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Souvenir_6th SHTI Conference 2017

6th Annual National Conference Souvenir of Society for Hand Therapy, India

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Souvenir_6th SHTI Conference 2017

  1. 1. SOCIETY FOR HAND THERAPY, INDIA   0   www.societyforhandtherapyindia.in   6th Annual National Conference of Society for Hand Therapy, India In collaboration with 41st Annual National Conference of Indian Society for the Surgery of the Hand (ISSH) Active participation from Therapy Section (SSHT) of Singapore Society for Hand Surgery (SSHS) 22nd (Friday) & 23rd (Saturday) September, 2017 Venue: J. W. Marriott, Juhu Tara Road, Mumbai‐400049, Maharashtra, India Website: http://isshcon2017.com Theme: Restoring Hand Functions: Versatile Therapies                   
  2. 2. SOCIETY FOR HAND THERAPY, INDIA   1 Restoring Hand Functions: Versatile Therapies  “Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” ~ Mary Reilly, EdD, OTR, FAOTA (1916 - 2012) Published by Society for Hand Therapy, India © Written, Compiled and Edited by Punita V. Solanki With Support and Help from: Office Bearers of Society for Hand Therapy, India & Organizers of 6th Annual National Conference with special thanks to Charmie A. Dave September, 2017. Mumbai, Maharashtra, India
  3. 3. SOCIETY FOR HAND THERAPY, INDIA   2 Table of Contents S. No. Topics Page No. 1 Message from President of Indian Society for Surgery of the Hand (ISSH) ~ Dr. Ravi Gupta 3 2 Message from President of Singapore Society for Hand Surgery (SSHS) ~ Dr. David MK Tan 4 3 Message from 41st ISSHCON Organizing Chairperson ~ Dr. Pankaj N. Ahire 5 4 Message from President of Society for Hand Therapy (SHT), India ~ Amol V. Sangekar 6 5 Message from Vice‐President of Society for Hand Therapy (SHT), India ~ Dr. Shovan Saha 7 6 Message from Secretary of Society for Hand Therapy (SHT), India ~ Suresh Mani 8 7 Message from Organizing Secretary of the 6th Annual National Conference of Society for Hand Therapy (SHT), India ~ Hemant P. Nandgaonkar 9 8 Message from Scientific Committee Chairperson & Co‐Organizing Secretary of the 6th Annual National Conference of Society for Hand Therapy (SHT), India ~ Punita V. Solanki 10 9 Message from President of All India Occupational Therapists’ Association (AIOTA) ~ Dr. Anil K. Srivastava 11 10 Message from President of Indian Association of Physiotherapists (IAP) ~ Dr. Umasankar Mohanty 12 11 About Conference Organizers and Faculty Speakers 13‐23 12 Current Office Bearers of Society for Hand Therapy, India & Current Position of SHT India 24‐26 13 Conference Brochure, Workshop Flyers and Scientific Programme 27‐46 14 Abstracts of Oral Papers, ePoster Papers, Mini Movies, Hand Gestures and Essay Writing 47‐87 15 Expert Opinion One Liners 88‐90 16 Membership Details of Society for Hand Therapy, India and Memories of the Past Conferences and 6th Pre‐Conference Preparations 91‐96 17 SHTI Website Launch 97 18 Our Sponsors 98
  4. 4. SOCIETY FOR HAND THERAPY, INDIA   3 Message from President of Indian Society for Surgery of the Hand (ISSH) I am immensely pleased to write this message for the upcoming 6th Annual National Conference of Society for the Hand Therapy India being held on 22nd and 23rd September 2017 in Mumbai. Hand therapy is an inseparable component of hand surgery. In fact, many a times the hand therapy plays more vital role than the hand surgery in restoring the function of the hand, especially in the neglected and inappropriately treated cases. A few years back, there was no specialized field of hand therapy and the cases were being treated by general physiotherapist in the same manner as the hand surgery, a few decades back, was being performed by general/ plastic/orthopaedic surgeons. With the evolution of highly specialized treatment modalities for the hand ailments, the hand surgery as well as hand therapy have evolved together as specialized areas. I would also like to share a fact here that I have the honor of witnessing the launch of the Indian chapter of Hand therapists in 2006 in Chandigarh during the annual ISSH meeting which was hosted by us. During that conference we also conducted a one day session of the hand therapist with the international faculty from Australia and Netherland along with our national faculty. I am happy to know that now we are organizing this meeting for two days, showing that our hand therapists are really active. I convey my greetings and good wishes to the organizers for the success of the meeting and am hopeful that this will turn out to be an excellent academic feast to the delegates. Dr. Ravi Gupta, MS, DNB, FRCS (Glasgow), FAMS, FIMSA, FAPOA Professor & Head (Unit II), Orthopaedics cum Project Director, Sports Injury Centre, Government Medical College Hospital, Chandigarh President, Indian Academy of Arthroscopy and Sports Medicine President, Indian Society for Surgery of Hand Chairman Ethics Committee, GMC. Mewat (Haryana); Ex. Member Senate PU, Chd. Editor‐in Chief Journal of Arthroscopy & Joint Surgery; Chairman Hand Section, Indian Orthopedic Association; Member Task Force Health and Med Ed Punjab; Member Board of Studies, PG Med Ed & Research PU Chd.; Member Research Advisory Board Swami Rama Himalayan University, Dehradun Member, Board of Control, Institute of Dental Science, PU Chd.; AO Fellow Austria; Sports Med. Fellow USA; Hand Fellow Australia; Asia Pacific Fellow Japan; Dartmouth Hitchcock Fellow USA
  5. 5. SOCIETY FOR HAND THERAPY, INDIA   4 Message from President of Singapore Society for Hand Surgery (SSHS) On the advent of the 6th Annual National Conference of Society for Hand Therapy, India, it gives me great pleasure to share a few congratulatory thoughts and notes. The success and the steady road to recovery after injury or complex hand surgery and reconstructive efforts is dependent equally on the ability and merit of the surgeon as well as the diligent and thoughtful ministrations of the therapist. Hand therapists are a natural extension of the continuum of care that the patient will experience well beyond their first encounter with the attending specialist and sometimes make the difference between success and failure in the more complicated of conditions. In my experience, meaningful collaborations with therapists are achieved by engaging them one on one soon after a complex surgery has been performed for challenging hand and wrist problems and I appreciate not only the read back, but considered and constructive suggestions to better arrive at the desired outcome for a patient. A detailed look at the program on the 22nd September and 23rd September 2017 shows a well‐organized and balanced schedule of talks that encompasses the breadth of hand therapy matched equally with depth. I would like to congratulate both the organizers as well as participants who have registered for this event which is an important cornerstone in establishing and promulgating the role of therapy in the noble specialty of hand surgery.     Dr. David MK Tan, MBBS (Singapore), MRCS (Edinburg), MMed (Surgery) Senior Consultant, Department of Hand Reconstructive Microsurgery, National University Hospital, Singapore President, Singapore Society for Hand Surgery (SSHS)
  6. 6. SOCIETY FOR HAND THERAPY, INDIA   5 Message from 41st ISSHCON Organizing Chairperson Dear Members of SHTI, As ISSHCON makes its appearance for the 41st time, in Mumbai after 16 years along with SHTI which enters its second decade of growth, I am delighted to invite all of you to witness what we have poured our hearts & souls into. The Society for Hand Therapy, India has made its presence felt to the world during the IFSHT meeting in 2013. It seems to have evolved into a focused force driven by passion. For SHTI to grow to its deserved dimensions, it is important that SHTI conferences are well attended. The SHTI is well poised to play an important role in the Asia Pacific region, it is important that we show our strength in academics both in quality & quantity. With Singapore Society for Hand Surgery joining ISSHCON 2017, we will have a conference which will shape the future collaborations in Asia Pacific region. On behalf of my team I welcome you all to Mumbai. Come, let’s make SHTI great! Dr. Pankaj N. Ahire, MS Orth Organizing Chairman, 41st ISSHCON Consultant Hand Surgeon, Mumbai, Maharashtra, India
  7. 7. SOCIETY FOR HAND THERAPY, INDIA   6 Message from President of Society for Hand Therapy, India As an organizing chairman of this conference and president of Society for Hand Therapy (SHT), India, it gives me immense pleasure to welcome all delegates, speakers and guest to this 6th Annual All India Conference of Society for Hand Therapy. This year our conference is in conjunction with the 41st Annual Conference of Indian Society for Surgery of the Hand (ISSH) and Singapore Society for Hand Surgery (SSHS), and I take this opportunity to welcome all hand surgeons. The treatment of hand injury is largely a team effort, between the hand surgeon and hand therapist and hence this conference platform presents a unique opportunity for comprehensive learning and understanding of various hand related diagnoses. We have meticulously selected experts, who will be speaking on various hand related topics. These speakers are hand surgeons and hand therapists from across the globe and will help us in our endeavor to offer a wide ranging understanding of hand cases. This conference will provide a great experience to the seasoned therapist as well as provide a global view on approach to hand treatment for the novice therapist. I wish all committee members a very successful conference and thank them for their efforts in putting this conference together. I am confident that this conference will be a mile stone in the history of Society for Hand Therapy, India Amol Vinod Sangekar, BOT (Mumbai) OTR (USA), CEAS II (USA) Occupational Therapist, Ergonomics Consultant, Mumbai, Maharashtra, India President, Society for Hand Therapy (SHT), India Organizing Chairman, 6th Annual National Conference
  8. 8. SOCIETY FOR HAND THERAPY, INDIA   7 Message from Vice‐President of Society for Hand Therapy, India It is my pleasure to pen down my thoughts on the occasion of 6th Annual National Conference of Society for Hand Therapy (SHT), India to be held on 22nd & 23rd September, 2017 at Mumbai, Maharashtra. The event assumes greater significance as it is jointly been held with the 41st Annual Conference of Indian Society for the Surgery of the Hand. I have been personally involved with SHT, India since its early days, and take great pride in its endeavor to strive ahead. The 6th academic meet, I am sure would prove to be a significant moment in the annals of SHT, India. There is a growing concern of the increasing number of people getting involved in industry related injuries or road traffic accidents resulting in dysfunctional hands. It is leading to increasing social compulsions and degrading socio‐economic fabric. Therefore there is a compelling need for hand therapists to be skilled, enthusiastic, knowledgeable, committed and sensitive. It is India’s need of the hour to maintain the sustained growth in terms of its available robust skilled workforce functional, and to make that happen it is critical that people with functional limitations become integral part of this workforce with reasonable competency. The hand therapists will have to face challenges of constraints, rise up to the occasion and shoulder this enormous social responsibility. With the theme “Restoring Hand Functions: Versatile Therapies”, the 6th academic meet will definitely go a long way to energize young minds to walk the talk in the field of hand rehabilitation. Dr. Shovan Saha, MOT, PhD Associate Professor, Department of Occupational Therapy, SOAHS, Manipal University, Manipal, Karnataka, India Vice President, Society for Hand Therapy (SHT), India EC Member, ACOT, AIOTA Advisor and Workshop Committee Incharge, 6th Annual National Conference
  9. 9. SOCIETY FOR HAND THERAPY, INDIA   8 Message from Secretary of Society for Hand Therapy, India Dear All, We are greatly honored to invite all the delegates for the 6th Annual National Conference of Society for Hand Therapy, India, in collaboration with 41st ISSH Conference & Active Participation from Therapy Section (SSHT) of Singapore Society for Hand Surgery (SSHS) to be held on 22nd & 23rd September, 2017 at J. W. Marriott, Juhu Tara Road, Mumbai‐400049, Maharashtra, India. I personally witness, the growth of Society of Hand therapy, India as one of the eminent society and life member of International federation of societies for hand therapy (IFSHT) since it is started in 2009. Hand is a complex mechanical and sensory device, and an important tool of communication, represents 40 percent of the somato‐sensory cortex. Over 20% of disabling workplace injuries involve the hand. Apart from cuts and lacerations, the sprain, strain, and ligament tear were the common injuries of the hand. In addition, the loss of hand function resulted from traumatic cervical spine injuries accounts for 50% of total spinal cord injuries are tetraplegia with C7 level. Impairment and disability of the hand results in inability to perform simple daily activities of life. The hand therapy restores hand and upper limb functions, which improves the quality of life. Therefore, enhance the recovery and improve the hand functions is an imperative rehabilitation goal for these populations. The 6th Annual National conference with a theme of “Restoring Hand Function: Versatile Therapies” aimed to provide a common platform for physiotherapist and occupational therapist to share their knowledge and evidence in emerging evidence in therapeutic methods for the management of hand and upper limb related disorders. We wish to thank all the participants, sponsors, and invited speakers and scientific advisory board and volunteers and those who have contributed in the successful organization of great events. With Best Wishes, Dr. Suresh Mani, MPT Associate Professor, Department of Physiotherapy, School of Physiotherapy & Paramedical Sciences Faculty of Applied Medical Sciences Lovely Professional University, Punjab, India Secretary, Society for Hand Therapy (SHT), India
  10. 10. SOCIETY FOR HAND THERAPY, INDIA   9 Message from Organizing Secretary of the 6th Annual National Conference of Society for Hand Therapy, India The aim of hand therapy is to improve and maintain hand function to lead good quality of life. With this message in mind, Mumbai team of Society of Hand Therapy has collaborated with Indian Society of Surgery of the Hand. The purpose of collaboration is to facilitate surgeon‐therapist coordination during client care. Theme of the conference is “Restoring Hand Functions: Versatile Therapies”. It’s going to feast for delegates attending the conference, where we will be having presentation on various topics from international and national leaders in the field of hand rehabilitation. Society for Hand Therapy, India is celebrating its ten years of dedicated services for the promotion of Hand Therapy in India. This conference will be a common platform for discussion on various issues like certification examination, research and giving quality of care to our clients. Hope to see you in large number. Hemant P. Nandgaonkar, MSc (OT) Assistant Professor (Occupational Therapy) O. T. School and Centre, Seth G. S. Medical College & King Edward VII Memorial Hospital Mumbai, Maharashtra, India Ex‐President and Ex‐Officio, Society for Hand Therapy (SHT), India Organizing Secretary, 6th Annual National Conference
  11. 11. SOCIETY FOR HAND THERAPY, INDIA   10 Message from Scientific Committee Chairperson & Co‐Organizing Secretary of the 6th Annual National Conference of Society for Hand Therapy, India Hand therapy is a specialized and advanced branch of practice for occupational therapists and physiotherapists with keen interest, experience, expertise and skills in the rehabilitation of the upper quarter region of the body. Society for Hand Therapy (SHT) has been vital in promoting, enhancing and advancing the field of hand therapy in India, since the year 2008. The year 2017 will be pondered for the society’s remarkable 6th annual national conference to be held in collaboration with the 41st annual national conference of Indian Society for Surgery of the Hand (ISSH), co‐hosted by Singapore Society for Hand Surgery (SSHS) and active participation from Therapy Section (SSHT) of Singapore Society for Hand Surgery (SSHS), in Mumbai, Maharashtra, India. This conference will be a landmark in the history of SHT, India to host an annual academic meet on a larger platform with wider audience and versatile participants. The theme of the conference “Restoring Hand Functions: Versatile Therapies” have been aptly chosen to inform all the stake holders involved in hand care (i.e.) hand surgeons, hand therapists, physicians and others, about the importance and the need of versatile therapies in getting the clients/patients back to their roles and work, faster and earlier. This conference will have participation from national and international faculty speakers, various research authors will be presenting their work in oral, eposter, mini movie, hand gesture and essay formats. There will be awards for each category of presentation. Our best wishes to all the presenters and looking forward to meeting you all on a positive note. Punita V. Solanki, MSc (OT), ADCR Ex‐Assistant Professor, Seth GSMC & KEMH, Parel, Mumbai, Maharashtra, India Visiting Consultant Occupational Therapist, NM Medical, Malad, Mumbai, Maharashtra, India Visiting Hand Therapist, Kanchi Nursing Home, Goregaon, Mumbai, Maharashtra, India Associate Editor, Indian Journal of Occupational Therapy (IJOT) EC Member, Society for Hand Therapy (SHT), India Co‐Organizing Secretary and Scientific Committee Chairperson, 6th Annual National Conference
  12. 12. SOCIETY FOR HAND THERAPY, INDIA   11 Message from President of All India Occupational Therapists’ Association I am extremely happy to know that 6th Annual National Conference of Society for Hand Therapy, India is being organized on Sept. 22‐23, 2017 in Mumbai in active cooperation & collaboration with 41st Annual National Conference of the Indian Society for the Surgery of the Hand (ISSH) and Singapore Society for Hand Surgery (SSHS) on the appropriately chosen Theme ‘Restoring Hand Functions: Versatile Therapies’. I must congratulate the members of AIOTA who have taken a lead in constituting ‘Society for Hand Therapy’, thereby effectively promoting the area of OT practice in Hand Therapy in the country. Hand is a very delicate & amazing structure of human body, essential for self‐care, work and day to day activities. Any injury, burn, disease or disabling condition to hand calls for a special focus and approach for restoration of its complex functions. Hand therapy, a specialty practice area of occupational therapy, is specifically concerned with treating orthopedic, neurological and traumatic‐based upper‐extremity conditions to maximize the function and use of the hand and arm to improvise the quality of life. The lively workshops designed with dictatic presentations, hands‐on and demonstrations by eminent national and international faculties will be academically enrich the knowledge base of delegates. I am confident that the delegates participating from all part of the country will have a comfortable stay and great learning experience. On behalf of All India Occupational Therapists’ Association, I sincerely wish, the 6th Annual National Hand Therapy Conference a great success under the dynamic and potential leadership of Dr. Amol Sangekar, Dr. Hemant Nandgaonkar and Dr. Punita Solanki. I would appreciate to receive the brief report of the conference. With best wishes Dr. Anil K. Srivastava, BSc, DOT, D.Y. Ed., PG (Rehab), FACOT President, All India Occupational Therapists’ Association (AIOTA) & WFOT Delegate Executive Chairman, Academic Council of Occupational Therapy (ACOT), AIOTA Editor‐in‐Chief, Indian Journal of Occupational Therapy (IJOT) 93, Laxmanpuri, Faizabad Road, Lucknow‐226016, Uttar Pradesh, India Tel: +91 522 2350582, +91 9415405095, +91 9140879761 E‐mail: president@aiota.org Website: www.aiota.org
  13. 13. SOCIETY FOR HAND THERAPY, INDIA   12 Message from President of Indian Association of Physiotherapists Felicitous is this my left hand, yet more felicitous is this the right one. This hand contains all healing properties, its gentle touch brings peace and welfare. (Atharva Veda 4.13.6) I am pleased to know that 6th Annual National Conference of Society for Hand Therapy, India is being organised in Mumbai on 22nd and 23rd September, 2017. The event is being organised with prestigious collaboration of 41st Annual National Conference of the Indian Society for the Surgery of the Hand (ISSH). Hand plays an extremely important role sine qua non for a happier life of every human being. Restoration of hand function after any injury/ impairment is a team work involving Hand Surgeons, Hand Therapists, Occupational Therapists and Physiotherapists. The conference will definitely provide unique opportunity for experts to share their valuable knowledge, skill and science of hand rehabilitation. The Theme: Restoring Hand Functions: Versatile Therapies is appropriate and will benefit pro bono publico. I am sure that recent researches and concepts will be discussed in the conference. I wish the event a great success and hope the delegates attending this conference will reap maximum benefit from the academic deliberations. I appreciate efforts of the Organising Committee for their professional zeal, dedication and commitment. Dr. Umasankar Mohanty, BPT (Hons), MPT, PhD, SRP (London), FAGE, MISEP President, The Indian Association of Physiotherapists (IAP) Dr. Mohanty’s Manual Therapy and Pain Clinic Bunt’s Hostel Road, Mangalore‐575003 Karnataka, India
  14. 14. SOCIETY FOR HAND THERAPY, INDIA   13 6th Annual National Conference Organizers
  15. 15. SOCIETY FOR HAND THERAPY, INDIA   14 About 6th Annual National Conference Organizers                                   Shovan Saha, PhD Associate Professor, Manipal, India Occupational Therapist, working in the field of hand rehabilitation. He facilitates return to work for people with dysfunctional hand. He wants to be the change himself. He is passionate about hand splinting Shrikant Chinchalkar, BSc OT, M.Th.O, OTR, CHT Certified, experienced and expert hand therapist from Canada with more than 30 years of practice in the field of hand rehabilitation Passionate about biomechanics of hand and upper limb, an avid teacher and loves visits to India for sharing knowledge in hand therapy Anuradha V. Pai, MSc (OT) Assistant Professor, LTMGH & LTMMC, Sion, Mumbai, India An avid teacher of Occupational Therapy with extensive experience, expertise and interest in the field of musculoskeletal and neurosciences in occupational therapy Shailaja S. Jaywant, MSc (OT) Assistant Professor, LTMGH & LTMMC, Sion, Mumbai, India An avid teacher of Occupational Therapy with extensive experience, expertise and interest in the field of musculoskeletal sciences and pediatric rehabilitation Advisor Advisor & Workshop Committee Incharge Advisor Advisor
  16. 16. SOCIETY FOR HAND THERAPY, INDIA   15 About 6th Annual National Conference Organizers          Organizing Chairman Organizing Secretary Scientific Committee Chairperson & Co‐Organizing Secretary Scientific Committee Member Shweta G. Joijode, MOTh Assistant Professor (Occupational Therapy) Seth G. S. Medical College & KEM Hospital, Parel Consultant Pediatric Occupational Therapist, Bhakti Vedanta Hospital, Mira Road Mumbai, Maharashtra, India Passionate about adult and pediatric occupational therapy in India and loves being with friends Amol Vinod Sangekar, BOT (Mumbai) OTR (USA), CEAS II (USA) Occupational Therapist, Ergonomics Consultant Mumbai, Maharashtra, India President, Society for Hand Therapy (SHT), India Passionate about ergonomic approach towards rehabilitation Hemant P. Nandgaonkar, MSc (OT) Assistant Professor (Occupational Therapy) Seth G. S. Medical College & KEM Hospital, Parel Ex‐Officio, SHT, India Director, Hands‐On‐Therapy Concepts, Mulund Mumbai, Maharashtra, India Passionate about hand therapy propagation in India Punita V. Solanki, MSc (OT), ADCR Occupational Therapist Specialized in Orthopaedic and Hand Rehabilitation, Mumbai, Maharashtra, India Associate Editor, IJOT; EC Member, SHT, India Passionate about preventive musculoskeletal health education, clinical research and medical writing. Believer of exploring innate potentials to fullest!
  17. 17. SOCIETY FOR HAND THERAPY, INDIA   16 About 6th Annual National Conference Organizers                         Shilpshree P. Palsule, MSc (OT) Assistant Professor, Seth GSMC and KEMH, Parel Mumbai, Maharashtra, India Occupational Therapist with over two decades of experience. She is a post‐graduate teacher with special interest in studying the functional aspects of hand rehabilitation Scientific Committee Member Treasurer; Registration Committee Incharge Accommodation Committee Incharge Registration Committee Member Charmie A. Dave, MS OT (USA), OTR Occupational Therapist, Mumbai, Maharashtra, India She has 7 years of clinical experience. She has worked for 3 ½ years in the USA after having pursued a Masters in Occupational Therapy from Tufts University, Boston She is passionate about hand rehabilitation Kanan Doshi, MOT Director, Lakshya Pediatric Occupational Therapy Centre, Ghatkopar, Mumbai, Maharashtra, India Passionate Pediatric Occupational Therapist with more than 20 years of experience in pediatric rehabilitation Yogita Chhawchhria, MOTh Occupational Therapist, Mumbai, Maharashtra, India She has more than 10 years of experience with special interest in musculoskeletal and hand rehabilitation. She is a pragmatic, perseverant and an industrious entrepreneur in occupational therapy
  18. 18. SOCIETY FOR HAND THERAPY, INDIA   17 About 6th Annual National Conference Organizers                    Registration Committee Member Accommodation Committee Member Souvenir, Food Committee Incharge Souvenir, Food Committee Member Jyotsna Gaikwad, BOT Occupational Therapist, LTMMC & LTMGH, Sion, Mumbai, Maharashtra, India EC Member, Mumbai Branch of AIOTA She has more than 10 years of experience in hand therapy and neuropsychiatry. She is a young, dynamic and proactive therapist Suhas Bongade, BOTh, OTR/L (USA) Occupational Therapist, LTMMC & LTMGH, Sion, Mumbai, Maharashtra, India Co‐Convener, Mumbai Branch of AIOTA She has extensive interest and experience in hand splinting. She is a young, dynamic and enthusiast therapist with special interest in orthopaedic and pediatric rehabilitation Sushant Sarang, MSc (OT) Assistant Professor, LTMMC & LTMGH, Sion, Mumbai, Maharashtra, India Recognized PG Teacher, MUHS; Core Founding Committee Member, Autism Intervention Centre, at LTMGH, Sion; Past Convener, Mumbai Branch AIOTA; Ex‐Occupational Therapy Expert, Sarva Shiksha Abhiyaan Shubhangi More‐Lad, MOTh Occupational Therapist, LTMMC & LTMGH, Sion, Mumbai, Maharashtra, India She takes interest in research presentations, academic activities and has more than 10 years of experience in occupational therapy She participated in Sarva Shiksha Abhiyaan
  19. 19. SOCIETY FOR HAND THERAPY, INDIA   18 About 6th Annual National Conference Organizers     Taslina Kader, BOTh Occupational Therapist, Mumbai, India A fanatic girl who loves creativity, which she applies in her therapy work. Calm and composed. Currently, postgraduate student of Occupational Therapy in Musculoskeletal Sciences Abhinav Mishra, BOTh Occupational Therapist, Mumbai, India A young enthusiast, a true student of occupational therapy and a believer of “having a hobby is therapeutic” Has a vivid creativity in photography! Currently, postgraduate student of Occupational Therapy in Neurosciences Souvenir, Food & Photography Committee Member Souvenir, Food & Photography Committee Member Workshop Committee Member Accommodation Committee Member Atishree Kamdar, MOT Occupational Therapist specialized in Hand Therapy, Ahmedabad, Gujarat, India Atishree has a hand clinic in Ahmedabad after pursuing her master’s degree in Hand and Musculoskeletal conditions from Manipal University, Manipal, India Saurabh Phadke, MOTh Occupational Therapist Assistant Professor, Seth G S Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India Young, dynamic and enthusiast occupational therapist
  20. 20. SOCIETY FOR HAND THERAPY, INDIA   19 International and National Faculty
  21. 21. SOCIETY FOR HAND THERAPY, INDIA   20   About 6th Annual National Conference Faculty Speakers   Shrikant Chinchalkar, BSc OT, M.Th.O, OTR, CHT Certified Hand Therapist, Canada Key Note Address: Restoring Hand Functions: Versatile Therapies Workshop: Therapeutic Plan in Wrist Instability Dr. Jeffrey Ecker, BMedSc (Hons), MBBS, FRACS, FAOrthA Hand, Wrist, Elbow & Microsurgery Director Hand + Upper Limb Centre (HULC) South Perth WA, Australia Faculty Talk: Non‐Operative Measures: When & Where? Surgeon’s Perspective Dr. Rohan Habbu, MS (Orth) Hand & Upper Extremity Surgeon Mumbai, Maharashtra, India Faculty Talk: Elbow Injuries: Latest Orthopaedic Managements Hemant P. Nandgaonkar, MSc (OT) Occupational Therapist Mumbai, Maharashtra, India Faculty Talk: Evidence‐Based Hand Therapy Dr. Sumedh Talwalkar, MBBS, MRCS, MS (Orth), MCh (Orth) Liverpool, FRCS (Trauma and Orthopedics) Consultant Upper Limb Surgeon, United Kingdom Faculty Talk: 3D Printing in Upper Limb Injury Management
  22. 22. SOCIETY FOR HAND THERAPY, INDIA   21               About 6th Annual National Conference Faculty Speakers               Dr. David MK Tan, MBBS (Singapore), MRCS (Edinburg), MMed (Surgery) Senior Consultant, Department of Hand Reconstructive Microsurgery, National University Hospital, Singapore Faculty Talk: TFCC and SL Injury Protocol Akanksha Singh, MPT Indirapuram, Ghaziabad, Uttar Pradesh, India Faculty Physiotherapist at VARDAN, Welfare initiative by Bennett Coleman & Co. Ltd., New Delhi, India Workshop: Functional Manual Therapy in Wrist and Hand Dr. Anil Bhat, MS (Ortho), DNB (Ortho), MNAMS Professor and Head, Department of Orthopedics, KMC, Manipal Manipal, Karnataka, India Faculty Talk: Wrist Arthroscopy: Current Scenario in India and its Implications on Rehabilitation Dr. Tejashree Ajit Dabholkar, PhD Physiotherapist, Pad Dr. D. Y. Patil College and University of Physiotherapy Faculty Talk: Hand: Repetitive Task and Fatigue
  23. 23. SOCIETY FOR HAND THERAPY, INDIA   22   About 6th Annual National Conference Faculty Speakers Shailaja S. Jaywant, MSc (OT) Assistant Professor in Occupational Therapy L. T. M. M. C & G. Hospital, Sion, Mumbai, Maharashtra, India Faculty Talk: Contemporary Approach to Rehabilitation in Rheumatoid Hand Dr. Shovan Saha, BOT, MOT, PhD Associate Professor, Department of Occupational Therapy, Manipal University Faculty Talk: Clinical Reasoning for Therapy in Stiff Hand Dr. Parag Munshi, D Orth, MS (Orth), DNB (Orth), MCh (Orth), Liverpool, FRCS(Gen. Surgery), FRCS (Orth), CCST, UK Shoulder Specialist Orthopaedic Surgeon Mumbai, Maharashtra, India Faculty Talk: When Does A Frozen Shoulder Need Surgery? Punita V. Solanki, MSc (OT), ADCR Visiting Consultant Occupational Therapist, Mumbai, Maharashtra, India Panel Discussion Moderator: Post Traumatic Hand Stiffness: Therapy vs. Surgery
  24. 24. SOCIETY FOR HAND THERAPY, INDIA   23   About 6th Annual National Conference Faculty Speakers Anuradha V. Pai, MSc (OT) Assistant Professor in Occupational Therapy L. T. M. M. C & G. Hospital, Sion, Mumbai, Maharashtra, India Panel Expert: Post Traumatic Hand Stiffness: Therapy vs. Surgery Vivek N. Kulkarni, B.Sc. PT, PGCR, PGDR, MPT Principal and Professor at Sancheti Institute College of Physiotherapy, Shivajinagar, Pune, Maharashtra, India; Consultant Hand Therapist Panel Expert: Post Traumatic Hand Stiffness: Therapy vs. Surgery Dr. Narender Saini, MBBS, MS, SR (Hand Surgery) Specialty: Orthopaedic Surgeon/ Hand Surgeon SMS Hospital, Jaipur, Rajasthan, India Panel Expert: Post Traumatic Hand Stiffness: Therapy vs. Surgery Dr. Praveen Bhardwaj, MBBS; MS (Ortho); DNB (Ortho); FNB (Hand & Microsurgery); European Diploma Hand Surgery Associate Consultant: Hand and Reconstructive Microsurgery at Department of Plastic, Hand and Reconstructive Microsurgery; Ganga Hospital, Coimbatore, Tamil Nadu, India Panel Expert: Post Traumatic Hand Stiffness: Therapy vs. Surgery
  25. 25. SOCIETY FOR HAND THERAPY, INDIA   24 Office Bearers Society for Hand Therapy, India
  26. 26. SOCIETY FOR HAND THERAPY, INDIA   25 Current Office Bearers of Society for Hand Therapy, India Dear Hand Therapists We are here to promote, facilitate and enrich the field of hand therapy in India As an integrated profession in liaison with hand surgeons, focusing on patient centered approach and care- giver implicit protocols!  
  27. 27. SOCIETY FOR HAND THERAPY, INDIA   26 Current Position of Society for Hand Therapy, India Society for Hand Therapy, India is celebrating its ten years of dedicated service for the promotion of hand therapy in India. Chronicles of Society for Hand Therapy, India With the concept formation in August 2006, Coming to consensus in January 2007, and Formal registration in September 2009… Society for Hand Therapy, India is proud to represent profession of hand therapy in India in 2017! So far we have more than 170 hand therapist members, organized 5 conferences and this will be the 6th annual national hand therapy conference, conducted 3 hand therapy certification examinations, more than 10 continuing education programs. We are the full country member of International Federation of Society for Hand Therapy (IFSHT).       “Education is a weapon whose effects depend on who holds it in his hands and at whom it is aimed.” ~ Joseph Stalin
  28. 28. SOCIETY FOR HAND THERAPY, INDIA   27 Conference Brochure
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  41. 41. SOCIETY FOR HAND THERAPY, INDIA   40 Breakfast Session Workshops I on 23rd September, 2017 Functional Manual Therapy in Wrist and Hand
  42. 42. SOCIETY FOR HAND THERAPY, INDIA   41 Breakfast Session Workshop II on 23rd September, 2017 Therapeutic Plan in Wrist Instability
  43. 43. SOCIETY FOR HAND THERAPY, INDIA   42 Scientific Schedule
  44. 44. SOCIETY FOR HAND THERAPY, INDIA   43 Scientific Schedule
  45. 45. SOCIETY FOR HAND THERAPY, INDIA   44 Scientific Schedule
  46. 46. SOCIETY FOR HAND THERAPY, INDIA   45 Scientific Schedule Scientific Schedule
  47. 47. SOCIETY FOR HAND THERAPY, INDIA   46 Scientific Schedule Looking forward to meeting you all in 2018!
  48. 48. SOCIETY FOR HAND THERAPY, INDIA   47 Abstracts Oral Papers ePosters Mini Movies Hand Gestures Essay Writing
  49. 49. SOCIETY FOR HAND THERAPY, INDIA   48 Oral Presentations
  50. 50. SOCIETY FOR HAND THERAPY, INDIA   49 Oral Papers O1. Functional Outcome After Post Burns Hand Deformity Correction Authors: M. Priyadharshini, Raja Sabapathy Institute: Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery and Burns Ganga Hospital, 313, Mettupalayam Road, Coimbatore‐641043, Tamil Nadu, India Corresponding Author: Mobile: 91‐422‐2485000 Abstract Background: The hand is particularly at risk from burn injuries because of its exposed position. 40% of all burn injuries involving the hand. Post burn contracture and hyper‐tropic scarring result in deformities which mainly affects the overall movements and functions of the hand. This paper is discusses the Functional Outcome Scores of the post burn hand deformities after surgical contracture release and rehabilitation Objective: To assess the functional outcome scores after intervention of Post burns hand deformity correction. Methods: From October 2016 to March 2017, 40 patients with post burn deformity underwent correction. All the 40 patients were followed up for 6 months (19 males, 21females). 20 patients were below 40 years of age, 20 patients were above 40 years of age .30 patients were involving the dominant hand, 10 patients were involving non dominant hand. Causes of post burn deformity were thermal burns in 24, Electric burns in 10, Chemical burn injury in 6 patients. Out of 40 patients, 16 patients had SSG, 9 patients had abdomen flap, 7 patients had MCP joint capsulotomy, and 8 patients had finger deformity correction. Post‐operative therapy was started on the 14th day following SSG, 21st day following abdominal flap and deformity corrections and 2nd day following MCP capsulotomy. They were assessed using Outcome scores measured by Range of motion (ROM), Grip strength, Kapandji, DASH questionnaire and Michigan hand outcome questionnaire. Results: Out of 40 patients 30% of patients has improvement in Total Active Motion (TAM) (from pre ‐ operative TAM is 15% to post‐operative TAM is 35%), DASH score reduced to 32% (from average pre‐ operative DASH score of 77% to post‐operative DASH score of 42%), Michigan hand outcome score has been increased by 20% (from pre ‐ operative MHQ is 37% to post‐operative MHQ is 55%). Conclusion: We concluded that after proper surgical intervention following hand therapy. The Post Burn non‐functional hand can be turned into a functional hand. Functional outcomes depends timely surgical intervention and strict supervised Physiotherapy protocol. O2. Outcome of Rehabilitation Following Repair of Glass Cut Injuries in Flexor Zone Authors: Dapinder Kaur Parmar Institute: Department of plastic surgery and physiotherapy and rehabilitation clinic, Amandeep hospital, Amritsar, Punjab, India Corresponding Author: Email: physio.dapinder2010@gmail.com
  51. 51. SOCIETY FOR HAND THERAPY, INDIA   50 Abstract Background: Hand injuries are common and account for 5‐10% of emergency department injuries and 4.7% of all trauma patients. Various mechanisms of injury can lead to volar wrist injuries, and the most common are; machine injuries, glass lacerations, knife wounds, and suicide attempts. So the success of the surgical tendon repair depends much on the application of physical therapy and splinting. Objective: To determine the clinical outcome for early repair and programmed rehabilitation of glass cut injuries. Also to confirm the role of physical therapy and splinting in returning of range of motion in the injured fingers, preventing development of contracture, increasing the muscle strength, coordination and functionality of the hand. Study Design: Descriptive study Methods: Duration: from June 2015 to May 2017. 15 patients of glass cut injuries, age ranged from 16yrs to 48yrs, average age (23.8yrs) were included in the study, with no skeletal injury. The surgeries were done by a team of plastic surgeons. Repair of tendons and nerves were done with standardized techniques. Postoperatively, hand was kept in a splint and elevated. All patients were included in a rehabilitation program using the early passive mobilization protocol based on the work of Duran. Initially, (0‐4weeks) dorsal block splint (DBS) with wrist in 20‐30degee of volar flexion, MP joint in 50‐ 70degree of flexion with full IP extension is permissible. 5‐8weeks onwards, passive flexion with active extension with muscle stimulation and after 8‐12 weeks onwards stretching and strengthening exercises were followed. Observation of data was taken from the pool of patients with follow up from 6 months to 2 years with active range of motion, hand strength and functional return to work , evaluated by goniometry , hand dynamometer and DASH scale (disability of arm, shoulder and hand) respectively. Results: For 15patients over the period of clinical follow‐up , the four most common structures involved were FCU,FDS,FDP and MEDIAN +ULNAR NERVE, FCR were involved in 2 cases whereas 7 cases reported with only ulnar nerve and artery and 3 cases with only median nerve, with 2 cases of ulnar and radial artery. It was evaluated that there was marked improvement in range of motion, 70‐80%of grip strength along with patients have high intent of recovery and return to work. Conclusion: With earlier performed primary surgical repair followed by early passive mobilization protocol may achieves satisfactorily functional results for flexor tendon injuries zone 5. O3. To Assess the Functional Independence with Use of Early Positioning & Adaptive Device in a Hemiplegic Hand Authors: Gaikwad Jyotsna Suresh, Jaywant Shailaja Sandeep, Pai Anuradha Venkatesh Institute: Lokmanya Tilak Municipal Medical College, Sion, Mumbai Corresponding Author: Mobile: 9821211079 Email: gaikwad.jyotsna@gmail.com Abstract Background: Poor control of movement due to muscle imbalance can have an impact on the daily occupational functioning of patients with CVA. When one side of the body functions are better than the
  52. 52. SOCIETY FOR HAND THERAPY, INDIA   51 other in patients with CVA, they often prefer to use the sound upper extremity for completion of self‐care activities. So they face lots of difficulties while performing the self‐care activities. The attempt was made to design and fabricate early positioning splint cum Adaptive device to prevent the neglect of the involved side. Objective: To assess functional independence with use of early positioning and adaptive device. Study Design: Single case study Methods: A 40 years old, housewife was referred to Occupational therapy department with complaints of spasticity and difficulty in performing Self‐care activities such as brushing, eating & grooming. Patient’s main concern was her dependency on care givers. So, using the Client centered approach and considering anti‐spasticity positioning for hand, a sponge roll was made over the half inch diameter hollow PVC pipe as per span of patient’s hand. This was attached on palmar aspect to an aluminum strip which was attached to a wrist cuff proximally. The purpose of this strip was to stabilize the wrist in functional position. The Niwar straps was passed through the pipe for harnessing the device in figure of eight manner on hand. Another strap was added on wrist cuff & one more on fingers. The space in the pipe was used for holding the devices used for self‐care activities. Pre and post assessment of spasticity with modified Ashworth’s scale, Modified Barthel index scores and COPM scores were noted at end of two weeks. Results: The spasticity was reduced from grade 2 to 1+. An improvement in quality of movement and use of the more‐involved extremity after splinting, with some continuing improvement was evident at follow‐up especially in grooming activities. The patient could use the affected hand more spontaneously for completion of daily activities. It positions hand in anti‐deformity & anti spasticity position. Thus more beneficial to patients as compared to use of universal device. Modified Barthel scores improved from grade 1 to 7 in feeding and grooming activities and COPM scores also improved from 2 to 8 in performance and satisfaction components. Conclusion: The results of outcome this splint is encouraging. It is a simple, light‐weight and affordable to all patients and has improved the functional independence of this patient. Further research with a randomized, controlled design is necessary to determine the effectiveness of the focused use with of splint for dominant extremity. O4. Assessing Functional Independence after Occupational Therapy Intervention in a Child with Radio Ulnar Synostosis Authors: Mulye Mansi Manoj, Jaywant Shailaja Sandeep Institute: Lokmanya Tilak Municipal Medical College, Sion, Mumbai, and Maharashtra, India. Corresponding Author: Mobile: 9768201027 Email: mansi.mulye@gmail.com Abstract Background: Synostosis, or osseous union, of any two adjacent bones can involve any part of the upper extremity. Radio‐ulnar synostosis is a rare anomaly and approximately 400 cases were reported worldwide. It restricts the pronation‐supination movements. In few patients it also restricts wrist movements. This leads to difficulty in performing daily functional activities.
  53. 53. SOCIETY FOR HAND THERAPY, INDIA   52 Objective: 1. To assess functional limitations in a child with Radioulnar synostosis. 2. To assess the functional recovery after Occupational Therapy intervention in the child with radio‐ulnar synostosis. Study Design: Single case study Methods: 3.5 years old male assessed for functional activities. Patient presented with difficulty in self‐ care such as eating, bathing, personal hygiene, dressing, toileting. Family centered approach was used while planning OT intervention. Child was assessed using ICF. Child had limitations in participation due to body structure & environmental structures. Various adaptations utilizing local resources were provided after procedural & pragmatic clinical reasoning. Child was also assessed on COPM pre & post intervention. Results: Environmental factors during functional activity have improved from ‐2 to +1. Child improved significantly in his functional activities participation, his performance has reached to the maximum capacity. Parent’s satisfaction level has improved from 3 to 8 on COPM scale. Conclusion: Strategies to improve level of functioning & functional retraining has improved the participation & activity limitations with parent’s satisfaction. Thus the intervention has also improved Quality of life of child. Key Words: Synostosis, Radioulnar, Activity Limitation, Functional Difficulties, ICF O5. Hand Functions: A Study of Variance between Dominant and Non‐Dominant Hand in Healthy Adults Authors: Verma Chhaya Vijaykumar, Dhole Neha Bhalchandra Institute: PT School and centre, BYL Nair Hospital & TN Medical College, Mumbai Central, Mumbai‐ 400008. Corresponding Author: Mobile: 9167095755 Email: dholeneha007@gmail.com Abstract Background: The human hand is irreplaceable by any machine when it comes to performing gross or skilled activity. Grip strength, Pinch strength & Dexterity provide an objective index of the functional integrity of upper extremity. Objective: to study the effect of dominance on hand functions (Grip strength, Pinch strength, Dexterity) of either gender. Study Design: Cross sectional, Observational Study Methods: After receiving the approval from the departmental review board, written informed consent was taken from all the study participants, Right handed 14 Males, 14Females &Left handed13Males, 14Females (Total 55 participants)in age group of 18‐50 years. Grip strength was assessed by using Jamar hydraulic dynamometer (Model SH5001, SAEHAN Corporation). Pinch strength was (Tip‐to‐Tip and Tripod) assessed by using Jamar hydraulic pinch gauze (Baseline evaluation instruments, model number‐ 50 lb. standard head 12‐0235). The position of the upper limb and the hand for the measurements was according to the recommendations of the American society of hand therapists. (As described by Mathiowetz V, The Journal of hand surgery1984).Dexterity was assessed by using the Box and Block
  54. 54. SOCIETY FOR HAND THERAPY, INDIA   53 test. Each participant performed 3 attempts of all tests and average values of these trials were recorded for both hands. Results: An independent t test was used and a statistically significant difference was found between the pinch strength (Tip to tip‐ p value 0.034 & Tripod ‐p value 0.019) in Right handed participants between dominant and non‐dominant hand. There was statistical significant difference of Dexterity (p value‐ 0.014) and no statistical significant difference of Grip and Pinch strength in Left handed participants between dominant and non‐dominant hand. There was highly statistical significant difference of Pinch strength (Tip to tip‐ p value 0.002 & Tripod ‐p value 0.007) and Dexterity (0.034) in Right handed participants over Left handed participants. Conclusion: Right handed people have more strength in precision activity and are more powerful in precision as well as in dexterity .Left handed people are more dexterous by their dominant side compare to non‐dominant side but no such significant difference was noted of Grip and Pinch strength. Key Words: Hand Functions, Grip Strength, Pinch Strength, Dexterity, Hydraulic Dynamometer. O6. Functional Hand Assessment: A Review from the Indian Perspective Authors: Shilpshree Prashant Palsule, Jayashri Shripad Kale Institute: Occupational Therapy School and Centre, Seth G. S. Medical College, KEM Hospital, Parel, Mumbai‐400012, Maharashtra, India Corresponding Author: Mobile: 9987798660 Email: sppalsule@gmail.com Abstract Background: The hand is an amazing, complex part of the human body. It is essential for self‐care, work and everyday activities. Upper extremity disability can result in disruption of many basic and instrumental activities of daily living. Severity of injury may not necessarily correlate with functional performance hence, standardized tests to evaluate hand function form an important part of the evaluation process. Existing standardized tests have been developed on the population abroad, hence their applicability to the Indian population (based on cultural and social differences needs to be evaluated. Choosing the most appropriate outcome measure, with a clear understanding of their strengths and limitations, is important in both clinical and research terms. Study Design: Descriptive study Objectives: 1. To discuss the components of commonly used tests evaluating hand function. 2. To evaluate them from the Indian perspective Methods: Literature search will be used to review the components of the available tests evaluating hand function. Their applicability to the Indian context will be discussed. Conclusion: Whether hand function assessment tests need to be developed from the Indian perspective will be evaluated. Key Words: Hand Function Assessment, Activities of Daily Living
  55. 55. SOCIETY FOR HAND THERAPY, INDIA   54 O7. Reference Values of Gross Manual Dexterity Using Minnesota Manual Dexterity Test in Indian Community Dwelling Older Adults Authors: Verma Chhaya Vijaykumar, Karande Prajakta Ramchandra Institute: P.T School and Centre, Seth G.S medical college, KEM Hospital, Parel, Mumbai, Maharashtra, India, Pin code–400 012 Corresponding Author: Mobile: 8082567500 Email: prajaktakarande.pk@gmail.com Abstract Background: Manual dexterity is frequently evaluated in rehabilitation services to estimate hand function because of its contribution to upper limb performance and individual functional independence2. In assessment of the upper extremity, dexterity is considered as the important assessment component. With an increasing age hand function declines due to sensorimotor impairment such as decreased motor coordination, decreased manual dexterity as reduced grip strength4. Therefore, it is essential to differentiate difficulties attributable to normal aging and difficulties attributable to pathological aging. Minnesota manual dexterity test.(MMDT) is the new version of Minnesota rate of manipulation test (MRMT). It is valid and reliable tool to evaluate manual dexterity and can be used to study the prognosis of the patient. This new MMDT is used in the elderly as it consists of only two subtests: Placing test and turning test1. Reference values of community dwelling older adults is required to do the evaluation and implement the suitable interventional programmes. Objective: To find out the reference values of the new version of MRMT which is MMDT in Indian Community dwelling older adults. Study Design: cross‐sectional observational study Methods: Three hundred and nine community dwelling older adults were evaluated with Minnesota Manual Dexterity Test .Subjects were divided into 2 groups. Group 1: 61‐70 years (n = 113), Group 2: 71‐ 80 years (n = 196). All subjects performed one practice trial followed by one test trial of two subtests. Results: the statistics of the study is awaited. The statistics of the study is awaited. Key Words: Community Dwelling Older Adults, Reference Values, Manual Dexterity, Minnesota Manual Dexterity Test O8. Assessment of Reaction‐Time and Percentage of Accuracy for Laterality Recognition in Healthy Adults Authors: Satej Dalvi, Chhaya Verma, Amita Mehta Institute: : P.T School and Centre, Seth G. S. Medical College, KEM Hospital, Parel, Mumbai‐400012, Maharashtra, India Corresponding Author: Mobile: 9869011392 Email: cvverma100@gmail.com Abstract Background: Disruption and alteration of somatotopic and spatial representations within the cortex are seen in chronic neurological and musculoskeletal conditions like CRPS I and II, Graded Motor Imagery (GMI) provides an effective treatment alternative in the rehabilitation of these patients aimed at
  56. 56. SOCIETY FOR HAND THERAPY, INDIA   55 normalizing the cortical reorganization patterns through graded exposure of the patient to three specific sequential tasks Laterality Recognition, Explicit Motor Imagery and Mirror Therapy. Objective: 1. To find out Reaction‐time (RT) & Accuracy Percentage (AP) for Laterality Recognition in healthy adults.2. To assess abovementioned variables based on gender difference& handedness. Study Design: Observational, cross‐sectional study Methods: Subjects: Healthy adults of either gender in the age‐group of 18‐50 years willing to participate with no musculoskeletal and/or neurological impairments were included in the study. Materials: Hand image flashcards made by authors, table, chair and an electronic timer. The three steps of Graded Motor Imagery, the test procedure for its first step and the purpose of the study were explained to every eligible participant following which a written consent was taken. The aim for every participant was to identify whether a flashcard image belongs to the left or right side of the body and slot it to that side as soon as possible but without guessing. RT of <500 ms or 0.5 seconds was considered a guess. Learning trial with few cards was given for familiarization with the procedure after which every participant had to identify 30 flashcards in one trial. The timer was switched on when the participant viewed the first flashcard and switched off when the last flashcard (30th card) was slotted to the left or right. Two such trials were conducted for every participant using their dominant hand only with shuffling of cards between every trial and average values of RT and AP were calculated for every participant. Results: The mean Reaction‐time (RT) for 103 individuals was found to be 2.57 + 0.64s and Accuracy Percentage (AP) was found to be 86.67 %. Males (RT =2.40s) were found to be faster than females (RT=2.72s) with statistical significance (p< 0.05). Left‐dominant individuals (RT=2.41s) were faster than right‐dominant individuals (RT=2.61s) (p> 0.05). Females (AP= 85.57%) were more accurate than males (AP=84.43%) (p> 0.05) whereas right‐dominant individuals (AP=85.54%) were more accurate than left‐ dominant individuals (AP=82.55%) (p> 0.05). Conclusion: : Reaction‐time and Accuracy percentage values for laterality recognition as determined by this study may serve as a preliminary guideline when evaluating and setting treatment goals for Indian population belonging to said age‐group undergoing Graded Motor Imagery (GMI) protocol. O9. Effect of Occupational Therapy Rehabilitation on an Established Volkmann’s Ischemic Contracture: A Case Report Authors: Nalawade Vanashree C Institute: Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai‐400706 Maharashtra, India Corresponding Author: Mobile: 9869354698 Email: vanashree.nalawade@gmail.com Abstract Background: Volkmann ischemic contracture (VIC) is the end result of prolonged ischemia and associated with irreversible tissue necrosis. Patients with an ischemic contracture do not have pain but rather have deformity and dysfunction resulting from the ischemic event and subsequent muscle scarring
  57. 57. SOCIETY FOR HAND THERAPY, INDIA   56 and fibrosis. Various studies on VIC have shown that the moderate and severe type are recalcitrant to therapy and need some surgical management. Objective: To emphasize effectiveness of vigorous therapy on severe type of VIC. Study Design: Case report Methods: A 26 year old male presented with inability to use his left hand in daily activities along with flexion contracture of wrist and hand since 3 months following radial head and proximal ulna fracture due to fall from roof of car managed by reduction of radial head and ulnar plating. He developed compartmental syndrome post‐surgery immobilization and developed VIC (severe type). Client reported to Occupational therapy department in 3rd month post injury and was started with vigorous occupational therapy rehabilitation in the form of splinting, stretching, light massage, hand function activities and sensory re‐education therapy (2, 3). Initially Robert Jones splint, replaced by MP (metacarpophalangeal) stop with thumb spica were given. Passive and active stretches for 20 sec 5 repetitions, soft tissue mobilization in circular manner, active and resistive ex with finger weights, activities like pegs, clay, rings, ball flickering, magnets, spring and classic sensory re‐education program via different rough textures were given. A long term follow up evaluation was taken from 3rd month to 18 months post injury. Results: Data showed significant improvement in range of motion, severity of contracture, muscle strength, sensation and hand function score on upper extremity functional Index(UEFI) of left hand pre and post therapy. Conclusion: Vigorous rehabilitation is effective for improving hand function in severe type of VIC managed conservatively Key Words: Volkmann Ischemic Contracture, Occupational Therapy Rehabilitation, Upper Extremity Functional Index O10. Assessment of Fear of Fall Using Short Falls Efficacy Scale‐International in Females with Distal End Radius Fracture Authors: Verma Chhaya Vijaykumar, Revankar Mamata Vinod Institute: P.T School and Centre, Seth G. S. Medical College, KEM Hospital, Parel, Mumbai‐400012, Maharashtra, India Corresponding Author: Mobile: 9920249151 Email: mamatavr@gmail.com Abstract Background: Distal end radius fractures are amongst the most common bone fractures in adults comprising 8‐15% of all bony injuries in them [ 1].93% of distal end radius fractures are caused by falls[2]. Patients with a distal end radius fracture have been found to carry twice the risk of a latter fracture of the hip. There is an array of risk factors which may predispose distal end radius fracture population to falls which include balance impairment, decreased physical activity level, fear of fall or the fall that caused distal end radius fracture itself. Thus, the purpose of our study is to assess one of these risk factors namely, fear of fall in women with distal radius fractures above 40 years of age so that they may receive timely interventions.
  58. 58. SOCIETY FOR HAND THERAPY, INDIA   57 Objective: To assess fear of fall using short fall efficacy scale‐International in women with distal end radius fractures above 40 years of age Study Design: Cross sectional observational study Methods: After fulfilling the inclusion criteria, fear of fall was assessed in 35 women with distal radius fracture above 40 years of age using the short falls efficacy scale‐international and was compared with age matched controls Results: The average short falls efficacy scale‐international score in women with distal radius fracture above 40 years of age was found to be 13.97(thus falling in high concern) as compared to age matched controls (average S FES‐I score of 7.65 thus falling in low concern category). Mean age of the sample population was 52.02. Conclusion: Fear of fall is high in female patients post sustaining a distal radius fracture and it represents a potential target for interventions to improve functional outcome after the fracture in addition to hand therapy. Thus, a distal radius fracture should be treated as a sentinel event for a future fracture and fall risk assessment should be done even in apparently healthy middle aged females. Key Words: Distal Radius Fractures, Fear of Fall, Short Falls Efficacy Scale‐International O11. Effectiveness of Kinesiotape Versus Counterforce Brace as an Adjunct to Occupational Therapy in Lateral Epicondylitis Authors: Phadke Saurabh S. Institute: Seth G. S. Medical College and KEM Hospital Corresponding Author: Mobile: 9967555797 Email: saurabh.otist88@gmail.com Abstract Objective: The purpose was to investigate and compare effectiveness of Kinesiotaping and counterforce brace as an adjunct to Occupational Therapy in lateral epicondylitis. Study Design: Prospective, comparative and interventional randomized study Methods: The study was conducted on 26 patients with a total of 14 males and 12 females diagnosed as a case of Lateral epicondylitis as per the inclusion criteria. In Group A, (Kinesiotaping): 12 subjects, 7 males and 5 females. In Group B (counterforce brace): 14 subjects, 7 males and 7 females. Jamar dynamometer. Visual Analog Scale was used to quantify grip strength, pain. Interventional protocol was of 6 weeks. Re‐evaluation was done on the 1st day, end of 2nd week, end of 4th week and finally end of 6th week. Mann Whitney U test was used for comparison of mean between two groups and repeated measures ANOVA test was used for comparison within group. Results: showed significant pain reduction and improvement in grip strength but no statistically significant difference seen in between two groups (p>0.05). Conclusion: The study concludes that Kinesiotape as well as Counterforce brace is equally effective in respect to pain, grip strength and decreasing disability in patients with lateral epicondylitis. Key Words: Lateral Epicondylitis, Counter‐Force Brace, Kinesiotaping, Grip Strength, Pain
  59. 59. SOCIETY FOR HAND THERAPY, INDIA   58 O12. Hand Stiffness: Still a Menace? Authors: Naveen Kumar, Terrence Jose Jerome Institute: Olympia Hospital & Research Centre Corresponding Author: Email: olympiahospital@gmail.com Abstract Background & Objective: Hypothesis: Multiple hand fractures, post‐operative adhesions, tendon adhesions, poor follow up and compliance ads up to the struggling hand therapist a night mare. Methods: 20 patients with different types involving metacarpal, phalanges fractures, flexor, extensor tendon post‐operative adhesions, stiffness, distal radius fractures, compartment sequel were analyzed between 2012 and 2014. Active (assisted, resisted), passive assisted, Flexor/ Extensor out‐trigger traction, ultrasound, wax and hot fermentations were the protocols followed in these patients. The follow up included pain sensitivity, motor function, muscle strength, function and identification of shapes and textures, VAS, quick DASH, Mayo’s Elbow and wrist score and return to school/previous status. Results: The average follow up of the study was 2.5 years (range 2.0 to 3.1yrs). Multiple metacarpal fractures operated and conservative managed (4/20), phalangeal fractures (6/20) treated were the most common presentation with stiffness at both MCP (‐10 to 30°) and PIP (0‐20°) joints. The delay in presenting to our institution was 6 weeks (range 42 days to 75 days). Flexor tendon rehabilitation (Zone I‐IV) without trigger traction unit had excellent outcome with active digit palmar distance‐IMRL‐0 cms; with full active and passive range of motions. Grip strength, VAS, were found excellent (18/20). Conclusion: Hand fractures needs to be early mobilized under hand therapist supervision. Phalangeal fractures are more prone for early stiffness which has to be dealt with caution. Tendon rehabilitation should be done staged manner with/ without splints. O13. Functional Outcome Following Tendon Transfer for Radial Nerve Palsy: Physiotherapist Perspective Authors: G. Sujitha, S. Raja Sabapathy Institute: Department of Plastic Surgery, Hand Surgery, Reconstructive Microsurgery and Burns Ganga Hospital, 313, Mettupalayam Road, Coimbatore‐641 043, Tamil Nadu, India Corresponding Author: Mobile: 91‐422‐2485000 Abstract Background: The radial nerve is the frequently injured nerve following humerus fracture, because of its close proximity to the bone. Injuries can be divided into high, complete radial nerve injuries and low, posterior interosseous radial nerve injury (PIN injury). It results in wrist drop, loss of extension of finger and thumb. Grip strength is substantially reduced, because loss of wrist extension creates an unstable wrist and minimizes the power of long flexors. Tendon transfer procedure which have been used commonly PT to ECRB, FCU to EDC, PL to EPL. Good functional outcome can be obtained by following comprehensive pre‐operative and post‐operative physiotherapy program.
  60. 60. SOCIETY FOR HAND THERAPY, INDIA   59 Objective: To study the functional outcome following tendon transfer for radial nerve palsy. Methods: 25 patients were selected in this study. The mean age was 32.81 years. 18 patients were male and 7 patients were female. 16 patients were involving the dominant hand, 9 patients were involving non‐dominant hand. Causes of radial nerve injury was fracture of humerus in 13, crush injury in 7, brachial plexus injury in 3, neuroma over the radial nerve in 2 patients. The muscle strength of wrist and digit extensor was grade 0(MRC) pre‐operatively. Tendon transfer was done using donor (PT, FCU, PL) with grade 5. All the patients were under regular physiotherapy for duration of 12 weeks post‐ operatively and followed up with monthly reviews for 6 months. The physiotherapy protocol comprised of splinting, protective range of motion exercises, active movements, ultrasound and massage, muscle re‐ education by visual feedback and strengthening exercises. Post‐operative assessment was done by measuring the AROM, grip strength, ADL and Ganga multipurpose therapeutic equipment score and BINCAZ scale. Results: At 6 months follow up, the active range of motion has improved 60 degree, average grip strength was increased 24.8kgs, BINCAZ score increased by 5. With the results obtained it is clear that, patients had good amount of wrist, thumb and finger extension. Power grip has also improved in all patients. The overall results were rated excellent in 16 patients, good in 6 patients and fair in 3 patients according to BINCAZ scale. O14. Assessment of Scapula Position in Brachial Plexus Injury Patients – A Pilot study Authors: Thosar Jyotsna A, Verma Chhaya V, Puri Vinita A, Shigvan Tapasya Institute: KEM Hospital, Parel, Mumbai, Maharashtra, India Corresponding Author: Mobile: 9821066016 Email: jyotsnathosar@rediffmail.com Abstract Background: Brachial Plexus is a network of nerves that originate in the neck region and branch of to form most of the nerves that control movements and sensations in the upper limbs. The upper extremity is a delivery system to position the hand in space for numerous functional activities. An imbalance can be created in this system by loss of rotator cuff muscles or scapular stabilisers which can disturb balance of scapulo humeral rhythm following brachial plexus injury. Hence, finding out the resting scapula position and comparing it with individual’s unaffected side will help in assessing and formulating rehabilitation to improve function of upper extremity following brachial plexus injury (BPI).On comparison, scapula position may show alteration in patients with brachial plexus injury when compared to unaffected side. Objective: 1. To assess static scapular position of both sides of patients with BPI, By Observation and linear measurement method.2. To compare the scapula position of affected and non‐affected side. Study Design: Observational study Methods: This observational study will include 25 participants diagnosed with unilateral brachial plexus injury referred by plastic surgery department, KEM Hospital. For assessment of scapular position, two methods will be used: Observational analysis and Linear Measurement of Static Scapula Posture. The components of observational analysis will be scapular plane, sagittal plane, transverse plane, Vertical plane, Horizontal plane. Components of linear measurement of scapula position will be Distance from
  61. 61. SOCIETY FOR HAND THERAPY, INDIA   60 medium scapular border to fourth thoracic spinus process, pectoralis minor index, distance from acromion to table, scapular distance measurement( acromion to T3 vertebra), scapular length measurement. Outcome measures will be: upward rotation/ downward rotation, anterior tilt/ posterior tilt, internal rotation/ external rotation, elevation/depression, protraction/retraction for observational analysis. Whereas linear measurement of scapula will include abduction/adduction, protraction/retraction, anterior/posterior tilt. Outcome measures of affected side due to plexus injury will be compared with normal side of the individual. Results: Collected data will be analysed depending on distribution of variables. Key Words: Scapula position, Brachial Plexus Injury. O15. ‘Bilateral Brachial Plexus Injury’: Case Report of Earthquake Victim Who Needs a ‘Helping Hand’ Authors: Verma Chhaya V, Jadhav Kshitija J Institute: School of Physiotherapy, BYL Nair Hospital & TN Medical College, Mumbai Central. Mumbai‐ 400008. State: Maharashtra. Country: India Corresponding Author: Mobile: 9975167210 Email: kshitijadhavkem@gmail.com Abstract Background: Bilateral Brachial Plexus Injury (BPI) is a rare condition caused by damage to Brachial Plexus leading to symptoms ranging from complete paralysis of upper limbs to lack of control in the arms, wrists and hands. Being an unusual phenomenon, its outcome is variable based on its type and severity. It not only physically disables the person but also handicaps his social, economic and emotional well‐ being. To understand it, we present this case‐study. Objective: To understand rehabilitation approach, prognosis, functional status and quality of life of Bilateral BPI individual Study Design: Observational study Methods: With written consent, Bilateral BPI case was assessed in Physiotherapy OPD of tertiary care hospital. Along with subjective and physical evaluation, questionnaires to assess disability level, functional status, stress and quality of life were taken. Results: A25‐year‐old, right‐handed, young man from Gujarat, with high hopes started working as a farmer in Nepal in January‐2015. But life took a heavy toll on him, as an earthquake stuck Nepal on 25‐ April, 2015. He was one of the survivor victims of the tragic incident. However, he landed up with Bilateral BPI as a slab fell on him during the natural calamity. Thereafter, he was unable to move both his upper limbs. Due to economic constraints, he came to Mumbai for treatment and investigations revealed Bilateral Pan Brachial Plexopathy (left>right). His right upper extremity being comparatively less affected was managed conservatively using splints and physiotherapy whereas for left upper extremity neurotisation surgery was performed in October‐2015. He religiously adhered to physiotherapy regime pre and post‐operatively which included muscle stimulation, strengthening and splinting. Two years down the line, he has improved physical abilities, in terms of strength, range and health‐status owing to
  62. 62. SOCIETY FOR HAND THERAPY, INDIA   61 his strong will‐power, perseverance and holistic treatment approach. He is able to carry out his self‐care activities independently with improved quality of life. Conclusion: Such cases, unfolds the secrets of unusual survivals and helps to understand burden placed by bilateral BPI, which can serve as framework for their rehabilitation. Key Words: Bilateral, Brachial Plexus Injury, Rehabilitation O16. Assessment of Elbow Joint Position Sense in Brachial Plexus Injury Authors: Pratha Umesh Mehta, Dipti Baban Geete Institute: PT School and centre, Seth G. S. Medical College, K.E.M Hospital, Parel‐420001, Mumbai, India Corresponding Author: Mobile: 9762338637 Email: prathamehta2003@gmail.com Abstract Background: Road traffic accidents account for 94% of patients of brachial plexus injury(BPI).1The motor deficit is usually accompanied by reduced somatosensory function as a result of activity‐ dependent changes in the central nervous system. As proprioceptive information is critical for the learning and execution of well‐coordinated movements, it is important to understand whether peripheral nervous system injury leads to deficits in the use of sensory feedback that, in turn, may further compromise motor function. This can be achieved by assessing joint position sense (JPS). JPS measures an individual’s ability to actively perceive and reproduce a previously presented position of a joint, with minimal exteroceptive cues.2 Hence, in this study, elbow JPS is assessed in BPI. Objective: To assess elbow JPS in brachial plexus injuries. Study Design: Cross‐ sectional study. Methods: Sample size: 20 Inclusion criteria 1. All brachial plexus injury patients. 2. If operated, motor recovery≥ BMRC grade 2 3. Full passive elbow ROM Exclusion criteria 1. Patient with spinal cord/ brain injury. 2. Any pathology of elbow joint. 3. Patient with generalized ligament laxity Procedure: Patients will be blindfolded using an eye mask and headphones applied to eliminate visual and auditory cues. Two tasks will be performed: Ipsilateral remembrance‐ The patient’s affected hand will be positioned in either 10◦ flexion, 45◦ flexion or 100◦ flexion. Position will be maintained for 10 seconds and the patient will be asked to remember the position. Then the angle will be changed passively. The patient will be instructed to ask examiner to halt when the patient thought the elbow had returned to preset angle. The angle will be measured using a goniometer. Test will be performed on both the sides. 2. Contralateral concurrent‐ The contralateral side will be placed passively in either 10◦ flexion, 45◦ flexion or 100◦ flexion. Therapist will move the affected limb, asking the patient to stop at a similar angle on the contralateral side. Similar procedure will be carried out by placing the affected side in a preset
  63. 63. SOCIETY FOR HAND THERAPY, INDIA   62 position and asking the patient to mimic similar angle on the contralateral side. Both the tests will be repeated 3 times and the mean of the values will be considered. Results: Awaited and will be presented at the conference. Conclusion: Awaited and will be presented at the conference. Key Words: Joint Position Sense, Brachial Plexus Injury O17. Do We Need To Incorporate Comprehensive Patient Rated Outcome Measure In Assessment Of Traumatic Brachial Plexus Injury Patient? ‐ A Case Study Authors: Chhaya Verma, Vinita Puri, Neha Verghese, Jyostna Thosar, Kshitija Jadhav, Sujata Yardi Institute: PT School and centre, Seth G. S. Medical College, K.E.M Hospital, Parel‐420001, Mumbai, India Corresponding Author: Mobile: 9869011392 Email: cvverma100@gmail.com Abstract Background: Brachial Plexus Injury (BPI) is a devastating condition which not only leads to physical impairments but also severely affects a person’s social, psychological and economic well‐being. Objective: To understand the importance of comprehensive patient rated outcome measure in assessment of BPI patient Study Design: Case‐study Methods: With written informed consent, BPI case treated with multidisciplinary treatment approach at government tertiary care hospital is included in the study. Along with objective evaluation of body structure function, patient’s activity level and social participation was assessed with the help of subjective patient‐rated‐outcome‐measures like DASH and WHOQOL‐BREF scale. Results: A 33‐year‐old lady lived with her in‐laws, husband and two sons in suburbs of Mumbai. Her husband’s Alcohol addiction ruined her marriage. In November‐2014, being assaulted by husband, she sustained sharp‐cut across axilla and felt her arm going flail. She was diagnosed as Left BPI (maximal medial cord involvement) leading to complete loss of median‐ulnar nerve functions. Her rehabilitation was multidisciplinary. After initial assessment, muscle strengthening & functional‐training by Physiotherapist and splinting by Occupational Therapist was assigned. After a year’s rehabilitation, muscle functions recovered in forearm but not in hand, leading to claw‐hand and ape‐thumb deformity for which tendon‐transfer and opponensplasty was performed. But, there came another challenge; she lost her husband: only source of income. Her sons turned to drugs. She faced financial, physical and emotional poverty. Therefore, Psychological intervention was sought. Surgery however, was successful with excellent post‐exercise rehabilitation results. Her disability level, assessed by DASH‐Score from (Pre‐op) 60.83 to (Post‐op) 46.44 indicated functional improvement in upper extremity and hand functions. WHOQOL‐BREF‐Score showed marginal improvement in QOL, from (Pre‐op) 60% to (Post‐op) 65%. Unfortunately due to family tragedies, psychological and economical barriers, she did not appreciate any improvement in her QOL which resulted her completely blinded towards appreciating improvement in upper extremity & hand functions. This made the entire team responsible in treating her unhappy & discouraged.
  64. 64. SOCIETY FOR HAND THERAPY, INDIA   63 Conclusion: There is a need to incorporate patient rated outcome measure in assessment of BPI patient which encompasses not only functional status but also evaluates impact of injury on psychological and social status of patient. O18. Barriers to Treatment Adherence in Traumatic Brachial Plexus Injury Patients Attending Physiotherapy Outpatient Department at Government Tertiary Care Hospital in Mumbai Authors: Chhaya Verma, Vinita Puri, Jyostna Thosar, Amita Mehta, Sujata Yardi Institute: PT School and Centre, Seth G. S. Medical College, K.E.M Hospital, Parel‐420001, Mumbai, India Corresponding Author: Mobile: 9869011392 Email: cvverma100@gmail.com Abstract Background: Adherence with treatment is an important factor which can influence the outcome of that treatment. Adherence has been defined as the extent to which a person’s behaviour corresponds with agreed recommendations from healthcare provider (WHO 2003). Adherent patients may have better treatment outcome than non‐adherent patients. Poor adherence to treatment among TBPI to physiotherapy is multi‐dimensional which has implications on treatment cost and effectiveness. Objective: 1.To study epidemiology of BPI patients visiting our centre 2. To identify barriers to adhering with treatment in BPI patients visiting outpatient department of physiotherapy at our centre. Study Design: Cross sectional Methods: The study was undertaken after taking permission from Institutional Ethics Committee. All the BPI patient records from 2011‐2016 were studied who have been referred from Department of Plastic & Reconstructive Surgery for management at Hand section of Department of Physiotherapy. Results: Our patient group involved only post TBPI & does not include iatrogenic injuries or tumours of Brachial Plexus. Total number of patients:115.;Male 93.91% (108) & Female 6.09% (7) Road traffic accidents accounted for 78.26% (90) of the total BPI & of these 94.44% (85) were associated with 2 wheeler accidents. The mean age of patients was 29.38 years & age group 21‐30 years accounted for 48.70% (56) of patients. Dominant side was involved in 65.22% (75) of the patients. 70.43% (81) of patients had associative injuries while 29.57% (34) had isolated BPI. Among total patients pan BPI were
  65. 65. SOCIETY FOR HAND THERAPY, INDIA   64 most common55.65% (64) & 68.27% (76) patients were from outside of Mumbai. Patients underwent various surgical procedures like Nerve transfers with/ without grafts, Muscle transfer. The average time interval from date of injury to surgery was 3‐9 months. Patients following up for physiotherapy till month of June 2016 were 31 out of 115.We had telephone numbers of 59 patients of total 84 who had stopped follow up with physiotherapy. We could successfully get through only 28 patients to enquire the reasons for not following up with physiotherapy at our centre. Various reasons cited for non‐adherence to physiotherapy treatment by BPI patients will be discussed in detail at the time of presentation. Conclusion: This study gives an insight into epidemiological aspect of BPI at our centre & as to why BPI patients find it difficult to adhere to Physiotherapy recommendations in a long run. O19. Comparison of Upper Extremity Strength in Patients with Obstructive Airflow Limitation and Matched Healthy Individuals Authors: Joshi Saylee Ashok, Mistry Hetal Manoj Institute: PT School and centre, BYL Nair Hospital & TN Medical College, Mumbai Central, Mumbai‐ 400008, Maharashtra, India Corresponding Author: Mobile: 8600455020 Email: sayleejoshi6@gmail.com Abstract Background: Skeletal muscle dysfunction is a common systemic co‐morbidity of Chronic Obstructive Airflow Disease (COAD). Patients with severe COAD report a marked increase in the sensation of dyspnea during routine tasks that require arm use, especially activities requiring unsupported arm elevation. As a result of mechanical changes, many patients with COAD struggle with or even avoid performing essential ADLs that involve upper extremities which mainly isotonic muscle works. There have been many studies showing reduced skeletal muscle strength and endurance, especially in the lower limbs of COAD patients. However, there has been little research into the upper limb skeletal muscle dysfunction in COAD patients. Objective: To compare and correlate Upper extremity strength and functional capacity in subjects with OAL and matched healthy individuals Study Design: Cross sectional, Observational Study Methods: The approval for the study was taken from the local institution Ethics Committee and MUHS research board. 40 OAL and 40 healthy individuals meeting the inclusion criteria were included in the study and written consent was taken. Upper extremity muscle strength was measured by calculating 1‐ Repetition Maximum (1‐RM) of Shoulder Flexors, Extensors, Abductors, External Rotators and Internal Rotators using Brzycki’s equation and functional capacity was measured by using 6‐Minute Walk Distance (6MWD). Upper extremity muscle strength between the two groups was compared and correlated with 6MWD. Results: Wilcoxon signed rank test (non‐parametric test for paired sample) was used and statistically significant difference (p<0.05) was found between 1 RM mean of upper extremity strength.
  66. 66. SOCIETY FOR HAND THERAPY, INDIA   65 Spearman correlation test (non parametric test) was used to find the correlation between 1 RM mean of Upper Extremity and 6MWD in Experimental group which was statistically not significant (p = 0.244 which is > 0.05). Conclusion: There was a statistically significant difference in the upper extremity strength in patients with Obstructive Airflow Limitation when compared to the age, gender and BMI matched healthy individuals (p= 0.000< 0.05).There was no statistically significant correlation between the upper extremity strength and functional capacity in patients with OAL (p=0.244> 0.05). O20. Use of Six Minute Peg Board and Ring Test to Assess Arm Function in Patients with Obstructive Airway Disease Authors: Dhanorkar Gauri Dhananjay, Rachna Arora Institute: PT School and centre, BYL Nair Hospital & TN Medical College, Mumbai Central, Mumbai‐ 400008, Maharashtra, India Corresponding Author: Mobile: 9867158970 Email: dhanorkargauri@gmail.com Abstract Background: Physical performance in Obstructive Airflow Disease (OAD) patients is affected not only during walking or stair climbing but also during simple activities of daily living that involve the upper extremities. The main purpose of the study was to compare the arm function in patients with OAD and in healthy matched controls using Six Minute Peg Board and Ring Test (6MPBRT) and to correlate the arm function with functional capacity Objective: To compare Arm function in patients with Obstructive airway disease and matched healthy individuals using 6MPBRT Study Design: Interventional, Comparative, Cross sectional Study. Methods: After receiving the approval from Institution Ethics Committee, written informed consent was taken from all the study participants, 40 OAD patients with mild to severe obstruction and 40 non‐ smoker age, gender and BMI matched healthy individuals underwent 6MPBRT AND 6 Minute walk test (6MWT). For 6MPBRT, subjects were asked to move rings as many rings as possible from the pegs placed in front of them and the score calculated was the total number of rings moved in 6 minutes. Functional capacity was measured using 6MWT by following the ATS guidelines. Results: On comparing the scores of 6MPBRT using Paired t test, a mean difference of 64.20 ± 22.31 was found between the study group and control group, suggesting a reduction in the score of study group as compared to the control group and was statistically significant (p=0.000). A strong correlation was found between 6MPBRT score and Percentage predicted value of 6MWD (r = 0.750) in the study group, which was statistically significant. (p = 0.000) A strong correlation was found between the severity of disease and the 6MPBRT scores (rho = ‐ 0.859) in the study group, which was statistically significant (p = 0.000). Conclusion: Arm function in patients with obstructive airway disease is reduced significantly as compared to the age, gender and BMI matched controls and had a strong linear association with functional capacity and inverse association with the severity of obstruction.
  67. 67. SOCIETY FOR HAND THERAPY, INDIA   66 Key Words: OAD, Arm Function, Six Minute Peg Board and Ring Test Patient Performing Six Minute Peg Board and Ring Test for Assessing Arm Function “As you grow older, you will discover that you have two hands, one for helping yourself, the other for helping others.” ~ Audrey Hepburn
  68. 68. SOCIETY FOR HAND THERAPY, INDIA   67 ePosters
  69. 69. SOCIETY FOR HAND THERAPY, INDIA   68 ePosters eP1. Neuroplasticity: A Boon in the Rehabilitation of Traumatic Brachial Plexus Injury Patients Authors: Verma Chhaya, Kini Raveena Ramkrishna Institute: PT School and centre, BYL Nair Hospital & TN Medical College, Mumbai Central, Mumbai‐ 400008, Maharashtra, India Corresponding Author: Mobile: 8108666141 Email: raveenarkini@gmail.com Abstract Background: Neuroplasticity is the structural reorganization that takes place in the cortex. The cortical homunculus is basically the physical representation of each part of the human body in the brain. Sensory deprivation is supposed to be one of the major causes of this cortical reorganization. Traumatic Brachial Plexus Injury (BPI) also leads to a considerable deprivation of sensory input to the cortex from the upper limb. One such physiotherapeutic treatment technique which is not only a novel treatment strategy but also an increasing reminder that body representation in the brain should be considered in the patients is Graded Motor Imagery (GMI), which includes sequential components of implicit motor imagery, explicit motor imagery and mirror therapy. Objective: Epidemiological Studies show an increasing rate of traumatic BPI occurrence; hence it is important to find out ways of rehabilitation to get back the patient to his functioning capacity. The various nerve transfers work on the principles of neuroplasticity. Physiotherapeutic treatment should act as an adjunct to the surgery by working on the above principle and enhancing the results of the surgical transfer. The objective is to describe one such technique that is GMI Study Design: Narrative Review Methods: The review involves searches of electronic databases including PEDro, Google Scholar and PubMed and reference to the GMI Handbook. The review includes3Case Studies, 2Experimental Studies,
  70. 70. SOCIETY FOR HAND THERAPY, INDIA   69 2Observational Studies,3Systematic Reviews, 2 Randomized Control Trials, 1 perspective article, 1 opinion article and 1 book review Results: All the articles majorly focus on the fact that neuroplasticity occurs throughout life. There is synaptic formation and dendritic arborization in the brain. This aspect not only helps in the success of the surgical procedure but also aids in rehabilitation. Mirror therapy has shown considerable improvement in Upper Limb rehabilitation and reduction in chronic pain. Brain has mirror neurons which play a key role in this aspect. Conclusion: The novel concept of GMI should be put to clinical use as well as researched further for the benefits of patients. Key Words: Neuroplasticity, Brachial Plexus Injury, Graded Motor Imagery, Mirror Therapy eP2. Recent Advances in Management of Different Zones of Extensor Tendon Injuries of the Hand Authors: Shubhangi More Lad Institute: Lokmanya Tilak Municipal Medical College, Sion, Mumbai‐400022, Maharashtra, India Corresponding Author: Mobile: 9869445126 Email: suitshubu@gmail.com Abstract Background: Extensor tendon injuries are very common, which if not properly treated can cause severe lasting impairment for the client. Appropriate splinting for management of any tendon injuries of hand is important as it not only lessen the complications like repaired tendon adhesion and joint stiffness but also is helpful in early return to work .The advances in splinting techniques along with the protocols for management of repaired extensor tendon injuries showed good improvement in hand functions. Objective: To assess the composite flexion with measuring tape/ruler, ROM of hand with goniometer, pinch and grip strength with pinchometer and dynamometer ,Michigan hand outcomes questionnaire(ADL scale),hand function test (box and block test). Study Design: A prospective, observational study was designed. Methods: Efforts was made for management of different clients as per Zones involvement along with the recent advance treatment protocol. In Zones I, II, III & IV the template splint (it is a splint which was designed and moulded with set ROM for the required joint as per the treatment protocol) was introduce, along with the other traditional splints for early rehabilitation of fingers .In Zones V & VI while immobilizing the fingers and wrist ,dynamic splint along with the dorsal forearm support ,wrist in 30◦ of extension, single outriggers for four fingers and volar pad on the palm as an insert which will keep fingers in extension and when fingers early controlled motion is allowed then dynamic splint ,along with the template splint as a volar pad on the palm, which will keep MCP joint in 10°‐15° of flexion as per the protocol. In Zones VII & VIII static volar half cock up were used for management of hand after tendon repaired. All the splints were discontinued after 6 weeks and active ROM, tendon gliding, graded strengthening exercises were advised. ADL assessment scale, composite flexion of hand, pinch and grip strength, hand function test.

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6th Annual National Conference Souvenir of Society for Hand Therapy, India

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