neurophysiotherapists for moderate-to-severe-patients, N=74, comprehension from50% to 80%. The percentage of production male-female, children to elderly with varied neurological of meaningful sentences increased from 53.76 % to 86.04%. conditions, developmental-disorders(comorbid-epilepsy)-rare Conclusion: The findings of this case study indicate the brain-diseases-TBI-PostStroke-Parkinsons-Alzheimer’s- efficacy of combining the principles of deblocking and semantic dementia, given about 5-6 weeks, 2-weeks daily 1-hour, naming treatment in improving the communication skills of alternate-day-2weeks, then twice-thrice-a-week. 15-days- individuals with Wernicke’s Aphasia that can further enhance follow-ups with Clinical-Neuropsychologist, revised previous their quality of life. and added new cognitive exercises, rehab-program continued at home after 6-weeks with follow-ups every month. 2-severe-in- Impact of maternal stress on the motor patients admitted, 1hour-2sessions-daily, observed for 15 days. functions of children with cerebral palsy Post-stroke and developmental-gross-motor-deficit supported with other rehab-therapies at hospital after “BrainNext” C. M. Radhika, Katuree Dutta, M. Rajeswari program. To measure progress 1 to 10 scale (1=10%,10=100%) used, baseline condition 0%. Department of Faculty of Physiotherapy, SRI Ramachandra Institute Results: Patient-centered-memory-cognitive-rehab sessions of Higher Education & Research, Chennai,Tamil Nadu, India. by trained neurophysiotherapists at hospital showed >5% E-mail: [email protected] improvement in 1st week, orientation-visual focus-stability- S30 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Background and Aim: Mothers of children with cerebral palsy of backpain with progressive neurological deficit needs to have showed increased level of stress as compared to mothers properly be evaluated for further management and prevention of normally developing children. Most of our rehabilitation in of complications. cerebral palsy revolves primarily around the child and less importance is given to reducing mental stress of the mothers. Effect of combined low volume interval Reduced stress level will enhance the active participation of treadmill training and resistance exercise the mother which can have an impact on the motor function of on gait speed and muscle strength among the child. The aim of this study is to reduce the mental stress of the mothers of children with cerebral palsy and analyze the individuals with post-stroke influence it could have on the motor function of the child. Materials and Methods: 24 mother-child pairs were randomly Nur Ainna Binti Adanan, divided into two groups. The mothers of experimental group Mohd Haidzir Bin Abd Manaf received parental counseling, parental education and relaxation exercises. The mothers of the control group received parental Department of Physiotherapy, Hospital Selayang, Batu Caves, counseling alone. The children of both the groups underwent Malaysia. regular physiotherapy. Parental stress scale was used to E-mail: [email protected] measure maternal stress and the Gross Motor Function Background and Aims: Loss of walking ability is one of the Measure (GMFM-88) was used to measure the motor function major problems among individuals with post-stroke. They of the child. The intervention period was for 4 weeks before and enter a vicious cycle of limited activity and deconditioning after which the stress and motor outcomes were measured. that limits functional recovery. Conventional gait training is an Results: The mothers of the intervention group showed a effective intervention to improve gait performance after stroke. decrease in the level of stress after the intervention period. The A previous study has demonstrated that improves overground mean stress score of the mothers of the experimental group gait speed and stride length were improved following low reduced from 47.92 ± SD 8.11 to 46.08 ± SD 8.6 (p 0.05). volume interval treadmill training (LVITT). Therefore, this study Conclusion: Reducing the maternal stress through relaxation aims to determine the effect of combined LVITT and resistance exercises and parental counseling will allow more active exercise training on gait speed and paretic lower limb muscle participation of the mother during therapy sessions and can strength among individuals with post-stroke. be influential in improving the motor functions of children with Methods: Thirty-nine chronic post-stroke participated. cerebral palsy. Participants performed the combined exercise program for 18 sessions (3x /week for 6 weeks). Gait speed was measured using Cauda Equina syndrome: An unusual 10-meter walk test and quadriceps muscle strength of paretic presentation in chronic rheumatoid arthritis leg was measured using a handheld dynamometer (MicroFET 2). A repeated measure ANOVA within group analysis was used Monica Moirangthem, A. K. Joy Singh, to determine the effects of baseline and after 3 and 6 weeks. L. Nilachandra Results: A one-way repeated measure ANOVA revealed statistical significance for comfortable gait speed, fast gait Department of Physical Medicine and Rehabilitation, Regional speed and paretic leg quadriceps muscle strength (All p < Institute of Medical Sciences, Imphal, Manipur, India. 0.05). Post hoc analysis for gait speed and muscle strength E-mail: [email protected] revealed significant differences from PRE to POST-3 weeks Background and Aims: Rheumatoid arthritis (RA) is a (both, p= 0.001), PRE to POST-6 weeks (both, p= 0.001) and symmetric inflammatory polyarticular arthritis that affects the from POST-3 weeks to POST-6 weeks (both, p=0.001). small joints of hands and feet. Affection of the lumbar spine in Conclusions: The findings show significant improvement in chronic RA is very rare though it has been reported. It can cause paretic leg quadriceps muscle strength, comfortable and fast chronic low back pain and even cauda equina syndrome (CES) gait speed in 6 weeks combined LVITT and resistance exercise which is uncommon but is a serious neurological condition program. affecting the bundle of nerve roots at the lower end of the spinal cord. This report is to emphasize that CES can possibly occur Improvement in balance and gait after in longstanding cases of RA and must be kept in mind as a proximal control training in a patient with diagnosis in such patients. Methods and Results: We report a case in a 65-year-old male severe gullian barre syndrome – A case who had history of seropositive RA for 13 years. He presented study with weakness of both lower limb and difficulty in passing urine. Plain X-ray lumbosacral spine showed disc space reduction, Shreya Gada, Poonam Bajaj, Aashish Contractor poorly defined endplates erosion and sclerotic changes. MRI whole spine showed spinal canal stenosis at L3-L4, L4- L5 Department of Rehabilitation and Sports Medicine, Sir H. N. levels caused by facet joint hypertrophy most probably due to Reliance Foundation Hospital, Mumbai, Maharashtra, India. pannus. A diagnosis of CES was made based on the history E-mail: [email protected] and radiological findings. After neurosurgical consult, he was Background and Aims: Importance of proximal control training managed conservatively. on balance and gait in a patient with severe Gullian Barre Conclusion: Although, rheumatoid arthritis presenting Syndrome (GBS). with CES is uncommon, such patients having complaints Methodology: We present a case study of a 23 year old severe GBS male patient, who had lower limbs, upper limbs Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S31

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract and bulbar weakness with prolonged hospital stay of 3 months. Does somatosensory training have a At 6 months, his upper limb strength was 3/5, lower limbs significant effect on proprioception strength was 2++/5 except ankle muscles which were zero, and balance in patients with diabetic abdominals grade 1+ and back extensors grade 2, plantar and ankle jerk were absent. He had difficulty in standing and neuropathy? walking, poor trunk control, hypersensitivity in feet. Thrice a week training for 2 ½ years included proximal control, strategy Shivangi Salian, Poonam Bajaj, training, strengthening, proprioceptive training, desensitization, Aashish Contractor body weight support treadmill training, balance, gait training on challenging surfaces and stair climbing with bilateral crutches Department of Rehabilitation and Sports Medicine, Sir H N Reliance and AFOs. Foundation Hospital, Mumbai, Maharashtra, India. E-mail: [email protected] Results: Initially, his Functional Index Measure (FIM) score Background: Type 2 Diabetes mellitus is one of the leading was 91/126, 10 meter walk test (10MWT) was 30 secs with metabolic disorders with several associated complications, crutches and AFOs, 5 times sit to stand (5 times STS) and causing multi-system involvement. Peripheral Neuropathy is independent standing were not possible. Currently, trunk and the most common complication, which often causes balance proximal lower limb strength improved to 4/5, plantar flexors impairments. 1/5, but other ankle muscles strength remained near zero or Aims: The aim of the study is to investigate the effect of flicker. FIM is 115/126, unsupported standing for 2 minutes somatosensory training on proprioception and balance in without AFOs, 10MWT is 7 secs, 5 times STS is 44 secs patients with diabetic neuropathy. independently. Methods: 15 patients (13 males & 2 females) in the age group 70-85 years with diabetic neuropathy and with impaired balance Conclusion: Overall standing balance and gait improved due were included for the study. Subjects with other co morbidities to improvement proximal control despite persistent poor ankle & cognitive issues were excluded for the study. These patients control. underwent specific sensorimotor agility training targeted to improve proprioception 3 times a week for a month. MiniBEST Awareness of post-stroke pelvic floor scale (MCID value 4) was taken as the primary outcome dysfunction in general adult population measure. Pre and post values were calculated & compared. Results: It was observed that there was significant difference Disha Padmaraja Hegde in the pre and post scores of MiniBest scale after training (P value 0.0032). Department of Rehabilitation and Sports Medicine, Sir HN Reliance Conclusion: Somatosensory training has significant effect on Foundation Hospital and Research Centre, Mumbai, Maharashtra, proprioception and balance in patients with diabetic neuropathy. India. E-mail: [email protected] Effect of cognitive activities on the functional mobility and reaction time in Background and Aim: Pelvic floor dysfunction is a lesser- explored area of rehabilitation, more so in patient populations young adults with stroke. The aim of this study to evaluate the awareness of the prevalence of post-stroke pelvic floor dysfunction among Bhagyashree Hajare, R. Lakshmiprabha the general adult population, as increased awareness of the same would improve the quality of care provided to these Department of Physiotherapy, Seth GS Medical College and General individuals multi-fold. Hospital, Mumbai, Maharashtra, India. E-mail: [email protected] Methods: 106 subjects above the age of 18 years were Background: Cognitive Activities are mentally engaging interviewed using an online questionnaire, consisting of multiple activities that challenge a person’s ability to think by enhancing choice questions related to stroke, the pelvic floor and its attention, memory, executive function, language, speed of dysfunction. 61.32 % of the subjects were females and 41.51% processing, visuospatial, perceptuomotor and reasoning skills. of the total subjects were health care professionals. Functional mobility (including dual tasking) and Reaction time need intact cognitive processing, motor and sensory system, Results: 88.68% of the subjects knew what a stroke is, for optimal performance. Effect of physical activities/exercise on while 70.75% of them were aware of the pelvic floor. Of all cognition is very well known. But the effect of cognitive activities the subjects, 63.21% agreed that chances of pelvic floor on functional mobility and reaction time needs to be explored. dysfunction increase post-stroke and 48.59% believed in the Hence the Aim of the study is to examine the Immediate effect possible link between stroke & pelvic floor dysfunction. 79.25% of Cognitive activities on Functional Mobility and Reaction time of subjects agreed that post-stroke pelvic floor dysfunction is in healthy young adults. a significant issue, while 63.21% of subjects believed that not Methodology: The present study is awaiting Institutional many in the general population are aware of these issues. Ethics Committee approval very soon. Young adults in the age group of 18-25 years will be recruited by convenient sampling. Conclusion: There is a lack of awareness among the Subjects with any history of medical, Psychiatric, acute general population regarding the functions of the pelvic musculoskeletal, cardiorespiratory, neurological conditions floor, its likely dysfunction post-stroke and its implications will be excluded. Pilot study will be conducted to calculate the on a person’s activities of daily living. More research and sample size. In this Randomised Clinical Trial subjects will be proactive dissemination of relevant information by health care professionals is imperative to ensure better quality of care. S32 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract allocated into three groups namely: Group A-Cognitive activities sitting position, often termed sit to stand (STS), is a commonly (15mins), Group B-Sham Cognitive activity (15mins) and Group assessed movement in patients with hemiplegia. A concise C-No Activity (15mins). Functional Mobility (Including dual measure to assess the quality of STS is not available. The tasking) will be assessed using Timed Up and Go Test (TUG), purpose of this study was to develop a measure to assess the TUG Manual, TUG Cognitive and Simple Reaction Time will quality of sit to stand in patients with hemiplegia. be assessed using Deary-Liewald Reaction Time software pre and post in all three groups. Inter and Intra group comparison Methods: The first phase consisted of a literature review using appropriate statistical tools will be done. Results and for item generation. The second phase consisted of semi- conclusion will be shared later. structured interviews with 9 physiotherapy practitioners to understand the prevailing practice of qualitative assessment Profile of dysarthria in persons with of sit to standSTS in patients with hemiplegia and a to know Wilson’s disease (pWD) - A retrospective identify the need fora new measure for assessing the quality of sit to standSTS. The third phase comprised a Delphi technique study in the on-medication group involving 9 physical therapists to develop the components for the qualitative measure of sit to stand. Aditi Ravikumar, B. K. Yamini, D. V. Seshagiri, Mariamma Phillip, N. Madhu, S. Sinha Results: All the participants in the semi-structured interview expressed a need for qualitative measure for sit to stand. Department of Speech Language Pathology, National Institute of Availability of a measure for qualitative assessment of sit Mental Health and Neuroscience, Bengaluru, Karnataka, India. to stand in patients with hemiplegia was not evident from E-mail: [email protected] the literature search. A total of 8 components were listed Background: Dysarthria is reported in atleast 90 % of patients in the first round of Delphi for agreement. Based on the (Prashanth and others, 2004; Machado et al, 2006) with comments through the second round of Delphi, a measure Neurologic form of WD and thus is a significant manifestation. with components to observe in the sagittal and frontal plane In order to capture the details of non speech oro-vocal status was developed. All the components reached 80% agreement and speech impairment in Persons with WD (pWD), the from the Delphi experts. current preliminary retrospective study analysed the Frenchay Dysarthria Assessment - 2(FDA2) administered on confirmed Conclusion: A measure with additive scoring was developed, pWD. with a total score ranging from 0 to 7, higher scores indicating Aim: The aim was to delineate the dysarthria characteristics better quality of STS movement. The total score can be used on FDA-2 in pWD (on-medication group). for longitudinal evaluation. But, before the measure can be Methods: Seventeen pWD(n=17; 11M, 6F; Mean age-22.18 used in clinical practice its construct validity, reliability and yrs, SD-5.25) of a tertiary hospital, who were on regular responsiveness must be investigated. medication for WD constituted the study group. The ratings of FDA-2 [(five best-fit descriptors from a (normal function) to Importance of early versus late multimodal e (no function)] on each of its seven sections were tabulated. neurorehibilitation therapy in stroke The intelligibility rating was done for conversation task only, as the pWD spoke vernacular languages. Statistical analysis Pramod Virbhadra Dhonde, Mayura Dhonde, was done to describe dysarthria characteristics. Ashwini Dhonde, Gayatri Khandale, Results: The median duration of WD was 84 months(6-228) Varsha Gore and speech impairment was 48 months (5-174). Speech impairment for two years or more was seen in 75.6% (n=12). Department of Neurology, Dhonde Hospital and Shivansh The mean duration of medication was 84 months (12-168). Neurorehabilitation Centre, Nanded, Maharashtra, India. Results of preliminary analysis of FDA-2 showed that 50-80 E-mail: [email protected] % of pWD had deficits of mild abnormality(b) and obvious abnormality(c) suggesting varied dysarthric presentation. The Background and Aims: We have studied effects of early conversational speech showed an intelligibility deficit in 89 % neurorehabiltation including multimodality therapies in stroke of pWD. patients results were observed retrospectively. Conclusion: Findings suggested continued use of management and compensatory strategies for dysarthria and in turn improving Materials and Methods: We studied retrospectively twenty communication in this speech compromised population. two patients at Shivansh Neurorehabilitation centre with our standardized protocols for stroke patients between august Development of a qualitative outcome 2020 to jun2021. We treated patients with conventional e.g. measure for sit to stand function electrotherapy, exercise therapy and advansed therapies e.g. Hydrotherapy, Mirror box device andvirtual reality. Sivakumar Ramachandran, Zainab Ali Results: Early neurorehabilitation with hydrotherapy and virtual Department of Physiotherapy, Sri Ramachandra Institute of Higher reality shown good recovery. Education and Research, Chennai, Tamil Nadu, India. E-mail: [email protected] Conclusions: 1. Early neurorehabilitation shown 90-95% Background and Aim: Physical therapists clinically assess recovery within 15-20 days of admission at our centre. the quality and quantity of movement. Standing up from a 2.Patients who have taken lateneurorehabilitation required 2-3 months for 60-70% of recovery. 3. Patients treated with advansed modalities e.g. Hydrotherapy and Virtual reality have shown early and significant changes in recovery. Keywords: Hydrotherapy, mirror box device, virtual reality Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S33

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Functional decline with progression in the potential to enhance outcomes beyond what may result age in children with duchenne muscular from face-to-face interventions by enabling naturalistic, in vivo interventions. Some studies suggest that telerehabilitation can dystrophy - A correlational study also reduce health care costs, improve treatment adherence, improve physical and mental function and quality of life, and be Sakshi Desai, Hema Biju delivered in a manner that is satisfactory to patients. The tools of telerehabilitation help minimize the barrier of distance, both of Department of Occupational Therapy, Neurogen Brain and Spine patients to rehabilitative services and of researchers to subject Institute, Mumbai, Maharashtra, India. populations. This enhanced access opens up new possibilities E-mail: [email protected] for discovering and implementing optimized intervention Background: Duchenne Muscular Dystrophy (DMD), is an strategies across the continuum of care. This e-poster would X-linked disorder resulting from a defect in the gene Dystrophin. thus be prepared with the rationale for how telerehabilitation There is progressive loss of skeletal muscle, decline in can be used to promote client self-care and self-management. pulmonary capacity, loss of ambulation in early teen years and premature death due to cardiac and respiratory failure. Long term functional outcomes in patients Functional Independence Measure (FIM) is used to determine with hypoxic ischemic encephalopathy the level of functional participation in people with disabilities. Aim: The aim of this study is to understand and determine the Tanushree Bhat, Poonam Bajaj, extent of correlation between the age of children with DMD and Aashish Contractor their FIM score to ascertain the changes in functional capacity as these children progress in age. Department of Rehabilitation Medicine and Sports Sciences, Sir H N Methods: This study included 262 children diagnosed with Reliance Foundation Hospital, Mumbai, Maharashtra, India. DMD in an age range of 3-20 years. Their FIM scores were E-mail: [email protected] reviewed and a correlation between this score and age in these Background: Hypoxic brain injury is commonly caused as children was done to determine the relationship between the a complication of cardiac arrest, poisoning such as drug two variables. The software SPSS version 23 was used to find overdose, drowning resulting a respiratory failure or head this correlation. trauma. This can result in widespread neurological, behaviour Result: After analysis, the bivariate correlation computed and cognitive impairments. p<0.001 and r = -0.532, which depicts a moderate negative Methods: This study included 6 patients with hypoxic brain correlation i.e with an increase in the age of these children injury whose data was retrospectively analysed. Clinical data, with DMD, there is a decrease in their functional capabilities. outcome measures including Glasgow Coma Scale (GCS), Conclusion: As these children reach the age of 8-10 years, Functional Independence Measure (FIM) were recorded. there is a decline in their ambulatory skills leading to increased Results: Causes for the hypoxia were cardiac arrest (n=5), dependency on others for their daily functional activities. ARDS (n=1). 3 patients underwent PTCA after resuscitation. Occupational Therapists focus on adapting the environment All the patients received intensive physical, speech and to optimize function, maintain and/or enhance residual skills language and cognitive therapy throughout their hospital and teach new skills to children with progressive disorders like stay and one year post discharge on an outpatient basis. At muscular dystrophy. discharge- Out of 6 patients, 3 patients had a GCS of 15, 2 had score of 8 and 1 had a score of 4 out of total score of 15. Tele- rehablitation: A new dimension to After one year follow up 5 patients had a GCS of 15 and 1 had community based holistic rehabilitation 6.The FIM scores were analysed at discharge and one year follow up in which 4 patients improved significantly (with more Neeraj Singh, A. K. Gupta than 50%) improvement in their scores. 2 patients FIM scores showed no change. Low scores of GCS and FIM scales at Department of Physical Medicine and Rehabilitation, King George’s discharge were related to poor long term outcomes. Duration Medical University, Lucknow, Uttar Pradesh, India. of hypoxia and resuscitation were also strong predictors of E-mail: [email protected] prognosis. Age and presence of seizure did not affect the Telerehabilitation refers specifically to clinical rehabilitation physical outcomes. services with the focus of evaluation, diagnosis, and treatment. Conclusion: GCS scores 8 at discharge showed better It is an emerging method of delivering rehabilitation services functional outcomes in long term in patients with hypoxic that uses technology to serve clients, clinicians, and systems ischemic encephalopathy. by minimizing the barriers of distance, time, and cost. It make use of Information and Communication Technologies Predictive analysis for anticipating (ICT) to provide rehabilitation services to people remotely in spasticity after stroke: Findings from Sabah, their homes or other environments. The concept of telecare, when telerehabilitation is used to deliver services to helps Borneo to empower and enable individuals to take control of the management of their medical needs and interventions by Fatimah Ahmedy, Syahiskandar Sybil Shah, enabling personalized care, choice and personal control. The Jamie Joseph, Khin Nyein Yin, driving force for telerehabilitation has been as an alternative Christina Eleanor Martin, Kamarul Hakim Hairudin, to face-to-face rehabilitation approaches to reduce costs, Nooralisa Mohd Tuah increase geographic accessibility, or act as a mechanism to extend limited resources. A rationale for telerehabilitation is S34 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Rehabilitation Medicine Unit, Faculty of Medicine rapid involvement of upper limbs. He experienced diarrhoea and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, and vomiting episodes 2 weeks prior to this event. Despite Malaysia. claiming to have mild productive cough, he required oxygen E-mail: [email protected] supplementation. Severe Acute Respiratory Syndrome Background and Aims: Predictive analysis in healthcare can Coronavirus 2 (SARS-CoV-2) was detected from naso- guide treating physicians on anticipating outcomes among oropharyngeal swabs. Physical examination revealed patients presented with particular features. The study was to sensorimotor quadriparesis sparing the cranial nerves, areflexia identify cluster of clinical features associated with spasticity and limb hypotonia, clinically suggestive of GBS. Presence development after stroke. of autonomic dysfunction caused persistent tachycardia and Methods: A cross-sectional study at a rehabilitation medicine disruption of bladder and bowel control. Lumbar puncture specialist clinic in Kota Kinabalu, Sabah from June to October and electrodiagnostic studies were not done. Intravenous 2019. Those aged 18 years and above with stroke duration of immunoglobulin and standard medical treatment for Category more than four weeks were recruited while stroke survivors 4 COVID-19 pneumonia were initiated. having concurrent conditions that may cause spasticity Results: He underwent intensive inpatient neurorehabilitation were excluded. Clinical features evaluated include age, 3 weeks after admission and gained neurological and functional gender, stroke duration (months), type of stroke (ischaemic improvement in muscle strength, respiratory function, mobility, or haemorrhagic), and severity of stroke (mild, moderate or balance, self care and regained bladder and bowel control. severe). All patients were assessed for presence of spasticity Conclusions: Early rehabilitation for patients with COVID-19 using Modified Ashworth Scale (MAS). Univariate analysis was infection with associated extrapulmonary systemic manifestation used to identify significant clinical features when comparing including GBS is crucial to enhance functional capacity, those with and without spasticity. Then, K-means clustering preventing long-term complications and to improve quality of algorithm was implemented to identify cluster of clinical features life in survivors. among those with spasticity. Results: A total of 150 individuals with stroke were recruited Delayed rehabilitation intervention of a and 66 of them had developed spasticity. Three attributes chronic stroke with severe rheumatic mitral showed significant associations with spasticity: duration after stroke (<0.001), type of stroke (p<0.05), and severity of stroke stenosis (p<0.05). The resultant predictive modelling demonstrated that spasticity is less likely to occur if an individual has a shorter Arya, Farida Arisanti, Sunaryo B. Sastradimaja duration after stroke (<20 months), ischaemic stroke type, and mild stroke severity. Department of Physical Medicine and Rehabilitation, Hasan Sadikin Conclusion: Predictive analysis using clustering model can General Hospital, Bandung, Indonesia. be applied for heterogeneous population such as stroke in E-mail: [email protected] order to anticipate spasticity outcomes for guiding rehabilitation Background and Aims: Severe rheumatic mitral stenosis is management. associated with a worse prognosis after stroke. Exercise and increased physical activity level (PAL) have been proven to Interdisciplinary rehabilitation reduce the risk of recurrent stroke in mitral stenosis patients. management of Guillain Barre syndrome This case report presents a rehabilitation intervention for associated with COVID-19 infection in a improving functional capacity and PAL in chronic stroke due to severe rheumatic mitral stenosis. Malaysian tertiary hospital Methods: A-36 years old housewife, complaining of difficulty in walking and fatigue when performing activities after having Sharifah Hanisah Wan Mohamad Akbar, an infarct stroke in right corona radiata and basal ganglia in Fazreen Nur Abdullah, December 2019. Her in-house activities were carried out with Ahmad Fauzi Ahmad Termizi, Suhani Yacop partial dependence due to those problems. The Berg Balance Scale (BBS) was 41/56, six minutes walking test (6MWT) Department of Rehabilitation Medicine, Sultanah Bahiyah Hospital, showed low cardiorespiratory endurance fitness (METs 2.67), Alor Setar, Malaysia. Barthel Index (BI) was 18/20 (mild disability), and the Functional E-mail: [email protected] Independence Measure (FIM) was 108/126. She started a Background and Aims: Guillain Barre Syndrome (GBS) is late rehabilitation intervention in April 2021 that focused on an acute immune- mediated polyradiculoneuropathy resulting cardiorespiratory endurance, balance, and functional task in varying degrees of sensorimotor impairment and is usually training twice a week. preceded by recent gastrointestinal or respiratory infections. Results: Despite delayed rehabilitation intervention, eight The ongoing Coronavirus disease (COVID-19) worldwide weeks after following the comprehensive rehabilitation pandemic has caused much morbidity, mortality and disruption intervention, the patients showed improvement of functional to healthcare services. This case report highlights the capacity (METs 3.18), balance functions (BBS 47), and importance of interdisciplinary neurorehabilitation approach in independence of activities (BI 20/20 and FIM 121/126) management of GBS associated with COVID-19. regardless of the poor prognosis of motor function recovery. Methods: A 46 year old male prisoner with background of Conclusions: A comprehensive rehabilitation intervention active intravenous drug abuse and Hepatitis C presented provides a beneficial result in the functional capacity of a chronic with progressive ascending symmetrical lower limb weakness stroke patient due to severe mitral stenosis, which is expected 2 weeks prior to admission leading to inability to walk, with to reduce the risk of recurrent stroke, even if it is done quite late. Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S35

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Importance of postural control training in spinal cord decompression sickness (type 2) was transferred to chronic traumatic brain injury - Case series our hospital after receiving hyperbaric oxygen therapy. Clinical evaluation revealed a complete thoracic spinal injury at T8 report level. A comprehensive inward rehabilitation programme was carried out by a multidisciplinary team (MDT) based on the Shreya Shah, Mamta Vedak, Poonam Bajaj, WHO international classification of functioning (ICF) model. Aashish Contractor Patient centred short term and long term goals were set and the MDT meetings were held every 4 weeks. These goals included Department of Neuro Rehabilitation, Sir H N Reliance Foundation management of pain, spasticity, neurogenic bladder and bowel, Hospital, Mumbai, Maharashtra, India. sexual function and prevention of complications associated with E-mail: [email protected] spinal cord injury. Health education, psychological support, Background: Neurorehabilitation is currently the most recreational and vocational rehabilitation were provided preferred treatment option for long-term improvement with throughout the stay. chronic Traumatic Brain Injury (TBI). Recent advances have Results: After a 7-month inward rehabilitation, patient was shown plasticity of neuronal connections as a key for successful discharged with good hand function and the ability to walk recovery of motor functions, and great therapeutic potential is indoors independently with bilateral elbow crutches and bilateral attributed to high-intensity training for motor deficits, including ankle foot orthoses. However, long distance mobility, required postural instability, which can affect their level of independence, a wheelchair. causing risk of falls. Conclusion: Patient centred comprehensive rehabilitation Methods: We present 3 case report of chronic TBI cases who programme can improve functional outcomes in type 2 have undergone therapy with us for 2 years or more. decompression sickness. Case 1: A case of 25 years old female with Quadriparesis for Keywords: Decompression sickness, rehabilitation, spinal the past 8 years came to us 5 years post her injury. cord injury Case 2: A case of 21 years old female with Ataxia for the past 7 years came to us 4 years post her injury. Impact of obstructive sleep apnea on Case 3: A case of 31 years old male with Ataxia for the past 3 balance disorder in Parkinson patients years came to us 1 year post his injury. Outcome Measure: World Health Organization Quality of Shreya Shah, Shivangi Salian, Poonam Bajaj, Life questionnaire (WHOQOL-Bref) Functional independence Aashish Contractor measure (FIM), Goal attainment questionnaire. Intervention: Patients underwent rehabilitation for Balance and Department of Neuro Rehabilitation, Sir H N Reliance Foundation Postural control training in which different components were Hospital, Mumbai, Maharashtra, India. targeted for static and dynamic stability by challenging visual, E-mail: [email protected] proprioceptive and vestibular system. Background: Parkinson’s disease (PD) is the second most Result: All 3 patients who came to us after more than 1 year common chronic neurodegenerative disorder. In addition, from the injury, showed significant improvement in outcome patients with PD may suffer from different types of sleep measure scores. disorders such as Obstructive Sleep Apnea (OSA) which Conclusion: We conclude that even after more than one occurs in 20 to 60 percent of patients. OSA is characterized by year post their injury, patients with TBI have shown promise recurrent upper airway obstruction leading to periodic arrests in regaining postural control. of breathing during sleep, resulting in intermittent hypoxia and frequent arousal, which aggravates cognitive and motor Improving functional outcomes following manifestations in the early stages of PD. spinal cord decompression sickness: A case Aim: We aim to assess the impact of OSA on Balance disorder in PD patients. report Methods: This study has included four PD patients between the age group of 60 to 75 years, out of which two patients Chamara Badrakumara Jayatunga, have OSA, and two of them did not have any diagnosed sleep Duminda Abeysinghe1 disorder. All the patients came within 2 years of their onset and had undergone similar medical and therapeutic management. Department of Spinal Injury Rehabilitation Unit, Rheumatology and Their initial evaluation was done with Unified Parkinson’s Rehabilitation Hospital, Ragama, Sri Lanka, 1Rheumatology and disease rating scale (UPDRS), MiniBest Test, and Fall risk Rehabilitation. assessment as baseline outcome measures. E-mail: [email protected] Result: We found PD patients with OSA had a higher UPRS Introduction: Decompression sickness is a serious condition score, increased risk of fall, and their baseline mini best scores associated with scuba diving which is caused by the liberation were lower than those without any sleep disorder despite of dissolved gas in the form of bubbles inside the diver’s tissues. similar medical management possibly due to OSA as a co- Spinal cord is the most common site of neurological injury and morbid factor. management includes prompt hyperbaric oxygen therapy, Conclusion: Our study lacks enough data to conclude supportive measures and a comprehensive rehabilitation that patients with OSA and PD have increased severity of programme. symptoms. However, we see a trend that requires further Case Report: In February 2020, a 46-year-old previously healthy professional scuba diver from Kalpitiya, Sri Lanka with S36 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract studies to corroborate these findings and whether OSA can skills hence become a point of worry when it comes to writing, accelerate the neurodegenerative process. wearing clothes or holding and manipulating objects. These children often have delayed milestones and hence most of the Effect of transcranial direct current times confined to exercises and achieving those milestones. stimulation (tDCS) on plantar flexor Bharatanatyam is an ancient form of dance based on Carnatic spasticity, balance and on gait in post stroke music. To introduce them to richer thing in life in the world of art along with aiming at improving there fine motor skills using patients Hasta Mudra’s Of Bharatanatyam this study was done. Aims and Objectives: To assess the effect of Bharatanatyam Shilpa Khandare, Tushar Palekar Mudra’s to improve quality of fine motor skill in downs syndrome children. To improve the dexterity using various Bharatanatyam Department of Neuro Physiotherapy, Dr. D.Y. Patil College of Mudra’s (Hand gestures). To improve the time taken to Physiotherapy, Pimpri, Pune, Maharashtra, India. complete the task that involves fine motor skill. E-mail: [email protected] Methodology: 40 children with downs syndrome are recruited Background: This study aimed to compare the effects of in the study. Total 10 sessions were conducted. In first 5 cathodal, anodal, Bi-hemispheric and sham transcranial Direct sessions, two Hasta Mudra’s were taught every session and in Current Stimulation (tDCS) in the treatment of plantar flexor next 5 sessions those leaned Mudra’s were performed in speed spasticity, balance and on gait in post stroke patients. (Slow, Medium, Fast) along with functional training. Pre and Materials and Methods: 60 patients with stroke were randomly post intervention the functional outcome measures were noted. divided into four groups using chit method of randomisation. Result: Comparison between the pre and post intervention on The cathodal group (n = 15) received the cathodal tDCS outcome measuresshowed that Bharatanatyam Hasta Mudra’s on ipsilesional side, with intensity 1.5mA and duration of are effective statistically as well as clinically in improving the 20 minutes. The anodal group (n = 15) received the anodal fine motor skills in daily activities. tDCS ipsilesional, with intensity 1.5mA and duration of 20 Conclusion: Bharatanatyam Hasta Mudra’s are seen to be minutes. The bi-hemispheric group (n = 15) received the tDCS effective in improving the quality of fine motor skills. Also, its application on both sides of the cortex,with intensity 1.5mA and seen to be effective in improving the time required to carry out duration of 20 minutes. The sham group (n = 15) received the the activity in daily living. sham tDCS, with intensity 0mA and duration of 20 minutes. All groups received the treatments for 4 weeks with alternate day Physiotherapy interventions for motion session. The Modified Ashworth Scale (MAS), berg balance sickness: A systematic review score (BBS), step Over (SO) test using balance master and the timed up and go (TUG) were assessed at baseline from Rasika Panse Kaluskar, Tushar Palekar, day zero, 14th day, and on 28th day. Saloni Gundecha Results: The MAS Score, BBS score, SO and TUG showed significant improvement across all the groups. However, the Department of Physiotherapy, TMVs Indutai College of BBS scores, and TUG improved significantly within groups. The Physiotherapy, Pune, Maharashtra, India. results showed significant difference in cathodal tDCS group E-mail: [email protected] for all outcome measures when compared with other groups. Background: Motion sickness is popularly known as travel Conclusion: The cathodal, anodal, Bi-hemispheric and sham sickness or seasickness. Motion sickness occurrence is transcranial Direct Current Stimulation had similar effects, but dependent on the sensitivity of each individual and the ability the cathodal tDCS showed more effective in reducing ankle of the vestibular system to adapt to continued exposure to plantar flexor spasticity, balance and gait in post stroke patients. the stimulus affecting activities of daily living and may lead to social isolation. The effect of Bharatanatyam Mudra’s Aim: To systematically review physiotherapy interventions for to improve quality of fine motor skill in motion sickness. Materials and Methods: Data was extracted from PubMed, Downs syndrome children Pedro, Cochrane and Google scholar from the year 2000 to 2021 publication date using the following keywords: ‘Motion Mudra Mahale, Sabah Thaver, Ali Irani sickness’, ‘exercise’ ‘physiotherapy’ OR ‘physical therapy’ with language limitation in English. Department of Physiotherapy, Nanavati Max Super Speciality Results: A total of 41789 articles were identified from 2 Hospital, Mumbai, Maharashtra, India. databases. After the first screening 41,767 articles were E-mail: [email protected] excluded and 18 articles were saved for secondary screening. Background: Down’s Syndrome is a genetic disorder also After the investigators reviewed the remaining articles, at known as Trisomy 21. It is the most common chromosomal the end 7 articles were selected to be included in the review. abnormality in humans. Globally, almost 1 child out of 1000- These 7 studies included RCTs, case studies, experimental 1100 live birth has Down syndrome. In India alone, around studies. Strong evidence was identified for 2 strategies used 32,000 cases are observed annually. A child with Down for individual having symptoms of motion sickness. These syndrome will typically have some degree of slow mental strategies included uses of breathing techniques (with or growth, different facial feature, problems with vision, and without the use of virtual reality) and the vestibular adaptation various health related issues. While physical therapy helps in achieving the gross motor functions in these children but often the fine motor skills are not treated that readily. These fine motor Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S37

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract exercises. Along with these gaze stabilization exercises Madhusree Sengupta, Jaydeep Nandi has shown to be less effective than vestibular adaptation exercises. Department of Neurorehabilitation, Institute of Neurosciences, Kolkata, West Bengal, India. Conclusion: Physiotherapy interventions play an important role E-mail: [email protected] for individuals with motion sickness by alleviating the symptoms Background: Chronic neck pain leads to neuromuscular and improving the functional well-being. and psychological disturbance, which may lead to a reduced quality of life, emotional health and productivity of a person. Keywords: Motion sickness, physiotherapy, PRISMA Absenteeism and presenteeism are both measure of work productivity. Homemakers are a neglected but an essential part Performance evaluation and application of the society. In Central Indian cultural scenario, a homemaker of postural stability assessment system for rarely takes complete rest from her household chores. So presenteeism can be used as a marker for work productivity. patients with balance disorders Aims and Objectives of the Study: To analyze the impact of chronic neck pain in the pre-treatment quality of life, Somya Saxena, M. S. Dhillon, Swapnil Bari, presenteeism and emotional health in homemakers and to Neelesh Kuma find the association of the findings with the cause of chronic neck pain. Department of Physical and Rehabilitation Medicine, PGIMER, Results: The causes of neck pain were divided into chronic Chandigarh, India. primary pain, chronic neuropathic pain chronic musculoskeletal E-mail: [email protected] pain and others. The highest VAS score was found in chronic musculoskeletal pain. The psychological de arrangement was Introduction: Postural stability assessment is an important significantly high in the younger homemakers below 40 years task that has found widespread medical and therapeutic of age and in those with primary or no education. The average applications. The quantitative score of postural balance is very score of presenteeism was 5.5, highest being for chronic important in determining improvement of patients suffering from musculoskeletal pain and significantly low for the ‘Others’ balance disorder. Postural stability is highly dependent on the category. Medical disability score was found to be significantly position of centre of pressure of the body. high in the ‘Others’ category. Conclusion: Chronic neck pain leads to a plethora of Background: Injuries due to falls represent a major public dysfunction. Homemakers are a neglected but an important health problem in patients with neurological disorders. There population at risk for occupational hazard. The concept of is an unmet need for simple, safe, portable and inexpensive presenteeism can be an important marker for work productivity device for assessment and training of these patients. in chronic health conditions. Keywords: Homemakers, neck pain, presenteeism Aim: 1. To assess the performance and utility of Postural Stability Assessment System. 2. To assess quantitative The effect of scapular kinesiotaping as changes in the postural stability of patients suffering from an adjunct to dynamic neuromuscular balance disorders after providing them biofeedback-based stabilization exercises on upper limb balance training. functions in stroke patients Materials and Methods: We used Force Sensing Resistors to sense magnitude of forces acting at both feet. The COP was Shamla Wamanrao Pazare, Rutuja Jadhav1 determined using the positions of various force points and magnitude of the force acting on them. The higher capability Department of Neurophysiotherapy, CMF’s College of of the body to remain at that position implies higher postural Physiotherapy, 1St. Andrew’s College of Physiotherapy, Pune, stability and a lower power of sway. The repeated analysis Maharashtra, India. shows the amount of change in patient’s postural behaviour, E-mail: [email protected] before and after the training. Background and Aim: Stroke patients exhibit a combination of muscle weakness, spasticity, poor voluntary control and Results: Post intervention trials resulted in higher scores of malalignment leading to reduction in functional use of upper postural performance. Hence, favourable results were obtained limb. Postural changes secondary to stroke affects the ideal showing improvement in postural stability of the patients. position of scapula and reduces the efficiency of the scapular muscles as stabilizers for upper limb functions. Scapular Conclusion: Our newly developed system is capable of alignment remains a challenging issue in rehabilitation. This estimating COP displacement and providing biofeedback-based study was undertaken with the hypothesis that application balance training. Thus, it can be used to assess the postural of Kinesiotape may help improve scapular alignment and performance of patients suffering from different postural in combination with Dynamic Neuromuscular Stabilization disorders. Simple home-based balance training program and Exercises will facilitate upper limb functions. The objective quantitative assessment of progress is feasible and is safe, was to study the effect of scapular kinesiotaping as an adjunct effective, and reliable. to dynamic neuromuscular stabiization exercises (DNSE) on upper extremity functional index (UEFI), grip strength and Prospective analysis of pre-treatment scapular abduction. quality of life, presenteeism and emotional health due to chronic neck pain in homemakers - An Indian tertiary care hospital perspective S38 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Methods: This experimental study included 30 post stroke A case study of hypoperfusion and patients with Brunnstrom’s grading for hand > 3 and free dementia; using “brainnext” program for of cognitive involvemnt while presence of subluxation and memory and cognitive rehabilitation at contractures in upper limb and hypersensitivity to tape were excluded. Participants were divided into two groups, Sancheti hospital (SIOR), Pune, India A (kinesiotaping & DNSE) and B (DNSE). Kinesiotape was applied to upper trapezius, Serratus Anterior and Rhomboids. Mangal Kardile Both the groups received DNSE intervention for 5 days/week for 4 weeks along with the conventional execises. Outcomes Department of Clinical Neuropsychology, Sancheti Institute for were assessed on 20 items of upper extremity functional index, Orthopedics and Rehabilitation, Pune, Maharashtra, India. grip strength measured with aneroid spygmomanometer and E-mail: [email protected] scapular abduction distance using MB ruler. Background and Aims: Dementia, broadly explained as Results: On analyzing normal distribution, data was subjected progressive neurodegenerative disease and often ends-up to statistical tests. Group A and B showed significant difference in multiple functional disability. “UMACE” screening-tool, in UEFI, grip strength and scapular abduction while comparison and “BrainNext”rehabilitation-research in cognitive-deficit between the groups showed significant difference in UEFI and in 18+ages neurology-patients, observed reasons for deficit grip strength (0.0001) and not the scapular abduction (0.51). and not just-age-related-atrophy. The case study-focuses Conclusions: Scapular kinesiotaping as an adjunct to dynamic on a-rare-brain-condition of hypoperfusion &history of neuromuscular stabiization exercises is significantly effective major-depression, use of psychotropic medications >35 in improving upper extremity functions and grip strength in years. Person “Y” with dementia was extremely-intelligent poststroke patients but not on scapular alignment of abduction. with successful career-graph as a design engineer until his retirement-age-of 62years started developing dementia- A case study of tendon transfer surgery in like-symptoms. He was given “BrainNext” rehab-sessions brachial plexus injury at Sancheti Hospital before-Covid-19 and continued online- sessions during-Covid-19. His memory-retrieval was critically N. K. Suvarna, Swapnil Sonune, Anuradha Shenoy, handled with special-sessions by the-author and successful- S. Y. Kothari recall was achieved in 8 months. Methods: With consent, “BrainNext” rehab-program at Department of Physical Medicine and Rehabilitation, AIIMS, Bhopal, Sancheti-Hospital given to person ”Y” clinically diagnosed Madhya Pradesh, India. with dementia, with online-offline sessions before-&-after E-mail: [email protected] Covid-19. Author developed new methods of memory recall, Introduction: Brachial plexus injuries are usually due to and strokes and shapes training using 3D acrylic material in high-speed motor vehicle accidents. These are devastating “BrainNext” used, and alphabet&number-recognition critically injuries which will cause a significant decrease in the quality managed with specially designed-person-centered-rehab- of life. Apart from non-operative management, through which program. 2Rehab-sessions per week with follow-ups every we can achieve reasonable mobility with help of rehabilitation 15 days for 2-months, 1 follow-up-each-month-for-6-months and exercises therapy, we also have surgical options, such observed. Responses recorded by hardcopies-audio-video. as neurolysis, nerve repair, use of nerve grafts and nerve Measured progress 1 to 10 scale-(1=10%, 10=100%), transfer, tendon transfers and free muscle transplantation baseline as 0%. and arthrodesis. Tendon transfer surgery is one of the current Results: Person “Y” with dementia improved orientation- surgical treatment to restore functional deficit of brachial plexus following-instructions-object recognition >5% in 1-week, injury. short-term-memory (STM) improved>15% by 1month, Aims and Objectives: To report a case of surgical rehabilitation objects-basic-shapes (monocolour) & strokes-recognition- in a patient with brachial plexus injury with major involvement word-formation-behaviour-improved >35% by 3-months. Word- of posterior cord for hand function improvement. recall-STM-alphabet&number recognition improved >50% by Methods: A 55-year-old male presented with right brachial 8-months, rehab continued at home-by-caregiver. plexus injury with major involvement of posterior cord secondary Conclusion: Cognitive-decline after 55 years, without much to trauma of 25yrs duration. To improve hand function flexor interrogation often-diagnosed as Alzheimer’s with-or-without carpi ulnaris tendon transfer to extensor carpi radialis brevis, dementia with age-related-atrophy, but cognitive decline has-a- rerouting Extensor pollicis longus with palmaris longus, and reason and memory cannot-be-lost-forever. Hypoperfusion-for- extensor digitorum double plication was done. Hand function brain challenges memory & cognitive rehab, using “BrainNext” was assessed pre and post procedure. special set for memory retrieval-person “Y”, achieved-STM- Result: Hand function in terms of power and active range of recall>48 hours(2days) in 8 months, improving quality of life, motion, in 55-year-old male with right brachial plexus injury lessening little burden of caregiver. with major involvement of posterior cord has improved post tendon transfer surgery. Therapeutic effects of lower limb cycling Conclusion: Brachial plexus injury in young patient can be on selected motor performance variables challenging in terms of social and economic aspect. Therefore, any improvement in function through invasive procedure should among middle cerebral artery stroke also be considered to improve quality of life. patients with hemiplegia A. Brammatha Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S39

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Stroke Rehabilitation, KMCH, Coimbatore, months. Convenient sampling method was used to categorize Tamil Nadu, India. the patients in 3 groups viz. Group A with patients using CPAP E-mail: [email protected] alone, Group B with patients on Occupational Therapy alone Background: Stroke is the sudden loss of neurological who are not willing to buy and use CPAP Therapy or cannot function caused by an interruption of the blood flow to the afford CPAP, and Group C including patients on Occupational brain The loss or difficulty with ambulation is one of the most Therapy along with CPAP. The assessment of cognitive devastating sequelae of stroke, so restoration of gait is often function and occupational performance was done on day 1, one of the primary goals of rehabilitation. Limitations in gait and at the end of 8 weeks. and gait-related activities are associated with an increase in Results: The overall difference in mean scores of Occupational fall risk. Cycling and walking has shared synergies of lower Identity (p=0.814) and Occupational Settings (p=0.529) limb kinematics and kinetics. The reciprocal movements in components of OPHI-II in the 3 treatment groups were cycling helps for functional range of motion of knee and hip statistically non-significant, while that of Occupational joints required for walking, lower limb motor coordination and Competence (p=0.038) was found to be statistically significant. thereby it improves the ambulatory function in stroke patients. The overall difference in mean scores of total MoCA score Aim: To find out the therapeutic effectiveness of 3 weeks Lower (p<0.001) were statistically significant across the 3 treatment limb Cycling on lower extremity motor performance variables groups. However, the difference in difference analysis shows among subacute stroke patients. no statistical difference between the change in the mean Methodology: A Pilot experimental study was conducted on scores of MoCA or OPHI II at the end of 8 weeks across the 10 Inpatients who satisfied the selection criteria and assigned 3 treatment groups. into two groups. Cycling Group received lower limb Cycling Conclusions: All the three treatment groups are equally for 25 minutes along with standard therapeutic exercises for effective in treatment of OSAS patients in terms of cognitive 40 minutes, 5 days /week, for Continuous 3 week for a total function and occupational performance. 15 sessions. Control Group received 60 minutes of standard therapeutic exercises. The Functional Ambulation Category Correlation between perceived stress and (FAC), Fugl-Meyer Assessment (FMA) and Five Times Sit to dual tasking ability in young individuals Stand Test were used as outcome measures. Results: There was a significant increase on all outcome Bhakti T. Salgaonkar, R. Lakshmiprabha measures (P < 0.05). The reciprocal and rhythmic nature of cycling motion improves the motor performance among patients Department of Physiotherapy, Physiotherapy School and Centre, with stroke. A. Brammatha [email protected] Professor/ Seth G.S.M.C and K.E.M Hospital, Mumbai, Maharashtra, India. Kovai Medical Centre Hospital College of Physiotherapy E-mail: [email protected] Coimbatore. Dual tasking implies the concurrent performance of two tasks performed independently with distinct, separate goals. One task Effect of occupational therapy intervention requiring significant attentional demands while simultaneously on occupational performance and cognitive performing an alternative task (motor or cognitive) which function in patients with obstructive sleep results in greater demands being imposed on the processing capacity of the brain than any one of the tasks individually. apnea syndrome (OSAS): A prospective An individual’s level of perceived stress can have a negative analytical study impact on the performance of tasks that require divided attention. The cognitive appraisal of a stressor plays a major Vaishnavi Hiren Joshi role in the interaction of the person with his/her environment. This study aimed at finding the relationship between a young Department of Occupational Therapy, Government Medical College individual’s perceived level of stress on their ability to dual task. and Hospital, Nagpur, Maharashtra, India. Our study consisted of 70 young individuals between 18-30 E-mail: [email protected] years. All participants filled the ‘Perceived Stress Stress-10’ Background and Aims: OSAS leads to significant cognitive a self-reported measure of perceived stress and performed impairment and the occupational health of the patients, which the ‘Timed Up and Go Test’ (TUG) and its two modifications further leads to absenteeism from work, work disability and (cognitive and motor). The Dual task costs were then calculated decreased productivity at work. Continuous Positive Airway for both and correlated with their stress scores. The results Pressure (CPAP) is the conventional treatment in OSAS. It is showed a moderate correlation between perceived stress and known that restful and adequate sleep provides the foundation cognitive dual task but no significant correlation with the motor for optimal occupational performance, participation, and modification. As the stress scores went on increasing, the engagement in daily life. The impact of sleep on function and time taken to perform the simple TUG, cognitive TUG went on participation is incorporated into the repertoire of occupational increasing significantly, but not for the motor task. This implied therapy practitioners and addressed across the lifespan. Hence, that the attentional demands imposed by the cognitive task were the aim of this study was to compare the effect of Occupational more than that imposed by the motor task on the TUG. It was Therapy Intervention along with CPAP; CPAP alone & concluded that even in seemingly healthy, young individuals Occupational Therapy alone on Occupational performance, devoid of any known musculoskeletal, cardiovascular or and Cognitive function in OSAS patients. neurological disorders, the time taken to perform a cognitive Methods: A hospital based prospective comparative study was dual task increased significantly with an increase in perceived conducted in 57 eligible patients of OSAS over a period of 6 stress levels. This finding implies that one’s subjective perception of stress warrants consideration while evaluating S40 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract his or her performance in a dual task paradigm, especially PubMed, Cochrane. Articles of last 5 years were included in if one of the imposed evaluation tasks is cognitive in nature. study. Results: Data was summarised using the articles Conclusion: Development and clinical validation of Early intervention therapy is integral part of treatment for high cognitive linguistic assessment protocol in risk infants. It plays key role in their development. It should start from birth as soon as possible. Also, the parental involvement Odia in it is crucial. Bibhu Prasad Hota, Jayasankar Panda Effectiveness of multi-sensory balance training versus vision deprived balance Department of Speech and Hearing, Swami Vivekan and National training on balance and gait speed in stroke Institute of Rehabilitation Training and Research, Cuttack, Odisha, India. patients – A comparative study E-mail: [email protected] Background: In order to assess the cognitive-linguistic abilities Abhijit N. Satralkar, Rutuja Indapure in Odia speaking adult aphasic population, it is needed to develop and standardize a test material and measure its clinical Department of Physiotherapy, P.E.S Modern College of validity. Therefore, this study was undertaken to prepare and Physiotherapy, Pune, Maharashtra, India. develop a tool to assess cognitive-linguistic abilities in Odia E-mail: [email protected] speaking normal and adult aphasic population. Background: Stroke is one of the leading causes of death Aim: The present study aimed to assess changes in the and disability in India. Stroke patients usually show uneven performance on cognitive-linguistic tasks in normal and aphasic weight distribution and increased postural sway in standing. adults. Many studies have seen the effect of multi-sensory balance Methodology: A total of 60 participants (30 aphasics and training and vision deprived balance training on balance and 30 normal) aged between 30–60 years were taken for the gait speed in stroke, but hardly any study is done on comparing study. The persons having an aphasia quotient of less than these two effects. 56 were considered. The study was carried out in three Aim: The present study aimed at comparing the effects of phases i) Transadaptation of CLAP from Kannada to Odia ii) multisensory balance training and vision deprived balance Administering the test material on 60 participants iii) Checking training on balance and gait speed when assessed using bergs reliability of the test material iv) Measuring clinical validity. To balance scale and 10 meter walk test respectively at the end estimate age related changes, the response of the participants of 6 weeks of intervention. was studied across three age groups: group-I (30-40 years), Methods: 40 participants were selected based on the selection group- II (40-50 years) and group-III (50-60 years) using the criteria. They were randomly assigned to two groups by chit one-way analysis of variance (ANOVA) test. Comparison method: Group A (n=20) received Multisensory Balance between the normal and aphasic population was done using Training protocol and Group B (N=20) received Vision Deprived independent sample “t” test. Balance Training protocol. Group A training included, 5 minutes Results: The results indicated significant difference observed of warm up followed by 30 minutes of multisensory balance among three age groups and also significant difference training program and 5 minutes of rest post exercise. Group B observed in performance among the normal and aphasic group. training included 5 minutes of warm up followed by 30 minutes Conclusion: Thus the study asserts that the development of of balance training with deprivation of vision and 5 minutes of Odia Cognitive- Linguistic Assessment Protocol is an effective, rest post exercise. reliable, and valid tool to be used for assessing cognitive Results: There was no significant difference seen between both linguistic function in the aphasic population. the groups for balance (p= 0.851) and gait speed (p=0.948). Conclusion: Both the training program were effective in Early intervention therapy for high risk improving balance and gait speed in stroke patients(40- infants - A scoping review 60years).But on comparison, both the training program showed equal effect on balance and gait speed in stroke patients. Tejas Borkar Effects of attentional focus during balance Department of Pediatric Physiotherapy, Dr APJ Abdul Kalam College training on patients with Parkinsons of Physiotherapy, PIMS, Ahmednagar, Maharashtra, India. E-mail: [email protected] Preeti Gazbare, Manisha Rathi Background and Aim: Infants born before 37 weeks are high risk infants who may need stay in NICU Various risk factors Department of Neuro, Dr. D Y Patil College of Physiotherapy, Pune, for preterm infants may result into a long term disability or Maharashtra, India. developmental delay. Hence the early intervention programs E-mail: [email protected] for these infants are important. Aim of this scoping review was Background: Parkinson disease [PD] is degenerative to access various aspects of early intervention therapy for high neurological disorder characterised by rigidity, bradykinesia, risk infants. tremor and postural instability leading to high risk of falls. PD Methods: Recent literature was searched for various articles patients in the use of [compensatory] movement strategies. for early intervention therapy for high risk infants. Review was Gait and balance disturbance is common in parkinson’s disease carried out by searching databases including google scholar, and is a major contributor to increase disability and decrease Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S41

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract health-related QOL and survival. Theorized strategy to improve Methods: Case reported is of a 60 year old general surgeon balance in parkinsons is to give individuals attentional focus with relapsing remitting Multiple Sclerosis. He underwent a 12 instructions while performing balance activities. This method week program of aquatic and land based intervention (4 times/ either directs the persons attention towards the effect of the week). TUG, balance evaluation system test (BEST), Functional action (external focus) or the body movements (internal focus) reach test were taken at baseline. need to be explored further. Results: At 12 weeks, BEST score improved from 54.62% to Methods: An experimental study carried in Parkinson society 71.29%. The FRT improved from 11 inches to 14 inches TUG in Pune after an institutional ethical approval, on 30 diagnosed improved from 43 seconds to 34 seconds. Parkinson’s patient, age- 40 to 80 years, Both gender, stage Conclusion: WST and TTTA in aquatic therapy combined with 2 & 3 on Hoehn & Yahr scale Exclusion other neurological functional land based rehabilitation may help improve activity impairment affecting balance & movement, surgical treatment and participation in adults with multiple sclerosis. for parkinson’s, severe cognitive impairment, severe sensory deficits. Written consent was taken. Pre training scores of MS- Rehabilitation experience in a case of UPDRS were taken. Patients were divided into Group A, B & Klippel-Trenaunay-Weber syndrome C by chit method. Group A- Internal Focus- performed a listed task with focus on their own active limbs Group B- External presenting with Spastic Paraplegia focus: performed a listed task with focus on the external object (colourful plastic ball). The object moved at the subject eye Vira Vaibhav Kalyanji, Amit Mhambre, Vinay Goyal contact level Group C- No focus: perform task without any focus. Intervention protocol included relaxation technique, flexibility Department of Physical Medicine and Rehabilitation, All India exercise, listed task for Balance in standing & sitting performed Institute of Physical Medicine and Rehabilitation, Haji Ali, Mumbai, for 4 days/ week for 2 weeks. Post Assessment taken. Maharashtra, India. Result: Data was analysed using anova test. All 3 group E-mail: [email protected] showed significant improvement with p= 0.0001. mean score Background and Aims: Klippel-Trenaunay-Weber syndrome of MS-UPDRS in external focus group is more as compared (KTWS) is a rare limb overgrowth disorder with unknown to group A (internal focus) & group C (no focus) with p=0.003. etiology. Myelopathy in such cases is uncommon but has When Comparing of sub-activities in MS-UPDRS. group B been reported in association with spinal hemangiomas, showed better results in Q1. mentation, mood & behaviour. angiomyolipomas and A-V malformations. There is no Q2. activities of daily living. Q3. motor examination& Q4. literature documenting the rehabilitation in KTWS with complication of therapy. spinal cord involvement. This case study presents a unique Conclusion: Thus external focus in balance training has a experience in rehabilitation of 24 years old male with KTWS greater effect & has shown significant improvement in overall with limb overgrowth of all the four limbs with intelligence evaluation of MS-UPDRS. quotient of 39 presented with spastic paraplegia (level D2) after embolization and laminectomy (D3-D4) done for epidural Water specific therapy and task type AV malformation. training in aquatic therapy combined with Methods: He presented with difficulty in bed mobility, transfers and had attendant dependent wheelchair mobilization. He functional land based rehabilitation to underwent comprehensive rehabilitation program with a improve activity and participation multiple weekly review. He was given Tab. Baclofen for spasticity management. Regular therapeutic exercise for maintenance of sclerosis: Case report joint suppleness, improvement of endurance and prevention of edema progression and above knee night splint for prevention Shraddha Pawar, Brinda Merchant of deformity and therapeutic standing. Response over period of 4 months was monitored with the help of FIM® instrument Department of Physiotherapy, Aquacentric, Mumbai, Maharashtra, (Uniform Data System for Medical Rehabilitation. 2018. The India. FIM System® Clinical Guide, Version 5.2.1. Buffalo: UDSMR) E-mail: [email protected] and The Barthel Index. Background: Multiple Sclerosis (MS) is a progressive Results: At the end of 4 months, the FIM® ratings showed neurologic disease that affects the central nervous system change from score of 34 to 51 with improvement in transfer leading to impairments of balance, muscle tone, strength and and indoor mobility. The Barthel Index changed from 15 to 35 gait. Aquatic therapy is shown to be an effective adjunct to indicating achievement of rehabilitation. conventional therapy owing to unique properties of water which Conclusion: In this study intellectual disability and limb increase exercise compliance with less fatigue. Task type overgrowth were limiting factors interfering the rehabilitation. training approach (TTTA) is a restorative, therapeutic approach Understanding of the disease pathology and the limiting factors based on the system theory of motor control. TTTA is relevant to with comprehensive approach will help in executing effective an individual and context, is randomly assigned, repetitive and rehabilitation. involves massed practice. WST strategies include interventions to improve strength and postural control. Appropriate land Development and standardization of a based carryover helps the individual return to activity. novel verb picture corpus in Kannada Purpose: Purpose of case report is to provide an overview of therapeutic benefits with combination of aquatic therapy and Wasim Ahmed, Gopee Krishnan land based rehabilitation. S42 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Speech and Hearing, Manipal College of Health gait parameters, postural control, and balance, in addition Professions, Manipal Academy of Higher Education (MAHE), Udupi, to enhancing cognition, attention, psychosocial and sensory Karnataka, India. functions. There were several outcome measures used in E-mail: [email protected] these studies, including the Gross Motor Function Measure 66 Background and Aims: Clinicians and researchers engaged and 88 (GMFM-66 and -88), Paediatric Evaluation of Disability in rehabilitating persons with aphasia (PWA) often need Inventory-Functional Skills Scale (PEDI-FSS), Gross Motor standardized and language-specific pictorial stimuli that, in Function Classification System (GMFCS), which showed turn, are sparse in many Indian languages. Cross-culturally significant improvement post-hippotherapy, conducted for a and cross-centrally appropriate picture stimuli have several mean of 6-12 weeks. Some studies also used changes on advantages. Converse to noun-based picture corpora, verb electromyography (EMG) of various muscles as a measure picture sets are available only in a handful of languages, of improvement. globally. In a multilingual country like India, it is crucial to Conclusion: Hippotherapy shows great promise to be used develop such standardized stimulus sets, which are not a as an adjunct to conventional rehabilitation of children with mere translation of the preexistent foreign corpora. Hence, we cerebral palsy. Further research is needed to establish the long- present a novel verb picture set based on argument structure term benefits and feasibility of hippotherapy in this population. categorization for the adult Kannadiga population. Methods: Two hundred and sixty-nine picturable verb names Physiotherapeutic management of were selected from a published database of 100,000 words and somatosensory tinnitus Poonam Bajaj, later developed into colored clipart images. This dataset is the Raashi Khatri Punjabi, Aashish Contractor first of its kind, as every verb picture was developed around individual model sentences, framed based on their respective Poonam Bajaj, Raashi Khatri Punjab, argument structure. One hundred twenty clinically normal Aashish Contractor adult participants (Mean age=49.65±18.68, Females=60) were recruited to standardize these pictures across four Department of Rehabilitation and Sports Medicine, Sir H N Reliance psychometric tasks: the verb name & argument agreement, Foundation Hospital, Mumbai, Maharashtra, India. image agreement, concept familiarity, and visual complexity. E-mail: [email protected] The participants represented four major dialects of Kannada Background and Aims: 65% of tinnitus arises from and diverse socio-economic and educational backgrounds. somatosensory causes. This is heavily underdiagnosed. Results: Overall, the verb corpus showed good name Somatosensory tinnitus can arise from muscular contractions of agreement, higher ratings, and strong correlations among the head, face, jaw, neck and upper extremities. Management the psychometric tasks, indicative of the quality, cultural and for tinnitus mostly includes medication, white noise devices linguistic appropriateness of corpus. and psychotherapy. The aim of this study is to highlight Conclusion: Pictures and model sentences from this unique physiotherapeutic management of somatosensory tinnitus in data set can be suitably adapted into experiments, diagnostic association with intra-oral device provided by a dentist. tools and therapy programs for PWA and persons/children with Methods: Three individuals, who had been diagnosed with language impairment, in general. tinnitus for over one year with normal ENT examinations and no hearing loss, were considered for this study. Further Use of hippotherapy in children with evaluation was undertaken to check modulation of tinnitus with cerebral palsy specific movements of the head, face, neck, jaw and changing postures of the cervical spine. One individual was found to Disha Padmaraja Hegde have a history of soft tissue trauma around the cervical spine. All three were found to have significant trigger points in the Department of Rehabilitation and Sports Medicine, Sir HN Reliance head, face, neck and jaw region and poor cervical posture and Foundation Hospital and Research Centre, Mumbai, Maharashtra, mandibular derangement. All three had asymmetrical tinnitus India. which changed with movements and postures of the head, neck E-mail: [email protected] and jaw. The Tinnitus Handicap Inventory (THI) was used as Background and Aims: Hippotherapy is an innovative an outcome measure. All three underwent physiotherapeutic treatment method which uses the movement of a horse as measures for release of trigger points, postural and ergonomic part of a structured treatment protocol to achieve certain goals. correction, strengthening and biofeedback over three months. The aim of this study is to evaluate the use of hippotherapy in Results: All three showed improvement in THI scores by more children with cerebral palsy. than 7 points which is the MCID (Minimal Clinically Important Methods: 33 studies published between 2011 and 2021 were Difference) value for the scale. searched using search words like “hippotherapy”, “cerebral Conclusion: Somatosensory tinnitus is a treatable entity and palsy”, etc. and a literature review was conducted. it is essential to distinguish it from other causes of tinnitus and Results: Hippotherapy works on the principle that the treat it appropriately. movement of the equine pelvis shows a trial-axial pattern of movement during walking (about 6.98 degrees, 3.9 degrees High or low-frequency repetitive and 9.1 degrees in the frontal, sagittal and transverse planes transcranial magnetic stimulation in respectively), as is observed in the human pelvis. A common theme across these studies was the host of benefits of cerebellar ataxia hippotherapy such as improvement in the gross motor skills, Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S43

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Jong Hwa Lee, Won Wook Ha performance on the Berg Balance Scale, 10-meter walk test, and Functional Ambulation Category than the control group. Department of Physical Medicine and Rehabilitation, Dong-A There were no significant differences in maximal isokinetic University College of Medicine, Busan, South Korea voluntary contraction torque or manual muscle tests between E-mail: [email protected] the groups. Background and Aims: Many researchers have demonstrated Conclusions: Our results suggest that additional training with the effects repetitive transcranial magnetic stimulation (rTMS) whole-body vibration may effectively improve the balance and over the cerebellum on patients with ataxia. The aim of this gait performance of subacute stroke patients. Further studies study is to compare the effect of low frequency rTMS and that on large populations are required to determine the therapy’s of high frequency rTMS in ataxia after posterior circulation clinical efficacy. stroke (PCS). Methods: We enrolled patients who were confirmed as acute Development and validation of a screening PCS with symptoms of ataxia. All patients were randomly tool for detection of dysphagia in neonates assigned to low (LG) or high frequency rTMS group (HG). Coil was placed 2cm below the inion and 2cm lateral to the D. Seshasri midline on the cerebellar hemisphere. Both groups received a session of rTMS that comprised 900 stimuli for 10 days. The Integral Coach Factory Hospital, Chennai, Tamil Nadu, India. intensity of stimuli 100% of patient’s resting motor threshold E-mail: [email protected] at both groups. The frequency of LG was 1Hz and that of HG Background and Aim: Early detection of feeding and was 10Hz. Before first and after last intervention, patients swallowing difficulties in neonates helps in reducing the were evaluated using Berg Balance Scale (BBS), 10meter associated developmental and medical complications. A look walk test (10MWT), Modified Rankin Scale (MRS), Functional into the literature revealed limited screening tools to detect Ambulation Category (FAC), Modified Barthel Index (MBI), neonatal dysphagia. The existing tools have been developed and Sacale for the Assessment and Rating of Ataxia (SARA). for neonates with specific issues and some of them are not Results: Eighteen patients were recruited in each group. There validated as well. Further since feeding practices vary with were no significant differences in the baseline characteristics culture, there is a need to context specific tool. The present and initial measurements between two groups. After treatment, study aimed at developing a standardized screening tool for both groups showed significant improvements in BBS. 10MWT, the detection of dysphagia in neonates. The objectives were FAC, SARA. MBI was improved only in HG. There were no a) To establish content and clinical validity and reliability of the significant differences in change of any measurements between tool and b) To establish its sensitivity and specificity. the two groups. Methods: A tool titled Neonatal Dysphagia Screening Tool Conclusions: We found therapeutic effectiveness of low and (NDST) was constructed, which was validated for its contents high frequency rTMS on PCS with ataxia. The result showed by a multidisciplinary group of professionals. The final version no superiority between two protocols. of NDST comprised of 17 questions with a binary choice scoring system. To ascertain clinical validity, NDST was administered Effect of whole-body vibration therapy in on 178 mothers of neonates in the age range of 1-5 days, who subacute stroke patients were divided into three groups based on the medical history such as typical group (TG), high risk group (HRG) and very Jong Hwa Lee, Won Wook Ha high risk group (VHRG). In order to establish the sensitivity and specificity, the tool was administered on a different group of Department of Physical Medicine and Rehabilitation, Dong-A participants with and without dysphagia. The NDST was also University College of Medicine, Busan South Korea. assessed for its inter-rater reliability. The data was analysed E-mail: [email protected] using SPSS (version 20) statistical software. Background and Aims: The aim of this study was to Results: Mann Whitney test revealed a significant difference investigate the effect of whole body vibration therapy on lower across groups. The feeding and swallowing difficulties were extremity function in subacute stroke patients. significantly higher in the VHRG, followed by HRG. Further, Methods: Subacute stroke patients who were able to undergo the tool had high sensitivity (89.12%), moderate specificity gait training were randomly divided into a vibration therapy (55.59%) and a very good inter-rater reliability. group and a control group. All patients attended 20-minute Conclusions: The outcome of the study was a highly sensitive, training sessions twice daily, five times a week for two weeks. valid and reliable screening tool to identify dysphagia, which Each session included 45 squats. The vibration group trained facilitates early identification along with quantification of extent on a vibration platform and the control group trained on the of dysphagia in the high risk neonates. ground. The degree of maximal isokinetic voluntary contraction torque was evaluated, and manual muscle tests of hip and knee Diagnostic peripheral motor nerve block flexion and extension were performed. The Berg Balance Scale, for management of upper limb and lower 10-meter walk test, Timed Up and Go Test, and Functional limb spasticity in physical medicine and Ambulation Category were used. Results: A total of 38 patients, 20 in the vibration group and rehabilitation setting 18 in the control group, were included in the analysis. After the two-week therapy, the vibration group showed significant Mohd Hakim Bin Zenian, Chung Tze Yang, improvements in lower extremity strength, balance, and gait Chan Soo Chin performance. The vibration group showed significantly better S44 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Department of Rehabilitation Medicine, University Malaya Medical Sanjivani Kamble, Gaurang Baxi, Tushar Palekar Centre, Petaling Jaya, Malaysia. E-mail: [email protected] Department of Physiotherapy, Dr. D. Y. Patil College of Objective: To assess the efficacy and practicality of Physiotherapy, Pune, Maharashtra, India. peripheral motor nerve block in a local physical medicine E-mail: [email protected] and rehabilitation setting for management of post stroke Background and Aims: Dry needling (DN) is a therapeutic spasticity. intervention used to treat myofascial trigger point and a Methodology: Three patients with post stroke spasticity (more variety of pain syndromes. Evidence for application of DN than one year) involving either the upper or the lower limb were in neurological conditions with functional assessment is still recruited. Two candidates received peripheral motor nerve lacking. This case series was conducted to explore the effects block injection to the upper limb and one patient received it to of DN on spastic soleus muscle in chronic stroke patients. the lower limb. One patient received exclusive peripheral motor Methodology: 10 stroke survivors (>3 months onset) were nerve block only, while the other two received peripheral motor included. Spasticity was assessed using the Modified Ashworth nerve block followed by botulinum toxin injection. All procedures scale (MAS) and Modified Tardieu scale. Balance was were conducted in outpatient clinic settings. Lignocaine and assessed using the Berg balance scale (BBS). 6 sessions of Bupivacaine were the agent of choice, administered directly DN were conducted for the spastic soleus muscle for a period to perineural area under ultrasound guidance. Spasticity of 2 week. Outcome measures were reassessed. scoring is measured according to Modified Ashworth Scale and Results: A significant improvement was seen for all 3 outcome Modified Tardieu Scale at pre and post procedure, as well as measures (p.0.05). MAS showed improvement from Grade 3 on subsequent clinic follow up. to 1+. Tardieu scale showed significant improvement for ankle Result: All three candidates show positive improvement in ranges by 12 degrees. Berg balance scale score increased by 7. spasticity immediately after the procedure. On subsequent Conclusion: After application of DN, a reduction in muscle tone assessment, the patient who received exclusive peripheral of the spastic soleus was seen. Also, there was improvement motor nerve block without botulinum toxin had lasting effect in static balance. Discussion: DN was effective in decreasing up to three months. While the other two patients who received the spasticity and improving balance, range of motion and both peripheral motor nerve block and botulinum toxin injection accuracy of maintaining stability in stoke survivals. These initial has potentially longer lasting effect. There was no reduction in results are promising, further research needs to be conducted motor strength related to the procedure. to validate the findings. Conclusion: Peripheral motor nerve block could be a viable Keywords: Berg balance scale, dry needling, modified option for post stroke spasticity management. On case to case ashworth scale, spasticity, stroke, Tardieu scale basis, it could be considered as an alternative to botulinum toxin or could be administered together with potential synergistic Role of wnt5a downregulation in effect. It might also serve as diagnostic tool for differentiating promoting stroke recovery by 5-AZA- spasticity from contracture. DC administration combined with a task CRPS among first ever stroke patient: A study specific training in rats from tertiary care centre in eastern India Inae Choi, Ji Hee Yu, Dong-Hee Choi, Rezwana Parvin Jongmin Lee Department of Physical Medicine and Rehabilitation, IPGMER and Center for Neuroscience Research, Konkuk University, Seoul, SSKM Hospital, Kolkata, West Bengal, India. South Korea. E-mail: [email protected] E-mail: [email protected] Background: CRPS is a common cause of upper limb pain Background and Aims: Stroke is a major cause of death in post stroke patient. It remains undiagnosed & untreated as and disability. Inflammation responses after stroke impede it’s a diagnosis of exclusion. functional recovery. Epigenetic modulation promotes Inclusion Criteria: 1. Patient age> 18yrs 2. Patient with NIH stroke recovery regulating gene expression. Inhibiting DNA score <20 3. Patient with ICH score < 3 4. Patient with MRS methylation increases the expression of anti-inflammatory score < 4 5. Patient willing to regular follow up in opd. cytokines. To identify a therapeutic effect of modulating Exclusion Criteria: 1. Previous history of stroke 2. Any history DNA methylation in stroke, this study investigated the of brain injury 3. Any history of other neurological deficit 4. Any effects of 5-aza-2’-deoxycytidine (5-Aza-dC), the DNA known orthopedic injury involving extremities. methyltransferase inhibitor, and task-specific training Methodology: Patients are given questionnaire & data is combination (TST) therapy on recovery and anti-inflammatory collected upto 6 months post stroke. effects after stroke. Result: CRPS is more common in ischemic stroke with basal Methods: The experimental group consisted of control group, ganglia involvement with associated co morbidities with age stroke group, post-stroke TST treatment group, post-stroke distribution between 40-60 yrs. 5-Aza-dC treatment group, post-stroke TST and 5-Aza-dC combination treatment group. Systemic injection of 5-Aza- Effect of dry needling on spasticity and static dC and TST were administered starting 5 days post-stroke balance in stroke survivors: A pilot study for one week. Functional recovery was assessed using the staircase, and cylinder tests. Proinflammatory cytokines, Wnt family member 5A (Wnt5a)/Ca2+/calmodulin-dependent protein Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S45

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract kinase II (CaMKII) signaling pathway, and localization of Wnt5a Visual versus verbal feedback: Which were determined. is better in improving motor control in Results: Combination therapy comprised 5-Aza-dC and TST individuals with ambulatory stroke? promoted stroke recovery. The levels of proinflammatory cytokines and Wnt5a/CaMKII signaling pathway were Sharvari Samant, Preeti Gazbare suppressed by 5-Aza-dC and TST combination therapy. Increased Wnt5a expression in the astrocytes of the stroke Department of Physiotherapy, Dr. D. Y. Patil College of group was significantly reduced in the 5-Aza-dC and TST Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. combination therapy group. IL-10, a Wnt5a transcription E-mail: [email protected] suppressor, was significantly increased in the 5-Aza-dC and Background and Aim: Patients with hemiplegia tend to support TST combination therapy group. their body weight on unaffected side which disrupts the balance, Conclusions: Our results suggest that 5-Aza-dC and TST symmetry, postural control and function. Feedback is important combination therapy has an anti-inflammatory effect via the for effective skill learning. Hence this study aims to compare Wnt5a/CaMKII pathway, which aids stroke recovery. visual and verbal feedback on motor control in stroke patients. Keywords: CaMKII, DNMT inhibitor, interleukin-10, Methods: Thirty ambulatory stroke patients, fulfilling the proinflammatory cytokines, stroke, task-specific training, Wnt5a inclusion and exclusion criteria were selected. Patients were divided into 2 groups randomly, 15 in each group. Group Language systems from lesion-symptom A received visual feedback and Group B verbal feedback mapping in aphasia: A meta-analysis of for functional training using the Balance Master along with conventional therapy. Duration was for 60 min. 3 times/week voxel-based lesion mapping studies for 4 weeks. Pre-post outcome measures were Postural Assessment Scale for Stroke (PASS) and squatting, sit to Sung-Bom Pyun, Yoonhye Na, JeYoung Jung, stand, walk across using neurocom balance master equipment. Christopher Tench, Dorothee P. Auer Results: Visual feedback (group A) was more effective than verbal feedback (group B) in improving time required for weight Department of Physical Medicine and Rehabilitation, Korea transfer in sit to stand. Within group analysis, both the groups University Medical Center Anam Hospital, Korea Universiy, Seoul, showed improvement in PASS score, squatting at 0,30,60,90 South Korea. of knee flexion - percentage of weight bearing on the affected E-mail: [email protected] side improved, mean step width in walk across also improved Background: Aphasia is one of the most common causes (p<0.05). In between group analysis sit to stand: weight transfer of post-stroke disabilities. As the symptoms and impact of showed improvement. (p<0.05). post-stroke aphasia are heterogeneous, it is important to Conclusion: Visual and verbal feedback are equally effective understand how topographical lesion heterogeneity in patients in improving motor control, however visual feedback is more with aphasia is associated with different domains of language beneficial than verbal feedback in improving weight transfer impairments. Here, we aim to provide a comprehensive time in sit to stand. overview of neuroanatomical basis in post-stroke aphasia through coordinate based meta-analysis of voxel-based lesion- Effect of extended duration of cortical symptom mapping studies. stimulation in adults who stutter (AWS) - A Methods: We performed a meta-analysis of lesion-symptom mapping studies in post-stroke aphasia. We obtained preliminary study coordinate-based functional neuroimaging data for 2,007 individuals with aphasia from 25 studies that met predefined Chanchal Chaudhary, Gopee Krishnan inclusion criteria. Results: Overall, our results revealed that the distinctive Department of Speech and Hearing, Manipal College of Health patterns of lesions in aphasia are associated with different Professions, Manipal Academy of Higher Education, Manipal, language functions and tasks. Damage to the insular-motor Karnataka, India. areas impaired speech with preserved comprehension and E-mail: [email protected] a similar pattern was observed when the lesion covered Background: Stuttering is a neurodevelopmental disorder the insular-motor and inferior parietal lobule. Lesions in the characterized by excessive speech behaviors that disrupt the frontal area severely impaired speaking with relatively good flow of speech. Neural markers in stuttering show impairments comprehension. The repetition-selective deficits only arise from in speech motor-related brain regions and atypical brain lesions involving the posterior superior temporal gyrus. Damage activation patterns in areas involved in speech production.[1] in the anterior-to-posterior temporal cortex was associated with The combined use of transcranial direct current stimulation semantic deficits. (tDCS) and behavioral speech therapy shows promising results Conclusion: The association patterns of lesion topography in enhancing fluency. However, the data is available only from and specific language deficits provide key insights into the short-term intervention (up to 6 sessions).[2-4] specific underlying language pathways. Our meta-analysis Aim: We present preliminary evidence of benefit of extended results strongly support the dual pathway model of language duration of cortical stimulation (tDCS) clubbed with behavioral processing, capturing the link between the different symptom intervention (choral speech + metronome) on fluency in AWS. complexes of aphasias and the different underlying location Methods: Four AWS completed a three-week (5 days /week) of damage. intervention. In each of the 40-mins sessions, they received 1mA anodal stimulation over the left inferior frontal cortex for S46 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract initial 20 minutes with behavioral fluency therapy. The latter Conclusion: This study highlights both interventions are continued for another 20 minutes and included temporary equally effective in improving Balance, gait and risk of fall, fluency enhancing conditions such as choral speech and VRT has similar potential in preventing age-related fall. VRT metronome task. Fluency levels were assessed at baseline, showed more exercise adherence and positive feedback among 5th day, 10th day, and post-intervention (15th day) using individuals. %stuttered syllables, reading, and speaking tasks. Result: Change in percentage of stuttering from baseline Role of physical therapy for improving the was observed at the end of week 1. Further reductions in functional independence of a child with dysfluencies were noted at the end of week 2. However, SMA type 2 - Case report assessments on the 10th and 15th days did not show any notable differences. Sharvani Chogle, Pradnya Gadgil, Conclusion: This data shows the beneficial effect of extended Abhishek Srivastava, Navita Purohit Vyas duration of cortical stimulation in AWS. Thus, our findings support the assumption that extending the tDCS with concurrent Department of Physical Medicine and Rehabilitation, Kokilaben speech therapy could optimize treatment outcomes in AWS. Dhirubhai Ambani Hospital, Mumbai, North West, Maharashtra, References India. Chesters J, Watkins KE, Möttönen R. Investigating the feasibility of E-mail: [email protected] Background: Spinal muscular atrophy (SMA) is a group of using transcranial direct current stimulation to enhance fluency autosomal recessive genetic disorders characterized by loss in people who stutter. Brain Lang 2017;164:68-76. of anterior horn cells of spinal cord. This leads to progressive Chesters J, Möttönen R, Watkins KE. Transcranial direct current muscle weakness and atrophy in muscles affecting the posture, stimulation over left inferior frontal cortex improves speech movement etc. The disease is classified into 4 types based on fluency in adults who stutter. Brain 2018;141:1161-71. severity, age of onset & highest attained milestone. SMA type1 Garnett EO, Chow HM, Choo AL, Chang SE. Stuttering severity is severe & life threatening, SMA type2 is intermediate, SMA modulates effects of non-invasive brain stimulation in adults who type3 is mild & SMA type4 is adult onset. stutter. Front Hum Neurosci 2019;13:411. Aim: Our aim is to describe outcomes of early & intensive Yada Y, Tomisato S, Hashimoto RI. Online cathodal transcranial neurorehabilitation for a child with SMA type2.Clinical direct current stimulation to the right homologue of Broca’s area presentation: Master X reported to us at 1yr 8m. Genetics and improves speech fluency in people who stutter. Psychiatry Clin clinical examination confirmed SMA type2. At presentation, Neurosci 2019;73:63-9. he was able to roll, sit when made to sit, but had complains of weakness in b/l upper & lower extremities, inability to Effect of virtual reality on balance and gait independently come to sit, transition out of sitting, standing in geriatric population & walking. His baseline assessment was done for MMT, GMFM(35%)& HFMS(16/40). Sneha B Iyer Intervention: Goal directed therapy using following strategies was implemented:a) low intensity exercises with submaximal Department of Neurosciences, Dr D Y Patil College of loading in weight bearing positions using muscle co-contractions Physiotherapy, Mumbai, Maharashtra, India. to improve muscle endurance & postural stability.b) Balance E-mail: [email protected] training in various functional positions incorporating play Background: Falls result in injuries which account for 20%- activities.c) Respiratory exercises like blowing a balloon.d) 30% of all injuries combined in age groups >60 years. Mild supramalleolar orthosis given for foot planus, thereby improving physical activity prevents falls, but due to low adherence foot alignment. Adequate rest periods were given to avoid to unsupervised exercises at home, improvements remain fatigue. Progression was done in intensity & repetitions as inconclusive. A multimodal home-based balance and gait tolerated. Exercises sessions were undertaken for 40 mins at training program, shows better outcomes. Nonetheless, virtual a frequency of 3 times/week. reality training (VRT) programs may potentially improve the Results: With ongoing therapy, he started standing & walking effects on balance, gait and fall risk among geriatrics. independently, ride tricycle and was able to attend school. There Aim: Study intends to compare the effect of virtual reality have been no muscle contractures or respiratory complications. training (VRT) as compared to conventional physiotherapy His latest assessment (at age 4 years) shows significant exercises to improve balance, gait and fall risk. improvement from baseline scores for MMT,GMFM(58.44%), Methods: An experimental study design conducted among 42 HFMS (28/40). participants (aged 65 to 75 years), randomly divided into two Conclusion: Thus we conclude that regular, goal directed groups namely VRT and conventional exercises using modified physical therapy can improve functional independence and Otago Home Exercise program. Intervention was given for 4 avoid respiratory & musculoskeletal complications that could weeks, with 3 sessions per week and pre-post assessment arise from mobility restrictions in children with SMA type 2. were done using Berg balance scale (BBS), Dynamic gait index (DGI) and Modified fall efficacy scale (MFES) to check balance, Person-environment-occupation model- gait performance & fall risk respectively. based occupational therapy intervention Result: Post 12 sessions of intervention, significant improvement for functional recovery in a chronic case of seen on balance, gait and fall risk within both groups on BBS, DGI, MFES with (p<0.0001). On comparison, both groups multiple myeloma - A case study showed equal effect on BBS (p=0.42), DGI (p=0.39), MFES (=0.53) with low statistical significance. Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S47

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Pooja P. Kamble Results: Audiological evaluation was done and it revealed no indication of cochlear pathology and retrocochlear pathology Department of Occupational Therapy, LTMMC & GH, Mumbai, uptill brainstem in both sides. Cortical Auditory Evoked Potential Maharashtra, India. revealed reduced P1 amplitude and absent P2 potential in E-mail: [email protected] left side. Temporal resolution- pitch patterning test and Gap Background: A 50-year-old unknown male patient was brought detection test was administered and it revealed Central Auditory to a tertiary care hospital in a state of severe pain, inability to Processing Disorder. Speech and Language assessment was sit or stand, and in an unkempt condition. On investigation carried out which revealed non fluent aphasia, dysarthria and and clinical correlation, this patient was diagnosed as a case dysphagia. Comprehensive management goals for improving of Multiple Myeloma. auditory processing deficit through temporal patterning task, Aim: To study the effect of Person-Environment-Occupation swallowing through manuevres & postural modification; speech (PEO) model-based occupational therapy intervention on through articulatory drills and feedback. activity participation and functional recovery in chronic Multiple Conclusions: Systematic approach using appropriate test myeloma. tools are important for diagnosis and symptomatic therapy yield Methods: The PEO model was used where the patient’s unique better prognosis for recovery. qualities and strengths were recognized, the environmental factors that promoted or demoted his functional independence Systematic evaluation and comprehensive were modified and thus, he was able to engage in the management for traumatic brain injury - A occupational roles that he wasn’t able to independently engage in due to his condition. An interdisciplinary approach was case report used while formulating goals for the patient. The intervention was for 3 weeks and given in the ward. Standardized scales Sangeetha Ram were used to measure pre-intervention and post-intervention functional status. Department of Speech and Language, MERF-Institute of Speech Result: Using PEO based occupational therapy intervention and Hearing (P) Ltd, Chennai, Tamil Nadu, India. coupled with high motivation and participation of the patient, E-mail: [email protected] despite not having family or any other support, he was able Background and Aims: Traumatic Brain Injury (TBI) is caused to achieve all the short-term goals i.e., being able to sit by a head injury leading to alterations in brain functioning and independently and eat, wear his own splints, groom himself result in speech & Language disturbances, auditory processing and independently propel a manual wheelchair. The patient deficit which in turn affects the quality of life. The aspect of was discharged to a charitable home after a long stay at the assessment and rehabilitation following TBI is challenging tertiary care hospital. because of many factors that. This study emphasizes on Conclusion: Individualized PEO-based occupational therapy diverse assessment and rehabilitation procedure for a patient intervention is effective in improving activity performance and following TBI. functional recovery, thus improving the patient’s self-esteem, Case Description: A 39 year old male client was enrolled for self-image, and quality of life in chronic Multiple myeloma. assessment with the complaint of unclear speech and difficulty in perceiving auditory commands following road traffic accident Systematic evaluation and comprehensive on 20/12/2020. MRI results revealed diffuse axonal injury management for traumatic brain injury - A noted in left frontal and temporal cortices; focal contusions with edema in bilateral frontal lobes and mild subarachnoid case report haemorrhage seen in left parietal regions. VII and VIII nerve complexes appear normal. Sangeetha Ram Results: Audiological evaluation was done and it revealed no indication of cochlear pathology and retrocochlear pathology Department of Speech and Language, MERF-Institute of Speech uptill brainstem in both sides. Cortical Auditory Evoked Potential and Hearing (P) Ltd, Chennai, Tamil Nadu, India. revealed reduced P1 amplitude and absent P2 potential in E-mail: [email protected] left side. Temporal resolution- pitch patterning test and Gap Background and Aims: Traumatic Brain Injury (TBI) is caused detection test was administered and it revealed Central Auditory by a head injury leading to alterations in brain functioning and Processing Disorder. Speech and Language assessment was result in speech & Language disturbances, auditory processing carried out which revealed non fluent aphasia, dysarthria and deficit which in turn affects the quality of life. The aspect of dysphagia. Comprehensive management goals for improving assessment and rehabilitation following TBI is challenging auditory processing deficit through temporal patterning task, because of many factors that. This study emphasizes on swallowing through manuevres & postural modification; speech diverse assessment and rehabilitation procedure for a patient through articulatory drills and feedback. following TBI. Conclusions: Systematic approach using appropriate test Case Description: A 39 year old male client was enrolled for tools are important for diagnosis and symptomatic therapy yield assessment with the complaint of unclear speech and difficulty better prognosis for recovery. in perceiving auditory commands following road traffic accident on 20/12/2020. MRI results revealed diffuse axonal injury Ataxia telangiectasia like disorder: Rare noted in left frontal and temporal cortices; focal contusions clinical profiles of siblings and its impact on with edema in bilateral frontal lobes and mild subarachnoid haemorrhage seen in left parietal regions. VII and VIII nerve caregiver complexes appear normal. S48 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Subhiksha Murali, M. Suhada, P. C. Sooraj, of stimulation, however his out hair cell functions were normal. N. Swapna Upon evaluation he was diagnosed with bilateral auditory neuropathy, Cortical potentials suggested right ear better Department of Audiology and Speech Language Pathology, All than left ear. He underwent cochlear implantation in right ear India Institute of Speech and Hearing, Manasagangothri, Mysuru, followed by programming and rehabilitation. Karnataka, India. Results: Post-operatively he had good electric stapedial reflex E-mail: [email protected] and his speech perception scores improved by 45% on open Background and Aims: Ataxia Telangiectasia (AT) is a rare, set and 55% on closed set. On non-implanted ear his hearing progressive, autosomal recessive disorder characterized by sensitivity deteoriated with absent outer hair cell functioning. cerebellar signs and telangiectasia. Atypical presentations, The details of the functional outcomes will be discussed during also called AT like Disorders (ATLD) have also been reported. the presentation. This clinical case study aims to highlight the enigmatic speech, Conclusion: Cochlear Implant is an option for patients with language, swallowing, psychological and motor profiles and ANSD irrespective of degree of hearing loss. However early supportive management in siblings with ATLD, along with the identification with systematic evidence-based diagnosis is impact of ATLD on the kindred. crucial for decision making. Without detailed audiological test Methods: Two female siblings, 29.2 years and 25 years battery decision making for candidacy and rehabilitation is old, reported with the complaint of slurring and slow rate of challenging. speech, difficulty in eating and motor activities. The facets of communication, swallowing and motor faculties were Utilization of post stroke rehabilitation assessed using performance based and subjective speech, services at a tertiary care center in the language and cognition tests. Speech therapy focussing on programmed subsystem approach and physiotherapy focusing Northern Province Sri Lanka on amelioration of equilibrium and balance were provided as part of supportive management. The consequences of the Sivanesan Shivaram, R. Sampavi, R. Ghobika, disorder on the clients and custodian were assessed. L. Suvethini, B. Yathev, A. A. D. R. Amarasingha, Results: The siblings showed features of ataxic dysarthria and S. Shiyananth, S. Shivaram, G. Sivakumar, motor signs of cerebellar lesion. Language and psychological A. A. A. Suramiya, A. Paherathy, S. Thivacaren, status was intact. The elder sibling presented with greater A. Arasalingam speech difficulties and lesser motor problems compared to younger sibling who exhibited a reverse pattern, substantiating Department of Medicine, University of Jaffna, Jaffna, Sri Lanka. the claim that no two persons with AT have the same clinical E-mail: [email protected] presentation. The Quality of Life (QOL), which was moderately Introduction: Stroke care is a comprehensive, inter-disciplinary affected before treatment changed to mildly affected QOL with process which comprises post-stroke rehabilitation as an treatment. However, the impact of these problems was minimal integral component, involving the patient, family, healthcare on the custodian. staff, and therapists. Conclusion: Considering variations in the presentation of Objectives: To study the utilization of post-stroke rehabilitation ATLD is ineluctable to provide pertinent treatment. Supportive from acute to home care. therapy and caregiver motivation are essential components of Methods: Records of 792 patients extracted from the Sri neurorehabilitation, which improves QOL. Lanka Clinical Stroke Registry during the study period 1st April 2016 to 30th June 2017, were statistically analyzed. Variables A case study on outcomes with cochlear include referrals to stroke rehabilitation services; inward and implant in auditory neuropathy spectrum on discharge and are expressed as percentages. Results: Of 792 patients 425 (53.4%) were male; 594 disorder (75%) had ischemic stroke and 198 (25%) had intracerebral haemorrhage. On discharge, the number of referrals to post Gauri Singh, Ranjith Rajeswaran, Subhashini stroke rehabilitation services were physiotherapy 607/792 (76.6%), speech pathology 162/792 (20.5%), occupational Department of Audiology, MERF- Institute of Speech and Hearing, therapy 27/792 (3.4%), counselling 1/792 (0.1%), and social Chennai, Tamil Nadu, India. services 1/792 (0.1%). E-mail: [email protected] Conclusion: There is an overall underutilization of post Background: Auditory neuropathy spectrum disorder (ANSD) stroke rehabilitation services, especially occupational therapy, is a rare disorder of auditory nerve, in which the person may counselling, and getting financial/social assistance from social have normal hearing or hearing loss ranging from mild to services. severe. Cochlear (CI) Implant isseldom performed in ANSD with normal hearing. Indication for CI in ANSD with normal hearing Utilization of speech and language and outcomes are profiled in this case study. pathology services for stroke patients with Case Description: A 34 years old male came with complaint of difficulty in hearing and speech perception. The radiological dysphagia in the acute care setting at a evaluation revealed patent cochlea and auditory nerve. tertiary care centre in the Northern Province Audiological findings reveals minimal hearing loss in both ears with very poor speech perception abilities. He had of Sri Lanka normal middle ear with absent acoustic reflexes in both ears. Auditory brainstem responses were absent even at lower rate Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021 S49

[Downloaded from http://www.pjiap.org on Saturday, July 29, 2023, IP: 43.246.243.196] AOCNR EPoster Abstract Sivanesan Shivaram, R. Sampavi, R. Ghobika, a self-administered questionnaire where 20 components were L. Suvethini, B. Yathev, A. A. D. R. Amarasingha, tested and knowledge scored out of 100. S. Shiyananth, S. Shivaram, G. Sivakumar, A. A. A. Suramiya, A. Paherathy, S. Thivacaren, Results: Of the 67 respondents, 43(64.1%) were intern A. Arasalingam medical officers; 52(77.6%) had worked in a medical ward; 5(7.5%) had undergone stroke rehabilitation training; 57(85%) Department of Medicine, University of Jaffna, Jaffna, Sri Lanka. knew the aims of stroke rehabilitation. Knowledge on the E-mail: [email protected] use of scales in stroke assessment varied from 11.9% to Introduction: Dysphagia, a common problem in acute stroke 56.7% based on the scales; 32(77.6%) made appropriate patients, is a frequent cause of complications particularly referrals to post stroke rehabilitation services; 58(91%) aspiration pneumonia. A speech pathologist conducts a formal gave appropriate advice on discharge; and 40.3% knew assessment within 24-48 hours. A bed side swallow test is the available rehabilitation centres in the Jaffna district. done on admission. S4coring of knowledge 24(35.8%) were in the first quartile Objectives: To assess the utilization of speech and language and 33(49.3%) in the second quartile. pathology services in the management of dysphagia and assess the occurrence of aspiration pneumonia in the acute Conclusion: Compared to an audit done in 2017 there has post stroke setting in a tertiary care centre in the Northern been a significant improvement in the utilization and knowledge Province of Sri Lanka. with regard to stroke services. The knowledge on the use of Methods: A retrospective study based on data extracted from scales was low probably due to the fact that these are not the Sri Lanka Stroke Clinical Registry during the study period applied by the interns and nursing officers. of 1st April 2016 to 30th June 2017. Results: Of a total of 792 patients bedside swallow test was Tinnitus as presenting symptom of not done or documented in 729(91.8%); referral to speech and arachnoid cyst of the anterior cranial fossa - language pathologist was documented in 158/792(19.9%) and 152 (19.5%) had dysphagia. Sub analysis of the 152 patients A case report with dysphagia - bed side swallow test was not documented in 149(98%) and 25(16.1%) were referred to the speech Anusha Nagamalai, C. Pachaiappan, and language pathologist. 33/152 (21.3%) had aspiration Dhulase Krithega pneumonia. Conclusion: The documentation of bed side swallowing test Department of Audiology and Speech-Language Pathology, MERF was found to be lower than the optimal standards and there is Institute of Speech and Hearing, MERF Institute of Speech and a significant underutilization of speech and language pathology Hearing, Chennai,Tamil Nadu, India. services in assessing dysphagia. E-mail: [email protected] An audit on the knowledge and utilization Background and Aim: Arachnoid cysts are rare CSF of stroke rehabilitation amongst intern collections which occur on the arachnoid membrane and sub medical officers and nursing officers arachnoid space. It is commonly seen in the middle cranial fossa, the suprasellar region, followed by the posterior cranial attached to a tertiary care centre in Jaffna, fossa. Localization in the anterior cranial fossa is an uncommon Northern Province of Sri Lanka finding and it may remain asymptomatic or cause general symptoms. This study aims to report tinnitus as presenting Sivanesan Shivaram, R. Sampavi, R. Ghobika, symptom of arachnoid cyst of the anterior cranial fossa. L. Suvethini, B. Yathev, A. A. D. R. Amarasingha, S. Shiyananth, S. Shivaram, G. Sivakumar, Case Description: A 34-year-old male, came to the department M. Mithuriha, S. Thivacaren, A. A. A. Suramiya, with the complaint of right-sided tinnitus occasionally A. Paherathy, A. Arasalingam accompanied by dizziness, headache and nausea. It was also subjected to a psychological overlay of depression and Department of Medicine, University of Jaffna, Jaffna, Sri Lanka. insomnia. These symptoms occurred at late age without any E-mail: [email protected] evident causative factors. Magnetic-Resonance Imaging Introduction: With no designated neurorehabilitation centre, showed an extra-axial CSF signal intensity lesion in the right rehabilitation of neurology patients is covered by general anterior temporal region, suggestive of Arachnoid cyst. rehabilitation centres. Knowledge and utilization of stroke rehabilitation services is paramount amongst the intern house Result: Audiological evaluation was carried out through officers and nursing officers who are the first contact points to Auditory Brainstem Responses, OtoacousticEmission, and a stroke patient and their relatives. Pure Tone Audiometry which revealed minimal hearing loss Objectives: We aimed to assess (1) the knowledge of in both ears. Vestibular Evoked Myogenic Potential indicated rehabilitation and the concept of multidisciplinary teams; (2) the normal vestibulocollic reflex pathway functioning. The post stroke complications during the rehabilitation phase: and impression of Tinnitus Handicap Inventory denoted a ‘severe (3) the utilization of rehabilitation services amongst the intern handicap’. Tinnitus matching and masking qualified him as a house officers and nursing officers at the Teaching Hospital candidate for Tinnitus Retraining Therapy. Jaffna, Sri Lanka. Randomly selected 100 subjects answered Conclusion: It is often difficult to interpret the relationship between intracranial arachnoid cysts and inner ear symptoms. Patients may be misdiagnosed due to varied range of symptoms. Test battery approach and symptomatic assessment is required for appropriate diagnosis and treatment. S50 Physiotherapy - The Journal of Indian Association of Physiotherapists - Volume 15, Supplement 1, December 2021